WASHINGTON (AP) — Longtime advocates of paid family and medical leave are scrambling to make sure that the long-sought Democratic priority remains in a massive social and environmental spending bill after House Speaker Nancy Pelosi revived it. But the outcome will likely come down to the support of one man.

The one Senate Democrat who opposes including paid leave in the spending package is West Virginia Sen. Joe Manchin, a moderate who has used his leverage in the evenly divided chamber to whittle away some of his party's most ambitious and costly policy proposals.

Through cable TV ads, personal conversations on the Senate floor — even a banner at a West Virginia University football game — Democrats and advocates are pleading with Manchin to support the paid leave proposal in the broader $1.85 trillion legislation. The effort is expected to intensify over the coming days and weeks as the House prepares to pass the massive bill and send it to the Senate.

"For the sake of West Virginia's workers, the businesses that employ them, and an economic recovery that works for everyone, Sen. Joe Manchin must prioritize passing paid family and medical leave now," says one radio ad playing in the state.

There are no signs yet that the efforts have worked on Manchin, and many Democrats are openly pessimistic about the paid leave proposal's fate. On Sunday, Treasury Secretary Janet Yellen said on CBS' "Face the Nation" that while she and President Joe Biden support the provision, "it looks like it won't be a component of this package."

The paid leave proposal would bring the United States more in line with the rest of the world's wealthiest countries, all of which offer some sort of paid time off. It would give new parents, caregivers and those recovering from major illness four weeks of leave — down from the 12 weeks Biden originally proposed. It would temporarily pay workers a portion of their wages, with the lowest-income earners earning the highest percentage of their pay.

Manchin hasn't outright opposed the proposed program. But he has made clear that he thinks it shouldn't be part of the larger bill, citing concerns about its almost $200 billion cost and worries about the long-term solvency of Social Security. The program's advocates argue that it would actually increase participants' return to work and help boost the economy.

Khrista Messinger, a recovering opioid addict in West Virginia who used paid leave to get help when she suffered a relapse during the pandemic, has been emailing Manchin and traveled to Washington to lobby him.

Messinger, who works for the city of Charleston, said in an interview that she probably would not be alive today if her job hadn't afforded her the paid time off to get better last year. In one email to Manchin, she noted that more than 1,200 West Virginians died of overdoses in 2020. She asked him to remember that number "as you are making excuses for long term sustainability of this bill."

Dawn Huckelbridge of Paid Leave for All, a group that is helping organize advocacy efforts in Manchin's home state, says supporters are doing "everything we can" to make sure the Senate bill keeps the policy if the House passes it. After a decadeslong push, "this can't be the year that we fail at this," Huckelbridge says.

House Democrats, backed by Biden, took the paid leave language out of the spending package in late October after Manchin's opposition became clear. But Pelosi put it back in the bill on Nov. 3, the day after Democrats faced losses in elections in Virginia and other states. Her move was a nod to Democratic concerns that the party risked alienating voters by not following through with their bold campaign promises.

Pelosi said her message to Manchin is that "with all the respect in the world for the point of view he represents," she disagrees with him.

Paid leave "fits very comfortably with child care, health care, home care" and other priorities included in the bill, "and it has the full support of our caucus," she said.

After its revival, Manchin insisted that "I'm all for paid leave" but suggested it should be done outside of the current spending bill, in separate bipartisan legislation.

Fellow Democrats have pushed Manchin for weeks to try to get him on board, especially Sens. Patty Murray of Washington and Kirsten Gillibrand of New York. Gillibrand said in October that in multiple conversations the West Virginian had asked "good questions" but was "not focused on specifics" of the proposal.

Murray was more blunt, telling reporters that "we are not going to allow one man to tell all of the women in this country that they can't have paid leave."

Advocates hope that the paid leave proposal is stronger now that it died and was brought back to life by Pelosi.

"This is the one proposal that could touch every household in America," says Vicki Shabo of New America, a left-leaning think tank. "The fact that it was taken out and put back in just demonstrates that there is a real hunger and a need for paid leave."

In West Virginia, supporters hope to gain Manchin's attention and the attention of his constituents, who live in one of the country's poorest states.

The banner at the Oct. 30 Mountaineers football game read "Paid Leave for All." It's unclear whether Manchin, a former quarterback for the team, saw it.

"@WVUfootball was an underdog today but got the come from behind victory in the 4th quarter," tweeted the group Paid Leave Works for West Virginia, a coalition of small businesses and non-profits in the state that is pushing for the policy. "@paidleaveWV is going to leave it all on the field too."

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AP Congressional Correspondent Lisa Mascaro contributed to this report.