As the midterm elections draw closer, Democrats are increasingly focusing their messages on affordable health care. Heidi Heitkamp, the incumbent Senator in North Dakota, has made her Republican opponent’s voting record on this issue one of her main talking-points.

In a Bismarck Tribune op-ed published this week, Heitkamp argued that her opponent, U. S. Rep. Kevin Cramer, "looks at health care through a strictly political lens." Heitkamp attacked Cramer for voting for several bills to repeal and replace Obamacare, and wrote that "President Donald Trump even referred to one of Cramer’s health care repeal bills as 'mean' because the bill gutted protections for North Dakotans with preexisting conditions."

Although Trump praised the American Health Care Act (AHCA), when it was passed in the House in May 2017, he later said that the Republican bill was "mean." The bill didn’t make it out of Congress.

What Trump said about Trumpcare

The American Health Care Act was passed by House Republicans on May 4, 2017, by a narrow majority of 217 to 213. We have analysed the AHCA, and found that it had the potential to allow insurers to set premiums based on the health status of an individual, making costs higher for consumers who are sicker.

When the bill was passed in the House, Trump expressed his support of the Republican plan. "This is a great plan," Trump said in a White House announcement with House Republicans. "I actually think it will get better. And this is, make no mistake, this is a repeal and replace of Obamacare."

However, in June 2017, the Associated Press reported that Trump told 15 Republican senators that the House bill was "mean, mean, mean," and that they needed to make the Senate version of the bill "more generous."

On June 25, in an interview on "Fox and Friends", Trump was asked about about a Facebook post by former President Barack Obama, who criticised the GOP plan and said that the amendment made to the Senate bills would not change "the fundamental meanness at the core of this legislation."

Fox News’ Pete Hegseth told Trump that it was "unprecedented for a former president to come out the way President Obama has" and asked, "What do you say to the former president?" Trump responded by saying that Obama "actually used my term, mean. That was my term, because I want to see -- and I speak from the heart, that’s what I want to see -- I want to see a bill with heart."

Shortly afterward, Trump said again that he was pleased with his party’s health care plan: "Honestly, nobody can be totally happy, even without the votes, forget about votes, this has nothing to do with votes. This has to do with picking a plan that everybody is going to like. I'd like to say love, but like. But we have a very good plan, we have a few people that are, I think you could say modestly, they're not standing on the rooftops and screaming. They want to get some points. I think they'll get some points."

Our ruling

Heitkamp said that a House bill to repeal Obamacare supported by Kevin Cramer was referred to as "mean" by President Donald Trump.

Trump did say that the American Health Care Act, which was passed in the House on May 2017 and which Cramer voted for, was "mean." It’s worth pointing out that Trump also said the the Republican health plan was a "great plan." Trump didn't specifically say it was mean because of how it handled pre-existing conditions, but that was certainly one of the controversial aspects of the bill. The statement is accurate but needs additional information. We rate the statement Mostly True.