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The Republican candidates hoping to win the White House — Donald Trump and JD Vance — are facing criticism for their resistance to outline a health care plan to replace the Affordable Care Act (ACA), which Trump has aimed to repeal since his first run for the White House.

Democrats are using the crack in specific policy as an opening to target such positioning as dangerous to the country.

The Harris for President campaign has just released a report titled “The Trump-Vance ‘Concept’ on Health Care.’ WHYY News was given an advance look at the report, which offers specific data relating to the potential impact a repeal of the ACA would have on Pennsylvanians.

Using data previously collected by federal agencies, including the Health and Human Services and the U.S. Centers for Medicare & Medicaid Services, the report calculates the overall impact repealing the ACA would have on residents of Pennsylvania.

For example, 420,000 Pennsylvania residents who currently purchase their health insurance from the state’s health care exchange may see their health care costs rise unless an alternative were put in place. It’s not clear how many would be impacted, but many residents who use the exchange enjoy subsidies they receive through tax credits and would, therefore, pay more in insurance premiums. The costs are estimated to run several thousand dollars for an average middle-class family.

Pennsylvania residents who do not receive employment-based health insurance can sign up on the state exchange known as Pennie. They can also use the Kaiser Family Foundation’s “health insurance marketplace calculator” to determine the amount of subsidy they are eligible for.

The report also claims that “more than 5.2 million people with preexisting conditions in Pennsylvania could be denied health care coverage or charged thousands of dollars more under the Trump-Vance plan for high-risk pools.” According to the most recent data issued by the Pennsylvania Insurance Department, that number may actually be higher at 5.4 million patients who are currently protected by the ACA. This safeguard currently prohibits insurance companies from denying coverage based on preexisting conditions or from charging such patients higher premiums.

In response to a WHYY News request for a response, Karoline Leavitt, Trump campaign national press secretary, said in an emailed statement that “President Trump is not running to terminate the Affordable Care Act.

“He is running to make health care actually affordable, in addition to bringing down inflation, cutting taxes, and reducing regulations to put more money back in the pockets of all Americans who have been robbed by Kamala Harris’ disastrous economic policies,” she added.

Donald Trump has long criticized the ACA — popularly known as “Obamacare”—since his first race for president.

“Obamacare has to be repealed and replaced,” Trump told reporters in October of 2016. “Otherwise, this country is in even bigger trouble than anybody thought.”

Despite the 2012 Supreme Court ruling that upheld the health care law as constitutional, Trump and Congressional Republicans made 33 attempts to repeal it up to and during his presidency—and managed to chip away at key components.

The ACA was instantly controversial when then-President Barack Obama introduced the bill, which Congress eventually passed on a bipartisan basis. Nearly 15 years later, the law designed to reduce overall health care costs for lower-income and middle-class families is very popular among Americans.

Trump promised to repeal it as recently as January. During the presidential debate in Philadelphia with Vice President Kamala Harris earlier this month, Trump said he was working on “concepts of a plan” that would replace the ACA. During Vance’s visit to Newtown on Saturday, a reporter asked if Vance would guarantee that if elected, President Donald Trump and Vice President Vance would not repeal the ACA until they had another health care plan in place.

The vice presidential nominee did not answer but said that health care in the country needed more “transparency.”

The report also repeats the assertion that Trump, who has taken credit for overturning Roe v. Wade, would seek to expand abortion bans, even to Pennsylvania. The campaign report adds that investigations into the deaths of two women in Georgia were likely the result of that state’s strict abortion ban and that an analysis shows an increase in maternal mortality in Texas after an abortion ban there.

This article has been updated to include the response from the Trump campaign that was requested before publication.