The Obamacare wars return to the campaign trail: From the Politics Desk

Welcome to the online version of From the Politics Desk, an evening newsletter that brings you the NBC News Politics team’s latest reporting and analysis from the campaign trail, the White House and Capitol Hill.

In today’s edition, senior national political reporter Sahil Kapur examines how the political fight over Obamacare was reignited this week. Plus, “Meet the Press” moderator Kristen Welker breaks down why Pennsylvania is shaping up to be so critical to the battle for the White House and the Senate.

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The Obamacare wars return to the campaign trail

By Sahil Kapur

Obamacare has re-entered the chat.

Nearly 15 years after then-President Barack Obama signed the Affordable Care Act into law, the political fight over the health care overhaul is flaring up again in the final stretch of the 2024 presidential race.

Vice President Kamala Harris has begun to lean in heavily on the issue, launching multiple ads this week vowing to protect the law, weaponizing former President Donald Trump’s ongoing calls to replace the ACA by arguing that he’d rip away subsidies to afford coverage and undo insurance regulations that protect pre-existing conditions.

Trump won the 2016 election while campaigning on repealing Obamacare — which had long been used as a punching bag on the right — but the law gained popularity among the public after he tried to repeal it. Nevertheless, he has continued to criticize the law and says he still wants to replace it, but only if he devises a better program. He said in the Sept. 10 debate with Harris that he has “concepts of a plan,” but his campaign isn’t saying when he will release that proposal.

Harris’ latest ad features a farmer with a brain tumor crediting Obamacare for saving her life and her farm. “Trump is coming for our health care. That’s pretty damn scary,” the woman says to the camera.

Also this week, Trump’s running mate, Sen. JD Vance, raised eyebrows by rewriting the history of Trump’s attempts to repeal Obamacare when he was president.

“Donald Trump could’ve destroyed the program. Instead he worked in a bipartisan way to ensure that Americans had access to affordable care,” Vance said in Tuesday’s VP debate.

Vance was wrong. As president, Trump fought to destroy the ACA through repeal legislation (which failed) that was projected to result in millions losing their coverage, through executive actions to weaken its insurance regulations and by asking the Supreme Court to wipe out the law entirely in 2020. 

Obamacare survived despite Trump’s efforts. Now, Harris wants to capitalize on the issue, as Democrats were able to do in the 2018 and 2020 elections. 

On Capitol Hill, many Republicans have sought to turn the page, seeing the Obamacare fight as a losing issue. But others are prepared to reopen it next year if they win the election.

That includes Sen. Tom Cotton, R-Ark., who is running to be the new No. 3 Senate GOP leader. Cotton told NBC News that he supports including a health care overhaul in major tax legislation that Congress is poised to consider next year, with much of the Trump tax cuts expiring at the end of 2025.

Also expiring at the end of 2025: enhanced subsidies for Obamacare that limit premiums for many Americans to 8.5% of income, costing about $25 billion per year.

Extending those subsidies is a priority for Harris and Democrats. The winners of the 2024 election will decide whether it happens.

Strategy shift: In addition to the newly launched health care-focused ads, Monica Alba, Jonathan Allen, Peter Nicholas and Yamiche Alcindor report that Harris’ campaign is planning to more aggressively attack Trump in the remaining weeks of the race as part of an attempt to win over the small number of remaining undecided voters, according to five Harris campaign officials.

Meanwhile, some Democratic strategists and activists are expressing concern that by largely eschewing town hall-style events with voters and media interviews, Harris has failed to fully capitalize on the excitement surrounding her initial entry into the race, Peter Nicholas, Natasha Korecki, Monica Alba and Matt Dixon report. 

How the Keystone State remains key to 2024

By Kristen Welker

With a month to go until Election Day, there is no state — right now — that’s more important than Pennsylvania.

It’s key to both Kamala Harris’ and Donald Trump’s paths to 270 electoral votes, and public polls suggest the race in Pennsylvania is incredibly close. 

Trump, in fact, is set to campaign Saturday in Butler, Pa., the site of the attempt on his life nearly three months ago. Meanwhile, Barack Obama will make his first appearance on the campaign trail this fall next week in Pittsburgh at an event for Harris. 

What’s more, the Keystone State is home to an important Senate contest between Democratic incumbent Bob Casey and GOP challenger Dave McCormick. The two debated Thursday night for the first time, with Casey criticizing McCormick’s past residency in Connecticut, and with McCormick hitting Casey for standing behind President Joe Biden before he exited the 2024 race.

For his part, Biden is scheduled to travel to Philadelphia next Tuesday for a Casey campaign event. 

And Pennsylvania features as many as five competitive House contests that could determine which party controls the chamber next year.

A month from now, it’s possible another state dominates the political discussion on Election Night. After all, Wisconsin was the tipping-point state in 2016 and 2020 that pushed the winning presidential candidate across the Electoral College threshold. 

But for 2024, my money is on Pennsylvania being that must-watch state on Nov. 5 — and possibly beyond.

That’s all from the Politics Desk for now. If you have feedback — likes or dislikes — email us at [email protected]

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