Ron Brownstein: “Vance’s evasive response to the questions about health care, on a night when he took the offensive on most other subjects, exposed how fraught most Republicans still consider the issue, seven years after Trump’s attempt to repeal the ACA died in the Senate. But Vance’s equivocations should not obscure the magnitude of the changes in the program that he has signaled could be coming in a second Trump presidency, particularly in how the law treats people with significant health problems.” “The ACA provisions that mandate risk-sharing between the healthy and sick underpin what polls show has become its most popular feature: the requirement that insurance companies offer coverage, at comparable prices, to people with preexisting conditions.” “In numerous appearances, Vance has indicated that he wants to change the law to restore to insurance companies the ability to segregate healthy people from those with greater health needs.