Two healthcare issues the Tuesday presidential debate will highlight are the coronavirus pandemic and Obamacare. While former Vice President and Democratic nominee Joe Biden looks to have the advantage on those issues, President Trump will have his opportunities to counterpunch.
The pandemic ranked second as the most important issue for voters, according to a recent Kaiser Family Foundation poll, with 20% saying it will decide their vote for president. Healthcare ranked fifth, with 10% saying it was the most important issue.
“I think this is a topic that, in theory, should be favorable to Joe Biden given that we just passed 200,000 deaths” from COVID-19, said Aaron Kall, the director of debate and a dean at the University of Michigan. “It appears that hot spots are breaking out, and cases and hospitalizations are increasing again. … The numbers aren’t as good, so there is a lot of meat for Biden to attack in terms of how Trump has handled the pandemic.”
“You can expect Biden to hit him on the various failings and miscommunications within the administration,” said Jack O’Brien, finance editor at HealthLeaders, a healthcare media company.
Most recently, Dr. Scott Atlas, a conservative neuroradiologist from Stanford who has become the top adviser to Trump on the coronavirus, has come under fire from both Dr. Anthony Fauci, the government’s top infectious disease expert, and Dr. Robert Redfield, the director of the Centers for Disease Control and Prevention.
Yet Cary Covington, a political science professor at the University of Iowa, doesn’t think there is much ground for Biden to gain on this issue. Rather, Trump faces the danger of losing voters.
“Trump has something to lose, probably among older voters who voted for him in 2016,” Covington said. “If he doesn’t show some empathy for COVID-19 deaths, which will be hard for him, that may lead some voters to say, ‘Well, maybe he doesn’t have my vote.'”
Trump does have some positive accomplishments to tout.
“I would expect Trump to respond in a way that tries to highlight what you might say are some of the better responses the administration has had, like providing ventilators and Operation Warp Speed [to speed up a vaccine],” said O’Brien.
Trump can also be expected to bring up his administration’s plan to distribute 150 million rapid coronavirus tests.
Obamacare, also known as the Affordable Care Act, has become front and center since Trump nominated Judge Amy Coney Barrett to replace the late Supreme Court Justice Ruth Bader Ginsburg.
“It magnified Obamacare, but it still would have been a timely issue without it,” said Kall.
A week after Election Day, the Supreme Court is scheduled to hear a case, California v. Texas, involving Obamacare’s individual mandate, the law’s controversial requirement that people must buy health insurance or pay a fine. The Republican attorneys general who brought the case claim the mandate was made unconstitutional when it was set to $0 by Trump’s 2017 tax overhaul. They argue that, since the mandate was considered an essential component of Obamacare and it has been removed, the entire law must fall.
How Barrett will rule on that question likely plays to Biden’s strengths, with many voters who lost their jobs during the pandemic worried about health coverage.
“Biden might put out a public option, like he did in the primary debates,” said O’Brien. “I think he’ll roll it out and say it is a gradual approach, it is not a government takeover, but it is something where more people are able to get covered, which is something people are looking for.” A public option would be a federally run healthcare plan that would compete with the private sector.
O’Brien also noted that Trump has been promising to roll out his own healthcare plan and hasn’t yet done so. He was asked about it by Fox News’s Chris Wallace in July. Chances are, Wallace, who is one of the moderators, will bring it up again.
Grace Marie-Turner, president of the conservative healthcare group the Galen Institute, thinks Trump has some definite strengths on Obamacare.
“Premiums doubled under the first four years under Obamacare,” Turner said. “The benchmark plan in the Obamacare exchanges dropped 4% this year. Trump can say that he has given people more choices and lower costs via executive orders.”
She also claims that bringing up the public option has hazards for Biden.
“I hope Trump says that Biden clearly does not believe that Obamacare works because the centerpiece of his plan is to fix it with a public option,” she said. “It’s not working for millions of people who are losing their coverage because you’ve made it so expensive.”
Biden will also have to step around the possible landmine of former President Barack Obama’s promise that “if you like your healthcare plan, you can keep your healthcare plan.” Somewhere between 2.6 million and 4.7 million people lost their health plans under Obamacare.
“That was probably Barack Obama’s biggest misleading statement,” said Covington. “There is a defense of those words [for Biden], but when you are playing defense, you’re losing. And so, Trump will try to use that.”
Covington also said that Trump’s overarching objective will likely not be to hit Biden on particular policies. Rather, he’ll look for openings to knock Biden off stride.
“He trades in throwing other people off their footing, and that is Trump’s go-to strategy,” he said. “He will look for openings to make Biden uncomfortable. The substance of Biden’s answer won’t matter to voters. What will matter is his demeanor. If he answers it calmly and confidently, it’ll be fine. If he hems and haws, that will work against him.”
