Debate Discussion of Health Costs Was Mostly Absent

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Tuesday night’s presidential debate provided many memorable quotes including one from former President Trump when he was asked about his replacement plan for the Affordable Care Act (ACA) or Obamacare. Trump responded that he had “concepts of a plan” to replace the ACA but included no additional information on what those concepts were. Former President Trump’s rhetoric about an ACA replacement plan continues his 2016 campaign promise to replace the 2010 health care legislation, but also reflects the reality that replacing the legislation is more difficult than talking about it.

Since the 2017 repeal efforts, the ACA has increased in popularity with 62% of the public holding a favorable view of the law in the most recent KFF polling. Even more telling is that while the ACA has been the subject of both legal challenges and Congressional actions, many of the law’s provisions are popular among Democrats and Republicans, with majorities saying it is “very important” for these provisions to remain law. This is especially true of the pre-existing conditions protections that Vice President Kamala Harris touted during the debate. Throughout the Trump presidency, KFF polled on the various health care plans put forth by Republicans and no replacement plan garnered majority support. In fact, amid the Senate repeal discussion in 2017, support for the proposed new health care plan decreased among both Republicans and Trump supporters.

Repealing the ACA continues to be a popular rallying cry among Republicans, and four in ten Republicans still support this approach.  But when voters were asked what health care issue they wanted to hear the candidates talk about, the most common response among all voters – regardless of their political party –related to bringing down health care costs, far outranking any other health care issue. In fact, just 1% of Republican voters even mentioned repealing the ACA. While both candidates mentioned that health care is too expensive, mostly in passing, there wasn’t any substantive debate on how they would approach addressing this issue that is at the top of voters’ minds.