Climate, drug prices, child care and other issues at stake in reconciliation rift

It is a crucial day of negotiations on both sides of Pennsylvania Avenue in Washington, D.C., where Democrats are working around the clock to pass 2 significant bills — on infrastructure and major Democratic priorities in a reconciliation bill. Capitol Hill correspondent Lisa Desjardins joins Amna Nawaz with the latest on the negotiations and what's at stake.

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  • Amna Nawaz:

    Well, it is a crucial day of negotiations on both sides of Pennsylvania Avenue today.

    As we reported earlier, Democrats are working around the clock to pass two significant pieces of legislation central to President Biden's agenda. One is the bipartisan infrastructure bill, and the other is the president's $3.5 trillion spending package.

    Our Capitol Hill correspondent, Lisa Desjardins, is here with me now for more of what's at stake.

    Lisa, good to see you.

  • Lisa Desjardins:

    Good to see you.

  • Amna Nawaz:

    It's a busy day on Capitol Hill.

    Let's start with these two big bills. Just where are we right now?

  • Lisa Desjardins:

    Well, it's about as clear as a glass of mud, to be honest, at this point.

    (LAUGHTER)

  • Lisa Desjardins:

    And, somehow, it got even muddier today.

    Let me explain what's going on here. As we reported, the infrastructure bill has long been connected to that larger we call it reconciliation package. That's how they want to pass it in the Senate.

    And Speaker Nancy Pelosi had said she would take a vote on that infrastructure bill Thursday. Well, she has an all-out rebellion from progressives, who think, if that happens, it will jeopardize that reconciliation bill. So we saw this statement today from progressives.

    Pramila Jayapal, someone we have talked to here on the show, reiterated, doubled down on this statement, saying: "We will only vote for the infrastructure bill after passing the reconciliation bill."

    That then was bolstered by Senator Bernie Sanders, one of the top progressives in this country. He came out and said today, we thought we had a deal that the two would only go together. He told people not to vote for the infrastructure bill this Thursday.

    So how do they get the reconciliation bill moving? First, they need to figure out how big it's going to be. There's a real divide over that. And we're watching two key senators. Everyone is watching them, Senators Kyrsten Sinema and Joe Manchin. They are moderates who have said that $3.5 trillion number for kind of gross spending in this is too large for them.

    But, Amna, they have not come up with their figure yet. Everyone is watching and waiting. The clock is ticking. And we will see if this infrastructure vote happens Thursday or not.

  • Amna Nawaz:

    We will see. There's a lot of maneuvering. You're going to be following it all.

    We talk a lot about those politics and the procedures. But let's take a step back and talk about what's at stake. Democrats are fighting hard for what's in that reconciliation bill. Let's just dig in and talk about where they are and why they're still divided.

    Let's start with one of the biggest issues, climate. Where are they?

  • Lisa Desjardins:

    I'm so happy we're doing this, talking about the substance of what's in these things.

    So, this is one of the biggest portions of this bill, especially for progressives. And I want to just run through really quickly what they want, what is in this bill. This is a kind of a very minimum look. But look at what's in here.

    First of all, the reconciliation bill would have extensive clean energy tax credits for individuals and businesses. But it also has some carrots and sticks. It would reward or penalize businesses based on how much renewable fuel they're using vs. how much fossil fuel they're using.

    And then, also, I have to say there's issues with this, of course, Manchin is one of them. He's worried about coal jobs in the short term. There's also a real question about Senate rules and whether all of these mechanisms can pass the kind of narrow channel that reconciliation measures have to.

    A reminder that, obviously, climate change is one of the biggest issues facing this country. That's why the stakes are so high right now, because Democrats realize this may be their only chance, perhaps this generation, to really get something significant through.

    And I talked to members leading this effort today. And they really are sweating this. They're worried about these provisions staying intact.

  • Amna Nawaz:

    There's another issue that really resonates with American voters out there. That is drug costs. Where's the discussion on that?

  • Lisa Desjardins:

    This is a point of contention between Democrats amongst themselves about what they should do.

    First of all, let's talk about drug costs in this country. I don't think I need to tell any of our viewers they're high. They're higher than the rest of the world. And, in fact, they're about two-and-a-half times higher than most of the rest of the world.

    America, on its own, represents almost half of all of the money coming into drug companies in this country — in the world.

    So we talked to one of the experts who's testified before Congress on this, Harvard Medical School's Aaron Kesselheim, about this issue.

  • Dr. Aaron Kesselheim, Harvard Medical School:

    There have been, of course, reports from patients with diabetes unable to afford their insulin and having to ration their insulin, or patients who are needing to get cancer treatment not able to afford the cancer therapy that they need.

    And those kinds of things can have important impacts on their health.

  • Lisa Desjardins:

    That's why this is on the table.

    What would Democrats do in reconciliation? So far, what we have seen in the bill, a few things. First, they would like to expand Medicare to include vision and dental over a series of years. They would also have Medicare negotiate drug prices. That — Medicare has such leverage in the industry, could completely change what people pay in drugs.

    And it would be based on what other countries pay.

    The issues here, moderate Democrats are worried that Medicare would go too far, change the drug pricing for too many drugs, and that American drug companies would be harmed. They are in the minority, but they are enough to potentially hold up the bill. So we're going to watch that very closely.

  • Amna Nawaz:

    So, another thing we have heard them talk about is making historic investments in child care, especially after this first pandemic year. What could the bill do? Where's the disagreement here?

  • Lisa Desjardins:

    Right.

    So a reminder on child care, of course, we have an affordability problem in this country when it comes to child care. And, matter of fact, when you look at 41 industrialized nations around the world, America is almost at the bottom in terms of affordability for child care.

    So, on this, we also talk to an expert to get us a sense of where we're at.

    Brandy James Lawrence is with the Bank Street College Education Center.

    Brandy Jones Lawrence, Bank Street College of Education: In more than 40 states, I think 40 states, plus the District of Columbia, the cost of child care is upwards of a mortgage payment for an average family.

  • Lisa Desjardins:

    My apologies. That's Brandy Jones Lawrence.

    Quickly, here's what they would do on this. Democrats' plan right now, they would cap child care costs based on income. There would be a tax credit, that they would continue the current tax credit, $3, 600 up to per child. The question is, would they limit this based on income more than they're doing right now?

  • Amna Nawaz:

    Very quickly, before we let you go, a couple of other looming deadlines, raising the debt ceiling, funding the government. Where do we stand on those?

  • Lisa Desjardins:

    Right.

    It does look like Democrats, I can report, will have a way to fund the government past Thursday. We should learn about that tomorrow. We're cutting it close.

    On the debt ceiling, Amna, there's two ways to do things in the modern Congress, the hard way or the excruciatingly hard way. This is excruciatingly hard. There is not a path yet on the debt ceiling. We're going to watch it day by day, week by week.

  • Amna Nawaz:

    We will be watching it.

  • Lisa Desjardins:

    OK.

  • Amna Nawaz:

    Thank you so much, Lisa.

  • Lisa Desjardins:

    You're welcome.

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