WASHINGTON ― Democrats say they’re really close to voting on the Build Back Better Act in the House, just as soon as they finish up a few outstanding issues. Those issues just happen to be some of the most contentious provisions: prescription drugs, paid leave, climate change, taxes and immigration.
House Speaker Nancy Pelosi (D-Calif.) said Democrats would resolve the outstanding issues by the end of Tuesday, and responded sarcastically to a question about whether the outstanding issues are significant.
“It’s all significant,” Pelosi told reporters. “I wouldn’t be having them if they weren’t significant.”
House progressives blocked a vote on a bipartisan infrastructure bill last week, saying they wouldn’t support the bill until they got the text of the Build Back Better Act, the spending and tax budget reconciliation bill meant to reflect many of President Joe Biden’s major agenda items.
Democrats posted a new Build Back Better draft on Thursday, and now progressives are hoping to quickly lock in their interests without much further debate, saying they want votes this week on both bills.
“We’ve been saying for three months that what we need is the text and a vote on both bills at the same time,” Congressional Progressive Caucus Chair Pramila Jayapal (D-Wash.) told HuffPost. “That is why we are now comfortable with moving forward because it is very different than last Thursday when we did not have legislation. We did not have votes scheduled on both bills at the same time. This week, we will.”
But Democrats are still negotiating some of the biggest policy issues in the bill, and Pelosi declined to commit to a vote this week.
The bill text resulted from what was supposed to be a deal between Biden, Sen. Joe Manchin (D-W.Va.) and fellow conservative Democrat Sen. Kyrsten Sinema (D-Ariz.), that would include $1.75 trillion in spending on climate policies and an expansion of the social safety net, including an extension of the child tax credit plus new child care subsidies, investments in health care, housing, elder care and more.
But since then Manchin has suggested he actually dislikes major parts of the bill, renewing his longstanding concerns over the bill’s price tag, and the possible inflationary impacts. Democrats cut down their original $3.5 trillion proposal to $1.75 trillion, but the West Virginia Democrat is still grousing.
On Tuesday, Manchin expressed fresh concerns about a proposal to expand Medicare to cover hearing benefits, after Democrats stripped out proposed benefits that would have included dental and vision.
“It’s going to be a while ... we’re not in a rush right now,” Manchin told reporters.
Sen. Bernie Sanders (I-Vt.), a big advocate for expanding Medicare, could be heard grumbling to his colleagues about the most popular provisions falling out of the Build Back Better bill.
“So we drop what’s most popular?” Sanders said, showing colleagues a Morning Consult poll on his phone that found that voters’ top priorities are no longer in the mix.
Using government power to reduce the price of prescription drugs may be the single-most popular item on the Democratic agenda that’s been under last-minute deliberations.
The original idea was to let the federal government negotiate prices directly with manufacturers, restrict how much companies can raise prices year after year, and to redesign the Medicare drug benefit so that it limits out-of-pocket expenses.
While Biden, congressional leaders and most Democratic lawmakers all want this kind of initiative, a small handful objected, like Sinema, arguing it would deter innovation and lead to fewer breakthroughs. These lawmakers, not surprisingly, have ties to the drug industry.
Democrats now say they have consensus on a scaled-back proposal that would limit the number and type of drugs subject to price negotiation, and modify the formula for inflation caps so they don’t affect pharmaceutical revenue as much. They’ve also proposed massive new investments in scientific research and support for biotech startups, in order to sustain (and maybe even promote better) innovation.
Democrats have been promising action on drug prices for more than a decade. “Frontline” House members in vulnerable districts seem especially determined to deliver a meaningful initiative, because they believe it will appeal to Republican-leaning voters they need to keep their seats. It’s hard to imagine Democrats walking away from these conversations with nothing at all on drug pricing.
Meanwhile, others, like Sen. Kirsten Gillibrand (D-N.Y.), Elizabeth Warren (D-Mass.) and Patty Murray (D-Wa.) are fighting a more difficult battle to find a way to get a paid leave program back in the bill. Only 20% of Americans in the private sector have access to paid family leave and roughly 42% have access to paid medical leave to recover from illness or injury; the United States is far behind its international peers in failing to provide such worker protections.
This policy gap proved particularly devastating during the pandemic, when many workers felt pressure to work despite being sick themselves or having to care for a sick family member.
But still, Manchin is the only Senate Democrat to oppose Democrats’ paid leave program, which has lived and died in many forms. Manchin has raised concerns about cost, the duration of the program, who would pay into the program and the potential for abuse.
Gillibrand insisted that the fight to win over Manchin is ongoing, but the senator seems to be finding new issues with the program, most recently floating that it’s unlikely paid leave would comply with Senate budget rules.
The list of contentious unresolved policy issues continues: Manchin is reportedly still not on board with all the climate provisions included in the bill. Progressive Democrats want to include some alternate pathways to citizenship for undocumented residents, even if such provisions will be struck down under Senate rules. The White House’s negotiated deal included around $100 billion in funds to address court backlogs at the border.
And Democrats are still unsettled on taxes, too, with Sen. Ron Wyden (Ore.) continuing to push for an annual levy on billionaires’ stock holdings. House Democrats omitted the proposal in favor of “surcharges” on annual incomes above $10 million and $25 million. Wyden complained that the surcharges would hit NBA players, but not team owners, whose wealth is invested.
Another tax hangup is a proposed repeal of a 2017 limit on state and local tax deductions. A small group of House Democrats, and Sen. Bob Menendez (D-N.J.), have demanded the limit be repealed, even though a full repeal would overwhelmingly benefit the richest 1% of Americans. Democrats have so far omitted any SALT provisions from their bill drafts, but leaders have said something will make it into the final bill.
Progressives hate the SALT repeal but have been willing to go along with some version of it in order to get the bill done.
“Nobody is going to get everything they wanted,” Warren said. “There are multiple calculations that are under discussion but it’s not clear that any of them will make it. I don’t want to oversell.”