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Abortion, COVID, and Obamacare Highlighted in Trump-Harris Debate

— Trump says he has "concepts and options" for fixing the ACA, but offers no specifics

MedpageToday
A photo of Vice President Kamala Harris and former president Donald Trump on the debate stage.

Vice President Kamala Harris and former president Donald Trump clashed over the Affordable Care Act (ACA), reproductive rights, and Trump's response to the COVID-19 pandemic during Tuesday night's presidential debate in Philadelphia.

On Repealing Obamacare

At the debate, hosted by ABC News, co-moderator Linsey Davis for the ACA. Trump said that "Obamacare was lousy healthcare -- always was. It's not very good today," adding that "If we can come up with a plan that's going to cost our people, our population, less money ... than Obamacare, then I would absolutely do it, but until then, I'd run it as good as it can be run."

He declined to be more specific when Davis asked how he would fix it. "There are concepts and options we have to do that, and you'll be hearing about it in the not-too-distant future," he said.

In 2016, . More recently, he has said unless Republicans can come up with something better.

Meanwhile, Harris was asked about her support for Medicare for All in 2017 -- which would have eliminated private insurance and established a government-run health plan -- and her decision 2 years later to , which preserved a role for private insurance. She answered by reaffirming her support for private insurance.

"What we need to do is maintain and grow the Affordable Care Act," Harris said. She added that in addition to strengthening the ACA, the Biden administration allowed Medicare to negotiate drug prices -- something she said Trump promised but never achieved -- and capped the cost of insulin at $35 a month, and capped prescription drug costs for seniors at $2,000 annually.

"And when I am president, we will do that for all people," she added. "Access to healthcare should be a right and not just a privilege of those who can afford it, and the plan has to be to strengthen the Affordable Care Act, not get rid of it. Past is prologue in terms of where Donald Trump stands on that."

Abortion, Reproductive Rights

Harris' support for abortion rights has been a central feature of her campaign. Trump, on the other hand, has given varied responses on the issue.

In 2023, Trump described himself as "" in American history, as ABC moderator Davis pointed out. Then last month, he posted on social media that he would be ." Yet, Trump also said he would

Asked why women should trust him on abortion issues, Trump redirected his response, saying he felt an urge to support the 6-week ban after hearing the former Virginia Gov. Ralph Northam (D) -- suggest "that the baby will be born, and we will decide what to do with the baby. In other words, we'll execute the baby." (He erroneously attributed Northam's comments to the governor of West Virginia.) Trump's claim about Northam -- which he also made during his prior debate with President Biden -- because Northam was referring to a third-trimester abortion of a nonviable fetus. Trump made a similar claim.

Trump also said Harris's running mate, Minnesota Gov. Tim Walz (D), says "abortion in the ninth month is absolutely fine." At that point, Trump said, it's "no longer abortion because the baby is born."

Walz has not called for any "execution" of babies. He " of babies born alive to instead require care for those babies in a manner consistent with good medical practice. Davis, the co-moderator, clarified during the debate that "There is no state in this country where it is legal to kill a baby after it's born."

Harris argued that as a result of Trump's selection of three Supreme Court justices and the subsequent Dobbs decision, which reversed Roe v Wade, more than 20 states have "Trump abortion bans" (trigger bans) which make it a crime for clinicians to provide healthcare. "In one state, it provides prison for life," she said. In Texas, anyone who performs or attempts an abortion can be

Harris said that if she's elected and Congress passes a bill to reinstate the protections of Roe v. Wade, she would sign it into law. Harris also alleged that Trump would sign a national abortion ban into law, and according to ", appoint a monitor to track pregnancies and miscarriages." Trump said he has "nothing to do with Project 2025," a conservative playbook for the next Republican president. However, were involved in the project, according to CNN.

Trump was asked whether he would, as his running mate Sen. JD Vance (R-Ohio) has argued, if Congress passed one. He said he and Vance had not discussed the issue. "I don't mind if he has a certain view, but I think he was speaking for me," Trump said, adding that Harris' pledge to sign a reproductive rights bill into law would be "impossible" because Congress would never pass such a law.

Asked whether she supported any restrictions on abortions, it was Harris' turn to hedge. "I absolutely support reinstating the protections of Roe v Wade," she said. She disputed Trump's claim that the majority of people wanted Roe overturned and are happy with abortion laws being left to the states.

"Pregnant women who want to carry a pregnancy to term suffering from a miscarriage, being denied care in an emergency room because the healthcare providers are afraid they might go to jail and she's bleeding out in a car in the parking lot? She didn't want that," Harris said. "Her husband didn't want that. A 12- or 13-year-old survivor of incest being forced to carry a pregnancy to term? They don't want that."

Pandemic Response, Gun Rights

When the topic of the COVID pandemic came up, Harris argued that "Donald Trump left us the worst public health epidemic in a century." Trump disagreed. "We did a phenomenal job with the pandemic," he said. "Nobody's ever seen anything like it. We made ventilators for the entire world. We got gowns, we got masks, we did things that nobody thought possible. And people give me credit for rebuilding the military. They give me credit for a lot of things, but not enough credit for the great job we did with the pandemic."

In an effort to highlight Harris' radical tendencies, Trump said that Harris "wants to do transgender operations on illegal aliens that are in prison ... She wants to confiscate your guns." Harris did not speak to the issue of transgender care. As for confiscating guns, Harris said, "Tim Walz and I are both gun owners. We're not taking anybody's guns away."

Harris owns a gun for "personal safety" but supports an assault weapons ban and universal background checks. In 2023, Walz signed legislation in Minnesota supporting universal background checks and "red flag" orders, which would remove firearms from a person deemed a danger to themselves or others.

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    Shannon Firth has been reporting on health policy as 51˶'s Washington correspondent since 2014. She is also a member of the site's Enterprise & Investigative Reporting team.