President Joe Biden's clumsy, halting performance at the first presidential debate was nothing short of disastrous. But the substance of his remarks, especially on healthcare, is just as worrying.
Take his defense of the Inflation Reduction Act's price controls on insulin for Medicare Part D enrollees. As the president put it, "We brought down the price of prescription drugs, which is a major issue for many people, to $15 for — for an insulin shot, as opposed to $400."
To begin with, the price cap he's referring to is set at $35, not $15 — a mistake the president himself corrected later in the debate.
As for his assertion that seniors were paying $400 for a dose of insulin, that can only be described as a gross and deliberate exaggeration.
According to the president's own Department of Health and Human Services (HHS), Medicare enrollees weren't paying $400 for a shot of insulin before Biden's price controls took effect.
They were paying an average of about $450 per year.
Biden's misstatements didn't stop there. "No senior has to pay more than $200 for any drug — all the drugs they [inaudible] beginning next year," he said during the debate.
He was off by a factor of 10. Starting next year, Medicare Part D will cap seniors' out-of-pocket drug expenses at $2,000.
It's a good idea, one that will make drugs more accessible and affordable for seniors.
Biden's defense of Obamacare was less convincing. Consider his claim that "under the ACA [Affordable Care Act], as I said, you're in a circumstance where 400,000 people — I mean, 40 million people — would not have insurance because they have a preexisting condition.
"The only thing that allows them to have that insurance is the fact that they in fact are part of the ACA."
But there aren't 40-some million Americans who would lose their coverage due to a preexisting condition in a post-Obamacare era.
As of 2023, there were only 40 million Americans insured through Obamacare in total.
That includes people covered through the exchanges created by the law as well as those who have taken advantage of the law's Medicaid expansion.
Biden seems to believe that every single person enrolled in the exchanges or newly signed up for Medicaid has a preexisting condition that would make them uninsurable absent the 2010 health law and its subsequent expansions. That's deeply mistaken.
Even if Republicans succeeded in repealing Obamacare, Americans with preexisting conditions wouldn't be without options for affordable coverage.
For example, the Republican Study Committee's most recent budget proposal envisioned giving high-risk patients access to insurance through a state-based Guaranteed Coverage Pool. Patients who qualify for coverage through these pools would receive federal subsidies to defray the cost of insurance.
Such a move would ensure that Americans in poor health have access to affordable coverage. But by taking them out of conventional insurance risk pools, the proposal would help drive down the cost of coverage for everyone else.
It's a far more cost-effective way to ensure that people can secure affordable coverage than Obamacare's "guaranteed issue" and "community rating" provisions, which barred insurers from denying coverage to people and limited how much they could vary premiums.
The ACA capped premiums for the old at three times what they are for the young. That has had the effect of raising premiums for the young to subsidize premiums for the old.
Democrats have papered over these distortions with enhanced subsidies that obscure the true cost of coverage, as provided for by the Inflation Reduction Act of 2022. Those subsidies are scheduled to expire on Dec. 31, 2025.
Beneficiaries have no idea what their premiums are; taxpayers are covering them. This year alone, the projected cost of Obamacare's subsidies is roughly $125 billion.
That Biden failed to accurately portray the conservative position on this matter is hardly surprising. His grasp of his own policies appeared tenuous at best during the debate. But that's no excuse.
President Biden has made healthcare a centerpiece of his reelection campaign. Yet instead of reasoned argument and factual rigor in defense of his positions, Americans received a mess of half-truths, exaggerations, and falsehoods.
The mess he's made of our nation's health insurance market is evidence enough that Joseph Robinette Biden is unfit for office.
Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is "False Premise, False Promise: The Disastrous Reality of Medicare for All," (Encounter Books 2020). Follow her on Twitter @sallypipes. Read Sally Pipes' Reports — More Here.
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