During the October 1 CBS News vice presidential debate, moderators Margaret Brennan and Norah O’Donnell allowed Republican nominee Sen. JD Vance to tell a massive lie that his running mate Donald Trump “salvaged Obamacare” when in fact he repeatedly attempted to destroy the Affordable Care Act and strip health insurance from millions of Americans.

The debate’s exchange on health care began with O’Donnell asking Vance about Trump’s much-derided presidential debate answer that he has “concepts of a plan” to repeal and replace the Affordable Care Act, and Vance’s own comments during a September 15 interview and continued during a September 18 rally “about changing how chronically ill Americans get health insurance.” 

Vance had proposed putting millions of Americans with chronic illness into their own insurance pool, as was standard practice in many states before adoption of the ACA. That had resulted in unaffordable insurance premiums, exclusions for preexisting conditions, and limits on both care and enrollment. 

A Media Matters review over the two weeks prior to the debate found that CBS and the other corporate broadcast networks entirely ignored Vance’s proposal.

During the debate, Vance replied that the ACA “was doing disastrously until Donald Trump came along,” and that he “could have destroyed the program” but instead he “salvaged Obamacare.” Vance also falsely claimed that Trump protected people with preexisting conditions. 

O’Donnell built on this false premise to ask Walz: “Did enrollment under the Affordable Care Act go up under the Trump administration?”

Walz repudiated Vance’s lie that Trump had somehow “salvaged” the ACA, pointing out that Trump had tried to end the ACA through executive action, a GOP-backed lawsuit, and legislation that failed to pass by just one vote in the Senate. He also explained that health insurance enrollment is higher under the Biden-Harris administration.

The truth is that Trump did everything he possibly could to run the ACA into the ground. 

First and foremost, after campaigning for president on the promise that he would repeal and replace Obamacare, Trump pushed a bill through the Republican-controlled House in 2017 that would have dismantled the ACA and left millions of Americans without health insurance coverage. 

The bill came within a single vote – from the late Sen. John McCain – of passing the Republican-controlled Senate and moving to Trump’s desk for enactment into law. (At the time, then-Rep. Tim Walz voted against Trump’s repeal bill in the House, and then-Sen. Kamala Harris voted against the Senate version.)

According to a list maintained by the Center on Budget and Policy Priorities, the Trump administration also undertook nearly 100 actions to sabotage the law. These actions included undermining the ACA's Medicaid expansion, approving new health care plans that were exempt from protections for preexisting conditions and that charged those customers more, cutting financial assistance for ACA plans, and almost entirely eliminating the federal government's outreach to encourage enrollment.

ACA enrollment also declined through most of Trump’s presidency, increasing slightly only in 2020 during the COVID-19 pandemic, though the year still ended with fewer people enrolled than during the beginning of the Trump administration. Enrollment didn’t soar until the Biden-Harris administration, when the number of enrollees nearly doubled from 2020, as this image from health policy organization KFF shows:

Additionally, the moderators failed to note that Vance had previously attacked Trump over the 2017 legislation he pushed to repeal the ACA, casting it as a betrayal of Trump’s own voters.

This discussion demonstrates the need for live fact-checking during debates, which CBS announced in advance it would not do. (Vance angrily talked over the moderators when they offered one clarification earlier during the debate, correcting his lie about legal Haitian immigrants living in Springfield, Ohio. He complained, “The rules were that you guys weren’t going to fact-check.”)

CBS posted an excellent fact check of Vance’s lie online but only a fraction of the tens of millions of viewers who tune in for debates are likely to see that article – 58 million people watched the 2020 vice presidential debate. (Many other news outlets and reporters also fact-checked this lie from Vance, showing how important it was for the moderators to correct this on the air.)

The ABC News presidential debate moderators last month were applauded by fellow journalists for their live fact-checking efforts. The GOP presidential ticket is so averse to live fact-checking that Trump reportedly delayed an interview with the National Association of Black Journalists to object to their plans to fact-check him, and the day of the VP debate, Trump backed out of an interview with CBS’ 60 Minutes due to their insistence on also fact-checking him. His opposition underscores the reality that live fact-checking is critical to holding serial liars accountable to the public.