Former President Donald J. Trump’s suggestion in Tuesday’s debate that he had “concepts of a plan” to replace the Affordable Care Act instantly became one of the night’s most memorable lines, transposed into memes across social media.
It was also a continuation of a strategy Mr. Trump has practiced since he first ran for president nearly a decade ago: promise an overhaul to the health care system, then surrender to the political and practical challenges of developing such a plan.
“If we can come up with a plan that’s going to cost our people, our population, less money and be better health care than Obamacare, then I would absolutely do it,” he said at the debate. “But until then I’d run it as good as it can be run.”
Mr. Trump’s position straddled two seemingly contradictory ideas. He could both replace the Affordable Care Act with something better, and keep it in place making incremental changes, as he did during his first term. The growing popularity of the law — around 60 percent of Americans approved of it in a recent poll, and a record number of people signed up for plans this year — has made any renewed push to repeal it politically perilous.
Yet Mr. Trump suggested that he might try anyway, promising a health plan “in the not-too-distant future.” In Mr. Trump’s telling on Tuesday, his administration took over flailing health care marketplaces and sturdied them, allowing the Affordable Care Act to mature even as his own health officials, Republican lawmakers and his Justice Department sought to restrict and nullify the health law.
“I had a choice to make when I was president: Do I save it and make it as good as it can be? Never going to be great. Or do I let it rot?” he said. “And I felt I had an obligation, even though politically it would have been good to just let it rot and let it go away.”
