October 8, 2020

Weekly line: Our takeaways from the biggest health care clashes in the VP debate

Daily Briefing

    The 2020 presidential race has been anything but ordinary, as America's coronavirus epidemic has altered just about every aspect of the race—from the way candidates campaigned to the way they've debated.

    The 2020 elections—and what they mean for health care

    Last night's debate between vice-presidential candidates Sen. Kamala Harris (D-Calif.) and current Vice President Mike Pence (R) was no exception, with the candidates seated more than 12 feet from each other and a plexiglass barrier between them—measures intended to protect the candidates from possible coronavirus transmission.

    And as the scene offered a visual reminder of the epidemic, the epidemic—along with some other health care issues—dominated much of the debate, as well. Here's what the candidates said, and some key takeaways to keep in mind.

    America's coronavirus epidemic: Candidates square off on a plan, vaccine

    USA Today's Susan Page, who moderated last night's debate, kicked off the event by asking Harris and Pence a series of questions focused on America's coronavirus epidemic.

    During her responses, Harris—much as her presidential candidate running mate, former Vice President Joe Biden (D), did in his recent debate with President Trump—said the Trump administration mishandled America's response to the epidemic, calling their response "the greatest failure of any presidential administration in the history of our country."

    Harris cited reports from interviews in which Trump said he initially downplayed the epidemic to avoid creating "panic" in the United States. She also claimed that Trump had dismissed the novel coronavirus as "a hoax" and minimized the epidemic, which she said cost more than 200,000 Americans their lives.

    Further, Harris alleged that the Trump administration still doesn't have a plan to get America's coronavirus epidemic under control. In contrast, she said, Biden has released plans that call for a national strategy focused on contact tracing and testing for the coronavirus, as well as ensuring a vaccine can be distributed to all Americans at no cost to them.

    Pence, by contrast, said Trump and his administration "from the very first day" has put "the health of America" first. Pence said Trump quickly suspended all travel from China, which Pence claimed saved hundreds of thousands of lives.

    In addition, Pence said the Trump administration worked to revamp testing, ensure medical workers had adequate protective equipment, and launched an effort to create a vaccine against the virus—which Pence said America should have by the end of this year.

    Ultimately, Pence said that Biden's proposals to combat the coronavirus are similar to what the Trump administration already is doing. "When you look at the Biden plan, it reads an awful lot like what President Trump and I and our task force have been doing every step of the way," he said.

    Later, Page noted that a recent ceremony at the White House has emerged as a suspected source of a coronavirus outbreak among top federal officials, and that many staff at the White House have frequently been observed not practicing physical distancing or wearing face masks—strategies touted by public health experts to reduce the coronavirus' potential spread. She asked Pence whether the Trump administration is leading by example.

    Pence did not answer directly, but he said Americans have demonstrated that, when they're given facts, they'll do what's needed to protect themselves and others.

    Pence also alleged that Harris and Biden are undermining Americans' confidence in a vaccine—which he said is "unacceptable." Pence was referring to Biden's and Harris' public comments about potential political influence over federal agencies' efforts to evaluate a vaccine.

    Harris countered that if public health professionals and scientists, such as National Institute of Allergy and Infectious Diseases Director Anthony Fauci, say a coronavirus vaccine is safe and effective, she'll be "first in line" to get it—but she won't get the vaccine if Trump is the only one pushing for the vaccine.

    Key takeaways

    Christopher Kerns—vice president of executive insights for Advisory Board, which publishes the Daily Briefing—said that while "the mostly civil nature of" last night's vice-presidential debate "distinguished" it from last week's presidential debate, "the overall shape of the health care discussion was in almost every respect a repeat of the prior debate."

    "Harris predictably attacked the Trump administration's response while Pence unsurprisingly defended it, and neither candidate offered anything beyond what has been widely reported on what they would do next," Kerns said.

    However, Kerns said, "the one exception was the subtle change in rhetoric coming from" Pence regarding the timing of when America might have a vaccine against the novel coronavirus. Kerns noted that Pence "referenced a promised a vaccine by end of year, rather than prior to the election," as Trump has touted. Kerns suggested that Pence's comments "represent a cessation of opposition (at least for now) to stricter vaccine guidelines" that FDA published this week, "which will likely push limited approval for any vaccine past Election Day."

    The ACA: Candidates clash over protections for people with pre-existing conditions

    Also as in last week's presidential debate, the Affordable Care Act (ACA) emerged as a point of contention.

    Harris several times noted that the Trump administration is supporting a lawsuit currently before the Supreme Court that seeks to strike down the health reform law. The Court is scheduled to hear oral arguments in the case on November 10—one week after the presidential election.

    Harris explained that striking down the entire ACA means the law's insurance protections for Americans with pre-existing medical conditions would be eliminated, as well as portions of the law that allow young adults to remain on their parents' health plans until age 26. Further, she noted that striking down the law could lead to about 20 million Americans losing their health coverage.

    Harris noted that Biden has released a health reform proposal that seeks to expand the ACA, implement a so-called "public option" health plan, and lower the Medicare eligibility age.

    In response, Pence called the ACA a "disaster," and he said Trump and his administration have promised to "protect every single American with pre-existing conditions."

    Key takeaways

    Kerns noted that although Harris "voiced support for a public option for health coverage," she "offered no details on how it should or would work."

    Likewise, while Pence "reiterated the Trump administration's support for keeping protections" for individuals with pre-existing conditions in place, he did so "without elaborating on the regulatory authority that could maintain them," Kerns said.

    And it's worth noting: Many legal experts have said the actions Trump has taken so far regarding protections for people with pre-existing conditions have been largely symbolic, and those actions haven't included detailed or binding proposals that would ensure the protections endure if the ACA is eliminated.

    Looking forward: Another (possibly) unique debate, thanks to the coronavirus

    The next debate in the 2020 presidential race is scheduled to be held Oct. 15 between Trump and Biden. And while we likely can expect the debate will once again touch on the same health care issues, the debate itself will be remarkably different—if it takes place.

    On Thursday, the Commission on Presidential Debates announced that, because of Trump's recent Covid-19 diagnosis, the commission would no longer hold the debate in person and instead would proceed in a virtual format.

    Kate Bedingfield, a deputy campaign manager from Biden's camp, said Biden would participate in the new, virtual debate.

    Trump, however, dismissed the change as "ridiculous" and said he wouldn't participate. During an appearance Thursday morning on Fox News, Trump said, "No, I'm not going to waste my time on a virtual debate. … That's not what debating is all about. You sit behind a computer and do a debate—it's ridiculous."

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