President Barack Obama appears to have two options to flesh out healthcare spending priorities when he delivers his annual budget recommendations Feb. 2.
Political reality leaves him with these choices: Submit a status quo spending blueprint or propose new initiatives he knows Republicans will reject for the sake of shaping the healthcare debate that will be part of the 2016 presidential election.
“He's in finishing-the-job mode,” said Nancy-Ann DeParle, who served as Obama's deputy chief of staff for policy before stepping down in 2013. “I'm assuming that the budget will just be in the mode of ensuring that CMS is able to continue implementing” the Patient Protection and Affordable Care Act, she said.
Obama, during his recent State of the Union address, touted the coverage achievements of the ACA as an integral part of the economic recovery that he characterized as vindication of his policies over the past six years.
“In the past year alone, about 10 million uninsured Americans finally gained the security of health coverage,” Obama said in the annual address.
One notable exception to DeParle's more-of-the-same prediction did surface in the address in Obama's call for a “precision medicine” initiative. Few details have been released, such as how much it would cost or which agencies might receive funding. But precision medicine typically refers to the use of genomics to tailor treatments to the individual based on a DNA analysis.
The president, in recent budgets, has generally yielded to the climate of fiscal austerity on Capitol Hill.
Last year's recommendations, for example, proposed essentially flat budgets for the National Institutes of Health and the Food and Drug Administration, and more than $400 million in cuts to Medicare over a decade.
But since Democrats got drubbed in November's midterm elections, leaving Obama as a lame duck facing a hostile Congress, the president has seemed to pay little heed to what may be embraced on Capitol Hill before acting.