“Vote like your health care is on the ballot—because it is,” Democratic presidential candidate Joe Biden tweeted this September following President Donald Trump’s nomination of Judge Amy Coney Barrett to the Supreme Court. Indeed, our health as a nation depends on the government’s response to urgent issues like the coronavirus, drug policy, health care access including abortion, and climate change.
Here’s where Biden stands on these key health issues today.
On the coronavirus response:
As Biden pointed out in the first presidential debate, the U.S. makes up about 4% of the world’s population but 20% of the global coronavirus death toll, with the virus disproportionately affecting Black communities. It’s no surprise, then, that Biden said Trump was responsible for contracting coronavirus this month after the president refused to consistently wear a mask and practice social distancing. “Anybody who contracts the virus by essentially saying, ‘Masks don’t matter, social distancing doesn’t matter,’ I think is responsible for what happens to them,” Biden said. Despite derision from Trump advisors and Trump himself, Biden has heeded authorities’ recommendations and consistently worn a mask, according to an analysis by the Washington Post.
Meanwhile, Biden’s plan to tackle COVID-19 prioritizes decisions informed by science. SELF previously reported that testing is key to containing the virus even once we have a vaccine; Biden’s plan promises to double the number of drive-through coronavirus testing sites, invest in rapid testing, and mobilize at least 100,000 Americans in a contact-tracing program. Then there’s the masks aspect, which can make a life-saving difference in this pandemic. Health authorities estimate that consistent mask-wearing between August 6 and December 1 would save about 70,000 American lives. Biden says that if elected, he’ll use the Defense Production Act to ramp up mask production and call on governors to make masks mandatory in their states. He has also promised to reestablish the U.S.’s relationship with the World Health Organization, which Trump severed earlier this year, to better coordinate the American COVID-19 response. Biden says he’ll establish a COVID-19 Racial and Ethnic Disparities Task Force, which his runningmate Senator Kamala Harris proposed, to better address the disproportionate impact the coronavirus is having on Black and brown communities. And with federal authorities currently tallying case counts by state, Biden says he’ll create a nationally run Pandemic Dashboard to help Americans know the real-time coronavirus case count by their zip code.
On health care access:
Biden has long been a staunch supporter of the Affordable Care Act (ACA or “Obamacare”), the health care law put in place under former President Barack Obama. The ACA guarantees that most health care plans offer free preventive care for things like vaccines and disease screenings. It makes it illegal for insurers to deny service or treatment to people with preexisting conditions (previously a common practice) that affect up to one in two Americans, according to the Centers for Medicare and Medicaid Services. The ACA also prohibits insurers from setting lifetime and annual limits on the amount of care you can receive, and it mandates coverage for birth control, breastfeeding equipment and counseling, and mental health and substance abuse services. With the ACA in place, more than 20 million Americans gained health coverage, dropping uninsured rates by a third or more among people of all incomes, according to the Center on Budget Policies and Priorities. The ACA has also had its downsides, such as the unpopular individual mandate, which the Trump Administration repealed in 2017. The Trump Administration has gradually chipped away at Obamacare beyond that as well and asked the Supreme Court to overturn the law this June.
Biden has repeatedly said he doesn’t support “Medicare for all”; his health care platform instead doubles down on the ACA. Biden’s plan will add a public option “like Medicare” to guarantee free health care access to the 4.9 million Americans who live in one of the 14 states that refused to take up the ACA’s Medicaid expansion. The plan proposes to reduce costs for patients by negotiating lower prices from hospitals and other health care providers, and covering primary care without copayments. Other highlights include banning health care providers from charging patients surprise out-of-network rates in certain situations (if you’re hospitalized, for example); limiting drug price increases to inflation (to keep pharmaceuticals companies from drastically raising prices overnight); and allowing consumers to buy prescription drugs from other countries.
Before the 1973 Supreme Court decision Roe v. Wade legalized the right to abortion, illegal abortions accounted for around 17% of all reported pregnancy- and childbirth-related deaths, according to the Guttmacher Institute; the actual number was likely a lot higher. With Trump’s nomination of Barrett to the Supreme Court, pundits say that Roe v. Wade is potentially at risk. If the Court overturns Roe v. Wade, abortion rights would be up to individual states. (Barrett has said she would follow the Court’s precedent on abortion, but in a 2016 presidential debate, Trump said he would appoint “pro-life judges” and that the legality of abortion would indeed go back to individual states. There are also other cases the Court could use to jeopardize access to safe and legal abortion.) Without Roe v. Wade, less than half of U.S. states and no U.S. territories would have other legal protection for abortion access, according to an analysis by the Center for Reproductive Rights; one-third of all women of reproductive age wouldn’t be able to access abortion in their state, according to Planned Parenthood. In October, Biden told reporters that if the Supreme Court does overturn Roe v. Wade, his “only response to that is [to] pass legislation making Roe the law of the land.” It’s not clear how he’d make that happen, given that the Supreme Court could then challenge those laws. Still, Biden has won the endorsement of pro-choice groups including Planned Parenthood and NARAL Pro-Choice.
Biden’s support for abortion hasn’t been unwavering. A devout Catholic, Biden wrote in his 2007 book, Promises to Keep, that he’s “personally opposed to abortion” but that he didn’t feel he had the “right to impose [his] view on the rest of society.” However, as a Senator in 1977, Biden voted against a bill that allowed Medicaid to fund abortions in the case of rape, incest, and concerns for the life of the pregnant person. In 1982, Biden voted for a constitutional amendment that would allow individual states to overturn Roe v. Wade, although the bill never made it to the full Senate and Biden eventually voted against it the following year. Throughout most of his career, Biden also supported the Hyde Amendment, a fiscal measure Congress first passed in 1976 that prevents Medicaid from covering abortion except when a pregnant person’s life is in danger, according to the American Civil Liberties Union. In a 2006 CNN interview, Biden called himself an “odd man out” of the Democratic party for his stance on abortion. Amid criticism from his Democratic rivals during the 2019 presidential primaries, Biden changed his position and said he’d repeal the Hyde Amendment. “If I believe health care is a right, as I do, I can no longer support [the Hyde Amendment],” he said, adding that it was clear states are “passing extreme laws” and “going to stop at nothing to get rid of Roe.”
More recently, Biden has called abortion an “essential health service.” He’s promised to reverse the “global gag rule” (also called the Mexico City policy), which blocks U.S. aid to international organizations that offer or even counsel on abortions. He’s also vowed to restore federal funding for Planned Parenthood by overturning the “domestic gag rule” Trump created, which blocks federal funding for U.S. organizations that provide abortions or abortion referrals outside of medical emergencies. Finally, Biden chose Harris as his running mate—she is a longtime reproductive rights advocate, as SELF has reported, with a 100% rating from NARAL Pro-Choice America.
On climate change:
When you think of climate change, this year’s massive wildfires and nearly record-setting hurricane season probably come to mind. Even beyond those obvious health risks, climate change could have big trickle-down effects on our health, according to the Centers for Disease Control and Prevention (CDC). To name a few: increasing allergies from longer pollen seasons, more food-borne and waterborne diseases, and growing mental health and stress-related disorders linked to climate disasters.
During his 36 years in the Senate, Biden cast pro-environment votes 83% of the time, according to the League of Conservation Voters. He was vice president when former president Barack Obama formally entered the U.S. into the Paris Climate Accord, an international agreement signed by 189 countries to date that seeks to limit global warming to 2°C above pre-industrial levels. In 2017, Trump withdrew the United States from the agreement. Now the United Nations Intergovernmental Panel on Climate Change’s 2018 report concludes that we must limit global warming to 1.5°C to reduce climate change risks like the virtual extinction of coral reefs. To do so, we’ll have to reach “net zero” human-caused emissions of carbon dioxide (CO2) by 2050 by making unprecedented changes in energy use, transportation, and more—a goal the European Union set this March with its European Climate Pact that was reaffirmed by individual European countries.
During the first presidential debate, Trump tried to tie Biden to the Green New Deal, which the president previously (falsely) claimed would ban owning cars and cows. Biden has never fully endorsed the climate change initiative, which New York representative Alexandria Ocasio-Cortez and Senator Edward J. Markey of Massachusetts originally created, although earlier on in his candidacy he said he wanted to rejoin the Paris Climate Agreement with specific emissions reductions targets. Critics said this wasn’t enough; during the 2019 Democratic primaries, a group of young climate change activists gave Biden’s original climate plan an F.
Many critics changed their tune when Biden announced a new climate change plan this August. The updated plan includes a $2 trillion climate change budget over four years—significantly more than the initial $1.7 billion over 10 years he promised during the primaries. It features specific and aggressive targets, including net-zero emissions no later than 2050, a carbon-pollution-free power sector by 2035, upgrading 4 million buildings and weatherizing 2 million houses to improve energy efficiency and emit less carbon, and clean energy investments into carbon-capture technologies and hydrogen power technologies. It also features environmental justice measures, creating an Environmental and Climate Justice Division within the Department of Justice, and aiming 40% of infrastructure benefits to disadvantaged communities. An increase in the corporate tax rate from 21% to 28% would fund these measures, according to the New York Times.
On cannabis legalization and the opioid crisis:
Two-thirds of Americans support cannabis legalization, according to a nationally representative November 2019 Pew survey, reflecting fast-evolving attitudes on the issue. Although Biden has a long history of supporting legislation to limit cannabis use, he’s recently proposed decriminalizing cannabis use and researching therapeutic uses. And with Harris—a lead sponsor of 2018 legislation to legalize cannabis— on the ticket, some pundits speculate Biden may go further.
As a senator, Biden was an author of or proponent for many cannabis restrictions in the ’80s and ’90s, including multiple bills to make federal cannabis laws more punitive. Throughout the 2019 Democratic primaries, critics pointed out Biden’s weak stance on cannabis while his opponents supported legalization in one way or another. Last November, Biden said that cannabis might be a “gateway drug,” then backpedaled, telling a reporter “there’s no evidence I’ve seen that suggests that.” As recently as January 2020, Biden told the New York Times that he opposes cannabis legalization without further research.
Biden’s vision has evolved. His campaign’s criminal justice plan would end prison time for drug use alone, diverting people instead to drug courts and treatment, while his plan for Black America would “automatically expunge all prior cannabis use convictions.” Meanwhile, his veterans plan and his plan for people with disabilities both support the legalization of cannabis for medical purposes and rescheduling the drug to a less restrictive category. This would enable researchers to study medical cannabis so federal law treats it like alcohol and nicotine instead of heroin.
Biden has also proposed a plan to address the opioid crisis. Almost 47,000 Americans died from an opioid drug overdose in 2018, according to the CDC; opioids remain one of the leading causes of death among young people, as SELF previously reported. Biden’s plan calls for $125 billion, paid for by higher taxes on pharmaceuticals companies, to cover opioid programs like substance abuse treatment, overdose prevention, and recovery services. He promises to expand laws requiring insurers to cover and pay for substance abuse treatments and to curb the marketing and overprescription of opioids. Finally, Biden promises to reform the criminal justice system to decriminalize the use of opioids alone.