POLITICO-Harvard poll: Drug price negotiation is Americans' top priority in spending bills

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Americans support letting the government negotiate drug prices above all the other major priorities in the infrastructure and social spending packages now before Congress, according to a new POLITICO-Harvard poll that suggests health care is at the top of most respondents' minds.

But the drug pricing plan could be in peril as some centrist Democrats spar with Speaker Nancy Pelosi over the scope and details. Democratic leaders are now considering scaling back a House leadership-backed proposal or dropping it entirely from the $3.5 trillion social spending package.

The poll signals that despite President Joe Biden’s “Build Back Better” agenda and weekslong debates about the economic recovery, Americans are still most concerned about issues that impact them directly, said Robert Blendon, a professor of health policy and political analysis at the Harvard T.H. Chan School of Public Health who designed the poll. “I think a lot of people who were interviewed here are just thinking about their own life experience.”

Asked to chose among 20 policy priorities, 39 percent of respondents picked direct government price negotiations with drug manufacturers first. That was followed in order of preference by increased federal spending to prepare for pandemics, more resources for long-term and home-based care and expanding Medicare to include dental, vision and hearing care. All of the proposals are included in the sweeping $3.5 trillion social spending package, but have been hotly contested as the Democratic caucus splits over ways to lower the overall price tag and garner enough votes.

Only 23 percent of poll respondents rank rebuilding roads, bridges and airports “extremely important,” and just 15 percent said high-speed internet in rural communities was vital, despite those issues being cornerstones of Biden’s agenda and key provisions in the $500 billion infrastructure package.

“When I looked at the priorities, I was actually quite surprised because I thought infrastructure was supposed to be number one. A lot of these are very personal things that came out,” Blendon said. “Long-term care doesn’t usually rank that high, but thousands have just died in nursing homes.”

The health priorities also cut across party lines, with Democrats and Republicans alike ranking drug price negotiation high.

A House-leadership drug pricing plan was projected to save as much as $700 billion over a decade by allowing the government to directly negotiate prices on some of the highest-priced drugs in Medicare. But lawmakers are now discussing narrowing the list of drugs covered by the plan and dropping language that would have made the negotiated prices apply to private insurance.

Despite the feverish negotiations and the stakes involved, more than half of Americans are not closely watching the debate in Congress, according to the poll. Just 16 percent of people are ‘very closely’ following the process, most of them Republicans.

“Half of the public is not following this great debate at all,” Blendon said. “And that’s important because when I looked at the priorities, I see people picking things that relate to their own lives.”

The poll surveyed 1,006 adults from Sept. 14-19. The margin of error was plus or minus 4.1 percentage points.