The healthcare topics from the debate

The Affordable Care Act

During his time in office, former President Donald Trump attempted repeatedly to repeal the ACA, and since then has been vague about his plans for the law if elected as president again.

Vance has previously said that insurers should be allowed to cover sick people separately from healthy people. When asked about the ACA, Vance described his former statement as being about reinsurance regulations and said that Trump favors the idea to "allow states to experiment a little bit on how to cover both the chronically ill but the non-chronically ill," adding that "the reason that [the Affordable Care Act] was crushing under its own weight is that a lot of young and healthy people were leaving the exchanges."

Vance also declined to detail any part of Trump's plan, saying he is "not going to propose a 900-page bill standing on a debate stage. It would bore everybody to tears."

"And it wouldn't actually mean anything, because part of this is the give-and-take of bipartisan negotiation," he added.

Vance also guaranteed that "we're going to cover Americans with pre-existing conditions."

Walz argued that Vance is saying "if you're healthy, why should you be paying more? So what they're going to do is let insurance companies pick who they insure. Because guess what happens? You pay your premium. It's not much. They figure they're not going to have to pay out to you. But those of you a little older, gray, you know, got cancer? You're going to get kicked out of it. That's why the system didn't work. Kamala Harris will protect and enhance the ACA."

Walz added that what Vance explained "might be worse than just a concept. Because what he explained is pre-Obamacare."

Walz also said that the question about young people leaving the ACA markets is "the individual mandate piece of this." When asked by Vance whether Walz thought the individual mandate was a good idea, Walz said "I think the idea of making sure the risk pool is broad enough to cover everyone, that's the only way insurance works. When it doesn't, it collapses."

Reproductive rights

When asked about reproductive rights, Vance cited the story of a woman who is "very dear to me" who told him "a couple years ago that she felt like if she hadn't had that abortion that it would have destroyed her life because she was in an abusive relationship."

"I think that what I take from that as a Republican who proudly wants to protect innocent life in this country, who proudly wants to protect the vulnerable, is that my party we've got to do so much better of a job at earning the American people's trust back on this issue, where they frankly just don't trust us," Vance added.

To do this, Vance said he wants the Republican Party "to be pro-family in the fullest sense of the word. I want us to support fertility treatments. I want us to make it easier for moms to afford to have babies. I want it to make it easier for young families to afford a home so they can afford a place to raise that family. And I think there's so much that we can do on the public policy front just to give women more options."

When asked about previous comments he made supporting a federal ban on abortion after 15 weeks, Vance said he "never supported a national ban" but during his Senate run in 2022 supported "setting some minimum national standard. For example, we have a partial birth abortion ban … in place in this country at the federal level."

During the debate, Trump posted on X that he "would not support a federal abortion ban, under any circumstances, and would, in fact, veto it, because it is up to the states to decide."

Vance added that since the United States is such a diverse country in so many ways, rulemaking should be devolved as much as possible to the states.

"We have a big country and it's diverse and California has a different viewpoint on this than Georgia," he said.

Walz said that in Minnesota, "what we did was restore Roe v. Wade. We made sure that we put women in charge of their healthcare."

Walz also said that leaving abortion up to the states puts pregnant women at risk, citing the case of Amber Thurman, a woman in Georgia who died after a long delay in getting a procedure to clear fetal tissue from her body that hadn't been fully expelled after she took abortion pills.

"The fact of the matter is, how can we as a nation say that your life and your rights as basic as the right to control your own body is determined on geography?" Walz said.

Drug prices

During a conversation about the ACA, Vance said that in 2018, prescription drug prices fell "for the first time in a very long time."

"Under Kamala Harris's leadership, prescription drugs are up about 7%," Vance said. "Under Donald Trump's entire four years, they were up about 1.5%."

Meanwhile, Walz touted the Medicare drug price negotiations put in place by the Inflation Reduction Act, saying that "Kamala Harris negotiated drug prices for the first time with Medicare. We have 10 drugs that will come online, the most common ones that'll be there."

Paid family/medical leave

During the debate, Vance argued there should be more childcare options for American families, saying there is a "bipartisan solution" for paid family and medical leave.

Vance said he believes there should be a family care model "that makes choice possible" and said that federal funding for how childcare is promoted should be considered, including for families who seek out childcare at churches or with neighbors.

"One of the biggest complaints I hear from young families is people who feel like they don't have options, like they're choosing between going to work or taking care for their kids, that is an incredible burden to put on American families," Vance said. "We're the only country that does it. I think we can do a heck of a lot better."

Walz also said that paid family and medical leave would help bring growth to the United States, adding that leaders have to make it easier for people to get into the childcare business and make it affordable for people who need to pay for family care.

"A federal program of paid family medical leave and help with this will enhance our workforce, enhance our families, and make it easier to have the children that you want," Walz said. (Wilkerson, STAT, 10/2; Bradner et al., CNN, 10/2; Pitofsky et al., USA Today, 10/1; Becket, CBS News, 10/2)

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