By Alexandra Glorioso and Nicholas Nehamas
As a 44-year-old, Gov. Ron DeSantis of Florida might be an unlikely candidate to wrest his party’s older voters away from Donald J. Trump, a 76-year-old baby boomer.
But he is trying anyway.
As Mr. DeSantis closes in on the official rollout of a 2024 campaign for president, he is seeking to make early inroads with this large, politically influential group of voters, and doing so by appealing to their pocketbook concerns.
He has focused especially on his efforts to lower prescription drug costs in Florida, including pushing the federal government for permission to import cheaper drugs from Canada. This month, he signed a bill that he says will bring down costs by regulating drug industry middlemen.
“We think that health care is too expensive,” Mr. DeSantis said as he signed the bill in Palm Beach County. “Prescription drugs are too expensive.”
“In our health care system,” he went on, “you see a lot of bureaucracy, red tape.”
The attempts to highlight drug costs come as Mr. Trump, who would be Mr. DeSantis’s main Republican rival, has attacked him for having supported plans to restructure Social Security and Medicare — programs that are sacrosanct to many older Americans. (Mr. Trump himself has expressed similar sentiments in the past.)
More than 60 percent of Republican and Republican-leaning voters are over 50 years old, according to the Pew Research Center. Older voters also powered Mr. DeSantis’s overwhelming re-election victory last year. He won 6 in 10 votes from those over 65.
The issue of prescription drugs, the prices of which have surged in recent years, reflects one of Mr. DeSantis’s advantages in a primary: the ability to promote a lengthy list of laws he has signed this year.
But talking about drug costs also illustrates the potential messaging challenges that Mr. DeSantis could face as a candidate. The governor, who considers himself a policy expert, has sometimes struggled when trying to make the topic accessible for voters. Drug costs are far drier and more complicated than the red meat he has fed to his base on conservative causes like defunding diversity programs at state schools, banning gender-transition care for minors and restricting the ability of undocumented immigrants to find work and gain access to social services.
And because he is signing so many new bills — including 37 in a single day — even some attentive Floridians are unaware of his latest attempt to bring down drug costs.
Al Salvi, 61, is the kind of voter who would seem likely to know about the new law. Mr. Salvi, a cancer survivor who traveled to Tallahassee from South Florida to testify about three bills during this year’s lawmaking session. In 2019, he appeared with Mr. DeSantis at an event promoting the initiative to import prescription drugs from Canada and other countries. But he hadn’t heard about the law targeting pharmacy benefit managers.
“The hell is that?” Mr. Salvi said in an interview. “Every time I go to the pharmacy, I see a pharmacist. I’ve never seen a pharmacy benefit manager.”
“The problem with the messaging,” he added, “is that people are not going to understand it, because they’ve got to know how the supply chain works.”
When Mr. DeSantis publicly discusses the issue, he can sometimes come off as opaque. He tends to talk briefly about how he believes that benefit managers hurt both consumers and neighborhood pharmacies, before diving into detailed explanations of practices that he disparages, using technical terms like “arbitrage opportunity” and “vertically integrated entities.” He often refers to pharmacy benefit managers by the acronym “P.B.M.s.”
The governor’s office says that if voters don’t know about the policy changes, it is the news media’s fault.
Those who study the issue say they believe Mr. DeSantis’s plan could have a real impact on drug prices and transparency, particularly in comparison with Mr. Trump’s efforts, who ultimately dropped the issue for most of his term.
Under Florida’s new law, a state advocate will field consumer and pharmacy complaints against the drug middlemen. And state regulators will have broad enforcement authority, including the ability to dole out hefty fines and even revoke a pharmacy benefit manager’s right to operate in Florida.
The state will also be able to inspect contracts by benefit managers, who are involved in nearly every step of drug pricing. The three largest middlemen, CVS Caremark, Express Scripts and OptumRx, own a majority of the market.
“The oversight should help shine a light into the black box of drug prices,” said State Senator Jason Brodeur, an Orlando-area Republican who sponsored the bill.
President Biden, for his part, is popular with older voters and has pushed his own plans to cut drug prices. But his administration has blocked Florida and other states from bringing in Canadian drugs, leading Mr. DeSantis to sue the Food and Drug Administration last year. Florida passed its bill allowing for the import of Canadian drugs four years ago.
For now, Mr. DeSantis still appears to be workshopping his messaging on prescription drugs.
The New York Times
