Biden Finally Gets His Bill
Terry H. Schwadron
Aug. 8, 2022
After a year of wrangling, the whittled-down, but still apparently mighty climate, tax and health conglomerate bill may serve as a mainstay for the Joe Biden administration finally pushed through the Senate yesterday. A House vote on the same bill is expected this week.
The proposal was repeatedly whittled and reshaped to win the bare minimum of votes of various Democratic senators. Even in this cut-down form, it remains the most comprehensive response to climate change, prescription drug prices and corporate taxes as we have known in decades, maybe ever.
Naturally, as these things go, the bill drew weird responses from the Left and the Right before passing. From the progressive aisles, the Senate voted down a proposal from Sen. Bernie Sanders, (I-Vt.) 97-to-Bernie to add childcare tax credits to the bill. From the right, a surprisingly narrow vote to uphold a parliamentarian ruling that had the effect of limiting a $35 cap on insulin to Medicare patients, but denying it to the wider insured public, left Republicans trying to defend how they oppose prescription price declines.
Even with all the negotiating, lobbying and wheedling, what has emerged from the Senate at core will vastly bolster moves to alternative energy sources, advance electric cars over gas-fueled vehicles, allow Medicare/Medicaid to negotiate for lower drug prices and get corporations to pay a minimum annual tax on profits.
After all the side deals and announcements with Senators Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.), the outcome of a full weekend’s work seemed a foregone conclusion — despite last minute maneuvering to accommodate each of the last two Democrats.
The measure would inject nearly $400 billion into climate and energy programs. In addition to the health benefits. The effect could allow the United States to cut greenhouse gas emissions about 40 percent below 2005 levels by the end of the decade, The New York Times summarized.
Its passage It is a big deal for Biden, the administration, Democrats and it will prove to be endless fodder for politics for the rest of the year.
The Insulin Cap Vote
The insulin matter, a side issue in a big spending bill, popped up to remind us how partisan politics dictates over whatever might be good policy for Americans.
Republican lawmakers led by Sen. Lindsay Graham suddenly were sticklers for a ruling by the Senate parliamentarian to strip the $35 price cap on the cost of insulin for most Americans. The cap on insulin prices violated the Byrd Rule, Graham argued, because it would set prices in the commercial market and therefore couldn’t pass with a simple majority vote.
Republicans left the portion that applies to Medicare patients untouched but eliminated the insulin cap for other patients by invoking the arcane rules that govern the process called “reconciliation” that moves the bill from requiring 60 votes to 50.
At 50, the Democrats can pass the bill. At 60, it would fail. With 50 in hand for the entire bill, Republicans still pitched a last-stand over the insulin provision, which failed 57–43 — with seven Republicans voting with the Democrats.
It was all part of a weekend “vote-a-rama” of lots of would-be amendments meant to undercut support for the whole bill. None of that worked.
But it has left Senate Republicans defending high insulin prices, even as they talk on the campaign trail about the need to fight inflation, high prices and the like. What they want to fight is any perceived win by the Biden administration and Democrats who now will campaign on exactly this issue, as well as on response to covid, maintaining rights to abortion, contraception, same-sex marriage and the culture wars more generally.
It seems like dumb politics to those of us outside the sanctified halls.
We’ll be hearing lots that Democrats want to spend to spur jobs and more sustainable energy costs and to tax corporations often paying nothing, and that Republicans want to solve inflation through magic and press for extreme anti-abortion laws. And we’ll be hearing that Democrats are erroneous in thinking more government spending ever will address high prices, close the border to illegal immigrants or reduce urban crime.
Of course, it could just be that Republican senators who voted against insulin cost caps are funded by Big Pharma, which is true, and would somehow make their opposition yet worse as self-referential rather than thinking about a nation of patients.
More than 1 in 5 insulin users on private medical insurance pay lots more than $35 per month for the medicine, according to a recent analysis from the Kaiser Family Foundation. Seven million Americans require insulin daily. A Yale University study found that 14 percent of those insulin users are spending more than 40 percent of their income after food and housing costs on the medicine. One in three Medicare beneficiaries have diabetes and more than 3.3 million Medicare beneficiaries use common forms of insulin, according to the Centers for Medicare and Medicaid Services
Republican lawmakers earlier had tried to offer their own, more scaled-back version of an insulin price limit, but Democrats rejected it as too narrow.
Maybe we can concentrate on getting the bigger provisions of the bill adopted in practical ways.