Build Back Better Gets A Deadline And A Poster Child

[ Posted Thursday, December 9th, 2021 – 16:49 UTC ]

Congress seems to be dispensing with all the other high-profile things that were on its calendar for the end of the year, and it's still only the second week in December. This could bode well for the chances of the Build Back Better bill actually passing the Senate on Majority Leader Chuck Schumer's stated timeline ("before Christmas"). Additionally, the bill seems to have acquired two things that will ultimately help both its passage through Congress and its appeal to the public: a deadline and an excellent "poster child" issue.

The deadline is an easy one to understand. The Child Tax Credit program which is currently mailing checks out or making automatic deposits in parents' bank accounts (of up to $300 per month per child) is about to run out. When it passed as part of Biden's first big legislative achievement (the COVID-19 relief package), the benefit was only paid for through the end of this calendar year. The checks started going out in the mail this summer and have appeared on the 15th of every month since then. But December 15th will see the last of these checks go out, unless Congress extends the program.

A one-year extension is currently included in both the House and Senate versions of Build Back Better. But the Internal Revenue Service has put Congress on notice -- if no action is taken by December 28th, then the January checks will not go out. If the program is extended but it takes longer than that to get through Congress and onto President Joe Biden's desk, then the checks will just have to resume in February.

That's a hard deadline with concrete and tangible consequences. It's not quite the political magnitude of the interruption of Social Security checks going out each month, but it is comparable in terms of the tens of millions of families who will be affected. And some of those families live in West Virginia and Arizona, the two states with a senator that still isn't on board with Build Back Better yet. That is a different kind of pressure on them than their congressional peers trying to convince them to act swiftly. If Joe Manchin and/or Kyrsten Sinema don't strike a deal and vote "Yea" by the end of the month, parents in their home states will miss their checks in January, period. There's simply no other way to see it.

The bill also seems to have gotten a poster child. From Joe Biden on down, Democratic politicians have been leaning in hard on one particular provision in the bill that was almost a last-minute addition (to make up for the weakness of other efforts to lower prescription drug prices, but whatever...) -- capping patients' out-of-pocket expenses for insulin at $35 a month.

This is an excellent thing for Democrats to highlight, for several reasons: (1) it is easy to understand, (2) it is almost impossible to argue for the status quo, and (3) it is a case of pure corporate greed, plain and simple.

Nobody needs "$35 per month" explained to them. It is self-evident. This contrasts with what diabetics pay now, which (as Joe Biden has been explicitly pointing out) can easily climb to over $1,000 per month. The price of insulin from the handful of companies who make it has exploded over the past two decades, for no real reason. This has hit patients hard for a drug that is not some luxury item or optional treatment -- it is literally necessary for them to continue living. Why are such patients being gouged so badly? Because there's no law against it. Until now, that is.

The status quo is to let giant pharmaceutical companies extort exorbitant prices out of people who would die if they didn't buy the product. There is more than just one company making insulin, but they collude to hike their prices together so nobody undercuts anybody else. The patients have no market power, and no real choice (unless you count "dying for lack of insulin" as a choice). There simply is no rational argument for continuing this obscene cycle, other than sheer corporate greed.

Which brings us to the third point. All the arguments Big Pharma usually trots out to explain why American consumers have to continue paying extortionate prices for drugs (while the rest of the world pays a tiny fraction of what we do) fall apart when the drug in question is insulin. Insulin is almost 100 years old. It is not a new miracle cure at all -- it's a very old one. There was zero research and development necessary to continue producing insulin today, or at least "zero research and development done by anyone still alive today." All of that happened a long time ago, so the costs have already long been absorbed. There is no need for advertising for insulin, either. Nobody sees a television ad and then asks their doctor: "Hey, Doc, I've been hearing about this insulin stuff, maybe it's for me -- how about a trial prescription?" It doesn't work like that. And nothing has changed in the past two decades to justify any price increase, much less the exponential one it has gone through. There is only one reason for it -- the drug companies have been able to get away with it up until now.

All of this taken together is why the issue is so perfect as a Build Back Better poster child. Sure, it is one tiny program that is a mere fraction of the totality of the bill, but it is one that is easy to understand and impossible to take a political stance against.

It may seem ridiculous to focus in on this one tiny part of such a sweeping bill. Build Back Better has so much more in it, after all -- programs that will improve child care and health care and elder care and all sorts of other good stuff. But up until now, that's been a problem for Democrats, because there are just so many things contained in the bill that it's hard to focus on any one of them as the prime political talking point. This is why "$35 insulin!" is perfect. It's impossible for Republicans to claim it is something that it is not, and it's impossible for them to argue that patients really should pay over $1,000 out of their own pockets rather than $35. So I for one hope this focus continues. Let's get the bill passed -- later on Democrats can expand outward to highlight other good things it does. For now "$35 insulin!" will do the trick quite nicely.

Politically, these things can work -- they can completely change the political calculus. Think of the way that Democrats effectively used the phrase "pre-existing conditions" in the years-long fight over Obamacare. While Republicans were desperately trying to repeal the entire Obamacare effort, Democrats very effectively painted them as wanting to go back to the bad old days when insurance companies could deny insurance to anyone with any pre-existing condition. This was impossible for even the Republicans to defend against, so they all tried to shift to saying they had some magic plan that would repeal everything else in Obamacare while still protecting those with pre-existing conditions. This, like everything else Republicans were saying at the time, was a lie. They had no magic plan to make this happen. And Democrats made them pay a political price for it. The threat of those with pre-existing conditions being kept from buying any health insurance may in fact be what saved Obamacare from all the GOP efforts to repeal it. So one particularly easy-to-understand and impossible-to-defend-against issue can indeed be very politically potent.

Of course, the bill still has to get through the Senate. Progress is being made -- solid legislative language has been written, budgetary impacts are being released, and Democrats are making their cases to the Senate parliamentarian. When all these efforts wrap up, there will be nothing standing in the way of bringing the final product to a vote. This is possible before Christmas, but in no way guaranteed. And, of course, nobody can guarantee what Manchin and Sinema will eventually decide to vote for.

But now they are at least facing a deadline. If the Senate refuses to act by the 28th, then parents won't get their Child Tax Credit checks in January. That is the Damoclean sword hanging over Manchin and Sinema right now. And in the meantime, other Democrats can make a very potent and understandable case to the public for what Build Back Better will do for the country: $35 insulin. Both of these things increase the chances for action before the end of the year.

-- Chris Weigant


Follow Chris on Twitter: @ChrisWeigant


16 Comments on “Build Back Better Gets A Deadline And A Poster Child”

  1. [1] 
    nypoet22 wrote:

    the insulin issue is just the tip of the iceberg when it comes to pharma gouging sick people for the medicine they need to survive. epi pens are another big one that was more or less successfully dealt with by the DoJ, but it needs to stop being dealt with piecemeal. there need to be pharmaceutical regulations to prevent any lifesaving drug from being sold at more than a certain level of profit.

    being poor and sick should finally stop being a death sentence, full stop.

  2. [2] 
    MtnCaddy wrote:

    The first thing I thought upon finishing this column was Why, THIS is a column-length talking point.

  3. [3] 
    Elizabeth Miller wrote:

    "Talking points" don't have to be short. :)

  4. [4] 
    MtnCaddy wrote:

    Nope, they don't. This one seemed especially elegant to me.

    On a different topic,

    I like both Trevor Noah and Seth Meyers.

    This one is likewise especially funny (11:34)

  5. [5] 
    Elizabeth Miller wrote:

    I miss what's his name from the Daily show ... oh, jon stewart and Stephen Colbert. I find Trevor Noah unfunny.

  6. [6] 
    MtnCaddy wrote:

    John Stewart's new program is The Problem.

  7. [7] 
    Michale wrote:

    I hope Jussie Smollet is not beating himself up over yesterday's verdict...

  8. [8] 
    nypoet22 wrote:


  9. [9] 
    BashiBazouk wrote:


    Possibly, but you know Duggar won't have to beat him self up over his verdict, he'll have plenty of help...

  10. [10] 
    nypoet22 wrote:


    please don't mention any reality tv stars if you can avoid it. i had to look it up, and as i read i could feel my IQ fall. covid-19 kids and counting.


  11. [11] 
    C. R. Stucki wrote:

    Michale [8]

    I hope somebody else beats up on the asshole.

  12. [12] 
    MtnCaddy wrote:


    Now that's funny!
    *rimshot* indeed.

    Yeah, "Jussie" already been there and done that, sorta.

  13. [13] 
    MtnCaddy wrote:


    Talking points" don't have to be short. :)

    THIS reminds me of a question that I've had since I first got here:

    What exactly is a talking point and how does it compare to a soundbite (hard hitting and, at most, a short paragraph)?

    What I found in this column was an especially excellent blend of soundbites and the always required background and context that the reader needs to consider.

    Now don't get me wrong -- I like CW's writing style.

    CW columns are like beer -- there ain't no bad. Both are always enjoyable...


    ALTHOUGH it's okay in a plastic 42 ounce (aka ONE football game's Adult-size portion) "Steel 211" in a can is an abomination.

  14. [14] 
    MtnCaddy wrote:


    Trevor Noah is unfunny? Really? What is wrong with you, Gurlfriend?

  15. [15] 
    Elizabeth Miller wrote:


    I know 'talking points' from my days long ago when I used to watch the Sunday morning shows. You know, back when Biden was a senator and frequent guest on these shows, including the one on Fox.

    To me, talking points were what most pols on those shows used when answering questions because they didn't know any better or were under strict orders to stick to them. Which resulted in some pretty boring chatter, in any case.

    Biden, on the other hand, never used "talking points" - he always had such a wealth of knowledge and experience since I've known him that he never needed tp to engage in an intelligent discussion.

    So, when I came here, I already had a healthy disdain for the term, "talking points" but I soon realized that Chris's Friday Talking Points were some whole other animal and I came to love them. Yeah, I love them!

  16. [16] 
    Elizabeth Miller wrote:

    As for Trevor, lately, I haven't been able to get past the first few minutes of asinine chatter so, I guess I don't know enough to say that he is unfunny.

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