Sen. JD Vance (R-Ohio), who was tapped as former President Trump’s running mate Monday, has been in the Senate for less than two years but has staked out health care positions that both buck his party and toe the GOP line.
Vance is a Yale-educated venture capitalist, but rode the wave of Trump-era populism to a Senate seat. Like most Republicans, he is strongly anti-abortion, opposes gender-affirming care and wants to exclude “Dreamer” immigrants from federal health programs.
But he’s also expressed opposition to completely repealing ObamaCare, has supported Medicare drug price negotiation, and worked across the aisle to push federal health authorities to support the people of East Palestine, Ohio, after a train derailment caused a chemical spill.
Here’s where he stands on key issues:
ObamaCare
Vance authored a 2017 New York Times op-ed in which he criticized the House and Senate efforts to repeal the health law because each would eliminate support for low-income individuals and leave too many people uninsured.
“We’ll rail against the way the government has destroyed our health care market in one breath and resist the support offered to the poor and middle class to navigate this brokenness with the other. This is not conservative; it is incoherence masquerading as ideological purity,” he wrote.
When Trump expressed support last year for reviving repeal efforts, Vance was among the many Senate Republicans who shrugged it off.
When asked about Trump’s comments, Vance told Semafor at the time that while health care was too expensive and “ripe for reform,” some parts of the law were “broadly popular,” like protections for people with preexisting conditions.
“I don’t think there’s any effort to try to change them,” Vance told the outlet.
But there will likely be a major battle in Congress next year about whether to extend enhanced ObamaCare subsidies that helped people afford insurance. Congressional Republicans and outside conservative groups are largely opposed to such a move, though Trump has not weighed in.
Medicare drug price negotiation
In a 2022 interview with AARP during his Senate campaign, Vance said he supports allowing Medicare to negotiate drug prices.
“I think we have to let Medicare negotiate prescription drug prices so that our seniors aren’t paying through the roof for prescription drugs,” Vance said.
Drug price negotiation is one of the key provisions of President Biden’s Inflation Reduction Act, which Republicans oppose. Many in the GOP argue Medicare negotiations are government price controls that could hurt new drug development.
Trump originally campaigned on Medicare drug price negotiations in the run-up to the 2016 election, but later dropped it in favor of a “most favored nation” policy tying Medicare drug payments to overseas pricing.
Vance also backed letting U.S. companies import drugs from overseas, another policy Trump supported while in office.
Health care for ‘Dreamers‘
Vance opposes using taxpayer money to provide health care for “Dreamers,” people brought to the country illegally as children but shielded from deportation under the Deferred Action for Childhood Arrivals (DACA) program.
He introduced a bill to explicitly exclude DACA recipients from ObamaCare and bar the use of any federal taxpayer dollars through Affordable Care Act waivers for providing health insurance coverage for immigrants living in the country illegally.
Vance blasted a Biden administration policy finalized in May that would allow DACA recipients to enroll in certain ObamaCare exchange plans, saying Biden was “giving your hard-earned money away to illegal immigrants in the form of taxpayer-funded health care.”
Transgender health
Vance last year introduced a bill that would make providing gender-affirming care to minors a felony with a 10 to 25-year prison sentence.
The bill mirrors state bans on the procedures, but also would block taxpayer funding for it, including banning coverage of gender-affirming care from ObamaCare plans. It banned universities from providing instruction on “gender-affirming care,” and deemed noncitizens who performed any gender-related procedures on a minor ineligible to receive visas or admittance to the United States.
Vance has also cast doubt on the mental health impact of such treatment.
Abortion/reproductive rights
Vance has a strong anti-abortion record and was given an A+ ranking by Susan B. Anthony Pro-Life America, a prominent anti-abortion group.
He campaigned against Ohio’s 2023 ballot measure that guaranteed the right to abortion, and previously said he’d vote for a nationwide abortion ban at 15 weeks.
During his campaign for Senate, Vance applauded the overturning of Roe v. Wade and supported Texas’s ban on abortion, which does not allow exceptions other than cases where the mother’s life is at risk.
“Two wrongs don’t make a right,” he said in 2021 when asked whether abortion laws should allow for exceptions for rape and incest.
However, the next year, Vance said during a debate “I’ve always believed in reasonable exceptions.”
Much like Trump, Vance has been trying to show he can moderate on the issue.
In an interview on Meet the Press earlier this month, Vance said he supports mifepristone “being accessible,” despite many conservatives wanting the drug banned.
