Health Advice



Sen. Wyden: $3.5T budget may have to trim but it can set a path to 'ambitious goals'

Michael McAuliff, Kaiser Health News on

Published in Health & Fitness

“Many of these components of the plan on their own would be considered major policy accomplishments, maybe the highlight of a congressional session,” Ginsburg said. “This just multiplies it all, puts a number of these programs together, many of which on their own would be major, major accomplishments.”

Yet there remain major question marks, as well. For instance, some of the proposals tread into territory that has never been tried before, and policy experts aren’t sure how they will work. Ginsburg pointed to the dental, hearing and vision proposals for Medicare, noting there has been relatively little careful analysis related to including those benefits in Medicare.

“Nobody’s talked about that. We don’t know how to do it,” Ginsburg said. “It’s very different from medical insurance issues.”

The plan is moving through what’s known as the budget reconciliation process. First Congress approves budget instructions for bills that affect spending, revenue or debt. Under congressional rules, those bills can then advance on an expedited basis and pass in the Senate with a simple majority, with no threat of a filibuster.

Still, there is no room for error. With just 50 Democrats, Schumer will need every one of them — and Vice President Kamala Harris’ tie-breaking vote — if Republicans remain united against the package. In the House, Democrats also have a tiny majority and could likely lose only a handful of members as they try to pass the budget framework.

Wyden and others are trying to help lawmakers reach consensus on a plan. Moderate Democrats have raised concerns about how these initiatives would be paid for, and not all are keen on the drug price measures, including allowing Medicare to negotiate. Progressives, on the other hand, have called for higher spending to cover even more robust initiatives.


Wyden said he is shuttling between the Senate and the House and moderates and progressives, and he intends to stay glued to the Capitol to meet Schumer’s deadline.

He cautioned, though, that people should not expect to see every detail in whichever package is released this week. It will be an outline that tells committees to get to work on specifics. More details will come later.

“They will not be bills that people think of as legislation — Section 406-B and paragraph three and the like. This is a general framework. We’re kind of flushing this out,” Wyden said.

And even though he calls the overall effort ambitious, Wyden prefers to work out the details quietly, and make sure they are acceptable to his colleagues and the Senate parliamentarian, who determines if provisions of the bill qualify for the reconciliation process. “We’re putting in the time to do this right,” Wyden said, pointing to previous bills he has gotten passed. “That’s kind of my style — underpromise and lower the decibel level and focus on getting it done.”


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