WASHINGTON — President Biden wants to more than double the size of Medicare’s new drug price negotiation program and will preview the plan in his State of the Union address, the White House announced Wednesday.
While the current program will eventually allow Medicare to negotiate the prices of up to 20 drugs per year, Biden will propose increasing that number to 50, and bringing more drugs into the negotiation process sooner.
The expansion is one of several appeals Biden will make to Congress to build on health care measures to lower prescription drug costs and protect patients from surprise medical bills, the White House said. The policies have little chance of being enacted with a Republican House of Representatives this year.
The proposal to go bigger is the pharmaceutical industry’s worst nightmare: Companies long feared Democrats’ creation of the negotiation program would be a slippery slope that would lead to deeper cuts. It’s also a tightrope walk for Biden, who is simultaneously trying to build awareness that his administration passed drug pricing policies, even though the biggest ones haven’t gone into effect yet, and pitch a vision to go even further if voters reelect him for a second term.
Most of the Inflation Reduction Act’s drug pricing policies only apply to the Medicare program. Biden will propose that lawmakers expand the law’s $2,000 annual cap on out-of-pocket drug costs and penalties for drug price hikes to apply to patients with insurance through their jobs, not just Medicare.
“What’s good for seniors on the $2,000 cap is good for all Americans,” said White House Domestic Policy Advisor Neera Tanden on a call with reporters.
Biden will also ask lawmakers to extend a $35-per-month cost cap for insulin to the commercial market, a policy that Senate Majority Leader Chuck Schumer (D-N.Y.) has promised to bring up for a vote for nearly two years, but has not.
He also wants to build on a law passed in 2020 to protect consumers from surprise medical bills. While the law provided new protections in many situations, it did not apply to bills from ground ambulances, which Biden will propose codifying.
Biden will also call to close the Medicaid coverage gap in states that have chosen not to expand Medicaid despite federal funding offers. Sen. Raphael Warnock (D-Ga.) is bringing a guest to the speech who is a former emergency room nurse who now falls into the coverage gap.