As of 26 October, the United States continues to record the world’s highest number of COVID-19 cases at over 86 lakh, and the world’s highest COVID-19-related deaths at over 2.25 lakh. Although President Donald Trump has cited several reasons for the situation in his country (including pushing conspiracy theories), and has insisted repeatedly that the pandemic is “going away”, the issue has taken centre stage in this year’s presidential debates. In the final presidential debate in Tennessee this year, Trump said “we’re learning to live with” the coronavirus. Democratic nominee Joe Biden interrupted the president and said, “We’re learning to die with it”.
Biden and Trump also disagree fundamentally on broader issues of healthcare in America. The main bone of contention between the two candidates has to do with the degree of the federal government’s involvement in citizens’ healthcare issues; while Trump wants to reduce the national government’s role, Biden plans to expand it. This has a direct effect on health insurance coverage, medicine prices and the Affordable Care Act.
Where Trump stands
President Trump, who tested positive for COVID-19 earlier in October, has squarely and consistently blamed China for the coronavirus outbreak, although he recently hinted at taking responsibility for the situation in the United States. However, he is fighting the election on the basis of what he says he achieved towards minimising the damage.
In terms of policy, Trump established a White House Coronavirus Task Force which “coordinates and oversees the administration’s efforts to monitor, prevent, contain, and mitigate the spread of the virus”. A Coronavirus Global Response Coordination Unit was also set up to coordinate international action through diplomatic and economic channels. In addition to these, Operation Warp Speed was set up to “produce and deliver 300 million doses” of effective vaccines by January 2021. In an unprecedented move, Trump also halted funding and pulled out of the World Health Organisation this year over the institution’s handling of the coronavirus pandemic.
However, when it comes to the specifics of the coronavirus response such as contact tracing, devising institutional restrictions and acquisition of key medical equipment, the Trump administration has palmed off the responsibility to the states.
Among other healthcare issues, Trump has sought to repeal the Affordable Care Act and replace it with a better alternative since the day he took office, but has been unable to achieve either so far. Among many critical provisions, Barack Obama’s signature healthcare Act protects citizens with pre-existing conditions from being denied health coverage. Although Trump has promised to keep this part of the law, he is yet to explain how. This is significant as the number of Americans without medical insurance continues to rise.
When it comes to Medicare (the federal programme for people over 65) and Medicaid (the health programme for low-income households and people with disabilities), Trump has sought to reduce drug prices and provide private plan alternatives to Medicare beneficiaries while supporting spending caps for those under Medicaid.
Where Biden stands
From wearing masks at every public gathering to reiterating that he will follow “scientific advice” while designing policy, Biden has made an effort to be seen as far away from Trump’s stand on COVID-19 as possible, painting the president as a clueless leader who does not care. While healthcare in general has been at the top of Biden’s agenda, the former vice-president has ensured in his rallies that the focus does not shift away from Trump’s handling of the pandemic.
Biden has proposed a seven-point plan to deal with the coronavirus in the United States if elected. This includes vastly improved testing capacity, ramping up production of personal protective equipment (PPE), investing $25 billion in a vaccine plan to guarantee every American access to free COVID-19 vaccines, and establishing a COVID-19 Racial and Ethnic Disparities Task Force. Biden has also promised to implement a national mask mandate and “immediately restore” United States’ relationship with the World Health Organisation.
It's clear Donald Trump will stop at nothing to tear down Obamacare.
We can't let him. pic.twitter.com/ytaqBBd8DW
— Joe Biden (@JoeBiden) October 25, 2020
On the Affordable Care Act, Biden has proposed further bolstering the health insurance law by expanding federal subsidies and implementing a plan which will insure “an estimated 97 percent of Americans”. He has also proposed lowering the age of eligibility under Medicare from 65 to 60, in addition to creating a new federal health insurance programme like Medicare, which he said would be a public option. The two presidential candidates agree on the need to bring down prescription drug prices and end surprise billing at health facilities. Biden promises to do away with the existing laws that prevent Medicare from negotiating lower prices with drug corporations.
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