Fact Check: Does Donald Trump Want to Abolish the Affordable Care Act? | News about the 2024 US elections

US Vice President Kamala Harris stated in a campaign ad on September 27, 2024: “Former President Donald Trump wants to abolish the Affordable Care Act.”

In the September 27 online ad, a man identified as Dr. Cesar Quintana says: “I have dedicated my life to keeping people healthy, here in my office and throughout the community, helping others access the healthcare they need. That’s what the Affordable Care Act does. It helps our families access life-saving health care. Donald Trump would take that away.”

The ad then shows a short clip of Trump saying, “Repeal and replace Obamacare.” Quintana then says this would leave millions of people “without access to health insurance.”

The advertisement, which has also arrived Spanishpartially correct. Trump opposes the Affordable Care Act, also known as Obamacare, which was introduced in 2010 during the administration of former President Barack Obama. As president, Trump cut enrollment assistance and supported the repeal and replacement effort in Congress. But his position on ending the law has changed.

Here are the facts.

Trump’s position on the ACA in his 2016 campaign and as president

In his 2016 presidential campaign, Trump promised to repeal the law. The Harris commercial in which Trump says he will “repeal and replace Obamacare” is from January 26, 2017, when Trump discussed his administration’s plans during a Republican congressional retreat in Philadelphia.

Trump said they would have an “ambitious legislative agenda” and that the first step would be to repeal the Affordable Care Act. He called it “a disaster” and said he wanted to save families from what he described as a “catastrophic increase in premiums and a debilitating loss of choice and just about everything else.”

Trump supported Republican repeal and replace efforts in Congress, but they ultimately failed. An example is the American Health Care Act, a bill to repeal the Affordable Care Act’s subsidies and regulations that the Affordable Care Act House passed in May 2017 but failed to pass in the Senate. In June 2020, the Trump administration asked the US Supreme Court to block the law, but the court dismissed the case.

Trump also cut costs for the law’s marketing, outreach and enrollment assistance. He expanded access to short-term plans with limited coverage that Democrats call “junk insurance,” arguing that they limit care and can lead to surprise medical bills.

During Trump’s presidency, enrollment in the Affordable Care Act fell by more than 2 million and the number of uninsured Americans rose by 2.3 million, government data show.

Trump’s ACA position during his 2024 presidential campaign

During his 2024 campaign, Trump has gone back and forth on his position on the Affordable Care Act. At times he has said that he wants to replace the law with a “alternative“. But he also said he wouldn’t end it.

In March he has wrote on Truth Social that he “doesn’t plan to end the health care law,” but wants to make it “better” and “cheaper.” On September 10, during the presidential debate with Harris, Trump said he has “concepts of a plan” to replace the law. He said he would “run it the best he can” before drafting his own plan. Trump still hasn’t specified his plan.

Karoline Leavitt, Trump’s national press secretary for the campaign, told PolitiFact that Trump will implement “real solutions to make America healthy again without relying on Big Insurance and Big Pharma,” but she did not specify how.

PolitiFact contacted the Harris campaign for evidence that Trump wants to end the Affordable Care Act. It pointed us to a Harris campaign document, which the campaign says shows how Trump is aligned with Project 2025.

Project 2025 is a 900-page handbook of policy proposals for the next Republican administration, prepared by the conservative Heritage Foundation. Trump has took distance from Project2025.

Project 2025 calls for changes to the Affordable Care Act. It for example recommends that the Food and Drug Administration is reversing the 2000 approval of mifepristone, the first pill taken in a two-drug regimen for medication abortion. The document also says that some forms of emergency contraception – particularly Ella, a pill that women can take within five days of unprotected sex to prevent pregnancy – should be excluded from the free cover. It also calls for the separation of the subsidized law exchange market from the unsubsidized insurance market. But it does not advocate ending the law.

Trump’s campaign platform makes no mention of the Affordable Care Act.

Our statement

A Harris campaign ad stated that Trump wants to repeal the Affordable Care Act.

Trump has provided mixed and incomplete information about his plan for the law. It is said that he wants to end it, that he wants to improve it and that he has “drafts for a plan” to replace the law. But he did not provide more details.

As president, Trump supported several efforts to get rid of the Affordable Care Act.

We rate the statement as Half True.

KFF Health News Senior Correspondent Julie Appleby contributed to this report.