As a 44-year-old Gen Xer, Governor Ron DeSantis of Florida could be an unlikely candidate to wrest older voters in his party from Donald J. Trump, a 76-year-old baby boomer.
But he tries anyway.
Like Mr. DeSantis closes the official deployment of a 2024 campaign for the president, he seeks to make early inroads with this large group of politically influential voters by appealing to their financial concerns.
He has been particularly focused on his efforts to reduce prescription drug costs in Florida, including lobbying the federal government for permission to import cheaper drugs from Canada. This month he signed an invoice which he says will reduce costs by regulating intermediaries in the pharmaceutical industry.
“We think health care is too expensive,” DeSantis said as he signed the bill in Palm Beach County. “Prescription drugs are too expensive.”
“In our health care system,” he continued, “you see a lot of bureaucracy, paperwork. And people are making money with this system that doesn’t really add value to the system.
Like him travels the nation appearing at Republican fundraisers, the governor added a line about the new law to his stump speech.
Attempts to highlight drug costs come as Mr Trump, believed to be Mr DeSantis’ main Republican rival, attacked him for having supported plans to restructure Social Security and Medicare — programs that are sacrosanct for many older Americans. (Mr. Trump himself has Express similar feelings in the past.)
More than 60% of Republican and Republican-leaning voters are over 50, according to the Pew Research Center. Older voters also fueled DeSantis’ landslide re-election victory last year. He won 6 out of 10 votes among those over 65, according to exit polls.
The issue of prescription drugs, the whose prices have skyrocketed in recent years, reflects one of Mr. DeSantis’ advantages in a primary: the ability to promote a long list of laws he has signed into law this year.
But talking about drug costs also illustrates the potential messaging challenges Mr. DeSantis could face as a candidate. The governor, who considers himself a political expert, has at times struggled to make the subject tangible to voters. Drug costs are much drier and more complicated than the red meat he donated to his base for conservative causes like definancing diversity programs in public schools, prohibition gender transitional care for minors and restrict the ability of undocumented immigrants to find work and access social services.
And because he signs so many new bills – including 37 in one day — even some observant Floridians are unaware of his latest attempt to lower drug costs with legislation that regulates industry intermediaries called pharmacy benefit managers.
Al Salvi, 61, is the kind of voter who seems to be aware of the new law. Mr. Salvi, a cancer survivor who volunteers with AARP in Florida, traveled to Tallahassee from South Florida to testify on three bills during this year’s legislative session. In 2019, he appeared with Mr. DeSantis at an event promoting the initiative to import prescription drugs from Canada and other countries. But he hadn’t heard of the Pharmacy Benefit Managers Act.
“Fuck is that it?” Mr. Salvi said in an interview. “Every time I go to the pharmacy, I see a pharmacist. I have never seen a pharmacy benefit manager.
“The problem with messaging,” he added, “is that people aren’t going to understand it, because they need to know how the supply chain works.”
Pharmacy benefit managers work with drug manufacturers, insurance plans and pharmacies to provide medications to patients at reduced prices. But patient advocates question whether benefit managers are doing enough savings to consumers. All 50 states have requested greater monitoring of them, according to the National Academy for State Health Policy.
Industry lobbyists dispute that benefit managers do not help consumers. And they say Florida’s new law, which was passed with broad bipartisan support, will not reduce drug costs.
When Mr. DeSantis publicly discusses the issue, he can sometimes appear opaque. He tends to talk briefly about how he thinks benefit managers harm both consumers and neighborhood pharmacies, before diving into detailed explanations of the practices he disparages, using technical terms like “arbitrage opportunity” and “vertically integrated entities”. He often refers to Pharmacy Benefit Managers by the acronym “PBM”
The governor’s office says if voters aren’t aware of policy changes, it’s the media’s fault.
“Could it be that people are missing the great things that Governor DeSantis is doing because outlets like the New York Times are instead choosing to amplify only the angles and stories that promote their leftist agenda?” Mr. DeSantis’ publicist, Bryan Griffin, wrote in an email. (Mr. Griffin joined the Governor’s Political Operation Monday.) “We have had a press conference almost every day for the past two weeks to promote the governor’s record number of legislative accomplishments this session. The problem is not with us. »
Those studying the matter say they believe Mr. DeSantis’ plan could have a real impact on drug pricing and transparency, especially compared to Mr. Trump’s efforts. When Mr. Trump was in the White House, he tried to end discounts for pharmacy benefit managers, arguing that they drive up drug prices. But he finally dropped the issue for most of his term.
“Trump’s plan was substantial. But it ended up being more bark than bite,” said Antonio Ciaccia, chief executive of 46brooklyn, an Ohio-based nonprofit focused on price education and research. medication. “DeSantis’ plan is more biting than barking.”
Under Florida’s new law, a state attorney will file consumer and pharmacy complaints against drug middlemen. And state regulators will have broad enforcement power, including the ability to hand out steep fines and even revoke a pharmacy benefit manager’s right to operate in Florida.
The State will also be able to inspect the contracts by the benefit managers, who are involved in nearly every step of drug pricing. The three largest intermediaries, CVS Caremark, Express Scripts and OptumRx, own a majority of the market. They are under common ownership with insurance plans and sometimes retail pharmacies. For example, CVS Health owns CVS Caremark, as well as the CVS retail pharmacy chain and health insurance company Etna.
“Oversight should help shed light on the drug price black box,” said State Sen. Jason Brodeur, an Orlando-area Republican who sponsored the bill.
President Biden, for his part, is popular with older voters and has pushed its own plans to reduce drug prices. But his administration has blocked Florida and other states to import Canadian drugs, which led Mr. DeSantis to sue the Food and Drug Administration last year. Florida passed its bill allowing the importation of Canadian drugs four years ago.
“He’s been held back by the Biden administration and the FDA because they say it’s not safe to buy drugs in Canada,” DeSantis said recently. “They’re just interfering with the pharmaceutical companies.”
Carly Kempler, spokesperson for the FDA, said the agency had a duty “to ensure that the proposed importation would pose no additional risk to the health and safety of the public while achieving a significant reduction in the cost covered products for the U.S. consumer”.
For now, Mr. DeSantis still seems to be working his posts on prescription drugs.
AT stop in rural Wisconsinhe briefly mentions the law on pharmaceutical benefit managers.
“We’ve decided to hold Big Pharma accountable by highlighting and limiting things like pharmacy benefit managers charging you more for expensive drugs,” he said.
The crowd reacted with light applause, having burst into cheers moments earlier when Mr DeSantis described a bill he signed allowing the death sentence for child sexual abuse.