The White House has repeatedly insisted for weeks that Biden’s high-profile debate gaffe was an anomaly and that the president is fit to fulfill his duties. But administration officials, lawmakers from both parties and Democratic donors have pointed to surprising moments when Biden appeared aloof and confused in private, as well as multiple public gaffes, raising questions about his cognitive ability.
Republicans on Sunday called for Biden to resign.
“If Joe Biden is unfit to run for president, then he is unfit to serve,” House Speaker Mike Johnson, R-Louisiana, said in a statement. “He must resign immediately.”
Democratic leaders generally do not share that view. Lawmakers lavished praise on Biden on Sunday, with several saying they continued to have confidence in his leadership as president. Biden, who is recovering from COVID-19, has repeatedly said he can both run the country and campaign for reelection.
“I’m OK,” Biden said at a July 11 news conference after the NATO summit, adding that with age comes “a little wisdom, if you pay attention.”
White House press secretary Andrew Bates said Sunday that Biden will continue to focus on priorities such as job creation and fighting abortion bans for the remainder of his term. “He looks forward to completing his term and delivering even more historic accomplishments for the American people,” Bates said in an email.
Some Democratic officials and allies have privately argued that further benefits would come from Biden stepping down as president and immediately elevating Vice President Harris to the Oval Office. There is political advantage to be gained from challenging Donald Trump.
Outside medical and policy experts said the job of a campaign — energizing voters, engaging donors and giving speeches across the country — requires a different set of physical and cognitive skills than making decisions as president and being surrounded by advisers. Some say Biden is equipped to serve a full term.
“The presidency is not a one-man show,” said Ezekiel Emanuel, a bioethicist at the University of Pennsylvania who has advised the Biden administration on COVID-19 and other health issues. “It’s an administration where the president is the boss and the ultimate decision-maker. And the president has a very capable team around him that he knows very well, and they know the president very well.”
David Grabowski, a Harvard Medical School professor who specializes in aging research, highlighted the difference between Biden’s ability to serve out the remainder of his term and his ability to serve another term into his 80s.
“President Biden’s decision to not run has to do with his ability to serve the next four and a half years,” Grabowski said in an email. “From an aging and health perspective, that is distinct from his fitness to serve from now through the end of his current term. The two must be evaluated independently.”
Some of Biden’s aides and allies had insisted as recently as Sunday morning that he would not drop out of the 2024 presidential race. But changing political realities were making his reelection difficult: The president was trailing Trump in polls in key battleground states, while other Democratic candidates were beating him in hypothetical matchups.
While Trump, 78, has his own issues with name confusion, factual errors and often incoherent speeches, voters are generally more concerned about Biden’s age than Trump’s. A CBS News/YouGov poll last month found that 72% of registered voters believe Biden lacks the mental or cognitive health to serve as president, compared with 49% who said the same about Trump.
Biden was last examined by a team of medical experts earlier this year, according to a summary released in February by his longtime physician, Kevin O’Connor. The doctors concluded that Biden is “a healthy, active and robust 81-year-old man who remains physically capable of successfully discharging the duties of the Presidency,” O’Connor wrote.
Specialists ruled out a stroke or a neurological condition like Parkinson’s disease, but said Biden’s gait had become increasingly stiff and he appeared to have peripheral neuropathy — a type of muscle weakness or nerve damage — in both his legs. Kevin Canard, a neurologist who specializes in movement disorders like Parkinson’s disease, was one of the doctors who examined Biden as part of the test.
Biden’s performance in the June 27 debate with President Trump, in which the president struggled to explain some of his core policies and stumbled over words multiple times, raised concerns not only from Democrats but also from medical experts who fear a more serious health issue. Three former members of the White House medical unit who cared for Biden told The Washington Post that the president should undergo cognitive testing given his shaky performance in the debate.
Biden has repeatedly refused to take the cognitive testing, telling reporters that his job as president meant he was “taking fitness tests every day,” but he showed signs of softening his stance at a press conference on July 11.
“I wouldn’t be opposed,” Biden said at a news conference. “If the doctors say I should get another neurological exam, I’ll do that.”
Biden’s physical and verbal stumbles have worried lawmakers, administration staff and high-ranking donors who have interacted with him privately in recent months. They say he has become visibly weaker, sometimes needing physical assistance to climb stairs or move around a room, and that the lifelong politician known for his long, free-flowing speeches is becoming increasingly hard to listen to and understand.
Biden’s occasional glitches or sudden drifts were easy to ignore before the debate, but they have raised doubts about his ability to handle the job for another four years.
Those weaknesses have been exposed during the campaign, as donors including actor George Clooney have said Biden appeared weak, tired and confused in small meetings in recent weeks and have stepped up their calls for him to not seek reelection.
One Democratic donor who had a small meeting with Biden at the White House early in his presidency and spoke candidly about the president’s fitness to run on the condition of anonymity recalled meeting Biden at a fundraiser this year.
“He was different from my experience in the White House,” the donor said, adding that his impression of Biden during the closed-door fundraiser was similar to his performance at the debate: The president was “quiet,” his speech tapered off and he sometimes “stared into space.”
“He felt like a senior citizen,” Donner said.
White House aides who work with the president regularly and accompany him on overseas trips said while Biden may move slower and look older, they show no signs of mental decline and his physical aging will not affect his ability to continue serving as president.
“I think two things are true. One, while he is fully capable of serving the full term as president, it’s not realistic to expect him to serve vigorously for another four years,” said Jonathan Reiner, a cardiologist and professor of medicine and surgery at the George Washington University School of Medicine. “I think it would be appropriate for the White House medical team to issue a public statement attesting to his fitness to serve as president.”
