JD Vance Rewrites Trump’s Health Care History

During the presidential debate three weeks ago, Republican candidate Donald Trump made a stunning statement about his record on health care: He said he tried to “save” the Affordable Care Act when he was president.

During Tuesday night’s vice presidential debate, JD Vance repeated that claim, then went further: Trump not only tried to save the health care law, but did so with the help of Democrats.

“Donald Trump could have destroyed the program,” Vance said. “Instead, he worked in a bipartisan manner to ensure Americans had access to affordable care. »

This is pure fantasy, literally the opposite of the truth.

And that’s important, because the health care of tens of millions of Americans could depend on the outcome of the election. Voters have a right to know what Trump would do if he returned to the White House, and that means understanding what he actually did during his last visit.

The real story goes like this:

Trump, during his 2016 presidential campaign, pledged to repeal the Affordable Care Act, also known as Obamacare. And it wasn’t some random, throwaway line.

He mentioned it constantly, often at the start of his meetings. His campaign website said: “On day one of the Trump administration, we will demand that Congress immediately repeal Obamacare. »

And Trump kept that promise. He spent most of his first year in office working with Republican leaders to pass legislation repealing the bill.

But while Trump had repeatedly said he would provide “great health care for a lot less money” and vowed that “we will have insurance for everyone,” the Republican legislation he supported would have Significantly reduced public health care spending and weakened protections. for people with pre-existing conditions.

Several million people were at risk of losing their coverage, as several independent projections showed.

Republicans knew that these bills were unlikely to win support from Democrats. Unlike former President Barack Obama and Democrats in 2009 and 2010, who spent months trying (unsuccessfully) to negotiate with a handful of Republicans over what became the Affordable Care Act, Party leaders Republicans like then-House Speaker Paul Ryan (R-Wis.) focused almost exclusively on consolidating support within their own party and getting legislation through Congress as quickly as possible.

Republicans managed to pass their bills in the House but failed in the Senate, thanks to the no votes of a handful of Republican lawmakers.

In this sense, the only bipartisan action during the debate over repealing the Affordable Care Act occurred when Republican senators like Lisa Murkowski of Alaska and John McCain of Arizona – in one of the final public acts of his life – sided with Democrats and voted to stop Republican legislation. of the passage.

That defeat didn’t deter Trump, who spent the rest of his presidency looking for other ways to undermine or destroy the law. He cut funding for outreach and enrollment counselors and asked the federal government to join a lawsuit asking the Supreme Court to declare the entire program unconstitutional.

All of these efforts had little effect, and one backfired, sparking a backlash from the insurance industry that made Obamacare financial aid more generous. But Trump’s intention was clear: “to repeal and replace the disastrous Obamacare law,” as an official White House statement put it at the time.

And Trump still talks about it today. Last November, he posted on Social truth that he was “always seriously looking for alternatives.” And after acknowledging that “a few Republican senators” blocked his 2017 efforts, he declared that Republicans “should never give up!” »

Last month, during the debate with Democratic presidential candidate Kamala Harris, Trump said he still wanted to replace the law and had “ideas of a plan” to do so – although, as d Usually, he did not specify what these concepts were. .

Conservatives have many serious and intellectually coherent reasons to oppose the Affordable Care Act.

The law significantly expanded Medicaid, an already large government program that provides health care to the poor. He also introduced a new set of subsidies to help people get health insurance.

Both steps required considerable new government spending, estimated at around $1 trillion in the first ten years alone. The law financed this spending primarily by cutting Medicare payments to hospitals and other health care providers, and imposing new taxes on the wealthiest Americans.

The Affordable Care Act also imposed new rules on private insurance, requiring insurers to sell more comprehensive insurance policies and prohibiting them from denying coverage to people with preexisting conditions.

New government spending, new regulations, new taxes: Republicans oppose all of these things, arguing that they make Americans’ lives worse instead of better.

And when Trump first ran for office, his calls to repeal the ACA likely won him votes. Many people were still struggling with health care costs, including some people whose insurance premiums had increased due to changes in the law.

But public opinion strongly opposed repealing the ACA once people realized it would mean giving up some legal protections for people with pre-existing conditions, not to mention the prospect of seeing a si large number of people lose their insurance completely. Whatever their disappointments and frustrations, voters did not want to go back to the way things were.

And the anger over the repeal didn’t disappear when the legislation died. This backlash was a key reason why Republicans lost control of the House of Representatives in 2018 and then abandoned the Senate and White House in 2020.

Today’s Republicans know this, which is why most of them have tried to avoid the subject of health care altogether — and, if it comes up, they now insist they won’t don’t want to take away what Obamacare provided.

But there are all kinds of signs that Republicans remain interested in repealing the Affordable Care Act, or at least rolling back parts of it. These signs include references to conservative agenda documents like Project 2025, as well as statements made by Vance during an interview on NBC’s “Meet the Press.”

Vance’s comments were particularly revealing because he said Republicans were interested in a “deregulatory agenda” to avoid a “one-size-fits-all approach that would put a lot of people in the same insurance pools.”

That’s how Republicans described their plans to relax the rules of the Affordable Care Act during the repeal debate – an episode that Vance did his best Tuesday night to put out of the public eye.