RICARDOALONSO-ZALDIVAR and LISAMAS CAROAP communication

Washington (AP) — Dental Treatment for the Elderly Medicare.. End of marginal pricing for prescription drugs. A new option for home care.Coverage for locked out low-income earners Medicaid By the battle of ideology.

These are just a few of the changes to health that Democrats want to achieve with President Joe Biden’s large-scale “Build Back Better” program. NS $ 3.5 trillion domestic agenda bill It touches on almost every aspect of American life, from taxes to climate change, but the health component is the foundation for Democrats and was amplified during the COVID-19 crisis.

But Democrats can only succeed if they bridge the division between them. Don’t look for and help Republicans.

Medicare’s long-term finances are under the clouds, and Republicans say it’s not time to add new profits. They plan to oppose not only the healthcare provisions, but the entire Voting package, which is too big and costly to lock step into a slide to “socialism”. Vote

With future politics in mind, Democrats are keeping Congress slim and assembling packages.Instead of launching new experiments preferred by many progressives, they chose to devote more resources to existing programs, from Medicare and Medicaid established during the Great Society to the Obama era. Affordable care method..

This is a kind of compromise led by Biden’s approach, paid by taxes on businesses, wealthy people, people who earn more than $ 400,000, and savings on the price of prescription drugs that the government pays pharmaceutical companies. ..

“I’ve said it many times before. I believe we’re at an inflection point in this country. It’s one of the moments when the decisions we’re about to make can change, literally for years. It could change the course of the country across the board, Biden said in a statement at the White House last week.

Opinion polls have shown that core medical provisions appeal to voters across political boundaries. For example, many Republican voters generally allow Medicare to negotiate prescription drug prices without the approval of GOP lawmakers. While Obama’s health law focused primarily on helping people of uninsured working age and their families, Biden’s coder puts a great deal of emphasis on older people who are also voters in credible midterm elections. increase.

The main medical provisions for the mix are:

-Allow Medicare to negotiate the price of the most expensive drugs, including insulin. Private insurers and employer plans have access to these low prices. Annual price increases for established drugs are limited. There is an upper limit to the out-of-pocket costs for the elderly.

According to a study by RAND Corporation, such an approach could cut spending on top US medicines in half.

Fierce opposition from major pharmaceutical companies and major business industry groups has split the Democratic Party over the structure of the program.

Four Democrats opposed the bill during the Commission’s vote Enough to put the entire invoice in the tank last week. In the past, they supported giving Medicare the power to negotiate, but they have expressed various concerns about the scope of Speaker Nancy Pelosi’s plans. The Senate can take a slightly different approach.

Medicare negotiators are the cornerstone of health care packages as the expected savings are used to provide new benefits.

— Expand Medicare to cover dental care, vision and hearing aids for the elderly. This provision, endorsed by Senator Bernie Sanders (I-Vt.), Has been around for a long time. Sight care will begin later next year and hearing aids will begin in 2023, but due to the apparent cost, dental treatment will not begin until 2028.

— Built on Obama’s Health Act. The idea is to provide health insurance to more than 2 million low-income people in the Republican-led state who refused to expand Medicaid in Obamacare. Workarounds are the greatest demand for health inequalities for black lawmakers, as many of the lawmakers involved in the coverage gap are minorities in the southern states.

Biden’s plan also calls for making health insurance more affordable for those who buy their own insurance by expanding the increase in subsidies to Obama’s health law. More abundant grants are being temporarily provided to those who are under-covered by their employers under Biden’s COVID-19 Relief Bill, and the White House wants to make the grant permanent. Legislators may only meet the president on the way.

— Promotes the transition of patients to long-term care at home, in contrast to long-term care facilities that have turned into coronavirus incubators as the pandemic spreads. Biden wanted $ 400 billion for this initiative under Medicaid, but Congress seems to give him about half of that.

— Permanently funding the politically popular Children’s Health Insurance Program, it is not subject to regular parliamentary voting that could disrupt service.

— Improve maternal health by providing 12 months of postpartum compensation through Medicaid.

Major Democrats, including Senator Joe Manchin of West Virginia and Kyrsten Sinema of Arizona, have said the overall $ 3.5 trillion price tag is too high, and Democrats will either eliminate some programs or eliminate some programs. We are looking for ways to reduce costs, perhaps by scraping. Some cost or duration from what was proposed.

But other Democrats warned that slimmer packages could disappoint voters who sent them to Washington with a promise to make major changes.

“My members expect me to deliver and I promise to do it,” said Democratic Congressman Lauren Underwood, who has a professional background in health policy. rice field.

Biden’s approval rating plummeted following the withdrawal of the United States from Afghanistan and the chaotic and violent consequences of the resurrection of the coronavirus at home after declaring a weakened pandemic.

Democratic pollster Celinda Lake said the budget’s medical provisions appeal to lawmakers’ own self-preservation instincts. The proposal resonates with two major groups in the 2022 contest, senior voters and women, and Democrats are fighting to maintain the House of Representatives.

“If you want to protect yourself in your district, you should double your healthcare regulations,” she said.

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