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Build Back Better & Health Care

The Build Back Better Act Will Transform Health Care for Millions of Americans

The Build Back Better Act will be the most significant expansion of U.S. health care since the passage of the Affordable Care Act. The legislation includes transformative measures to lower the cost of prescription drugs and insurance premiums, extend affordable coverage to millions, expand Medicare benefits to cover hearing, and invest $150 billion in home care for seniors and people with disabilities. By passing Build Back Better, Democrats will show their commitment to building a future where health care is a right, not a privilege.

Under The Build Back Better Act: 

  • 48 million Medicare Part D enrollees will have out of pocket costs for prescription drugs capped at $2,000 per year. 
  • 9 million Americans will save on their monthly health insurance premiums
  • 2.2 million Americans currently in the Medicaid “coverage gap” will gain health coverage
  • 62 million Americans on Medicare will gain coverage for hearing 
  • ALL Americans will be protected from Big Pharma’s arbitrary price hikes that rise faster than inflation

Democrats ran and won on health care in 2018 and 2020, and now they are on the cusp of promises to bring down drug prices, expand coverage, improve care, and lower health care costs. Polling shows the health care measures in Build Back Better have nearly universal support, and voters of all parties want bold action on health care. 

Millions of people will gain coverage as a result of the Build Back Better Act. Lowering drug and premium costs, increasing health care access, and closing the Medicaid coverage gap will reduce racial inequities in health care, put more money in working families’ pockets, and save lives. Congress must act quickly to get this legislation to President Biden’s desk so millions of families can finally access the care they need. 

Message Guidance: The Build Back Better Act Will Lower Health Care Costs and Improve Care


  • The Build Back Better Act is an historic reform that levels the playing field for working people, lowering their everyday health care costs so they can have a little bit of breathing room. Health care is the kitchen table issue in every household in America and this plan brings down costs so people worry a little less when they go to sleep at night. 
  • Build Back Better will deliver lower costs for families struggling to make ends meet. For too long, Americans have had to pay too much to see the doctor or get the medications they depend on. They had to choose between health care and putting food on the table or paying the rent. Now, working families, seniors, and parents will pay less for prescription drugs and health insurance, and millions of Americans will now have health insurance they previously couldn’t afford. 
  • Democrats ran and won on health care in 2018 and 2020, and now they have delivered on their promise to bring down drug prices, expand coverage, improve care, and lower health insurance costs. 
  • Every Republican in the House voted against lowering costs for everyday families through Build Back Better. They chose drug company profits over lower drug prices. They voted against hearing benefits for seniors and lower prices for prescription drugs. They voted to deny working families health insurance because of where they live, and voted to let children’s health care expire. 
  • Polling shows the health care measures in Build Back Better have overwhelming support across party lines and are some of the most popular elements of Build Back Better. Voters from all parties support giving Medicare the power to negotiate lower prescription drug prices, strengthening Medicare benefits, expanding coverage, and lowering health insurance premiums for people who buy coverage on their own. 

Bring Down Drug Prices

  • Build Back Better ends the status quo where drug companies get to dictate whatever price they want to charge, raise prices every year and make record breaking profits. Americans will no longer pay three times more than people in other countries for the same prescription drug. Now, Medicare will have the power to negotiate for lower drug prices and all Americans will be protected against outrageous and arbitrary price increases. 
  • The plan puts a $2,000 yearly cap on how much seniors have to pay for prescription drugs so no one goes bankrupt because of high drug prices
  • For the millions of people who depend on it, insulin prices will be capped at $35/month for anybody with health insurance. 
  • Drug companies will no longer be able to raise prices faster than the rate of inflation so families will be able to keep up with the costs, and outrageous price increases will be a thing of the past for every American.
  • Medicare will finally have the power to negotiate for lower drug prices, so patients pay less and drug companies can’t charge whatever they want and raise prices every year. 

Make Health Insurance Premiums Cost Less

  • Millions of American families — including farmers and small business owners — who buy health insurance on their own will pay less for their premiums so they’ll be able to stay healthy and see a doctor if they need one. For example, a family of four earning $80,000 per year would save nearly $3,000 per year (or $246 per month) on health insurance premiums.

More People Have Health Care, Stay Healthy

  • Millions of low-income working people in states like Georgia, Florida and Texas who have been denied health coverage because of where they live will now get the health care they need. This ends the days where workers in some states can get health care and others can’t. 
  • Closing the Medicaid coverage gap is the single most important step Congress could have taken to reduce racial inequities in our health care. 

Better Care For Seniors & People With Disabilities

  • Medicare benefits will now include coverage for hearing, including making sure seniors can get hearing aids as they age.
  • Makes it easier for disabled and aging people to stay at home and get the care they need without being pushed into institutions, and ensures the people who care for them are paid fairly and treated with dignity.

FACT SHEET: What The Build Back Better Act Does For American Health Care

President Biden, Congressional Democrats, and patient advocates fought tirelessly to pass the historic health care investments included in the Build Back Better Act.Build Back Better will extend Medicaid coverage to 2.2 million Americans who were previously not eligible, reduce costs for more than nine million Americans purchasing coverage on their own through the ACA marketplaces, enhance Medicare benefits for seniors to include hearing, extend maternal health coverage, and provide increased funding for home and community-based services. 

Health care is a fundamental part of the Build Back Better agenda, and the proposals to reduce costs and expand care are overwhelmingly popular with voters across the political spectrum. Build Back Better will reduce racial inequities in health care, improve the health and well-being of seniors and people with disabilities, strengthen families, and save lives. 

Build Back Better Lowers Prescription Drug Prices

Giving Medicare The Power To Negotiate Lower Drug Prices. For nearly 20 years, Medicare has been banned from negotiating the price of prescription drugs, and Big Pharma has been able to dictate prices while Americans pay three times more for their medications than people in other countries. Under Build Back Better, Medicare will be empowered to negotiate prices for select drugs purchased at the pharmacy counter and administered at a doctor’s office. Beginning in 2025, 10 drugs, in addition to insulin, will be negotiated with that number increasing to 15 drugs in 2026, and 20 drugs in 2028 and into the future. By 2030, more than 100 drugs will be eligible for Medicare price negotiation, in addition to insulin products. Drug companies who refuse to come to the negotiating table will be subject to an excise tax.

Capping Out-Of-Pocket Spending For Seniors. Seniors with serious conditions like cancer, multiple sclerosis, and rheumatoid arthritis could save thousands of dollars on prescriptions under the Build Back Better Act. Medicare Part D out-of-pocket costs for prescription drugs will be capped at $2,000 per year beginning in 2024. The redesign of Medicare Part D will also allow out-of-pocket spending to be smoothed over the course of the year, so patients are not forced to pay the entirety of their out-of-pocket cost all at one time. 

Making Insulin Accessible And Affordable. Insulin co-pays for all Americans with insurance will also be capped at $35 each month. 

Putting An End To Outrageous Price Increases. Build Back Better stops Big Pharma from raising price increases faster than the rate of inflation. For example, Humira, a medication commonly used to treat rheumatoid arthritis, is one of the nation’s highest revenue generating drugs, raking in $21 billion in sales in 2019. AbbVie, Humira’s manufacturer, has hiked the price of Humira 27 times, including in January 2021 when it raised its cost by 7.4 percent. This cap would apply to all Americans, no matter whether you are insured or not, and no matter what kind of insurance you have, and is essential to stop arbitrary price increases on essential medications. Over the past 20 years, price increases for brand-name drugs in Medicare Part D have risen at more than twice the rate of inflation.

Build Back Better Lowers Health Insurance Premiums

Nine Million Americans Will Save On Monthly Premiums. Nine million Americans will save an average of $600 annually on their premiums when they buy insurance on their own through the ACA Marketplaces. For a family of four making $80,000 a year, premiums will drop nearly $250 a month, or nearly $3,000 a year. 

Expanding Health Coverage For Millions Of Americans. The Congressional Budget Office estimates that ACA enrollment would increase by 3.6 million people including 1.4 million who would otherwise be uninsured and 600,000 would have received unsubsidized coverage.

Reducing Income Coverage Disparities. Build Better Better ensures families pay no more than 8.5 percent of their income towards health coverage. This will help middle-income families facing excessive premiums or living in high-premium areas. 

Expanding Coverage for Communities of Color. The Center on Budget Policy and Priorities estimates the increased savings continued under Build Back Better will cause a sharp decline in the uninsured rate across every racial group, with one in three uninsured Black adults gaining coverage. Prior to the American Rescue Plan, more than 11 million uninsured adults were eligible for premium tax credits, with people of color making up roughly half of the group.

Build Back Better Closes The Medicaid Coverage Gap

2.2 Million Americans Currently Denied Medicaid Will Gain Health Coverage. The Build Back Better Act will allow more than two million Americans currently trapped in the Medicaid coverage gap to access zero dollar premium health coverage. Of those currently in the coverage gap, 62 percent are in the labor force, 30 percent are parents with children at home, more than 25 percent are essential workers, and 15 percent of adults have a disability. 

Zero Dollar Premiums for Millions. In addition to covering the 2.2 million Americans in the Medicaid coverage gap, Build Back Better delivers zero dollar premium coverage to the 1.8 million uninsured individuals with incomes between $12,880 and $17,774 each year (100-138 percent of the federal poverty level).

Drastically Reducing Racial Health Disparities. Closing the Medicaid coverage gap is the single most important policy to expand coverage and reduce racial inequities in the American health care system. People of color are more likely to have a lower median income and live in a state without Medicaid expansion, compared with their white counterparts. In 2019, 60 percent of individuals in the coverage gap were people of color. 

Improving Coverage For Millions of Working Americans Whose Employer Coverage is Too Expensive Or Of Poor Quality. Millions of low-wage workers are offered employer health coverage that is cost prohibitive and not comprehensive. Over the past decade, premiums for low-wage workers have increased at nearly double the rate of wages. Build Back Better ensures that individuals who would be eligible if their state expanded Medicaid, can enroll in an ACA marketplace plan even if their employer offers coverage. This will allow low-wage workers to access comprehensive health coverage at little or no cost. 

Build Back Better Expands Medicare Benefits

Millions Will Gain Access To Hearing Care. Build Back Better would add hearing coverage to Medicare Part B starting in 2023. Kaiser Family Foundation estimates that a Medicare hearing benefit could aid all 62 million Medicare beneficiaries, particularly the 36 million purchasing coverage on their own or simply going without. Hearing coverage under Build Back Better would include hearing rehabilitation and treatment services, as well as hearing aids. Build Back Better would also allow audiologists and hearing aid specialists to qualify for Medicare reimbursement.

Addressing High Out-Of-Pocket Costs. In 2018, Medicare beneficiaries paid an average out-of-pocket cost of more than $900 for hearing care. Only 30 percent of seniors over 70 who need hearing aids are able to use them, with Kaiser Family Foundation citing affordability as the likely culprit millions do not seek hearing care or hearing devices. Build Back Better expand Medicare to include hearing coverage by providing $35 billion in funding for hearing care.

Build Back Better Will Dramatically Improve Maternal & Infant Health 

Providing 12 Months Of Continuous Coverage To Postpartum Women. In 2018, 45 percent of births were paid for by Medicaid, with 50 percent or more births covered by the program in 22 states. Medicaid covers 65 percent of all births to Black mothers. With Black maternal mortality rates 3.2 times higher than for white women, Build Back Better recognizes the expansion of Medicaid coverage to post-partum individuals is a pressing racial justice issue by providing 12 months of continuous coverage to postpartum women. 

Millions Invested To Address Social Determinants Of Health. The Black Maternal Health Momnibus Act provisions included in the Build Back Better Act contain $100 million to address social determinants of maternal health at the local level. This would include once-in-a-generation investments in housing, nutrition, and environmental conditions with the explicit focus of improving maternal health. 

Funding Health Equity Measures. The Build Back Better Act includes $170 million to bolster and diversify the perinatal health workforce, including funding for midwives whose involvement is essential to reducing maternal deaths, as well as $50 million to enhance doula services. An additional $100 million has been included for maternal mental health equity and $50 million for maternal health research at Minority-Serving Institutions.

Directly Confronting Systemic Racism in Maternal Care. $50 million for training to address racism, discrimiation, and bias — originally part of the Black Maternal Health Momnibus Act — is included in the Build Back Better Act. This training for health care professionals is just one of the many necessary steps required to begin addressing racism in the American health care system and improve maternal health equity. 

How Build Back Better Ensures Continuous CHIP Coverage

Keeping Children on Medicaid For A Full Year Who Abruptly Lose Coverage. The Build Back Better Act would require states to provide 12-month continuous coverage for children on Medicaid and CHIP. As of January 2020, 31 states provided continuous coverage. States that don’t provide continuous coverage experience increased churn, or children who dis-enrolled and re-enrolled in coverage within the same year. Continuous coverage would help reduce racial disparities as nearly 14 percent of Hispanic, 12 percent of Black, and 13 percent of children in low or moderate income households faced uninsurance for all or part of the year.

Build Back Better Expands Home And Community-Based Services

Build Back Better Will Allow Millions of Americans To Grow Old At Home. Medicaid is currently the largest provider of home and community-based care, providing essential services to seniors and people with disabilities. Build Back Better will provide an additional $150 billion for home and community-based services, that would provide care to the 2.5 million Americans already participating in the program, and help alleviate the current waitlist of more than 800,000 individuals. Federally provided home and community-based services funds helped more than 100,000 individuals return to their homes and communities from nursing facilities between 2008 and 2019, highlighting the enormous need for Build Back Better to strengthen this essential program.

Nearly 820,000 People On HCBS Waiting Lists Gain Assistance. In 2018, Medicaid waivers provided care for 2.5 million HCBS enrollees. As the aging population continues to grow, over three-quarters of states have HCBS waiver waiting lists. Individuals spend an average of 39 months on waiting lists prior to eligibility screening. The Build Back Better Act will provide HCBS funding to help the nearly 820,000 Americans on waiting lists.

HCBS Expansion Strengthens Direct Care Workforce. The direct care workforce is disproportionately composed of black, female, and lower-wage workers. In 2018, 58 percent of direct care workers earned less than $30,000 a year. Additionally, nearly one-third of workers live in a low-income family that makes less than 200 percent of the federal poverty line. 82 percent of the direct care workforce are women and one in four workers are Black. The Build Back Better Act will combat the HCBS workforce shortage that has been exacerbated by the Covid-19 pandemic and historically low wages.

Families Will Save An Estimated $5,800 In Home Care Costs. Older Americans and people with disabilities are often forced to liquidate their assets to afford as little as two years of in-home care. The HCBS provisions included in the Build Back Better Act will save families paying out-of-pocket an estimated $5,800 a year for four hours of care per week.

Recent Polling Confirms Health Care Provisions Included in the Build Back Better Agenda Are Voters’ Top Priorities

Democrats in Congress are on the cusp of passing the historic Build Back Better Act, which includes measures to lower prescription drug costs, expand Medicare benefits, close the coverage gap, and make premiums more affordable for millions. Poll after poll makes it clear that the health care provisions included in the Build Back Better Act are top priorities for citizens across America, as there is overwhelming bipartisan support for reducing costs, expanding coverage, and improving health care. 

Democrats are working towards making sure Americans have more affordable health coverage and access to better care, and they must deliver on their promises and quickly pass the transformative measures included in the Build Back Better agenda.


Kaiser Family Foundation Poll Shows Overwhelming Majority Supports Medicare Drug Price Negotiation. “Eight in ten adults (83%) say they either “strongly favor” or “somewhat favor” allowing the federal government to negotiate with drug companies as do 84% of older adults (65 and older), including the vast majority (93%) of those ages 65 and older who identify as either a Democrat or lean Democratic, and three-fourths (76%) of older adults who are Republican or lean Republican.” [Kaiser Family Foundation, 10/12/21]

Kaiser Family Foundation Poll

Hart Research Poll Finds Closing The Coverage Gap Among Most Important Provisions In Build Back Better Act. “When making the case for the Build Back Better Act, it’s significantly strengthened by including health care. Support for the investments in critical priorities in the act is strong (74-26%) but is significantly stronger (80-20%) when the description includes that the plan reduces health care costs and the price of prescription drugs.” [Hart Research, 9/13/21]

Hart Research Poll

CBS News Poll Finds Medicare Coverage For Hearing Among Top Issues For Voters. “84 percent of respondents support Medicare coverage for dental, eye, and hearing.” [CBS News, 10/10/21]

CBS News Poll

Morning Consult/Politico Poll Find Bipartisan Support For Home Health Care Funding For Seniors And People With Disabilities. “Among the 18 provisions listed in the poll, voters’ second-highest priority is funding for home health care for seniors and people with disabilities, followed by Medicare drug price negotiation. Those two measures, which were included in the most recent White House proposal, rank above non-health care provisions such as funding for affordable housing and free community college, which have about as much voter support as adding hearing benefits to Medicare.” [Morning Consult, 11/2/21]

Morning Consult Poll