Welcome to POLITICO’s West Wing Playbook, your guide to the people and power centers in the Biden administration. With help from Lawrence Ukenye.

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When President JOE BIDEN nominated MONICA BERTAGNOLLI to run the National Institutes of Health, it seemed like a choice meant to make everyone happy.

A renowned cancer surgeon, Bertagnolli fulfilled Biden’s personal demand that his next NIH chief come from the oncology world he’s long admired. Bertagnolli had already done a stint atop the government’s National Cancer Institute, where she was well-liked by staff scientists and clinicians. And throughout the broader medical research community, support for her was instant and full-throated.

“We wholeheartedly applaud the announcement from President Biden for this outstanding choice,” KAREN KNUDSEN, the CEO of the American Cancer Society, said in a May statement urging swift confirmation for a pick she called “an exceptional surgical oncologist, innovative scientist and leader with a strong track record of transforming organizations.”

Yet two months later, what many viewed as a slam-dunk selection has become the latest personnel headache for the White House.

Bertagnolli’s candidacy is stalled indefinitely, caught up in a standoff between the administration and Sen. BERNIE SANDERS (I-Vt.) over Biden’s drug pricing agenda.

A second senator, ELIZABETH WARREN (D-Mass.), has made her own demands, pressuring Bertagnolli to sign expanded ethics agreements that include swearing off working for or on behalf of major drug companies for four years after leaving NIH. Bertagnolli has so far resisted over concerns about the scope of those commitments, two people familiar with the matter said.

Biden has been without a permanent NIH director for a year-and-a-half, alarming medical research groups. The logjam has also raised fresh questions about the White House’s personnel operation, and why it didn’t anticipate that its NIH nominee would run into roadblocks.

Sanders, who chairs the Senate committee responsible for vetting Bertagnolli’s candidacy, said in a recent interview that he began warning the administration in January that he wanted more unilateral actions to slash drug prices. Frustrated by the lack of response, he went public in a June interview with The Washington Post, vowing to oppose all health nominees until the White House met his demands.

Despite those running tensions, the White House did not alert Sanders it planned to nominate Bertagnolli before the news broke, said the two people familiar with the matter, who were granted anonymity to describe internal decision making. In the weeks after Bertagnolli’s nomination, some Biden officials also expressed internal optimism that Sanders would grant her a hearing in June, the people said.

No hearing has been held. Instead, Sanders insists he feels no pressure to move on Bertagnolli’s nomination as long his requests remain unmet, telling POLITICO “the public is probably more on my side.”

“What the American people want now is not just another head of an agency,” he said. “They want policies to address the major crises facing this country.”

The impasse is just one of several Biden has encountered with respect to his nominees.

Biden’s pick to run the Labor Department, JULIE SU, has seen her nomination founder for five months amid skepticism from a trio of senators. Nominees for both the Federal Aviation Administration and Federal Communications Commission withdrew this year after it became clear they couldn’t win confirmation. In May alone, Biden lost two judicial nominees. Sen. TOMMY TUBERVILLE (R-Ala.), meanwhile, has singlehandedly halted the promotions of around 250 military officers.

In response to questions about Sanders’ demands, the White House declined to comment on the record.

But a White House official pointed to its passage of the Inflation Reduction Act and said the administration remains committed to getting Bertagnolli confirmed.

“The president shares the Senator’s concerns on drug pricing,” the spokesperson said, calling the IRA “the most consequential law addressing the high cost of prescription drugs.”

The White House also defended its nominations process by noting it’s confirmed more nominees than the Trump administration had to this point in the term, despite holding fewer Senate seats at the beginning of Biden’s presidency.

In Bertagnolli’s case, the fight over her nomination has proved particularly frustrating for Biden officials because it has little to do with her actual qualifications.

Bertagnolli continues to meet with senators in hopes the White House and Sanders resolve their standoff, including a sit down on Tuesday with Warren to discuss her ethics demands. Outside allies have also ramped up their lobbying in recent weeks, sending letters to Sanders and Senate leadership pushing for her confirmation.

But Biden allies dismissed the prospect that the White House would bend to Sanders’ demands just to jumpstart Bertagnolli’s confirmation, arguing that despite what the senator says, there’s little more it can realistically do to make a major dent in drug prices.

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Who was the first president to brew beer at the White House?

(Answer at bottom.)

MEMBERSHIP HAS ITS PRIVILEGES: President Biden heralded the all but certain admission of Sweden to NATO on the first day of the alliance’s annual leaders summit, calling it a “historic moment.” He also cited it as further evidence of how Russian President VLADIMIR PUTIN’s decision to invade Ukraine last year has backfired. But as our JONATHAN LEMIRE reports from Vilnius, Lithuania, Biden and other NATO allies have work to do to placate Ukrainian President VOLODYMYR ZELENSKYY, who blasted the alliance for slow-walking his own country’s NATO membership.

Zelenskyy, who will meet Wednesday with Biden on the summit sidelines, ripped the organization’s unwillingness to clarify a timeline and path for Ukraine’s NATO membership as “unprecedented and absurd.” In its summit communiqué released Tuesday, the 31-member nations declared “Ukraine’s future is in NATO” but that more democratic and security reforms are required first. “We will be in a position to extend an invitation to Ukraine to join the Alliance when Allies agree and conditions are met,” the communiqué stated.

GIVE HIM THAT ROOM SERVICE PASTA AND THE REMOTE: Biden opted not to attend the formal leaders dinner in Vilnius on Tuesday evening. According to print pooler ANDREW RESTUCCIA of the Wall Street Journal, a U.S. official explained that “the president has four full days of official business and is preparing for a big speech tomorrow in addition to another day at the summit.” Biden did make some calls Tuesday evening to federal and state officials responding to floods in Vermont, the White House said.

This has become Biden’s default pattern when attending summits overseas. In May, he left the leaders dinner at the G-7 summit in Hiroshima, Japan, after less than an hour — officials said he was returning to his hotel for a briefing on debt negotiations, even though it was the middle of the night back in Washington. Last November in Bali, Indonesia, he similarly retreated to his hotel suite instead of attending the G-20 leaders dinner.

WHAT THE WHITE HOUSE WANTS YOU TO READ: This piece by the Washington Post’s CATHERINE RAMPELL arguing Biden has reversed Trump-era efforts to curtail the Affordable Care Act. One way the previous administration sought to weaken Obamacare was through promoting short-term “junk” health plans, which often contain loopholes and deny coverage for preexisting conditions, Rampell writes. She notes the White House on Friday announced new rules designed to target these plans as part of its Bidenomics push. Deputy press secretary ANDREW BATES tweeted out Rampell’s piece.

WHAT THE WHITE HOUSE DOESN’T WANT YOU TO READ: This piece in The Atlantic by ANNIE LOWERY warning that America’s debt, now at $32 trillion, could become unsustainable as Medicare and Social Security costs balloon and Congress continues to spend more than the government takes in.

“The aging of the American population — with the falling employment-to-population ratio and greater need for government spending that it entails — is no longer coming. It is here,” Lowery writes. “And at some point, the country will need a budget that accounts for it.” There’s a bit of hedging from quoted economists on the country’s long-term economic forecast. But if you’re the White House, in the midst of revving up a major messaging push around the upsides of “Bidenomics,” you’d just as soon have readers miss this piece.

FIRST IN WEST WING PLAYBOOK: PHIL BREST has been promoted to special assistant to the president and senior counsel in the White House counsel’s office, where he is heading up their judicial nominations efforts, DANIEL LIPPMAN has learned. He replaces PAIGE HERWIG, who is now deputy general counsel for technology and economic growth at the Commerce Department.

— STACY EICHNER is now deputy assistant to the president and deputy director of the White House Office of Presidential Personnel, Lippman has also learned. Eichner, a Biden campaign alum, was promoted after serving as chief of staff of PPO.

MORE PERSONNEL MOVES: ELIANA M. LOYA is now special adviser in the office of the deputy secretary at the Commerce Department. She most recently was special assistant in the office of the executive secretariat at Commerce.

— GINA ABERCROMBIE-WINSTANLEY has been named president of the Middle East Policy Council. She previously was chief diversity, equity and inclusion officer at the State Department and is the former U.S. ambassador to Malta.

— DHS has recently expanded its public affairs team with JACK DAVIES as director of strategic comms and speechwriting, ERIN HEETER and NAREE KETUDAT as assistant press secretaries, GRANT HAVER as a social media specialist and DANA GALLAGHER as a press assistant.

VILSACK’S GOT A DEPUTY: The Senate on Tuesday voted 84-8 to confirm XOCHITL TORRES SMALL, a former House member from New Mexico, as the deputy secretary of Agriculture, our GARRETT DOWNS reports for Pro subscribers. The No. 2 position at the Ag Department had been vacant for several months after JEWEL BRONAUGH resigned earlier this year citing family reasons.

HYDROFLUOROCARBONS? DROP EM LIKE BECAUSE IT’S HOT: The Environmental Protection Agency on Tuesday approved a new regulation to reduce the use of hydrofluorocarbons, a powerful greenhouse gas, by 40 percent, our own ALEX GUILLÉN reports. The new rule is part of the agency’s congressional mandate to limit consumption of the refrigerant by 85 percent by 2036.

FINDING A DEAL: The White House is working on an agreement to normalize ties with Israel and Saudi Arabia, Axios’ BARAK RAVID reports. Although Biden told CNN’s FAREED ZAKARIA on Friday both sides are “a long way” from reaching a deal, senior White House adviser AMOS HOCHSTEIN traveled to Jerusalem on Tuesday to meet with Israeli Prime Minister BENJAMIN NETANYAHU amid tensions near the Israeli-Lebanese border.

How MTG’s district became Biden’s climate poster child (POLITICO’s E&E News’ Robin Bravender)

Ukrainian pilots’ F-16 training to start in August, officials say (Reuters’ Niklas Pollard and Justyna Pawlak)

Et Tu, Megadonor? (Slate’s Alexander Sammon)

When she’s not working in the Department of Treasury as deputy assistant secretary for public affairs, KRISTIN LYNCH enjoys creative writing. She describes most of her stories as “campy, lighthearted comedies.” “Kermit,” for example, is about a young queer woman helped by a French frog named Pierre, according to a copy of the play.

Her short essay, “A Burger and a Salad Are the Best Combo,” was featured as a “Tiny Love Story” in the NYT’s Modern Love column in 2019.

And when asked by West Wing Playbook about how she got into writing fiction, Lynch told our Daniel Lippman said it happened when she talked her way into taking a screenwriting seminar while working on her graduate degree at Princeton University.

BARACK OBAMA. While GEORGE WASHINGTON was distilling spirits at Mount Vernon and THOMAS JEFFERSON was making wine in Monticello, Obama is the first president to brew beer on White House grounds, according to Smithsonian Magazine.

A CALL OUT! Do you think you have a harder trivia question? Send us your best one about the presidents, with a citation or sourcing, and we may feature it!

Edited by Eun Kyung Kim and Sam Stein.