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When former President Donald Trump and President Joe Biden face off in their first debate tomorrow, it is likely that Trump will use the national stage and massive TV audience to lie, distract, play the victim, and recite a laundry list of grievances. In short, Trump will talk about anything except what he plans to do if he regains the keys to the White House. Voters have seen the same show over and over since he first started running for president in 2015: distract, deflect, project.
What Trump will do in the upcoming debate is obvious; what Biden will do is unknown.
Biden could choose to play on Trump's turf and attempt to show the public how deranged and detached from reality Trump is, or he could use his time on stage—in front of possibly the largest TV audience he will have for the rest of the election—to draw a sharp contrast with Trump about their visions for the country and the policies each would pursue for the next four years.
An actual policy debate may shock the political world, but it is the smartest political strategy for Biden, given all that's at stake.
Poll after poll has shown that far too many voters have memory-holed Trump's White House years. And while it is a massive political problem for Biden and Democrats that voters have forgotten about many of the horrific, cruel, and dangerous policies Trump enacted while he was in office, it is an even bigger problem for Biden and Democrats that most voters have no idea about Trump's even more extreme plans for a second term.
A second Trump presidency could have a devastating impact across many issues, but the difference between Trump and Biden could not be starker than on health care—the issue that most Americans still cite as one of their top concerns.
Trump wants to take a wrecking ball to the health care system in this nation, rolling back progress on everything from affordable coverage to lower-cost prescriptions and new rules to stop price-gouging in Medicare.
And most voters have no idea. Biden must use the debate to change that.
The truth is Trump and his allies have not been shy about their plans to destroy the health care system as we know it. As Ron Brownstein recently laid out, Trump and his Republican allies in Congress have plans to repeal the requirement for insurers to offer affordable coverage to people with preexisting conditions, transform Medicare from insurance into a private voucher program, and turn both Medicaid and the Children's Health Insurance Program (CHIP) into a state block grant which will ration care and could deny people access to coverage even if they're eligible.
And Trump wouldn't stop there. He has also promised to repeal the Inflation Reduction Act's provision allowing the government to negotiate lower prices in Medicare for certain prescription drugs.
Taken all together, Trump's vision for health care would take health care coverage away from tens of millions of people, enable the big insurance and pharmaceutical corporations to price-gouge at will, privatize Medicare, and raise the cost of prescription drugs. All while denying women access to our basic freedoms and rights.
Trump's impact on health care is not theoretical—we've all witnessed it before. Republicans have attempted to repeal the Affordable Care Act—and take away health care coverage from more than 40 million people—more than 100 times. In Trump's first term, repealing the ACA was his top priority. He also proposed massive cuts to both Medicare and Medicaid and appointed health insurance and pharmaceutical executives to key positions throughout his administration.
Trump and other Republicans have made clear they are not only planning on doubling down on the worst of his policies from his first term but preparing for a stunning and unprecedented attack on our health care system in a second term.
Despite Trump and his allies' openly announcing their intentions, most voters have no idea about any of it. Biden needs to use the debate stage to change that—because time is running out. And this might be his last best chance. He cannot afford to squander it.
In politics, it is always better to be on offense than to play on your opponent's turf. And when it comes to health care, Biden is on offense. Health care is one of the issue areas where the vast majority of voters trust Biden over Trump. And what better place to go on offense than in a nationally televised debate in front of tens of millions of voters.
So much of voters' perceptions of Trump are already baked into his poll numbers. Voters are aware of his character flaws, his loose association with the truth and reality, his chaotic behavior, and his ugly and divisive rhetoric. Biden highlighting that on the debate stage simply won't move the needle, as voters want a substantive debate about the future.
Elections are not just about what you have done; they are also about what you will do. And what is not yet baked into the voter's equation is what Trump would do with a second term in the White House, one in which he would not be reined in by any laws or norms.
The debate stage is a unique opportunity to drive home the consequences of reelecting Trump in terms that voters can easily understand: consequences for our health care.
Passing up this opportunity would be political malpractice.
Margarida Jorge is the executive director of Health Care for America Now.
The views expressed in this article are the writer's own.
