Democrats, as they have in the previous two debates, engaged in an intense round of questions about whether Medicare-for-all is a realistic health-care plan.
Biden represents the wing of the party that feels it goes too far and would be too costly, so the more liberal members of the group (such as, but not necessarily led by, Castro) rebutted him. The three candidates in the top tier — Biden and Sens. Elizabeth Warren (Mass.) and Bernie Sanders (I-Vt.) — got the first questions and went a few rounds among themselves before the others were called upon.
On Castro’s turn, he immediately sought to draw a contrast with Biden, who is the leader in the polls. Castro cast Biden’s plan as one that would make people opt in to Medicare, accusing Biden of falling short of Barack Obama’s ultimate goal of having every American insured. Here’s the exchange that resulted.
Castro: “If they choose to hold on to strong, solid private health insurance, I believe they should be able to do that. But the difference between what I support and what you support, Vice President Biden, is that you require them to opt in, and I would not require them to opt in. They would automatically be enrolled. They wouldn’t have to buy-in.
That’s a big difference, because Barack Obama’s vision was not to leave 10 million people uncovered. He wanted every single person in this country covered. My plan would do that. Your plan would not.”
Biden: “They do not have to buy in. They do not have to buy in.”
Castro: “You just said that. You just said that two minutes ago. You just said two minutes ago that they would have to buy in. ”
Biden: (trying to talk over Castro) “I said if they can’t afford it … If you qualify for Medicaid, you’d automatically be …”
Castro: “You said they would have to buy in. Are you forgetting what you said two minutes ago? Are you forgetting already what you said just two minutes ago? I mean, I can’t believe that you said two minutes ago that they had to buy in and now you’re saying that they don’t have to buy in. You’re forgetting that.
Biden: “I said anyone — your grandmother who has no money — she would, you’re automatically enrolled.”
Castro: “We need a health-care system that automatically enrolls people regardless of whether they choose to opt in or not. If you lose your job, for instance, his health-care plan would not automatically enroll you; you would have to opt in. My health-care plan would. That’s a big difference. I’m fulfilling the legacy of Barack Obama, and you’re not.
Biden: “That will be a surprise to him.”
Here’s the quote Castro may have been referring to, from Biden’s earlier exchange with Sanders and Warren: “The option I’m proposing is Medicare-for-all — Medicare for choice. If you want Medicare, if you lose the job from your insurance — from your employer, you automatically can buy in to this. You don’t have — no preexisting condition can stop you from buying in. You get covered, period.”
But what Castro doesn’t mention is Biden also said this: “Okay, number one, my health-care plan does significantly cut the costs of — the largest out-of-pocket payment you’ll pay is $1,000. You’ll be able to get into a — anyone who can’t afford it gets automatically enrolled in the Medicare-type option we have.”
There are two backstories here, the politics and the policy.
Let’s start with the politics. Castro was calling Biden old, plain and simple, by accusing him of forgetting what he said. Whispers about Biden’s age have followed him on the campaign trail.
At 76, he’s not the oldest candidate in the primary. (Sanders is 78. And, for reference, President Trump is 73.) But Biden was most recently on the national stage three years ago, and some people think he’s, well, aged since then.
“Voters are going into events with him expecting ‘Uncle Joe,’ but they come out having seen ‘Grandpa Joe,’ ” strategist Rebecca Katz said in May.
Plus, Biden’s bumper-sticker line to voters is that he is the most experienced, most knowledgeable and most skilled candidate to take on Trump. One reason his age resonates so much is because it’s a symbol of his electability.
Sometimes he does things that make the perception he’s aged worse. “Make sure you have the record player on at night,” he said in Thursday’s debate, referring to how communities can help educate children.
In the first debate, he misstated how people should reach out to his campaign. He has given mediocre debate performances during which, at times, he cuts himself off rather than continuing to fight his primary challengers. (“My time’s up,” he said in one debate.) The Washington Post has found he has mixed up three separate wartime stories into one that never happens, but he tells it every chance he gets on the campaign trail.
His primary opponents have mostly avoided talk of this, at least so directly. It risks coming across as mean or even ageist. Rep. Eric Swalwell (Calif.) repeatedly told Biden to “pass the torch” during the first debate. And Rep. Tim Ryan (Ohio) said last week he thinks Biden is “declining.”
But Swalwell dropped out and Ryan didn’t make the debate stage. Castro was onstage, and went there.
He told ABC after the debate, “I wasn’t taking a shot at his age. It’s about the health-care policy.” But look at the exchange, and you’ll see Castro accused Biden of forgetting not once but several times. It’s hard to believe he didn’t know how his words would be taken.
It looks as though Biden’s age is now fair game for some of his top opponents.
But Biden didn’t actually forget anything. At least, not on the substance of the policy. Biden explained earlier that his plan does allow people to choose Medicare (“Medicare by choice,” he called it), but that people who qualify for it financially will automatically be enrolled in it.
There are people who automatically get enrolled in his plan. As Biden said, these people “do not have to buy in.” Castro might take issue with the fact some people do have to buy in. (Biden said earlier that if you lose your job and need new insurance, you could buy in to this.) But he was incorrect that Biden forgot something about his own plan. It was Castro who forgot what Biden said.
Biden plans to build on Obamacare, which set up a market for private insurance and encouraged states to expand Medicaid, to create a government-run public option as well. Castro’s issue was that Biden’s plan does not create universal coverage; he singled out that an estimated 10 million Americans would still be uninsured under Biden’s plan.
A risky move for Castro just became riskier: He called out Biden in a way that could be considered below the belt. And he didn’t nail the substance. But it got us talking about him.