Thursday's budget blueprint released by Biden would fulfill a campaign promise of helping poor people who were denied Medicaid expansion in the South because of partisan battles. It would also give low-income seniors, disabled people more options to get support at home and avoid nursing homes. The budget blueprint also provides for 12-months of Medicaid coverage for low-income mothers after childbirth, which is a significant step in addressing national deficiencies in maternal health, which are disproportionately affecting Black women.
However, Democrats couldn't reach a consensus regarding prescription drug price negotiations with Medicare. While polls indicate broad bipartisan support for Medicare's ability to negotiate lower prices than the current price, a few Democratic lawmakers voted to block it. This is despite evidence from the pharmaceutical industry that it would reduce investment that fuels innovation. AARP and other advocacy groups have voiced outrage at the omission. Some Democratic lawmakers claim they aren't giving up yet.
The immediate result: Medicare vision coverage and Medicare dental coverage are being canceled because of the expected savings from lower drug costs. Although the Biden framework calls for coverage of hearing aids, it is far more affordable. A long-requested limit on Medicare beneficiaries' out-of-pocket drug expenses is also on hold.
Medicare is a political favorite, but Medicaid has been long considered the stepchild of all health care programs due to its past ties with welfare. A few years back, former President Donald Trump tried unsuccessfully to limit federal funding for the program.
Judy Solomon, of the Center for Budget and Policy Priorities (a non-profit that advocates for low income people), said that during that battle "many people realized how important Medicaid was for their families and communities." "I believe there was a new appreciation for Medicaid, and that is what we are seeing."
The Democrats made Medicaid their political center as it grew to include more than 80million people, or nearly 4 percent of Americans. Biden's Medicaid-related policies have a strong racial justice component, as many of those who would be able to access health insurance in the South and expanded coverage for mothers throughout the country are Black or Hispanic.
For years, the Democrats in the Deep South have made expanding Medicaid their top priority because of the high levels of poverty and poor health throughout the region. Some Republican-led states rejected expanding Medicaid under Obama's health law, which meant that 2,000,000 poor people were effectively locked out of coverage in a dozen of the states and 2 million couldn't afford even subsidized plans. Among the Medicaid holdouts are Georgia, Florida, and Texas.
Georgia Sens. Jon Ossoff and Raphael Warnock campaigned for closing the Medicaid coverage gap. Their election was what brought the Senate to the Democrats this year. Warnock made it his top priority to get a Medicaid fix.
"Georgians came out in record numbers to alter the structure of our federal government. Many did so in the hope that Washington would finally fulfill its promise of the Affordable Health Care Act and make healthcare coverage available to the hundreds of thousand of Georgians currently uninsured," Warnock said, Thursday's first Black U.S. senator.
The freshman must achieve a major achievement as he is up for reelection next year and seeks a full six-year term. He is being challenged by multiple Republican opponents, including Herschel Walker, a former football star. Warnock claims that Georgians are denied federally subsidised care that is available to residents in 38 other states, including Georgia. He calls it "a matter for life and death."
The Biden blueprint allows eligible people who are not covered by Medicaid to get private, subsidized coverage through HealthCare.gov. This budgetary trick is intended to lower the cost estimates. The fix is only funded for four year. Biden would also provide through 2025 additional financial assistance to consumers who purchase "Obamacare" plans.
Biden's framework also includes $150 billion in Medicaid funding for community- and home-based care for seniors, and people with disabilities. This is less than half of the money Biden had originally requested for his long-term plan. However, it will reduce waiting lists and improve wages and benefits for home care aides.
"This plan marks a historic shift how our country cares about people with disabilities and older Americans," stated Sen. Patty Murray, D.Wash., chairperson of the Health, Education, Labor and Pensions Committee. "Getting this critical care will not be available to the few lucky enough to get on a waiting list.
Nearly 4 million people get home and community-based services. These services are cheaper than nursing home care. There are approximately 800,000 people on waiting lists for these services.
The importance of home care options for seniors was highlighted by the coronavirus pandemic. Nursing homes were used as incubators for COVID-19.
The Biden framework provides funding for Medicaid in all U.S. territories, Puerto Rico included, as a sort of coda. It would also permanently reauthorize Children's Health Insurance Program to avoid periodic nail-biting about coverage for almost 10 million children.
