Obama sees 'hard choices' on health costs

President Barack Obama used his second inaugural address to underline his promise to reduce federal healthcare costs without cutting benefits. In an address light on healthcare references, he never mentioned his signature healthcare law, which launches its major provisions next year.

Obama's speech echoed campaign trail comments that while changes are needed to keep Medicare and Medicaid solvent, they should not impact beneficiaries.

“We must make the hard choices to reduce the cost of healthcare and the size of our deficit,” he said. “But we reject the belief that America must choose between caring for the generation that built this country and investing in the generation that will build its future.”

In the run-up to another round of discussions on changes to the federal entitlement programs, Obama framed the federal healthcare programs in the sharp terms of a divisive election that turned in part on Republicans' proposed changes to the federal entitlement programs.

“The commitments we make to each other with Medicare and Medicaid and Social Security—these things do not sap our nation, they strengthen us,” he said. “They do not make us a nation of takers; they free us to take the risks that make this country great.”

Senate Republican Leader Mitch McConnell (Ky.) released a statement after Obama's speech echoing the need to address the “unsustainable federal spending and debt.”

“Republicans are eager to work with the president on achieving this common goal, and we firmly believe that divided government provides the perfect opportunity to do so,” he said.

Obama never directly addressed the Patient Protection and Affordable Care Act, on which the 2012 election was seen by many as a referendum.

However, Obama made several oblique references to benefits the law provides. He decried a time when “parents of a child with a disability had nowhere to turn.” That could have referred to the law's expected expansion of insurance coverage to about 30 million people without insurance or its ban on insurer coverage denials for pre-existing conditions.

The president and other speakers at the inaugural repeatedly referenced the work that lies ahead for his final term in office. And much of that work will include implementation of many of the landmark healthcare law's most far-reaching provisions, such as the launch of health insurance exchanges later this year, the expansions of Medicaid in states that choose that option and educating the uninsured in how to purchase coverage for the first time.