According to White House officials, President Joe Biden
's budget will explicitly call for major health-care legislation this year, even though it will not include specific numbers or policy details on several key proposals.
“The Budget document will reiterate the President’s strong call to Congress
during his joint address for immediate action to reduce prescription drug costs and expand and improve health coverage,” White House press secretary Jen Psaki
told Stardia via email.
“The structure for this budget is that it’s the things we’re trying to get done this year, and we’re definitely saying health care
is one of those things,” said another senior official.
The statements came in response to ongoing concerns that Biden will postpone or abandon a push for several policies he supported during the 2020 campaign, including legislation giving the federal government new authority to set prescription drug prices.
Anxiety about Biden's commitment to these policies grew even stronger on Friday, following new reporting in The Washington Post
, which quoted several officials as saying that Biden's budget would not include specifics on prescription drugs
or other past Biden health-care promises, such as a pledge to create a public option in which any American could enroll.
The budget will be released on May 28, according to the White House.
What Is In The Budget And Why Is It Important?
The president's budget is not a legally binding document; rather, it is a statement of how the president would like to see Congress allocate revenue and spending as it passes bills in the coming year.
However, when the president's party controls Congress, as Democrats
now do, and especially when it is the first year of a new term, as it is this year, the presidential budget tends to set the legislative agenda because lawmakers usually follow the president's lead.
The budget itself is divided into narrative
sections that explain what the president wants to do and why, as well as detailed statistical tables that break down the fiscal impact of each proposal on a year-by-year basis.
Senior officials told Stardia that the narrative section on health care in this year's budget will include all of the major ideas that Biden has previously endorsed, including not only prescription drug legislation and the creation of a public option, but also adding new benefits (visual, dental, and hearing) to Medicare
and allowing people
60 and older to buy into a version of Medicare.
The budget will also include funding for health insurance
for people who live in one of the 12 Republican-controlled states that have not expanded eligibility to include everyone with incomes below or just above the poverty
However, while the narrative section will mention these policies, the statistical sections will not say how much they will cost or save.
The big question is whether or not this means anything.
On Friday, administration officials told Stardia that interpreting the lack of numbers on the health-care proposals as a sign that Biden is less serious about pushing for them is a mistake.
Officials said that by including health care in the narrative sections, Biden is conveying that he still considers health care to be a priority.
“By being very explicit about [health care legislation] in the budget, the intent is to signal that this is something we are truly committed to pursuing,” one of the senior officials explained.
According to the officials, one reason for avoiding too many specifics on health care right now is to give Congress more room to work
through some still-contentious policy debates.
What Vice President Joe Biden Has Already Said About Health Care
The lack of specifics on those health-care ideas is consistent with Biden's previous approach to health-care policy.
In March and April
, Biden outlined two major policy packages, the American Jobs
Plan and the American Families Plan
, both of which included health-care proposals, and administration officials have stated that those two packages should serve as the foundation for legislation passed by Congress this year.
The American Jobs Plan included a major initiative to finance home health aides and other supports that allow the disabled and elderly to avoid institutional care, while the American Families Plan called for making permanent some significant, but currently temporary, increases in financial assistance available to people purchasing health insurance through HealthCare.gov and state-based insurance programs.
The cost impact of these two proposals will be quantified in the budget released on May 28.
However, neither the American Jobs Plan nor the American Families Plan included any specifics on prescription drugs, adding a public option, or closing the Medicaid
gap, which alarmed progressives
and their allies, who interpreted the decision as evidence that Biden was less determined to push for these policies.
Officials at the White House insisted at the time that this was not the case, and Biden specifically mentioned prescription drug legislation during his April address to a joint session of Congress.
“Let us give Medicare the authority to negotiate lower drug prescription prices and save hundreds of billions of dollars,” Biden stated.
The same sequence appears to be repeating itself right now.
Why Are People Paying Close Attention to Biden's Signals?
The political backdrop for the latest maneuverings is an ambitious agenda that, on the one hand, recognizes the enormous crises that America still faces but, on the other hand, is almost certainly more than Congress can pass, especially given Democratic majorities in both the House and Senate
As a result, Biden and Democratic leaders will have to make some difficult decisions about what to pursue now and what to pursue later, as well as where and how to make compromises. Each piece of Biden's health care agenda, like every major idea he has endorsed, comes with a set of tradeoffs affecting both policy and politics
That is clearly true for action on prescription drugs, which would provide relief to struggling consumers while saving the federal government money
, which could then be used to offset the cost of other initiatives, such as adding dental benefits to Medicare or closing the Medicaid gap.
However, any meaningful action on prescription drugs will face opposition from the drug industry, which will argue that reducing its revenue will limit innovation and development of new drugs. Regardless of how valid that argument is, the drug industry has historically been among the most powerful and influential in Washington.
Overcoming that opposition would almost certainly necessitate a strong push from the White House, which is why everyone is closely monitoring its signals.