Health care was one of the topics at the forefront of Tuesday night’s debate between former President Donald Trump and Vice President Kamala Harris.
Trump said he was interested in replacing the Affordable Care Act — also known as “Obamacare” — but implied that he didn’t have any specific plans in place.
“Obamacare was lousy health care. Always was,” Trump said. “It’s not very good today and, what I said, that if we come up with something, we are working on things, we’re going to do it and we’re going to replace it.”
When asked by ABC News moderator Linsey Davis to clarify if he had a health care plan, the former president said he had “concepts of a plan” to replace the ACA but provided no details.
“If we can come up with a plan that’s going to cost our people, our population, less money and be better health care than Obamacare, then I would absolutely do it,” Trump said.
“But if we come up with something, I would only change it if we come up with something better and less expensive,” he said later in the debate. “And there are concepts and options we have to do that. And you’ll be hearing about it in the not-too-distant future.”
Last year, Trump posted on Truth Social that the ACA “sucks” and that he didn’t want to “terminate” the law but “replace it with much better health care.”
Dr. Dennis Scanlon, a distinguished professor of health policy and administration at Penn State, told ABC News there’s been much less of a focus on repealing and replacing ACA from Trump than seen in 2016 and 2020.
“I think what’s been noticeable in this election cycle [is] less discussion about the Affordable Care Act in terms of let’s repeal it or get rid of it,” he said. “I think last night in the debate, [Trump] basically straddled and said, ‘You know, if I can figure out a way to make it better, and we’re working on some concepts, we’ll do it, but not, that we will get rid of it.’ So I think that’s just different from what it’s been in the last two cycles.”
Scanlon mentioned that repealing the ACA is not even mentioned in the official 2024 Republican Party platform.
In 2010, then-President Barack Obama signed the ACA into law, requiring most Americans to have insurance and directing states to create health insurance exchanges to allow residents to sign up for insurance if they don’t receive coverage via an employer.
During his administration, Trump attempted to partially repeal the ACA by passing the American Health Care Act (ACHA). The plan would have repealed the individual mandate and the employer mandate, amended Medicaid eligibility and weakened protections for patients with pre-existing conditions.
The ACHA passed the House in May 2017 but failed to pass in the Senate. Perhaps mostly infamously, the Senate attempted to pass a so-called “skinny repeal” in late July 2017 but it was rejected, with Republican Sens. John McCain, Susan Collins and Lisa Murkowski siding with Senate Democrats to kill the bill.
In December 2017, a Republican tax reform law was passed that eliminated individual mandates, which Gallup said may have reduced participation in the insurance marketplace.
At the end of 2019, 13.7% of adults were without health insurance at the end of 2018, the highest level seen since early 2014, according to Gallup data.
In December 2019, Trump issued an executive order requiring all hospitals to make public standard charges, payer-specific negotiated charges, the amount the hospital is willing to accept in cash and the minimum and maximum negotiated charges.
“This an area where an attempt has been made … but the way it has played out has been challenging and not very effective,” Scanlon said, referring to a KFF analysis which found that transparency data was often inconsistent and confusing. “Such transparency is fundamental to reform and improvement in health care markets.”
In a statement to ABC News, Karoline Leavitt, national press secretary for the Trump campaign, restated the former president’s commitment to release details soon.
“As President Trump said, he will release more details but his overall position on health care remains the same: bring down costs and increase the quality of care by improving competition in the market place,” she said. “This is a stark contrast to Kamala Harris’ support for a socialist government takeover of our healthcare system which would force people off their private plans and result in lower quality care.”
During the debate, Harris criticized Trump’s previous attempts to repeal the ACA, saying she wants to grow and expand the legislation. Her campaign platform mentions expanding the $35 cap on insulin and $2,000 cap on out-of-pocket prescription medication costs for seniors to all Americans.
“There’s been a little bit of detail from the Harris campaign, but I would say also not much,” Scanlon said. “There’s some discussion about negotiating drugs, insulin prices, there has been some work done in that … but there’s a lot more to be done.”
