Health Care

Biden Spins the Facts in Campaign Speech

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At a campaign reception in Denver, President Joe Biden distorted some of the facts and the position of his predecessor:

  • Biden claimed that the U.S. has the “lowest inflation rate of any major country in the world right now.” As of October, at least Italy and Canada reported lower inflation rates than the U.S.
  • The president claimed to have “cut the federal deficit” by making some corporations pay higher taxes. But the deficit in fiscal year 2023, when the tax went into effect, still increased.
  • He said that former President Donald Trump “is proposing …. cutting Social Security and Medicare.” But in January, Trump advised Republicans against cutting funding for the Social Security and Medicare programs.
  • Biden said Trump’s “plan” was to end the Affordable Care Act, jeopardizing health insurance for 40 million people. But that worst-case-scenario figure is based on Trump not replacing the ACA with anything. He says he would replace it with something — though he has given no details on what that would be.
  • The president claimed that 100 million people with preexisting conditions have protections “only” because of the ACA. That’s the case only for those buying insurance on their own; before the ACA, employer plans couldn’t deny a policy based on health conditions.

Biden made his remarks at a private residence on Nov. 28. He repeated some of the same claims in a speech the next day in Pueblo, Colorado. The president has stepped up his campaign appearances recently and has three fundraisers in Massachusetts on Dec. 5.

Inflation

At the Nov. 28 campaign event, Biden said that the U.S. has the “lowest inflation rate of any major country in the world right now.” But that’s not accurate, at least not according to the most recent data from the Organization for Economic Cooperation and Development — or the White House’s own calculations.

OECD data as of October 2023 show that Italy and Canada — which are also members of the G7, a group of seven of the world’s most advanced economies — had lower year-over-year inflation rates than the U.S. While the U.S. inflation rate was 3.2% that month, Italy’s was 1.7% and Canada’s was 3.1%.

If the list were expanded to include other “advanced economies,” Denmark (0.1%), Belgium (0.4%), Latvia (2.1%) and Lithuania (2.8%) also had lower rates than the U.S., according to OECD figures as of October.

Even by the White House’s latest figures, Biden’s claim was not exactly right.

Because of differences in how countries calculate inflation rates, the White House Council of Economic Advisers said it “assembles and constructs harmonized inflation data for G7 countries, allowing for more apples-to-apples inflation comparisons.”

But last month the CEA reported that inflation in the U.S. was “among the lowest” of major economies – not the lowest.

“Measured on an apples-to-apples HICP basis to allow global comparisons, both core & headline U.S. inflation were among the lowest in the G7 in September, the latest month with complete G7 data,” the CEA wrote in a Nov. 14 thread on X, the platform once known as Twitter. HICP stands for Harmonised Index of Consumer Prices.

The language is notable because in June, the CEA had said “the U.S. now has the lowest 12-month harmonized inflation in the G7, both for overall and core inflation.”

In his Nov. 29 remarks, Biden also labeled some companies greedy for not lowering prices since inflation has been declining in the U.S.

“Let me be clear: Any corporation that is not passing these savings on to the consumers needs to stop the … price gouging,” Biden said, noting that Democratic Sen. Bob Casey of Pennsylvania calls it “Greedflation.”

But a decline in the year-over-year inflation rate doesn’t automatically mean lower prices, as Biden suggested.

As the Federal Reserve Bank of St. Louis wrote in August, inflation is the increase in the prices of goods and services over time, and deflation occurs when those prices start to go down.

What the U.S. has been experiencing for the last year is known as disinflation, which is when the rate of inflation decreases but prices still go up – just at a slower pace. Prices wouldn’t be expected to go down until the year-over-year inflation rate is below zero, or negative, which has not happened.

Deficits

In his Nov. 28 campaign speech, Biden continued to misleadingly claim that he reduced the deficit, which he attributed to raising taxes on corporations.

“But by making sure they pay that 15% minimum tax, we paid for everything that we’ve proposed,” the president said. “We didn’t increase the debt. We cut the federal deficit. And we have more work to do.”

Biden was referring to the 15% corporate alternative minimum tax that was included in the Inflation Reduction Act that he signed into law in August 2022. As the Congressional Research Service explains, the CAMT “applies to firms with an average of $1 billion or more in profits in any three-year period and to foreign-parented U.S. firms with profits of over $100 million if the aggregated foreign group has over $1 billion in profits.”

The Joint Committee on Taxation did estimate that the tax, which went into effect in January of this year, would reduce federal deficits by more than $222 billion over 10 fiscal years, including by roughly $35 billion in 2023.

But the national debt has continued to increase under Biden, and the final deficit for fiscal 2023, which ended on Sept. 30, increased to roughly $1.7 trillion, or about $320 billion more than the almost $1.4 trillion deficit in fiscal 2022.

In his Nov. 29 remarks, Biden claimed to have reduced the deficit by “over $7 billion,” when he meant to say “over $1 trillion,” according to a White House transcript that corrected the president’s statement.

Deficits have declined from the record of $3.1 trillion in fiscal 2020, before Biden took office. But as we’ve explained, the primary reason that deficits went down by about $350 billion in Biden’s first year, and by another $1.3 trillion in his second, is because of emergency COVID-19 funding that expired in those years.

Budget experts said that if not for more pandemic and infrastructure spending championed by Biden, deficits would have been even lower than they were in fiscal 2021 and 2022.

Social Security and Medicare

Biden also claimed that Trump is pushing to cut Social Security and Medicare, which is the opposite of what Trump has said publicly.

On Nov. 28, Biden said, “Trump is proposing — and the MAGA Republicans — of cutting Social Security and Medicare.” In remarks the next day, the president said making sure that billionaires “pay their taxes” would allow the U.S. “to strengthen the Social Security and Medicare system instead of cutting them” like “Trump and Boebert want to do,” a reference to Republican Rep. Lauren Boebert of Colorado.

However, in January, when lawmakers were negotiating an increase in the federal debt limit, Trump, in a video message, warned Republicans not to make cuts to those two entitlement programs.

“Under no circumstances should Republicans vote to cut a single penny from Medicare or Social Security to help pay for Joe Biden’s reckless spending spree,” he said. “While we absolutely need to stop Biden’s out of control spending, the pain should be borne by Washington bureaucrats, not by hard-working American families and American seniors.”

Some critics argue that Trump’s words cannot be trusted because of his past budget proposals. But on Medicare, those budgets included bipartisan ideas to reduce the growth of spending.

For example, in 2020 we wrote about Democratic claims that Trump’s budget for fiscal 2021 included cuts to Medicare and Social Security. While the proposal called for reductions in future Medicare spending, budget experts said that would not mean cuts in benefits. As for Social Security, we wrote that the budget proposed reductions to the Social Security Disability Insurance and Supplemental Security Income programs, but not to the Social Security retirement program.

We also wrote in 2019 about Democratic claims that Trump was “once again trying to ransack Medicare” with his budget for fiscal 2020.

In that case, Trump’s budget again called for reducing Medicare spending by hundreds of billions of dollars, largely by lowering payments to providers. In fact, some of Trump’s Medicare proposals were similar to cost-cutting measures that had been proposed by former President Barack Obama.

But Trump’s 2020 budget did propose changing out-of-pocket costs for Medicare Part D prescription drug coverage, which we said would increase costs for some beneficiaries and decrease costs for others.

Scrapping/Replacing Obamacare?

The Affordable Care Act — once again — has become a focal point of the presidential campaign.

After former President Donald Trump posted on social media that Republicans “should never give up” on terminating the ACA, or Obamacare, Biden resurrected talking points about what would happen to insurance coverage and preexisting condition protections if the ACA were repealed. The problem is, Trump claims he would replace the ACA with something else. The problem for Trump is that he hasn’t provided a plan, and he never released one while in office, either.

There’s support for the idea that whatever Trump might advocate wouldn’t be as comprehensive as the ACA and would lead to an increase in the uninsured and fewer protections for those with health conditions. But at the same time, Biden takes advantage of Trump’s vagueness to claim the former president wouldn’t replace the ACA with anything at all.

We’ll go through Biden’s statements and explain what Trump has supported in the past.

In Truth Social posts on Nov. 25 and 29, Trump said he was “seriously looking at alternatives” and would replace the ACA with something “MUCH BETTER.” (He made similar claims as president.) We asked his campaign for more details on what Trump’s health care plan might be, but we haven’t received a response.

Biden broached the subject at his Nov. 28 campaign reception. “Let’s be clear about what the Affordable Care Act means. There are 40 million people in America today who get their health insurance through the Affordable Care Act,” Biden said. “His plan is to throw every one of them off that — that legislation. It would mean the number of uninsured African Americans would go up by 20 percent. Latinos would go up by 15 percent.”

He made the same claims in his speech the next day in Pueblo, Colorado.

The 40 million figure is the number of people who were enrolled, as of early 2023, in insurance plans on the ACA marketplace, or exchanges — where people buy their own coverage, mostly with the help of premium tax credits — and those with Medicaid coverage thanks to the ACA’s Medicaid expansion policies, according to the Department of Health and Human Services. For marketplace plans, the law, which Obama signed in 2010, provides tax credits to those earning between 100% and 400% of the federal poverty level. As of February, 91% of the 15.7 million people with marketplace plans qualified for tax credits.

The Medicaid expansion allows adults earning up to 138% of the poverty level to obtain coverage in states that have chosen to participate. Forty states, plus the District of Columbia, have implemented the ACA’s Medicaid expansion, the most recent being North Carolina.

If the ACA were eliminated, the number and rate of the uninsured would increase significantly. Some who would lose coverage could get insurance through another means, but the jump in the uninsured would likely be tens of millions of people. Most of those who got coverage under the Medicaid expansion would likely become uninsured without the law, according to the nonpartisan health policy research group KFF. A 2020 report by the Urban Institute estimated that a net 21.1 million people would become uninsured in 2022 if the ACA were scrapped. At the time, there were fewer Americans with coverage either on the ACA marketplace or through Medicaid expansion, so such an estimate would likely be higher today.

As for Biden’s figures for the increase in the number of the uninsured by race, his campaign pointed to that same Urban Institute report. It found much larger percentage increases for the uninsured rates. If the ACA were eliminated, the report said, the uninsured rate for Black Americans would increase from 11% to 20%, and for Hispanic people from 21% to 30%.

As we said, Trump claims he would replace the ACA, but he hasn’t said with what. He hasn’t released his own health care plan, but Republican bills he supported in 2017 would have increased the number of people without health insurance by millions, as we’ve explained before. One GOP House bill would have led to 24 million more uninsured by 2026, according to an analysis at the time by the Congressional Budget Office and Joint Committee on Taxation. The House passed that bill, but it failed in the Senate, despite both chambers being controlled by Republicans then.

In 2017, Trump also supported a so-called “skinny” repeal bill in the Senate, which would have sent a placeholder bill, with only some changes to the ACA, to a conference committee with the House. The House and Senate would have had to agree upon final legislation. But that bill, which also would have increased the number of people without insurance, failed, too.

In a court case challenging the constitutionality of the ACA, the Trump administration argued the entire law should be nullified. The Supreme Court ultimately ruled in 2021 that the plaintiffs lacked standing.

In a June 2019 interview with ABC News, while that lawsuit was working its way through the courts, Trump said he would be releasing a health care plan to replace Obamacare “in about two months.” But that didn’t happen.

Trump’s record indicates he would likely support a replacement that would lead to fewer Americans having health insurance, and it raises questions about whether Trump will release a health care plan. But the Biden campaign fills in the blanks to claim Trump has a “plan” to get rid of the ACA without anything in its place.

Protections for Those with Preexisting Conditions

Biden repeated a misleading talking point about the ACA’s preexisting condition protections.

“There are over 100 million people today who have — who have protections against preexisting conditions only for one reason: because of the Affordable Care Act. Trump wants to get rid of it,” Biden said at the campaign reception.

As we explained a few times during the 2020 campaign, the 100 million figure is an estimate of how many Americans not on Medicare or Medicaid have preexisting conditions. The ACA instituted sweeping protections for those with preexisting conditions, prohibiting insurers in all markets from denying coverage or charging more based on health status. But only those buying their own plans on the individual or nongroup market would immediately be at risk of being denied insurance.

Even without the ACA, employer plans couldn’t deny issuing a policy — and could only decline coverage for some preexisting conditions for a limited period if a new employee had a lapse in coverage.

As of 2022, 20 million people, or about 6.3% of the U.S. population, got coverage on the individual market. It is the case that the ACA’s broad protections would benefit people who lost their jobs or retired early and found themselves seeking insurance on their own.

As for Trump, he has said he supports preexisting condition protections, but while in office, he worked to reduce the protections under the ACA in several ways, as we’ve written before. In the lawsuit mentioned above, the Trump administration initially argued that the ACA’s preexisting condition provisions would have to go if the suit were successful. The administration later backed the full invalidation of the law.

The 2017 GOP bill Trump supported would have included some, but not all, of the ACA’s protections. Trump also pushed the expansion of cheaper short-term health plans that wouldn’t have to abide by the ACA’s protections, including prohibitions against denying or pricing coverage based on health status.

In late September 2020, less than two months before Election Day, Trump signed an executive order that said “[i]t has been and will continue to be the policy of the United States … to ensure that Americans with pre-existing conditions can obtain the insurance of their choice at affordable rates.” He said the order put the issue of preexisting conditions “to rest.”

But it didn’t. At the time, Karen Pollitz, who was then a senior fellow at KFF, told us the order was “aspirational” and had “no force of law.”

With this issue, too, Trump doesn’t have a plan that can be evaluated — and his record indicates he could support a plan that weakens the preexisting condition protections in the ACA. But Biden’s talking point suggests no plan means no protections, and it glosses over the fact that even without the ACA, employer policies still wouldn’t be able to deny insurance.


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