Who Could Drive Bipartisan Health Reforms In The U.S. Senate?

By Ken Perez, vice president of healthcare policy and government affairs, Omnicell, Inc.

Ken Perez

During the 2020 presidential election campaign, the top dozen or so health policies advocated by the Biden-Sanders Unity Task Force Recommendations, the Democratic Party Platform, and the Joe Biden for President Campaign Website fell into two distinct categories: ambitious progressive policies that would probably require a “go-it-alone” approach by the Democrats; and more moderate bipartisan policies that could be passed under the current rules in the Senate as an outcome of traditional political compromise.

Pursuit of the former approach is fashionable, as many Senate Democrats have advocated elimination of the filibuster. In addition, Senate Parliamentarian Elizabeth MacDonough recently determined that Democrats may be able to employ a fast-track process known as budget reconciliation multiple times before next year’s midterm elections, potentially allowing them to pass a bill with a simple majority, assuming that all 50 Democrats fall in line and Vice President Kamala Harris casts the tie-breaking vote as president of the Senate.

Nevertheless, there are key players in the Senate dedicated to pursuing bipartisanship.

By a simple majority vote, the Senate can change its rules at the beginning of a term and eliminate the filibuster. Without it, the Democrats would need just 50 votes in the Senate to pass a bill, allowing them to be untrammeled by Republican opposition. However, Sens. Joe Manchin (D-W.Va.), Jon Tester (D-Mont.), Kyrsten Sinema (D-Ariz.), and Dianne Feinstein (D-Calif.) have one time or another publicly voiced their opposition to eliminating the filibuster, expressing concern that such a move would only deepen the polarization in Washington.

Manchin is also staunchly opposed to the use of budget reconciliation. In an April 7 Washington Post op-ed, he warned that relying on the maneuver to ram through the majority’s agenda without bipartisan support would set a “new and dangerous precedent.” He concluded, “Instead of fixating on eliminating the filibuster or shortcutting the legislative process through budget reconciliation, it is time we do our jobs.”

There are also individuals with bipartisan track records on key Senate committees.

The Senate Finance Committee is chaired by Ron Wyden (D-Ore.). He and fellow committee member Chuck Grassley (R-Iowa) have collaborated for years on prescription drug pricing legislation.

Similarly, the Senate Committee on Health, Education, Labor and Pensions (HELP) is chaired by a senator with a long history of bipartisanship, Patty Murray (D-Wash.). Murray and Lamar Alexander (R-Tenn.), who retired at the end of 2020, worked together on several pieces of legislation aimed at reducing healthcare costs. Fortunately, moderate Republicans Susan Collins (R-Maine), Lisa Murkowski (R-Alaska), and Mitt Romney (R-Utah) are also on the HELP Committee.

The most promising area for bipartisan agreement would appear to be the high cost of prescription drugs, which polls consistently show is the number one healthcare issue for Americans. Moreover, there is strong disapproval of Congress on this issue. A November 2019 Kaiser Family Foundation Health Tracking Poll found that about three quarters of those surveyed felt that Democrats and Republicans alike were not doing enough to lower prescription drug costs.

With the filibuster likely to remain in place and budget reconciliation unlikely to be successful, productive bipartisan compromise holds the key to moving beyond the current polarization and gridlock that characterizes Washington.

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