The House late Friday passed a $1 trillion infrastructure bill, leaving a vote on President Biden’s larger social and climate package until centrists in the Democratic Party get estimates on its full cost.
The Infrastructure Investment and Jobs Act now heads to the president’s desk for his signature, while the larger Build Back Better Act, which contains many of the healthcare provisions being considered, will go to a vote the week of November 15, according to a statement by President Biden.
“I’m also proud that a rule was voted on that will allow for passage of my Build Back Better Act in the House of Representatives the week of November 15,” Biden said.
The House of Representatives passed a key procedural vote early Saturday morning to line up passage of the Build Back Better Act, according to CNBC.
The Build Back Better Act has cost estimates of $1.75 to $2 trillion. But a group of five centrists in the Democratic Party released a statement Friday night that they would vote for the bill once the Congressional Budget Office confirmed that the cost figures are in line with White House estimates.
“We commit to voting for the Build Back Better Act, in its current form other than technical changes, as expeditiously as we receive fiscal information from the Congressional Budget Office – but in no event later than the week of November 15th,” the group said, according to The Wall Street Journal.
WHY THIS MATTERS
Many of the healthcare provisions are in the Build Back Better Act, but the infrastructure bill does include expanded broadband internet. This will help consumers, especially in rural areas, take advantage of new telehealth policies in the physician fee schedule final rule released by the Centers for Medicare and Medicaid Services last week.
The Build Back Better spending bill includes $165 billion to reduce healthcare premiums for people covered through the Affordable Care Act.
The bill would also provide insurance for an additional four million people through Medicaid and establish a health insurance affordability fund.
It would offer hearing coverage through Medicare and increase coverage for hearing aids.
The law would also permanently extend the Children’s Health Insurance Program (CHIP), which covers nearly eight million children.
The bill also proposes prescription drug reform, allowing Medicare to negotiate lower drug prices – a hard-fought provision of the bill that Democrats have long wanted to include, and which was the subject of intense negotiation this week.
Large majorities want Medicare to negotiate drug prices, with about 83% of all voters in favor of letting the federal government negotiate drug prices, including majorities across all political stripes, according to an October poll from the Kaiser Family Foundation.
PhRMA has spoken out against the proposal as a drug-innovation buster.
The bill includes increased investment in the Teaching Health Center Graduate Medical Education (THCGME) Program and would provide additional funding for healthcare-related initiatives of the Department of Veterans Affairs and $400 million for nursing home worker grants.
THE LARGER TREND
Passage of the massive spending bill has major implications for the nation’s healthcare system at a time when Medicare is in an increasingly precarious financial situation.
While Medicare beneficiaries in a recent survey said they are more concerned about doctor networks than paying premiums, experts say modernizing Medicare and Medicaid means addressing the affordability crisis.
The healthcare provisions in the bill would increase deficits by $553.2 billion from 2022 to 2031, according to cost estimates released by the Congressional Budget Office in October.
Meanwhile, healthcare spending for working Americans has reached all-time high: Between 2015 and 2019, spending increased by 21.8%, or $1,074 per person, with prices rising and utilization declining.
The package has gone through weeks of deal-making and disputes among members of the Democratic Party, resulting in numerous changes to the bill. There was additional last-minute horse trading on Thursday evening in Washington as Democratic leadership tried to bridge divides between its members.