Trump says Obamacare must die. Biden says he'll make it into 'Bidencare.'

Sahil Kapur
·3 min read

WASHINGTON — Democratic presidential nominee Joe Biden touted his "Bidencare" plan to create a government-run insurance option Thursday as President Donald Trump defended his push to eliminate the Affordable Care Act and craft a "beautiful" alternative.

"What I'm going to do is pass Obamacare with a public option — becomes 'Bidencare,'" Biden, who was vice president when the law was passed, said at the final presidential debate in Nashville, Tennessee, using the word twice to describe his proposal to extend Medicaid coverage, allow Americans on private plans the option of a government-run policy and expand federal subsidies.

While Biden has fiercely defended President Barack Obama and the ACA, his promises of a "Bidencare" plan indicate a desire to build a health care legacy of his own. His campaign has estimated that the plan would cost $750 billion.

An analysis by the nonpartisan Kaiser Family Foundation found that a proposal like Biden's would reduce prices on the ACA exchanges and lower employer-based premiums.

Trump, by contrast, stood by his support for a lawsuit headed to the Supreme Court that seeks to invalidate Obamacare. The justices will hear the case one week after Election Day.

"I would like to terminate Obamacare, come up with a brand new, beautiful health care," Trump said at the debate, which was moderated by NBC News' Kristen Welker.

But Trump lacks a replacement plan, and he wasn't able to point to policy details he'd support in lieu of the ACA, which has extended insurance coverage to about 20 million Americans and enhanced protections for sick people who were denied care or were thrown off their plans before the 2010 law took effect.

The back and forth, 12 days before Election Day, captured a momentous contrast between the candidates on an issue that ranks highly among voters as the coronavirus continues to infect Americans and claim lives.

Voters trust Biden over Trump by 55 percent to 39 percent to handle health care, according to a Quinnipiac University poll released Thursday. Overall, Biden led Trump by 51 percent to 41 percent among likely voters.

Trump promised a "better" plan than the ACA, which he said would "always protect people with pre-existing conditions," but he has yet to make any plan public. He didn't endorse policies to achieve that, and a previous Republican House-passed bill that he endorsed in 2017 would have chipped away at pre-existing condition rules by granting waivers to states that would have allowed insurers to vary prices on the basis of health status.

Experts say such a plan would lead to higher prices for sick people and lower costs for the healthy.

Trump sought to tie Biden to a plan endorsed by some progressives to eliminate private insurance and put all Americans in the Medicare program, an idea that Trump called "socialized medicine."

"It's not that he wants it — his vice president, I mean, she is more liberal than Bernie Sanders and wants it even more," Trump said, referring to Biden's running mate, Sen. Kamala Harris, D-Calif. "Bernie Sanders wants it. The Democrats want it. You're going to have socialized medicine."

He was referring to "Medicare for All," or a single payer plan, which is backed by Sen. Bernie Sanders, I-Vt., and other left-leaning Democrats. Harris has co-sponsored his bill, but she backed away from it during her unsuccessful presidential run last year.

Biden, however, noted that he ran against the idea in his successful primary campaign.

"He's a very confused guy. He thinks he's running against somebody else. He's running against Joe Biden," Biden said. "I beat all those other people because I disagreed with them."