Krysten Sinema is choosing lower taxes for the richest Americans over better healthcare for average Americans - and cutting the legs out from under the Build Back Better plan

• With the Build Back Better bill, Congress has the best opportunity to expand healthcare in America.
• Yet donations from Big Pharma have incentivized Senator Kyrsten Sinema to block reform.
• It's time to tax the rich and use those funds to expand healthcare access.
• Laura Packard is executive director of Health Care Voter, and founder of Health Care Voices.

Four years ago I walked into a doctor's office as a successful and healthy self-employed woman. Or so I thought. I walked out with a stage 4 cancer diagnosis. I'm still here and in remission because of the care I received. I was lucky, because across America many people are still priced out of our healthcare system.

As Congress advances the Build Back Better Act - a plan that would tackle many pressing issues in our society, including healthcare - they're also deciding what, and who, to leave out. And since Democrats are committed to making sure the plan doesn't add to the national debt, a lot of the decision making on what is in or out depends on how much money the bill can raise to offset the cost of the critical investments we need.

Much depends on the votes of two Democratic senators: Kyrsten Sinema and Joe Manchin. They have both opposed various means of raising revenue by increasing taxes on the rich and corporations. Their stances make it harder to expand access to healthcare, so that no American has to choose between their finances and their life. Congressional allegiances should be with their constituents, not the giant pharmaceutical industry, big corporations, and the wealthy - and that means they should support raising taxes on the rich.

The path ahead is clear

It's clear what the American people want: Polls show that eight in 10 American believe wealthy people and corporations aren't paying their fair share. At the same time, Americans want accessible and affordable healthcare and lower drug prices. The Build Back Better Act is the best way to achieve those goals: raise taxes and use that revenue to make Affordable Care Act plans more affordable, fill the Medicaid gap so low income Americans can get covered, and expand Medicare services to existing beneficiaries. At the same time, we can lower drug prices by giving Medicare the power to negotiate with pharmaceutical companies.

Back when Sinema was a member of the House, she opposed Trump's 2017 tax cut, which slashed taxes for corporations and the richest households. Now, having since emerged as the "Pharma favorite" and raising more campaign money in the last three months than in any other quarter since she became a senator, Sinema is voicing staunch opposition to upping taxes for the ultra wealthy. In a 50-50 split Senate, Sinema's opposition is enough to force Democrats into dropping some of their most popular ideas.

Speaking of the high costs of pharmaceutical drugs, while I was going through six months of chemotherapy, my insurance that I purchased through the Affordable Care Act picked up most of the tab. Cancer patients are incredibly vulnerable after treatment, because our immune systems have been knocked down to nothing. After my first chemotherapy session, my doctors prescribed a drug for me to help my immune system recover faster. The drug, Neulasta, is made by pharma giant Amgen and would have cost me over $13,000 per injection. My insurance didn't cover it, so I went without and hoped for the best. But I spiked a fever from infection, and wound up back in the hospital for a week. The high cost of prescription drugs nearly led to my death.

We shouldn't have to live like this. Congress has an opportunity to lower the outrageous costs of medications and healthcare. Not only could a more robust BBB bill rein in these prices, but it could also force greedy corporations like Amgen - one of Sinema's top three campaign contributors - to pay their fair share of taxes too.

Tap dancing around the taxman

In 2018 Amgen saw its tax bill slashed by over $1.1 billion thanks to Trump's tax law, plus it snagged an additional estimated $5.5 billion of savings from a one-time tax break to incentivize corporations to repatriate untaxed offshore profits. Amgen used their gigantic tax cut for a $10 billion stock buyback, which just helped their CEO and wealthy shareholders get richer.

And even with the cut, big corporations like Amgen don't pay even what they owe. In August of 2021, an IRS audit revealed that the company owed $3.6 billion in back taxes, which Amgen is disputing.

I'm a small business owner, and I pay my taxes every quarter. Like many Americans, I often face a big bill each year on Tax Day. I don't have the benefit of fancy lawyers and lobbyists to avoid my responsibilities. It's time for big corporations and ultra-rich CEOs to pay up too. But Amgen and other big pharma companies have been pouring money into campaigns to make sure Sinema and other holdouts protect their interests, even if it's worse for most Americans.

Amgen has spent $4.7 million, and PhRMA (the trade association for Big Pharma corporations) has racked up $15.2 million on lobbying this year alone. Pharmaceutical companies have spent the most of any industry on federal lobbying in 2021: They've showered Congress with $171 million so far, almost roughly twice the amount of the next highest-spending industry.

PhRMA made a seven-figure ad buy to attack the lower prescription drug pricing proposals in Build Back Better, and, along with their allies, have also spent $18 million on ads opposing Medicare negotiation proposals for more affordable drugs.

Unfortunately, their money is having an effect. The Build Back Better framework originally released by the White House didn't include pieces to lower drug prices. Taxes on billionaires' wealth, and higher tax rates on big corporations? Gone too. And because of the lack of revenue, Americans would be limited to a partial expansion of Medicare - just hearing services - and a time-limited version of ACA tax credits and filling the Medicaid gap, which expire after 2025.

Thankfully, Sinema struck a deal with President Biden and Senate Majority Leader Chuck Schumer on drug pricing reform, agreeing to a plan that would allow Medicare to negotiate some medication costs and lower out-of-pocket costs for millions. It's now on the House and Senate to get the Build Back Better Act passed as quickly as possible, and for it to reach the president's desk without any further cuts or compromises.

Taxing the rich and corporations continues to be very popular among Americans. Now we need elected officials to listen to people like you and me instead of their wealthy elite donors. The future of our healthcare depends on Congress' financial incentives to improve it, and that's a dangerous prescription for America.