What We are Watching as Congress Closes out 2021

Posted by Reeve Staff in Life After Paralysis on September 21, 2021 # Advocacy and Policy

Congress is preparing to end the year with a whirlwind of action. All of it is designed for the White House and Congressional leaders to pass the largest, most sweeping domestic legislation in over a decade. It can be hard to keep up with the complex set of considerations, so let’s take a moment to review what’s happened this summer and what we expect through the fall and winter.

Basically, there are three pieces of legislation moving through Congress simultaneously, which are likely to eventually be braided together and overlap. First, we have the bipartisan infrastructure bill, negotiated by Democrat and Republican Senators and the White House in August. Then, the Build Back Better reconciliation package is being drafted now in both the House and the Senate. And, finally, there are general fiscal year appropriations to keep the government-funded, which are set to expire at the end of September. The last element may also carry an increase to the nation’s “debt limit” or borrowing authority, which needs to pass so the government can make good on their obligations to important programs, such as Social Security.

Let’s look at these three lanes in more detail:

Bipartisan Infrastructure Legislation

On August 10, the Senate voted 69-30 to advance a $1 trillion infrastructure spending bill, the Infrastructure Investment and Jobs Act, that adds around $500 billion in new federal spending to upgrade American infrastructure. Some important items covered in the bill include: $110 billion to rebuild roads and bridges, $73 billion for the electric grid and power infrastructure, $65 billion for broadband investments, $55 billion for water systems and infrastructure and $39 billion for public transit.

As the White House and Congressional leaders try and thread the needle and pass two major bills that represent the various priorities of their diverse caucus, this bipartisan bill has been used as a negotiating tool.

In the House, Speaker Pelosi secured moderate Democrats’ support for a budget resolution that allowed committees to begin work on a broader, pricier reconciliation package by promising a House vote on the infrastructure bill by September 27. Meanwhile, progressive Democrats in the House have threatened to torpedo the bipartisan bill if the reconciliation package does not pass.

In other words, there is still a lot to work out and the fate of this bill is intimately tied to the fate of other Democrat priorities. So, while we are not advocating for a specific provision in the bill, we will be closely watching how this bill plays into the other two lanes.

Build Back Better Legislation/Budget Reconciliation

This budget reconciliation package represents the other side of the legislative coin when it comes to advancing President Biden’s agenda. It picks up the pieces left out of the bipartisan infrastructure bill, such as paid leave, universal pre-K, childcare subsidies, and an investment in Medicaid home and community-based services (HCBS). While the bill is still being drafted in both House and Senate committees, we anticipate the final package could invest as much as $3.5 trillion over 10 years, in what the White House has called “human infrastructure.”

There are a few things to keep in mind as Congress works through this process. First, this is a budget reconciliation bill, so while it allows the Senate majority to avoid a filibuster and pass the bill with a simple majority, in a 50-50 Senate, Democrats will need every member of their caucus (and Vice President Harris to cast a tie-breaking vote) to support the final text. The same thing holds true in the House, where Democrats’ slim majority means they need near-unanimous support. Otherwise, it won’t pass.

As House and Senate committees met last week to begin drafting their respective sections of the bill, divisions have begun to emerge over the size, scope, and what should be prioritized. For example, some members want to see more generous Affordable Care Act (ACA) benefits passed earlier this year made permanent, others would like to see Medicaid benefits extended into states that have not yet adopted Medicaid expansion, while still others want to see Medicare’s scope of covered services expanded to include vision, hearing, and dental coverage. These health provisions must be paid for with savings from the health sector, which Democrats are primarily seeking through new provisions allowing Medicare to negotiate prescription drugs. Yet, that proposal, which could save hundreds of billions of dollars to taxpayers, also does not currently have universal support among Democrats in either the House or Senate.

Then, there is Senator Joe Manchin (D-WV). Considered to be the most conservative of Senate Democrats, the former coal-state governor, has expressed concern for some of the clean energy provisions being discussed, but has also signaled he would not support a bill at the current price tag.

We anticipate this process will last well into the fall and are monitoring the negotiations around the various health provisions, paid leave, and childcare, which we know are vitally important to the SCI and paralysis community.

We are also urging the community to take action and reach out to their Representatives and Senators and tell them to support investments into Medicaid HCBS. President Biden called for a $400 billion investment in his budget, but draft language from the House Energy and Commerce Committee has allotted $190 billion.

Take action today to tell Congress to support an HCBS investment in the final version of this bill.

Appropriations/Continuing Resolution/Debt Limit

Hanging over all these negotiations is the very real need to fund the government to avoid a shutdown and the parallel, but no less substantial, need to increase the debt limit. Without Congressional Action on appropriations, the government shuts down on October 1. Without Congressional Action on the debt limit, the U.S. could default on its debt, with potentially catastrophic consequences for the global economic systems sometime in the fall.

One possibility is for Congress to pass a continuing resolution (CR) to fund the government through November or December, which means that the government will be funded at the same level as last fiscal year. It is also likely that House and Senate leaders will attach both a debt limit increase and funding for disaster relief and Afghan refugee resettlement to that CR. This will require 60 votes in the Senate and therefore must be bipartisan and attaching things like disaster relief to must-pass legislation makes it harder for members to say no.

What we’re tracking is whether the Senate releases any legislative text on appropriations before the CR. As you may remember, the House passed their appropriations bills that, thanks to your advocacy efforts, included an increase in funding for the National Paralysis Resource Center (PRC). The Senate has yet to take up the same bill. But Congressional appropriations require action from both chambers, so we will continue to monitor the progress in the Senate and may call on advocates to reach out to their members when the time comes.

Of course, this is all happening while the nation continues to struggle with the COVID-19 pandemic and children have gone back to in-person learning for the first time in over a year. While there are many moving pieces at this stage in the process, that also means there are many ways for us to get involved and advocate for our community. With so much going on, we want to be a resource for the community, to monitor these complex legislative procedures and let you know where your voice can have the greatest impact.

You can join the above action alert in support of HCBS. You can also join us on September 23 at 3 pm ET for our next Regional Champions webinar. We will review what has happened so far, what to expect for the fall and winter, and where we can put our advocacy tools to best use.

Register here.

The National Paralysis Resource Center website is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $8,700,000 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.