Joe Biden

Biden's Families Plan Excludes Medicare Expansion, Drug Price Changes Backed by Democrats

Brendan Smialowski | AFP | Getty Images
  • President Joe Biden's new American Families Plan does not include an expansion of Medicare eligibility or a provision allowing the program to negotiate prices directly with drug companies.
  • Dozens of Democratic lawmakers have urged the president to include the health-care provisions in the second piece of his economic recovery plan.
  • Biden's plan would make permanent premium cuts for people buying insurance on the individual market.

President Joe Biden's new plan to boost the social safety net would not expand Medicare coverage, an omission that could irk dozens of Democratic lawmakers who urged him to extend the program to more Americans.

The White House on Wednesday outlined the $1.8 trillion American Families Plan, the second piece of the president's more than $4 trillion economic recovery program. It calls to expand paid leave and free pre-K, make child care and higher education more affordable, and extend tax credits for families passed as part of the coronavirus relief bill this year.

The plan does not include Biden's campaign pledges to create a public health-insurance option and cut the Medicare eligibility age to 60. It calls to put $200 billion into making permanent premium cost cuts for people who buy coverage on the individual market. The policy passed as part of the pandemic aid bill.

Dozens of lawmakers from Biden's party have pushed him to lower the Medicare eligibility age as part of the proposal, saying the move would expand coverage to millions more Americans. They have also asked him to allow Medicare to negotiate prices with drug companies to cut costs. The provision did not make the new package.

Seventeen senators wrote to Biden on Sunday asking him to include both policies in the families plan. More than 80 House Democrats sent a similar letter to the president on Monday.

Biden plans to outline the recovery proposal before a joint session of the Democratic-held Congress on Wednesday night.

Asked Tuesday why the administration did not call to lower the Medicare eligibility age or allow for direct drug-price negotiations as part of the plan, a senior administration official pointed to the funding to cut premium costs. The policy is "one of the most impactful investments we can make" to reduce prices and expand coverage, said the official, who declined to be named.

"The president has been very, very clear that he remains fully committed to negotiations to reduce prescription drug prices — that, you will hear him reiterate as a very top priority and something he deems urgent," the official said.

It is unclear now whether the exclusion of the health-care policies will threaten passage of Biden's plan in Congress. As Republicans have opposed both major expansions of the social safety net and tax increases to pay for them, Democrats may have to approve the proposal on their own through budget reconciliation.

Health-care coverage emerged as the most important issue in last year's Democratic primary — even before millions of people lost their private insurance during an economic plunge and deadly pandemic. A wing of White House hopefuls led by Sen. Bernie Sanders, I-Vt., called for a single-payer system to cover all Americans.

Biden opted for more gradual expansion, championing a public option and then a Medicare eligibility age of 60. Despite the intense focus on insurance during the campaign and a health crisis that exposed holes in the current system, the White House has not yet put forward those health-care plans.

The administration has taken steps to keep people covered during the pandemic. Along with the subsidy expansions passed earlier this year, the federal government opened up a special Obamacare enrollment period to allow Americans to buy plans.

The Democrats in Congress who back Medicare expansion have called it a direct tool both to increase insurance coverage and curb inequities in the health-care system. The representatives and senators who wrote to Biden pointed to an estimate that lowering the eligibility age to 60 would allow 23 million more people to qualify for Medicare.

Cutting the threshold to 55 would make 42 million more people eligible for the program, lawmakers wrote.

Meanwhile, proponents of direct Medicare price negotiations with drug companies say the change would not only cut costs for consumers, but also free up money for the federal government to pay for their coverage.

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