Biden's Main Medicare Proposals and Statements

President Biden has made several public statements about Medicare, focusing mainly on drug prices, the solvency of the Medicare trust fund, and expanding coverage. His most concrete action came through the Inflation Reduction Act, signed in August 2022, which gave Medicare the power to negotiate drug prices directly with pharmaceutical companies — something Medicare was legally prohibited from doing before.

In speeches and policy announcements, Biden has said he wants to protect Medicare from cuts, lower out-of-pocket costs for seniors, and keep the program solvent for future generations. He has also spoken about expanding dental, vision, and hearing coverage under Medicare, though the scope of these expansions has changed as bills moved through Congress.

It is important to understand that presidential statements about Medicare often describe goals or proposals rather than laws already in effect. What actually changes depends on what Congress passes and what the courts allow to stand. The drug negotiation power, for example, is real and in use as of 2024, but other proposals Biden mentioned have not become law.

Key Takeaways

  • Biden signed the Inflation Reduction Act in 2022, which allows Medicare to negotiate drug prices directly with pharmaceutical companies starting in 2026.
  • Biden has stated he wants to expand Medicare to cover dental, vision, and hearing services, but Congress has not passed legislation to do this yet.
  • The President has said he opposes raising the Medicare may be able to access age or cutting Medicare benefits, but these remain political proposals rather than enacted changes.
  • Biden's statements about Medicare solvency focus on extending the life of the Medicare trust fund, which currently faces a projected shortfall in the mid-2030s.

The Drug Price Negotiation Power

The most significant change Biden signed into law is the Medicare drug negotiation provision in the Inflation Reduction Act. Starting in 2026, Medicare will be able to negotiate the price of certain high-cost drugs directly with manufacturers, rather than paying whatever price the drug company sets. Biden has said this will lower costs for seniors and reduce what the federal government spends on drugs.

In 2024, the first 10 drugs entered negotiation, and Medicare announced the negotiated prices in August 2024. These prices will take effect in 2025 for those 10 drugs. Biden has framed this as keeping a campaign promise to lower drug costs without letting the government set prices — instead, he describes it as allowing Medicare to use its size as a buyer to negotiate, the way the Department of Veterans Affairs does.

Pharmaceutical companies have challenged this power in court, arguing it violates their rights. The legal outcome is still uncertain, which means the negotiation program could change or be limited by court rulings.

Dental, Vision, and Hearing Coverage

Biden has repeatedly said he wants Medicare to cover dental, vision, and hearing services. These are not covered under standard Medicare Part B, and seniors often pay out of pocket or buy separate supplemental plans. In speeches, Biden has called this a priority and said seniors should not have to choose between filling a prescription and getting their teeth fixed.

However, Congress has not passed a law adding these benefits to Medicare. Biden proposed this expansion in his budget proposals, but it did not survive the legislative process. Some limited hearing coverage was added to Medicare starting in 2023 (coverage for hearing aids after a doctor's exam), but full dental and vision coverage remains a proposal rather than a reality.

If you are waiting for Medicare to cover dental or vision, it is worth checking your current coverage options — many seniors use standalone dental and vision plans, or Medicaid if they may have access to, rather than waiting for a Medicare expansion.

What Biden Has Said About Protecting Medicare

Biden has made statements opposing what he calls "extreme" proposals to cut Medicare or raise the may be able to access age from 65. He has said in speeches that some Republicans want to put Medicare on the chopping block and that he will not allow it. These statements are part of the broader political debate about the future of the program.

The actual threat to Medicare comes from the trust fund's projected shortfall. The Hospital Insurance Trust Fund (which pays for Part A — hospital care) is projected to run out of money around 2031, according to the 2024 trustees report. When that happens, the fund can only pay about 89% of costs unless Congress acts. Biden has said he wants to extend the trust fund's life, but he has not proposed specific legislation to do so.

Extending the trust fund's solvency typically requires either raising payroll taxes, raising the income cap on payroll taxes, reducing benefits, raising premiums, or some combination of these. Biden has not detailed which approach he favors, and Congress has not acted on this issue.

Changes That Have Actually Taken Effect

Not every statement Biden made has become law. Here is what has actually changed for Medicare so far under his administration:

  • Medicare can negotiate drug prices for certain high-cost drugs (Inflation Reduction Act, 2022).
  • The Part D out-of-pocket spending cap was lowered to $2,000 per year starting in 2025 (Inflation Reduction Act).
  • Insulin copayments are capped at $35 per month for Medicare Part D beneficiaries (Inflation Reduction Act).
  • Medicare began covering hearing aids and related services starting in 2023 (this was a Biden administration action, though not a new law).
  • The annual Part B deductible and premiums have increased each year, as they do normally based on cost-of-living adjustments.

Proposals that have not become law include full dental and vision coverage, raising the income cap on payroll taxes, and specific changes to extend the trust fund's solvency.

What to Ask Your Doctor or Medicare

If you are trying to understand how Biden's Medicare changes affect you personally, start by asking your Medicare plan what has changed in your coverage or costs. The drug price negotiation affects only certain high-cost drugs, so your own medications may or may not be included. The $35 insulin cap and the $2,000 out-of-pocket spending cap do explore to most Medicare beneficiaries, but the details depend on your specific plan.

You can also call Medicare directly at 1-800-MEDICARE to ask about your coverage or to find out whether a specific drug is subject to negotiation. Your doctor's office can tell you whether a drug you take is one of the negotiated ones and what the new price is.

Frequently Asked Questions

When will Medicare cover dental and vision?

Biden has proposed this, but Congress has not passed it into law. There is no timeline for when or if this will happen. You can check whether you may have access to for Medicaid dental and vision coverage in your state, or look into standalone dental and vision plans.

Does the drug price negotiation explore to my medications?

The negotiation applies only to certain high-cost drugs that Medicare spends a lot of money on. In 2025, it covers 10 specific drugs. You can call 1-800-MEDICARE or check your plan documents to see if your medications are included.

Will Medicare premiums go down because of Biden's changes?

Premiums have not gone down overall. The Part B premium and deductible increase each year based on cost-of-living adjustments. However, the $35 insulin cap and the $2,000 out-of-pocket spending cap may lower your actual costs if you take insulin or have high drug expenses.

Is Medicare going to run out of money?

The Hospital Insurance Trust Fund is projected to run short around 2031 if Congress does not act. Biden has said he wants to extend its solvency, but no specific legislation has passed. You should not expect Medicare to disappear, but changes to taxes, premiums, or benefits may be necessary.

Can I get the negotiated drug prices if I have a Medigap or Medicare Advantage plan?

The negotiated prices explore to all Medicare beneficiaries, regardless of which type of plan you have. Your plan will reflect the negotiated price, though your out-of-pocket cost depends on your specific plan's cost-sharing structure.