President Joe Biden in his State of the Union address, March 7, 2024

President Joe Biden has been making his case for reelection to voters by telling them he is good for their pocketbooks, including at the pharmacy counter.

During his , Biden said legislation he signed gave Medicare the power to negotiate lower prescription drug prices.

“That’s not just saving seniors money and taxpayers money,” , a reference to the Inflation Reduction Act, which passed in 2022. “We cut the federal deficit by $160 billion because Medicare will no longer have to pay those exorbitant prices to Big Pharma.” 

Biden added, “This year, Medicare is negotiating lower prices for some of the costliest drugs.” He called for giving Medicare the power to negotiate prices for 500 drugs over the next decade.

, the federal government announced the first 10 drugs that it will negotiate for lower prices as part of the Inflation Reduction Act. A respected source of legislation analysis projects the change will save the government a lot of money, but those dollars haven’t been realized.

There is a reason Biden touted this legislation during his address:  shows that people, regardless of their political leanings, overwhelmingly support the idea of allowing Medicare to negotiate drug prices. But most people don’t know that such negotiations are underway.

Impact of Inflation Reduction Act Will Take Many Years

In August 2022, Biden signed the Inflation Reduction Act, which will allow the federal government to negotiate prices with drugmakers for Medicare. Biden  to repeal the law that barred Medicare from negotiating prices.Ìý

°Õ³ó±ðÌý a 10-year cumulative savings of $161.7 billion from two provisions of the Iaw: a phased-in effort to negotiate with drugmakers for lower prices and a rebate for price increases above the overall inflation rate. (°Õ³ó±ðÌý has previously pointed to this analysis.)

However, not all the savings will be permanent. About $44.3 billion over 10 years will be funneled into related provisions that expand access and lower out-of-pocket costs for Medicare beneficiaries.

“Negotiations are still ramping up, so the savings generated by the Inflation Reduction Act negotiation provisions are still in the future,” said Matthew Fiedler, a Brookings Institution expert on the economy and health studies. “The Congressional Budget Office did expect the inflation rebate provisions of the IRA (which are encompassed in the $160 billion) to begin generating modest savings during 2023 and 2024, but there, too, most of the savings are in the future.”

The legislation involves price negotiations for  that lack generic equivalents. Those  the blood thinners Eliquis and Xarelto; the diabetes drugs Januvia, Jardiance, and NovoLog; Enbrel, for rheumatoid arthritis; the blood-cancer drug Imbruvica; Entresto, for heart failure; Stelara, for psoriasis and Crohn’s disease; and Farxiga, a drug for diabetes, heart failure, and chronic kidney disease.

°Õ³ó±ðÌý that the negotiated prices will translate to nearly $100 billion in federal savings from 2026 to 2031.

“Biden is jumping the gun on claiming savings for seniors,” said Joe Antos, an expert on health care at the conservative American Enterprise Institute. “Price negotiations haven’t been completed; the new prices for selected drugs aren’t in place until 2026.”

Biden said the legislation is “saving seniors money and taxpayers money,” which could be interpreted to mean it is saving them money now on prescription drugs. But the negotiations for these drugs would define the prices to be paid for prescriptions starting in 2026. For 2027 and 2028, 15 more drugs per year will be chosen for price negotiations. Starting in 2029, 20 more will be chosen a year.Ìý

That said, other provisions in the legislation have already led to savings for seniors, said Tricia Neuman, a senior vice president at KFF:

• Certain recommended adult vaccines covered under Medicare Part D, such as shingles, are covered at no cost.Ìý
• The act established a cap on Part D spending that begins phasing in this year. This year, Part D enrollees will pay no more than $3,300 on brand-name drugs. In 2025, the cap for all covered Part D drugs drops to $2,000.
• The Inflation Reduction Act included the $35-a-month insulin cap, improvements in coverage for low-income beneficiaries, and the inflation rebate.

When we pressed the White House to provide examples of savings that have already occurred, a spokesperson pointed to the insulin cap.

Meanwhile, Antos said that although the Part D rebate has kicked in, the savings come from a small subset of Part D drugs taken by older Americans and that the government reaps the savings, not older Americans.Ìý 

“There is no reason to expect that seniors will see significant savings since there’s no obligation for the feds to distribute savings to Part D enrollees,” Antos said.

Our Ruling

Biden said, “We cut the federal deficit by $160 billion because Medicare will no longer have to pay those exorbitant prices to Big Pharma.”

Biden’s statement omits the time frame; the savings have not been realized. The CBO projected 10-year cumulative savings of $161.7 billion from two provisions of the legislation. And as for saving older Americans money on their prescriptions, that hasn’t happened yet. The federal government is negotiating the first 10 drugs with the new prices set to take effect in 2026.

We rate this statement Half True.

Sources

°­¹ó¹ó,Ìý“,” Jan. 31, 2024

White House,Ìý“Budget Cuts Wasteful Spending on Big Pharma, Big Oil, and Other Special Interests, Cracks Down on Systemic Fraud, and Makes Programs More Cost Effective,” March 9, 2023

Email interview, Matthew Fiedler, senior fellow in economic studies, Center on Health Policy at The Brookings Institution, March 8, 2024

Email interview, Tricia Neuman,Ìýa senior vice president of ËØÈËÉ«ÇéƬand the executive director of its Program on Medicare Policy, March 8, 2024

Email interview, Joe Antos, a senior fellow at the American Enterprise Institute, March 8, 2024

White House, statement to PolitiFact, March 8, 2024

President Joe Biden,Ìý, Aug. 29, 2023

Congressional Budget Office, “,” Sept. 7, 2022

Congressional Budget Office, “,” February 2023

KFF, “,” Jan. 24, 2023

NBC News, “,” Aug. 29, 2023

PolitiFact, “,” Aug. 10, 2022

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Biden said that taxes should be increased on corporations and the wealthy to pay for new spending, as well as to address escalating inequality.Ìý

“My fellow Americans, trickle-down economics has never worked. It’s time to grow the economy from the bottom up and middle out,” Biden said.

He repeatedly urged Congress to act on a variety of measures, including issues like gun control and immigration that have frozen Congress for decades. He said police reforms proposed in the wake of the death of George Floyd should be enacted and specifically urged bipartisan consensus.Ìý

“I know the Republicans have their own ideas and are engaged in productive discussions with Democrats. We need to work together to find a consensus,” Biden said.

And he recounted a visit he made to a mass-vaccination clinic in Glendale, Arizona. “I asked a nurse what it’s like,” Biden said. “She looked and said every shot feels like a dose of hope.”

The coronavirus pandemic limited the audience to 200 masked and distanced members of Congress and other officials, down from a typical audience of about 1,600.Ìý

Only two members from the president’s Cabinet were invited: Secretary of State Antony Blinken and Defense Secretary Lloyd Austin. Chief Justice John Roberts represented the Supreme Court. First lady  were invited to watch the event virtually.

And for the first time in U.S. history, two women sat directly behind the president as he delivered his speech: House Speaker Nancy Pelosi (D-Calif.) and Vice President Kamala Harris, the first woman to serve in that position.

“Madam vice president,” Biden said. “No president has ever said those words, and it is about time.”

For the most part, Biden’s statements about his progress and future plans aligned with estimates from think tanks or government data. In some cases, he left out information that would give Americans a full picture. Our PolitiFact partners checked his statements regarding a range of subjects. You can read their complete story . Biden also discussed the ongoing covid pandemic and other health care issues. Here are highlights from his speech:

During these 100 days, an additional 800,000 Americans enrolled in the Affordable Care Act when I established a special sign-up period to do that. 800,000 in that period.

This appears accurate but needs context.Ìý

Biden did create a special enrollment period for Americans to sign up for health insurance through the Affordable Care Act marketplace plans, due to the covid-19 pandemic. That special enrollment period began Feb. 15 and will run through Aug. 15. According to  by the Department of Health and Human Services, more than 528,000 Americans enrolled in health insurance coverage since that special enrollment period began through March 31. A senior administration official said that Biden’s reference to the 800,000 new sign-ups reflected the most up-to-date tally, though it hasn’t been previously announced.

When I was sworn in on Jan. 20, less than 1% of seniors in America were fully vaccinated against covid-19. One hundred days later, 70% of seniors over 65 are protected. Senior deaths from covid-19 are down 80% since January.

This is largely accurate.Ìý

According to the , 0.8% of those age 65 and older had been vaccinated by Jan. 20. So Biden is correct on this point.Ìý

However, when Biden took office, the U.S. vaccination program had been in place only for about a month — the Pfizer-BioNTech and Moderna vaccines weren’t authorized for emergency use until mid-December. And  from the independent Advisory Committee on Immunization Practices prioritized vaccination of health care workers, and then long-term care facility residents. The next two phases included people 75 and older and then 65 and older, meaning that some states may not have started vaccinating these age groups until mid-January.Ìý

As of Wednesday, the CDC reported the share of those 65 and up who had received complete doses of a covid-19 vaccine and are fully protected at nearly 70% — it was 68.3%. The percentage who have received at least one dose is higher: 82%.

A senior administration official provided for all Americans, but not statistics specifically about seniors. That data shows the covid daily death rate dropped by nearly 80% from Jan. 20 to April 27.ÌýBased on additional,Ìý provided Thursday by the White House, the overall decrease in the daily death rate for people older than 65 was between 92% and 95% — an improvement better than what Biden cited in his speech. [Editor’s note: This section was updated to clarify the data.]

°Õ³ó±ðÌý reported on April 22 that the best available data appeared to show covid deaths for those 65 and older had declined by more than 50% since a peak in January, but said the “picture is not entirely clear because the most recent data on deaths by age from the Centers for Disease Control and Prevention is incomplete and subject to revision.” 

The recession caused by the coronavirus pandemic was ‘the worst economic crisis since the Great Depression.’

Two key metrics back this up.

The biggest economic hit since the Great Depression in the 1930s was generally considered to be the Great Recession from 2007 to 2009, but the recession caused by the pandemic packed a bigger punch.

The peak unemployment rate in the Great Recession was 10% in October 2009, but that pales compared with the peak unemployment rate during the pandemic, 14.8% in April 2020.

Sen. Tim Scott and the Republican Response

Sen. Tim Scott (R-S.C.), the Senate’s lone Black Republican, was chosen to deliver the GOP rebuttal to Biden’s speech. He said the president is dividing Americans and has failed to deliver on his promise of unity.

“I want to have an honest conversation,” Scott said. “About common sense and common ground. About this feeling that our nation is sliding off its shared foundation and how we move forward together.”

PolitiFact checked , including this statement in which he asserted that it has been safe for some time for schools to conduct in-person learning.

Our public schools should have reopened months ago. … Private and religious schools did. Science has shown for months that schools are safe.

Scott’s statement about what the science has shown is generally accurate, but omits public health experts’ warnings that schools should implement infection control precautions.

“Most private and religious schools have been open for the majority of the school year, and the vast majority have been extremely successful with minimal in-school transmission,” said Dr. David Rosen, an assistant professor of pediatrics at Washington University in St. Louis. “But this is based on the premise that schools are performing the proper mitigations, especially universal masking and preventing symptomatic children from being in the classroom.”

There have also been many examples of large public school districts that have had very few cases of SARS-CoV-2 transmitted in the classroom, Rosen said.

The American Academy of Pediatrics that said, “All policy considerations for the coming school year should start with a goal of having students physically present in school” for the fall 2020 semester. The recommendations included requiring students to wear masks, maintaining a physical distance of 3 to 6 feet and potentially including testing and temperature checks in the safety protocol.Ìý

Schools have increasingly opened for in-person instruction throughout the year, but some remain virtual. As of April 19, 4% of districts were fully remote while 47% of districts were fully in-person and about 48% of districts are offering some type of hybrid instruction, according to a tracker by the .Ìý

Rosen said it was the right thing to do to shut down schools in March 2020 when we didn’t know much about the virus.Ìý

“We continued to learn over the summer of 2020, and by the fall it was pretty clear that the virus was not as morbid in children and that masking was key in preventing person-to-person spread,” Rosen said.

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“President Trump marshaled the full resources of the federal government and directed us to forge a seamless partnership with governors across America in both parties,” Pence said during his speech Wednesday night at the Republican National Convention.

Clearly, the federal government has provided supplies and funding to states led by both parties in response to the pandemic, and Pence himself has held regular with governors in both parties. But Pence was speaking about the actions of Trump, not his own.

Pence’s comments ignored Trump’s multiple feuds, frequently with Democratic governors, about state-federal responsibilities and the pandemic response.

A Trump campaign spokesperson sent us a list of dozens of teleconferences and meetings that Trump or Pence had with ,Ìýincluding Democrats such as  and Michigan’s . In March, Trump sent a  to governors thanking them for “stepping up to help America confront this unprecedented global pandemic.” The campaign pointed to actions by administration officials to brief governors about making available supplies, such as ,Ìý, and .

Trump Argued With Governors Over COVID-19 Supplies, Tests

Early in the pandemic, Trump traded barbs with governors, especially over where the responsibility lay in .

After declaring a national emergency over the health crisis on March 13, Trump directed governors to order their own ventilators, respirators and supplies, saying the federal government is “not a shipping clerk.” Governors in both parties shot back that Trump’s stance, and the lack of coordination from Washington, left states bidding against one another and the federal government for access to critical equipment.

said it was akin to competing on eBay with all the other states plus the Federal Emergency Management Agency.

Whitmer and Maryland Gov. Larry Hogan, a Republican and then chair of the National Governors Association, were among those pleading for better coordination from FEMA to ensure that supplies were distributed based on need.

“The lack of any centralized coordination is creating a counterproductive competition between states and the federal government to secure limited supplies, driving up prices and exacerbating existing shortages,” they wrote in a joint March 30  in The Washington Post.

´¡Ìý, Trump said during a White House briefing that governors should be “appreciative” toward him and the federal government.

Speaking of Pence, Trump said: “He calls all the governors. I tell him — I mean, I’m a different type of person — I say, ‘Mike, don’t call the governor of Washington. You’re wasting your time with him. Don’t call the woman in Michigan.’” On , Trump said Whitmer was “way in over her head, she doesn’t have a clue.”

In April, Trump said that testing “is a local thing” and that states should turn to commercial labs for help. After he was ,ÌýTrump said the federal government would step up efforts to get testing supplies.

Governors also called on Trump early on to enact the , a law that gives the president authority to expedite the supply of materials for national defense, in order to ramp up production of personal protective equipment and COVID-19 testing supplies. While the president did eventually invoke the act to produce ventilators and medical equipment, he  to do so and did it sparingly.ÌýÌý²¹²Ô»åÌý called for him to broaden its use.

Trump’s justification for slow-rolling the act was that he didn’t want the government to intervene in the private sector.

“You know, we’re a country not based on nationalizing our business,” Trump said at a coronavirus task force  on March 22. “Call a person over in Venezuela, ask them how did nationalization of their businesses work out? Not too well.”

In April, Trump said that Georgia Gov. Brian Kemp, a Republican, had reopened Georgia  In May, he criticized Pennsylvania Gov. Tom Wolf, a Democrat, for keeping parts of his state closed that Trump said were 

°Õ°ù³Ü³¾±èÌý in mid-April that it was up to him — not the governors — to decide when to reopen states on lockdown.

Some Governors Bypassed the Federal Government to Work Together

Frustrated with the responses from the Trump administration, some governors teamed up with one another to get needed supplies.

, a coalition of governors from seven Northeastern states, including New York, Connecticut, New Jersey, Rhode Island, Pennsylvania and Delaware, joined together to buy personal protective equipment and ventilators and create a unified reopening strategy.

, some governors were calling on the feds for help and not getting what they needed. There were shortages of testing supplies, as well as personal protective gear. Washington state asked for 4.2 million N95 respirators. It received a bit under 500,000. It asked for about 300,000 gowns. It got about 160,000.

On Aug. 18, a bipartisan group of governors — five Democrats and five Republicans —  they would be partnering with the Rockefeller Foundation to create a national testing strategy in the absence of federal action. The 10 states are Louisiana, Maryland, Massachusetts, Michigan, Ohio, North Carolina, Utah, Arkansas, Rhode Island and Virginia. Their goal is to buy and deploy 5 million COVID-19 antigen tests.

Feuds Between Trump Administration and States Continue

°Õ³ó±ðÌý sought to pressure states to reopen schools for in-person instruction. In July, to cut off funding if schools didn’t reopen.

This summer, the Trump administration reduced the federal share of National Guard assistance to the states to help with pandemic response, despite pleas from governors in both parties. An Aug. 3  said that the federal government would no longer continue to pay for 100% of the tab for most states and that it would be reduced to 75% as of Aug. 21.

And when the CDC unveiled new testing guidelines that downplayed the need to test people who don’t show symptoms — Ìý— Ìý²¹²Ô»åÌý said that they wouldn’t follow it. Asymptomatic people are thought to be significant spreaders of the virus.  at times praised certain responses by the Trump administration to help their states respond to the pandemic.

Our Ruling

Pence said, “President Trump marshaled the full resources of our federal government from the outset. He directed us to forge a seamless partnership with governors across America in both political parties.”

Trump and top administration officials have communicated with governors of both parties for months in meetings, phone calls and written communication. But Pence’s comment ignores that Trump has feuded with governors over state-federal responsibilities, supplies and policies for shutting down or reopening. Trump also has suggested a lesser role for the federal government and said that the handling of COVID-19 should be left to the states.

We rate this claim Mostly False.

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Speaking from the , President Donald Trump suggested that people with health insurance shouldn’t have to worry about that.

“Earlier this week, I met with the leaders of the health insurance industry who have agreed to waive all copayments for coronavirus treatments, extend insurance coverage to these treatments, and to prevent surprise medical billing,” Trump said March 11.

We found that’s an exaggeration, at best.

We contacted spokespeople for the White House and the Department of Health and Human Services seeking clarification and did not get a response. But March 12 on CNN, Vice President Mike Pence said insurers have agreed to waive copays for coronavirus tests — not treatment.

The of Trump’s March 10 meeting with the insurance industry shows that, in fact, company leaders agreed to waive all copayments for coronavirus tests — not treatments.

“All the insurance companies here ― either today or before today — have agreed to waive all copays on coronavirus testing and extend coverage for coronavirus treatment in all of their benefit plans,” Pence said.

That’s a big distinction.

An Incomplete Picture

For one thing, a shortage in diagnostic supplies means that . You have to present symptoms to qualify. If you don’t receive a test but do get screened, that qualifies as a doctor’s visit ― not a coronavirus test. That qualifies for a copay.

“It’s not even waiving copays or deductibles for services you need to get tests — emergency visits, doctors, etc.,” noted Sabrina Corlette, a professor at Georgetown University’s Health Policy Institute. “It’s ‘we’ll waive copays for the tests,’ which is the lab service.”

Health plans will cover treatment for coronavirus, including hospital stays, said Kristine Grow, a spokesperson for America’s Health Insurance Plans, a major lobbying group. But they won’t necessarily waive copays or cost sharing for that treatment.

And there are other nuances to getting treatment that might entail higher cost sharing. If a coronavirus diagnosis ultimately means a patient needs to be put in a private room, or some other form of isolation, that service costs more. And even if it’s covered, patients could end up paying part of the price out-of-pocket, Corlette said.

For surprise medical bills, it’s trickier. Insurance plans can do a lot, such as waiving in-network cost sharing when someone gets treatment for the coronavirus, or agreeing to change their benefit structure if a patient gets out-of-network care. But they don’t appear to have explicitly committed to do those things, Corlette said.

And the responsibility for surprise billing doesn’t fall just on insurance companies, said Zack Cooper, a health economist at Yale University, who studies surprise billing. Doctors and hospitals who are out-of-network are still able to balance-bill — that is, send patients a bill for whatever insurance has not paid.

Plus, big insurance companies are only part of the picture. About 61% of Americans with employer-sponsored health care have . Those plans, which are regulated by federal law,Ìýcan opt out of the agreements around copayments.

With all those caveats, Corlette said, Trump’s assertion is “misleading.”

What The Insurance Plans Said

The statements released by health insurance companies about waived costs are not as comprehensive as Trump indicated.

that it has “waived all member cost sharing, including copays, coinsurance and deductibles, for COVID-19 diagnostic testing provided at approved locations in accordance with Centers for Disease Control and Prevention guidelines for all commercial insured, Medicaid and Medicare members. UnitedHealthcare is also supporting self-insured customers choosing to implement similar actions.”

Ethan Slavin, a spokesperson for Aetna, gave a similar response: He said the company will waive associated costs for members who get tested “at any authorized location.”

Anthem March 6 that it would provide coverage of the coronavirus screening test at no out-of-pocket cost.

But again, those commitments are not comprehensive.

The statement by UnitedHealthcare doesn’t state it is waiving all cost sharing with respect to emergency treatment or post-stabilization, for example.

“The only place you can get tested in a lot of communities is still the hospital emergency room department, so that’s an emergency visit,” said Sara Rosenbaum, a George Washington University professor of health law and policy.

While the White House meeting shows that at the moment health insurance companies have agreed to not charge copays for the tests, the rules could change rapidly for other costs, said Thomas Miller, an expert on health care policy at the conservative American Enterprise Institute.

“Looking over the horizon, we are going to be doing a lot of things differently,” he said.

Joseph Antos, another health care expert at AEI, said that since the final bills for treatment are settled after the patient has been treated, patients who can’t cover in full what could be very high cost-sharing amounts have room for negotiation or special consideration.

“Most higher-income people with good insurance should be able to deal with those costs and should not expect additional discounts related to coronavirus,” he said.

It’s also possible that Congress will decide to pass surprise-billing legislation given the circumstances.

Our Ruling

Trump said the health insurance industry has “agreed to waive all copayments for coronavirus treatments.”

This isn’t what those companies said. They agreed to waive copayments for coronavirus testing. That’s only one component, and it’s a far cry from waiving copayments for all treatment. And, despite what the president’s phrasing implies, Americans who seek a test and are turned away will not have their copayments waived, either.

Patients who seek testing for coronavirus, and even those who end up needing treatment, will likely still end up facing medical bills. The size and scope depends on their insurance plans and on which doctors they see.

The president’s statement is inaccurate. We rate it False.

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