On November 6, the House of Representatives adopted procedural rules for the further consideration of the Build Back Better Act, which contains numerous health care and social spending provisions in President Joe Biden’s agenda. The Democrats in Congress are pushing for final votes on the legislation before the end of the year.

The CAP endorsed several provisions of the reconciliation bill that seeks to improve the lives of Americans across the country by expanding access to health care coverage and improving patient access to high-quality care. The CAP pushed for expanded insurance coverage for low-income populations, cost-sharing subsidies, marketplace subsidies, Medicaid coverage, and closing a Medicaid coverage gap affecting millions of Americans. The legislation includes several funding provisions supported by the CAP:

• $7 billion to support public health infrastructure activities
• $2 billion in funding for grants for modernizing projects to increase capacity and update hospitals and other medical facilities
• $5 billion for critical manufacturing supply chain resilience
• $1.4 billion for renovation, expansion, modernization of state and local public health lab infrastructure, including money for Centers for Disease Control & Prevention (CDC) laboratories
• $1.3 billion to prepare and respond to public health emergencies, including shoring up the strategic national stockpile supply chains, global and domestic vaccine manufacturing, biosecurity, and therapeutics

The CAP further recommended adding other provisions that would strengthen the legislation but are not included in the House draft. The CAP urged Congress to address future Medicare cuts and raise Medicaid payments to Medicare levels. Other provisions that did not make it into the House bill include laboratory system and testing capacity improvements, improving public health data surveillance and disease warning system, enhancing and strengthening early warning and detection systems, strengthening vaccine confidence, addressing physician shortages, and funding for anti-discrimination and bias training in medical schools and training programs

By a 50-49 party-line vote, the Democratic-controlled Senate passed a reconciliation resolution to instruct Senate and House committees to draft a budget bill amounting to $3.5 trillion. This package is likely to be paired down to between $1.5 and $2 trillion if it passes Congress by the end of the year.