Democrats Plot Biggest Health Care Expansion Since Obamacare

Democrats Plot Biggest Health Care Expansion Since Obamacare

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Plus, a brutal timeline to pass Biden agenda
Thursday, August 26, 2021

Twelve American service members and dozens of Afghan civilians were killed Thursday in attacks by two suicide bombers outside the Kabul airport, officials said. At least 15 U.S. service members were injured. The attacks by ISIS-K, the Afghan affiliate of the Islamic State terrorist group, came after officials had warned of a threat at the airport. The U.S. military deaths were reportedly the first in Afghanistan since February 2020 and marked one of the highest single-day tolls in the two decades of war there. “We’re outraged as well as heartbroken,” President Biden said, vowing to hunt down those responsible. Read more at CNN, The New York Times or The Washington Post.

Here’s what else is going on:

Democrats Face Brutal Timeline to Pass Biden Agenda

Democratic lawmakers have an enormous amount of work to do to pass two major spending bills that contain the bulk of President Joe Biden’s economic agenda, and just a few weeks to get it done.

In order to advance that agenda, House Speaker Nancy Pelosi (D-CA) appeased a small but crucial group of centrists by agreeing to hold a vote on the $1 trillion bipartisan infrastructure bill by September 27. But a larger and equally crucial group of progressives within the Democratic caucus want to vote on the $3.5 trillion “human infrastructure” plan before then, creating a race to finish the larger piece of legislation before the deadline.

“The coming weeks will be intense,” Pelosi said in a letter to Democrats Wednesday.

In an interview with Punchbowl News, Rep. Pramila Jayapal (D-WA), the chair of the Congressional Progressive Caucus, explained why her group wants to vote first on the larger bill. “[T]he reality is, the totality of the Biden agenda, the Democratic agenda that we ran on and we now have to deliver on, is really contained within the reconciliation bill,” she said. “So let’s pass that first, and then we’ll make sure we send both bills to the president’s desk to sign.”

Preparing for the race: The $3.5 trillion spending framework passed by the Senate two weeks ago is basically an outline with topline dollar figures that needs to be filled in with policy details. Pelosi has set an ambitious but non-binding deadline of September 15 for finishing that process, with the House committees that create those details reportedly looking to start their markups next week. All committees will look to report their pieces of the package to the House Budget Committee by mid-month, theoretically leaving enough time for the legislation to be turned into a final package and receive a vote on the House floor before the end of the month.

Battle over spending: A central question in the markup process will be the spending total. The Senate authorization allows for up to $3.5 trillion in the final bill, but it could be less — and there is already pressure from more conservative Democrats to reduce the total.

Democratic Sens. Joe Manchin (KY) and Kyrsten Sinema (AZ) have repeatedly expressed their opposition to the size of the $3.5 trillion bill, and party leaders will need to figure out a way to get them on board given their 50 seats in the Senate. But they’re not the only ones who want to see a smaller bill.

“Kyrsten and Joe get the most attention, but they’re not alone in wanting that number to be lower,” Sen. Chris Murphy (D-CT) told Politico. “My hope is that we're not making decisions based on an arbitrary number. That we're looking at the programs we need to fund and the programs that we don't need to fund.”

The battle could be intense, though, with progressives pushing to maintain the $3.5 trillion total.

“I already negotiated. The truth is we need more,” Sen. Bernie Sanders told Politico. “The needs are there. This is, in my view, the minimum of what we should be spending,” Sanders, who had called for $6 trillion in spending, added.

Quote of the Day

“I think Democrats have a lot of momentum after this week’s vote. I don’t think anyone dreamed that the speaker would be able to, in effect, bully every member of her conference into giving a green light to these tax increases. But she did.”

— Rep. Kevin Brady (R-TX), the ranking member of the House Ways and Means Committee, in an interview with CNBC. Brady said he thinks the odds “could be good” for Democrats to pass their spending bills despite the severely compressed timeline.

Democrats Plot Biggest Health Care Expansion Since Obamacare

As Democrats get down to negotiating and writing their budget reconciliation bill, The Washington Post’s Rachel Roubein notes that the legislation is poised to be the biggest health expansion since Obamacare.

Roubein breaks down what’s likely to be included in that expansion — and adds that one major progressive policy change likely won’t make the cut. Here’s an overview.

Expanding Medicare coverage to include dental, vision and hearing: This seems a foregone conclusion,” Roubein says, but adding those benefits will likely take years. “In the meantime, a Senate Democratic aide said the chamber is crafting a stopgap policy to help seniors afford these services right away.”

Expanding Medicaid in states that haven’t done so under Obamacare: Democrats are working on a plan to extend Medicaid coverage to 2.2 million more adults via a federal plan for states that have resisted expanding the health care program for low income people under the Affordable Care Act. Under a leading option, Roubein reports, “people would get free coverage on Obamacare’s marketplaces for several years, giving time for federal officials to create a new Medicaid-like program providing more robust benefits.”

Plans to lower prescription drug prices: Democrats have pushed to allow the federal government to negotiate prices with drugmakers, but there are likely to be some differences between a plan passed by the House in 2019 and legislation being developed by Senate Finance Committee Chair Ron Wyden (D-OR).

“The House bill tied Medicare drug negotiations to prices for selected drugs overseas — a plan that has faced pushback from moderates,” Roubein writes. “Instead, Wyden is eyeing a new route: tying price negotiations to a domestic benchmark, according to three lobbyists familiar with the discussions.” The details of these and other drug-pricing measures are going to be the subject of “pretty fierce negotiations,” one health policy lobbyist tells the Post.

No reduction in Medicare eligibility age: President Biden and other key Democrats have endorsed the idea of lowering the Medicare eligibility age to 60, but the proposal isn’t likely to make the cut.

Read the full piece at The Washington Post.

Number of the Day: 100,000

The U.S. will see nearly 100,000 more deaths from Covid-19 by December 1 if current conditions persist, according to an estimate from a leading forecasting model. Deaths are projected to peak in September at 1,400 per day before gradually decreasing during the fall. If accurate, it would bring the official number of deaths from the disease in the U.S. to 730,000.

Forecasters noted that the number could be reduced significantly if Americans were to change their behavior by getting vaccinated in greater numbers, limiting social gatherings and wearing masks. “We can save 50,000 lives simply by wearing masks,” forecaster Ali Mokdad of the University of Washington told the Associated Press. “That’s how important behaviors are.”

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