Democrats reached agreement Tuesday on plan to lower prescription drug costs for older people, capping out-of-pocket Medicare costs at $2,000 and reducing the price of insulin, salvaging a campaign promise as part of President Joe Biden's $1.75 trillion domestic policy proposal.
Senate Majority Leader Chuck Schumer announced the deal, which is one of the few remaining provisions that needed to be resolved in Biden's big package as the party moves closer to wrapping up negotiations. Schumer acknowledged it's not as sweeping as Democrats had hoped for, but a compromise struck with one key holdout Democrat, Sen. Kyrsten Sinema of Arizona.
And Biden sounded upbeat about winning overall backing from another holdout, Democratic Sen. Joe Manchin of West Virginia, who threw the president's plan in flux this week by refusing to endorse it.
"He will vote for this," Biden said of Manchin during remarks at a global climate summit in Scotland.
Not a Modern Healthcare subscriber? Sign up today.
Biden said without divulging their private conversations, the senator was looking for the fine print details of the legislation. "But I think we'll get there," the president said.
Democrats are rushing to overcome party battles and finish a final draft of Biden's plan. House Speaker Nancy Pelosi said privately she expects to wrap up final draft by midday day and pave the way for voting as soon as Thursday on the overall package, according to her remarks at a closed-door caucus meeting. But no votes have been scheduled.
The stakes are stark as Democrats are warily watching governors' races Tuesday in two states — Virginia and New Jersey — that are seen as bellwethers in the political mood of the electorate. Democrats are struggling to hold states that recently favored the party from Republicans.
Blame is pointing all around as negotiations over Biden's ambitious package have dragged on, with Democrats unable to pass the bill. Progressive and centrist lawmakers, particularly Manchin and Sinema, have fought over details of the sprawling 1,600-page package.
"I think what most people think: the situation is like, 'Okay, we elected Democrats to have the majority in the House, the Senate and the presidency. They should be getting things done,'" Democratic Rep. Elaine Luria, who represents a swing district in Virginia, told reporters at the Capitol.
Still, Democrats shored up at least one unsettled provision — the prescription drug deal that had been scrapped from Biden's framework in a blow to Democrats' years-long effort to reduce pharmaceutical costs by allowing Medicare to negotiate for lower prices.
"It's not everything we all want. Many of us would have wanted to go much further, but it's a big step in helping the American people deal with the price of drugs," Schumer said at the Capitol.
Schumer said for the first time, Medicare will be able to negotiate prescription drug prices in its Part B and Part D program. "There will be an annual cap on out of pocket costs, a new monthly cap on the price of insulin, and an 'inflation' rebate policy to protect consumers from egregious annual increases in prices," he said.
Democrats later said insulin prices would fall from as high as $600 a dose to $35. The penalties on drug manufacturers for raising prices beyond the inflation rate will be retroactive to Oct. 1.
Sinema's office issued a statement saying the senator "welcomes a new agreement on a historic, transformative Medicare drug negotiation plan that will reduce out-of-pocket costs for seniors."
AARP, the powerful organization for older Americans, signaled support as it waits for details. CEO Jo Ann Jenkins said in a statement there was "no greater issue affecting the pocketbooks of seniors on Medicare than the ever-increasing costs of prescription drugs."
Despite efforts to drive momentum, Manchin interjected fresh uncertainty Monday by publicly wavering again over whether or not he would support the party's ambitious effort.
The conservative West Virginia Democrat has been an unreliable partner for Biden's big vision, raising questions and concerns about the president's plans expand healthcare, child care and other social services and tackle climate change.
Manchin's outlook angered some lawmakers who have tired of his protests but energized others, particularly progressives, to speed up the vote. Manchin also showed no signs of relenting Tuesday, despite widespread criticism over the power of a single senator to hold up the party's signature domestic priority.
"It's going to be a while," Manchin said in brief comments Tuesday at the Capitol.
With Republicans staunchly opposed and no votes to spare, Democrats have been trying to unite progressive and centrist lawmakers around Biden's vision.
Pelosi told Democrats at Tuesday's morning caucus that "hopefully by midday" they will be able to "freeze" the design of the bill. She announced a process for possible vote as soon as Thursday. The remarks were conveyed by a person familiar with her comments who requested anonymity to share the private meeting.
"I think we're going to pass both bills — hopeful this week if we get the differences that are still outstanding resolved," Majority Leader Steny Hoyer, D-Md., said at the Capitol.
Rather than providing assurances to his progressive colleagues that he was on board, Manchin on Monday reiterated his long-running concerns. He then urged progressives to quit holding "hostage" a smaller $1 trillion public works bill they have withheld as leverage as negotiations continue on the broader package.
Rep. Pramila Jayapal, D-Wash., the leader of the progressive caucus said, "I don't know what Sen. Manchin is thinking, but we are going to pass both bills through the House and we are going to deliver transformative change to the people."
Biden unveiled a framework for the package last week, a sizable investment in social service programs and climate change strategies, but Democrats are trying to negotiate immigration law changes and other final updates.
The $1.75 trillion package is sweeping in its reach, and would provide large numbers of Americans with assistance to pay for healthcare, education, raising children and caring for elderly people in their homes. It also would provide some $555 billion in tax breaks encouraging cleaner energy and electrified vehicles, the nation's largest commitment to tackling climate change.
Much of its costs would be covered with higher taxes on people earning over $10 million annually and large corporations, which would now face a 15% minimum tax in efforts to stop big business from claiming so many deductions they end up paying zero in taxes.
Some moderate Democrats in the House said they want to see the final assessment from the Congressional Budget Office, which will offer a nonpartisan review of the overall bill's entire budgetary costs, before taking the vote.