随着乔·曼钦(Joe Manchin)在分歧严重的参议院获得批准，总统乔·拜登(Joe Biden)和民主党领导人已准备好在下次休会前推动众议院通过一项以医疗保健为重点的精简支出法案。但是并不是所有的参议院民主党人都这么认为。

伯尼·桑德斯参议员去世后的第二天。,严厉批评西弗吉尼亚州参议员曼钦参议院财政委员会主席罗恩·怀登拒绝了民主党关于气候和税收的一揽子计划，称他在破坏“后代”，他表示，他希望为将气候政策纳入即将到来的和解计划留有余地，包括曼钦搁置的政策。

“关于清洁能源的对话必须继续保留我们前进的选择，”俄勒冈州的怀登在周一的一份声明中说。“虽然我强烈支持拜登总统采取额外的行政措施，但我们知道共和党将会提起大量诉讼。立法仍然是最好的选择。气候危机是我们这个时代的问题，我们应该保留我们的选择。”

怀登没有威胁要撤销对医疗保健法案的支持，似乎没有其他参议院民主党人划出这样的红线。但鉴于共和党的反对，进展需要在50-50的议院中达成共识:民主党人打算使用只需要简单多数的快速通道预算工具来通过他们的和解法案。

曼钦已经同意允许医疗保险计划谈判处方药价格，这可能为联邦政府节省2880亿美元，并降低老年人的费用，此外，疫情时代对在患者保护与平价医疗法案登记的低收入美国人的保费补贴将延长两年。

但是，由于担心关于历史高通胀曼钦上周在民主党立法中大力抨击气候提案。他当时说，他需要看到7月份的通胀数据，然后才能决定如何处理气候因素。

至于桑德斯对他“故意破坏总统议程”的批评，曼钦周一被要求做出回应，他说:“我已经这样做了很长时间。人们有时会说一些他们可能并不打算说的话，我不会往心里去。”

伊利诺伊州民主党党鞭迪克·德宾周一表示，如果纽约州多数党领袖查克·舒默(Chuck Schumer)在与曼钦的讨论中能够做到最好，他可以“接受”推进一项只专注于医疗保健的法案。

“我最大的挫折是我认为乔应该在很久以前就明确他的立场，”德宾说，呼应桑德斯周日的批评，“问题是我们继续和曼钦说话，好像他是认真的。他不是。”

“如果他们做处方药，给他们信用，这是一个好问题，”德宾周一说。"但是我们已经在谈判中浪费了很多时间."

其他民主党人周一也表示，他们准备接受不包括气候和支出的一揽子计划。

“我们有一个五五开的参议院。事实就是如此，”夏威夷参议员Mazie Hirono说。“对我来说，任何改进都是需要考虑的。”

共和党人不太可能为民主党叛逃者收拾残局。在周一的发言中，共和党少数党领袖米奇·麦康奈尔称这项以医疗保健为重点的计划是“鲁莽的”

“华盛顿民主党人正在努力寻找一种方法，在美国患者和他们所依赖的治疗之间建立更多的官僚主义。他们想在美国创新者和衰弱性疾病的新疗法之间设置社会主义价格控制，”麦康奈尔周一表示。“在一党民主控制政府的情况下，他们可能会逍遥法外，但我们的同事需要三思。”

Sen. Joe Manchin and Sen. Shelley Moore Capito pay respects to Hershel Woodrow Woody Williams in the United States Capitol Rotunda during a Congressional tribute ceremony on July 14, 2022, in Washington, D.C.

汤姆威廉姆斯，通过盖蒂图片社池

曼钦:“我没有走开”

曼钦在周一与记者的谈话中坚称，他将继续就气候和其他条款进行谈判。他坚定地等待7月份的通胀数据，然后再继续行动。

“我没有放弃任何事情，通货膨胀是我最大的担忧，”他说。“我不知道明天会带来什么。”

但民主党人的时间不多了，他们知道在8月份长达一个月的休会后，他们必须在10月1日之前专注于为政府提供资金，这几乎总是一个令人担忧的过程。11月的中期选举紧随其后。

随着许多州的医疗保险费在8月份确定，疫情时代的ACA补贴将在年底到期，如果成本在通货膨胀的痛苦下在中期选举之前飙升，民主党人可能会面临愤怒的选民，因为国会的控制权岌岌可危。

周五，拜登支持推进医疗保健法案，同时承诺在气候问题上采取行政措施。

总统说:“经过几十年强大的特殊利益集团的激烈反对，民主党人已经走到一起，击退了制药行业，并准备给予医疗保险公司谈判降低药品价格的权力，并防止患者保护与平价医疗法案下覆盖的数百万家庭的医疗保险费上涨。”"如果国会采取这一行动，全国的家庭都会睡得更安稳。"

Manchin shrugs off Sanders' climate rebuke as Dems make peace with health care-only bill

With Joe Manchin's stamp of approval in the closely divided Senate, President Joe Biden and Democratic Party leadersare ready for the chamber to move forward before the next recess on a slimmed-down spending bill that focuses on health care. But not all Senate Democrats feel the same.

One day after Sen. Bernie Sanders, I-Vt.,castigated West Virginia's Sen. Manchinfor rejecting the Democratic package on climate and taxes -- saying he was sabotaging "future generations" -- Senate Finance Committee Chair Ron Wyden said he wants to keep a path open for adding climate policies into the upcoming reconciliation package, including those put on ice by Manchin.

"Conversations on clean energy must continue to preserve our options to move forward," Wyden, of Oregon, said in a statement on Monday. "While I strongly support additional executive action by President Biden, we know a flood of Republican lawsuits will follow. Legislation continues to be the best option here. The climate crisis is the issue of our time and we should keep our options open.”

Wyden stopped short of threatening to revoke support for a health care-only bill and no other Senate Democrat appears to have drawn such a red line. But progress requires consensus in the 50-50 chamber, given GOP opposition: Democrats intend to pass their reconciliation bill using a fast-track budget tool that needs only a simple majority.

Manchin has agreed to allow Medicare to negotiate prescription drug prices, potentially saving the federal government $288 billion and bringing down costs for seniors, in addition to a two-year extension of pandemic-era premium subsidies for lower-income Americans enrolled in the Affordable Care Act.

But, citing concernsabout historically high inflation, Manchin last week pumped the breaks on climate proposals in the Democratic legislation. He said then that he needed to see July's inflation data before he could determine how to proceed on the climate component.

As for Sanders' criticism that he was "intentionally sabotaging the president’s agenda," Manchin was asked Monday to respond and said: "I've been at this a long time. People say things some times they might not mean, and I don't take it personally."

Democratic Whip Dick Durbin, of Illinois, said Monday that he can "live with" moving forward on a bill focused only on health care if that's the best that Majority Leader Chuck Schumer, of New York, can achieve in discussions with Manchin.

"My major frustration is I think Joe should have made his position clear a hell of a long time ago," Durbin said, echoing Sanders' criticism Sunday that "the problem was that we continue to talk to Manchin like he was serious. He was not."

"If they do prescription drugs, give them credit, that's a good issue," Durbin said Monday. "But we've spent a lot of time wasted in negotiation."

Other Democrats also signaled Monday that they're prepared to swallow a package that excludes climate and spending.

"We have a 50-50 Senate. It is what it is," Sen. Mazie Hirono of Hawaii said. "Any improvement to me is something to be considered."

It's unlikely Republicans would pick up the slack for Democratic defectors. In floor remarks Monday, Republican Minority Leader Mitch McConnell called the health care-focused plan "reckless."

"Washington Democrats are working right now to find a way to put more bureaucracy between American patients and the treatments they rely on. They want to put socialist price controls between American innovators and new cures for debilitating diseases," McConnell said Monday. "With one-party Democratic control of government they just might get away with it, but our colleagues need to think again."

Manchin: 'I haven't walked away'

Manchin, in conversation with reporters on Monday, insisted he was continuing to negotiate on climate and other provisions. He was firm on waiting for the July inflation numbers before proceeding.

"I haven't walked away from anything, and inflation is my greatest concern," he said. "I don't know what tomorrow brings."

But Democrats are running out of time and know that after the monthlong August recess they must return with a focus on funding the government by Oct. 1, nearly always a fraught process. November's midterm elections come soon after that.

And with both health care premiums in many states set in August and pandemic-era ACA subsidies set to expire by year's end, Democrats could be facing angry voters if costs skyrocket -- amid the pain of inflation -- ahead of the midterms where control of Congress is at stake.

On Friday, Biden backed moving forward with a health care bill while promising executive action on climate.

"After decades of fierce opposition from powerful special interests, Democrats have come together, beaten back the pharmaceutical industry and are prepared to give Medicare the power to negotiate lower drug prices and to prevent an increase in health insurance premiums for millions of families with coverage under the Affordable Care Act," the president said. "Families all over the nation will sleep easier if Congress takes this action."