Health

U.S. Senate passes major health, tax and climate bill in boost for Democrats

The U.S. Senate, along party lines, passed a sweeping energy, health care, climate and tax package Sunday afternoon, following an overnight marathon of votes that resulted in just a handful of notable changes to the legislation.

The 755-page bill was passed after Vice President Kamala Harris broke a 50-50 tie in the evenly divided Senate. It now heads to the House, where Democratic leaders have announced they will take it up on Friday.

“At last, we have arrived,” Senate Majority Leader Chuck Schumer said. Democratic senators broke out into applause as Harris announced passage of the bill, expected to total more than $700 billion.

Schumer, a New York Democrat, said he dedicated the measure to young Americans who have pushed and protested for the Senate to take action on climate change.

“This bill will kick-start the era of affordable clean energy in America,” Schumer said. “It’s a game changer.”

Senate passage marks a major recovery for President Joe Biden’s domestic agenda, after a larger package the White House largely wrote and pushed for the better part of a year could not win the support of centrist Democratic Sens. Joe Manchin III of West Virginia and Kyrsten Sinema of Arizona, dimming the prospects of enacting health and tax policy changes and major climate spending.

Just two amendments during what is called vote-a-rama were added to the bill, known as the Inflation Reduction Act, after Democratic leaders earlier struck agreements needed to get Sinema and Manchin on board. Under budget reconciliation rules, the legislation only needed a simple majority for passage rather than the usual 60-vote threshold.

In the final stretch of voting and at the last minute, the Senate agreed to an amendment by John Thune, Republican of South Dakota, that made a 15% corporate tax included in the bill apply to fewer businesses owned by private equity firms.

The amendment was backed by Sinema, along with six other Democrats — Raphael Warnock and Jon Ossoff of Georgia, Maggie Hassan of New Hampshire, Jacky Rosen and Catherine Cortez Masto of Nevada and Mark Kelly of Arizona.

The revenue lost initially was expected to be paid for by extending the cap on the State and Local Tax deduction. But that would have drawn opposition from lawmakers in high-tax states like New Jersey who want to get rid of the cap. Instead, Democrats found their offset in another tax provision, dealing with limits on writing off business losses.

In another major change Republicans successfully stripped a provision to cap insulin co-pays at $35 in private health insurance plans, citing budget rules. A similar price cap for Medicare remains in the version of the bill the Senate approved.

The price cap has been a priority for Warnock and likely will become a prime campaign issue for Democrats to use against Republicans who voted to remove it. Similarly, Republicans will try to use many of the amendment votes in the vote-a-rama against Democrats as the midterm campaign heats up.

Seven Republicans did vote with Democrats on the insulin amendment: Bill Cassidy and John Kennedy of Louisiana, Susan Collins of Maine, Josh Hawley of Missouri, Cindy Hyde-Smith of Mississippi and Lisa Murkowski and Dan Sullivan of Alaska.

Progressive changes thwarted
The bill would spend nearly $370 billion on clean energy programs, allow the Medicare health insurance program to negotiate some drug prices beginning in 2026, impose stiffer corporate taxes and bolster Internal Revenue Service enforcement to bring in more than $400 billion in new revenue over 10 years.

Independent Sen. Bernie Sanders of Vermont pushed an expansion of the child tax care credit and other progressive changes to the legislation, but was defeated repeatedly as Democratic leaders argued the bill needed to remain intact in order to secure those two votes from Manchin and Sinema.

The amendment on the child tax care credit, which expired in December, was shot down, in a vote of 1-97.

Last year Democrats tried to include in an earlier version of their reconciliation bill a 10-year expansion of the program, which would have lifted millions of children out of poverty, but Manchin objected to it, arguing the price tag of the provision — in the Build Back Better bill — was too big.

Sen. Sherrod Brown, an Ohio Democrat, said that Democrats will continue to work on an expansion of the child tax credit, and noted the “fragile arrangement” of the bill.

Another unsuccessful Democratic amendment came from Warnock, who wanted a provision included in the bill to end a gap in Medicaid coverage for low-income people in his state and others, calling it a “moral moment” for senators.

“I rise on behalf of nearly four-and-a-half million Americans in 12 states, including 646,000 Georgians, who a decade after the Affordable Care Act became law, still do not have access to affordable health care. They are the working poor,” Warnock said. “They are being blocked by governors and legislatures.”