Biden calls for insulin cap extension, making boosted ACA subsidies permanent in State of the Union

President Biden called for extending a $35 monthly cap on insulin costs to all Americans and to permanently extend enhanced Affordable Care Act subsidies during his State of the Union address to Congress on Tuesday.

Here are some of the health policies and priorities Biden outlined in his speech to lawmakers:

Making coverage gains

Biden also touted the increases in insurance coverage during his tenure, including 16 million in signups for the Affordable Care Act’s exchanges, thanks in large part to enhanced tax credits that expire after 2025.

“Let’s finish the job, make those savings permanent, and expand coverage to those left off Medicaid,” he said.

Biden was referring to efforts last year to offer benefits to people eligible for Medicaid but live in a non-expansion state. The legislation was left out of the Inflation Reduction Act that was passed last year.

Protecting Medicare

Biden issued a warning to House Republicans that he will not let through any cuts to Social Security or Medicare as part of a deal to raise the debt ceiling. Republicans have been pushing for spending cuts as part of any deal to raise the ceiling.

“Other Republicans say if we don’t cut Social Security or Medicare, they’ll let America default on its debt for the first time in our history. I won’t let that happen,” he said.

Biden also hinted that he will float a provision to extend the Medicare Trust Fund by “at least two decades” by making “the wealthy and big corporations begin to pay their fair share.”

More money for COVID-19 vaccines and treatments

The president said that even though the COVID-19 public health emergency is ending in May, the fight over the virus is not done.

“We still need to monitor dozens of variants and support new vaccines and treatments,” he said. “So Congress needs to fund these efforts and keep America safe.”

The remarks come as efforts to add more relief funding and money for vaccines or treatments have dried up. The Senate failed to pass $10 billion in additional relief last year and any more dollars appears doubtful with Republicans in control of the House.

Expanding access to low-cost insulin

One of the key policy reforms passed as part of the Inflation Reduction Act last year was a $35 monthly cap on insulin for all Medicare beneficiaries. Efforts to expand the cap to every American ran aground during the debate over the massive spending package in 2022.

Biden made a new push to expand the benefit to Americans outside of Medicare during the speech.

"Let’s finish the job this time," he said. "Let’s cap the cost of insulin at $35 a month for every American who needs it."

Making such a pledge a reality is going to be extremely difficult with Republicans in control of the House.