As a 44-year-old member of Generation X, Gov. Ron DeSantis of Florida is perhaps an unlikely candidate to wrest his social gathering’s older voters away from Donald J. Trump, a 76-year-old baby boomer.
But he’s attempting anyway.
As Mr. DeSantis closes in on the official rollout of a 2024 marketing campaign for president, he’s looking for to make early inroads with this massive, politically influential group of voters, and doing so by interesting to their pocketbook issues.
He has centered particularly on his efforts to decrease prescription drug prices in Florida, together with pushing the federal authorities for permission to import cheaper medication from Canada. This month, he signed a bill that he says will deliver down prices by regulating drug trade middlemen.
“We think that health care is too expensive,” Mr. DeSantis mentioned as he signed the invoice in Palm Beach County. “Prescription drugs are too expensive.”
“In our health care system,” he went on, “you see a lot of bureaucracy, red tape. And people are making money off this system that aren’t really providing value to the system.”
As he travels the nation showing at Republican fund-raisers, the governor has added a line in regards to the new regulation to his stump speech.
The makes an attempt to spotlight drug prices come as Mr. Trump, who could be Mr. DeSantis’s foremost Republican rival, has attacked him for having supported plans to restructure Social Security and Medicare — applications which can be sacrosanct to many older Americans. (Mr. Trump himself has expressed related sentiments previously.)
More than 60 p.c of Republican and Republican-leaning voters are over 50 years previous, in accordance to the Pew Research Center. Older voters additionally powered Mr. DeSantis’s overwhelming re-election victory final yr. He gained 6 in 10 votes from these over 65, according to exit polling.
The problem of pharmaceuticals, the costs of which have surged in recent times, displays certainly one of Mr. DeSantis’s benefits in a main: the flexibility to promote a prolonged checklist of legal guidelines he has signed this yr.
But speaking about drug prices additionally illustrates the potential messaging challenges that Mr. DeSantis may face as a candidate. The governor, who considers himself a coverage knowledgeable, has typically struggled when attempting to make the subject accessible for voters. Drug prices are far drier and extra difficult than the pink meat he has fed to his base on conservative causes like defunding variety applications at state faculties, banning gender-transition care for minors and restricting the flexibility of undocumented immigrants to discover work and achieve entry to social companies.
And as a result of he’s signing so many new payments — together with 37 in a single day — even some attentive Floridians are unaware of his newest try to deliver down drug prices with laws that regulates trade go-betweens known as pharmacy profit managers.
Al Salvi, 61, is the type of voter who would appear seemingly to know in regards to the new regulation. Mr. Salvi, a most cancers survivor who volunteers with AARP in Florida, traveled to Tallahassee from South Florida to testify about three payments throughout this yr’s lawmaking session. In 2019, he appeared with Mr. DeSantis at an occasion selling the initiative to import pharmaceuticals from Canada and different nations. But he hadn’t heard in regards to the regulation focusing on pharmacy profit managers.
“The hell is that?” Mr. Salvi mentioned in an interview. “Every time I go to the pharmacy, I see a pharmacist. I’ve never seen a pharmacy benefit manager.”
“The problem with the messaging,” he added, “is that people are not going to understand it, because they’ve got to know how the supply chain works.”
Pharmacy benefit managers work with drug producers, insurance policy and pharmacies to present medication to sufferers at a reduction. But affected person advocates query whether or not profit managers go sufficient financial savings onto shoppers. All 50 states have sought greater oversight of them, in accordance to the National Academy for State Health Policy.
Lobbyists for the trade dispute that profit managers aren’t serving to shoppers. And they are saying that Florida’s new regulation, which handed with broad bipartisan help, is not going to cut back drug prices.
When Mr. DeSantis publicly discusses the difficulty, he can typically come off as opaque. He tends to speak briefly about how he believes that profit managers harm each shoppers and neighborhood pharmacies, earlier than diving into detailed explanations of practices that he disparages, utilizing technical phrases like “arbitrage opportunity” and “vertically integrated entities.” He usually refers to pharmacy profit managers by the acronym “P.B.M.s.”
The governor’s workplace says that if voters don’t know in regards to the coverage modifications, it’s the information media’s fault.
“Could it be possible that people miss the great things that Governor DeSantis does because media like The New York Times choose instead to amplify only those angles and stories that promote their leftist agenda?” Mr. DeSantis’s press secretary, Bryan Griffin, wrote in an e mail. (Mr. Griffin joined the governor’s political operation on Monday.) “We have had a news conference nearly every day for the last two weeks promoting the governor’s record number of legislative accomplishments from this session. The problem does not lie with us.”
Those who examine the difficulty say they consider Mr. DeSantis’s plan may have an actual impression on drug costs and transparency, significantly compared with Mr. Trump’s efforts. When Mr. Trump was within the White House, he tried to finish rebates for pharmacy profit managers, arguing that they had been driving up the costs of medicines. But he finally dropped the difficulty for most of his term.
“Trump’s plan was substantial. But it ended up being more bark than bite,” mentioned Antonio Ciaccia, the chief govt of 46brooklyn, an Ohio-based nonprofit group centered on drug-pricing schooling and analysis. “DeSantis’s plan is more bite than bark.”
Under Florida’s new regulation, a state advocate will area shopper and pharmacy complaints towards the drug middlemen. And state regulators could have broad enforcement authority, together with the flexibility to dole out hefty fines and even revoke a pharmacy profit supervisor’s proper to function in Florida.
The state may also have the ability to examine contracts by profit managers, who’re concerned in almost each step of drug pricing. The three largest middlemen, CVS Caremark, Express Scripts and OptumRx, personal a majority of the market. They are under common ownership with insurance policy and typically retail pharmacies. For instance, CVS Health owns CVS Caremark, in addition to the CVS retail pharmacy chain and the health insurance coverage firm Aetna.
“The oversight should help shine a light into the black box of drug prices,” mentioned State Senator Jason Brodeur, an Orlando-area Republican who sponsored the invoice.
President Biden, for his half, is popular with older voters and has pushed his personal plans to minimize drug costs. But his administration has blocked Florida and different states from bringing in Canadian medication, main Mr. DeSantis to sue the Food and Drug Administration final yr. Florida handed its invoice permitting for the import of Canadian medication 4 years in the past.
“It’s been held up by the Biden administration and the F.D.A. because they say it’s not safe to purchase drugs from Canada,” Mr. DeSantis mentioned lately. “They’re just running interference for the pharmaceutical companies.”
Carly Kempler, a spokeswoman for the F.D.A., mentioned the company had an obligation “to ensure that the proposed importation would pose no additional risk to the public’s health and safety while achieving a significant reduction in the cost of covered products to the American consumer.”
For now, Mr. DeSantis nonetheless seems to be workshopping his messaging on pharmaceuticals.
At a cease in rural Wisconsin, he briefly talked about the regulation on pharmacy profit managers.
“We’ve moved to hold Big Pharma accountable by shining a light and reining in things like pharmacy benefit managers that cause you to pay more for expensive medication,” he mentioned.
The crowd reacted with delicate applause, having burst into cheers moments earlier when Mr. DeSantis described a invoice he signed permitting the loss of life penalty for sexual battery towards kids.