Nation/World

Mike Johnson vows major changes to Affordable Care Act if Trump wins election

House Speaker Mike Johnson pledged “massive reform” of the Affordable Care Act if Donald Trump is elected president, reopening a politically sensitive policy issue for Republicans a week before Election Day.

Johnson (R-Louisiana), who appeared at a campaign event Monday for a Republican House candidate in Pennsylvania, told attendees that GOP leaders are again weighing how to overhaul the 14-year-old law, which provides health coverage to tens of millions of Americans and has been a frequent target of Republican repeal efforts.

“Health-care reform’s going to be a big part of the agenda,” Johnson said, wearing a personalized jacket emblazoned with the Trump-Vance campaign logo. He added that a caucus of Republican physicians has shared proposals with him and that GOP leaders hope “to take a blowtorch to the regulatory state” and “fix things.”

“No Obamacare?” an attendee asked the speaker, invoking the term popularized by Republicans to describe the health law.

“No Obamacare,” Johnson responded. “The ACA is so deeply ingrained, we need massive reform to make this work, and we got a lot of ideas on how to do that.”

Johnson’s comments were first reported by NBC News, which published video of his remarks.

The Affordable Care Act, which Democrats enacted in 2010, has become one of the party’s more popular achievements after initially being perceived as a political liability. Sixty-two percent of adults had favorable views of the law in April, up from 38 percent a decade earlier, according to polling by KFF, a nonprofit health policy research, polling and news organization.

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The law also has transformed the nation’s health-care landscape. The White House last month touted data showing that nearly 50 million Americans have obtained health coverage through the Affordable Care Act’s health insurance exchanges since they were established more than a decade ago, helping to lower the national uninsured rate to record lows in recent years.

Vice President Kamala Harris, the Democratic presidential nominee, has promised to expand enrollment through the law if elected president.

Republicans, meanwhile, mounted dozens of efforts in Congress to overturn the law, and Trump won the presidency in 2016 by pledging to “repeal Obamacare.” But several Trump-led repeal efforts fell short - with the Senate in July 2017 coming one vote away from overturning the Affordable Care Act - and the law’s near death catalyzed new support for it.

The backlash to Republicans’ repeal efforts also helped Democrats win back control of the House in 2018, prompting GOP leaders in recent years to avoid talking about doing away with the law. Trump’s running mate, Sen. JD Vance (R-Ohio), last month even praised Trump as a good steward of the Affordable Care Act.

But Democrats remain eager to highlight Republicans’ past pledges to “repeal Obamacare,” with the Harris campaign and its allies on Tuesday night portraying Johnson’s comments as a vow to do away with the Affordable Care Act.

“Speaker Mike Johnson is making it clear - if Donald Trump wins, he and his Project 2025 allies in Congress will make sure there is ‘no Obamacare,’” Sarafina Chitika, a campaign spokeswoman, said in a statement. “That means higher health-care costs for millions of families and ripping away protections from Americans with preexisting conditions like diabetes, asthma, or cancer.”

Johnson “finally told the truth about Donald Trump and his MAGA Republican allies’ agenda for health care in their first 100 days. They want to repeal the ACA,” Leslie Dach, the chairman of Protect Our Care, a Democratic-aligned health-care advocacy group, wrote in a statement.

Johnson’s office disputed Democrats’ interpretation, with a spokesman accusing Harris of “lying about Speaker Johnson” by claiming that he had pledged to repeal the law.

“The audio, transcript, and even the NBC News article her campaign cites make clear that the Speaker made no such comments,” spokesman Taylor Haulsee wrote in a statement.

Haulsee declined to comment on what health-care changes Johnson would pursue next year or whether the House speaker would rule out an attempt to repeal the Affordable Care Act.

The Trump campaign said that he did not support repealing the Affordable Care Act.

“This is not President Trump’s policy position,” campaign spokeswoman Karoline Leavitt said in a statement Tuesday night. “As President Trump has said, he will make our healthcare system better by increasing transparency, promoting choice and competition, and expanding access to new affordable healthcare and insurance options.”

Trump has worked to downplay his past criticism of the Affordable Care Act ahead of the election, saying in a September debate that he would keep the “lousy” law in place, while acknowledging he still hopes to replace it with something “much better.” Vance recently floated a plan to roll back the law’s approach to how chronically ill people shop for health plans.

More voters side with Democrats on questions related to health-care costs and coverage, according to recent surveys. A KFF poll released in September found that 48 percent of voters trust Harris to do a better job than Trump on handling health-care costs, compared with 39 percent who favor Trump. The nine-point edge is one of Harris’s strongest advantages against Trump, who retains double-digit polling leads on the economy and immigration.

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