Build Back Barely better than nothing

Passing a compromise bill will foster Democratic chances in 2022

President Biden earlier this week agreed to slim down Build Back Better into a sub-$2 trillion package to win the votes of a handful of Democratic Party centrists. Call it Build Back Barely.

It remains to be seen what Democrats will put on the chopping block to win universal backing from members of its Senate caucus. Since the Republican Party remains firmly opposed to the bill, Build Back Barely must win every Democratic and independent vote it is going to pass via the budget reconciliation process, which is not subject to the Senate’s filibuster rule.

Sens. Joe Manchin (Barely D-W. Va.) and Kyrsten Sinema (Weirdly D-Ariz.) have gotten most of the attention because of their opposition to parts of the original plan. But in the health care arena, Sinema has been joined by Sen. Robert Menendez (D-N.J.) and a small faction of House Democrats who are opposing giving Medicare the right to negotiate prescription drug prices – a central plank in Democratic Party platforms for over three decades.

As I’ve pointed out before, one of the ironic realities about the pharmaceutical and biotechnology industries is that their headquarters and major R&D facilities are located in areas of the country – Boston, New Jersey, Maryland, California and blue areas of Arizona and North Carolina – with deep benches of university-trained scientists. These are people who are liberal on most issues, and whose congressional districts routinely send Democrats to Congress.

A few of those representatives are proposing drug negotiation compromises that would affect only a small number of drugs. Alas, such compromises would go unnoticed by most seniors, and certainly wouldn’t raise the revenue needed to fund the health insurance coverage expansions included in the original bill.

That leaves liberals and progressives at each other’s throats over what to retain from the insurance coverage expansions. Sen. Bernie Sanders (D-VT) and other progressives are insisting on expanding Medicare to include dental, vision and hearing benefits. They see it as one more plank in the slow construction of the ark that will carry the U.S. to universal coverage through Medicare for All.

Rep. James Clyburn (D-S.C.), on the other hand, who as House Majority Whip has most of the caucus in his corner, is pushing for the federal government to take over Medicaid expansion. A dozen Republican-run states are still refusing to expand the program’s income limits to 133% of poverty, which denies insurance coverage to more than 2 million people, most of them living in the Deep South and Texas, 60% of whom are minorities. They also prioritize maintaining higher subsidies for exchange-based individual plans.

The HuffPost’s Jon Cohn has an excellent discussion of the tensions created by this unfortunate conflict in this article.

Less family friendly

The health care provisions are less than a quarter of the original package. The New York Times’ Upshot column today offers one analyst’s synopsis of the main provisions in the original program. It included $1.9 trillion to aid American families; $1.1 trillion for housing, economic development and other infrastructure; and $600 billion for clean energy (all of these are 10-year totals).

Clearly, much of the new aid for families (universal pre-K, childcare, child tax credits, family leave, higher earned income tax credits) will have to go to keep the bill under $2 trillion. This investment in human capital represents the single largest component of the bill. Shrinking or eliminating much of it will retain the U.S.’s position as the least family-friendly nation in the OECD.

Meanwhile, Sen. Joe Manchin (D-W. Va.) appears to be demanding almost total elimination of the clean energy investment in the bill. Why remains something of a mystery since his state has fewer than 14,000 coal industry jobs. The Washington Post did a review a few days ago about how this position is at odds with the interests of his own constituents.

No matter, the corporate Democrat, whose financial disclosures reveal he earns a significant amount of income from his holdings in fossil fuel companies, seems intent on sending President Biden to Glasgow with empty hands for next month’s United Nations climate change conference.  

Now that I’ve laid out the bad news, let me end on a somewhat optimistic note. Given the looming political battles of 2022 for control of the House and Senate, and the growing prospect that Donald Trump will win the Republican nomination for president in 2024, a half a loaf is better than nothing. Another $3 trillion in economic stimulus ($1 trillion in the traditional infrastructure bill that even some Republicans in the Senate support; plus the Build Back Barely package), coupled with a continued emphasis on universal vaccination, should allow Democrats to enter the next two elections seasons with the economy in good shape and life returning to normal.

Moreover, Democrats will be able to say that it was only because of Republican recalcitrance that they couldn’t get more done.  That’s a far better position to be in that having done nothing at all.