President Obama is using his last budget proposal as an opportunity to strengthen the legacy of the Patient Protection and Affordable Care Act.
Despite the long odds of getting anything that expands the landmark health law through a GOP-controlled Congress, Obama hopes at the very least to show the public that Democrats' plans for improving health care did not stop with the passage of the PPACA in 2010, and that there are ways to both improve the law and build around it in order to make care more affordable and better quality.
For one, he is giving Republican-run states that rejected the expansion of Medicaid another chance to accept two years of expanded Medicaid services entirely funded by the federal government. States that accepted the expansion from the start are, in-keeping with the deal, beginning to shoulder a small percentage of the costs of covering those with incomes up to 138 percent of the federal poverty level, however, under the president's proposal, states that join the Medicaid expansion now will enjoy 100 percent federal funding of the additional services for the first two years of operation.
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Congressional GOP leaders have dismissed the Medicaid proposal, saying that there is little chance they will support more federal spending on an expansion that they didn't support to begin with. However, there will undoubtedly be pressure from state governments on Republicans to reassess their position.
And piggybacking on concerns about the rising cost of prescription drugs, Obama proposes requiring pharmaceutical companies to disclose the amount they spend on research and development, with the hope that the public will get a better sense of how much prices are designed to reimburse the companies for their investment, and how much is geared towards profit.
And finally, Obama is trying once more to get a version of the "Cadillac Tax" through. He has changed it a bit to reflect regional differences in the cost of care, but it is still aimed at discouraging very high-cost insurance plans that economists say are driving the inflation of health costs. It seems unlikely that the criticisms from both the left and the right that doomed the first incarnation of the tax will disappear in response to this new version. In fact, critics have already emerged.
Other priorities that Obama is putting in the budget include $1.5 billion to combat opioid abuse, a cause that has attracted bipartisan support in recent months. In fact, GOP presidential candidate Marco Rubio just added his name to a bipartisan bill that also seeks to expand services for prevention and addiction treatment.
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