Mar 9, 2023
What stands out in Biden's budget
Mar 9, 2023
Photo illustration: Annelise Capossela/Axios. Photo: Bastiaan Slabbers/NurPhoto via Getty Images
President Biden's budget proposal is out. You already know about his Medicare solvency plan, but here's what else jumped out at us:
1. Health care access
- The budget calls for permanently expanding enhanced tax credits for Marketplace health plans, which currently expire at the end of 2025, and proposes “Medicaid-like” coverage for eligible people in states that haven’t expanded Medicaid coverage yet..
- It asks for $150 billion over 10 years to improve Medicaid home- and community-based services, and it wants to work toward doubling the size of the community health center program. The budget also includes new funding to bolster the health care workforce.
- Additionally, Biden repeated an ask from last year’s budget for a new program to provide free vaccines to uninsured adults.
2. Prescription drugs
- The budget would expand the IRA’s number of drugs to be negotiated and move up the timeline (but we don’t have details yet on the exact numbers there).
- Biden wants to create a mandatory national program to expand testing, treatment and prevention of Hepatitis C infections, along with a subscription model for Hepatitis C drugs. Sen. Bill Cassidy was instrumental in passing a similar program in Louisiana.
- The budget would extend inflation rebates to the commercial market, a major step in extending the IRA’s reach not just to Medicare but to private plans. That move was struck by the Senate parliamentarian during the IRA debate.
- It also calls to extend the $35 insulin price cap to the commercial market.
3. Behavioral health
- The proposal seeks to lower consumer costs for Medicare beneficiaries and require parity in coverage between medical and mental health services.
- For commercially insured people, the budget would expand mental health coverage and strengthen the network of providers, though the initial documents don’t give details on the idea.
4. Pandemic preparedness
- While the budget doesn’t ask for any new COVID-19 relief funding, it does emphasize the need to prepare for future pandemics. Biden wants to give the assistant secretary for preparedness and response $400 million in new resources.
- According to the budget summary, this is the first time in decades that the budget includes $50 million for an emergency fund to help HHS respond rapidly to public health threats.
5. Maternal and reproductive health care
- In the wake of Roe v. Wade being overturned, the Biden administration is proposing to increase Title X family planning funding by almost 80% from 2023 levels with the goal of serving more patients.
- It includes $471 million in funding for maternal health initiatives that are part of the existing White House maternal health blueprint, and it also requires all states to provide Medicaid coverage for 12 months postpartum (though the majority of states already provide this).
Remember: The GOP House Budget Committee, Republican Study Committee and House Freedom Caucus are expected to release their own budget frameworks soon.
- “Congressional Republicans keep saying they want to reduce the deficit, but they haven't put out a comprehensive plan showing what they'll cut,” OMB Director Shalanda Young said on a press call Thursday morning.
- “We're looking forward to seeing their budget so the American people can compare it to what we're putting out today.”
