What’s happening: President Biden submitted his fiscal year (FY) 2025 budget request to Congress.
What else to know: The budget is a blueprint of the administration’s priorities and is not legislation.
The $7.3 trillion budget request is not binding and includes health care initiatives to:
- Extend solvency of the Medicare hospital insurance trust fund indefinitely (currently projected to run out in 2031).
- Permanently extend premium tax credits for health coverage purchased through the Health Insurance Marketplace (currently scheduled to expire in 2025).
- Provide “Medicaid-like” coverage to low-income individuals in states that have not expanded Medicaid.
- Extend eligibility for Medicaid and the Children’s Health Insurance Program.
- Expand the number of drugs subject to price negotiation under the Medicare Program.
- Limit Medicare Part D cost-sharing for high-value generic drugs to $2 per month.
- Extend the $2,000 Medicare cap on out-of-pocket prescription drug costs and $35 cost-sharing cap for insulin to include the commercial market.
- Set aside financial incentives to assist hospitals in defending against cyberattacks with funds provided first to approximately 2,000 hospitals determined to have the greatest need for assistance.
- Require all health plans to cover mental health and substance use disorder benefits and have an adequate network of behavioral health providers.
- Ban facility fees for telehealth and certain outpatient services in the commercial insurance market.
- Permit the Centers for Medicare & Medicaid Services to publicly disclose all accrediting organization survey reports and require reporting of patient-level demographic and social determinants of health data in quality measurement programs.
- Extend the Medicare sequester through 2034.
The budget also supports health equity, maternal health, and strengthening of the public health infrastructure. Additional details are available in a fact sheet.
