Sep 28, 2023 - Health

Some GOP candidates talk tough against health industry

The second GOP 2024 presidential debate.

Photo: Justin Sullivan/Getty Images

Republican candidates during the second GOP presidential debate Wednesday night offered some unconventionally tough talk about the health care industry, even if they failed to offer substantive policy answers.

Between the lines: No one on the debate stage offered major new ideas about how they would tackle health care costs, lower the uninsured rate or address Obamacare — and many of the candidates have typically hewed to conservative orthodoxy on health care.

  • But in a shift, some embraced more populist rhetoric, blaming an industry that Republicans have typically been more friendly with.

Why it matters: Health care has largely faded into the background for Republicans in recent years. But the cost of care continues to rise, ensuring it remains near the top of voters' minds.

  • Health costs are projected to make a major jump this year, and the uninsured rate is expected to rise as millions are dropped from the Medicaid rolls — potentially elevating health coverage as a more prominent 2024 campaign issue.
  • President Biden has made clear he plans to go on offense on the issue, touting a new law allowing Medicare to negotiate with pharmaceutical companies — an issue that polls well across the parties.

Driving the news: When asked about Florida's high uninsured rate, Gov. Ron DeSantis blamed "economic decline," but also railed against the health sector, saying that "our health care is putting patients at the back of the bus."

  • "We have Big Pharma, Big Insurance and Big Government, and we need to tackle that."
  • DeSantis' rejection of the federal Medicaid expansion wasn't specifically mentioned, although he did say his state doesn't "have a lot of welfare benefits."
  • When former South Carolina Gov. Nikki Haley was asked about medical debt and bankruptcies, she questioned how the U.S. has the world's most expensive health care system and vowed that "we will break all of it."
  • Haley also called for more transparency in the system — from drugmakers to insurers to pharmacy benefit managers and more.
  • Former Vice President Mike Pence declined to answer whether the Affordable Care Act is here to stay, saying instead that he'd shift more money and power to the states.

The big picture: Former President Trump is certainly no friend of the pharmaceutical industry, and other Republicans — including DeSantis — have soured on pharma over COVID-19 vaccines.

  • The GOP has largely abandoned major health care reforms since its failure to repeal the ACA in 2017, and instead has focused on more targeted measures that would have a much smaller impact.
  • Meanwhile, the party's alliance with business groups has also fractured, and its populist surge has led to major shifts in other policy areas, like trade.

The bottom line: If tough campaign talk translates into big plans to go after the health industry, that will be a major shift — and a major liability for whichever groups become the target.

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