House Speaker Nancy Pelosi, D-San Francisco, at a live taping of Political Breakdown at KQED on Oct. 13, 2021. (Alain McLaughlin/KQED)
At a taping of KQED's "Political Breakdown" Wednesday night, House Speaker Nancy Pelosi outlined the tough choices facing her Democratic caucus over what to keep in their landmark social policy and climate bill — deeming it a “lamb-eat-lamb” moment and indicating that a popular proposal to allow Medicare to negotiate prescription drug pricing may have to be left out of the final version.
“Everything is good. What do we keep?” said Pelosi, appearing in front of a live audience in San Francisco as part of the KQED Live event series. "Is it a timing thing? Or is it a prioritizing? That's the negotiation."
Pelosi made her appearance at KQED as Democrats struggle to pare down a bill that aims, in part, to reduce carbon emissions, expand Medicare and Medicaid coverage, make child care free to millions and create universal pre-K. Democrats hope to pay for the programs through tax increases on corporations and high-earning people.
The bill, originally priced at $3.5 trillion, will likely shrink to roughly $2 trillion in order to meet the demands of centrist Democratic Sens. Joe Manchin of West Virginia and Kyrsten Sinema of Arizona. Those two votes are crucial, with all Republicans in an evenly divided Senate opposing the legislation.
“We’ll have to come down [on our goals] because the money is coming down,” Pelosi told hosts Marisa Lagos and Scott Shafer.
With just over two weeks until a self-imposed Oct. 31 deadline to pass the bill, as well as a companion $1 trillion infrastructure bill, Pelosi and the Democratic caucus are at a legislative crossroads.
Should they keep the wish list of President Biden, but phase out the initiatives over a shorter period of time — allowing Democrats to run on the promise of extending programs currently popular with the public?
Or should the party limit the breadth of the legislation to fewer ideas that can be fully funded for at least a decade — making it so any future Republican government would have to proactively cut the programs, rather than quietly letting them sunset?
Pelosi seemed more inclined toward the latter — to fully fund key priorities.
“You can shorten the time frame, but if you shorten it too much you lose the continuity and the impact,” she said. "So it's not like something you put in a computer and something comes out. It's judgments that have to be made."
Pelosi's preferred vision of allowing Medicare to negotiate prescription drug prices is one idea that could be scaled back, she said. The proposal has been a progressive focus for more than a decade, but faces heavy lobbying opposition from the pharmaceutical industry and skepticism from moderate Democrats in both the House and Senate.
“We’re still making that fight,” Pelosi said, noting that House Democrats first passed legislation to allow those negotiations in 2006. “I’m not even sure we’ll get it in this bill. We’ll get something of that, but it won’t be the complete package that many of us have been fighting for [for] a long time.”
For some watchers of Congress, the current moment facing Democrats is reminiscent of 2010, when the Pelosi-led majority passed the Affordable Care Act, but was ultimately routed in the midterm elections.
But Pelosi expressed confidence that the bill’s benefits — particularly its focus on improving the lives of American women — will be rewarded in next year’s midterms.
“Women understand what this means,” said Pelosi. “This is about women in the workplace, this is about women taking their rightful place, this is about women not going to work and worrying about their loved one at home."
Outside of KQED, roughly a dozen demonstrators rallied for Democrats to address immigration policy by expanding citizenship in their legislative push.
On stage, Pelosi made no commitments, but acknowledged the protestors as she indicated her personal preference to include immigration in the package.
"If we are going to 'build back better,' we have to respect the newcomers to our country," she said.
This post has been updated to clarify Pelosi’s view on the negotiations over prescription drug price reform.
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