November 26, 2020

CP Online Health

Eat Well, Life Well

In a near-empty arena on the river in his hometown of Wilmington, Delaware, former Vice President Joe Biden accepted the Democratic nomination for president, promising hope over fear, fairness over privilege, love over hate.

And, he said, “Facts over fiction.”

Let’s see about that.

Our partners at PolitiFact examined a range of claims made by Biden, fact-checking or putting them in context. Here are excerpts related to health policy and the COVID-19 pandemic:

“Five million Americans infected with COVID-19.”

It’s a little higher than that. According to data from Johns Hopkins University, the number of positive tests as of Aug. 20 was 5,573,517.

“More than 170,000 Americans have died.”

This is accurate. Johns Hopkins data counted 174,248 U.S. deaths through Aug. 20.

“More than 50 million people have filed for unemployment this year.”

This, too, is accurate. Since March 21, 57.4 million Americans have filed initial unemployment claims.

“By far the worst performance of any nation on Earth.”

The United States leads the world in the number of COVID-19 cases and deaths. Using other metrics that account for population, the U.S. isn’t the absolute worst, but it still lags behind many other countries. For instance, the United States has the fifth-highest death rate per 100,000 people.

The virus is known to have infected a higher percentage of the population in the U.S. than in many other places. The U.S. has one of the highest rates globally of people who have tested positive — 16,430 per million residents, which is lower than Chile’s, but higher than that of any other large country.

“More than 10 million people are going to lose their health insurance this year.”

This number may be an underestimate. In a July report, the Urban Institute estimated that from April through December 2020, 10.1 million people will lose health insurance tied to a job that they lost during the pandemic. This analysis was done by looking at employment loss projections data from U.S. Labor Department reports.

But that number is lower than another estimate. KFF estimates that nearly 27 million people could lose their employer-sponsored health insurance and become uninsured due to the COVID-19 pandemic. (KHN is an editorially independent program of KFF, the Kaiser Family Foundation). This 27 million figure includes both those who lost employer-sponsored insurance as well as dependents who may have been covered on the same plan. The estimate was based on assessing data from Labor Department unemployment claims and determining whether workers were eligible for ACA insurance.

“The assault on the Affordable Care Act will continue until it’s destroyed, taking insurance away from 20 million people, including more than 15 million people on Medicaid. And getting rid of the protections that President Obama worked so hard to get passed.”

Biden was referring to the coverage losses that would result if a Trump administration-backed lawsuit to overturn the Affordable Care Act is successful. And health policy experts and press reports cite numbers close to what Biden listed.

Close to 20 million people gained health insurance after the Affordable Care Act was enacted, either through the Medicaid expansion or as a result of its marketplace subsidies for individuals below 400% of poverty. So, it follows that if the ACA were overturned, their health coverage would be at risk.

Additionally, an Urban Institute estimate matches Biden’s 15 million figure regarding how many people would lose Medicaid coverage if the ACA were struck down. That would be a result of the federal government no longer helping states pay for Medicaid expansion.

There are other estimates that take into account the effects of the COVID-19 pandemic. The left-leaning Center for American Progress estimates that 3 million additional people (beyond the already estimated 20 million) could lose health insurance coverage because of COVID-19 and be eligible for other government programs, such as Medicaid.

And because the ACA ensures that those with preexisting conditions must be covered by health insurance, that “protection,” as Biden called it, would no longer be in place if the law were overturned, because President Donald Trump has not issued a health care plan that would offer a similar guarantee.

“And after all this time the president still does not have a plan” for the COVID-19 pandemic.

It’s unclear exactly what type of plan Biden is referring to in this general statement. It is true that, thus far, no national testing or contact tracing plan has been issued. Nor has the White House issued a national blueprint to address the COVID-19 pandemic, despite Trump saying he would do so in July.

“We are in the process of developing a strategy that’s going to be very, very powerful. We’ve developed as we go along,” Trump said July 21.

However, the White House has said that Trump does have a plan. Several plans, in fact, seem to have emerged.

Part of one Trump administration plan included restricting travel from areas that have been affected by the virus in March. This initially targeted only China, but then extended to Iran, Italy, South Korea and other European countries. The White House also said Trump worked to expand testing capacity by developing a public and private partnership that would bring more coronavirus testing to parking lots of big-name chain stores. (There were only a few in operation when we checked in April.)

Trump has also touted a plan to develop a COVID-19 vaccine as quickly as possible, called Operation Warp Speed. The goal of Operation Warp Speed is to deliver 300 million doses of a COVID-19 vaccine by January 2021. A federal plan for vaccine distribution is not yet ready.

Throughout the COVID-19 pandemic, Trump has emphasized he wanted state leaders to take control of virus response within their states. But critics say these efforts do not represent a coordinated strategy.

“We’ll have a national mandate to wear a mask, not as a burden, but to protect each other.”

A nationwide mask mandate is easier said than done, given current law.

The Congressional Research Service found that the Centers for Disease Control and Prevention could use the Public Health Service Act (Sec. 361) to issue regulations mandating the use of masks. But a mandate would likely run into legal problems with the Constitution and other laws, including the Religious Freedom Restoration Act of 1993, which requires courts to grant certain religious exemptions.

Meanwhile, the Supreme Court’s interpretation of the 10th Amendment prevents the federal government from controlling or requiring states to carry out federal directives. Congress could incentivize states to enact mask mandates, as long as the incentives aren’t considered significant enough to coerce or force states into enacting the mandate, the CRS report said.

A number of courts have affirmed state and local authority to impose social distancing measures and temporary business closures. Opponents of masks say that the requirement violates their First Amendment rights. At least one federal court has already rejected this claim and said the requirement regulates conduct, not speech.

Daniel Funke,  Louis Jacobson, Victoria Knight, Bill McCarthy, Samantha Putterman, Amy Sherman and Miriam Valverde contributed to this report.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

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