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Democrats have made significant progress toward adding compromise provisions curbing prescription drug prices to their massive social and environment package, two congressional aides said Sunday. Talks were continuing and no final agreement had been reached. But the movement raised hopes that the party’s 10-year, $1.75 trillion measure would address the longtime Democratic campaign promise to lower pharmaceutical costs, though more modestly than some wanted. (Fram and Mascaro, 10/31)

Democrats are zeroing in on a deal to lower prescription drug prices that the party hopes it could add to President Joe Biden’s $1.75 trillion social spending bill as soon as Monday, according to sources familiar with the effort. The conversations involve a group of Senate Democrats, including Sen. Kyrsten Sinema of Arizona, House leadership and rank-and-file, as well as the White House. Prescription drug reform was left out of last week’s draft proposal due to ongoing disagreements between moderates like Sinema and House Democrats like Energy and Commerce Chair Frank Pallone (D-N.J.), who is hoping for a more expansive effort to lower drug prices. (Everett, Ollstein and Caygle, 10/31)

Transportation Secretary Pete Buttigieg sounded confident Sunday that the House is close to passing both the bipartisan infrastructure bill and President Joe Biden’s domestic agenda spending bill. “What I know is that we’re the closest that we’ve ever been, and it looks like we’re teed up for major action soon,” Buttigieg said on “Fox News Sunday.” “And the president is sounding that note of urgency not just because the president needs it, but because the country needs it.” (Hooper, 10/31)

Sen. Kirsten Gillibrand long has called on Congress to provide paid family and medical leave to the millions of Americans who don’t have it. So when she found out last week the plan had been dropped from her party’s landmark spending bill, she began an 11th-hour campaign to try to resurrect it. The New York Democrat targeted the chief objector to the program, Sen. Joe Manchin III (D-W.Va.). She hit the phones Friday and fired off a flurry of texts to her moderate-leaning colleague that continued into the weekend, saying she would be willing to “meet him in D.C. or anywhere in the country” to make the case for the benefits, she said in an interview. (Romm, 10/30)

Jessi Garman, the mother of 3-year-old twin girls, has been searching for a job while also trying to have a third child with her husband, who’s in the military. Optimistic that Congress finally would approve paid family medical leave, she thought the time seemed right. But that was before opposition by Democratic Sen. Joe Manchin of West Virginia torpedoed the proposal. Both having another baby and getting full-time work doesn’t seem feasible now, and Garman’s hopefulness has turned into anger. “It almost feels personal because Joe Manchin is my senator,” said Garman, of Milton. (Reeves, 10/31)

In late 2019, with bipartisan backing, including from the iconoclastic Senate Democrat Kyrsten Sinema of Arizona, President Donald J. Trump’s daughter Ivanka hosted a summit at the White House to promote her vision for paid family and medical leave. As with many domestic initiatives of the Trump years, the effort went nowhere, thanks in part to the former president’s lack of interest in legislating. But it also stalled in part because of opposition from Democrats like Senator Kirsten Gillibrand of New York, who saw the plan not as a true federal benefit but as a “payday loan” off future Social Security benefits. Ms. Gillibrand believed she could do much better. (Weisman, 10/31)

President Joe Biden had to make numerous concessions to bridge the divide among congressional Democrats, but even the slimmed-down version of his Build Back Better agenda would expand health coverage and make new investments in the healthcare workforce. The overall package shrank down to about $1.75 trillion in new spending from $3.5 trillion, in part by downsizing Biden's healthcare goals. The House could vote on the latest iteration of the proposal as soon as early November but the Senate has not yet released its version. Congressional Republicans uniformly oppose the legislation. (Hellmann, 10/29)

A $1.75 trillion social and climate spending framework Democrats unveiled Thursday would reform the health-care market in several ways, expanding access and reducing costs for millions of Americans. Chiefly, the proposal would expand subsidies available for Affordable Care Act marketplace health plans, add coverage of hearing services to Medicare and improve access to home care for seniors and disabled Americans. (Iacurci, 10/30)

KHN: If Congress Adds Dental Coverage To Medicare, Should All Seniors Get It?

William Stork needs a tooth out. That’s what the 71-year-old retired truck driver’s dentist told him during a recent checkup. That kind of extraction requires an oral surgeon, which could cost him around $1,000 because, like most seniors, Stork does not have dental insurance, and Medicare won’t cover his dental bills. Between Social Security and his pension from the Teamsters union, Stork said, he lives comfortably in Cedar Hill, Missouri, about 30 miles southwest of St. Louis. But that cost is significant enough that he’s decided to wait until the tooth absolutely must come out. (Sable-Smith, 10/29)