President Joe Biden released his budget for the 2024 federal fiscal year, outlining new investments to expand Medicaid, drug price reforms and other new policies.
While the budget itself is unlikely to get enacted by a divided Congress, the document does outline key health priorities for the administration.
Here are some of the top health policies to be aware of in the budget:
1. Close the Medicaid coverage gap
The budget proposes to close the Medicaid coverage gap in states that have not expanded under the Affordable Care Act (ACA). A legislative effort to offer subsidies to people in such a gap ran aground in the last Congress but still enjoys wide support among Democrats.
2. Make permanent ACA enhanced subsidies
A major driver of record growth on the ACA’s exchanges has been a boost to subsidies included in the American Rescue Plan Act. Those subsidies were recently extended last year through 2025, but the budget would seek to make them permanent.
3. Build upon drug price negotiation reforms
The budget would install new drug price reforms that include limiting Medicare Part D cost-sharing for high-value generic drugs used in cholesterol, hypertension and other conditions to no more than $2. This would also apply to all Medicare Advantage prescription drug plans.
It would also give the Department of Health and Human Services the power to negotiate drug rebates under Medicaid and the Children’s Health Insurance Program. The goal would be to help interested states pool their purchasing power. The proposal is estimated to save $5.3 billion in savings over the next decade, an HHS budget blueprint found.
A key part of the budget would be to increase the number of drugs subject to negotiation under the Inflation Reduction Act. Currently 10 drugs will be selected for price negotiation with the prices being applied in 2026 and more drugs are added thereafter.
Administration officials didn’t specifically say how many more drugs they were targeting.
Another proposal would apply a cap on insulin prices at $35 a month, building on a similar reform passed under the Inflation Reduction Act that applies the cap to only Medicare beneficiaries.
4. Boost funding for Medicaid home services
The White House aims to invest $150 billion over 10 years to boost Medicaid home- and community-based services. The money would go to help with personal care services and “improve the quality of jobs for home care workers.”
Biden also aims to expand the reach and size of the Health Center Program that aids community health centers. It would also give $350 million to expand programs for training and supporting new nurses amid a labor crisis that is still roiling the hospital industry.