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House Speaker Nancy Pelosi, D-Calif., is seen Wednesday, a day after a tough election night for Democrats.

J. Scott Applewhite/AP

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J. Scott Applewhite/AP

House Speaker Nancy Pelosi, D-Calif., is seen Wednesday, a day after a tough election night for Democrats.

J. Scott Applewhite/AP

Paid family and medical leave is back in Democrats’ sweeping domestic policy bill.

In a letter to colleagues Wednesday, House Speaker Nancy Pelosi, D-Calif., wrote that the inclusion of paid leave is at the urging of members of the House Democratic caucus.

It also comes the morning after Republicans performed strongly in Tuesday’s elections, including among suburban voters and women in places like Virginia.

Pelosi said she expects the changes to the legislation to be debated in the House Rules Committee Wednesday, potentially setting up a vote later this week.

Among the other changes to the bill to be debated is a plan to reduce the cost of prescription drugs for seniors. Democrats announced a deal on that Tuesday.

The legislation that House Democrats are working on has a four-week paid leave program. It would include all leave types and not just be for new parents, start in 2024, and be permanent.

The price tag would be around $200 billion, a source familiar with the legislation tells NPR.

Manchin’s position

Pelosi had hoped to craft a spending bill that would pass the Senate unchanged, but centrist Joe Manchin, a Democrat from West Virginia, had opposed inclusion of paid leave in the so-called Build Back Better bill, and it was taken out.

Given his opposition to the measure, it is unclear that it would pass the Senate. Pelosi acknowledged the difficult road ahead for this priority.

“Because I have been informed by a Senator of opposition to a few of the priorities contained in our bill and because we must have legislation agreed to by the House and the Senate in the final version of the Build Back Better Act that we will send to the President’s desk, we must strive to find common ground in the legislation,” she said.

Manchin told reporters Wednesday that he’s “all for paid leave. I’m just not for unpaid leave.”

He’s been concerned that revenues raised through the bill would not fully pay for all the programs in it. Throughout the negotiations on President Biden’s agenda, he’s been calling for a fiscally responsible bill that does not add to the nation’s debt.

On paid family leave, Manchin said Congress should be working in a bipartisan way on the issue and that he’s been talking to Republicans “who want to work with us.”

NPR’s Kelsey Snell contributed to this report.

This story originally appeared on the Morning Edition live blog.