Health Care Is Front And Center As Ron DeSantis And Gavin Newsom Prepare For Fox News Debate

Republican presidential candidate Ron DeSantis and Democratic Gov. Gavin Newsom — political rivals from opposite coasts and representatives of red and blue America — face off in the first debate on November 30 in Georgia.

Newsom, a liberal in his second term as governor of California, will not run for president in 2024. But he asked DeSantis, in his second term as Florida governor, to run. "I'll bring my hair salon. You bring your hairspray," she joked on social media.

The contest is expected to be a fierce battle between the political stars who lead one of the country's two most populous and diverse states. It will be the first meeting between the politicians, although they have traded insults and insults very publicly in recent weeks and attacked each other in fundraising videos and campaign ads.

The focus will be on homelessness and health care, top priorities for voters and issues that have largely determined governors' policies and leadership style. From abortion to COVID-19 vaccines, Newsom and DeSantis couldn't be further apart.

Earlier this year, DeSantis criticized California for being too generous with public welfare programs like Medicaid, which the Golden State extends to all eligible residents, regardless of immigration status. This comprehensive policy goes into effect in January and goes beyond the additional Medicaid expansion provided by the Affordable Care Act. And in Florida, one of 10 states that refused to expand Medicaid under Obamacare, DeSantis takes pride in the state's 11% uninsured population.

"We're not going to be like California, where a lot of people get into public programs and don't have work requirements," DeSantis said during the first presidential debate in Southern California earlier this year.

DeSantis has pushed his state to reduce the focus on abortions and gender-affirmation and to ban the mandatory use of masks and COVID-related vaccines.

Newsom, a prominent and vocal alternative to Democratic President Joe Biden, criticized DeSantis for endangering and disenfranchising Floridians.

"Join us in California, where we still believe in freedom," Newsom said in a political ad earlier this year.

News earned the title of "health care governor" by prioritizing the issue. He made California an abortion haven and dramatically expanded health care benefits. During his first presidential campaign, he promised to implement single-payer health care in the nation's most populous state, but the idea faced stiff political opposition early in his term. Now Newsom is bragging about lowering the state's uninsured rate to a record low of 6.5 percent while expanding coverage in other ways.

These questions are expected to be the focus of a 90-minute national debate on Fox News, which could have far-reaching implications for next year's presidential race and even help shape the field of candidates for the White House in 2028.

Ahead of that fight, KFF Health News looked at the governor's top 10 health care jobs and how their policies improved or hindered the health of the populations they represent.

Affordable Health Care Act

Florida: DeSantis refused to expand Medicaid eligibility to more people under the Affordable Care Act. Partly as a result, more than 3 million Floridians had insurance through the federal Obamacare program in February, more than any other state. Florida has no statewide exchange and no state-funded aid.

California: The state enthusiastically passed the Affordable Care Act, expanding Medicaid and creating its own insurance exchange, Covered California. Under Newsom, he also went beyond Obamacare and imposed a state health insurance requirement on Californians after removing the federal mandate.

abortion

Florida: In April, DeSantis passed a law banning abortions after six weeks of pregnancy. However, the Florida Supreme Court has appealed the 15-week ban imposed in 2022, which will decide whether the six-week ban can remain in place.

California: In 2022, the News championed efforts to amend the state constitution to preserve abortion and birth control rights. He also approved $60 million to help pay for abortions in California for uninsured and out-of-state patients, and signed reproductive health legislation, including legislation to protect doctors who ship abortion pills to other states.

Transgender care

Florida: According to DeSantis, Florida passed a law this year banning transgender people from providing sex-affirming medical care and requiring adult patients to sign an informed consent before starting or continuing hormone therapy. The law also limits which doctors can prescribe hormone therapy and prohibits the use of telemedicine to obtain new prescriptions. A federal lawsuit challenging the law is scheduled to go to trial by mid-December.

California: Newsom and other state leaders changed state law to ensure that all California adults and children have the right to access gender-affirming health care services. And insurers doing business in California must include gender verification information with network providers by 2025. State health agencies are developing "mandatory quality standards" to ensure transgender patients receive comprehensive treatment.

Florida Governor Ron DeSantis speaks during the first presidential debate on November 8, 2023 at the Adrienne Arsht Center for the Performing Arts in Miami-Dade County. (AP)

without a home

Florida: DeSantis has not made homelessness a priority. In a video filmed on the streets of San Francisco and posted on social media in June, DeSantis used the issue as a rallying cry to criticize what he called "left-wing politics" in California. Florida is experimenting with using Medicaid funds to address homelessness, but the program is limited. Nearly 26,000 people, or 12 out of every 10,000 residents, are homeless in Florida.

California: Newsom spent more than $20 billion on homelessness, and billions more on health and social services. For example, some homeless Californians can receive social services through the state's Medicaid program, such as mortgage payments, utility bills, and first and last month's rent. Newsom also pushed for a new state initiative that could force some homeless people to seek treatment for mental illness or drug addiction. More than 171,000 people, or 44 per 10,000 residents, are homeless in California.

Psychological health

Florida: DeSantis has kept his promise as governor to protect mental health treatment programs, even though Florida still ranks 43rd in the nation in access to mental health care and has the highest number of uninsured adults with mental illness, Psychiatry Center. take care Health and healing. According to DeSantis, Florida increased state funding for school-based mental health programs and peer mental health services for emergency responders, and directed funding for suicide prevention.

California: In 2020 Newsom signed one of the nation's strictest mental health parity laws, requiring insurers to cover mental health and substance use disorders the same way they cover physical health costs. It funds a $4.7 billion initiative to provide mental health care in schools. Newsom is also leading a campaign to pass $6.4 billion in statewide bonds in 2024 to modernize and expand community-level behavioral health programs, including thousands of new treatment beds.

Addiction

Florida: Florida's drug overdose death rate for 2021 was 37.5 per 100,000. A coordinated network of support services. DeSantis allowed Florida counties to adopt needle exchange programs in 2019 to reduce the spread of blood-borne diseases and encourage drug addiction treatment.

California: In 2021, California's drug overdose rate was 26.6 per 100,000 people. Newsom is sending the Highway Patrol and National Guard to San Francisco to combat open-air fentanyl trafficking and expand drug addiction treatment programs statewide. But last year, he vetoed legislation that would have allowed interstates like Los Angeles, San Francisco and Oakland to establish safe injection sites.

California Governor Gavin Newsom speaks during a Clean California event on November 9, 2023 in San Francisco. (AP)

Prescribed medications

Florida: A proposal submitted by DeSantis to the US Food and Drug Administration (FDA) in 2020 involves allowing the importation of drugs from Canada. The new state law also imposes price caps on pharmacy benefit managers — intermediaries between insurers, pharmacies and manufacturers — and establishes new price transparency rules. The law also requires pharmaceutical companies to disclose significant price increases.

California: Newsom is leading the nation's first $100 million initiative to get California into generic drug manufacturing, starting with insulin and the opioid naloxone. When News took office, California had a price transparency law. This year he signed legislation tightening state regulations for pharmacy benefit managers.

Access to health care

Florida: In 2019, DeSantis signed the Patient Savings Act, which allows health insurance companies to share cost savings with members who purchase medical services such as imaging and diagnostic tests. Under his leadership, Florida lawmakers also approved short-term health insurance plans with terms of less than a year and direct health care arrangements between a patient and a health care provider, which are not considered insurance and are not subject to state insurance law.

California: One of Newsom's first health initiatives was funding state-funded health insurance subsidies for low- and moderate-income residents who purchase insurance through Covered California. Berria also agreed this year to lower co-pays and eliminate some discounts on plans sold through the exchange. California's newly created Office of Health Care Affordability limits the growth of industry costs and may regulate the consolidation of the health care industry. California prohibits short-term health insurance.

health care

Florida: DeSantis signed a bill in 2021 that prohibits governments, schools and private employers from requiring COVID vaccines. In 2023, he pushed lawmakers to pass laws banning some vaccinations and mask requirements. He also established the Public Health Integrity Commission, chaired by Surgeon General Joseph Ladaba, to ensure that official recommendations on Covid vaccines are in line with those of the Centers for Disease Control and Prevention. The Sunshine State's COVID-19 readmission rate among residents 5 years and older is 12.4%.

California: News became the first US governor to issue a statewide stay-at-home order at the start of the Covid-19 pandemic. He has pushed for strict vaccination and mask requirements and accused DeSantis of a lax approach to public health. Newsom also signed legislation that tightens vaccination requirements for children, including measures to combat fraudulent medical benefits offered by doctors. The Golden State's coronavirus revaccination rate among residents 5 and older is 21.9%.

Medical care for immigrants

Florida: As DeSantis has made immigration a priority, lawmakers passed a state law requiring all Florida hospitals to ask on admission forms whether a patient is a US citizen or in the country legally. Doctors, nurses and health policy experts say the law targets marginalized people who have difficulty navigating the health care system and will prevent them from seeking health care.

California: Starting in January, all immigrants who meet income criteria will be eligible for the state's Medicaid program. Before News took office, California expanded that right to include immigrants under the age of 18 living in the state without permission. Newsom then signed legislation that expanded the program to include youth up to age 26, adults over age 50, and later immigrants of any age who met eligibility requirements.

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