The Skinny

A Troubling Diagnosis - As more polls show her trailing Democrat Mark Kelly, Sen. Martha McSally rolls out a flawed healthcare bill

The bad news keeps arriving for appointed Sen. Martha McSally as she strives to avoid losing two U.S. Senate races in two years.

A pair of recent polls show McSally continuing to trail her Democratic challenger, retired NASA astronaut Mark Kelly. First, there was the February homegrown poll from Phoenix-based political consulting firm HighGround, which showed Kelly holding the support of 46 percent of the 400 surveyed voters, while McSally had only 39.3 percent. (Margin of error was plus or minus 4.9 percent). Meanwhile, the left-leaning Public Policy Polling released a survey last week showing Kelly with the support of 47 percent of 666 voters surveyed, while McSally had the support of just 42 percent. (Margin of error was plus or minus 3.8 percent.) And, tracking what earlier surveys have shown, McSally just isn't very popular with Arizona voters: Just 37 percent approve of the job McSally is doing in the PPP survey, although her approval rating was a little better at 43 percent in the HighGround survey.

One of McSally's key weaknesses remains her record on healthcare—which isn't a good place to be when the nation's attention is focused on a raging pandemic. While she insists she supports protection for people with pre-existing conditions, she has repeatedly voted to repeal the Affordable Care Act and remove the legal requirements that ban insurance companies from discriminating against people with such chronic illnesses. In fact, she boasted in her 2018 campaign ads about pushing the House of Representatives to repeal Obamacare with the words "Let's get this fucking thing done."

Last week, McSally tried to improve her image on the healthcare front by introducing legislation aimed at the ever-rising cost of prescription drugs. Her legislation—which has no cosponsors on either side of the aisle, which suggests she hasn't gotten much support for the bill—would allow the federal government to negotiate prices for drugs that are past their patent; limit some of the legal strategies that drug companies have used to extend their patents and prevent generic alternatives; cap annual out-of-pocket prescription medication expenses at $3,100 for seniors on Medicare; and allow Americans to purchase their medication from Canadian pharmacies.

But even if McSally's bill became law, it's not clear it would do much to lower drug prices. Sure, it's great to allow the government to negotiate with drug companies to try for lower prices, but once a patent has expired, drug prices drop anyhow because the free market allows competitors to offer lower prices. The most expensive drugs are those that are protected from competition by patents—and McSally said last week that she opposes allowing the government to negotiate the prices of patent-protected drugs because it would discourage innovation by Big Pharma.

By contrast, the bipartisan prescription drug legislation passed by the House of Representatives—that's been bottled up by Senate Majority Leader Mitch McConnell—does allow Medicare to negotiate the prices of all medications with the drug companies. And it also passes along those savings to private insurers, which McSally's bill does not do. In addition, it caps annual out-of-pocket expenses for seniors on Medicare at $2,000, which is $1,100 a year lower than McSally's bill.

McSally's proposal to allow Americans to simply buy their drugs from a Canadian pharmacy fits with another effort by the Trump administration. Because Canada uses its massive buying power to force drug companies to negotiate lower prices on all drugs, McSally reasons that Americans should have access to that market.

McSally explained that by allowing Americans to buy from Canadian pharmacies, it would force the Canadian government—which does negotiate with drug companies for lower drug prices for its citizens—to start raising prices on its own citizens to better spread the cost of research and development.

McSally said the strategy is to "force the pharmaceutical companies to change their business model so that Americans are not continuing to subsidize the rest of the world for these important drugs that are discovered. ... We need to push them to actually negotiate higher prices in other countries so they pay their fair share of the R&D, and it's not just Americans paying the R&D."

But McSally waved away concerns about whether drug companies might just limit how many drugs they send to Canada, or whether Canada might block the export of drugs to the United States rather than increasing prices on its own citizens.

"There's often ways that big companies try and figure out a way around things, but we've got to monitor the implementation, and we provide that oversight to implementation as well," McSally said.

Given how little the legislation would do, critics are saying that McSally is just trying to make it seem like she's doing something on the issue in order to get some positive press.

McSally bristled at the suggestion during an interview with reporters last week.

"You should know me better," McSally said. "I don't do messaging bills."

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