Paid Leave and Health Care Proposals Added to Budget Reconciliation Bill

By Chatrane Birbal posted 11-05-2021 12:01


House Democrats updated their Build Back Better Act (budget reconciliation bill) to include paid FMLA leave and provisions to lower drug costs as they negotiate their way to votes on the social spending bill and the bipartisan infrastructure bill.

The latest version of the bill still includes civil monetary penalties for directors for company labor law violations and tax increases on corporations, as we reported last week

The updated bill text now also includes the following notable proposals: 

  • Four weeks of paid family and medical leave for illness, the birth of a new child, or to take care of a sick family member.  Although this proposal was added to the bill text, and likely has support of a majority in the House, it is still in limbo as it does not have the support of 50 senators. Senator Joe Manchin (D-WV) has continued to express concerns about the program’s cost and the potential for fraud. 

  • Prescription drug price reform that penalizes drug companies for raising prices faster than inflation for Medicare and employer plans.  The measure would also allow Medicare to negotiate lower prices for a limited number of drugs.  In addition, the proposal would increase drug pricing transparency by requiring PBMs to report their manufacturer rebates to employer plans.

  • Five years of work authorization for undocumented immigrants living in the U.S. This proposal will still have to get past the Senate parliamentarian, who twice has rejected more expansive immigration proposals, arguing they did not meet the budgetary rules.

Negotiations on the Build Back Better Act are fluid and bill text is still subject to change.  Democratic leaders are planning for a vote on the social spending and infrastructure bills this afternoon.  However, requests from centrist Democrats for a Congressional Budget Office cost estimate of the Build Back Better Act before a House floor consideration could jeopardize a vote today.

Even if the bill passes the House, the Senate parliamentarian will likely strike elements of the bill that contain non-budgetary provisions. Then during consideration, the bill will be subject to hundreds of amendments by Republican senators. If the Senate passes an amended version of the Build Back Better Act it will go back to the House for consideration, where it is again subject to additional changes. There is no formal deadline to complete action on the legislation, so it’s possible this effort could continue through December. With neither chamber in session next week and the week of November 22 being Thanksgiving week, the number of legislative days left in November is limited.  

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