No discuss of Obamacare. Or abortion.

On the Republican Nationwide Conference in Milwaukee this week, the place delegates formally nominated Donald Trump because the celebration’s 2024 presidential candidate, well being care points acquired little consideration from prime-time audio system.

The silence is stunning, given well being care makes up the biggest chunk of the federal finances, almost $2 trillion, in addition to 17% of U.S. financial output.

It additionally stands in stark distinction to the GOP’s priorities when it first nominated Trump.

In 2016, the final time Republicans gathered en masse for a presidential conference, repealing the Inexpensive Care Act was a favourite matter. So was overturning Roe v. Wade and its constitutional protections for abortion.

The change in tone displays Trump’s political sensitivities. The failed try below the previous president to repeal Obamacare in 2017 contributed to a crushing GOP defeat within the 2018 congressional elections, and the legislation now enjoys broad help. Abortion, too, has develop into a treacherous matter for Republicans since Roe was overturned in 2022, with most People against a nationwide ban.

In one of many solely items of well being coverage within the GOP’s 2024 platform, the previous president vows to not reduce Social Safety or Medicare, the well being program for older and disabled People, or change the federal retirement age.

In his speech accepting the nomination Thursday evening, Trump promised to guard Medicare and discover cures for Alzheimer’s illness and most cancers. However he didn’t define any well being care proposals for a second time period. “Democrats are going to destroy Social Safety and Medicare,” he stated.

Well being care isn’t a profitable topic for Republicans, stated Charles Coughlin, CEO of a Phoenix public affairs agency who was a longtime GOP political operative earlier than he grew to become an unbiased in 2017.

Audio system on the conference have as a substitute targeted on inflation, crime, and immigration. “They’ve the tried-and-true polling information to point out these are profitable points for them, and that’s the place they need to preserve the narrative targeted,” he stated.

Immigration has bled into just a few well being points, together with the U.S. opioid disaster and public insurance coverage protection. Some Republicans — together with Georgia U.S. Home Rep. Marjorie Taylor Greene, who addressed the conference on July 15 — have claimed a rise in folks crossing the southern border has brought on a surge of drug overdoses and deaths.

Nonetheless, most fentanyl seized on the border with Mexico enters by way of authorized ports of entry, in keeping with the Cato Institute, a libertarian assume tank, and most of the people sentenced within the U.S. for fentanyl trafficking are Americans, in keeping with the U.S. Sentencing Fee.

Talking on July 17, U.S. Home Rep. Monica De La Cruz of Texas claimed Democratic insurance policies enable individuals who come into the nation with out authorization to obtain authorities advantages, despite the fact that they’re largely not eligible for federal well being applications.

De La Cruz additionally stated the Biden administration had reduce Medicare Benefit for seniors. Whereas the Biden administration this 12 months modestly reduce spending on the non-public plans, the federal authorities nonetheless spends extra money per beneficiary on Medicare Benefit than for these within the conventional Medicare program.

The paucity of conference audio system targeted on well being care displays the brand new GOP platform, a doc hewing intently to each the substance and tone of Trump’s views. Together with its promise to guard Medicare, the 28-page doc vows that Republicans will increase veterans’ well being care decisions, in addition to entry to “new Inexpensive Healthcare and prescription drug choices” extra broadly, with out elaboration.

On abortion, the celebration stripped from the platform its decades-old name for federal limits, together with as a substitute language suggesting the 14th Modification prohibits abortion. The platform additionally says the celebration helps state-level elections on abortion coverage and opposes “Late Time period Abortion.” Solely about 1% of abortions within the U.S. happen after 21 weeks of being pregnant, in keeping with KFF, a well being data nonprofit that features KFF Well being Information.

In distinction, the 2016 platform — a 66-page doc — additionally known as for shifting open-ended federal Medicaid funding into block grants and introducing a Medicare “premium-support mannequin” to cap spending. It additionally known as for limiting payouts from medical malpractice lawsuits and combating drug abuse.

The phrase “abortion” seems 32 instances within the 2016 platform, in contrast with as soon as within the 2024 doc.

“The GOP is in a headlong dash away from that concern,” Coughlin stated.

Throughout the week of the conference, video of a name between unbiased presidential candidate Robert F. Kennedy Jr. and Trump appeared on-line. Within the video, Trump is heard sharing disproven claims about childhood vaccines, saying falsely that the pictures may cause a child to “change radically” and dismissing their well being advantages.

As a candidate, Kennedy has repeatedly made false claims in regards to the security and efficacy of vaccines. Trump has lengthy entertained vaccine skeptics. (Earlier than Trump took the oath of workplace in 2017, Kennedy informed reporters Trump had invited him to chair a presidential fee on vaccines, although the fee by no means materialized.) However as president, Trump ordered the creation of the “Operation Warp Pace” program in 2020 that helped drive growth of covid-19 vaccines.

For the reason that begin of the pandemic, nevertheless, vaccine skepticism has blossomed within the Republican Occasion. Simply 36% of Republicans say they’re assured covid vaccines are secure, and 44% of Republicans and Republican-leaning independents say mother and father ought to be capable of determine to not vaccinate their kids towards measles, mumps, and rubella “even when that will create well being dangers for different kids and adults,” in keeping with KFF polling.

KFF Well being Information is a nationwide newsroom that produces in-depth journalism about well being points and is among the core working applications at KFF—an unbiased supply of well being coverage analysis, polling, and journalism. Study extra about KFF.