The Definitive Take on Joe Biden's Age
Everyone else shared their opinions about it, so I figured I should too
Much has been said about Joe Biden’s age, but I think the media is overlooking a key point: Joe Biden has worked tirelessly to make prescription drugs more affordable for seniors, who are also old.
For decades, both parties1 have promised to take on Big Pharma and get prescription drug prices in check. President Biden followed through on his promise and passed the Inflation Reduction Act.
Biden beat Big Pharma, senior citizens are already starting to see huge benefits, and it’s only going to get better as more and more parts of his agenda take effect. Donald Trump — who by the way is also very old — has promised to repeal these crucial benefits for senior citizens.
The Inflation Reduction Act has several provisions that lower prescription drug costs for seniors:
Insulin price caps: seniors and people with disabilities now only pay $35/month for the drugs and equipment to manage their diabetes. While the law only affects seniors and people with disabilities, Joe Biden has used the bully pulpit to encourage Big Pharma to lower prices for everyone else. Once it became clear that pharmaceutical companies could still profit off of the lower $35/month cost, it became unsustainable for them to be seen charging hundreds or more per month.
Free vaccines for seniors: a full course of shingles vaccines could often cost upwards of $350, but with the IRA the vaccine is now free for seniors on Medicare Part D. Hepatitis and tetanus shots are also now free. The law also fills in coverage gaps for those on Medicaid or CHIP.
Medicare prescription drug negotiation: Anytime anyone buys anything, there’s some amount of negotiation over the price of that good. Maybe directly, maybe indirectly. But when Medicare buys drugs from pharmaceutical companies, they just accept whatever price the company asks for. This is intuitively very silly! And it means that Medicare drug costs are sky high. But the Inflation Reduction Act is changing this. The Centers for Medicare and Medicaid Services has selected ten drugs to begin price negotiations on, and in the coming years they will expand so that even more seniors save. The first ten include pricey drugs to manage diabetes, cancer, heart disease, and more. This wave of drugs will see lower prices starting in 2026. Like the insulin price caps, it is expected that these lower costs for seniors will also drive prescription drug costs down for everyone else.
Prescription drug cap: starting in 2025, Medicare will cap the total annual patient expenditures on prescription drugs at $2000. For many seniors, this will save them thousands — or even tens of thousands—of dollars. Cancer patients and seniors with multiple conditions will save the most.
Drug rebates: pharmaceutical companies have to pay a rebate if the price of drugs rises faster than the rate of inflation. This phased into effect this year, and we’ve already seen several pharma companies cut prices in response, especially for diabetes medication.
Reduced cost sharing: low income seniors below 150% of the federal poverty line will see reduced cost sharing, lowering their healthcare costs across the board.
I mention this in such detail because lowering the cost of prescription drugs is the best polling Biden accomplishment. It’s not even close. Voters love this stuff. It is directly responsive to inflation and cost of living concerns, and helpfully positions Biden in opposition to Big Pharma. A fight between drug companies with massive profits and senior citizens who can’t afford lifesaving medication is a very favorable messaging frame.
Unfortunately, while it’s the best polling Biden accomplishment, it’s also one that basically no one has heard of. Even among senior citizens — who are directly effected by these policies — most of Biden’s prescription drug reforms are invisible:
Figure 1: KFF Polling on Senior Citizen Awareness of Biden Prescription Drug Reforms
Awareness is ticking up slightly, but most seniors remain unaware of Biden’s wins. And the numbers are much worse among younger voters.
There’s no shortage of theories on why voters are unaware of Biden’s prescription drug price cuts:
They were tucked into the Inflation Reduction Act, a sprawling piece of legislation that touched on dozens of controversial topics, so they received relatively little attention as the bill worked its way through Congress
Republicans know how wildly unpopular their stance is, so they uniformly refuse to talk about it. Even the many Republicans who voted against the IRA and want to repeal the IRA will never mention the prescription drug price reforms specifically.2 This limits the potential for high profile arguments that might draw attention.
Healthcare policy is complicated and boring, limiting press attention from many segments of the media, and making it tougher for voters to know what the changes are even when they do hear about it.
Each piece of the law came into effect at different times, and some haven’t phased in yet, which limits attention. It’s tougher to message around benefits that come into effect in 2025 than it is for benefits that people can take advantage of right now.
Many of the benefits are passive. Medicare recipients may not know why a given drug costs less — it’s not like your pharmacy gives you a packet about how Biden’s IRA saved you money when your insulin is more affordable. Indeed, many drug companies even suggested that they were voluntarily choosing the lower their prices to try to get a PR win for themselves.
Elected Democrats aren’t talking about it enough, as Matt Yglesias suggests. It’s a frequent subject in Democratic paid media, but is much less prevalent in earned media.
Democratic activists are less enthusiastic about the wins because much of the 2016 and 2020 primary debates focused on a public option vs Medicare4All, and this is a different side of the healthcare reform conversation.
I suspect it’s a mix of all of these factors. Some are tough to change, but most of them are things that we can improve between now and November 5th. And you can help spread the message in your own life: senior citizens are more likely to answer the phone or open the door when phonebankers or canvassers reach out. You probably know several senior citizens in your own family. Make sure that they know about Biden’s efforts to help them afford lifesaving medication.
In conclusion, please stop talk about Joe Biden’s age and start talking about his work to lower prescription drug prices for seniors. Especially if you’re someone who wants us to win in November!
Housekeeping Notes
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Last Week: The Types of Criminals That Republicans Love
Not really both parties. More like “every Democrat and a couple of Republicans.” But it’s noteworthy that Presidents Clinton, Obama, Trump, and Biden all promised to allow Medicare to negotiate prescription drug prices. Trump got rolled by Big Pharma, but President Biden actually got it done.
Seriously, if you’re a reporter reading this, try to get your local Republican Congressman on the record about whether he would end Medicare prescription drug negotiation. They’ll avoid answering.