A new Biden campaign ad highlights the president’s work to lower health care costs. His allies are appearing on cable news to warn that a victory for former president Donald Trump would strip insurance from millions of Americans. Biden’s team is blasting out statements seeking to tie other Republicans to Trump’s calls to repeal Obamacare.
The 2010 Affordable Care Act, often called Obamacare, has become a flash point in the presidential race in recent days as Biden and his allies have sought to contrast Trump’s recent dismissive remarks with what they frame as Biden’s commitment to health-care affordability.
On Friday, Biden hailed North Carolina’s expansion of Medicaid under the ACA, which officials say will provide immediate coverage to 300,000 North Carolinians, and lambasted “MAGA Republicans” who want to repeal the law. His campaign warned that millions of Americans who get health care through Obamacare “could wave goodbye to their coverage” if Trump wins the White House again.
“To those who want to repeal this lifesaving law, let me be clear: I won’t let it happen on my watch,” Biden said in a statement.
Trump has argued since his 2016 campaign that the ACA is a “disaster” that has increased Americans’ health costs while providing inadequate coverage.
North Carolina Gov. Roy Cooper (D), a surrogate for Biden’s campaign, appeared on CNN to argue that Trump is underestimating the importance of the health-care law to the working Americans who are central to his appeal.
“We’re talking about child care workers, we’re talking about people who take care of seniors, we’re talking about people who work in restaurants,” Cooper said. “These are the people that Donald Trump wants to rip away insurance from, and that is a message that I think will resound during these next campaigns.”
The flurry of activity suggests that Biden and Democrats are preparing to highlight health care, along with abortion, as central to their message that unlike Republicans, they are concerned about Americans’ pressing needs. While Democrats also plan to focus on such issues as the economy and Trump’s threat to democracy, they increasingly think that health care and abortion rights could be powerful motivators in their favor.
The politics of health care have changed dramatically in recent years. After President Barack Obama pushed through the ACA in 2010, Republicans won a string of elections by criticizing it as an overbearing big-government program.
But when Republicans, led by Trump, actually sought to repeal the ACA in 2017, the threat made the law far more popular, and the repeal effort collapsed. Since then, Republicans have largely shied away from talking about health care.
Abortion rights have in some ways had a similar trajectory. Republicans for years gained political advantage from attacking abortion rights, but when those rights were overturned by the Supreme Court in June 2022, it upset even many conservatives, and the issue almost overnight became a strength for Democrats.
The ACA expanded health coverage to millions of American by subsidizing their purchase of private insurance through newly created marketplaces, as well as by providing money to states that made more people eligible for Medicaid. Republicans have continually challenged the law in court, and GOP members of Congress for years campaigned on a pledge to repeal the legislation. But once the GOP held majorities in both chambers of Congress and the White House, they could not agree on exactly how to do that.
Trump criticized the Affordable Care Act last Saturday, writing on Truth Social that its cost “is out of control” and that he is “seriously looking at alternatives” to it. He followed up Wednesday with another post asserting that the law “sucks.”
Trump has not proposed an alternative to the ACA, a challenge that has long bedeviled Republicans despite their years-long promises to “repeal and replace” Obamacare. The Trump campaign did not respond to a request for comment.
In a sign of his renewed emphasis, Biden personally spoke on Obamacare twice this week, saying on Monday that Republicans “just don’t give up” on trying to destroy it and contending on Wednesday that repealing it would especially hurt minorities.
“Folks, this is not your father’s Republican Party,” Biden said Wednesday at an event in Pueblo, Colo.
Biden and his allies are also seeking to tie other GOP candidates to Trump’s comments. After presidential candidate Nikki Haley declined this week to say whether she would support repealing Obamacare, Biden’s campaign responded with an email saying she had “left the door open to ripping away health care coverage from millions of Americans.”
Haley’s remarks came on a New Hampshire-based podcast, where the former U.N. ambassador and former South Carolina governor listed aspects of the American health-care system that she would work to alter but did not say whether those changes would include repealing the ACA — a cause that remains popular among a small segment of the GOP base.
“It’s not about one small policy of, you know, Affordable Care Act,” she said on “Good Morning New Hampshire.” “It’s about fixing the entire health care system.”
Democratic National Committee officials highlighted several Republicans’ positions on the law going back more than a decade. They cited Florida Gov. Ron DeSantis’s comments in 2012 and 2013 that it should have never been passed and he intended to repeal it. They noted former New Jersey governor Chris Christie’s record of calling for an Obamacare replacement and saying more recently on the campaign trail that he would not commit to expanding the ACA.
The DNC also attacked entrepreneur Vivek Ramaswamy for calling Obamacare a “disaster” while campaigning. Christie and Ramaswamy have criticized Trump this election cycle for failing to fulfill his promise to repeal and replace the health-care law when he was president.
While perceptions of the Affordable Care Act remain divided along partisan lines, its popularity hit an all-time high in March, with 62 percent of adults saying they had a favorable view of the law, according to KFF, an independent health research and polling organization.
KFF’s latest poll on the topic, conducted in May, found that 59 percent of adults viewed the law favorably. Among its most popular elements is a provision that prevents insurance companies from refusing to cover someone or charging them more because of a preexisting condition. Those who disapprove of the ACA, in contrast, argue that it has increased health care costs, according to KFF.
The Department of Health and Human Services announced last month that 4.6 million people had selected health care coverage through the Affordable Care Act marketplace in the first three weeks of this year’s open enrollment period.
Rep. Dean Phillips (Minn.), an underdog Democratic primary challenger to Biden, jumped into the fray Thursday by suggesting on the left-leaning podcast “Pod Save America” that he would “start from scratch” in building a national health insurance program.
Some Democrats seized on his remarks, accusing him of backing Trump’s call to ditch the health-care law. Phillips’s campaign clarified that his plan would “supplement” the Affordable Care Act and that he had no intention of scrapping it.
The Biden campaign’s new health care ad began airing Thursday in seven swing states, including Pennsylvania, Georgia and Michigan. It targeted general-interest programming such as “The Voice” and “Survivor,” the campaign said.
In the TV spot, a pediatric nurse from Nevada says Biden has lowered health-care costs in ways that support families in her state.
“The last administration’s policies were so troubling, and our health-care system has become a business, and people are becoming billionaires off the backs of sick people,” says the nurse, identified as Jody. “The idea that we could go back to the policies that help the rich get richer and left so many people behind … I don’t want to go back.”
Abortion access — no longer considered a constitutional right after the Supreme Court overturned Roe v. Wade last year — helped fuel several electoral wins for Democrats last month. The party is pushing for ballot initiatives on abortion rights in competitive states such as Arizona and Florida in 2024.
As Democrats try to maintain a thin majority in the Senate, some members facing tough races are embracing the issue. In conservative-leaning Ohio, where voters this year passed an amendment to add abortion rights to the state constitution, Sen. Sherrod Brown (D) has been defending abortion rights on the campaign trail. Montana Sen. Jon Tester (D) has also been pressing the topic.
Vice President Harris, meanwhile, has made abortion rights a central theme of her campaign message. In Houston on Tuesday, she castigated “extremist so-called leaders” for criminalizing abortion in their states and argued that many people are “silently suffering” because of abortion bans.
“This is not just some intellectual conversation about where do you stand on this issue,” Harris said. “I have met and talked with and heard the stories about women who are literally having miscarriages in a toilet. Understand, every day in America, what this issue means to real people.”
Meryl Kornfield, Azi Paybarah, Tyler Pager and Mariana Alfaro contributed to this report.