But disagreements among Democrats about how to use the savings generated by drug-price negotiation has complicated its path forward. While Democratic leaders like Mrs. Pelosi indicated they want to put that money toward reducing costs for people getting healthcare through the ACA, other Democrats have proposed using it to expand eligibility for Medicare.
Democrats in both the House and Senate have recently encouraged the White House to allow drug-price negotiation, reduce the age of eligibility for Medicare below 65 and expand its benefits so it includes dental and vision care.
"We write to ask that, as part of the American Families Plan, you propose reducing the Medicare eligibility age, expanding Medicare benefits to include hearing, dental, and vision care, implementing a cap on out-of-pocket expenses under traditional Medicare, and negotiating lower drug prices,” a group of 17 Democratic senators including Bernie Sanders (I., Vt.) wrote to the White House in a letter Sunday.
Pharmaceutical companies have staunchly opposed Medicare negotiating the cost of prescription drugs.
On several fronts, aspirations among Democrats on Capitol Hill for the White House package are set to come up short. The White House is expected to propose a temporary extension of an enhanced child tax credit, rebuffing Democratic demands for a permanent extension. Some Democratic aides are also expecting that a proposal to overhaul unemployment insurance won’t end up in the proposed plan.
The White House will also likely face pushback on the plan’s proposed tax changes, which are expected to increase taxes on capital gains for people making more than $1 million, adjust how capital gains are taxed at death, and raise the top marginal income rate. Democrats who represent areas with many high-income individuals may have concerns about how capital-gains taxes are changed in particular.
Mr. Deese defended the president’s plans on the capital-gains tax Monday, emphasizing that the president’s proposal would only impact those making more than $1 million a year, which he said would mean 0.3% of taxpayers. He said the changes would fund investments in children and would “equalize the treatment of ordinary income and capital gains.”
—Catherine Lucey contributed to this article