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A year ago, President Joe Biden used his first State of the Union address to push top Democratic priorities that were sure to face a battle in the narrowly divided Congress but he also laid out a four-pronged “unity agenda” that would be an easier sell.
Biden's unity goals would be hard for anyone to argue against: improving mental health, supporting veterans, beating the opioid epidemic and fighting cancer. The president is still pushing for some of those big Democratic goals, like an assault weapons ban, but he's fared better on the unity goals.
Susan Rice, the president's domestic policy adviser, pointed to “very significant progress” on all four aspects even as she noted that issues like meeting the demand for mental health services or combating drug abuse won't be solved overnight.
"We’re happy with the progress that’s been made and we’re determined to keep pushing forward and make more progress," Rice said in an interview.
A look at where things stand:
OPIOIDS
IN THE SPEECH: Biden asked Congress for increased funding for prevention, treatment, reducing harm and recovery. He also called for the elimination of rules that keep doctors from prescribing treatments, and he aimed to stop the flow of illicit drugs by having the federal government work with state and local law enforcement officials to go after drug traffickers.
SINCE THEN: Biden sent his first national drug control strategy to Congress, focused on harm reduction or preventing death and illness in drug users while trying to engage them in care and treatment. The strategy calls for changes in state laws and policies to support expanding harm reduction.
It also calls for targeting the financial activities of transnational criminal organizations that manufacture and traffic illicit drugs in the United States, reducing the supply of illegal drugs smuggled across U.S. borders, improving data systems and research that guide drug policy, and making sure the people most in danger of overdosing on drugs can get evidence-based treatments, including people experiencing homelessness and those in prison or jail.
The Department of Health and Human Services awarded nearly $1.5 billion in grants to all states and U.S. territories to increase access to treatment for substance abuse, remove barriers to treatments like naloxone, which is used to reverse an opioid overdose, and expand access to support services and treatment programs.
The Food and Drug Administration approved several naloxone products in the past year, including a higher-dose injection as an additional option to treat opioid overdoses, a second generic naloxone nasal spray, and a naloxone auto-injector product for use by the military and for responding to chemical incidents.
MENTAL HEALTH
IN THE SPEECH: Biden emphasized mental health care for children, citing turmoil in their lives and in their schooling caused by the COVID-19 pandemic. He called for holding social media platforms accountable for their negative impact on children, strengthening privacy protections, banning advertising targeted at children and demanding that tech companies stop collecting children’s personal data. And he urged parents to make sure their kids’ schools use the $122 billion in pandemic relief funds they got from Washington to hire teachers and help students make up for lost learning.
SINCE THEN: The Bipartisan Safer Communities Act, the gun violence bill Biden signed into law last June, allocates more than $1 billion over five years to mental health support for schools, in line with the president's goal of doubling the number of school counselors, social workers and other mental health professionals. The Department of Education has begun releasing those funds.
A new “988” national suicide and crisis hotline opened in July and has been receiving vastly more calls and texts than the old system did during the same time period the previous year, according to the White House.
Biden released a national strategy on mental health. But legislation to address children's tech privacy issues has not yet cleared Congress.
“This is an area where we still have more to get done,” Rice said.
VETERANS
IN THE SPEECH: Biden asked Congress for legislation guaranteeing health care for veterans who became ill from their exposure to toxic smoke on bases in Iraq and Afghanistan.
SINCE THEN: In August, he signed into law a major expansion of federal health care services for millions of veterans who breathed the toxic smoke emitted from huge “burn pits," which were used to dispose of chemicals, plastics, medical equipment, human waste and other substances on U.S. military installations in the two countries.
More than two-thirds of disability claims that cited exposure to the pits were being denied by the Department of Veterans Affairs.
The new law, known in Washington and among veterans as the PACT Act, directs officials to assume that certain respiratory illnesses and cancers were related to burn pit exposure. The change helps veterans, and their survivors, collect disability payments without having to prove their illness was caused by their service. Up to 3.5 million veterans could benefit, according to estimates.
The issue is a personal one for Biden, who many times has suggested that the aggressive brain cancer that killed his son Beau may have been caused by his exposure to burn pits in Iraq. Beau Biden was stationed in Iraq for about a year as a major in the Delaware Army National Guard.
Biden held a large White House bill-signing ceremony and gave the pen to the young daughter of Sgt. 1st Class Heath Robinson, who died of cancer and for whom the legislation is named.
Separately, veterans in need mental health care can now press 1 after dialing 988 to connect with the Veterans Crisis Line.
CANCER
IN THE SPEECH: Biden noted how personal the cancer issue is to him and his wife, Jill, as well as Vice President Kamala Harris, along with millions of people like them who have lost friends and loved ones to various forms of the disease.
Just before last year's State of the Union address, Biden announced that he was “reigniting” a federal cancer-fighting initiative that was first launched in 2016, when he was vice president and after his son Beau's death in 2015. As president, Biden set a new goal for the “cancer moonshot” initiative of cutting cancer death rates by at least half over the next 25 years.
He asked Congress in the speech to fund the Advanced Research Projects Agency for Health, describing it as based on a Defense Department research agency that led to creation of the internet, GPS and more. He said the new health research agency's “singular purpose” would be to drive breakthroughs in cancer, Alzheimer's disease, diabetes and more.
SINCE THEN: ARPA-H was created in March 2022 in the Department of Health and Human Services.
The $1.7 trillion government funding bill Biden signed in December included $1.5 billion for the new health agency.