House Speaker Mike Johnson's suggestion that Republicans would undertake “massive reform” of the Affordable Care Act – known as Obamacare – is causing a bit of a headache for the Trump campaign.

At a campaign rally on Monday in Pennsylvania, a battleground state in the presidential election, Johnson made the statement.

“No Obamacare?” one event attendee asked Johnson.

“No Obamacare,” Johnson replied. “The ACA is so entrenched that we need major reforms to make this work, and we have lots of ideas about how to make that happen.”

Johnson didn't go into details but said Republican doctors in the House, known as the GOP Doctors Caucus, have been working on possible legislative ideas. The speaker said Republicans want to “take a blowtorch attack on the regulatory state” and “fix things in the health care sector.”

Health care is a key issue in the 2024 election, and both parties have different views on the ACA, which sets minimum standards for benefits, allows more people to qualify for Medicaid and ensures consumers with pre-existing conditions can have health insurance coverage.

“Health care reform will be an important part of the agenda. When I say we're going to have a very aggressive agenda for the first 100 days, we still have a lot of things on the table,” he said.

The speaker said: “Taking government bureaucrats out of healthcare and fostering a doctor-patient relationship is better, more efficient and more effective for everyone. This is the free market. Trump will be pro-free market.”

The Harris campaign sharply criticized Johnson's comments. Spokeswoman Sarafina Chitika said in a statement: “Speaker Mike Johnson is making clear: If Donald Trump wins, he and his Project 2025 allies in Congress will ensure there is 'no Obamacare.'” That means higher health care costs for millions of families and the loss of protections for Americans with pre-existing conditions such as diabetes, asthma or cancer. Voters see Trump's “plan concepts” for what they are: repealing the Affordable Care Act and raising prices, leaving millions of Americans without the care they need.

Former President Donald Trump's campaign quickly sought to distance itself from the speaker's comments. A spokeswoman told the New York Times that this is “not President Trump's policy position.”

The ACA has become increasingly popular since it went into effect in 2010. A KFF poll in February found that two-thirds of the public thought it was very important to maintain the law's ban on charging people with health problems higher rates for health insurance or denying them coverage.

Former President Donald Trump attempted to repeal the ACA while in office but failed.

“Obamacare was lousy health care. “It’s always been that way,” Trump said at ABC’s presidential debate. “It's not very good today and I said that if we think of something, we will work on it, implement it and replace it.”

Asked for details about what he would replace it with, Trump said he didn't have a specific plan, but rather “concepts of a plan.”

NBC News first reported the speaker's remarks.