Senator from small, poor state roils big plan to improve U.S. health

Record numbers of poor, working poor, and middle-class Americans are signing up to receive federal help to get affordable insurance to safeguard their health and finances. But will congressional politicking cost them this invaluable coverage — just before the nation goes to the polls for midterm elections?

For months now, President Biden and the Democrats have labored to put together a multitrillion-dollar legislative package dealing with the nation’s health needs, climate change, and more. Because Capitol Hill is so riven — among Democrats, as well as between Republicans and Democrats — the ambitious aspirations of those in the party barely in power have needed to be wrapped into a sprawling measure that can sidestep the filibuster and survive a complex legislative maneuver and on to passage.

Let’s be clear that 50 Republicans in the Senate and hundreds of GOP House members have refused to act in any way like American lawmakers, declining at all to work on the package and to sticking to partisan position that Democrats will need by themselves to pass measures needed and popular with voters.

In the Senate, Joe Manchin, a Democrat from West Virginia, has decided to be the deal-killing naysayer, demanding his colleagues slash the party plans from more than $3 trillion over 10 years to less than $2 trillion. Then, just before lawmakers went on holiday break, he trashed the plans of his party and president, announcing on Fox News that he could not for the Build Back Better program at all.

This is interesting conduct from a wealthy former governor who drives around the District of Columbia in a Maserati and lives on a yacht while away from his home state. He appears to be acting — in the name of professed financial rectitude — against the interests of the people in his poor and desperately needy state, the sixth highest ranking by poverty rate. It has a population less than a third of that of the Washington, D.C., metropolitan area.

By attacking the Democrats’ plan, Manchin will ensure that Big Pharma can gouge diabetics in his state and nationwide for the price of life-saving insulin and that poor seniors will not get dental care through federal retirement programs.

He is blocking a limited but breakthrough effort to allow the government, via Medicare, to use significant federal sway to dicker with Big Pharma to slash at least some skyrocketing prescription drug prices.

He has raised big objections, too, to federal aid programs that benefit children — including the tens of thousands of needy kids in his own state, which is among the top 10 in poverty rates among youngsters.

And while Manchin assails the Democrats’ efforts to battle in a big way the giant threat of climate change, critics sigh. They know that he long has been a beneficiary of sizable donations and support from the coal industry, which is dwindling by the day in his state. (Union miners, however, have called on Manchin to support the Democratic plan).

Democrats, including the president, have zinged Manchin, arguing that he has forced them to negotiate with him and others in the party while promising that he would find a way to support Build Back Better. Party progressives, with arm twisting aplenty, played a key role in advancing a trillion-dollar infrastructure bill. They did so with pledges that BBB — with their important wishes, including continued funding to make the increasingly popular Obamacare even more affordable and to provide Medicaid coverage in states that have balked at its expansion — would be passed in tandem.

Things look grim for passage of a measure that analysts say could improve Americans’ health in major ways, as well as providing boosts for childcare help, pre-kindergarten education, and for community colleges.

The parties are talking again, and there is a slim window at the year’s start before Congress’s efforts will grind to a halt with the campaigning revving up for the midterms.

In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, efficient, and excellent medical care. This has become an ordeal due to soaring cost, complexity, and uncertainty of treatments and prescription medications, too many of which turn out to be dangerous drugs.

Here’s hoping that the seeming holiday collapse of a noteworthy attempt to address people’s serious health and other needs will not go for naught and that what the nation witnessed was some last-minute theatrics before Democrats, in particular, do the right thing.

If not, shame on Manchin, Democratic Senator Kristyn Sinema and others who call themselves “moderates” but adopt positions aligned with wealthy, conservative, corporate interests. And, of course, the public should see clearly that Republicans refuse like a religion to take any actions that benefit Americans’ health, proffering only the weak tea contention that the federal government should have zero role in U.S. health care — an in which American spending rose to a record, exceeding $4 trillion annually in recent days.

If Congress can approve, without a blink and without questioning how it will be paid for, a military budget just shy of $800 billion for this year, what’s the fuss about domestic outlays that would on an annual basis be less than half that — and which Democrats have taken pains to seek to ensure it is paid for (with taxes, fees, and cost offsets)? The GOP, just to remind, gave wealthy corporations and the richest Americans $2.3 trillion in tax cuts with no pretense about fiscal rectitude.

We have much work to do in the new year and beyond to improve the nation’s health and wellbeing and voters need to provide a real reckoning at the ballot box for members of Congress who can’t see the importance of this challenge.