Healthcare Takes Backseat in Biden-Trump Debate. Biden's Age Not So Much

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The presidential candidates didn't spend a lot of time talking about healthcare issues last night, but Democrats are concerned about Biden's performance, especially early on.

Although healthcare issues were mentioned largely in glancing fashion during last night’s acrimonious debate between President Joe Biden and former President Donald Trump, both men attempted to work them to their advantage in talking about economic, immigration and other issues.

But the health-related issue that may have the biggest effect in the debate’s aftermath could be Biden’s age and perceptions that he is frail. Especially at the beginning of the debate, Biden, who is 81, spoke in a muffled, raspy voice and wound up in verbal dead ends as he seemed to lose his train of thought. His campaign said he was suffering from a cold.

When asked directly about his age, Biden said about Trump, “This guy’s three years younger and a lot less competent.” In that part of the debate the two men got into an exchange about their fitness and golf handicaps.

Polling suggests that abortion rights may be the health issue that has the most influence on voter. When moderator Dana Bash asked them directly about their views on abortion, Trump said he would not block access to abortion medication and defended the overturning of Roe v. Wade and returning abortion rights to state-level lawmakers and courts. He said he favored exceptions to abortion bans in cases of incest, rape or life of the mother.

Biden defended Roe v. Wade and compared returning abortion law and rights to states to letting states decide about civil rights. When asked about late-term abortion, Biden said the law under Roe v. Wade only allowed them when the woman’s life is in danger. “But we are not for late-term abortion — period, period, period.

Despite healthcare’s relatively minor role the debate, there were hints of issues that Democrats and Republicans may emphasize in their campaigns — or have done so already.

For example, Biden referenced the monthly cap on insulin out-of-pocket costs for Medicare beneficiaries that was part of the Inflation Reduction Act (IRA) of 2022 in both his response to the debate’s opening question on inflation and in his closing statement. An Associated Press factcheck noted that Biden exaggerated, as he has in the past, the insulin out-of-pocket costs before the cap went into effect.

And without naming the IRA, Biden also mentioned in his closing remarks the IRA provision that sets a $2,000 limit on Part D out-of-pocket costs that goes into effect next year.

Biden’s other mentions of healthcare-related issues included a reference to the Affordable Care Act’s (ACA) prohibition on insurers refusing or charging more for health insurance for people with pre-existing conditions. Biden was vice president when the ACA was signed into law by President Obama and he has stake out a position of strengthening it. In an exchange with Trump about veterans, Biden took credit the PACT Act that expanded Department of Veteran Affairs (VA) healthcare and benefits to veterans exposed to burn pits, Agent Orange and other toxic substances. 

Trump circled back repeatedly to the issue of immigration and border control. In that context, he accused Biden of "destroying Social Security, Medicare and Medicaid” by allowing people to enter the country illegally.

In his closing statement, Trump mentioned the Right to Try Act, which he signed into law in 2018. It allows people with terminal conditions to try unapproved, investigational treatments outside of a clinical trial.

At another point in the debate, Trump took credit for the Veterans Choice Program that allows veterans to get care outside of the VA system. Obama signed into law the legislation that created the program. In 2017, Trump signed into law an expansion of the program.

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