Healthcare is biggest issue for voters but not for Congress

More than half of registered voters nationally consider healthcare one of their top issues in the 2020 presidential election, a new poll found, but observers and congressional aides said healthcare will likely be on the legislative back burner early this year.

When asked their top three policy issues for the 2020 presidential election, 56% of nearly 2,000 registered voters surveyed named healthcare as a top factor in determining their vote in a poll conducted nationally by the Bipartisan Policy Center and Morning Consult. The second most-cited issue was the economy at 44%.

Within healthcare, out-of-pocket costs were the issue of greatest concern for those surveyed. Though there are several proposals in Congress that would lower out-of-pocket drug costs and out-of-network medical bills, aides are not expecting much progress while other high-profile issues take center stage.

The Senate is expected to navigate an impeachment trial—though timing is unclear—and monitor escalated tensions with Iran. A GOP Senate aide said impeachment proceedings will shorten the negotiating timeline to reach an agreement on contentious issues. The most likely legislative vehicle to address healthcare issues is a spending bill Congress must pass by May 22 to extend funding for several Medicare and Medicaid programs.

“Enacting comprehensive drug-pricing reforms during a presidential election year is already an unlikely prospect, and the current focus on Iran and impeachment makes it even more unlikely,” said Marc Samuels, CEO of healthcare consulting firm ADVI.

While the calendar will be a challenge, Senate Finance Committee ranking member Ron Wyden (D-Ore.), a co-author of a bipartisan drug-pricing bill, sees a larger threat. “I think the biggest obstacle is that (Senate Majority Leader) Mitch McConnell is saying that pharma counts more than the person who’s getting beat up at the pharmacy counter,” Wyden said.

The pharmaceutical industry vehemently opposes the Senate Finance drug-pricing legislation.

In the House, action on surprise medical bills is expected to be high on the agenda, but first members must overcome some turf battles. A dispute late last year between the House Energy & Commerce and Ways & Means committees helped derail a bipartisan, bicameral surprise billing fix that providers opposed.

The Ways & Means Committee is drafting legislative text to flesh out its one-page outline of an apparently more provider-friendly proposal, but there is no firm timeline for progress yet.

“We’re working on legislative language with the minority and hope to have a markup in the next couple months,” said Erin Hatch, a spokesperson for Ways & Means Committee Chairman Richard Neal (D-Mass.).

House Education & Labor Committee Chairman Bobby Scott (D-Va.) said he doesn’t plan to offer an entirely new proposal. However, Scott said he would like to mark up some sort of compromise legislation on the issue. “We’re trying to coordinate our activities with the other two committees and we can, rather than come up with another alternative, come up with something that is consistent.”

House Democrats already passed a major drug-price negotiation bill, but it won’t get a vote in the Senate as-is. Senate Finance Committee Chairman Chuck Grassley (R-Iowa) last week appealed to House Speaker Nancy Pelosi (D-Calif.) to take up the less ambitious Senate Finance drug-pricing bill instead during a television appearance on CNBC. The White House also supports the Grassley-Wyden legislation.

“There’s no question that the constant crises in the White House inhibit Congress’ ability to tackle complex policy issues,” FTI Consulting Managing Director Charlene MacDonald said. “But healthcare, and drug pricing specifically, remains a top legislative priority for Democrats, so expect efforts to negotiate to continue into the spring.”

The margin of error for the Bipartisan Policy Center-Morning Consult survey was 2 percentage points. Polling was conducted online from Dec. 3 to 4 and Dec. 19 to 21 and results were weighted.