Democrats up pressure on Biden to include Medicare expansion, prescription drugs in ‘families plan’

WASHINGTON — Democrats on Capitol Hill are ramping up pressure on President Joe Biden to make Medicare expansion and prescription drug measures part of his his upcoming American Families Plan proposal as the White House signals it won’t include major health care policy reforms. 

In a letter to Biden Sunday, 17 senators led by Senate Budget Chairman Bernie Sanders, I- Vt., who caucuses with Democrats, pushed for Medicare expansion to be part of the American Families Plan, the second piece of Biden’s “Build Back Better” agenda that he plans to roll out in a speech to Congress Wednesday.

House Speaker Nancy Pelosi last week called for Biden’s plan to include measures to lower health costs and prescription drug prices as House Democrats revived a drug price negotiation bill. 

The American Families Plan is expected to include investments in child care, paid family leave and education, paid for by a combination of tax increases on high-income earners. The White House has described the investments as “human infrastructure” to complement a $2.3 trillion infrastructure and jobs plan, dubbed the American Jobs Plan, that Biden proposed earlier this month. 

WASHINGTON, DC – APRIL 13: U.S. Sen. Bernie Sanders (I-VT) speaks to reporters in the Senate Subway during a roll call vote on April 13, 2021 in Washington, DC. Senate Republicans criticized U.S. President Joe Bidens plan to remove all troops from Afghanistan by September 11, which has been delayed from its initial deadline of May 1. (Photo by Stefani Reynolds/Getty Images) ORG XMIT: 775643907 ORIG FILE ID: 1232293621 (Photo: Stefani Reynolds, Getty Images)

White House press secretary Jen Psaki last week listed health care separately from the families plan as she previewed what Biden will discuss in his speech.

“He will definitely talk in his speech about his commitment to expanding and increasing access to health care,” Psaki said Friday, pointing to action the president already took in his COVID-19 rescue plan to expand Affordable Care Act subsidies and extend the ACA enrollment period.

She added that the American Families Plan “will not represent the totality of every priority item for him and every item on his agenda that he wants to move forward as president.”

President Joe Biden, accompanied by Vice President Kamala Harris, speaks Tuesday, April 20, 2021, at the White House in Washington, after former Minneapolis police Officer Derek Chauvin was convicted of murder and manslaughter in the death of George Floyd. (Photo: Evan Vucci, AP)

While the families plan proposal is still fluid, the Washington Post reported the package will come in at around $1.8 billion. That includes $300 billion for education, including free two-year community college; $225 billion for child care; $225 billion for paid family and medical leave; and $200 billion for pre-kindergarten expansion.

In a last-minute change, The Post reported the plan will also include $200 billion to extend more health insurance subsidies through the Affordable Care Act. It would mean the families plan would include some spending on health care but not at the scale demanded by progressives.

The families plan will not include a $700 billion effort to expand health coverage or reduce government spending on prescription drugs, according to the New York Times, which reported the administration is opting to pursue that as a separate initiative later. 

Sunday, Sanders and Democratic senators asked Biden include proposals to reduce the Medicare eligibility age, which is currently 65, expand Medicare benefits to include hearing dental and vision care, implement a cap on out-of-pocket expenses and negotiate lower drug prices.

“As you know, Medicare has been one of the most successful and popular federal programs in our nation’s history since it was signed into law by President Lyndon Johnson in 1965,” the Senate Democrats’ letter reads. “Now, 55 years later, the time is long overdue for us to expand and improve this program so that millions of older Americans can receive the health care they need, including eyeglasses, hearing aids and dental care.”

Other senators who signed the letter are Debbie Stabenow, D-Mich., Ben Cardin, D-Md., Chris Van Hollen, D-Md., Elizabeth Warren, D-Mass., Ed Markey, D-Mass., Tammy Baldwin, D-Wis., Richard Durbin, D-Ill., Tammy Duckworth, D-Ill., Cory Booker, D-N.J., Kirsten Gillibrand, D-N.Y., Jeffrey Merkley, D-Ore., Richard Blumenthal, D-Conn., Tina Smith, D-Minn., Sherrod Brown, D-Ohio, Sheldon Whitehouse, D-R.I., and Alex Padilla, D-Calif.

Democrats, including Pelosi, have pushed for Biden to make permanent a child tax credit passed earlier in his $1.9 trillion American Rescue Plan. The Post reported the families plan will include a provision that would extend the child tax credit to 2025, which would cost around $400 billion.

In a statement, Pelosi said seniors and families across the country are “counting on us to finally deliver the drug price negotiations they need to afford their medications. Families cannot afford to lose the enhanced ACA benefit passed in the American Rescue Plan, and we must make it permanent.”

Combined, Biden’s American Jobs Plan and American Families would cost around $4 trillion. The president has proposed a hike in the corporate tax rate to pay for the former and is expected to propose increasing the capital gains tax to cover the families plan. The White House has vowed that no families earning less than $400,000 a year would pay more in taxes under the plan.

Republicans have opposed Biden’s infrastructure plan – a group of senators propose a counteroffer one-quarter the price tag – and are expected to also fight the families plan.

Biden could choose to seek passage of both through budget reconciliation, which would require no Republican votes in the evenly divided Senate. The White House has not said whether it will seek passing the jobs and families separately or combine them into one bill.

Reach Joey Garrison on Twitter @joeygarrison.

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