Vance spoke about coverage continuing, but putting people with pre-existing, chronic conditions in a different "risk pool" from people who have no such conditions. The current ACA requires insurance companies to put the insured into the same risk pool so that those with chronic conditions don't have to pay significantly more. If that were changed it could price some people out of coverage or cause their premiums to skyrocket.
I don't think Trump has spoken much about this, but maybe I missed it.
As far as abortion goes, I'm not so sure his pushing it back to the states is the end of the story. I'm interested to see how that vote goes in Missouri. The GOP in Missouri tried everything they could to keep it off the ballot. That blew my mind, let's not allow the people to vote on it.
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