Healthcare Preview: Week of November 15, 2021

Healthcare Front and Center

The Road to a Vote on the Build Back Better Act Stretches On. This week, all eyes are once again on the Congressional Budget Office (CBO), as Washington awaits the CBO’s provisional scores for the Build Back Better Act (BBB), and on the House, as Democratic leadership pushes for House passage of BBB this week.

CBO does not anticipate completing the score for the entire BBB this week, but that doesn’t mean there won’t be a vote. House moderates, who prevented a vote from occurring two weeks ago in the absence of a CBO score, have indicated that they are open to voting if CBO is able to score most provisions and those scores are in line with the scores put out by the Administration previously. Failure to have the House vote on BBB this week would reduce the likelihood of enactment this year. House Democratic leadership wants House passage this week —even if that means slipping into this weekend or early next week.

And on the topic of the CBO score, Democratic leadership has promised that BBB will be fully paid for, and members will be looking to CBO for confirmation. If CBO indicates that the bill costs more than the offsets provide for, the legislation may need to be re-opened to include additional payfors. In that case, the House would need to start over with a new rule vote—which would open the door for additional changes to secure the near-unanimous Democratic support necessary to pass the BBB.

It is also still unclear which provisions will survive the Byrd Rule, and Senate Majority Leader Schumer has indicated that the Senate cannot start the “Byrd Bath” process until a CBO score is issued. On top of that, at any point, a single senator could upend the entire process. And even if and when the BBB gets through the Senate, the Byrd process and the need to have all 50 Democrats in agreement will mean changes to the House bill, requiring it to return to the House for final passage.

There’s also the small issue of the continuing resolution that expires on December 3, not to mention the debt limit (although that deadline may be extended). Suffice to say, the longer the BBB takes to get done, the less likely it is that an end-of-year omnibus/budget deal will come together. We may be looking at a continuing resolution into the new year, with the hopes of revisiting the topic once tensions around BBB have cooled.

Bottom line: Nothing can happen until CBO has spoken.

LISTEN HERE: All eyes are on the Congressional Budget Office scoring on the costs of the President’s economic agenda against the federal budget. Debbie Curtis and Rodney Whitlock share what lawmakers are watching for, what their reactions could signal, and the likeliness of a vote in the House — this week.