Biden Steps Up as Republicans Struggle to Outline Budget Cuts

The president has tried to highlight years of Republican proposals that call for scaling back popular — and increasingly expensive — federal programs.

VIRGINIA BEACH — President Biden accused Republicans of “playing politics” with people’s lives on Tuesday as he tried to strike a contrast between his plans to expand access to health care and Republican efforts to cut into federal programs to reduce the budget deficit.

Republicans have not officially said whether their plans to balance the federal budget include cuts to the Affordable Care Act or Medicaid, but they have signaled that they are willing to scale back the programs.

Without a public consensus from conservative lawmakers, Mr. Biden seemed happy to step up and speak for them. After he spent the first minute of his remarks discussing his health struggles, Mr. Biden said that scores of Americans were worried about rising health care costs, and that Republicans were not interested in helping.

“Make no mistake: MAGA Republicans are trying to take away people’s health care,” Mr. Biden said at a community center in Virginia Beach, referring to the hard-right flank of the party loyal to former President Donald J. Trump.

Mr. Biden will release his budget on March 9 at a time of deep political polarization over the economy and a fight over the debt limit. Republicans, who hold the majority in the House, have refused to raise the debt limit unless Mr. Biden accepts deep cuts in federal spending. The president has said that the White House will not negotiate.

Instead, on Tuesday, Mr. Biden defended Democratic efforts to expand provisions of the Affordable Care Act, the landmark health care law that has withstood some 13 years of Republican attempts to repeal it. He also touted a law that requires Medicare to bargain with drug manufacturers on behalf of seniors to lower their prescription costs.

Mr. Biden said he wanted to continue his efforts to make health care more affordable by instituting a nationwide cap of $35 a month for insulin, a measure that failed last year and is unlikely to pass in a majority-Republican House.

A record 16.3 million Americans signed up for health insurance plans through the law’s marketplaces during this year’s open enrollment period, a sign of its enduring popularity. But it has also become more expensive for the government: Generous new policies that were introduced during the coronavirus pandemic have made more health care subsidies available to Americans across income levels.

Mr. Biden said his budget would pay for increasing Medicare, Social Security and health care costs by increasing taxes. The proposal, which revisits a so-called billionaire tax Mr. Biden introduced in last year’s budget, faces slim odds in a divided Congress.

In recent weeks, Mr. Biden and his advisers have tried to draw attention to Republican proposals that call for scaling back federal health care programs, starting with his State of the Union address, in which he accused Republicans of threatening Social Security and Medicare, which offers federal health insurance for older Americans.

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Senator Rick Scott of Florida, who had proposed the plan, subsequently stopped promoting the entitlement cuts, with Mr. McCarthy later adding that those were “completely off the table.

“I was pleased to see so many Republicans stand up,” Mr. Biden said on Tuesday, mocking Representative Marjorie Taylor Greene for shouting at him as he accused conservatives of wanting to eliminate entitlement programs. “They all stood up. They’re all on camera.”

The federal government has run a budget deficit every year since 2000, forcing it to borrow money and add to a national debt that now sits at $31.4 trillion. The Committee for a Responsible Federal Budget recently estimated that it would require $14.6 trillion in deficit reduction to balance the budget over the next decade.

House Speaker Kevin McCarthy has called the president’s refusal to negotiate on spending cuts “childish.” On Tuesday, a spokesman for Mr. McCarthy did not return a request for comment about the president’s accusation that Republicans were poised to propose deep cuts to the Affordable Care Act and Medicaid.

On Tuesday, Mr. Biden said that Mr. McCarthy was “not a bad guy,” but called on the speaker and other Republicans to release a budget plan on the same day Mr. Biden releases his: “We can agree and we can disagree, and we can fight it out.”

The United States, which borrows huge sums to help pay for everything from military salaries to Social Security benefits, hit its $31.4 trillion borrowing cap on Jan. 19. Since then, the Treasury Department has been employing what are known as extraordinary measures to ensure that the government has enough to pay what it owes, including payments to bondholders.

A Washington think tank warned last week that the United States faces a default sometime this summer or early fall if Congress does not raise or suspend the debt ceiling.

“They voted three times to keep paying America’s bills to pay the debt without preconditions, without crisis,” Mr. Biden said, a reference to Republicans voting to raise the debt limit under Mr. Trump. “If they paid the American debt then, then why in God’s name are they threatening not to pay it now?”

Republicans have yet to release a specific plan to balance the budget, which has left room for the president to go on the offensive and portray the party as extreme. Mr. Biden has argued that lawmakers must raise the cap to fund obligations that Congress — including Republicans — have already approved.

In Virginia Beach, the president also warned that Republicans seeking to cut into Medicaid entitlements run the risk of dismantling an already fragile rural hospital system. The Affordable Care Act’s Medicaid expansion has provided some $12 billion to hospitals, many of them rural, and three-fourths of hospital closures have occurred in states that have not expanded Medicaid benefits, according to figures released by the White House.

“Communities depend on these hospitals,” Mr. Biden said. “Not getting Medicaid would shut many of them down.”

Mr. Biden on Tuesday mentioned a budget plan by Russell Vought, a former senior Trump administration official, that has been referenced by Republicans as they hash out their budget priorities. Mr. Vought, who did not respond to a request for comment on Tuesday, leads a Trump-aligned think tank called The Center for Renewing America. He recently released a budget plan that would slash Medicaid coverage and cull $600 billion from the Affordable Care Act.

On Monday, Representative Jodey C. Arrington, Republican of Texas and the chairman of the House Budget Committee, told Reuters that lawmakers were reviewing items “consistent” with what is in Mr. Vought’s plan. A press secretary for Mr. Arrington did not return a request for comment.

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