WASHINGTON — Eight years after he was elected president on a promise to repeal and replace the Affordable Care Act, former President Donald Trump still hasn’t decided how he wants to do it.
In a presidential debate with Vice President Kamala Harris on Tuesday, Trump said he had “concepts of a plan” to replace the Affordable Care Act, but offered no details.
“We’re looking at different plans. 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. “You’ll be hearing about it in the not too distant future.”
Despite an embarrassing defeat in 2017 for Trump’s effort to repeal and replace the health care law, Trump just can’t seem to let the prospect go — even though many in his party have dropped their attacks on the Affordable Care Act as it’s become more popular. As he continues to toy with the prospect of attacking a popular policy, it creates more uncertainty for his party and for the health care industry, and an opportunity for Democrats to claim the law is under threat.
When Trump was elected in November 2016, just 43% of adults supported the law, according to a tracking poll conducted by the nonpartisan polling and analysis firm KFF. The most recent poll, from April, shows that number has risen to 62%.
Trump on Tuesday tried to walk a tightrope of claiming the law isn’t working, while also taking credit for keeping it afloat while in office.
“I had a choice to make. Do I save it and make it as good as it can be, or do I let it rot? And I saved it,” Trump said.
While in office, Trump’s administration shortened open enrollment periods, cut funding for navigators who help people enroll in coverage, expanded short-term insurance plans, lowered standards for health benefits provided by small employers that banded together into larger groups, and enabled employers with religious or moral objections to contraceptive coverage to opt out of requirements to provide no-cost coverage.
Harris, for her part, called out Trump for not having a health care plan. But she didn’t present a grand new vision for health care reform, either, and mostly stuck to her platform talking points of incrementally expanding drug pricing reforms passed under President Biden to apply to more people. She specifically proposed expanding to all Americans the Inflation Reduction Act’s policies that cap out-of-pocket costs for insulin at $35 per month and overall out-of-pocket costs for medications at $2,000 per year.
“What we need to do is maintain and grow the Affordable Care Act,” Harris said.
Repealing the Affordable Care Act is not in the Republican party platform, and Trump didn’t mention the prospect in his campaign’s stated plans on health policy, which included tying drug prices to what patients pay in other countries, restricting gender-affirming care provided to minors, imposing harsh new penalties on convicted drug dealers, and creating a commission to study the rise of chronic illness in children, among others.