Missouri voters earlier this week sided with a supporter of a drug rebate program that benefits Republican-leaning, rural and working-class voters but has come under fire from large pharmaceutical companies seeking to eliminate it to boost their profits.
Lieutenant Governor Mike Kehoe defeated incumbent Secretary of State and powerful Ashcroft family scion Jay Ashcroft to win the Republican nomination for governor of the Show Me State.
The outcome reflects a number of factors, including the fact that it was a three-candidate race, Ashcroft’s alleged lies about his professional status as an engineer, and the launch of an investigation into current Senator Josh Hawley. Ashcroft, the other “biggest name,” called for an open “Repeal[ing]“the 340B drug rebate program that benefits many Missourians. While Kehoe did not take an explicit stance on the legislation, the Missouri Hospital Association – a supporter of the program that sees it as crucial to keeping rural health care providers open and serving patients –supported him, and not Ashcroft.
Kehoe was also endorsed by outgoing Governor Mike Parson. President Trump remained neutral among three Republican candidates.
Earlier this year, Missouri lawmakers adopted by an overwhelming majority Legislation to protect the 340B drug rebate program Imitation of laws from other very red states with immense rural, white working-class populations such as West Virginia, Louisiana, Arkansas, Mississippi, and neighboring Kansas. Governor Parson allowed this legislation to become law. This was probably all done on the basis that for any flaws in the program that 2004-style Republicans might point to, rural, working class American—often derided as “Trumpers”— benefit disproportionately from 340B.
This in turn explains why former Representative. Vicky Hartzler, former Representative. Billy H. LongAnd current representative. Sam Graves– all of Missouri – are staunch supporters of the program. This probably explains why Under President Trump, maximum price legislation was introduced to ensure that drug manufacturers cannot refuse price reductions. Notably, a former Mike Pence aide who is running an anti-340B campaign (and who also supports establishment Republican Glenn Youngkin) recently attempted to crush This plan failed in Missouri, even though it was not a program – just as Ashcroft, who had allied himself with opponents of the drug rebate program, now failed in his attempt to become governor.
There is a broader political lesson to be drawn from all this. As the Republican nomination of Trump in 2016 – a proponent of more populist, less libertarian economic policies – and twice since then should make clear, the era when Republicans who win at the ballot box tend to come from the Chamber of Commerce and believe that “whatever is good for big business is good” is long gone. Trump’s decision to nominate Senator JD Vance for vice president should make this doubly clear.
Many conservative opinion leaders, especially in the more moderate or establishment GOP race, may like Youngkin — and may have liked Bush and even Mike Pence. But even when Trump was politically delicate and potentially challenged for the GOP nomination, Youngkin never jumped into the fray — likely because while he may have had support from some large donors, he simply wasn’t as popular with actual Republican voters as Trump or Vance, or possibly even lesser-known Missouri Republicans like Hartzler.
Bush has long since disappeared from the political scene. Pence, who was running for the Republican nomination in 2024, found that there was less of a market for his brand of Republican thought than for that of Nikki Haley – who from the start seemed to be walking a tightrope when she ran against Trump, for whom she had worked as a UN ambassador.
Like it or not, the Republican style we all remember from 20 years ago is gone today, and we can see that in Missouri, where large names like Ashcroft are now losing elections while figures like Kehoe, who has sided with actual, rural health care providers, are on the rise. Given the money at stake, we will no doubt not stop seeing “big” corporations attack programs and policies that benefit actual GOP voters through consultants who previously worked for large GOP names of yesteryear.
But these attacks are unlikely to be successful if they were not at least linked to the name Ashcroft – which continues to play a major role in Missouri.
