What Biden’s sweeping social safety plan might include — and what it likely won’t

By CNN

Published October 20, 2021 5:46 pm

CNN, POOL, SENATE TV

By Tami Luhby and Katie Lobosco, CNN

Democrats in Congress are negotiating a sweeping budget reconciliation package that is the centerpiece of President Joe Biden’s domestic agenda.

The 10-year spending plan, originally priced at $3.5 trillion, marks the biggest step in the Democrats’ drive to expand education, health care and child care support, as well as tackling the climate crisis and making further investments in infrastructure. But it has also raised concerns among moderate Democrats in both chambers who worry some of the elements of the package go too far and are too costly.

With only narrow majorities in both chambers of Congress, Democrats are under pressure to finalize the package, which party leaders have pledged to move in tandem with a separate $1 trillion infrastructure bill that’s already been approved by the Senate and is waiting for a vote in the House before it can be signed by Biden.

Unlike the Democrats’ infrastructure package, the budget plan is unlikely to gain bipartisan backing — but under Senate rules it can be passed with 50 Democratic votes alone. GOP lawmakers have lashed out at the size of the package and multiple provisions the Democrats are considering.

After weeks of back-and-forth, Biden laid out details of a scaled back version of the plan, bringing the top line number down to roughly $1.9 trillion from $3.5 trillion and specifying that certain provisions like free community college would be left out.

The legislation has yet to be finalized, but here’s what we know could be in the package, based on negotiations underway between the White House and key lawmakers, draft bills from various House committees and a Senate Budget Committee resolution summary:

Establishing universal Pre-K

The House Committee on Education and Labor proposal would establish a universal Pre-K program for 3- and 4-year-olds.

Biden’s original proposal, which he called the American Families Plan, spells out some of the details. The federal government would invest $200 billion in universal preschool for all 3- and 4-year-olds through a national partnership with states. The administration estimates it would benefit 5 million children and save the average family $13,000 when fully implemented. It would be accessible to families of all income levels, but states would be required to foot about 50% of the cost when the measure is fully up and running.

Expanding the child tax credit

The House Ways and Means Committee is also seeking to extend expansions of the child tax credit, the earned income tax credit and child and dependent care tax credit — all of which were enhanced as part of the Democrats’ $1.9 trillion coronavirus rescue plan but are only in effect for 2021.

Under the current negotiations, the enhanced child tax credit would be available for an additional year or two, instead of through 2025 as Democrats originally envisioned. Under the expansion in place for this year, families can receive a child tax credit totaling $3,600 for each child under 6 and $3,000 for each one under age 18.

The tax credit, half of which is being paid out in advance monthly installments through December, is fully refundable so that more low-income parents can take advantage of it — a provision the House legislation would make permanent. Families can claim the other half at tax time next year.

The committee’s proposal would also make permanent the expansions of the earned income tax credit and the child and dependent care tax credit.

Making child care more affordable

Democrats are also looking to enhance child care for working families.

Under a proposal from the House Committee on Education and Labor, low- and middle-income households would pay no more than 7% of their income on child care for kids up to age 5. Parents earning up to 200% of their state median income for their family size would qualify.

The House Ways and Means Committee is also working on legislation that would invest in child care. It seeks to ensure that that parents and caregivers have up-to-date information on available child care options and help them apply for slots. It would fund the construction and remodeling of child care facilities and raise the wages of child care workers by providing grants to agencies.

The President has also said he wants to bring the wages of the child care workforce up to $15 an hour, from the typical $12.24 hourly rate they earned in 2020.

Funding for these provisions remains under discussion.

Creating paid family and medical leave program

Democrats are aiming to create the first federal paid and medical leave benefit.

Initially, Biden called for giving workers a total of 12 weeks of guaranteed paid parental, family and personal illness/safe leave by the 10th year of the program. But he more recently laid out a plan that reduces the duration to four weeks and limits benefits to those who earn less than $100,000, CNN has reported.

Boosting child nutrition programs

The House Education and Labor Committee proposal also calls for $35 billion for child nutrition programs, which would allow nearly 9 million more children to receive free school meals by expanding eligibility and eliminating paperwork, add healthier foods to school kitchens and help get more low-income children food during the summer months.

Lawmakers have taken many steps during the pandemic to address child hunger, which rose in 2020. In one of the early relief bills, Congress created the Pandemic EBT program, which provides benefits to children who normally receive free or reduced-price school meals but were studying remotely because of the coronavirus. States, however, were slow to roll out the complex measure.

Expanding Medicare benefits

Democrats have been eager to add vision, hearing and dental benefits to Medicare. But under the current negotiations, it looks like only the first two will be included in the package, with a possible “pilot” program to explore adding dental benefits, which are much costlier.

The House Energy and Commerce Committee draft legislation calls for adding all three benefits, one of the longstanding goals of Budget Committee Chairman Bernie Sanders, an independent from Vermont who caucuses with the Democrats.

However, dental coverage would not have kicked in until 2028. Vision care — specifically routine eye exams, glasses and contact lenses — would have been covered starting in October 2022, and hearing aids the following October.

Nearly half of Medicare beneficiaries, or 24 million people, did not have dental coverage, as of 2019, according to a recent Kaiser Family Foundation report.

The Senate blueprint also called for lowering the eligibility age of Medicare, another of Sanders’ missions, but that measure did not make it into the House draft legislation.

Extending beefed-up Affordable Care Act subsidies

The draft legislation by the House Ways and Means Committee also calls for making permanent the enhanced Affordable Care Act subsidies contained in the Democrats’ American Rescue Plan, which passed in the spring.

But under the deal being hammered out at the White House, a three-year extension is more likely.

The subsidies reduce the amount Obamacare enrollees have to pay to no more than 8.5% of their income and make assistance available to more Americans. Also, lower-income policyholders can receive subsidies that eliminate their premiums completely. But the boost in aid is only available this year and next at this point.

Creating a federal Medicaid expansion program

To extend coverage to more low-income Americans, the House Energy and Commerce proposal would permanently broaden Medicaid eligibility to those who live in the states that have not adopted Medicaid expansion. This would allow up to 4 million uninsured people to gain access to coverage.

It would create a federal Medicaid program in the non-expansion states, starting in 2025. Until then, it would allow those below the federal poverty line to receive premium and cost-sharing subsidies to select policies on the Affordable Care Act exchanges — assistance that is not available to them at this time.

Currently, 12 states have declined to expand Medicaid. None of them have accepted the enhanced funding available in the Democrats’ $1.9 trillion coronavirus relief plan, which was enacted in March.

Allowing Medicare to negotiate drug prices

The committee’s draft legislation also calls for lowering the price of prescription drugs, citing a Congressional Budget Office report that said it could save the federal government $456 billion over a decade. The provision would require the Health & Human Services secretary to negotiate maximum fair prices of at least 50 and as many as 250 high-cost medications that lack competition, including insulin. The price would be available to Medicare beneficiaries and to individuals enrolled in group health plans.

Democrats have long pushed to reduce drug costs by allowing Medicare to negotiate prices, though some in the party, as well as GOP lawmakers and the pharmaceutical industry, have opposed it.

But House Speaker Nancy Pelosi has cast doubt on whether this provision would make it into the final package in an interview with KQED in San Francisco.

The proposal would also require drug manufacturers who increase their prices faster than inflation to pay back the excess amount to the federal government, which would benefit enrollees in Medicare and employer-sponsored plans. And it would add a cap to out-of-pocket costs in Medicare drug plans for the first time. Beneficiaries would each pay no more than $2,000.

Additional savings would come from blocking the implementation of a Trump administration regulation that called for changing the rebate system within the drug industry.

Investing in home health care

The House committee proposes investing $190 billion in home and community-based services to help seniors, the disabled and home care workers. It would help those who care for patients by increasing provider payment rates and giving states funding to improve their care infrastructure. It would also make permanent two Medicaid programs that help low-income older adults and those with disabilities get home-based services.

Biden had included a $400 billion investment in these areas in his original infrastructure proposal, but it did not make the latest House proposal.

Funding for these provisions remain under discussion.

Bolstering health equity

In addition, the Senate framework calls for promoting health equity, particularly investing in maternal, behavioral and racial justice health measures. The House Energy and Commerce Committee proposal would ensure that all pregnant women on Medicaid could keep their coverage for the first year after giving birth.

Health equity has been one of the priorities of the Biden administration.

Combating climate change

Investments in fighting climate change remain the most fluid, with an understanding that the long-planned $300 billion in tax credits and incentives is in the proposal and intense negotiations are ongoing to see what else can be included, CNN has reported.

Democrats seek to make investments aiming to meet Biden’s goals of reducing economy-wide carbon emissions by 50% and for the US power grid to get 80% of its power from emissions-free sources before 2030.

The Senate resolution calls for implementing new polluter fees, creating new consumer rebates for home electrification and weatherization, providing clean energy, manufacturing, and transportation tax incentives and grants and electrifying the federal vehicle fleet and buildings.

It would also invest in agriculture conservation, drought and forestry programs to help reduce carbon emissions and prevent wildfires.

The House Energy and Commerce Committee proposal provides more details on how much certain provisions would cost. It calls for $150 billion in grants for electricity companies that provide clean energy, $13.5 billion for electrical vehicle infrastructure in underserved communities and public buildings, and $9 billion to modernize the energy grid — to name a few.

But after facing opposition from Democratic Sen. Joe Manchin of West Virginia, party leaders are working to develop a replacement for the proposed the Clean Electricity Performance Program, or CEPP, which would have given utilities federal grants to increase their share of electricity from clean sources and penalize those who fail to increase their clean electricity portfolios.

Investing more in infrastructure and jobs

The Democrats want to make even more investments in infrastructure projects that would not be funded by the bipartisan infrastructure package.

Biden wanted some of these investments in the infrastructure bill — like improving aging Veterans Administration hospitals, boosting American manufacturing, job training and workforce development programs — but he also wanted bipartisan support and the provisions were cut out during months of negotiations.

The budget resolution would invest in affordable housing, Native American infrastructure, and create what Biden is calling a Civilian Climate Corps to employ thousands of young people to work conserving public lands and waters, bolstering community resilience and advancing environmental justice.

Democrats also wanted the bill to provide green cards to millions of immigrant workers and families, but that will likely be left out of the final legislation after the Senate parliamentarian ruled that a pathway to citizenship could not be included if Democrats use the reconciliation process.

Draft legislation from the House Education and Labor Committee specifies that a total of $80 billion would be allocated for a variety of workforce development programs. This would include money to raise the wages of direct care workers, fund jobs fighting climate change and expand apprenticeships and other job training programs targeted to serve laid-off workers and young people.

The committee’s draft legislation also calls for providing $82 billion for public school infrastructure. It would target funding to districts with the greatest need and allow schools to repair, modernize and rebuild outdated school buildings.

Dealing with the state and local tax deduction

It’s critical to some Democrats that the package lifts or repeals the $10,000 cap on state and local tax deductions, known as SALT, that was put in place by the Republican-backed Tax Cuts and Jobs Act in 2017.

Most progressives and the White House are, in theory, opposed to the idea of lifting or revising the cap, which would benefit wealthier Americans. It’s clear, due to its cost, the revision will be more modest than the northeastern Democrats — including Senate Majority Leader Chuck Schumer of New York — had hoped, but the final scope is still fluid.

Hiking taxes on the rich and corporations

House Democrats want to increase taxes on wealthy Americans and corporations to pay for the budget package.

A draft proposal calls for increasing the top marginal rate on individuals to 39.6%, up from the 37% rate set by the Republicans’ 2017 tax cut law.

The rate would apply to individuals with taxable income over $400,000 a year and married couples filing jointly earning over $450,000 annually.

The top capital gains rate would increase to 25%, from 20%.

In addition, lawmakers would add a 3% surtax on individuals with adjusted gross incomes in excess of $5 million.

The proposal also calls for increasing the top corporate tax rate to 26.5%, up from the current 21% set by the Republicans’ 2017 tax cut law. It would only apply to businesses with income in excess of $5 million. Biden had called for hiking the corporate rate to 28% to pay for his economic recovery agenda. Prior to the 2017 law, the top rate was 35%.

And it would broaden the net investment income tax to cover net income derived in the ordinary course of a trade or business for single taxpayers with greater than $400,000 in taxable income or joint filers with earnings greater than $500,000.

Currently, as part of the Affordable Care Act, some higher-income Americans are subject to an additional 3.8% Medicare tax on certain investment income and an 0.9% Medicare surcharge on wages.

Altogether, the additional levies on high-income individuals would raise approximately $1 trillion. Biden has promised that those earning below $400,000 a year would not see a tax hike.

And the House proposal would raise the minimum tax on foreign earnings of US companies to 16.5%, from the current 10.5%. Biden had suggested pushing it up to 21%.

The plan would also increase a variety of other taxes on the wealthy and businesses, among other measures, including modifying rules involving cryptocurrency transactions.

It would also give the Internal Revenue Service an additional $80 billion over the next 10 years for tax enforcement of high-income Americans, which the Congressional Budget Office estimated could raise $200 billion. And the proposal projects it would raise an additional $700 billion by allowing Medicare to negotiate drug prices and eliminating a controversial drug rebate rule enacted by the Trump administration.

All told, the measures would raise an estimated $2.9 trillion, though the plan cautions that “this number remains very preliminary.” When combined with an estimated $600 billion in dynamic revenue growth estimated by the White House, the proposal would fully offset the cost of the Democrats’ budget package, according to the drafters.

Free community college is out

Biden’s plan called for making community college tuition-free for two years, but that has been dropped entirely from the package, CNN has reported.

Under the original plan, the federal government would cover about 75% of the average tuition cost in each state when the program is fully implemented, with states picking up the rest. States would also be expected to maintain their current contributions to their higher education systems.

But the package could still include funds for scholarships and an expansion of Pell grants for low-income students.

This story has been updated with additional details on the Democratic proposals.

CNN’s Phil Mattingly, Lauren Fox and Ella Nilsen contributed reporting.

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