Press Release

Key Health Policy Provisions of the Build Back Better Act

The House of Representatives could vote as early as next week on the Build Back Better Act (BBBA), which contains a vast array of health policies and spending. In a new insight, Director of Health Care Policy Christopher Holt examines the most significant health-related provisions and their potential implications.

Key Points:

  • The BBBA expands who is eligible for Affordable Care Act premium tax credits (PTCs) and makes those PTCs more generous for everyone. According to the American Action Forum’s (AAF) Center for Health and Economy, these policies would increase the number of insured individuals by 2.2 million in 2022, increasing to 3.9 million in 2025 relative to current law, and would cost $272 billion over those four years. The coverage gains would, however, evaporate in 2026 without further congressional action.
  • In a series of last-minute negotiations, Democrats added a number of policies aimed at reducing prescription drug spending. Significantly, the BBBA would allow the Secretary of Health and Human Services to directly negotiate what Medicare pays for drugs for the first time. The details of the proposal make it abundantly clear, however, that this negotiation will amount to little more than government price-fixing.
  • The BBBA includes long-sought reforms to the Medicare prescription drug benefit—originally put forward by AAF in 2018—aimed at realigning insurer and drugmaker incentives to hold down Part D costs, and capping Part D beneficiaries’ out-of-pocket spending on drugs.

Read the analysis