Tim Walz-J.D. Vance debate: What they said about healthcare

Tim Walz and J.D. Vance went head-to-head over healthcare and abortion rights in their debate.

Tim Walz, the Democratic vice presidential nominee, and J.D. Vance, the Republican nominee, clashed over abortion and the Affordable Care Act in their debate Tuesday night.

Walz, the Democratic vice presidential nominee, and Vance, the Republican nominee, met in New York City Tuesday night for their only scheduled debate.

The debate was dominated by the economy, foreign policy, and immigration, and it took a while for healthcare to come up. After about 40 minutes, Walz said, “I hope we have a conversation on healthcare.”

Eventually, Walz and Vance did have that conversation, and it became contentious at times.

Battling over abortion

Vance, a U.S. senator from Ohio, and Walz, the governor of Minnesota, shared moments of civility at times. After the debate, they spoke to each other, and their wives joined them on stage.

But similar to Kamala Harris and Donald Trump in their debate, the clashes over abortion provided some of the most heated moments in the Walz-Vance debate.

Walz pointed to Trump’s reshaping of the U.S. Supreme Court, which led to the decision to overturn Roe v. Wade in 2022, Over the past two years, a total of 22 states have enacted laws restricting abortion or banning it in almost all cases.

“Donald Trump put this all into motion,” Walz said. “He brags about how great it was that he put the judges in and overturned Roe vs. Wade, 52 years of personal autonomy.”

Walz cited measures to protect those rights as Minnesota’s governor. In 2023, Walz signed legislation expanding protections of abortion rights to ensure that they remain in place, regardless of the future composition of state courts. He also signed legislation aimed at protecting those seeking abortions in Minnesota against legal attacks from groups outside the state.

“In Minnesota, what we did was restore Roe vs. Wade. We made sure that we put women in charge of their healthcare,” Walz said.

Vance reiterated his opposition to abortion. But he also said Republicans must convince Americans they will do more to support families and women with unplanned pregnancies.

“As a Republican who proudly wants to protect innocent life in this country, who proudly wants to protect the vulnerable … my party, we've got to do so much better of a job at earning the American people's trust back on this issue where they, frankly, just don't trust us,” Vance said.

Vance said that the abortion issue should be left to the states.

“The proper way to handle this, as messy as democracy sometimes is, is to let voters make these decisions. Let the individual states make their abortion policy and I think that's what makes the most sense in a very big, a very diverse and, let's be honest, sometimes a very, very messy and divided country,” Vance said.

But Vance and Walz became particularly animated in barbs over Minnesota’s law. At one point, Vance said that Minnesota law states that a doctor is under no obligation to provide life-saving care to a baby who survives a botched late-term abortion. Walz said that is not true and not an accurate description of the law.

Walz said as president, Harris would do more to support families while also ensuring women would be able to make their own choices. Walz also pointed to the frustration of doctors who have said state abortion laws have made it difficult for physicians to provide emergency care for patients having complications.

“We're pro-women,” Walz said. “We're pro-freedom to make your own choice. We know what the implications are to not be that …. women having miscarriages, women not getting the care, physicians feeling like they may be prosecuted for providing that care.”

Walz also referenced Amber Thurman, a Georgia woman who died following complications after taking abortion medication in another state; she waited 20 hours before doctors began emergency surgery. A state committee reviewing her case said her death was preventable, ProPublica reported.

The Minnesota governor also pointed to “Project 2025,” which outlines policies conservatives hope to see if Donald Trump is re-elected, and he warned there would be monitoring of abortions under a second Trump administration.

Trump has said he's not responsible for Project 2025 and has sought to distance himself from it. When asked if there will be a federal pregnancy monitoring agency during the debate, Vance said, “Certainly, we won’t.”

Vance has previously said that Trump would veto legislation to ban abortion nationwide, though Trump would not say if he’d reject such a bill during his debate with Harris.

Vance’s language in the debate represents a shift from earlier statements. When Vance was running for the U.S. Senate in 2022, he said on a podcast, “I certainly would like abortion to be illegal nationally.”

The Affordable Care Act

Toward the latter part of the debate, Walz and Vance clashed on the Affordable Care Act.

Vance at one point tried to make the case that Trump “salvaged” the law enacted by President Barack Obama. Walz cited Trump’s efforts to eliminate the law, and said Harris would ensure the continuation of the Affordable Care Act.

“Kamala Harris will protect and enhance the ACA,” Walz said.

If the Affordable Care Act is eliminated, Walz said, “What that means to you is you lose your pre-existing conditions.”

Walz also pointed to Trump’s repeated efforts to abolish the Affordable Care Act as president.

“On day one, he tried to sign an executive order to repeal the ACA. He signed on to a lawsuit to repeal the ACA, but lost at the Supreme Court, and he would have repealed the ACA had it not been for the courage of John McCain to save that bill,” Walz said.

Trump has shifted his rhetoric on the Affordable Care Act, saying he’d like to make it better. During the debate with Harris, Trump said he wants to improve the law. When asked for specifics, Trump said he had “concepts of a plan.”

Last night, Vance sought to defend Trump’s statements in the presidential debate, saying, “You're not going to propose a 900-page bill standing on a debate stage.”

Walz also chided Trump over his still-developing healthcare plan. “When Donald Trump said, ‘I’ve got a concept of a plan,’ it cracked me up as a fourth grade teacher, because my kids would have never given me that,” Walz said.

But Walz added, “What they're going to do is let insurance companies pick who they insure.”

Vance said that if Trump is re-elected, “Of course, we’re going to cover Americans with pre-existing conditions.”

Affordable Care Act enrollment rose to more than 21 million people in 2024, a record, and nearly double the 11 million people in 2020, according to KFF.

Vance cited Trump’s efforts to lower healthcare costs. He also pointed to the Trump administration’s steps to add more transparency in hospital prices.

“Think about healthcare,” Vance said. “You go into a hospital, you try to buy something, and nobody knows what it actually costs. That price transparency will actually give American consumers a little bit more choice, and will also drive down costs.”

Walz pointed to the Biden-Harris’s passage of the Inflation Reduction Act, which led to the reduction of Medicare prices for 10 common drugs

Gun violence

Vance and Walz also talked about gun violence, and shared some common sympathy on the victims of gun violence. Walz pointed to pragmatic solutions that wouldn’t impede on Second Amendment rights.

Vance also pointed to addressing more mental health issues in the epidemic of gun violence.

“We have a mental health crisis in this country we really do need to get to the root causes of,” Vance said.

Walz said he recognized Vance’s sincerity in the desire to curb gun violence but cautioned against “stigmatizing mental health.”

"Just because you have a mental health issue, doesn't mean you're violent," Walz said, adding, "Sometimes it just is the guns."