Joe Biden has found over the last few weeks that his “Build Back Better” $3.5 trillion budget reconciliation spending bill might be overly ambitious even for Washington Democrats.
Perhaps most notable among the radical progressive Democrats is Bernie Sanders. He has been typically unwilling to discuss a compromise on one of the most extensive parts of the bill, Medicare expansion.
Sanders envisions Medicare expansion as a stepping stone toward the leftist goal of a complete federal takeover of America’s $2 trillion health care system. The current bill proposes broadening coverage to include dental, vision, and hearing care for individuals already covered by the program.
However, adding even that level of new coverage would be astoundingly expensive. Because of that reality and pressure from moderate Sens. Joe Manchin (D-WV) and Kyrsten Sinema (D-AZ), Biden has decided that Medicare expansion is expendable to get anything at all passed before next year’s crucial midterm elections. Manchin and Sinema have both said they would not vote for the bill’s current proposed $3.5 trillion price tag. Sinema has additionally been insistent that she will not support any new taxes as part of the spending package.
Biden has been blamed for striking Medicare expansion on Manchin and Sinema while saying that he thinks “it’s a good idea” and “not that costly in relative terms” if Medicare is allowed to negotiate drug prices.
As to drug price negotiating, Sanders and the progressives believe that what the proposed plan calls “negotiating” will lower drug prices and generate revenue for coverage expansion. Sanders appears completely unwilling to negotiate away expansion as things currently stand.
Biden may be stuck in the middle of a stand-off he cannot win. If he cannot find some measure that Sanders will support that is not rejected out of hand by Manchin or Sinema, he will be left with at least one vote less than the 50 he must-have in the Senate to move any bill forward.
Meanwhile, the House Progressive Caucus seems insistent that it will not move forward with even the $1.2 trillion bipartisan infrastructure bill unless the Senate first agrees to a reconciliation spending bill that they will accept.
The next few days may still spell doom for the “Build Back Better” spending spree. That could indeed be encouraging news for America.