Elizabeth Warren’s plan to break up Big Everything

“mergers don’t just affect consumers: “The world has changed for those workers,” Warren said.”

“Studies have shown that as markets become more concentrated, wages stagnate.”

“Under Warren’s new bill, mergers over a certain size or that consolidate the market too much are forbidden. And consummated mergers that have harmed competition, workers, consumers, or competitors can be broken up.”

Congress could finally pass a Covid bill. They’ll soon have to do it all again.

“The roughly $10 billion in pandemic aid the Senate is preparing to vote on after a weekslong impasse will keep the nation’s testing, treatment and vaccination programs afloat for only a couple months, lawmakers, Biden administration officials and public health experts warn.”

“This round of funding — if it can pass the House and Senate — would help restart key Covid-19 programs that recently ran out of resources, including the development of future variant-specific vaccines and federal government purchases of drugs for people at risk of hospitalization.
But the package was whittled down from more than $30 billion federal officials originally argued was needed to $22.5 billion the White House pitched to Capitol Hill last month to $15.6 billion congressional leaders tried to attach to the 2022 spending bill.

Now, $10 billion is on the table and the money for the global vaccination effort and for testing, treating and vaccinating the uninsured was dropped, all but guaranteeing the Biden administration will shortly need Congress to do this all over again.”

“Public health leaders warn that these short-term bursts of cash are creating gaps in preparedness, leaving millions vulnerable to a new Covid surge.”

“with no global money in the current deal, policymakers fear the disruption to the U.S.’ pandemic work overseas will continue indefinitely.

“Doing nothing to slow the global spread of COVID-19 is foolhardy,” Senate Appropriations Chair Patrick Leahy (D-Vt.) warned Monday. “As the virus continues to mutate and wreak havoc overseas, more Americans will become sick and die.”

For months, officials at the U.S. Agency for International Development have warned lawmakers that they would soon run out of money to help facilitate vaccinations in low- and middle-income countries, and advocated for at least $19 billion for the global Covid fight.”

“On the domestic front, the funding delays have forced the federal government to halt purchases of enough additional booster doses for all Americans and slash the purchase and distribution of monoclonal antibody treatments and antiviral pills for high-risk Covid patients. It has also disrupted research into new treatments and cut off reimbursements to doctors around the country for testing, treating, and — as of Tuesday — vaccinating the uninsured. Even if Congress manages to approve the funding this week, public health experts say, there’s a good chance all of these threats will reemerge in just a few months, damaging the stability and continuity of their fight against the virus.”

Congress’s short-term funding bills are a terrible way to govern

“Congress’s dependence on CRs is due to lawmakers’ inability to agree on full-year appropriations bills.

Congress’s actual deadline for passing appropriations legislation is at the end of September each year. Because bills from the previous year expire at that time, lawmakers need to approve a new set of 12 appropriations bills to fund federal agencies and make sure the government doesn’t run out of money. (If the government runs out of money and shuts down, agencies are forced to furlough employees and reduce their services.)

Had these bills passed on time, all spending would have been approved last fall. Instead, because Democrats and Republicans couldn’t come to an agreement, they passed a short-term spending bill that gave them a new deadline in December. When they couldn’t reach an agreement then, they passed another short-term spending bill that postponed the deadline to February 18. And because of ongoing conflicts, they’re planning to pass one more short-term spending bill to give them until mid-March.

Whether lawmakers procrastinate again is an open question.”

“Because Democrats control 50 Senate seats, but need 60 votes to pass the funding bills, members of the minority have leverage over what they’d like to see included.”

Congress is on the brink of an immense health policy failure

“The coronavirus pandemic has fully exposed the flaws in the US health care system and deepened many of its disparities. Yet there is a serious possibility, now that Sen. Joe Manchin (D-WV) has rendered the current version of the Build Back Better Act dead, that the current Congress will not pass any long-term provisions to cover more people, make health care more affordable, or better prepare the nation for the next pandemic.

Though they have not attracted as much attention as other parts of the legislation, Democrats had written a wide-ranging health care section in Build Back Better. They were planning to patch up holes in the Affordable Care Act, extending assistance to middle-class families as well as people in poverty; to reduce drug costs for millions of Americans; and to make investments in the country’s health care infrastructure, with the goal of better preparing the US for the inevitable next pandemic.”

‘A lot of money on the table’: Fight brews over surprise medical bills

“The law, which takes effect Jan. 1, protects patients from receiving expensive bills for unexpected out-of-network care but doctors, hospitals and insurers are still at odds over which factors an independent arbitrator should rely on to decide who picks up the tab.

The outcome could swing billions of dollars in payments, significantly influence how doctors and hospitals negotiate prices with insurers and possibly affect premiums for millions of Americans.

“This is probably one of the most significant overhauls in the health system since the [Affordable Care Act] ACA,” said a spokesperson for the Coalition Against Surprise Medical Billing, which represents insurers, employer and union groups, and works with patient groups. “We certainly don’t see any end in sight in terms of the battle in making sure that these regs are implemented.”

The coalition supports the Biden administration’s interim final rule that instructs arbitrators to rely primarily on a single factor — the median in-network rate in a geographic area — when settling disputes between providers and payers. It has sponsored multiple six-figure digital ad-buys, including one that runs through Christmas, urging regulators to stay the course.”

“Hospitals and doctors allege the Biden administration’s decision to emphasize the median in-network rate, a figure the insurance companies calculate, gives large insurers a huge advantage when negotiating how much a service should cost.

Insurers would have an incentive to keep the in-network rates lower to avoid paying more to out-of-network doctors. And they say payers would know doctors and hospitals have little recourse if they choose to remain outside an insurer’s network.

“Being out of network is really the physicians’ only control over how their contracts look,” said Randall Clark, the president of the American Society of Anesthesiologists. “If the insurance companies can treat us the same whether we’re in network or out of network, there is no impetus on the part of the insurance companies to negotiate fair contracts.”

Trade groups representing providers say the law lists several other factors that should be equally weighted when calculating how much a service costs, such as the doctor’s experience and the complexity of the procedure. While these metrics can still be introduced during the dispute resolution process, the Biden administration’s rules don’t give them as much weight as the median in-network rate metric, which providers say puts them at a disadvantage before the process even begins.”

The ‘Build Back Better’ Bill Will Spend a Lot of Money To Make Our Problems Worse

“First, the legislation doesn’t address why child care is so expensive in the first place. More people seeking it will only collide with ill-advised government restrictions on the supply of such care—restrictions like the excessive occupational licensing and credential rules that prevent plenty of qualified people from offering their services. A bill that truly aims to reduce the cost of child care would remove these restrictions and allow parents to choose any capable provider.

BBB doesn’t lift any restrictions and adds more. As University of Chicago economist Casey Mulligan explains, “the bill requires that child-care workers be paid a ‘living wage’ and that their earnings be ‘equivalent to wages for elementary educators with similar credentials and experience.'” As a result, child care will become even more expensive for all families that don’t qualify for “free” child care.”

The Build Back Better Bill Will Give You $12,000 for Buying an Electric Car. Unless It’s a Tesla.

“As part of Biden’s plan to rein in carbon emissions, the bill contains a provision which would provide a $7,500 tax rebate to any consumer who purchases an electric vehicle (EV), including both all-electric and plug-in hybrids. However, that amount increases by $4,500 if the car was manufactured in a unionized U.S. factory, as well as by an additional $500 if the vehicle contains a U.S.-made battery.

Ostensibly, this provision is part of Biden’s “Buy American” policy of incentivizing or mandating purchases to be made domestically. In practice, the order has simply carried over the protectionism of the Trump trade policy and increased costs to taxpayers. The EV credit proposal, though, is much more egregious, in that it not only incentivizes a particular type of product, but incentivizes particular brands, as well.

If enacted as written, the bonus $4,500 in EV credits could only apply to cars made by Ford, General Motors, and Stellantis (formerly Fiat Chrysler). In other words, a driver who wants to purchase a hybrid Toyota Camry, which U.S. News & World Report ranks as having “Great” reliability, does not qualify for the extra money, even though the car is manufactured in Kentucky. But if that same shopper elects to purchase a Chevrolet Bolt, which recently halted production because the batteries were catching fire, they would receive the extra rebate. As a matter of fact, out of more than 50 EVs currently on the market, the only vehicles which currently qualify for the extra money are two variations of the Bolt.

This is what is most pernicious about this policy: Rather than simply a blanket advantage for American companies (which would be bad enough), it is a clear giveaway to the United Auto Workers (UAW).”

How 14 policies could survive — or die — after Manchin’s ‘no’

“The West Virginia moderate said he can’t back the $1.7 trillion package. But Manchin has supported many of the bill’s individual policies, giving hope for Democratic leaders now plotting to get the centrist senator on board with a far slimmer proposal or spinning off other bills that include some of the package’s well-liked items.”

“Extension of the beefed-up Child Tax Credit that Democrats pushed through in March, which many of them considered a landmark legislative achievement since taking control of the White House and Congress.
The huge expansion of the program, which benefits an estimated 61 million children, will expire at the end of the year unless Democrats find some way to keep it alive or revive it after it lapses. The IRS cut its final round of monthly checks for 2021 last week, sending about $16 billion to more than 36 million families.

The demise of the expansion would mean the end of payments for millions of children whose families would no longer qualify. The maximum credit would fall to $2,000 from $3,600, it would revert to a yearly benefit instead of a monthly payment and a work requirement for parents would be reinstated.”

“Manchin wanted fewer upper-income households to qualify for the benefit and said the work requirement should be brought back. He also considered the one-year extension a budget gimmick because it was likely to be extended again later.

Many Democrats wanted to make the expansion permanent. But bowing to Manchin’s objection to the price of the overall spending package, they settled on a one-year extension in the House bill.”

White House lights up Manchin after he crushes Biden’s megabill

“Biden left negotiations with Manchin this week thinking the two men could cut a deal next year on his sweeping agenda. Then the West Virginia Democrat bluntly said he is a “no” on the $1.7 trillion in an interview on “Fox News Sunday.”

“If I can’t go home and explain to the people of West Virginia, I can’t vote for it. And I cannot vote to continue with this piece of legislation. I just can’t. I’ve tried everything humanly possible. I can’t get there,” Manchin said. “This is a no on this piece of legislation. I have tried everything I know to do.”

Those comments prompted an immediate war with the White House, who took personal aim at Manchin for what officials saw as a breach of trust. White House press secretary Jen Psaki released an unusually blunt statement saying that Manchin’s comments “are at odds with his discussions this week with the President, with White House staff, and with his own public utterances.”

In announcing his opposition, Manchin raised the same concerns about the bill that he’s had all along: inflation, rising debt and a mismatch between the package’s 10-year funding and its shorter-term programs. But until Sunday, Manchin had never taken a hard line on the legislation. In the past week, he’s spoken directly to Biden several times, with the president and other Democrats furiously lobbying him to support the bill.

With an evenly split Senate, Senate Majority Leader Chuck Schumer needs every Democrat to go along with the legislation, which only requires a simple majority vote. That dynamic gives Manchin enormous leverage over Biden’s agenda, allowing him to single-handedly sink a priority that Democrats have spent much of the year working on.

Manchin’s rollout on Fox News infuriated Democrats Sunday morning. Psaki said that the senator had brought Biden an outline of a bill similar in size and scope that “could lead to a compromise acceptable to all.”

“If his comments on FOX and written statement indicate an end to that effort, they represent a sudden and inexplicable reversal in his position, and a breach of his commitments to the president and the senator’s colleagues in the House and Senate,” Psaki said. “Just as Senator Manchin reversed his position on Build Back Better this morning, we will continue to press him to see if he will reverse his position yet again, to honor his prior commitments and be true to his word.”

And while the centrist senator’s staff informed White House and Democratic aides about his forthcoming blow to Biden’s agenda, some Democrats were steamed that Manchin himself hadn’t called Biden or Schumer.”

“now may be an opportunity to revisit a concept of the bill that included fewer programs but was paid for over more years — an option that moderate House Democrats and party leaders such as Speaker Nancy Pelosi had pushed for previously. Centrist New Democrat Coalition Chair Rep. Suzan DelBene (D-Wash.) said in a statement Sunday that including fewer programs in the legislation but for longer durations “could open a potential path forward for this legislation.””

“The West Wing saw Manchin’s Sunday comments as a shocking about-face — White House officials believed he had been sending signals that a deal could eventually be struck.”

“Manchin’s position is a validation of progressive fears — they believed passing that infrastructure bill was a mistake without an explicit guarantee from all 50 Democratic senators to support the rest of Biden’s agenda. Progressive House Democrats fumed at Sunday’s developments, though the nearly 100-member caucus had not regrouped to find a path forward.
“I wish we would have kept both bills together. That was the plan throughout several months of negotiation,” Bowman said. “I was frustrated then and obviously frustrated now that we decided to decouple those bills, because, as Manchin has shown in the past, we cannot just take his word for something.””