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President Biden said Thursday that expanding Medicare to include hearing, dental and vision benefits would be a “reach” amid ongoing negotiations with Democrats over his sweeping economic agenda. During a CNN town hall, Biden told anchor Anderson Cooper that Sens. Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.) — two key moderates at the center of ongoing negotiations about how to scale back Democrats’ reconciliation bill — are opposed to the expansion. (Chalfant, 10/21)

President Biden said definitively on Thursday that his proposal for paid family and medical leave has been reduced from 12 weeks to four weeks in a compromise reconciliation bill being negotiated by the White House and lawmakers on Capitol Hill. “It is down to four weeks,” Biden said at a CNN town hall Thursday evening when asked about the proposed program. “The reason it’s down to four weeks is I can’t get twelve weeks.” (Chalfant, 10/21)

The Democrats’ social spending and climate change bill would put the United States back on a path to reducing its persistent pool of uninsured people, with estimates ranging from 4 million to 7 million Americans gaining health coverage. Those getting covered would include about one-third of uninsured Black Americans, according to an analysis by the Urban Institute and the Commonwealth Fund, nonpartisan research groups that support the goal of expanding health insurance. Other estimates from the Congressional Budget Office and the center-right American Action Forum project a similar overall trend. (Alonso-Zaldivar, 10/21)

Democratic lawmakers and their allies are moving quickly to dull a dagger aimed — from the left, of all places — at their much-touted plan to make child care more affordable for American families. The party is in the throes of negotiating what will and won't make it into its multitrillion-dollar social spending package. On the table: A multibillion-dollar program that would funnel money to states to expand their child care industries and provide parents with child care subsidies. The proposal is one of the package's most popular: A September poll found that nearly 8 in 10 voters support it. (Mueller, 10/21)

When a powerful Democratic Senate chairman assembled his Special Committee on Aging to confront what he called a “crisis of affordability” for prescription drugs, he proposed a novel solution: allow the government to negotiate better deals for critical medications. The year was 1989, and the idea from that chairman, former Senator David Pryor of Arkansas, touched off a drive for government drug-price negotiations that has been embraced by two generations of Democrats and one Republican president, Donald J. Trump — but now appears at risk of being left out of a sprawling domestic policy bill taking shape in Congress. (Weisman, 10/21)

The fate of the Democratic party’s ambitious goal of allowing Medicare to negotiate drug prices rests with a handful of key moderate senators. Negotiations on the exact scope of the reforms heated up this week after months of stalemate. But as lawmakers push to compile an outline of the massive domestic spending package that forms a cornerstone of President Biden’s domestic agenda, solid consensus on drug pricing policies has proved elusive. (Cohrs, 10/22)

Physician legislators from both parties said that expanding access to medication and therapy for obesity is crucial to turning the tide in one of America’s great public health challenges. Rep. Raul Ruiz (D-CA) and Rep. Brad Wenstrup (R-OH), who are both medical doctors, discussed their proposal to increase prevention and modernize health policy at The Hill’s “Improving Obesity Care” event on Wednesday.  (Wilson, 10/21)

KHN: KHN’s ‘What The Health?’: Dems Agree To Agree, But Not On What To Agree On

Negotiations over what to include in — and cut from — the domestic spending package on Capitol Hill are reportedly making progress, but so far all Democrats have to show for their efforts to enact President Biden’s health and other social spending agenda is a continuing promise to keep trying. Meanwhile, Biden administration officials unveil plans to provide covid-19 vaccines to younger children without looking like they are prejudging the science, in an attempt to avoid the mixed messaging that presaged the rollout of booster doses for adults. (10/21)