The key climate provision—the Clean Electricity Performance Plan, which would provide incentives to utilities to hasten their transition from coal- and gas-powered electricity generation to clean sources—is also out, a victim of Manchin. That’s a problem for Biden, who has a global climate summit to attend in Glasgow, Scotland, in a matter of weeks and needs something to bring there. He has committed the U.S. to cutting emissions by as much as 52% below 2005 levels in this decade. Achieving that without the entirety of the climate plan he had in Build Back Better is challenging, to say the least.
Another decades-long priority is also on the chopping block: reducing prescription drug costs. For 30 years, Democrats have been trying to pass legislation allowing for Medicare to negotiate drug prices. This was the best opportunity they’ve had since the Affordable Care Act was passed. The pharmaceutical industry won out in that one, and they’re in danger of winning again, though Democrats say they’re still fighting for it.
“Senate Democrats understand that after all the pledges, you’ve got to deliver,” Sen. Ron Wyden of Oregon, chair of the Finance Committee, told The New York Times. “It’s not dead,” echoed his counterpart in the House, Rep. Richard Neal of Massachusetts, who is chair of the Ways and Means Committee.
“It would mean that the pharmaceutical industry, which has 1,500 paid lobbyists, the pharmaceutical industry, which made $50 billion in profits last year, the pharmaceutical industry, which pays its executives huge compensation packages, and which is spending hundreds of millions of dollars to defeat this legislation, will have won,” Sanders said Wednesday. “And I intend to not allow that to happen.” There are, however, a few House members opposing it, along with Sinema and fellow Democratic Sen. Bob Menendez, who is also a good friend of the drug industry. Speaker Nancy Pelosi can only afford to lose three votes, Majority Leader Chuck Schumer none.
Wyden remains optimistic that something will be done on drug prices, even if it isn’t fully allowing Medicare to negotiate—for instance, a scheme he worked up with Republican Sen. Chuck Grassley that would force pharmaceutical companies participating in Medicare to offer rebates on drugs that rise in price faster than inflation. Menendez is okay with that plan. Sinema’s position is unclear.
The biggest change this week from the weeks and weeks in which this has been dragging on is that Biden is now fully engaged. “The president is being very clear about the direction we’re going in, where he wants to go, and it’s that kind of leadership that’s going to get us to the finish line,” said Rep. Debbie Dingell of Michigan. She’s among the progressives who have met with Biden this week. Rep. Pramila Jayapal from Washington State, head of the Congressional Progressive Caucus, is optimistic too, saying the debate is “moving in the right direction.”
Manchin is being appeased, and has apparently come up in his bottom line of $1.5 trillion. He has succeeded in severely truncating the proposal, which was his primary goal, so at this point everyone seems to be assuming he’s on board. Keeping him on board and making Sinema stand alone seems to be the only strategy available to salvage something out of this effort.