Congressman Sam Graves -- Bill Would Modernize Transportation, Cut Waste

By Congressman Sam Graves’ Office

The Transportation and Infrastructure Committee, led by Chairman Sam Graves (MO-06), approved its budget reconciliation proposal to secure the border, support President Trump’s national security agenda, and modernize America’s air traffic control system. These investments will be more than offset by slashing funding for Green New Deal style programs, requiring electric vehicles (EVs) begin paying for their use of the highway system just like other highway users, and other deficit reduction measures. The T&I Committee will now send its proposal, which reduces the deficit by more than $10 billion, to the House Budget Committee.

“The Committee took decisive action in support of the President’s America First agenda,” said Transportation and Infrastructure Committee Chairman Sam Graves (MO-06). “My bill cuts wasteful Green New Deal spending and ensures that electric vehicles finally start paying for the maintenance of our roads and bridges. We also approved historic investments in the United States Coast Guard to strengthen our national and border security, and we took equally important strides towards finally modernizing the nation’s outdated air traffic control system. ”

Chairman Graves’ proposal would reduce federal spending and deficits by rescinding unobligated funds and eliminating seven unnecessary Green New Deal style programs created in the Inflation Reduction Act (IRA). Those programs include the Neighborhood Access and Equity Grants, Environmental Review Implementation Funds, and Low-Carbon Transportation Materials Grants under the Federal Highway Administration, among others. 

The proposal ensures that electric vehicles pay to fix our roads and bridges like other vehicles. The Highway Trust Fund (HTF) is funded by user-fees. However, since EVs do not use gas, they do not pay the user fee, and this inequity contributes to a growing shortfall in the funds to repair roads and bridges across the country.

Chairman Graves proposal provides additional investments in the U.S. Coast Guard to protect national security and secure our maritime borders. It gives the Coast Guard the tools it needs to better protect our borders, stopping illegal immigrants and drugs from entering the country, and protect our national and economic security in the Arctic, where competitors such as China and Russia are aggressively expanding their activities.

It also invests in the improved safety and reliability of America’s air traffic control (ATC) system, replacing outdated ATC technology, modernizing the ATC system, and enhancing the hiring of air traffic controllers following several aviation tragedies in recent months, which are priorities of the President and DOT Secretary Duffy.

 

Opinion -- Inflation Reduction Act Cuts Health Care Costs for Missourians

By the White House

President Biden believes that health care should be a right, not a privilege. Every American deserves the peace of mind that quality, affordable health insurance brings, and Americans facing illness should never have to worry about how they are going to pay for their treatment or face a choice between buying life-saving medications and putting food on the table. 

The Inflation Reduction Act of 2022 will lower health care costs for millions of Americans and put money back in the pockets of American families and seniors. The Act will cap prescription drug costs for hundreds of thousands of Missouri Medicare beneficiaries, reduce health insurance premiums for hundreds of thousands of Missourians by about $820 per year on average while expanding coverage to about 29,000 Missourians, and cap insulin co-payments for the tens of thousands of Missouri Medicare beneficiaries that use insulin. 

Cutting Prescription Drug Costs

Americans pay two to three times what citizens of other countries pay for prescription drugs. For some drugs, U.S. prices are even higher than that. For example, a GAO study found that Spiriva, used to control asthma and used by about 700,000 Medicare beneficiaries in 2020, had an estimated U.S. net price of $250 in 2020 and cost between $30 and $52 in France, Australia and Canada. Myrbetriq, used to control overactive bladder and used by over 600,000 Medicare beneficiaries in 2020, had an estimated U.S. net price of $164 and cost $43 in Canada. The Inflation Reduction Act finally takes on this problem by allowing Medicare to negotiate prices for high-cost drugs. It also provides seniors and people with disabilities who have  Medicare coverage with new protections against unaffordable prescription drug bills. 

• Protecting Hundreds of Thousands of Missourians from Catastrophic Drug Costs by Capping Medicare Beneficiary Out-of-Pocket Costs in Part D at $2,000. Currently, Medicare beneficiaries with conditions such as cancer, multiple sclerosis, and lung disease  can face thousands of dollars in out-of-pocket prescription drug costs, and millions of people in Medicare struggle to afford their medications. The Act will require Part D plans to offer improved financial protections that would phase in starting in 2024, with the $2,000 out-ofpocket cap taking effect in 2025. Each year, that will benefit about 34,000 Missouri Medicare beneficiaries who would otherwise have out-of-pocket costs above the cap, according to estimates from the Kaiser Family Foundation (KFF). And, for the first time, all 966,000 Missourians with Medicare Part D will have the peace of mind of knowing their pharmacy costs are capped.

• Saving Billions of Dollars for Seniors and People with Disabilities and the Federal Government by Allowing Medicare to Negotiate Prices for High-Cost Drugs. By bringing down the cost of these drugs, the legislation will save billions of dollars for both Medicare beneficiaries, who will see reduced out-of-pocket costs, and the federal government. Nationwide, KFF estimates suggest that some 5 to 7 million beneficiaries each year use the types of high-cost drugs that would be subject to negotiation and could see reduced cost sharing as a result.

• Addressing Rapid Prescription Drug Price Growth in Medicare. The Act requires companies to pay Medicare a rebate if they increase drug prices faster than inflation. That will achieve billions more in savings for the federal government and will further reduce outof-pocket costs for Medicare beneficiaries, starting in 2023.

• Saving Missouri Medicare Beneficiaries Money by Capping Insulin Copays at $35 per Month. Drug manufacturers have raised insulin prices so rapidly over the last few decades that some Medicare beneficiaries struggle to afford this life-saving drug that costs less than $10 a vial to manufacture. Starting in 2023, the legislation will cap the out-of-pocket cost of insulin for Medicare beneficiaries at no more than $35 for a month’s supply. Some 69,000 Missouri Medicare beneficiaries used insulin in 2020.

• Providing Extra Help Paying for Drugs for Missouri Medicare Beneficiaries with Low Incomes. The Act expands eligibility for full Part D Low-Income Subsidies – known as Extra Help – in 2024 to low-income beneficiaries with incomes up to 150% of poverty and modest assets. Currently, individuals with incomes between 135% and 150% of poverty only receive partial help, meaning that they still pay premiums and face more significant co-pays. About 11,000 Missouri Medicare beneficiaries received partial Extra Help in 2020 and could be helped by the expansion of income eligibility for full Extra Help, KFF estimates. 

• Saving Tens of Thousands of Missouri Medicare Beneficiaries Money by Ending Cost Sharing for Vaccines in Part D. While Medicare Part B covers vaccines such as the flu vaccine at no cost-sharing, patients receiving vaccines covered under Medicare Part D, such as the vaccine for shingles, must pay for a portion of the cost out of pocket. Starting in 2023, the legislation will require $0 cost-sharing for vaccines for Medicare Part D beneficiaries. Some 73,000 Missouri Medicare beneficiaries received a Part D vaccine in 2020, and that number is likely to rise as those vaccines become more affordable.

Lowering Health Insurance Premiums and Expanding Coverage

Since their creation in 2014, the Affordable Care Act (ACA) marketplaces and premium tax credits have played a critical role in providing affordable, quality health insurance coverage for people who don’t get health insurance through their jobs. As the ACA’s major coverage expansions took effect, the share of Missourians without health insurance fell by 32 percent. But because premium tax credits weren’t adequate for people with lower incomes, and weren’t available to middle-income people with high premium burdens, some people still couldn’t afford health insurance coverage or paid for health insurance at the expense of meeting their families’ other basic needs. 

President Biden promised to build on the Affordable Care Act by making premium tax credits more generous and lowering health care premiums for working families. The American Rescue Plan (ARP) kept that commitment by improving premium tax credits, and helped the U.S. reach its lowest uninsured rate in history. But those improvements were set to expire at the end of 2022. The Act continues those critical improvements through 2025, preventing premium spikes this January. Continuing these ACA improvements means: 

• Saving Hundreds of Thousands of Missourians about $820 per Year. About 250,000 Missourians with Marketplace coverage are saving an average of about $820 annually from the ARP subsidies that the Inflation Reduction Act would continue. Those savings increase to thousands of dollars per year for some middle-income older people who would otherwise face very high premium burdens. Among those benefiting the most from these affordability improvements are:

o Missouri small business owners and self-employed people. ACA coverage plays a critical role in providing affordable health coverage to 49,000 small business owners and self-employed adults in Missouri, Treasury data show. In fact, this population makes up 25 percent of ACA marketplace enrollment among working-age Missourians. 

o Middle-income older people who have retired or don’t have health coverage through their jobs. For example, a 60-year old Missourian with income of $60,000 would pay about 19 percent of income for benchmark health coverage without expanded premium tax credits, which cap premiums at 8.5 percent of income. 

• Allowing Tens of Thousands of Missourians to Gain Coverage. About 29,000 more Missourians will have health insurance next year compared to without the Inflation Reduction Act, according to HHS projections. The Act’s coverage expansions will:

o Improve health outcomes and likely save lives. Health insurance improves access to care and health, a large body of research finds. That includes a randomized trial finding that expanding Marketplace coverage saves lives: mortality fell among people  who gained Marketplace coverage due to randomized outreach. 

o Improve financial security. Health insurance reduces medical debt and improves credit scores and access to credit, research finds – making it possible for people to buy a home or take out an auto loan that in turn allows them to get or keep a job. Health insurance also reduces the frequency of bankruptcies and evictions, with one study finding that access to premium tax credits significantly reduces the share of people delinquent on rent or mortgage payments. 

o Narrow disparities in health coverage and access to care. Continuing the ACA improvements will reduce uninsured rates for all demographic groups, but the uninsured rate will fall disproportionately for Black people – narrowing existing gaps in coverage, Urban Institute researchers estimate. Narrowing gaps in coverage also narrows gaps in access to care, research finds. 

Editorial -- A Deathbed Conversion?

The Inflation Reduction Act, which is a watered down version of the Build Back Better Act that the Democrats touted when they first took power, miraculously passed the Senate recently. It is expected to pass the House and be signed into law. It will create incentives to fight climate change through clean energy tax credits, a green bank, and incentives to plug methane leaks. 

There will also be healthcare reforms in the measure. Protecting human lives is always a good thing. And there will be measures in it to reduce the deficit, important since inflation, although it has eased recently, is still there and gas prices are still too high.

No, the Democrats did not just save civilization. But they finally, belatedly, woke up and realized that there was more to life than just sticking it to the Russians.

We’re all called to stewardship of God’s resources. You can’t love the creator and hate the creation. If you hate the creation, then you hate the creator who made it. Jesus’ parables made consistently clear time and time again that we would be judged based on how well we were stewards of his creation. So anything that helps prevent the planet from overheating is a good thing. 

This measure will undoubtedly help the Democrats at the polls this year. But will it help enough? 

The problem with the bill is that it doesn’t go far enough. Last year, the International Energy Agency said fossil fuel development must stop in order to meet emissions targets. The bill will allow more oil and gas lease sales on public lands and waters. This means more spills and accidents waiting to happen on fragile ecosystems that cannot afford it.

The positive side of this bill is that maybe the Biden Administration, for once, is on to something – you’re much more likely to get meaningful legislation passed by carrots and not sticks. Maybe we could apply this to other issues. On abortion, for instance, maybe we could focus on passing legislation that helps make every child a wanted child and that rewards motherhood; after all, Missouri has a near total abortion ban, but women can still go to other states to get one.

And maybe the way to conduct diplomacy is through carrots and not sticks. Ever since Russia began its “Special Military Operation” on February 24th, the US policy has been to try to stick it to the Russians. That hasn’t worked. All that has happened is that Putin has dug his heels in and is more entrenched in power than ever. If sanctions were an effective tool, we would have resolved the North Korea conflict decades ago.

You have to be careful in how you go about transitioning to a green economy. The danger is that many jobs will be lost and many families destroyed, many more women will get abortions, and many communities decimated if it is not done right. However, it turns out that, according to a working paper from the National Bureau of Economic Research published this month that green jobs are frequently created in counties that have high shares of employment in fossil fuel extraction. Green jobs are also created in occupations that are about 21% higher paying than average. 

On the healthcare side, there are some meaningful measures passed as well. One of the most obvious measures, one of the most common sense, and consequently, one most strenuously resisted in Washington is the notion that Medicare should be able to negotiate prescription drug prices. That measure is finally on the books. Other measures on the Inflation Reduction Act include limiting Medicare drug price growth to inflation, and limiting commercial drug price growth to inflation.

About $125 billion in taxpayer money would be raised though improving tax compliance. The IRS would be funded by $80 billion over the next ten years, which, according to the CBO, would result in an additional $204 billion over the next 10 years. The CBO estimates every dollar spent to reduce the tax gap would generate $2.50 of revenue.

On July 29th, the Penn Wharton Budget Model came out with an estimate saying that the Inflation Reduction Act would reduce non-interest cumulative deficits by $248 billion over the budget window. 

More work needs to be done. Much of the social spending in the original BBB Act that Joe Manchin tanked – child tax credits, universal pre-K, and more – would have helped with the goal of making every child a wanted child. That is well worth the price of investment and one likely to give a big return.