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Department of Health and Human Services Secretary Leavitt began his press conference on the FY2009 budget by warning that Medicare in its current form will be bankrupt within 11 years. Unlike Social Security, which he called "a math problem," Medicare will need to be heavily reformed in order to remain functional. He said that some people will see this budget's attempts to bring Medicare "into a more sustainable" form as a cut, but the changes in the new budget are aimed at improving the program's sustainability by improving efficiency and bringing in market forces, citing the Medicare prescription drug reforms as a positive example. He also said that the changes reduce the premiums that beneficiaries pay.

Leavitt also said work needed to be done to remove the tax discrimination against people who do not buy health insurance through their employer, saying up to an additional 20 million people might be covered if that change were made.

Leavitt said that the SCHIP program retains coverage of people with gross incomes of up to 200% of the poverty line, and it allows states to cover people up to 250% of the poverty line.