Public option plan left out of Biden budget proposal

President Biden’s budget for the next fiscal year leaves out financial plans for a public option, lowering prescription drug costs and Medicare expansion, despite several Democrats’ calls for the administration to prioritize these health care reforms.

In the $6 trillion budget released Friday, Biden called on Congress to “take action” this year to reduce prescription drug costs and “to further expand and improve health coverage.” 

The president specifically indicated his support for creating a public option, lowering the minimum eligibility age for Medicare and expanding Medicare to include vision, hearing and dental coverage. 

But the budget proposal does not detail how the administration plans to make any of these changes, several of which were campaign promises, nor does it include the expected price tag of these reforms in the overall budget costs. 

Biden’s budget does include the American Families Plan’s move to make Affordable Care Act subsidies permanent to help people afford health insurance premiums, a move that is estimated to cost $163 billion over the next 10 years.

Another $400 billion is dedicated to providing home care for the elderly and people with disabilities over a decade, a proposal included in the American Jobs Plan. 

The president campaigned on establishing a public option, saying it could help build access to health insurance without going the “Medicare for All” route and ending private insurance. But without specifics in the budget, the effort falls to congressional lawmakers for now. 

Sen. Patty Murray (D-Wash.), chair of the Senate Health, Education, Labor and Pensions Committee, and Rep. Frank Pallone Jr. (D-N.J.), chair of the House Energy and Commerce Committee, made a public request for feedback on public option legislation. 

Sens. Michael Bennet (D-Colo.) and Tim Kaine (D-Va.) also unveiled their plan to create a public option in February. 

The Biden administration previously excluded plans to reduce prescription drug prices and decrease the minimum Medicare eligibility age when it originally released the American Families Plan last month. 

Still, Democrats have requested the president add these health care initiatives in the plan, with 156 House Democrats signing a letter and launching a pressure campaign this week calling for expanded Medicare coverage and decreased prescription drug costs.

Speaker Nancy Pelosi (Calif.) and other Democrats have also advocated in recent weeks for H.R. 3, a measure that would permit Medicare to negotiate drug prices, which Republicans and the pharmaceutical industry have opposed.