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What Happens If Trump's Health Worsens After Testing Positive For The Coronavirus


The story we are covering this morning was first revealed in a tweet from President Trump in the middle of the night. He and first lady Melania Trump have tested positive for the coronavirus. Now, many people, we should say, never develop serious symptoms. And even if they do, they recover. But Trump is 74 in an age group that is more likely to develop serious complications and to be hospitalized. The White House physician says the president is doing well as of now but will remain in the White House residence. A White House official told NPR's Tamara Keith that the president plans to stay engaged, but that Vice President Mike Pence is ready to step in as needed. Now, if and when a president falls ill, there are significant questions about how the nation is governed. And John Fortier has studied and written about scenarios just like this. He's executive director of the Continuity of Government Commission, which was set up in the wake of the 9/11 attacks. He also runs the government studies program at the Bipartisan Policy Center, and he joins us on Skype. Thanks for being here.

JOHN FORTIER: Thanks for having me.

GREENE: So, I mean, as someone who looks at these questions so closely, how did you react when you heard that the president got a positive test?

FORTIER: Well, given all that's happened, it was probably the one thing that might stir up some more turmoil in this very tumultuous election season we've had. Look, there are some real questions, both about a president - as president having an illness, especially if it were to get worse, but also in terms of a presidential candidate. Those are different issues about being on the ballot and what happens afterwards. So I do think there are some significant concerns if things were to worsen.

GREENE: Well, let's separate those things out. Let's talk about the here and now. I mean, what sort of things are being discussed right now inside the White House? And were the president's health to deteriorate, I mean, you've written that there can be confusion, there can be chaos. I mean, take us inside that building.

FORTIER: Well, first, as a precedent, the question would be, is the president - at some point, does he feel that he doesn't - isn't able to carry out the duties of the presidency for a time? And there's a pretty clear provision in the 25th Amendment where he can sign over the power of the presidency to the vice president and then, when recovered, take it back. And that's happened a few times in recent years, basically for elective surgeries. That would be pretty clear. I think, you know, what would be a little harder is if the president got sick enough that he wasn't able to make the determination. There's still a provision in the Constitution where you can have the vice president - a majority of the Cabinet say it's time for the vice president to take over. And then in the most contentious situation, we have heard about in other contexts that if the president disagreed with that diagnosis, Congress might have to decide whether to keep the president on or to keep the vice president. So it could go further down the line. But, you know, that would be the more extreme version. Look, we also have the election. And how would the president be on the ballot or not be on the ballot if it really came to the point where the president had to withdraw? There's a very difficult procedure in trying to replace him at this time.

GREENE: Yeah, what - who makes that decision? I mean, how - who determines that?

FORTIER: Well, if it happened earlier, I think it's pretty clear the party could have just stepped in. And the party still has a role of selecting a new person. And that would be the party committee - could elevate Mike Pence to the presidency and pick someone else as vice president. But that's a relatively simple vote. We've actually done that once in the '70s with a vice presidential candidate being replaced, Tom Eagleton. But the question now that the ballots are out is much more difficult. Could the president's name be removed from the ballot? I think it would be very difficult. But one further complication is in our election of president, we're really not voting for president, but we're voting for these electors in the Electoral College. They are still there on the ballot. Even if you don't see them in your state's ballot, they are behind those names. And in theory, those people can be elected and then make a choice of another person come December with some complications that have come up recently to the Supreme Court. But basically, there is a possibility that even if Donald Trump's name is still on the ballot and he were to have withdrawn, that those electors could still end up voting for the Republican ticket, whatever that is, in December.

GREENE: They could actually decide. I mean, you would have electors around the country making a decision that should, in theory, be made by health experts, but they would be actually deciding who would be president.

FORTIER: Assuming if Donald Trump won the election, even though he had withdrawn, then there's this question in November of, well, who are these electors going to vote for? They're going to vote for the Republican ticket, whatever it is. Again, there are some complications. The Supreme Court has allowed some states to really bind those electors. But basically those electors, many of them at least have the freedom to choose another person. We assume that would be coordinated by the party. And of course, there would be great questions about the legitimacy for the American public. But constitutionally, it's possible.

GREENE: I mean, this is obviously so, so speculative, as you said. I mean, these are extreme circumstances we're talking about. But I wonder, I mean, this is your line of work. Like, I wonder if you get people sometimes saying like, oh, why do you dedicate so much time to scenarios that might never happen? But I guess there's an argument that these are really important questions that you want to answer. You have to plan for the worst and most chaotic scenarios.

FORTIER: You do. And I think we'd be better off with some better plans in place for a lot of these continuity scenarios. I mean, obviously questions of national security might matter if we're not absolutely sure if the president is well. We had cases well before the 25th Amendment - Woodrow Wilson, who was, you know, essentially incapacitated for his last almost year and a half in the White House. And, you know, there is a real question as to who was really running the government. The vice president hadn't stepped in. And so, you know, there are these questions. We don't want uncertainty in times of trouble.

GREENE: And you're saying that you're not satisfied with the plans that are in place, that the government could do a better job planning for scenarios like this.

FORTIER: Well, in some. I do think - there's a very clear transfer of power to the vice president. That's - the 25th Amendment has made that very clear. If we get into a much more complicated scenarios like they're both sick or the question of how you get somebody on the ballot and how the electors would pick because it happens this close to the election, look, I think we could have more clarity.

GREENE: John Fortier is executive director of the Continuity of Government Commission, a nonpartisan think tank set up by the conservative-leaning American Enterprise Institute and the liberal-leaning Brookings Institution. Thank you so much for helping us work through some of these big questions that, you know, we hope don't have to come up. We hope the president remains healthy, but things we have to think about. We really appreciate it.

FORTIER: Thank you. Transcript provided by NPR, Copyright NPR.