Indeed, by the time voters see their impact, the election will have passed. Penalties on drugmakers that hike prices faster than inflation and a new $35-per-month cap on insulin won’t begin until 2023. A $2,000 cap for all out-of-pocket drug spending for seniors won’t be implemented until 2024, and the lower prices Medicare will negotiate with pharmaceutical companies for some of the most expensive drugs won’t be available until 2025 — with a full phase-in coming in 2028. Coverage of hearing aides under Medicare, another one of the provisions most popular with voters, will similarly not begin until 2024.

Some of these provisions aim to lower the cost of the drugs themselves, while others shift the burden onto insurance companies and the governments, and still others aim to simply slow the speed at which prices increase.

“It may all feel a little theoretical rather than tangible for voters, and that poses a challenge for Democrats in the midterm elections,” said Larry Levitt, the executive vice president of the Kaiser Family Foundation. “Any time when there’s a gap between a bill passing and it going into effect, that gives opposition forces time to mobilize. The Affordable Care Act, for example, had a long lag between its passage and when it took effect, and the opposition certainly mobilized during that time. It’s still standing, but Democrats took a big political hit.”