Biden's health care speech gets the figures mostly right

On the same day the Affordable Care Act made its third appearance before the Supreme Court, President-elect Joe Biden gave a speech on health care and took questions from the press. When asked what he would say to Americans regarding President Donald Trump’s refusal to concede, he responded: "I think it’s an embarrassment," and that "it will not help the president’s legacy." 

But the focus of Biden’s speech was on health care. He, along with Vice President-elect Kamala Harris, warmly defended the importance of the ACA — especially as the coronavirus pandemic continues its hold on the nation. Biden renewed some of his campaign trail promises by pledging that "beginning on Jan. 20 … we are going to do everything in our power to ease the burden of health care on you and your families…. That starts by building on the ACA." 

He also called attention to the people who are either now suffering from COVID-19 physically or economically, noting that 10 million people who lost their jobs have also lost their health insurance. We checked this number when Biden referenced it in his Democratic convention speech and found it may actually be the low end of estimates. A July report by the Urban Institute found that from April through December 2020, 10.1 million people will lose health insurance tied to a job that they lost during the pandemic. But the Kaiser Family Foundation estimates that number closer to 27 million, counting both people who could lose their employer-sponsored health insurance and become uninsured due to the COVID-19 pandemic as well as dependents who may have been covered on the same plan. (KHN is an editorially independent program of KFF.)

Harris warned that a decision to nullify the ACA could "take health care away from 20 million Americans" and "could take away protections for more than 100 million people with pre-existing conditions" — figures that we have previously checked and found accurate — as well as returning to the days when insurers were able to charge women more than men and when pregnancy could be a pre-existing condition. 

Biden and Harris stuck to the health care ideas they raised on the campaign trail, most of which we have checked in the past. Here are some highlights: 

Harris: "We all know that if the Affordable Care Act is struck down, communities of color would be hit particularly hard. Black, Asian, Hispanic and Native American. Because they are at a greater risk of preexisting conditions from asthma to diabetes to lupus. And they are also three times as likely to contract COVID-19 and twice as likely to die as others." 

This is true. An analysis by KFF shows that before the ACA, people of color were more likely to be uninsured than white people. Once the ACA was implemented, insurance coverage rates increased for everyone and while there were larger coverage gains for people of color than for white people, disparities remained. Much of the coverage gains for people of color were through states’ expansion of who was eligible for Medicaid programs. So, if the ACA were overturned and Medicaid expansion were eliminated, it is likely that people of color would be more affected than their white counterparts, since they experienced larger gains in coverage under the ACA. 

People of color are more likely to have certain underlying health conditions than white people. 

According to August data from the Centers for Disease Control and Prevention, American Indian or Alaska Natives, Black or African-Americans and Hispanic or Latino people are all almost three times more likely to contract COVID-19 compared to White people. Black people are two times as likely to die from COVID-19 while the risk is about one times higher for Hispanics and American Indians, all compared to White people. 

Biden: The pandemic "has infected more than 10 million Americans — nearly one in every 32 Americans." 

This is true. There have been more than 10 million confirmed cases of COVID-19 in the U.S., according to the Johns Hopkins Coronavirus Resource Center. And in 2019, the U.S. population was more than 328 million people, according to the Census Bureau. Thus, it’s accurate to estimate that about one in 32 Americans has been infected with COVID-19. 

Biden: The ACA "is a law that reduced prescription drug price costs for 12 million seniors." 

This statement requires context. It’s a point that Biden raised during the campaign in reference to Medicare’s so-called doughnut hole, the name given to the coverage gap in Medicare’s drug program which left beneficiaries who reached that gap responsible for 100% of their prescription drug costs. AARP and other Medicare advocates used the 12 million in an amicus brief filed with the Supreme Court. The ACA included a provision designed to gradually close this coverage gap. But in 2019, Congress acted separately to expedite this action. As of 2019, the gap was closed. As a result, experts we consulted were mixed on whether this action would be overturned even if the law was.