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Illustration: Sarah Grillo/Axios

The success of Democrats' attempt to allow Medicare to negotiate prescription drug prices hinges on whether the drug industry can persuade voters — particularly seniors — that the policy would result in fewer new drugs, an endeavor that experts say is an uphill battle.

Why it matters: Seniors are both directly impacted by the policy and disproportionately likely to vote in midterm elections, meaning what they think is incredibly influential.

The big picture: Allowing Medicare to negotiate drug prices is, by itself, overwhelmingly popular with voters. But when polls ask whether people would support the measure if it results in fewer new drugs, support drops drastically.

  • That means the drug industry's best chance to influence public opinion — and thus lawmakers' opinions — is to convince people that allowing Medicare negotiations would mean less innovation, an argument that it's actively trying to make.

Yes, but: Experts say convincing the public that this tradeoff is real will be an uphill battle.

  • "If you were to believe that new drugs won't be introduced because of this, it would depress public support," said Robert Blendon, a professor at the Harvard T.H. Chan School of Public Health.
  • "But my guess is, at the moment, people are skeptical enough of the pharmaceutical industry that they’re going to have a tough time saying that if the government gets you a discount, you won't get new discoveries.”

State of play: The pharmaceutical industry and advocates for drug pricing reform alike are dumping millions of dollars into the messaging war.

By the numbers: A KFF poll released in June found that 88% of respondents favor allowing the government to negotiate for lower drug prices, including 77% of Republicans, 96% of Democrats and 89% of adults 65 and older.

  • But if told the policy would lead to less research and development of new drugs, or limit people's access to newer drugs, 65% said they opposed the measure.

PhRMA has repeatedly cited this figure as a warning sign.

  • "Non-partisan, independent public polls have repeatedly demonstrated that support for government 'negotiation' evaporates once voters learn that these policies could result in restrictions in access to medicines or slow down innovation into new treatments for challenging conditions," the industry group recently wrote in a memo responding to a recent poll finding strong support for the policy.

The other side: “I think the counterpoint to that is that the drug industry has been making those arguments for a long time, and yet when you poll the public, it’s still wildly popular," said KFF's Liz Hamel.

  • "Either they’re not getting through to people or they’re not connecting them to the policy, because the policy itself is still really popular," she added.

Between the lines: Lowering prescription drug prices is a particularly salient issue with seniors, especially compared with some of the other prominent policies Democrats are attempting to pass this fall.

  • “This is something that seniors absolutely worry about, [whereas] if I'm a parent worried about day care, I'm a lot less worried about the price of an Alzheimer’s drug," Blendon said. "So it really affects a constituency that's very active and they care a lot about it.”
  • Similarly, other topics — such as child care or infrastructure — aren't as directly relevant to seniors, he added. "Subsidizing day cares and schools says to retirees, 'We're not going to help you.'”

Go deeper

Focus group: Child tax credit expansion divides swing voters

Photo by Chip Somodevilla/Getty Images

Some swing voters say the most important elements to preserve in Democrats' massive social spending package are the ones that would lower prescription drug costs, reduce pollution and make childcare or pre-K free or more affordable.

Yes, but: Considerably less popular among Trump-to-Biden voters: Extending the expanded child tax credit to 2025.

Poll shows eroding school satisfaction

Note: Percentages are rounded to the nearest whole number; Data: Nashville Public Education Foundation; Chart: Axios Visuals

The Nashville Public Education Foundation released on Thursday a new poll showing deepening dissatisfaction with public schools during the pandemic.

Why it matters: Nearly half of the 500 voters polled in September said they thought Metro Nashville Public Schools had gotten worse over the last five years.

Updated 60 mins ago - World

Reports: Brazil leader to be accused of crimes against humanity over COVID

Brazilian President Jair Bolsonaro. Photo: Andressa Anholete/Bloomberg via Getty Images

A Brazilian Senate panel will recommend President Jair Bolsonaro be charged with "crimes against humanity," alleging his COVID-19 pandemic response led to hundreds of thousands of deaths, per the New York Times and the Washington Post.

The latest: The lawmakers initially said Bolsonaro should be charged with mass homicide and genocide, but lawmakers updated the report to replace these with the new charge, its lead author, Sen. Renan Calheiros, told the NYT.