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Biden's Build Back Better bill: What made it in and what was stripped out

The $1.75 trillion bill would fund universal free preschool and provide a hearing benefit under Medicare but no longer includes paid leave.
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The Build Back Better framework unveiled by the White House on Thursday revises key climate change proposals, keeps funding for universal pre-kindergarten and jettisons earlier plans to provide paid family and medical leave.

The changes come after months of negotiations between moderates, progressives and the White House over the components of a massive social safety net package.

Here's a look at what's new, what's out and what was kept intact in the $1.75 trillion package that's now half the size of the initial proposal from President Joe Biden.


Climate: The proposed framework contains over $550 billion to tackle the climate crisis, down from an initial proposal of $600 billion. Instead of imposing fines for electric utility companies that don’t switch from fossil fuels to renewable or clean energy sources — an approach opposed by Sen. Joe Manchin, D-W.Va. — the climate portion of the bill relies heavily on providing $320 billion in expanded clean energy tax credits. Biden said the bill will lower carbon emissions and "help people do things like weatherize their homes so they use less energy, install solar panels and develop clean energy products, help businesses produce more clean energy."

Medicare benefits: The framework would expand Medicare coverage to include a hearing benefit, at an estimated cost of $35 billion. The initial version of the proposal included vision and dental benefits as well, but that plan was scrapped after objections from Manchin and Sen. Kyrsten Sinema, D-Ariz.


Paid family leave: Despite it's popularity in public polling, paid family and medical leave plan was left on the cutting room floor due to opposition from Manchin. The four week version had been whittled down from the initially proposed 12 week version in the $3.5 trillion version of the bill.

Free community college: The initial version of the plan included two years of free community college, which would have cost the government $109 billion.

Dental and vision: An initial proposal championed by Sen. Bernie Sanders, I-Vt., to add dental and vision benefits to Medicare coverage was stripped out, along with an effort to provide $800 vouchers to help cover dental costs that was floated by Biden.

Lower prescription drug prices: A proposal to allow Medicare to negotiate lower drug prices was yanked after pushback from some moderate Democrats, but some Democratic lawmakers say the provision could find its way back into the bill. The influential AARP blasted the proposal's omission on Thursday, with executive vice president Nancy LeaMond saying, "It would be a monumental mistake for Congress not to act on an historic opportunity to improve the lives of virtually every American family."


Universal pre-K: The federal government would expand access to pre-school for 3- and 4-year-olds, with funding for the next 6 years. The White House said that would mean free pre-school for more than 6 million children.

Child and earned income tax credits: The bill would fund a one-year extension of the child tax credit. Originally expanded under a Covid relief bill, the credit has benefited households earning up to $150,000 a year by providing direct cash payments from the IRS for their kids. The program provides a monthly child cash allowance of $300 per child under 6 years of age and $250 for each child between 6 and 17 years old. The Build Back Better bill would also make the refundability of the tax credit permanent. Separately, the measure would continue the expanded earned income tax credit for 17 million low-wage workers. The estimated cost is $200 billion.

Child care funding: A plan to expand funding for child care centers would limit child care costs for families to no more than 7 percent of income, for households earning up to 250 percent of their state's median income, the White House said. The administration said the plan — which along with universal pre-K would cost $400 billion — is expected to expand child care access to about 20 million children.

College grants: Pell Grants for low-income college students would increase by $500 from the current rate of $6,495 in annual assistance. The proposal also increases funding for HBCUs and tribal colleges while adding funding for job training programs. The estimated price tag is $40 billion.

Elder care: The proposal would expand home-based services through Medicaid coverage for seniors and people with disabilities and reduce backlogs for care. It would also increase benefits for caregivers. The estimated cost is $150 billion, down from $400 billion in the original bill.

Affordable Care Act subsidies: The proposal would boost Affordable Care Act subsidies for those using the federal system to buy insurance. The White House said that on average, premiums would be reduced by $600 a year per person. It would also offer ACA premium tax credits to as many as 4 million uninsured people in states that have rejecting expanding Obamacare to help them get coverage. The two proposals would cost $130 billion.

Housing: The proposal sets aside $150 billion for affordable housing. The White House said the money will go toward "building more than 1 million new affordable rental and single-family homes, rental and down payment assistance, and public housing."

Rural funding, supply chain, maternal health: The White House said the framework also sets $90 billion for "equity and other investments," including a rural partnership program that will provide flexible funding for locally-led projects. It also provides money for community violence intervention, maternal health, pandemic preparedness and combating supply chain disruptions.