A broad framework for the deal released by the White House on Thursday shows that Mr. Biden has abandoned his calls to expand Medicare services to cover vision and dental services for seniors. Both programs were favored by progressives but were unacceptable to moderate Democrats.
Sen. Joe Manchin III, West Virginia Democrat and a key swing vote for the White House’s agenda, in particular argued that a costly expansion of Medicare would be improper, given the long-term funding issues already facing the entitlement program.
“I’ve been very clear: To expand social programs, when you have trust funds that aren’t solvent … just can’t do it,” Mr. Manchin said.
Instead of offering dental and vision benefits, Mr. Biden‘s framework only proposes to expand Medicare to cover hearing services at a cost of $35 billion.
Also out is a proposal by Sen. Bernard Sanders, a self-described socialist from Vermont, to allow Medicare to negotiate the price of prescription drugs.
The proposal was sidelined after another moderate Democrat, Sen. Kyrsten Sinema of Arizona, raised objections.
Ms. Sinema, along with several House Democrats, says allowing Medicare to negotiate prescription drug prices would devastate innovation in the pharmaceutical industry.
The exclusion of his proposal presents a major blow to Mr. Sanders, who chairs the Senate Budget Committee and was officially responsible for putting the package together.
For weeks, Mr. Sanders had publicly claimed that Medicare expansion and lowering the cost of prescription drugs were his “red lines.”
“I have said many times, what the American people want is for us to substantially lower the cost of prescription drugs and have Medicare negotiate prices with the pharmaceutical industry,” he said Wednesday after a meeting at the White House. “The American people want to see Medicare expanded, so that our elderly people will have teeth in their mouths, will be able to have the hearing aids they need, to have the eyeglasses that they need. … Those are the provisions that must be in any bill that we vote for.”
Mr. Biden ignored such calls, and the White House bowed to political reality.
Democrats are planning to push the package through Congress along party lines using budget reconciliation, a process allowing spending measures to pass the 50-50 Senate by a simple majority. So Mr. Biden cannot afford to lose any single vote.
That required tailoring a deal to suit the two lawmakers least likely to support it, Mr. Manchin and Ms. Sinema. It remains to be seen whether the watered-down framework will garner the support of progressives.
“It’s very general right now,” said Rep. Pramila Jayapal, Washington Democrat.
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