Two debate moments in recent weeks have made health care, previously a minor issue in the presidential campaign, a top issue for the final phase of the campaign.

It started with Trump saying last month that he had “concepts for a plan” to replace the Affordable Care Act – also known as Obamacare – and continued Tuesday night at the vice presidential debate in New York.

On stage this week, Republican vice presidential candidate JD Vance appeared to portray Trump’s previous repeated repeal attempts as a victory for Americans and also sought to reassure voters that he did not want to return to an era in which pre-existing conditions could be a reason for a denial of coverage.

“I think you can make a really good case that (Trump’s actions) saved Obamacare,” Vance said.

“Trump could have destroyed the program. Instead, he worked across party lines to ensure Americans had access to affordable health care,” he added.

It was a claim that raised more than a few eyebrows.

As almost every post-debate fact check noted, then-President Trump used his presidential powers to undermine the 2010 law, and he also pushed Congress to try to repeal it entirely.

The effort only failed when some members of Trump’s own party – most notably then-Sen. John McCain of Arizona – voted no.

Trump’s actions in office, including making it harder to enroll in the program’s health insurance exchanges, also contributed to a decline in enrollment from 2016 to 2020, according to government data.

Still, Vance claimed that it was Trump who “saved the program from a Democratic administration that was collapsing and would have collapsed without his leadership.”

Beyond the numerous fact checks, Tuesday’s exchange also highlighted the changing politics of health care, with rising enrollment and public support for Barack Obama’s signature achievement that Republicans sought to repeal from the moment it took effect.

Since Biden took office, the number of stock market participants has skyrocketed. Currently, more than 21 million people are enrolled in plans through the law’s marketplaces. Surveys show the law is becoming increasingly popular.

Read more: What the 2024 Election Means for Your Wallet: The Yahoo Finance Guide to the Presidential Election

After years of Republican attacks, it’s an issue that the Harris campaign hopes could become a liability for Republicans in the final month of the campaign. Minnesota Gov. Tim Walz responded to the claims in the debate by saying that exchanges have thrived and grown in recent years because they are popular.

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“Look, people are using it,” Walz said, “the system works.”

Other important topics: insulin prices and price transparency

Tuesday night’s back-and-forth covered a range of health topics and was just the latest attempt by Vance to reframe health issues and Trump’s related tenure in office.

Another key focal point is the cost of prescriptions. At a recent rally, Vance said it was Republicans who “lowered insulin to $35 a vial.”

“Thank you Donald Trump for this,” he added.

Vance is correct that the former president led an effort to obtain $35 insulin and signed a 2020 executive order aimed at saving money for seniors enrolled in Medicare Part D are. But the effort was remarkably voluntary.

The Rand Health Care report concluded that while Trump’s efforts reduced out-of-pocket insulin costs, many still paid more than $35.

It was the Biden-Harris administration that made this mandatory, at least for seniors, with the passage of the Inflation Reduction Act in 2022.

Today, some still pay more for insulin, and Kamala Harris promised to cap the price of insulin at $35 for Americans of every age group.

Read more: Trump vs. Harris: 4 Ways the Next President Could Impact Your Bank Accounts

On Tuesday, Vance also announced regulations announced during Trump’s term that would force hospitals to publicly disclose the prices paid by insurance companies, saying, “This price transparency will actually give American consumers a little more choice and also lower costs.” “

However, according to a New York Times fact check, the impact of the change remains unclear as economists still disagree about what impact Trump’s rules will ultimately have on overall prices.

The sentence that started it all: “Concepts of a plan”

The health care debate has grown in recent weeks following a debate on September 10, when Trump ran against Harris and agreed to his push to replace Obamacare with something better – but then refused to provide details.

“I have concepts of a plan,” Trump said at the debate hosted by ABC.

“I would only change it if we came up with something better and cheaper,” he added, promising a plan “in the not too distant future.”

Vance also tried to defend Trump’s comments on the issue this week, calling it “simple common sense” that a 900-page bill would not be presented on stage.

“It would bore everyone to tears and it wouldn’t actually mean anything,” Vance added, overlooking that despite his debate promises, Trump has given no indication that a plan is in place.

And when Vance recently appeared to reveal some possible details of a Trump-Vance healthcare plan, he suffered a political blowback.

What Vance was discussing was the idea that insurers could be given more power to group people with chronic illnesses into special “risk pools.” This immediately sparked fears of a return to a time when insurance companies could deny coverage or charge inflated prices for people with pre-existing conditions.

“What he declared is pre-Obamacare,” Gov. Walz charged Tuesday night about the Republican health care proposal, saying that Trump and Vance “will let the insurance companies choose who they insure.”

Don’t expect this problem to go away in the coming weeks. The Harris campaign on Tuesday launched the first part of a series of health care-focused ads scheduled to air in the coming weeks.

Ben Werschkul is a Washington correspondent for Yahoo Finance.

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