Though repealing the Affordable Care Act is not a main focus of this year’s election, Vice President Kamala Harris is pushing hard to put health care front and center in the campaign – hoping it will help Democrats at the ballot box as it has in recent years.

This week alone, the Harris campaign unveiled a health care ad blitz, including one spot saying that Americans risk losing their coverage and Obamacare protections if former President Donald Trump returns to the White House and another focusing on Harris’ efforts to lower the cost of prescription drugs, including insulin. More health care-related spots are forthcoming.

The ads follow the Harris campaign’s release of a 43-page report that seeks to fill out the “concepts” of a health plan that Trump mentioned in September’s debate, slamming him and his running mate, Sen. JD Vance, for comments the vice president argues will reduce access to coverage and raise costs.

“Democrats always want to be talking about health care because they have a political advantage over Republicans on the issue with voters,” Larry Levitt, executive vice president for health policy at KFF, a nonpartisan health policy research organization, told CNN. “Trump and Vance have both opened the door to criticism that they want to once again try to replace the ACA, and the Harris campaign has walked right through that door.”

In an election where neither Harris nor Trump has rolled out detailed policy platforms, voters are hungry for more information on the candidates’ views on health care.

Around two-thirds of US adults say the topic is not receiving enough attention during the 2024 presidential campaign, according to a poll from West Health and Gallup released Monday. Among Democrats, that figure jumps to 78%, but even 53% of Republicans feel that way. Among independents, about two-thirds think health care is not getting enough attention.

“Americans care about health care. They want to know where the candidates stand when it comes to health care,” Sarah Fioroni, a senior researcher at Gallup, told CNN. “It’s always on the front of minds of Americans because it really affects their daily lives and continues to be really important.”

What the candidates have said

Both Harris and Trump have promised on the campaign trail to make health care more affordable – a longstanding complaint of many Americans.

Harris laid out several goals for reducing costs and increasing coverage in her initial economic package in August, as well as in a subsequent policy platform. The proposals, which largely build on the Biden administration’s accomplishments and are not very fleshed out, include making permanent the enhanced Obamacare premium subsidies; broadening the $35 monthly cap on insulin and $2,000 annual limit on out-of-pocket costs to all Americans, not just Medicare enrollees; speeding up Medicare drug price negotiations; and working with states to cancel patients’ medical debt.

Early in the campaign, Trump revived talk of wanting to repeal the Affordable Care Act and replace it with something better. More recently, he has pivoted to saying that he saved Obamacare, although he continues to criticize it.

Asked at September’s ABC debate whether he has a plan to replace the landmark health reform law, Trump said, “I have concepts of a plan.”

“I would only change it if we come up with something better and less expensive. And there are concepts and options we have to do that. And you’ll be hearing about it in the not-too-distant future,” continued Trump, who has long promised to propose an Obamacare replacement plan.

Vance has since sought to fill out some of the details in interviews, advocating for lifting some of the law’s sweeping regulations and providing people with more choices of health insurance policies. But his comments, particularly on separating healthy and sick enrollees into different risk pools, raised concerns that doing so would weaken Obamacare’s protections for people with preexisting conditions.

Asked about maintaining these protections at Tuesday’s vice presidential debate, Vance said that Americans with preexisting conditions would be covered and referenced the Trump administration’s approval of states’ reinsurance waiver requests for their Affordable Care Act exchanges. This generally lowered Obamacare premiums by providing funding for insurers that enrolled many high-cost patients.

Harris has jumped on her Republican rivals’ comments, using them as an opportunity to draw contrasts between her and her party’s health care measures and Trump’s past efforts – and future intent, she argues – to repeal Obamacare. The report her campaign released Monday says that Trump and Vance would “rip away” coverage from those with preexisting conditions and raise premiums, drug prices and out-of-pocket costs for millions of Americans.

The Trump campaign accused the Harris campaign of “lying because they are losing,” Karoline Leavitt, the campaign’s national press secretary, said in an email to CNN.

“President Trump is extremely aware of the healthcare struggles our country is facing from the rise of chronic childhood illnesses to the high price of healthcare and insurance that hardworking families simply cannot afford,” she said. “By increasing transparency, promoting choice and competition, and expanding access to new affordable healthcare and prescription drug options, President Trump will make healthcare affordable again.”