all right, hello again, thank you for joining me this saturday. i'm fredricka wlit field. happening right now, the u.s. senate is now in session. democrats beginning the arduous process to vote on a monumental climate and economic bill. if passed it will be the largest investment in american history while also addressing other issues of president biden's agenda. let's get right to cnn's jessica dean live on capitol hill. jessica, paint the picture for us, what is happening? >> reporter: right, so this is a long process that will stretch out all throughout today and into the night and into early tomorrow morning. you're looking there live at the senate floor.

we do expect their gaveling in as we speak and we do expect to see them at some point in the next many hours to move forward with this democrat's climate and tax and health care bill. we'll see them gavel in and then there will be a vote on a nomination, to get all of the senators here. behind the scenes, because democrats are using this very specific budget process that required all 50 of the democratic senators' support but has to go through the senate parliamentarian to make sure it meets the rules and could pass muster to be included in this bill. so the parliamentarian is continuing to rule on this as we speak. she's making her way through yowl of these provisions. just earlier today, we learned that the bulk of what they wanted with medicare being able to negotiate drug prices for the first time is remaining in the bill. the parliamentarian did strike a smaller provision on caps for

medicine and the private sector that democrats wanted to put a cap on medication, that the price didn't rise faster than inflation. that had to be pulled out for the private insurance industry. but that is applicable. and a number of climate visions are staying. senate democrats are said to want to have all of the rulings before they proceed followed with this because they want to make as many changes as possible. they want to make them before the process starts but not during the process. so what we'll see, when they decide to move forward they'll have a motion to proceed and that will kick all of this off. a big question mark on when that will happen. it requires a simple majority and then from there, there could be 20 hours of debate from both sides and that sets off a vote-a r vote-a-rama and that leads us to passage. noon ott on the east coast, it

is a long day and evening and we'll keep an any on it as we move along. >> eat your wheaties and pace yourself. it is a long day. i hope you have comfortable shoes too. that is a must on capitol hill. >> a must, yes. >> very good. and in that live shot earlier, the lady in blue was senator tammy baldwin. we spoke with her last hour, she's leading this process today. all right. so, so far no republicans have expres expressed support for the inflation reduction act even though it includes some provision that's have been very popular with the gop in the past. and it is a big bill and i'll try to go through some of the measures for you. there are a series of tradeoffs in this bill. here are some of the facts about what is in this legislation as it stands. again, jessica mentions there will be motions to make some changes. so for starters, it provides $369 billion for climate and energy spending. that includes consumer tax credits on electric vehicles,

rooftop solar panels and energy-efficient water heater as mong other things. but there are also billions in tax credits to fossil fuel companies to encourage them to invest in clean energy manufacturing. and then the bill supports expanding investment in domestic oil and gas exploration on federal lands and in off shore federal waters. in fact, for the next decade, any new wind or solar energy project on federal land could only be approved if a new lease is approved for oil and gas drilling as well. on taxes, the bill abandons tax increases opposed by republicans including raising the corporate tax rate. the personal tax rate, or the capital gains tax rate. the bill also includes changes to the health care system, including a measure on prescription drugs, specifically the bill would empower medicare

to negotiate the prices of certain costly medications which is garnered bipartisan support. bill would also extend the obamacare subsidies that are set to expire at the end of the year until 2025. and as for the provision that tightened the carried interest loophole which senator sinema nixed, even trump has expressed for support of it in the past. and a word comes to mind and a rare one in washington this day, compromise. it would be another victory for president biden who has seen a string of wins just in the last last week. arlette saenz is at the white house. even though the president remains in isolation, what is the white house saying it about today and how the week has gone for them. >> the white house is watching this vote very closely today as it would mark another step as

they're trying to get the president's agenda across the finish line. but this is the latest development in what has been a string of victories for the president while he has been isolating here at the white house with covid. his second stint with covid this week. if you just take a look at what the president has accomplished in isolation starting with the announcement of the successful operation that killed that al qaeda rleader al zawahiri and h was cooped up in the residence due to his covid-19 diagnosis. he got some good economic news this week with gas prices trending down for over 50 days now and also a much better than expected jobs report released on friday. and of course, the major developments of that surprise deal between senator joe manchin and senator chuck schumer on the inflation reduction act which would have historic investments in climate initiatives as well

as new initiatives when it comes to prescription drugs and other tax measures as well. but one thing for the white house going forward is how exactly all of this is going to resonate with american voters. president has said in the past that they've had some trouble selling their accomplishments to voters and so that is something that will play out over the course of the next few weeks. of course there are also major challenges still facing this white house. especially in the foreign policy arena, when you take a look at the ratcheting up of tensions with china after house speaker nancy pelosi's visit to taiwan. also the u.s. is still trying to secure the release of wnba star brittney giner and also paul whelan who have been held in russia that is something that the president said they are still working towards. but certainly this week has been a week of accomplishments for president biden. now we are still awaiting word on what the president's latest covid tests has looked like this morning. typically we've been getting it

in this noon hour so hopefully we'll have more news soon on whether the president will need to continue isolating or if he has now tested negative for covid. >> arlette saenz at the white house. thank you so much for that. indiana has become the first state to pass an abortion born since roe v. wade was overturned last month. the bill would provide exceptions for the life of the mother is at risk and for fatal fetal anomalies and allow exceptions for some abortions if the pregnancy was a result of rape or insist. indiana allows abortions up to 22 weeks after fertilization. protesters have filled the halls of indiana state capitol as lawmakers voted on the measure. the new law will go into effect september 15th. still to come, the biden administration declares monk pox a public health emergency. and the cdc is now urging people to limit the number of sex partners. we will talk with a public health specialist about the best

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all right, let's go live to capitol hill where the senate has just gavelled in and is set to take up the democrats' sweeping health care and climate bill. let's listen in to senator chuck schumer. >> -- by the wealthy. and reducing the deficit. this is a major win for the american people. and a sad commentary on the republican party as they actively fight provisions that lower costs for the american family. as the inflation reduction act works its way through the floor, the american people are going to learn an unmistakable truth about this proposal. it was written first and foremost with the american people in mind. it reduces inflation, it lowers their costs and it fights

climate change. for seniors, who will face the indignity of rationing medications or skipping them altogether, the inflation reduction act will lower prescription drug costs and finally cap out-of-pocket expenses. for families that have fallen behind on the electric bill, while trying to stay cool through a heat wave, this bill will lower energy costs and provide a largest investment in clean energy ever in american history. for every child, deprived of clean air in a neighborhood where they could play safely outside away from smog and exhaust fumes, this bill will help reverse air pollution. and help clean up communities that have been endured the shadow of a congested highway and industrial site. and as the most significant action of climate change ever, it will help deliver our children and grandchildren the planet they deserve. the inflation reduction act -- >> you're listen to chuck

schumer there kind of tick through what he believes the advantages are of this inflation reduction act. it is going to be a very long day of making modifications along the way to the measure before in this parliament process. there are 50 democrats who will be voting on it before it moves on to the next stages. of course we'll continue to keep close tabs on the goings on there on capitol hill. all right. new urgency from the white house as monkeypox cases rise across the u.s. the biden administration declaring monkeypox a public health emergency. cases now topping 7,000, surging in recent weeks since the first was identified in mid may. every state except montana and wyoming have reported cases. the white house also naming a monkeypox response coordinator. ront fenton, who also served as a top fema administrator. mine wheel. >> lines for vaccines are often

line, but now unbelievably long. and there is concern, growing concern over both the lack of supply and what seems to be a lack of urgency in many parts of the country. here is cnn's david culver. >> reporter: we started early. just before 6:00 a.m. our destination, familiar to our uber driver. we were her third passenger that morning also headed to san francisco's zuckerberg general hospital. as we arrived, so to the sun. and revealing a line of mostly men waiting all night. >> this line started building around 2:00 in the morning. >> all of them wanted to be vaccinated against the monkeypox virus. >> it definitely shows that people are concerned about it arks. >> reporter: and willing to stand in hours long lines to spill on to the sidewalk. inside, exhausted hospital staff

face another days surge in vaccine demand. covid-19 still raging and now monkeypox. >> i think one of the biggest challenges is really just the inconsistency of the supply. >> here in california, nearly all of those who have reported probable or confirmed cases, more than 98% are men. with 97% of patients identifying as lgbtq. while deaths are rare, the symptoms are visible and painful. >> oh, i had between 6 and 800 lesions. it was like someone taking a hole puncher all over my body and there were points where i can't walk or touch things. pretty difficult. >> kevin said his symptoms lasted two weeks and he chronicled it on social media. >> i didn't want to be alone and see if other people were experiencing what i was. >> reporter: a familiar sentiment for long time lgbtq advocates live and working in san francisco's famed castro district.

>> you get a sense there is some growing uneasiness about monkeypox. for a lot of people it is reminiscent of what they experienced here in the early 80s with the aids crisis. there is fear and anger and anxiety and stigma. >> reporter: partly sunny per -- it is personal for tyler and he lived with hiv. >> we have a responsibility to not further stig mattize or politicize this issue for a community has faced issues dating back to the aids epidemic. >> on thursday the biden administration declared monkeypox a public health emergency. >> the feeling this were not getting the attention it would if it were effecting straight people is real. >> cody aarons makes his third attempt to get vaccinated against the virus. off camera, a hospital staffer updates the crowd. >> i hear them announcing

something. i don't know if you could make it out. >> just 45 minutes in the hospital distribution. >> no guarantee for vaccines. >> they had already reached their daily limit. david culver, cnn, san francisco. >> here now, to talk more about this, is dr. matthew. he's a primary care physician and public health specialist. so the white house is now calling this a public health emergency. i mean 7500 cases and counting. so, in your view, given the numbers, given the availability of vaccine, is the response catching up with the demand for the response. >> fred, i'll tell, i think the white house was a little late. i don't want to criticize them but i'm glad they did because it is going to bring a lot of attention to this problem that is escalating. we're talking over 7,000 cases in the u.s., fred. that is a lot more than 7,000. there is a lot of community transmission, there is a

two-week incubation period from the time you are exposed to when you show symptoms. so people could walk around with the virus and not even know it. >> so do you atribute the rise to maybe a lack of awareness or is it also because of restrictions on the access to the vaccine, is it all of that wrapped up in one. >> i think it is all of that. in my office, luckily we're a large corporation, we just got an email saying, hey, listen, if you suspect somebody has monkeypox and you see this lesion, here are the swabs and now we have five laboratories that we could send those cultures to and get a diagnosis. but a lot of small offices don't have it. and remember for american physicians, i grew up in africa, i've learned about muonkeypox ad i've seen a few patients as a high school student but not as a physician. so my red flags go up when i see a gentleman, especially with lesions in the private parts in

the genitalia area, you want to a high number of suspicion. >> eric adams is calling on president biden to invoke the defense production act to fulfill demand for the vaccines. so far only about 600,000 doses have been delivered. when experts say what is needed is 3 million to stop the spread. so, can the defense production act help keep up with the demand if that is kicked in? >> i think that is definitely going to help. the biggest problem is we have the recipe for the vaccine. so unlike covid-19, we've got a vaccine waiting. but now you have to manufacture it in bulk amounts. there was one place in europe doing it. but we need multiple manufacturers and the white house is working on that. and also a couple of misconceptions about monkeypox that i think we should clarify. number one, it is not a gay person's disease. all of us are at risk of getting

this viral infection. it is really more about your social network, than it is about your sexuality. >> and what do you mean about that? >> what i mean about that is it is not necessarily what a person does in the bedroom, it is who you hang out with. while most of the cases are being transmitted sexually, the misconception is to say or the misinformation is to say that it is exclusively transmitted sexually. it is not. if two people in the club prolonged skin to skin contact and unfortunately respiratory droplets, prolonged exposure. so unlike in covid-19, somebody could could have in an elevator and you could get it. it doesn't happen that way. but if you have prolonged contact with someone with monkeypox, there is a chance of getting it from them via respiratory, prolongs respiratory droplets. >> and then also as a result of lesions. the blisters, or lesions open and that is helping to release

the contagious quality of monkeypox. >> exactly. people don't realize the amount of micro abrasions we have on our skin. you don't have to have an open lesion. so just skin to skin rubbing, whether it is nonintimate or intimate contact. absolutely with those lesions because they have millions of viral particles under the pox lesions. >> i heard one doctor say it is simple as sharing of towels, of bed sheets that the lesions could open up and it will leave contaminants in those places, you use it and that exposure and you too could pick up monkeypox. is that simple. >> i don't think it is that simple. ity think the most common method of transmission is still prolonged skin to skin contact, intimate contact. when it comes to the chance, it is a lower chance. i don't want people to panic, if i go into a gas station and exchange money that could be a

source. the strain in africa could be different because this virus could also mutate. not as rapidly as covid-19. so if this is a new strain, there could be new properties that we don't really know about. >> and as you mentioned, everybody is vulnerable. but the lgbtq community has been particularly more vulnerable. and you remember the community as well. and i wonder if this stigma that is now been associated with monkeypox and the community, whether that makes it that much more difficult to get understanding, to get assistance, to get help? >> 100%. i think that we have to be very careful about not stig mattizing monkeypox like hiv was. we know how wrong we were when that happened and i heard another physician on another station saying that the rest of the populations could relax, that is not true. i would actually go out and a

limb fred and say that college students before college starts should all line up for the vaccine. because it is prolonged contact. you could hang out with someone in a dorm or go to a party, people are hanging out for long periods of time. so people need to remember that everybody is at risk, including children. >> wow, all right. important advice and everybody wants to get the help sooner rather than later. >> quickly. >> dr. matthew, so good to see you. and always even better when we're in the same space. thank you. >> appreciate it. >> come up, schools across the country are dealing with teachers and staff shortages. why so many educators are leaving their field and what some school districts are doing to fill the classrooms next. e p. just you and your peoplele. ♪ ♪

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back to school may mean utter chaos in classrooms across america. three years after the pandemic forced widespread closures and a shift to virtual learning, many school districts are now grappling with a teacher shortage, it is being called catastrophic. some districts are being forced to go to four-day school weeks or crowd more students into classrooms. camilla bernal has more from los angeles. camilla, this is pretty serious and school starts in just a matter of days and in some places weeks. >> reporter: hey, fred, it is really a problem. and when you talk to teachers what they will tell you is that they are tired, that tear job is difficult, that they are

underpaid, that after the pandemic, they really are struggling to go to work. and a lot of them are just tired in general. so what happens here is that the school districts all over country, they are seeing shortages. and they're having to come up with random solutions like a four-day school week as you mentioned. or bringing incentives in, trying to offer teachers more money. just doing everything they can to retain the teachers and then to have new hires as well. here is how the madison metropolitan school superintendent described his situation in wisconsin. >> we've had a teacher shortage before the pandemic. but now since the pandemic, it is really increased. in fact, this is our largest number of vacancies since 2017, so about 37 more vacancies than we had in 2017. but we've been working diligently as superintendents across the country sharing best practices about what we need to

do to address this. >> reporter: here in los angeles, l.a. usd needs about 240 teachers before they start school. so the idea is to do everything they can, have their h.r. department working 24/7 in order to get these teachers in the classrooms, fred. >> oh, my goodness. this is a big number. camilla bernal, thank you so much. all right, and this just into cnn. an update on the president's health. arlette saenz is at the white house. so now there is an update on his covid test for today? >> reporter: that is right, fred. and president biden has tested negative for covid 19 today. that is according to his physician, who just released another letter updating on the president's condition. but even as he tests negative, he will remain in isolation until they receive a second negative test. so the president will continue to isolate. but it was just one week ago where the president had tested

positive for covid-19 in that rebound case. after he had taken that paxlovid treatment after his first diagnosis with covid-19 on july 21st. so we will see whether the president might be able to emerge from his isolation a bit later today or perhaps over the weekend. but this is certainly a welcome development for the president who has been here at the white house for the past 17 days without leaving due to his covid-19 diagnosis. now president has been participating in these events virtually from the residence. he did emerge after testing negative a little over a week ago. but then went back into isolation once he received that positive test last saturday. so we will see what further updates we get from the president's physician about when the president will be taking that second covid-19 test. but for the time being, he has tested negative for covid-19. but will continue to isolate until the second test comes in.

>> 17 days, that is pretty significant. thanks for that reminder. arlette saenz at the white house. >> thanks. russia said it is ready to discuss a prisoner swap with the u.s. after basketball star brittney giner was convicted of drug smuggles and sentenced to nine years in prison. details straight ahead. the stronger, lasts-longer energizer max.

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you don't know how much pressure you put on your septic system. but rid-x does. in a 21 month study, scientists proved that rid- x reduces up to 20% of waste build up every month. take the pressure off with rid-x. president joe biden said the u.s. is doing everything possible to bring wnba star brittney giner back home after a russian court sentenced her to nine years in jail. griner was found guilty of carrying cannabis oil through a moscow airport. the white house considers griner and fellow american paul whelan to be wrongfully detained. and it wants the kremlin to look at a deal to swap prisoners. fred pleitgen looks at what happens now. >> reporter: for the first time,

russia is saying it is willing engage with the u.s. on a possible prisoner swap to bring wnba star brittney giner home. but the kremlin warning talks must remain secret or they'll fail. >> if we discuss a few details by the press, then those exchanges will never take place. the americans have already made that mistake. suddenly deciding to use mega phone diplomacy to resolve these issues. this is now how they are resolved so we will not give any comments. >> reporter: the u.s. has said it put an offer on the table to get brittney giner and paul whelan in russian for espionage which he denies released. cnn learning that the biden administration is offering convicted russian arms dealer victor bout in return. secretary of state blinken said washington will take up moscow's offer to negotiate. >> we put forward as you know a

substantial proposal that russia should engage with us on. and what foreign minister lavrov said this morning and said publicly is that they are prepared engage through channels we've established to do just that and we'll be pursuing that. >> reporter: president biden saying bringing brittney giner home remains a priority for his administration. >> i'm hopeful. we're working hard. >> reporter: the russians say they want to use a mechanism for such swaps put in place after president biden summit with russian leader vladimir putin in switzerland last year. >> as specifically on the issue of persons convicted in russia and in the u.s., i have already said there is a special channel agreed to by the presidents. whatever might be said publicly, this panel is still relevant. >> reporter: after being handed a nine year jail sentence, brittney giner's lawyer said the two time olympic gold medallist is in shock but is in a fighting

spirit. >> she's doing better than yesterday. she's still processing what has happened. but we tried to cheer her up. we told her about the huge support she's getting in russia now as well because everybody is surprised with this very harsh sentence. >> reporter: and while her legal team will immediately appeal the verdict, which they say was deeply unfair, they welcome a pri prisoner swap to get brittney giner back to the u.s. >> it is hopeful to get home soon. >> fred pleitgen, cnn, moscow. >> daniel gilbert is from dartmouth college. so good to see you. so, as we just heard, russia has demanded that any negotiations take place behind closed doors. but i'm wondering, does it seem that the back and forth here has been unusually public. or has this been how it usually

goes? >> yeah, this is quite unusual. the white house would not normally make a statement like they did last week that they had previously put a substantial offer on the table to get our citizens home. and for the russians, they're committing to keeping this process quiet because they're still operating under the farce that this is a legitimate legal process. and they need to pretend this is for real and not the political leverage that they're really pursuing. >> and why do you suppose then the u.s. has been in your view unusually public about negotiations, is it largely because you're talking about a high profile prisoner, hostage, american who has global recognition? >> that is a really good point. there could be several reasons why the administration went public about their involvement in this deal, about the offers that they made. and those might have strategic

implications behind the scenes. but certainly there is a domestic political purpose for making this announcement publicly which is to assure brittney giner's family and team and fans, to assure those supporting paul whelan and the other americans wrongfully detain add broad, that the white house is working on this. that they're serious about these negotiations and serious about bringing our people home. >> and do you think, too, that the u.s. has kind of taken this calculus because it is also been very outspoken about russia's invasion of ukraine. and the timing is quite striking in terms of when she was detained, when she was arrested, in step with when russia invaded ukraine? >> absolutely. brittney giner was arrested just one week before vladimir putin invaded ukraine. and so this entire case is playing out against the back drop of this completely horrifying unjust war that is

going on in ukraine right now. so, that plays a really important part to this as well. >> so, in your view, what can the u.s. state department do? because, i mean, obviously negotiations, you don't want to allow the other side to have leverage. so, the u.s. state department could take their approach and say okay we'll be less public because that is the demand coming from russia, but then that is now a feather in the cap of russian negotiators. so how does it proceed to try to ultimately win the release of griner and whelan? >> these negotiations sort of play out in two different phases. so, right now the administration is putting offers on the table. they are offering that leverage to get our citizens home. and they're committed in my opinion to using every tool at their disposal to bringing home americans who are held in these kind of positions overseas.

but the administration is also take another tack at the same time. which is to remind the american public and remind the global community that russia is in the wrong here. that vladimir putin is the bad guy. that it is not appropriate, it is not legal, it violated international norms and international laws to arrest americans or any other foreigners in this kind of way. so the administration has proposed different policies that would really weigh in on that side of the equation. first to announce new travel warnings for americans -- sorry about that, new travel warnings for americans traveling overseas. as well as sanctions on the different countries and leaders and people who are involved in and complicit in these hostage taking overseas. >> apologies on the interrupt. i thought there was a pause there. okay. so now we just heard from griner's russian attorney. where each she expressed that she thought that the penalty was

harsh and i wonder just as russian authorities didn't want to hear the u.s. speak publicly about negotiations or what steps are being taken, might this impact negotiations by even having her russian attorneys speaking out against the government? >> well, my impression is that she's speaking fully within the confines of the expectations of russia law. so for what brittney giner did, which was carry less than a gram of cannabis for personal use in her suitcase, she would not receive the kind of egregiously harsh punishment that she did which is nine years of labor in a prison camp. i mean this is completely disproportionate to even what the russia criminal justice system would propose for such a crime. so they're going to be appealing. they're going to be following the legal tact here of seeing if they could appeal her charge. while the negotiations happen behind the scenes.

>> and i know you don't have a crystal ball, but we all want both griner and whelan home, so i'm wondering, do believe that this negotiation will go on for a period of days before a deal is made or do you see that it is a -- something even worse, months or even years? >> if we look to pass cases that it really takes months or years to bring our citizens home from these kind of wrongfully detentions and that hostage situations abroad. if we look at trevor reed who was released just a few months ago, he had been in prison in russia in 2019 and paul whelan is still there since 2018. so that is the normal amount of time that it takes. though there does seem to be a lot of attention on this case, a lot of action and energy behind this case. and hopefully vladimir putin sees how important it is to release them and send them home soon. >> all right. danielle gilbert, thank you so much.

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all right, the los angeles dodgers returns home last night with a pregame ceremony to honor broadcasting legend vince skully, paul shows how fans tributed the beloved voice of the city's baseball team. paul. >> fred, on a beautiful breezy night in los angeles, the adoration for the late vin scully flowed at dodgers stadium. fans could be seen taking photos in front of the press box named after vin scully.

others wore shirts including one man who had young vin scully on his back. >> we're very grateful to all sharing respects here at 1,000 vin scully avenue. >> reporter: and in the pregame ceremony, so much emotion. >> then was most comfortable in the booth. >> reporter: they played an 11-minute video tribute to vin scully and narrated by dodgers announcer charlie steiner. >> 12 all-star games -- >> vin was above and beyond the greatest baseball broadcaster who ever lived. may have been the best sports announcer who ever lived. he was a friend and that is one of those things i'm having difficulty coming to terms with here in the last few days. i knew he was going to pass away. it came as no surprise. but still you get the call. and it is a gut punch. and so this is -- tonight for me, i'm calling a game but it is also a sentimental journey.

>> reporter: vin scully, fordham university class of 1949. >> it was just like, you had goosebumps because you got to see and hear him again. >> a high fly ball to deep left field and would you believe a home run and the dodgers have clinched the division and will celebrate on schedule. >> any time you hear the words "it's time for dodger baseball", you get chills because you know that is vin. >> he's just a great man and what a career. what a career. and so humble. >> i fell asleep to him. his voice was soothing to me. i just -- i'm going to miss him. >> my grandma was a dodger, bled blue, couldn't go anywhere unless we listened to the dodger

game online. >> the sound of l.a., anywhere you would be, a dodger game, would you hear vin scully. >> it is time for dodger baseball. >> i was in tears, actually. it the culmination of an entire life that was dedicated to baseball and to the city of l.a. >> reporter: for these dodger fans if he ran for mayor of los angeles, vin scully would have won. to them, in a way, vin scully was the sportscasting what van gogh was to art or louie arm strong to jazz. he was simply the best. they don't want to forget him and glad to say good-bye on this night. i typed in my dad's name... and i found his childhood home.

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hello, everyone, thank you for joining me, i'm fredricka whitfield. right now the u.s. senate is in session on track to vote on sweeping health care on -- on a sweeping health care and climate bill. the bill known as the inflation reduction act would be the largest investment in energy and climate programs in u.s. history and for the first time it would give medicare the power to negotiate prescription drug prices. cap medicare out of pocket costs