THE STATE OF RECONCILIATION — West Virginia Democrat Joe Manchin — who met with President Joe Biden this weekend to settle some agenda priorities — doesn’t seem to be settled on the path forward. A deal is unlikely this week. The moderate Democratic senator told POLITICO’s Burgess Everett on Monday that, even if the text is complete, “that would be difficult from the Senate side because we have an awful lot of text to go through.” What is the holdup? “I'm concerned about an awful lot of things,” Manchin said. “It expands programs ... we don't even have programs we’re paying for properly.” (A major contention point, of course, has been expanding Medicare for dental, vision and hearing coverage to the tune of $350 million.) Speaking of that: “My big concern right now is the 2026 deadline, when we hit insolvency,” the senator said. “You've got to stabilize that first before you look at basically expansion, so if you're not being fiscally responsible that's really concerning.” Parting words: “I've always said that I believe that government should be your best partner, but it shouldn't be your provider. We have a moral obligation to provide those who have incapacity … physical or mental, but everyone else should be able to help and chip in,” Manchin told Burgess. Manchin also underscored Monday that his budget line is $1.5 trillion. It’s a stark reminder that the Senate is at a standstill … and Biden’s Sunday breakfast meeting with Manchin and Majority Leader Chuck Schumer may not have broken ground. MEDICAID BACKERS CONFRONT MANCHIN — It’s drama: Congress’ two biggest champions of closing the Medicaid gap cornered Manchin on Monday after he came out in opposition to the provision and lobbied him to preserve at least short-term coverage for people in the 12 remaining holdout states. House Majority Whip Jim Clyburn (D-S.C.) and Sen. Raphael Warnock (D-Ga.) confirmed to reporters they spoke to Manchin, Alice reports. “I wasn’t making any arguments with him,; I just laid out what I think we ought to do,” Clyburn said. Warnock said he and other members are fighting to protect the provision from being dropped from the bill and bristled at Manchin’s assertion that a federal expansion wouldn’t be “fair” to states that expanded years ago. “What’s unfair is for the people of Georgia to be paying for health care in other states that they have no access to because they woke up in the wrong state,” Warnock told Alice. “People are literally dying because they can’t get health care.” The Georgia senator said Manchin seemed receptive to his arguments, but no agreement has yet been reached. SPOTTED: TOP HEALTH STAFF CONVENE FOR GOTTLIEB — Health experts, lobbyists and officials came together Monday night for a Friends of Cancer Research event featuring former FDA commissioner Scott Gottlieb in conversation with anoher FDA veteran, Mark McClellan, to discuss Gottlieb's new book, Uncontrolled Spread. In attendance: Sen. Roy Blunt (R-Mo.), former Trump adviser Joe Grogan, Council on Foreign Relations fellow Luciana Borio, former HHS deputy chief of staff Judy Stecker, and a slew of former FDA officials including past commissioner Peggy Hamburg, former deputy commissioner Anna Abram, former chief of staff Keagan Lenihan, former principle associate commissioner for policy Lowell Schiller and Gottlieb's former chief of staff Lauren Silvis. BIO's Michelle McMurry-Heath, once floated for the commissioner post, also attended. BIDEN LOOSENS LIMITS FOR VAXXED INTERNATIONAL TRAVELERS — The administration Monday rolled out new details on U.S. travel rules for foreign nationals, which take effect in early November. Starting Nov. 8, fully vaccinated adults must show proof of vaccination before boarding their flight to travel to the U.S. Only vaccines approved or authorized by either the FDA or the World Health Organization will be accepted, according to senior administration officials. Fully vaccinated individuals will also have to show proof of a negative Covid-19 test taken within three days before boarding an airplane, POLITICO’s Nick Niedzwiadek reports. That documentation will fall to airline companies. “We have taken the deliberate step of taking this time to ensure implementation goes as smooth as possible, particularly with something this wide-ranging,” a senior administration official told reporters Monday. The rules include an exemption for people hailing from a country with limited vaccine availability, which the Biden administration is defining as a place where less than 10 percent of the population is fully vaccinated “due to lack of vaccines,” according to one senior administration official. Roughly 50 countries fall under that threshold, including much of Africa.
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