Medicare will eventually be able to negotiate the prices of 20 drugs under the current law, but White House officials told reporters Wednesday that Biden will propose expanding that number to 50 and bringing more drugs into the program sooner.   

Biden will also propose extending Medicare’s $2,000 annual cap on out-of-pocket drug costs to people with commercial insurance, officials said, as well as the law’s penalty on drugmakers who raise prices faster than the rate of inflation.   

The policies that the president is set to pitch to Congress represent the Biden campaign’s effort to remind voters of the administration’s actions to lower health costs, even though many of the biggest wins won’t take effect this year, while also trying to showcase a path forward for the next four years.   

The administration is focusing on pocketbook issues aimed at helping families keep expenses in check by tying health policies to Biden’s economic successes and drawing a contrast to former President Trump. 

The proposals would also represent a major expansion of the Inflation Reduction Act. While the law was sweeping, many of its biggest health provisions only apply to Medicare rather than the commercial market because Democrats had to scale it back in order to pass it through the Senate.   

Still, the policies represent a wish list and are not likely to be enacted with Republicans in control of the House. In addition, the proposal to expand Medicare negotiations would likely see fierce pushback from the drug industry. 

The administration has already entered negotiations with manufacturers for the first 10 drugs in the program, though the final prices won’t take effect until 2026. There are multiple industry lawsuits challenging the policy, and a Republican president could potentially derail the changes before they take effect.