Even as President Trump has tried to make lowering drug prices a signature policy issue for his administration, Democrats are leveraging the topic on the campaign trail in competitive races.
Taking on pharmaceutical costs has been part of Trump’s plan since his presidential bid in 2016. He initially touted the idea of allowing Medicare to negotiate drug prices. But his blueprint released in May backed away from that promise and Democrats said it fell short of its goal.
Now Democratic hopefuls are including the issue as part of their campaigns in toss-up races around the country.
“I hear over and over and over again from people about their concerns about the costs of living, simply being able to make ends meet at the end of the month,” said Brendan Kelly, a Democrat running in Illinois’s 12th District. Kelly's website boasts that he was the first state’s attorney in Illinois to file suit against drug manufacturers for their role in the opioid crisis.
“They say over and over and over again that, 'Yeah, on paper I might be making a little bit more money, but I was living better 10 years ago,'" he said. "Because at the end of the month they look at the cost of their health care, they look at the cost of gas, they look at the cost of their cable bill, and they look at the cost of their prescriptions, and they can’t make ends meet.”
Polls and strategists suggest that this could be more of a winning issue for Democrats than Republicans, although both sides of the aisle have tried to address the topic.
Asked about the drug-pricing issue, National Republican Congressional Committee spokesman Jesse Hunt said GOP candidates were focused on a broader critique of Democrats' support for a single-payer health care system. Such a system, critics contend, would result in higher taxes and reduced access to some treatments.
A recent poll by Global Strategy Group and GBA Strategies, both Democratic firms, found that the cost of health care, including prescription-drug prices and rising premiums, was a top concern for 47 percent of voters. Around 71 percent of voters viewed drug companies unfavorably, and 49 percent found it more difficult to afford health care compared to last year.
The poll also indicates that more voters trust Democrats than Republicans to stand up to pharmaceutical companies that raise drug prices.
“I think for most persuadable voters, they are far past the point where they put much stock in a Trump tweet,” said Jesse Ferguson, a Democratic strategist. “So they’re looking for what the administration is actually doing, and when Trump backed away from his promise for volume negotiation and abandoned taking any serious action that would clamp down on the drug companies, voters got the message. When he put a drug CEO to head his health care policy, it told voters mountains more than what he might tweet.”
The Health and Human Services Department has argued that the administration is not getting credit for progress in the area of drug pricing.
“[T]wo of the world’s largest pharmaceutical companies announced that they will postpone the kind of broad, steep price increases that have characterized America’s market for prescription drugs for far too long, “ wrote Dan Best, senior adviser to the secretary for drug-pricing reform, in a post last month. “It is hard to imagine, in light of this news, that some in the media are still claiming that the Trump Administration’s plan for reforming drug pricing isn’t delivering. Yet that’s the tired story many are sticking to, and they’re leaving out crucial facts in the process.”
The administration’s challenge is not just implementing reforms to lower prices; it’s also ensuring that voters are aware of the White House’s plan at all. Trump’s blueprint to lower drug prices remains a blip on voters’ radar. A Politico-Harvard T.H. Chan School of Public Health poll found that 27 percent of adults had heard of or read about the drug plan. Of those adults, around 42 percent thought the strategies would lower drug prices in the U.S.
“This is an area where people originally thought, 'Well, Donald Trump is good on this,'” said Celinda Lake, a Democratic political strategist.
“Then Donald Trump’s solutions were so anemic that nobody gives him credit for this issue now,” she added. “So Democrats are way ahead of him on this issue. Originally he understood exactly the power of this populist issue, but he won’t follow through on policy and it’s left him and the Republicans vulnerable.”
The cost of health care, including the price of prescription drugs, is a very personal and important issue to voters, said Tyler Law, a spokesperson for the Democratic Congressional Campaign Committee. “People sometimes talk about health care, the economy, and jobs as separate issues, but they really are linked and inseparable,” he said.
Law noted that drug-price hikes can have a substantial impact on people living on fixed incomes in Social Security and Medicare, an age group that also turns out for midterm elections at a higher rate. While Trump says he is making high drug costs a priority, Law said what will matter at the polls is if progress has been made.
“The only thing that is going to move the needle is the actual result, what are the costs,” he said. “People vote their pocketbooks; that’s just a reality. People know every day what their health care costs are, and they’re going to hold the party in control of all of government accountable.”
The reason drug pricing may not be a top-line issue among GOP candidates is that the initiative is still early in the process, said Jessica Anderson, vice president of Heritage Action. She added that Republicans have other accomplishments, such as their tax-reform bill, that have yielded tangible outcomes.
“I think it’s more a product of the cycle and less a product of one campaign prioritizing it than another,” she said. “It’s more of, OK, what can voters tangibly feel and see the benefits of, and what’s right in front of all of our faces about the successes of the GOP and President Trump’s administration.”
Democrats argue that Trump did not keep his promise to allow Medicare to negotiate drug prices. Kelly has touted the idea as something Democrats and Republicans can get behind.
“[People] know instinctively that it makes no sense in a free market system that we cannot negotiate on Medicare Part D,” he said. “So many people that are covered by that, that the federal government can’t negotiate with the pharmaceutical companies—and if we’re a free-market economy and we believe in competition—that makes no sense. It seems to most people, whether you’re Democrat or Republican, that is an obvious step that we have to take that would create some healthy pressure to bring prices down.”
But HHS Secretary Alex Azar said in a speech at the Heritage Foundation last month that this was not a good idea. “Those insisting we must have, quote, ‘direct negotiation’ between the government and drug companies aren’t really interested in negotiation,” he said. “They are calling for the federal government to impose a formulary for all Medicare patients, with no right to choose another option, and use the possibility of denying coverage of certain drugs to drive prices down.”