In recent appearances, Republican nominee Donald Trump and his running mate JD Vance have been portraying Trump's actions towards the Affordable Care Act (ACA) during his presidency as a selfless effort to save it. However, these claims are misleading, as Trump consistently fought against the ACA throughout his term in office.

Despite Trump's statements suggesting he wanted to improve the ACA, evidence shows that he actively sought its repeal. Larry Levitt, from the nonpartisan research group KFF, has stated that Trump encouraged congressional efforts to dismantle the ACA and took administrative steps to weaken it when legislative attempts failed.

On his first day in office, Trump signed an executive order declaring his administration's intention to promptly repeal the ACA. Subsequently, in 2017, the Republican-led Congress prioritized repealing the ACA, passing the American Health Care Act. This bill aimed to eliminate ACA subsidies and regulations, which experts projected would result in 23 million fewer people having insurance. Trump celebrated the passage of this bill, calling it a "repeal and replace" of Obamacare.

Although the repeal effort in the Senate fell short by one vote, with three Republican senators joining Democrats to vote it down, Trump continued his campaign against the ACA. His administration successfully removed the ACA's tax penalty for Americans who failed to obtain insurance, and he cut funding for programs that advertised and promoted ACA sign-ups. These actions were believed to have contributed to a decline in enrollment.

Moreover, Trump expanded short-term insurance plans that did not have to comply with ACA regulations, including the coverage of pre-existing conditions. These modifications further undermined the ACA's provisions and protections.

In 2020, Trump endorsed a lawsuit that sought to invalidate the ACA entirely, even as the case reached the Supreme Court. Despite the political risks leading up to the election, Trump's administration formally requested the court to side with the challengers and terminate the law. However, the court upheld the ACA the following year when Trump was no longer in office.

Although Trump has occasionally expressed a desire to revisit the ACA battle as he looks to a potential comeback in 2024, his campaign has yet to present a replacement plan. While Trump claims to have "concepts and options" for a better healthcare system, no specific details or timelines have been provided.

In contrast, Democratic nominee Kamala Harris has campaigned on preserving the ACA without providing explicit details of her plan for expanding coverage. Harris has abandoned her previous proposal to place all Americans on Medicare.

As the campaign picks up pace, Harris has seized on Trump's claims about having a plan, highlighting the lack of a concrete replacement. With millions of Americans insured through the ACA, the potential end of the law based on vague concepts raises concerns about the possible return to a time of immense hardship for many individuals.

In conclusion, Trump and Vance's assertions that Trump saved and protected the ACA during his presidency are contradicted by the facts. Trump actively sought to dismantle the ACA through various means, including legislative efforts, executive actions, and support for a lawsuit aiming to overturn the law. As the debate around healthcare continues, the differences between the two candidates' positions are becoming increasingly evident.

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