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Democrats are close to making good on long-held promises to lower prescription drug costs and make health care more affordable. The rub? Voters won’t feel much of it until after the 2022 elections. ... Indeed, by the time voters see their impact, the election will have passed. Penalties on drugmakers that hike prices faster than inflation and a new $35-per-month cap on insulin won’t begin until 2023. A $2,000 cap for all out-of-pocket drug spending for seniors won’t be implemented until 2024, and the lower prices Medicare will negotiate with pharmaceutical companies for some of the most expensive drugs won’t be available until 2025 — with a full phase-in coming in 2028. Coverage of hearing aides under Medicare, another one of the provisions most popular with voters, will similarly not begin until 2024. (Miranda Ollstein and Barrón-López, 11/15)

House Democrats will return this week with the goal of passing a roughly $2 trillion social spending and climate package. To be successful, members must remain united amid intraparty friction that some lawmakers say is the worst they have seen in their time in Congress. The tensions ramped up this month as Democrats worked to pass their  separate $1 trillion bipartisan infrastructure bill, which has been linked for months with the larger spending package. Party leaders emerged victorious on the infrastructure bill, but only because 13 Republicans brought it over the finish line after six Democrats voted no, protesting a decision to delay the social spending bill. (Andrews, Collins and Parti, 11/14)

Longtime advocates of paid family and medical leave are scrambling to make sure that the long-sought Democratic priority remains in a massive social and environmental spending bill after House Speaker Nancy Pelosi revived it. But the outcome will likely come down to the support of one man. The one Senate Democrat who opposes including paid leave in the spending package is West Virginia Sen. Joe Manchin, a moderate who has used his leverage in the evenly divided chamber to whittle away some of his party’s most ambitious and costly policy proposals. (Clare Jalonick, 11/15)

A coalition of conservative religious groups is waging an intensive lobbying effort to remove a nondiscrimination provision from President Biden’s ambitious prekindergarten and child care plans, fearing it would disqualify their programs from receiving a huge new infusion of federal money. The fight could have major consequences for a central component of Mr. Biden’s $1.85 trillion social policy bill, which the House is to consider as soon as this week. It could go a long way toward determining which programs, neighborhoods and families can benefit from the landmark early-childhood benefits established in the legislation, given that child care centers and preschools affiliated with religious organizations make up a substantial share of those offered in the United States — serving as many as 53 percent of families, according to a survey last year by the Bipartisan Policy Center. (Broadwater, 11/14)

President Joe Biden named former New Orleans Mayor Mitch Landrieu to oversee implementation of the $1 trillion infrastructure plan, the White House said on Sunday. Landrieu, also a Democratic former Louisiana lieutenant governor, led New Orleans from 2010 to 2018. He played a key role in helping the city rebound from the devastating Hurricane Katrina in 2005. Biden, who will sign the infrastructure bill into law on Monday, named Landrieu senior adviser responsible for coordinating implementation of the bill that includes big jumps in spending on roads, bridges, rail, airports, transit, ports, broadband internet and removing lead pipes. (Holland and Shepardson, 11/15)