A version of the article below ran as the second edition of our Midterms in 30 newsletter, which you can sign up for here. We’ll have a round-up of the results first thing tomorrow.  

WASHINGTON — In Idaho, Nebraska, and Utah, voters will directly decide whether their states should expand their Medicaid programs. In Wisconsin, they could elect a candidate for governor who has pledged to sharply curtail drug prices. And across the country, Democratic congressional candidates are running on platforms highlighting their support for protecting insurance coverage for those with pre-existing conditions and lowering drug prices.

Health care is on the ballot across the country, with issues ranging from medical marijuana to abortion rights to insurance coverage dominating the conversation.


Below, STAT rounds up the eight elections that have centered on drug prices and the pharmaceutical industry, as well as a number of health-focused ballot initiatives, and outlines how today’s elections will impact the health care and life sciences industries.

Eight races we’re watching — almost all too close to make a prediction

U.S. Senate, New Jersey: Can Bob Hugin, the former Celgene CEO, pull off a stunner against Bob Menendez, the embattled Democrat plagued by corruption charges?

U.S. Senate, Missouri: Sen. Claire McCaskill (D) has made high drug prices and the pharmaceutical industry’s political influence central to her campaign.

Michigan’s 6th Congressional District: Long a key figure in health policy, Rep. Fred Upton (R) was a leader in Republican efforts to repeal the Affordable Care Act in 2017. Upton’s Democratic opponent — an M.D. — has criticized him in ads for accepting campaign contributions from health insurance and drug companies.

California’s 48th Congressional District: Harley Rouda is a Democrat in a traditionally red district, challenging Rep. Dana Rohrabacher. Protecting people with pre-existing conditions has been a central campaign theme — oh, and one of Rouda’s first major campaign statements was a blog post titled “No Thanks, Big Pharma.”

New York’s 27th Congressional District: Could Rep. Chris Collins, a Republican facing insider trading charges for selling off shares of a biotech firm in which he was the biggest shareholder, win anyway? If he does, expect to hear plenty more about Innate Immunotherapeutics.

U.S. Senate, West Virginia: Attorney General Patrick Morrisey, the Republican candidate, has lobbied for drug companies, and is taking flak for it from Democrats. Sen. Joe Manchin, the Democrat, is the father of Mylan CEO Heather Bresch, and is taking flak for it from Republicans.

Maine’s 2nd Congressional District: Rep. Bruce Poliquin, a Republican, is a target of the drug pricing advocacy group Patients for Affordable Drugs. His Democratic opponent is in favor of Medicare negotiating for prescription drug prices.

Wisconsin governor: Tony Evers, the Democratic candidate for governor in Wisconsin, is running on a promise to install a board that would fine drug companies for excessive price hikes. Scott Walker, the Republican governor, opposes the plan.

STAT will have updates throughout the night on all these races, plus a host of other key ballot questions in states around the country — stay tuned here.

Pharma pivots to Dems in the election’s closing weeks

The drug and health products industry has slightly favored Republicans this cycle, but in the final weeks of the campaign, 63 percent of contributions have gone to Democrats. It’s a shift that comes as election forecasters say the party is increasingly likely to capture the House of Representatives today (they have an outside shot at the Senate, too).

It also mirrors a trend in which major industries shift last-minute spending toward whichever party is favored to wield power in the coming years in Washington.

So far, industry employees and affiliated political committees have sent $24.6 million to candidates around the country running for Congress and state offices. It’s a record for a midterm year, but falls short of recent elections featuring a presidential race. Read more.

Three pharma allies in the Senate? Two upsets today could make it a reality

Patrick Morrisey, West Virginia’s attorney general and a former lobbyist for companies like Bayer and Novartis, is looking to become the state’s next Republican senator today. Bob Hugin, the Republican challenger for Senate in New Jersey, is the former CEO of the drug manufacturer Celgene.

If they both win, they’ll join Sen. Jon Kyl (R-Ariz.), a former senator and former PhRMA lobbyist who was appointed to fill the seat of the late John McCain. After a year that has seen a Republican president and Democratic lawmakers shame drug companies for their pricing practices, a Senate that includes a former pharma CEO and two industry lobbyists would be an unexpected ending. Read more.

‘Right to try’ gets airtime for Democrats and Republicans

The “right-to-try” bill signed into law by President Trump in May probably won’t dramatically expand access to experimental medications for terminally ill patients, as the White House has argued. But you wouldn’t know that from campaign ads playing around the country.

Rep. Brian Fitzpatrick, a Republican facing a difficult re-election race in Pennsylvania, is using a 60-second spot featuring a father with ALS to tout his role getting the legislation passed. Rep. Karen Handel, a Republican struggling to keep her seat in suburban Atlanta, has an ad that claims “government red tape blocks life-saving treatments,” highlighting her yes vote on the bill.

And Sen. Joe Donnelly, a Democrat from Indiana, has his own TV ad that even includes a President Trump quote from the bill signing: “Senator Donnelly, thank you very much.”


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Everything else you need to know

A coalition of 135 candidates for Maryland’s state legislature is running on a pledge to support a bill that would install a price-setting committee for prescription drug purchases there. Local candidates across the country, much like a number of national Democrats, are discovering the power of drug pricing as a campaign issue. Read more.

A gubernatorial election in Maine and ballot initiatives in Idaho, Nebraska, and Utah will decide whether those states expand Medicaid. California is considering a controversial measure to regulate dialysis clinic profits, Massachusetts votes on a cap on nurse-to-patient ratios, and Alabama and West Virginia voters could amend their state constitutions to narrow abortion rights. The New York Times lays out the health issues being decided by state ballot initiatives around the country.

Just 10 percent of Democratic campaign advertisements in 2016 mentioned the Affordable Care Act. It came up in more than half this year — and voters continue to make clear which issue matters most to them, Annie Lowrey writes in The Atlantic.

Republicans continue to mislead on whether their policies will protect those with pre-existing health conditions, Margot Sanger-Katz writes in the New York Times.

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