Health care gets a brief mention in State of the Union speech

Whereas last year, President Barack Obama used nine full paragraphs of his State of the Union speech to sell his health care plan, the subject got less attention tonight.

President Obama said that “health care inflation is at its lowest rate in 50 years,” and he briefly touted expanded coverage. “More of our people are insured than ever before,” he said.

Roughly 10 million U.S. residents gained health coverage under the Affordable Care Act – his signature domestic achievement — in the last year. About 6.8 million people have enrolled in health plans through the federal marketplace during the ACA’s second open enrollment period so far. Several major provisions of the ACA went into effect in 2014, including the expansion of Medicaid and the opening of health insurance marketplaces that make it easier for people to buy their own insurance – many with a subsidy from federal government.

But the past year has also been a turbulent one for the administration’s health agenda. The website continued to flounder during the first part of the year, HHS Secretary Kathleen Sebelius stepped down, replaced by Sylvia Mathews Burwell, and Republicans promised to continue chipping away at the law after seizing control of the Senate in the midterm elections last fall. To kick off 2015, Centers for Medicare and Medicaid Services head Marilyn Tavenner announced she would be leaving, following the November acknowledgment that her agency had mistakenly inflated enrollment numbers under the ACA by as many as 400,000 people.

While the exchanges have been running much smoother during this year’s open enrollment season, ACA supporters are bracing for still more challenges. Millions could lose their insurance subsidies this year if the Supreme Court decides in King vs. Burwell that people who live in states that did not set up their own insurance exchanges are barred from receiving federal subsidies to help purchase their plans.

Even so, the White House chose to subtly highlight several favorite initiatives in its selection of guests sitting with the First Lady Michelle Obama this evening. Included were CVS Health President and CEO Larry Merlo (the company is the first major pharmacy to ban the sale of tobacco products), a mother who was able to have a brain tumor removed after signing up for the exchange, a health care worker who found insurance on an exchange after he lost his job, and a doctor who helped establish and run Ebola treatment and training centers in Liberia.