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"What's at stake is we are reverting back to a system where a person's financial ability to be able to pay will determine their ability to be healthy."
The latest coronavirus vaccine costs up to $200 for the roughly 25 million uninsured people in the U.S., due to the defunding of a federal program that previously covered the costs, The Washington Postreported Tuesday.
It's the "latest tear in the safety net" as pandemic-era programs wind down, the newspaper reported. Covid-19 vaccines were free for everyone in the U.S. in 2021 and 2022, per federal policy. However, in January, congressional Republicans negotiated a deal that rescinded $6.1 billion in emergency coronavirus relief funding, which killed the Bridge Access Program, launched in April 2023, that covered the cost for the uninsured.
The latest version of the Covid-19 vaccine was approved on August 22 and costs just over $200 for uninsured patients at CVS pharmacies in Nashville and St. Louis—examples cited by the Post.
Raynard Washington, head of the Mecklenburg County health department in North Carolina and chair of the Big Cities Health Coalition, said that vaccine manufacturers Moderna and Pfizer-BioNTech should lower their prices to make the shots more affordable for health agencies.
"What's at stake is we are reverting back to a system where a person's financial ability to be able to pay will determine their ability to be healthy," Washington said.
News of the lack of affordable access to the Covid-19 vaccine for uninsured people led to outrage on social media, with one X user asking "Is this the way to keep the rest of us safe?" and another declaring: "This makes me want to scream."
People covered by Medicare—which insures Americans over the age of 65—and Medicaid can still receive Covid-19 vaccines for free. But roughly 25 million people in the U.S. under the age of 65 are uninsured and left to pay the sky-high rates; people of color are disproportionately represented in the ranks of the uninsured.
Moderna, Pfizer, and BioNTech have profited off of the sale of the vaccines even though U.S. and European taxpayers heavily subsidized their development. The companies told the Post that free vaccines would be available through patient assistance programs, but provided no details.
The Center for Disease Control and Prevention (CDC) said it had identified $62 million to purchase Covid-19 vaccines for distribution to health agencies, but officials say that's a "sliver" of what's needed, the paper reported.
The Biden administration in its budget requests repeatedly tried to establish a Vaccines for Adults program aimed at providing shots, including Covid-19 boosters, to uninsured adults, but the efforts stalled in Congress. The proposal was based on a federal Vaccines for Children program that's been active since the 1990s.
The new Covid-19 vaccine is recommended for everyone 6 months of age or older. It includes a level of protection against the KP.2 variant that accounted for roughly one quarter of U.S. cases this summer.
The public health emergency for Covid-19 ended in May 2023 but the virus has killed tens of thousands of people in the U.S. since then and can cause long-term complications.
From the $35 insulin co-pay to capping insurance premium costs, the legislation has been health-changing and life-changing.
I was honored to be at the White House this month for the Inflation Reduction Act anniversary event, featuring Americans sharing their stories of saving money and saving lives.
Thank you to the millions of people fighting every day for lower drug prices, to Congress for passing the Inflation Reduction Act, U.S. Vice President Kamala Harris for casting the deciding vote in the Senate, and President Joe Biden for signing it into law.
Meet Bob Parant, from New York. He’s a 71-year-old man who has been living with type 1 diabetes for over fifty years. He lost his leg in 2010, and became eligible for Medicare. Before the Inflation Reduction Act, the last price Bob paid for a vial of insulin was $580, which was “horrendous.”
We have made so much progress on healthcare. But as everyone reading this knows, there is so much more to do.
Listen to Pam Parker, from Maryland: She’s a retired electrician, 62 years old, and has been diabetic since she was 30. “I had to decide, a lot of months, between mortgage, groceries, utilities, and other things… I would juggle my expenses, and really juggle my healthcare.. I would eat less, or ration my insulin to make it last.. I had high blood pressure, I fell into a coma, my kidneys failed… they told me I coded.”
Learn from Robin Craycroft, from Missouri: When she turned 65 and had access to Medicare, the pharmacist told her that one insulin for three months was $3,000. “Everything that we had planned, cancelled, and our life just changed. And I felt such guilt over that… We’re gonna spend $2,000 a month (two insulin vials) to keep me alive. You start going through, am I worth it? Should I do that to [my husband]?”
Hear Steven Hadfield, from North Carolina: “Before the $35 cap, sometimes you had to skip a dose, sometimes you had to not test yourself, watch what you eat because you couldn’t afford it…”
The $35 insulin co-pay cap for people on Medicare is just one of the health-changing and life-changing parts of the Inflation Reduction Act.
This year, people on Medicare have their out of pocket Part D drug costs capped at around $3,500. And next year, the maximum drops down to $2,000. This means seniors on a fixed income won’t have to choose medicine over food or housing or anything else. Also recommended adult vaccines such as the new shingles vaccine are now free for Medicare recipients.
Pharmaceutical companies that raise their prices higher than inflation are required to pay Medicare a rebate, to encourage them to stop price gouging patients. And in 2026, price negotiations for the first 10 drugs under Medicare go into effect: lowering the costs of those drugs for millions of Americans. The savings will continue for patients and taxpayers as more drug prices are negotiated each year.
But the Inflation Reduction Act doesn’t just help people on Medicare. Over 21 million Americans like me get their health insurance through the Affordable Care Act marketplaces. When I was diagnosed with stage 4 cancer in 2017, I did not qualify for financial help for insurance. Thankfully I was able to afford a plan anyway, and to pay the maximum deductible for that year. A bargain compared to the over half a million dollars it cost to save my life.
I am so grateful to still be here, and for the Affordable Care Act made truly more affordable to millions of working Americans like me.
The American Rescue Plan, and then the Inflation Reduction Act, provided financial help for health insurance to many more who needed it. This law caps the cost of premiums at no more than 8.5% of your income, meaning people—especially older folks who face higher premiums, or people in more expensive healthcare markets—don’t get penalized, and can still afford the care they need.
We have made so much progress on healthcare. But as everyone reading this knows, there is so much more to do.
First, we have to defend the advances in the Inflation Reduction Act. A new administration and a new Congress next year means everything we’ve gained could be on the chopping block.
Second, the health insurance tax credits piece expires in 2025. Without that renewal, millions of Americans would go back to being priced out of health insurance.
Third, the Medicare provisions such as the $35 insulin cap, the drug price negotiation, and more, need to be expanded to everyone.
We are grateful to still be here, and to keep fighting until every American can get the healthcare they need. We cannot go back.
The changes made in four years don’t just repudiate the left, they defy public opinion on one issue after another, driving the party backward even as U.S. Vice President Kamala Harris runs as the candidate of change.
I reviewed the Democratic Party platform for 2024 and found something interesting: When it comes to economic policy, this year’s platform is less progressive and less ambitious than it was four years ago. Democrats have tacked right or retreated on health insurance reform, drug prices, Medicare and Social Security expansion, poverty, labor, taxes, Wall Street, and the minimum wage.
(I didn’t review military policy, since David Swanson has done that, as have Stephen Zunes and Matthew Petti. Schuyler Mitchell has reviewed its handling of immigration and policing.)
Why become less ambitious on economic issues, especially when public confidence in the economy remains low? Is it the influence of big donors? Is it the willingness of the party’s internal left to back its candidates without first demanding policy concessions? Is it both?
Democrats are less likely to win it with a platform that reflects the politics of caution—which, for voters, means the soft despair of the status quo.
Lobbying certainly played a part. 2024’s scaled-back health proposals, for example, are a big win for the for-profit health sector and its massive lobbying investment. Health corporations spent $751,540,000 (more than three-quarters of a billion dollars) on lobbying in 2023 alone. They employed 3,344 lobbyists, which is more than six lobbyists for every member of Congress. (Source: Open Secrets, using Senate records.)
My economic views are well to the left of the Democratic Party’s, even in its best years. But these changes don’t just repudiate the left. They defy public opinion on one issue after another, driving the party backward even as U.S. Vice President Kamala Harris runs as the candidate of change.
Party platforms aren’t exactly binding contracts, of course, and this one was written while President Joe Biden was still the presumptive nominee. Vice President Harris has already proposed several changes, including a $6,000 tax credit for the first year of a child’s life and a first-time homebuyer’s credit of $25,000 instead of the platform’s $10,000. But her changes have not been substantial, at least so far.
The platform still matters. It represents the consensus view of the party’s leadership and, despite the references to reelecting Biden, was adopted just this week at the convention.
This year’s platform also undercuts a favored argument from the Democratic Party’s left wing: that Biden has been “the most progressive president since FDR.” That’s always been debatable. Biden has been anything but progressive on military issues (including the Gaza genocide). By contrast, Lyndon Johnson’s domestic achievements included Medicare and Medicaid, major anti-poverty legislation, and the Voting Rights Act.
Biden did notch some progressive achievements, however, and would have had more had he not been hamstrung by Congress. A party in this situation wouldn’t normally lower its ambitions. It would raise them, pledging to do more if given full control of Congress.
Again, why? Democrats may be operating under the misguided notion that these proposals are “too far left” for voters, which polling tells us is wrong. It may also feel that it no longer needs to appease its own left flank, which is probably true. But even if the party’s internal left has fallen in line behind its leaders, key voting blocs still need and want more than this platform offers.
The race is still close. Democrats are less likely to win it with a platform that reflects the politics of caution—which, for voters, means the soft despair of the status quo.
That’s the end of commentary. What follows is a list of policy differences between the 2020 and 2024 platforms, together with public opinion polling on each policy area.
Health Insurance: The “Public Option”
The 2020 document offered a proposal for the so-called “public option.” While it fell short of full health reform, it was ambitious in today’s political context. The section, entitled “Securing Universal Healthcare Through a Public Option,” included the following text:
Private insurers need real competition to ensure they have incentive to provide affordable, quality coverage to every American. To achieve that objective, we will give all Americans the choice to select a high-quality, affordable public option through the Affordable Care Act marketplace. (Emphasis mine.)
It goes on to say:
The public option will provide at least one plan choice without deductibles; will be administered by CMS, not private companies; and will cover all primary care without any co-payments and control costs for other treatments by negotiating prices with doctors and hospitals, just like Medicare does on behalf of older people. Everyone will be eligible to choose the public option or another Affordable Care Act marketplace plan...
That’s not Medicare For All, but it’s genuinely progressive. This public option plan also provided coverage for low-income Americans in states whose Republican governors had refused to expand Medicaid. Significantly, it would also have allowed people to enroll in Medicare (rather than employer-provided plans or other coverage) at age 60, rather than waiting until they reach the current eligibility age of 65.
What does the 2024 platform say about the public option? Nothing. The phrase doesn’t appear anywhere, and neither do these proposals. (According to a quote-tracking service, President Biden stopped using the phrase “public option” the month after he was elected.)
Public Opinion
Healthcare costs were the third-highest concern of American voters, according to recent polling, with 57% of those polled saying these costs are “a very big problem” and only 2% saying they were not a problem at all. The 2020 proposal would have helped address those concerns.
Drug Prices
Democrats included a provision in the Inflation Reduction Act (IRA) allowing Medicare to negotiate prices on a limited list of medications. While that provision was cut back significantly during congressional negotiations, it was a step forward. The IRA also permits Medicare to demand reimbursement when pharmaceutical corporations raise prices faster than overall inflation. It will also cap out-of-pocket costs for seniors, beginning next year, albeit at a level that’s still onerous for some.
These are all positive, if incremental, steps. But activists disappointed by the final bill’s limitations were told that this was only the beginning and that more action was coming. Not so, according to the 2024 platform.
The 2020 platform proposed empowering Medicare to negotiate drug prices “for all public and private purchasers—for families and businesses, as well as older Americans—no matter where they get their coverage.” It pledged to “prevent the price of (all) brand-name and outlier generic drugs from rising faster than the inflation rate,” and to ensure that treatment for chronic health conditions would be available “at little or no cost.”
All these 2020 proposals would have expanded the IRA’s cost provisions and extended them to everyone, including people on private insurance. All of them—enabling Medicare negotiate drug prices for everyone, limiting price hikes on brand-name and some generic drugs for everyone, and low- or no-cost access to chronic health treatments for everyone—are missing from the 2024 platform.
Public Opinion
Again, this runs against public opinion. A June poll found that expanding the IRA’s prescriptions drug provisions—negotiating lower prices, applying the $2,000 out-of-pocket cost cap to people with private insurance, and capping the cost of insulin and inhalers for all Americans—was supported by a staggering 84% of voters.
Labor Rights
The 2020 platform called for strengthening whistleblower and anti-retaliation protections for workers, and for reining in non-compete clauses, mandatory arbitration, and no-poaching agreements. The 2024 platform cites the administration’s work on non-competes and mandatory arbitration, but doesn’t mention whistleblowers or anti-retaliation protections.
The 2020 platform also supported the right to organize through majority sign-up (“card checks”) and advocated a ban on “captive audience” employee meetings. Neither is mentioned in the 2024 platform.
The 2020 platform said, “We will hold executives personally accountable if they interfere in workers’ efforts to organize, including issuing criminal penalties for intentional obstruction.” This language is missing from 2024’s platform.
In 2020, Democrats called for changing labor law “so that it is easier for unions and employers to enter into multi-employer agreements establishing minimum workplace standards related to wages, benefits, and working conditions.” This language is also absent in 2020.
Public Opinion
Roughly 7 out of 10 Americans approve of labor unions.
Social Security
The 2020 platform said this about Social Security:
We will enact policies to make Social Security more progressive, including increasing benefits for all beneficiaries, meaningfully increasing minimum benefit payments, increasing benefits for long-duration beneficiaries, and protecting surviving spouses from benefit cuts.
The 2020 document also noted an important and under-recognized aspect of the retirement crisis: the struggle of unpaid caregivers, most of whom are women, to survive in their senior years. It correctly noted that these family members “sacrifice not only wages but Social Security benefits when they swap paid labor for unpaid care work,” and called for changes that would recognize this disparity and correct it.
By contrast, the 2024 document only says this about benefits: “We’ll strengthen the program and expand benefits by asking the wealthiest Americans to pay their fair share.”
No specifics are provided and unpaid caregivers are not mentioned.
Public Opinion
Polling shows that majorities in key voting blocs—Black, Hispanic, lower-income, and under-30—support expanding Social Security benefits.
Poverty
The 2020 platform included a section called “Ending Poverty”; in 2024, it’s called “Fighting Poverty.” That seems like a subtle downsizing of expectations.
The 2020 document made this important observation:
We recognize that the official poverty rate, as measured and communicated by the federal government, fails to capture critical needs like housing, education, healthcare, transportation, energy, and other necessities, and therefore understates the true share of Americans living in poverty.
The 2024 platform leaves that language out and says instead, “Some 40 million Americans still live in poverty.” That’s the official rate—the one that, as the 2020 platform correctly observed, undercounts the “the true number of Americans living in poverty.”
But undercounting the poor isn’t the new platform’s only step backward. The 2020 platform proposed using the “10-20-30” funding approach, which would direct “at least 10% of federal funding to communities where 20% or more of the population has been living below the poverty line for 30 years or longer.”
The new document doesn’t include any specific funding proposal. (Wisely, it does propose restoring the Child Tax Credit and Earned Income Tax Credit.)
Public Opinion
While support for anti-poverty efforts has declined, a plurality of voters thinks government “should provide more assistance to people in need.” That includes majorities of younger, Black, and Democratic voters.
Taxes
Like its predecessor, the 2024 platform proposes raising taxes on the wealthy and corporations while closing loopholes. Unfortunately, it also uses this unfortunate yet popular political catchphrase: “A hedge fund manager or CEO should never pay a lower tax rate than a teacher or firefighter.”
While that’s self-evidently true, each repetition of this so-called “Buffett rule” subtly lowers public expectations about progressive taxation. It sounds reasonable until you think about it for a second: In a just world, would teachers and billionaires really pay the same percentage of their income in taxes? Of course not. Most people would agree that billionaires should contribute a higher percentage; this rhetoric lowers expectations.
And speaking of billionaires: The 2020 platform pledged to restore the estate tax “back to the historical norm,” before Trump and the Republicans reduced the burden on multimillionaire heirs. “Historial norm” presumably means a return to something like the levels in 2007-2008, when the minimum taxable inheritance was $2 million and the maximum tax rate was 45%.
The 2020 platform, however, says nothing about the estate tax.
Public Opinion
Polling shows that 69% of swing-state voters support raising taxes on people earning $400,000 and above, while 77% of swing-state voters support raising taxes on billionaires to support Social Security.
Wall Street
The 2024 document includes a section on “Corporate Greed” but is light on new proposals. That’s odd, since the Biden administration’s work on monopolization is one of its strongest achievements. 2024’s platform does call for an updated version of the Glass-Steagall Act, as the 2020 document did. But the 2020 document included an entire section called “Curbing Wall Street Abuses,” which declared:
Financial institutions should never be “too big to fail.”
... when justified by the law, we will back criminal penalties for reckless executives who illegally gamble with the savings and economic security of their clients and American communities.
...creat(e) a public credit reporting agency to provide a non-discriminatory credit reporting alternative to the private agencies, and... require its use by all federal lending programs, including home lending and student loans.
We will also give bankruptcy judges the authority to “cram down,” or modify, mortgages for primary residences during bankruptcy proceedings, so working families can benefit from the same debt relief tools currently available to those who own assets like vacation homes and yachts.
None of these ideas appears in the 2024 platform.
Public Opinion
A scant 10% of Americans in a 2023 poll expressed a great deal of confidence in U.S. banks, while nearly two-thirds said the government is doing an “inadequate” job of regulating them.
Minimum Wage
Both the 2020 and 2024 platforms call for a $15-an-hour minimum wage. It should be noted, however, that inflation has seriously eroded the value of a $15 wage. If they want to be consistent, Democrats should propose between $17.75 and $18 an hour.
As it is, they’ve already lowered their proposed minimum wage by 16-18% in real-dollar terms.
Public Opinion
An April 2024 poll found that 64% of voters supported raising the minimum wage to $17 an hour, including 85% of Democrats, 65% of Independents and 45% of Republicans.