President Joe Biden will urge Congress to allow Medicare to increase its ability to negotiate drug prices and expand prescription drug spending caps during his State of the Union address on Thursday.
White House domestic policy adviser Neera Tanden told reporters on Wednesday that the president will ask Congress to build on work from the 2022 Health Care and Climate Act, which gave the feds the power to negotiate the price of some Medicare drugs , put limits on personal spending on prescription drugs for seniors and charge drug companies if they raise prices at a rate higher than inflation.
“The president’s work on health care is a signature issue for us,” Tanden said.
Biden will specifically ask Congress to allow Medicare to negotiate for at least 50 drugs a year, up from the 20 a year allowed under current law. The president will also specify the $2,000 out-of-pocket cap that will apply to Medicare Part D beneficiaries in 2025 as a model cap for private insurers. Congress abandoned a provision extending the cap to the private market during debate before the law passed.
A senior administration official said the president felt confident in expanding the model used for the 10 drugs currently under negotiation with the administration. The number of negotiable drugs will eventually increase to 20 per year in the coming years, under current law.
Biden will also ask Congress to expand inflation-linked drug rebates under the 2022 law to include commercial drug sales.
He will also review that the White House budget, expected on Monday, will ask Congress to cap cost-sharing for so-called high-cost generic drugs at $2 across all Medicare plans. The Department of Health and Human Services listed some of those drugs as part of a new drug pricing model on Wednesday.
The actions follow a White House roundtable held Monday to discuss the role of pharmacy managers, drug prices and the formation of a new task force.
Biden will also press Congress to extend premium tax credits, last renewed under the 2022 law, before they expire in 2025. The credits help low-income individuals in states without Medicaid expansion who earn too much to qualify for traditional Medicaid.
“We know that the promise and benefits of the federal Affordable Care Act are really at stake, and the president will continue to implement the ACA as he has done this term,” Tanden said, referring to the 2010 health care law.
Biden will also preview upcoming regulatory actions as the administration works to finalize a mental health parity rule and to finalize a proposed rule to restrict health plans that do not meet the safeguards of the 2010 health care law .
Senate Majority Leader Charles E. Schumer, DNY, speaking on the Senate floor Wednesday, praised the health care actions taken since Biden’s previous addresses to Congress. He pointed to efforts to contain insulin costs for some individuals and the upcoming Medicare spending cap that will take effect in 2025.
“Sometimes it can take a while for the effects of an ambitious program to take root. We saw that happen with the ACA,” Schumer said.
Other health priorities
Biden is also expected to make reproductive freedom a key component of his remarks Thursday, according to a second senior administration official, who declined to elaborate on specific calls for action.
Democrats in Congress are using this year’s address as a way to get a message out about access to reproductive health care, including IVF, abortion and maternal health. More than two dozen lawmakers have announced guests related to these issues.
Keeping the increased focus on IVF following a recent Alabama Supreme Court ruling, Sens. Tim Kaine, D-Va., and Tammy Duckworth, D-Ill., and Reps. Gerald E. Connelly, D-Va., and Lori Trahan, D- Mass., announced their guests, which included Elizabeth Carr, the first person in the US to be born through IVF, two reproductive endocrinologists and the president of RESOLVE: The National Infertility Association.
House Minority Leader Hakeem Jeffries, DN.Y. invited Reproductive Freedom for All President Minnie Thimmaraju and House Minority Representative Catherine M. Clark, D-Mass., Congresswoman Joyce Beatty, D-Ohio, and Sen. Patty Murray, D-Wash., will bring women affected by the state bans abortions, according to their offices.
Biden is expected to use the address to ask Congress to increase investment in women’s health research more broadly.
