Manchin Deals a Blow to Biden’s Agenda

Plus, Democrats scramble for a drug pricing compromise ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ [The Fisc](   By Yuval Rosenberg and Michael Rainey [*] Manchin Deals a Blow to Biden’s Agenda Sen. Joe Manchin (D-WV) on Monday slammed the brakes on House Democrats’ effort to push through a $1.85 trillion social spending package this week, demanding that lawmakers slow down and consider the full fiscal and economic ramifications of their proposed legislation. Manchin’s comments came as an unpleasant surprise to those Democrats who had been counting on the senator to endorse President Joe Biden’s Build Back Better bill, smoothing the path for rapid approval. The senator made it clear that he has serious concerns about the content of the legislation, as well as its potential effects on the economy and the national debt. "Throughout the last three months I have been straightforward about my concerns that I will not support a reconciliation package that expand social programs and irresponsibly adds to our $29 trillion in national debt that no one seems to really care about or even talk about," Manchin said at an appearance at the Capitol. "Nor will I support a package that risks hurting American families suffering from historic inflation. Simply put, I will not support a bill that is this consequential without thoroughly understanding the impact that it will have on our national debt, our economy, and most importantly all of our American people." Manchin said he was concerned that lawmakers were ignoring other serious fiscal problems as they pursued their spending plan. "[H]ow can I in good conscience vote for a bill that proposes massive expansion to social programs, when vital programs like Social Security and Medicare face insolvency and benefits could start to be reduced as soon as 2026 for Medicare and 2033 for Social Security? How does this make sense? It doesn’t," he said. Emphasizing the need for fiscal responsibility, Manchin also accused his fellow Democrats of misrepresenting the cost of the plan. "[A]s more of the real details outlined in the basic framework are released, what I see are shell games and budget gimmicks that make the real cost of this so-called ‘$1.75 trillion dollar’ bill estimated to be twice as high if the programs are extended or made permanent," he said. "That is recipe for economic crisis. None of us should ever misrepresent to the American people what the real cost of legislation is." Taking aim at House strategy: Manchin, clearly bristling at progressive efforts to pin him down, called on Democrats in the House to pass the separate bipartisan infrastructure bill immediately, striking a blow against progressives’ strategy of linking the two bills to ensure that the larger and more controversial social spending package makes it through Congress. "The political games have to stop," Manchin said, with anger in his voice. "Holding this bill hostage is not going to work in getting my support for the reconciliation bill." He also warned: "I’m open to supporting a final bill that helps move our country forward, but I’m equally open to voting against a bill that hurts our country." Progressives want to press ahead anyway: House Democrats have now backed away from their demand that Manchin (along with his fellow Democratic holdout, Sen. Kyrsten Sinema of Arizona) express their approval for their bill before proceeding to a vote. Progressive Caucus chair Rep. Pramila Jayapal (D-WA) said she plans to move forward on a vote as soon as this week on the bipartisan infrastructure deal, even without Manchin’s support, while leaving the political arm-twisting to the White House. "We are taking the President's word at the fact that he believes he can get 50 votes in the Senate," Jayapal told MSNBC. "We've been able to do what we said from the beginning, which is pass both bills at the same time, get the entirety of the President's agenda to his desk for signature and ultimately deliver transformative change for people across this country." Jayapal said the reconciliation bill could be ready in a matter of days. "We are ready pending some final negotiations on things we care very much about – immigration and prescription drug pricing," Jayapal said on CNN. "We know senators are still negotiating that, some details on child care. But those are the last pieces and once we have those we will be happy to vote both those bills." The White House responds: Soon after Manchin spoke, White House Press Secretary Jen Psaki released a statement saying that Manchin’s concerns have already been addressed for the most part. "Senator Manchin says he is prepared to support a Build Back Better plan that combats inflation, is fiscally responsible, and will create jobs," Psaki said. "The plan the House is finalizing meets those tests—it is fully paid for, will reduce the deficit, and brings down costs for health care, child care, elder care, and housing. Experts agree: Seventeen Nobel Prize-winning economists have said it will reduce inflation. As a result, we remain confident that the plan will gain Senator Manchin’s support." The bottom line: Manchin [told CNN]( Monday morning that he thought there needed to be "clarity on where everybody stands." He may have clarified his position at his afternoon press conference, but his comments — and tone —only served to sow more confusion about the ultimate fate of Biden’s Build Back Better bill. Democrats are still hopeful that the senator from West Virginia can be convinced to support the plan. At the same time, Manchin’s angry declaration of independence from the Democratic timeline raises the possibility that it could take longer than expected to reach a final agreement, while serving as a reminder that a deal that can pass the Senate is by no means guaranteed. Democrats Scramble for a Deal on Prescription Drug Pricing Reform As they work to finalize the details of their Build Back Better plan, Democrats reportedly say they are close to a compromise deal that would restore to the package measures to lower prescription drug prices. The latest plan would allow the government to negotiate prices on a reduced number of drugs. "The proposal has coalesced around allowing Medicare, with nearly 50 million participants in its drug program, to negotiate the price of some drugs no longer covered by exclusivity periods granted by the Food and Drug Administration, which protect drug makers from generic competition," The Washington Post [reports](. "Medicare would be able to negotiate with drugmakers five years after regulators approve certain small-molecule drugs — which account for most drugs sold in the United States — and 12 years for the more complicated medications known as biologics, which target conditions like cancer, said four people who spoke on the condition of anonymity to detail the current talks." The tentative deal comes after the White House sparked criticism from progressives and patient advocates by excluding drug pricing provisions from the Build Back Better framework it released last week. "The moment is now," a group of 15 vulnerable House Democrats led by Rep. Angie Craig (D-MN) wrote in a Sunday letter to Speaker Nancy Pelosi (D-CA) and House Majority Leader Steny Hoyer (D-MD). "We must deliver on our promise to lower the amount of money our constituents pay for prescription drugs. We must demonstrate that we work for the American people and not the pharmaceutical industry." Administration officials said that decision to leave out drug pricing reforms from the framework was necessary because the proposals under discussion did not have the votes needed to pass. But Pelosi and numerous other Democrats in both the House and Senate [continued to press]( for the issue to be addressed in the final package and negotiators worked in recent days to finalize narrower reforms and convince lawmakers who had objected to earlier proposals, including Sen. Kyrsten Sinema (D-AZ), to back those scaled back plans. What’s next: Democrats hope that a compromise on drug pricing reforms can still be included in the package before the House votes on it, potentially this week. (Congress is scheduled to be on recess next week.) But Sinema and other holdouts, including Rep. Scott Peters (D-CA), reportedly have yet to commit to supporting the latest plan, and key details remain subject to negotiation. The bottom line: This may be Democrats’ best chance to finally enact some version of a long-sought policy goal — and an opportunity for Democrats to generate some additional revenue that could help pay for the rest of their economic agenda. But the final version is likely to fall far short of the sweeping reforms passed by House Democrats (and ignored in the Senate) in 2019. "Though the drug industry's goal is preventing any government price negotiation whatsoever, limiting the bargaining to a narrow subset of drugs and leaning more heavily on measures like out-of-pocket caps that don’t impact the companies’ bottom line would be a victory in itself," the Post notes. --------------------------------------------------------------- Send your feedback to yrosenberg@thefiscaltimes.com. Follow us on Twitter: [@yuvalrosenberg]( [@mdrainey]( and [@TheFiscalTimes](. 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