Senate Could Take Up Infrastructure, Budget Resolution As Soon As July 19

Inside Health Policy

July 8, 2021 3:10 pm

The Senate is aiming to move the bipartisan infrastructure bill and the fiscal 2022 budget resolution as early as July 19, and the size and framework of the budget resolution could drive which health care provisions are ultimately included in Democrats’ upcoming reconciliation bill. Sources say it’s still unclear what Medicaid, Medicare and drug-pricing provisions might make it into the bill.

Senate Budget Committee Chair Bernie Sanders (I-VT) is seeking a $6 trillion budget resolution, but moderate Democrats want it ratcheted back to $2 trillion.

House Majority Whip Jim Clyburn (D-SC) and other lawmakers and beneficiary advocates are pushing hard for a federal solution to the Medicaid gap, and Senate Democratic leadership supports a gap fix as well but is also pushing to expand Medicare benefits. Whether and what form of drug-pricing legislation — considered a key pay-for — is factored into the budget resolution could help determine what Medicaid and Medicare reforms make it into the reconciliation package.

A Democratic Senate aide Thursday (July 8) told Inside Health Policy that leadership is supportive of the effort to close the so-called Medicaid coverage gap in states that haven’t expanded Medicaid eligibility under the Affordable Care Act, and is reviewing options for the best path forward.

House Democratic leaders have also shown support for legislation to close the coverage gap. A spokesperson for Clyburn said earlier this week that closing the gap is the lawmaker’s priority for the reconciliation package.

Multiple committees are said to be discussing how to best close the coverage gap. The only concrete proposal so far is a bill introduced by Rep. Lloyd Doggett (D-TX), chair of the House Ways & Means health subcommittee, that would allow local governments to contract with CMS directly to expand Medicaid in their jurisdictions, though Doggett himself has said a more comprehensive solution would be welcome.

Meanwhile, Senate Majority Leader Chuck Schumer (D-NY) has also thrown his support behind expanding Medicare to cover dental, hearing and vision care. Doggett also introduced a bill Tuesday (July 6) to add the three benefits to Medicare Part B.

The bill has wide support among House Democrats, with more than 75 cosponsors, though a Families USA staff member said it’s possible a provision in the reconciliation bill won’t look exactly like Doggett’s proposal. A spokesperson for Rep. Robin Kelly (D-IL) said in June that there have been some discussions around including only one of the three benefits in a reconciliation package due to financial considerations.