Preview: Tonight’s VP Healthcare Debate

us_vice_president_seal-svgHealthcare was barely mentioned during the ninety minute Presidential debate between Secretary Hillary Clinton and Real Estate mogul, Donald Trump back on September 26th.

Both campaigns have a chance to redeem themselves with tonight’s first and only Vice Presidential debate that will be held tonight at Longwood University in Farmville, Virginia.

Mike Pence is the Republican Party nominee for Vice President and currently serves as the Governor of Indiana. He has a long history in politics, previously serving in the U.S. Congress since 2000. He rose to the position of chairman of the House Republican Conference in 2011 before leaving Congress to run for Governor.

Tim Kaine is the Democrat Party nominee for Vice President. He currently serves as a U.S. Senator representing Virginia. He chaired the Democratic National Committee for four years and served as the Governor of Virginia. He too held past roles in government as the Lieutenant Governor of Virginia and the Mayor of Richmond.

On To The Debate

Similar to the Presidential debate, it will last for 90 minutes without commercial breaks. Elaine Quijano, CBS News anchor and correspondent, will serve as the moderator. She will personally make history serving as the first Asian American moderator for a general election debate.

The debate will be divided into nine 10 minute segments. After an opening question, the Vice Presidential candidates will have 2 minutes to respond. The remaining time will be used to further discuss the issue at hand.

There is an even greater burden on Ms. Quijano tonight, since Lester Holt did not bring up healthcare in the prior debate. Even though the Vice Presidential candidates historically serve as surrogates to the candidate at the top of the ticket, both VP nominees have a storied history on Healthcare themselves that should be examined tonight.



Governor Pence took the Indiana Governorship in 2013. At that time over 15% of Hoosiers lacked health insurance coverage. As of today, the uninsured rate has dropped to 9.6%. Despite this success, Mike Pence voted against the Affordable Care Act in 2010 as a congressman. In fact, when the law passed Politico reported that compared it to the September 11th terrorist attacks.

Pence later co-sponsored HR 6079 in 2012, which was one of many bills seeking to repeal the Affordable Care Act. Ironically, the fiscally conservative Congressman co-sponsored and voted for a bill that the CBO stated would add $109 billion to federal budget deficits from 2013 to 2022.

While repealing the law would generate $1.1 trillion in savings; the CBO said it would also cause an increase in direct spending of $711 billion and reduced tax revenues of $569 billion which equated to more than the savings generated by the repeal.

Oddly enough though, Mike Pence as Governor implemented the expansion of Medicaid, a key feature of the Affordable Care Act, despite fighting to repeal the law as a congressman serving the same state.

It should be mentioned that Pence’s implementation of the Medicaid expansion was one of the most complex of the entire nation. He did, however, implement the expansion leveraging many Republican/Conservative principles.

Hoosiers now have:

  • Access to “Personal Wellness & Responsibility” health savings accounts, a key feature of many Republican health care reform bills.
  • To pay monthly premiums for Medicaid coverage depending on their income and health status.
  • Can purchase a more enhanced Hoosier Insurance Plan (HIP) with access to more benefits if they pay the monthly premium. This is a key Republican provision that seeks to ensure even low income Americans have accountability and skin in the game for their healthcare coverage.
  • Can only receive non-emergency medical transportation after 1 year once it is deemed medically necessary.

Some provisions were even denied by CMS such as requiring Medicaid members to show they were employed to continue enrollment in the health plans.

Lastly, in 2016, four companies announced they would be exiting the market in Indiana by the end of 2016: UnitedHealthcare, Southeastern Indiana Health Organization, Physicians Health Plan, and Indiana University Health Plans. This was mainly due to the financial losses these companies felt 3 years into the Affordable Care Act’s Health Exchanges. There are a little under 200,000 Hoosiers that will negatively be impacted by these market changes.

Pence is pro-life similar to Tim Kaine. However, unlike Kaine, he has aggressively voted to defund Planned Parenthood. He also voted on many anti-abortion bills that some have called extreme.  Most recently, Pence signed an aggressive anti-abortion bill into law in March of this year that creates many hurdles for mothers to access the service.

Questions to ask him tonight:

Question 1: As a fiscally conservative Republican, please explain the co-sponsorship of a bill to repeal the Affordable Care Act that would raise the federal deficit by $109M? 

Question 2: As a congressman, you voted multiple times against the Affordable Care Act, yet as Governor you expanded Medicaid in your state. How do you rationalize being for the Affordable Care Act after you were against it? What changed between the halls of Congress and Governor’s mansion. Please be specific. 

Question 3: Indiana lags the nation in lowering the uninsured rates, so why should we believe a Trump/Pence administration would be better for America? Please offer up to three specifics. 


Tim Kaine was Governor of Virginia from 2006 to 2010. The uninsured rate in Virginia was 14.1% when Kaine entered office. By 2010, it increased 0.5% to 14.6% leaving more than 1 million Virginians without health insurance coverage. The vast majority of those uninsured were aged 19-64, earned 200% of the federal poverty level or below, and had at least one person working in the family. Interestingly enough, Virginia residents who were not US citizens were three times more likely to be uninsured during his Governorship. Secretary Clinton has discussed at lengths expanding the Affordable Care Act to those who are undocumented and in the United States.

While Kaine was not in Congress to vote on the Affordable Care Act, he has been a vocal proponent of the law as the head of the Democratic National Committee. He even co-sponsored S.2782 (States Achieve Medicaid Expansion Act) in 2016 which sought to provide financial incentives to states reluctant to expand Medicaid. CBO estimates as of 10/3 have not been received on this bill to see how it would impact the deficit.

The Affordable Care Act has yet to insure all Americans. There are still roughly 30 million Americans that lack insurance. Additionally, health insurance premiums have skyrocketed since the implementation. Virginia has seen rate increases as high as 28%. In 2016 alone, Virginia witnessed UnitedHealthcare threaten to leave the state and Humana officially exit the state. These changes greatly impact the 378,000 Virginians currently getting health care coverage through the Affordable Care Act.

Kaine is also a Senator of a state that is reluctant to expand Medicaid despite their Democrat Governor, Terry McAuliffe being a proponent of the law. If Virginia expanded Medicaid it would help cover 131,000 people who earn too much for Medicaid, but not enough income to get financial assistance through the Affordable Care Act. Additionally, another 462,000 would be eligible for Medicaid benefits under the increased income guidelines.

Kaine is known as personally pro-life, however backs many pro-choice legislations including Planned Parenthood. Under his term, Virginia was the first state to require all girls to get the HPV vaccine. Lastly, and maybe most notably, as Governor, Kaine signed a $42 million package to overhaul mental health services after the 2007 mass shooting at Virginia Tech.

Questions to ask him tonight:

Question 1: The uninsured rate in your state increased under your Governorship. Please explain why the American people should trust you in your pursuit to “defend and further extend” the Affordable Care Act? Please offer up to three specific reasons.

Question 2: Americans continue to see double digit increases on their health insurance premiums and health plans continue to exit the market year after year. In fact, your home state of Virginia has not expanded Medicaid under the Affordable Care Act provisions. Why do you believe the law is working for America? Please offer up to three specific reasons.

Question 3: The Affordable Care Act as written does not offer insurance coverage to undocumented Americans; however they are the most uninsured individuals in your state. Your platform seeks to expand access to healthcare regardless of someone’s immigration status. How do you intend to implement and pay for this for Virginia and the rest of the nation?

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