President Biden warned on Tuesday that if former President Donald J. Trump returned to office by winning next month’s election, he would enact policies that could deprive tens of millions of Americans of health insurance coverage and explode the price of prescription drugs.
During a speech in Concord, N.H., Mr. Biden assailed Mr. Trump for repeatedly trying to repeal the 2010 Affordable Care Act, and he mocked the former president for offering only ephemeral and unspecified “concepts of a plan” to replace it.
“My predecessor, the distinguished former president, he wants to replace the Affordable Care Act with what he calls the ‘concept of a plan,’” Mr. Biden told an audience at NHTI — Concord’s Community College. “I’ve heard that ‘concept of a plan’ now for almost eight years. Concept of a plan. What the hell is a concept of a — he has no concept of anything! No plan!”
Mr. Biden continued. “If we don’t elect Kamala and he gets elected,” he said, referring to Vice President Kamala Harris, “Trump could kick up to 45 million people off of health insurance. Forty-five million! Over 100 million people could lose health care coverage because they have a preexisting condition. The only reason they can get it is because of the Affordable Care Act.”
About 21 million people signed up for a health plan this year through the marketplaces set up by the Affordable Care Act. All told, nearly 50 million Americans have been covered by such plans since they were first created a decade ago. A federal government analysis released last month found that 50 million to 129 million non-elderly Americans have some sort of preexisting condition, which could put them at risk of losing coverage or being charged exorbitant prices without the protection of the 2010 law.
Democrats hope to make health care a defining issue in the final two weeks of the campaign, seizing on Mr. Trump’s comment at his debate last month with Ms. Harris that he would still try to eliminate the Affordable Care Act if he could come up with a better version. Pressed on whether he actually had such a plan, he said, “I have concepts of a plan” and that “you’ll be hearing about it in the not-too-distant future.”
Mr. Trump made the repeal of the law a signature effort of his presidency, only to see it collapse in the middle of the night when Senator John McCain, Republican of Arizona, turned a dramatic thumbs down to signal his no vote. Mr. Trump has promised a concrete replacement plan repeatedly in the years since, but other than saying he supports protections for people with preexisting conditions, he has never delivered a comprehensive plan. His administration separately supported an effort to eliminate the health care law through the courts only to fail there too.
Instead, he and his running mate, Senator JD Vance of Ohio, have lately tried to turn the issue around by claiming that Mr. Trump as president actually saved the Affordable Care Act because he administered it better than his predecessor — a claim widely ridiculed by Democrats and health care policy specialists.
Mr. Trump has sent conflicting messages during this year’s campaign about whether he would try again to repeal the Affordable Care Act if he wins re-election. “If we can come up with a plan that’s going to cost our people, our population, less money and be better health care than Obamacare, then I would absolutely do it,” he said at the debate. “But until then I’d run it as good as it can be run.”
The politics of the health care law, often called Obamacare because it was passed under President Barack Obama, have evolved dramatically since Mr. Trump was first elected. While it was initially unpopular, Mr. Trump’s effort to kill it seemed to make the public view the law more favorably. Only 43 percent of Americans had a positive assessment of the law in November 2016 when Mr. Trump was elected, while 62 percent now support it, according to polling by KFF, a health policy research organization.
Mr. Biden, appearing with Senator Bernie Sanders, the Vermont independent popular with progressives, also argued that Mr. Trump would cause the price of prescription drugs to go up if he tried to repeal the 2022 Inflation Reduction Act, which imposed cost curbs. The law capped the price of insulin for Medicare patients at $35 per month and authorized the federal government to negotiate lower prices for other drugs through the program.
“Not a single Republican voted for this, not one single Republican in the House or the Senate voted, not one,” he said. “But thanks go the Inflation Reduction Act, we finally beat Big Pharma.”
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