Breaking down Biden's $7.3T proposed budget for 2025: Here are his top health priorities

President Joe Biden unveiled a proposed $7.3 trillion budget for fiscal year 2025 on Monday, which continued upon and expanded key health items from previous years.

The administration said his budget (PDF) will lower healthcare costs and drug prices, expand access to prescription drugs, build upon the Affordable Care Act (ACA) and fortify Medicare through a tax on the wealthy. Many of these priorities were previewed during Biden's State of the Union address last week.

Biden argues his plan will reduce the deficit by $3 trillion, whereas Republican-backed plans do the opposite over 10 years. The national debt would rise to $45.1 trillion by 2034.

"The national debt is on a steady march upwards, and it would take nearly $8 trillion of savings just to stabilize the debt over the next decade," said Maya MacGuineas, president of the Committee for a Responsible Federal Budget, in a statement. "It’s dangerous that we’ve let things get this bad, and we need to treat it like the priority that it is. The President’s call for over 3 trillion of deficit reduction is a welcome start, and he deserves credit for presenting a budget that pays for new initiatives and improves our fiscal situation, but the budget doesn’t go nearly far enough."

Department of Health and Human Services (HHS) Secretary Xavier Becerra said the fiscal year budget proposes $130 billion in discretionary spending and $1.7 trillion in mandatory funding.

While not necessarily a focus of the budget itself, much of the news briefing was dedicated toward the administration's stance on defending abortion rights.

"The department is fighting tooth and nail to protect and expand reproductive health care including making contraception, IVF, and basic pre- and postnatal healthcare not only available, but more affordable," said HHS Deputy Secretary Andrea Palm during a press briefing.

Becerra said federal agencies are focused on how they can help protect reproductive rights. He cited the FDA working to protect patient access to mifepristone along with the Office of Civil Rights allowing patients to receive the right care for them.. He also referenced the Braidwood case, where the federal government is trying to protect the ACA's preventive services clause in court, and the Centers for Medicare & Medicaid Services (CMS) working to provide adequate maternal health care.

Here are three of the top health policies to be aware of in the budget:

1. Drug price negotiations

As the government is engaged with pharma companies in the courtroom to defend its Medicare drug price negotiations program, Biden wants Congress to join the administration's efforts in "accelerating our ability to negotiate more drugs," said CMS Administrator Chiquita Brooks-LaSure.

During Biden's address last week, he announced he wants to expand the program from 20 selected drugs per year to 50, totaling 500 capped drugs in a decade.

The administration also wants to expand the Inflation Reduction Act's $2,000 out-of-pocket prescription drug cost cap to the commercial market, as well as make available the $35-a-month cost-sharing policy for insulin to the commercial market. Biden's budget would limit cost-sharing for "high-value generic drugs" to a $2 per month for Medicare beneficiaries.

2. Tax hike to fund Medicare

Choosing to contrast rhetoric from the other side of the aisle, Biden's plan attempts to make the Medicare program financially sound instead of cutting the program.

HHS said the 2025 budget will extend the solvency of the Medicare trust fund by at least 25 years. Previous estimates have found the fund would be depleted by 2031 without any intervention.

The budget calls for raising taxes on individuals making more than $400,000 a year from 3.8% to 5%, closing loopholes and transferring net investment income tax revenue to the trust fund.

3. "Medicaid-like coverage"

Unsurprisingly, Biden is urging statewide Medicaid-like coverage for states that have not yet adopted Medicaid expansion. Other states would be offered financial incentives to maintain existing expansions.

The budget called this proposal "critical" for rural communities. Currently, just nine states have not yet expanded Medicaid under the ACA, according to KFF.

"When that happens, another 1.5 million Americans will have healthcare coverage and the peace of mind that comes with it," said Becerra.