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January 15, 2020

After months of Medicare-for-All, Rx drug prices edge into Democratic presidential debate

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    Candidates seeking the 2020 Democratic nomination for president again sparred over so-called "Medicare-for-All" proposals during Tuesday's primary debate, but some also shared their proposals for address rising prescription drug prices—an issue that's been top of mind for voters but that hasn't gotten much air time in previous debates.

    Where the 2020 Democratic candidates stand on health care

    Debate details

    The debate featured seven candidates seeking the Democratic nomination for president:

    • Former Vice President Joe Biden;
    • Former South Bend, Indiana, Mayor Pete Buttigieg (D);
    • Sen. Amy Klobuchar (D-Minn.);
    • Sen. Bernie Sanders (I-Vt.);
    • Billionaire Tom Steyer; and
    • Sen. Elizabeth Warren (D-Mass.).

    The next Democratic presidential primary debate is scheduled for Feb. 8. Two more debates are scheduled for February 2020, and another two are planned to occur later in the year—though dates for those debates have not yet been announced.

    Candidates highlight proposals to lower Rx drug prices

    According to STAT News, rising U.S. drug prices was "a central theme" during Tuesday's debate, "making it one of the most substantive debates on health care since the first Democratic debate more than six months ago."

    Candidates criticized the prescription drug industry and shared their proposals to lower prescription drug prices in the country.

    Klobuchar and Warren both vowed to immediately take action to directly lower prescription drug prices if elected president. Both candidates noted that the U.S. president already has the legal authority to lower prescription drug prices, though neither candidate provided extensive details on which executive powers they would use to reduce drug prices.

    Klobuchar noted that she has released a list of 137 actions she could take to lower drug prices without congressional action if she is elected president. Klobuchar also said she'd be willing to allow the federal government to manufacture generic drugs in an effort to reduce prescription drug prices and said she would allow the United States to import lower-cost drugs from other countries.

    Warren said if she is elected president, she would sign an executive order on her first day in office that would allow drugmakers to manufacture generic versions of brand-name drugs that were developed using federally funded research. Warren said she would take action to lower the prices of EpiPens, HIV/AIDS drugs, insulin, the opioid overdose reversal drug naloxone, and other treatments. Warren also highlighted her proposal to allow the federal government to manufacture generic drugs to spur more competition in the prescription drug market.

    According to STAT News, all of the candidates participating in the debate endorsed allowing Medicare to directly negotiate prescription drug prices with manufacturers—a proposal that serves as the centerpiece of House Speaker Nancy Pelosi's (D-Calif.) bill to reduce prescription drug prices.

    Buttigieg said he would be open to reevaluating drugmakers' patents if they are unwilling to reduce U.S. drug prices. Likewise, Sanders and Warren both have introduced proposals that would use patents and monopoly rights as negotiating leverage with drugmakers to lower prices.

    Buttigieg also proposed establishing a $250 cap on U.S. residents' out-of-pocket cost for prescription drugs, USA Today reports.

    Candidates again debate 'Medicare for All' and 'public options'

    Democratic candidates also sparred over Medicare-for-All and so-called "public option" proposals during Tuesday's debate—an issue that has dominated the Democratic presidential primary debates thus far.

    Biden, who has called for implementing a public option health plan, suggested that Sanders, who has long touted his Medicare for All proposal, has not been "candid" about the cost of his Medicare-for-All plan.

    Sanders said his Medicare-for-All proposal would require increasing taxes on some U.S. residents in order to fund the new single-payer health system. Specifically, Sanders said his proposal would implement a new "4% tax on income, exempting the first $29,000, so the average family in America that today makes $60,000 would pay $1,200 a year compared to that family paying $12,000 a year" for health coverage. Sanders said his plan would eliminate the "absurdity" of private health insurance costs, saving U.S. residents money because they would no longer would have to pay premiums or co-payments.

    Buttigieg said his public option proposal would give people the option to keep their current health plans, rather than eliminating those plans to create a single-payer health care system, as called for under many Medicare-for-All proposals. Buttigieg said his plan would cost $1.5 trillion over a decade. He said eliminating corporate tax cuts and savings generated by allowing the federal government to directly negotiate prescription drug prices would help offset the cost of his plan.

    Klobuchar said Medicare for All is so impractical for the United States that the "debate" candidates keep having over such proposals "isn't real." Instead, Klobuchar said she supports creating a nonprofit public option health plan, which she claims would offer drastically lower premiums when compared with the premiums some U.S. residents currently are paying.

    Candidates touch on other health care issues

    Some candidates briefly touched on other health care issues, as well.

    For example, Klobuchar pushed for improvements to long-term care insurance and mentioned proposals intended to help individuals afford treatment for substance use disorders and mental health conditions.

    And Warren during her closing statement brought up health care issues that were not otherwise mentioned during the debate but that she plans to tackle if elected president, such as reducing infant mortality and gun violence  (Facher, STAT News, 1/14; Huetteman, Kaiser Health News, 1/15; Jones, USA Today, 1/15; Washington Post Staff, Washington Post, 1/15; AP/PBS News Hour, 1/14).

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