Health care policy will be the decisive factor for 2020 candidates

Health care policy will be the decisive factor for 2020 candidates
© Greg Nash

A decision is expected from a federal appeals court in New Orleans this week regarding the constitutionality of the Affordable Care Act, otherwise known as ObamaCare.

Previously, the Supreme Court upheld the Affordable Care Act’s constitutionality by declaring that the penalty for not buying insurance was to be interpreted as a tax, and thus within the federal government’s power to enforce.

In 2017 the Republican-controlled Congress repealed the penalty for not buying insurance and, last December, a federal judge in Texas ruled that without that penalty, the ACA was unconstitutional.


While it is uncertain as to what the decision will be in the New Orleans appeals court regarding the Texas judge’s finding, it is likely that the ruling, whatever it is, will be appealed to the Supreme Court.

Already, health care has become a focal point of the Democratic presidential primaries. There is a deep, bitter divide between progressive candidates like Sen. Bernie SandersBernie SandersBiden tax-hike proposals face bumpy road ahead Senate Democrats leery of nixing filibuster 'Almost Heaven, West Virginia' — Joe Manchin and a 50-50 Senate MORE (I-Vt.), who champion “Medicare for All,” and moderate candidates like former vice president Joe BidenJoe BidenFear of insider attack prompts additional FBI screening of National Guard troops: AP Iran convicts American businessman on spying charge: report DC, state capitals see few issues, heavy security amid protest worries MORE, who advocate for strengthening the ACA.

Moreover, polling has shown that health care will be a top issue for voters in the 2020 election.

A RealClearPolitics survey from May found that the most important issue for American voters is health care. A plurality of Americans (36 percent) said that health care was the “top issue facing America” today, ranking higher than the economy (26 percent) and immigration (15 percent). 

To be sure, health care is the issue that matters deeply to voters, and the consequences if the ACA is overturned would impact millions. 

If the law is indeed overturned, nearly 20 million people will lose their health insurance, those who currently rely on their parents’ health care plan until they are age 26 will lose access, and people with preexisting conditions will lose the protections that they desperately need.


Moreover, a critical point of debate going into the 2020 elections will not just be health care, but access to and the cost of prescription drugs in particular.

In a disappointing decision this week, the Trump administration withdrew its comprehensive proposal to remove rebates from government drug plans. 

“Based on careful analysis and thorough consideration, the President has decided to withdraw the rebate rule,” White House spokesperson Judd Deere said in a statement.

The proposal sought to eliminate discounts on prescription drugs that insurers typically negotiate with pharmaceutical companies.

To be clear, this move harms affordability and does patients a great disservice.

The canceled policy would have saved costs for consumers by cutting out pharmacy benefit managers (PBMs) and ensuring that any cost saved from a drug manufacturer’s rebate is redirected to the consumer, not to a middleman. 

To be sure, PBMs have long kept the drug discounts via rebates for themselves, rather than pass the savings on to consumers as the rebates were originally intended to do.

The now-withdrawn proposal from the Trump administration would have given PBMs a flat fee for including drugs on their plan and would allow discounts to be passed on to patients at the pharmacy counter, leading to savings for American consumers.

Simply put, the time for drug pricing reform is now. While the Trump administration said in its statement that it is “encouraged by continuing bipartisan conversations about legislation to reduce outrageous drug costs imposed on the American people,” it is clear that there has been minimal progress when it comes to finding a bipartisan solution.

Ensuring the American people have access to the most advanced medicines — and at affordable prices — has long been a bipartisan goal, and is one that our elected representatives can and should come together to solve.

Representatives on both sides of the political aisle are capable of crafting a bipartisan policy to ensure that Americans have access to affordable health care and drug prescriptions. With health care’s immense importance to 2020 voters, it will remain imperative that candidates on both sides are ready to discuss how they will improve care for all Americans.

Douglas E. Schoen (@DouglasESchoen) served as a pollster for President Clinton. He is a political consultant, Fox News contributor, and the author of “Collapse: A World in Crisis and the Urgency of American Leadership.”