Illustration: Brendan Lynch/Axios
With Congress in recess, we're watching key Senate races that could shape the direction of health policy next year and possibly bring some new faces to debates over drug prices, Medicare and PBMs:
1. Florida: Sen. Rick Scott vs. Debbie Mucarsel-Powell
Scott has broken with the Republican playbook and made Medicare a central issue in his re-election bid.
- He's tried to link his opponent to the Biden administration's planned cut in payment to Medicare Advantage plans next year, saying that "Joe Biden doesn't care about hardworking Florida seniors."
- Scott has himself come under a firestorm of attacks related to Medicare, when Democrats seized on his plan to sunset all federal laws in five years, saying that would include Medicare. He later amended his plan to exclude Medicare.
- Scott has a health care background as the former CEO of hospital chain Columbia/HCA, which was fined $1.7 billion for Medicare fraud on his watch.
- In May, Scott linked that case with the New York charges brought against former President Trump, saying they were both instances of "political persecution."
2. Wisconsin: Sen. Tammy Baldwin vs. Eric Hovde
Baldwin is one of the lead sponsors of legislation that would permanently extend the enhanced Affordable Care Act subsidies that are expiring next year.
- She is seeking to highlight the issue as an effort to stop "millions of hardworking Americans from having their health care costs jacked up."
- And she is attacking Hovde for wanting to repeal the law and "kick millions off their health insurance," as she said at a rally with Vice President Kamala Harris, per the Milwaukee Journal Sentinel.
- Hovde told WMTV in Madison in June that he "100%" wants to repeal the ACA, though added he wants to keep protections for preexisting conditions.
- Of note for the hospital industry, in the same interview he critiqued hospital consolidation and blamed the ACA for fueling it. "How do you make sure prices stay low? Through competition," he said.
3. Nevada: Sen. Jacky Rosen vs. Sam Brown
Many campaigns have attacked drug manufacturers over high prices, but Rosen has added a twist by also targeting PBMs.
- In a June letter, Rosen questioned why PBMs were not making a prostate cancer drug, abiraterone, available at the much lower price offered by the nonprofit Civica.
- She also has a bill with Sen. John Cornyn to require that drug coinsurance payments for patients in Medicare be calculated off of the lower net price rather than the list price.
- Brown told the Nevada Independent last year that the IRA's Medicare drug price negotiations mean "more regulations and more government control" leading "to less innovation and fewer new drugs and therapies being available to the public."
4. Nebraska: Sen. Deb Fischer vs. Dan Osborn
This race is unusual for a couple of reasons: Statewide contests in Nebraska are not usually competitive, and Fischer's challenger is an independent, union leader Osborn.
- Osborn is trying to hit populist themes — and is the rare candidate raising questions about the role of private equity in health care, including in buying nursing homes.
- He's calling for blocking private equity purchasing of health care entities when "takeover would put those being served at risk" and for increased funding for nursing home inspections.
- Fischer is also focused on the nursing home issue but from a contrasting direction: critiquing the Biden administration's nursing home staffing mandate.
- She introduced legislation to block the rule, arguing that it could force some senior facilities to close if they can't find enough staff to meet the regulations.
5. New Jersey: Rep. Andy Kim vs. Curtis Bashaw
This race is not particularly competitive — it's a solid Democratic hold, per the Cook Political Report.
- But it is interesting because Kim, the Democrat and favorite, is much more progressive on drug pricing issues than the seat's former occupant, Bob Menendez, who resigned following a corruption conviction.
- Menendez was one of a dwindling number of Democrats who was an ally of the pharmaceutical industry, which has a major presence in New Jersey.
- Kim, by contrast, proudly attacks "Big Pharma" in his messaging and has touted his vote for legislation allowing Medicare to negotiate drug prices.
- He also touts progressive health care priorities like expanding Medicare to cover dental, vision and hearing.
