House Passes Build Back Better Act, Next Stop: Senate

​The U.S. House of Representatives passed the Build Back Better Act (H.R.5376) last Friday by a vote of 220-213. The bill was passed solely by Democratic lawmakers as Republicans oppose the expansion of many of its initiatives and the tax increases proposed to finance the plan. The bill now goes to the Senate where it is likely to change as key Senators question major spending priorities and tax provisions. 

HCAOA will continue to update members on the Senate discussions on this important plan.  

Unfortunately, the Credit for Caring program was not included in the approved House Bill. Below is a summary of what is contained in the House-passed bill:

Medicaid Boost
One of the largest investments the package makes is in Medicaid’s Home and Community-Based Services.  Democrats are proposing to inject states with $150 billion to give more elderly and disabled Americans the opportunity to get long-term care at home as well as to boost pay for home care workers.

Medicare Expansion
For the first time, Medicare would cover hearing services for seniors if the bill were enacted into law. Progressive Democrats had pushed for a much wider expansion of Medicare benefits, including dental and vision services, but were blocked by party moderates like Manchin. Sanders has said he still wants dental and vision benefits to be added back.

Child Tax Credit
The bill would extend through 2022 the extra $250-to-$300 monthly payments per child that parents earning up to $150,000 are now getting. The legislation also makes the tax credit permanently refundable. Democrats are hoping the popularity of the enlarged benefit means they can extend it further in the future.

Child Care
The plan approves funding for children under five, as well as increases in wages for childcare workers. The amount parents pay for child care would be capped, to ensure that no family pays more than 7% of their household income.

Corporate Taxes
The bill imposes a 15% minimum corporate levy on companies that have traditionally been able to pay little-to-no taxes because they were eligible for a long list of credits and deductions. It also includes a 1% excise tax on companies when they buy back their own stock. The 21% corporate rate is left untouched, maintaining a key part of President Donald Trump’s 2017 tax law.

Levies on High Earners
A millionaire surtax would place a 5% levy on individual incomes in excess of $10 million and an additional 3% tax on those over $25 million. There’s a 3.8% investment income tax for high earners who own businesses and a limit on how business owners can use losses to reduce their taxes. The plan puts a $10 million cap on individual retirement accounts, after concerns that some wealthy individuals were using these tax-advantaged vehicles to skirt IRS bills.

SALT Deduction
After weeks of haggling, House lawmakers settled on raising the cap on the federal deduction for state and local taxes, or SALT, to $80,000 from the $10,000 imposed by Republicans in 2017. The higher cap would be in place through 2030, and then revert to $10,000 in 2031.

IRS Enforcement
The bill would give the Internal Revenue Service an additional $80 billion to hire more auditors, improve customer service and modernize technology. Democrats hoped to pull in an additional $400 billion in new revenue from cracking down on tax cheats and increasing compliance. But CBO concluded IRS enforcement would raise $207.2 billion over a decade, or $127.2 billion after subtracting the $80 billion in additional funding for the agency, according to a footnote in the estimate. However, it is not included in the official tally because of certain budget estimating rules.

Pre-School
The plan includes funding for states to start or grow universal pre-kindergarten for three- and four-year-old children. States would be directed to begin rolling out the programs in high-need and low-income areas first before expanding to other areas.

Paid Leave
A last-minute addition to the House package provides four weeks of paid parental and medical leave, starting in 2024, for workers who don’t receive such a benefit from their employers. The House had dropped the measure last month, but reinstated it after pressure from lawmakers and the public. The idea is likely to continue being debated in the Senate, where Senator Joe Manchin, a West Virginia Democrat and crucial swing vote, has said he is concerned about the cost.

Drug Prices
The bill would empower the government to negotiate with pharmaceutical companies on drugs that have been on the market for at least seven years, or longer for more complex medicines. Drugmakers would be required to rebate the government for raising the price of their product above the pace of inflation, starting in 2023.

Obamacare Extension
The package represents a massive investment in bolstering the Affordable Care Act to make good on the health law’s promise of reasonably priced insurance coverage. It would extend boosted premium subsidies into 2025 and offer a new tier of low-cost plans to people in the 12 states that have declined to expand their Medicaid programs under the ACA.

Immigration
The House measure would offer parole status to an estimated 6.5 million undocumented immigrants who entered the U.S. before 2011, offering deportation protections and work permits if they meet certain requirements. It’s a big step away from the pathway to citizenship initially sought by Democrats in both chambers, but the Senate parliamentarian has twice rejected proposals in that chamber that would do that -- arguing that they aren’t budget-oriented enough to qualify for the so-called reconciliation process that bypasses a Senate filibuster.