Nancy Pelosi Reveals Strategy Behind 'Build Back Better' Cuts

The Build Back Better reconciliation package is still being negotiated in congress. It appears the main thing holding the bill up is the $3.5 billion over ten years pricetag. Manchin and Sinema want the bill to be smaller. Pelosi has given insight into how the Democrats might do that.

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Sam: I don't want to read too much into this but it's better than a poke in the eye. Manu Raju at CNN about an hour ago now tweeted out ask Pelosi if they'd have to drop any of the key pillars of their plan to reduce the price tag. This is the build-back better BBB plan. Universal pre-k child. tax credit. Tuition-free community college. Paid family leave. Medicare expansion. And she suggests that they will instead look at parrying back the number of years this is the smartest and most obvious play. Looking yesterday we played on the show the ad that the medicare the some republican PAC put out about the government you know squeezing medicare.

Emma: And here's a photo of Joe Biden.

Sam: And here's yeah you can look upon the web who the president is. And then call him. Stop touching my medicare. But if your opponent in a two-party system is running claiming that you are squeezing medicare and you are the party which relative to the other party certainly but maybe even in a vacuum this instance is seeking to protect or expand medicare it should be a tip-off to you that they don't want to be considered the party that is not doing those things yeah to the point where they're actually outright lying. They've done this before in 2010 after the the the ACA the affordable care act Obamacare one of the ways in which they raised money for that Obamacare in the plan was they had found and they and there was an awareness of this for next you know for a while before this but they decided to do something about it. that the medicare advantage plan which is a supplemental plan within medicare that is more private than their reimbursement rates for healthcare providers were about 20 higher than they should be. Private insurers don't tend to negotiate very hard because why would they? It's if they make money off of like the sort of the the the volume of dollars that passed through them. because they have a markup right? If I’m raising rates 18 percent well that that's actually just relative to their own market but there is markup and and and we can see the dynamic within the context of the ACA now 80 of their money that they take in from premiums has to go to pay providers. So if you want to raise the actual dollar figure of that 20 that you keep for you you pay more than you need to right? I mean this is a basic like you know if I’m doing a markup if I’m a caterer you know or I’m doing like I’m an event planner and I get a 10 markup on every service I provide.

Emma: You fudge the numbers.

Sam: Well no I don't need to fudge numbers I get a more expensive caterer because of the caterer. is charging 2500 bucks I put 250 in my pocket. If they're charging 5000 bucks I put 500 in my pocket. And the work I’m doing is exactly the same. And so but you know in that instance the the the wedding person may say like hey I don't want the 5 000 caterers. And then everybody around sam says you're cheap no that's I’m not talking about me. But in this instance what do you you know individuals aren't saying like hey this that's not what a cat scan should cost me or whatever it is. Anyways the so the ACA cut back on those payments to providers by medicare advantage. no difference to the medicare participants. It only hurt the providers. But the republicans ran on the decrease of payments to medicare advantage. Even though it didn't implicate the medical services that individuals received at all. And they ran on that cut saying that democrats were cutting medicare. And they ran on that in 2010 they were hugely successful. That should be a hint to democrats that you want to get on the right side of the medicare issue and you want to make it explicit.