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Donald Trump spent the 2016 presidential campaign promising to repeal the Affordable Care Act. He spent most of his first year in office trying to do just that.
Now he wants you to believe he is responsible for saving the law.
This novel reinterpretation of history emerged on Tuesday evening at the ABC News presidential debate between Trump and Vice President Kamala Harris, the Democratic presidential nominee.
Near the end of the debate in Philadelphia, moderator and ABC News anchor Linsey Davis asked whether Trump still intended to repeal and replace the health care law ― and, if so, what his replacement plan was.
Trump swore he had an alternative to the 2010 law, also known as Obamacare. When Davis pressed him to actually describe his alternative, he said “there are concepts and options we have to do that. And you’ll be hearing about it in the not-too-distant future.”
Trump has, of course, made such promises many times before ― like in 2015 , when he promised to replace the Affordable Care Act “with something terrific,” or in 2016 , when he said “it’ll be great health care for much less money,” or in 2017 , when he said “we’re going to have insurance for everybody.”
Trump never produced plans living up to those lofty promises, or any plans at all. Instead, he tried desperately to get congressional Republicans’ plans passed that projections suggested would cause many millions of Americans to lose coverage while stripping away protections for people with pre-existing conditions.
That effort failed in a dramatic late-night vote on the Senate floor when John McCain, the Arizona Republican, gave his thumbs-down ― a moment Harris recalled during the debate.
“The late great John McCain ― I will never forget that night ― walked onto the Senate floor and said, No you don’t,” Harris said.
The repeal effort sparked a political backlash that played a key role in Republicans losing control of the House in 2022 ― and then, two years later, Trump losing the White House.
Most Republicans stopped talking publicly about Obamacare repeal after that election, lest they incur the voters’ wrath again. Trump has obviously taken notice of the politics as well.
Last year, after posting on social media that the Affordable Care Act “sucks” and that Republicans should “never give up” on trying to “terminate” it, he followed up with posts saying he was only interested in finding something that would be a better alternative ― again, without specifying what that alternative is.
All of that was the setup for Davis’ debate question, when Trump decided to add a new twist to his story on what really happened when he was president:
I inherited Obamacare because Democrats wouldn’t change it. They wouldn’t vote for it. They were unanimous. They wouldn’t vote to change it. If they would have done that, we would have had a much better plan than Obamacare. But the Democrats came up, they wouldn’t vote for it. I had a choice to make when I was president: Do I save it and make it as good as it can be? Never going to be great. Or do I let it rot? And I felt I had an obligation, even though politically it would have been good to just let it rot and let it go away. I decided ― and I told my people, the top people, and they’re very good people ― I have a lot of good people in this ― that administration. We read about the bad ones. We had some real bad ones, too. And so do they. They have really bad ones. The difference is they don’t get rid of them. But let me just explain. I had a choice to make: Do I save it and make it as good as it can be or let it rot? And I saved it. I did the right thing.
Trump’s argument ― if you can follow it ― seems to be that Democrats refused to address the Affordable Care Act’s shortcomings, leaving that job to Trump.
The shortcomings were (and remain) real enough. But President Barack Obama and his allies repeatedly proposed ways of addressing those. Republicans, who got control of the House in 2010 and control of the Senate in 2014, refused to consider reforms that wouldn’t repeal the law outright.
It wasn’t until Joe Biden became president in 2021, and Democrats won back control of Congress, that improvements to the law finally came, primarily in the form of extra financial assistance that reduced the price of coverage for individuals by hundreds, sometimes thousands of dollars a year and helped millions more to get coverage.
Those subsidies expire in 2025. Their future is among the issues at stake in this election.
Harris has said she wants to keep them going. Trump hasn’t said what he’d do, though he seems unlikely to support renewal given his actual record on the Affordable Care Act, as opposed to the fictional one he described on Tuesday.