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Biden’s Policies Are Lowering the Costs of and Expanding Access to Health Care
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Biden’s Policies Are Lowering the Costs of and Expanding Access to Health Care

Recent legislative victories are making it easier for Americans to obtain health coverage, afford prescription drugs, and live healthier lives.

Photo shows Joe Viden giving a speech behind a podium, with a large blue sign in the background reading
Joe Biden delivers remarks about the Affordable Care Act and COVID-19 after attending a virtual coronavirus briefing with medical experts in Wilmington, Delaware, October 2020. (Getty/Drew Angerer)

President Joe Biden’s economic plans are building an economy that works for all Americans. This new CAP Action newsletter focuses on elevating trend stories on how the president’s economic policies are growing the economy by investing in people and places all over the country.

The United States has made enormous strides in boosting health care access and affordability, as well as improving health outcomes, under President Biden’s leadership. For example, the national uninsured rate reached a record low in 2022, and 8.2 million fewer Americans were struggling with medical debt in early 2022 compared with early 2020. None of these achievements were predestined; rather, they are the direct result of critical legislative victories that are improving Americans’ health and financial security.

Here is a snapshot on how President Biden’s policies are already bettering the lives of Americans across the country.

Expanding access to coverage and reducing medical debt

The Biden administration’s policies are making health care coverage easier to afford and access, boosting families’ health and financial security:

  • In January, the U.S. Department of Health and Human Services (HHS) announced that “a record-breaking more than 16.3 million people have selected an Affordable Care Act (ACA) Marketplace health plan nationwide during … Open Enrollment.” HHS notes: “Since President Biden took office, the number of people who have signed up for an affordable health care plan through HealthCare.gov has increased by nearly 50%. Because of [President Biden’s American Rescue Plan (ARP)], millions of working families saved an average of $800 on their health insurance premiums last year.”
  • Thanks to the Inflation Reduction Act signed into law last year, Americans will continue to benefit from these expanded savings. According to Healthcare Finance, HHS estimates that “​​four out of five HealthCare.gov consumers [could] find a health plan for $10 a month or less,” and “Ninety-two percent of HealthCare.gov enrollees [had] access to [coverage] options from three or more insurance companies.”
  • Earlier this month, leaders in the North Carolina General Assembly announced that they have struck a deal to expand Medicaid coverage to 600,000 low-income North Carolinians under the ACA after a decade of intransigence on the issue. The deal was made possible thanks to President Biden’s ARP, which provided financial incentivizes for holdout states such as North Carolina to adopt the expansion in exchange for additional federal resources—$1.5 billion in the case of the Tar Heel State, to be exact.
  • To address barriers to coverage, poor maternal health outcomes, and rampant racial disparities, the ARP created pathways and incentives for states to extend access to coverage for low- and moderate-income postpartum individuals for a full calendar year—building on the 60-day floor mandated under federal law. According to the Kaiser Family Foundation, 29 states, including those led by Democratic and Republican governors, plus Washington, D.C., have already implemented the 12-month coverage extension, with another seven states planning to do the same when given approval by the Centers for Medicare and Medicaid Services (CMS). Five other states are either currently debating whether to adopt the expansion or are seeking approval for partial coverage expansions by the CMS. According to HHS, “If all states adopted this option, as many as 720,000 people across the United States annually would be guaranteed Medicaid and CHIP coverage for 12 months after pregnancy.”
  • A recent report from the Consumer Financial Protection Bureau found that 8.2 million fewer Americans were struggling with medical debt in the first quarter of 2022 than were struggling in the first quarter of 2020. The significant drop in the number of Americans with medical debt is especially striking given the COVID-19 pandemic forced many Americans to utilize costly health care services. While this positive change is in part due to the efforts to improve access to coverage, which is associated with lower levels of medical debt, the ARP has also empowered local governments to alleviate the burdens of medical debt.
    • Ohio state Rep. and former Toledo City Council Member Michele Grim (D) wrote about this in Fortune last week, saying the ARP “granted money to local governments like ours and empowered us to enact targeted solutions to our communities’ most serious challenges. After supporting the use of [ARP] funds for priorities like job creation, safe neighborhoods, and youth programs, I looked for other strategies to foster a stronger and more equitable recovery. Medical debt disproportionately affects lower-income and working-class households, where the budget is already stretched thin. Alleviating this burden helps families make ends meet and put food on the table.”

What Americans are saying about expanded health care coverage

Yamelisa Taveras
Allentown, Pennsylvania
CEO, Counseling Solutions of the Lehigh Valley

In an op-ed in The Morning Call, Taveras said:

The Biden administration … dedicated federal funds to ensure states can more feasibly, quickly transition mothers and guarantee a full year of postpartum coverage. … Now, new mothers will have continuous coverage and will be able to spend more time bonding with their new babies. I am grateful … for … this plan, which will save lives and would have prevented some of the problems I had during my first pregnancy.

Photo shows Jazzmine Jacks smiling at the camera as she takes a selfie

Jazzmine Jacks smiles for headshot photo. (Photo credit: Jazzmine Jacks)

Jazzmine Jacks
Phoenix, Arizona
Hairstylist and makeup artist; mother of a 2-year-old boy

In a quote submitted to CAP Action, Jacks said:

It’s good to have Medicaid because a lot of people can’t afford health care, but they should still be able to get care for themselves, especially Black woman who are going through things that others don’t. It’s good to have health care for mother and baby for a full year after because so many things happen. Pregnancy is unpredictable, and the ability to have coverage is important.

Lowering the cost of prescription drugs and vaccines

The Biden administration’s policies are lowering the cost of needed health care, including insulin and vaccines:

  • As of January 1, 2023, out-of-pocket insulin costs for older adults on Medicare are capped at $35 per month thanks to the Inflation Reduction Act. In a recent report, HHS estimated that if the cap were in place in 2020, “1.5 million seniors across the country would have saved an average of $500 on insulin for the year”—totaling more than $760 million per year in savings for Medicare Part D and Part B beneficiaries.
  • In his State of the Union address earlier this year, President Biden called on Congress and drugmakers to build on this recent legislative victory by adopting the out-of-pocket cost cap for all insulin users. On March 1, pharmaceutical company Eli Lilly announced “price reductions of 70% for its most commonly prescribed insulins” and that it would “cap out-of-pocket costs at $35 at participating retail pharmacies for people with commercial insurance using Lilly insulin” and provide a pathway for the uninsured to also take advantage of the $35 cap. As The American Prospect’s David Dayen points out, however, another law signed by President Biden—the ARP—may actually be responsible for provoking the policy change from Eli Lilly: “Medicaid prevents drug companies from raising list prices above the rate of inflation. Any company that does so must pay Medicaid a rebate. … But since 2010, this rebate has been capped at 100 percent of the cost of the average purchase price of the medication, so drug companies wouldn’t have to essentially pay Medicaid whenever their product is used. That changed in a little law called the [ARP]. Starting in 2024, the Medicaid rebates become uncapped. … Put another way, if Lilly had the same list price for Humalog [insulin] next year, they would have had to pay Medicaid $150 for every vial used, according to a Stat News estimate. So Lilly instead reduced the list price by 70 percent, to get out of the Medicaid penalty. … Federal policy in the ARP, then, forced Eli Lilly to atone for its historical practice of jacking up the price of insulin. Slashing that price back will save all patients and health plans, not just Medicaid, billions of dollars.”
  • Following Eli Lilly’s lead, this week, The Wall Street Journal reports: “Novo Nordisk A/S [announced it] is set to cut the U.S. list prices for several insulin drugs by up to 75%. … Novo’s NovoLog currently has a list price of $558.83 for a five-pack of injection pens and $289.36 for a vial, though the company said most people with commercial insurance and Medicare don’t pay list price. After the price cuts go into effect, those list prices will fall to $139.71 and $72.34, respectively, Novo said.” The price cuts cover insulin that comes in both vials and injection pens.
  • Thanks to the Inflation Reduction Act, as of January 1, 2023, older adults on Medicare are eligible for free vaccines recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, including those protecting against shingles and tetanus, among other diseases and infections. Today, the White House released a fact sheet on a new HHS report estimating how much older adults on Medicare could save because of this policy change. According to the fact sheet, “The report finds that 3.4 million people with Medicare would have saved $234 million in out-of-pocket costs in 2021 – an average of $70 per person – had the Inflation Reduction Act been in effect then.” The report also includes state-by-state breakdowns for the number of individuals who would have benefited and the average amount saved because of this change.
  • A host of U.S. senators have hit the road in recent weeks to tout the new benefits available to older adults, including Jon Tester (D-MT), Joe Manchin (D-WV), Jacky Rosen (D-NV), and Ben Cardin (D-MD). Already, local health departments are preparing for an influx of older adults looking to take advantage of the new benefit. According to the Chatham County Health Department nurse manager in Georgia, “[T]he Shingles [vaccine] specifically can be over $100 for one [dose] and it is a two dose series, so that could be $200 plus” in savings.
  • The Biden administration’s prescription drug law requires drugmakers that raise prices faster than the rate of inflation on Medicare Part B prescription drugs to pay Medicare a rebate. According to a White House fact sheet, today, HHS will announce “27 prescription drugs … raised prices faster than inflation in the last quarter of 2022. … [Because of the new law, s]eniors may see their out-of-pocket costs for these drugs decrease by $2 to as high as $390 per average dose starting April 1st.”

What Americans are saying about prescription drug and vaccine savings

Robin Craycroft
Springfield, Missouri
Counselor; future retiree

In an HHS video, Craycroft said:

I have to have insulin to stay alive. When I heard about that $35 cap, I cried tears of joy. … That’s life-changing for us. We can buy a house now, we can save money.

Photo shows Robin Craycroft wearing a colorful, floral shirt standing on a deck with green trees in the background

Robin Craycroft is pictured in August 2022. (Photo credit: Robin Craycroft)

Read more about Robin’s story here.

An anonymous reader of the Chicago Tribune submitted this quote to the publication’s “Speak Out” series:

Recently, I went to a Walgreens in Elgin to get a long-delayed shingles vaccine. It was delayed so long because as a senior citizen on Social Security, the vaccine price was a hardship for me. But when I stepped up to the window to pay, I was surprised to learn it was free. Thanks to a bill that was passed by the Democrats last fall and signed into law by President Joe Biden, a number of vaccines are now free for senior citizens with Medicare Part D. I just wanted to thank them they have made a real difference in the lives of seniors like me.

Patricia Smith
Locust Grove, Virginia

In an op-ed in the Fredericksburg Free Lance-Star, Smith wrote:

I wish to thank Rep. Spanberger for her support of the Inflation Reduction Act and for her continuing support for lower health care costs. I recently received a shingles vaccine, and I am happy that this, and all my vaccines, have been free.

In the news

  • Bloomberg: “The billions of dollars of fiscal incentives baked into the [Inflation Reduction Act] mean the world’s biggest energy and industrial companies now view the US as the most attractive place to build renewable, carbon capture, and hydrogen facilities. That’s a problem for allies in Europe, Canada and elsewhere who are now playing catch-up to attract the capital for large-scale clean-energy projects.”
  • Barrons: “President Joe Biden’s policies appear to be having their desired effect. It should mean more jobs and cheaper electric vehicles for American[s] in the long run.”
  • Reuters: “The blood thinner Eliquis from Bristol Myers Squibb, Pfizer’s breast cancer drug Ibrance and AbbVie’s leukemia treatment Imbruvica are likely to be among 10 big-selling medicines subject to U.S. price negotiations for 2026, according to five Wall Street and academic analyses shared with Reuters. Last year Congress passed the Inflation Reduction Act (IRA), giving the U.S. government power to start the first price negotiations over prescription drugs for its Medicare health program covering more than 60 million Americans, most over age 65.”

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