Economist Paul Krugman: How 'completely unaware' Vance is failing Trump miserably on a key issue

Under President Joe Biden, the Affordable Care Act of 2010, a.k.a. Obamacare, has enjoyed record enrollment and support. Yet 2024 GOP presidential nominee Donald Trump is once again hoping to see the ACA overturned.
During his September 10 debate with Democratic nominee Kamala Harris, Trump was asked if he had a plan for replacing or improving the ACA. And he responded, "I have concepts of a plan" — a line that, liberal economist Paul Krugman notes in a biting September 23 column for the New York Times, Trump has been "ridiculed, rightly" for.
Trump's running mate, Sen. JD Vance (R-Ohio), has tried to help Trump out on the health care issue. But Krugman argues that Vance is only making things worse for the former president.
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Krugman points out that during a September 15 appearance on NBC News' "Meet the Press," Vance "called for deregulation, saying that we should 'promote some more choice in our health care system and not have a one-size-fits-all approach that puts a lot of people into the same insurance pools, into the same risk pools.'"
"Apart from anything else," Krugman observes, "he sounded like someone completely unaware of the history of health care economics and the reasons we ended up with the policies we have — someone who completely missed the debates that led to the creation of the ACA, a.k.a. Obamacare. We don't need to speculate about how his proposal, such as it is, would work, because we've seen this movie; that's exactly how health insurance worked before Obamacare went into effect in 2014, after which insurers were prevented from discriminating based on medical history."
The economist continues, "Under the pre-Obamacare system, insurers often refused to cover Americans with preexisting health conditions or required that they pay very high premiums — which meant that they effectively denied health care, in many instances, those who needed it most."
Krugman recalls that before Obamacare, "attempts to take care of Americans who couldn't get private insurance" via "government-subsidized high-risk pools" were "dismal failures: unaffordable, underfunded and covering only a small fraction of those needing help."
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The Times columnist writes, "Why would Vance stake out such an unpopular position, conveying the impression that he was speaking for Trump as well?... In any case, while Trump doesn't have a health care plan, Vance's remarks offer a pretty good preview of what he'll propose if he wins. It might be summed up, to borrow from the famous old Daily News headline, as: 'Trump to Sick Americans: Drop Dead.'"
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Paul Krugman's full New York Times column is available at this link (subscription required).