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A fact check on health care topics in Biden's State of the Union address

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
Jabin Botsford
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Joshua Davis, a teen with Type 1 diabetes, applauded from the gallery as Biden urged capping the cost of insulin at $35 a month. It was among the health issues touched on during the president's speech.

As expected, President Joe Biden used his State of the Union address on Tuesday to condemn Russian President Vladimir Putin’s use of force against Ukraine while touting the strength of the Ukrainian people and the NATO alliance.

He also went through a fairly lengthy domestic to-do list that touched on a number of health policy issues.

NPR: 5 takeaways from Biden's State of the Union address

Biden one-hour speech was given to a largely unmasked crowd of lawmakers, Supreme Court justices and Cabinet members in the House chamber, a sign of the diminished threat of the COVID omicron variant.

Speaking on the subject of the coronavirus, Biden attempted to thread the needle between being optimistic and on guard, saying the nation was entering a phase in which “COVID-19 need no longer control our lives,” although the U.S. should stay focused on expanding vaccines, treatments, and testing and monitoring new variants.

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
Shawn Thew
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

He spoke about the need to cut the cost of prescription drugs, citing the high price tag of insulin.

Joshua Davis, a 13-year-old Virginia boy who has Type 1 diabetes, attended the speech as one of first lady Jill Biden's guests. He watched and applauded from the gallery as the president urged capping the cost of insulin at $35 a month “so everyone can afford it.”

Biden also renewed his call to let “Medicare negotiate lower prices for prescription drugs.”

The president also promised nursing home reforms through the Medicare program that would lead to higher quality-of-care standards. H

He unveiled what he called his “Unity Agenda for the Nation.” It includes initiatives aimed at ending the opioid epidemic, taking on the nation’s mental health needs — especially those of children — improving services for veterans, and ending cancer.

He was also firm in the need to protect access to health care, preserve women’s reproductive rights, and advance maternal health care.

KHN and PolitiFact’s team of reporters and editors watched it all. You can read the detailed fact check here.

Here are the health care highlights:

“Under the new guidelines, most Americans and most of the country can now go mask-free. And based on projections, more of the country will [cross] this point in the next couple of weeks.”

This is accurate. Under updated guidelines that the Centers for Disease Control and Prevention released Feb. 25, about 70% of Americans live in communities with low to medium risk from COVID and will be allowed to go out in public and indoor spaces maskless.

The agency considers counties to be at high risk if they are recording 200 or more new infections for every 100,000 people, or if 10% or more of hospital beds have been occupied by COVID patients within the previous seven days. An area is also deemed at high risk if 10 or more people for every 100,000 residents are being admitted to hospitals for the disease.

Under the new rules, residents of high-risk areas will have to mask up. In medium-risk communities, however, masks are recommended only for those who are immunocompromised. In communities with low levels of COVID, there is no recommendation to wear a mask.

In addition, recent CDC projections for the next four weeks suggest continued drops in hospitalizations and deaths. If those forecasts play out, more Americans will likely be able to go maskless.

“75% of adult Americans are fully vaccinated, and hospitalizations are down by 77%. Most Americans can remove their masks and stay in the classroom and move forward safely.”

This is a largely accurate description of official numbers and guidance. According to the CDC, as of March 1, 75% of Americans 18 or older are fully vaccinated, or 193,643,363 people.

It was unclear what the starting point was for Biden’s claim that COVID-related hospitalizations are down by 77%, but about 60,000 people with the coronavirus are hospitalized nationally, down from about 160,000 in January, according to New York Times data. This translates to a 62.5% drop.

Additionally, it is accurate that most Americans are not required to wear a mask under the CDC’s updated guidelines.

“The American Rescue Plan is helping millions of families on Affordable Care Act plans save $2,400 a year on their health care premiums.”

This is accurate. The American Rescue Plan Act expanded subsidies for marketplace health insurance plans to many Americans — more than 3 million — who didn’t previously qualify for them.

The subsidies meant Affordable Care Act insurance premiums for many families were much lower. The Department of Health and Human Services estimated that for 4 in 5 enrollees it would cost $10 or less a month, after tax credits, to sign up for health insurance.

The $2,400-per-year savings appears to be derived from a 2021 HHS press release that described examples of how the expanded subsidies will save money, such as: “A family of four making $90,000 will see their premiums decrease by $200 per month.” That would translate to $2,400 per year.

Estimates from other organizations support savings in this number range. According to KFF, a nonprofit health policy organization, individual consumers could save, on average, $70 per month on health insurance because of the American Rescue Plan subsidies. For a family of three, that would translate to a savings of $210 per month, or about $2,500 per year. But not all kids would necessarily automatically qualify for ACA coverage — many instead qualify for the Children’s Health Insurance Program, known as CHIP.

Still, KFF’s 2021 subsidy calculator shows that a 40-year-old couple with two kids who make 200% of the poverty level (a midrange income) would receive $16,247 per year in subsidies. Compared with a KFF subsidy calculator dating back before the American Rescue Plan, that same family would have received $13,878 in subsidies. That’s exactly a $2,369 difference in savings.

“So, the $2,400 does seem very reasonable,” said Cynthia Cox, vice president and director for the program on the ACA at KFF.

PolitiFact reporters Jon Greenberg, Louis Jacobson, and Amy Sherman contributed to this report.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.