En español | In an address to Congress that included proposals to rebuild the nation's infrastructure, create jobs and stem climate change, President Joe Biden also promised to give Medicare the power to negotiate lower prices for prescription drugs; bolster the Affordable Care Act (ACA); improve access to long-term care; and create a national research agency to tackle diseases that mostly attack older Americans.
Biden led off his address with a plea to Americans to get a COVID-19 vaccination. He pointed out that 70 percent of older adults are now fully vaccinated and that deaths among the oldest adults are down by 80 percent since January. Because of the pandemic, on the eve of his 100th day in office, the president delivered the speech in front of just over 200 lawmakers instead of the customarily packed U.S. House of Representatives chamber.
"If this pandemic taught us anything, it is that America's care infrastructure and physical infrastructure are failing,” AARP CEO Jo Ann Jenkins said in a statement issued after the just over 70-minute speech ended. “More than 182,000 people died in long-term care facilities, demonstrating the urgency of overhauling the system. Meanwhile, older Americans continue to see rising prescription drugs prices, forcing many to choose between their medicines and putting food on the table."
Much of what Biden spoke about is contained in the infrastructure and families plans he has introduced in recent weeks, including enhancements to America's long-term care system.
"Two million women have dropped out of the workforce during this pandemic,” Biden said, “and too often because they couldn't get the care they needed to care for their child, or care for an elderly parent who needs help; 800,000 families are on the Medicare waiting list right now to get home care for their aging parent or loved one with a disability.” The president's infrastructure plan includes $400 billion to expand access to long-term care, including home- and community-based care.
"Forty-eight million unpaid family caregivers help keep their older parents, spouses and loved ones at home and they need more help and support,” Jenkins said in her statement, adding that our communities also “need access to high-speed internet, safe transportation and better housing options,” elements also included in Biden's infrastructure proposal.
Medicare fixes needed this year
While Biden has yet to unveil any formal proposal on Medicare or prescription drugs prices, he made it clear in his speech that he wants Congress to act on health care in 2021.
"And let's lower prescription drug costs,” Biden said. “We all know how outrageously expensive drugs are in America. In fact, we pay the highest prescription drug prices of anywhere in the world right here in America today — three times what other countries pay."
Biden told lawmakers to “give Medicare the power to save hundreds of billions of dollars by negotiating lower prescription drugs prices.” He said that won't help only people on Medicare but will lower prices for everyone. “It's within our power to do it,” Biden said. “Let's do it now.” In her statement, Jenkins said that this issue “affects our pocketbooks and our health, and Congress must take bold action to lower drug prices."
The president also asked for the creation within the National Institutes of Health of a new agency described as an advanced research projects agency for health. It would be patterned after DARPA, the Defense Advanced Research Projects Agency, the Department of Defense agency credited with developing the internet and GPS. This new health research agency, Biden said, would “develop breakthroughs to prevent, detect and treat diseases like Alzheimer's, diabetes and cancer … I can think of no more worthy investment."
Pushes to make temporary ACA breaks permanent
Biden also asked lawmakers to make permanent the increases to ACA subsidies that were included in the American Rescue Plan. As part of that law, the income cap on ACA subsidies (400 percent of the federal poverty level) was lifted and no one would have to pay more than 8.5 percent of their income on premiums for ACA marketplace plans. That provision is especially important for older adults who often have to pay more than that in premiums.
Under the American Rescue Plan, these ACA benefits are only in effect in 2021 and 2022. “Let's make that provision permanent so their premiums don't go back up,” Biden said. He also called for lowering “deductibles for working families on the Affordable Care Act."
Dena Bunis covers Medicare, health care, health policy and Congress. She also writes the Medicare Made Easy column for the AARP Bulletin. An award-winning journalist, Bunis spent decades working for metropolitan daily newspapers, including as Washington bureau chief for the Orange County Register and as a health policy and workplace writer for Newsday.