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The Democratic Strategist

Political Strategy for a Permanent Democratic Majority

Political Strategy Notes

By now it is obvious to most swing voters that there is only one political party that is doing anything to improve health care for America’s working people, and the other political party has provided zero leadership for needed health care reforms. That realization is paying off in a big way in a key swing state. In her article, “With prescription drug costs, Nevada Democrats believe they’ve found a winning issue,” Gabby Birenbaum writes in The Nevada Independent: “As Democrats have fanned out across the country this summer to sell voters on the president’s agenda a year out from the election, Cabinet members and elected officials have honed in on a specific theme in appearances in Las Vegas — the cost of prescription drugs…..The bulk of the IRA, passed just over a year ago, focused on kickstarting clean energy production across the country, providing incentives for companies and consumers alike to go green. But it also included health care policies from Biden’s broader domestic agenda, referred to as Build Back Better. The IRA capped the price of insulin at $35 per month for Medicare beneficiaries, which went into effect in January. Eli Lilly, the largest manufacturer of insulin in the U.S., announced it too would cap the cost of insulin for private insurance users in March….Additionally, out-of-pocket prescription drug costs for seniors will be capped at $2,000 annually beginning in 2025. And the law will allow Medicare to negotiate lower prices of 10 drugs with pharmaceutical companies, with negotiated prices to be implemented by 2026; further drugs will be subject to negotiation each successive year. (Medicare’s list, which is due September 1, is expected to include the most widely prescribed drugs for common conditions including blood disorders, arthritis  and heart disease.)….Democrats say the messaging is part of a concentrated effort to highlight what has proven to be one of the most popular elements of the party’s signature policy achievement, hoping to bring the campaign to the comfortable turf of health care while also signaling engagement on the issue of rising costs.”

Birenbaum continues, “And in a legislative landscape in which the infrastructure, clean energy and manufacturing efforts spurred by Democrat-passed laws will take years to implement, the focus on prescription drug pricing provides what party members say is a simple, effective electoral message….“Historic legislation is fantastic, but it’s conceptual,” White House Chief of Staff Jeff Zients said to a group of regional reporters last week. “That’s why we need to be on the ground, and be comfortable being repetitive about telling the story … $35 insulin is resonating so quickly with people. It’s immediate savings.”….By retroactively applying the IRA’s $2,000 out-of-pocket cap to 2020 costs paid by Nevadans, HHS estimates that 143,000 Nevada seniors will save $434 per year on the cost of their prescription drugs in 2025. On the cost of insulin, nearly 11,000 Nevadans qualify for the $35 cap, saving an average of $439 annually per person….“It’s incredible,” Becerra said at an event in Las Vegas. “This is going to be a game-changing law.”….In a press conference, Horsford said he’s unsurprised by these provisions’ popularitybecause he hears from constituents and family members about how beneficial the insulin caps have already proven. He said he had family members who saw their monthly payment go from over $300 to $35….“They were explaining it to me at the dinner table, and I said ‘Yeah, I voted for that!’” Horsford said. “That’s real money that people can use to pay the cost of rent, of putting food on the table, of spending time with their kids and doing other activities with their grandkids.”….With Nevada’s population of seniors 65 and older growing — having seen an increase of 40 percent between 2011 and 2018 — the political calculus of the law’s appeal is straightforward. The IRA passed without a single Republican vote in either chamber, meaning Democrats will own the law next November, for better or worse.”

Birenbaum adds, “A July poll of registered voters from Navigator Research and Democrat-aligned Global Strategy Group found that the insulin cap was the most popular provision in the bill, with 82 percent support. Allowing Medicare to negotiate drugs was similarly well-received, with 81 percent approval, and the $2,000 out-of-pocket cap earned 77 percent support….Most of the voters polled were also able to identify the prescription drug provisions as being part of the Inflation Reduction Act — 81 percent of respondents agreed the IRA allowed Medicare to negotiate the price of drugs, compared to only 51 percent of voters who think the IRA provides tax incentives for manufacturing job creation….As the biggest health care law since the ACA, strategists said that Medicare negotiating the price of drugs and prescription drug cost caps have the benefit of being easily understood, as opposed to the ACA, and thus far, have had a smooth rollout, the lack of which plagued the Obama administration….The Biden campaign is banking on the popularity of a prescription drugs-based message….“Simple policies can go very far,” White House National Economic Council Deputy Director Joelle Gamble said to reporters. “And I think this is a policy that people understand. They know how much they pay; they know the president and Democrats in Congress are lowering [those costs.]”….With the insulin cost caps already in place, that message should be easy to promote. But Democrats will have to be proactive in advertising the negotiation and out-of-pocket cost caps, given that they will not kick in until after the election….Peter Koltak, a Democratic strategist who’s worked on several Nevada campaigns, said the cost of prescription drugs should be a winning issue for Democrats….“This is already popular — this starts way more popular than the ACA was,” he said. “It’s only going to get more popular … it’s all upside, really.”….Koltak added that several key swing demographics — Latinos, seniors and suburban voters among them — shift toward voting for a generic Democrat who supports capping the cost of prescription drugs when juxtaposed with a standard Republican who does not, citing state data from Democratic pollsters Global Strategy Group.”

Birenbaum notes further, “Strategists said the issue marries health care and rising costs, the latter of which typically benefits Republicans more. Combining the two allows Democrats to address a potential weakness while campaigning on an area that voters trust them on….“[Health care] is kind of a bread-and-butter Democratic issue,” UNLV political science professor Dan Lee said….The fact that it targets seniors — a group with high voter turnout — is another political appeal….Though AARP Nevada is nonpartisan, it plans to engage all elected officials during the campaign season and beyond on the prescription drug provisions of the IRA, which Jessica Padrón, the organization’s associate state director of advocacy and outreach, said has resonated with members….“Older Americans are tired of promises to tackle these issues,” she said. “And they’re thrilled that Congress finally took action. We’re getting a lot of positive feedback.”….An analysis of per capita prescription drug spending between 2004 and 2019 from the Kaiser Family Foundation and the Peter G. Petersen Foundation found that Americans, on average, spend $1,126 annually on prescription drugs, double the average of peer nations. Democrats argue these high prices are because, up until next year, the government can not negotiate drug prices the way it can in Canada, the United Kingdom, France and Germany, for example….The next step for Democrats is to expand the program to institute maximum prices for those not on Medicare. That can only be done with majorities in both chambers and Biden re-elected to the White House — making it an explicit part of their campaign appeal….And it’s not just Congress that can bring the benefits to Nevadans younger than 65. Democrats in the Legislature passed a bill to apply the Medicare-negotiated price caps statewide in 2026, allowing private insurance beneficiaries to take advantage of the new lower costs as well, though Gov. Joe Lombardo (R) vetoed the bill.” Birenbaum’s article focuses on Nevada, but the very substantial economic and health benefits she cites apply nation-wide.

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