Democrats are facing tough choices as they grapple with how to make good on their promise to deliver a sweeping social spending bill crucial to President Biden’s agenda, The Hill reported. The high-profile balancing act is testing Democrats’ razor-thin majorities and putting a spotlight on long-dormant divisions. “This is a little bit like a Rubik's cube on steroids…. It's complicated,” said Sen. Mark Warner (D-Va.) about the state of play. Where Democrats land on the top-line is a decision that will affect everything else in the bill, forcing lawmakers to either scale back their ideas or drop some entirely. Progressives, including Senate Budget Committee Chairman Bernie Sanders (I-Vt.) and Rep. Pramila Jayapal (D-Wash.), argue the bill must stand at $3.5 trillion, which they view as a compromise from their initial $6 trillion goal. Democrats are also debating how much to focus on Medicare, versus boosting Medicaid and shoring up the Affordable Care Act. The House bill creates a new federal health insurance program to provide Medicaid coverage in the 12 states that didn’t expand it under former President Obama’s health care law. Senate Democrats haven’t yet decided whether to take the House approach amid pushback within the caucus about potentially rewarding states that didn't expand Medicaid earlier. A rebellion from three House Democrats against a prescription drug plan is foreshadowing bigger headaches awaiting Biden and Democratic leadership on the key provision. Democratic leaders are vowing that the final bill will allow the government to negotiate with drug companies to lower the prices for prescription medications. The plan is crucial because the savings expected to be generated could help cover the costs of other pieces of the spending bill’s healthcare provisions. The House Energy and Commerce Committee included a Clean Electricity Payment Program, which incentivizes transitioning to clean energy, in its portion of the spending bill and Democratic senators who support the policy have been working behind the scenes to ensure it gets into their version of the bill.
