This week on Facing the Future, Concord Coalition Policy Director Tori Gorman and I spoke to Joshua Gordon, Director of Health Policy for the Committee for a Responsible Federal Budget about some of the health care provisions that are contained in the version of the Build Back Better Act (BBBA) passed by the House, that now awaits action in the US Senate. According to CRFB estimates, the bill includes close to $330 billion in new health care costs, mostly offset by about $325 billion in health care cost savings and new revenue.

Healthcare provisions in BBBA include:

Extending Affordable Care Act (ACA) subsidies for individuals who sign up through the health care exchanges;

• Offering ACA premium subsidies to residents of 12 states who did not opt to expand Medicaid and whose incomes are too high to currently qualify for Medicaid in their states;
• Funding for more home and community based health services through Medicaid;
• Investments in the health care work force; and
• Offering a new hearing benefit as part of Medicare.

Some of the ways these provisions are funded include:

• Changing formula for Medicare prescription drug (Part D) benefits;
• Capping out-of pocket costs, limiting price increases for prescription drugs to the rate of inflation; and
• Initiating Medicare prescription drug negotiations with private industry for certain pharmaceuticals.

“Prescription drug pricing is going to be the big challenge in the Senate,” says Gordon. “It was really the last deal that was made in the House. Originally, when President Biden released the Build Back Better framework earlier this fall, prescription drug pricing was ultimately left out of it because they could not come to agreement among House Democrats. At the last minute, something on pricing was added back in for the inflation rebates and the negotiations. Certainly, the interest groups are fighting like heck to re-open that provision.”

Gordon says he is disappointed that aside from the drug pricing provisions, there are no provisions in the BBBA that would reduce the cost of healthcare. He also claims that from a budgetary point of view, Congressional Democrats seem to be offering expanded Medicare coverage for seniors without paying for it with modest increases in their monthly premiums.

“This is going to be a huge fiscal problem going forward. We already know that Medicare is unsustainable, and this will only make that happen even faster,” says Gordon.

Later in the program, Gorman, Concord Coalition Chief Economist Steve Robinson, and I discussed all of the pending priorities facing Congress in the next few weeks. Aside from the BBBA, there are critical items with looming deadlines such as passing a Continuing Resolution to avert a government shutdown, the annual Defense Appropriations Authorization Act, a vote to raise or suspend the national debt ceiling, as well as other key tax and spending deadlines that could impact millions of Americans.

Hear more on Facing the Future. I host the program each week on WKXL, NHTalkRadio.com (N.H.), and it is also available via podcast. Join me and my guests as we discuss issues relating to national fiscal policy with budget experts, industry leaders, and elected officials. Past broadcasts are available here. You can subscribe to the podcast on Spotify, Pandora, iTunes, Google Podcasts, Stitcher or with an RSS feed. Follow Facing the Future on Facebook, and watch videos from past episodes on The Concord Coalition YouTube channel.