Yves here. This post does provide useful information about the positions of each campaign on health care and does point out that Team Trump has been in handwave mode about what they intend to do.<\/p>\n
However, it depicts Trump actions against the ACA as absolutely awful. One has to point out, as our readers often do and we did at the time, that the ACA was written by the heatlh care industry for its benefit. Pharma and health insurer stocks went up when it was passed. US health care costs as a percent of GDP has continued to rise even as our health care system delivers poor results by world standards (the one area where the US does score well is in preventive care, which makes the overall poor results even more glaring).<\/p>\n
One area, again not sufficiently acknowledged, where the ACA was a clear step forward was Medicaid expansion, even though only Democratic-party controlled states took that up. However, the rest of the ACA was a mixed bag. Those in lower income groups could come out doing well via the subsidies. At the same time, I had multiple low income workers complain to me bitterly that they could not afford Obamacare premiums or found the coverage too costly relative to what they could pay for and receive, and very much resented having to pay the $600 penalty. And it\u2019s not as if I sought out this line of conversation; they seemed to be unloading to anyone who would listen.<\/p>\n
Similarly, readers would regularly complain that Obamacare was extremely expensive catastrophic insurance, that they would have to incur thousands of dollars in expenses, plus pay policy premiums, before they got a dime of benefits.<\/p>\n
So not that Trump has any sort of consumer-benefitting schemes up his sleeve, and the reverse is vastly more likely, but the implicit veneration of the ACA below is way overdone.<\/p>\n
Second is that the treatment of the dustup between Vance and the moderators over the legal status of the Springfield migrants is arguably misrepresented below. Vance was attempting to recite technical issues regarding their legal position and was shut down.<\/p>\n
One can argue that conservative quibbling is hair-splitting, but it does not seem accurate to claim that they have no point, as opposed to perhaps a strained point. I admit to not having re-listened to that part of the debate, but Vance seemed to be making a more legally detailed version of this argument, which appears on many right-wing sites:<\/p>\n
As an illegal immigrant, if you enter the US under one of the countries deemed to be hostile, you may apply for Temporary Protected Status (TPS). This status allows an illegal immigrant from specific countries to file for TPS as a safety precaution given their own country is in turmoil. It is a temporary status. It does not confer on them a green card, or a legal status, in essence they are in limbo. The status must be updated regularly as circumstances in their country change.<\/p>\n
This is what the Haitians coming across the border illegally are directed to do by immigration. They are NOT legal. They are \u2018temporary\u2019 illegals living under a protected status.<\/p>\n
So conservatives focus on the fact that the entry was illegal but has been forgiven on a temporary basis by the TPS program. A depiction in Business Insider is not inconsistent with that way of looking at the issue:<\/p>\n
TPS is not a permanent legal status; rather, it offers protection to migrants already in the US from deportation, while also granting them the right to work legally.<\/p>\n
Lambert call this the rules-based immigration order.<\/p>\n
IMHO, the failure to clarify the underlying immigration issues and not resort to casual blow-offs is a big political and media lapse. <\/p>\n
By KFF Health News and PolitiFact staffs. Originally published at KFF Health News<\/p>\n
Ohio Republican Sen. JD Vance and Minnesota Democratic Gov. Tim Walz met in an Oct. 1\u202fvice presidential debate\u202fhosted by CBS News that was cordial and heavy on policy discussion \u2014 a striking change from the Sept. 10 debate between Vice President Kamala Harris and former President Donald Trump.<\/p>\n
Vance and Walz acknowledged occasional agreement on policy points and respectfully addressed each other throughout the debate. But they were more pointed in their attacks on their rival\u2019s running mate for challenges facing the country, including immigration and inflation.<\/p>\n
The moderators, \u201cCBS Evening News\u201d anchor Norah O\u2019Donnell and \u201cFace the Nation\u201d host Margaret Brennan, had said they planned to encourage candidates to fact-check each other, but sometimes clarified statements from the candidates.<\/p>\n
After Vance made assertions about Springfield, Ohio, being overrun by \u201cillegal immigrants,\u201d Brennan pointed out that a large number of Haitian immigrants in Springfield, Ohio, are in the country legally. Vance objected and, eventually, CBS exercised the debate ground rule that allowed the network to cut off the candidates\u2019 microphones.<\/p>\n
Most points were not fact-checked in real time by the moderators. Vance resurfaced a recent health care theme \u2014 that as president, Donald Trump sought to save the Affordable Care Act \u2014 and acknowledged that he would support a national abortion ban.<\/p>\n
Walz described how health care looked before the ACA compared with today. Vance offered details about Trump\u2019s health care \u201cconcepts of a plan\u201d \u2014 a reference to comments Trump made during the presidential debate that drew jeers and criticism for the former president, who for years said he had a plan to replace the ACA that never surfaced. Vance pointed to regulatory changes advanced during the Trump administration, used weedy phrases like \u201creinsurance regulations,\u201d and floated the idea of allowing states \u201cto experiment a little bit on how to cover both the chronically ill but the non-chronically ill.\u201d<\/p>\n
Walz responded with a quick quip: \u201cHere\u2019s where being an old guy gives you some history. I was there at the creation of the ACA.\u201d He said that before then insurers had more power to kick people off their plans. Then he detailed Trump\u2019s efforts to undo the ACA as well as why the law\u2019s preexisting condition protections were important.<\/p>\n
\u201cWhat Sen. Vance just explained might be worse than a concept, because what he explained is pre-Obamacare,\u201d Walz said.<\/p>\n
The candidates sparred on numerous topics. Our PolitiFact partners fact-checked the debate here and on their live blog.<\/p>\n
The Affordable Care Act:<\/p>\n
Vance: \u201cDonald Trump could have destroyed the [Affordable Care Act]. Instead, he worked in a bipartisan way to ensure that Americans had access to affordable care.\u201d<\/p>\n
False.<\/p>\n
As president, Trump worked to undermine and repeal the Affordable Care Act. He cut millions of dollars in federal funding for ACA outreach and navigators who help people sign up for health coverage. He enabled the sale of short-term health plans that don\u2019t comply with the ACA consumer protections and allowed them to be sold for longer durations, which siphoned people away from the health law\u2019s marketplaces.<\/p>\n
Trump\u2019s administration also backed state Medicaid waivers that imposed first-ever work requirements, reducing enrollment. He also ended insurance company subsidies that helped offset costs for low-income enrollees.\u202fHe backed an unsuccessful repeal of the landmark 2010 health law and he\u202fbacked the demise of a penalty imposed for failing to purchase health insurance.<\/p>\n
Affordable Care Act enrollment declined\u202fby more than 2 million people during Trump\u2019s presidency, and the\u202fnumber of uninsured Americans rose\u202fby 2.3 million, including 726,000 children, from 2016 to 2019, the U.S. Census Bureau reported; that includes three years of Trump\u2019s presidency.\u00a0 The number of insured Americans rose again during the Biden administration.<\/p>\n
Abortion and Reproductive Health:<\/p>\n
Vance: \u201cAs I read the Minnesota law that [Walz] signed into law \u2026 it says that a doctor who presides over an abortion where the baby survives, the doctor is under no obligation to provide lifesaving care to a baby who survives a botched late-term abortion.\u201d<\/p>\n
False.<\/p>\n
Experts said cases in which a baby is born following an attempted abortion are rare. Less than 1% of abortions nationwide occur in the third trimester. And infanticide, the crime of killing a child within a year of its birth, is illegal in every state.<\/p>\n
In May 2023, Walz, as Minnesota governor, signed legislation updating a state law for \u201cinfants who are born alive.\u201d It said babies are \u201cfully recognized\u201d as human people and therefore protected under state law. The change did not alter regulations that already required doctors to provide patients with appropriate care.<\/p>\n
Previously, state law said, \u201cAll reasonable measures consistent with good medical practice, including the compilation of appropriate medical records, shall be taken by the responsible medical personnel to preserve the life and health of the born alive infant.\u201d The law was updated to instead say medical personnel must \u201ccare for the infant who is born alive.\u201d<\/p>\n
When there are fetal anomalies that make it likely the fetus will die before or soon after birth, some parents decide to terminate the pregnancy by inducing childbirth so that they can hold their dying baby, Democratic Minnesota state Sen. Erin Maye Quade told PolitiFact in September.<\/p>\n
This update to the law means infants who are \u201cborn alive\u201d receive appropriate medical care dependent on the pregnancy\u2019s circumstances, Maye Quade said.<\/p>\n
Vance supported a national abortion ban before becoming Trump\u2019s running mate.<\/p>\n
CBS News moderator Margaret Brennan told Vance, \u201cYou have supported a federal ban on abortion after 15 weeks. In fact, you said if someone can\u2019t support legislation like that, quote, \u2018you are making the United States the most barbaric pro-abortion regime anywhere in the entire world.\u2019 My question is, why have you changed your position?\u201d<\/p>\n
Vance said that he \u201cnever supported a national ban\u201d and, instead, previously supported setting \u201csome minimum national standard.\u201d<\/p>\n
But in a January 2022 podcast interview, Vance said, \u201cI certainly would like abortion to be illegal nationally.\u201d In November, he told reporters that \u201cwe can\u2019t give in to the idea that the federal Congress has no role in this matter.\u201d<\/p>\n
Since joining the Trump ticket, Vance has aligned his abortion rhetoric to match Trump\u2019s and has said that abortion legislation should be left up to the states.<\/p>\n
\u2014 Samantha Putterman of PolitiFact, on the live blog<\/p>\n
A woman\u2019s 2022 death in Georgia following the state passing its six-week abortion ban was deemed \u201cpreventable.\u201d<\/p>\n
Walz talked about the death of 28-year-old Amber Thurman, a Georgia woman who died after her care was delayed because of the state\u2019s six-week abortion law. A judge called the law unconstitutional this week.<\/p>\n
A Sept. 16 ProPublica report found that\u202fThurman had taken abortion pills and encountered a rare complication. She sought care at Piedmont Henry Hospital in Atlanta to clear excess fetal tissue from her uterus, called a dilation and curettage, or D&C. The procedure is commonly used in abortions, and any doctor who violated Georgia\u2019s law could be prosecuted and face up to a decade in prison.<\/p>\n
\u2014 Samantha Putterman of PolitiFact, on the live blog<\/p>\n
What Project 2025 Says About Some Forms of Contraception, Fertility Treatments<\/p>\n
Walz said that Project 2025 would \u201cmake it more difficult, if not impossible, to get contraception and limit access, if not eliminate access, to fertility treatments.\u201d<\/p>\n
Mostly False. The Project 2025 document doesn\u2019t call for restricting standard contraceptive methods, such as birth control pills, but it defines emergency contraceptives as \u201cabortifacients\u201d and says they should be eliminated from the Affordable Care Act\u2019s covered preventive services. Emergency contraception, such as Plan B and ella,\u202fare not considered abortifacients, according to medical experts.<\/p>\n
PolitiFact did not find any mention of in vitro fertilization throughout the document, or specific recommendations to curtail the practice in the U.S., but it contains language that supports legal rights for fetuses and embryos. Experts say this language can threaten family planning methods, including IVF and some forms of contraception.<\/p>\n
\u2014 Samantha Putterman of PolitiFact, on the live blog<\/p>\n
Walz: \u201cTheir Project 2025 is gonna have a registry of pregnancies.\u201d<\/p>\n
False.\u202f<\/p>\n
Project 2025 recommends that states submit more detailed abortion reporting to the federal government. It calls for more information about how and when abortions took place, as well as other statistics for miscarriages and stillbirths.<\/p>\n
The manual does not mention, nor call for, a new federal agency tasked with registering pregnant women.<\/p>\n
Fentanyl and Opioids:<\/p>\n
Vance: \u201cKamala Harris let in fentanyl into our communities at record levels.\u201d<\/p>\n
Mostly False.<\/p>\n
Illicit fentanyl seizures have been rising for years and reached record highs under Biden\u2019s administration. In fiscal year 2015, for example, U.S. Customs and Border Protection\u202fseized\u202f70 pounds of fentanyl. As of August 2024, agents have\u202fseized\u202fmore than 19,000 pounds of fentanyl in fiscal year 2024, which ended in September.<\/p>\n
But these are fentanyl seizures \u2014 not the amount of the narcotic being \u201clet\u201d into the United States.<\/p>\n
Vance made this claim while criticizing Harris\u2019 immigration policies. But fentanyl enters the U.S. through the southern border mainly at official ports of entry. It\u2019s\u202fmostly smuggled\u202fin by U.S. citizens, according to the U.S. Sentencing Commission. Most illicit fentanyl in the U.S.\u202fcomes from Mexico\u202fmade with chemicals from Chinese labs.<\/p>\n
Drug policy experts have said that the illicit fentanyl crisis began\u202fyears before\u202fBiden\u2019s administration and that Biden\u2019s border policies are not to blame for overdose deaths.<\/p>\n
Experts have also\u202fsaid\u202fCongress plays a role in reducing illicit fentanyl. Congressional funding for more vehicle scanners would help law enforcement seize more of the fentanyl that comes into the U.S. Harris has\u202fcalled for\u202fincreased enforcement against illicit fentanyl use.<\/p>\n
Walz: \u201cAnd the good news on this is, is the last 12 months saw the largest decrease in opioid deaths in our nation\u2019s history.\u201d<\/p>\n
Mostly True.<\/p>\n
The U.S. had an estimated 107,543 drug overdose deaths in 2023 \u2014 a 3% decrease from the 111,029 deaths estimated in 2022. This is the\u202ffirst annual decrease\u202fin overall drug overdose deaths since 2018. Nevertheless, the opioid death toll remains much higher than just a few years ago,\u202faccording to KFF.<\/p>\n
More Health-Related Comments:<\/p>\n
Vance Said \u2018Hospitals Are Overwhelmed.\u2019 Local Officials Disagree.<\/p>\n
We asked health officials ahead of the debate what they thought about Vance\u2019s claims about Springfield\u2019s emergency rooms being overwhelmed.<\/p>\n
\u201cThis claim is not accurate,\u201d said Chris Cook, health commissioner for Springfield\u2019s Clark County.<\/p>\n
Comparison data\u202ffrom the Centers for Medicare & Medicaid Services tracks how many patients are \u201cleft without being seen\u201d as part of its effort to characterize whether ERs are able to handle their patient loads. High percentages usually signal that the facility doesn\u2019t have the staff or resources to provide timely and effective emergency care.<\/p>\n
Cook said that the full-service hospital, Mercy Health Springfield Regional Medical Center, reports its emergency department is at or better than industry standard when it comes to this metric.<\/p>\n
In July 2024, 3% of Mercy Health\u2019s patients were counted in the \u201cleft-without-being-seen\u201d category \u2014 the same level as both the state and national average for high-volume hospitals.\u202fIn July 2019, Mercy Health tallied 2% of patients who \u201cleft without being seen.\u201d That year, the state and national averages were 1% and 2%, respectively.\u202f Another CMS 2024 data point shows Mercy Health patients spent less time in the ER per visit on average \u2014 152 minutes \u2014 compared with state and national figures: 183 minutes and\u202f211 minutes, respectively. Even so, Springfield Regional Medical Center\u2019s Jennifer Robinson noted that Mercy Health has seen high utilization of women\u2019s health, emergency, and primary care services.<\/p>\n
\u2014 Stephanie Armour, Holly Hacker, and Stephanie Stapleton of KFF Health News, on the live blog<\/p>\n
Minnesota\u2019s Paid Leave Takes Effect in 2026<\/p>\n
Walz signed paid family leave into law in 2023\u202fand it will take effect in 2026.<\/p>\n
The\u202flaw\u202fwill provide employees up to 12 weeks of paid medical leave and up to 12 weeks of paid family leave, which includes bonding with a child, caring for a family member, supporting survivors of domestic violence or sexual assault, and supporting active-duty deployments. A maximum 20 weeks are available in a benefit year if someone takes both medical and family leave.<\/p>\n
Minnesota used a projected budget surplus to jump-start the program; funding will then shift to a payroll tax split between employers and workers.<\/p>\n
\u2014\u202fAmy Sherman of PolitiFact, on the live blog<\/p>\n
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