Joe Biden

Press Call by Senior Advisor to the President Anita Dunn and a Senior Administration Official on Historic Action to Make Healthcare More Affordable and Accessible

March 25, 2024

Via Teleconference

5:04 P.M. EDT

MODERATOR: Hi, everyone. Thanks for joining today's call. This is Kelly Scully from the White House Press team. Thanks for joining today's call with Assistant to the President and Senior Advisor to the President Anita Dunn to discuss the adminis- --


-- to discuss the administration's work to make healthcare more affordable and accessible ahead of President Biden and Vice President Harris's trip to North Carolina tomorrow.

Remarks at the top will be on the record. We will then transition to the QA portion of the call, which will be on background and attributable to a "senior administration official."

For your awareness and not for reporting, joining us for the QA portion of the call is [senior administration official].

As a reminder, this call and the factsheet I sent around earlier are embargoed until tomorrow at 5:00 a.m.

And with that, I will turn it over to Anita to kick us off.

MS. DUNN: Thank you, Kelly. And thank you -- excuse me -- everyone who has joined the call this afternoon. (Coughs.)

PARTICIPANT: (Inaudible.)

MS. DUNN: I know. Sorry.

Tomorrow, in Raleigh, North Carolina, President Biden and Vice President Harris will deliver remarks laying out their vision to protect and strengthen the Affordable Care Act, Medicaid, and Medicare. They will also discuss their plan to lower healthcare costs, including for prescription drugs. This stands in stark contrast to a budget proposed by congressional Republicans just last week that would gut healthcare coverage for millions while allowing Big Pharma to drive up prescription drug costs.

The difference is simple: The President and Vice President have always believed that healthcare is a right, not a privilege.

Fourteen years ago last week, then-Vice President Biden stood by President Obama's side as President Obama signed the Affordable Care Act into law. And as the Vice President so memorably said at the time, it was a big deal.

After more than 50 attempts by Republicans to repeal it, including attempts that had the strong support of the President's predecessor, the ACA stands stronger than ever thanks to the Biden-Harris administration.

In 2024, more than 21 million Americans, including over 1 million North Carolinians, signed up for ACA healthcare coverage. Forty states, including D.C., have passed the Medicaid expansion. Four of those happened under this President's watch.

One year ago, thanks to Governor Roy Cooper's leadership, North Carolina passed Medicaid expansion, helping over 400,000 North Carolinians. And Governor Cooper will be joining the President and the Vice President tomorrow.

Americans are saving an average $800 a year on their premiums thanks to, first, the ARP and then the IRA.

But the Affordable Care Act is still very much under attack by Republican officials. Just last week, the Republican Study Committee that represents every member of the House Republican leadership and 80 percent of the House Republican Conference introduced a budget that would gut the ACA, gut Medicaid, and end protec- -- protection for preexisting conditions.

So, if they got their way, these Republican officials would want a country where 45 million Americans, including 1.4 million North Carolinians, lose their health insurance. One hundred million Americans with preexisting conditions would lose those protections, including 1.8 million people in North Carolina. Young people would be kicked off their parents' coverage. It would be harder for millions of seniors, people with disabilities, and children to access healthcare.

And prescription drug prices would skyrocket, because once you strip Medicare's authority to negotiate prescription drug costs, you repeal the $35 insulin and the $2,000 out-of-pocket cap for healthcare costs. And needless to say, you also increase the federal deficit as well.

Well, President Biden has been clear: not on his watch. Not only will he protect the ACA, Medicaid, and Medicare, he will expand coverage and lower healthcare costs. He will make expanded Affordable Care Act tax credits permanent. These tax credits expire in 2025, and they're going to need to be renewed. There's a real risk of them being taken away by the Republicans.

President Biden also believes that you should have Medicaid-like coverage to those people in the 10 states that have not (inaudible) the ACA's Medicaid expansion. And some of those, as we know, are very large states.

President Biden and Democrats beat Big Pharma. Now Medicare can negotiate lower drug prices for the first time in history. He wants to go further and faster: have Medicare negotiate lower prices of at least 50 drugs per year –- 500 drugs over the next decade. This could save taxpayers up to 200 billion additional dollars over the 10-year period, in addition to the $160 billion that the current program would save.

And then, finally, expand the $35-a-month cap on insulin and the $2,000 cap on out-of-pocket drug spending to everyone, not just seniors.

Vice President Harris has been leading our fight to defend reproductive freedom, and she will drive a clear contrast on how President Biden's predecessor handpicked the three Supreme Court Justices who overturned Roe v. Wade and that President Biden has sworn to restore Roe v. Wade as the law of the land. And if Congress sends him that bill, he will sign it immediately.

He -- she will talk about the fact that Republicans in Congress want a national abortion ban -- President Biden will veto that; that in the face of relentless, politically driven attacks by Republican officials, President Biden is fighting for access to contraception.

And, of course, as you all know, tomorrow is the Supreme Court oral argument on medi- -- medical abortion. So, that is going to be context and background for the conversation tomorrow.

And that's the split screen on healthcare you will see on clear display. President Biden, Vice President Harris, and Democrats want to expand access, make it more -- make healthcare more affordable for everyone, and defend reproductive freedom. Republicans want to gut healthcare, raise prices, and rip away those basic re- -- reproductive freedoms even more than they have already been endangered.

So, that is the split screen. That is the discussion tomorrow. And that is the two very different visions for moving this country forward, as the President outlined in his State of the Union Address.

So, thank you, Kelly. And I'll turn it back to you.

MODERATOR: Thanks, Anita. We will now transition to the QA portion of the call, which will be on background and attributable to a "senior administration official."

If you have a question, use the "raise hand" feature at the bottom of your screen.

Let's go to Ron Brownstein.

Q: Hi, guys. I was wondering, as you noted a little, there are many moving parts in this Republican Study Committee proposal: block granting Medicaid, the premium support voucher idea for Medicare, repealing the ACA, undoing the prescription drug negotiating authority. I'm just wondering: What -- what do you see as the common thread in all of these ideas?

And could someone talk about what they would mean cumulatively? When you kind of put all of them together, if you did all of these things, what would be the biggest changes people would see in the healthcare system?

SENIOR ADMINISTRATION OFFICIAL: Yeah. Happy -- happy to walk through that.

I mean, fundamentally, what you see in the RSC budget is a set of proposals that would take us backwards, raise Americans' healthcare costs, and leave millions more people without health insurance.

So, you know, they want to completely repeal the President's reforms to lower prescription drug costs. That means higher prescription drug costs for seniors. It means higher government spending and handouts to Big Pharma, as Medicare can't negotiate drug prices.

They want to convert Medicare into a premium support program, getting rid of the core guarantee of the Medicare program and leaving seniors facing, you know, higher premiums if they want to stay in the same kind of coverage that they have today.

The cuts to Medicaid, CHIP, and the Affordable Care Act in this proposal are devastating, taking $4.5 trillion out of this program over a decade. To do that, you would need to zero out the Affordable Care Act's marketplaces, you would need to zero out Medicaid expansion, and then, after you've done that, you'd need to make further steep cuts to the base Medicaid budget.

These are, you know, astonishing -- astonishing cuts that would just devastate a program -- a set of programs that millions and millions of people rely on. It's 45 million people who would just have their coverage ripped away from them and tens of millions of more who could lose benefits or lose coverage altogether as states, you know, try to react to the, again, completely devastating cuts.

And they do all of this while -- while fundamentally undermining and eliminating federal protections for people with preexisting conditions. So, it's taking us back to days of medical underwriting and -- and ensuring that, you know, insurance companies are once again in the driver's seat to charge higher prices to people who are sicker or older.

It is a -- it is a completely different vision from the one the President and the Vice President have laid out and will continue to lay out tomorrow, where we -- where we -- instead of moving backwards, instead of raising costs and throwing people off healthcare programs, we need to build on our progress. We need to lower prescription drug cros- -- costs even further, and we need to bring these reforms to more people. We need to, you know, continue to build on the Affordable Care Act to deliver health insurance, and we need to close the Medicaid coverage gap once and for all.

I think the -- you know, the contrast could not -- could not be more stark. And, you know, as -- as Anita said, it is -- it is quite the split screen when it comes to a healthcare vision.

MODERATOR: Let's go to Tami with CNN.

Q: Thank you for taking my call. So, the administration has been trying to sweeten the pot for a state -- the 10 hold-out states to expand Medicaid. There were various efforts in Kansas, Georgia. Mississippi is still ongoing. Has the -- what has the administration been doing to try to get this over the finish line in these Republican legislatures?

SENIOR ADMINISTRATION OFFICIAL: Yeah. Thanks for that question.

As I'm sure you know, four states have expanded Medicaid since President Biden took office -- most recently, North Carolina, where just in the last couple of months, nearly 400,000 people have gained Medicaid expansion coverage.

But, you know, we are clearly putting points on the board here and getting more Medicaid expansion coverage to -- to more people. You know, the four states that have expanded can deliver Medicaid expansion to about a million people. So, that's obviously making a huge dent in this -- in this issue and delivering coverage to more folks.

The -- as I'm sure this group is aware, the American Rescue Plan included additional financial incentives for states that -- that had been hold-outs and choose to expand Medicaid. And those new financial incentives remain available for any state that wants to take them up and bring lifesaving health- -- healthcare coverage to hundreds of thousands of their lowest-income residents.

We continue to be encouraged by conversations that advocates and hospital systems and others across the -- across the country are having in their states about opportunities to -- to, you know, address funding gaps for their rural hospitals and bring Medicaid expansion coverage to folks who need it. And we will, you know, continue to work with any state that wants to on how we can drive the ball forward on Medicaid expansion in some of those hold-out 10 states.

MODERATOR: Courtney with Bloomberg.

Q: Hi. Can you hear me?


Q: Thank you. You mentioned that you're planning this event tomorrow to happen in the backgrou- -- or have in the background the oral arguments at the Supreme Court. Can you talk about how you're preparing for any outcome from those arguments? I understand that you're (inaudible) hesitant to talk about pending cases, but this is a topic that's really important to Americans that rely on medication abortion -- right now especially, given how limited abortion is in general across the country.

SENIOR ADMINISTRATION OFFICIAL: Yeah. Thanks for that question.

You know, DOJ continues to defend the FDA's actions on this, you know, critical medication that is -- is an important part of our healthcare system before the Supreme Court. And the President and Vice President remain firmly committed to defending women's ability to access reproductive healthcare.

As you -- as you heard from Anita, we'll hear from the Vice President tomorrow about our broader vision on reproductive health. For, sort of, particulars on the litigation and next steps, I would refer you to DOJ.

MODERATOR: Let's go to Jonathan with Huffington Post.


We can't hear you --


MODERATOR: -- if you're speaking.

Q: Is that better? Can you hear me now?


Q: Okay. Sorry about that. This is actually a question for [senior administration official], I think. There were some reports earlier about Mark Robinson made some statements about the ACA, saying he favored -- he didn't favor repeal and replace, just repeal, some other things. Is that likely to come up tomorrow?

SENIOR ADMINISTRATION OFFICIAL: Yeah. So, we have -- we have lost [senior administration official], and we are, you know, having this call from the -- from the White House.

And so --

Q: Ah.

SENIOR ADMINISTRATION OFFICIAL: -- you know, I want to stay focused on the -- on, you know, the -- the President's agenda and the contrast with Republicans in Contr- -- in Congress.

But, you know, more broadly, Republican elected officials have made clear that they have a very different vision for healthcare in this country. And you can absolutely expect to hear from the President and Vice President about the broader contrast.

MODERATOR: All right. Let's go to Sarah.

Q: Hi. Thanks for doing this. I wanted to ask: One of the main criticisms from Republicans of these plans has been that the main reason for high enrollment is subsidies or the premium tax credits that you're looking to make permanent in the 2025 budget. So, how is President Biden going to respond to that criticism? And, you know, what would it do not to have those subsidies extended again in the next year's budget?

SENIOR ADMINISTRATION OFFICIAL: Yeah. You know, candidly, I'm not sure how it is a criticism that President Biden has made healthcare too affordable for American families. You know, we are incredibly proud of the fact that 21.3 million people are enrolled in ACA coverage.

And a big part of that is because we have made that coverage more affordable for folks, and we are going to keep -- keep standing up for that affordability and ensure that Americans continue to see those low premiums and can get access to healthcare they need at a price they can afford.

MODERATOR: Let's go to Joyce.

Q: Yeah, hi. Thanks for taking my question. It sounds like tomorrow is all about contrasting the Biden administration agenda with the -- what the Republicans are doing. I'm just clarifying that -- are there going to be any new initiatives announced tomorrow?

SENIOR ADMINISTRATION OFFICIAL: I don't have anything in particular to preview beyond what is in the factsheet.

MODERATOR: Let's go to Amy with InsideHealthPolicy.

Q: Yeah. Hi. I want to know if -- we've heard about the -- keeping the a- -- the enhanced subsidies and a couple other policies. But I'm curious -- I'm not hearing public option or turning -- changing it from -- changing the benchmark from silver to gold and things like that. I'm just curious if those policies that were from a couple years ago are still in play.

SENIOR ADMINISTRATION OFFICIAL: Yeah. Thanks for that question, Amy. The President's budget for FY '25 laid out a clear set of commitments in healthcare. It includes extending the enhanced subsidies for Affordable Care Act coverage; closing the Medicaid coverage gap; making a series of other changes to make it easier for kids, in particular, to get and keep health insurance; taking on -- taking on junk facility fees; and continuing to lower drug prices, of course.

And so, that -- that's the -- that's the agenda that the President's budget, you know, clearly laid out and that the President and Vice President will be -- will be talking about. Those are obviously not the only ideas in health policy that are important to American families and can lower -- can lower healthcare costs.

But -- but that is the -- that is the agenda that the White House has articulated and that you'll hear from the President and Vice President about tomorrow.

MODERATOR: Okay. Seeing no additional questions, we can wrap the call.

As a reminder, this call and the factsheet I sent over are embargoed until tomorrow at 5:00 a.m.

If you have additional questions, you can follow up with me directly.

Thank you, everyone.

5:23 P.M. EDT

Joseph R. Biden, Press Call by Senior Advisor to the President Anita Dunn and a Senior Administration Official on Historic Action to Make Healthcare More Affordable and Accessible Online by Gerhard Peters and John T. Woolley, The American Presidency Project

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