In Washington, Congress faces a daunting to-do list this week before lawmakers leave for the holidays, including an expected vote to increase the nation’s borrowing limit and approve a massive defense spending bill.

But the push to pass President Joe Biden’s sweeping social safety net and climate legislation by Christmas faces a familiar obstacle – a fellow Democrat.

What You Need To Know

  • Advocates say the provisions addressing the rising costs of prescription drugs in the Build Back Better Act warrant the immediate passge of the are massive spending bill

  • Iesa Meza, a legal assistant living with diabetes, says the bill's proposal to cap insulin copays is invaluable

  • "The most vulnerable people in our society... are people who don't have insurance," said Clayton McCook, a father of two in Oklahoma also calling on Democrats to expand coverage to the uninsured

  • Advocates say The Lower Costs, More Cures Act reintroduced by Sens. Mike Crapo, R-Idaho, and Richard Burr, R-N.C., also fails to address the costs of the uninsured

Sen. Joe Manchin, D-W.Va., is skeptical about the urgency of passing the president’s climate and social safety net spending plan before the new year.

“I know people have been in a hurry for a long time to do something but basically we’re seeing stuff unfold that allows us to prepare better,” Manchin told the press on Monday ahead of a phone call with the president. “And that’s what we should do.”

The senator discussed a path forward for the legislation with Biden during their call. But Manchin says he’s still concerned the nearly $2 trillion measure would make inflation worse. Some advocates say Americans cannot wait for it’s passage any longer.

“Stop talking about it and putting out press releases and pass some substantive legislation that addresses the problem,” said Clayton McCook, an Oklahoma father of two. "It is time for action."

McCook’s has been wrestling with the rising the cost of insulin for his oldest daughter. He says it doubled from what they first paid several years ago.

“An initial order of insulin for my daughter, which typically lasts four to five months, cost me over $2,000 out of pocket,” he says. “And that's for six vials of insulin.”

The Build Back Better Act has a provision that would cap the price of the drug at $35 for insured patients. He says that measure is invaluable even if it’s not perfect.

“It's not enough. And the reason I say it's not enough is because that copay cap specifically applies to those who have insurance,” said McCook. “And the most vulnerable people in our society when when we're talking about health care, and prescription drugs are people who don't have insurance.”

Advocates say the bill’s failure to address the drug costs paid by the uninsured is also a shortcoming of dueling legislation by Republicans aimed at curbing rising drug prices. Iesha Meza, a legal assistant in Arizona living with diabetes, says she fell into a coma several years ago because she was uninsured and had to ration her insulin she could afford.

“Now, I can reflect back on it and be like, ‘that was a very heavy time,’” said Meza. “And that's a huge burden for someone at [age] 23 or 25 to deal with.”

She met with Biden at the White House last week to share her story and advocate for the uninsured.

“He, Mr. President, is trying find ways around those issues,” she said. “He mentioned that with the [Build Back Better Act], [the uninsured] could enroll in Obamacare. And through that, they could have insurance and also have the $35 cap on insulin.”

Her advocacy work didn’t stop there. Meza spoke during a press conference at the White House after meeting the president and urged Senate Democrats to get to work. She says millions are waiting for them.

“I would urge them to stop procrastinating and to think about their constituents,” she said.

The Senate doesn’t have much time to act. It’s supposed to adjourn at the end of the week for Christmas.