Biden, divided Congress seek common ground on health care reforms

President Biden's budget proposal includes ambitious measures seeking to bring down health care costs, but the divided government poses a steep challenge to these proposals, and lawmakers have yet to indicate where they're willing to come together.

Biden's budget proposes increasing discretionary funding for the Department of Health and Human Services (HHS) by $14.8 billion over 2023, raising taxes on people making more than $400,000 a year to keep Medicaid solvent, making ObamaCare tax premiums permanent and enacting a $35 cap on monthly insulin costs across the commercial market.

Republicans leaders have already stated that a tax increase is a non-starter, and GOP lawmakers have indicated a desire to cut the Affordable Care Act (ACA) tax premiums that Biden is seeking to set in stone.

While Republicans have not yet released their own budget plan, which Biden has not hesitated to point out while promoting his proposal, they are expected to call for cuts in health care spending in some areas, such as the ACA and Medicaid. Programs including Medicare and Social Security have been deemed off the table, but lawmakers in the party insist that cuts are necessary to address the national debt.

With the House under GOP control, compromises will have to be made in order for the budget to pass in Congress. Democratic senators seemed optimistic on Thursday that they could come together with their Republican colleagues on a few issues.

Sen. Ben Ray Luján (D-N.M.) said he wasn't aware of any measures that Republicans had expressed an openness to considering yet, but pointed to the ACA tax credits as one where he felt bipartisanship could occur.

"There's constituents in every one of our states that benefit from these credits, and when I hear all my colleagues talk about issues that constituents are facing, every one of us is concerned about higher costs in whatever the space may be," Luján said. "As someone that survived a stroke, I can tell you how important it is to have access to care. It's life-saving."

Fellow Senate Committee on Health, Education, Labor and Pensions member Sen. Tim Kaine (D-Va.) signaled a degree of confidence in several issues that he felt both sides could come together on.

"I was pleased to see good solid investments on the technology on the border that can be used to stop fentanyl from coming in and that should be a place where we can work together," Kaine said. "Some of the child care stuff, we got some good, solid [Republican] votes on that with an omni last year so there may be some possibilities there."

Sen. Mitt Romney (R-Utah) said he appreciated the effort and the amount of measures that Biden had put into his budget.

"A lot of them I disagree with. On the health care front, we're going through them, so I don't have a response for it yet," said Romney.

When asked which of Biden's health care proposals he was open to considering, Sen. Rand Paul (R-Ky.) said he wanted to see expansions in health savings accounts (HSA), which were not included in the president's budget.

HSAs are savings accounts where pre-tax dollars can be contributed for later use to pay qualified medical expenses. Individuals can only contribute to HSAs if they have a high deductible health plan. In December, Paul introduced legislation that would allow more people to contribute to HSAs, regardless of if they have insurance or not, and also expand what expenses HSA contributions could go towards.