Pelosi: Reconciliation Bill Likely Will Fund Policies For Shorter Periods

Inside Health Policy

October 12, 2021 4:45 pm

House Speaker Nancy Pelosi (D-CA) said at her Tuesday (Oct. 12) press conference that Congress will mostly be funding policy priorities for a shorter period of time in a smaller reconciliation package, coming just one day after she sent a Dear Colleague letter saying members requested Congress include fewer, but better-funded, policies in the package.

Pelosi on Tuesday again emphasized a need to aide home health workers in the reconciliation package.

She also said the House will only vote on whatever iteration of the package can pass the upper chamber, which reports indicate will likely be the $2 trillion range.

Sens. Joe Manchin (D-WV) and Kyrsten Sinema (D-AZ) repeatedly have said they won’t support a $3.5 trillion reconciliation bill as called for earlier by Democratic leaders, leaving the White House and congressional leaders scrambling to decide how to fit their health care priorities into a shrinking package.

Pelosi’s seemingly contradictory comments over the last two days reflect differences among Democrats over whether to include scaled-back versions of all the health policies or to instead pick a few to robustly fund and leave others out. Senate Budget Committee Chair Bernie Sanders (I-VT) and the Congressional Progressive Caucus continue to advocate adding dental, vision and hearing benefits to Medicare, while other key House Democrats push to close the Medicaid coverage gap and to extend the enhanced Affordable Care Act tax credits.

A new top-line for the partisan reconciliation package has yet to be reached, but President Joe Biden has asked Congress to consider something closer to $2 trillion.

The White House reportedly has been advocating for cutting funding for policies across the board to bring the package’s cost down, and Sen. Bob Casey (D-PA) told Inside Health Policy Thursday that the goal in the Senate also seems to be to include each policy but at a lower level of funding.

Pelosi’s Monday (Oct. 11) letter to representatives seemed to be at odds with the White House and Senate’s positions on how to cut down the package.

“Overwhelmingly, the guidance I am receiving from Members is to do fewer things well so that we can still have a transformative impact on families in the workplace and responsibly address the climate crisis: a Build Back Better agenda for jobs and the planet For The Children!” Pelosi’s Monday letter said.

But Pelosi indicated Tuesday that the House hasn’t yet made any firm decisions about how to craft a smaller package. She told reporters that with fewer dollars to work with, choices will have to be made.

“Some members have written back to me and said I want to do everything, so we’ll have that discussion,” she said.

“Mostly we would be cutting back on years and something like that, but those are decisions that we have to” make, Pelosi said.

In response to a question from a CNN reporter about whether Congress could strike from the package proposals like Medicare expansion, universal pre-K, the child tax credit expansion, tuition-free community college and more, Pelosi said she hopes not.

She also mentioned the “transformative nature” of policies in the package that would help families, specifically highlighting home care reforms. The House has proposed investing $190 billion in Medicaid home- and community-based services in reconciliation, but Pelosi suggested last month that she’d be in favor of a higher number in the final bill.