How Campaign Ad Spending Indicates Potential Lame Duck & 2025 Congressional Health Policy Priorities

Introduction

A professional advocate should have many prisms by which they look at the landscape in front of them. Raw politics is one - both how issues are affected by the way in which elections are won, but also the margins by which victory is achieved. Hard policy is another, diving deep into the weeds of legislative and regulatory language to craft ideas that eventually make their way into law. But one, frequently less relied upon prism, is examining the issues upon which campaigns are won, and if that emphasis led to the electoral margins a candidate desired. And nothing indicates more the issues a candidate thinks will win an election than where they spend their campaign dollars.?

In today’s dispatch, we take a look at Republican and Democratic ad spending between August and October 14 and examine what that could mean for activity in official Washington during both the lame duck session of Congress and for policymaking in 2025.?

Republican Campaign Ad Spending

In August, according to AdImpact, Republican broadcast TV spending focused little on ads related to taxation. However, between October 1 and 14, that drastically rose to $25.3 million, a whopping 1500% increase from August. At the same time, GOP ads on issues of crime, the economy, and inflation, began to slow. As we head deeper into the election cycle, this represents a period where reporting focused on a declining crime rate, the economy improving and inflation cooling, just as Americans are looking more closely at the election. What may be most fascinating is that even though voters continue to say the economy is not good, Republican ad spending is de-emphasizing that dynamic, which means either it is not as salient in moving voters from their beliefs to actual voting or that other issues are more motivating.

Democratic Campaign Ad Spending

Shifts in Democratic ad spending between August and October are not as stark as on the Republican side. While there was a marked shift in spending on advertising associated with taxation, rising from 25% of spending in August to 49% during the first half of October, inflation ad spending declined by almost 70%, perhaps mirroring data Republican campaigns are seeing during a time of improving economic conditions and decreasing inflation. Spending on traditional Democratic issue-area strengths also declined, but did not disappear (healthcare declined from 26% of spending in August to 14% so far in October, abortion went from 33% to 12% and Medicare was reduced from 18% to 4%). The sharpest spending increase from Democratic campaigns has been reserved for “character,” rising from 17% to 28% of total ad buying and indicating potency in that area in terms of motivating Americans to vote in the final stretch of the campaign.?

Note To Healthcare Watchers While the declines in Democratic healthcare related advertising may seem significant, they also remain present, with ads being aired highlighting efforts to lower prescription drug costs, protect the Affordable Care Act, and expand Medicare coverage.?

What Could This Ad Spending Mean For Healthcare Policy Making In 2025?

For both sides, it seems one of the issues the campaigns see motivating voters - whether positively or negatively - is taxation. This makes sense, as a major legislative achievement of the Trump administration was the Tax Cuts and Jobs Act, portions of which are set to expire in 2025. Washington is already preparing for this legislative showdown (see Washington Prepares for the ‘Super Bowl of Tax’ and Progressives gear up for 2025). As we wrote in August, the collision of the expiration of both the Trump tax cuts and enhanced subsidies for insurance on the exchanges, combined with the significant increase in ACA enrollment in red states, is a coming fight, and campaign ad spending is reflecting part of that dynamic. How that collision is resolved certainly depends on the balance of power after the election, but if even one part of the government is controlled by each party, there will be deals to be had on that front.?

Less paid attention to is how healthcare and taxation could converge depending on the balance of power. Republicans traditionally have looked to the tax code to achieve policy ends including Flexible Spending Accounts, Health Savings Accounts and Individual Coverage Health Reimbursement Arrangements (ICHRAs). Of course, the largest tax expenditure in the IRS code is the pre-tax treatment of employer provided health insurance coverage, which a GOP policy committee has proposed to cap in a specific way. ?

On the Democratic side, the ad spending demonstrates that while healthcare issues may be further down the line of issues motivating voters to get to the polls, issues of prescription drug costs, preservation of the Affordable Care Act, abortion, and Medicare remain potent and in the mix.?

As the election heads towards its conclusion, its outcome - particularly the margins of those results - will inform how the lame duck session of Congress and the 2025 congressional agenda shape up. The bigger the win for each side, the less incentive either will have to make deals in lame duck, but the greater the partisan possibilities will become in 2025. Alternatively, tighter margins - both electorally and in the composition of Congress - will likely force a moderation of policies being put forward.?

Finally, elections are both directional choices for America and also calibrate the degree of change at hand. The core societal issues that need attention, however, remain. In 2025, healthcare players will navigate:

• Potential reform of Medicare physician payment
• The future of Medicare Advantage as it enters its third decade
• Whether or not prescription drug negotiation will remain or be expanded
• Changes to the regulation of pharmacy benefit managers
• What telehealth will look like; and?
• Potentially the regulation of artificial intelligence and how it’s used by insurers, hospitals and clinicians to deliver care to the American people (A broader, AI bill is being considered for lame duck)?

November's election will tell us a lot about where these issues are going, but the current ad spending tells us what the candidates are seeing as they ask the American people for their vote.???

BONUS CONTENT → During The October Before An Election, Washington, DC Is Different?

We wanted to touch on an often overlooked advocacy dynamic - what it’s like in Washington, DC during the lead up to a presidential election - because it is different from any other period of our two-year congressional cycle. During this time, Capitol Hill is quiet, the hallways of the House and Senate Office buildings are almost abandoned, and much rulemaking at the agencies slows to a crawl as the executive branch deploys cabinet secretaries and agency heads out into the country on official business but in politically potent ways.?

For firms, trade and member associations, and companies with business and policy priorities before the federal government, during this time there are two primary activities in which to engage:

1. Identifying potential scenarios and balances of power which could exist after the election and what they may - or may not - mean for your policy priorities
2. Knowing that in Washington, personnel is policy, and that it is therefore critical to map potential officials who may soon be in charge of the areas of the federal government you care about

While many organizations do take this time to recharge, a mistake often made is to sit back for too long, leaving you unprepared for the sprint after the election. One secret I have found about this time is that it is a phenomenal opportunity to bring executives to Washington and have deep and often long conversations with top staff who are more relaxed and focused while their politician-bosses are out campaigning.?

Platform Government Strategies excels at the above two points, and is here to assist you in:

1. Developing a strategy
2. Finding a way forward
3. Understanding the landscape; and
4. Most importantly, serving as an exclusive partner with you to implement your plan

Interested In More?

Platform Government Strategies brings 20 years of experience to bear. If you or your teams have questions on these issues or other areas of government health policy, consider visiting our website, Platform Government Strategies, and looking over the services we offer. You can also email [email protected].