The 90-minute debate, moderated by NBC's Kristen Welker, took place at Belmont University in Nashville, Tennessee, covered a wide range of topics, including Covid-19, race, immigration and climate change.
This live coverage has ended. Continue reading election news from October 23, 2020.
Read highlights, fact checks and takeaway below:
Fact check: Trump falsely claims 180 million people will lose health care if Biden wins
Trump said Thursday, "We have 180 million people out there that have great private health care — far more than what we’re talking about with Obamacare."
"Joe Biden is going to terminate all of those policies," he added.
"Under what he wants to do, which will basically be socialized medicine, he won’t even have a choice, they want to terminate 180 million plans," Trump added.
Trump has made this claim repeatedly, and NBC News has fact checked it repeatedly. This claim is false. It conflates Biden's plan with those of other Democrats pushing "Medicare for All."
While estimates vary about how many Americans have private insurance, the Centers for Medicare and Medicaid Services estimates that 180 million people have private insurance.
But Biden's plan wouldn't end private insurance, though that was part of some of Biden's Democratic primary opponents proposals. Instead, Biden's health care plan would create a public option for those who want to get government health insurance while allowing those with private insurance to stay on their plans.
Many Republicans have sought to tie the proposals for "Medicare for All" to all Democrats — and it is true that many Democratic members of Congress are sponsoring the bill (118 in the House and 14 in the Senate). But Biden has criticized "Medicare for All" throughout his campaign.
On immigration, Biden gives a gentle diss to Obama
Pushed by Trump on immigration and asked about what his administration would do differently from his time as vice president, Biden referenced Barack Obama, but not in a particularly fond way.
"It was a major mistake," Biden said of the Obama-era immigration policies. "It took too long to get it right."
Biden added that things will be different if he's in the big chair.
"I'll be president of the United States, not vice president of the United States," Biden says.
Fact check: Who pays tariffs? Trump says China, Biden says taxpayers
Trump, responding to a question about confronting China, said the country is “paying billions and billions of dollars" to the U.S. and suggested this was money his administration has used to bail out American farmers.
Biden interjected to say that was “taxpayer money” going to the farmers.
So, who is paying for tariffs?
We’ve fact checked this before, and Biden’s right. Tariffs are taxes on goods coming in to the U.S., paid by the importer; those taxes are largely tacked onto the purchase price paid by American consumers.
Tariffs are designed to make foreign-made goods more expensive, boosting domestic producers or, sometimes, forcing international exporters to slash prices to stay competitive. But there's no evidence China has been cutting prices to accommodate Trump’s tariffs, and there’s clear evidence that American families are picking up the tab.
Fact check: Where does Kamala Harris stand on health care?
Trump claimed that Biden's running mate, Sen. Kamala Harris, D-Calif., supports "socialized medicine."
"He wants socialized medicine, and it's not that he wants it — his vice president, I mean, she is more liberal than Bernie Sanders and wants it even more," Trump said.
Harris' position on health care — at least when she was a presidential candidate — was, in fact, difficult to pin down. In January 2019, she appeared to call for abolishing all private insurance, only to walk it back in May.
Then, during a Democratic primary debate in June 2019, she raised her hand when candidates were asked whether they would get rid of private health insurance. The next day, she said that she had misunderstood the question and that she wouldn't abolish private health insurance in favor of "Medicare for All" if elected — but then she struggled to clarify her position about the role private insurers had to play.
Then, in July 2019, she released a plan that sought to stake out a territory somewhere between "Medicare for All" and the Affordable Care Act, with private insurers allowed to compete in a controlled marketplace dominated by government insurance options. So charges that she has flip-flopped on the issue largely ring true.
But that's mostly irrelevant: As vice president, Harris would be charged with helping to implement Biden's vision on health care — not her own.
Biden's health care plan involves improving Obamacare and creating a public option for those who want to get government health insurance while allowing those with private insurance to stay on their plans.
This is who’s staying on topic (spoiler: both candidates are)
An hour into the debate and the nominees have stuck close to the moderator’s questions.
According to an NBC News analysis, Joe Biden and President Donald Trump have stayed on topic 82 percent of the time. This is better than the first presidential debate on Sept. 29, when the candidates were on topic close to half the time, also according to an NBC News analysis.
Biden tended to stay more on topic for questions about Covid-19. He was on topic for those about 89 percent of the time, and deviated more for questions relating to China, where he has only been on topic for 75 out of 113 seconds. Trump has stayed on topic for questions relating to ethics, where he was on topic the whole time, compared to staying on topic a little more than half the time for questions relating to the election.
See the latest on what the candidates are talking about and whether they’re staying on topic with the interactive NBC News presidential debate tracker.
No one knows what Trump’s ‘big, beautiful health care’ looks like
Trump has long promised a replacement for the Affordable Care Act, or Obamacare, with a plan that will provide people "big, beautiful health care,” going back to January 2017, when he told The Washington Post he would provide “insurance for everybody.”
The president has continued to say he will soon pass a new health care plan and told his supporters not to worry about overturning Obamacare because his plan will protect pre-existing conditions. In July, Trump told Fox News he would sign a bill within two weeks. In August, he said at a press briefing they would have the plan at the end of the month.
The White House and Republicans still have not disclosed their plan, and it is unclear whether they have one.
Analysis: Trump rips states he needs to win
Trump said he didn't want to spend more federal Covid-19 relief money to help "Democrat" cities and states.
Those include the critical swing states of ... Pennsylvania, Michigan and Wisconsin, all of which elected Democratic governors in the Democratic mid-term wave in 2018.
Biden and Trump have attacked each other more than 120 times combined
Fact check: Trump gets rates of recovery for Covid-19 wrong
Trump said Thursday that "99.9 [percent] of young people recover" from Covid-19 and that "99 percent of people recover" from the virus.
Neither statistic is true.
Last month, a research paper published in JAMA Internal Medicine found that among more than 3,200 adults ages 18 to 34 who were hospitalized with the disease, 21 percent required intensive care, 10 percent required mechanical ventilation and nearly 3 percent died.
Of those who survived, 3 percent — 99 patients — had to be discharged to another health care facility to continue their recoveries.
The claim that 99 percent of people infected with Covid-19 recovered is also false. There have been 8.4 million confirmed Covid-19 infections in the U.S. and more than 224,000 deaths from the virus.
A cursory calculation of the U.S. death rate, based on those numbers, would mean that 2.6 percent of all people with confirmed infections have died of the virus.
Experts have explained that the exact death rate is far more difficult to identify, because there could be a far greater number of people who were infected but were never tested because they were asymptomatic.
Separately, Trump's claim that so many "recover," as well as the figures above, don't take into consideration people who were infected who have suffered from symptoms that have lingered for months, and in some cases have been debilitating.
Analysis: Sarcasm isn’t working for Biden
A couple of times, Biden has turned to sarcasm to make a point about Trump. It’s not his strong suit because it’s so deadpan it’s hard to tell he’s being sarcastic. The last one involved the ultimate debate loser: Adolf Hitler.
Biden was trying to make the point that North Korean leader Kim Jong Un didn’t meet with then-President Obama because Kim wouldn’t agree to give up nuclear weapons. Trump said Obama should have met with Kim and that Trump’s meetings were important.
Biden’s response: "We had a good relationship with Hitler before he invaded the rest of Europe. C’mon man."
The point was Hitler was always bad and so is Kim. But it sounded like he was saying it made sense for the U.S. to have ties to Hitler before World War II. And, for the record, President Franklin Roosevelt pressed Hitler, through letters, to refrain from invading other countries.
First mic cut of the night goes to Trump
Trump’s discursive response about protecting health care and preexisting conditions while also dismantling the Affordable Care Act resulted in the first mic cut of the night.
His mic was muted just as he was trying to finish his response. It was an effective way to keep the moderator in control and get a response from Biden.