Democrats pressure Biden to include Medicare expansion, prescription drugs in his American Families Plan

WASHINGTON – Democrats on Capitol Hill are ramping up pressure on President Joe Biden to make Medicare expansion and prescription drug measures part of his upcoming American Families Plan proposal as the White House signals it won't include major health care policy reforms.

In a letter to Biden on Sunday, 17 senators led by Senate Budget Chairman Bernie Sanders, I- Vt., who caucuses with Democrats, pushed for Medicare expansion to be part of the American Families Plan, the second piece of Biden's "Build Back Better" agenda that he plans to roll out in a speech Wednesday to Congress.

House Speaker Nancy Pelosi last week called for Biden's plan to include measures to reduce health care costs and prescription drug prices as House Democrats revived a drug price negotiation bill.

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The American Families Plan is expected to include investments in child care, paid family leave and education, paid for by a combination of tax increases on high-income earners. It would complement a $2.3 trillion infrastructure and jobs plan, dubbed the American Jobs Plan, that Biden proposed this month.

But White House press secretary Jen Psaki last week listed health care separately from the families plan as she previewed what Biden will discuss in his speech.

"He will definitely talk in his speech about his commitment to expanding and increasing access to health care," Psaki said Friday, pointing to action the president already took in his COVID-19 rescue plan to expand Affordable Care Act subsidies and extend the ACA enrollment period.

She added that the American Families Plan "will not represent the totality of every priority item for him and every item on his agenda that he wants to move forward as president."

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While the families plan proposal is still fluid, The Washington Post reported the package will come in at around $1.8 billion. That includes $300 billion for education, including free two-year community college; $225 billion for child care; $225 billion for paid family and medical leave; and $200 billion for pre-kindergarten expansion.

In a last-minute change, The Post reported that the plan will also include $200 billion to extend more health insurance subsidies through the Affordable Care Act. It would mean the families plan would include some spending on health care but not at the scale demanded by progressives.

The families plan will not include a $700 billion effort to expand health coverage or reduce the cost of prescription drugs bought through government programs , according to The New York Times, which reported the administration is treating health care as a separate initiative.

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Sunday, Sanders and Democratic senators asked Biden include proposals to reduce the Medicare eligibility age, which is now 65, expand Medicare benefits to include hearing, dental and vision care, cap out-of-pocket expenses and negotiate lower drug prices.

"As you know, Medicare has been one of the most successful and popular federal programs in our nation’s history since it was signed into law by President Lyndon Johnson in 1965," the Senate Democrats' letter reads. "Now, 55 years later, the time is long overdue for us to expand and improve this program so that millions of older Americans can receive the health care they need, including eyeglasses, hearing aids and dental care."

Other senators who signed the letter are Debbie Stabenow, D-Mich., Ben Cardin, D-Md., Chris Van Hollen, D-Md., Elizabeth Warren, D-Mass., Ed Markey, D-Mass., Tammy Baldwin, D-Wis., Richard Durbin, D-Ill., Tammy Duckworth, D-Ill., Cory Booker, D-N.J., Kirsten Gillibrand, D-N.Y., Jeffrey Merkley, D-Ore., Richard Blumenthal, D-Conn., Tina Smith, D-Minn., Sherrod Brown, D-Ohio, Sheldon Whitehouse, D-R.I., and Alex Padilla, D-Calif.

Democrats, including Pelosi, have pushed for Biden to make permanent a child tax credit passed earlier in his $1.9 trillion American Rescue Plan. The Post reported that the families plan will include a provision that would extend the child tax credit to 2025, which would cost around $400 billion.

In a statement, Pelosi said seniors and families across the country are "counting on us to finally deliver the drug price negotiations they need to afford their medications. Families cannot afford to lose the enhanced ACA benefit passed in the American Rescue Plan, and we must make it permanent."

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White House sets $1 millilion threshold for capital gains tax increase

Pelosi also called lowering prescription drug prices a "top priority for House Democrats to be included " in the families plan. Echoing that push, 124 health care advocacy organizations last week called on the Biden administration to take action to make prescription drugs more affordable.

"Patients today face significant prescription drug affordability challenges that have only grown worse," the groups wrote in a letter to Health and Human Services Secretary Xavier Becerra. "While recent actions have been taken to make health insurance premiums more affordable, more work must be done to ensure that once beneficiaries have insurance, it will work effectively for them and their families."

Combined, Biden's American Jobs Plan and American Families would cost about $4 trillion.

The president has proposed raising taxes paid by corporations to pay for the jobs plan and is set to propose increasing taxes on income earned from selling stocks and other assets. Biden is expected to propose nearly doubling capital gains taxes from a 20% rate to 39.6%, mirroring a policy he introduced as a presidential candidate.

Brian Deese, director of the National Economic Council, said the capital gains tax increase would affect only taxpayers who earn more than $1 million a year, which he said would is around 500,000 Americans – around three-tenths of 1 percent of taxpayers.

"For the other 997 out of 1,000 households in the country – or the other 150 million households in the country – this is not a change that will be relevant," he said.

Deese said the policy reflects a pledge to reward "work, not just wealth." He said it would eliminate a dynamic that allows the top 1,400 tax-filers in the U.S. – who earn $60 million annually – pay a smaller share of their income in taxes than the middle class because wealthiest Americans earn most of their money from capital gains, not wages.

Republicans have opposed Biden's infrastructure plan – a group of senators propose a counteroffer one-quarter the price tag – and are expected to also fight the families plan, particularly the tax increases tied to it.

Biden could choose to seek passage of both through budget reconciliation, which would require no Republican votes in the evenly divided Senate. The White House has not said whether it will seek passing the jobs and families separately or combine them into one bill.

Reach Joey Garrison on Twitter @joeygarrison.

This article originally appeared on USA TODAY: Democrats up pressure on Biden to include health care in families plan