James S. Brady Press Briefing Room
1:03 P.M. EDT
Q Good afternoon.
MS. JEAN-PIERRE: Good afternoon. Oh, it's usually very quiet in here. You guys are, like, chatting about.
Okay. So, good afternoon. As you know, we have two — two guests today. Neera Tanden is here, and we'll have the — the FEMA Administrator with us here shortly. She's currently in the Oval Office briefing the President. So, as soon as she gets out, she'll join us.
So, a couple of things at the top, and then we'll get going.
So, in today's bilateral meeting, President Biden and President Chaves of Costa Rica will continue to deepen the strong relationship between our two countries. Costa Rica has been a regional leader. They are a strong democracy with a thriving economy and leading by example on migration management.
Costa Rica is an endorsing — is an endorsing country on the Los Angeles Declaration on Migration and Protection, and has led the way in offering protections and legal pathways to vulnerable populations.
During their meeting, President Biden and President Chaves will discuss how we can continue to expand and strengthen these legal pathways as an alternative to irregular migration.
The two leaders will also discuss how they can continue to work together to strengthen economic ties and build inclusive and resilient economies by developing supply chains and creating good family-sustaining jobs for our people.
We'll have a readout after the meeting as we normally do, but one thing you'll see is an even closer partnership between the two countries coming out of today's bilat.
Also today, the Biden-Harris administration is announcing a new package of security assistance for Ukraine to meet Ukraine's critical security and defense needs. It includes additional mine-clearing equipment, missiles for air defense, ammunition for artillery and HIMARS systems, and over 3 million rounds of small arms ammunition.
This package will help Ukrainian forces on the battlefield and support its air defenses as Russia continues to launch brutal — brutal strikes against the people of Ukraine, including attacks this past week that ha- — that have taken the lives of innocent Ukrainian civilians.
The Kremlin could send — could end this war. They can end it today anytime by withdrawing its forces from Ukraine and stopping its brutal attacks. Until it does, the United States and our allies and partners will stand with Ukraine for as long as it takes.
Now today, as you've all been reporting and you've heard from us already, we are taking another important step in bringing the President's historic Infla- — Inflation Reduction Act to life for the American people.
This morning, Medicare announced the first 10 drugs selected for price negotiation for the first time ever, which will reduce healthcare costs for American families and lower the deficit as well.
With more on the President's plan, as I mentioned at the top, I'll turn it over to Domest- — to the President's Domestic Policy Advisor, Neera Tanden, who's back a second time in just, like, less than two weeks or something like that.
The floor is yours.
MS. TANDEN: Thanks, Karine. Good afternoon, everyone.
Millions of Americans struggle to afford prescription drugs. We understand that. Far too many Americans have to ration prescriptions, cutting a pill in half or taking a lower dose than they need, because their drugs are simply too expensive.
One in five seniors struggle to pay for prescription drugs. In fact, Americans pay two to three times more for pre- — prescription drugs than citizens in other developed countries.
Meanwhile, Pharma has spent hundreds of millions of dollars to stop Medicare from negotiating lower costs. In fact, years ago, they got a special carveout that prohibited drug negotiation that allowed Pharma to charge whatever they can.
For decades, we've been talking about giving Medicare the power to negotiate lower drug prices. President Biden actually got it done. Under the Inflation Reduction Act, finally Medicare will be able to negotiate lower prescription drug costs for seniors and other beneficiaries.
This is a historic victory. In fact, over 80 percent of the public supports giving Medicare the power to negotiate lower prescription drug costs.
Today, as Karine pointed out, the Centers for Medicare and Medicaid Services announced the first 10 drugs selected for Medicare price negotiation. These 10 drugs are taken by 9 million seniors. They cover chronic conditions like cancer, heart disease, arthritis, and diabetes that can cost up to $14,000 per month.
For example, over half a million Medicare beneficiaries rely on one of these drugs, Entresto, to treat their heart disease. These — this drug costs less than $150 in Australia and over $300 here in the U.S.
Imbruvica, one of the selected drugs that treats cancer, costs $6,000 a month in France. In the United States, it's almost $14,000 a month — more than double.
Last year, about 9 million Medicare beneficiaries spent over $3.4 billion in these dru- — 10 drugs.
An additional 15 drugs will be selected for negotiation each of the next two years and then 20 drugs a year going forward.
Allowing Medicare to negotiate lower prices will bring more cost savings to American families. It will give them breathing room and peace of mind. It will make a real difference for millions of Americans.
And with that, I'm happy to take your questions.
Q This is obviously, you know, a major step forward in the Inflation Reduction Act. The lower prices won't take effect until 2026. The President has sometimes said, you know, the America people need to be patient to see the benefits of this program. Is that, you know, too long for people to wait? And are you worried that Americans may not see those benefits, you know, and the connection to the Inflation Reduction Act?
MS. TANDEN: Well, first and foremost, the Inflation Reduction Act is already delivering benefits. Already, there's $35 insulin for seniors. And I would note that many providers have replicated that for the private sector.
There are also lower costs from people who are trying to get healthcare from the America — the Affordable Care Act; that's $800 a year for 15 million people. It's to lower savings — lower — increase savings for them.
And the inflation rebate aspect of the drug bill, which basically provides that insur- — drug — drug — pharmacy — pharmaceutical companies that are charging higher than inflation — that if prices are going higher than inflation, they have to pay a rebat- — rebate back to the Medicare system.
So those are all creating savings for Americans now.
Q Thanks, Karine. A quick follow-up on that. Obviously, consumers don't see the benefits until 2026. How concerned is the administration that Republicans could potentially derail the process by then and roll back these negotiations after the next election?
MS. TANDEN: Well, I would say, first and foremost, this — Medicare's ability to negotiate drug prices is hugely popular; 80 percent of Americans support the ability to negotiate drug prices.
I do think it's important to point out that many Republicans opposed the Inflation Reduction Act and, obviously, opposed the ability to negotiate drug prices. So, they are on the side — they have been on the side of allowing pharmaceutical companies to charge whatever they can, and that's what the American people really oppose.
As I've said in other — at other times, I was part of the team that negotiated the Affordable Care Act. I was here during the — I was — I was arguing for the Affordable Care Act when Republicans were trying to repeal the Affordable Care Act. During the Trump administration, they fought tooth and nail to do so. But because the Affordable Care Act had delivered lower prices — basically, it delivered healthcare to 20 million Americans — they — they found it hard to do so.
And I think, given the insulin reduction — the $35 insulin costs that people are bearing now; the fact that in — that people will see that these — these 10 drugs are being negotiated at price will be provided in September of 2024 — that will be public-ed — I think it would be hard to repeal the Inflation Reduction Act.
And it's specifically hard to re- — take away — basically claw back these benefits, these lower prices. I think people really rise up against that kind of thing because they know they are paying too much for prescription drugs in the United States and they are paying more than in any other country.
MS. JEAN-PIERRE: Go ahead, Selina. Welcome to the briefing room.
Q Thank you so much. The CBO estimates that the government will save around $98.5 billion over a decade with this new program. So how much of those savings will go directly to seniors on Medicare?
MS. TANDEN: So, that is savings — there is significant savings to the Medicare program, but seniors pay out-of-pocket costs for prescription drugs. In fact, the person who will be introducing the President pays significant out-of-pocket costs. So, the people who have out-of-pocket costs, this will deliver lower prices for them.
We don't know what the negotiated price will be. This is a subject in negotiation. So, we can't tell you the specific amount that people will save, but there will be savings to people both paying out of pocket and also to the Medicare program itself.
MS. JEAN-PIERRE: Go ahead, Jeff.
Q Thanks. Hi, Neera. There are currently eight lawsuits challenging this Medicare drug negotiation program. Which of those lawsuits do you see as the biggest threat to this program? And how confident are you that, you know, between now and 2026 when all this kicks in, that one of these lawsuits won't result in an injunction or preventing this program from actually going forward?
MS. TANDEN: Well, first and foremost, we should recognize that CMS, HHS negotiates drug price — negotiates prices for every other element of the healthcare system: doctors' rates, providers' rates, hospital rates.
The only reason why Medicare has not been negotiating drug prices is because Pharma got a sweetheart deal decades ago to basically prohibit negotiations.
Negotiations are part of market system. It's very normal for that to happen.
And so, we are very, very confident because, basically, it is because of the Inflation Reduction Act that we have negotiations. We are very confident in the law, and we should recognize there is no part of the Constitution that prohibits Medicare drug negotiation.
So, we are very confident and in — in these cases and very confident that the law will deliver results.
And just important to remember that basically what Pharma is arguing in these court cases is that they should have — they should have no limit to be able to charge whatever they want. And that is exactly why Americans support Medicare drug negotiation by 80 percent.
Q So, you're not especially concerned by any of these lawsuits?
MS. TANDEN: I — I mean, I refer to the Department of Justice on the particularities of the — of each litigation — or each piece of litigation.
But I would say that, first and foremost, Medicare should — Medicare's ability to neg- — negotiate drug prices is clear in the law and is — is well established.
MS. JEAN-PIERRE: Go ahead.
Q Thanks. So, one of the main criteria — criteria for selecting these drugs is lack of competition. But for at least 1 of these 10 drugs, there is actually going to be a competitor coming into the market for 2026.
So, given that, I mean, why is the government willing to come in on top of that — for that drug, and is that a waste of, effectively, a slot, you know, early on here that can be put toward a drug that actually doesn't have competition?
MS. TANDEN: The Inflation Reduction Act specifies the criteria for selection. That criteria is highest drug spend. Also, that the drugs need to be on the market for nine years or longer.
So, there will be also additional drugs, as noted. This is the first — this is the first 10. There'll be 15 next year and 15 after that. So, drugs that haven't made it on this list will — may well be on in the future.
And for particu- — particularities about the specifications of selection, I would — I would refer you to CMS.
MS. JEAN-PIERRE: Kelly.
Q Do you have any concerns that given the lead time here that the pharmaceutical industry will adjust its pricing to, sort of, compensate for an anticipated reduction? You talked about faster than inflation in certain instances. But do you get a sense that broader price inflation will happen anticipating this?
MS. TANDEN: Well, this — the — the selection of the drugs are on — on current price. So, that will be the source of the negotiation back and forth.
You know, if — if Pharma looks at price negotiation and says, "We don't want to be on the list, and we're going to lower our prices," that's all to the better. That would be a way in which this — this law is actually having the important effect of lowering drug prices across the board.
MS. JEAN-PIERRE: Go ahead, Ed.
Q Let me just take you back to what Chris was asking about first. And that is, again, the delay as to why do we have to wait until 2026 to see these changes?
MS. TANDEN: Well, the Inflation Reduction Act specified that, but I understand the — the frustration that can be out there on this topic. It's been 30 years that people have been trying to get Medicare drug negotiation.
I will say it is this president, President Joe Biden, that actually delivered it. There is a yearlong process. We will have the drug prices out by September of 2024. It takes time to implement.
But Americans today are seeing lower drug prices from the Inflation Reduction Act from insulin and in other arenas, and we look forward to the process being set by which we have lower and lower drug prices year to year.
Q So, then, let me ask you: Since it was sent by the law, for those who weren't paying attention when the law was being put together, was delaying it until 2026 a big sticking point for the Republicans or others? Why didn't the White House push to have it happen sooner?
MS. TANDEN: Well, we are — we were — we are excited by the fact that we are beginning this process and that we will have these 10 drugs and then 15 drugs after that and then 15 drugs after that and 20 drugs year to year.
So, we think it is important that these drugs — that this negotiation will take place over this year and that in September of 2024 people will see this price.
I will also note that when this price is public, other — you know, other insurers can look at that price. It is — in many arenas, private insurance has looked at CMS and Medicare as a leader in how to determine prices. So, it may well be that insurers use this — the price negotiated as prices that they use for — that they use in their own insurance models to affect the private sector.
Q Thank you so much. Trying again, I understand you don't want to comment what specific prices you're trying to achieve, but can you give us a sense of what the broader objective is here? You said that seniors paid more than $3 billion out-of-pocket for these drugs. So, in terms of bringing down, like, minus 10 percent, 25 percent — you know, half, less?
MS. TANDEN: Well, I'll say a few things. First of all, the VA negotiates drug prices and has always had the power to negotiate drug prices. It sets as — its drug prices are 50 percent what American consumers pay. But this is all subject to a negotiation.
So, we can't — we — we do not and cannot determine the price that Americans will see because that is — this is a true negotiation. And — and that will be subject for this yearlong conversation between CMS and the – and pharmaceutical companies that put out these specific drugs.
But we do expect that negotiations will drive prices significantly lower, as they have done for VA and DOD. And just to — as a reminder, VA and DOD have been negotiating drug prices for decades and pharmaceutical companies have not successfully sued them. In fact, they all stay on the formulary.
MS. JEAN-PIERRE: All right, thank you so much.
MS. TANDEN: Thank you.
MS. JEAN-PIERRE: I know you've got to go.
MS. TANDEN: Thank you so much.
MS. JEAN-PIERRE: Thank you much, Neera. Come back again.
MS. TANDEN: Okay, great. It was so much fun the first time.
MS. JEAN-PIERRE: (Laughs.) I know.
MS. TANDEN: Thank you.
MS. JEAN-PIERRE: Thank you. Thank you so much.
Okay. Very quickly, you all, as you know, are going to hear from the FEMA Administrator, who is here with us to — to my right here, and, as you all know, at the President's direction, has been leading — FEMA has been leading a whole-of-government effort to prepare and respond to the — to Hurricane Idalia.
Yesterday, the President approved an emergency declaration. And since then, hundreds of FEMA personnel have pre-deployed ahead of Ida- — of Idalia making landfall in Florida.
And with that, I know that you're coming back — coming from the Oval Office.
ADMINISTRATOR CRISWELL: Thank you very much, Karine. And good afternoon, everybody. I know it hasn't been very long since I have been up here briefing all of you, but I think that this really is indicative of the pace of the major disasters that we are seeing across the nation.
And the reality is we are just now approaching peak hurricane season. And in addition to responding to the current storms, as well as other incidents, we have to remain focused on making sure that we are also preparing people across the nation for these types of extreme weather events.
I did just come from the Oval Office where I briefed the President on the trajectory of Hurricane Idalia and what the impacts are projected to be. And I want to just give a quick update on the preparations that we are making in response — or in preparation for the response in Florida, as well as other states that are in the path of Hurricane Idalia.
Yesterday, I had an opportunity to speak with Governor DeSantis. I also had an opportunity to connect with South Carolina Governor McMaster and Georgia Governor Kemp to help understand what their concerns were and to identify any unmet needs that they may foresee. And we'll remain in close contact with all of them in the hours and the days to come as Hurricane Idala — Idalia makes landfall and moves across these states.
As the President said to Governor DeSantis in his own conversations yesterday, FEMA and the entire federal family are activated to support the people of Florida.
The President also quickly approved an emergency declaration in advance of the storm in Florida, turning on the many tools that are available at my disposal to provide the governor any support or resources he may need in advance of landfall and then after.
This allows me to pre-stage people, equipment, and resources in Florida, Georgia, and the Carolinas, and I have done just that. We have pre-positioned different types of resources across all three states to include several Incident Management Assistance teams, our Urban Search & Rescue teams, our Disaster Survivor Assistance teams. And they are all ready to pivot to the most impacted areas immediately after the storm passes.
We also have warehouses filled with commodities like food, water, blankets, and medical supplies that are re- — ready to rapidly move into the impacted area at the state's request.
But we are not in this alone. We have an entire federal family that is postured to support. Our National Response Coordination Center here in Washington, D.C., is fully activated. And this means that there are several hundred staff from across the federal family that are working together to support any requests for federal assistance.
We have our partners from the U.S. Army Corps of Engineers who are pre-positioned to support any power restoration needs. Health and Human Services is assisting with evacuations from hospitals and assisted living centers. And the Red Cross has 50,000 meals to support the immediate needs as requested and has pre-staged shelter support to supplement the 19 shelters that are already opened by the state.
And this is a really important point that I want to talk about next. It's on preparedness. And again, I really asked for all of your help to help me ensure the people in the storm's path get this message. While we are engaged with our states to prepare for the path of this storm, it's critical that the people that are in the path of this storm are also prepared.
And I know that the people of Florida are no stranger to storms, and I encourage all Floridians to take this storm seriously. This storm is very strong and is expected to strengthen to a major hurricane by the time it makes landfall due to high surface temperatures in the Gulf of Mexico. This means heavy winds, high winds, heavy rain, and a forecasted 12-foot storm surge in some of the areas along the western coast.
This storm surge — this is one of the highest-risk parts of a hurricane and is especially problematic along the west coast of Florida due to the underwater geography. The coastal shelf gets shallow very quickly, which increases the amount of the storm surge, putting more people at risk. Very few people can survive being in the path of major storm surge, and this storm will be deadly if we don't get out of harm's way and take it seriously.
So I ask all Floridians to be vigilant and heed the warnings of your local officials. Have a plan to communicate with your family and your loved ones, charge your cell phones, your batteries, any devices that you may have, and ensure that you are receiving emergency alerts.
And most important, please listen to the warnings of local officials. If they tell you to evacuate, please do so immediately. And remember, you don't have to evacuate far. If you are in a storm surge warning area, it could mean just traveling 10 or 20 miles to get out of the most significant impact areas. It does not mean having to travel hundreds of miles to get out of the storm's path.
And finally, we are all in this together. I ask that you check on your neighbors, especially those who are older adults, people living with disabilities, or may need additional assistance.
But before I close, I want to provide an update on another topic that has been widely reported in recent days and asked by many of you: FEMA's Disaster Relief Fund, which as of this morning has a balance of $3.4 billion.
So, today, I am directing the implementation of Immediate Needs Funding. This means that FEMA will prioritize available funding for critical response efforts to Idalia, the Maui fires, and any other extreme weather events that may come our way without interruption while continuing to meet the immediate needs of survivors through the remaining weeks of the fiscal year.
I want to repeat: We are prioritizing funding for Idalia, for the Maui fires, and any other extreme weather events that are coming our way without interruption.
And I want to stress that while Immediate Needs Funding will ensure we can continue to respond to disasters, it is not a permanent solution. Congress must work with us on the supplemental request that the administration has made on behalf of FEMA. And you're going to hear more from me on that soon.
My primary responsibility at FEMA is to ensure that we are always postured to respond to any disaster and to provide the lifesaving and life-sustaining support when needed.
And with that, I'll take any questions.
MS. JEAN-PIERRE: Go ahead.
Q Can you relate what your conversation — what you talked about with Governor DeSantis and add any details about what coordination you're undertaking with Florida officials?
ADMINISTRATOR CRISWELL: Yes, when I spoke with Governor DeSantis yesterday, my — my main question is always: What are your main concerns? What are the areas that you have the greatest concern about? And do you have any unmet needs or resources that we can bring in?
He shared with me what his posture at the state is going to be and where he has some great concerns. And we are working and embedded with his staff. And I assured him that we have teams working side by side with our colleagues — our emergency management colleagues there at the State Emergency Operations Center — to be able to quickly respond as needed.
Q And can I ask — following up real quick — I mean, what were those concerns that he had at that time?
ADMINISTRATOR CRISWELL: He shared with me the concern, again, about people taking this seriously and being able to evacuate as a result of the storm surge. He has concerns about the vulnerable populations — right? — and making sure that we are providing any assistance we can to help them get out of harm's way.
MS. JEAN-PIERRE: Go ahead, Justin.
Q You mentioned the supplemental request after getting a fuller idea of what has happened in Hawaii and with this storm threatening, you know, a severe impact. Do you anticipate raising the level of that supplemental request as you start to negotiate with Congress?
ADMINISTRATOR CRISWELL: Right now, the supplemental request that we have put in is $12 billion, and that will be a bridge to get us through the end of the fiscal year. If we continue to see more storms, we're going to continuously monitor very closely the health of the Disaster Relief Fund to determine what more may be needed. But right now, as situation stands, the supplemental request will get us through the end of this fiscal year.
Q In some places, there is frustration with institutions and authorities. We've seen that in the wake of some other disasters. Do you have concern about people taking the warnings from public officials, acting on them, and when — we saw with Hurricane Ian, there was a pla- — the forecast indicated it was going to one place, it went farther south, and some people did not get out of the way.
So, my question is: Given what we don't know, are you concerned that there is any wariness, mistrust, or fatigue about listening to officials in times of crisis like this?
ADMINISTRATOR CRISWELL: I think the important thing to look at — and when we look at Hurricane Ian — is it's not just the path of the hurricane that we need to be concerned about. We have to be communicating what the entire risk is and the significant risk and the — the highest risk for loss of life is storm surge. And that storm surge right now shows impacts all along the western coast.
And so, I encourage people — and I really appreciate your help in getting that message out that it's not just the path of the storm — and it will continue to change — but look at all of the risks that are associated with this storm — storm surge being the most life threatening, not just where the path is going to go or where the eye of the storm is going to make landfall.
Q And in terms of the credibility of authorities, do you sense that there is any erosion of that at a time when you're trying to get that message out?
ADMINISTRATOR CRISWELL: I don't have any indications that there are. I think that what we are seeing right now in Florida is people are heeding their advice of local officials and people are moving out of harm's way.
MS. JEAN-PIERRE: Ebony.
Q Thank you. When — I want to go back to Hurricane Ian. When Hurricane Ian hit, you had many communities of color, you also had poor communities complaining that they were not prioritized during this time. And so, they didn't get necessary — the relief that they wanted. And they felt like they were, kind of, put on the — on the back burner. Many of these areas are in places that are more physically vulnerable.
What is your message to those who have that concern that there may be a repeat in their community?
ADMINISTRATOR CRISWELL: Yeah. So, during Hurricane Ian, we had a large amount of people that were impacted by that storm. And we had teams of personnel that went out into communities across the state. And as we heard of stories of maybe pockets of people that we had missed, we immediately sent our teams out into those areas to ensure that they were getting registered for assistance and we were bringing all of the resources that are available.
And so, what I would say is: If you hear about groups of individuals in parts of the state that, after the storm passes, are in need and they aren't getting that, let me know. I will send my teams out to those areas to make sure that they're getting all of the assistance that they're eligible for and that they need.
MS. JEAN-PIERRE: Jon.
Q Thanks a lot. FEMA, of course, has been dealing with the aftermath of the wildfires in Maui, and now you're preparing for a very powerful hurricane hitting Florida's southwest coast. To what extent is FEMA overextended or stretched too thin in dealing with these two natural disasters?
ADMINISTRATOR CRISWELL: We are certainly postured and have the staff that are available to support multiple large events at the same time.
We do have several open recovery disasters that we can pull some personnel from if we needed to extend or increase the amount of personnel we have.
We also have a very layered approach, right? We can also reach out into all members of the Department of Homeland Security through what we call the Surge Capacity Force for individuals that have volunteered to support during a disaster.
And so, I'm confident right now that with these two storms that we're currently dealing with in Maui and this one — or even another one to come — that we have enough personnel to go in and support these immediate lifesaving efforts.
MS. JEAN-PIERRE: Last question. Alex.
Q You mentioned just extreme weather that we've seen all — all summer from, you know, Hawaii, storms in Southern California. Is this — is this, in your view, the new normal — just summers where we're seeing these kinds of events more frequently and maybe more intense events than before?
ADMINISTRATOR CRISWELL: What I can say is that we don't have a typical operational season like we've had in the past. We would normally prepare our staff to be on extra alert during the peak of hurricane season, which is where we find ourselves right now. But our operational tempo has been year-round.
We started with atmospheric rivers in California in January, extreme tornadoes in the spring, to the wildfires, and now we are in peak hurricane season. And we have had an unprecedented number of disaster requests from governors because of the extreme weather that they're experiencing.
This is our new normal. This is the operational tempo that we find ourselves in. We have to continue to invest in mitigation and resilience to help these communities reduce the impact from these storms so we don't have such complicated recoveries afterward.
MS. JEAN-PIERRE: All right. Thank you so much.
Q Good luck to you.
ADMINISTRATOR CRISWELL: Thank you.
MS. JEAN-PIERRE: Thank you so much.
Okay, we have about 10 minutes before we have to move for the President's event.
Chris, you want to —
