Advocates continue to push the Senate to pass reconciliation legislation that contains some pieces of the House-passed Build Back Better Act, but the list of human needs wins a package may contain appears slim.

The latest reports are that Sen. Joe Manchin (D-WV), a key vote needed to pass reconciliation legislation, may be open to a package that includes provisions to lower the cost of prescription drugs, some limited climate and energy provisions, and provisions meant to raise revenues and reduce the deficit. An expansion of the Child Tax Credit (CTC) and Earned Income Tax Credit (EITC), as well as money for affordable housing and other human needs programs, will likely not be included, though advocates continue to push for their inclusion. Sen. Manchin has insisted that much of the revenue increases in the package go to deficit reduction, rather than investments in services. There are reports that Senate negotiators are reducing the total amount of revenue increases to closer to $1 trillion (the House-passed bill had nearly twice that). If about half of the increased tax revenues are held to reduce the deficit, the amount available for investments will be severely constrained.

Senators appear to be close to agreeing on prescription drug provisions, allowing a limited number of high-cost prescription drugs plus insulin to be subject to negotiation by the HHS Secretary within the Medicare program. It is reported that there would be a $2,000 out of pocket cap on prescription drug costs to patients with Medicare prescription drug coverage, and that there would be full subsidies for patients with incomes up to 150 percent of the poverty line. The provisions would not take effect until 2023.

Advocates also continue to show the need for the inclusion in a package of other health provisions, including an extension of the Affordable Care Act premium tax credits and closing the Medicaid coverage gap. According to the Center on Budget and Policy Priorities, if Congress does not act to extend the ACA premium subsidies enacted in the American Rescue Plan, the large majority of the 14.5 million people who signed up for marketplace coverage this year, including those in low- and moderate-income households, will either lose coverage altogether or pay much more for premiums in 2023. Fourteen governors sent a letter to Congress urging action on this issue as well.

Advocates from the Center for Law and Social Policy (CLASP), the National Women’s Law Center, MomsRising, nearly 130 Representatives, and others are also urging the Senate to include in a reconciliation package provisions to make child care more affordable and accessible. According to CLASP, a proposal by Sens. Patty Murray (D-WA) and Tim Kaine (D-VA) would provide direct support for child care to families and build up the supply of child care, including investments in the child care workforce. It will also invest in preschool, Head Start, and establish a pilot program for states that would further expand access and affordability to reach families with higher incomes and cap families’ child care expenses. Advocates also hope to see provisions to expand funding for housing and nutrition services in the package.

The reconciliation process, under which Democrats hope to pass a package in the Senate, allows legislation in the Senate to proceed without the possibility of filibuster (which stymies legislation by threatening unlimited debate). Ending a filibuster takes 60 votes; with no filibuster, reconciliation bills can pass with only a simple majority (51 votes in the Senate). However, they have been repeatedly thwarted by Sens. Joe Manchin (D-WV) and Krysten Sinema (D-AZ), whose support is needed to reach the 51-vote threshold.

If a reconciliation package is not passed before Congress leaves for the August recess, most predict it may not get done at all as members of Congress hit the campaign trail. The timing of passing such legislation is also complicated by the fact that Sen. Patrick Leahy (D-VT) is recovering from an unplanned surgery, and the date for his return to the Senate is unknown. With no Republicans expected to support the package, all Democrats are needed to get to pass the legislation.

Advocates are disappointed by the logjam in the Senate, as the House-passed Build Back Better Act would make major investments to reduce child poverty by 40 percent, expand access to health care, invest in affordable housing, child care, home and community-based care for the aging and people with disabilities, and promote broadly shared economic security, with special attention to the needs of people with low incomes, communities of color, and immigrant families. For more details on the legislation, see the Nov. 22 Human Needs Report.

Assuming the Child Tax Credit provisions are not included in a reconciliation package, advocates are looking at other vehicles that may be available to move the improvements. One possibility is a year-end package that could combine all 12 appropriations bills as well as health extenders and tax extenders that will expire at the end of the year. Another possibility is a research and development competitiveness bill (the COMPETES Act passed the House in February; the Senate version, the U.S. Innovation and Competition Act, passed the Senate in June, and differences between the two versions are currently being worked out). Each of these pieces of legislation will need 60 votes to pass the Senate. Advocates are insisting that neither of these pieces include extensions of corporate tax breaks without also including the extension of the CTC/EITC improvements. However, in the latest twist, Senate Minority Leader Mitch McConnell threatened last week to sink the bipartisan competitiveness bill if Democrats pursue a reconciliation package.

Sen. Mitt Romney (R-UT) also recently introduced a bill that would address the Child Tax Credit. According to the Center on Budget and Policy Priorities, the proposal improves on some elements of current law, but it fails to provide the full CTC to the lowest income children and dramatically cuts the Earned Income Tax Credit, eliminates the filing status for single parents, and eliminates a tax credit for child care. This would leave many families with low incomes and immigrant families worse off under the Romney plan than they are under current law.

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