Passage of the proposal, Stevens said, would give her some freedom and a chance to do more than just sit home watching TV. They never go out to eat or on vacation, and she sometimes goes without cholesterol drugs to cut costs. She is a retired nurse and her husband a retired accountant, and said that while they aren’t poor, drug costs leave them little wiggle room. Pamela Stevens, a 69-year-old from San Dimas, California, pays around $10,000 annually in out-of-pocket expenses for drugs to treat diabetes and other conditions. Sinema backed Manchin last year in insisting on making the legislation less expensive but objected to proposals to raise tax rates. Kyrsten Sinema, D-Ariz., was still reviewing the agreement, a spokeswoman said. Several prongs of the proposal have the potential to bring relief to millions of people: She is afraid the powerful pharmaceutical lobby might still thwart the plan, but said, “If this goes through, it will help a lot of people.”

“We worry constantly, ‘Will we be able to afford this?’” said Becky Miller, a 67-year-old retired teacher from Bradenton, Florida, who spends thousands of dollars each year for drugs to treat epilepsy, heart problems and an inflammatory disease that affects her spine. But Manchin’s backing brought new optimism to many who have lobbied and prayed for relief. Some of the issues addressed in the deal have been talked about for decades and proved elusive. Joe Manchin includes landmark provisions that could help senior citizens, including a cap on out-of-pocket Medicare drug costs and a requirement that the government negotiate prices on some high-cost drugs. The health care and climate agreement struck by Senate Majority Leader Chuck Schumer and Democratic Sen.

A deal on Capitol Hill that could cut prescription drug costs for millions of Medicare beneficiaries was cautiously cheered by older Americans and their advocates Thursday even as many worried it might never come to fruition.

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