As a 44-year-old member of Generation X, Florida Gov. Ron DeSantis may be an unlikely candidate to snatch his party’s older voters away from Donald J. Trump, a 76-year-old baby boomer.
But he’s still trying.
As Mr. DeSantis nears the official launch of a 2024 presidential campaign, he’s trying to take early steps with this large and politically influential group of voters, and he does so by appealing to their wallet concerns.
He focused especially on his efforts to reduce the cost of prescription drugs in Florida, including pushing the federal government to be allowed to import cheaper drugs from Canada. This month, he signed a bill which he believes will reduce costs by regulating pharmaceutical industry intermediaries.
« 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 healthcare system,” he continued, “you see a lot of red tape, red tape. And people are making money on this system that doesn’t really provide value to the system.
As he travels the nation attending Republican fundraisers, the governor added a line about the new law to his monotonous speech.
Attempts to highlight drug costs come as Trump, allegedly 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 expressed similar feelings in the past.)
More than 60 percent of Republican and Republican-leaning voters are over the age of 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 the over 65s, according to exit polls.
The issue of prescription drugs, whose prices have risen in recent years, reflects one of DeSantis’s advantages in a primary: the ability to push through a long list of laws he 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 pundit, has at times struggled to make the subject tangible to voters. Drug costs are far drier and more complicated than the red meat it has fed its base for conservative causes like underfunding diversity programs in state schools, banning gender transition assistance for minors, and limiting the ability of irregular immigrants to find work and access social services.
And why is he signing so many new bills, including 37 in one day — even some observant Florida locals are unaware of his latest attempt to slash drug costs with legislation regulating industry middlemen called pharmacy benefit managers.
Al Salvi, 61, is the type of voter who would seem familiar with 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 law targeting drug benefits managers.
« What the hell is that? » Mr. Salvi said in an interview. “Every time I go to the pharmacy, I see a pharmacist. I have never seen a pharmaceutical benefit manager.”
« The problem with messaging, » he added, « is that people aren’t going to get it, because they need to know how the supply chain works. »
Pharmacy benefit managers partner with drug manufacturers, insurance plans, and pharmacies to provide discounted drugs to patients. But patient advocates question whether benefit managers are spending enough consumer savings. All 50 states searched more control of them, according to the National Academy for State Health Policy.
Industry lobbyists argue that benefit managers are not helping consumers. And they say the new Florida law, passed with broad bipartisan support, won’t reduce drug costs.
When Mr. DeSantis discusses the matter publicly, it can sometimes come across as opaque. He tends to talk briefly about how he believes benefit managers harm both consumers and neighborhood pharmacies, before diving into detailed explanations of the practices he decries, using technical terms like « arbitrage opportunity » and « vertically integrated entities. » . He often refers to pharmaceutical 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 possible that people are missing out on the great things Governor DeSantis does because media outlets like the New York Times choose instead to amplify only those angles and stories that further their leftist agenda? » Mr. DeSantis’ publicist Bryan Griffin wrote in an email. (Mr Griffin joined the governor’s political operation Monday.) “We’ve held a press conference nearly every day for the past two weeks to promote the governor’s record number of legislative accomplishments this session. The problem is not ours. »
Those studying the matter say they believe DeSantis’ plan could have a real impact on drug pricing and transparency, especially compared to Trump’s efforts. When Mr. Trump was in the White House, he tried to end the discounts for drug subsidy managers, claiming they were driving up the prices of medicines. But in the end he abandoned the matter for most of his tenure.
“Trump’s plan was substantial. But ultimately it was more barking than biting,” said Antonio Ciaccia, chief executive officer of 46brooklyn, an Ohio-based nonprofit group focused on drug pricing education and research. “DeSantis’ plan is more biting than barking. »
Under the new Florida law, a state attorney will file consumer and pharmacy complaints against drug brokers. And state regulators will have broad enforcement authority, including the ability to issue hefty fines and even revoke a pharmaceutical benefits manager’s right to operate in Florida.
The state will also be able to inspect the contracts of benefit managers, who are involved in almost each stage of drug pricing. The three largest brokerages, CVS Caremark, Express Scripts and OptumRx, own by majority of the market. They they are jointly owned with insurance plans and sometimes retail pharmacies. For example, CVS Health owns CVS Caremark, as well as retail pharmacy chain CVS and health insurance company Etna.
« The oversight should help shed some light on the drug pricing black box, » said state Senator Jason Brodeur, an Orlando-area Republican who sponsored the bill.
President Biden, for his part, is popular with older voters and pushed his own plans to cut drug prices. But his administration does blocked Florida and other states from the introduction of Canadian drugs, leading Mr. DeSantis Sue last year the Food and Drug Administration. Florida passed the bill allowing the importation of Canadian drugs four years ago.
« It’s been blocked by the Biden administration and the FDA because they say it’s not safe to buy drugs from Canada, » DeSantis said recently. « They are just interfering on behalf of pharmaceutical companies. »
Carly Kempler, spokeswoman for the FDA, said the agency has a duty to « ensure that the proposed importation poses no additional risk to the health and safety of the public while achieving a significant reduction in the cost of covered products for the American consumer ».
For now, it appears Mr. DeSantis is still crafting his prescription drug messaging.
During a stop in rural Wisconsin, he briefly mentioned the Pharmaceutical Benefit Manager Act.
« We’ve moved to hold Big Pharma accountable by shining a light and curbing things like pharmaceutical benefit managers charging you more for expensive drugs, » he said.
The crowd responded with mild applause, after erupting in applause moments earlier when Mr. DeSantis described a bill he signed that authorized the death penalty for sexual assault against children.