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Arizona Sen. Kyrsten Sinema announced late Thursday she will "move forward" with Democrats' massive climate, prescription drug and spending bill, after Democrats appeared to reach an agreement about Sinema's concerns with the legislation. Sinema's announcement all but locks in the bill for Democrats, who need all 50 Democratic votes on board in order for the bill to pass, with a tie-breaker vote from Vice President Kamala Harris. The legislation solidifies key portions of President Biden's domestic agenda. (Shivaram, 8/4)

Earlier in the day, Schumer said the chamber would take Friday off as he works to clarify a murky timeline for passing Democrats’ bill, which still faces multiple outstanding issues. Schumer also warned on Thursday of “some late nights and extended debates” as he vowed to pass the legislation in the “coming days.” There’s still more uncertainty to button up in those days. Democrats and Republicans will continue arguing into Friday about what can be included in the bill. But Sinema’s commitment to the package removes a major question mark ahead of an unlimited “vote-a-rama” on amendments. (Everett and Levine, 8/4)

Steve Ubl, who leads the nation’s top industry group for drugmakers, is offering a final salvo to Congress as Democratic lawmakers inch closer to passing their sweeping reconciliation package that includes drug pricing measures — and threatening swift retaliation if they don’t listen, he told POLITICO. Ubl’s group, the Pharmaceutical Research and Manufacturers of America, or PhRMA, and its 31 board members sent a letter to every member of Congress on Thursday afternoon, urging them to vote against the package. (Wilson, 8/4)

Democrats' party-line drug pricing legislation will likely cause manufacturers to raise the launch prices of new drugs, the Congressional Budget Office projected yesterday. (Owens, 8/5)

A key provision in the Senate Democrats’ budget reconciliation bill that caps out-of-pocket spending on prescription drugs for Medicare recipients at $2,000 per year could be a lifeline for millions of older adults struggling to pay for heart medications. (Lovelace Jr., 8/5)

Reining in the soaring prices of insulin has thus far been elusive in Congress, although Democrats say they’ll try again — as part of their economic package that focuses on health and climate. The price of the 100-year-old drug has more than tripled in the last two decades, forcing the nation’s diabetics to pay thousands of dollars a year for the life-saving medication. Democrats are considering capping the cost of that drug for at least some, although it’s unclear what the final proposal will look like and how many insulin users will get a price break. (Seitz, 8/5)

Gas and groceries aren’t the only necessities costing more these days. In an effort to accommodate higher health care costs, Americans have been delaying or skipping treatments altogether. According to a new survey from West Health and Gallup, 38% of Americans, or roughly 98 million people, cut back on food, gas, utilities, and other costs to pay for health care expenses in the past six months. The poll, which was conducted in June 2022 when inflation reached a 40-year high of 9.1%, included 3,001 adults from all 50 states and the District of Columbia as part of the Gallup panel. (Payton, 8/4)