2010-01-27

President Obama is set to deliver his first State of the Union address at 9:00 p.m. Wednesday, January 27. It is expected that the President’s speech will focus on a number priorities, including health reform, providing economic relief and tax cuts to middle class families, reforming the nation’s public education system, and freezing most federal discretionary spending.

One of the key issues the President is expected to address in his speech is renewing his call for Congress to act quickly to pass a final health reform bill that he can sign into law. Following the loss of a 60-seat super-majority in the Senate, Democratic congressional leaders have been exploring various options to complete action on a final health reform bill. While there is not yet any agreement on how to proceed with health reform, there continues to be a wide range of lawmaker support on several elements of an overhaul bill, including insurance coverage of pre-existing conditions, expansion of Medicaid coverage eligibility, establishment of state insurance exchanges, adjustment to Medicare Part D prescription drug coverage levels, and malpractice reform. There are also a variety of other health issues that lawmakers could move forward as separate measures. Additional topics include limits on drug manufacturer payments to generic drugmakers to hold off introduction of generic drug versions, eliminating health insurance antitrust protections, new Food and Drug Administration regulatory authority over generic biologic drugs, and food safety legislation. There is also the continued need to resolve Medicare physician reimbursement rates. Because congressional leaders have not identified a strategy to move forward, the level of priority and specificity of the President’s remarks on health issues will be closely watched. Practically, it is recognized that the Obama administration will not be able to focus on other issues while health reform legislation is still on the table.

Another major focus of the President’s speech is expected to be the economy. In addition to proposing tax cuts for the middle class, the President is expected to propose a three-year freeze in all federal discretionary spending that is not directly related to national security. This would mean that federal agencies such as the National Institutes of Health and the Centers for Disease Control and Prevention would likely not receive increases in the President’s proposed budget that is expected to be released on February 1. Although Congress has the final say in determining the annual federal budget, the President’s proposal effectively sets a baseline for the budget process and makes significant increases beyond proposed levels unlikely.

Please visit the ASH Web site following the President’s State of the Union speech for updated information on the health-related issues discussed in his speech.

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