KFF Health Tracking Poll September 2024: Support for Reducing Prescription Drug Prices Remains High, Even As Awareness of IRA Provisions Lags

Key Takeaways

• The Biden administration recently announced a projected reduction of out-of-pocket costs for seniors as part of the Medicare drug negotiations, yet large majorities of voters have not heard about these savings, with almost half (45%) who say they have heard “nothing at all,” while a quarter have heard “a lot” or “some.” Larger shares of older voters, those ages 65 and older, say they’ve heard “a lot” or “some” about these savings, with a third (32%) who say so, compared to two in ten (22%) of those under age 65. Most voters continue to be unaware of the Medicare drug pricing provisions in the Inflation Reduction Act, or IRA, that was passed by Congress and signed into law by President Biden more than two years ago, though awareness of some of the provisions is higher among older voters – the group most impacted by the provisions.
• While awareness of Medicare drug negotiations continues to lag, KFF finds widespread support for this policy. Majorities of voters support authorizing the federal government to negotiate drug prices, while one in seven (14%) oppose. This provision is supported by nine in ten Democrats and independent voters (92% and 89%, respectively) and three-quarters of Republican voters (77%). It is also supported by 88% of older adults, those ages 65 and over, including majorities across partisans.
• Voters’ views of who is responsible for the legislation as well as the expected savings from the negotiations are largely partisan. Overall, a slight majority (55%) of voters ages 65 and older think Medicare negotiating will lower their own prescription drug costs, but the share who expect to see savings increases to nearly two-thirds (64%) of older Democratic and Democratic-leaning voters. On the other hand, about half (52%) of older Republican and Republican-leaning voters say they don’t expect the negotiations to have any impact on their drug costs. In addition, voters are also more likely to give their own party leaders credit for passing legislation aimed at lowering the price of prescription drugs for people on Medicare, though Republican voters are less enthusiastic about their party leaders’ roles. Larger shares of Democratic voters than Republican voters say President Biden, Vice President Harris, and the Democrats in Congress played a “major” or “minor” role in passing legislation for lowering drug prices for people on Medicare, while Republican voters are more likely than Democratic voters to say the same about Republicans in Congress. A similar share of Republican voters give former President Trump credit for passing the legislation as give credit to President Biden.
• Vice President Harris’ campaign has announced proposals for expanding some of the IRA provisions beyond those with Medicare coverage. Majorities of voters, overall and across partisanship, support these proposed provisions, though smaller shares of Republicans are on board. Three-quarters (77%) of voters support the proposal to expand the $35 cap on out-of-pocket costs for insulin beyond those with Medicare, including majorities of Democratic voters (84%), independent voters (79%), and Republican voters (70%). Seven in ten (69%) voters support the proposal to expand the $2,000 annual limit on out-of-pocket prescription drug costs beyond those with Medicare, including 83% of Democrats, 70% of independents, and 58% of Republicans.

Most Voters Continue to Be Unaware of IRA Provisions to Reduce Prescription Drug Prices

Most voters continue to be unaware of the Medicare drug pricing provisions in the Inflation Reduction Act, or IRA, that was passed by Congress and signed into law by President Biden more than two years ago, though awareness of some of the provisions is higher among older voters – the group most impacted by the provisions.

Four in ten voters are now aware there is a federal law in place that caps the cost of insulin for people with Medicare at $35 per month, while another third (35%) are aware of the law that requires the federal government to negotiate the price of some prescription drugs for people with Medicare. A quarter of voters (27%) are aware of the federal law that places a limit on out-of-pocket prescription drug costs for people with Medicare, and one in eight (12%) are aware that there is a law in place that penalizes drug companies for increasing prices faster than the rate of inflation for people with Medicare.

Larger shares of voters ages 65 and older are aware of some of these drug pricing provisions of the IRA. For example, six in ten (61%) voters ages 65 and older are aware of the law that caps the cost of insulin for people with Medicare and about a third (34%) of older voters are aware of the provision that places an out-of-pocket limit on prescription drug costs. Similar shares of older voters compared to younger voters are aware of the provision that requires the government to negotiate the price of some prescription drugs and that penalizes drug companies for increasing prices faster than the rate of inflation for people with Medicare.

While awareness of the Medicare drug pricing provisions increased, especially among older voters, from November 2023 to May 2024, awareness has remained steady over the past several months.

Voters Remain Unaware of Impact of Medicare Drug Negotiations, Older Adults Are Unclear if It Will Reduce Their Prescription Costs

The Biden administration recently announced that the lower prices negotiated for some prescription drugs would have saved the federal government $6 billion in 2023 with an estimated $1.5 billion reduction in out-of-pocket costs for older adults when lower prices take effect in 2026. Large majorities of voters have not heard about these projected savings, with almost half (45%) who say they have heard “nothing at all” about the negotiations, while a quarter (25%) have heard “a lot” or “some.” Another three in ten (30%) have heard “a little” about the negotiations.

Larger shares of older voters, those ages 65 and over, say they’ve heard “a lot” or “some” about these savings, with a third (32%) who say so, compared to one in five (22%) of those under age 65.

Similarly, larger shares of Democratic and independent voters have heard about the projected savings, with about a third (34%) of Democrats and a quarter (27%) of independents who have heard at least “some,” compared to about one in six (16%) Republican voters.

Overall, almost nine in ten (85%) voters support authorizing the federal government to negotiate drug prices, while one in seven (14%) oppose. This provision is supported by 92% of Democratic voters, 89% of independent voters, and 77% of Republican voters. While support for the law is lower among Republicans, most Republican voters support it.

In addition to supporting the federal government negotiations, a slight majority (55%) of voters ages 65 and older think Medicare negotiations will lower their own prescription drug costs, while four in ten (43%) older voters think negotiating won’t have any impact on their prescription drug costs. Expectations that Medicare negotiations won’t lower drug costs seem to be partisan, with two-thirds (64%) of older Democratic and Democratic-leaning voters thinking it will lower their drug costs, while about half (52%) of older Republican and Republican-leaning voters thinking it won’t have any impact on their drug costs.

The Inflation Reduction Act was enacted under President Biden without any Republican support in Congress. Six in ten voters say President Biden had a “major” or “minor” role in passing the recent law aimed at lowering drug prices for people on Medicare, including four in ten (37%) who say he had a “major” role. Similar shares of voters say the same about Democrats in Congress, with six in ten (60%) who say they played a “major” or “minor” role. Another four in ten (42%) voters say Vice President Harris played a role. Credit for the recent law could be key as she picks up these issues on her own platform for president.

Almost half (46%) of voters think that Republicans in Congress played a role in passing the recent law, with a small share saying they played a “major” role (14%). About a quarter of voters credit former President Trump for the passage of the law aimed at lowering drug prices for those on Medicare, with a quarter (28%) who say he played a “major” or “minor” role, while 41% say he had no role in passing the recent law. Between a quarter and a third of voters aren’t sure how big of a role these groups played in the health care legislation.

Partisans are more likely to give their own party leaders credit for passing legislation aimed at lowering the price of prescription drugs for people on Medicare, though Republican voters are less enthusiastic about their party leaders’ roles. Larger shares of Democratic voters than Republican voters say President Biden, Vice President Harris, and the Democrats in Congress played a “major” or “minor” role in passing legislation for lowering drug prices for people on Medicare. While Republican voters are more likely than Democratic voters to say former President Trump and the Republicans in Congress played a role, only about a quarter of Republican voters said either (23% and 24%, respectively) played a “major role.” In fact, a similar share of Republican voters give former President Trump credit for passing the legislation as give credit to President Biden.

Overall, eight in ten (81%) Democratic voters say Biden played a role in passing the legislation, four in ten (39%) of Republican voters say the same about Trump. Another eight in ten Democratic voters say Democrats in Congress played a “major” or “minor” role in passing the legislation, while over half (54%) of Republicans say the same about Republicans in Congress.

Voters Support Expanding on IRA Provisions

Vice President Harris’ campaign has announced that, if elected, her administration hopes to expand some of the drug pricing legislation beyond just those with Medicare, allowing others to benefit from the cap on monthly out-of-pocket costs for those with insulin and the annual limit on out-of-pocket prescription drug costs. Former President Trump has remained silent on some of these issues, though his administration implemented a program under which Medicare plans voluntarily lowered insulin copays to $35 per month. Majorities of voters, overall and across partisanship, support these proposed provisions, though smaller shares of Republicans are on board. Three-quarters (77%) of voters support the proposal to expand the $35 cap on out-of-pocket costs for insulin beyond those with Medicare, including majorities of Democratic voters (84%), independent voters (79%), and Republican voters (70%). Seven in ten (69%) voters support the proposal to expand the $2,000 annual limit on out-of-pocket prescription drug costs beyond those with Medicare, including 83% of Democrats, 70% of independents, and 58% of Republicans.

This KFF Health Tracking Poll/Health Misinformation Tracking Poll was designed and analyzed by public opinion researchers at KFF. The survey was conducted August 26-September 4, 2024, online and by telephone among a nationally representative sample of 1,312 U.S. adults in English (1,244) and in Spanish (68). The sample includes 1,028 adults (n=53 in Spanish) reached through the SSRS Opinion Panel either online (n=1,018) or over the phone (n=18). The SSRS Opinion Panel is a nationally representative probability-based panel where panel members are recruited randomly in one of two ways: (a) Through invitations mailed to respondents randomly sampled from an Address-Based Sample (ABS) provided by Marketing Systems Groups (MSG) through the U.S. Postal Service’s Computerized Delivery Sequence (CDS); (b) from a dual-frame random digit dial (RDD) sample provided by MSG. For the online panel component, invitations were sent to panel members by email followed by up to three reminder emails.

Another 284 (n=15 in Spanish) interviews were conducted from a random digit dial telephone sample of prepaid cell phone numbers obtained through MSG. Phone numbers used for the prepaid cell phone component were randomly generated from a cell phone sampling frame with disproportionate stratification aimed at reaching Hispanic and non-Hispanic Black respondents. Stratification was based on incidence of the race/ethnicity groups within each frame.

Respondents in the phone samples received a $15 incentive via a check received by mail, and web respondents received a $5 electronic gift card incentive (some harder-to-reach groups received a $10 electronic gift card). In order to ensure data quality, cases were removed if they failed two or more quality checks: (1) attention check questions in the online version of the questionnaire, (2) had over 30% item non-response, or (3) had a length less than one quarter of the mean length by mode. Based on this criterion, no cases were removed.

The combined cell phone and panel samples were weighted to match the sample’s demographics to the national U.S. adult population using data from the Census Bureau’s 2022 Current Population Survey (CPS), September 2021 Volunteering and Civic Life Supplement data from the CPS, and the 2024 KFF Benchmarking Survey with ABS and prepaid cell phone samples. The demographic variables included in weighting for the general population sample are gender, age, education, race/ethnicity, region, civic engagement, frequency of internet use, political party identification by race/ethnicity, and education. The sample of registered voters was weighted separately to match the U.S. registered voter population using the same parameters above derived from the 2024 KFF Benchmarking Survey. Both weights account for differences in the probability of selection for each sample type (prepaid cell phone and panel). This includes adjustment for the sample design and geographic stratification of the cell phone sample, within household probability of selection, and the design of the panel-recruitment procedure.

The margin of sampling error including the design effect for the full sample is plus or minus 4 percentage points and is plus or minus 4 percentage points for registered voters. Numbers of respondents and margins of sampling error for key subgroups are shown in the table below. For results based on other subgroups, the margin of sampling error may be higher. Sample sizes and margins of sampling error for other subgroups are available by request. Sampling error is only one of many potential sources of error and there may be other unmeasured error in this or any other public opinion poll. KFF public opinion and survey research is a charter member of the Transparency Initiative of the American Association for Public Opinion Research.