Republicans have told many lies about health care over the years, with JD Vance recently doubling down on their newest one during an appearance on NBC’s “Meet the Press.” Vance claimed that Donald Trump protected Americans getting insurance through the Affordable Care Act from losing their coverage, which is not true. In reality, Trump spent the first year of his presidency attempting to repeal the ACA, which allowed millions of Americans to get insurance and prohibited insurers from denying coverage to those with preexisting conditions. Trump never had a plan to replace the ACA as he had promised, instead pushing for bills that would undermine the new rules on insurers and reduce funding and eligibility for new insurance offerings.
One such piece of legislation Trump backed was the “American Health Care Act of 2017,” which would have resulted in millions of Americans losing insurance if it had become law. Trump and his allies noted that some Americans could find cheaper insurance under this plan without the ACA’s rules, but this would have resulted in inadequate coverage or no coverage at all for those with serious medical conditions. The prospect of so many people losing insurance and the rules on preexisting conditions being eliminated led to a political backlash and forced some Republican lawmakers to vote against repeal, ultimately allowing Democrats to retake control of Congress and the White House.
Trump’s intentions and record on health care matter because signs indicate that the future of the ACA depends on what happens in the 2024 presidential election. Conservative manifestos and proposals call for rolling back key parts of the law, with Trump expressing interest in replacing the ACA with a better plan. However, details on what that plan might entail remain unclear. Trump and Republicans have historically been critical of the ACA, leading to doubts regarding their support for extending financial assistance that has lowered insurance premiums for millions. Renewing this assistance would require significant federal spending, which would need to come from new taxes, spending cuts, or increased federal deficits.
Although the Affordable Care Act is not without flaws, a majority of Americans approve of the law. Vice President Kamala Harris, the 2024 Democratic presidential nominee, has pledged to bolster the ACA by renewing financial assistance that has been put in place. However, the future of the ACA remains uncertain, as Republicans continue to call for its repeal and replacement with a plan that offers more choice in the healthcare system. This approach may result in higher prices, inadequate benefits, or lack of coverage for those with serious medical conditions. The ongoing debate over the ACA and healthcare policy will likely remain a key issue in the 2024 presidential campaign, as parties continue to spar over the best way to provide affordable and comprehensive healthcare for all Americans.
