Healthcare Preview: Week of December 13, 2021 - McDermott+Consulting

Healthcare Preview: Week of December 13, 2021

Will BBB Get Done This Year?

Congress has been clearing the decks of everything other than the Build Back Better (BBB) Act. Late last week, President Biden signed into law legislation to avert some of the reductions that were set to take place for Medicare providers. That legislation also set up the big event for early this week: passing legislation to raise the debt limit. We expect the Senate to act first to raise the debt limit, which only needs 50 votes thanks to a provision in the Medicare provider legislation that allows the Senate a one-time-only debt limit vote that can pass with a simple majority.

With regard to BBB, we’re watching for signals from the two most important people in the Senate right now: the Senate parliamentarian and Sen. Joe Manchin. We await the parliamentarian’s rulings on many of BBB’s key healthcare sections, such as drug pricing. We have also already seen other pieces drop out entirely, such as the proposed disproportionate share hospital payment reductions and the language to require nurse-staffing ratios in skilled nursing facilities.

After the parliamentarian completes the “Byrd Bath,” all eyes will turn to Sen. Manchin, and pressure will grow for him to agree to advance the legislation. We know he has concerns about inflation, which is why Treasury Secretary Yellen put out a memo last week intended to alleviate some of those concerns. We also know that Sen. Manchin may demand that certain provisions—such as a hearing benefit in Medicare and paid family leave—be removed in exchange for his support. Majority Leader Schumer wants to begin the procedural votes needed to actually move to BBB as soon as this Friday. A lot needs to happen between now and Friday for that goal to become a reality, but stranger things have happened in Washington around the holidays.

Bottom line: We wait on the Senate.

LISTEN HERE: Senate Majority Leaders Chuck Schumer wants to pass the President’s Build Back Better bill before the holiday. Debbie Curtis and Rodney Whitlock preview the work Democrats must undertake in the Senate this week to accomplish this goal.