Asked about his promise to “repeal and replace” the Affordable Care Act, President Donald Trump pushed back on moderator Chris Wallace’s assertion that he has not come up with a comprehensive plan to replace the health care plan that his predecessor, President Barack Obama, enacted in 2010. He cited his efforts to cut prices of drugs such as insulin, but did not go into specifics of a plan of his own. Congress voted to repeal the ACA’s financial penalty on the individual mandate in 2017, and a Republican-led effort to overturn Obamacare is now headed to the Supreme Court. Trump said his administration has protected people with pre-existing conditions, but most alternative plans supported by Trump would provide less coverage to people with pre-existing medical conditions. Between 50 and 129 million non-elderly Americans have at least one pre-existing condition that would threaten their access to health care and health insurance without the protections of the Affordable Care Act, according to the Centers for Medicare and Medicaid services.

Former Vice President Joe Biden defended his own health care plan proposal, which would provide a “public option” for low-income Americans who qualify for Medicaid, but not eliminate private insurance. Trump then accused him of proposing “socialized medicine” even though Biden does not support options like Medicare for All, a universal health care plan which is favored by some members of the Democratic left such as Vermont Sen. Bernie Sanders.

“He is not for help for any people needing health care,” said Biden of Trump. Biden added that roughly 20 million Americans receive health insurance through the ACA. In 2019 more than 33 million American received their health insurance by purchasing it directly, rather than through an employer, including plans made available on the exchanges through ACA, and the share of people without health insurance declined from 2012 to 2019, from 15.4% to 8%, according to USA Facts. Biden and Trump participated in the first 2020 presidential debate at Case Western Reserve University in Cleveland, Ohio on Sept. 29.

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