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Fourth Democratic Debate: What We’re Watching For

Twelve Democratic presidential candidates have qualified for the October debate in Ohio. Before the candidates take the stage, we asked Bipartisan Policy Center experts in the areas of health care, congressional reform, and energy innovation how they hope to hear the moderators and candidates address their key issues. For BPC’s previous pre-debate coverage, check out our posts from before the first, second, and third rounds of debates.

Here’s what BPC experts are watching for.

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Marilyn Werber Serafini, director of the Health Policy Project

The top Democratic candidates will certainly continue to spar over their health insurance overhaul plans, but a troubling jump in the uninsured rate and recent attention to the opioids crisis – particularly as it affects Ohio, where the debate will occur – may take center stage.

In the September debate, candidates Joe Biden, Elizabeth Warren and Bernie Sanders argued about health insurance, which is a top priority for Democratic voters. For a decade, the number of people without health insurance has been declining, but the U.S. Census Bureau reported in September that the positive trend has reversed: In 2018 the uninsurance rate rose to 8.5 percent of the U.S. population, up from 7.9 percent the previous year. This spike is unexpected because insurance rates usually improve when employment rates are strong. Both health care and immigration have proven to be contentious issues in the Democratic debates, so it’s important to understand that nearly one-third of the rise in the uninsured rates may be attributable to non-citizens. Medicaid coverage dropped by 0.7 percent in 2018, and Joe Antos, a health economist at the American Enterprise Institute, tied that change to immigration in a Kaiser Health News article. Given President Trump’s recent action to bar legal immigrants who don’t have the means to pay for health insurance, I hope moderators will ask Democratic candidates about the connection between health coverage and immigration and how they would get insurance rates back on track.

Opioids may also be at play in the debate, especially since Ohio has one of the highest rates of fatal opioid overdoses in the nation. Johnson & Johnson and two Cleveland counties reached a $20 million opioid settlement deal in late September.

Both health care and immigration have proven to be contentious issues in the Democratic debates, so it’s important to understand that nearly one-third of the rise in the uninsured rates may be attributable to non-citizens.
Marilyn Werber Serafini, director of the Health Policy Project

John Richter, director of the Congress Project

Many topics critical to the nation will be covered during this week’s presidential debate. One that may not receive the attention it deserves is: what specific steps would the candidates take should they become president to contribute to congressional reform?

Obviously, the president is head of the executive, and not the legislative, branch. But there are steps that a chief executive can take that would help make congress more functional and lay a foundation for bipartisan problem-solving. I will be watching to see if candidates are willing and able to articulate a vision for working with Congress, and using the presidential pulpit to drive grassroots support for changes in Congress. Ideas could include:

  1. Identifying three specific policy areas where the candidate pledges to work across the aisle as president to pass legislation. These don’t need to be major controversial issues, but should be more than symbolic resolutions.
  2. BPC’s Commission on Political Reform recommended that the president should hold regular, monthly meetings with congressional leaders and be invited by leadership to attend joint congressional caucuses twice a year. Presidential candidates could adopt this position.
  3. Calling on Congress to institute five-day work weeks while lawmakers are in Washington, to allow more time for legislative consensus-building and oversight of the federal government.
  4. Not being too quick to urge full abandonment of the filibuster, which is an important protection for the rights of the minority party in the Senate and incentive for consensus-building. Clearly the process has been abused by both sides; BPC’s Commission on Political Reform recommended the step of eliminating filibusters that block bills from consideration on the floor, in exchange for a more open amendment process that permits minority party amendments.

Presidential candidates have an ideal stage for advancing congressional reform ideas in the national conversation. My hope is that they will use it.

I will be watching to see if candidates are willing and able to articulate a vision for working with Congress, and using the presidential pulpit to drive grassroots support for changes in Congress.
John Richter, director of the Congress Project

Addison Stark, associate director of energy innovation

I’ll be looking to hear the candidates flesh out their climate and energy policy plans beyond the soundbite level. At this point, most of the candidates have released an outline of their climate and energy policy platforms. Unfortunately, these platforms are simultaneously heavy on ambition while being light on the details that matter. It’s imperative that the candidates do this, since early primary state voters are looking for serious climate plans. Candidates need to answer some pressing questions: What are the roles of innovation and regulation in your plan to decarbonize our economy by midcentury? How will you mobilize the necessary buildout of new energy and climate infrastructure? How will you pay for it?

What are the roles of innovation and regulation? Today there are two general narratives about how we can address climate change. From the left, a regulatory approach—through emissions regulations, efficiency standards, and so on. And from the right an innovation approach—focus on R&D to drive down clean energy technology costs until the free market drives their adoption. In reality we need both, we need regulation to set the right emissions targets and continual innovation to drive down the costs of compliance. We need to hear from candidates that they have plans that balance both innovation and regulation. Innovation to develop the low-cost energy technologies we need—like long-duration grid-scale electricity storage and carbon capture technologies—and smart regulatory approaches to drive down green house gas emissions across all sectors.

How will you mobilize the build-out? Today none of the candidates are actually talking about what really needs to be done if the United States is to achieve economy-wide net-zero emissions by 2050. A quick back-of-the-envelope calculation will tell you that we need to reduce the equivalent amount of emissions of a large nuclear power plant every four days. In other words, we need to be building the equivalent of 1.75 nuclear power plants every week. This is a mobilization rate that we have not seen since World War II and no one is truly grappling with that fact. Doing this will require new institutional arrangements. It will require public-private partnerships on technology demonstration and deployment. We need to hear from candidates that they recognize the scale of the solutions.

How will you pay for it? Truly solving and reversing climate change will not be cheap (though not addressing it will be much more expensive). Candidates need to address how their plans pay for themselves. However, there will be upside to the investments made, such as a renewal of U.S. infrastructure which will have a large payoff. Further, an innovation-centric approach will allow the United States to take a leading role in the energy technology industries of the future.

Candidates need to answer some pressing questions: What are the roles of innovation and regulation in your plan to decarbonize our economy by midcentury? How will you mobilize the necessary buildout of new energy and climate infrastructure? How will you pay for it?
Addison Stark, associate director of energy innovation
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