Joe Biden Answers Your Questions About Disability, Chronic Pain and Mental Health Care

Primary season voting ahead of the 2020 presidential election began with the Iowa Caucus and a fourth-place finish for former Vice President Joe Biden’s Democratic presidential campaign. However, the Iowa Caucus only represents a small part of the country, whereas approximately 25% of the population lives with a disability. That means your vote can make a big difference.

While Biden is the last candidate to issue a formal disability-specific policy (yet to be released), he has voted in favor of laws and health care policies (like the Affordable Care Act) that support the needs of people living with a disability or health condition. His campaign website stressed, “We’ve got to make sure our democracy includes everyone.” He also opened up about living with a stutter.

While Biden’s record is strong, several disability-related gaffes have come up. Biden was recently filmed stroking disability advocate Samuel Habib’s face while answering a question about education policy. This led to backlash from the disability community for infantilizing the 20-year-old student and disability advocate. Biden was also criticized for stating a stutter is the “only handicap that people still laugh about.”

The Mighty reached out to all the leading Democratic presidential candidates, including Biden, and asked them to weigh in on some of the most pressing questions our disability, chronic illness and mental health communities wanted answers to.

Here’s how Biden answered your questions:

How will you lower medical costs for people with disabilities and chronic illnesses?

I know that access to quality, affordable health care can affect almost everything else in life – especially for people with disabilities and chronic illness. My own son fought cancer for almost two years, and I can’t imagine how much tougher that would’ve been if we’d had to worry about the insurance company telling us in the hospital, “Sorry your coverage is over; you’re on your own.” No family should ever have to hear that.

That’s why, years before, we pushed so hard in the Obama-Biden Administration to pass the Affordable Care Act. Not only did it cover 20 million uninsured Americans – it protected 100 million more with pre-existing conditions, so they can no longer be denied coverage or charged higher premiums. And, it banned insurers from capping coverage with annual or lifetime limits.

The most important thing we can do to lower medical costs for everyone is to protect and build on Obamacare. I’ll offer a new public option, so you can choose between a Medicare-like plan or private insurance. My plan will lower premiums further by increasing the value of tax credits to make sure that no one, regardless of medical circumstances, ever spends more than 8.5 percent of their income on health insurance; and it places that cap even lower for low-income families. And, we’ll further reduce costs for everyone buying insurance in the individual marketplace by making more generous plans – with lower deductibles and out-of-pocket spending – cheaper. That way, middle-class people with disabilities, not just the well-off or very low-income, will be able to afford quality coverage.

My plan will also protect and strengthen Medicaid, which pays for more of the long-term care that people with disabilities rely on than any other insurer. I’ll fight state work requirements and any other effort to undermine the essential program, and make sure that beneficiaries can access home and community-based long-term care when they want it, which is so important to many people with disabilities. And, in the 14 Republican-led states that have refused to expand Medicaid, I’ll automatically enroll roughly 4 million low-income Americans in my public option, premium-free, and with benefits equal to those in Medicaid.

Finally, I’ll end pharmaceutical companies’ abuse of power. First and foremost, I will repeal the outrageous exception allowing drug corporations to avoid negotiating with Medicare over drug prices. There’s no justification for this except the power of prescription drug lobbying. In addition, if drugmakers want to participate in Medicare or our new public option, I’ll require them to limit price increases to inflation. What’s more, to boost competition, I’ll let consumers import prescription drugs from other countries, as long as they’re safe. And for brand new specialty drugs that no other companies make, I’ll create an independent review board, to set reasonable launch prices for those drugs.

How will you protect patients with pre-existing conditions and ensure they have access to affordable, high-quality health care?

The Affordable Care Act protected 100 million Americans with preexisting conditions. It prohibits insurers from denying coverage or charging higher premiums due to preexisting conditions or imposing annual or lifetime limits to benefits – a key protection for people with disabilities or chronic conditions who require regular care.

Passing Obamacare was a victory 100 years in the making, and it’s still a big deal. I oppose every effort, by Republicans or Democrats, to get rid of it. My plan will protect and build on that landmark legislation instead, letting people choose between a new public option or their private insurance. It’ll boost tax credits to reduce premiums; and eliminate income caps, so that no family ever has to spend more than 8.5% of its income on health insurance. I’ll protect Medicaid to ensure that its beneficiaries can access home- and community-based long-term care when they want it. And I’ll lower prescription drug costs by ensuring that Medicare can negotiate lower prices, letting consumers import safe medications from abroad, and requiring any drugmaker that wants to participate in Medicare or our new public option to cap price hikes at inflation – all providing key relief to people who rely on medications every day.

There are a lot of progressive ways to achieve universal coverage, lower health care costs, and reduce the complexity of our health care system. I don’t believe that we should require 160 million people to give up their private insurance for Medicare for All. I don’t think we should tell workers that the plans their unions fought so hard for suddenly have to go. And I don’t think we should hike taxes on the middle class to pay for these things. That’s a non-starter for me.

My plan is the fastest, most effective way to get every American, including those with preexisting conditions, access to affordable health insurance today and at one-thirtieth the cost of Medicare for All.

How will you improve mental health care in the U.S., including access and affordability?

Mental health is health, period. It should be treated that way by our insurers and our culture.

As a senator, I was a strong supporter of mental health legislation and consistently advocated for mental health parity, including as a co-sponsor of the Mental Health Equitable Treatment Act and an original co-sponsor of the Mental Health Parity Act of 2007.

As Vice President, I worked hard to improve access to mental health care. Passing the Affordable Care Act was central to that fight. It not only insured 20 million more people – and protected 100 million with preexisting conditions – it expanded access to coverage for mental health and substance use and parity protections for 60 million Americans. But those parity provisions — requiring insurers’ coverage of mental health and substance use disorder care to be equal to their coverage of physical health care — are still too often underenforced, leaving too many people without the coverage they’re entitled to. And in many areas, transportation, doctor shortages, and even limited internet access can make it hard for people to get the mental health care they need.

As president, I’ll make sure that we enforce mental health parity laws. And I’ll expand funding for mental health services.

I know how often friends and family don’t seek mental health services because of the stigma associated with it. As president, I’ll use the bully pulpit of the White House to eliminate the stigma around mental health. As Vice President, I hosted the National Conference on Mental Health at the White House where organizations, from the American Medical Association and the American Psychiatric Association to the Boys and Girls Clubs of America, the National Education Association, and the American Federation of Teachers, committed to educating families and health care providers about mental health. As president, I’ll build on that work and ask organizations, ranging from faith to education and the private sector and from media to health care, to make commitments to raising awareness about mental health.

I’ll work to close that care gap in rural areas – issuing federal grants to build and support new mental health clinics, or to deliver care to remote areas via video conferencing and other telehealth services. And I’ll boost funding to rural hospitals generally, and invest in training more rural doctors, nurses, therapists, and other health practitioners.

And, I’ll make sure that all kids get the support they need early in life – in part by doubling the number of psychologists, counselors, and nurses in our schools and by funding schools with innovative programs to help kids deal with violence or trauma that they’ve experienced in school, at home, or in their communities.

Survivors of domestic violence, gun violence, hate crimes, and other types of violence often experience health challenges, including mental health issues from trauma. I will direct the U.S. Department of Health and Human Services to undertake a comprehensive review of all federal programs to identify how they can be more trauma-informed and support survivors of violence. I will work to raise the funding cap for the Victims of Crime Act programs, which provide financial support to help victims of crimes pay for expenses including medical and dental costs, counseling, lost wages, and temporary lodging expenses that result from the crime. In addition, I will create a network of trauma care centers for survivors of violence that could be housed at rape crisis centers, domestic violence programs, universities, and existing mental health centers, and I will train health care and other service providers in trauma-centered care. I will also train college administrators and staff how to support survivors of sexual assault or other gender-based violence through victim-centered, trauma-informed interview techniques. And I will invest $20 million per year in creating Regional Sexual Assault Investigative Training Academies, which will provide cutting-edge, evidence-based, and trauma-informed training on investigating and prosecuting sexual assault crimes and offer incentive grants for teams of law enforcement, victim advocates, and prosecutors all over the United States to attend.

What is your perspective on pain medications (especially opioids) for those with chronic pain and how does that fit into your health care plans?

Consistent access to quality, affordable health care is a right, not a privilege. This includes ensuring that Americans living with chronic pain have access to medications that help them manage their pain. I will invest in research that will focus on developing less addictive types of prescription drugs for pain. And, as I noted earlier, I’ll end pharmaceutical companies’ abuse of power and put a stop to runaway drug prices, including by limiting launch prices for any new, less addictive pain medications. In addition, I will give every American access to health care to address, as much as medically possible, the underlying causes of the chronic pain they are enduring.

How will you prioritize the needs of the disability community if you are elected?

One in four American adults has a disability. I believe that every policy – from health care to education to climate change – must be developed with them in mind and at the table for decision-making.

I’ve fought for the rights and opportunities of people with disabilities for my whole career. I worked to pass the Rehabilitation Act of 1973, a key first step toward protecting people with disabilities under civil rights law. I supported the original Individuals with Disabilities Education Act in 1975, which requires access to equitable education. I co-sponsored the Fair Housing Amendments Act of 1988, which protects people with disabilities from housing discrimination. I helped my friend Tom Harkin to get the landmark Americans with Disabilities Act across the finish line in 1990. And, I fought to secure passage of the Affordable Care Act, which prevents insurers from denying coverage to children or adults with disabilities, or setting annual or lifetime caps on benefits. As president, I’ll protect and build on those gains – in health care, education, housing, and across the board.

To expand access to the home and community-based services that are so key to so many people with disabilities living fuller, more independent lives, I will push to reauthorize the Obama-era Medicaid program (Money Follows the Person), which has helped more than 75,000 people with disabilities move from institutions back into their communities.

I’ll also fight to level the economic playing field and to reduce the unemployment rate for people with disabilities. That starts by banning subminimum payments nationwide. It’s wrong that federal law still lets employers pay people with disabilities below minimum wage. I’ll change that.

I’ll also make the federal government a model for all others in the employment of people with disabilities. The Obama-Biden Administration made key gains in that area, providing key employment services to help people find and succeed on the job; boosting funding to state and local supported employment programs, and employing more workers with disabilities than any administration in three decades. The Trump Administration’s Justice Department has quit enforcing essential civil rights protections in employment services. It’s disgraceful. As president, I will restore and expand access to supported and customized employment services and enforce anti-discrimination laws. And I will issue an executive order directing the federal government to recruit, hire, and retain more people with disabilities, system-wide. In addition, I will commit to ensuring that political appointees look like the country they serve, including representation from the disability community.

And, I’ll work to fully fund the landmark Individuals with Disabilities Education Act (IDEA), so that districts can better implement its provisions and provide millions of students with disabilities with free appropriate public education – preparing them for jobs and independent lives. The law promised the federal government would cover 40% of the extra cost of special education, but it today only provides 14%. That ends with me. I’ll also appoint a Secretary of Education truly committed to fully including students with disabilities. And I’ll restore and build on Obama-Biden-era guidance to help keep students with disabilities safe in their classrooms.

And, I’ll instruct my administration to aggressively enforce key aspects of the Americans with Disabilities Act that the Trump administration has ignored. That includes pushing the Department of Education’s Office of Civil Rights to prioritize IDEA enforcement so that every child gets the education they deserve. It means pushing the Justice Department to fully implement the Help America Vote Act, so that everyone, regardless of disability, can exercise their fundamental right to vote.

I’ll also fight to support direct care providers – who play such a key role in so many lives, but are in such short supply. I’ll make sure that they earn a living wage: raising the federal minimum wage to $15 an hour, codifying overtime and wage protections, and supporting the Domestic Workers’ Bill of Rights, which would grant them other federal labor protections, including workers comp and unemployment benefits. I’ll help them advance in their careers, offering two years of community college without debt. And I’ll give long-term, informal caregivers – the family members and loved ones who quietly give so much of their lives – a $5,000 yearly tax credit, so they can better afford to forego other wages and keep caring for their loved ones in their community.

Anything additional you would like to add?

When President Obama asked me to lead the White House Cancer Moonshot Task Force, we set a goal of doubling our rate of progress in every aspect of cancer from prevention to survivorship. People and organizations from all over the country made commitments to help us achieve that goal. By sharing information and research – and using the convening power of the White House to bring people together for good – we improved the cancer research system. And, we got Congress to appropriate an additional $1.8 billion for cancer research in 2016.

As president, I will take the mission of the Cancer Moonshot to accelerate our progress toward ending cancer as we know it and extending that mission to other devastating diseases like Alzheimer’s and diabetes.

This is all in our wheelhouse – despite everything that has happened in recent years, I’m more optimistic today than I was when I first got started in public service as a 29-year-old kid. We are better positioned than any other nation to own the 21st century. This is the United States of America – there is nothing we can’t do. We just need to pick our heads up and remember who we are.

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