Eyeing another Trump term, Vance leaves ACA repeal on the table

Democrats want voters to realize that the future of the Affordable Care Act is on the ballot in 2024. It's generous of JD Vance to admit they're right.

Aug. 2, 2024, 4:32 PM UTC

Vice President Kamala Harris’ 2024 campaign announced this week that it’s investing $50 million in support of a new television ad called “Fearless.” It’s a good 30-second spot, with a fairly straightforward message.

Viewers are told (a) about the Democrat’s background as a prosecutor; (b) Donald Trump’s plan to give more tax breaks to the rich; and (c) Republican plans to end the Affordable Care Act. The commercial wraps up with Harris declaring, “We are not going back.”

The fact that the ad specifically referenced the ACA might’ve surprised some viewers. After all, when we think about the hot-button issues that are dominating the public discourse this year, health care isn’t widely seen as one of them.

But Democrats clearly hope to change that, and the candidates on the Republican Party’s presidential ticket occasionally lend a hand. Sen. JD Vance, for example, spoke with NOTUS this week, and the report noted, the Ohio Republican “suggested repealing Obamacare would still be a priority” if voters return Trump to power.

“Well, I think we’re definitely gonna have to fix the health care problem in this country,” he said. “The problem with Obamacare is that for a lot of people, it just doesn’t provide high-quality health care, right? So you have a lot of people paying out the ass, paying very high prices for health care that isn’t high quality. And I think the president actually, unlike a lot of Republicans, frankly, cares a lot about people having access to high-quality care.”

The report added that Vance went on to say in the same interview that the Trump-era “repeal and replace efforts” were “fundamentally focused around the idea of fixing what was broken, not about stripping people’s health care away. So yeah, I think you’re certainly gonna see efforts to reform the system. Obviously, what that looks like will depend a little bit on Congress because Congress has to have a role to play.”

As a substantive matter, Vance’s assessment didn’t make a lot of sense. His condemnation of the ACA — which he’s too inexperienced to have voted on — not only misdiagnoses the existing challenges surrounding the Affordable Care Act, it also badly misstates what transpired during Trump’s first term.

But looking ahead, what arguably matters most about Vance’s comments was the fact that he left little doubt in a Trump second term, Americans should “certainly” expect a prospective Republican White House to “reform” the nation’s health care system.

“Donald Trump and JD Vance are the greatest threat to Americans’ health care today,” Harris for President spokesperson James Singer said in a statement, responding to the NOTUS interview. “Terminating the Affordable Care Act has been Trump’s goal for years, which will make America sicker, rip away preexisting condition protections from more than 100 million Americans, and increase health care costs. . The stakes this November couldn’t be higher for the American people.”

The problem, of course, goes well beyond Vance and his latest comments. Indeed, Trump largely ignored the ACA after leaving the White House, but as regular readers know, the former president had targeted Obamacare in increasingly explicit terms over the past year, and as recently as December, the Republican posted a video to his social media platform attacking the late Sen. John McCain for not helping him “terminate” the ACA in 2017.

Trump soon after vowed to tear down the nation’s existing health care system and replace it with something he said would be “better” — though his assurances didn’t include any details.

What’s more, as we’ve discussed, some of his congressional allies have added their voices to this debate. Republican Sen. John Cornyn of Texas told Axios in late November, “I think Obamacare has been one of the biggest deceptions on the American people. I mean just look at your health care premiums.” (Premium costs, in reality, have gone down, not up.)

The same report added that Republican Sen. Mike Crapo of Idaho, who’d likely chair the Senate Finance Committee if the GOP retakes control of the chamber, also said he’s open to repeal-and-replace plans.

Remember, the Republicans’ 2017 effort to tear down the ACA was a disaster for the party, which Democrats exploited to help take back the House majority in the 2018 midterm elections. Democrats would love little more than to have this fight again in 2024 — a recent national survey from NBC News found the party with a 23-point advantage over the GOP on health care — which made Vance’s comments this week all the more significant.

Steve Benen is a producer for "The Rachel Maddow Show," the editor of MaddowBlog and an MSNBC political contributor. He's also the bestselling author of "Ministry of Truth: Democracy, Reality, and the Republicans' War on the Recent Past."