Monday, July 25, 2022

All Dem (and doc) hands on deck to get Medicare drug negotiation/ACA subsidy boosts across the finish line

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It struck my eye last week  that Doctors for America, a physician advocacy group that supports single-payer healthcare, saw fit to call on member docs (via email) to lobby for what's left of the Democrats' reconciliation bill:

This is a decisive week in Congress with the Senate poised to vote on several crucial pieces of legislation, including allowing the HHS Secretary to negotiate for Medicare drug pricing, out-of-pocket caps in Part D, and rebates for price increases exceeding inflation. There are also new provisions to make vaccines free for Medicare beneficiaries, to stabilize premiums, and expand the Medicare low-income subsidy programs.

We hope the Senate will move forward with a meaningful reconciliation package that includes the drug price provisions before the August recess. But we need to apply pressure to do so.  Remind your senators to choose #PatientsOverPolitics and pass the reconciliation bill this week, including all of the health care provisions promised to the American people. 

Here in New Jersey, where pharma is a dominant industry, we worry about not only Senator Bob Menendez running interference for drug companies, but Rep. Josh Gottheimer, the ultimate corporate Democrat and chief saboteur of the party's agenda and the Build Back Better bill, rustling up a posse to torpedo what's left the reconciliation bill, as he did just before Manchin dropped his bomb in mid-July, killing all the bill's climate change and tax provisions.  Gottheimer, who has amassed a huge war chest, threatened to kill the bill if it included any rollback of Republicans' tax cuts for corporations and the wealthy. Notoriously, he won support from Rep. Mikie Sherrill, NJ-11, a mainstream-to-centrist Democrat who's also the darling of progressive New Jersey activists who got her elected in a longtime Republican district in 2018. 

Sherrill said she wouldn't back the bill unless it rolled back the 2017 Republican tax bill's cap on SALT (state and local tax) deductions -- an essentially progressive measure that disproportionately hits blue states. Rep. Tom Malinowski, who faces a much tougher reelection fight than Sherrill, held steady* at least for raising taxes on corporations, without joining the SALT stickup.  It's obligatory for New Jersey reps to pay at least lip service to rolling back the SALT deduction cap -- but torpedoing what's left of the party agenda in service to this essentially regressive cause should be a third rail -- progressives in the state need to make it one.

This morning, BlueWaveNJ, of which I'm a member, echoes the Doctors for America call, asking members to call NJ senators and reps and demand that they back the emerging Medicare/ACA bill:

While Senator Joe Manchin dealt a hard blow to Democrats' agenda last week by withdrawing support from climate change investments and a partial rollback of Trump's tax breaks for corporations and the wealthy, the remaining parts of an all-Democratic bill, which Manchin expressed support for, are all healthcare-related and vitally important.

...the pharmaceutical industry is dead-set against enabling Medicare to negotiate prices for even a limited subset of drugs, and the industry has substantial influence on Congressional Democrats, including New Jersey Democrats. On Monday, please urge both our Jersey Senators and your Representative to pass these vital healthcare reforms – Medicare negotiation of the prices of vital drugs, a cap on Medicare Part D out-of-pocket costs, and extension of Obamacare subsidy increases that led to a 21% enrollment increase this year.

Meanwhile, Axios reports that it's crunch time for the bill, the strength of which depends in part on which parts the Senate parliamentarian judges to have budgetary impact and therefore be allowable in a budget reconciliation bill. While Senate Democrats don't have to accept the parliamentarian's ruling, I gather that Manchin has allowed her an effective veto.  Democrats aim to pass a bill before the August recess. If they fail, chaos will likely ensue in the ACA marketplace.


* Correction: I earlier reported erroneously that Malinowski also called for SALT inclusion at this juncture, in mid-July. He did so last September, but not at the more recent juncture.

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