On the Issues

Where the Republican Candidates Stand on Health Care

The Republican presidential candidates all oppose the Affordable Care Act, though not all of them have indicated that they would try to repeal it. Confronting a health care system that is much more expensive than those of other wealthy countries, several have called for more transparency in how costs are determined and greater regulation of the middlemen between pharmaceutical companies and insurers, known as pharmacy benefit managers.

Headshot of Donald J. Trump

Donald J. Trump

Former President

He wasn’t successful in repealing Obamacare when he was president, but he says Republicans should “never give up” trying to do so.

Former President Donald J. Trump said in November that he was “seriously looking at alternatives” to the Affordable Care Act. Repealing that law was a major promise of his 2016 campaign, but Congress defeated such bills while he was president, and the Supreme Court rejected a challenge to the law backed by his administration.

Headshot of Nikki Haley

Nikki Haley

Former Governor of South Carolina Dropped out

She has spoken broadly about her health care plans, and she opposes expanding Medicaid.

Nikki Haley has said on multiple occasions, including at a Republican debate in September, that it is unacceptable for the United States to have some of the most expensive health care in the world.

Headshot of Ron DeSantis

Ron DeSantis

Governor of Florida Dropped out

His health care promises have been delivered in broad strokes, and he has pledged to release more detailed plans later.

Gov. Ron DeSantis of Florida said in December that he would pursue legislation that would “supersede” the Affordable Care Act, calling its repeal a broken promise from Mr. Trump. (As a member of Congress, Mr. DeSantis voted multiple times to repeal it.)

Headshot of Vivek Ramaswamy

Vivek Ramaswamy

Entrepreneur Dropped out

He wants to ease the approval process for new drugs and create a more competitive market by ending antitrust exemptions for insurers.

Vivek Ramaswamy has criticized Mr. Trump for not fulfilling his 2016 campaign promise to repeal the Affordable Care Act, and said he would not make the same promise because he could not control legislators. “It is a false promise if it is contingent on Congress,” he said in September.

Headshot of Asa Hutchinson

Asa Hutchinson

Former Governor of Arkansas Dropped out

He opposes Obamacare and worked to repeal it, and wants to regulate the middlemen between drug manufacturers and insurers.

Former Gov. Asa Hutchinson of Arkansas supported repealing the Affordable Care Act in 2017 and was one of several Republican governors who worked behind the scenes, after initial efforts failed, to devise another repeal plan that itself was ultimately unsuccessful.

Headshot of Chris Christie

Chris Christie

Former Governor of New Jersey Dropped out

He expanded Medicaid as governor, and has focused on addiction treatment.

Chris Christie broke with many Republicans when he expanded Medicaid in New Jersey under the Affordable Care Act. He stood by that decision in 2016, citing an increase in insured New Jerseyans and a decrease in the state’s share of Medicaid expenses, and he opposed a proposal to repeal the Affordable Care Act in 2017 because it would have scaled back the expansion.