The healthcare priorities in Biden's proposed budget

Some of the healthcare priorities in Biden's $7.3 trillion proposed budget include:

Drug price negotiations

In his State of the Union speech, Biden proposed expanding drug price negotiations to 500 drugs over the next decade, which he said would save taxpayers $200 billion.

The budget also proposes limiting cost-sharing for "high-value generic drugs" to $2 a month for Medicare beneficiaries. In addition, it would expand a provision from the Inflation Reduction Act (IRA) that caps out-of-pocket prescription drugs costs at $2,000 for Medicare beneficiaries to the commercial market.

Medicare

The proposed budget calls for increasing taxes on individuals making over $400,000 a year, going from 3.8% to 5%. It would also close loopholes and transfer net investment income tax revenue to the Medicare trust fund.

Currently, the Medicare trust fund is projected to run out in 2031, but HHS said that the proposed budget would extend the solvency of the fund indefinitely. 

Medicaid

The budget proposes $150 billion to strengthen and expand home- and community-based services for Medicare beneficiaries over the next 10 years. It would also permanently expand premium tax credits that were initially extended by the IRA.

Biden also called for the creation of a Medicaid-like coverage program for people who live in the 10 states than have not expanded Medicaid eligibility under the Affordable Care Act. According to the budget, this proposal is "critical" for rural communities.

The budget also proposes increasing continuous Medicaid and Children's Health Insurance Program eligibility for children from 12 months to 36 months. It would also allow states to implement continuous eligibility for children from birth to the age of six.

Cybersecurity

The budget proposes $1.3 billion in Medicare payment incentives for hospitals to implement and invest in cybersecurity programs, $141 billion for HHS cybersecurity initiatives, and $12 million for the Administration for Strategic Preparedness and Response.

HHS Deputy Secretary Andrea Palm said that assistance to hospitals would shift to penalties for facilities that don't meet minimum security standards beginning in 2029.

"There are a series of essential goals that are really meant to lift all boats, to make sure that we are really targeting the common vectors and vulnerabilities in cyberattacks, and then there are the enhanced practices which really allow us to get to a greater level of complexity in responding to this," Palm said.

Increased access to care

The proposed budget also calls for investments in several different areas to increase access to care and improve outcomes for patients.

For example, the budget includes $376 million to support ongoing implementation of the White House Blueprint for Addressing the Maternal Health Crisis, which aims to reduce maternal mortality and morbidity rates. The budget would also double funding for NIH's Office of Research on Women's Health and set aside funding to expand paid family and medical leave programs through the Social Security Administration.

The budget also includes several mental health investment proposals, including $216 million in mental health programs for students and an additional $50 million for the children's mental health initiative. Similarly, the budget proposes $1 billion in funding for behavioral health providers so they can advance technology adoption and engagement.

Currently, more than 60 million Americans live in rural areas, and the budget proposes investments to provide additional assistance to rural hospitals, including direct primary care and mental healthcare services. It also requests $8 billion in discretionary funding for the Indian Health Service, a 12% increase from 2021 levels.

Commentary

According to Modern Healthcare, it's unlikely Biden's budget proposal will be enacted, but it provides a starting point for negotiations for the FY 2025 budget.

"This president's budget introduced today doubles down on the investments that made the comeback of our jobs, our economy and our health possible," said HHS Secretary Xavier Becerra during a news conference on Monday. "It lays out a vision for a nation that invests in its most vulnerable, fosters innovation and protects Americans' access to the care they need."

Senate Majority Leader Chuck Schumer (D-N.Y.) also praised Biden's plans. "That budget will help improve the solvency of vital programs like Medicare and Social Security, which tens of millions of Americans rely on every single day," Schumer said. "President Biden’s budget will help ensure we continue to make good on the investments from our agenda and build an economy that works for everyone."

However, Republicans leaders in Congress were more critical of the proposed budget.

"The price tag of President Biden’s proposed budget is yet another glaring reminder of this administration's insatiable appetite for reckless spending and the Democrats' disregard for fiscal responsibility. Biden's budget doesn't just miss the mark — it is a roadmap to accelerate America's decline," said House Speaker Mike Johnson (R-La.) and other House GOP leaders. (Tong, Fierce Healthcare, 3/11; McAuliff, Modern Healthcare, 3/11; Sink/Wasson, Bloomberg, 3/11; Boak/Hussein, Associated Press, 3/11; Ashley et al., Becker's Hospital CFO Report, 3/11; White House fact sheet, 3/11)