Republican presidential candidates vow to take on 'big insurance'

Replacing the Affordable Care Act has returned as a central healthcare policy issue for Republican presidential candidates following a brief pause from the national spotlight in the 2022 elections.

At the fourth GOP primary debate on Dec. 6., presidential hopefuls discussed their goals of taking on "big insurance" to lower healthcare costs.  

"We are going to go after the cost. You're paying too much for everything," Florida Gov. Ron DeSantis said. "We've actually addressed this in Florida in some ways, but you need price transparency. You need to hold the pharmaceuticals accountable. You need to hold big insurance and big government accountable, and we're going to get that done."

Mr. DeSantis told NBC Dec. 3 he aims to "replace and supersede" the ACA with a different system, though details of what that would entail have been sparse. Mr. DeSantis said his campaign will likely roll out a "proposal" in the spring.

Vivek Ramaswamy, a 38-year-old biotech entrepreneur, weighed in at the debate about the need to address consolidation among health insurers.

"We need to start having diverse insurance options in a competitive marketplace that cover actual health, preventative medicine, diet, exercise, lifestyle and otherwise," Mr. Ramaswamy said. "And here's how we deliver that — end the antitrust exemptions for health insurance companies."

The candidates' comments follow online postings from former President Donald Trump in November proposing the replacement of the ACA.

"Getting much better Healthcare than Obamacare for the American people will be a priority of the Trump Administration," Mr. Trump wrote Nov. 28 on Truth Social, the online platform under the Trump Media umbrella. "It is not a matter of cost, it is a matter of HEALTH. America will have one of the best Healthcare Plans anywhere in the world. Right now it has one of the WORST!" 

A follow-up post one hour later from Mr. Trump read: "I don't want to terminate Obamacare, I want to REPLACE IT with MUCH BETTER HEALTHCARE. Obamacare Sucks!!!!" 

President Joe Biden's reelection team has indicated the White House is prepared to make the ACA a central piece of the 2024 campaign.

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