Most Americans support Medicare negotiation despite claims it would hurt innovation

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IMAGE: FEW AMERICANS BELIEVE NEGOTIATING DRUG PRICES WILL HURT PHARMACEUTICAL INNOVATION AND COMPETITION; MOST WANT GOVERNMENT TO PLAY MAJOR ROLE IN CONTROLLING COSTS view more 

CREDIT: WEST HEALTH-GALLUP

WASHINGTON, DC - JUNE 3, 2021 -- A new West Health/Gallup survey finds nearly all Democrats (97%) and the majority of Republicans (61%) support empowering the federal government to negotiate lower prices of brand-name prescription drugs covered by Medicare. Overall, 8 in 10 Americans prefer major government action to control prices over concerns about it hurting innovation and competition from the pharmaceutical industry. The results come from a nationally representative poll of more than 3,700 American adults.

While President Joe Biden, Democrats in Congress and former President Donald Trump have called for such negotiation, Republicans on Capitol Hill and the pharmaceutical industry itself have been fiercely opposed to the measure, claiming lower prices would hurt competition and reduce innovation. However, this belief is not widely shared among the American people. According to the survey, less than 20% of all Americans believe Medicare negotiation would hurt innovation or market competition, including a minority of Republicans (39%).

"Americans aren't buying the claim that attempts to reign in drug prices will stifle innovation and devastate the pharmaceutical industry," said Tim Lash, Chief Strategy Officer for West Health, a family of nonprofit and nonpartisan organizations dedicated to lowering healthcare costs to enable successful aging. "These misleading arguments are meant to preserve profits rather than protect patients. The time has come to finally enable Medicare negotiation. Americans are becoming increasing restless for it to happen even if the pharmaceutical companies are not."

If enacted, Medicare negotiation as described in H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, is projected to save the federal government, businesses, and workers hundreds of billions of dollars by 2030. According to a new analysis from West Health and its Council for Informed Drug Spending Analysis (CIDSA), private employers could also save $195 billion and workers would see another $98 billion in savings. These savings are in addition to the estimated savings of $456 billion in federal direct spending forecast by the Congressional Budget Office (CBO).

When choosing between the need for major reform in drug pricing and maintaining the status quo, 90% of Americans chose to support reforms, including 96% of Democrats, 88% of Independents and 83% of Republicans. Sweeping support also exists for specific actions including setting limits on out-of-pocket costs for prescription drugs (87% strongly or somewhat supporting) and general healthcare (84%) in Medicare and limiting hospital charges for those with private insurance (83%), and allowing Medicare to negotiate drug prices for all Americans, not just Medicare beneficiaries, is supported by 70% of respondents.

"There is little question that substantial public support exists for more government action when it comes to addressing drug costs," said Dan Witters, Gallup senior researcher. "And while there are differences across the political spectrum, even among Republicans, sentiment for public action is substantial."

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About Gallup

Gallup delivers analytics and advice to help leaders and organizations solve their most pressing problems. Combining more than 80 years of experience with its global reach, Gallup knows more about the attitudes and behaviors of employees, customers, students and citizens than any other organization in the world.

About West Health

Solely funded by philanthropists Gary and Mary West, West Health is a family of nonprofit and nonpartisan organizations including the Gary and Mary West Foundation and Gary and Mary West Health Institute in San Diego, and the Gary and Mary West Health Policy Center in Washington, D.C. West Health is dedicated to lowering healthcare costs to enable seniors to successfully age in place with access to high-quality, affordable health and support services that preserve and protect their dignity, quality of life and independence. Learn more at westhealth.org and follow @westhealth.

 

New Study Reveals Flawed Predictions of Runaway Costs and Usage Under Medicare for All

"Analysts who've confidently projected a tsunami of healthcare use and costs after Medicare for All are ignoring history."

by

Kenny Stancil, staff writer

The audience waves signs as Sen. Bernie Sanders (I-Vt.) speaks during an 

event to introduce the Medicare for All Act of 2017 on Wednesday, September 13, 2017. (Photo: Bill Clark/CQ Roll Call)

With the Covid-19 pandemic raging and recognition of the inadequacy and injustice of America's for-profit healthcare system at a possible zenith, a new study released Tuesday reveals that projections of large and costly usage increases under a single-payer program have been overstated, bolstering the case that Medicare for All would save both lives and money.

In a paper published Tuesday in Health Affairs, Drs. Adam Gaffney, David Himmelstein, and Steffie Woolhander of Cambridge Health Alliance/Harvard Medical School and James Kahn of the University of California San Francisco—all associated with Physicians for a National Health Program, which advocates for Medicare for All—analyze the relationship between universal healthcare and the use of medical services.

"Nearly all predictions of utilization surges stemming from universal coverage expansions are overestimates."
—Gaffney et al., Health Affairs

What the researchers find is that most estimates of the effect of universal coverage expansion on healthcare utilization are overblown, adding to a growing consensus that Medicare for All is less costly than previously thought due to lower administrative costs and usage rates that increase only slightly or not at all.

The authors anticipate that "debate over public coverage expansion and its costs" is likely to grow as a result of the pandemic's exposure of the problems with employment-based insurance and the return of a Democratic administration to the White House.

In contrast to most models of the relationship between coverage expansions and utilization changes, the authors' findings, based on examining the history of past coverage expansions in the U.S. and 10 other affluent countries, are more modest.

While demand for medical services is elastic, meaning that "people use more healthcare when the price they pay is lower and less care when prices rise," the authors contend that prior research documenting the effect of coverage expansions on healthcare use and costs have underestimated the impact of "supply-side constraints."

Although the number of physicians and hospital beds is malleable in the long-run, current limitations on supply can provoke a reduction in the provision of low-value services and yield a more egalitarian prioritization of care, the authors say.

As Dr. Gaffney explained in a statement Tuesday,  "Our findings clash with the traditional economic teaching: that giving people free access to care would cause demand and utilization to soar."

"That traditional thinking ignores the 'supply' side of the health care equation: doctors' and nurses' time and hospital beds are limited, and mostly already fully occupied," Gaffney added. "When doctors get busier, they prioritize care according to need, and provide less unnecessary care to those with minimal needs to make way for patients with real needs."

Between 1973 and 2020, various models have projected utilization increases ranging from 2% to at least 21%, but according to the authors, "nearly all predictions of utilization surges stemming from universal coverage expansions are overestimates."

There are a handful of studies that have sought to quantify how extending coverage to individuals affects healthcare consumption, but "the effect of universal coverage on society-wide utilization may differ from the effects of providing coverage for individuals," the authors write.

"Past society-wide coverage expansions haven't caused surges in healthcare use, so analysts who've confidently projected a tsunami of healthcare use and costs after Medicare for All are ignoring history," said Dr. Woolhandler. 

According to the authors' review of the historical record, "universal coverage expansion would increase ambulatory visits by 7-10% and hospital use by 0-3%," while "modest administrative savings could offset the costs of such increases."

New @Health_Affairs study finds that “first-dollar universal coverage expansion would increase ambulatory visits by 7–10% and hospital use by 0–3%.” #MedicareForAll would *not* overwhelm the health care delivery system. https://t.co/ayeZkzyrTq via @awgaffney @swoolhandler

— Physicians for a National Health Program (@PNHP) January 5, 2021

Notwithstanding discrepancies about the extent to which usage rates change in relation to coverage expansions, one finding shared by all analyses, the authors emphasize, is that "utilization-related cost increases would be partially or fully offset by savings on drug prices or reductions in provider fees, waste, and administrative costs."

As Common Dreams reported last month, the Congressional Budget Office (CBO) has estimated that implementing a single-payer health insurance program in the U.S. would reduce overall healthcare spending nationwide by about $650 billion per year.

"When doctors get busier, they prioritize care according to need, and provide less unnecessary care to those with minimal needs to make way for patients with real needs."
—Dr. Adam Gaffney, Harvard Medical School

Between the CBO's finding that Medicare for All's administrative cost savings have been underestimated and Gaffney et al.'s finding that the effects of universal coverage reforms on healthcare utilization and costs have been overestimated, it is becoming increasingly clear that in addition to saving lives, Medicare for All would be less expensive than previously acknowledged.

"In projecting the impacts of coverage expansions, analysts who fail to accurately account for supply-side factors will overestimate the costs of reform," the authors write. "Such errors may cause policymakers to mistakenly conclude that reforms that would cover millions of Americans are unaffordable."

"Conversely," they continue, "policies that increase the supply of medical resources are likely to increase utilization, even without coverage expansions... Supply expansions that are not tailored to need could have the unintended consequences of boosting the provision of low-value care and costs."

The authors insist that like other countries, the U.S. can constrain "utilization and cost growth without resorting to cost barriers while achieving universal coverage and a more equitable distribution of care."

As Matt Bruenig of the People's Policy Project wrote last month, "The barriers to the policy are not technical deficiencies or costs, but rather political opposition from Republicans and conservative Democrats who would rather spend more money to provide less healthcare."

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Protesters disrupt traffic, light fires in France over Macron’s retirement age push


Demonstrators holds banners as they gather on the place de la Concorde near the National Assembly, with the Eiffel tower in the background, to protest after French Prime Minister Elisabeth Borne delivered a speech to announce the use of the article 49.3, a special clause in the French Constitution, to push the pensions reform bill through the lower house of parliament without a vote by lawmakers, in Paris, France, March 16, 2023. (Reuters)

The Associated Press
Published: 17 March ,2023: 

Protests against French President Emmanuel Macron’s decision to force a bill raising the retirement age from 62 to 64 through parliament without a vote disrupted traffic, garbage collection and university campuses in Paris as opponents of the change maintained their resolve to get the government to back down.

Striking sanitation workers blocked a waste collection plant that is home to Europe’s largest incinerator to underline their determination, and university students walked out of lecture halls to join the strikes. Leaders of the influential CGT union called on people to leave schools, factories, refineries and other work places.

Union leaders were not the only ones angry about Macron’s plan to make French citizens work for two more years before becoming eligible to collect full pensions. Opposition parties were expected to start procedures later Friday for a no-confidence vote on the government led by Prime Minister Elisabeth Borne. The vote would likely take place early next week.

Macron ordered Borne on Thursday to make use of a special constitutional power to push the highly unpopular pension bill through without a vote in the National Assembly, France’s lower house of parliament.

His calculated risk infuriated opposition lawmakers, many citizens and unions. Thousands gathered in protest Thursday at the Place de la Concorde, which faces the National Assembly building. As night fell, police officers charged the demonstrators in waves to clear the Place. Small groups then moved through nearby streets in the chic Champs-Elysees neighborhood,. setting street fires.

Similar scenes repeated themselves in numerous other cities, from Rennes and Nantes in eastern France to Lyon and the southern port city of Marseille, where shop windows and bank fronts were smashed, according to French media.

French Interior Minister Gérald Darmanin told radio station RTL on Friday that 310 people were arrested overnight. Most of the arrests, 258, were made in Paris, according to Darmanin.

The trade unions that had organized strikes and marches against a higher retirement age said more rallies and protest marches would take place in the days ahead. “This retirement reform is brutal, unjust, unjustified for the world of workers,” they declared.

Overwhelming streets with discontent and refusing to continue working is “the only way that we will get them to back down,” CGT union representative Régis Vieceli told The Associated Press on Friday. He added: “We are not going to stop.”

Macron has made the proposed pension changes the key priority of his second term, arguing that reform is needed to make the French economy more competitive and to keep the pension system from living into deficit. France, like many richer nations, faces lower birth rates and longer life expectancy.

Macron decided to invoke the special power during a Cabinet meeting a few minutes before a scheduled vote in the National Assembly, where the legislation had no guarantee of securing majority support. The Senate adopted the bill earlier Thursday.

Opposition lawmakers demanded the government to step down. If the expected no-confidence motion fails, the pension bill would be considered adopted. If it passes, it would also spell the end Macron’s retirement reform plan and force the government to resign, a first since 1962.

Macron could reappoint Borne if he chooses, and a new Cabinet would be named.

Macron’s centrist alliance has the most seats in the National Assembly, where a no-confidence motion also requires majority support. Left-wing and far-right lawmakers are determined to vote in favor.

Leaders of the The Republicans have said their conservative party would not back the motion. While some party lawmakers might stray from that position, they are expected to be a minority.

Fiery Protests Erupt Across Paris as Macron Tries to Force Pension Changes

‘DENIAL OF DEMOCRACY’

Lawmakers swore to introduce a no-confidence motion after Emmanuel Macron’s government invoked Article 49.3 of the French Constitution, ducking the need for a vote on the bill.

AJ McDougall
Breaking News Reporter
Updated Mar. 16, 2023 

Stephane Mahe/Reuters

Thousands of people furious with the French government’s plan to raise the retirement age by two years gathered to stage a protest on Thursday, with the demonstrations escalating into clashes with the police and fire-setting after reports emerged that President Emmanuel Macron would ram the reform through without a parliamentary vote.

Inside the National Assembly chamber, where lawmakers had just learned they’d been denied a vote on the measure, equally livid representatives from both sides of the aisle banged on their desks and belted out La Marseillaise, the French national anthem, trying to drown out Prime Minister Élizabeth Borne as she attempted to explain what had just happened—and why.



“We cannot bet on the future of our pensions,” she said from the speaker’s dais, according to CNN. Macron’s deeply unpopular pension bill would raise the legal retirement age from 62 to 64 and tighten restrictions around granting full pensions before age 67.

“This reform is necessary,” she added, barely audible over the jeers.


Pacal Rossignol/Reuters

Borne gave up after less than 10 minutes, The New York Times reported. Opposition lawmakers streamed out of the chamber to angrily denounce the decision to invoke Article 49.3 of the French Constitution, allowing Macron to avoid a vote in the assembly, where he’d had no guarantee of a majority. He’d invoked the constitutional power in a Cabinet meeting just minutes before the vote had been scheduled to be held.

“Today is the first day of the end of Emmanuel Macron’s term,” Mathild Panot, the leader of the left-wing France Unbowed party, fumed to reporters downstairs.

“The government’s use of the 49.3 procedure reflects the failure of this presidential minority,” Charles de Courson, an independent lawmaker, told the BFMTV news channel. “They are not just a minority in the National Assembly, they are a minority in the whole country. The denial of democracy continues.”

Elsewhere in the throng, Marine Le Pen, the head of the far-right National Rally party, expressed the same sentiment. Later, she tweeted, “After the slap that the Prime Minister just gave the French people, by imposing a reform which they do not want, I think that Élisabeth Borne should go.”

Stephane Mahe/Reuters

Opposition leaders on both sides suggested that a no-confidence motion would be brought against Macron and his government on Friday. If successful, it would mark the first such case since 1962. Macron previously survived two no-confidence votes over a budget bill similarly forced through under 49.3 last October, four months after his centrist alliance lost its parliamentary majority.

Outside and across the river Seine, people had gathered in the Place de la Concorde to demonstrate, waving flags, signs, and balloons amid a generally jovial atmosphere. Students marched and called for a general strike. A group of women danced to Gloria Gaynor’s “I Will Survive,” the Times reported, having amended the lyrics slightly: “To the grave for the working class. No to 64 years.” One man sold sandwiches out of the back of his van.

But as night fell, police moved in to clear out the square, and the protests became more chaotic. Jean-Luc Melenchon, a leftist and former member of the National Assembly, told the crowd at the Place that Macron had “gone over the heads of the will of the people,” according to the Associated Press. A fire was lit in the center of the square as officers in riot gear fired tear gas at the crowds. At least 217 people were arrested, Paris police headquarters said late Thursday, according to Le Monde.

Union leaders vowed to maintain their opposition to the pension reform, a deeply sensitive subject in France, with the Confédération Générale du Travail announcing another national day of strikes and demonstrations next Thursday. It would mark the ninth such day in two months, according to the Times.

What's Happening in France? Videos Show Paris Burning in Protest

BY KAITLIN LEWIS 

ON 3/16/23 

Protests have broken out across the city of Paris in response to French President Emmanuel Macron raising the retirement age by two years on Thursday, a controversial decision that sidestepped a vote that was scheduled to occur just minutes later in the National Assembly.

Macron and his proponents argue that the reform, which raised the retirement age from 62 to 64, was necessary to save the country's pension system from going bankrupt. France's lower house of parliament was scheduled to vote on the reform, but Macron invoked Article 49.3, a constitutional provision that allows the measure to be pushed through without a parliamentary vote.

The debate mimics an ongoing discussion in the United States as analysts predict that the country's Social Security program could become insolvent by the middle of the next decade. However, any suggestions to the pension system, including raising the age requirement to access its benefits, have been met with hard scrutiny.

Protesters on Thursday rally against the French government at Place de la Concorde after lawmakers pushed pension reform through parliament without a vote in Paris. According to preliminary reports, at least 120 people were arrested in clashes with Parisian police.

KIRAN RIDLEY/GETTY IMAGES

Videos began circulating on Twitter Thursday evening of protesters clashing with Parisian police forces in response to Macron's decision. French broadcaster BFMTV posted a compilation of videos taken in the Place de la Concorde—a plaza in Paris adjacent to the National Assembly building—that captured several fires ignited in the protests.

Another video posted by the Trades Union Congress, a union federation based in the United Kingdom, shows a large mass of people gathered at the plaza, with fires dispersed throughout the crowd.



According to a report from British broadcaster Sky News, Macron's decision also elicited protests within the French parliament, including some politicians singing the French national anthem and holding plaques reading: "No to 64 years."

The report from Sky News also captured police dressed in riot gear tossing what they labeled as tear gas toward the rioters. Another video from the broadcaster showed police charging at the crowd gathered at Place de la Concorde.

Preliminary reports say that at least 120 demonstrators were arrested Thursday night, according to a report from France Bleu.

In the U.S., some GOP-proposed reforms have included raising the eligibility age for Social Security and Medicare from 67 to 70. At the moment, any citizen born after 1960 is entitled to full retirement benefits at age 67.

Meanwhile, Democratic leaders, including President Joe Biden, have accused the GOP of wanting to slash Social Security in its entirety. The topic is shaping up to be a potential defining issue in the 2024 presidential election, with some candidates like Republican Nikki Haley proposing an older age of retirement.

Newsweek has contacted the French Embassy to the U.S. via email for comment.

IN PHOTOS: Fiery protests erupt across France after Macron pushes pension reform

By Sean Boynton Global News
Posted March 16, 2023 


Fiery protests raged across France Thursday night and into Friday morning after President Emmanuel Macron ordered his prime minister to wield a special constitutional power that skirts parliament to force through a highly unpopular bill raising the retirement age from 62 to 64 without a vote.

At the Place de la Concorde across from the National Assembly in Paris where the legislative drama unfolded, thousands of protesters gathered and lit a bonfire. The demonstrators included members of workers’ unions who have been holding strikes and marches against the pension reform since January.

READ MORE: France’s Macron invokes special power to adopt pension reform without vote

Riot police moved in to clear the area as night fell, sending small groups into nearby streets where they set garbage on fire.

At least 120 people were detained, police said.

Pallets burn as protesters demonstrate at Concorde square near the National Assembly in Paris, Thursday, March 16, 2023. French President Emmanuel Macron has shunned parliament and opted to push through a highly unpopular bill that would raise the retirement age from 62 to 64 by triggering a special constitutional power. (AP Photo/Thomas Padilla).

Firefighters put out a fire near Concorde square after a demonstration in Paris, Thursday, March 16, 2023. French President Emmanuel Macron has shunned parliament and imposed a highly unpopular change to the nation’s pension system, raising the retirement age from 62 to 64. (AP Photo/Lewis Joly).

Garbages are set on fire by protesters after a demonstration near Concorde square, in Paris, Thursday, March 16, 2023. French President Emmanuel Macron has shunned parliament and imposed a highly unpopular change to the nation’s pension system, raising the retirement age from 62 to 64. (AP Photo/Lewis Joly).

Police officers clear the Concorde square after a demonstration near the National Assembly in Paris, Thursday, March 16, 2023. French President Emmanuel Macron has shunned parliament and imposed a highly unpopular change to the nation’s pension system, raising the retirement age from 62 to 64. (AP Photo/Lewis Joly).

Protesters stand in a cloud of teargas after a demonstration in Paris, Thursday, March 16, 2023. French President Emmanuel Macron has shunned parliament and imposed a highly unpopular change to the nation’s pension system, raising the retirement age from 62 to 64. (AP Photo/Lewis Joly).

Similar scenes repeated themselves in numerous other cities, from Rennes and Nantes in the east to Lyon and the southern port city of Marseille, where shop windows and bank fronts were smashed.

Radical leftist groups were blamed for at least some of the destruction.

The unions announced new rallies and protest marches in the days ahead. “This retirement reform is brutal, unjust, unjustified for the world of workers,” they declared.

Sanitation workers have been among those participating in the strikes, which have led to piles of garbage in the streets of Paris.

People run from tear gas fired by French riot police during a demonstration in Marseille, southern France, Thursday, March 16, 2023. French President Emmanuel Macron has shunned parliament and imposed a highly unpopular change to the nation’s pension system, raising the retirement age from 62 to 64. (AP Photo/Daniel Cole).

Protesters march during a demonstration in Marseille, southern France, Thursday, March 16, 2023. French President Emmanuel Macron has shunned parliament and imposed a highly unpopular change to the nation’s pension system, raising the retirement age from 62 to 64. (AP Photo/Daniel Cole).

A French riot policeman stands next to a broken shop window during a demonstration in Marseille, southern France, Thursday, March 16, 2023. French President Emmanuel Macron has shunned parliament and imposed a highly unpopular change to the nation’s pension system, raising the retirement age from 62 to 64. (AP Photo/Daniel Cole).

Police advance as protesters light bins on fire during a demonstration in Marseille, southern France, Thursday, March 16, 2023. French President Emmanuel Macron has shunned parliament and imposed a highly unpopular change to the nation’s pension system, raising the retirement age from 62 to 64. (AP Photo/Daniel Cole).

Macron has made the proposed pension changes the key priority of his second term, arguing that reform is needed to keep the pension system from diving into deficit as France, like many richer nations, faces lower birth rates and longer life expectancy.

The president decided to invoke the special power during a Cabinet meeting at the Elysee presidential palace, just a few minutes before the scheduled vote in France’s lower house of parliament, because he had no guarantee of a majority.

Speaking above the cries of protesting lawmakers in the National Assembly Thursday, Prime Minister Elisabeth Borne acknowledged that Macron’s unilateral move will trigger quick motions of no-confidence in his government.

Marine Le Pen said her far-right National Rally party would do just that, and Communist lawmaker Fabien Roussel said such a motion is “ready” on the left.

Policemen clear the protesters out of the Concorde square after a demonstration near the National Assembly in Paris, Thursday, March 16, 2023. French President Emmanuel Macron has shunned parliament and imposed a highly unpopular change to the nation’s pension system, raising the retirement age from 62 to 64. (AP Photo/Thomas Padilla).

Firefighters put out a fire near Concorde square after a demonstration in Paris, Thursday, March 16, 2023. French President Emmanuel Macron has shunned parliament and imposed a highly unpopular change to the nation’s pension system, raising the retirement age from 62 to 64. (AP Photo/Lewis Joly).

Protesters demonstrate at Concorde square near the National Assembly in Paris, Thursday, March 16, 2023. French President Emmanuel Macron has shunned parliament and opted to push through a highly unpopular bill that would raise the retirement age from 62 to 64 by triggering a special constitutional power. (AP Photo/Thomas Padilla).

—With files from the Associated Press

WATCH: Protests in France as pension reform bill forced through National Assembly without a vote

AOC Warns Pelosi and Schumer: 'We Can't Negotiate Reconciliation Bill Down to Nothing'

"The Build Back Better reconciliation package is a once-in-a-generation opportunity to build a sustainable and prosperous future for our country."



Rep. Alexandria Ocasio-Cortez speaks at a rally in New York City on June 5, 2021.

 (Photo: Lev Radin/Pacific Press/LightRocket via Getty Images)

JAKE JOHNSON

COMMON DREAMS

October 12, 2021

Rep. Alexandria Ocasio-Cortez joined seven of her fellow New York Democrats on Tuesday in issuing a warning to House Speaker Nancy Pelosi and Senate Majority Leader Chuck Schumer: Don't cut funding for housing, transportation, or immigration reform from the emerging reconciliation bill in an attempt to appease right-wing lawmakers.

"We can't let corporate interests, Big Pharma, and a few conservative Democrats stand in our way of delivering."

"We can't negotiate the reconciliation bill down to nothing," Ocasio-Cortez tweeted.

In their letter, the New York Democrats argued that "the Build Back Better reconciliation package is a once-in-a-generation opportunity to build a sustainable and prosperous future for our country—affordable housing; quality, sustainable, and accessible public transportation; and sound immigration reform must remain priorities in the debate."

Specifically, the House Democrats urged Pelosi and Schumer to ensure that the final reconciliation package includes $80 billion in funding for public housing, a $10 billion investment in public transportation, and $107 billion to "expand safety-net protections and create a pathway to citizenship for millions of DACA recipients, people with temporary protected status, essential workers, and farm workers."

"It is vital that we preserve the entirety of this funding allocation, not only because these communities have been the backbone of our national economy throughout this pandemic and beyond, but also because the U.S. is their only home and refuge from the political, economic, and climate disasters they are fleeing," the lawmakers wrote.


The message from Ocasio-Cortez and other members of the New York congressional delegation was made public hours after Pelosi circulated a "Dear Colleague" letter indicating that the Democratic leadership could be considering cutting programs from the reconciliation bill in order to lower its $3.5 trillion price tag—an effort aimed at securing the votes of Sens. Joe Manchin (D-W.Va.), Kyrsten Sinema (D-Ariz.), and other corporate-backed holdouts.

"Overwhelmingly," Pelosi wrote, "the guidance I am receiving from members is to do fewer things well so that we can still have a transformative impact on families in the workplace and responsibly address the climate crisis."

That approach could spark backlash from progressive lawmakers such as Ocasio-Cortez, who has argued that Democrats should shorten the duration of programs to reduce costs, not cut out key priorities. Pelosi did not specify which programs are at risk of being removed from the reconciliation package, which is a centerpiece of President Joe Biden's domestic policy agenda.

"One of the ideas that's out there is: fully fund what we can fully fund, but maybe instead of doing it for 10 years, we fully fund it for five years," Ocasio-Cortez said during an interview with CBS earlier this month. "I think it's unfortunate that we have to even, as Democrats, have a discussion about not having a child tax credit. I think it's unfortunate that we have to compromise with ourselves for an ambitious agenda for working people."

Speaking to the press Tuesday morning, Pelosi suggested that Democrats could go the route suggested by Ocasio-Cortez and other progressives—a message that conflicts with the sentiment of her "Dear Colleague" letter. The House Speaker voiced "hope" that Democrats ultimately won't have to drop any programs from the reconciliation measure.

The push by right-wing Democrats to slash the reconciliation bill's price tag has set off a scramble among lawmakers to ensure that programs they support—from Medicare expansion to the expanded child tax credit to paid family leave—aren't left on the cutting room floor. Progressive lawmakers in the House and Senate have argued that there is no need to pit priorities against one another in the name of fiscal restraint.

Sen. Bernie Sanders (I-Vt.) told reporters Tuesday that "$3.5 trillion is already a major compromise."

"The time is now long overdue for Sen. Manchin and Sen. Sinema to tell us… where do they want to cut?" Sanders added.

Referring to progressives' effort to expand Medicare benefits to cover dental, hearing, and vision, the Vermont senator said: "This to me is not negotiable. This is what the American people want."



During a recent closed-door Congressional Progressive Caucus (CPC) meeting, according to the Washington Post, "members stood up one by one to vouch for establishing universal pre-K, making the child tax credit permanent, and guaranteeing 12 weeks of paid family leave."

"Others mentioned the need to expand Medicare to cover dental, hearing, and vision, which would get them one step closer to the progressive goal of Medicare for All," the Post noted.

In a tweet on Tuesday, Rep. Pramila Jayapal (D-Wash.)—chair of the 96-member CPC—declared that "the agenda that Progressives are fighting for IS the president's agenda."

"We must pass the full Build Back Better Act—and we can't let corporate interests, Big Pharma, and a few conservative Democrats stand in our way of delivering," Jayapal added.

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Sanders, Jayapal Say Medicare Expansion in Reconciliation Package 'Not Negotiable'

"This is what the American people want," the socialist senator from Vermont insisted.


Sen. Bernie Sanders (I-Vt.) and Reps. Pramila Jayapal (D-Wash.) and Alexandria Ocasio-Cortez (D-N.Y.) appear at a press conference outside the U.S. Capitol in Washington, D.C., on June 24, 2019. (Photo: Saul Loeb/AFP via Getty Images)

BRETT WILKINS

COMMON DREAMS

October 12, 2021

As congressional progressives push back against right-wing Democrats seeking to shrink the size and scope of the Build Back Better Act, Sen. Bernie Sanders and Rep. Pramila Jayapal on Tuesday insisted that expanded Medicare benefits must remain part of the $3.5 trillion budget reconciliation package.

"I do understand that the healthcare industry does not like this idea, but maybe, just maybe, we stand with the American people."

In a call with journalists reported by The Hill, Sanders (I-Vt.), who chairs the Senate Budget Committee, adamantly declared that dental, hearing, and vision benefits must be added to Medicare as part of the Democrats' flagship package.

"This to me is not negotiable," he said. "This is what the American people want."

Jayapal (D-Wash.), chair of the Congressional Progressive Caucus, backed Sanders—the group's only Senate member—saying his stance is also "the position of the House Progressive Caucus."

Sanders, in recent tweets, has pointed to polling showing that expanding Medicare to cover dental, hearing, and vision is overwhelmingly popular, with 84% of U.S. voters supporting the proposal. A new survey published Tuesday by the Kaiser Family Foundation also found that 83% of respondents favor empowering Medicare to leverage its prodigious purchasing power to secure lower prescription drug prices.

Sanders noted industry opposition to Medicare expansion during Tuesday's call.

"I do understand that the healthcare industry does not like this idea, but maybe, just maybe, we stand with the American people," he said. "There are millions of seniors who have rotting teeth in their mouths or are unable to hear what their grandchildren are saying."

Echoing her progressive colleagues, Sen. Elizabeth Warren (D-Mass.) tweeted: "We are fighting for roads and bridges, universal child care, Medicare expansion, and climate investments. We know what we need and progressives in Congress will continue to hold strong."

Earlier Tuesday, Common Dreams reported that eight House Democrats representing New York City—including progressive Reps. Alexandria Ocasio-Cortez and Jamaal Bowman—sent a letter to House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Chuck Schumer (D-N.Y.) warning them against slashing funding for public housing, transportation, and immigration reform from the Build Back Better Act.

"We can't negotiate the reconciliation bill down to nothing," Ocasio-Cortez tweeted.

However, Pelosi indicated in a Monday letter to House colleagues that Democratic leaders are open to considering scaling back the proposed legislation to reduce its $3.5 trillion cost in a bid to win the support of right-wing Democrats including Sens. Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.), who have balked at the bill's price tag.

Responding to the letter, Sanders said that "$3.5 trillion is already a major compromise."

Tweeting Tuesday against potential cuts in the bill, Rep. Mondaire Jones (D-N.Y.) said that "we cannot pit child care against Medicare expansion, or pre-K against free community college."

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The Media Keeps Getting It Wrong: The Democrats Are Not Divided

Just a few members out of the hundreds of Democrats elected to the House and Senate are stalling the President's agenda.

(L-R) Rep. Lisa Blunt Rochester (D-DE), Speaker of the House Nancy Pelosi (D-CA), Senate Minority Leader Charles Schumer (D-NY) and other Congressional Democrats hold a rally and news conference ahead of a House vote on health care and prescription drug legislation in the Rayburn Room at the U.S. Capitol May 15, 2019 in Washington, D.C. 

(Photo: Chip Somodevilla/Getty Images)

PETER DREIER

October 12, 2021

 by Talking Points Memo (TPM)

Historians describe Franklin D. Roosevelt's 1936 presidential victory (with 60.8% of the popular vote), Lyndon Johnson's 1964 triumph (61.1%), and Ronald Reagan's 1984 win (58.8%) as "landslide" elections. Likewise, in 2018, the San Diego Union-Tribune and many other news outlets described Democrat Gavin Newsom's defeat of Republican John Cox for the California governorship by a 62% to 32% margin as a "landslide." When a recent poll found that 65% of Americans support vote-by-mail during the COVID pandemic, a USA Today headline proclaimed that the support was "overwhelming." Reporting on a survey showing that 73% of American voters supported President Biden's plan to withdraw U.S. troops from Afghanistan, another news outlet, The Hill, described it as an "overwhelming majority." A news story reporting that 94% of American voters embrace universal background checks for gun-buyers called that support "near unanimous." A few years ago, another news story used the same phrase—"near unanimous"—when 61 of 64 coaches (95.3%) ranked the University of Alabama football team as the best in the country.

Senators Joe Manchin of West Virginia and Krysten Sinema of Arizona, typically described as "moderates" or "centrists," are the only hold-outs.

Currently, 96% of Democrats in Congress support President Biden's social safety net and clean energy reconciliation package, but the the media have consistently described the Democrats as "deeply divided," "fractious," "feuding," and even "in disarray" over the plan. "The Democrats are at war with each other," said Washington Post reporter Robert Costa on a recent episode of the Bill Maher show.

In the Senate, 48 of the 50 Democrats (96%) embrace the Biden legislation. Senators Joe Manchin of West Virginia and Krysten Sinema of Arizona, typically described as "moderates" or "centrists," are the only hold-outs.

In the House, 210 out of 220 Democrats (again, 96%) have indicated that they will vote for Biden's plan, which would invest $3.5 trillion over ten years in child care, education, health care, and climate change. Only 10 House Democrats (also described as "moderates" or "centrists")—Carolyn Bourdeaux (Georgia), Ed Case (Hawaii), Scott Peters and Jim Costa (California), Henry Cuellar, Filemon Vela, and Victor Gonzalez (Texas), Jared Golden (Maine), Josh Gottheimer (NJ), and Kurt Schrader (Oregon)—are not yet on board the Biden plan.

The 95-member House Progressive Caucus initially embraced Senator Bernie Sanders' plan for a $6 trillion (over ten years) package, but agreed to support Biden's much trimmed-down $3.5 trillion alternative. As a result, almost every Democrat in Congress—all the progressives and liberals and even most of the so-called moderates—agree on the Biden plan.

In other words, the Democrats are quite unified. But they are being held hostage by a handful of corporate-friendly Democrats. The problem is that the Democrats' margins in both chambers are so slim that they can't afford defections. The Democrats are clinging to an eight-seat majority in the House. The Senate is split between 50 Democrats and 50 Republicans, requiring Vice President Kamala Harris to break ties votes. As a result, even a small number of defectors can derail the Democrats' agenda—forcing Biden to make huge cuts or killing the plan altogether—which gives the tiny handful of hold-outs undue influence.

This doesn't mean that 96% of elected Democrats who support the Biden plan agree on every policy issue, from abortion to bank regulation to military spending. Some disagree with parts of the president's plans, but are willing to swallow their concerns for the sake of unity. By embracing Biden's Build Back Better plan, they recognize the importance of restoring Americans' faith in the ability of the federal government to address fundamental problems and to help the country recover from the existential crisis we faced, and that still persists, because of Trump and Trumpism.

Soon after Biden took office in January, he, House Speaker Nancy Pelosi, and Senate Majority Leader Chuck Schumer agreed to draft two bills that reflected key parts of the president's campaign promises. One involved a $1 trillion (over ten years) public-works infrastructure plan, about $550 billion of which would be new spending not previously allocated by Congress. The other focused on expanding the nation's social safety net and addressing climate change, and would cost $3.5 trillion over ten years—though that figure is misleadingly high, as explained below.

In August, the Senate approved a $1 trillion physical infrastructure plan to rebuild roads, replace water pipes that have toxic lead, expand broadband internet, shore up coastlines against climate change, modernize the electric grid, protect public utility systems from cyber attacks, pay for new public transportation, and upgrade airports and railroads. Speaker Pelosi has postponed a vote on that bill; Biden, Schumer and Pelosi have all insisted that both bills should move in unison.

The safety net and climate change plan is stuck primarily because Manchin and Sinema won't go along. Manchin has demanded that at least $2 trillion be lopped off Biden's plan, which would result in a $1.5 trillion bill—an amount that Rep. Cori Bush (D-MO) dismissed as "crumbs." Sinema won't even say what her ideal figure is.

The Build Back Better plan would expand Medicare and, for the first time, provide dental, vision, and hearing coverage to the 60 million elderly and disabled Americans who rely on it. It would expand health care for roughly four million low-income people in the states (most of which are run by Republicans) that have refused to expand Medicaid on their own. The provision to expand the Child Tax Credit to $300 a month per child under six and $250 a month per child age 6 to 17 would cut child poverty by half, according to some estimates. The Biden plan would also offer free public pre-kindergarten and two years of free community college and provides 12 weeks of paid family and medical leave, which would guarantee that all Americans have the time to care for themselves and their families and loved ones.

The plan also includes provisions to deal with climate change and cut greenhouse gas emissions, including a clean-electricity program designed to significantly reduce fossil fuel emissions from U.S. power plants by 2035. It would invest billions of dollars to build 500,000 electric-vehicle charging stations and update the electrical grid to make it more effective during extreme weather events.

The Republicans and the handful of Democratic dissenters typically describe the plan as "massive," "big government," and "unprecedented."

In fact, the plan would only amount to roughly 1.5% of the country's gross domestic product. This is a smaller increase than that of President Franklin Roosevelt's New Deal (which included Social Security and unemployment insurance) and President Lyndon Johnson's Great Society programs (which included Medicare and Medicaid).

Even the $3.5 trillion figure is misleading. It would stretch over ten years, a fact that many news reports ignore or downplay. One expert estimated that the total cost is less than three dollars (actually $2.88) a day.

Moreover, the $3.5 trillion would be offset by $2.9 trillion in new revenue, according to recent estimates. So the actual cost is just $0.6 trillion.

To pay for the plan, Biden proposed raising the corporate tax rate from 21 percent to 26.5 percent on companies' annual income over $5 million. He's also proposed restoring the top tax rate to 39.6 percent on individuals earning more than $400,000—or $450,000 for couples—plus a 3 percent surtax on wealthier Americans with adjusted income over $5 million a year. As such, the plan would partially reverse the trillions that the Trump administration and the Republican Congress gave away to the wealthy and big business in tax cuts through their signature legislative achievement of the Trump era. Moreover, Biden's plan would reduce federal taxes for eight out of 10 households.

One thing is certain. Those Democratic dissenters are out of sync with what Americans—and not just Democratic voters—think.

The Democrats' plan is very popular among Americans.

A Quinnipiac poll conducted July 27-Aug. 2 asked, "Do you support or oppose a $3.5 trillion spending bill on social programs such as child care, education, family tax breaks and expanding Medicare for seniors?" and found 62% support, 32% opposition.

Support is even higher for some key provisions of the plan. For example, over two-thirds of voters (69%) support raising taxes on the wealthy and corporations. A whopping 84 percent of likely voters (including 74 percent of Republicans) support paid family leave programs. According to recent polls, 84% of voters want to expand Medicare coverage to include dental, vision and hearing; 88% want Medicare to negotiate with pharmaceutical companies to reduced prescription drug prices. Data for Progress polling earlier this year found that nearly two thirds of likely voters support government action moving the country away from fossil fuels to a fully clean energy grid by 2035, including 86% of Democrats, 60% of independents, and 40% of Republicans.

So why are those two Democratic senators and 10 Democratic House members trying to subvert legislation that most Americans and 96% of their own colleagues support?

Most of the 10 House Democrats who are still waffling over the Biden plan are from swing congressional districts that they won by small margins, although other Democrats from battleground districts are on board with the plan. But in each of their districts, the Build Back Better plan would significantly improve the lives of their constituents as well as lower their taxes.

The opposition of the handful of Democrats can be explained in part by their close ties to big business and wealthy donors. They are doing the bidding of corporate America, which wants the physical infrastructure projects that is part of the separate $1 trillion bill, but doesn't want the higher taxes or stiffer regulations to reign in corporate greed that is part of the $3.5 trillion safety net and clean energy bill.

For example, Rep. Scott Peters of California is leading the opposition to the drug pricing provisions. Last month, he voted to block it from advancing out of the Energy and Commerce Committee. Since he was elected from his San Diego area district in 2012, the pharmaceutical industry has showered him with $860,465 in campaign donations. So far this year alone, he's received $88,550 from the drug lobby—the most of any member of Congress, according to the Center for Responsive Politics, which tracks political spending on the website OpenSecrets.org.

Manchin and Sinema insist that their stances reflect the concerns of voters in their home states. Last November, 68 percent of West Virginians voted for Trump, though Arizona narrowly went to Biden by a 49.4% to 49.1% margin.

But both West Virginia and Arizona are states with high levels of poverty and poorly funded schools and health centers, so there's no question that their residents would benefit from the plan's key provisions regarding health care, education, and other programs—indeed, more than residents of most other states. Manchin's insistence that the bill incorporate means tests and eligibility caps, and Sinema's fierce opposition to allowing Medicare to negotiate with drug companies to lower the price of medicine, will only hurt their constituents.

Manchin also has opposed many of the plan's provisions to deal with the climate crisis—provisions that could hurt both his political fundraising and his pocketbook. He's pocketed more contributions from coal, oil, and gas companies this campaign cycle than any senator, according to OpenSecrets. And his ties run deeper than the campaign donations he's received from these corporate interests. Last year, Manchin made half a million dollars in stock dividends from a coal company that is now controlled by his son, according to the New York Times. The Intercept reported that since joining the Senate, he has earned more than $4.5 million from that coal company and another, both of which he founded in the 1980s.

For her part, Sinema promised to push to lower prescription drug prices when she ran for the Senate in 2018. Now she's changed her tune, having taken in over $750, 000 from the pharmaceutical and medical device lobbies since then. In late September, Sinema held a fund-raiser with five business lobby groups that oppose the Biden bill.

Since Biden took office, America's corporations have significantly ramped up their campaign donations and lobbying efforts. According to OpenSecrets, corporations have deployed more than 4,000 lobbyists to scuttle core provisions of the Biden bill. During the first six months of this year, business groups spent $1.5 billion lobbying Congress, much of it directed at undermining the Build Back Better legislation. In addition, business lobby groups have significantly increased their campaign contributions to key members of Congress, including Manchin and Sinema.

The U.S. Chamber of Commerce, the Business Roundtable, the National Association of Manufacturers, and other business lobby groups are investing big bucks to kill the proposed tax increases on big corporations and the rich. The oil and coal companies don't want to wean the country off fossil fuels and are working overtime to kill Biden's clean energy provisions. During just one week last month, oil giant Exxon Mobil spent $275,000 on Facebook ads against the Biden plan.

Prescription drug prices in the U.S. are about three times higher than in other affluent democratic countries, according to a RAND Corporation study. But the pharmaceutical companies don't want to negotiate with Medicare to lower drug prices and are swarming Congress with big donations and lobbying efforts. The industry spent $171 million and deployed almost 1,500 lobbyists through the first half of the year, more than any other industry. Even the American Dental Association is mobilizing its 162,000 members to fight a proposal to include dental coverage for all Medicare recipients

On behalf of their corporate benefactors, Manchin and Sinema may be sabotaging the potential success of Biden's presidency and the odds that the Democrats will have legislation to tout as they seek to maintain even their slim hold on Congress in next year's midterm elections. They may also be undermining the last best chance to address America's most pressing problems.

Democrats' support for the Biden plan is—pick your adjective—overwhelming or near unanimous.

If Biden's bill doesn't make it through Congress, don't blame "the Democrats." Blame every Republican, and the tiny faction of Democrats, who have put their personal ambitions over the public good.


Peter Dreier is the E.P. Clapp distinguished professor of politics at Occidental College. He is the author of "The 100 Greatest Americans of the 20th Century: A Social Justice Hall of Fame" (2012) and an editor (with Kate Aronoff and Michael Kazin) of "We Own the Future: Democratic Socialism, American Style" (2020). He is co-author of the forthcoming "Baseball Rebels: The Reformers and Radicals Who Shook Up the Game and Changed America" (2021).