A hot mess. A train wreck. A national embarrassment. Just plain annoying. It’s clear that the first presidential debate between President Trump and former Vice President Joe Biden was painful to watch. But before you look to purge all memory of the disturbing debacle — and President Trump’s outlandish, hectoring performance won’t soon be forgotten — here’s a look at some of the little substance, on health care specifically, that got intermingled with the interruptions, insults and mockery.
Protections for those with preexisting conditions: Biden used the first question of the night, about Trump’s nomination of Amy Coney Barrett to fill the late Justice Ruth Bader Ginsburg’s Supreme Court seat, to say that the future of the Affordable Care Act is at stake.
The Trump administration is backing a challenge to the Obama health care law that will be heard by the court on November 10. Biden said that the law’s protections for people with preexisting medical conditions could be wiped out and that there are 100 million people with pre-existing conditions. Trump disputed the number, but as Larry Levitt of the Kaiser Family Foundation points out, 54 million non-elderly Americans have a pre-existing condition that made them uninsurable before the Affordable Care Act and as many as 133 million had a condition that could have led insurers to decline coverage, exclude coverage of the condition or charge significantly higher premiums.
Biden and “socialist medicine”: Trump accused Biden of pursuing “socialist medicine,” trying to tie Biden to those in the Democratic Party who are pushing for a single-payer “Medicare for All” system. Biden, who does not support a single-payer system and is instead proposing a public option, pushed back. "The party is me. Right now, I am the Democratic party," he said.
When asked by moderator Chris Wallace whether his public option would, as Republicans and insurers argue, lead to the end of private insurance “and create a government takeover of health,” Biden said the public option would be limited to low-income people who would be eligible for Medicaid but whose states have not expanded the program under the Affordable Care Act. The Democratic platform says that the public option would also be available to people who are offered coverage through their jobs, Modern Healthcare notes.
Trump’s missing health care plan: Wallace said that the president has never issued a comprehensive plan to replace Obamacare. “Of course I have,” Trump said. “The individual mandate. Excuse me. I got rid of the individual mandate, which was a big chunk of Obamacare.”
Wallace pressed for more, and Trump touted his administration’s yet-to-be-implemented plans to lower drug prices. “Drug prices will be coming down 80 or 90%,” he claimed. Trump also claimed he has brought down the price of insulin. “I’m getting it for so cheap it’s like water,” he said.
The Trump administration has cut insulin costs for some seniors through a plan capping out-of-pocket costs at $35 a month, but as STAT’s Nicholas Florko explains, for most people, insulin still costs just as much as before.