Stephen Collinson reports at CNN Politics that “Joe Biden is tantalizingly close to fulfilling what supporters see as the historic promise of his presidency in the coming days, at a critical moment for his social policy transformation at home and his hopes of reclaiming US leadership overseas….After weeks of feuding between moderate and progressive Democrats and his agenda’s several brushes with extinction, the President’s double play of social spending and a bipartisan infrastructure program may finally come to fruition this week. Democrats hope to agree on a framework on a trimmed down package of social, health care and education programs in order to lift a House progressive blockade on a vote on the bipartisan bill fixing roads, bridges and railroads….”I think we’re pretty much there now,” House Speaker Nancy Pelosi told CNN’s Jake Tapper on “State of the Union” on Sunday. A Democratic source told CNN’s Manu Raju the goal is now for the House to have a vote on the infrastructure package on Wednesday or Thursday and send it to Biden’s desk. The exact content of the final social spending bill is not yet known, since negotiations on paring back a more ambitious program to win moderate votes have been taking place behind closed doors. But Democrats still appear to be determined to provide free pre-kindergarten education, an extension of Medicare, home care for seniors and more affordable child care.”

At The Hill, however, Lexi Lonas reports that “Senate Budget Committee Chairman Bernie Sanders (I-Vt.) said Saturday that the expansion of Medicare to include dental, hearing and vision coverage is staying in the human infrastructure bill despite doubts from President Biden….Biden said Thursday during a CNN town hall that it would be a “reach” for the spending bill to include the Medicare expansion due to opposition from moderate Democrats Sens. Joe Manchin (W.Va.) and Krysten Sinema (Ariz.)….“The expansion of Medicare to cover dental, hearing and vision is one of the most popular and important provisions in the entire reconciliation bill,” Sanders tweeted on Saturday….“It’s what the American people want. It’s not coming out,” he added….Biden said Thursday during a CNN town hall that it would be a “reach” for the spending bill to include the Medicare expansion due to opposition from moderate Democrats Sens. Joe Manchin (W.Va.) and Krysten Sinema (Ariz.).” The Kaiser Family Fund reported in September that “Results from a recent KFF poll indicate that 90% of the public says expanding Medicare to include dental, hearing, vision is a “top” or “important” priority for Congress.”

As for lowering prescription drug costs, “Democrats have been at an impasse for weeks as a small handful of House and Senate centrists continue to push back on the planned sweeping system for negotiating drug prices, ” Jennifer Scholtes, Marianne Levine and Alcie Miranda write at Politico. “Now lawmakers acknowledge they will end up with a far narrower drug pricing bill, if they can secure one at al l….Fallback plans include negotiating a smaller set of drugs under Medicare Part B, which covers drugs people usually wouldn’t self-administer, like vaccines and IV fluids. Lawmakers are considering leaving out drugs covered under Medicare Part D, which covers other prescriptions. They are also mulling negotiation only for the cost of drugs with expired patents and setting prices based on a U.S. standard, rather than an international baseline….Other options for scaling back the plan include applying the lower prices in Medicare and not private insurance plans, or phasing in the changes more slowly to give corporations time to adjust.” The KFF poll reports that 83 percent of respondents favor “Allowing the gov’t to negotiate with drug companies to get a lower price on Rx drugs that would apply to both Medicare and private insurance (Oct. 2021).”

Geoffrey Skelley addresses a question of increasing concern “Could Manchin Actually Leave The Democratic Party?” at FiveThirtyEight, and writes, “Sen. Joe Manchin told reporters Wednesday that suggestions he would leave the Democratic Party were “bullshit” with a “capital B.” He’d previously told Democratic leaders that he’d consider becoming an independent if they felt it would help them explain to the public why the party was having such a hard time coming to an agreement on its social spending plans, but he denied that he’d made threats about leaving the party.” In an extensive study, political scientist Antoine Yoshinaka “found party-switchers performed 4 to 9 percentage points worse in their next general election than non-switchers between 1952 and 2010.” Skelley adds, “Yet while one can make a fairly convincing electoral case for why Manchin should consider switching parties, it’s most likely he’ll stay where he is considering the enormous amount of leverage he has. He essentially can veto any proposal he disagrees with while also working within his party to adjust legislation to better reflect what he wants. And because Democrats have full control of government, he’s more likely to get laws passed that are agreeable to him….if Manchin were part of a 51-member Republican caucus, he would wield a similar amount of veto power. But outside of that, it’s unlikely he would be as influential as he is right now….And he’d also be unlikely to influence the trajectory of GOP legislation in the way he does as a longstanding member of the Democratic caucus.”