JD Vance has broken with GOP on key healthcare policies

Sen. J.D. Vance (R-OH), Republican vice presidential candidate, has broken from traditional GOP thoughts on healthcare system reform, signaling a change in the trajectory of Republican health policy should former President Donald Trump win reelection in November.

Vance has been a sharp critic of many Republican healthcare policies since he rose to prominence following his bestselling memoir Hillbilly Elegy , arguing that a laissez-faire philosophy cannot fix the system.

“The conservative policy world has offered a number of ideas, but elected Republicans have failed to coalesce around any particular strategy,” wrote Vance in a 2017 New York Times op-ed . “And this is because they’re unable to accept that the government must play a role in paying to solve this problem.”

Vance has a background in healthcare already from his days as a venture capitalist, investing in a variety of biomedical research organizations, upstart pharmaceutical companies, and health data privacy groups. He also is a staunch advocate of curbing the opioid crisis, a reflection of his family’s struggles with addiction.

But on several key areas, including Obamacare, Medicare, and prescription drug prices, Vance has sharply criticized members of his own party and has embraced strong government involvement to improve the healthcare system.

Vance’s July 2017 statements against Republican wisdom on healthcare policy stemmed from the Obamacare “repeal and replace” efforts of the first two years of the Trump presidency, which eventually lost steam following the Democratic victory in the House in the 2018 midterm elections.

Although Vance was not in the Senate to have an official say during the multitude of attempts to repeal the Affordable Care Act , Vance specifically criticized Republican bills to replace Obamacare as insufficient to provide medical coverage for the poor.

“We’ll rail against the way the government has destroyed our healthcare market in one breath and resist the support offered to the poor and middle class to navigate this brokenness with the other,” wrote Vance. “This is not conservative.”

Despite criticizing his fellow Republicans, Vance flashed his conservative credentials in the piece, citing that both free market economist F.A. Hayek and former President Ronald Reagan supported a meager minimum social safety net.

During his 2022 Senate campaign, Vance reiterated his call to provide a basic level of healthcare for all Americans.

"I've always been one of these people who says, we're not going to let people die on the streets. We're the richest country in the world, and we can't let people die from preventable illnesses because of lack of health care. Broadly speaking, we could do a lot better job on that in this country," Vance told the Cincinnati Enquirer in October 2022.

Vance’s support for both Medicare and Social Security became a centerpiece of his 2022 Senate campaign. This is in large part because Ohio has roughly 2.5 million Medicare beneficiaries, making it one of the top 10 states for Medicare recipients.

Vance told the Cincinnati Enquirer he was strongly against cutting the retirement social safety net.

“When you see people aggressively leaning into, we need to cut Medicare, we need to cut Social Security, I think there are ways we can save costs by bringing down the price of prescription drugs, for example, but I don't think that we should be throwing people out on the streets and saying, well, you're on your own now,” said Vance.

Vance also told AARP during his Senate campaign that elected officials “have to fight back against efforts to strip money from the Medicare program to pay for other things.”

During his time in office, Vance has also worked on a bipartisan basis to expand and improve certain aspects of the Medicare program.

This April, Vance introduced the Continuous Skilled Nursing Quality Improvement Act to mandate the secretary of Health and Human Services to establish a working group to create national standards of care applicable for Medicare and Medicaid recipients.

The bill is co-sponsored by Sens. Maggie Hassan (D-NH) and Dan Sullivan (R-AK).

Vance has also worked with Sen. Raphael Warnock (D-GA) to close gaps in coverage of cardiovascular care for Medicare beneficiaries.

Vance’s position on letting both Medicare and private prescription buyers directly negotiate drug prices with the pharmaceutical industry in an effort to lower prescription drug prices has been consistent during his rapid political ascendancy.

Most traditional Republicans and insiders in the pharmaceutical industry have cautioned against Medicare directly negotiating drug prices for fear that it will stifle innovation and investment in the industry.

But Vance maintained that allowing Medicare drug price negotiation was essential to cut costs for the program while still keeping it afloat. In fact, Vance’s proposals as a then-Senate candidate foreshadowed some recent calls from leading liberals , as Vance also supported letting private insurance renegotiate prices with pharmaceutical companies.

“It's one of these really weird things where people who say they believe in the free market would allow a drug to be sold to Europe at a certain price and then wouldn't allow a European to sell that drug back into the United States at whatever price they said,” Vance told the outlet in 2022.

During his campaign, Vance was adamantly opposed to President Joe Biden ’s sweeping Inflation Reduction Act, which implemented the Medicare Drug Price Negotiation program . Vance’s critique of the IRA, however, focused on the law’s environmental policies, not its medical provisions.

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The IRA also expanded the pilot program established by the Trump administration in 2020 by capping the monthly price of insulin for all Medicare beneficiaries to $35, of which Vance approved.

Since assuming office, Vance has co-sponsored an effort with Warnock and four other Republicans to cap the price of insulin on the private health insurance market to “$35 or 25% of the plan’s negotiated price, whichever is less.”