Building a Constituency for What Was Left Out of IRA

Climate Change DC Politics Health Care

            Marble Falls     I’ve had this chart from the Times sitting on my desk for a couple of weeks now, while I pondered, scratched my head, and tried to sort out what it means, and, frankly, what it portends for the future we might hope to see someday.  There’s a lot of good stuff in the Inflation Reduction Act even with the Manchin-Sinema giveaways and donor gifts.  There’s no question in my mind that this half-a-trillion-dollar package is still a big win.  Unfortunately, it comes with a big “but” and a bit of mourning for the pieces of the Build Back Better bill that ended up on the cutting room floor once the wheeling and dealing was over.

The “goodies” were all in climate and health care, along with some more equitable tax moves on getting corporation to pay their fare share.  Climate change items got darned close to 70% of their “asks” from the BBB measure, so it’s easy to see why all sides agree that the IRA was an historic step forward in confronting that crisis.  Expanding the subsidies for the Affordable Care Act got about 50% exactly of what it might have received from the original Biden proposal, so, everything being equal, that’s not too shabby and it goes to the right people.  Furthermore, winning that piece continues to solidify Obamacare as a Democratic measure that all sides of the party see as a signature part of their brand and willing to fight for.  That’s a good thing and pours more cement on the program making it even more inconceivable that Republicans will try to undo it in the future, even if Congress flips.  The drug caps on Medicare and some of those reforms in the IRA were also huge and welcome.

Looking at what was lost on the other hand is a different thing.  Seniors were handled on drugs so Medicare hearing benefits, a relatively small piece at $35 billion, bit the dust, but I bet that was also politically expendable because prices are expected to drop with the new rule that simple aids can be bought without prescription over the counter.  Seniors, as a constituency still have to be served.  Looking at the other losses seems to point to a weakness in building a grassroots constituency with some muscle and the ways and means to use it.

Home health and health workers, fared less wells.  Unions are huge in the home health industry, but not nearly as dense or as united among general health care workers, and that hurts us politically.  Bigger losers were in family benefits that could have gotten almost $600 billion, much of it for new programs in child care, annual paid leave, and universal preschool.  How could anyone argue that younger families with children don’t desperately need these programs that will shape our future and our workforce to come?  Unfortunately, there’s no real organized constituency here to push for those programs.  Yes, there are advocates and policy shows aplenty that excel at saying what’s right, but they only vote once and aren’t in the faces of Congressional folks back home or in the voting booths compared to older cohorts.  The question in the abortion fight now is whether conservatives are going to support families now that they are forcing women to have children and increase their families.  I’m not holding my breath, because there’s no real evidence of a sea change in policy on the right to support families, but, just maybe something might happen to build this constituency.

Affordable housing, money for higher education and workforce training, and immigration reform, all are vital, but one piece of this constituency can’t vote and needs to unite on reform, and as desperate as families and tenants are for affordable housing, all parties are willing to write off those lower-income more casual voters.  Damn shame, but it’s the facts, Jack!

The moral of this story is clear.  If we want to see these programs become law and get funding, there’s a lot of organizing that lies ahead of us.  Who’s ready?