The GOP vice-presidential nominee’s proposal to overhaul ACA insurance markets could mean higher costs for sicker patients.
By Dan Diamond and Meryl Kornfield, The Washington PostSen. JD Vance , the Republican vice-presidential candidate, on Sept. 18 advocated a significant overhaul of the Affordable Care Act during a campaign appearance in Raleigh, N.C.
Experts said the ideas sketched out by Vance threaten consumer protections enshrined in the 2010 health law, such as rules that guarantee health coverage to the tens of millions of Americans with preexisting conditions. “Senator Vance was simply talking about the significant improvements President Trump made to the Affordable Care Act through his deregulatory approach, which aimed to bring down the cost of premiums while ensuring coverage for pre-existing conditions,” spokesman William Martin wrote in a text message.
The Harris campaign had already scheduled a week of events focused on Trump’s debate comments and past record on health care, with the vice president and her allies repeatedly warning voters that a second Trump administration could put their health care at risk. The Affordable Care Act imposed restrictions on private health insurers, limiting how much the plans could charge patients based on age and other factors, and barring health plans from turning away patients who had preexisting conditions. Because of those changes, the health insurance market was significantly revamped; young and healthy patients now subsidize the cost of health insurance for older, chronically ill patients, with federal subsidies also underpinning the market’s operations.
“Providing all states the freedom to adopt these smart reforms would significantly increase access to private health insurance, reduce costs and reduce federal spending,” the influential House GOP group argued. Vance, who was elected to the Senate in 2022, has not served on one of the key health-care committees, and his record on health care is limited. He has been a longtime critic of the Affordable Care Act, writing in a 2010 letter to the editor in the Journal-News newspaper in Ohio that “Obama-Care does nothing to reduce the inflationary trend of medical costs, it is an abject failure of a reform package. That’s why most conservatives opposed it.
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