The importance of those Rx savings to other initiatives is one reason I continue to think — and continue to hear from some veteran operatives and staff — that ambitious reforms could actually pass despite all of the familiar obstacles huffpost.com/entry/prescrip…
There are, to be clear, other places to find health care savings.
Hospital and physician fees. Medicare Advantage payments. Etc.
Can make a case for these too, although each one alienates a powerful interest. That is especially difficult if Dems are already battling pharma.
And of course these deliberations are taking place in the context of a larger conversation including other ambitious initiatives that matter to Democrats just as much, if not more.
Climate. Child care. Paid leave. Education. Etc. Even $3.5T can’t cover it all.
Some agenda items could have sunsets, long phase-ins, or both in order to reduce budget impact.
In theory we could see some deficit spending too, although not outside 10-year window because of reconciliation rules. And not clear how that would play, say, with Joe Manchin.
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Via multiple sources, Dem budget negotiators may scale back funding increase for home and community-based care. Like, by more than half -- from $400B, which was what Biden proposed, to below $200B.
Very much in flux, nothing decided. (1)
This is the initiative to boost funding of home care aides and other services that let the elderly, people w/disabilities live at home, stay in labor force, etc. (2)
Medicaid funds these services, but with limited allotments. That creates long waiting lists, plus the care workers are famously underpaid. huffpost.com/entry/joe-bide… (3)
In case you thought conservatives were done with the "death panel" smear, here's the Wall Street Journal editorial page this morning. (1) wsj.com/articles/the-a…
The subject of the editorial is the outrage over a new Alzheimer's drug that will cost $56,000 with scant evidence of benefit.
Editorial sneers about "experts" making that case. Also takes a swipe at Sen. Ron Wyden, who has spoken out against the drug. (2)
Wyden has spent his career as an advocate for seniors & their health care, going back to 1970s when he was with Oregon's chapter of the Gray Panthers.
Also his mother had Alzheimer's, a fact he's cited repeatedly when making the case to help patients & their families. (3)
@JHWeissmann ...although I really think it depends on the issue. With a lot of these, you can dial it down, one way or another, and still get serious benefits.
@JHWeissmann And then you build on later. Make paid leave longer, expand child care to more kids or make it more generous, add dental now and visual later, etc.
Per this chart I made this week, of Senate seats that changed parties 2009 to 2021, Dems had more than a dozen in R-states. Survival strategy for most was to create distance from party & liberal-sounding policies. (2) citizencohn.substack.com/p/one-reason-2…
Here's what Phil Schiliro, who was director of legislative strategy at the White House under Obama, told me for @HuffPost article on this. (Similar quotes in my book on the ACA.)