In a heated presidential debate with Kamala Harris, former President Donald Trump revived the longstanding partisan battle over the Affordable Care Act (ACA), commonly known as Obamacare. Trump criticized the healthcare law, stating that it has always been "lousy health care" and continues to be inadequate today. He expressed his intent to replace it with a better and more cost-effective system, emphasizing that he would only eliminate the ACA if a superior alternative could be devised.

When pressed for details on his plan, Trump revealed that he has "concepts of a plan" and intends to release these concepts and options in the near future. However, he did not provide a specific timeline for their introduction. Trump's remarks marked a significant turning point in the 15-year battle over the ACA, an issue that Republicans have attempted to distance themselves from. While Trump had downplayed the prospects of repealing the ACA earlier this year, his comments during the debate refocused attention on the matter.

The Harris campaign aims to capitalize on Trump's comments, considering various strategies such as paid advertisements and healthcare-focused events. Sources familiar with the campaign's thinking believe that Trump's revival of the ACA issue provides them with a significant advantage in appealing to crucial voter groups.

Coinciding with the debate, the Biden administration announced that ACA enrollment reached an all-time high this year, with 20.8 million Americans signing up. Since 2014, approximately 50 million people have obtained insurance coverage through the ACA's private marketplaces, in addition to those who have benefited from the law's Medicaid expansion.

Harris' senior adviser, David Plouffe, pledged that voters would hear more about Trump's healthcare remarks. He criticized Trump for making promises about a healthcare plan back in 2015, which never materialized, and highlighted Trump's apparent intention to remove healthcare coverage from millions of people.

The ACA, signed into law by former President Barack Obama in 2010, initially faced public backlash and became a political weapon for Republicans. However, in 2017, when Trump and the Republican-controlled Congress sought to repeal the law, it generated a strong public backlash, subsequently bolstering the ACA's popularity. A repeal bill backed by Trump aimed to reduce coverage expansion subsidies and roll back protections for individuals with pre-existing conditions, a highly popular feature of the ACA. The bill narrowly failed, with Senator John McCain unexpectedly voting against it.

During the debate, Harris reminded Trump of the ACA's achievements, highlighting the elimination of the insurance industry's ability to deny coverage to individuals with pre-existing conditions. She also underscored the Biden administration's efforts to strengthen the ACA over the past four years.

In the 2018 election, Democrats turned the tables on Republicans, accusing them of trying to strip millions of Americans of healthcare coverage and reinstate insurance companies' ability to deny coverage based on pre-existing conditions. These accusations resonated with voters, and Trump continued his efforts to dismantle the law throughout his presidency. In 2020, he endorsed a lawsuit aimed at eliminating the ACA, ultimately losing his re-election bid to President Joe Biden.

In Congress, Republicans, including conservative members, have shown little enthusiasm for reopening the fight against the ACA. The law's benefits have become deeply entrenched in the healthcare system, leading some Republicans to prioritize reforms within the existing framework. Senator Rick Scott of Florida highlighted the problems of rising costs, deductibles, and co-payments, emphasizing the need to fix the system rather than focus solely on the ACA.

When asked about Trump's call to reopen the ACA debate, Senator John Barrasso of Wyoming stressed the importance of ensuring that people have access to affordable and appropriate healthcare. He acknowledged the challenges faced by many Americans under Obamacare, citing rising rates and broken promises from the Obama administration.

The debate between Trump and Harris has reignited the contentious discussion surrounding the ACA, bringing it back to the forefront of political discourse. As both campaigns strategize their messaging on this issue, healthcare remains a critical concern for voters across the nation.