Sep 10, 2021
More expansive than Obamacare –– Newsletter Issue #140

Congressional committees are working feverishly on the largest single spending bill in the nation’s history—a mind-boggling $3.5 trillion blowout that would dramatically expand the welfare state and make Americans beholden to the federal government for decades to come, “a cradle-to-grave entitlement agenda…that would transform America.”

The chief architect is Vermont Socialist Bernie Sanders who chairs the Senate Budget Committee.  His view: At the “very least,” the bill must be $3.5 trillion to barely squeeze his climate and entitlement priorities into the bill.

President Biden is all in with the “Build Back Better Act.”  The only obstacles to enactment are West Virginia Sen. Joe Manchin and Arizona Sen. Kyrsten Sinema, moderate Democrats from red states.

In a Wall Street Journal op-ed last week, Sen. Manchin called for a pause saying, “some in Congress have a strange belief there is an infinite supply of money to deal with any current or future crisis, and that spending trillions upon trillions will have no negative consequence for the future. I disagree.”  If he and/or Sen. Sinema hold firm, Sen. Majority Leader Chuck Schumer won’t have the 50 votes he needs to pass this monstrous, socialist spending spree.

Each provision in the package should receive months of scrutiny through congressional hearings and policy analysis.  Instead, Democratic leaders want to jam it through without any scrutiny, even though it is more expansive than Obamacare. This new bill truly is mind-boggling in its scope and almost impossible for any legislator to grasp.

Here are highlights.  Galen Senior Fellow Brian Blase describes here the top 12 worst health policy provisions in just one committee’s part of the bill.  
  • Expanding the Medicare program, which the Obama administration’s own Trustees reported last week is quickly running out of money, by adding new dental, hearing, and vision benefits to fee-for-service Medicare—benefits that any senior can access by enrolling in a Medicare Advantage plan that already covers these services.  Progressives are pushing to also lower the Medicare eligibility age to 60.
  • Co-opting states that choose not to expand Medicaid by allowing their residents with incomes below 100% of poverty access to Obamacare plans for three years while the federal government sets up a new “federal Medicaid program” for non-expansion states.
  • Spending at least $200 billion for home and community-based services, dramatically expanding unionization of health care workers and likely suffocating more innovative private sector options.
  • Making permanent the expansion of Obamacare tax credits which passed earlier this year as a temporary Covid measure.  Most of the expansion money would finance coverage for upper-income Americans who already have private coverage, likely crushing the individual and small group markets for health insurance in the process. 
  • And even with all this, the most consequential and destructive provisions involve importing price controls from abroad (or possibly basing them on Veterans Administration prices) and draconian taxes on pharmaceutical companies that fail to comply.  Imposing price controls, which would cripple investment in pharmaceutical research, is a major “pay-for” in the bill, expected to reap $456 billion in savings for the government.  How short sighted can they be!
The Democrats are betting that Republicans won’t know how to address this onslaught of spending—saying they are heartless in denying these new programs and benefits.  But each one of them adds new debt that the nation’s children and grandchildren will have to pay, generates inflation that impacts everyone now, and upends the opportunity for more efficient, cost-effective private sector solutions, such as those we propose in our Consensus Group’s Health Care Choices proposal.

And Bernie’s bill will put a generation of people on the federal done with the massive federal spending for child care, universal pre-K, free community college, and untold new spending on climate change (including declaring that natural gas is not clean energy).

The Democrats have no belief in the private sector and immense trust in government—despite the cascade of bad decisions made by government during the Covid crisis, as Galen Senior Fellow Doug Badger details.

But once the government moves into a market, the endless stream of taxpayer dollars and deficit spending swamp the ability of creative governors and legislators and private sector innovators to raise capital and implement creative solutions.

Pray that Sens. Manchin and Sinema hold strong.
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