JD Vance is an existential threat to our health care. In recent weeks, he has been making headlines for his attacks on the Affordable Care Act (ACA) and its protections for more than 100 million people with pre-existing conditions. Last week, Vance told reporters he wanted to implement a “deregulatory agenda” for health care, declaring, “[T]he best way to do that is to…not have a one-size-fits-all approach that puts a lot of people into the same insurance pools, into the same risk pools.” Translation: he wants to put insurance companies back in charge and give them the power to charge more or deny coverage for people with common conditions like asthma, cancer, and diabetes.
Trump is fully supportive of Vance’s latest comments attacking people with pre-existing conditions. Earlier this week, a spokesperson for the Trump campaign confirmed that “the president and Vance [are] broadly aligned on health care policy.” At the same time, Trump and Vance are trying to cover their tracks. Recognizing just how unpopular the MAGA health care agenda is across the nation, Vance falsely claimed Donald Trump “chose to build upon” the Affordable Care Act – despite Trump’s top policy priority being a full repeal and replacement of the law. The bottom line is that Trump and Vance will stop at nothing to repeal and sabotage the ACA, hike costs for middle-class families, rip away protections for people with pre-existing conditions, and throw millions of people off their coverage.
HEADLINES
KFF Health News: Vance Rewrites History About Trump and Obamacare.
- “Sen. JD Vance (R-Ohio) on Sept. 15 told viewers of NBC’s ‘Meet the Press’ that former President Donald Trump built up the Affordable Care Act, even though Trump could have chosen to do the opposite. […] The remarks follow statements the former president made during his Sept. 10 debate with Vice President Kamala Harris in Philadelphia. Trump said of the ACA, ‘I saved it.’”
- “Both Vance’s and Trump’s statements are false. We contacted Vance’s campaign; it provided no additional information. But here’s a review of policies related to Obamacare that Trump pursued as president. Most of the Trump administration’s ACA-related actions involved cutting the program, including reducing by millions of dollars funding for marketing and enrollment assistance and backing the many failed efforts in Congress and the courts to overturn the law. In June 2020, for example, the administration asked the Supreme Court to overturn the law in a case brought by more than a dozen GOP states. The high court eventually rejected the case.”
Georgetown University Center on Health Insurance Reforms: High-Risk Pools: A High Risk Proposition for People with Pre-Existing Conditions.
- “J.D. Vance, candidate for Vice President of the United States, has recently called for a return to the “high-risk pools” that existed prior to the Affordable Care Act (ACA) for people with pre-existing conditions. Similarly, when Congress debated repealing the ACA in 2017, several members of Congress advanced the idea of replacing the ACA’s insurance reforms with high-risk insurance pools. Unfortunately, high-risk pools didn’t work before the ACA, they wouldn’t have worked in 2017, and they won’t work now.”
- “But before the ACA, 35 states had high-risk pools. They were basically health insurance ghettos for people with pre-existing conditions – and expensive, poor quality ghettos at that. On the eve of the ACA market reforms, they enrolled 226,615 people, a tiny fraction of those potentially eligible. Here’s why:
- 1) Coverage was unaffordable. Nearly all of the high-risk pools had to set premiums at higher-than-market rates. Even though the high-risk pools were government-subsidized, those subsidies couldn’t cover the actual costs of this high-need population.
- 2) Coverage didn’t cover the care needed. To keep costs in check, nearly all the high-risk pools imposed pre-existing condition exclusions, meaning that even if you could afford the premiums, the insurer could refuse to cover any costs for your pre-existing condition for as many as 12 months.
- 3) Coverage was limited. All but two of the pools imposed lifetime dollar limits on coverage, usually between $1-2 million. Others imposed annual dollar limits on coverage, or limits on specific items or services, such a prescription drugs or rehabilitative services.
- 4) High out-of-pocket costs. Many of the pools offered plans with high deductibles, requiring people to spend considerable amounts out-of-pocket before coverage kicked in.”
The Washington Post: Vance Floats New Health Plans For Chronically Ill, Reopening ACA Debate.
- “Sen. JD Vance (R-Ohio) this week said the Trump campaign wants to roll back the Affordable Care Act’s approach to how chronically ill Americans shop for health insurance, with the Republican vice-presidential candidate reopening a health-care debate that Democrats are eager to have — and resurrecting a fight that has repeatedly burned the GOP.
- “Speaking in North Carolina on Wednesday, Vance floated an idea to group chronically ill patients together in health-insurance pools based on their elevated risks. That would reverse a shift driven by the Affordable Care Act, which largely ended the practice of shunting chronically ill patients into what are known as high-risk pools and provided new protections for patients with preexisting conditions.”
New York Magazine: Vance: Trump’s Health-Care Plan Is to Let Insurers Charge More for Preexisting Conditions.
- “What Vance came up with is not only surprising but, if understood properly, far more damaging than Trump’s original statement. The Trump plan, according to Vance, is to permit insurance companies to discriminate against people with preexisting conditions.”
The New Republic: J.D. Vance Reveals Atrocious Little Detail of Trump’s Health Care Plan.
- “Vance said that under Donald Trump’s plan, Americans wouldn’t be put ‘into the same risk pools.’… But doing so, as Vance suggests, would come at the expense of much higher charges for everyone else—especially older Americans and those with pre-existing conditions. Right now, the law allows insurance companies to bill older people up to three times as much as they do for the young, Vance is talking about making that gap even higher.”
Bloomberg: Vance’s Pitch Puts Obamacare Repeal Efforts Back in the Spotlight.
- “Democrats are seizing on JD Vance’s pitch to do away with a bedrock part of the Affordable Care Act, saying it would cause costs for chronically ill people to spike.”
- “At a rally on Wednesday, Vance said a second Trump administration would work to separate people into different risk pool…Such a policy would effectively end the ACA’s guarantee that people pay the same prices and get the same benefits regardless of their health status, a popular part of the program.”
Politico: How JD Vance Reopened The Health Care Fight.
- “Vance on Meet the Press last Sunday and in Raleigh on Wednesday, outlined a plan to ‘deregulate’ health care while somehow still making sure everyone had coverage, including the tens of millions of Americans with pre-existing conditions.”
- “‘You also want to implement some deregulatory agenda so that people can choose a health care plan that fits them,’ he said. ‘And we want to make sure everybody is covered.”
- “‘But the best way to do that is to actually promote some more choice in our health care system and not have a one-size-fits-all approach that puts a lot of people into the same insurance pools, into the same risk pools, that actually makes it harder for people to make the right choices for their families,’ Vance added.”
The Hill: Vance Revives Old GOP Fights On ObamaCare Insurance Coverage.
- “Republican vice presidential nominee Sen. JD Vance (R-Ohio) on Sunday floated an idea that would turn back the clock on covering people with preexisting conditions, relitigating a position that was a hallmark of GOP proposals to replace ObamaCare during Donald Trump’s presidency.”
- “In an interview on NBC’s ‘Meet the Press,’ Vance said Trump’s health plan would ‘promote choice’ in the health system by separating sicker people into different health insurance coverage pools from the healthier populations.”
The 19th: Health Plan Floated By JD Vance Could Weaken Protections For Pregnant People.
- “A health care proposal suggested by Republican vice presidential candidate JD Vance could gut a popular Affordable Care Act protection, making it legal for companies to charge more for or deny coverage of expensive medical conditions, including pregnancy.”
- “Speaking at a Wednesday event in North Carolina, Vance said that if elected, former President Donald Trump would change health insurance regulations so that people who are healthier and use their insurance less can have cheaper coverage, while those with chronic conditions or who use health care more would have different insurance.”
Vox: Trump’s Health Care Plan Exposes The Truth About His ‘Populism’.
- “On that program, NBC’s Kristen Welker asked Vance to explain what — if anything — Trump planned to change about America’s health care system. […] [T]he one concrete policy Vance did detail would actually involve making health care coverage less affordable for those with chronic illnesses.”
Semafor: JD Vance Reopens The Pre-Existing Condition Debates.
- “Vance’s comments in the same interview appeared to reference policy ideas advanced by Trump during his presidency that would have significantly changed, pared back, or eliminated aspects of the law’s protections for people with pre-existing conditions. […] He also criticized the law for putting people into ‘the same risk pools’ with a ‘one-size-fits-all approach’ — a seeming reference to prior Republican proposals to offer insurance to people with expensive conditions in separate ‘high risk pools’ rather than require insurers to cover everyone together under similar plans.”
HuffPost: The GOP’s Obamacare Agenda Just Reemerged From Hiding.
- “Vance was careful to say he and Trump would “make sure everybody is covered,” just as Trump has promised before. But the actual plans Republicans put forward during the 2017 repeal fight would have caused the number of Americans without insurance to rise by millions or even tens of millions, partly because they did not protect people with pre-existing conditions, partly because they simultaneously proposed to slash funding for Medicaid, the program the insures low-income Americans.”
STAT: Vance’s Confusing Health Insurance Remarks Give Democrats A New Attack Line.
- “The Ohio senator obliged. In describing Trump’s health care plan, he started off by saying ‘you want to make sure that pre-existing coverage — conditions — are covered.’ Then he said people should be sorted into risk pools, instead of a ‘one-size-fits-all approach that puts a lot of people into the same insurance pools.’”
Allbritton Journalism Institute: The Ghost of Obamacare Repeal Haunts the GOP.
- “JD Vance has endorsed an old policy that would strip protections for people with preexisting conditions — and many Republicans in Congress, having been through this fight before, are sprinting away from the idea.”
- “With Vance’s suggestion that Republicans turn to “high-risk pools” — which, prior to the passage of the Affordable Care Act in 2010, separated very sick people into a more expensive insurance market — he revived a fiercely contested debate that his Senate GOP colleagues seem to still have nightmares about.”
The Washington Post (Opinion): Trump’s ‘Concepts Of A Plan’ Would Destroy The Health-Care System.
- “Vance is referring to letting insurance companies offer different plans and pricing based on whether patients have preexisting conditions or might need more medical care because of their age, health status, gender, etc., or perhaps even their genetic profile. Rather than spreading the insurance risk around to a larger group of people who to some extent cross-subsidize one another, Vance wants to segment riskier patients into their own ‘pools.’ Sicker, higher-risk, more expensive people can ‘choose’ to go into one pool; healthier, less risky, cheaper-to-insure people can ‘choose’ to land in another.”
- “Allowing insurers to discriminate based on age or preexisting conditions has long been politically unpopular. But politics aside, the bigger problem with this design is that it would probably cause insurance markets to implode.”
The New York Times (Opinion): Trump Learned Nothing From the Obamacare Debate. Neither Did Vance.
- “[T]he other day JD Vance, his running mate, gave us a bit more insight into those concepts — concepts that, if implemented, would have the effect of denying health care to millions of Americans, particularly those who need it most. On Sept. 15 on ‘Meet the Press,’ Vance — after noting that people in good health have very different needs from those with chronic conditions — called for deregulation, saying that we should ‘promote some more choice in our health care system and not have a one-size-fits-all approach that puts a lot of people into the same insurance pools, into the same risk pools.’”
- “To my ear, however, these remarks by Vance — who is closely associated with the Heritage Foundation’s president, Kevin Roberts, one of the architects of Project 2025 — sounded similar to this airy statement in the Project 2025 manifesto…”