In his 2014 address to the American Enterprise Institute in 2014, Pence told crowds that "when it comes to the issue of health care, I believe that people in my party need to be 'solutions conservatives,' offering real alternatives to the big government answers of the liberal establishment … Fortunately, Hoosiers have found a better way. In Indiana, we have learned that the way to change Medicaid is to base the program on what we know improves health and lowers costs, namely consumer-driven health care using health savings accounts."

Planned Parenthood

His policies regarding women's health issues have also drawn stern criticism. While serving in Congress, he introduced a bill to cut federal funding from Planned Parenthood so long as facilities associated with the organization continued to conduct abortions.

As governor, he spearheaded a succession of legislative hurdles for abortion clinics under clear intention of complicating attempts at obtaining the procedure. A state law passed this spring would demand burial or cremation of all fetal remains (even those resulting from miscarriage), prevent abortions initiated due to genetic abnormalities, and require a preliminary ultrasound 18 hours beforehand.

While Pence's staunch opposition to abortion represents a lifelong crusade, Donald Trump only declared his support for the "pro-life" movement in 2011.

In prior years, Trump had donated to candidates fiercely protective of women's reproductive rights, and, as recently as last March, applauded Planned Parenthood for helping millions of women without other recourse. Political insiders have speculated that the choice of a conservative firebrand like Pence was meant to reassure members of the Republican Party's evangelical wing still uncertain about Trump's commitment to conservative ideals. When Trump announced his choice, the Clinton campaign's response was immediate: "Pence is perhaps the most extreme VP pick in a generation."

ACA expansion

Nevertheless, with 19 states still holding out against further acceptance of the ACA, expansion within an ostensibly Republican state was still considered a presidential victory by many observers.

During a July 14 briefing, in what was widely viewed as an oblique taunt at the opposing party, White House Press Secretary Josh Earnest responded to a question about the presumptive Republican vice presidential nominee by noting only "that Governor Pence did do some important work with the administration to expand Medicaid in his state … something that President Obama has been encouraging Democratic and Republican governors across the country to do."

While health coverage promises to be a central battleground during the presidential campaign, surveys have repeatedly found the electorate to be deeply conflicted about the government's role.

According to a Gallup poll released in May, a significant majority of Americans over the age of 18 (including 41 percent of Republicans) favor a single-payer system similar to the "Medicare for all" plan proposed by candidate Bernie Sanders. However, nearly half of all respondents also welcomed the Affordable Care Act's repeal even without a clear alternative to take its place.

Republican presidential front-runner Donald Trump initially appeared to tap into both the public's confusion and general distress, but pundits have argued that his campaign has yet to deliver a comprehensive plan.

An April 8 New York Times analysis entitled "Donald Trump's Health Care Ideas Bewilder Republican Experts" struggled to delineate a practical policy from the candidate's various proposals. Within the article, economist (and avowed Obamacare foe) Thomas P. Miller compared Trump's platform to "the efforts of a foreign student trying to learn health policy as a second language."

Meanwhile, though the amended Healthy Indiana Plan pushed forward by Governor Pence attracted criticism from both sides of the ideological aisle, the eventual 'HIP 2.0′ reportedly extended protection to more than 150K otherwise uncovered residents within the program's first year.

In November 2015, the Indiana Hospital Association honored Pence with its annual Health Policy award in appreciation for his efforts. "HIP 2.0 has led to tremendous improvements in patients seeking preventive care," said IHA president Doug Leonard. "Thanks to the partnership between hospitals and the Pence administration, we firmly believe our state has turned a corner, and that HIP 2.0 will lead to lasting improvements in the health of Hoosiers for generations to come."