By the time the final frenzy of ads both for and against Issue 2 airs this week, the two sides will have broken a record for campaign spending in Ohio.
The question is, will people have any better understanding of what the issue is about?
Many voters are still expressing confusion about the prescription drug price ballot issue as Election Day looms, despite the $73 million that had been raised by supporters and proponents as of mid-October to convince voters to back their side.
RELATED: Ohio’s drug price ballot issue: What’s really going on?The general wisdom among political scientists is that if an issue is too confusing, voters reject it. And that may be what is driving the immense spending by the opposition side to Issue 2, said Daniel Birdsong, political science lecturer at the University of Dayton.
The more than $40 million that has been spent since July 1 — all of it money provided by PhRMA, an industry trade group that includes drug companies like Johnson & Johnson, Merck, Pfizer and Eli Lilly — could be an effort to sow confusion, according to Birdsong.
”By selling the confusion, it makes it easier for people to vote no,” he said.
Issue 2 would require the State of Ohio to pay no more for prescription drugs than the price paid by the United States Department of Veterans Affairs.
It also gives standing to four petitioners to intervene in any legal challenge of the law, with the state responsible for “reasonable” attorney fees and other expenses, according to the language on ballot.
A group called Ohio Taxpayers for Lower Drug Prices is pushing the measure, saying it will save the state an estimated $400 million annually. The group has its own outside funding, virtually all of it coming from the Los Angeles-based AIDS Health Care Foundation.
The main opposition group, Ohioans Against Deceptive Rx Ballot Issue, disputes the $400 million figure and argues that the proposed law could lead to increased drug prices for all Ohioans, including veterans.
More than 80 state and national organizations opposed to the issue include groups representing doctors, nurses, pharmacists, veterans, business, labor, and patients, the group says.
A yes vote would allow the state to use the savings the measure will generate for other uses in the budget, or give Ohioans a tax break, the Ohio Taxpayers for Lower Drug Prices says.
Supporters also argue that once the state — a $2.9 billion purchaser of prescription drugs — demands lower prices from drug companies, it will put pressure on the industry to give lower prices to other entities like private health insurance companies and Medicare.
“If you’re waiting for the federal government to fix this problem, I’d encourage you, don’t hold your breath,” said Matt Borges, a spokesman for the campaign. “This is an opportunity for the citizens of Ohio to take the power into their own hands. If you want lower drug prices, you have to vote yes and it’s the drug companies that want you to vote no.”
The two sides have some unusual partners. U.S. Sen. Bernie Sanders, I-Vt., has endorsed the measure, which has as its main spokesman Borges, the former chairman of the Ohio Republican Party.
And although a number of prominent Republicans are standing on the No side, its spokesman is Dale Butland, the former chief of staff to longtime Democratic Sen. John Glenn.
Butland admits he’s being paid to carry water for the drug companies on the issue, but he says he wouldn’t do it if he didn’t believe in the message.
“Virtually every expert who has studied this proposal, including a former state budget director and three former Ohio Medicaid directors, have all concluded the same thing,” he says. “This is a flawed proposal that will not work or do what it promises. In fact, it’s only going to make things worse by likely raising drug costs for the majority of Ohioans and reducing access to needed medicines for some of our most vulnerable people.”
An analysis of the issue by the Ohio Office of Budget Management concluded Issue 2 is unlikely to result in any savings for Ohio’s Medicaid program, which makes up the bulk of the state’s spending on prescription drugs.
Mark Caleb Smith, director of the Center for Political Studies at Cedarville University, said the atypical alliances have contributed to the confusion many voters have.
“When you see groups you usually follow being fractured on an issue, it makes it more confusing,” he said.
Where the governor candidates stand
The Issue 2 vote is coming a year before Ohioans select their next governor, yet not all the candidates are willing to say where they stand on the issue that is garnering most of the election attention this year.
Republican Attorney General Mike DeWine said he’s not taking a position on the ballot issue because he’s filed lawsuits against drug companies over the opioid crisis.
“I don’t want to get involved in Issue 2,” he said.
Dayton Mayor Nan Whaley also says she is not taking a position. Dayton, too, has filed a lawsuit accusing drug companies of contributing to the opioid crisis.
Lt. Gov. Mary Taylor and Ohio Secretary of State Jon Husted, two Republicans vying for the GOP nomination in next May’s primary, both oppose Issue 2.
“She believes it is unworkable from an administrative perspective, primarily because we can’t always know what the VA pays for prescriptions due to a lack of transparency in pricing,” said Michael Duchesne, Taylor’s communications director. “She is also, as a general rule, leery of government price control because it invariably leads to costs being shifted to someone else, like our small businesses who are the engine of Ohio’s economy. Finally, she is concerned about how a drug that is not used by the VA will be priced.”
Husted said: “The fact that the taxpayers of the state of Ohio would be forced to foot the legal bill for the battle over these special interests is reason enough.”
The Yes side has said the language about attorney fees was added to ensure that the state follows the law if voters approve the issue.
Former U.S. Rep. Betty Sutton, one of five Democrats who have said they are running for governor, is voting yes, according to her campaign.
“Betty supports lower prescription drug costs, has fought for quality, affordable health care and lower prescription drugs at the state and federal level, and regardless of how Issue 2 comes out, as governor she will be ever vigilant in the fight against the special interests and Republicans in Columbus that favor the drug companies over hard working Ohioans,” said spokesman Randy Borntrager.
And while Dennis Kucinich has refused to confirm rumors that he is considering a run for governor, the former congressman and Cleveland mayor is unequivocal about his support for Issue 2.
“If health care is going to be affordable, we have to make prescription drugs affordable,” Kucinich said. “To me its a basic economic principle.”
Issue proposes to enact Chapter 194 of the Ohio Revised Code. Here is the exact language on the ballot measure. A yes vote would:
- Require the State of Ohio, including its state departments, agencies and entities, to not pay more for prescription drugs than the price paid by the United States Department of Veterans Affairs.
- Establish that the individual petitioners responsible for proposing the law have a direct and personal stake in defending the law.
- Require the State to pay petitioners’ reasonable attorney fees and other expenses.
- Require the petitioners to pay $10,000 to the State if the law is held by a court to be unenforceable and limit petitioners’ personal liability to that amount.
- Require the Attorney General to defend the law if challenged in court.