Administration of Joseph R. Biden, Jr., 2023

February 28, 2023

The President. Hello, hello, hello! Iââ

Audience member. We love you, Joe! [Laughter]

The President. Robin, you know, my dadâ[applause]. And by the way, you docs are good, but if there's any angels in Heaven, they're all nursesâmale and female. [Laughter] You know why? You guys let usâyou guys make usâallow us to live. Nurses make you want to live. I'm not joking. You lie there in the ICU, which I've done for a long time, and you look at those machines. And you know, the line goes flat, that it's over. But you just get tired. You don't care.

When I was at Walter Reed all that time, after a couple of craniotomies, I was lying there. And I had a nurse named Pearl Nelson, military. She'd come in and do things that I don't think you learn in medicalâin nursing school. [*Laughter*] She'd whisper in my ear. I didn'tâcouldn't understand her, but she'd whisper, and she'd lean down. She'd actually breathe on me to make sure that I wasâthere was a connection, a human connection. She even went home and brought back her pillow from her own bed because they didn'tâknew the one I had wasn't comfortable.

But I'm not joking. My son Beau came back from Iraq after being, all that time, within shouting distance of a burn pit. He had stage-4 glioblastoma. He went as an incredibly healthy guy, came back. And for 18 months, he fought. And the nursesâthe docs were incredible. But the nurses would sayâtoward the end, they'd come in to look at him, and they'd say: "No, no. Not now, Doc." And the doctors knew enough to know that it wasn't the time. The nurse didn't think it was there.

You're so underestimated. You really are. And in no way is to diminish doctors, but I want to tell you something. Nursesâsingle most underestimated profession in the world. Thank you, thank you, thank you.

And Robin talking about her journeyâmy dadâif you have a seat, please take it. If you don't, come on up on stage with me. [*Laughter*] You knowâand, Robin, thank you for that introduction. Robin, my dad used to say it a little differently. My dad used to say everybody needs a little bit of breathing room. Just a little bit of breathing room. At the end of the month, can you in fact pay your bills and still be certain your family is going to be okay?

We lived in a threeâwe weren't poor; we were a typical middle class family. Four kids. We lived in a three-bedroom split-level home with a grandpop. And my headboard was up against the wall where my dad is on the other sideâmy dad and mom.

One night, I remember my dadâyou could hear how restless he was. When I got up the next morningâI was in high school, my senior yearâand I said: "What's the matter, Mom? What's the matter with Dad?"

She said, "His company just dropped health insurance." Well, you know, a lot of people face that. A lot of people worry about it right now. But he said: "Just a little breathing room. A little bit of certainty. Just a little bit of certainty." It matters.

So, Robin, thank you for the introduction.

And Mayor Bobby Dyerâthe mayor came out toâI told the mayorâhe was very gracious with me, even though I'm one of those Democrats. [*Laughter*] Bobby, where are you? There you are. He came out to the airport to greet me. And I said: "You know what the worst sentence in the

English language is? 'I'm at the airport.'" [*Laughter*] Thank you again for your graciousness, Mr. Mayor. I appreciate it very much.

And to all the mayorsâall the mayors, stand up. Come on. All the mayors stand up.

Toughest job in American politics. You know why? You all know where they live. [*Laughter*] No way to go to the Dunkin' Donuts or the local store without, "Mr. Mayor, what about this?" But, anyway, thank you for what you do. I really genuinely mean it.

And it's great to be back in Virginia Beach, home of so many brave women and men who served our Armed Forces and thisâmake this Nation so strong. I really mean it.

Although they couldn't be here today, you have two amazing Senators. You know that. Tim Kaine and Mark Warner. They are true champions of this great State.

And Representative Bobby Scott, a lifelong fighter for Virginia workers and families, who's back in DC introducing what we call the PRO Act to make sure unions have an equal right to organize if they want to organize.

And I want to thank all the health care workers here today whoâ[*applause*]âno, I really mean it. Thank you. Thank you. By the way, you care for people when they need it most. But the most important thing isâyou know what you do when you help someone in trouble, in need?

You provide them the dignity they're looking for. The dignity. Just to be treated with dignity.

That's what all Americans deserve. Peace of mind that comes from knowing that an illness, if it strikes, or an accident occurs, you can get quality medical care and recover and heal.

But we all know that too many folks don't have that peace of mind. Too many folks lie in bed at night staring at the ceiling, wondering what will happen if their spouse gets cancer or their child gets sick or something happens to them. Will they have toâwill they have the money to pay the medical bills? Will they have to sell the house?

I get it. That's why, since I was sworn in as President 2 years ago, my administration has focused intensely on getting more people affordable health care and bringing down medical costs so you have a little bit of breathing room again. Just breathing room.

And that's exactly what happens when we protect and strengthen programs like Medicare and Medicaid, which millions of Americans rely on. Millions.

And it's been my focus, and I believe we made significant progress. Now we need to finish the job. And that's what I'd like to talk about a littleâa little bit about today.

My plan that's in stark contrast to notâby the way, there's an awful lot of really good Republicans, but the MAGA Republicans are a different breed of cat. [*Laughter*] No, they're not bad or good. It's just veryâthey're very different. There's kind of like, in my view, sort of two Republican parties.

And I've served a long time. Some of my closestâas that joke goes, but not a jokeâmy closest friends in Government have been my Republican colleagues in the Senate. And folks in Congress, they want to eliminate a lot of health care coverageâthose MAGA Republicansâ increase costs for millions of Americans, and make deep cuts in programs that families and seniors depend on. And that's what's at stake now.

Two years ago, when I was sworn in, the economy was reeling, and the pandemic was raging. We lost over a million people. Hard to believe, but over a million people. And our health care system was at the breaking point.

And all the health care workers here remember better than anyone those dark, dark months as the number of COVID deaths kept rising and hospitals had to have patients in hallways,

literally setting up tents in their parking lots, in a situation where everyâbecause everything was full. Every bed was full. And that's what we were up against when I took office.

We immediately got to work. We turned it around. I signed into law the landmark American Rescue Plan, which provided the resources to get COVIDâ19 under control, our economy back on its track. And many of you worked around the clock to get people vaccinated against COVIDâ

19. We went from 3.5 million people vaccinated when I took office to 230 million fully vaccinated today.

We made vaccinations available to all Americans with a plan based on equality.

Many of you went into communities that had been ignored in the past. You went into public housing areas. You went to places where they didn't usually go to make sure that everyoneâ everyoneâhad equal access to this lifesaving shots. And it worked. And we came through, but with a terrible cost. As I said, over a million people died from the virus.

In addition, we expanded health insurance for millions under the Affordable Care Act by making it easier to sign up and by making it cheaper to get better health care in the Affordable Care Act, saving families $800 a year. Where I come from, $800 matters.

The result is, more than 3 million people have newly signed up to the Affordable Healthcare Act. And today, more Americans have health insurance under the Affordable Healthcare Act than ever before.

And, folks, it didn't stop there. Americans pay more for prescription drugs than any nation on Earth. Let me say that again: In the United States of America, we pay more for prescription drugs than anyâanyânation on Earth. And I've been fighting for years as a Senator and as a Vice President to get Medicare to be able to negotiate lower drug prices with these companies.

Guess what? The only outfit they couldn't negotiate withâyou know, but that's how the VA works, and it should workâthey negotiateâsay, "We're willing to pay x amount of dollars for that particular treatment." And if you wanted any help onâfrom the VA system, you pay thatâ you charge that or no more.

Well, finally, we got it done. I signed the historic Inflation Reduction Act. We took on powerful interests, bring down health care costs so you can sleep better at night. And it's had profound impact.

For example, 1 in 10 Americansâ1 in 10 Americansâhas diabetes. Every day, millions need insulin to control their diabetes to stay alive. Insulin has been around for a hundred years. The cost to make that drug and package it isâmake it, $10, and package it, $13. But you've been paying three, four, five hundred dollars a month for that. But Big Pharma has been unfairly charging you thatârecord profits. Not anymore.

We capped the cost of insulin at $35 a month for seniors on Medicare.

When I introduced it, it was for all Americans. We've got over 200,000 kids with type 2 diabetes that are not covered. But guess whatâtype 1 diabetes. It saves their lives.

But here's the deal: Myâsome of my friends cut out everything but the Medicare piece. But guess what? We've got it covered for everybody. We've got to finish the job.

And by the way, look at the profit margins of these companies. They're hundreds of billions of dollars. It's not like they're getting hurt. Come on.

Let's cap the cost of insulin at $35 a month for every single American who needs it. We're the only country who doesn't do that.

This law also caps out-of-pocket drug costs for seniors on Medicare at a maximum of $2,000 a year, no matter what drug you have to take. Total.

And a lot of you know we're making real progress in my cancer initiative. Cancer drugs, though, can cost up to $10-, $12-, $14,000 a year. But you're never going to have to payânext yearâmore than $2,000 a year for all the drugs you consume.

Plus, if drug companies raise prices faster than inflation rises, they'll have to pay Medicare back the difference. And guess what? It's not only fair, it reduces the deficit when you do that. Folks, we're really giving Medicare the power to negotiate lower drug prices, just like the VA has done for years for veterans.

Bringing down prescription drug cost doesn't just save money for seniors and Medicare; it's going to have a significant effect on the Federal deficit. It's going to lower the debt by $159 billion.

And you say, "Well, how can that be, Joe?" Well, right now the Governmentâour tax dollars pay out through Medicare the help for the prescription drugs. If they have to pay out 150

â159 thousandâbillion dollarsââ

[*At this point, the President stared at the audience.*]

ââ[*laughter*]âless for prescription drugs, then it reduces the deficit. So, folks, it's a win- win. It saves taxpayers money, it makes Medicare stronger, and it reduces Government spending overall. For years, we've been trying to make that happen, Democrats and Republicans. For years, Big Pharma has been able to block it.

But at long last, we got it done. This is historic progress. And I wish I could say my friends on the other sideâall of my friends on the other sideâare there to protect and defend and build on it like I am.

Again, sadly, the MAGA Republicansâthe Congress or those in Congress who threaten to undo the gainsâthey want to do away with the Affordable Care Act. Some threaten to default on the national debt unless I accept certain economic plans.

Now, let me explain the national debt. You all knowâwe think we all know it. It's the accumulated debt over 200 years. Every year it's accumulated, over 200 years. The Federal Government has never, ever once reneged on that debt. We've never questioned our credit. And guess what? Let's remember the last administration increased the Federal debt by 25 percent. The 200-year debtâin 4 years, they increased it by 25 percent. Two hundred years.

And, folks, how did Congress respond? Well, quite frankly, they did the only responsible thing: They paid the debt. They voted three times to keep paying America's bills to pay the debt without preconditions without a crisis. If they paid the American debt then, why in God's name are they threatening not to pay it now?

So, folks, it's not all the other team. I'm not saying everybody on the other team says that. But it's just politics. And we've got no business playing politics with the lives of the American people and our Nation's economy.

Folksâand by the way, you know, you hear anâads of "Big-Spendin' Joe Biden." In 2 years, I reduced the debt $1.7 billionâ$1.7 billion [trillion; White House correction], the largest deficit reduction in American history.

And I met with the new House Speakerâwho's not a bad guyâabout how we should proceed to settle our differences without jeopardizing the full faith and credit of the United States of America, which would be a disaster in terms of our economy.

Here's what he saidâwhat I said to him, actually: Instead of making threats about default, which could be catastrophic even if doesn't happen, because the markets around the world begin to hedge against it and it affects economies, let's take that off the table. And let's have a conversation about how we're going to grow the economy, lower the costs, and reduce the deficit, each of us.

I said, let's lay out our respective budgets. On March the 9, I'm going to lay down in detail every single thingâevery tax that's out there that I'm proposingâand no one over 400âmaking less than $400,000 is going to pay a penny more in taxes. But lay it out by March 9, everything, and what we're going to cut, what we're going to spend, what we're going to. Just lay it on the table.

And I've invited them toâRepublicansâthat they should do the same thing: lay their proposal on the table. And we can sit down, and we can agree, disagree. We can fight it out.

When I introduce my budget, you'll see that it's going to invest in America, lower health costs, and protect and strengthen Social Security and Medicare while cutting the deficit more than

$2 trillion over the next 10 years.

But by the way, I want to make it clear, I'm going raise some taxes. Many of you are billionaires out there. You're going to stop paying at 3 percent. [*Laughter*] Not a joke.

The idea that a billionaireâwe used to have 600 or so in the United States of America; now there's 1,000. The idea that they pay at a rate that is lower than the rate of a police officer, a schoolteacher, a nurse, is bizarre. You're going to see the people making less than $400,000, as I said from the very beginning, will not pay an additional single penny in any tax.

If I can hold a second. One of the reasons I was able to keep the debt down this time aroundâthey'reâthe Fortune 500 companies, they're good companies. Iâand by the way, I come from the corporate capital of the world, Delaware. [*Laughter*] More corporations are incorporated in the State of Delaware than every other State in America combined. I got elected 36 years' worthâ[*inaudible*]. So I'm not anticorporation, but I think everybody should pay aâ take a fair shot, pay a fair share.

Now, look, here's the deal: The reason weâI was able to lower the deficit and still expand programs, like health care, was, there were 55 corporations in 2020, when I came to office, who made $40 billion and didn't pay a single penny in taxânot one penny. Well, guess what? I did a terrible thing. I got passed, overwhelmingly, with just my team's voteâI got passed a 15-percent tax. My God, 15 percent.

Raise your hand if you'd accept a 15-percent tax? [*Laughter*] No, I'm not joking. Well, it raised enough money to allow me to do the things I've been able to do. Fifteen-percent minimum tax. Like I said, $40 billion in profit. That's just 55 corporations who paid zero.

As for my MAGA Republican friends, they say they want to reduce the deficit. Well, we did the math. Based on what we know so farâthey could change their mindsâtheir plans would explode the deficit, increasing it more than $3 trillion over the next 10 years.

Here's what they want to do: They want to cut taxes for the very wealthy, again. They want to cut taxes for large corporations. They want to take back the power we just gave Medicare and Medicaid to negotiate, which would raise prices. And they would have huge giveaway to Big Pharma and cost taxpayers billions of dollars. And if they say they want to cut the deficit, but their plans actually would explode the deficit, how are they going to make the numbers add up? What are they going to cut? That's the big question.

For millions of Americans, health care hangs in the balance. Will they continue to fight to cut the Affordable Care Act and make health insurance more expensive for millions of

Americans? Republicans have been trying to undo the Affordable Care Act since it passed 13 years ago. They voted to change or repeal the actâthis is a fact; it's on the recordâmore than 50 times in 4 years that it existed. Fifty times. And they made repealing it part of virtually every Republican budget since the law was passed, from the Trump administration budgets to congressional budgets to their budget plans from just this past year.

So let's be clear about the consequences. If you get rid of the Affordable Care Act, it would mean that more than 100 million Americans with preexisting conditions would lose the critical protections they have now. The only reason people with preexisting conditions, who don't have private insurance, are able to pay is because they have the Affordable Care Act.

But by the way, if they cut the Affordable Care Act, millions could lose free preventive care, like cancer screenings. Millions could lose basic services, like maternity care, which insurers would no longer have to cover.

Up to 3 million young adults would lose access to their parents' health insurance, which they're on right now, if the Affordable Care Act goes. They're the facts. I'm not making any of it up. As they used to say, as evenâis no longer relevantâbut Google it. You know, you'll see. [*Laughter*]

And nearly 40 million Americans would be in danger of losing health coverage completely. That includes millions of low-income Americans who currently get their health insurance through Medicaid, which the Affordable Care Act expanded in 39 States. And it includes millions of middle class and working class families who currently are covered by the ACA Marketplace.

Even if they did manage to keep their health insurance, it would cost them thousands of dollars more per year than it does now. That's just a glimpse of the damage of repealing the Affordable Care Act would do.

You know, the MAGA Republicans in Congress areâwantâdo they still want to cut Medicaid? Well, the former Trump Budget Director, who's now advising themâthat is the Republicans in the Houseâon their fiscal strategy has a plan to slash over $2 trillion from Medicaid.

Audience member. Boo!

The President. Well, whether it gets passedâI'm notâthat's the plan. Okay?

He wants to end Medicare [Medicaid; White House correction] expansion under the Affordable Care Act and then additional deep cuts that could lead to nearly 70 million people losing critical services. Most of them are seniors, people with disabilities, and children. Some could lose their health insurance altogether.

Millions of seniors and people with disabilities who depend on Medicaid to help pay for their home care, including home health aides, could lose their ability to remain in their homes. And by the way, it saves the Government money if they're home and not in a nursing home.

And those long waiting lists for home care, which has gone down under the last 2 yearsâthe last 5 years 20 percent, would likely rise again, and States with no waiting lists would likely have them again.

Medicaid also pays for nursing home care for about two-thirds of all Americans who live in nursing homes. Cut Medicaid, and the quality of care at nursing homes goes down because the help goes down, the salaries go down, access goes down.

Rural hospitals across the country that depend on Medicare [Medicaid; White House correction] to cover uncompensated care could close their doors. Already, more than 500 rural hospitals across the country are in risk of closing.

You know what the statistics show? If in fact you have a serious accident and you're in a rural community, you have a four-times greater chance of dying than if you had the same exact accident in a community that is more populated, because you can't get to the hospital. You can't getâmany places throughout the Midwest, you have to drive 30, 40 miles to get to a hospital. By that time, you're dead. Not a joke. It's not hyperbole. It's a fact.

And so, folks, lookâin fact, twoâfrom 2010 to 2021, over 130 hospitalsârural hospitals did close. Entire communities depend on these hospitals. Getting Medicaid would shut many of themânot getting Medicaid would shut many of them down.

Studies show, further, that the more likely you are to pass or have serious injury, the further you are from access to a hospital.

At the time when so many of our kids are dealing with the painful mental health challenges, millions could lose access to mental health care as well.

At a time when so many of our loved ones and neighbors are struggling with opioidâ epidemic, the millions could lose access to drug treatment facilities. It would be devastating.

What about Social Security and Medicare? Well, are they safe? During the State of the Union, as some of you may have seenâ[*laughter*]âI wasâI've been around for a lot of State of the Unions. [*Laughter*] I never saw one where the President got to negotiate in the open with everybody. [*Laughter*] I was pleased to see so many Republicans stand up. Remember when Marjorie Taylor Greene was yelling: "Liar! Liar! Biden's a liar!"? [*Laughter*]

[*The President made the sign of the cross.*]

[*Laughter*] I'm going to be good. I'm going to be good.

They don't want to cut anything. Iâso Iâwhen I askedâI said: "Okay, you don't want to cut anything? Everybody who says we're not going to cut Medicare or Social Security"âwhen I asked them to join us and reject the cuts to Medicareâwasn't it something? They all stood up. [*Laughter*] They all stood up. And they're all on camera. [*Laughter*] Got all their pictures.

Like I said, I believe in conversion. [*Laughter*] Maybe they foundâas my grandfather said, "Maybe they found religion"â[*laughter*]âon Social Security and Medicare. I sure hope soâall kidding aside. But I'll believe it when I see it.

For example, Senator Rick Scott of Florida, the guy who has been saying for a yearâfor a long time that he wants to sunset Social Security and Medicare every 5 years. What that means is, every 5 years, it comes up; if you don't vote for it back in existence again with the sameâexactly like it was, it goes away. Or you can reduce it. You can do whatever you want. But every 5 years, it has to be voted on.

Now he says: "Never mind. Don't need to do that." [*Laughter*] Although I noticed he didn't say "never mind" about Medicaid and the Affordable Care Act. They're still on the chopping block even in Senator Scott's plan.

Look, make no mistake: If MAGA Republicans try to take away people's health care by gutting Medicaid and the Affordable Care Act, I will stop them.

Folks, here's the bottom line. The work that we've done to get more people affordable health care and bring down the cost is going to reduce the deficit significantly. It's making a real difference in people's lives. It means more security, more dignity for millions of families.

We've got more work to do, but we've made a lot of progress.

I was in the northern part of your State about a year ago, doing a town meeting. And a woman stood up and started talking about the cost of insulin. She said, "I have two kids." And she

went on. She was very articulate. And she got very emotional. She said: "What do I do? I don'tâ can't afford the insurance. Whatâhow do I look at my child and say 'I can't help'?" "I can't help." But I'd like you all to put yourself in that position. Your child has type 2 diabetes. She said, "We share the insulin."

What do you do? Imagine being in that circumstance. There's no means by which you couldâwe've changed it now. We've changed it in terms ofâwe haven't changed it permanently, in terms of making the same requirements for theâfor all people as they do for the elderly on Medicare.

Folks, families across the country are starting to breathe just a little easier. We've just got to keep it going.

I've long said it's never been a good bet to bet against the American people. And I can honestly say, as I stand here today, I've never been more optimistic about America's future. We just have to remember who we are. We are the United States of America.

And there is nothingânothing, nothing beyond our capacity. When we work together, we can do anything.

So God bless you, and may God protect our troops. Thank you, thank you, thank you.

NOTE: The President spoke at 3:06 p.m. at the Kempsville Recreation Center. In his remarks, he referred to Virginia Beach, VA, resident, Robin Kessler; Speaker of the House of Representatives Kevin O. McCarthy; former Director of the Office of Management and Budget Russell T. Vought; Rep. Marjorie Taylor Greene; and Midlothian, VA, resident Shannon Davis and her sons Joshua and Jackson. He also referred to his sister Valerie Biden Owens and brothers James B. and Francis W. Biden.

Categories: Addresses and Remarks : Health care costs in Virginia Beach, VA. Locations: Virginia Beach, VA.

Names: Biden, Francis W.; Biden, James B.; Davis, Jackson; Davis, Joshua; Davis, Shannon; Dyer, Robert M. "Bobby"; Greene, Marjorie Taylor; Kaine, Timothy M.; Kessler, Robin; McCarthy, Kevin O.; Owens, Valerie Biden; Scott, Richard L.; Scott, Robert C.; Trump, Donald J.; Vought, Russel T.; Warner, Mark R.

Subjects: Cancer research, prevention, and treatment; Corporate tax rates; COVIDâ19 pandemic; COVIDâ19 vaccines; Economic improvement; Eldercare and home health services; Federal deficit and debt; Health care costs and affordability; Health care workers, service and dedication; Health insurance exchanges; Health insurance, access and availability; Insulin cost controls; Medicare and Medicaid programs; Mental health programs and services; Opioid epidemic, efforts to combat; Prescription drug costs, reduction efforts; Public debt limit; Social Security program; Speaker of the House of Representatives; Tax Code reform; U.S. servicemembers, service and dedication; Virginia, President's visit.

DCPD Number: DCPD202300146.