Five days before the Iowa caucuses, former U.S. Ambassador to the United Nations Nikki Haley stood on stage at Drake University in Des Moines alongside Florida Governor Ron DeSantis, vying for Iowa voters’ support at CNN’s Republican presidential debate. 

Aside from former President Donald J. Trump, who declined his invitation, Haley and DeSantis were the only two Republicans to qualify for the debate as the number of candidates dwindles. 

Haley’s recent surge has voters and others considering her record as UN Ambassador in the Trump administration and her tenure as governor of South Carolina from 2011 to 2017, looking for an indication as to how she might govern if she wins the presidency. Trump still leads the Republican field by a wide margin, but Haley has risen in the polls since the summer and is now staking a claim for second place among Republican voters, matching and in some cases surpassing DeSantis’ poll numbers. 

Among those attempting to anticipate what a Haley presidency could look like are analysts and experts who see hints at how Haley might approach both domestic and foreign health policy. 

Haley on Global Health 

Foreign aid often involves resources to address global health threats, such as disease and pandemics. The 2024 election season is occurring amid clashes in Washington over funding for international conflicts and the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR. 

Haley, a daughter of South Asian immigrants, served as ambassador to the UN from January 2017 to December 2018, and her tenure offers clues on how she could approach global health policy and foreign aid as president. 

A few months into her tenure as ambassador, Haley gave a speech at the Council on Foreign Relations, where she outlined a platform that largely foretold her approach on the global stage. Her speech denounced human rights violations in Syria against children and civilian infrastructure such as hospitals—and she continued to be outspoken on humanitarian crises in the Middle East and in places such as Venezuela. 

Yet her ambassadorial legacy included pulling out of the UN Human Rights Council, and in her resignation letter she touted how the Trump administration reduced U.S. contributions to the UN by $1.3 billion, which included a monetary cap on peacekeeping missions. 

Alan Yu, senior vice president for national security and international policy at the Center for American Progress, observed a transactional America First approach to foreign aid that was the centerpiece of Trump’s foreign policy while Haley served as UN Ambassador.  

Haley wrote in the New York Post that she would cut foreign aid to “anti-American” countries

“As I looked back on research that my staff did on the United States’ UN work, Haley’s view was, if you don’t vote with us at the UN, we’re going to cut your aid, stipulating that foreign assistance decisions should be key to UN votes,” Yu says. “It just really didn’t make sense from a broader national security or U.S. diplomatic perspective.” 

Last year, Haley wrote in the New York Post that she would cut foreign aid to “anti-American” countries, including China, Pakistan, and Zimbabwe. 

Yu says the globe is in a period of increasing geopolitical competition, and it is important to be able to work well with allies and—more important—with non-allies. 

Haley on Abortion and Gender 

Haley’s record on health-related topics as South Carolina governor could inform her policies as president, says Kelli Parker, director of communications and marketing for the Women’s Rights and Empowerment Network, a South Carolina-based nonprofit focused on advancing the health and economic well-being of women and girls. 

“She’s already said that as president she would support any federal abortion restrictions that could pass in Congress. I don’t believe her past positions have changed despite her currently moderate language,” Parker says. 

While governor, Haley signed into law a bill banning abortions after nineteen weeks of pregnancy unless the mother’s life is at risk or a doctor determines the fetus can’t survive outside the womb, with no exceptions for rape and incest. 

Her ‘consensus’ position is a way to soften her voting records and past positions

Kelli Parker

In public statements and speeches during her presidential campaign, Haley has described her stance as “unapologetically pro-life” but also opines that “the pro-life laws that have passed in strongly Republican states will not be approved at the federal level.” She supports voters deciding their state’s abortion laws but is not opposed to working toward a federal policy and building a “national consensus” on abortion access. 

“Haley is a savvy politician who is seeing several states where abortion is being voted for on the ballot and she’s responding accordingly,” Parker says. “Her ‘consensus’ position is a way to soften her voting records and past positions.” 

On LGBTQ+ rights Parker points to Haley’s record in South Carolina as both a state representative and as governor, when she sought to uphold the state’s ban on same-sex marriage. More recently, Haley has opposed transgender girls’ participation in sports and stated that Florida’s Parental Rights in Education Act, also known as the Don’t Say Gay law, did not go far enough in restricting dialogue about LGBTQ+ topics in schools. 

Haley on Health Care and Entitlements 

Medicaid expansion was a central component of the Affordable Care Act (ACA), or Obamacare, which was passed in 2010, shortly before Haley was elected governor. While holding that office, Haley declined federal funding for Medicaid expansion, which Parker says could have provided an additional 340,000 eligible South Carolina residents with access to medical coverage. 

South Carolina is still only one of ten states that have not expanded Medicaid. 

According to Larry Levitt, executive vice president for health policy at KFF, although Haley was a vocal opponent of the ACA at the time, her campaign has not been clear about her current position on repealing and replacing it. 

“This has not been a policy-oriented campaign so far,” Levitt says. “Haley has been quiet on the campaign trail about the Affordable Care Act, but it’s certainly hard to imagine her doing much to expand or strengthen the ACA.” 

Levitt says one thing Haley’s campaign has been vocal about is its support for Medicare Advantage, a private-sector policy Medicare option that is popular among conservatives and Republicans. Although this position is consistent with most of her party, Haley has distinguished herself by being the only GOP candidate entertaining the concept of increasing the eligibility ages for Medicare and Social Security as a strategy for cost savings. 

“No doubt, increasing the age of eligibility for Medicare and Social Security would save the government money and make those programs more financially sustainable in the long term, at a cost of reduced benefits for people,” Levitt says. As KFF Health News reported Friday, Haley was also responsible for a policy that reimbursed rural hospitals across South Carolina for all their uncompensated care costs. 

Haley on Vaccines and COVID-19 

Haley has a mixed record on vaccine mandates. As a South Carolina state legislator, Haley cosponsored a bill in 2007 to mandate that school-age girls be vaccinated against human papillomavirus, a sexually transmitted disease tied to developing cancer later in life. The legislation was vetoed, but Haley remained a sponsor even as other legislators pulled support. Later, as governor in 2012, she vetoed a similar bipartisan measure for HPV vaccine requirements.  

Early in the first year of the pandemic, Haley praised investments into the development of the COVID-19 vaccines, and she announced in December 2020 that her sister-in-law had died of the disease. In November 2021, she stated her opposition to the COVID-19 vaccine mandates because she said taking the inoculation was a personal decision and that people struggled to comprehend and trust the messaging around the shots.  

“Mandates are not what America does,” Haley told CBN News. Last year, she voiced strong opposition against school closures and lockdowns. 

Haley supported the concept of a coronavirus stimulus package only if it could be distributed without waste. Her presidential campaign has continued to decry the billions of unaccounted COVID relief funds, though her public comments have cited both Democrats and Republicans for “reckless spending.”  

On the campaign trail, Haley has accused China of covering up the origins of the SARS-CoV-2 coronavirus, stating the “Chinese Communist Party bears responsibility for the worst worldwide pandemic in a century, with up to 20 million deaths,” and she has consistently described Trump and President Joe Biden as being too easy on China.  

 

Nikki Haley’s campaign and the Heritage Foundation did not respond to requests for comment.