ObamaCare and its protections for pre-existing conditions have been a political taboo in recent years. But that hasn’t stopped Republican vice presidential candidate JD Vance from floating ideas last week that critics say could roll back popular protections, setting up a fight that Democrats are elated to take on.
During a campaign rally in North Carolina on Wednesday, Vance outlined a plan to remove federal regulations on the health care system while still ensuring care is available to people who need it.
“We will actually implement regulatory reform in the health care system that will allow people to choose a health insurance plan that works for them,” Vance said.
He added that the idea was to “allow people with similar health conditions to be placed in the same risk pools,” meaning sicker people would have to take out different insurance policies than well people.
“That’s the biggest and most important thing we need to change,” Vance said.
His remarks during the rally expanded on his remarks in the interview on NBC’s “Meet the Press” last week, where he said former President Trump does not believe in a one-size-fits-all approach that puts “a lot of people into the same insurance pools.”
Vance did not provide further details, so it is unclear whether his comments represent an official Trump campaign health plan, but Trump aides have said he and Vance largely agree on health care. Vance also said he has “learned his lesson” about speaking for Trump, having previously had to walk back comments about Trump’s veto of a national abortion ban.
During the presidential debate, Trump said he had “concepts for a plan” to replace the health care law if it were repealed, drawing ridicule from Democrats. Trump’s official program makes no mention of ObamaCare.
In an attempt to fill the gaps in Trump’s plan, Vance described the same “high-risk pools” that House conservatives championed when they drafted legislation to replace ObamaCare in 2017.
The Democrats were keen to point out these echoes.
“It looks to me like one of the protections that everyone is advocating for is effectively being repealed,” Senator Ron Wyden (D-Oregon) said at a Senate Finance Committee hearing last week.
“The concepts proposed by JD Vance are a recipe for discrimination against people with pre-existing conditions,” he added.
The Harris campaign team also responded quickly to Vance’s comments.
“There should be no doubt about Donald Trump’s determination to end the Affordable Care Act – he and House Republicans have tried to do so over 60 times,” Harris spokesman Joseph Costello said in a statement.
“One of the ‘concepts’ he is now reviving is his plan to eliminate protections for pre-existing conditions, strip millions of people of their health insurance, and drive up costs for millions of Americans with pre-existing conditions.”
A spokesman for Vance said the senator was “simply talking about the significant improvements President Trump has made to the Affordable Care Act through his deregulation approach. The goal was to reduce the cost of premiums while ensuring coverage for pre-existing conditions.”
The Affordable Care Act (ObamaCare) has experienced a significant political renaissance.
Almost immediately after its passage in 2010, the law became a burden for Democrats, costing them control of the House and Senate, and Trump promised to “repeal and replace” the health care law on his way to the 2016 presidential election.
But after Trump and Republicans in Congress failed to repeal the law by a single vote in 2017, his popularity soared. In the 2018 midterm elections, Democrats regained control of the House of Representatives, in part because they supported protections for people with pre-existing conditions.
When Trump was elected in November 2016, only 43 percent of adults supported ObamaCare. according to a tracking survey conducted by the non-partisan health research group KFF. The most recent poll, published in May, found that 62 percent of respondents viewed the law positively.
“I think there is a broad consensus across geographic, partisan, age and ethnic groups that people should not be disadvantaged or discriminated against because of their pre-existing conditions,” said Anthony Wright, CEO of the health organization Families USA. “And yet we are at this point. It’s bizarre that we’re still talking about it.”
Vance’s ideas are not unique to the Trump campaign.
For example, the budget proposal for 2025 by the Republican Study Committee, which includes most members of the Republican caucus in the House of Representatives, recommends eliminating many of the existing protections for people with pre-existing conditions. This includes allowing states to offer separate risk pools for younger, healthier people.
Experts say high-risk pools can theoretically work if they are sufficiently subsidized by the government. For more than 35 years before the Affordable Care Act was passed, both red and blue states used high-risk pools to cover people with steep medical conditions separately from the rest of the insurance market.
But the funds did not have sufficient resources and so they rarely managed to cover the people who needed insurance most.
“I have never seen an example of them ever being done right,” Wright said.
Polls show that voters want to be informed about plans to reduce health care costs. And according to a KFF tracking survey According to a poll released earlier this month, voters believe Vice President Harris will do better than Trump in the fight over health care costs by a 48 percent to 39 percent margin.
Democratic groups are also portraying Trump as an “existential threat” to drive voters to the polls.
The Democratic-aligned group Protect Our Care is launching a bus tour through battleground states on September 23 under the slogan “Lower Costs, Better Care.” The tour aims to highlight the efforts of the Biden-Harris administration while “raising the alarm about the threat that Donald Trump and MAGA Republicans pose to America’s health care system.”
Updated: Sept. 23, 11:05 am
