Much of the public appears to be largely in the dark about Democrats’ signature effort to let Medicare negotiate drug prices, a potentially troubling sign ahead of next month’s midterm elections. 

The inclusion of a provision allowing those negotiations in the Inflation Reduction Act marked the culmination of an at least 20-year push by Democrats and was touted as a major win over Big Pharma.

Health care has been a winning issue for the party in previous midterm elections, and the law’s passage was intended to give lawmakers a major political victory to campaign on.

“In this historic moment, Democrats sided with the American people and every single Republican in the congress sided with the special interests,” President Biden told lawmakers in August when he signed the legislation into law. 

Speaking to donors during a Democratic fundraiser on Thursday, Biden again highlighted overcoming the drug lobby, saying the biggest part of the law was “taking on pharma.” 

“You know, we pay the highest drug prices of any nation in the world for the same exact drugs, I might add. Same exact prescription,” Biden said. “Well, guess what? We got it changed so that, now, no senior on Medicare will have to pay more than $2,000 a year for their drug prices, no matter what the cost of their cancer drugs are, no matter what it is.”

But a new Kaiser Family Foundation (KFF) poll shows most adults are unaware of the law’s key health provisions.

Only 36 percent of Americans said they were aware that the Inflation Reduction Act allows Medicare to negotiate drug prices; 29 percent said they knew the law put a cap on insulin prices for people on Medicare and only 29 percent said they knew about a cap on out of pocket prescription drug costs. 

Those provisions are popular. Majorities of voters in the same poll said they would be more likely to vote for a candidate who supports policies like Medicare drug negotiation and an out-of-pocket cap on drug spending for people on Medicare.

“If Dem candidates want to take advantage of their popularity they have to talk about it on the stump,” KFF President and CEO Drew Altman tweeted.

David Mitchell, president and founder of the advocacy group Patients for Affordable Drugs, said he wasn’t surprised that a relatively small percentage of the public were aware of the drug pricing parts of the new law, but he also wasn’t concerned.

“People pay closer and closer attention to the issues the closer we get to Election Day. And so the numbers in terms of awareness will go up in the coming weeks,” Mitchell said. 

Mitchell noted that the law only passed about six weeks ago, and it takes time to increase public awareness.

“I’d like the numbers to be higher. Don’t get me wrong, but you can only go so fast. Educating people, and making people aware of policy issues like this takes time and effort,” Mitchell said. 

Outside allies are trying to help spread the message. 

Democratically-aligned advocacy group Protect Our Care is running a nationwide bus tour this fall to educate Americans about the legislation and promote the work of lawmakers who helped pass it.

Leslie Dach, Protect Our Care’s founder and chairman, said he wanted to avoid the mistakes made regarding the Affordable Care Act, where he said Democrats didn’t do enough to counter Republican attacks and let the opposition hijack the narrative.

“One of the mistakes we allowed to happen was … we talked about the name of the law, not the things [the law did], and the name of the law doesn’t matter,” Dach said. “People would say, you know, I hate Obamacare, but I love the fact that my kids can stay on my insurance till the age 26.”

Biden was set to highlight the benefits of the Inflation Reduction Act to older Americans during events in California and Oregon over the weekend. His messaging aims to reinforce the idea that Democrats are tackling issues of importance to the average family. 

“Americans are squeezed by the cost of living – that’s been true for years and is a key reason the president ran,” the White House said in a fact sheet. “Health care costs in particular are driving inflation.”

According to the White House, Biden will also highlight how every Republican in Congress voted against the legislation, and that they now want to repeal it.

Yet voters won’t see the law’s biggest drug benefits until years down the road. A provision capping insulin costs at $35 per month for diabetic Medicare patients takes effect in 2023. A $2,000 cap on annual drug costs for people enrolled in Medicare’s prescription drug benefit won’t begin until 2025. 

And the most well-known health provision in the bill, letting Medicare negotiate the costs of select drugs, won’t start until 2026. Even then, the negotiations will at first be limited to just 10 drugs; it will be expanded to 20 drugs by 2029.

“Less than a month to the election, you’re going to talk about something you’re gonna give me in two years, or three years or four years. And I’m hurting right now,” said Joel White, a healthcare industry consultant and former House GOP staffer.