President Joe Biden delivered his second State of the Union address Tuesday night, where he discussed several health-related issues facing the nation.

Biden spoke about public health initiatives taken by the White House during the ongoing COVID-19 pandemic, adding that “COVID no longer controls our lives.”

He also outlined the implications of the recently passed Inflation Reduction Act on both consumers and the pharmaceutical industry, as well as his ambitions to build on the framework of the Affordable Care Act (ACA).

Below are five healthcare takeaways from Biden’s speech.

1. Commits to protecting Medicare

Perhaps the most contentious and widely-discussed moment of the night occurred when Biden accused Republicans of threatening to sunset Medicare and Social Security every five years.

Biden committed to not making cuts to either social safety net program but received boos and jeers from Republicans, including some from members who called him a “liar” for suggesting that the party wanted to slash Medicare.

In addition to the feud over potentially sunsetting Medicare and Social Security, Biden heralded the passage of the IRA and how it empowers Medicare to negotiate prices for selected prescription drugs. 

“Now, some members here are threatening to repeal the Inflation Reduction Act. Make no mistake, if you try to do anything to raise the cost of prescription drugs, I will veto it,” he said.

Beyond the polarized response from lawmakers on Capitol Hill, Biden was praised by healthcare stakeholders for publicly standing up for Medicare and pressed him to do more for seniors.

“We urge President Biden to honor his commitment to protect Medicare,” Better Medicare Alliance CEO Mary Beth Donahue said in a statement. “Medicare Advantage is Medicare, and these benefits belong to the American people, including the 30 million seniors and people with disabilities who choose it. The administration’s massive proposed cuts to Medicare Advantage would threaten the high-quality, affordable care that beneficiaries depend on.”

2. Calls for a universal $35-per-month insulin cost cap

Building on the structure of the IRA, Biden called for a $35-per-month cap on insulin for all Americans. Currently, insulin is capped at $35-per-month for Medicare beneficiaries as part of the IRA. 

Biden asserted that Big Pharma “has been unfairly charging people hundreds of dollars – and making record profits,” a practice he said he would aim to stop.

By proposing a universal cap on the cost of insulin, Biden received praise from both sides of the aisle, including Sen. Chuck Grassley, (R-Iowa), and Lauren Aronson, executive director of the Campaign for Sustainable Rx Pricing, who said “Americans who face financial difficulty affording their medications deserve relief, especially patients who rely on insulin to survive.” 

3. Proposes permanent extension of subsidies to bolster the ACA

When Biden served as vice president under President Obama, he was an instrumental force in getting the ACA passed. Now, he’s seeking to bolster the landmark healthcare law by making the enhanced advance premium tax credit (APTC) subsidies for people with low incomes permanent. 

These subsidies, which have led to record-high enrollment in health insurance plans sponsored through the ACA, are scheduled to expire at the end of 2023.

Larry Levitt, EVP of health policy at the Kaiser Family Foundation, tweeted that an extension of the APTC subsidies likely hinges on the outcome of the next presidential election. 

Meanwhile, Association for Community Affiliated Plans CEO Margaret Murray said in a statement that the organization is “delighted” that Biden has proposed to make the enhanced subsidies permanent, adding that it would “squarely address the biggest problem with the American healthcare system: its unaffordability for workers with low incomes and their families.”

4. Supports additional investment in mental health care

Biden acknowledged the nation’s ongoing mental health crisis, calling for increased investments to remedy the severe provider shortage while also seeking to hold Big Tech more accountable for the effects of social media on children. 

“We must finally hold social media companies accountable for the experiment they are running on our children for profit,” he said. “And it’s time to pass bipartisan legislation to stop Big Tech from collecting personal data on kids and teenagers online, ban targeted advertising to children, and impose stricter limits on the personal data these companies collect on all of us.”

His call to action comes as social media companies continue to receive considerable public criticism from lawmakers for its detrimental impact on the mental health and physical safety of consumers. 

Bloomberg reported two weeks ago that the Federal Bureau of Investigation is examining Snapchat’s role as a tool for drug dealers to dispense fentanyl to young people across the U.S.

5. Booed by Republicans over fentanyl overdoses

It wouldn’t be a true State of the Union address without the president receiving a vocal rebuke from members of the opposition party.

Biden said the White House is working to stem the fentanyl overdose crisis which claimed the lives of more than 70,000 Americans last year. This statement prompted Republicans to summarily boo Biden, with some shouting “it’s your fault!”

Following the outburst, Biden called for a “major surge to stop fentanyl production, sale, and trafficking,” specifically mentioning the need for more drug detection machines to inspect cargo and stop the flow of pills and powder over the border.