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Biden, Trump Spar Over Abortion, COVID in Debate and Face Questions on Their Age

— Opioid crisis also briefly discussed

MedpageToday
 A screenshot of President Joe Biden and Donald Trump on the debate stage.

Healthcare issues played a big role in Thursday night's first presidential debate, which spanned topics from the handling of the COVID pandemic to abortion to the candidates' physical fitness.

The mention of healthcare issues began fairly early in the debate -- hosted by CNN at its studio in Atlanta -- during a discussion about the economy. "The pandemic was so badly handled" by Trump, Biden said. "All he said was, 'It's not that serious. Just inject some bleach and you'll be all right.'" In the wake of the "chaos" left by Trump, Biden continued, "we brought down the price of prescription drugs [in Medicare], which is a major issue for many people, to $15 for an insulin shot as opposed to $400. No senior has to pay more than $200 for all the drugs that they take beginning next year, and we're going to make that available to everybody."

The president's numbers were not entirely accurate; the law he was referring to, the Inflation Reduction Act, capped the price of insulin for Medicare beneficiaries at $35 per month, and beneficiaries' maximum annual out-of-pocket drug costs , not $200.

Disagreement Over COVID Policies

Former president Trump fired back. "We got hit with COVID, and when we did, we spent the money necessary so we wouldn't end up in a Great Depression, the likes of which we had in 1929," he said. "By the time we finished, we did a great job, we got a lot of credit for the economy ... But the thing we never got the credit for, and we should have, is getting us out of that COVID mess."

Trump criticized Biden's COVID mandates -- although he didn't specify whether he meant vaccine mandates or mask mandates -- which he said were "a disaster for our country," adding that Biden "had more people die [from COVID] in his administration." The pandemic first appeared in the U.S. in March 2020, during Trump's last 10 months in office; the Biden administration declared the COVID public health emergency over in May 2023, after Biden had been in office for more than 2 years.

Biden, who appeared stiff when he walked onto the stage and spoke in a quiet voice, seemed to get a little confused while answering a question on the national debt. If Trump had increased taxes on the wealthy, Biden said, "we'd be able to help ensure the things we need to do: childcare; making sure that we continue to support our healthcare system; making sure we're able to make every single solitary person eligible for what I've been able to do with ... the, uh, COVID ... excuse me, dealing with everything we had to do with..." He stopped speaking for a moment, then said, "Look, we finally beat Medicare."

Trump pounced on that answer. "You're right -- he did beat Medicaid; he beat it to death, and he's destroying Medicare," the former president said, mistaking Biden's mention of Medicare for Medicaid. "It's because all of these [immigrants] are coming in. They're putting them on Medicare, they're putting them on Social Security ... He will wipe out Social Security, He will wipe out Medicare."

Sharp Division on Abortion

The first question about abortion came about 13 minutes in, when co-moderator Dana Bash of CNN asked Trump whether, in the wake of the Supreme Court's recent decision on mifepristone, he would block access to the abortion drug. "The Supreme Court just approved the abortion pill, and I agree with their decision and I will not block it," Trump said. The Supreme Court, in the case that Trump was referring to, actually did not address the pill's legality, but rather decreed that the plaintiffs bringing the case that sought to restrict use of the pills didn't have the "standing," or legal authority, to file suit.

Trump used the question to discuss his views on abortion; he asserted that everyone all along had wanted the issue decided only at the state level. "Fifty-one years ago, you had Roe v. Wade, and everybody wanted to get back to the states," he said, referring to the 1973 Supreme Court decision that legalized abortion nationwide. "Everybody without exception -- Democrats, Republicans, liberals, conservatives, everyone, religious leaders. And I put three great Supreme Court justices on the court, and they happened to vote in favor of killing Roe v. Wade and moving it back to the states."

Biden disagreed. "The fact is that the vast majority of constitutional scholars supported Roe when it was decided," he said. "This idea they were all against it is just ridiculous ... We're in a state [Georgia, that bans abortion] in 6 weeks ... you don't even know you're pregnant yet, but you can't see a doctor and have him decide what your circumstances are when you need help." He added, "The idea that states are going to decide this is a little like saying, 'We'll turn civil rights back to the states and let each state have a different rule.'" Biden said he would work to restore Roe v. Wade if he is reelected.

Biden also attacked Trump regarding the Affordable Care Act (ACA), arguing that the former president and Republicans in Congress "want to get rid of the ACA ... They tried 50 times, and they're going to try again if they win."

Opioid Crisis, Candidates' Age Also Discussed

On the issue of the opioid crisis, CNN co-moderator Jake Tapper didn't get very far when he tried to ask both candidates what they would do to reduce opioid overdoses. "We were doing very well on addiction until COVID came along," Trump said, before accusing Biden of not doing enough to secure the border, thereby causing many illicit drugs to come across. Biden talked about the use of large machines to detect fentanyl at the border and said that the machines had been included in a congressional deal to pass legislation on securing the border -- a deal that tanked because Trump told Republican lawmakers not to vote for it. "We need those machines," Biden said.

The debate moderators also raised the issue of concerns about the candidates' advanced ages. "I spent half my career criticized for being the youngest person in politics," responded Biden, who would be 86 at the end of his second term. "This guy's 3 years younger and a lot less competent. Look at how I've turned around the horrible situation he's left me." Trump bragged that he "took two cognitive tests and aced them" and that he took physical exams every year during his presidency. "We knock wood that I'm in very good health. I just won two club [golf] championships, and they weren't even for seniors." Biden said he would be happy to golf with Trump "if you carry your own bag."

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    Joyce Frieden oversees MedPage Today’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy.