Biden's State of the Union: 13 healthcare takeaways

During his State of the Union address March 7, President Joe Biden highlighted more than a dozen issues affecting healthcare leaders, from reproductive rights to prescription drug costs. 

Here are 13 key healthcare takeaways from the speech with context:

1. Expanding Medicare's drug price negotiation scope: Medicare is limited to negotiating prices for 20 drugs per year. President Biden asked Congress to allow Medicare to negotiate prices for at least 50 drugs per year, including drugs used for treating heart disease, cancer and diabetes. "This year Medicare is negotiating lower prices for some of the costliest drugs on the market that treat everything from heart disease to arthritis," he told Congress. "Now it's time to go further and give Medicare the power to negotiate lower prices for 500 drugs over the next decade." 

2. Limiting drug costs: President Biden also called for expanding the $2,000 out-of-pocket cap on prescription drugs. The cap, part of the Inflation Reduction Act, applies in Medicare in 2025. Now, President Biden wants Congress to expand this out-of-pocket cap to all private insurance.

3. Expanding rebate requirement: Additionally, President Biden called for expanding the Inflation Reduction Act's requirement that drug companies pay rebates to Medicare if their price increases for certain drugs are faster than inflation. He specifically is urging Congress to require those rebates for commercial drug sales, as well as sales to Medicare, per fact sheets released by the White House ahead of the State of the Union address. 

4. Closing Medicaid coverage gap: President Biden also continues to urge Congress to provide "Medicaid-like coverage" to individuals living in states that have not adopted Medicaid expansion as well as keeping those enrolled through Medicaid expansion covered, per the fact sheets from the White House. There are 10 states that have not expanded Medicaid.

5. Capping the cost of insulin: President Biden referenced the existing $35 cap on out-of-pocket costs for a month's supply of insulin for older adults and people with disabilities on Medicare. During his speech to Congress, he said he wants this cap "for every American who needs it." 

6. Abortion access: President Biden promised to restore Roe v. Wade if the country "send[s] me a Congress that supports the right to choose," noting that — like most Americans — he believes the landmark decision "got it right." He shared stories from two women present at the address who had been affected by harsher reproductive laws: one whose IVF treatments were halted in Alabama and one who had to travel outside Texas to save her life and fertility when her fetus had a fatal condition. 

7. COVID-19: The president gave an overview of post-pandemic recovery, acknowledging the loss of more than 1 million American lives and an isolation-based mental health crisis, but stated that Americans are currently "writing the greatest comeback story ever told." He said the vaccines used to fight COVID-19 are now being used to help beat cancer, and that the virus "no longer controls our lives." 

8. Affordable Care Act: President Biden voiced support for Obamacare, saying he is protecting and expanding it. He said tax credits he enacted have saved millions of families $800 per person per year by reducing healthcare premiums, and he aims to make those credits permanent ahead of their expiration next year. 

9. Women's health: The White House is launching an Initiative on Women's Health Research to be led by first lady Jill Biden, EdD. He urged Congress to pass his plan for $12 billion to support and transform women's health research.  

10. Taxes: President Biden said he wanted to end tax breaks for "Big Pharma, Big Oil, private jets and massive executive pay," noting that the average federal tax rate for America's 1,000 billionaires is 8.2%. He proposed a minimum tax of 25% for billionaires, which would raise $500 billion over the next decade. 

11. Gun violence: Health system CEOs are taking action on gun violence, and President Biden said he plans to do so as well. He demanded a ban on assault weapons and high-capacity magazines and urged Congress to pass universal background checks. He also mentioned that the White House has established its first Office of Gun Violence Prevention, led by Vice President Kamala Harris. 

12. PACT Act: President Biden signed the PACT Act in August 2022 and expanded it on March 5. The law aims to help veterans who were exposed to toxins and are now battling "more than 100 cancers," he said. Under the recent expansion, millions of veterans are becoming eligible for VA healthcare up to eight years earlier than written into the original law. 

13. ARPA-H: At the end of his speech, President Biden gave a shout-out to the Advanced Research Projects Agency for Health (ARPA-H), a federal agency for breakthrough biomedical and health research established in 2022. He said "we owe it to ourselves" to continue supporting the agency, and "remind us that we can do big things like end cancer as we know it." 

The GOP's response to President Biden's address — delivered by Alabama Sen. Katie Britt — called for stricter border policies and criticized inflation. 

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