NBC: Manchin cutting deal for BBB on drug pricing

(AP Photo/J. Scott Applewhite)

Three hundred billion dollars down, $200 billion to go? According to NBC News reporter Sahil Kapur, Joe Manchin has agreed to a key element of the rump Build Back Better reconciliation package. Manchin and Chuck Schumer have hammered out an agreement to spend $300 billion to reduce drug prices, assuming the policy qualifies for reconciliation.

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It might take the Senate parliamentarian a long time to parse that question out alone:

One hundred and ninety pages for just a portion of the rump BBB? Someone needs to send Senate parliamentarian Elizabeth McDonough a pallet of coffee, or at least a case of No-Doz.

Manchin has long expressed an interest in federal intervention in drug pricing, of course. He has argued that it will stabilize Medicare and Medicaid and allow for some deficit control, especially over a longer period of time. He’s been less enamored of an extension of ObamaCare subsidies, especially at the initial price, but Democrats are under tremendous pressure to avoid a big price spike in premiums that is due to happen in October if they can’t pass something. Manchin has apparently agreed to do something on a somewhat smaller scale, at least in principle:

As Democrats try to head off a looming premium hike for Affordable Care Act plans that could affect millions, Senator Joe Manchin, D-W.Va. is said to be sounding out options for a fix that might fit into a larger bill, although he has made no commitment.

Manchin is in talks with Senate Majority Leader Chuck Schumer on a filibuster-proof economic package that is currently centered on spending $500 billion and raising $1 trillion in revenue, according to two sources familiar with the talks.

While the details remain in flux, the bill is focused on energy, taxes, and drug prices. One source said the “ceiling” for energy funding is $300 billion. And the drug pricing measure is expected to save money.

That makes the ACA subsidies, which were boosted for two years in the 2021 pandemic relief bill, a potential fit for the remaining space. The cost of continuing them permanently would be $220 billion, according to the Congressional Budget Office.

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So we have $300 billion for drug pricing and $220 billion for ObamaCare subsidies, which comes to $520 billion. That’s over Manchin’s supposed spending target in these talks already, although perhaps the subsidies could get tweaked to get under $200 billion. That’s the deal … right?

Er 

Wait — what? On one hand, Kapur reports that Manchin has a ceiling of $500 billion in spending against tax increases that will (supposedly) generate $1 trillion in extra revenue. On the other hand, the components of this deal already add up to $820 billion, which transforms the deficit reduction that Manchin has prioritized into even more of a drop in the bucket — $180 billion over ten years while Joe Biden and Chuck Schumer offer budgets with trillion-dollar deficits every year.

And that’s assuming Schumer doesn’t try to force even more spending into the BBB reconciliation package. Given the progression just in this sequence from NBC News, I’d call that a bad bet to take. Especially with stakes going into the hundreds of billions of dollars, and possibly trillions.

In fact, I’d bet a CBO score will reveal that some of these dollar figures are based on gimmicky sunset clauses already, or will be soon to reverse-engineer the deal back under the $500 billion cap that Manchin now says he wants. Will Manchin fall for that if it happens? He held the line for months against those dishonest dodges, so we’ll have to hope for the best — or hope that Mitch McConnell’s threat to torpedo the USICA bill if Schumer presses ahead on reconciliation creates enough pressure for the BBB to fail yet again.

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Jazz Shaw 7:20 PM | March 18, 2024
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