Biden to GOP: Don't touch healthcare dollars 

Ten days before releasing his budget proposal, President Joe Biden contrasted his administration's efforts to lower healthcare costs with what he anticipates will be Republicans' preliminary plans to cut federal healthcare programs. 

The president made remarks for 30 minutes at a recreation center in Virginia Beach, Va., Feb. 28. In that time, he recounted his own healthcare experiences, praised healthcare workers, revisited his administration's healthcare policy changes and wins, and painted "MAGA Republicans" as a looming but likely threat to the Affordable Care Act, Medicare and Medicaid.

"Look, make no mistake: If MAGA Republicans try to take away people's healthcare by gutting Medicaid and the Affordable Care Act, I will stop them," the president said, referring to Republicans aligned with former President Donald Trump.

Here are 4 key takeaways from President Biden's speech, ahead of the March 9 release of his federal budget proposal. 

1. Healthcare spending cut proposals are still unclear

Republicans have not committed to cutting federal healthcare programs, but have signaled openness to budget changes. President Biden made mention of a proposal drafted by Russell Vought, who served as President Trump's budget director, that would fully repeal the ACA's Medicaid expansion, among other changes. Rep. Jodey Arrington, chairman of the House Budget Committee, told Reuters lawmakers are reviewing items "consistent" with the contents of Mr. Vought's plan.

The Feb. 28 event marked the return of a presidential speech centered around healthcare and the Affordable Care Act as partisan issues after a pause. While reproductive rights and abortion were prominent issues for voters in the midterm elections, controversy over former President Barack Obama's signature law grew relatively quiet for the first time in more than a decade.

2. Medicare

For the federal program serving seniors, the president touted the recently passed Inflation Reduction Act that caps insulin costs at $35 a month and said he wants the same policy extended to all Americans.

Biden repeated claims he made at his State of the Union address in February, saying that some parts of the GOP are looking to sunset federal healthcare programs every five years, including Medicare.

"[Republicans] want to take back the power we just gave Medicare and Medicaid to negotiate, which would raise prices," he said. "Those MAGA Republicans increase costs for millions of Americans, and make deep cuts in programs that families and seniors depend on. And that's what's at stake now."

Behind the scenes, the administration is quarreling with the health insurance industry over what payers say are proposed cuts to Medicare Advantage from CMS.

In an advance notice published Feb. 1, the agency proposed a rate increase of 2.09 percent for Medicare Advantage and Part D plans next year, which it says will result in a small revenue bump of 1.03 percent on average. 

Insurance trade group AHIP wrote Feb. 27 that CMS' conclusion is not based in fact and that the proposal actually represents a 2.27 percent cut in MA payments. Some groups have claimed the move will lead to $540 less spending per MA member annually.

"Any claim that this administration is cutting Medicare is categorically false," HHS Secretary Xavier Becerra said in a tweet on Feb. 17. "Leave it to deep-pocketed insurance companies and industry front groups to characterize this year's proposed increase in Medicare Advantage payments as a pay cut." 

3. Medicaid

The president was more specific around possible proposals to cut Medicaid spending, saying House Republicans are eyeing $2 trillion in cuts from the program for low-income individuals.

He also spoke about the impact of reduced Medicaid funding on hospitals, especially those serving rural areas.

"Entire communities depend on these hospitals. Not getting Medicaid would shut many of them down."

Across the country, 631 rural hospitals, or more than 29 percent nationwide, are either at immediate or high risk of closure. 

4. ACA

Biden was most specific about Republican plans to do away with the Affordable Care Act — a credible claim after 70 GOP-led attempts to repeal or modify the law since its passage in 2010.

"Again, sadly, the MAGA Republicans — or those in Congress who threaten to undo the gains — they want to do away with the Affordable Care Act."

The Inflation Reduction Act extended ACA premium tax credits through the end of 2025, meaning 80 percent of enrollees will be able to purchase a plan for $10 or less, according to the White House.

CMS said Jan. 25 that a record 16.3 million people enrolled in ACA coverage during the open enrollment period from Nov. 1, 2022, to Jan. 15, 2023, a sign of the program's enduring and growing popularity.

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