1. Health Insurance
Joe Biden
Biden vows to protect the Affordable Care Act (also known as the ACA or Obamacare) and buttress it with a Medicare-like public option for those over age 60. He also promises to keep healthcare costs down for all Americans, whether they choose a public or private option. “No family buying insurance on the individual marketplace, regardless of income, will have to spend more than 8.5 percent of their income on health insurance,” Biden declares on his campaign site, noting that this will lower the cost from a current maximum of 9.86 percent of income. What Critics Say According to The Hill, Biden’s policies don’t go far enough in making healthcare affordable for most families, and won’t accomplish universal coverage, the goal of proposed single-payer plans like Medicare for All.
Donald Trump
Trump kicked off his presidency in 2016 with a promise to end the ACA, claiming that it unfairly requires people to buy costly insurance or pay a heavy fine. By joining forces with the then-Republican-controlled Congress in 2017, he eliminated key provisions of Obamacare, including the penalty for not buying health insurance. On June 26 of this year, Trump asked the Supreme Court to declare the ACA unconstitutional; a ruling on the issue is expected this fall. On the campaign site PromisesKept.com, Trump claims his administration has expanded healthcare access to Americans in need, including 2.5 million people in rural areas. What Critics Say According to The New York Times, Trump’s policies would significantly reduce access to healthcare for most Americans and leave 23 million people uninsured in the midst of a pandemic. RELATED: Everything You Need to Know About Medicare Insurance
2. COVID-19
Joe Biden
Biden has a five-pronged plan for fighting COVID-19: provide free testing to all and hire at least 100,000 contact tracers; ensure sufficient personal protective equipment (PPE); support science-backed vaccines and medical treatments; require that reopening plans be safe and effective; and safeguard the health of older and at-risk populations. Biden also plans to raise the pay for healthcare workers on the frontlines, and to allow Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID), to speak directly to Americans without restrictions. What Critics Say An editorial in The New York Times says Biden’s plans lack the detail offered by some other prominent Democrats, including his strategies for producing adequate supplies of coronavirus tests, PPE, and any future vaccines and treatments.
Donald Trump
Trump touts his administration’s “Operation Warp Speed” for accelerating the search for a COVID-19 vaccine; in June 2020, the U.S. Department of Health and Human Services (HHS) announced a $628 million contract with Emergent BioSolutions to expand manufacturing of approved formulas. He has focused COVID-19 efforts on rural areas, supplying $225 million for testing in health clinics, and provided funding for 185 tele-healthcare providers in 38 states. What Critics Say Trump’s detractors believe he did not act early enough to stem the spread of the coronavirus; failed to provide federal leadership or clear communication; censored public health experts such as Dr. Fauci and the Centers for Disease Control and Prevention (CDC); set a dangerous example by refusing to wear a mask; and reduced the government’s COVID-19-battling capability by understaffing the pandemic response team, according to Reuters. RELATED: Mask Wars: Which Side Are You On?
3. Prescription Drug Pricing
Joe Biden
Biden promises he will fight pharmaceutical company profiteering by eliminating the law that says Medicare cannot negotiate with drug companies; creating an independent board to set price caps for new medications with no competitors; allowing Americans to buy medications overseas; making high-quality generics more available; ending tax breaks for pharmaceutical advertising; and limiting drug companies’ leeway in raising prices. What Critics Say Politico argues that Biden’s plan falls short in not allowing the government to break patents when companies set prices too high; some critics also note that as vice president, Biden fought against countries that tried to break American patents on highly priced medication. Critics have also assailed Biden for allowing the Cancer Moonshot program he led as vice president to be headed by a former Pfizer employee.
Donald Trump
Trump claims that during his presidency, the U.S. Food and Drug Administration (FDA) has approved more generic drugs than ever before. In July 2020, he signed four executive orders intended to discount prices on insulin and epinephrine for low-income patients; allow the import of lower-priced drugs from Canada and other countries; combat profiteering by intermediaries known as pharmacy benefit managers; and make sure Americans pay the lowest available prices among developed nations for Medicare Part B drugs. What Critics Say According to The New York Times, Trump’s executive orders are unenforceable unless Congress can pass long-elusive legislation, and that they represent an incoherent approach at a time when he needs to incentivize pharmaceutical companies to develop a coronavirus vaccine. RELATED: Your Budget-Friendly Guide to Prescription Drug Costs
4. Opioids
Joe Biden
Biden says he will demand accountability from pharmaceutical companies for their role in the opioid crisis; regularly update federal guidelines to prevent the overprescription of opioids; develop more nonopioid painkillers; invest $125 billion in federal funds for prevention, treatment, and recovery; make sure health insurance covers mental healthcare; end incarceration based purely on drug offenses; and step up efforts to keep countries like China and Mexico from sending fentanyl and heroin into the United States. What Critics Say Vox argues that Biden’s plan doesn’t go far enough in ensuring that the government-supported drug treatment programs he backs will be evidence-based or effective.
Donald Trump
Trump declared opioids a public health emergency in 2017 and provided $500 million to states for treatment and prevention, and since then has stepped up efforts to criminally prosecute those who possess, manufacture, or distribute the widely abused painkiller fentanyl. He credits his pressure on China for the reduction of its fentanyl exports to the United States. Under Trump, the Department of Justice has prosecuted hundreds of doctors and healthcare providers for needlessly prescribing opioids. What Critics Say Detractors say Trump’s plans have been largely ineffective in conquering the opioid crisis, and that his approach has focused more on penalizing drug users than on addressing the root causes of the issue. RELATED: Few U.S. Opioid Overdose Survivors Get Timely Addiction Treatment
5. Reproductive Rights
Donald Trump
Trump states on his campaign site that he “recognizes the precious gift of life and protects the sanctity of life at all stages.” He has worked to allow states to restrict funding to Planned Parenthood clinics for supporting reproductive rights, and vowed to ensure taxpayer money doesn’t support healthcare exchange plans that provide for abortions. Through his Mexico City Policy, he banned U.S. foreign aid to overseas healthcare organizations that offer information about abortion or perform the procedure. What Critics Say Critics argue Trump’s approach poses a threat to the survival of Roe v. Wade, denies individuals their rights to make their own reproductive decisions, and presents a danger for women in the United States and worldwide for whom a safe abortion is a necessity.
Joe Biden
Biden says he will prevent states from denying Medicaid funding to Planned Parenthood and will reverse Trump’s Mexico City Policy (also known as the global gag rule) in order to reinstate funding to overseas health organizations that also offer information about abortion. He plans to restore the Affordable Care Act’s coverage of contraception for all women, and to make sure women affiliated with religious organizations can still receive coverage through the government if their employer denies it. What Critics Say The Intercept argues that Biden will need to prove he is trustworthy on this issue, since he undermined reproductive rights as vice president by working to deny contraceptive coverage under the ACA and by supporting the denial of federal funding for abortions under the Hyde Amendment. RELATED: COVID-19 and Abortion Access: Politics and the Pandemic
6. Legalizing Marijuana
Donald Trump
Trump does not support legalizing marijuana, and has not offered plans to decriminalize the drug in order to lessen punishments for those charged with possession. What Critics Say Critics say Trump’s position runs contrary to the two-thirds of Americans who support legalizing marijuana, per Newsweek, and that keeping marijuana use as a criminal offense worsens an already overburdened criminal justice system and reinforces racial and class inequities.
Joe Biden
Biden has not articulated any plans to legalize marijuana if he’s elected president. His aim instead is to decriminalize the drug, so those caught using it face fines instead of jail time. He also plans to take marijuana off the schedule 1 list of drugs, which includes heroin, and to remove federal enforcement for states that have legalized marijuana. What Critics Say The Atlantic argues that Biden’s lack of support for legalizing marijuana risks keeping younger voters away from the polls in November, and that it misses an opportunity to generate higher tax revenues for state economies battered by the pandemic. RELATED: CBD: A User’s Guide
7. Healthcare and Long-Term Care for Older Americans
Donald Trump
On WhiteHouse.gov, Trump points to his administration’s $1 billion in grants for in-home care and home-delivered food for seniors and people with disabilities, and he credits his expansion of Medicare telehealth coverage and increased funding for nursing home inspections for helping protect seniors’ health. What Critics Say According to the Center on Budget and Policy Priorities, Trump’s intended 2021 budget cuts to Medicaid, food stamps, Social Security, rental assistance plans, and programs like the Social Services Block Grant — which help keep seniors fed, housed, and protected from elder abuse — will harm older Americans. They also note that his failure to manage the pandemic has led to the deaths of tens of thousands of seniors from COVID-19; as of August 13, more than 40 percent of U.S. coronavirus deaths have been linked to nursing homes.
Joe Biden
Biden says he will work to prevent cuts to Medicaid benefits, which 60 percent of Americans in nursing homes rely on to pay for care, and will allow seniors to use Medicaid to pay for home-based or community-based care. He also vows to create a tax credit for informal caregivers to pay for long-term care. Biden says his plan to make COVID-19 testing available for all will help ensure the safety of nursing home residents. He also promises to shore up the long-term solvency of Social Security by requiring higher-income earners to pay the same taxes on those earnings as middle-class people pay. What Critics Say According to an article published by Nasdaq, Biden doesn’t explain how his plan would pay for measures such as the tax credits and new programs it proposes.
