Democrats Add Weaker Paid Leave and Drug Pricing Plans Back Into Reconciliation

After weeks of negotiating, Democrats have written paid family and medical leave back into the reconciliation bill, along with a plan to allow Medicare to negotiate prescription drug prices — but the bill now includes caveats weakening the proposals from their original forms.

On Wednesday, House Speaker Nancy Pelosi (D-California) and House Democrats announced that paid leave has been included in the House version of the plan “at the urging of many Members of the Caucus.” The proposal only includes four weeks of leave for serious medical issues or childbirth, down from the original 12 weeks, a cut that was likely made to appease conservative Democrats who oppose the idea.

Sen. Joe Manchin (D-West Virginia), who was responsible for the proposal’s removal from the original framework for the bill, is not satisfied with the change. Regardless of the fact that the provisions are much weaker than originally proposed, Manchin said he views their inclusion as a threat to him. “That’s a challenge, very much a challenge,” he told reporters. Though he claims that he wants to support paid leave, he has blamed restrictions of the reconciliation process for his opposition — despite the fact that the parliamentarian has not ruled out the proposal.

In reality, Manchin likely simply opposes the idea, as he has opposed countless other proposals in the bill aimed at bolstering the social safety net for middle and working class people in this country. This week, he bemoaned the price of the bill, which he’s already succeeded in hacking in half, despite his support for allocating billions toward fossil fuel subsidies, and his silence on the expensive SALT tax deduction cap repeal.

If the House passes a version of the bill with paid leave included, the proposal may end up being written out to appease Manchin when it is sent to the Senate. It’s likely that the lawmaker will refuse to support any paid leave proposal, no matter how meager; last week, Sen. Kirsten Gillibrand (D-New York) suggested a version of the proposal that would just allow parents of newborns to receive the paid leave benefit, but Manchin rejected that too. He has bizarrely suggested that lawmakers attach a work requirement to the benefit — even though by definition, workers must already have a job in order to take leave from it.

The prescription drug price plan, on the other hand, may face better prospects. On Tuesday, Democrats announced that they had reached a deal on the plan to lower drug prices. The proposal is far weaker than the version that Sen. Bernie Sanders (I-Vermont) suggested earlier this year, which is likely how Democrats got Sen. Kyrsten Sinema (D-Arizona) to support the idea.

While the previous proposal placed few restrictions on which drugs Medicare could negotiate prices on, the new plan would only allow Medicare to negotiate prices for 10 drugs by 2025, and 20 per year by 2028. Prices of drugs that are under exclusivity periods of 9 to 12 years would not be eligible for negotiation — an especially restrictive clause since pharmaceutical companies often make small tweaks to drug formulas in order to keep certain drugs exclusive in perpetuity.

Perhaps because of how limited it is, Sinema, who enjoys close relationships with the massive pharmaceutical lobby, supports the new proposal, calling it “historic” and saying that it will help Americans access medications. Of course, the former version of the plan would have helped more Americans access drugs that they need to survive, so her staunch opposition to that plan negates her statement on the new one.