The Nurse’s Guide to Voting

The 2020 election is poised to be historic. Americans must navigate the reality of voting during a pandemic, while also choosing between two starkly different candidates: President Donald Trump (R) and former Vice President Joe Biden (D). Many issues are at stake during the election, and healthcare is among the most important to American voters, according to a recent poll by the Pew Research Center. This comes at no surprise, as the U.S., along with the rest of the world, struggle to contain the deadly COVID-19 virus. When it comes to issues of healthcare in the 2020 election, nurses vote with an in-depth understanding of how the healthcare system works, and how it can be improved. As members of the largest healthcare profession, nurses truly have an impactful collective voice with their votes. Ultimately, this election could have an enormous impact on healthcare in the United States. Understanding where each candidate stands on critical healthcare policy issues may seem complex. This healthcare election guide outlines policy priorities relevant to nurses, and summarizes each candidate's stance on major healthcare issues. The guide also walks you through voter registration, and how to vote while avoiding crowded polling places on Election Day.

Where Biden Stands on Healthcare Issues

Some of Biden's major healthcare policies in the 2020 election include battling the COVID-19 pandemic and the ongoing opioid epidemic. Biden also plans to reduce the high cost of prescription drugs, impose restrictions on big pharmaceutical companies, and add healthcare jobs to high-need rural and urban communities. Additionally, since Biden served as President Barack Obama's vice president, it comes as no surprise that he supports -- and plans to expand -- the Affordable Care Act (ACA). Read on to learn more about Biden's major healthcare goals. You can also find out more information about his campaign on his official website.

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COVID-19

Biden's campaign outlines a multi-point plan to manage the current COVID-19 pandemic, including accelerating vaccine research. The Biden administration would "immediately restore" the White House National Security Council Directorate for Global Health Security and Biodefense. The Obama Administration created this council in 2016 to respond to the Ebola virus, but Trump disbanded it in 2018. Biden promises to offer a COVID-19 test free of charge to anyone in need of one, a response to early criticisms of testing scarcity under Trump. Biden also proposes "speed testing" by setting up 10 mobile testing sites and drive-through facilities in every state. Additionally, Biden's platform involves giving frontline workers -- including nurses -- high quality protective equipment.

The Affordable Care Act (ACA)

The Trump administration has made repeated attempts to repeal the ACA through various legal challenges and executive orders. If elected, Biden plans to build upon and expand the current ACA law by introducing a public option. This means that individuals can select a public healthcare plan if they do not receive insurance from their employer, or do not like their employer's plan. In total, Biden's healthcare plans would aim to cover 97% of Americans with health insurance. Some of Biden's other healthcare priorities include expanding coverage to low-income earners, increasing tax credits, and lowering premiums. Biden's platform also commits to make the healthcare system less complicated. The plan promises to partner with healthcare workers to devise solutions to healthcare challenges and increase wages. You can learn more about the ACA and each candidate's position on the law with this guide.

Opioids

Although the opioid crisis may have fallen out of the headlines as COVID-19 dominates the news, the country's nationwide problem with opioids persists. In addition to protecting the ACA and substance abuse disorder treatment within the law, Biden plans to expand Medicaid to help cover treatment costs. Biden's plan proposes a federal investment of $125 billion for additional prevention and treatment services. In terms of tackling the crisis, Biden's proposed policies would end overprescribing and ban drug manufacturers from offering incentives to physicians. They would also remove tax breaks on prescription drug ads. Finally, Biden has committed to holding the big pharmaceutical companies and executives accountable for the role they played in creating and spurring on the opioid crisis.

Prescription Drug Prices

Biden's platform promises to "stand up to abuse of power by prescription drug corporations." Currently, drug corporations can legally avoid negotiating drug prices with Medicare, and Biden's plan would repeal this law. In addition, drug manufacturers can charge high prices for medications they put on the market without any competition. Biden's proposed policies would change this by limiting the price that drug manufacturers can charge when they introduce a new prescription drug. The Biden plan would also stop drug brands from raising their prices more than the general inflation rate. Finally, in an effort to increase competition for American drug companies, Biden's administration would allow Americans to buy medications from foreign companies.

Healthcare Workforce Expansion

Another major part of Biden's platform involves increasing opportunities within the healthcare workforce -- with the goal of creating 1.5 million jobs. As a part of this job creation effort, Biden aims to add 150,000 community health worker jobs in the nation's most underserved communities. Biden would also create a Public Health Jobs Corps to provide education about the COVID-19 pandemic. Once the pandemic is over, the Corps would work as general community health workers. Biden's policies would also increase funding for the Indian Health Services and prioritize the CARES Act, which allocates money to build a "national strategy to recruit, retain and empower nursing professionals."

Where Trump Stands on Healthcare Issues

Trump outlines general healthcare policy goals for a second term on his campaign website, although specific details on these goals remain scarce. The president's priorities include lowering prescription drug prices, lessening insurance premiums, covering pre-existing conditions, giving veterans good-quality healthcare services, and protecting Social Security and Medicare. Throughout his presidency, Trump has also attempted to repeal the ACA in order to replace it with a competition-based healthcare marketplace. You can read more details about his current stances and past actions on major healthcare issues below.

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COVID-19

Since the onset of the coronavirus pandemic, Trump has declared a public health emergency and restricted travel to certain foreign countries. Trump's campaign website proposes developing a COVID-19 vaccine by the end of 2020 and a "return to normal" in 2021. His coronavirus initiative also promises to provide critical medicines and supplies to healthcare workers, and to restock those supplies to prepare for any future pandemics. Trump has also released a guide to his Opening Up America Again, which would use public health expert's advice to open the country's borders in three phases.

The Affordable Care Act (ACA)

In short, Trump supports repealing the ACA. His administration has passed measures undermining certain components of the ACA and has asked the Supreme Court to deem the ACA as unconstitutional. While Trump has repeatedly promised to deliver a replacement to the ACA, no such plan has emerged. Broadly speaking, Trump backs policies in the American Health Care Act of 2017. This legislation would create a new federal grant program providing $115 billion to states to potentially create high risk pools. The proposed law passed in the House in May 2017, but it ultimately failed to pass in the Senate. Still, Trump's current campaign website promises to "put patients and doctors back in charge of our healthcare system."

Opioids

During Trump's tenure, his administration has put several measures in place to battle the opioid crisis. The administration passed the SUPPORT for Patients and Communities Act in 2019, which allows nurse practitioners and physicians assistants the authority to prescribe medications for opioid substance abuse disorders. Trump also prioritizes stopping the overprescription of opioid medications and confronting international and domestic drug supply trains. Under Trump In 2019, the president's administration announced it would give $1.8 billion to states in order to expand access to treatment and cover services.

Prescription Drug Prices

In 2018, the Trump administration published the blueprint for the president's American Patients First Initiative, which includes four main goals. This initiative plans to lower prescription drug prices by increasing competition and improving negotiation between Medicare and medication manufacturers. The initiative also aims to create incentives for lower drug prices, like making price increases more transparent to consumers. Additionally, the administration proposes lowering out-of-pocket drug costs by reforming certain laws within Medicare and the ACA.

Healthcare Policy Work

You can learn a significant amount of Trump's history and future plans regarding healthcare policy through the 2018 report Reforming America’s Healthcare System Through Choices and Competition. The document analyzes the current state of healthcare and suggests pathways for healthcare reform under the Trump administration. It's a good way to understand the Trump administration's priorities and the policies we might see if the president wins a second term. Essentially, the report underlines the importance of consumer-driven healthcare. It emphasizes a need for greater competition between healthcare provider markets and the healthcare workforce. The document also highlights the administration's position that government mandates should be reversed to promote more choice in healthcare insurance markets.

Preparing For the Upcoming Election

An informed voter is the most responsible voter. Of course, your knowledge can only make a difference if you actually vote. If you're a U.S. citizen over the age of 18, you have the right to vote. Exercising your right to vote, however, takes a bit more work. You must register to vote and then decide how to cast your ballot. Most states provide the option of either voting in-person at your polling place on Election Day, or voting by mail. Many people are choosing the latter option as a result of the COVID-19 pandemic. You can read more about how to approach these options below.

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Registering to Vote

Before you can show up to the voting booth on Election Day, you need to register to vote. For most people, registering to vote is generally more convenient than it's been in the past. You can register to vote online instead of physically visiting an office or mailing in documents (although you can still also register those ways). You can vote if you're a U.S. citizen, a resident of the state in which you're voting, and at least 18 years old. However, each state has different voter registration rules. You can find state-specific voting guides here. Most states require you to complete a voter registration form with your personal identification information and social security number. You may also need to provide certain documentation, such as a driver's license, utility bill, bank statement, or paycheck. If you register online, you should receive your voter registration card 2-4 weeks after filling out the application. Remember that if you've already registered to vote -- and even if you voted in the last election -- it's important to double check that you're still registered to vote. You can easily find out whether you're registered to vote through the Vote America app.

Voting by Mail

Many people cannot make it to the polls in-person for various reasons. They may live abroad, they may be traveling, or -- in the case of many nurses -- they may work on Election Day. In this case, voters can send in their ballots early through the mail. For those away from their voting precinct, this is called absentee voting. For many others, it is simply called mail-in voting. This election also faces a unique challenge. The COVID-19 virus spreads most rapidly in crowded, enclosed spaces. This is, of course, exactly how voting is conducted on Election Day, and public health experts have voiced their concerns about the consequences of holding a traditional Election Day during a pandemic. To attempt to curb the virus spread, at least 35 states have modified their absentee/mail-in voting procedures. That means you can request a mail-in ballot even if you are not absent from your precinct on Election Day. If you prefer to vote by mail, keep in mind that the deadline to request a mail-in ballot is Friday, October 30, 2020. Just like each state has different voter registration rules, each state also has unique vote-by-mail rules. You can find out more about those rules with this resource.

Voting in Person

Even though the majority of states have modified their absentee/mail-in voting procedures in light of the pandemic, voters can still go to the polls in-person. Still, if you've voted before, you'll likely see a change in the way precincts run polls. Expect states to set up coronavirus measures through establishing social distancing layouts, mask rules, and possibly different locations. Because of these changes, make sure to double check your polling place before Election Day, even if you've voted before. You can find your proper location by visiting Vote America's polling place locator tool. If you're nervous about going to the polls on Election Day -- but don't live in a state with modified mail-in voting rules -- you can also consider voting early. This resource from the National Conference of State Legislatures outlines early voting information for each state. Many states allow residents to begin early voting 30-45 days before the election, though be mindful that rules vary considerably. You can also check with your local election officials to find early voting locations and early voting hours.

Important Voting Deadlines to Know

When it comes to voter registration, early voting, and mail-in and absentee ballots, deadlines vary by state. You should check with your local election officials to mark your state's specific deadlines. If you're not sure where to look, Vote America's local election office directory can help you get in touch with your local election officials.

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How Nurses Can Advocate for Patients

As we've outlined above, this election has enormous consequences for a variety of healthcare issues. Nurses are uniquely situated to vote with an informed, insider perspective of the healthcare system. They know the weaknesses and strengths of the system, and they can use the power of their vote to make a difference in how the system operates. "The perspective that nurses offer is a unique one compared to other healthcare professions," says Rishe. "There are aspects of care and insights that we are able to recognize due to the intimate amount of time we spend with each patient." "We can see what’s working, and what’s not," she adds. If you're not registered to vote and not sure how, visit Vote America for a general overview of voter registration and how to find your polling place. You can also learn more through several nursing and healthcare-specific voting campaigns. The list below introduces some of these nationwide initiatives.

Nurses Vote 2020 The American Nurses Association (ANA) sponsors this campaign, which educates nurses on voting issues that affect them. The campaign lays out the ANA's priorities, which includes COVID-19, the opioid epidemic, and workforce development. The ANA also prioritizes healthcare transformation, which includes optimizing preventative services and offering a universal standard healthcare package to patients. Nurses can use the ANA portal to check whether they are registered to vote, or to get involved in campaigning.

Nursing Voices, Nursing Votes The American Association of Colleges of Nursing (AACN) describes itself as "the national voice for academic nursing." The AACN also runs this initiative, a nonpartisan effort to encourage nursing students and faculty to vote in November. The campaign offers information on how to register to vote in every state. Participants can find out more by completing an online form.

Med Out the Vote The American Medical Student Association (AMSA) organizes this initiative to advocate for students within the healthcare field to vote. Students can participate in this campaign by encouraging peers on their campus to vote. AMSA offers resources and kits students can use to register their classmates, friends, and family members to vote.

VotER Unlike the other campaigns on this list, VotER isn't sponsored by any specific organization. VotER is an independent nonprofit organization and a collaboration between healthcare professionals, designers, and behavioral scientists. The organization believes in community education and civil engagement, and it sends "healthy democracy kits" to participating healthcare facilities across the United States. These kits include badges with QR codes; nurses and doctors wear these badges to help patients easily register to vote on their own.

Civic Health Month This collaboration brings together healthcare organizations and workers to support the connection between voting and healthcare. August is officially Civic Health Month, but the organization still offers several resources online. Visitors can watch webinars from physicians, social workers, and medical students.They can also access voting guides and pick up voter registration tips. The organization's blog shares educational articles about social determinants of health and the power of voting during a pandemic, among other topics.

Disclaimer: NurseJournal is not affiliated with any political party, nor do we promote any particular candidate for office. Our goal is to provide information about issues that might be relevant to nurses and healthcare professionals, as well as resources to help them vote on the issues that matter to them.