Congressional Democrats’ first order of business is shoring up and expanding Obamacare, rather than the more ambitious proposals advanced during the election, such as President Biden’s public option or Bernie Sanders’s “Medicare for all.”
Democrats have discussed making Obamacare expansions in the recently passed American Rescue Plan permanent, further expanding Obamacare exchanges and Medicaid, and lowering prescription drug prices.
The American Rescue Plan expanded premium tax credits, also called subsidies, for people purchasing coverage on the Obamacare exchange for two years. On Tuesday, Rep. Frank Pallone said Democrats would be pushing to make that permanent.
“House Democrats as a whole would like to see that made permanent and not have it just for the next two years,” said Pallone, chairman of the Energy and Commerce Committee, one of the committees in the House that has jurisdiction over healthcare policy. “I can speak for all of us that we want to do that.”
DEMOCRATS’ $1.9 TRILLION SPENDING BILL PRESSURES STATES TO EXPAND MEDICAID
Democrats are set to hold hearings next week to examine a host of bills, including ones that would establish a reinsurance fund for health insurers on the Obamacare exchanges and would allow the federal government to fund at 100% for three years the Medicaid expansion for any state that has not yet expanded the low-income health insurance program. The original Obamacare law only funded the first three years at 100% if a state had expanded Medicaid by 2014.
Yet, the hearing will not discuss legislation related to “Medicare for all” or the public option.
Liberal Democrats have been pushing for consideration of sweeping bills to expand government-provided healthcare.
Rep. Ro Khanna, a Democrat from California and a member of the House Progressive Caucus, recently said that the healthcare expansions in the American Rescue Plan were not enough.
“Obviously, it’s an improvement, but I think that it is inadequate given the healthcare crisis that we’re in,” Khanna told the New York Times.
On Wednesday, the House Progressive Caucus, led by Rep. Pramila Jayapal of Washington, introduced the Medicare for All Act of 2021. Medicare is currently a program for the elderly and disabled. Previous versions of the bill would have eliminated private insurance and enrolled everyone living in the U.S. into a government-run plan.
“We’re in a national healthcare crisis,” Khanna said. “Fifteen million people just lost private health insurance. This would be the time for the government to say, at the very least, for those 15 million, that we ought to put them on Medicare.”
Pallone has said that he is committed to holding a hearing on “Medicare for all.” Others are noncommittal.
At a Bipartisan Policy Center panel on Tuesday, Shawn Bishop, chief health adviser for the Senate Finance Committee, and Amy Hall, staff director of the House Ways and Means Health Subcommittee, were asked if their committees would hold hearings on Medicare for all in the next three to six months. Neither could say they would.
“There are a gazillion options for Democrats, and the best option for us is the one that our caucus as a whole, our party, can coalesce around,” said Hall.
President Biden has opposed “Medicare for all.”
A White House spokesperson recently told the Washington Post that Biden “is continuing to pursue his own plan, not Medicare for all.”
Biden campaigned on a public option — a government-funded health insurance program that would be available to people purchasing coverage on the exchanges. Although some members of Congress have introduced legislation to establish a public option, the Biden administration has been silent on the issue since taking office.
Anne Shoup, communications director for the liberal healthcare advocacy group Protect Our Care, attributed that to Biden’s focus on the American Rescue Plan during his first two months.
When asked if she saw Congress voting on a public option this year, she suggested that more discussion was needed.
“There are a few plans out there, but I haven’t seen anyone really coalesce around one. I think there needs to be more discussion as to the best way to move forward with it,” she said. “I think it’s possible, but I wouldn’t have a prediction beyond that.”
Shoup said that there were proposals that her organization would be focusing on in the near term, such as a prescription drug bill.
In late 2019, House Democrats passed H.R. 3, a bill that would allow Medicare to negotiate with drug manufacturers and would require pharmaceutical companies to issue rebates to the federal government whenever the price of certain drugs rose faster than inflation. The bill died in the Senate.
There is considerable interest among Democrats in reviving it.
“We do intend to address H.R. 3 … legislation that will give the [Health and Human Services] Secretary the right to negotiate prices under Medicare, and in general, because of the high cost of prescription drugs,” said Pallone. “That’s another one of our priorities.”
Sen. Ron Wyden, an Oregon Democrat and chairman of the Senate Finance Committee, has also expressed interest in the issue.
“I had a virtual town hall meeting last weekend, and the first question was about prescription drug bills. People are getting mugged at the pharmacy counter,” Wyden said.
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To address that, Wyden wants Medicare to be able to negotiate drug prices and require drugmakers to issue rebates on drugs when prices rise faster than inflation.
