Concerns about President Biden’s age, which intensified after his recent falls and a string of mental misfires, have spurred speculation about worst-case scenarios that include the possibility he will become so ill that he can no longer do the job.
His performance has raised questions about the use of the 25th Amendment, which provides for the transfer of power if a president cannot carry out his duties. Others worry that Vice President Kamala Harris could become a de facto caretaker president as Mr. Biden’s abilities decline.
Mr. Biden is beset by several health issues. He wears an air mask at night to treat sleep apnea, was recently treated for a form of skin cancer, and has mobility issues attributed to arthritis in his back and neuropathy in his feet. The president is also being treated for high cholesterol and atrial fibrillation, which causes an irregular heart rate.
Most of the attention, however, has focused on his frequent gaffes in which he stumbles over words or confuses facts such as mixing up the wars in Ukraine and Iraq, giving critics a pathway to question his mental acuity. Mr. Biden has also suffered from falls, including while on a bike ride in Delaware, on stage at an Air Force Academy graduation ceremony and while climbing the stairs to board Air Force One.
Already the nation’s oldest president at 80, Mr. Biden will be 82 at the start of his second term if he wins reelection. He would be 86 at the conclusion of a second term. The next-oldest commander-in-chief was President Reagan, who was 77 when he left office.
Mr. Biden’s physician gave him a clean bill of health after his annual physical in February, declaring the president “a healthy, vigorous, 80-year-old male who is fit to successfully execute the duties of the presidency.”
But the falls and verbal miscues have only sharpened questions about Mr. Biden’s age and cognitive abilities. A slew of recent polls show voters are extremely concerned about Mr. Biden’s ability to serve effectively during a second term.
Only 27% of voters say Mr. Biden is “fit to serve another term as president” and 52% said his age is “a big problem,” according to a recent Yahoo News/YouGov poll. Separate polls by The Associated Press and Wall Street Journal found that 75% of voters view Mr. Biden as too old to be president. About half say the same about former President Trump, 77, who is the frontrunner for the 2024 Republican presidential nomination.
Given the uncertainties of aging, Mr. Biden’s health could deteriorate.
That could propel the country into unchartered territory in which a range of events would play out. The scenarios range from an acrimonious debate in Congress on whether to remove the president, to an unprecedented but conceivable worst-case scenario in which the nation would have two people declaring themselves president with dual Cabinets.
The 25th Amendment provides for the temporary — or potentially permanent — transfer of power in the event a president can longer discharge the duties of their office. It was ratified in 1967 in the wake of President Johnson ascending to the office upon the assassination of President Kennedy in 1963.
Some Republicans have already tossed around the idea of removing Mr. Biden through the 25th Amendment.
The option was floated after Mr. Biden’s press conference in Vietnam where he was unaware that his microphone was cut off and White House press secretary Karine Jean-Pierre abruptly ended the session. Sen. Mike Lee, Utah Republican, wrote on X, “Great time to deploy the 25th Amendment.”
The White House has rejected claims that Mr. Biden is too old to run in 2024, often laughing off questions about the president’s age.
When asked last week about polls revealing voters have significant concerns, Ms. Jean-Pierre responded by saying, “Eighty is the new 40.”
‘This is a president, if you think about it — in 2019, he got the same criticism, in 2020, he got the same criticism, in 2022, he got the same criticism. And every time he beats the naysayers,” she said. “You look at his record, you look at how he’s been able to bring both sides together, to get some really important things done. That matters.”
Former President Donald Trump, who faces similar questions about his age, implored House Republicans last week to invoke the 25th Amendment after listing a litany of grievances with his successor. During his four years in office, Mr. Trump also confronted calls to be removed through the 25th Amendment after what Democrats said his behavior was erratic.
Those pleas muddy the meaning of the 25th Amendment, which can only be invoked if the president is unable to carry out “the powers and duties of his office.” If the president cannot make such a declaration, it empowers the vice president and a majority of Cabinet members to declare the president’s “inability” to serve.
Yet, the amendment doesn’t define “inability,” leaving it up to the judgment of the vice president and Cabinet to determine whether a president can do his job. That’s intentional, said Brian Kalt, a professor at the University of Michigan College of Law. He said the drafters of the amendment feared that medical technology would advance rendering their terminology obsolete.
“It is not a medical determination. It is a political determination,” Mr. Kalt said.
That could create a nightmare scenario in which a president pushes back, declares no inability exists and simply refuses to declare he is disabled. It could happen if a president is suffering from senility or some other illness that prevents them from recognizing their diminished capacity.
It has already happened, though at a far less dramatic level. President Eisenhower suffered a stroke in 1957, following a 1955 heart attack and major surgery in 1956. After the stroke, he wrote to Vice President Richard Nixon saying he would be the one to determine when he was able to resume his duties.
Eisenhower also famously refused to declare a disability hours after his stroke, insisting he could attend a State dinner that night and shouting at his family, “There’s nothing the matter with me! I’m perfectly alright!”
Section 4 of the 25th Amendment provides that, if an incapacitated president refuses to step aside, the vice president and Cabinet would have four days to certify again that the president is unfit for the job. At that point, Congress would intervene to make the decision.
If that happens, two-thirds of both the House and Senate must declare the president is disabled, a higher bar than is required for impeachment.
It would also likely spark a very contentious partisan fight.
“A constitutional crisis arises when you have a president who doesn’t invoke the Amendment because he doesn’t see the problem. Then it goes to Congress and becomes as partisan a food fight as impeachment,” said Andrew Rudalevige, a professor of government at Bowdoin College.
Congress has 21 days to resolve the issue and, if lawmakers can’t reach an overwhelming decision, the president would take back power. Also, if the president loses, he can ask Congress to take another vote. In fact, if he repeatedly loses, he can keep asking Congress to vote until his power is restored.
That could create another chaotic scenario that would likely be the worst case. While Congress is mulling such a vote, a president could immediately announce he’s taking back power and begin firing the Cabinet and vice president. At that point, America would have two people claiming to be president and two sets of advisers insisting they are the true Cabinet.
“The whole point of the 25th Amendment is to make it clear at any given moment who the president is, but in that situation, it would fail because the drafting is not as clear as it should be,” Mr. Kalt said. “You don’t want it decided by the Secret Service and military. That would be horrible.”
Another crisis could arise if a president gets wind of his vice president and Cabinet plotting to remove him ahead of triggering the 25th Amendment. He could begin political maneuvering to remove those officials before they take action.
In the wake of the Jan. 6, 2021, attack on the U.S. Capitol, fears arose that Mr. Trump would do something similar, fueling talk of using the 25th Amendment to strip him of his powers.
The House voted 223 to 205 to approve a resolution imploring Vice President Mike Pence to use the 25th Amendment. Betsy DeVos, Mr. Trump’s secretary of education, has said she discussed with Mr. Pence and other Cabinet members about invoking the 25th Amendment. Mr. Pence did not support the idea.
A more likely but less dire scenario would be a president not understanding the gravity of the situation, with the Cabinet or vice president stepping in to prop up the commander-in-chief.
There is a long history in the U.S. of covering up a president’s ailments. Perhaps the most famous is President Woodrow Wilson, who suffered a massive stroke in 1919 that left him seriously disabled. The stroke was kept not only from the American public but also from his vice president. His wife, Edith Wilson, took over the decision-making at the White House.
President Warren Harding, who died in office, suffered from a litany of health issues that kept him disengaged from his staff. Cabinet officials took advantage of the opportunity to engage in rampant corruption, resulting in the Teapot Dome scandal after his death.
Propping up a diminished president would typically be the easier path for vice presidents who fear that raising questions about a president’s health would look like usurping power.
Wilson’s vice president, Thomas Marshall, once said he was relieved that the president’s inner circle lied to him about the stroke.
“In these earlier cases where the president is ill, vice presidents are really reluctant to look like they are trying to become president,” Mr. Rudalevige said. “There is a fine line between continuity and coup in the minds of those looking at this situation.”
• Jeff Mordock can be reached at jmordock@washingtontimes.com.