In a speech with a strong focus on unity among Americans and with a heavy emphasis on social progress, President Barack Obama briefly mentioned healthcare in his second inaugural address on Jan. 21 outside the U.S. Capitol in Washington, D.C., as he addressed a crowd estimated at approximately 600,000 people on the side of the Capitol and spreading across the National Mall, as well as millions on live television. “We must make the hard choices to reduce the cost of healthcare and the size of our deficit,” the President said. “But we reject the belief that America must choose between caring for the generation that built this country and investing in the generation that will build its future. For we remember the lessons of our past, when twilight years were spent in poverty, and parents of a child with a disability had nowhere to turn.” Instead, the President said a moment later, “The commitments we make to each other—through Medicare and Medicaid and Social Security—these things do not sap our initiative; they strengthen us. They do not make us a nation of takers; they free us to take the risks that make this country great.”
 
The new Congress goes back into session on Jan. 22, with Medicare spending in contention in a series of upcoming legislative showdowns, including discussions over whether and when to raise the federal debt ceiling; whether and how to fund the federal budget for another year, or possibly allow the federal government to temporarily shut down; and how to handle still-unresolved issues around the budget sequestration that was temporarily delayed by the Jan. 1 vote to avert the so-called “fiscal cliff.” All three of those issues will have to be resolved within the next few months, and the exact disposition of each of the three issues remains uncertain.