Lisa Jarvis: Trump's worst debate moments came on abortion, health care

Throughout Tuesday night’s hour and 45-minute debate against Vice President Kamala Harris, former President Donald Trump perpetuated a number of lies and half-truths about his record on health care — and seemed unable to offer Americans a concrete vision for how he would secure a healthier future for the country, instead referring only to “concepts of a plan.”

The most egregious falsehood came when Trump was backed into a corner on his flip-flopping position on abortion. He leaned into a fiction he has repeated throughout his campaign: that Democrats want to allow “post-birth abortions.” During the debate, he even claimed Minnesota Governor Tim Walz, Harris’ running mate, “says abortion in the ninth month is absolutely fine. He also says execution after birth, it’s execution, no longer abortion, because the baby is born, is OK.”

Hopefully most rational voters understand what moderator Linsey Davis noted after Trump’s tirade: “There is no state in this country where it is legal to kill a baby after it’s born.”

Trump’s lies about post-birth abortions are especially cruel because, as best I can understand, he is deliberately taking out of context tragic circumstances where a baby is delivered and is too sick to survive — and parents must make the heartbreaking decision to pursue palliative care.

And by ending the protections of Roe v. Wade, the justices appointed to the Supreme Court by Trump have ensured that more families must confront those choices. In the year after the court allowed Texas’ abortion ban to stand, infant deaths rose by roughly 13%, or 255 babies. That included a nearly 23% rise in deaths due to congenital anomalies. That means some women were likely forced to carry a child to term that they knew was going to die after birth.

Trump also slammed “late-term” abortions. But in the exceedingly rare case that someone is undergoing an abortion later in a pregnancy, it’s typically because the baby or mother are not going to survive if the pregnancy continues.

Yet Trump falsely portrayed these cases as situations in which a woman in the “eighth month, ninth month, seventh month” of pregnancy cavalierly decides to end a healthy pregnancy. That’s a twisted fantasy of the far-right. When there’s a medical emergency late in a pregnancy, as one fetal maternal medicine specialist told me plainly, “if the fetus is viable, we’re going to deliver it.”

Another glaring health care falsehood perpetuated by Trump last night was the notion that he had somehow helped to improve the Affordable Care Act. Although he had run on the premise that he would do away with Obamacare, Trump claimed that when faced with the choice to “save it and make it as good as it can be” or to “let it rot,” he “did the right thing.”

In reality, Trump made a number of calculated moves to undermine the ACA, like cutting the subsidies that helped lure insurers into the marketplace. He also made it harder for people to access public insurance options by cutting funding to advertise enrollments, shortening the enrollment window, and slashing by 80% funding to the navigator program, which helps people choose the right plan. As a consequence, ACA enrollments, which had been rising under the Obama administration as the marketplace gained momentum, fell throughout Trump’s presidency.

When President Joe Biden took office, he restored funding to those programs and opened a special enrollment period to offer another chance to people who had missed out under Trump, while also expanding subsidies and introducing tax credits that made care more affordable. That strategy worked and ACA signups began to climb, with the percentage of uninsured Americans eventually hitting an all-time low in 2023.

The question before voters now is how Trump will approach health care if he wins another term. While he continues to take jabs at the ACA and float the idea that he would entertain alternatives if they were better and cheaper, he hasn’t offered anything concrete.

Trump also claimed that his administration “did a phenomenal job with the pandemic,” despite ample evidence that he impeded public health experts’ ability to effectively respond to the crisis. That included undermining the value of masks — a stance that epidemiologists believe cost lives, as well as attempting to slow down the rollout of testing and promoting unproven and even dangerous therapies. And one analysis found that his health care policies leading into Covid’s arrival exacerbated the death toll during the first year of the pandemic.

Trump curiously did not mention the one area of the pandemic where he unambiguously succeeded: Operation Warp Speed. It yielded vaccines and treatments with breathtaking speed, and ultimately saved millions of lives. Yet with deep pockets of his base fixated on the imaginary dangers of these shots, Trump seems reluctant to remind voters of that amazing scientific achievement.

Trump’s omissions and fabrications on health care may have been overshadowed by a more meme-able moment: Trump’s bizarre quip that Harris “wants to do transgender operations on illegal aliens that are in prison.” This struck many viewers as a Mad Libs-style riff on Trump’s favorite divisive issues — transgender medicine, crime and immigration. It’s hard to tell, but the word salad may have been a misleading nod to Harris’ response to a 2019 candidate questionnaire provided by the American Civil Liberties Union, which asked about providing comprehensive health care to transgender people who rely on the state for medical care.

That moment — like “concepts of a plan”— will likely stick with many voters as a memorable example of the way Trump slid off the rails on Tuesday. But what will stick with me is the cruelty behind all of Trump’s health care lies.

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This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.