Joe Biden

On-The-Record Press Call on President Biden's Unity Agenda Ahead of the State of the Union

February 07, 2023

Via Teleconference

9:04 A.M. EST

MR. MUNOZ: Hey, everybody. Good morning. Thank you for joining us on this morning's press call to outline the progress the President has made on his Unity Agenda since the 2022 State of the Union and his ongoing commitment to this agenda ahead of his 2023 State of the Union speech.

As a reminder, this call will be on the record and embargoed until 10:30. You all should have received a factsheet that is also embargoed until 10:30.

I sent an email a few minutes ago, but on this call we have the following speakers: Kate Bedingfield, White House Communications Director; Dr. Gupta, Director of the Office of National Drug Control Policy; Christen Linke Young, Deputy Assistant to the President for Health and Veterans Affairs; Danielle Carnival, Cancer Moonshot Coordinator; and Terri Tanielian, Special Assistant to the President for Veterans Affairs.

So with all of that, I will kick it to Kate, and then we'll do some questions after. Kate?

MS. BEDINGFIELD: Great. Thanks, Kevin. And thank you all very much for taking the time to join us on a very busy and exciting day in the run-up to the State of the Union tonight.

So, during his first State of the Union address last year, President Biden announced a four-part Unity Agenda focused on areas where members of both parties can come together and deliver for the American people: ending cancer as we know it; delivering on the sacred obligation to veterans; tackling the mental health crisis; and beating the opioid and overdose epidemic.

As the President said last year when he announced the Unity Agenda, these are issues that affect all Americans, in red states and blue states, and ones where the American people are counting on their elected officials, no matter their party, to come together and do big things.

Over the last year, the President has made good on that promise. He was proud to work with Democrats and Republicans to enact major legislation that delivers on his Unity Agenda.

The Honoring our PACT Act and the Bipartisan Safer Communities Act both passed with bipartisan support, validating the President's belief that these are areas where politicians in Washington can and should find common ground on behalf of the American people.

This legislation is already making a real difference in communities across the country, from allowing veterans to better access the care they need, to expanding access to mental health supports to make our communities safer.

But this work is far from over, and you'll hear from my colleagues on that in just a few minutes.

In his State of the Union today, the President will announce a new set of policies to continue to make progress advancing his Unity Agenda and deliver results for families across the country.

And so, with that, I'm going to hand it over to Dr. Gupta, the head of the Office of National Drug Control Policy.

DR. GUPTA: Thank you, Kate. And good morning, everyone.

In the past year, we've lost more than 100,000 Americans to drug overdose or poisonings. That's an American dying every five minutes of every hour of every day. That is unacceptable, period.

The opioid crisis is affecting just about every community in every state, and it's being driven by synthetic opioids like illicit fentanyl.

Under President Biden's leadership, we've begun to make progress. In last year's State of the Union, the President called for removing barriers to treatment, and we have done just that -- working with Republicans and Democrats in Congress to remove the X-waiver. That's what it looks like when we work together to beat this.

In the last year, under President Biden's leadership, our nation has seized nearly 15,000 pounds of fentanyl at the border. Domestically, we've seized 26,000 pounds of fentanyl and denied nearly $9 billion of profits to drug traffickers.

And because of these efforts combined with our historic public health advances, we have now seen five straight months -- five straight months where overdose numbers have decreased.

That's almost 3,000 people who have not died and instead are at the dinner table each night.

So it is a hopeful sign, but we can't slow down our efforts to beat this.

So, tonight, during the State of the Union, you're going to hear the President talk about it. This is not a red-state problem or a blue-state problem. This is America's problem. And he believes it's going to take all of us -- all of us working together.

Tonight, President Biden will lay out a forceful approach for going after fentanyl trafficking and expanding public health efforts to reduce overdose deaths.

We are going to build on the historic progress we're making by using advanced technology to stop more fentanyl at the border, and working with commercial package delivery companies to catch more packages containing fentanyl.

And we're going to work with Congress to permanently control fentanyl-related substances so we can make sure that traffickers are held accountable.

We're also going to launch a national campaign with the Ad Council to educate young people on saving lives from the dangers of fentanyl.

And we're going to work to ensure that everyone who needs treatment for substance use disorder gets it, including people who are incarcerated and at higher risk for overdose death when they're released.

And we're going to continue to expand access to lifesaving medications for opioid use disorder.

Now, by taking these actions and under President Biden's leadership, we're going to also hold traffickers accountable. We will reduce -- by doing all this, we'll reduce overdose deaths, and we will save more American lives.

Thank you.

MR. MUNOZ: Danielle?

MS. CARNIVAL: Yes. Thank you, Dr. Gupta.

Let me touch on cancer. This is an important issue that impacts virtually every single American family and is the second-leading cause of death in this country.

Last year, ahead of his first State of the Union address, the President and First Lady reignited the Cancer Moonshot with the goal of cutting cancer death rates in at lea- -- by at least half over 25 years, and improving the patient, caregiver, and family experience.

Tonight's speech will highlight the progress we've made over the last year. This includes nearly 30 new federal programs, policies, and resources from a first-ever Cancer Cabinet -- from steps to increase screenings, to innovative approaches to improve care for patients and those that support them, to standing up and funding ARPA-H, a new agency to drive breakthroughs in the fight against cancer and other diseases.

Tonight's speech will also highlight what we need to do to further accelerate progress. This includes bringing America's cancer research and care systems into the 21st century.

To that end, the administration is urging Congress to reauthorize the National Cancer Act, which more than five decades ago set up the National Cancer Institute as we know it today. This would enable us to update our systems for today's fight against cancer and lock in the strong investment in cancer research that passed in 2016 as part of the broadly bipartisan 21st Century Cures Act, which otherwise expires this year.

With these steps, we could put modern and American innovation fully to work in the fight against cancer.

Two, accelerating progress also means increasing access to support for cancer patients and their loved ones. We know patient navigation services improve the experience for patients and their families as they go through their cancer journey, and they improve health outcomes.

So, the administration is going to take steps to ensure that patient navigation services are covered benefits going forward for as many people facing cancer as possible. Because the value and importance of having someone who can walk you and your loved one through the many decisions that come with a cancer diagnosis can't be overstated.

In addition to pushing forward on research and patient experience, we're going to continue to focus on prevention. That means taking steps to tackle the single-biggest driver of cancer deaths in this country -- smoking -- and to continue to address environmental exposures, including through the Bipartisan Infrastructure Law to accelerate clean-up at toxic Superfund sites and help states and communities replace lead pipes and service lines.

Together, these steps will draw us closer to our goal of saving American lives; improving the experience for patients, caregivers, and families; and ultimately ending cancer as we know it today.

MR. MUNOZ: Thanks, Danielle. Now we'll turn it to Christen Linke Young.

MS. LINKE YOUNG: Great. Thanks so much, Kevin.

First, when it comes to meeting our sacred obligation to veterans and their families, this administration has made significant progress.

We worked with Democrats and Republicans to pass the PACT Act, expanding access to healthcare and benefits related to toxic exposures for veterans and their survivors, which is the most significant new policy for toxic-exposed veterans in 30 years.

Already, VA has expedited the process to bring benefits to veterans and their families sooner, and has conducted more than 1.5 million screenings for toxic exposures.

But the PACT Act is just one part of our work. In 2022, VA processed an all-time record 1.7 million veteran claims and delivered $128 billion in benefits to 6.1 million veterans and survivors.

The number of veterans experiencing homelessness declined by 11 percent between 2020 and 2022, and the United States permanently housed more than 40,000 veterans last year alone.

Over the last year, the administration also expanded access for reproductive health services for women veterans, expanded eligibility for caregiver programs to veterans of all service areas, supported more than 2.3 million children through the First Lady's Joining Forces Initiative, and implemented key measures to protect veterans from predatory for-profit colleges.

The President will build on this work and announce additional actions in the months to come.

First, to address veteran suicide: While both DOD and VA reported declines in suicide deaths, we know that much more remains to be done.

We will provide new resources to states and territories to invest in community-based programs tackling veteran suicide.

We'll continue to focus on lethal means safety by training healthcare providers and expanding educational resources.

And we will support veterans at challenging moments that can increase suicide risk by expanding medical-legal partnerships and expanding outreach to justice-involved veterans.

To better address veterans' mental health needs, VA will expand proven peer support programs where veterans help fellow veterans to access mental health and substance use treatment and other support services, will hire more mental health clinicians, and will make it easier to expand mental healthcare through telehealth.

And we'll continue to expand job training for veterans and their spouses through partnerships across the federal government.

The President is also calling on Congress to ensure that every veteran has a roof over their head. His budget will propose that we pave the path to an entitlement to housing assistance for those who have served our country. So, a robust agenda to protect American veterans.

Turning now to mental health: The President worked with Congress to pass critical bipartisan legislation to help address our mental health crisis. President Biden signed into law the Bipartisan Safer Communities Act, which makes unprecedented investments in expanding trauma-informed youth mental health programs and supports school-based health services by creating new grant opportunities and technical assistance for schools.

We expanded Medicare coverage to include additional mental health and substance use disorder services and providers.

We worked with Congress to make major investments in training the next generation of mental health professionals.

And all of this builds on historically significant resources for community mental health services, which we saw continued in the most recent bipartisan spending legislation.

We've also worked across the federal government to coordinate resources and support Americans with mental health needs.

Last summer, we successfully transitioned to the 988 Suicide and Crisis Hotline. Thanks to new investments, those in crisis now have more timely access to trained counselors. Since the transition, calls to the Suicide and Crisis Hotline have grown by at least 50 percent, texts have increased more than 1,200 percent, all that's all while response rates have increased and wait times have been reduced.

We've also worked to make it easier for Medicare and Medicaid beneficiaries to access mental health services through their coverage, and we've worked across the federal government to provide new resources and assistance to states, territories, Tribes, Tribal organizations, and local communities.

But we know that too many Americans continue to struggle, especially young people, where mounting evidence indicates that social media and other tech platforms can be harmful to mental health, wellbeing, and development.

The President is calling for bipartisan support to ban targeted advertising online for children and young people; enact strong protections for their privacy, health, and safety online; and improve online privacy and transparency for all Americans.

And we will continue to implement a whole-of-government strategy to expand the mental health workforce, reduce barriers to care, and promote resilient environments.

We will issue new rules to enforce mental health parity requirements so that insurance companies meet their obligations to provide mental health and substance-use disorder care on the same terms as physical health services.

We'll continue to expand the crisis care workforce -- trained peers, first responders, licensed counselors and psychologists -- and we'll also expand mobile crisis intervention services.

And we will prioritize research so that we build an evidence base to deliver proven therapies at scale.

With that, I will turn it back to you, Kevin.

MR. MUNOZ: Thank you, Christen. And thank you, everybody, for joining.

With that, we can take a few questions.

All right, let's go to Andrea Shalal with Reuters first.

Q: Thank you so much. This agenda that you've outlined here is -- can you say what you think the chances are of passage? Is this the -- are these the agenda items that you think Congress will pass in a -- you know, in a split Congress? And is that why you're foregrounding it?

And if you could just say a few more words on the mental health aspect. What's driving that is, obviously, the statistics, but is there any piece of this that you want to link to gun safety too?

MS. LINKE YOUNG: Sure. I can start there. So, in last year's State of the Union, the President laid out a Unity Agenda focused on these same four pillars, and we saw Congress make enormous progress on a bipartisan basis over the last year.

We passed the PACT Act for veterans with 86 votes in the Senate. We passed the Bipartisan Safer Communities Act, which makes significant progress on mental health resources for kids, with 65 votes in the Senate. Congress provided funding for ARPA-H, a major investment in reducing cancer deaths and innovating across the healthcare system.

And, of course, when it comes to the overdose crisis and substance use disorder, Congress repealed the X-waiver to make it easier for people to access medication-assisted treatment for substance use disorder and enacted a variety of resources across this agenda to take on the overdose crisis.

So we have seen that we can deliver on these priorities and make life better for Americans by working together with members of Congress of both parties across this full agenda.

And what you'll hear him talk about in tonight's State of the Union is a desire to keep moving forward on that work, to build on these historic bipartisan achievements over the last year, and continue working with members of Congress of both parties to deliver results for the American people.

MR. MUNOZ: Thanks.

Next question, let's go to Maureen Groppe at USA Today.

Q: Hi, thanks. I had a broader question and then a specific question. On the broader question: Is this bipartisan emphasis -- is this going to be the largest part of the speech? And could we also expect the President to lay out areas where he has differences with Republicans?

And then, on the specific question: Is there anything more you can say about the action you're going to take to help people avoid smoking and stop smoking?

MS. LINKE YOUNG: So, on your first question -- you know, we are talking on this call about the Unity Agenda and these four pillars. We have also previewed broader pieces of the speech. And I will sort of leave you to tonight for the general themes.

I will turn it over to Danielle on the tobacco pieces.

MS. CARNIVAL: Yeah, thank you. So I think what the President is really focused on is the progress we've seen over the last 30 years in reducing adult and youth smoking rates. And that has contributed significantly to the gains we have seen in cutting the cancer death rate over the last three decades. And a lot of that is through tobacco cessation.

But it's still an issue. And so we're committed to continuing to use authorities and programs to keep making progress and especially with a focus on helping individuals avoid smoking in the first place and supporting Americans who want to quit. So, getting support services out for as many people, reaching as many people as possible so that we can prevent the cancer impact and we know the broader health impact that smoking has.

Thank you.

MR. MUNOZ: All right, next let's go to Darlene Superville at the Associated Press.

Q: Hi. Thanks for your time this morning. Apart from calling on Congress to reauthorize the National Cancer Act, can you say what other elements of the -- what other end -- agenda items laid out here today will require legislative action? It sounds like some of this -- some of these things the President or the administration can do on their own, but what else would require Congress? Thank you.

And could the person who is answering please identify? It's hard to know your voices.

MS. LINKE YOUNG: Sorry, this is -- this is Christen, and I can start here. So, across all four pillars of the Unity Agenda, the President is laying out both commitments to take additional administrative action, using authority that we have today, building on the work that we've done over the last two years. And he's also calling on Congress to take additional steps. And so in all four pillars of the Unity Agenda, there are components of action that require Congress and components that we will continue to work on ourselves.

Specifically, when it comes to mental health and veterans, we're calling for bipartisan support in Congress to ban targeted advertising online for children and young people and enact strong protections for youth privacy, health, and safety online, and improve privacy and transparency online for all Americans.

We also look forward to working with Congress on set policies that the President will announce in his budget to pave a path to entitlement -- to an entitlement for housing assistance to all those who have served their countries.

And I will turn it over to Danielle and Dr. Gupta on the other two pieces.

MS. CARNIVAL: Dr. Gupta, go ahead.

DR. GUPTA: Thank you. So, you know, one of the things that's very important and we were happy to see Congress, in a bipartisan way, schedule fentanyl-related substances as part of Schedule I for two years. But it is still a schedule that will expire on December 31st, 2024. So the President is going to be calling on Congress to look at that to make this permanent. And it's going to be important in order to protect Americans from the threat of lethal drugs, such as fentanyl and fentanyl-related substances.

MS. CARNIVAL: And this is Danielle. You mentioned the calling on the reauthorization of the National Cancer Act. And just to say one more sentence or two on that: The President has often said we need to update our cancer research and care systems for today's fight. What we -- what has delivered progress over the last 50 years was set up in the original National Cancer Act, and so we think it's time for another bipartisan effort to come together and realize a 21st century cancer system with clinical trial networks that reach every community, modern data system so we can share knowledge and make progress faster.

And in 2016, as I said earlier, Congress came together to pass the 21st Century Cures Act, which provided additional funding for the fight against cancer. We can lock in that strong bipartisan support going forward.

MR. MUNOZ: Thanks. Let's go to Josh Wingrove at Bloomberg.

Q: Hey there. Thank you so much. The factsheet talks about a diplomatic push on fentanyl. I'm wondering if you can talk a little bit more about that. Is that aimed at countries like China, for instance, where some of the substances that ultimately contribute to this come from? Or is it aimed at, like Mexico, where sometimes those are manufactured into the final drug product and then cross the border? Can you speak a little bit more about this push and whether the President will, for instance, call out particular countries? Thanks.

MR. MUNOZ: Dr. Gupta.

DR. GUPTA: Thank you, Kevin. Josh, one of the things that we know is important is to make sure that we're addressing the entire global supply chain of fentanyl and precursor compounds. This is why the President has been so forward leaning when it's talking with President López Obrador in Mexico or President Xi in China.

And this is important -- this is important to not only address the precursor chemicals that are being shipped predominantly from China. We have very specific asks of the PRC to take action that we know would -- will significantly reduce, if not eliminate, that shipping of precursor chemicals, but also at the same time to ensure that where the production happens of fentanyl, which is mostly in Mexico, that we're working with the Mexican authorities and the leadership there.

So that's part of the diplomatic push that the President is going to be calling on to ensure that we're working with these countries to hold illicit actors accountable in their countries. And we want to work with the leaders of these countries to make sure that they do just that.

MR. MUNOZ: Thanks, Josh.

Next, we'll go to Rebecca Kheel at

Q: Hi, yes. Thanks for doing this. I was wondering if you could elaborate a bit on the housing entitlement for veterans. What do you mean by "pave a path"? How are you going to do that? And how does that differ from existing assistance programs like HUD-VASH?

MS. TANIELIAN: This is Terri. So we are going to be releasing additional details of the President's budget in just a few weeks. But here we are looking at what ways we can firm up an entitlement to help support particularly low-income veterans who we know have a difficulty finding permanent housing. And so we're looking to make it easier for them to afford rent and stay housed. And so we'll be providing additional details in the President's budget in just a few weeks. Thank you.

MR. MUNOZ: Thanks, Rebecca. We'll take a few more questions.

Next, let's go to Shirish Dáte at Huff Post.

Q: Hey, can you all hear me?


Q: Okay. This is a kind of a big-picture question for -- I guess for Kate. Unemployment is really, really low right now -- most in, like, 50 years or 55 years or something. And yet, polls show that people are continuing to worry about the economy. What is the disconnect? I mean, how did we get to a point where you have this economy and people think it's terrible?

MS. LINKE YOUNG: So -- so, I think, you know, fundamentally, this President is focused on delivering results for the American people, and we've seen him do that over and over and over again. You've seen him do it on the Unity Agenda, which we we've -- we've talked about today, and you see him do it across the economy. And that's going to continue to be our focus for the next two years.

We are going to work with Congress on a bipartisan basis to make progress on the issues that we're talking about today. We're going to keep doing our work with the tools and resources that we have at our disposal to make improvements on mental health, on veterans' issues, and ending cancer as we know it, and on combatting the opioid and overdose crisis, and on so many issues that matter to the American people.

That's what we're focused on accomplishing, and we look forward to continuing to talk to the American people about the work that we are doing and the results that we're delivering every time.

MR. MUNOZ: Thanks. We'll take a couple more. Let's go to Tommy Christopher.

Q: Hi. Can you hear me?


Q: Oh, good. Yeah, my question is for you, Kate. Sorry, my question is for you, Kate. I'm wondering if you could talk a little bit about the post-speech strategy. Are you guys going to have -- who are you going to send out to the networks? Are you going to have a presence on Fox News? And what -- what's the mission going to be?

And then, secondarily, I know -- I know, you're probably not going to announce this now, but is there any more thought being given to the Fox News interview at the Super Bowl?

MR. MUNOZ: Hey, Tom, we can follow up on some of the specifics here, but as we've announced last week, there's going to be a blitz of Cabinet officials, the President, the Vice President, across the country -- to red states, blue states, states in between -- to talk about all of the ways the President and Vice President are delivering.

We have time for one more question. Let's go to Lenny Bernstein at the Washington Post.

Q: Hi, thank you very much. Can you talk a little bit about the changes you intend to make in the Mental Health Parity rules?

MS. LINKE YOUNG: Sure. This is -- this is Christen. As you know, the Mental Health Parity and Addiction Equity Act requires that health insurance plans of all types offer coverage for mental health services on the same terms as physical health services, and that they don't put barriers to care for people trying to access mental health benefits that don't apply in the physical health space.

This is a critical protection, but we know that too many insurance companies don't comply with the rules, and they place barriers in front of patient access that shouldn't be there, and contribute to the fact that, on average, it takes more than a decade for people to access mental health care after they first begin experiencing symptoms. And we need to change that.

So the reforms that we are focused on for rulemaking will make it easier to enforce the standards and ensure that insurance companies are meeting their obligations to the American people, and provide a structure that ensures that insurance companies are measuring their performance and meeting their obligations to offer mental health services on the same terms as physical health services.

MR. MUNOZ: Thanks, Christen. And thank you, everybody, for joining.

As a reminder, this call is on the record and embargoed for one more hour, until 10:30 a.m. If you don't have the factsheet, let me know. With that, have a good day.

9:31 A.M. EST

Joseph R. Biden, On-The-Record Press Call on President Biden's Unity Agenda Ahead of the State of the Union Online by Gerhard Peters and John T. Woolley, The American Presidency Project

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