WASHINGTON — Donald Trump took aim at the Affordable Care Act on Tuesday in his presidential debate with Kamala Harris, reviving a 15-year-old partisan fight over a law that has swung from a liability to a political asset for Democrats.
“Obamacare was lousy health care. Always was. It’s not very good today,” Trump said on the stage. “And what I said, that if we come up with something, and we are working on things, we’re going to do it and we’re going to replace it.”
Trump indicated that he’d only eliminate the ACA, also called “Obamacare,” if he could devise a better and cheaper system. Pressed by debate moderators on whether he has a plan, he said, “I have concepts of a plan,” adding that he intends to release “concepts and options … in the not-too-distant future.”
The former president didn’t provide a more specific timeline.
“We could do much better than Obamacare,” Trump said.
Trump’s remarks were another turning point in the 15-year fight over the ACA, which Republicans have sought to back away from. Trump, who revived the issue last fall, pivoted this year to downplaying prospects of repeal if he returned to the White House — until he was asked about it Tuesday in the debate.
The Harris campaign is exploring ways to weaponize Trump’s comments, including by considering paid ads and health care-focused events, among other options, according to two sources with knowledge of the campaign’s thinking. One called reviving the issue “a f— up” from Trump that gives Harris’ campaign “a huge opening” with key groups of voters.The day of the debate, the Biden administration announced that ACA enrollment hit an all-time high this year with 20.8 million Americans signing up. Overall, the White House said, about 50 million Americans have been covered through the ACA’s private marketplaces since 2014, in addition to those who have gained insurance through the law’s Medicaid expansion.
Harris senior adviser David Plouffe promised Wednesday that voters will hear more about Trump’s health care comments.
“He promised us a health care plan back in 2015. A long time ago. Never came. Last night, he said he had the concepts of the plan. But he still wants to basically throw tens of millions of people off health care,” Plouffe said on MSNBC. “People in swing states are going to hear about that very soon.”
The 2010 law, signed by then-President Barack Obama, was unpopular early on and weaponized politically by Republicans, who vowed to “repeal and replace” it if given power. But in 2017, when Trump and a GOP-led Congress sought to undo the law, it sparked a public backlash and enhanced the ACA’s popularity. A Trump-backed Republican repeal bill sought to roll back the subsidies for expanding coverage and unwind some of the ACA’s protections for people with pre-existing conditions, one of its most popular features. It fell one vote short when Sen. John McCain, R-Ariz., unexpectedly voted “no” during a late-night Senate session.
Harris, who was a senator then, recalled that vote on Tuesday.
“You have no plan,” she told Trump. “And what the Affordable Care Act has done is eliminate the ability of insurance companies to deny people with pre-existing conditions. I don’t have to tell the people watching tonight. You remember what that was like? Remember when an insurance company could deny if a child had asthma, if someone was a breast cancer survivor, if a grandparent had diabetes? And, thankfully, as I’ve been vice president, we over the last four years have strengthened the Affordable Care Act.”
Democrats turned the tables on the GOP in the 2018 election, accusing them of seeking to throw millions of Americans off health care and reinstate the option for insurers to refuse to cover people with prior illnesses. The ads wrote themselves. Still, Trump persisted in his push for undoing the law for the remainder of his presidency and endorsed a lawsuit to wipe out the law in 2020, the year he lost his re-election bid to President Joe Biden.
In Congress, Republicans have expressed little appetite to revisit the painful fight over undoing the law, now that its benefits are widespread and entrenched in the health care system. That includes some of the most conservative members, who favor changes to the health care system but not through the prism of undoing the ACA.
The Affordable Care Act “hasn’t worked from the standpoint that costs have skyrocketed. … Deductibles are way up. Co-payments are way up,” Sen. Rick Scott, R-Fla., who faces re-election this fall, said in an interview. “You want to have a safety net so people can get health care. … So the way I would look at it is, I wouldn’t talk about what we should do with the ACA. I say: How are we going to fix the system?”
Asked if he supports Trump’s call to reopen the ACA fight, No. 3 Republican Sen. John Barrasso, of Wyoming, didn’t answer directly.
“We want to make sure that people get the care that they want and get insurance that is affordable and appropriate for them,” he said. “And that’s been a real challenge for so many Americans under Obamacare, because the rates have gone up — more expensive for individuals, and so many of Obama’s promises have been broken.”
