Former President Joe Biden’s disastrous reelection attempt and a string of deaths among aging lawmakers have fueled a growing demand from donors and voters alike for full medical transparency from candidates in both parties moving forward.
News of Biden’s aggressive prostate cancer diagnosis on Sunday surfaced amid debates within the Democratic Party about his mental acuity and whether he should have withdrawn from the presidential race sooner last year.
Traditionally, losing the White House prompts a party to enter a phase of soul-searching and strategic recalibration. But Democratic operatives contend that the 2024 defeat, coupled with Biden’s handling of his reelection campaign, has triggered an unusually profound crisis of confidence, one that the party must now face head-on.
An Arizona-based Democratic consultant described a deep sense of betrayal that took hold last summer when it became clear that Biden was unprepared to face President Donald Trump, despite having publicly vouched for the president’s readiness.
“I didn’t know he was a f***ing vegetable, like they were lying to all of us. Sh*t, we all got taken for a ride and it really pissed me off,” the consultant said, speaking on the condition of anonymity to reflect candidly on the situation.
The consultant noted a growing consensus that the candidate seeking the party’s nomination in 2028 will be compelled to disclose extensive health information, offering the public transparency far beyond what has been typical in recent elections.
“I’ve heard from at least one donor I work with that he is going to be requiring this kind of health information moving forward. But, you know, he’s a billion-dollar man who can donate unlimited sums of money to your campaign, so you put up with it,” the person said.
Candidates seeking public office have long shared detailed health information to reassure voters of their fitness to serve. President Ronald Reagan, during his 1980 and 1984 campaigns, disclosed his history of prostate surgery to ease concerns about his health. Former President Bill Clinton was candid about his past smoking and heart surgery while in office. In the 1988 race, President George H.W. Bush revealed his treatment for Graves’ disease, and Sen. John McCain went even further, releasing over 1,000 pages of medical records, including a psychiatric evaluation that described his “histrionic personality.”
But there has been a noticeable decline in transparency, with many candidates now sharing less comprehensive or selective health details, raising questions about accountability and public trust. When Trump ran for his first term, he shared only a brief letter from his physician declaring his health “astonishingly excellent.”
Candidates vying for the Democratic nomination in 2020, the oldest group in U.S. history, adopted a similar approach. Four of the six major candidates were over 70, yet most declined to release comprehensive health records. Instead, they provided brief letters from physicians attesting to their fitness. Notably, Sen. Bernie Sanders (I-VT), who had suffered a heart attack five months prior, released letters from three doctors but withheld detailed medical records.
During the 2024 election cycle, health disclosures from both major candidates fell short of past standards. Biden’s February 2024 physical omitted a cognitive assessment, despite public concern about his age; the White House said his doctors found additional testing unnecessary, citing his performance in daily duties. Meanwhile, at 78, Trump offered only brief letters from his physician attesting to his “excellent health” and “exceptional” cognitive ability, despite previous promises to release more detailed records.
Jon Reinish, a prominent Democratic strategist based in New York, said the previously low bar for health disclosures is unlikely to be acceptable going forward.
“I am not surprised that donors would want to say, ‘If I’m going to back you, I need to know that you’re in good health.’ That seems pretty basic to me. I’m not surprised,” he said.
Reinish said he expects the push for greater health transparency to extend to congressional races, citing the recent deaths of Reps. Gerry Connolly (D-VA), Sylvester Turner (D-TX), and Rául Grijalva (D-AZ). Had they been alive, he noted, their anticipated “no” votes could have derailed Trump’s Reconciliation Bill, which passed by a narrow margin after three Republicans broke ranks on Thursday.
“The margins in the house are so close that every seat and every vote matters. If we had not had several members just die in office, a budget might not have passed,” he said.
Matt McDermott, a Democratic pollster and senior vice president of Whitman Insight Strategies, said there are growing concerns within both parties about the age and health of elected officials, emphasizing that the problem isn’t unique to Democrats.
“There is certainly a very broad and pretty public, at this point, conversation within the party about qualifications for office, and I think, you know, candidate fitness, broadly speaking, is being part of that,” McDermott told the Washington Examiner.
“The Republicans nominated and elected the oldest president to ever take office. And you know, even if you look at congressional dynamics right now, there’s obviously conversations about the age and wellness of the Democratic caucus,” McDermott continued. “On the inverse, though, the median age of both the House Democratic and House GOP caucus is almost exactly the same.”
The median age of House Republicans in the 119th Congress is 57.5, while the median age of House Democrats is slightly higher at 57.6. Senate Republicans and Democrats are pretty much the same age on average, with median ages of about 63.2 and 63.3 years, respectively.
McDermott highlighted that voters want leaders who can authentically communicate through modern channels such as social media, something many current politicians struggle with. He pointed out that reliance on staffers to manage digital outreach often results in messaging that feels disconnected and inauthentic.
“I think the Biden administration and campaign itself faced this issue, which is how can you authentically engage voters through channels that they consume media through when you’re a president in your 80s and you’ve obviously never authentically engaged on social media in your life,” McDermott said.
“When you have a bunch of Gen Z staffers sort of taking the reins and trying to be cool and edgy and innovative, the challenge becomes that no voter actually believes that that is the voice of the individual, and so again, I think that is the bigger problem,” he said.
Alex Conant, a Republican strategist who worked on Secretary of State Marco Rubio’s 2016 presidential run, said he has not heard calls from GOP donors for candidates to disclose extensive medical records, but predicted the next election would be the first in decades without a baby boomer leading the ticket.
“The next election will certainly be the first one that doesn’t feature a boomer at the top of the ticket in two generations,” Conant explained. “I think you’re gonna see a bias towards younger candidates.”
“Elections now are largely won and lost on social media, and younger candidates just tend to be a lot savvier on social media,” he said. “Trump is such an exception because he’s actually really good at Twitter [sic] and is an incredible content generator, which is very unusual for somebody of his age. I find it hard to believe that you’re going to find another 70-something-year-old in four years who is as digitally fluent as you need to be to succeed in national politics.”
BIDEN’S CANCER DIAGNOSIS FUELS FRESH DOUBTS AND DISTRUST AMONG DEMOCRATS
Conant believes that, moving forward, scrutiny of candidates’ health will intensify, although he doesn’t think it will become a defining issue.
“You’re already seeing renewed public interest in politicians’ health. The media is clearly not going to take a statement from a staffer at face value when it comes to health matters any longer,” he said. “I think as we enter 2028, I’d be surprised if a candidate’s health is the No. 1 issue, unless it becomes their primary issue like it did with Biden.”