Washington – A Huge Year End To Do List

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There is one month left in the year and the President and Congress have a huge “to do” list of legislation and not much time to do it. Just in case you’re interested, here’s what’s on the “to do” list.

First up, the annual Defense bill. This bill is usually a bipartisan bill and was passed by the House but has languished in the Senate. It’s become partisan in nature but must be passed this year.

The current stop gap measure for funding the government runs out on December 3rd. The only way to move forward on any other legislation is to pass the 2022 budget bill, which will never happen before the 3rd, so they will have to pass another stop gap continuing resolution. This again will probably turn into a finger pointing partisan exercise.

Raising the nation’s debt ceiling most likely must be done by December 15th or America defaults on its debts. Surprise . . . this is another partisan exercise that will no doubt run right up against the deadline.

Finally, the President’s 2.2 trillion-dollar social spending bill is waiting everyone’s return from the Thanksgiving break. It can’t be done until the tasks detailed above are finished, yet the President and the Democrats are pulling out all the stops to get it done this year.

The real question is, how does this impact you? The legislation that will directly affect you is the social spending bill or reconciliation bill, its formal name is the Build Back Better Act (BBB). It is the center piece of President Biden’s social transformation agenda and, according to House Speaker Pelosi it, “will be the pillar of health and financial security in America.” The Congressional Budget Office (CBO) estimates that it will cost $2.2 trillion and deals with many aspects of our lives. My focus here will be the bill’s impact on your and my healthcare.

While none of this is carved in stone the bill that narrowly passed the House a little over a week ago changed some of the basic ways our healthcare is administered and paid for. That bill contained the following changes to our healthcare:

  • Medicare expansion – Originally the Democrats wanted Medicare to begin covering eye, dental and hearing care. The final bill that passed the House only will cover hearing care.
  • The increasing cost of insulin – These insulin cost increases have been the focus of Congress for over a year. This bill further limits the monthly cost of insulin services to $35.00.
  • Prescription cost cap – Finally Washington has recognized the need to cap the yearly out-of-pocket prescription drug costs. The yearly cost would be capped at $2,000 with a mechanism to smooth the payment of those costs over the year. I have advocated for these changes for years.
  • Allow the government to negotiate prescription drug costs – I’ve talked about this approach often in earlier blogs, pointing out that using the term negotiating is misleading. Normally when you enter into negotiations both sides have some leverage in the discussion with either side having the option to walk away. In these “negotiations” the government sets the price and if the drug manufacturer doesn’t agree, they are taxed at a rate of 65% of last year’s GROSS sales growing to 95% in 9 months. This huge tax makes it impossible for the drug manufacturers to say no. So, the fact remains that the government will not negotiate the price, they will set the price of selected drugs in Medicare Part B and Part D. You have no doubt heard a lot from both sides of this issue. My simple evaluation is that I very, very rarely find it advantageous for the government to get MORE involved in any aspect of our life, especially healthcare.

The Build Back Better Act will surely be changed in the Senate. The discussion on the other legislation that must be passed may turn even more partisan and bitter. This could have an impact on what changes in the BBB or if it even passes. The Democrats cannot afford to lose one Senate Democrat’s vote. Democrat Senators Manchin and Sinema have already voiced concerns with different parts of the bill. Pelosi’s vow that the bill will pass by Christmas seems very optimistic. We’ll keep you updated on the status of this legislation.

If you also think it’s wrong for the government to get more involved in our healthcare, call, email or write to your Senators. Even if your Senators have indicated they are against this part of the bill, get in touch with them and tell them you appreciate their stance.

Best, Thair

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