In 2018, the threat Donald Trump and Republicans posed to health care was a primary animator behind the Democrats regaining control of the House of Representatives, putting many swing districts in the blue column. Those House Democrats know that a key to keeping them in office is returning to a variation on the theme, this time with a focus on the skyrocketing costs of prescription drugs.
"I have done 15 town halls in my district this year and the top issue I have talked about is lowering prescription drug costs," freshman Rep. Andy Kim of New Jersey told The New York Times. "The cost side of things is something people see on a daily basis. It's something tangible that they understand is a problem." Virginia freshman Rep. Abigail Spanberger agrees. She said that, in her first campaign in 2017, keeping protections for people with pre-existing conditions "was top of mind." Then, she said, "it would go into the cost of premiums and cost of prescription drugs. Now the starting point is the cost of drugs, and, 'Oh by the way, I want to make sure pre-existing conditions are protected.'"
It's an increasingly common theme. Rep. Elise Slotkin, a Michigan freshman Democrat, says that the most common question she hears at home is about medical costs: "People will pull me aside and clutch my arm and say: 'I can't afford my prescription drugs. My son is rationing his insulin. I can't afford my coverage. I'm paying more in health care and prescription drugs per month than I am for my mortgage. I'm underwater.'"
Democrats have seeded that debate for 2020 by passing far-reaching legislation in the House this year. Their prescription-drug pricing bill would allow the federal government to negotiate lower prices on dozens of drugs for Medicare, and penalize drug companies for refusing to negotiate and for price-gouging. The Senate, of course, is refusing to take up that legislation, and Donald Trump reversed his initial support for the effort.
The voters are on the side of the Democrats on this one, with more than 80% in a Kaiser Family Foundation survey saying that Congress should pass laws to lower the price of prescription drugs. That and retaining the ACA's protections for people with pre-existing conditions are the top two issues for voters in its surveys.
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