Biden Says Democrats’ Plan Will Have to Shrink

U.S. President Joe Biden talks to reporters after meeting with Democratic lawmakers to promote his bipartisan infrastructure bill at U.S. Capitol in Washington
KEVIN LAMARQUE
By Yuval Rosenberg

Biden Tells Democrats There’s Plenty of Time to Pass His
(Shrinking) Agenda

President Joe Biden visited the Capitol Friday afternoon in an
effort to rally feuding Democrats behind his economic agenda and
press lawmakers in his party to compromise as they seek to pass
both a $1 trillion bipartisan infrastructure bill and a larger
“budget reconciliation” package of social and climate programs
financed by tax increases on the wealthy and corporations.

The fate of both pieces of legislation has been clouded by
differences within the party — and become even more uncertain after
House Democrats late Thursday night were forced to push off a
planned vote on the infrastructure measure.

Biden, appearing before the House Democratic caucus for the
first time, delivered messages targeted at both centrists and
progressives. With no deal ready for him to close, he reportedly
urged both sides to compromise and capitalize on their chance to
deliver on their promises to the American public. He reportedly
also warned about the need to avoid handing Republicans a political
gift ahead of next year’s midterm elections.

Biden reportedly did not press members to vote for the
infrastructure bill, instead telling them that the public works
legislation “ain’t going to happen until we reach an agreement on
the next piece of legislation” — a message sure to disappoint at
least some moderates who had sought to delink the two. “Let’s try
to figure out what we are for in reconciliation … and then we can
move ahead,” Biden reportedly said, counseling patience.

But Biden also made clear to progressives that the proposed $3.5
trillion cost of the reconciliation bill would need to be scaled
back. “Even a smaller bill can make historic investments,” he
said.

Biden reportedly told Democrats that they might have to accept
something between $1.9 trillion and $2.3 trillion. House Speaker
Nancy Pelosi (D-CA) reportedly offered a
$2.1 trillion topline in talks with Sen. Joe
Manchin (D-WV), who has held fast to his view that the price tag
for the package should not exceed $1.5 trillion.

Rep. Pramila Jayapal (D-WA), chair of the Congressional
Progressive Caucus, acknowledged Friday that the $3.5 trillion
won’t happen. “We’re going to have to come down in our number," she
told reporters after the Biden meeting. "We're going to get to work
and see what we can do." Jayapal added that she would be staying in
town this weekend to keep negotiating a deal.

What it all means: After Thursday’s vote postponement,
two competing storylines quickly emerged. The delay, prompted by
progressives who are demanding to finalize the larger package
before they’ll vote for the infrastructure bill, was an
embarrassment and a major setback for Biden’s agenda — a failure
that showcased Democrats’ inability to get out of their own way as
they seek to prove that government can deliver results for the
American people. Or it was a minor blip at worst and perhaps the
necessary strategic play to spur warring centrists and progressives
to finally break their stalemate and pass bills.

So which was it?

How about both. In truth, we don’t know yet and may not know for
a little while as Democrats continue their negotiations.

Clearly, the delay was embarrassing and the drama
surrounding the promised vote isn’t what party leaders would have
chosen as the ideal path to enacting their plans. The ongoing
uncertainty about an infrastructure vote threatens to wipe out a
bipartisan victory Biden very much wants at a time when his sagging
poll numbers could sorely use a boost. House Speaker Nancy Pelosi
said a vote would happen on Friday, but she said the same thing on
Thursday and Democrats don’t yet appear close to an agreement on
the social and climate package.

At the same time, Biden and the White House are pressing for
progress on both bills and have not squeezed progressives to
support the infrastructure bill, indicating that they may welcome
the leverage liberals are providing. And Democrats’ deadlines this
week for an infrastructure vote were self-imposed and mostly
arbitrary. “It doesn't matter whether it's in six minutes, six days
or six weeks,” Biden told reporters as he left Friday’s Democratic
caucus meeting. “We're gonna get it done.”

The bottom line: A Friday vote on the infrastructure bill
seems impossible, but the clashes in recent days may have done more
than any talks over the past two months to clarify what Democrats
need to do to reach an agreement on both measures. But reaching a
compromise won’t be easy and without a deadline to force dealmaking
the drama could still drag out for weeks.

Drug Price Negotiation Is Americans’ Top Priority From
Democratic Plan: Poll

What do Americans want most from the array of new policies laid
out in Democrats’ sprawling infrastructure bills? According to a

new Politico-Harvard poll, it’s help with health
care costs.

When asked about their top priorities for the legislative
effort, the policy most frequently cited by respondents from a list
of 20 items was the proposal to allow the federal government to
negotiate lower prices with pharmaceutical companies. Thirty-nine
percent of poll respondents chose that issue as “extremely
important” to them, including 45% of Democrats and 38% of
Republicans.

Other popular health care provisions cited by respondents
include preparing for a future pandemic, providing long-term care
for senior citizens and expanding Medicare to include dental,
vision and hearing benefits.

The poll of 1,006 adults, carried out September 14-19, suggests
that as far as the Democratic agenda is concerned, Americans are
focused on the issues that affect their own lives, with drug prices
having a more obvious and immediate impact than bridge construction
or highway repairs.

Not that people are paying terribly close attention. Fifty-one
percent of respondents said they were following the debate “not
too/not at all closely,” while just 16% said they were following it
“very closely.” Another 32% said they were following the debate
“fairly closely,” bringing the total of all attention-payers to
48%.

“Half of the public is not following this great debate at all,”
Robert Blendon of the Harvard T.H. Chan School of Public Health

told Politico. “And that’s important because when
I looked at the priorities, I see people picking things that relate
to their own lives.”

Transportation Department Furloughs Workers as Congress Fails
to Extend Funds

Congress narrowly avoided a government shutdown this week,
sending a short-term funding bill to President Joe Biden Thursday
with just hours to spare. But in their ongoing battle over roughly
$1 trillion in infrastructure spending, lawmakers failed to extend
spending from the highway trust fund. As a result, the Department
of Transportation froze some transit programs and furloughed about
3,700 employees Friday.

Lawmakers are reportedly preparing a bill to restore the funding
for 30 days. It could take several days to move the bill through
Congress, though, leaving the affected programs and employees in
the lurch.

Jim Tymon, executive director of the American Association of
State Highway and Transportation Officials, expressed his concerns
about lawmakers’ failure to maintain funding. “Yesterday’s inaction
on the Infrastructure Investment and Jobs Act isn’t just
disappointing — it lapses our highway, transit, and highway safety
programs and halts work on vital transportation infrastructure
around the country, which is detrimental to our economy and the
quality of life of our communities,” he said in a statement. “We
are dealing with very real repercussions.”

The $50,000 Covid Test

The simple and still often necessary act of getting tested for
Covid-19 can generate eye-popping bills, thanks to the Wild West
that is the American health care system.

Kaiser Health News’ Aneri Pattani
tells the story of a Texas man who was exposed to
an infected co-worker and visited an emergency room to get tested.
The bill for the two Covid tests that were administered:
$56,384.

The great majority of the bill – $54,000 – was for a PCR test,
with a rapid antigen test and an ER fee accounting for the
rest.

Fortunately, the patient had insurance and didn’t have to pay
the bill. His insurance company negotiated a rate of $16,915.20,
which was paid in full — despite being remarkably high for the
services provided. Typical rates for PCR tests are closer to
$100.

Such bills are perfectly legal, Pattani says, since with “covid
tests — like much else in American health care — there is no cap to
what providers can charge.”

Niall Brennan, CEO of the Health Care Cost Institute, told
Pattani that part of the problem is the fact that medical service
providers can charge sky-high fees to patients who seek care
outside their insurance networks, as was the case here. “People are
going to charge what they think they can get away with,” Brennan
said. “Even a perfectly well-intentioned provision like this can be
hijacked by certain unscrupulous providers for nefarious
purposes.”

Although the patient in Texas didn’t have to pay the bill, he
was disturbed by the experience and asked his insurance company to
look into it. After several months, the insurance company said the
emergency room claimed that the bill was issued in error and
granted a refund.

The bottom line: The fact that the bill was so grossly
out of line points to a bigger problem in the American health care
system. According to one study cited by Pattani, between 3% and 10%
of all health care spending in the U.S. is lost to overpayments for
services.

Send your feedback to yrosenberg@thefiscaltimes.com.
And please urge your friends to
sign up here for their own copy of this
newsletter.

News

Views and Analysis