Biden's State of the Union: 7 healthcare takeaways

A theme of unity emerged from President Joe Biden's State of the Union address March 1 as he discussed the Russia-Ukraine conflict, the economy and strides made against the COVID-19 pandemic. 

"We’ve reached a new moment in the fight against COVID-19, where severe cases [are] down to a level not seen since last July," President Biden said. The daily average for new cases the day of the address was 58,986, down from the peak in January when new cases topped 800,000, data from The New York Times shows.

"Thanks to the progress we have made in the past year, COVID-19 no longer need control our lives," the president said, referring to access to vaccinations and tests and the development of antiviral treatments. 

Here are seven key healthcare takeaways from the speech with context:

1. "Test to treat" program: The government is launching a "test to treat" initiative "so people can get tested at a pharmacy, and if they prove positive, receive antiviral pills on the spot at no cost," President Biden said. He specifically called out Pfizer's COVID-19 antiviral pill regimen, Paxlovid, which was found to reduce the risk of death or hospitalization by about 89 percent. The treatment is intended for patients at high risk of developing severe illness and should be administered as soon as possible after diagnosis and within five days of developing symptoms. 

The U.S. has purchased 20 million courses of the treatment, with the first 10 million set to be delivered by the end of June. "Pfizer is working overtime to get us 1 million pills this month and more than double that next month," the president said, adding that the nation has ordered more of the pills "than anyone in the world." 

The program could launch this month, enabling eligible people to receive pills through pharmacies at places such as CVS, Walgreens and Kroger, a White House official who spoke on the condition of anonymity told The New York Times, adding the government will also distribute the pills directly to long-term care facilities. 

2. The Justice Department will name a chief prosecutor for pandemic fraud: "We're going to go after the criminals who stole billions in relief money meant for small businesses and millions of Americans," the president said. 

The prosecutor will "lead teams of specialized prosecutors and agents focusing on major targets of pandemic fraud, such as those committing large-scale identify theft," as well as "investigate major cases of criminal fraud in programs like the Paycheck Protection Program and Unemployment Insurance," the White House said in an accompanying fact sheet. It is not clear when the Justice Department will appoint someone to the role. 

3. Lowering prescription drug costs is part of the president's plan to fight inflation: "We pay more for the same drug produced by the same company in America than any other country in the world," President Biden said. "Just look at insulin. One in 10 Americans has diabetes."

Although insulin costs pharmaceutical companies about $10 per vial to make, "drug companies charge up to 30 times that amount," he said. "Let's cap the cost of insulin at $35 a month so everyone can afford it." 

The president urged Congress to allow Medicare to negotiate the price of prescription drugs. 

4. More free tests: Starting next week, Americans will be able to order a second round of free rapid at-home COVID-19 tests. "I'm announcing you can order another group of tests. Go to starting next week and you can get more tests," President Biden said. The government launched in January, where there was initially a limit of one order, which includes four individual tests, per residential address. 

In all, the Biden administration has said it plans to distribute a total of 1 billion at-home kits to Americans' homes. Since mid-January, fewer than 300 million tests have been ordered, Kevin Munoz, White House assistant press secretary, told CNN. 

5. He highlighted pediatric mental health: President Biden emphasized a commitment to mental health, "especially among our children, whose lives and education have been turned upside down." He specifically called for strengthening privacy protections, as well as banning targeted advertising to children. "And let's get all Americans the mental health services they need," President Biden said. "More people they can turn to for help, and full parity between physical and mental healthcare if we treat it that way in our insurance." His remarks come as the American Medical Association has been asking congressional leaders to prioritize parity and do more to ensure mental health care benefits to be covered at the same level as physical healthcare benefits, as called for in the Mental Health Parity and Addiction Equity Act. President Biden said his fiscal year 2023 budget will propose that all insurers cover robust behavioral health services with an adequate provider network, including three behavioral health visits annually without cost sharing.

6. He announced a unity agenda that includes plans to sign a clinician mental health bill: In January, HHS announced it would distribute $103 million to address staffing needs, burnout and mental health among healthcare workers. President Biden said he will also sign the bipartisan Dr. Lorna Breen Health Care Provider Protection Act into law. Congress passed the Dr. Lorna Breen legislation, named for a physician who died by suicide, in February to improve the mental health and well-being of healthcare workers. Among other things, the bill requires HHS to award grants for training health profession students, residents and healthcare professionals to reduce and prevent suicide, burnout, mental health conditions and substance use disorders, according to the Dr. Lorna Breen Heroes' Foundation. The grants are for hospitals, medical professional associations and other healthcare entities.

7. He called for higher standards for nursing homes: President Biden unveiled a nursing home quality improvement plan Feb. 28. The plan, which CMS will carry out, aims to increase nursing home staffing and oversight. President Biden said: "Medicare is going to set higher standards for nursing homes and make sure your loved ones get the care they deserve and that they expect." In a separate statement, CMS cited the COVID-19 deaths of nursing home residents and staff during the pandemic and emphasized the agency's commitment to implement the quality improvement plan. "The time is now for a bold new approach and a strengthened commitment to deliver on our moral responsibility to care for our nation's elders and people with disabilities," the CMS statement said. "These actions will be carefully coordinated alongside CMS' efforts to ensure people can access long-term care in an appropriate setting of their choice, including through home and community-based services."

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