Senate MP Elizabeth McDonough will continue to host Democratic and Republican aides behind closed doors today (no press allowed) to scrutinize a reconciliation bill for possible violations of the Byrd Rule.
McDonough broke the hearts of progressives on several occasions last year, including by removing the minimum wage from the COVID relief bill, which was passed using reconciliation, and rejecting three different versions of immigration reform from the Democratic reconciliation bill. which was eventually abolished in December. ,
Republican budget nerds reviewing the latest reconciliation bill still believe they can eliminate some of the provisions. On Thursday for the latest episode of the Playbook Deep Dive podcast, we sat down with two of the party’s leading experts on the process: Eric Uland, who spent 25 years in the Senate, including staff director on the budget committee, and lobbyist. Greg D’Angelo, who spent nearly a decade on the committee. Both men were closely involved with drafting language for reconciliation bills over the Trump years — including a successful attempt to open the Arctic National Wildlife Refuge to oil drilling and use reconciliation to end individual mandates in Obamacare. Included.
The fight over the individual mandate is instructive. McDonough rejected the original GOP plan to repeal the legal requirement for coverage, which he argued ran away from the reconciliation rules because the policy impact of the repeal outweighed any budgetary impact that a reconciliation bill would have. It is one of the main tests allowed in. Democrats thought they had won the battle. But D’Angelo returned to McDonough with a new idea: instead of abolishing the mandate, what if they simply abolished the tax penalty they used to implement it? McDonough agreed it was within the rules to keep the mandate on the books but dial the penalty down to zero. (His guidance on the issue led to a heated exchange behind closed doors, when Democratic staffers revealed what they perceived as his reversal.)
In the current bird bath debate, D’Angelo said he would “focus like a laser” on the three policies.
- Drug Negotiations Pricing Program in Democratic Bill. The policy allows Medicare to negotiate drug prices, which will reduce costs for beneficiaries. To extend those savings to Americans outside of Medicare, drug companies would have to offer drugs at Medicare prices to private insurers or face a 95 percent excise tax.
“It’s a tax penalty that doesn’t raise any federal revenue,” D’Angelo said. “IE has no budgeting effect, and it is designed for the purpose and intent to change behavior entirely: to force drug manufacturers to the table. So I would argue that it is not budgetary.”
If McDonough can be convinced that this is “contingent only to the policy motive of forcing manufacturers to the table,” she can strike it. (Democrats say they are confident the policy will survive any challenge.)
- Repeal the Trump Administration’s Drug Rebate Rule. “Questions are raised about whether it is appropriate to come to one sentence and repeal the 300-page regulation, the entire fabric,” D’Angelo said. “Despite the huge budgetary impact, it has a huge policy element to it.”
- Imposition of discounts on drug makers who raise prices faster than inflation. “It has huge implications with big costs which are major policy changes,” he said.
In this GOP Byrd Bath dream scenario, each domino would bring the bill closer to collapsing. Each of these three policies has about $100 million in savings. “If you can eliminate one or even part of them, you can dramatically reduce the estimated savings under this bill,” D’Angelo said. “And I think it complicates the deal that the majority has struck.” (Sen. Joe Manchin (DW.Va.) has pushed for $300 billion in deficit reduction.)
Euland said: “If enough of these are knocked out or modified, all of a sudden you’re leaving the edge of not making losses.”
Time: McDonough’s ruling on the bill’s prescription drug provisions could come as early as today, according to Burgess and Marianne.