On April 28, President Biden delivered his first address to a joint session of Congress. In addition to discussing the economy, education, and infrastructure investment, the President:

• Urged Congress to:
  • Address drug pricing this year. President Biden expressed his support for allowing Medicare to negotiate drug prices to reduce the cost of prescription drugs for Medicare beneficiaries as well as those enrolled in the commercial market. The President also directed funds saved from negotiation to be used to strengthen the ACA and expand Medicare coverage benefits.
  • Reduce deductibles for working families enrolled in ACA coverage by making permanent the expanded premium tax credits that were temporarily enacted in March in the American Rescue Plan. President Biden also included this priority in his American Families Plan.
• Celebrated his administration’s success in responding to the COVID-19 pandemic, namely in facilitating vaccine distribution.
• Proposed creating an Advanced Research Projects Agency for Health within the National Institutes of Health (NIH) for breakthrough disease research, particularly for Alzheimer’s disease, diabetes, and cancer.

Implications for Healthcare Stakeholders

This address to Congress signals that healthcare will continue to be a high priority for upcoming legislative debate, and President Biden’s full endorsement of government drug pricing negotiation could add momentum to the recent reintroduction of H.R.3. Other considerations for stakeholders:

• Expanded Medicare Benefits: The President recommended expanding fee-for-service Medicare benefits with funds saved from negotiation, but the current version of H.R.3 does not include expanded benefits. The House is scheduled to hold a hearing on the bill May 4. Stakeholders should monitor for potential future amendments on this topic.
• Alternate Policy Levers: As drug pricing negotiation legislation faces an uncertain future in the Senate, stakeholders should also consider how the Center for Medicare & Medicaid Innovation could be used to achieve President Biden’s drug pricing reform goal this year.
• ACA Enhancements: Beyond drug pricing, President Biden’s call for Congress to make permanent the temporary ACA enhancements included in the American Rescue Plan could lead to an increase in covered individuals and could also impact sources of insurance coverage. Permanent ACA enhancements would likely need to be offset by other savings-generating reforms.
• NIH Resources: Additionally, Biden’s request for more NIH resources could signal a greater role of the federal government in funding research for certain therapies. Upcoming appropriations processes could detail how this increased spending would be directed.

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