Democrats unite against Big Health Care

Democrats from conservative states are spearheading a push to challenge corporate health care giants and certain business practices they claim inflate health care expenses. Despite the lack of consensus on Medicare for All, Democrats are largely in agreement about tackling "Big Health Care" following a robust campaign built around the populist angle.

While expanding Medicare, reversing Republican Medicaid cuts and bolstering enhanced Obamacare subsidies dominate headlines, there's a subtle change in language and policy direction that blames large health companies for the affordability issue. This shift aligns with the fact that a major expansion of federal healthcare isn't feasible under President Trump, yet these populist themes could rally rank-and-file Democrats and even attract some Republicans.

Even candidates who had not previously focused on pharmaceutical companies or insurers have now embraced policy ideas once confined to left-leaning think tanks. For instance, Texas Senator-elect James Talarico campaigned on breaking up large health care entities and halting hospitals and insurers from overcharging patients. South Carolina Senator-elect Annie Andrews pledged to limit insurer profits per enrollee, broaden the scope of drugs under Medicare price negotiation, and outlaw private equity-owned hospitals.

Kansas Senator-elect Adam Hamilton advocated for expanding Medicare drug price negotiations and extending these prices to private health plans, alongside combating Medicare Advantage overpayments from the federal government. Other areas of focus include medical debt, pharmacy benefit manager practices, and limits on out-of-pocket drug costs.

Many of these proposals already garner support from senior progressives. Senator Elizabeth Warren (D-Mass.), a strong advocate for Medicare for All, introduced the Break Up Big Medicine Act alongside Republican Senator Josh Hawley, which aims to prohibit joint ownership of health plans and providers. The incoming Michigan Senator, Abdul El-Sayed, an ardent supporter of Medicare for All, backed this bill and called for expanded Medicare drug price negotiations.

The House's health care working group, comprising both progressives and moderates, suggested capping exorbitant hospital prices and introducing site-neutral payments. The overarching theme is that voters have clearly expressed their desire for reduced health care costs. Although a comprehensive overhaul of the healthcare system may not be imminent, Democrats are seeking ways to alleviate these concerns.

Large health industry entities are likely to resist these populist measures, arguing that they might compromise patient care and access in certain areas. Nonetheless, the discussed ideas might gain traction with some Republicans. When queried about the potential for Congress to tackle ownership ties between insurers, pharmacy benefit managers (PBMs), and pharmacies at a recent Axios event, Republican Representative Morgan Griffith, the chair of the House Energy and Commerce's Health Subcommittee, admitted that he has only heard arguments in favor of breaking these conglomerates apart.

As for the next steps, forcing pharmaceutical companies to lower prescription drug prices appears to be a particularly attractive target, particularly considering President Trump's known interest in this matter. He has previously urged Congress to legalize "most-favored-nation" deals he negotiated with drug manufacturers, which generally grant Americans prices comparable to those in other countries.

The Senate Finance Committee's top Democrat, Ron Wyden of Oregon, has expressed openness to a deal that codifies these agreements in exchange for an increase in the number of drugs subject to Medicare negotiation.