When big world events happen, the chattering classes love to think and talk globally. But that’s a big mistake if you care about elections. Voters don’t spend their days obsessing about trade disputes and conflicts in far-off countries. They are too busy looking after their families, earning a living and staying healthy. And nothing is more of a local concern than access to medicine, especially when a disabled relative or grandparents are in need.
President Donald Trump deserves some credit for his work to bring down the cost of prescription drugs, addressing one of the most persistent pressures facing American families. For years, Americans have paid significantly more for medications than patients in many other countries. TrumpRx is addressing that by offering Americans major discounts on a range of popular prescription drugs and matching prices paid in other developed nations.
With Democrats hoping for a “blue wave” that could flip the House of Representatives and potentially threaten the Senate, Republicans know they need strong, practical achievements to which they can point. Drug prices could be exactly what they need to celebrate — and party strategists already seem to understand this.
At a recent GOP strategy meeting, Trump’s pollster Tony Fabrizio told attendees that the president’s efforts to lower drug prices could become one of the most effective messages heading into the midterm elections. That shouldn’t be surprising. Drug affordability is exactly the kind of kitchen-table issue that resonates with voters.
However, progress can be easily undone. Across the country, several states are considering new policies aimed at lowering prices, motivated by understandable concerns about transparency and pricing structures. Lawmakers want to reduce costs and prevent abuse within the system.
One of these proposals that has popped up in state legislation would sever the relationship between Pharmacy Benefit Managers (PBMs) and retail pharmacies. PBMs are companies that act as intermediaries/middlemen in the U.S. prescription drug supply chain. They were created in the 1960s to help control drug costs, and now handle a huge portion of prescriptions, covering benefits for most Americans with insurance. They save money by negotiating aggressively and promoting generics and lower-cost options.
But these state legislative proposals could have unintended consequences, including forcing local pharmacies to close. If that happens, it will create real problems for the very patients policymakers are trying to help.
First, pharmacy closures would make it much harder for elderly patients to access the medications they rely on. For many seniors — particularly those in rural communities or small towns — a local pharmacy is essential. Public transportation options may be limited or nonexistent, creating “pharmacy deserts” in rural areas. Grandma might not be able to drive across town, let alone across the county, to pick up a prescription.
When pharmacies disappear, access to medication becomes harder, so it becomes more difficult for patients to follow their treatment plans. They may delay refilling prescriptions or skip doses entirely. Over time, that can lead to worsening health conditions and higher medical costs.
Second, local pharmacists provide a critical layer of medical oversight that is often overlooked in policy debates. Many Americans — especially older patients — take multiple medications simultaneously for complex health problems. A pharmacist who knows a patient’s history can quickly spot potentially dangerous drug interactions or dosing issues.
That kind of real-time guidance is incredibly valuable. Without it, the risk of medication errors increases. The wrong drug combination or the wrong timing can have serious consequences.
Third, a growing share of the drug pricing challenge today involves specialty medications used to treat complex conditions such as cancer, autoimmune disorders and rare diseases. These treatments can be extraordinarily expensive, and it is often specialty pharmacies that most often carry them.
The Trump administration’s policies are making progress in lowering some of those high prices. But pricing reforms take time to fully work. During that transition, the healthcare system cannot afford to create new barriers that limit patient access to critical medications.
Republicans in conservative states should remember something simple: making sure Grandma and Grandpa can easily fill their prescriptions is both good public policy and good politics. Senior citizens vote a lot.
Republicans have jumped on these bills because it seems like an easy, superficial way to look bipartisan, aligning with Democrats who want to stick it to big business. It’s easy to bash large pharmacies like CVS and act like you’re looking out for smaller pharmacies. CVS claims that it will close all of its pharmacies in Tennessee and 23 in Arkansas if these bills are signed into law. So far, the legislation in Arkansas has been held up in court, and the bill in Tennessee has not been signed into law yet.
Voters respond to policies that make their lives easier and protect their families. When people see that leaders are focused on practical outcomes — like affordable medication and accessible pharmacies — it builds trust. Ensuring strong pharmacy access helps turn drug pricing reforms into real benefits that families can see and feel in their daily lives. That is a reality Republicans would be wise to keep firmly in mind, especially if they hope to win the midterm elections and retain control of Congress.
Don't give the potential blue wave even more opportunity by removing Grandma’s access to prescription medicine. Double down on supporting Trump to increase the red wave.