House and Senate Democrats worked through the weekend negotiating to get prescription drug pricing back into the big reconciliation bill for President Joe Biden’s Build Back Better agenda. That bill will contain the “human infrastructure” companion to a roads and bridges bipartisan bill that already passed, including the climate change, education, health, and family support provisions of Biden’s plan. Democrats see this as their primary opportunity to get big things done for the country ahead of next year’s midterms and are using the budget reconciliation process because it is not subject to a filibuster and can be passed with only Democratic votes.

Getting those Democratic votes, however, has been a thing. On the one hand, you have Sen. Joe Manchin, the West Virginia Democrat who is so obsessed with the idea that working-class people are lazy and undeserving and looking for handouts from the government that, in talking to fellow lawmakers and staff, he “said a paid-leave program could invite fraud, likening it to those who tried to collect unemployment even when they were not eligible.” To keep people from faking the need for family and medical leave, Manchin “asked about work requirements, even though employment is a condition for one to take leave in the first place, some of the people said.”

No, that makes no sense, and it just a reflection of how out-of-his-depth the man is on any issue other than coal. Nonetheless, Senate Democrats are having to bow and scrape to him to get his vote. They’re still working on him to try to salvage paid leave, one of the elements jettisoned last week.

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The other problem vote in the Senate has been Sen. Kyrsten Sinema, who probably has a much better grasp on how stuff actually works, but still wants to work it to maximize her own agenda. Whatever that is. The positive news out of the weekend is that she has engaged with fellow lawmakers in both the House and Senate—something she’s refused to do for months—on getting some kind of prescription drug pricing back into the bill. It was also missing from the framework President Biden released last Thursday, when he and Speaker Nancy Pelosi attempted to shoehorn House Democrats into a vote on the bipartisan infrastructure bill that same day. That failure, in which progressive Democrats en masse said “no,” might have helped Sinema come around to the idea that, yes, she really does have to help get Build Back Better passed if she wants the hard infrastructure bill she’s invested in to pass as well. Maybe.

This isn’t going to be what Democrats have been pushing for years—full authorization for Medicare to negotiate all drug prices, following the precedent of the veteran’s health system. It’s more likely to be a set of prescription drugs—namely those administered by providers, like IV drugs and vaccinations—than the prescription drugs people take at home every day. But there has been discussion of setting caps on how much Medicare enrollees and people in employer-sponsored health plans have to pay out-of-pocket for drugs.

On the Senate side, Sinema and Democrats Sens. Chris Murphy of Connecticut, Elizabeth Warren of Massachusetts, Amy Klobuchar of Minnesota, Mark Kelly of Arizona, and Vermont Independent Bernie Sanders began talks Thursday that lasted into the weekend. They’ve been working with the White House and Energy and Commerce Chair Frank Pallone as well as Speaker Pelosi. Sinema herself has been in talks with Pelosi.

Pallone was optimistic on Thursday: “I think we’re very close to a deal. We’re going to get a bill that has negotiated prices and that’s going to make a difference in terms of people being able to afford their drugs.” On Sunday, Sanders told CNN that work had gone on Friday and Saturday and, “as soon as I leave the studio, I’m going to be going back home to get on the phone to make sure that we have it.” Sanders is also still working to restore his plan for Medicare expansion to include vision and dental coverage, along with hearing. As of Thursday, hearing was the only surviving element of that expansion. With some kind of drug pricing plan, though, enough could be saved to potentially add those programs back in.

“We’re in this fight because too many Americans are struggling to access their medications,” said U.S. Klobuchar told advocates in a roundtable discussion Saturday. “It is more expensive to get prescription drugs in our country than in other countries, even though it’s our taxpayers that have funded so much of the research in the past five years. That’s why I have been spearheading these efforts to let Medicare negotiate since I’ve been in the Senate. It’s common-sense policy.”

That call included patient advocates like Mindy Salango, a Type 1 Diabetic from West Virginia, who said Medicare price negotiation “is going to save lives.” Her message was geared to her senator, Joe Manchin. “That is what is at stake not only in West Virginia, but across the country. We need our leaders to step up and speak for us and help us because that’s what we voted for. That’s what we put them in office for. And this bill is completely across party lines. Diabetes didn’t ask me if I was a liberal or conservative when it decided to enter my life. People want it, we need it.”

Whether prescription drug pricing gets back in the bill remains uncertain, because Sen. Bob Menendez, a New Jersey Democrat, has also been fighting efforts by House Democrats to include Medicare negotiation. But if Sinema and Manchin sign on—not a guarantee at this point, but a possibility—Menendez will likely not be comfortable standing alone in opposition.

As for Manchin, Axios reports that he “stayed in contact with the speaker’s office, and Rep. Pramila Jayapal (D-Wash.), chair of the Congressional Progressive Caucus, to explain his concerns.” Manchin talking to them is at least something. We’ll see.

Meanwhile, the CPC continues to hold firm on sticking to the months-long agreement for linkage of the two bills. They won’t vote on the bipartisan infrastructure bill until there’s also a vote on the reconciliation bill. That could still happen this week.

The House Rules Committee had intended to meet Monday to mark up the reconciliation bill, the first step in sending it to the floor, but has postponed that hearing. A leadership aide said that the House is still planning to vote “as early as possible this week.”