President Biden and former President Donald Trump began their first debate on the coronavirus response on Thursday night. Both candidates closed the debate by touting their health care bills, with Biden talking up his efforts to lower drug prices and Trump talking up his plans to expand access to experimental drugs to terminally ill patients. In between the debate, the two candidates sparred over their stark differences on abortion access, Obamacare and other health care priorities for about 90 minutes.
There's a reason health care has come up again and again: It's an issue that has determined elections for more than a decade. Hostility to President Barack Obama's signature health care law, Obamacare, spawned the Tea Party movement and a wave of conservative support that helped Republicans take the House of Representatives in 2010, the Senate in 2014, and the White House in 2016.
But the political advantages have flipped in recent years: Biden successfully attacked Trump's COVID-19 response ahead of the 2020 presidential election, and the fight over abortion rights helped Democrats retake the House of Representatives in 2022.
Polls show health care remains a key priority for voters this year: About 80% of voters said affordability was a “very important” concern, according to a February poll by the nonpartisan health policy group KFF.
Biden and Trump spoke about health care:
Asked about abortion, perhaps Democrats' strongest political advantage this year, Biden struggled to give a coherent response. He pointed to Trump's appointment of three Supreme Court justices who helped overturn Roe v. Wade two years ago and denounced Trump's efforts to strip away the constitutional right to an abortion, which Biden said has led to suffering for women across the country seeking basic health care.
Trump countered that his Supreme Court appointments helped overturn Roe, thus successfully pushing the abortion issue onto the states.
But the former president has also had trouble speaking about the issue, including inaccurately claiming that the Supreme Court “approved the abortion pill.” The court did not rule on the legality of mifepristone, instead dismissing a lawsuit that would have restricted the drug, finding that the plaintiffs lacked standing to sue.
Trump also accused Biden of supporting abortion up to birth, to which Biden responded, “You're lying. That's simply not true.” Trump made other claims that medical groups say are false. [Democrats] “The biggest problem they have is the radicalism of taking a child's life at eight months, nine months, even just after birth,” Trump said. Killing a person after birth is illegal.
Biden has spoken enthusiastically about working to lower drug prices, bringing up the issue multiple times, sometimes unprompted.The White House sees this as an advantage for him, given that years of polling show Americans are unhappy with high prescription drug prices and with a series of drug pricing reforms included in Democrats' landmark 2022 legislation, the Stop Inflation Act.
The law includes changes such as giving Medicare the power to negotiate directly with drug companies, capping out-of-pocket costs for seniors and imposing penalties on drug companies that raise drug prices faster than the rate of inflation.
“Repealing the Contract with Inflation Act would mean higher costs for prescription drugs and many other areas,” Neera Tanden, the president's domestic policy adviser, said in a speech Wednesday to the left-leaning Center for American Progress think tank, noting that Republicans have targeted the law.
But Biden struggled to communicate what his administration had actually done. At one point he claimed “we finally won Medicare,” when he probably meant “we finally won the drug companies,” a gaffe that Trump used to mock Biden. The president at one point claimed he had lowered the cost of insulin to “$15” a dose, but his administration had actually overseen an effort to cap insulin copays to $35 a month for many Americans.
Trump appeared to be annoyed by Biden's comments about drug prices, claiming the current president was wrongly taking credit for it. “I was the one who lowered the price of insulin for seniors,” Trump said.
There is some truth to Trump's argument: His administration has pursued lower insulin costs, including through a Medicare pilot program, but Biden's team has gone a step further, writing insulin cost cuts into law.
The KFF poll also found that the law's popularity has grown since President Trump and Republicans tried to repeal it in 2017, with 6 in 10 Americans now having a favorable view of the law. Biden jumped on that positive sentiment during the debate, noting that tens of millions of people have health insurance thanks to the law.
As expected, Biden criticized Trump's previous efforts to weaken or replace Obamacare and accused him of targeting Americans' health care. Nationwide, 45 million people have health insurance through the Obamacare insurance marketplaces and Medicaid expansion, more than triple the number enrolled in 2014, according to the Department of Health and Human Services.
Biden is being credited with expanding enrollment aid that was cut by President Trump.
Trump did not directly respond to Biden's comments. Trump has been a contradictory candidate, saying he will never give up on repealing the health care law while at the same time denying that he is running on a platform of repealing the ACA.
The debate's first health topic was the issue that animated the 2020 election: COVID-19. Trump criticized Biden for making vaccinations mandatory, noting that COVID-19 deaths have risen under Biden's leadership. Biden highlighted that Trump had told Americans to drink bleach, a misinterpretation of Trump's suggestion that they should consider injecting disinfectant into their lungs.
The commentary comes as the United States grapples with the threat of avian flu outbreaks and the growing risk of dengue fever.
As the coronavirus pandemic has made clear, the candidates have vastly different views on how to respond to a national health crisis.
While Trump shifted the blame to states and publicly criticized the role of federal agencies, Biden took office the following year and coordinated a government-wide response, instituting mask and vaccine mandates.
In a recent interview with Time magazine, President Trump said he would probably disband the White House Office of Pandemic Preparedness and Response Policy, which Biden created.
Current projections suggest Medicare will run out of funds by 2036, and its solvency was a constant topic throughout the debate.
Biden, in his closing argument, emphasized the billions of dollars he has saved Medicare by cutting drug costs and tried to point to his efforts to protect the program throughout the debate. Biden has previously said he wants to raise taxes on high-income earners to fund the program, which Americans over 65 rely on for health insurance, and he spoke about doing so during the debate.
In contrast, Trump raised premiums for high-income earners but signed tax cuts that depleted Medicare funding and eliminated a commission set up to rein in Medicare spending. During the debate, Trump argued that Biden was hurting Medicare by allowing immigrants into the country, so that over time, immigrants who are legally in the country can qualify for Medicare.
Some Republican lawmakers have previously proposed raising the Medicare eligibility age to make the program more affordable, an unpopular idea that neither candidate has offered.
More than one in five Americans is covered by Medicaid, a health insurance program for low-income and disabled people, but the program barely featured in the debate, except when Trump argued that immigrants are draining funds from the program, most of which must wait five years to qualify for Medicaid.
But the candidates have very different approaches to the program. Trump previously supported adding work requirements for Medicaid enrollees and converting Medicaid funding into block grants to states. Biden has reversed Trump's efforts to impose Medicaid work requirements and has encouraged expanding coverage to eliminate disparities.
