Republican vice presidential nominee Sen. JD Vance (R-
Ohio) said he wants to roll back ObamaCare’s protections
for people with preexisting conditions, reopening a fight
that’s repeatedly burned Republicans in the past — and
one Democrats are eager to have.
During a campaign rally in North Carolina on Wednesday,
Vance described a plan to remove federal regulations from
the health care system but still ensure people get the
coverage they need.
“We’re gonna actually implement some regulatory reform in
the health care system that allows people to choose a
health care plan that works for them,” Vance said.
He added the idea would be to “allow people with similar
health situations to be in the same risk pools,” meaning
sicker people would have to buy different insurance plans
from people who were healthy.
“That’s the biggest and most important thing that we have
to change,” Vance said.
His remarks during the rally expanded on comments he made
in an interview on NBC’s “Meet the Press” last week,
where he said former President Trump doesn’t believe in a
“one-size-fits-all” approach that puts “a lot of people
into the same insurance pools.”
Vance did not offer any other details, so it’s not clear
if his remarks represent an official Trump campaign
health plan, but Trump aides have said he and Vance are
broadly aligned on health care. Vance also said he’s
“learned his lesson” about speaking for Trump, as he
previously needed to walk back comments about Trump
vetoing a national abortion ban.
On the presidential debate stage, Trump said he had
“concepts of a plan” to replace the health law if it were
repealed, drawing ridicule from Democrats. Trump’s
official platform doesn’t mention ObamaCare at all.
In attempting to fill in the blanks of Trump’s plan,
Vance described the same “high-risk pools” championed by
conservatives in the House when they were crafting an
ObamaCare replacement bill in 2017.
Democrats were more than happy to point out the echoes.
“This looks to me like what amounts to a de facto repeal
of one of the protections everyone says they’re for
around here,” Sen. Ron Wyden (D-Ore.) said during a
Senate Finance Committee hearing last week.
“The concepts proposed by JD Vance are a prescription for
discriminating against those with preexisting
conditions,” he added.
The Harris campaign was also quick to amplify Vance’s
comments.
“There should be no doubt about Donald Trump’s commitment
to end the Affordable Care Act — he and House Republicans
tried doing it over 60 times,” Harris spokesperson Joseph
Costello said in a statement.
“Now, one of the ‘concepts’ he’s bringing back is his
plan to rip away protections for pre-existing conditions,
throw millions off their health care, and drive up costs
for millions of Americans with pre-existing conditions.”
The Affordable Care Act, or ObamaCare, has experienced a
significant political renaissance.
Almost as soon as the law was passed in 2010, it became
an albatross for Democrats. It cost them control of the
House and Senate, and Trump pledged to “repeal and
replace” the health law on his way to winning the
presidency in 2016.
But after Trump and congressional Republicans failed to
repeal the law in 2017 by a single vote, its popularity
soared. Democrats won back control of the House in the
2018 midterms in part by campaigning on protecting
preexisting conditions.
When Trump was elected in November 2016, just 43 percent
of adults supported ObamaCare, according to a tracking
poll conducted by the nonpartisan health research group
KFF. The most recent poll published in May showed 62
percent of respondents view the law favorably.
“I think there is a broad consensus across geography,
party, age, ethnic group, that people should not be
denied or discriminated against based on their
preexisting conditions,” said Anthony Wright, CEO of the
health advocacy group Families USA. “And yet, this is
where we are. It is bizarre that we’re still talking
about it.”
Vance’s ideas are not unique to the Trump campaign.
For instance, the fiscal 2025 budget proposal from the
Republican Study Committee, which includes most of the
House GOP caucus, recommends removing many of the
existing protections for people with preexisting
conditions, including allowing states to offer separate
risk pools for younger, healthier people.
Experts have said high-risk pools can work in theory if
they are sufficiently subsidized by the government. For
more than 35 years, before the Affordable Care Act
passed, red and blue states alike used high-risk pools to
cover people with expensive medical conditions separately
from the rest of the insurance market.
But the pools lacked sufficient funding and so rarely
succeeded in covering people who needed insurance the
most.
“I have yet to see an example of them ever being done
right,” Wright said.
Polls show voters want to hear about plans to lower
health costs. And according to a KFF tracking poll
released earlier this month, voters trust Vice President
Harris to do a better job than Trump on health costs by a
48-to-39-percent margin.
Democratic groups are also painting Trump as an
“existential threat” to drive voters to the polls.
The Democratic-aligned group Protect Our Care is
launching a “Lower Costs, Better Care” bus tour on Sept.
23 across battleground states. They want to highlight the
efforts of the Biden-Harris administration while also
“sounding the alarm about the threat Donald Trump and
MAGA Republicans pose to American health care.”
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