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President touts health care improvements in 2024 budget


House Republicans rip spending plans’ effects on Medicare, drug innovation.

President Joe Biden’s 2024 budget will have ramifications for health care.

The White House this week published a fact sheet touting benefits in the next year’s federal spending plan. Biden and his administration “plan to invest in America, lower costs for families, protect and strengthen Social Security and Medicare, and reduce the deficit,” according to the plan.

But the plan is not without criticism: House Republicans called the president’s plan a “Medicare gimmick” that won’t save that insurance program from heading for insolvency. But it “will lead to fewer cures” when government-imposed price limits stifle spending on prescription drug development.

The topics set forth in White House budget summaries:

Health insurance available

With enrollment in Affordable Care Act (ACA) health insurance at a record high, the budget will make permanent the average savings of $800 a year for premiums, by expanding premium tax credits. Coverage similar to Medicaid will be offered in states that have not expanded Medicaid under the ACA.

Medicare solvency

The budget will extend solvency of the Medicare Hospital Insurance (HI) Trust Fund by 25 years, according to an estimate by the Medicare Office of the Chief Actuary. The fund will have money to last into the 2050s, well beyond the current estimated insolvency in 2028.

The Medicare tax rate will increase from 3.8% to 5% for earned and unearned income greater than $400,000. That rate increase will apply to high-income earners who “shield some of their income from tax by claiming it is neither earned income nor investment income.”

Savings from prescription drug pricing reforms will be credited to the HI Trust Fund. This builds on savings from the Inflation Reduction Act of 2022 (IRA), which allows Medicare to negotiate prices for high-cost drugs.

Lower drug costs

Medicare beneficiaries will have lower out-of-pocket costs for drugs due to negotiated prices. The White House said out-of-pocket savings for beneficiaries will be worth billions of dollars.

Medicare Part D cost-sharing on certain generic drugs will be capped at $2 per prescription per month.

Mental health care will have no cost-sharing for up to three visits a year. Medicare coverage will have parity between physical health and mental health.

Criticism follows

The budget effects on health care prompted criticism from Republican leaders of the Energy and Commerce Committee and the Ways and Means Committee of the U.S. House of Representatives.

“President Biden's newfound ‘concern’ for the solvency of Medicare comes only after he raided $716 billion from the program to pay for Obamacare and another $300 billion for more Obamacare subsidies and a down payment on the Green New Deal,” Rep. Cathy McMorris Rodgers (R-Washington) said in a news release. Rodgers is chair of the House Energy and Commerce Committee, which considers health- and medicine-related issues.

“Rather than seek bipartisan solutions that strengthen Medicare and preserve benefits that seniors enjoy today, President Biden wants to double down on government price setting policies from the IRA that have already stopped new and potentially life-saving treatments from reaching patients,” Rodgers said.

House Ways and Means Committee Chair Jason Smith (R-Missouri) said the budget will “dismantle Medicare and seniors’ access to life-saving medicines” while sticking small businesses with $252 billion in tax raises.

Meanwhile, Medicare faces more than $500 billion in cuts in the next 10 years, Smith said in a news release.

“President Biden sweeps these cuts under the rug and is instead showing his true plan: taxes on small businesses, bonafide budget gimmicks, and endangering seniors’ access to care with zero accountability,” Smith said.

Medicaid expansion

The White House summaries said the 2024 budget plans $150 billion over 10 years to improve and expand Medicaid home and community-based services, such as personal care services, for seniors and people with disabilities to remain at home.

The federal Health Center Program will double its size and expand its reach. The budget includes $966 million to expand the National Health Service Corps, which provides loan repayments and scholarships for health care professionals working in underserved areas. There will be $350 million to expand nursing training.

Maternal health

The budget has $471 million dedicated to reduce maternal mortality and morbidity rates, with programs ranging from initiatives for rural communities to bias training for health providers.

Cancer Moonshot

The administration’s Cancer Moonshot aims to reduce cancer deaths by at least 50% over the next 25 years, while improving living for those with cancer, their families, and survivors. The budget includes $1.7 billion for cancer activities in the U.S. Department of Health and Human Services, with targeted investments in the Departments of Veterans Affairs, Defense, Agriculture, and other agencies. The National Cancer Institute will get $7.8 billion, while the federal Advanced Research Projects Agency for Health will receive $2.5 billion.

Behavioral health

“The United States is facing a mental health crisis,” with much more to be done, according to the White House. The budget will invest in the behavioral health workforce, youth mental health care, and more.

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