Inside Health Policy – January 08, 2020
By Emily Martin
More than half of voters consider out-of-pocket costs for prescription drugs and other aspects of health care as top concerns ahead of the first primaries, according to a recent poll from Morning Consult and Bipartisan Policy Center. Nearly half also say use of illicit drugs and opioids is the most common public health issue within their community.
Health care has remained the number one issue for Democratic voters in the 2020 election cycle, as previously reported by the Kaiser Family Foundation in a November poll, though now it’s evident that the overall population is concerned about health care as nearly half of Republican voters polled by Morning Consult and BPC ranked it third. In key states with early primaries, such as Iowa, New Hampshire and South Carolina, an even higher percentage of voters ranked health care as an issue that will influence their vote the most.
Similarly, nearly 60% of voters nationally and in Iowa, New Hampshire and South Carolina signaled that prescription drug costs are the most significant to them or their family, just behind out-of-pocket health care costs. Rural voters overwhelmingly chose illicit drug and opioid use as a common public health issue in their communities, which Joanne Conroy, CEO of New Hampshire health group Dartmouth-Hitchcock, says may be true because residents struggle to stay sober without infrastructure typically provided by rural hospitals that continue to close.
Anthony Caroll, associate state director for advocacy for AARP Iowa, says that bills for rural hospital closures, hospice reform and prescription drug pricing will continue to be top priorities for lawmakers covering rural communities.
Caroll predicts that Republicans, especially President Donald Trump, will likely focus on prescription drug pricing policies in 2020 campaigns. Caroll points to Trump’s December drug importation proposal as an indication that the incumbent president will likely continue to include lowering prices as part of his platform during the 2020 election.
Trump, however, attacked House Speaker Nancy Pelosi’s (D-CA) drug pricing bill (H.R. 3) that would allow Medicare drug price negotiation and backed Sen. Chuck Grassley’s (R-IA) bill that would avoid government price negotiation. Pelosi’s bill passed the House, but likely will not overcome the 60-vote hurdle in the Senate. Grassley recently said he could overcome that hurdle, though he needs more support from the GOP to secure a floor vote. Grassley also asked Pelosi to back his bill instead, which potentially could find a legislative vehicle when Congress renews so-called Medicare and Medicaid extenders that expire in late May.
Caroll also says that Grassley’s push for prescription drug pricing legislation shows a path for Republicans to address voters’ concerns with the current health care system that avoids Medicare for All proposals and pivots away from the failed ACA repeal and replace campaign.
Conroy says that voters are becoming more aware of rapidly rising costs of medications, especially generic drug costs, and politicians are taking note of their concern by spreading print and TV advertisements on their plans to cap or lower costs.
Groups for and against H.R. 3 are airing competing ads. Groups backing Pelosi’s bill, which directs Medicare to negotiate drug prices, thanked lawmakers who voted for the bill in December, and those opposed praise lawmakers who voted for a House GOP alternative.
The ads by H.R. 3 backers aim to give cover to vulnerable Democrats and Republicans who voted for the bill, while the opposing ads praise Republicans, including some in leadership, who are mostly in comfortable seats and support the GOP alternative bill.
When it comes to reforms to lower health care costs, voters highly favor bills that would improve the current health care system rather than repealing and replacing the Affordable Care Act or transforming to a single-payer system.
Meg Kinnard, a national politics reporter for Associated Press in South Carolina, says that voters in the typically red state are leaning toward less-progressive candidates in the Democratic primary, such as former Vice President Joe Biden. South Carolina voters did the same in 2016, when Sen. Bernie Sanders (I-VT) lost by a landslide, because his Medicare for All proposal was considered too extreme by many, according to Kinnard.
Biden is currently leading across national polls, but Sanders is a close second and he was previously dubbed the most-trusted on health care in the primary by Democratic and Democratic-leaning independent voters.