Oroville Mercury-Register

Democrats to retool health care programs

Dental work for seniors on Medicare. An end to sky’s-the-limit pricing on prescripti­on drugs.

- By Ricardo AlonsoZald­ivar and Lisa Mascaro

Dental work for seniors on Medicare. An end to sky’s-the-limit pricing on prescripti­on drugs. New options for long-term care at home. Coverage for low-income people locked out of Medicaid by ideologica­l battles.

Those are just some of the changes to health care that Democrats want to achieve with President Joe Biden’s massive “Build Back Better” plan. The $3.5 trillion domestic agenda bill touches almost all aspects of American life, from taxes to climate change, but the health care components are a cornerston­e for Democrats, amplified during the COVID-19 crisis.

For the nearly 145 million Americans covered by government health programs, along with their families and communitie­s, the investment in the nation’s services could make a difference in the quality of life for decades.

“It’s a holistic look at how health care can be not just expanded, but better directed to the needs that people actually have,” Kathleen Sebelius, federal health secretary under President Barack Obama, said of the Biden bill. “You’ve got a plan that’s really aimed at the serious gaps in health care that are still causing people to either go totally uninsured, or run out of money in the course of their treatments.”

But Democrats can only succeed if they bridge divisions among themselves. Don’t look for Republican­s to help.

With Medicare’s longterm finances under a cloud, Republican­s say now is not the time to add new benefits. They are planning to oppose not just the health care provisions, but the entire Biden package, voting lockstep against it as too big, costly and a slide toward “socialism.”

Mindful of the politics ahead, Democrats are assembling the package with their slim hold on Congress. Instead of launching new experiment­s that many progressiv­es prefer, they have chosen to plow more resources into existing programs, from Medicare and Medicaid enacted during the Great Society to the Obama-era Affordable Care Act.

It’s a compromise, of sorts, led by Biden’s approach, paid for by taxes on corporatio­ns and the wealthy, those earning more than $400,000, as well as savings on prescripti­on drug prices paid by the government to the pharmaceut­ical companies.

“I’ve said many times before: I believe we’re at an inflection point in this country — one of those moments where the decisions we’re about to make can change — literally change — the trajectory of our nation for years and possibly decades to come,” Biden said in remarks last week at the White House.

Polling has shown that core health care provisions appeal to voters across political lines. Many Republican voters, for example, generally approve of Medicare negotiatin­g prescripti­on drug prices, even if GOP lawmakers do not. While the Obama health law focused mainly on helping uninsured working-age people and their families, Biden’s coda puts a big emphasis on older people, who also happen to be reliable midterm election voters.

Major health care provisions in the mix include:

—Authorizin­g Medicare to negotiate prices for the costliest drugs, including insulin. Private insurers and employer plans could then access those lower prices. Annual price increases for establishe­d drugs would be limited. Seniors’ out-of-pocket costs would be capped.

A RAND Corporatio­n study finds such an approach could cut U.S. spending on top drugs by half.

Sharp opposition from the big pharmaceut­ical companies and key business industry groups have left Democrats divided over the structure of the program.

Four House Democrats opposed the measure during committee votes this past week, enough to tank the entire bill. In the past, they had supported giving Medicare authority to negotiate, but they are expressing a range of concerns about the scope of House Speaker Nancy Pelosi’s plan. The Senate could take a somewhat different approach.

Medicare negotiatin­g authority is the linchpin of the health care package because expected savings would be used to provide new benefits.

 ?? BRETT COOMER — HOUSTON CHRONICLE VIA AP, FILE ?? A dentist smooths out the edges of new 3D printed dentures in Huntsville, Texas.
BRETT COOMER — HOUSTON CHRONICLE VIA AP, FILE A dentist smooths out the edges of new 3D printed dentures in Huntsville, Texas.

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