Speaker of the House Nancy Pelosi is moving full steam ahead on getting the budget reconciliation bill that comprises President Joe Biden’s Build Back Better plan to the floor, despite the demands from Sen. Joe Manchin to delay, delay, delay. What’s more, the House will include a provision that Manchin opposes: four weeks of paid family leave.

“It had been my intention throughout this process to put on the House Floor and pass a bill that would pass the Senate in the same form,”  Pelosi informed her colleagues in a letter Wednesday morning. She announced that the text of the legislation would go to the Rules committee Wednesday. “Because I have been informed by a Senator of opposition to a few of the priorities contained in our bill and because we must have legislation agreed to by the House and the Senate in the final version of the Build Back Better Act that we will send to the President’s desk, we must strive to find common ground in the legislation.”

That said, the opposition of one Senator isn’t stopping the House. “As we are reviewing priorities and at the urging of many Members of the Caucus, I have asked the Ways and Means Committee for its legislation for Paid Family and Medical Leave to be included in this morning’s hearing,” she said. “Chairman Richie Neal and the Committee staff have worked on this priority for a long time and were ready.”

The provision for leave would “cover all workers wishing to take paid time off to deal with the birth of a newborn, care for a family member, or deal with an illness or injury, among other things, beginning in 2024,” a source told Politico.

Predictably, that one senator is balking. Manchin says he had “no idea” the provision was still alive and—here’s the big joke—he’s been talking to Republicans who want to do it in a bipartisan way. Right. Like that old Republican idea from Sen. Marco Rubio to steal from Social Security to “pay” workers for leave. No word on whether Manchin still thinks you can slap work requirements on people taking leave from . . . work.

Senate Democrats are working to isolate Manchin on this one. Sen. Patty Murray—who has been incensed at Manchin for blocking this—immediately responded to the news that Pelosi is including paid leave, saying, “I am incredibly relieved to see Speaker Pelosi include paid leave in the House Build Back Better Act. This is a key step forward—but we are not done fighting to get this across the finish line.” Senate Finance Chair Ron Wyden backed her up, saying he would “pull out all the stops for paid family leave.”

Before celebrating too much on this one, note this from Rep. Richie Neal: “The Ways and Means Committee crafted a policy that will finally give workers and their families the peace of mind of knowing that when disaster strikes, they can rely on paid leave to avoid total crisis. We do this responsibly, fully paying for the means-tested program. [emphasis added]” So actually not “all workers” after all. Maybe they’ll get Manchin. He loves him some means-testing. Still, four weeks of leave for lower-income people isn’t 12 weeks for literally everyone, but it’s also better than a bucket of warm spit.

There’s also a small—but at the same time huge—win in the prescription drug price reform agreement the House finally settled on with Sen. Kyrsten Sinema. It will cap the cost of insulin at $35 a month, for insured people, anyway. That’s for everyone with insurance, both Medicare and private insurance. It would take effect immediately.

In addition to that, it includes a cap on out-of-pocket prescription drug costs for Medicare enrollees at $2,000/year, with a smoothing proposal that will allow seniors to pay a monthly installment to cover those costs, rather than each time they fill their prescriptions. As for drug price negotiation for Medicare, it’s not what Biden proposed or what the majority of people and Democrats in Congress wanted, but it’s what the saboteurs would agree to: Medicare being able to negotiate drugs in Part B (drugs administered by providers, like in hospital or outpatient settings) and in Part D (drugs purchased directly by consumers), but only for drugs that are outside the “exclusivity” period—the time in which the Food and Drug Administration allows them a monopoly on the drug. That means some of the most expensive drugs can’t be negotiated. So-called “orphan drugs,” those generally very expensive drugs used to treat rare illnesses are also exempted from negotiations, as are drugs from “small biotech” firms, though their exemption expires in 2028.

It’s a start on drug price negotiating, a foot in the door. It’s enough to bring advocates along. “This means so much for people,” Anne Shoup, a senior adviser with Protect Our Care, told Greg Sargent and Paul Waldman at the Washington Post. “It’s a kitchen table issue. It affects their health and well-being—their ability to live their lives.”

AARP added a strong endorsement. “AARP applauds the leaders in Congress who have fought so hard for so long to get to this point,” CEO Jo Ann Jenkins said. “Now it is time for Congress to deliver for their constituents by passing a Build Back Better Act that will truly lower their prescription drug prices and improve the lives of millions of older Americans. We will not stop until the President signs legislation that lowers drug prices.”

There seems to be an agreed-upon strategy now for dealing with Manchin. Sinema was brought along through both prescription drug and tax provisions where she got a lot of say, so now Manchin stands alone. It looks like Democrats are ready to just, en masse, call his bluff and force him to be all by his lonesome, tanking his president’s agenda.