Manchin plays spoil­er again, but drug pric­ing re­forms re­main on the ta­ble

West Vir­ginia De­mo­c­rat Sen. Joe Manchin has made loud and clear how much his sin­gle vote mat­ters for the Sen­ate Dems, and their even 50-50 split with Re­pub­li­cans, once again lay­ing guardrails around a rec­on­cil­i­a­tion pack­age that could pass with that sim­ple ma­jor­i­ty — thanks to VP Ka­mala Har­ris.

But for the for­mer My­lan CEO’s fa­ther, Manchin’s al­ready forged an agree­ment on drug pric­ing re­forms, which his daugh­ter’s for­mer in­dus­try group of­fi­cial­ly op­pos­es. The CBO has since pro­ject­ed the new ne­go­ti­a­tions will save the fed­er­al gov­ern­ment $288 bil­lion through 2031, a far cry from Nan­cy Pelosi’s HR 3, but could re­duce drug­mak­ers’ po­ten­tial out­put of about 1,300 to­tal drug ap­provals over 30 years by about 10 drugs.

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