Mar 12, 2024 - Health

Biden budget focuses on unfinished health care business

Illustration of a hand pulling back a red piece of fabric to reveal a health plus shape

Illustration: Natalie Peeples/Axios

President Biden's election-year budget lays out a possible second-term health care agenda focused on advancing policies that were scaled back or dropped from the defining legislative fights of his first term.

Why it matters: Presidential budgets are largely political messaging tools, and the fiscal year 2025 blueprint released Monday highlights Biden's preference to build on populist health reforms rather than push sweeping overhauls that tend to be divisive.

Where it stands: The budget calls for expanding Medicare's drug negotiation program and extending Medicare caps on insulin and out-of-pocket costs to people with private insurance.

  • Those measures were part of the 2022 Inflation Reduction Act passed by Congress with only Democratic votes, but Biden has gotten relatively little credit so far from voters even as polls show support for those ideas.
  • The budget also calls for a permanent expansion of enhanced subsidies for Affordable Care Act coverage that he pushed through Congress but are set to expire after 2025.

In other unfinished business, the budget outlines a 10-year, $150 billion increase for Medicaid home- and community-based services after a major expansion he campaigned on in 2020 was set aside by Congress.

  • It also renews Biden's call to create a federal coverage option for low-income people in states that haven't expanded Medicaid under the ACA.

What they're saying: "While my administration has seen great progress since day one, there is still work to do. My budget will help make that promise real," Biden wrote in his budget.

Zoom in: The $130.7 billion health care budget also proposes increases for public health preparedness funding and greater support for mental health and substance use disorder treatment, including requiring that insurers' provider networks include enough behavioral health providers.

  • It also calls for a more than $2 billion increase for the cancer moonshot, a core part of Biden's "unity" agenda that aims to bridge partisan divides.

Compared with budgets in previous years, it also places a greater emphasis on health care cybersecurity as the industry increasingly is targeted by hackers.

  • It pitches $1.3 billion in new hospital cybersecurity programs and $141 million to bolster the federal health department's own systems.
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