Majorities of Americans say they're more likely to vote for candidates in November who support ideas to lower their health costs, according to the latest Axios-Ipsos American Health Index.

Why it matters: Their support for ideas across the political spectrum — from renewing Affordable Care Act subsidies to expanding direct sales of prescription drugs — shows how much voters are seeking relief.

The big picture: Health care policy was pivotal in the 2018 and 2022 midterms. The economy impacts every election.

• This year, they're converging into a demand for health care affordability as consumers seek relief anywhere to offset high prices for gas, groceries and other basic needs.

Driving the news: About half of Americans say measures aimed at drug and insurance affordability will probably influence who they'll vote for.

• More than 6 in 10 respondents say they support direct-to-consumer drug sales that could reduce some out-of-pocket costs.
• Roughly the same proportion back reinstating the enhanced ACA subsidies that Congress let expire at the end of last year.

What we're watching: The cost concerns are particularly hitting price-sensitive individuals ages 30-49, parents of kids under 18 and those with household income below $50,000.

• "Anytime you hear 'lowering costs,' it's enough for most Americans to support an initiative even if they're not familiar with the ins and outs of the issue," said Mallory Newall, Ipsos vice president for U.S. public affairs.

Zoom in: The poll shows that bipartisan majorities support expanding prescription drug discount platforms like TrumpRx and GoodRx, with 54% overall saying they'd be likelier to support a candidate who backs the policy.

• Party affiliation is more of a factor on whether to revive enhanced ACA marketplace subsidies: 71% of Democrats and 49% of independents say they'd be likelier to vote for a candidate who supports bringing back the aid, while only 26% of Republicans would.
• That suggests Republicans could use the aid as a wedge issue.

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Trump administration efforts to strike more drug tariff deals took a step backward after the U.S. began a trade investigation against Germany, citing a plan that would lower the nation's pharmaceutical spending.

Why it matters: The White House is trying to press forward with its tough trade policy after the Supreme Court overturned most of the tariffs enacted over the first year of Trump's second term.

• Administration officials were hoping for a pact similar to the one they struck with Britain that exempted U.K. drug imports from tariffs in exchange for higher national health system spending for new medicines.

Driving the news: U.S. Trade Representative Jamieson Greer late last week launched an investigation of a German legislative plan to overhaul its public health insurance system that includes dozens of cost-saving proposals.

• Greer contends it would further reduce drug spending that already suppresses the price of pharmaceutical products below fair market value.
• The investigation comes under Section 301 of the Trade Act of 1974 and could result in tariffs on German drugs and ingredients. That would affect manufacturers such as Bayer and Boehringer Ingelheim.

USTR suggested a negotiated agreement still is possible. President Trump has frequently railed against European price controls that he says benefit from American pharmaceutical innovation.

States are increasingly deploying artificial intelligence to help manage safety net programs like Medicaid, despite warnings that there's little evidence of safeguards around the technology.

Why it matters: Without proper oversight, a machine's mistake regarding program eligibility could strip people of essential benefits.

The big picture: Last year's GOP budget law helped push state government into the AI era, Allison Buffett, senior health policy analyst at the Bipartisan Policy Center, tells Axios.

• Some are rolling out AI-assisted chatbots to answer Medicaid beneficiaries' eligibility questions, and Florida included an AI system to check a user's Supplemental Nutrition Assistance Program eligibility in its 2027 budget.
• Medicaid is adopting first-ever work requirements and more frequent eligibility verifications. Some of those time-consuming tasks are being given to AI rather than government workers, Buffett said.

Yes, but: A small discrepancy in data, such as slightly misreporting income on different aid applications, can boot people from benefit programs they are eligible for.

Case in point: Kevin De Liban, who founded the activist group TechTonic Justice, successfully sued Arkansas over its use of an algorithm to determine Medicaid home-based care.

• He says the system led to a drop in eligible hours for thousands of residents and operated in a "haphazard and harmful" way.

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