It's now 40 days until the Nov. 4 presidential election that will determine whether former President Donald Trump or Vice President Kamala Harris will lead White House policy for the next four years.
Earlier this month, with less than two months to go, a group of female executives formed Women Healthcare Leaders for Progress to call attention to what they see as critical healthcare issues at stake and on the ballot, namely, women’s healthcare.
The group publicized an open letter (PDF) that has now gained more than 400 signatures from executives across venture capital, health insurance, healthcare delivery, digital health, healthcare AI and life sciences. WHLP is galvanized to raise awareness around three key issues—reproductive rights, including maternal and child healthcare; affordable health insurance and prescriptions drugs; and preserving Medicare/Medicaid benefits to seniors and at-risk populations.
The group is very transparent on its political aim: supporting the election of Kamala Harris as president and Tim Walz as vice president of the U.S.
Healthcare organizations, such as the major medical industry groups, typically do not endorse candidates and strive to remain bipartisan in political issues. Executives at the top of major healthcare insurance, hospital or health tech companies tend to stay publicly quiet on politics.
However, Missy Krasner, a digital health investor and adviser at Redesign Health, along with the other members of WHLP, say they are motivated to get more publicly involved this election cycle due to their collective interest in women's health, healthcare affordability and access.
These are issues businesses that invest and build in healthcare should be watching closely and have a clear stance on, Krasner noted. Investors poured $481 million into health tech companies focused on women’s health in 2023, up 5% from $459 million in 2022, according to a Deloitte report.
"This is the first time where you've got a significant policy issue that will impact tech-enabled startups and startups that are in femtech, women's health, family planning and caregiving. Who ends up in the White House will materially impact the way in which we think about investing in women's health and fintech, and the way in which startup CEOs are going to go forward in their business," Krasner said in an interview with Fierce Healthcare. "As I was looking around and sort of waiting for lots of groups to come together, I thought, 'Why aren't women healthcare leaders forming an alliance and trying to talk about this?'"
The organizers of WHLP include Lori Evans Bernstein, former CEO and founder of Caraway; Molly Coye, M.D. former board member of Aetna and the American Hospital Association; Laurie McGraw, executive vice president at Transcarent; Audrey Mann Cronin, an advisor and comms expert to CEOs in healthcare and technology and Miriam Paramore, a health information technology expert.
Female executives who have joined WHLP's cause and endorsement of the Harris/Walz ticket reflect a growing list of digital health CEOs and founders, femtech CEOs and founders, VCs and femtech investors, heads of health systems, legislative fellows, professors, health economists, health tech advisers, physicians and comms experts and strategists.
WHLP contends that healthcare policies that restrict access to reproductive care, limit Medicare benefits for seniors or weaken the safety net by eliminating Medicaid waivers are detrimental to patients and also to the future of healthcare innovation.
Trump supports state rights on abortion procedures but opposes any taxpayer funding for abortions. On the campaign trail, Harris has said she would fight to protect abortion rights, a stance that would require working with Congress to codify federal protections such as those that existed under Roe v. Wade.
In the two years since the U.S. Supreme Court overturned Roe v. Wade, which eliminated the federal constitutional right to abortion, many states have enacted abortion bans. Approximately 41 states have abortion bans in effect with only limited exceptions—14 states have a total abortion bans, 27 states have abortion bans based on gestational duration and eight states ban abortion at or before 18 weeks’ gestation.
Research shows that restricted access to abortion is associated with negative social and health-related consequences for pregnant women. These laws also can constrain how providers treat pregnancy complications, leading to preventable deaths.
Further, the overturning of Roe v. Wade has had downstream effects on fertility treatments, specifically in vitro fertilization. In Alabama, a state Supreme Court ruled that frozen embryos count as children under state law, which shut down IVF programs in Alabama. The state legislature has since passed Republican-sponsored bills to protect IVF.
Frame Fertility is one fertility-focused startup on the front lines of reproductive health and is seeing the impact of how new laws change how fertility providers operate.
"Sadly, we are already seeing challenges. We saw what happened in Alabama that caused the entire fertility clinic industry to have to take a time out and recognize a lot of the regulatory risks that are already present," Jessica Bell van der Wall, CEO and founder of Frame Fertility and a member of WHLP, said in an interview.
"Our reproductive endocrinologist is based down in Louisiana, and he lives this every day. He can't even keep embryos in the state of Louisiana. We see it today with fertility. We see it with OB-GYNs exiting the workplace because they don't feel comfortable practicing in today's environment, and we see it with contraception. It's impacting every element of women's health, especially reproductive health," she said. "I'm running a company in this space. I am also a mom and someone who went through fertility treatment. We're unified together to keep fighting towards this. It's definitely clear to me why I want to be part of this coalition."
Krasner, who previously worked at Amazon, Google and Box and was an adviser at the Office of the National Coordinator for Health IT within the Department of Health and Human Services, says these policy issues have a direct impact on healthcare innovation and the startup ecosystem.
"From an investor standpoint, a VC standpoint, all VCs want to invest in opportunities where the regulatory winds are in the favor of the startup, and particularly that are going to create pockets of innovation. This election matters because there are a lot of VCs that have poured a lot of money into women's health and tech-enabled services and tech. These companies will continue to fight the good fight, but essentially, we are really at a turning point," Krasner said.
As a grassroots organization, WHLP aims to increase visibility around these policy issues and nudge larger companies to get more politically involved.
"We want women and even men that are allies to say, 'This is a large coalition. Look at at the names of significant leaders in the space. I should go inform myself about the policy issues. I should go talk to my government relations person. I should figure out, from a company standpoint and or an association standpoint, do we want to publicly make a stand here?' It's about unifying and trying to get the industry to actually take a point of view that's a little bit more public," Krasner said.
She also notes that access to reproductive health goes beyond an individual's personal opinion about abortion.
"It just has to be about services, and whether or not women are going to get services. And on top of that, this is an access issue. We're already seeing women of color and at-risk populations already have a hard time getting services anywhere, primary care, OB-GYN and even family planning," she said, adding that reproductive health policies also impact medical providers.
Krasner noted that she not seen a pullback on investment in women's health or femtech startups. However, healthcare policies at the state and federal levels impact whether reproductive health services and fertility treatments are covered by insurance and that could significantly affect the market.
"From an investor standpoint, this is a moment in time that if the regulatory winds come down negatively on fertility and other healthcare services around reproductive health, there will be an entire cash pay market," she said. "Investors will invest where there's a very defined market. If it the regulatory winds go one way, startups are going to essentially play within the mainstream, within insurance and within traditional CPT codes. That's blending more into the mainstream, and that's kind of where we want everything."
Nonpartisan efforts to get involved in voter engagement
The American Medical Association and other healthcare groups recognize voting as a social determinant of health.
Vot-ER is a nonpartisan, nonprofit organization working to integrate voter engagement into healthcare. The organization uses routine healthcare visits as opportunities for civic empowerment, partnering with trusted health professionals and reaching historically underrepresented communities, according to the organization's website.
Alister Martin, M.D., an emergency physician, started Vot-ER as a pilot program at Massachusetts General Hospital in 2019. He founded Vot-ER to provide medical professionals with voter registration resources.
Similarly to the Departments of Motor Vehicles, healthcare facilities can play an integral role in nonpartisan voter registration. Health touch points—like the University of Pennsylvania Health System, Massachusetts General Hospital, AltaMed Health Services and 700-plus more—have become a crucial part of the puzzle to keep voter registration information up to date and ensure patient voices are included in local, state and federal decisions, the organization said.
Vot-ER consists of 350 institutional partnerships, 700 participating sites and 50,000 healthcare professionals. Institutions can integrate Vot-ER materials into their waiting rooms and discharge paperwork. Healthcare professionals also can order a free Vot-ER badge, which includes a QR code patients with smartphones can scan to complete the voter registration process on their own time.