By KFF Health News and PolitiFact Staff
Loud voices and sharp words marked the fourth debate of the Republican presidential primary Wednesday night, as the four candidates debated everything from their own electability to maintaining former President Donald Trump’s leadership position. Abortion was never mentioned.
Florida Governor Ron DeSantis, former South Carolina Governor Nikki Haley, entrepreneur Vivek Ramaswamy and former New Jersey Governor Chris Christie faced off in Tuscaloosa, Alabama, just 40 days before the presidential caucuses. ‘Iowa. They also discussed anti-Semitism and the war between Israel and Hamas, as well as the conflict in Ukraine. It contained references to cryptocurrency and TikTok. The candidates also attempted to tackle, among other things, inflation, corruption, border issues and the internal workings of the Justice Department.
As he had done in three previous meetings, Trump opted this time not to attend a fundraiser in Florida. The event was moderated by Elizabeth Vargas of NewsNation; Megyn Kelly, host of “The Megyn Kelly Show” on SiriusXM; and Ileana Johnson, editor-in-chief of the Washington Free Beacon.
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Health care – in the form of the Affordable Care Act – took center stage in the final minutes of the debate. Until recently, it seemed that the Republican Party had abandoned its years-long effort to repeal and replace Obamacare. But Trump reignited the campaign with a social media post over Thanksgiving weekend, calling the Republican Party’s failure to achieve that goal during his first term “a low point for the Republican Party.”
DeSantis, who acknowledged some of Trump’s criticism of the ACA, has since promised he would have a health plan that would be “different and better.” The debate moderators challenged him by asking: “Why should Americans trust you more than any other Republican who has failed them on this issue?” » In his response, he touched on the main points but also raised some details. “There needs to be transparency on prices. You need to hold pharmaceutical companies accountable. You need to hold big insurance companies and big governments accountable, and that’s what we’re going to do.
Ramaswamy followed with his own approach, involving similar concepts but different wording. “We need to introduce diverse insurance options in a competitive market that cover real health, preventive medicine, diet, exercise, lifestyle and much more. »
Throughout the evening, some of the most heated clashes took place when the candidates debated transgender issues and gender-affirming care. PolitiFact investigated some of these claims:
DeSantis: “I authored a bill to prevent sexual mutilation of minors in Florida. This is child abuse and it is wrong. (Nikki Haley) Opposes this bill. She thinks everything is fine and the law shouldn’t get involved.
There are two parts to this statement, and each requires more context.
In May 2023, the Florida legislature passed a bill banning gender affirmation surgeries for minors. Experts told PolitiFact that gender-affirming surgeries are not the same as genital mutilation. And the law didn’t just ban surgery: It banned all gender-affirming medical care, including puberty blockers and cross-sex hormones, which are supported by most major U.S. medical organizations.
Surgery is rarely performed as part of gender-affirming care for minors.
In an interview with CBS in June, Haley said that when it comes to determining what care should be available to transgender youth, “the law should stay out of that, and I think parents should take care of it. He added, “When that child turns 18, if they want to make a more permanent change, they can do that.” »
Haley’s campaign highlighted an appearance on ABC in May in which she said a “sex reassignment procedure” should not take place for a minor and opposed funding it with “taxpayer dollars “.
Haley: “I said if you have to be 18 to get a tattoo, you have to be 18 to do anything to change your gender. »
During the debate, Haley compared her position on gender-affirming care for minors — that it should be the responsibility of parents until the child turns 18 — with the age requirements for getting it done. tattoo. : “I said that if you have to be 18 to get a tattoo, you have to be 18 to do something like a tattoo, to change your sex.
We’ve heard this comparison before. For what it’s worth, two-thirds of U.S. states allow minors to get tattoos if their parents consent. And medical experts tell us that gender-affirming treatments are considered medically necessary in many cases, while tattoos are cosmetic.
Ramaswamy: “I think transgender is a mental health disorder. »
PolitiFact called Ramaswamy’s claim false after he presented it during the second primary debate.
In the past, the medical community considered the experience of being transgender to be a “disorder,” but they no longer agree on this classification. Over the past decade, diagnostic manuals published by the World Health Organization and the American Psychiatric Association have updated language to clarify that being transgender is not a mental illness. Experts tell us that persistent gender dysphoria can lead to other mental health problems, but it is not a mental health disorder in itself.
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KFF Health News is a national newsroom that produces in-depth journalism on health issues and is one of KFF’s primary operating programs – an independent source of health policy research, polling and journalism. Learn more about KFF.
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