Vance and Walz acknowledged occasional agreement on policy points and respectfully addressed each other throughout the debate. But they were more pointed in their attacks on their rival’s running mate for challenges facing the country, including immigration and inflation.

The moderators, “CBS Evening News” anchor Norah O’Donnell and “Face the Nation” host Margaret Brennan, had said they planned to encourage candidates to fact-check each other, but sometimes clarified statements from the candidates.

After Vance made assertions about Springfield, Ohio, being overrun by “illegal immigrants,” Brennan pointed out that a large number of Haitian immigrants in Springfield, Ohio, are in the country legally. Vance objected and, eventually, CBS exercised the debate ground rule that allowed the network to cut off the candidates’ microphones.

Most points were not fact-checked in real time by the moderators. Vance resurfaced a recent health care theme — that as president, Donald Trump sought to save the Affordable Care Act — and acknowledged that he would support a national abortion ban.

Walz described how health care looked before the ACA compared with today. Vance offered details about Trump’s health care “concepts of a plan” — a reference to comments Trump made during the presidential debate that drew jeers and criticism for the former president, who for years said he had a plan to replace the ACA that never surfaced. Vance pointed to regulatory changes advanced during the Trump administration, used weedy phrases like “reinsurance regulations,” and floated the idea of allowing states “to experiment a little bit on how to cover both the chronically ill but the non-chronically ill.”

Walz responded with a quick quip: “Here’s where being an old guy gives you some history. I was there at the creation of the ACA.” He said that before then insurers had more power to kick people off their plans. Then he detailed Trump’s efforts to undo the ACA as well as why the law’s preexisting condition protections were important.

“What Sen. Vance just explained might be worse than a concept, because what he explained is pre-Obamacare,” Walz said.

The candidates sparred on numerous topics. Our fact-checked and on their .

The health-related excerpts follow.

The Affordable Care Act:

Vance: “Donald Trump could have destroyed the [Affordable Care Act]. Instead, he worked in a bipartisan way to ensure that Americans had access to affordable care.”

False.

As president, Trump worked to undermine and repeal the Affordable Care Act. He cut millions of dollars in federal funding for ACA outreach and navigators who help people sign up for health coverage. He enabled the sale of short-term health plans that don’t comply with the ACA consumer protections and allowed them to be sold for longer durations, which siphoned people away from the health law’s marketplaces.

Trump’s administration also backed state Medicaid waivers that imposed first-ever work requirements, reducing enrollment. He also ended insurance company subsidies that helped offset costs for low-income enrollees. He backed an unsuccessful repeal of the landmark 2010 health law and he backed the demise of a penalty imposed for failing to purchase health insurance.

 by more than 2 million people during Trump’s presidency, and the  by 2.3 million, including 726,000 children, from 2016 to 2019, the U.S. Census Bureau reported; that includes three years of Trump’s presidency.Ìý The number of insured Americans rose again during the Biden administration.

Abortion and Reproductive Health:

Vance: “As I read the Minnesota law that [Walz] signed into law … it says that a doctor who presides over an abortion where the baby survives, the doctor is under no obligation to provide lifesaving care to a baby who survives a botched late-term abortion.”

.

Experts said cases in which a baby is born following an attempted abortion are rare. Less than 1% of abortions nationwide occur in the third trimester. And infanticide, the crime of killing a child within a year of its birth, is illegal in every state.

In May 2023, Walz, as Minnesota governor, signed legislation updating a state law for “infants who are born alive.” It said babies are “fully recognized” as human people and therefore protected under state law. The change did not alter regulations that already required doctors to provide patients with appropriate care.

Previously, state law said, “All reasonable measures consistent with good medical practice, including the compilation of appropriate medical records, shall be taken by the responsible medical personnel to preserve the life and health of the born alive infant.” The law was updated to instead say medical personnel must “care for the infant who is born alive.”

When there are fetal anomalies that make it likely the fetus will die before or soon after birth, some parents decide to terminate the pregnancy by inducing childbirth so that they can hold their dying baby, Democratic Minnesota state Sen. Erin Maye Quade told PolitiFact in September.

This update to the law means infants who are “born alive” receive appropriate medical care dependent on the pregnancy’s circumstances, Maye Quade said.

Vance supported a national abortion ban before becoming Trump’s running mate.

CBS News moderator Margaret Brennan told Vance, “You have supported a federal ban on abortion after 15 weeks. In fact, you said if someone can’t support legislation like that, quote, ‘you are making the United States the most barbaric pro-abortion regime anywhere in the entire world.’ My question is, why have you changed your position?”

Vance said that he “never supported a national ban” and, instead, previously supported setting “some minimum national standard.”

But in a January 2022 podcast interview, Vance said, “I certainly would like abortion to be illegal nationally.” , he told reporters that “we can’t give in to the idea that the federal Congress has no role in this matter.”

Since joining the Trump ticket, Vance has aligned his abortion rhetoric to match Trump’s and has said that abortion legislation should be left up to the states.

— Samantha Putterman of PolitiFact, on the live blog

A woman’s 2022 death in Georgia following the state passing its six-week abortion ban was deemed “preventable.”

Walz talked about the death of 28-year-old Amber Thurman, a Georgia woman who died after her care was delayed because of the state’s six-week abortion law. A judge called the law unconstitutional this week.

A Sept. 16 found that Thurman had taken abortion pills and encountered a rare complication. She sought care at Piedmont Henry Hospital in Atlanta to clear excess fetal tissue from her uterus, called a dilation and curettage, or D&C. The procedure is commonly used in abortions, and any doctor who violated Georgia’s law could be prosecuted and face up to a decade in prison.

Doctors waited 20 hours to finally operate, when Thurman’s organs were already failing, ProPublica reported. A panel of health experts tasked with examining pregnancy-related deaths to improve maternal health deemed Thurman’s death “preventable,” according to the report, and said the hospital’s delay in performing the procedure had a “large” impact.

— Samantha Putterman of PolitiFact, on the live blog

What Project 2025 Says About Some Forms of Contraception, Fertility Treatments

Walz said that Project 2025 would “make it more difficult, if not impossible, to get contraception and limit access, if not eliminate access, to fertility treatments.”

. The Project 2025 document doesn’t call for restricting standard contraceptive methods, such as birth control pills, but it defines emergency contraceptives as “abortifacients” and says they should be eliminated from the Affordable Care Act’s covered preventive services. Emergency contraception, such as Plan B and ella, , according to medical experts.

PolitiFact did not find any mention of in vitro fertilization throughout the document, or specific recommendations to curtail the practice in the U.S., but it contains language that supports legal rights for fetuses and embryos. Experts say this language can threaten family planning methods, including IVF and some forms of contraception.

— Samantha Putterman of PolitiFact, on the live blog

Walz: “Their Project 2025 is gonna have a registry of pregnancies.”

. 

Project 2025 recommends that states submit more detailed abortion reporting to the federal government. It calls for more information about how and when abortions took place, as well as other statistics for miscarriages and stillbirths.

The manual does not mention, nor call for, a new federal agency tasked with registering pregnant women.

Fentanyl and Opioids:

Vance: “Kamala Harris let in fentanyl into our communities at record levels.”

Mostly False.

Illicit fentanyl seizures have been rising for years and reached record highs under Biden’s administration. In fiscal year 2015, for example, U.S. Customs and Border Protection . As of August 2024, agents have  of fentanyl in fiscal year 2024, which ended in September.

But these are fentanyl seizures — not the amount of the narcotic being “let” into the United States. 

Vance made this claim while criticizing Harris’ immigration policies. But fentanyl enters the U.S. through the southern border mainly at official ports of entry. It’s  in by U.S. citizens, according to the U.S. Sentencing Commission. Most illicit fentanyl in the U.S.  made with chemicals from Chinese labs.

Drug policy experts have said that the illicit fentanyl crisis began  Biden’s administration and that Biden’s border policies are not to blame for overdose deaths. 

Experts have also said  in reducing illicit fentanyl. Congressional funding for more vehicle scanners would help law enforcement seize more of the fentanyl that comes into the U.S. Harris has  increased enforcement against illicit fentanyl use.

Walz: “And the good news on this is, is the last 12 months saw the largest decrease in opioid deaths in our nation’s history.”

Mostly True.

Overdose deaths involving opioids decreased from an estimated 84,181 in 2022 to 81,083 in 2023, based on the most recent provisional data from the Centers for Disease Control and Prevention. This decrease, which took place in the second half of 2023, followed a 67% increase in opioid-related deaths between 2017 and 2023.

The U.S. had an estimated 107,543 drug overdose deaths in 2023 — a 3% decrease from the 111,029 deaths estimated in 2022. This is the  in overall drug overdose deaths since 2018. Nevertheless, the opioid death toll remains much higher than just a few years ago, .Ìý

More Health-Related Comments:

Vance Said ‘Hospitals Are Overwhelmed.’ Local Officials Disagree.

We asked health officials ahead of the debate what they thought about Vance’s claims about Springfield’s emergency rooms being overwhelmed.

“This claim is not accurate,” said Chris Cook, health commissioner for Springfield’s Clark County.

 from the Centers for Medicare & Medicaid Services tracks how many patients are “left without being seen” as part of its effort to characterize whether ERs are able to handle their patient loads. High percentages usually signal that the facility doesn’t have the staff or resources to provide timely and effective emergency care.

Cook said that the full-service hospital, Mercy Health Springfield Regional Medical Center, reports its emergency department is at or better than industry standard when it comes to this metric.

In July 2024, 3% of Mercy Health’s patients were counted in the “left-without-being-seen” category — the same level as both the state and national average for high-volume hospitals. In July 2019, Mercy Health tallied 2% of patients who “left without being seen.” That year, the state and national averages were 1% and 2%, respectively.  Another CMS 2024 data point shows Mercy Health patients spent less time in the ER per visit on average — 152 minutes — compared with state and national figures: 183 minutes and 211 minutes, respectively. Even so, Springfield Regional Medical Center’s Jennifer Robinson noted that Mercy Health has seen high utilization of women’s health, emergency, and primary care services. 

— Stephanie Armour, Holly Hacker, and Stephanie Stapleton of Â鶹ŮÓÅ Health News, on the live blog

Minnesota’s Paid Leave Takes Effect in 2026

Walz into law in 2023 and it will take effect in 2026.

 will provide employees up to 12 weeks of paid medical leave and up to 12 weeks of paid family leave, which includes bonding with a child, caring for a family member, supporting survivors of domestic violence or sexual assault, and supporting active-duty deployments. A maximum 20 weeks are available in a benefit year if someone takes both medical and family leave.

Minnesota used a projected budget surplus to jump-start the program; funding will then shift to a payroll tax split between employers and workers. 

—â¶Ä¯Amy Sherman of PolitiFact, on the live blog

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The debate was hosted by ABC with moderators David Muir and Linsey Davis, who occasionally fact-checked Trump. He complained on the Fox News show “Fox & Friends” on Wednesday morning that it was a “three-to-one” contest.

The two presidential candidates covered a wide range of issues — from job and inflation numbers to abortion and immigration — in exchanges marked by personal attacks. As our PolitiFact partners noted, Harris often directly addressed Trump while answering the moderators’ questions. Trump mostly stared straight ahead. In response to Trump’s claims about the Biden administration’s record on crime, Harris cited Trump’s criminal conviction in New York and other indictments.

The moderators questioned Trump about whether he would attempt to dismantle the Affordable Care Act, also known as Obamacare — the health insurance program he pledged and failed to repeal and replace during his previous administration.

He said, if president, he would “only change it if we come up with something that’s better and less expensive.” He went on to say, “There are concepts and options we have to do that, and you’ll be hearing about it in the not-too-distant future.”

Trump has promised an Obamacare replacement since he was on the campaign trail in 2015. He claimed during the debate that he “saved” the ACA by issuing regulations aimed at lowering insurance premiums.

Harris’ previous support for “Medicare for All,” a proposal to replace private health insurance with a government-run health system, drew questions from the moderators and attacks by Trump.

Abortion was a clear flash point. Harris called state restrictions on the procedure enacted since 2022 “Trump abortion bans” and said it was immoral to take away a woman’s ability to make decisions about her own body. She also pledged to sign any bill that would reinstate the protections outlined in Roe v. Wade, which the Supreme Court overturned in 2022.

Trump said that as president he would never face the question of signing a national abortion ban because the issue is now being settled in states. “I’m not signing a ban,” he said. “There’s no reason to sign a ban.”

Trump also resurfaced claims — repeatedly judged false by PolitiFact and other fact-checking organizations — that Democrats support abortions up to the moment of birth and the “execution” of babies after birth. ABC’s Davis flagged Trump’s statement, saying that willfully terminating a newborn’s life is illegal in every state. In addition, the majority of Democrats support abortion access up to fetal viability, when the fetus is able to survive outside the womb, typically around 24 weeks of pregnancy.

Harris brought up Project 2025, a policy blueprint created by the conservative Heritage Foundation from which Trump has sought to distance himself.

Moments after the debate ended, pop superstar on Instagram that she would be voting for Harris “because she fights for the rights and causes I believe need a warrior to champion them.” Swift’s post featured a photo of her with her cat and was signed “Childless Cat Lady” — a reference to comments made by JD Vance, the Republican vice presidential candidate.

Our fact-checked the debate in real time on , with , as Harris and Trump clashed on the economy, immigration, and abortion.

Excerpts detailing specific health-related claims follow.

Trump: “But the governor before, he said, ‘The baby will be born, and we will decide what to do with the baby.’”

Trump initially referenced a West Virginia governor. He meant Virginia, and corrected himself later in the debate.

Former Virginia Gov. Ralph Northam, a Democrat and a physician, never said he would sanction the execution of newborns. What he did say during a 2019 radio interview is that in rare, late-pregnancy cases when fetuses are nonviable, doctors deliver the baby, keep it comfortable, resuscitate it if the family wishes, and then have a “discussion” with the mother.

The issue is that Northam declined to say what that discussion would entail. Trump puts words in the then-governor’s mouth, saying doctors would urge the mother to let them forcibly kill the newborn, which is a felony in Virginia (and all other states) punishable by a long prison sentence or death.

Trump: “Every legal scholar, every Democrat, every Republican, liberal, conservative, they all wanted [abortion] to be brought back to the states where the people could vote.”

.Ìý

The 1973 Roe v. Wade decision inspired legions of supporters and opponents. Before the U.S. Supreme Court overturned it in 2022, numerous legal scholars wrote briefs urging the court to uphold the ruling.

Some legal scholars who favor abortion rights have criticized the 1973 ruling’s legal underpinnings, saying that different constitutional arguments, based on equal protection, would have provided a stronger case. But legal experts, including some who held this view, said those scholars would not have advocated for overturning Roe on this basis.

Trump: On the Affordable Care Act, “I saved it.”

False.Ìý

During 2016, Trump campaigned on repealing and replacing the Affordable Care Act. While president, he sought to repeal the measure — and failed.

But his administration pursued that hindered its reach and effectiveness, including cutting millions of dollars in advertising and outreach funding. He cut subsidies to insurance companies that offered coverage on the exchanges. He also took regulatory steps to permit less expensive and less comprehensive health coverage — for example, short-term health plans that didn’t comply with the ACA.

During the Trump administration, , and the by 2.3 million from 2016 to 2019, including 726,000 children, according to the

Trump: Harris “wants everybody to be on government insurance” for health care.

This is misleading.

Harris once co-sponsored a bill to expand Medicare to Americans of all ages, but she does not currently support this proposal.

In April 2019, Harris became of the Medicare for All Act of 2019 sponsored by Sen. Bernie Sanders (I-Vt.). The legislation would have established a national health insurance program administered by the federal Department of Health and Human Services.

The bill would have created an automatic, federally run health insurance program for all Americans, which would mirror the socialized medicine systems in such countries as the United Kingdom.

Harris backed the bill when she was preparing to run in the 2020 presidential primaries and many candidates believed that Democratic base voters wanted the most liberal positions possible.

However, Medicare for All failed to advance to a vote in the Senate. After her 2020 candidacy ended, Harris focused instead on bolstering the ACA as opposed to pushing for Medicare for All.

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La cadena ABC organizó el debate, moderado por David Muir y Linsey Davis, quienes ocasionalmente revisaron las afirmaciones de Trump. A la mañana siguiente, en el programa “Fox & Friends” de Fox News, Trump dijo que había sido un “debate de tres contra uno”.

Los dos candidatos presidenciales abordaron una amplia gama de temas, desde cifras de empleo e inflación hasta el aborto y la inmigración, en intercambios marcados por ataques personales.

Como señaló PolitiFact, Harris a menudo se dirigía directamente a Trump mientras respondía a las preguntas de los moderadores. Trump en su mayoría miraba al frente. En respuesta a las afirmaciones de Trump sobre el historial del gobierno de Biden en materia de crimen, Harris mencionó la condena penal de Trump en Nueva York, y otras acusaciones.

Los moderadores le preguntaron a Trump sobre si intentaría desmantelar la Ley de Cuidado de Salud a Bajo Precio (ACA, también conocida como Obamacare), el programa de seguro médico que prometió derogar y reemplazar durante su administración, algo que no logró.

Dijo que, si volviera a ser presidente, “solo lo cambiaría si encontráramos algo que fuera mejor y menos costoso”. Y agregó: “Hay conceptos y opciones para hacerlo, y los escucharán en un futuro no muy lejano”.

Trump ha estado prometiendo que reemplazaría el Obamacare desde su campaña de 2015. Durante el debate afirmó que “salvó” a ACA al emitir regulaciones destinadas a reducir las primas de los seguros.

El anterior apoyo de Harris al “Medicare para Todos”, una propuesta para reemplazar el seguro de salud privado por un sistema de salud administrado por el gobierno, generó preguntas de los moderadores y ataques por parte de Trump.

El aborto fue un claro punto de conflicto. Harris definió a las restricciones estatales impuestas al procedimiento, promulgadas desde 2022, como “las prohibiciones de Trump al aborto”, y dijo que era inmoral quitarle a una mujer la capacidad de tomar decisiones sobre su propio cuerpo. También prometió firmar cualquier ley que restableciera las protecciones descritas en Roe vs. Wade, que la Corte Suprema revocó en 2022.

Trump dijo que, como presidente, nunca enfrentaría la cuestión de firmar una prohibición nacional del aborto porque el tema ahora se está resolviendo en los estados. “No voy a firmar una prohibición”, dijo. “No hay razón para firmar una prohibición”.

Trump también sacó de nuevo a la luz afirmaciones, repetidamente consideradas falsas por PolitiFact y otras organizaciones de verificación de datos, de que los demócratas apoyan los abortos hasta el momento del nacimiento y la “ejecución” de bebés después del nacimiento.

Momentos después de terminar el debate, la super estrella del pop publicó en Instagram que votaría por Harris “porque lucha por los derechos y causas que creo que necesitan a un guerrero que las defienda”. La publicación de Swift incluyó una foto de ella con su gato y estaba firmada como “Childless Cat Lady” (“Dama de gatos sin hijos”), una referencia a los comentarios de JD Vance, el candidato republicano a la vicepresidencia.

verificó lo dicho en el debate en tiempo real en , mientras Harris y Trump chocaban sobre economía, inmigración y aborto.

A continuación, extractos que detallan afirmaciones específicas relacionadas con la salud:

Trump: “Pero el gobernador antes, dijo: ‘El bebé nacerá, y decidiremos qué hacer con el bebé’”.

.

Trump inicialmente mencionó a “un gobernador de West Virginia”. Se refería a Virginia y se corrigió más tarde en el debate.

El ex gobernador de Virginia, Ralph Northam, demócrata y médico, nunca dijo que sancionaría la ejecución de recién nacidos. Lo que dijo en una entrevista de radio en 2019 es que, en raros casos de embarazo avanzado cuando los fetos no son viables, los médicos entregan al bebé, lo mantienen cómodo, lo reaniman si la familia lo desea y luego tienen una “discusión” con la madre.

El problema es que Northam se negó a decir en qué consistiría esa discusión. Trump pone palabras en la boca del entonces gobernador, diciendo que los médicos instarían a la madre a que permitiera que mataran al bebé, lo cual es un delito grave en Virginia (y en todos los demás estados) castigado con una larga condena de prisión o la pena de muerte.

Trump: “Todos los estudiosos del derecho, todos los demócratas, todos los republicanos, liberales, conservadores, todos querían que [el aborto] volviera a los estados donde la gente pudiera votar”.

.

La decisión Roe vs. Wade de 1973 inspiró legiones de partidarios y opositores. Antes de que la Corte Suprema de Estados Unidos la anulara en 2022, numerosos estudiosos del derecho escribieron informes instando a la corte a mantener el fallo.

Algunos académicos que apoyan el derecho al aborto han criticado los fundamentos legales de la decisión de 1973, diciendo que otros argumentos constitucionales, basados en la protección igualitaria, habrían proporcionado un caso más sólido. Pero los expertos legales, incluidos algunos que sostenían esta opinión, dijeron que esos académicos nunca habrían abogado por anular Roe sobre esta base.

Trump: Sobre la Ley de Cuidado de Salud a Bajo Precio, “Yo la salvé”.

Falso.

Durante 2016, Trump hizo campaña para derogar y reemplazar ACA. Mientras fue presidente, intentó derogarla y fracasó.

Pero su administración que obstaculizaron su alcance y efectividad, incluido el recorte de millones de dólares en publicidad y financiación de divulgación. Cortó los subsidios a las compañías de seguros que ofrecían cobertura en los intercambios. También tomó medidas regulatorias para permitir planes de salud menos costosos y menos completos, por ejemplo, planes de salud de corto plazo que no cumplían con los requerimientos de ACA.

Durante la administración Trump, la y el número de estadounidenses aumentó en 2.3 millones de 2016 a 2019, incluidos 726,000 niños, según la .

Trump: Harris “quiere que todos estén en un seguro gubernamental” para la atención médica.

Esto es engañoso.

Harris una vez copatrocinó un proyecto de ley para expandir Medicare a estadounidenses de todas las edades, pero actualmente no apoya esta propuesta.

En abril de 2019, Harris se convirtió en originales de la Ley Medicare para Todos de 2019 patrocinada por el senador Bernie Sanders (independiente de Vermont). La legislación habría establecido un programa nacional de seguro de salud administrado por el Departamento de Salud y Servicios Humanos (HHS) federal.

El proyecto de ley habría creado un programa de seguro de salud federal automático para todos los estadounidenses, que reflejaría los sistemas de medicina socializada en países como el Reino Unido.

Harris respaldó el proyecto de ley cuando se preparaba para postularse en las primarias presidenciales de 2020 y muchos candidatos creían que los votantes de la base demócrata querían las posiciones más liberales posibles.

Sin embargo, Medicare para Todos no logró avanzar a una votación en el Senado. Después de que su candidatura en 2020 terminara, Harris se centró en fortalecer ACA en lugar de impulsar Medicare para Todos.

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Biden, who spoke in a raspy voice and often struggled to articulate his arguments, said at one point that his administration “finally beat Medicare.” Trump, meanwhile, repeated numerous falsehoods, including that Democrats want doctors to be able to abort babies after birth.

Trump took credit for the Supreme Court’s 2022 decision that upended Roe v. Wade and returned abortion policy to states. “This is what everybody wanted,” he said, adding “it’s been a great thing.” Biden’s response: “It’s been a terrible thing.”

In one notable moment, Trump said he would not repeal FDA approval for medication abortion, used last year in of U.S. abortions. Some conservatives have targeted the FDA’s more than 20-year-old approval of the drug mifepristone to further restrict access to abortion nationwide.

“The Supreme Court just approved the abortion pill. And I agree with their decision to have done that, and I will not block it,” Trump said. The Supreme Court ruled this month that an alliance of anti-abortion medical groups and doctors lacked standing to challenge the FDA’s approval of the drug. The court’s ruling, however, did not amount to an approval of the drug.

CNN hosted the debate, which had no audience, at its Atlanta headquarters. CNN anchors Jake Tapper and Dana Bash moderated. The debate format allowed CNN to mute candidates’ microphones when it wasn’t their turn to speak.

Our fact-checked the debate in real time as Biden and Trump clashed on the economy, immigration, and abortion, and revisited discussion of their ages. Biden, 81, has become the oldest sitting U.S. president; if Trump defeats him, he would end his second term at age 82. You can read the and excerpts detailing specific health-related claims follow:

Biden: “We brought down the price [of] prescription drug[s], which is a major issue for many people, to $15 for an insulin shot, as opposed to $400.”

. Biden touted his efforts to reduce prescription drug costs by referring to the $35 monthly insulin price cap his administration put in place as part of the 2022 Inflation Reduction Act. But he initially flubbed the number during the debate, saying it was lowered to $15. In his closing statement, Biden corrected the amount to $35.

The price of insulin for Medicare enrollees, starting in 2023, dropped to $35 a month, not $15. Drug pricing experts told PolitiFact when it rated a similar claim that most Medicare enrollees were likely not paying a monthly average of $400 before the changes, although because costs vary depending on coverage phases and dosages, some might have paid that much in a given month.

Trump: “I’m the one that got the insulin down for the seniors.”

Mostly False. When he was president, Trump instituted the , a program that capped insulin costs at $35 a month for some older Americans in participating drug plans.

But because it was voluntary, , including Medicare Advantage plans, participated in 2022, according to Â鶹ŮÓÅ. Trump’s plan also covered only one form of each dosage and insulin type.

Biden points to the Inflation Reduction Act’s mandatory $35 monthly insulin cap as a major achievement. This cap applies to all Medicare prescription plans and expanded to all covered insulin types and dosages. Although Trump’s model was a start, it did not have the sweeping reach that Biden’s mandatory cap achieved.

Biden: Trump “wants to get rid of the ACA again.”

. In 2016, Trump campaigned on a promise to repeal and replace the Affordable Care Act, or ACA. In the White House, Trump supported a failed effort to do just that. He repeatedly said he would dismantle the health care law in campaign stops and social media posts throughout 2023. In March, however, Trump walked back this stance, writing on his Truth Social platform that he “isn’t running to terminate” the ACA but to make it “better” and “less expensive.” Trump hasn’t said how he would do this. He has often promised Obamacare replacement plans without ever producing one.

Trump: “The problem [Democrats] have is they’re radical, because they will take the life of a child in the eighth month, the ninth month, and even after birth.”

False. Willfully terminating a newborn’s life is infanticide and illegal in every U.S. state.Ìý

Most elected Democrats who have spoken publicly about this have said they support abortion under Roe v. Wade’s standard, which allowed access up to fetal viability — typically around 24 weeks of pregnancy, when the fetus can survive outside the womb. Many Democrats have also said they support abortions past this point if the treating physician deems it necessary.

Medical experts say situations resulting in fetal death in the third trimester are rare — fewer than 1% of abortions in the U.S. occur after 21 weeks — and typically involve fatal fetal anomalies or life-threatening emergencies affecting the pregnant person. For fetuses with very short life expectancies, doctors may induce labor and offer palliative care. Some families choose this option when facing diagnoses that limit their babies’ survival to minutes or days after delivery.

Some Republicans who have made claims similar to Trump’s point to Democratic support of the , which would have prohibited many state government restrictions on access to abortion, citing the bill’s provisions that say providers and patients have the right to perform and receive abortion services without certain limitations or requirements that would impede access. Anti-abortion advocates say the bill, which failed in the Senate by a 49-51 vote, would have created a loophole that eliminated any limits on abortions later in pregnancy.

Alina Salganicoff, director of Â鶹ŮÓÅ’s Women’s Health Policy program, said the legislation would have allowed health providers to perform abortions without obstacles such as waiting periods, medically unnecessary tests and in-person visits, or other restrictions. The bill would have allowed an abortion after viability when, according to the bill, “in the good-faith medical judgment of the treating health care provider, continuation of the pregnancy would pose a risk to the pregnant patient’s life or health.”

Trump: “Social Security, he’s destroying it, because millions of people are pouring into our country, and they’re putting them onto Social Security. They’re putting them onto Medicare, Medicaid.”

False. It’s that immigration will destroy Social Security. Social Security’s fiscal challenges stem from a shortage of workers compared with beneficiaries.

Immigration is far from a fiscal fix-all for Social Security’s challenges. But having more immigrants in the United States would likely increase the worker-to-beneficiary ratio, potentially for decades, thus extending the program’s solvency.

Most immigrants in the U.S. without legal permission are also . However, people who entered the U.S. without authorization and were granted humanitarian parole — temporary permission to stay in the country — for more than one year are eligible for benefits from the program.

Immigrants lacking legal residency in the U.S. are generally in federally funded health care coverage such as Medicare and Medicaid. (Some Medicaid coverage under regardless of immigration status. Immigrants are eligible for regardless of their legal status.)

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With Biden and former President Donald Trump now the presumptive Democratic and Republican nominees, Biden used the roughly 68-minute speech to counter his lackluster public approval ratings and draw clear contrasts between his administration’s policies and those of Trump and some congressional Republicans. But he never mentioned Trump by name, instead referring to him as his “predecessor.”

Biden came out swinging, speaking about freedom and democracy, and support for Ukraine and NATO. And he reminded lawmakers that history is watching.

Our fact-checked the debate in real time. Read the .

Early in the speech, Biden pointed to the recent that effectively shut down in vitro fertilization treatments across the state, although its governor into law March 6 to shield patients and providers from potential legal liability.

Biden challenged his “friends across the aisle” to “guarantee the right to IVF nationwide,” and connected this issue directly to the 2022 Supreme Court decision overturning Roe v. Wade.

White House guests for the speech included Latorya Beasley of Birmingham, Alabama, whose IVF treatments were canceled because of her state’s court decision; and Kate Cox, who was denied an emergency abortion by the Texas Supreme Court. Members of the Democratic Women’s Caucus sat en bloc, wearing white to show solidarity for reproductive rights.Ìý

“Like most Americans, I believe Roe v. Wade got it right,” Biden said, adding that his “predecessor” came to office “determined” to see it overturned and has bragged about its undoing. “Clearly, those bragging about overturning Roe v. Wade have no clue about the power of women in America.”

Biden’s other health care hits included the first steps in implementing , something on Democrats’ longtime policy wish list that became law as part of the Inflation Reduction Act he signed in August 2022. He noted that the federal health insurance program for seniors is now — for the first time — negotiating lower prices for some of the costliest drugs on the market. He pointed not only to the savings it would bring seniors, but also to the federal budget. Currently, 10 drugs are on the list, which will be added to in future years. Biden called for an expansion of the program: “Now it’s time to go further and give Medicare the power to negotiate lower prices for 500 drugs over the next decade.”

He also claimed victory with other in that law — including a $35 insulin price cap and a $2,000 price cap on Medicare out-of-pocket drug expenses. In each of case, he challenged Congress to act with him to expand these steps to include everyone.

When it came to the Affordable Care Act, he said it is “still a very big deal” and pledged not only to protect it, but also to expand it by working to first advanced at the height of the covid-19 pandemic to make health insurance more affordable.

“My predecessor and many in this chamber want to take that protection away by repealing the Affordable Care Act; I won’t let that happen,” he said, drawing heckles from opponents in the audience.

Afterward, some Republicans, including House Speaker Mike Johnson (R-La.), said the address was . , telling Fox News that Biden “suffers from a terminal case of Trump derangement syndrome.” And Sen. Katie Britt (R-Ala.) gave .  

Here are health care highlights from PolitiFact:

“The Alabama Supreme Court shut down IVF treatments across the state, unleashed by a Supreme Court decision overturning Roe v. Wade.”

On Feb. 16, the Alabama Supreme Court that said frozen embryos should be considered children.

The decision lacks the power to shut down in vitro fertilization treatments statewide. But it caused in the state to pause IVF treatments as they reviewed the decision and potential liabilities.

Since then, Alabama lawmakers to shield IVF providers from civil or criminal liability in a rush to protect fertility treatments after backlash grew. they were resuming operations after Republican Gov. Kay Ivey signed the law.

Sen. Tammy Duckworth (D-Ill.) — who had two daughters using in vitro fertilization — introduced a aimed at protecting IVF. But Sen. Cindy Hyde-Smith (R-Miss.) Feb. 28, saying it was a “vast overreach that is full of poison pills that go way too far — far beyond ensuring legal access to IVF.”

“If you, the American people, send me a Congress that supports the right to choose, I promise you: I will restore Roe v. Wade as the law of the land again.”

PolitiFact continues to rate Biden’s promise to codify Roe v. Wade as “.”

Biden called on Congress to help him achieve his 2020 campaign promise to codify Roe v. Wade.

He can’t do it alone.

The Supreme Court ruled in 2022 to overturn Roe, ending nearly 50 years of federally protected abortion access.

Sen. Tammy Baldwin (D-Wis.) introduced the , which would prohibit governmental restrictions on access to abortion. But it has no Republican co-sponsors and didn’t advance.

PolitiFact has been tracking Biden’s campaign promise to codify Roe v. Wade, one of about 100 promises on the . The lack of 10 Republicans needed to overcome an expected filibuster has stalled Biden’s efforts on codification. That obstacle remained even after Democrats kept narrow control of the Senate in the midterms.

“Americans pay more for prescription drugs than anywhere in the world.”

PolitiFact rated a similar claim by Biden as “”

U.S. per capita spending on prescription drugs is nearly three times the average of other advanced, industrialized countries that comprise the Organization for Economic Co-operation and Development. A ., a nonpartisan research organization, found that, across all drugs, U.S. prices were 2.78 times as high as the combined prices in 33 OECD countries.

The gap was even larger for brand-name drugs, with U.S. prices averaging 4.22 times as much as those in comparison nations. The U.S. pays less than comparable nations for unbranded, generic drugs, which account for about 90% of filled prescriptions in the country yet make up only one-fifth of prescription drug spending.

Researchers say factors including country-specific pricing, confidential rebates, and other discounts can obscure actual prices, making comparisons harder.

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DeSantis and Haley fired a frenzy of attacks at each other’s records and positions. The faceoff was moderated by CNN “State of the Union” co-anchors Jake Tapper and Dana Bash.

Our fact-checked the debate in real time. You can read the .

The two candidates touched on a variety of health care topics. As in previous debates, they each questioned the other’s anti-abortion bona fides and reaffirmed their own. They sparred over covid-19 policies as well as whether to push China out of the U.S. supply chain for pharmaceuticals and other health-related products.

Asked whether, as president, they would preserve the Affordable Care Act’s Medicaid expansion, both said — after being pressed for clarification — they would like to convert the program to a block grant. That’s generally understood in which federal funding is capped but state flexibility is increased.

, but not South Carolina or Florida, have expanded Medicaid under the ACA, which is credited with providing insurance coverage to millions more Americans.

Block-granting Medicaid isn’t a new idea. The approach has and was advanced by the Trump administration. It’s strongly opposed by Democrats.

In terms of health care policy, Haley again promised to add transparency to the U.S. system, emphasize competition, and put patients “in the driver’s seat.” She also promised tort reform.

DeSantis argued for “health care that’s accessible, that’s affordable, and that’s accountable, and particularly an emphasis on mental health.” He also pointed to his Florida experience. “ for the pharmacy benefit middlemen that are causing your drug prices to go up,” he said, and claimed another victory in the war on high drug costs.

The Florida’s plan to import certain medicines from Canada for some state agencies. But the plan faces hurdles, including Canada’s government, which has warned it won’t allow U.S. imports if they risk causing drug shortages for Canadians.

Meanwhile, primary front-runner Trump again declined an invitation to debate. He instead participated in a Fox News town hall, also in Des Moines.

He claimed responsibility for the Supreme Court’s decision to overturn Roe v. Wade: “I did it. And I am proud to have done it,” he said.

But in response to a voter who sought assurances he would ban abortion nationwide if he won another presidential term, Trump acknowledged the politics of the issue. He told the voters “you still have to win elections” and that “a lot” of Republicans have been “decimated” as a result of advocating strict abortion bans. He carefully avoided saying what kind of ban, precisely, he would propose if he made it back to the White House.

Trump also revisited some of his favorite controversial covid-related themes. He minimized the role played by Anthony Fauci, who directed the National Institutes of Health’s National Institute of Allergy and Infectious Diseases and was a pandemic medical adviser in Trump’s administration. Trump called Fauci, who has been a lightning rod among Republican voters, “not a huge factor” in his pandemic policies but said the scientist took on outsize prominence in the Biden White House.

Trump waded into controversy about the virus’s origins, outlining his own theory on how it spread from China.Ìý

“It came out of Wuhan, the labs,” he said. “I think it was done out of incompetence.”

“I believe that a scientist went out, said hello to his girlfriend, and that was the end of that. She died, and then people started dying all over the place. But who knows, who knows?” (PolitiFact from Wednesday night’s town hall event.)

Meanwhile, entrepreneur Vivek Ramaswamy did not qualify to participate in the CNN forum. Candidates needed at least 10% support among respondents in three CNN-approved national or Iowa polls including one poll of likely Iowa Republican caucusgoers. Former New Jersey Gov. on the day of the debate that he was dropping out of the race.

What follows are health care-related fact checks excerpted from PolitiFact’s coverage:

Life Expectancy and Social Security

DeSantis and Haley sparred over whether to raise the Social Security retirement age.

Haley said life expectancy is longer today, so the age to start collecting Social Security and Medicare benefits, currently 65, should be raised. She said people in or near retirement should be protected from any retirement age increase, while people in their 20s should be told that “we’re going to change the retirement age to reflect life expectancy.”

DeSantis said he wouldn’t raise the retirement age, citing an erosion in life expectancy over the past few years.

“The problem now, in the last five years, is life expectancy is going down,” . “So, I don’t see how you can raise the retirement age when our life expectancy is collapsing in this country.” PolitiFact readers asked whether U.S. life expectancy is decreasing. We found that both candidates that supports their position.

During his town hall, Trump criticized both Haley and DeSantis over their stances on the retirement age, saying they both favor raising the age of Medicare eligibility above 65.

Gender-Affirming Care

DeSantis: On gender-affirming surgery for minors, “[Haley] said she’s against [it]. That wasn’t what she said this summer. She was asked about it. It’s on video, and she said the law should stay out of it.”

DeSantis is partially correct. Haley has said “the law should stay out of it,” but has also strongly opposed gender-affirming care for minors.

In a June , Haley said when determining what care should be available for transgender youth, the “law should stay out of it, and I think parents should handle it.” She followed up by saying, “When that child becomes 18, if they want to make more of a permanent change, they can do that.”

Haley’s campaign pointed to a May ABC News appearance during which that a minor shouldn’t be allowed to have a “gender-changing procedure” and opposed “taxpayer dollars” funding one.

In Wednesday’s CNN debate, Haley reiterated, “We shouldn’t have any gender transitions before the age of 18.”

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Florida Gov. Ron DeSantis, former South Carolina Gov. Nikki Haley, entrepreneur Vivek Ramaswamy, and former New Jersey Gov. Chris Christie faced off in Tuscaloosa, Alabama, before the Iowa caucuses. They sparred over antisemitism and the war between Israel and Hamas as well as the conflict in Ukraine. There were references to cryptocurrency and TikTok. Candidates also attempted to tackle inflation, corruption, border issues, and the inner workings of the Department of Justice, among other things.

As he did in the previous three meetings, Trump opted , this time attending a fundraiser in Florida. The event was moderated by NewsNation’s Elizabeth Vargas; Megyn Kelly, host of “The Megyn Kelly Show” on SiriusXM; and Eliana Johnson, editor-in-chief of The Washington Free Beacon.

Our fact-checked the candidates in real time. You can read the .

Health care — in the form of the Affordable Care Act — took center stage during the debate’s last minutes. Until recently, it seemed that the Republican Party had all but abandoned its years-long effort to repeal and replace Obamacare. But Trump resurrected the campaign with a social media post over Thanksgiving weekend describing the GOP’s failure to achieve this goal during his first term as “a .”

DeSantis, who seemed to pick up on some of Trump’s ACA criticisms, has since promised that he will have a health plan that is “.” He was challenged by debate moderators with the question: “Why should Americans trust you more than any other Republicans who have disappointed them on this issue?” In his response, he offered key buzzwords but few specifics. “You need price transparency. You need to hold the pharmaceuticals accountable. You need to hold big insurance and big government accountable, and we’re gonna get that done.”

Ramaswamy followed with his own take, involving similar concepts but different words. “We need to start having diverse insurance options in a competitive marketplace that cover actual health, preventative medicine, diet, exercise, lifestyle, and otherwise.”

Throughout the evening, some of the most heated clashes came as candidates sparred over transgender issues and gender-affirming care. PolitiFact examined some of these claims:

DeSantis: “I did a bill in Florida to stop the gender mutilation of minors. It’s child abuse and it’s wrong. [Nikki Haley] opposes that bill. She thinks it’s fine and the law shouldn’t get involved with it.”

This claim has two parts, and each needs more context.

In May 2023, the Florida Legislature that banned gender-affirming surgeries for minors. Experts told PolitiFact that gender-affirming surgeries are as genital mutilation. And the law didn’t ban just surgeries — it banned all gender-affirming medical care, including puberty blockers and cross-sex hormones, which are .

Surgeries are as part of gender-affirming care for minors.

In a June , Haley said that when it comes to determining what care should be available for transgender youth, the “law should stay out of it, and I think parents should handle it.” She followed up by saying, “When that child becomes 18, if they want to make more of a permanent change, they can do that.”

Haley’s campaign pointed to a in which she said that a minor shouldn’t have a “gender-changing procedure” and opposed “taxpayer dollars” funding one.

Haley: “I said that if you have to be 18 to get a tattoo, you should have to be 18 to have anything done to change your gender.”

During the debate, Haley likened her position on gender-affirming care for minors — that it should be up to parents until the child is 18 — to age requirements for getting a tattoo: “I said that if you have to be 18 to get a tattoo, you should have to be 18 to have anything done to change your gender.”

We’ve . For what it’s worth, two-thirds of U.S. states allow minors to get tattoos if their parents consent. And medical experts have told us gender-affirming care is in many cases considered medically necessary, while tattoos are cosmetic.

Ramaswamy: “I think the North Star here is transgenderism is a mental health disorder.”

PolitiFact after he introduced it at the second primary debate.

In the past, the medical community viewed the experience of being transgender as a “disorder,” but they no longer agree on that categorization. In the past decade, diagnostic manuals published by the World Health Organization and the American Psychiatric Association contained updated language to clarify that being transgender is not a mental illness. Experts told us that persistent gender dysphoria can cause other mental health issues, but it is not itself a mental health disorder.

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Our fact-checked the candidates in real time. You can read the .

The candidates spent a significant portion of the two-hour event on foreign affairs, focusing on the current Israel-Hamas conflict and the Ukraine-Russia war. There was also talk of what they, if elected president, would do to address the nation’s immigration and border issues as well as its mounting antisemitism — on this point, much of it involving college campuses and university presidents, terrorism, and the potential threat from China. They also discussed TikTok.

And their verbal salvos were not friendly fire.

Early on, Ramaswamy took aim at the media and tried unsuccessfully to pose aggressive, critical questions to NBC’s Kristen Welker, one of the moderators. She was joined by Lester Holt, also of NBC, and Salem Radio Network’s Hugh Hewitt.

The first official question for the candidates was why their party’s voters should pick one of them in the primary instead of the current front-runner by miles, former President Donald Trump, who again opted not participate, instead holding a in nearby Hialeah, Florida.

Christie brought up Trump’s legal issues: “Anybody who’s going to be spending the next year and a half of their life focusing on keeping themselves out of jail in courtrooms cannot lead this party or this country.” DeSantis countered that Trump no longer suits the times. Trump is a “different guy than he was in 2016” when he was elected president, DeSantis said, adding that Trump owes it to voters “to be on this stage and explain why he should get another chance.”

Welker used to focus on a health-related issue, pushing the candidates to offer their take on Republicans’ difficulties with its post-Roe v. Wade policies and asking what they see as a Republican “path forward” in the wake of abortion-rights victories in Ohio and Virginia, and earlier wins in Kansas and Kentucky.  

Ramaswamy said he was upset about the vote in Ohio, his home state, where voters approved a constitutional amendment to protect abortion rights. “Why, it’s back to that Republican culture of losing,” he said. But Scott was unshaken: “I’m 100% pro-life. I have a 100% pro-life voting record.” He pledged his support for a 15-week national abortion limit and challenged DeSantis and Haley to join him.

Haley, who also identifies as pro-life, took a different stance. “When it comes to the federal law, which is what’s being debated here, be honest, it’s gonna take 60 Senate votes, a majority of the House, and a president to sign it.” That level of support, she acknowledged, doesn’t currently exist. Instead, she recommended finding consensus on things like banning abortions late in pregnancy, increasing the availability of contraception, supporting adoption, and not criminalizing women who have the procedure. She also said, however, that if a national law came to her desk if she were president, she would sign it.  

PolitiFact examined the following abortion-related claims made during Wednesday’s debate:

Ramaswamy: Ohio “passed a constitutional amendment that now effectively codifies a right to abortion all the way up to the time of birth without parental consent.”This is a misrepresentation. On Nov. 7, Ohioans on a ballot measure that will guarantee “every individual has a right to make and carry out one’s own reproduction decisions,” enshrining the in the state’s constitution. The amendment allows for restrictions on abortion in pregnancy’s later weeks after a fetus is viable, but requires exceptions for the mother’s life and health — a standard similar to Roe v. Wade.Ìý

Anti-abortion activists have argued that “health” left undefined could be interpreted to include a wide variety of issues including finances. We found that claim to be . An expert told us this interpretation differs from how most people, including physicians, have understood the term.

Only of abortions take place at 21 weeks or later, data shows. The reports similar numbers.

The amendment does not eliminate parental consent, as Ramaswamy said. Anti-abortion groups that using the word “individual” in the bill could imperil parental consent because it does not distinguish between adults and minors. from the Ohio attorney general said defining “individual” would be left to the courts.

Scott: “Three out of four Americans agree with a 15-week limit” on abortion.

Survey data varies on this question.

A June 2023 poll sponsored by Susan B. Anthony Pro-Life America, an anti-abortion group, and conducted by the Tarrance Group found that 77% of respondents said abortions should be prohibited at conception, after six weeks, or after 15 weeks. But this poll was sponsored by a group with a position on the issue, and both questions told respondents that fetuses can feel pain at 15 weeks — an assertion that does not have universal consensus among medical experts.

Independent polls varied on the question of an abortion ban after 15 weeks.

A July 2022 survey from Harvard University’s Center for American Political Studies and the Harris Poll found that 23% of respondents said their state should ban abortion after 15 weeks, 12% said it should be banned at six weeks, and 37% said it should be allowed only in cases of rape and incest. Collectively, that’s 72% who supported a ban at 15 weeks or less.

In two subsequent polls, the support for abortion at 15 weeks or earlier was less strong. A September 2022 Economist/YouGov poll found that 39% of respondents supported a ban on abortions after 15 weeks, and 46% opposed it. And a June 2023 Associated Press-NORC poll found that for abortion up to 15 weeks, 51% of respondents said they would allow it, and 45% said they would ban it.

Scott: States like California, New York, and Illinois “allow for abortions up until the day of birth.”

This is misleading.

this rhetoric gives the impression that abortions often happen this late in a pregnancy. But this is not so, even in states with liberal abortion laws.

In , , and , abortion is legal up until fetal viability, or at about 24 weeks of pregnancy. Abortion in these states is also legal when the mother’s life is at risk.

The vast majority of abortions in the U.S., about 91%, occur in the first trimester. About 1% take place after 21 weeks, and fewer than 1% occur in the third trimester, according to

Meanwhile, entitlement reform was briefly discussed in the context of the dwindling Social Security trust fund, though there was a clear unwillingness to raise the retirement age and say what that age would be. And Haley staked out another hard line when it comes to broader changes.

“Any candidate that tells you that they’re not going to take on entitlements is not being serious,” she said. “Social Security will go bankrupt in 10 years, Medicare will go bankrupt in eight,” she added. But aside from a quick mention of expanding Medicare Advantage plans and “increasing competition,” she didn’t offer many policy details.

Fentanyl, which was blamed for tens of thousands of overdose deaths last year, drew agreement from across the stage about the need to bulk up the nation’s response at the southern border by using military technology and law-and-order approaches to stop the deadly drug’s flow into the U.S. Christie and Haley agreed on these points to attack the supply of the drug, but also emphasized treatment.

“We also need to lower demands here,” Christie said. As president, he said, “we’re going to call this what it is. It is a disease like heart disease, diabetes, or any other disease like cancer that can be treated and should be treated.”

North Dakota Gov. Doug Burgum and former Arkansas Gov. Asa Hutchinson did not qualify for this debate based on polling and fundraising thresholds set by the Republican National Committee. Former Vice President Mike Pence was also not on the stage, having dropped out of the 2024 presidential race last week.

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Florida Gov. Ron DeSantis, former South Carolina Gov. Nikki Haley, South Carolina Sen. Tim Scott, entrepreneur Vivek Ramaswamy, former Vice President Mike Pence, former New Jersey Gov. Chris Christie, and North Dakota Gov. Doug Burgum spent most of the evening talking loudly over — and sometimes quite angrily at — one another.

The moderators — Fox News’ Dana Perino, Fox Business’ Stuart Varney, and Univision’s Ilia Calderón — sometimes struggled to referee at the Ronald Reagan Presidential Library & Museum in Simi Valley, California, as the presidential hopefuls clashed on topics ranging from the autoworkers’ strike to foreign policy. At points, health care issues crept into the discussion.

Our partners fact-checked the candidates in real time. You can read their .

Candidates sparred over manufacturing and employment, inflation, and federal spending. When it came to the government shutdown threat, Haley promised to change the process, pointing out that Congress had delivered appropriations on schedule only four times in 40 years.

Asked about medical debt, which plagues tens of millions of Americans, she pledged a multipronged effort to protect people from financial ruin when they need care. She spoke of introducing more competition in the health system and putting “the patient in the driver’s seat” while increasing transparency.

“We’re going to have to make every part of the industry open up and show us where the warts are,” she said. She didn’t elaborate on how that could be accomplished.

Pence dodged a question about whether he would make good on his promise, from 2016 and the current campaign, to repeal the Affordable Care Act — also known as Obamacare — which Perino noted seemed more popular now than ever.

“It’s my intention,” the former vice president said, “to make the federal government smaller by returning to the states those resources and programs that are rightfully theirs under the 10th Amendment of the Constitution.” That would include all Obamacare and Health and Human Services funding, he said.

Pence also said he is “sick and tired” of mass shootings and promised, if elected, to advance an expedited federal death penalty “for anyone involved in a mass shooting” so they “meet their fate in months, not years.” The former vice president criticized DeSantis over the sentence handed down to a gunman who attacked Marjory Stoneman Douglas High School in Parkland, Florida, in 2018, calling it “unconscionable” that he’ll “spend the rest of his life behind bars.”

On the issue of health insurance coverage, DeSantis wore his state’s high uninsurance rate as a badge of honor.

“You can do well in the state, but we’re not going to be like California and have massive numbers of people on government programs without work requirements,” he said. Under DeSantis, Florida is that have declined to take advantage of federal funding available under Obamacare to expand Medicaid, the program that covers low-income Americans.

Throughout the evening, the candidates sometimes invoked Reagan’s name and memory. He wasn’t the only former president not in attendance but often mentioned. Donald Trump, who enjoys a in the polls, opted again to steer clear of the debate stage.

“Donald, I know you are watching — you can’t help yourself,” Christie said early on. He said Trump avoided the event because he was “afraid” of “being on the stage” and defending his record.

Trump in an interview after the debate that he hadn’t watched it.

Former Arkansas Gov. Asa Hutchinson did not meet the Republican National Committee’s donor and polling thresholds to participate. Former Texas Rep. Will Hurd also did not qualify.

Here are last night’s health-related claims checked by PolitiFact:

Ron DeSantis: 2.6 million Floridians going without health insurance “is a symptom of our overall economic decline.”

When moderator Varney pressed DeSantis on the relatively high number of Floridians without health insurance — Varney said it’s 2.6 million — DeSantis blamed politicians in Washington, D.C.

But the numbers from DeSantis’ own state health department show no correlation between economic conditions and the number of Floridians without health insurance. Despite population growth and economic changes, Florida had about 2.6 million uninsured residents from 2018 through 2021, and about 2.4 million in 2022.

In 2022, Florida’s uninsured rate was 11.2%, , according to the U.S. Census Bureau.

Vivek Ramaswamy: “Transgenderism, especially in kids, is a mental health disorder.” 

. Being transgender and having gender dysphoria — the distress that some people may experience when their sex assigned at birth does not align with their gender identity — is not considered a mental health disorder. Historically, the diagnosis has carried the term “disorder,” but experts no longer view it as a pathology and are working to destigmatize the diagnosis.

Previous terms such as “gender identity disorder” and “transexualism” have evolved into “gender incongruence,” a condition the World Health Organization now considers a condition related to sexual health — not mental health. The American Psychiatric Association’s “Diagnostic and Statistical Manual of Mental Disorders,” or DSM-5, contains a diagnosis for “gender dysphoria,” but experts say it remains partly to let insurance companies cover gender-affirming care and let incarcerated people access care.

Mike Pence: Linn-Mar Community School District in Iowa had a policy where “you could get a gender transition plan without notifying your parents.”

This needs . The Iowa school district outside Cedar Rapids in 2022 adopted that allowed students to request a “gender support plan.” , this plan would outline a student’s preferred name and pronouns as well as which locker rooms or bathroom the student would use, which is associated with a social, rather than a medical, transition.

The student could choose whether the parents were informed, but the plan was not related to medical transition, which, for minors, requires the consent of parental guardians. Schools often don’t inform parents when students signal they are socially transitioning, .

Tim Scott: The southwestern U.S. border under President Joe Biden is “unsafe, wide-open, and insecure, leading to the deaths of 70,000 Americans in the last 12 months because of fentanyl.”

Scott’s claim . Deaths from fentanyl jumped 23% in Biden’s first year in office to more than 70,000. But they have been increasing since 2014 and also rose during the Trump administration.

Although immigration encounters at the southern U.S. border have spiked under Biden’s watch, most of the fentanyl coming into the U.S. from Mexico reportedly comes through legal ports of entry. The vast majority of people sentenced for fentanyl trafficking are U.S. citizens, federal data shows.

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The eight-way faceoff, generally chaotic and contentious, included Florida Gov. Ron DeSantis; entrepreneur Vivek Ramaswamy; former Vice President Mike Pence; U.S. Sen. Tim Scott (S.C.); former New Jersey Gov. Chris Christie; Trump administration ambassador to the United Nations and former South Carolina Gov. Nikki Haley; North Dakota Gov. Doug Burgum; and former Arkansas Gov. Asa Hutchinson. Fox News anchors Martha MacCallum and Bret Baier often struggled to keep the evening on track. Former President Donald Trump chose not to attend, leading Baier to refer to him as “the elephant not in the room.”

Our partners fact-checked the candidates on topics ranging from foreign aid to climate change in real time. You can .

When it came to health care, Haley was the first on the stage to reference it, if only tangentially. About 15 minutes in, she blamed high government spending not just on Washington or Democrats but on her party, too. “The truth is that Biden didn’t do this to us,” she said. “Our Republicans did this to us, too. When they passed that $2.2 trillion covid stimulus bill, they left us with 90 million people on Medicaid, 42 million people on food stamps.”

Candidates sparred over whether, as the next U.S. president, they would sign a federal abortion ban into law, a discussion that highlighted how the GOP continues to struggle with the abortion question since the . Haley maintained that such a ban does not have the necessary support to pass the Senate and make it to the president’s desk, pointing to other abortion-related issues that could offer promising avenues for consensus. Pence, however, pledged if elected to sign such a ban, saying it’s a matter of leadership, not consensus. Also, he said, it is not only a states’ issue but a moral one. DeSantis touted his signature of Florida’s ban on abortions after six weeks, but pivoted from the idea of a federal ban, instead underscoring his opposition to policies that would allow what he described as “abortion all the way up till birth.”

Others on the stage voiced varying opinions about a federal ban, at what point during the gestational period that ban should apply, and even whether the question should be decided by the states.

Ramaswamy, a newcomer to politics, spoke about gun violence and crime in the context of the nation’s mental health crisis. He misspoke, though, when he referred to it as a mental health epidemic rather than a mental illness epidemic.

Here are some health-related claims checked by PolitiFact:

Abortion

Pence: “A 15-week [abortion] ban is an idea whose time has come. It’s supported by 70% of the American people.”

Survey data on this question varies. Pence’s team pointed PolitiFact to a sponsored by Susan B. Anthony Pro-Life America, an anti-abortion group, and conducted by the Tarrance Group. It found that 77% of respondents said abortions should be prohibited at conception, after six weeks, or after 15 weeks.

But this poll was sponsored by a group with a position on the issue, and questions were posed in a way that told respondents that fetuses can feel pain at 15 weeks — an assertion that among medical experts.

Independent polls have varied on the question of an abortion ban after 15 weeks. A from Harvard University’s Center for American Political Studies and The Harris Poll found 23% of respondents said their state should ban abortion after 15 weeks, 12% said it should be banned at six weeks, and 37% said it should be allowed only in cases of rape and incest. Collectively, that’s 72% who supported a ban at 15 weeks or less.

In two subsequent polls, the support for abortion at 15 weeks or less was not as strong. A September poll found 39% of respondents supported a national ban on abortion after 15 weeks, and 46% opposed it. And a June found that for abortion up to 15 weeks, 51% of respondents said they thought their state should allow it, while 45% thought their state should ban it.

Ron DeSantis: Democrats are “trying … to allow abortion all the way up to the moment of birth.”

This claim is and misleads about how rarely abortions are performed later in pregnancy. Several other candidates repeated similar claims, saying Democrats such as President Joe Biden are pushing for proposals for “abortion on demand” up to the moment of birth.

of abortions in the U.S. — about 91% — occur in the first trimester. About 1% take place after 21 weeks, and far less than 1% occur in the third trimester and typically involve emergencies such as fatal fetal anomalies or life-threatening medical emergencies affecting the mother.

Biden has said he supported Roe v. Wade, the landmark 1973 Supreme Court ruling that legalized abortion and was overturned in June 2022, and wants abortion access.

Roe didn’t provide unrestricted access to abortion. It legalized abortion federally but also enabled the states to restrict or ban abortions once a fetus is viable, typically around 24 weeks into pregnancy. Exceptions to that time frame typically were allowed when the mother’s life or health was at risk.

The Democratic-led of 2021, which failed to pass the Senate, would have effectively codified a right to abortion while allowing for similar post-viability restrictions as those in Roe.

Covid

Ron DeSantis: “In Florida, we led the country out of lockdown. We kept our state free and open.”

This is misleading. DeSantis revels in his record of snubbing public health recommendations to curb covid-19’s spread. But he largely omits the closures of schools and businesses that happened under his watch.

Seven states did not issue stay-at-home orders to their residents, but Florida did. On April 1, 2020, DeSantis issued an executive order directing all Florida residents to “limit their movements and personal interactions outside of their home.” The order expired at the end of the month, and Florida began a phased reopening in May.

Though he carved out an exception for religious services and some recreational activities, DeSantis didn’t exempt in-person classroom instruction. His Department of Education issued a March 13, 2020, recommendation that Florida schools close their facilities for an extended spring break and then lengthened the closure through the end of the school year in early June.

Schools reopened in person in August 2020.

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