'He thinks he's running against somebody else': Trump, Biden spar over health care at presidential debate

Christopher Wilson
·Senior Writer
·4 min read

President Trump’s attempt to paint Democratic nominee Joe Biden’s health care plan as a government takeover of the medical industry was met with stiff resistance in the second and final presidential debate Thursday night.

In Nashville, Tenn., Trump said that Biden’s plan, which would provide a “public option” that gives Americans the ability to buy into a government plan, would eliminate private insurance. But the former vice president, who frequently sparred with his more left-wing Democratic primary rivals over the issue, insisted that he would leave private insurance alone.

Biden shot down what he called “the idea that I want to eliminate private insurance.” He argued that his differing view on this issue was the “reason why I had such a fight with 20 candidates for the nomination.”

“I support private insurance,” he said, “that’s why not one single person with private insurance would lose their insurance under my plan.”

“When he says public option, he’s talking about socialized medicine and health care,” Trump said of Biden, referring to government-run health care programs. He added, “When he talks about a public option, he’s talking about destroying your Medicare,” which is a government-run health care program.

Joe Biden speaks during the second and final presidential debate Thursday, Oct. 22, 2020, at Belmont University in Nashville, Tenn. (Julio Cortez/AP)
Joe Biden speaks at the second and final presidential debate on Thursday, Oct. 22, at Belmont University in Nashville, Tenn. (Julio Cortez/AP)

Trump then began discussing the single-payer plan supported by Sen. Bernie Sanders, the Vermont independent, and by many Democratic primary voters, which would provide government-funded insurance for all Americans.

“He’s a very confused guy, he thinks he’s running against somebody else,” Biden replied. “He’s running against Joe Biden. I beat all those other people because I disagreed with them.”

Trump returned to his promise that he would soon unveil a “beautiful” health care plan. The president, however, has promised for years that he would release a replacement for the Affordable Care Act, otherwise known as Obamacare, but has never done so.

“What I would like to do is a much better health care, much better — we’ll always protect people with preexisting, so I’d like to terminate Obamacare and come up with a brand-new beautiful health care,” Trump said, discussing what he would do to improve health care. “The Democrats will do it because there will be tremendous pressure on them, and we might even have the House [of Representatives] by that time, and I think we’re going to win the House, OK?”

Republicans had control of both houses of Congress during Trump’s first two years in office, but were unable to repeal and replace the Affordable Care Act. Trump’s optimism notwithstanding, there are no nonpartisan analysts who expect Republicans to retake the House next month, and there’s a possibility that Democrats could build on their majority.

After the GOP was unable to eliminate Obamacare in Congress, Republican-governed states turned to the courts, bringing a lawsuit that would have the effect of overturning the ACA, which the Trump administration has joined. The case is set to be heard by the Supreme Court next month, and if Republicans succeed in seating Judge Amy Coney Barrett, she could cast the deciding vote.

Without the protections for preexisting conditions provided by Obamacare, the Kaiser Family Foundation estimated in 2016 that up to 52 million people could be denied coverage. Millions more would lose insurance if the ACA’s Medicaid expansion were thrown out. A full repeal with no immediate replacement plan could also jeopardize the fight against opioid addiction and HIV. Meanwhile, the coronavirus has killed more than 220,000 Americans and left many others with lingering health issues.

Last month, Trump rolled out a plan that he said would protect people with preexisting conditions, but it was little more than a slogan, rather than a proposal for legislation. White House officials said that his “protections” for preexisting conditions would not stand as law should the ACA be repealed, but were a “defined statement of U.S. policy.”

If the ACA is overturned by the Supreme Court, a “defined statement of policy” does not provide a legal mechanism that could prevent insurance companies from refusing coverage to those with preexisting conditions, or charging so much for insurance as to make it unaffordable in practice.

“There’s no way he can protect preexisting conditions,” Biden said of Trump, returning to an attack from the first debate. “None. Zero. You can’t do it in the ether. He’s been talking about this for a long time. He’s never come up with a plan.”

Biden was also asked what he would do if the Supreme Court overturned the ACA in next month’s hearing — and coined a new phrase in the process.

“What I’m going to do is pass Obamacare with a public option,” Biden said. “Become Bidencare.”

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