Mar 7, 2024 - Health

Biden speech again seeks credit on drug prices

Photo illustration of Biden reading a speech from a piece of paper shaped like a health plus.

Photo illustration: Aïda Amer/Axios. Photo: Jim Lo Scalzo/EPA/Bloomberg via Getty Images

President Biden will use Thursday night's State of the Union address to again claim credit for lowering Americans' drug costs — something the public just isn't willing to concede.

Why it matters: While policies around cheaper medicines poll extremely well with voters, Biden hasn't been able to squeeze political juice from Medicare price negotiations, out-of-pocket caps and other policies on his watch.

  • An AP-NORC poll in the fall found less than half of Americans approved of Biden's handling of drug prices even though a majority supported Medicare negotiations.
  • Only a subset of Americans are starting to see direct savings from the health provisions in the Inflation Reduction Act. The administration last month saw the need to launch a campaign to remind seniors of its benefits, KFF Health News reported
  • Change ripples slowly through the health care system, which doesn't help in a superheated campaign cycle. While Medicare officials are negotiating with manufacturers, most seniors won't see price tags of the most expensive drugs drop until 2026, at earliest.

The big picture: Drug prices still sync with the Biden campaign's bigger theme around helping Americans make ends meet.

  • And Biden can portray himself as a fighter who took on powerful pharmaceutical interests and won, even though the industry is trying to overturn price negotiations in multiple courts.

What they're saying: "Passage of the Inflation Reduction Act was a huge political win over the pharmaceutical industry, but voters haven't yet noticed," said Larry Levitt, executive vice president of health policy at KFF.

Zoom in: Biden tonight will try to build on the IRA by calling for expanded Medicare negotiations for at least 50 drugs each year, White House domestic policy adviser Neera Tanden told reporters.

  • Current talks are limited to 10 of the costliest prescription drugs to Medicare, and the law calls for negotiations to expand to up to 20 drugs annually by 2029.
  • Biden will also call on Congress to expand a $2,000 cap on out-of-pocket spending for prescription drugs in Medicare to all private insurance plans, and to limit patient cost-sharing for high-value generic drugs to $2 in all Medicare plans, Tanden said.
  • Medicare officials are already developing a pilot program with $2 cost-sharing for generics.
  • Biden has also tried to win recognition for rebates drugmakers have to repay to Medicare if their prices rise faster than inflation. He plans to call on Congress to expand rebates to private insurers.

Yes, but: In a hypercharged election, it's going to be hard to drive home the possible benefits to a brittle electorate.

Reality check: Congress is unlikely to get behind additional drug pricing reforms.

  • The IRA passed without a single Republican vote, and since then, lawmakers' health care interests have shifted to regulating pharmacy benefit managers, who negotiate with drugmakers on behalf of insurers and employers.

The other side: People are generally unhappy with the state of the health care system, said Joe Grogan, the former director of Trump's Domestic Policy Council.

  • "The Democrats have dominated policymaking and [Biden] wants to go out there and say, 'This is so great'? I think Republicans have to push back," Grogan told Axios.

Our thought bubble: A vigorous speech to a prime-time audience could put to rest some concerns about Biden's own health and vitality.

Read more: What to expect at Biden's State of the Union

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