IASHINGTON – For the most part, substantive health policy debates between President Biden and former President Trump were overshadowed by mistakes, gaffes and blatant falsehoods in Thursday night’s presidential debate.
Biden struggled to articulate his accomplishments in office and points of contrast with Trump on health care. Trump misrepresented how federal programs work, inflated policies during his tenure and simply evaded some questions.
Trump shed more light on his stance on abortion policy, while Biden touted his support for abortion rights and efforts to lower drug prices.
But an exchange on Medicare filled with fuzzy lines and falsehoods turned out to be more of the norm. Instead of having a serious debate about how to fund the program, a misstatement by Biden opened the door for Trump to respond with a false statement.
At one point, Biden mistakenly said that “we finally beat Medicare,” something Trump repeated in his response.
“Well, he’s right. He beat Medicare,” the former president said. “He destroyed it to pieces, and he’s destroying Medicare, because all these people who come to Medicare are being put on Medicare.” (Trump did not explain how he would shore up Medicare’s solvency.)
People who immigrate to the United States illegally are not eligible for the Medicare program. While the Medicare hospital fund is projected to be insolvent by 2036, that is five years later than the previous projection.
Biden also got it wrong when he talked about his signature achievements on drug pricing, passed in the Inflation Reduction Act.
It stated that costs for seniors were limited to $15 per month for insulin instead of the $35 cost-sharing limit set by law, and it claimed that drug costs were limited to $200 instead of $2,000 per year.
abortion
Biden stumbled when asked about his stance on abortion policy, failing to tap into one of his strongest themes among voters. Sixty percent of Americans believe the June 2022 Dobbs decision that struck down Roe’s nationwide protections for abortion was a “bad thing,” according to a Gallup poll this month.
Trump misleadingly portrayed overturning Roe in 2022 as a universally popular measure, saying “everyone wanted to send it back to the states… without exception, Democrats, Republicans, liberals, conservatives.”
But Trump also said for the first time that he would not “block” access to the abortion pill mifepristone after the Supreme Court ruled unanimously on June 13 that anti-abortion doctors had no standing to challenge the U.S. regulation of the pill. Food and Drug Administration.
That statement does not prevent him from introducing new restrictions on the drug. Some conservatives have proposed resurrecting the 150-year-old Comstock Act to block mail-in prescriptions for the pill; Justices Samuel Alito and Clarence Thomas asked the Biden administration’s lawyer about the law during arguments in the case in April.
Trump’s statement reflects his awareness that most Americans do not want broad abortion bans. He highlighted the importance of exceptions to the abortion ban in cases of rape, incest and danger to the life of a pregnant person. The former president has distanced himself from outright bans in recent months, saying members of his party “mishandled” the fallout from Roe by not prioritizing exceptions.
Reproductive rights advocates argue that exceptions don’t work in practice and unnecessarily endanger patients’ health, as illustrated by the Idaho abortion ban case that the Supreme Court returned to a lower court Thursday. tomorrow. Lawyers for the Biden administration told the court that since Idaho implemented the law, hospitals have airlifted at least six pregnant women with serious complications to neighboring states because of concerns about penalties.
Asked whether he would support any abortion restrictions, such as extremely rare third-trimester procedures, Biden said he supports the protections laid out in Roe v. Wade but stumbled in explaining them.
“We are not in favor of the late-term abortion period – period – under Roe v. Wade,” Biden said, using a phrase that abortion rights advocates and obstetricians have encouraged. The phrase “late-term abortions” has “no medical meaning” and is not used in practice, the American College of Obstetrics and Gynecology said.
But Biden did reject Trump’s “ridiculous” claim that overturning Roe is universally popular. “The idea that states can do this is a little bit like saying we’re going to give civil rights back to the states, but each state has a different role,” he said.
Insulin costs and drug prices
The two candidates later sparred over taking credit for lowering insulin costs.
Trump tried to take credit for limiting costs for seniors, saying, “I’m the one who lowered insulin for seniors. I took care of the elderly.”
Trump implemented a Medicare pilot project that allowed drug manufacturers and plans to voluntarily offer at least one insulin for $35 a month. An evaluation of Trump’s insulin experiment showed that people who used insulin in the pilot plans reduced their out-of-pocket costs and got an extra 30 days of prescription a year.
Biden claimed that only one company participated in the Trump-era pilot, which is not true since all three major insulin manufacturers participated. However, under the Biden administration, the policy became larger and more permanent when Democrats in Congress codified a $35 per month insulin copay limit for Medicare patients as part of the passed Inflation Reduction Act in 2022.
Under the new law, offering covered insulins at $35 a month became mandatory, not optional, for more insurance plans. The legislative limit also applies to insulin administered through a pump.
In his closing statement, Biden stumbled over an accusation that Trump would repeal Medicare’s new authority to negotiate drug prices.
Response to Covid-19
Trump also criticized Biden’s response to COVID-19. While he took credit for the development of coronavirus vaccines and therapies, he said Biden-era vaccination requirements were a “disaster for our country” and that more people died from the virus during the Biden administration.
The pandemic began during the final year of Trump’s presidency. While the Centers for Disease Control and Prevention recorded more Covid-19 deaths during Biden’s term, deaths per week peaked during Trump’s presidency.
“Often everything went well, but what we never got credit for, and we should get credit for, was getting us out of the Covid mess,” Trump said.
The drug addiction and overdose crisis
Biden and Trump were asked how they would help Americans struggling with addiction and getting treatment.
Each of them offered devious answers that pointed to border security. Biden mentioned drug-detecting machines. Trump touted drug-sniffing dogs.
But one word was conspicuously absent from their responses: “treatment.”
This is particularly noteworthy because Biden has pushed a number of substantial policies, such as harm reduction and increased access to methadone and buprenorphine. The number of overdose deaths, while still near a record high, declined slightly from 2022 to 2023.
The ages of the candidates
Toward the end of the debate, moderators asked both candidates how they would respond to voters’ concerns about their age and abilities, a question that has loomed large in both campaigns.
Biden said he was the second-youngest person ever elected to the Senate, but largely avoided discussing his age and mental acuity, instead focusing on claims about technology investments during his tenure.
That answer seemed unlikely to satisfy viewers after more than an hour of errors and confusion. Biden also had a hoarse voice, which he attributed to a cold.
“This debate (is) making it abundantly clear that Biden’s insistence on running for another term — when 66% of voters in our survey in the key swing state believe he is unlikely to be able to complete a second term — has seriously jeopardized (Democrats’) prospects of defeating Trump,” Dave Wasserman, an election analyst at Cook Political Report, wrote in X.
Trump said he had passed two cognitive tests with “flair” — a claim that has been disputed by the test’s creators — and recently won two golf championships. “I’m in very good health,” he said. “I’m in very good shape.”
Lev Facher contributed to this report.
