SAN FRANCISCO — California billionaire activist Tom Steyer made his name as an environmental activist, worked with Democratic groups to register a million new voters and redefined green politics with high-profile campaigns on climate change and clean energy.

Now as he weighs a run for public office, he's adding health care — specifically drug prices — to his brand.


“Health is becoming the lens for seeing a lot of policy issues, including addiction, including climate,” Steyer told POLITICO in an interview in the San Francisco offices of his environmental policy advocacy group, NextGen Climate.

The former hedge fund executive, 59, is backing a California effort to force drug manufacturers to give notice of price increases, a move Steyer sees as a first step to reining in drug costs and curbing the power of corporate interests.

Taking on the pharmaceutical industry could broaden his appeal if he opts to join the crowded Democratic field competing to succeed Gov. Jerry Brown next year. But even if he doesn’t run himself, adopting drug prices as a cause — soon after pushing a successful initiative to raise tobacco taxes — enhances his already substantial role as a counterweight to conservative donors such as the Koch brothers. Steyer himself has already emerged as the single biggest individual campaign donor in the last two election cycles.

Asked directly how close he is to deciding whether to run for governor, he demurred. “I’m going to be working on these same issues, no matter what,” he said. “The question is, what can I do that is going to have the best value, the most impact?”

Drug prices resonate with voters in both parties.

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The drug price battle is playing out in legislation passed last month by the California Senate that is slated to be heard June 27 in the Assembly health committee. It comes at a time when 86 percent of Americans are in favor of requiring drug manufacturers to release more information about how they set prices, according to a Kaiser Family Foundation poll last month. Sixty percent of respondents said lowering drug costs should be a “top priority” for the president and Congress.

Steyer first took up health care last year, pushing to raise California's tobacco tax by $2 a pack and use the more than $1 billion in annual proceeds to help finance the state's Medicaid program. He’s come to see the interconnections between his signature issues, among them climate, clean energy, health care and children’s well-being.

“We talk about climate in terms of the impact on people’s air quality and ability to breathe,” he said. “That is a lens through which you can get a lot of positive outcomes and positive policies.”

Outrage over the cost of drugs became a potent campaign issue in 2016, as lawmakers on both sides excoriated "pharma bro" Martin Shkreli and Mylan’s price hikes for its EpiPen. Since then, Trump seems to have softened his stance to allow Medicare to negotiate drug prices, though, and Congress seems unlikely to make substantive changes, leaving room for states like California to act.

That's created an opening for Steyer, who, despite a public demeanor sometimes described as stiff and scripted, relishes a big fight.

Steyer stepped down from his firm, Farallon Capital Management, in 2012 to focus full-time on political and philanthropic interests. He has since led a push to register 1 million new voters nationwide, partnering with local Democratic party chapters and groups such as Planned Parenthood. And he used his personal fortune to push back the Republican tide that consumed Washington, spending more than $166 million in 2014 and 2016 on Democratic causes and candidates.

In March, Steyer joined a coalition of California health advocates to throw his weight behind S.B. 17, authored by state Sen. Ed Hernández, who chairs the health committee and is running for state lieutenant governor next year. In addition to requiring drug manufacturers to give purchasers 90 days' notice before significantly raising prices, the bill would also make health plans report the percentage of premiums they spend on prescription medications.

“Until Steyer came around, there was no one who was an offset to the Kochs,” said Chris Lehane, a longtime Democratic strategist who’s served as Steyer’s political adviser. “He has had an incredibly successful career, and now he wants to use resources, his time, his energy and talent to energize different issues out there. ... He’s at a place in his life where he is really looking at how he can make the biggest impact on the things he really cares about.”

Steyer grew up on New York’s Upper East Side. A graduate of Yale, he moved west to get his MBA at Stanford. While he talks passionately about topics such as income inequality, he’s widely seen as lacking the charisma that’s propelled so many politicians to the forefront, including his potential Democratic rival and frontrunner in the governor’s race, Lt. Gov. Gavin Newsom. And as former eBay CEO Meg Whitman's 2010 gubernatorial bid showed, Steyer is playing in a state that's been traditionally cool to wealthy political neophytes.

Steyer is “not a guy who comes in and grabs the room,” said David McCuan, a political science professor at Sonoma State University. McCuan said concentrating on issues like drug prices makes sense as Steyer weighs his options.

“California clearly is a model and laboratory for what direction the Democrats could go,” he said, irrespective of whether Steyer is interested in public office “or just remaining an ATM.”

Jessica Levinson, who teaches politics and ethics at Loyola Law School in Los Angeles, said Steyer's push into health care makes him a more well-rounded candidate. “He doesn’t want to be known as the environmental guy who spends a lot of money,” she said.

Lehane, who is now head of global policy and public affairs for Airbnb in San Francisco, describes Steyer’s personality as authentic, and counters that he’s already been working on a range of issues for years.

Steyer made his mark through California’s oft-used ballot initiative process. He helped draft the tobacco tax measure and poured $11.5 million of his own money into what ultimately was a $35.5 million campaign to support it. Tobacco companies spent roughly twice as much in a bid to kill the proposition, which passed with more than 64 percent of the vote.

In 2010, Steyer teamed up with former Reagan administration Secretary of State George Shultz to oppose a state proposition that would have suspended California's landmark climate-change laws. Voters soundly defeated the measure, which was backed by out-of-state oil interests, by a 21-point margin.

Steyer was also the force behind a 2012 state measure that closed a tax loophole for multi-state corporations and diverted some of the recovered revenue to fund clean energy. (An Associated Press report three years later found job growth from the effort was slower than anticipated.)

His bid to be a Democratic kingmaker have been less successful. Three of the six NextGen-backed candidates for the U.S. Senate lost in 2016. His backing of green-friendly candidates in 2014 also met failure, including in the Colorado governor’s race and a House contest in Iowa. Steyer and NextGen also spent millions in Florida trying unsuccessfully to oust Republican Gov. Rick Scott.

This week, Steyer announced he will put more than $7.5 million into an effort to register and turn out young voters in eight states ahead of the midterm elections.

Steyer said in the interview he's frustrated that issues like the environment can’t be more bipartisan. But he's confident California can be a laboratory for a progressive agenda.

Though the drug bill Steyer backs doesn’t set prices, it would shed light on manufacturers' strategies by requiring advance notification of cost hikes and more information from insurers about how much they spend on drugs.

“The first step to fairness is transparency,” Steyer said. “The patents on drugs give them an effective monopoly. You’re getting a monopoly price where they don’t even want to tell you the costs. They don’t even want to tell you in advance when they’re going to be changing the price. That seems pretty outrageous to me.”

Supporters of a drug price ballot initiative that failed last year question whether Steyer's late arrival to the game is motivated by political convenience. Proposition 61 would have limited some state health programs from paying more for drugs than the negotiated prices paid by the federal Department of Veterans Affairs. Voters rejected it by a 6-point margin, 53 to 47 percent, after drug interests spent more than $111 million fighting the bid, making it the most expensive ballot measure in U.S. history.

“It’s a little ironic somebody could be out there raging against high drug prices, but played no role [whatsoever] as a supporter of Prop. 61 when we were getting carpet-bombed by the drug companies,” said Garry South, a longtime Democratic consultant and lead strategist for the campaign. “You’ve got to put your money where your mouth is.”

Steyer said he was focused on the tobacco tax at the time. The drug bill he’s backing this time has already drawn the ire of manufacturers, but battles over bills in the legislature are less expensive than ballot-box fights. Steyer said he didn't know how much he might invest to get the bill to the governor’s desk.

Drug companies don’t want to lose any ground and are expected to push back.

Hernández, the bill’s author, pulled a similar measure last year after it was watered down in the Assembly under pharmaceutical industry pressure. He's hoping for more success this time due to changes in the makeup of the Legislature and increased public angst over drug prices.

Priscilla VanderVeer, spokeswoman for Pharmaceutical Research and Manufacturers of America, said the group is willing to work with lawmakers on “solutions that have a meaningful impact on affordability.

“Unfortunately, this bill captures just one sliver of the larger drug supply chain and fails to shed light on other parts of the system, including its failure to explain why insurers aren't paying full list price for medicines but patients often are,” she said.

The legislation has drawn support from health insurers, hospitals and labor and consumer groups who could emerge as allies in future Steyer battles.

“This doesn’t seem to me to be a very controversial bill,” Steyer said, referring to the price-hike notification requirement. Drug manufacturers “obviously did these major price increases without telling anyone that were completely unsupportable. … They’ve been justifying their behavior, and when the real truth comes out, their justifications are going to fall apart.”