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Mr. Boehner and his leadership team have been slowly building support for the fast-track bill. But in recent days Mrs. Pelosi and other Democrats have balked at a provision in the Senate bill that pays for the workers’ aid program with cuts to Medicare providers. The fast-track bill and the trade adjustment assistance had been combined in the Senate in a delicate compromise designed to win over a bloc of Democrats. The prospect of cuts to Medicare has left many House Democrats unwilling to vote for the Senate-passed bill. The Republican leadership has offered to fix the problem by paying for the program with another source of money. But even then, Democrats have indicated they might balk because the fix would be made through a separate piece of legislation. Democrats don’t want to be on the record in support of a cut to Medicare even if they have assurances those cuts won’t take hold and will be replaced by cuts contained in another bill. (Hughes and Stanley-Becker, 6/10)

GOP leaders hoped to allay Democratic concerns about a minor Medicare provision in the sweeping legislation, but the issue remained unsettled after two closed-door party caucuses Wednesday morning. ... Opponents kicked off their final push to defeat Obama’s top remaining legislative priority by latching onto a relatively small cut in Medicare that was meant to offset increased funding for worker training. ... Boehner and Ryan, chairman of the Ways and Means Committee, do not want to alter the delicately balanced TPA-TAA package because that would require sending it back to the Senate for another vote and potentially several more weeks of debate there. They worked to avert this issue by advancing a separate piece of legislation that would replace the roughly $900 million cut in Medicare, slated for 2024, with some stricter enforcement of tax laws. (Kane and Nakamura, 6/10)

A separate bill, on customs and trade law enforcement, would move in concert with those two as a catchall for pet provisions, from language to crack down on international currency manipulation to measures to speed responses to countries that export products to the United States at prices below their cost of their production. That plan has become mired in controversy. Aid in the trade adjustment assistance bill is paid for with a slight tweak to Medicare financing, a provision that caused no problems in the Senate. But in the House, it has enraged Democrats, who accuse pro-trade forces of trying to harm the elderly. Republicans responded with a complicated solution. (Weisman, 6/10)

House Minority Leader Nancy Pelosi had already delivered the message to Speaker John Boehner: Democrats could not support Medicare cuts to pay for a job-training program that is critical to pass fast-track trade authority for President Barack Obama. But it was her good friend, Connecticut Rep. Rosa DeLauro, who offered the blunt political message to Democratic lawmakers in a closed meeting Wednesday: If you vote to cut Medicare, you could soon find yourself out of a job. (Sherman, Bresnahan and French, 6/10)

Beyond the trade bill, Ryan’s ideas for replacing Obama’s signature health care law, rewriting the tax code and overhauling the welfare system will have to wait for a new president, he says. (Kellman, 6/11)

Facing resistance from Pacific trading partners, the Obama administration is no longer demanding protection for pharmaceutical prices under the 12-nation Trans-Pacific Partnership, according to a newly leaked section of the proposed trade accord. But American negotiators are still pressing participating governments to open the process that sets reimbursement rates for drugs and medical devices. Public health professionals, generic-drug makers and activists opposed to the trade deal, which is still being negotiated, contend that it will empower big pharmaceutical firms to command higher reimbursement rates in the United States and abroad, at the expense of consumers. (Weisman, 6/10)