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Trump, Biden Spar Over Health Care in Final Debate

President attacks the Affordable Care Act, while Biden supports addition of public option


spinner image the two candidates in the final presidential debate on october twenty second twenty twenty
Kevin Dietsch/UPI/Bloomberg via Getty Images

President Donald Trump reaffirmed his opposition to the Affordable Care Act (ACA), and former Vice President Joe Biden promised to expand the health care law he helped get passed with a public option as the two went head-to-head in the second and final presidential debate Thursday night in Nashville.

The 90-minute face-off at Belmont University covered a wide range of topics: COVID-19, the economy, race relations, immigration, national security and climate change. With 11 days to go until the Nov. 3 general election, more than 50 million Americans have already cast their ballots, either via early-voting centers or by mailing them in.

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On Nov. 10 the U.S. Supreme Court will hear arguments on whether to declare the ACA unconstitutional. The issue is in court, Trump said, “because Obamacare is no good.” The lawsuit against the health care law was originally brought by Texas and 19 other states. The Trump administration supports the suit. AARP has filed an amicus brief urging the high court to maintain the law.

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Where AARP stands on the issues

Social Security

• Medicare

• Prescription drugs

• Long-term care

• The economy

Trump promised that whatever the decision of the high court, protections for people with preexisting conditions “will always stay. … I’d like to terminate Obamacare and come up with a brand-new, beautiful health care.” The president did not provide any details on what kind of plan he would propose if the ACA were invalidated.

Asked by moderator Kristen Welker of NBC News what he would do if the Supreme Court declared the ACA unconstitutional, Biden said: “What I’m going to do is pass Obamacare with a public option,” adding that the law would become “Bidencare.” The former vice president said that under his plan, low-income people who could not qualify for Medicaid in their state would be automatically enrolled in the public option: government-run health insurance that would serve as an alternative to private plans. In addition, Biden said, his plan would “reduce drug prices by making sure that there’s competition that doesn’t exist now by allowing Medicare to negotiate drug prices with the insurance companies.” Allowing Medicare to negotiate drug prices is one of AARP’s top advocacy priorities.

The two candidates also argued over what would happen to private insurance under Biden’s proposal.

“We have 180 million people out there that have great private health care,” Trump said. “Joe Biden is going to terminate all of those policies.” He said that Biden’s plan “will basically be socialized medicine.”

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Biden countered that “not one single person” with private insurance would lose their private insurance coverage under his plan and pointed out that commercial health insurance remains in force under the ACA. He also said coverage protections for preexisting conditions would remain under his plan and challenged Trump to detail how he would continue such protections.

The two candidates had a short exchange about the future of Social Security. Trump said that Biden “is talking about destroying your Social Security” but didn’t say which of his opponent’s plans would do that. Biden responded that Trump’s position in favor of eliminating the payroll tax, which largely funds Social Security, would bankrupt the program. According to the Social Security Administration’s chief actuary, if that tax were eliminated and no other funding mechanism replaced it, the federal government would be unable to pay out Social Security benefits beginning in mid-2023.

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