After two quick victories with the American Rescue Plan and the Bipartisan Infrastructure Bill, President Biden’s legislative agenda is now stalled in the Senate. Because of the Democrats’ narrow majority in the upper chamber (a 50/50 split with Vice President Kamala Harris able to cast tie-breaking votes), they originally planned to pass much of their agenda in one enormous Build Back Better reconciliation bill. However, with Senator Joe Manchin of West Virginia coming out against the bill, it is essentially dead. It remains to be seen whether the bill will be resurrected in a slimmed down version this term or if Democrats will attempt to pass it again next term if they retain power.

“Build Back Better” was a smorgasbord of Democratic legislative priorities, including many related to healthcare. Read on for ANA-Illinois’ analysis of the healthcare components of the bill.

Reduce Prescription Drug Costs

According to the White House’s analysis of the bill, it would allow the federal government to negotiate drug prices through Medicare and impose a tax penalty on drug companies that increase prices too quickly. The bill would also set a cap of $35 per month for insulin, a notoriously expensive prescription taken by people with diabetes. Lastly, it would expand Medicare so that hearing care for seniors is covered.

Expanding the Affordable Care Act

The New York Times states that the bill makes a number of improvements on the Affordable Care Act:

“The bill would extend generous subsidies that have lowered the cost of premiums for Americans who buy their own insurance. It would permanently extend a program that insures millions of children from low-income families, and would guarantee a year of Medicaid coverage for eligible women in the year after they have a child.”

While the ACA originally expanded Medicaid coverage to include a wider range of income levels, a lawsuit resulted in this expansion becoming optional, and 12 states have opted not to expand Medicaid. BBB would provide health insurance to individuals in these states.

Providing Elder Care

While in-home care is expensive and generally has a long wait list, the Washington Post reports, President Biden’s bill “would permanently increase by 6 percent the funding the federal government gives each state for in-home and community-based services, as long as the state creates a plan for strengthening and expanding services.” The end goal would be to provide additional care to older Americans and to allow them to stay in their homes longer.


As previously mentioned, Build Back Better’s prospects of passing the Senate are currently very low. Despite this, ANA-Illinois supports many of the healthcare provisions in this bill and encourages Congress to get them implemented, either through Build Back Better or a less expansive bill.