Monthly Archives

July 2017

Support for “Skinny Repeal” Is Looking Thinner and Thinner

Once more the people who know health care the best think the latest Republican plan to repeal and delay is the worst

From the left to the right, from the expert to the voter, more and more people are coming out against the Senate Republicans’ latest health care repeal scheme — known as “Skinny Repeal” — which is just another name for repeal and delay. The nonpartisan Congressional Budget Office found that the plan would cut coverage for 16 million Americans next year and raise premiums by 20%.

Sure enough, last night, a bipartisan group of governors, including Nevada Governor Brian Sandoval, came out against the scheme — saying it would destabilize the markets, raise premiums and leave more people without insurance. They are not alone. More and more stakeholders — from the American Medical Association to the Blue Cross Blue Shield Association to AARP- and health experts agree that the skinny plan would be a disaster.

The support for “Skinny Repeal” is growing more and more thin by the day. Take a look for yourself…

REPUBLICAN AND DEMOCRATIC GOVERNORS: “SKINNY REPEAL” PLAN WOULD RAISE PREMIUMS AND LEAVE PEOPLE WITHOUT INSURANCE

Bipartisan Group Of Governors: “Skinny Repeal” “Is Expected To Accelerate Health Plans Leaving The Individual Market, Increase Premiums, And Result In Fewer Americans Having Access To Coverage.” “The Senate should also reject efforts to amend the bill into a ‘skinny repeal,’ which is expected to accelerate health plans leaving the individual market, increase premiums, and result in fewer Americans having access to coverage.” [Governors John Hickenlooper (D-CO), Steve Bullock (D-MT), Brian Sandoval (R-NV), Larry Hogan (R-MD), Tom Wolf (D-PA), John Bel Edwards (D-LA), Terry McAuliffe (D-VA), Charlie Baker (R-MA), John Kasich (R-OH), Phil Scott (R-VT), 7/26/17]

STAKEHOLDERS: THE SKINNY PLAN REPEAL WOULD DESTABILIZE THE MARKETS AND INCREASE PREMIUMS

American Medical Association: “Skinny Repeal” Will Lead “To Adverse Selection That Would Increase Premiums And Destabilize The Individual Market.” “There has been considerable speculation regarding a so-called “skinny package” that would primarily eliminate penalties related to the individual and employer mandates and provide tax cuts to device manufactures and the health insurance industry. Eliminating the mandate to obtain coverage only exacerbates the affordability problem that critics say they want to address. Instead, it leads to adverse selection that would increase premiums and destabilize the individual market.” [AMA, 7/26/17]

Blue Cross Blue Shield Association: “A System That Allows People To Purchase Coverage Only When They Need It Drives Up Costs For Everyone.” “If there is no longer a requirement for everyone to purchase coverage, it is critical that any legislation include strong incentives for people to obtain health insurance and keep it year-round. A system that allows people to purchase coverage only when they need it drives up costs for everyone.” [New York Times, 7/26/17]

American Academy Of Actuaries Health Practice Council: Repealing The Individual Mandate Would Raise Premiums And Costs To The Federal Government. “Eliminating the mandate, by lowering financial penalties or exempting particular categories of individuals from its requirements, would likely have significant implications for health insurance coverage and costs both to consumers and the federal government….Eliminating the individual mandate would lead to premium increases….Higher premiums could lead to increased federal government costs for premium subsidies.” [American Academy of Actuaries, 7/25/17]

AARP: “AARP Has Vigorously Opposed All Of The Measures That Would Increase Costs And Strip Away Needed Health Care Coverage From Older Americans — And Will Continue To Fight Against Any Bill That Would Increase Costs And Lower Benefits.” “Senate leaders now hope they can convince a majority of senators to vote for a scaled-back bill that is being called a ‘skinny’ repeal bill… The Congressional Budget Office (CBO) has not published a score for this specific measure. But actuaries and the CBO in the past have said that if the individual mandate were eliminated, 15 million fewer people would have insurance, and premiums for older adults would escalate because many healthy people would drop their coverage and insurers would be left covering older and sicker Americans… AARP has vigorously opposed all of the measures that would increase costs and strip away needed health care coverage from older Americans — and will continue to fight against any bill that would increase costs and lower benefits.” [AARP, 7/26/17]

HEALTH EXPERTS: THE SKINNY PLAN IS A TROJAN HORSE THAT WOULD RAISE PREMIUMS AND BE A DISASTER FOR THE INDIVIDUAL MARKET

Atul Gawande, Harvard School of Public Health: “‘Skinny Repeal’ Is A Known Disaster.” “‘Skinny repeal’ is a known disaster. 1995: WA state repealed mandate; kept guaranteed issue. 1999: no insurers left.” [Tweet, 7/26/17]

Los Angeles Times: When Washington State Repealed The Individual Mandate, Double-Digit Rate Increases Followed Before Insurers Pulled Out Of The Market. “When the new Legislature convened in 1995, GOP lawmakers set about pulling apart the law, bringing along Democrats who feared Republicans would repeal it through a ballot measure if they didn’t cooperate. The hastily crafted repeal — which the Legislature sent to the governor in three months — kept some popular parts of the law such as the guarantee that everyone could get coverage, even if they were sick. It scrapped parts voters didn’t like, including the requirement that state residents have health insurance. The state’s insurance market started teetering soon afterward. First, health insurers sought a series of double-digit rate hikes in 1995 and 1996. The health plans warned that with no requirement to have coverage, people were signing up for insurance only when they got sick, sending costs skyrocketing. Then, in November 1998, Premera Blue Cross, one of the state’s leading insurers, announced it would stop selling health plans, citing more than $100 million in losses. Regence and Group Health Cooperative, the state’s other two leading plans, quickly followed.” [LA Times, 5/31/17]

Robert Greenstein, Center On Budget Policies And Priorities: “In Short, The ‘Skinny Repeal’ Bill Is A Trojan Horse Designed To Resuscitate The Effort To Repeal Large Parts Of The ACA And Impose Big Medicaid Cuts That Would Jeopardize Coverage For Millions Of The Nation’s Neediest People.” “In short, the ‘skinny repeal’ bill is a Trojan horse designed to resuscitate the effort to repeal large parts of the ACA and impose big Medicaid cuts that would jeopardize coverage for millions of the nation’s neediest people. Indeed, when asked today whether Medicaid cuts would be in the “skinny repeal” bill, Senate Majority Whip John Cornyn replied, ‘No, I think people understand we’ll address the Medicaid issue when we conference with the House.’” [CBPP, 7/26/17]

Center For American Progress: “Skinny Repeal” Raises Premiums $1,238. [Center for American Progress, 7/25/17]

Larry Levitt, Kaiser Family Foundation: “20% Premium Spike And 15 Million Uninsured Increase.” “CBO on repealing the individual mandate (‘skinny repeal’): 20% premium spike and 15 million uninsured increase.” [Tweet, 7/25/17]

Josh Bevins, Economic Policy Institute: “Skinny Repeal” Would Bring System To “Almost Complete Collapse.” “But, [Josh Bevins, Research Director of the Economic Policy Institute] says, doing away with the mandates would bring the health-care system to ‘almost complete collapse.’ This is because letting people freely opt out of buying insurance creates prohibitive premiums for everyone else.” [QZ.com, 7/25/17]

Vox: “Repealing The Individual Mandate Risks Sending Obamacare’s Insurance Markets Into A Death Spiral.” “…repealing the individual mandate risks sending Obamacare’s insurance markets into a death spiral. Health insurers have long said that a compulsion for people to buy insurance is necessary in order for the law to work, after it required that insurers cover everyone and charge everyone the same premiums no matter their health.” [Vox, 7/25/17]

FLASHBACK 2015: SENATE REPUBLICANS RUBIO, LEE AND CRUZ OPPOSE “SKINNY REPEAL”

Sens. Marco Rubio (R-FL), Mike Lee (R-UT), Ted Cruz (R-TX): Repealing Only Parts Of Obamacare “Simply Isn’t Good Enough.” “On Friday the House of Representatives is set to vote on a reconciliation bill that repeals only parts of Obamacare. This simply isn’t good enough. Each of us campaigned on a promise to fully repeal Obamacare and a reconciliation bill is the best way to send such legislation to President Obama’s desk. If this bill cannot be amended so that it fully repeals Obamacare pursuant to Senate rules, we cannot support this bill.” [Joint Statement, 10/22/15]

FLASHBACK 2015: HERITAGE FOUNDATION OPPOSES “SKINNY REPEAL”

Heritage Action Opposed A “Skinny” Repeal And Included It As A Key Vote. “On Friday, the House is scheduled to vote on the so-called Restoring Americans’ Healthcare Freedom Reconciliation Act (H.R. 3762). The bill would not restore Americans’ health care freedom because it leaves the main pillars of Obamacare in place, nor would it actually defund abortion giant Planned Parenthood. This bill violates an explicit promise made in the budget, which ‘affirm[ed] the use of reconciliation for the sole purpose of repealing the President’s job-killing health care law.’…Heritage Action opposes H.R. 3762 and will include it as a key vote on our legislative scorecard.” [Heritage Action, 10/22/15]

SENATE REPUBLICANS ADMIT “SKINNY” REPEAL IS A BAIT AND SWITCH TO THE HOUSE REPEAL BILL THEY SAID…

SENATE REPUBLICANS ADMIT “SKINNY” REPEAL IS A BAIT AND SWITCH TO THE HOUSE REPEAL BILL THEY SAID THEY OPPOSED

Cornyn says the House Bill Would Be A “Template”

The latest Republican repeal scheme — the so-called skinny repeal plan — is nothing more than a bait and switch. It goes like this: pass a bill that can get 50 votes in the Senate, or the “lowest common denominator” as HHS Secretary Tom Price admitted this morning. Then, use that bill to hold more partisan secret backroom deals with the House, using the House repeal bill — which only one in five Americans supported, took coverage away from 23 million people, raised premiums by double digits, ended Medicaid as we know it and allowed insurers to charge more for people with pre-existing conditions — as a “template.”

A vote to pass the Senate’s “skinny” plan is in effect voting for the House repeal bill, a proposal that many senators said they opposed. In other words, a vote for the “skinny” plan will break their promises to oppose the House repeal bill.

SENATE REPUBLICANS ADMIT THE “SKINNY” REPEAL BILL IS A SCHEME TO NEGOTIATE WITH THE HOUSE REPEAL BILL AS A “TEMPLATE”

Senate Majority Whip John Cornyn (R-TX): “All We’re Looking At Is A Way To Get That To Conference Quick” And The House Bill Would Be A “Template” For Negotiations. “Senate Majority Whip John Cornyn (R-Texas) indicated Wednesday that is it likely the Senate will try to pass a scaled-down ObamaCare repeal bill as a way to move to negotiations with the House. …Republicans view the so-called skinny bill as a way to keep the repeal process alive, given the chamber’s apparent inability to get the votes for a more sweeping bill. Cornyn said the House-passed bill could be the ‘template’ for the negotiations in the conference committee.…’So I think all we’re looking at is a way to get to that conference quick,’ he added.” [The Hill, 7/26/17]

  • Cruz Amendment Gutting Protections For People With Pre-Existing Conditions Would Be On The Table In Conference. “Cornyn noted that new Senate ideas — such as Sen. Ted Cruz’s (R-Texas) amendment to let insurers sell plans outside of ObamaCare’s regulations and Sen. Rob Portman’s (R-Ohio) amendment to add $100 billion to help people losing Medicaid afford private coverage — could be included and could help pave the way for a deal in the conference committee.” [The Hill, 7/26/17]

Sen. John Cornyn (R-TX): “My Personal Goal Is To Make Sure That We Find Something That 50 Of Us Agree On, That We Can Then Pass As A Vehicle To Get To Conference To Do A More Comprehensive Bill.” [Roll Call, 7/25/17]

Sen. Corker (R-TN): “Skinny” Repeal Is “Forcing Mechanism” To Get To Conference With The House. “Corker says ‘content’ of skinny bill not the point, rather it is ‘forcing mechanism’ for conference with House.” [The Hill’s Peter Sullivan Tweet, 7/26/17]

Sen. Mike Rounds (R-SD) Said Skinny Repeal Is A Way To Get To Conference. “Sen. Mike Rounds (R-S.D.) likewise said Wednesday that passing the skinny bill would be a way to get to the conference committee, and would also buy time for the Congressional Budget Office to score the new proposals, including the Cruz and Portman amendments.” [The Hill, 7/26/17]

GOP SENATORS WOULD BE BREAKING THEIR PROMISE TO OPPOSE THE HOUSE REPEAL BILL

Sen. Dean Heller (R-NV): “I Am Opposed To The American Health Care Act.” “As I have stated previously, while I am in favor of repealing Obamacare, I am opposed to the American Health Care Act (AHCA) in its current form. This bill does not do enough to address Nevada’s Medicaid population or protect Nevadans with pre-existing conditions. The AHCA is a first step, but not the solution; now the Senate is doing its own work to put forth its own ideas that could work for states like Nevada. I remain engaged in discussions with my colleagues from Medicaid expansion states as well as Governor Sandoval, the Administration, and senators on both sides of the aisle to find a viable path forward.” [Sen. Heller Statement, 5/24/17]

Sen. Shelley Moore Capito (R-WV): On The House Repeal Bill’s Impact On Medicaid, “I’m Concerned About What The House Bill Might Do With That.” “Another concern West Virginia health care advocates brought up is the cut to Medicaid expansion. They said that throughout the next 10 years, the bill would cut $4 billion in funding to the state. U.S. Sen. Shelley Moore Capito, R-W.Va., said she isn’t willing to let that happen. ‘I’m concerned about what the house bill might do with that,’ Capito said Wednesday.” [WSAZ, 5/3/17]

  • Sen. Shelley Moore Capito (R-WV): “I’m Not Satisfied.” “I’m not satisfied. I’m worried about a lot of folks in West Virginia, of opioid and drug abuse issues, and the expanded Medicaid has helped with that.” [Washington Post, 3/23/17]

Sen. Rob Portman (R-OH): “I’ve Already Made Clear That I Don’t Support The House Bill As Currently Constructed.” “I’ve already made clear that I don’t support the House bill as currently constructed because I continue to have concerns that this bill does not do enough to protect Ohio’s Medicaid expansion population, especially those who are receiving treatment for heroin and prescription drug abuse. We have an opioid crisis in this country, and I’m going to continue to work with my colleagues on solutions that ensure that those who are impacted by this epidemic can continue to receive treatment.” [Portman Statement, 5/4/17]

Sen. Rand Paul (R-KY): “I Would Be A No In The Senate.” [Tweet, 3/21/17]

Sen. Marco Rubio (R-FL): “It’s Not Our Bill.” “That’s the House bill. The Senate bill is going to be the Senate bill. Obviously the CBO score is one data point and it’s instructive, but it’s not our bill.” [Roll Call, 5/26/17]

Sen. Mike Lee (R-UT): “I Am A No.” [Tweet, 3/21/17]

Sen. Tom Cotton (R-AR): “I Still Cannot Support The House Healthcare Bill.” “Despite the proposed amendments, I still cannot support the House healthcare bill, nor would it pass the Senate.” [The Hill, 3/21/17]

  • Sen. Tom Cotton (R-AR): “The House Should Continue Its Work On This Bill.” “The House should continue its work on this bill,” Cotton said Tuesday in a statement, adding that the changes offered Monday night don’t address rising premiums and deductibles. “It’s more important to finally get health-care reform right than to get it fast.” [Bloomberg Politics, 3/21/17]

Sen. Ron Johnson (R-WI): “I Will Not Vote To Support It Until I Have Enough Information That Whatever We’re Going To Pass Will Work.” “Let’s be honest. Not a whole lot of people are loving the (House bill) right now. I will not vote to support it until I have enough information that whatever we’re going to pass will work.” [Milwaukee Journal Sentinel, 3/21/17]

Sen. Cory Gardner (R-CO): “Concerned That Any Poorly Implemented Or Poorly Timed Change In The Current Funding Structure In Medicaid Could Result In A Reduction In Access To Life-saving Health Care Services.” [Letter to McConnell, 3/6/17]

Sen. Bill Cassidy (R-LA): Radically Reshape the House Bill. “Bill Cassidy of Louisiana says he wants to radically reshape the House bill so that it covers more people, not the 24 million fewer estimated by the Congressional Budget Office. [Bloomberg Politics, 3/21/17]

Sen. John McCain (R-AZ): “I’m Very Worried What The House Bill Would Do To Arizona.” [Talking Points Memo, 3/13/17]

Sen. Susan Collins (R-ME): “I Am Not At All Comfortable With The House-Passed Bill.” “I am not at all comfortable with the House-passed bill. And, indeed, I would oppose the House-passed bill. The Senate bill is still a work in progress. We haven’t seen the actual language. We’re trying to influence the direction of that. But a bill that results in 23 million people losing coverage is not a bill that I can support. So, we will see what the Senate comes up with. It’s still being drafted.” [CNN State of the Union, 6/11/17]

  • Sen. Susan Collins (R-ME): “There Does Seem To Be A Consensus That The House Bill Could Never Pass The Senate And I’m Certainly Of That Belief As Well.” “‘There does seem to be a consensus that the House bill could never pass the Senate and I’m certainly of that belief as well,’ said Sen. Susan Collins (R-Maine), who cited the CBO report’s finding that 23 million people would lose insurance under the House bill over the next decade.” [The Hill, 5/29/17]

Sen. Lisa Murkowski (R-AK): “I Want To Get Right Rather Than Get It Behind Us, And That’s Going To Take Time.” “Speaking to reporters after her lunchtime Chamber speech, she said that she’d rather see Congress ‘get it right’ when it comes to health care reform. ‘There are some who are very interested in moving it as quickly as possible to ‘get it behind us.’ I don’t think that’s the responsible path. I want to get right rather than get it behind us, and that’s going to take time,’ she said.” [Juneau Empire, 6/1/17]

Sen. Lisa Murkowski (R-AK) Wanted The Senate To Start With A “Clean Slate.” [Bloomberg, 5/4/17]


Breaking News: Trump WH Made Secret Promise that Health Care Repeal Will Include Cruz Amendment

According to FOX Business, the Trump Administration has made a secret promise that the final health care repeal WILL include the “Cruz Amendment” which, according to bipartisan analysts, guts protections for those with pre-existing conditions and completely destabilizes the health care markets.

The Trump Administration has now made it clear that any Republican who votes to proceed on repealing health care will be responsible for the damage the Cruz amendment does to people’s health care.

Here’s what you need to know about what health care repeal would mean with the Cruz amendment — it guts consumer protections, turns the health care market into a real death spiral and raise costs.

Look at what Republican Senators and health experts have to say about it…

THE CRUZ PROPOSAL WOULD GUT CONSUMER PROTECTIONS LIKE GETTING RID OF ANNUAL AND LIFETIME LIMITS

Sen. Chuck Grassley (R-IA): “There’s A Real Feeling That That’s Subterfuge To Get Around Pre-Existing Conditions.” “‘There’s a real feeling that that’s subterfuge to get around pre-existing conditions,’ says Grassley. ‘If it is subterfuge and it has the effect of annihilating the pre-existing condition requirement that we have in the existing bill, than obviously I would object to that.’” [Iowa Public Radio, 7/5/17]

Sen. Shelley Moore Capito (R-WV): Cruz Amendment “Would Make It Too Difficult For People With Pre-Existing Conditions To Get Coverage.” “‘I think that reopens an issue that I can’t support, that it would make it too difficult for people with pre-existing conditions to get coverage,’ she said.” [Charleston Gazette-Mail, 7/8/17]

THE CRUZ PROPOSAL WOULD DESTABILIZE THE MARKETPLACE AND LEAD TO A DEATH SPIRAL

Larry Levitt, Senior Vice President, Kaiser Family Foundation: Cruz Plan “The Perfect Recipe For Destabilizing The Market And Turning The Marketplaces Into High-Risk Pools.” “‘If there were a Joy of Cooking for insurance, this would be the perfect recipe for destabilizing the market and turning the marketplaces into high-risk pools,’ said Larry Levitt, senior vice president at the Kaiser Family Foundation.” [CNN Money, 7/6/17]

Douglas Holtz-Eakin, Former Director, Congressional Budget Office Director, And President, American Action Forum: “That’s A Recipe For A Meltdown.” “‘What that will do is allow insurers to offer cheap policy to young invincibles. And on the exchange you’re going to get all the sick people,’ said Douglas Holtz-Eakin, a former Congressional Budget Office director and president of the American Action Forum. ‘That’s a recipe for a meltdown. You’ve split the risk pool into two exchanges.’ And, he added: ‘I think it would end up being bad politics.’” [Politico, 7/1/17]

Tara O’Neill Hayes, Deputy Director Of Health Care Policy, American Action Forum: “I Think That Really Would Be The Definition Of A Death Spiral.” “‘I think that really would be the definition of a death spiral,’ said Tara O’Neill Hayes, deputy director of health care policy at the conservative American Action Forum. ‘I think it would no longer be a question of whether that’s happening.’” [Politico, 7/11/17]

Craig Garthwaite, Health Insurance Expert, Northwestern University: “The Sick Would Be Attracted To Cheaper Plans, With The Knowledge They Could Always Move Into More Generous Plans If They Got Sick.” “‘The sick would be attracted to generous plans, while the healthy would be attracted to cheaper plans, with the knowledge they could always move into more generous plans if they got sick,’ said Craig Garthwaite, a health insurance expert at Northwestern University. ‘That kind of adverse selection makes pricing and offering insurance very hard.’” [Modern Healthcare, 6/30/17]

Vox: “The Fundamental Problem Is Sicker People Would Be Drawn To The More Robust Obamacare Plans, While Healthier People Would Gravitate Toward The Skimpier Non-Obamacare Coverage.” “The fundamental problem is sicker people would be drawn to the more robust Obamacare plans, while healthier people would gravitate toward the skimpier non-Obamacare coverage. That’s a reality that even Cruz acknowledges. Then inside the Obamacare market, as more and more sick people buy coverage there, costs for health insurers go up and so they increase premiums. It has the makings of a classic death spiral. Because only sick people remain, premiums eventually increase to astronomic levels. It turns the Obamacare exchanges into a high-risk pool.” [Vox, 6/29/17]

THE CRUZ PROPOSAL WOULD RAISE COSTS FOR PEOPLE WITH PRE-EXISTING CONDITIONS

Ceci Connolly, CEO, Alliance Of Community Health Plans: “You Are Increasing The Likelihood That There Will Be Some Smaller, Sicker Group With Higher Rates.” “Separating the sick and the healthy is ‘not the best path forward,’ said Ceci Connolly, CEO of Alliance of Community Health Plans, a lobbying group for non-profit, community-based insurers. Instead, it’s better to spread the risk around in a larger pools of enrollees. The Cruz option would do the opposite. ‘You are increasing the likelihood that there will be some smaller, sicker group with higher rates,’ Connolly said. ‘That’s what you want to get away from.’” [CNN Money, 7/6/17]

Larry Levitt, Senior Vice President, Kaiser Family Foundation: “If They Have Pre-Existing Conditions, They’d Be Stuck In Plans With Escalating Premiums.” “Americans with higher incomes who wanted to buy an Obamacare-compliant plan, people likely to have high medical costs themselves, would have no protection from skyrocketing premiums. ‘If they’re healthy, they could buy inexpensive non-compliant plans. But if they have pre-existing conditions, they’d be stuck in plans with escalating premiums,’ Levitt said.” [Vox, 6/29/17]

Tim Jost, Law Professor, Washington And Lee University: “If This Were Adopted, Premiums Would Skyrocket For People Who Need Comprehensive Coverage.” “Health analysts said the amendment would cause premiums for that demographic to jump, resurrecting a thorny political issue that drew national attention earlier this year when House Republicans added a similar measure to their bill, known as the MacArthur amendment. ‘If this were adopted, premiums would skyrocket for people who need comprehensive coverage,’ said Timothy Jost, a law professor at Washington and Lee University in Lexington, Va.” [Wall Street Journal, 7/5/17]

Joe Antos, Health Policy Expert, American Enterprise Institute: People With Chronic Illness “Will End Up Paying More.” “‘Someone with chronic illness, they’re going to end up wanting to buy the more comprehensive coverage,’ says Joe Antos, a health policy expert with the conservative American Enterprise Institute. ‘This means that people with those kinds of illnesses will end up paying more. Even if they receive a federal subsidy, they will likely see higher cost sharing.’ … ‘The people who don’t know something will happen and come down with something, those are the ones at issue,’ Antos argues. ‘It’s not the people who planned ahead and bought the more expensive plan. It’s those who didn’t.’” [Vox, 7/10/17]

Wall Street Journal: “Middle-Income Earners With Pre-Existing Conditions Would Be The Hardest Hit.” “Such a bifurcation likely would mean increased costs for comprehensive plans, analysts said. People receiving the bill’s tax credits would be buffered from the price increases, but those who earn 350% of the poverty level and wouldn’t be eligible for the credits would pay more, they said. Middle-income earners with pre-existing conditions would be the hardest hit.” [Wall Street Journal, 7/5/17]

Larry Levitt, Senior Vice President, Kaiser Family Foundation: Getting Premiums Down “Comes Down To Relaxing Rules That Protect People With Pre-Existing Conditions.” “‘When it gets to crunchtime on these health bills, the discussion comes down to getting premiums down,’ said Larry Levitt, a senior vice president at Kaiser Family Foundation. ‘And that comes down to relaxing rules that protect people with pre-existing conditions.’” [Wall Street Journal, 7/5/17]

Vote Today: Which Senators Will Break Their Promise?

To avoid a temper tantrum from President Trump, Senate Republicans are poised to take their first vote on health care repeal today — pushing forward on the same health care bill that passed the House of Representatives earlier this summer.

On top of the fact that the House bill will completely devastate people’s health care, voting for this House health care repeal bill would break the promise many Senators have made to oppose the House health care repeal.

Take a look at their promises…

Senator Susan Collins (R-ME): “I am not at all comfortable with the House-passed bill.” [CNN State of the Union, 6/11/17]

  • “There does seem to be a consensus that the House bill could never pass the Senate and I’m certainly of that belief as well.” [The Hill, 5/29/17]
  • “This is not a bill I could support in its current form.” [Press Herald, 3/17/17]

Senator Lisa Murkowski (R-AK): “Alaska’s Lisa Murkowski, who has been very critical of the House bill, said Thursday she hopes they start with ‘a clean slate’ in the Senate.” [Bloomberg, 5/4/17]

Senator Dean Heller (R-NV): “I agree with Governor Sandoval. I do not support the House bill in its current form.” [Associated Press, 3/17/17]

Senator Shelley Moore Capito (R-WV): “I’m not satisfied. I’m worried about a lot of folks in West Virginia, of opioid and drug abuse issues, and the expanded Medicaid has helped with that.” [Washington Post, 3/23/17]

Sen. Bill Cassidy (R-LA): “Bill Cassidy of Louisiana says he wants to radically reshape the House bill so that it covers more people, not the 24 million fewer estimated by the Congressional Budget Office.” [Bloomberg Politics, 3/21/17]

Senator Marco Rubio (R-FL): “That’s the House bill. The Senate bill is going to be the Senate bill. Obviously the CBO score is one data point and it’s instructive, but it’s not our bill.” [Roll Call, 5/26/17]

Senator Ted Cruz (R-TX): “The Senate bill will be significantly different from the House bill.” [The Hill, 5/26/17]

Senator Rob Portman (R-OH): “I continue to have concerns [the House bill] does not do enough to protect Ohio’s Medicaid population, especially those who are receiving treatment for heroin and prescription drug abuse.” [Portman Statement, 5/4/17]

  • Sen. Rob Portman (R-OH): “I could not support the current health legislation.” [Dayton Daily News, 3/23/17]

Sen. Rand Paul (R-KY): “I would be a no in the Senate.” [Tweet, 3/21/17]

Sen. Mike Lee (R-UT): “I am a no.” [Tweet, 3/21/17]

Sen. Tom Cotton (R-AR): “Despite the proposed amendments, I still cannot support the House health care bill, nor would it pass the Senate.” [The Hill, 3/21/17]

Sen. Ron Johnson (R-WI): “Let’s be honest. Not a whole lot of people are loving the (House bill) right now. I will not vote to support it until I have enough information that whatever we’re going to pass will work.” [Milwaukee Journal Sentinel, 3/21/17]

Sen. John McCain (R-AZ): “I’m very worried what the House bill would do to Arizona.” [Talking Points Memo, 3/13/17]

New Analysis: GOP’s Health Care Repeal Will Do More Harm To Trump’s “Obamacare Victims”

NEW ANALYSIS: GOP’S HEALTH CARE REPEAL WILL DO MORE HARM TO TRUMP’S “OBAMACARE VICTIMS”

President Trump highlighted the stories of four people who he claimed were “victimized” by the Affordable Care Act during a press stunt today.

Unfortunately for the Senate GOP, based on what’s known about the people President Trump highlighted, their health care repeal would do nothing for them. And could actually make things worse.

Uh oh.

PERSON #1

Trump Said: “After an excruciating series of events and complications, Melissa and her husband found themselves just before Christmas, emotionally and financially devastated, crying in a doctor’s office faced with yet another seemingly unpayable bill. When insurance wouldn’t cover the Ackisons’ care, they emptied out Melissa’s 401K to pay their bills.”

If GOP’s Repeal Passes: Under the Senate’s BCRA repeal effort, essential health benefits would be repealed, so routine doctor’s visits and hospitalizations may not even be covered by insurance plans.

PERSON #2

Trump Said:Democrats promised Americans like Steve Finn, a former police officer in West Virginia, that they would save $2,500 per year under Obamacare. Instead his premiums have more than tripled. That’s pretty bad. As a result of Obamacare’s skyrocketing costs, Steve and his family, and many of his employees, had no other option than going on Medicaid and giving up their existing coverage. For them Obamacare’s promise was a nightmare.”

If GOP’s Repeal Passes: Under the Senate’s BCRA repeal effort, premiums are projected to go up by 20% next year and deductibles would skyrocket to $13,000. Steve and his family could pay more out-of-pocket for their premiums and care because, unlike under current law, BCRA’s tax credits would not offset rising premiums. And if they are still Medicaid beneficiaries, the BCRA cuts over $700 billion from the program, so Steve and his family could lose their Medicaid coverage altogether.

PERSON #3

Trump Said: “Democrats promised families like the Weers that if they liked their doctor, they could keep their doctor — but now there is only one insurer left in the state exchange, and Marjorie says that every year she waits anxiously to learn if the doctors and hospitals which her son needs the most will remain in their network.”

If GOP’s Repeal Passes: Under the Senate’s BCRA repeal effort, insurance companies would be allowed to contract with hospitals and draw narrower networks than under what is permitted under current law. Under current law, consumers benefit from “network adequacy standards,” but the narrow networks of hospitals and doctors now could get even worse under the BCRA. In short, the Weers could still buy a plan where their doctor was out of network. But under the BCRA, the cost of coverage for people with pre-existing conditions would skyrocket.

PERSON #4

Trump Said: “Erin and Andy Witzig are small business owners from Illinois. They have six children. Their youngest daughter, Poppy, has a rare genetic condition. Children born with it are sometimes called Butterfly Children, because their skin is as fragile as the wings of a butterfly. Poppy has to wear special bandages all of the time. Unfortunately, under Obamacare, Poppy’s family insurance has been repeatedly discontinued and replaced with what Washington deems equivalent policies, but for Poppy these plans are not equivalent, and Poppy’s family has to spend precious time and tremendous resources fighting for exceptions for Poppy.”

If GOP Repeal Passes: Under BCRA, without insurance plans required to offer comprehensive coverage, people with complex medical needs such as the Witzig’s youngest daughter would be left to pay substantially more out-of-pocket for a similar level of coverage offered today. BCRA would also allow insurance companies to implement annual and lifetime limits. For someone with medical needs like Poppy, this could result in even higher out-of-pocket costs for her care.

Secretary Tom Price’s Next Job Should Be At Burger King: Because He Sells A Lot Of Whoppers

The Trump administration and Republicans in Congress will say anything to pass their repeal bill, including questioning the Congressional Budget Office’s (CBO) estimates. In fact, former directors of the CBO wrote Republican Leaders this week asking them to “maintain and respect the Congress’s decades-long reliance on CBO’s estimates in developing and scoring bills.”

But the American people know the truth: the GOP plan will raise costs, take away coverage and weaken protections. That is why only 12 percent support it.

Health and Human Services Secretary Tom Price is a leading ‘Health Repeal Truther.’

Here are Price’s top 5 biggest whoppers over the past few months — and one truth.

WHOPPER #1: “Nobody Will Be Worse Off Financially.”

Back in March, Secretary Price was on Meet the Press and he promised that “nobody will be worse off financially” under the Republican repeal bill. That is not true.

The facts:

WHOPPER #2 : Republican Repeal Plan Will Lower Deductibles

When asked back in May if he stood by President Trump’s comment that the Republican repeal bill will lead to lower deductibles, Secretary Price answered, “Absolutely.” That is not true.

The facts:

  • Congressional Budget Office: deductibles for people earning $26,500 would increase from $800 under the Affordable Care Act, to $13,000, a 1,525 percent increase.
  • Axios: “Because the ‘actuarial value’ of the coverage could go down [under the Senate bill] — meaning customers would have to pay more of the medical costs themselves — the deductible for a low-income person could shoot up to $13,000.”


WHOPPER #3: “There are No Cuts to the Medicaid Program.”

Back in May on CNN, Secretary Price said, “Remember that there are no cuts to the Medicaid program.” That is not true.

The facts:

WHOPPER #4: “We’re Gonna Be Able To Cover More Individuals on This Bill than are Currently Covered.”

In July, Secretary Price promised that the Republican repeal plan would mean “we’re gonna be able to cover more individuals on this bill than are currently covered.” That is not true.

The facts:

WHOPPER #5 : We Don’t Know How Great the GOP Repeal Plan is Because We Haven’t Seen All of It Yet.

In July, Sec. Price took issue with the Congressional Budget Office and other analyses showing that the Republican repeal bill would take away coverage and raise costs because, he argued, these analyses do not look at the “entire plan.” “The entire plan,” he argued, “includes not just this piece of legislation, which is a significant piece, but it’s not the entire plan. The other pieces of legislation that provide for increasing competition and increasing choices in the insurance market.” That is not true.

Price appears to be making the case for the “3 phases” of health repeal he made earlier this year. Sen. Tom Cotton (R-AR) put it best talking to Hugh Hewitt about why the three step process won’t work:

Hugh, there is no three-phase process. There is no three-step plan. That is just political talk. It’s just politicians engaging in spin. This is why. Step One is a bill that can pass with 51 votes in the Senate. That’s what we’re working on right now. Step Two, as yet unwritten regulations by Tom Price, which is going to be subject to court challenge, and therefore, perhaps the whims of the most liberal judge in America. But Step Three, some mythical legislation in the future that is going to garner Democratic support and help us get over 60 votes in the Senate. If we had those Democratic votes, we wouldn’t need three steps.

However, there is one true thing Sec. Price said:

TRUTH: Once Repeal Passes, Insurers Can Just “Dust Off How They Did Business Before Obamacare.”

On ABC, Sec. Price said that after repeal passes, insurance companies could “dust off how they did business before Obamacare.

KARL: There’s no doubt there’s significant problems with the current system. But if you look at the Republican plan to modify it and replace it, more than 10 medical groups are against it. Thirty-two cancer organizations oppose it. And on Thursday, in a rare joint statement by the biggest insurance companies in the country, called the Cruz Amendment unworkable in any form and warned it would lead to, quote, “widespread terminations of coverage” So, Dr. Price, why this wall of opposition?

PRICE: It’s really perplexing, especially from the insurance companies, because all they have to do is dust off how they did business before Obamacare.

We agree. As a reminder, here is how insurers “did business” before the Affordable Care Act:

  • They were allowed to deny coverage because of a pre-existing condition.
  • They were allowed to charge sick people more for the same coverage.
  • They were allowed to drop coverage once you got sick if you forgot to mention on your form previous medical conditions, such as acne.
  • They were allowed to put lifetime and annual limits on your care.

5 CBO Facts On Latest Devastating Health Care Repeal

5 CBO Facts On Latest Devastating Health Care Repeal

The nonpartisan Congressional Budget Office released an expert analysis of the latest health care repeal scheme from Republican leaders in the Senate.

Guess what? It said the same thing as the previous ones — health care repeal would devastate people’s health care. Every single time CBO has evaluated a health care repeal plan it has shown cuts to coverage and costs increase. CBO has made clear you’d pay more and you’d get less if health care repeal passes. It can’t be fixed.

Here are 5 facts you should know from the latest CBO report:

  1. 22 million people lose health insurance — more than the populations of 16 states, including Alaska, Maine, West Virginia and Nevada, combined.
  2. Premiums go up 20 percent in 2018.
  3. Deductibles for someone earning $26,500 a year would be $13,000 — that’s 1,525 percent higher than the $800 deductible under the ACA.
  4. $756 billion in Medicaid funding is cut — 26 percent cut by 2026 — slashing nursing home care for seniors and critical care for kids .
  5. ½ the country would have no insurers in the individual market by 2020.

Those are probably the reasons that people prefer the Affordable Care Act over the GOP’s repeal by a 2-to-1 margin (50% — 24%) according to the newly released Washington Post/ABC poll, while an analysis by an MIT professor found health care repeal is the least popular piece of legislation in 3 decades.

CBO Proves Republican Health Care Repeal Is Always Devastating

CBO Proves Republican Health Care Repeal Is Always Devastating

It doesn’t matter what version of health care repeal Republicans put forward, they’ve each proven to be completely devastating for the American people — cutting coverage, raising costs, gutting Medicaid and weakening protections — just to give the wealthy and drug and pharmaceutical companies another tax break.

The newly-released CBO report on their latest health care repeal attempt proves it yet again — 22 million people lose coverage, premiums go up 20% and 26% is gutted from Medicaid while giving $541 billion in tax breaks for the wealthy and corporations.

They keep promising it will get better but there is no way to fix repeal. It is always devastating.

See for yourself…


Given how every version of health care repeal has been devastating according to CBO, it makes sense that a growing group of Republican Senators are saying they should abandon repeal.

  • Sen. Jerry Moran (R-KS): “We must now start fresh with an open legislative process to develop innovative solutions that provide greater personal choice, protections for pre-existing conditions, increased access and lower overall costs for Kansans.” [7/17/17]
  • Sen. Susan Collins (R-ME): “The solution, Collins said, is to tackle health care through ‘the normal process of committee hearings, expert witnesses, and writing a bill with bipartisan support.” [7/16/17]
  • Sen. Lisa Murkowski (R-AK): “As I’ve been saying, the Senate should take a step back and engage in a bipartisan process to address the failures of the ACA and stabilize the individual markets. That will require members on both sides of the aisle to roll up their sleeves and take this to the open committee process where it belongs.” [7/18/17]
  • Sen. John McCain (R-AZ): “The Congress must now return to regular order, hold hearings, receive input from members of both parties, and heed the recommendations of our nation’s governors so that we can produce a bill that finally provides Americans with access to quality and affordable health care.” [7/17/17]

By a 2-to-1 margin (50% — 24%), people prefer the Affordable Care Act over the GOP’s repeal according to the newly released Washington Post/ABC poll.


New Polling: Voters Reject Republican Repeal

New Polling: Voters Reject Republican Repeal

Every day that goes by, rejection of the GOP’s health care repeal gets worse.

It’s already clear that experts who know health care the best — doctors, nurses, patient advocates, disease groups, seniors’ groups, etc. — all know the bill will make health care far worse with cuts to coverage, higher premiums and deductibles and fewer protections for people, including those with pre-existing conditions.

New polling this weekend makes clear the deep rejection of the GOP’s health care repeal with all kinds of voters.

By a 2-to-1 margin (50% — 24%), people prefer the Affordable Care Act over the GOP’s repeal according to the newly released Washington Post/ABC poll.

  • With moderates, 55% of people support the Affordable Care Act and only 15% support the GOP’s repeal and only 20% of independents support the GOP’s plan.
  • Voters intensely oppose repeal with 37% of people strongly preferring the Affordable Care Act and only 18% strongly preferring the GOP’s repeal.
  • The opposition continues even with voters 65+ (44–29), and white voters (38–31).

Most Americans (61%) have an unfavorable view of the GOP’s health care repeal plan according to the July Kaiser Health Tracking Poll.

  • More than four in ten (44%) have a very unfavorable view.
  • Opposition grew from 55% last month to 61% this month.
  • Nearly three-quarter of Americans (71%) would rather Republicans in Congress work with Democrats to improve the Affordable Care Act, not repeal it, while only 23% want them to continue on this path towards repeal.

The newly released Bloomberg poll shows voters rejecting President Trump’s health care agenda — with only 28% approving of his health care work while 64% of voters disapprove.

  • Health care is the top issue with voters. 35% of voters say it’s the most important issue — nearly 3 times more than the next most important issue.


In Iowa, 58% of voters oppose Congressional Republicans on health care while only 29% support it according to the new Des Moines Register poll. The opposition grows to 63% with Independents.

Those Who Know Health Care the Best Say the Senate Repeal Bill Is Still the Worst

Every time Senate Republicans rework their devastating health care repeal bill, they promise us they’re going to make it better.

Every time they end up making it worse.

Their health care repeal is the least popular legislation in 30 years, with the support of only 12% of the public and opposition from bipartisan group of governors.

On top of that, the experts who know health care the best — doctors, nurses, disease advocates, seniors’ groups, etc. — all know the bill will make health care far worse with cuts to coverage, higher premiums and deductibles and fewer protections for people, including those with pre-existing conditions.

The question is — are Senate Republicans listening to everyone or only listening to themselves?

PATIENT GROUPS

33 Leading Cancer Organizations: “The Senate’s BCRA, Just As The House’s AHCA, Is A Direct Threat To America’s 16 Million Cancer Patients And Survivors Who Rely On Timely And Uninterrupted Access To Comprehensive And Affordable Health Care.” “The Senate’s BCRA, just as the House’s AHCA, is a direct threat to America’s 16 million cancer patients and survivors who rely on timely and uninterrupted access to comprehensive and affordable health care,” said NCCS CEO Shelley Fuld Nasso. “With an estimated 22 million losing coverage, severe cuts to Medicaid, and elimination of pre-existing condition protections, this bill is devastating for the American people, especially for anyone with a cancer diagnosis. It is time to end this threat that is causing fear and anxiety throughout the cancer community, and work towards bipartisan solutions to strengthen current law.” [NCSS, 7/13/17]

American Cancer Society Cancer Action Network: “The Latest Proposed Changes To The Senate Health Care Bill Would Make Access To Health Coverage Worse For Those With Pre-Existing Conditions Like Cancer.” “The latest proposed changes to the Senate health care bill would make access to health coverage worse for those with pre-existing conditions like cancer. The reluctance by senators to include patient feedback and other relevant stakeholder perspectives in the process is preventing the development of a reasonable, bipartisan consensus that could improve the law and pass the Senate.” [ACS CAN, 7/13/17]

American Society Of Clinical Oncology: “ASCO’s Core Mission Is To Ensure That Cancer Patients Have Meaningful Access To High Quality Cancer Care. The Better Care Reconciliation Act Runs Counter To This Goal.” “ASCO’s core mission is to ensure that cancer patients have meaningful access to high quality cancer care. The Better Care Reconciliation Act runs counter to this goal. ASCO’s guiding principles for health reform support improvements to the current health care system, and outline specific areas where people with cancer need protections. We shared these principles in January of this year and stand by them today. ASCO believes that any health system reform must ensure that all people affected by cancer receive high-quality care. We know Congress shares this belief and call on the Senate to work in a bipartisan manner to ensure access to high-quality cancer care, rather than move forward with H.R. 1628. As cancer care providers, we are especially concerned with provisions that would erode critical protections for patients with cancer by allowing insurers to sell products that do not meet their needs, including coverage for essential screening services. Additionally, a six-month waiting period for those that fail to obtain continuous coverage could leave many cancer patients and survivors without access to needed care. Reducing access to affordable health insurance will add costs to the system, decrease access to appropriate treatment and increase existing disparities in care. Removing protections from current federal law through state waivers or other means allows for a weakening of these critical provisions and a system of inequitable treatment across state lines for cancer patients. We urge policymakers to ensure that robust requirements are in place to ensure that all insurance products cover the full scope of services and therapies that cancer patients require. ASCO strongly opposes passage of the Better Care Reconciliation Act.” [ASCO, 7/13/17]

American Lung Association: “The Revised Better Care Reconciliation Act Does Not Address The Major Concerns About Quality And Affordable Healthcare Previously Outlined.” “The American Lung Association is very disappointed to see that the revised Better Care Reconciliation Act does not address the major concerns about quality and affordable healthcare previously outlined by the American Lung Association and therefore, our organization must still oppose this bill. The legislation would still make devastating cuts to Medicaid, which will harm many patients living with a lung disease. It would also still result in removing key patient protections, including for patients with pre-existing conditions. The American Lung Association is particularly troubled by the Cruz Amendment, which would result in higher, not lower, premiums for people with serious and chronic conditions. The American Lung Association has long stated that any healthcare legislation must be adequate, affordable and accessible. This bill still fails to meet this standard. The American Lung Association urges Senators to vote no on both the motion to proceed and the underlying bill. Instead, the Senate should start over with a bipartisan process aimed at improving healthcare for all Americans.” [ALA, 7/13/17]

PHYSICIANS, NURSES, SOCIAL WORKERS, PSYCHOLOGISTS

American Medical Association: “The Revised Bill Does Not Address The Key Concerns Of Physicians And Patients Regarding Proposed Medicaid Cuts And Inadequate Subsidies That Will Result In Millions Of Americans Losing Health Insurance Coverage.” “The revised bill does not address the key concerns of physicians and patients regarding proposed Medicaid cuts and inadequate subsidies that will result in millions of Americans losing health insurance coverage. The additional funding to address the opioid epidemic is a positive step, however, those suffering from substance use disorder have other health care needs that are not likely to be addressed if they lose coverage through a rollback of the Medicaid expansion. While stabilizing the individual market is an initial step, more bipartisan collaboration is needed in the months ahead to improve the delivery and financing of health care.” [AMA, 7/14/17]

American Congress Of Obstetricians And Gynecologists: “The BCRA Is Deeply Flawed, Cannot Be Fixed And Keeps Getting Worse.” “This most recent version of the Better Care Reconciliation Act is not “better” for patients. The BCRA is deeply flawed, cannot be fixed and keeps getting worse. Its original version deliberately stripped landmark women’s health gains made by the Affordable Care Act, turning back the clock on women’s health. This new version threatens to leave patients with preexisting conditions without care. Senators drafting these proposals still aren’t listening to America’s doctors. Yesterday, ACOG joined leaders representing 560,000 frontline physicians on Capitol Hill with one unified message to Senators: the BCRA is dangerous for patients and must be rejected. ACOG’s bottom line is simple: No legislation should take away coverage that patients have today. There’s only one solution. The Senate should put the BCRA where it belongs, in the circular file, not on the floor for a vote. Republican and Democratic senators should work with ob-gyns and other physicians on a new approach that will preserve women’s access to contraception and maternity care and improve the health care system for everyone. We stand ready to partner with the U.S. House and Senate and the White House on practical solutions to improve our nation’s health and reduce health care costs.” [ACOG, 7/14/17]

American Psychiatric Association: “Wordsmithing And Throwing Money At Certain Constituencies To Gain More Votes Highlights A Deeply Flawed Senate Proposal That Is Insufficient.” “Wordsmithing and throwing money at certain constituencies to gain more votes highlights a deeply flawed Senate proposal that is insufficient. The changed bill still rolls back access to care and allows for the removal of essential health benefits, such as treatment for mental illness and substance use disorders that will affect millions of patients and their families — from the young to the elderly to the most vulnerable in all our communities.” [APA, 7/13/17]

American College Of Physicians: “These Changes, Especially Title III, Will Make The Bill Even More Flawed And Therefore Even More Harmful To Our Patients.” “On behalf of the American College of Physicians (ACP), today ACP wrote Senate leaders to reaffirm our strongest possible opposition to the Better Care Reconciliation Act (BCRA) of 2017, despite the changes released today, as part of a revised bill. We believe these changes, especially Title III, will make the bill even more flawed and therefore even more harmful to our patients by creating new and perhaps insurmountable coverage barriers for patients with pre-existing conditions and by severely weakening or completely eliminating requirements that insurers cover essential health benefits (EHBs) and abide other protections like a community rating… The BCRA — even with modifications — will not preserve and improve essential coverage, benefits and consumer protections, and access to care for both currently insured and uninsured individuals, children and families.” [ACP, 7/13/17]

American Psychological Association: “More Damaging Than The Original Draft, Since It Would Support The Creation Of Bare-Bones Health Insurance Policies That Do Not Cover Mental Health And Substance-Use Treatment And Other Vital Services.” “The latest version of the Senate bill to repeal and replace the Affordable Care Act, the Better Care Reconciliation Act of 2017, is more damaging than the original draft, since it would support the creation of bare-bones health insurance policies that do not cover mental health and substance-use treatment and other vital services, according to the American Psychological Association. The new bill would also weaken current legal protections, making coverage much more expensive — and perhaps unaffordable — for people with pre-existing conditions, including mental health and substance-use disorders, according to the APA.” [APA, 7/13/17]

Association Of American Medical Colleges: “The Revised Bill Released Today Still Falls Woefully Short In Providing Americans With Comprehensive, Affordable Health Coverage, And Will Leave Millions Without Any Coverage At All.” “Notwithstanding the widespread concerns with the original Better Care Reconciliation Act, the revised bill released today still falls woefully short in providing Americans with comprehensive, affordable health coverage, and will leave millions without any coverage at all. As Congress has discussed repealing and replacing the Affordable Care Act, the nation’s medical schools and teaching hospitals have held steadfast that any replacement bill should at least maintain current levels of health coverage, not weaken Medicaid, and be the result of a deliberative and transparent process. The first version of the BCRA failed to meet these criteria, as does the revised version. The changes do nothing to address provisions that would cripple Medicaid and put added financial pressure on state budgets and health care providers. Additionally, allowing insurers to sell plans without meaningful coverage will hurt those with preexisting conditions and further destabilize insurance markets. Finally, providing time-limited money to help individuals purchase insurance does not give patients the long-term health security they need. The nation’s medical schools and teaching hospitals see firsthand that when our patients do not have sufficient coverage, they often delay seeking much-needed care, turning manageable conditions into dangerous and costly emergencies. We urge members of the Senate to reject this bill and work together to craft legislation that will protect Americans’ health care and will not result in millions more Americans uninsured. The AAMC stands ready to work with Congress to shape a solution that improves the health of all.” [AAMC, 7/13/17]

HOSPITALS

American Hospital Association: “The Unacceptable Flaws Of BCRA Remain Unchanged, And There Are No Significant Changes To The Massive Medicaid Reductions.” “Last month, we urged the Senate to go back to the drawing board after its original proposal included dramatic cuts to the Medicaid program and the loss of health care coverage for tens of millions of Americans. If enacted, BCRA would mean real consequences for real people — among them people with chronic conditions such as cancer, individuals with disabilities who need long-term services and support, and the elderly. Unfortunately, in the latest update released today, the unacceptable flaws of BCRA remain unchanged, and there are no significant changes to the massive Medicaid reductions. Instead of merely tweaking a proposal that would harm our most vulnerable, we again call on the Senate to advance a solution aimed at protecting coverage for all Americans who currently have it. Instead of merely putting forth an update, we again call on the Senate to put forth an upgrade.” [AHA, 7/13/17]

Catholic Health Association: “Today’s Release Of The Updated Senate Better Care Reconciliation Act Reinforces The Fact That This Bill Is So Flawed It Cannot Be Fixed.” “Today’s release of the updated Senate Better Care Reconciliation Act reinforces the fact that this bill is so flawed it cannot be fixed. The proposed changes do not amend the core issue that this bill will ultimately take health care away from millions of our nation’s most vulnerable populations. For this reason we continue to encourage Senators to oppose this bill and to work together towards improvements in our health care system that will stabilize the insurance market, improve affordability, and strengthen and expand the coverage gains already achieved. The latest version of the bill would still radically restructure the Medicaid program through per capita caps or block grants which would shift the cost burden onto local and state governments, providers and individual beneficiaries. States would be focused on ways to cut eligibility, benefits and provider payments rather than ways to improve care and lower costs over the long term by creating a better delivery system. Additionally, this bill will harm older Americans who will face significantly higher costs through age rating and undermine protections for people with pre-existing conditions by allowing insurance companies to waive essential health benefits and make coverage for pre-existing conditions unaffordable.” [CHA, 7/13/17]

America’s Essential Hospitals: “Senate Leaders Again Have Put Forward An Entirely Unacceptable Bill To Repeal And Replace The Affordable Care Act.” “Senate leaders again have put forward an entirely unacceptable bill to repeal and replace the Affordable Care Act. Their revised Better Care Reconciliation Act leaves untouched the most destructive provisions of the original bill: those that would gut the Medicaid program and strip affordable coverage from millions of low-income working Americans and others who face financial hardships. Making a bad bill worse, the Senate added measures that would destabilize the private market by creating a two-tiered system that funnels the sick and others most in need of affordable coverage into the highest-cost plans. The bill’s attempts to placate critics represent nothing more than token efforts. The additional dollars to combat the nation’s opioid crisis fall far short of replacing the treatment funds lost through the bill’s deep Medicaid cuts. Likewise, added spending to help low-income people pales in comparison to the hundreds of billions of dollars this bill would drain from Medicaid by ending expansion and imposing spending caps. The Senate must stop and accept that this deeply unpopular bill is bad for patients, bad for hospitals, and bad for the country. We urge lawmakers to reach across the aisle and work with all stakeholders for solutions that ensure everyone can afford high-quality care.” [AEH, 7/13/17]

Arizona Hospital And Healthcare Association: “The Better Care Reconciliation Act Remains A Bad Deal For Arizona Patients, Families And Health Care Providers.” “The latest Senate healthcare plan pays lip service to concerns regarding massive federal cuts to drug treatment and state budgets, but does not markedly alter an underlying proposal that continues to promise higher costs and reduced patient access to care. Most significantly, today’s amended proposal still slashes more than $800 billion from Medicaid — safety-net healthcare for nearly 2 million Arizonans, including thousands of veterans and 1 in 2 children in the state. As the Ducey administration has noted, these Medicaid cuts would result in a $7.1 billion financial hit to our state budget. An estimated 400,000 Arizonans are likely to fall off Medicaid as a result, leaving these families just one illness or injury away from financial catastrophe. “For months, the Arizona Hospital and Healthcare Association has called on Congress to deliver a responsible proposal that addresses shortcomings with the Affordable Care Act, especially regarding the health exchanges. This latest proposal falls short. The Better Care Reconciliation Act remains a bad deal for Arizona patients, families and health care providers.” [AZHHA, 7/13/17]

MENTAL HEALTH AND SUBSTANCE USE DISORDER GROUPS

Mental Health America: “This New Proposal Is Opposed By Insurance Companies, Providers, Advocates, And An Overwhelming Majority Of The Public. This Should Tell Us Something.” “If the American Health Care Act (AHCA) was worse than the Affordable Care Act (ACA), and the initial Better Care Reconciliation Act (BCRA) was worse than AHCA, then this new version of the BCRA — released yesterday — is worst of all. It retains all the provisions of the original BCRA that frightened so many people: significantly higher insurance costs for older people, huge cuts to Medicaid, penalties for those who lose their insurance when they try to sign up again, higher average deductibles for everyone, and no guarantees of minimum payouts by insurers for those with chronic conditions, including mental illnesses. It also reduces subsidies offered to the middle class to help offset the cost of insurance, and eliminates these tax credits entirely for individuals making more than $42,210 a year, or couples earning more than $56,840. Meanwhile, it retains tax cuts for tanning salons. Worst of all, it incorporates language from Senator Ted Cruz that could literally flood the market in every state with completely unregulated health insurance products. Marketed under the illusion of “lower insurance rates,” these plans would not have to cover mental illnesses, cancers, or any other chronic conditions — or people who have ever had one of these conditions. They would not have to reimburse providers at any reasonable rate. They could pay out as little in benefits as they wanted, and could be cancelled at any time. They would force people who signed up for them and thought they were getting a bargain to pay thousands more each year in out-of-pocket costs, while forcing everyone with a chronic condition into a single health insurance program. This new proposal is opposed by insurance companies, providers, advocates, and an overwhelming majority of the public. This should tell us something: it is time for Congress to act in a bipartisan way to address the health and mental health care needs of all of us, not just unrelated enterprises like tanning salons.” [MHA, 7/14/17]

National Alliance On Mental Illness: “The BCRA Will Further Worsen The Mental Health Crises Communities Across The Country Are Currently Facing.” “NAMI is deeply disappointed that the revised Better Care Reconciliation Act (BCRA), released today retains provisions that impose significant barriers to treatment and services for people with mental illness. The BCRA contains severe cuts to Medicaid benefits that would threaten access to critical mental health services millions of Americans rely on to lead healthy and productive lives. Medicaid is the largest funding source for public mental health services in our nation. One-third of people covered by Medicaid expansion lives with a mental health or substance use condition. Medicaid also covers 1.75 million American veterans — nearly 1 in 10 of the veteran population — who rely on this coverage for primary and mental health care. The BCRA will further worsen the mental health crises communities across the country are currently facing in homelessness, suicides, emergency room boarding and burdens on law enforcement. Rather than moving forward with a bill that threatens to destabilize our nation’s already struggling mental health system, NAMI urges Senators to reject the revised BCRA and to focus instead on small group and individual insurance market reforms needed in many states. This will ensure that Americans will receive the mental health care they need to lead healthy and productive lives.” [NAMI, 7/13/17]

PUBLIC HEALTH GROUPS

American Public Health Association: “A Public Health Catastrophe.” “The revised Senate plan to replace the Affordable Care Act is still irresponsible policy. Millions would lose insurance coverage, the sickest could still be denied access to critically needed care and far too many would pay even more for fewer benefits, creating an expanded class of underinsured. The bill, like previous versions, guts essential investments in public health by eliminating the Prevention and Public Health Fund. I urge our elected leaders to work together to find a bipartisan solution to fixing the Affordable Care Act. Let’s build on the successes we’ve seen when lawmakers keep the health of the population at the forefront. We all can agree that affordable, accessible health care is a right, not a privilege. Any legislation coming out of Congress should reflect that fact and avoid a public health catastrophe.” [APHA, 7/14/17]

CONSUMER GROUPS

AARP: “This Bill May Have Changed But The Results Are The Same: Higher Costs And Less Coverage For Older Americans.” “This bill may have changed but the results are the same: higher costs and less coverage for older Americans. We urge the Senate to vote ‘NO’ and start from scratch on a new health bill that lowers costs and maintains vital protections and coverage that millions of Americans count on. AARP reiterates our opposition to the Age Tax which would allow insurance companies to charge older Americans five times more than everyone else for the same coverage while reducing tax credits that help make insurance affordable, and we strongly oppose increasing costs for people with pre-existing conditions. AARP also remains alarmed at the Senate bill’s drastic Medicaid cuts. The proposed cuts would leave millions of Americans, including 17.4 million poor seniors and people with disabilities, at risk of losing the care they need and their ability to live independently in their homes and communities. AARP will hold all 100 Senators accountable for their votes on this harmful health care bill. Our members care deeply about their health care and have told us repeatedly that they want to know where their elected officials stand. We strongly urge the Senate to reject this bill.” [AARP, 7/13/17]

Consumers Union: “You Can’t Simply Put A Bandage On This Bill To Make It Better For Consumers, Because The Approach Is Fundamentally Flawed.” “If the goal is to improve healthcare coverage, this bill takes us further away from that goal — much further, not closer. Senators on both sides of the political aisle opposed the last version of this bill. This latest version is not a solution. You can’t simply put a bandage on this bill to make it better for consumers, because the approach is fundamentally flawed.” [Consumers Union, 7/13/17]

Medicare Rights Center: “This Tweaked BCRA Still Ends Medicaid As We Know It.” “Today’s release of the updated Better Care Reconciliation Act (BCRA) confirms what we already knew: this broken bill can’t be fixed. This tweaked BCRA still ends Medicaid as we know it, and it still yanks health coverage out from under millions of Americans, including older adults, people with disabilities, and those with pre-existing conditions. On Medicare, the amended bill includes one notable change. The revised BCRA leaves in place a modest tax on high earners that puts the program on stronger financial footing. But that doesn’t mean people with Medicare are safe. The bill’s deep cuts to Medicaid would devastate the 11 million people who rely on both programs to help pay their Medicare bills, for long-term care, and to stay in their homes. Most Americans oppose the BCRA’s untenable cuts to Medicaid and its disregard for the families who need guaranteed, affordable health coverage. In drafting the BCRA, Senate leaders have avoided public debate, hearings, and even their own constituents. That’s not how good bills get done. The BCRA puts access to needed health care at risk for every older adult, person with a disability, and American family. It’s past time to abandon this broken bill. The American people have asked for, and deserve, an open, bipartisan approach to making health care more affordable for everyone.” [MRC, 7/13/17]

INSURERS

Blue Cross Blue Shield/America’s Health Insurer Plans: Cruz Amendment Is “Simply Unworkable In Any Form And Would Undermine Protections For Those With Pre Existing Medical Conditions, Increase Premiums And Lead To Widespread Terminations Of Coverage For People Currently Enrolled In The Individual Market.” “As the U.S. Senate considers the Better Care Reconciliation Act, we are writing to urge you to strike the “Consumer Freedom Option” from the bill. It is simply unworkable in any form and would undermine protections for those with pre-existing medical conditions, increase premiums and lead to widespread terminations of coverage for people currently enrolled in the individual market.” [BCBSA/AHA, 7/14/17]

America’s Health Insurer Plans: “This Proposal Would Fracture And Segment Insurance Markets Into Separate Risk Pools And Create An Un-Level Playing Field That Would Lead To Widespread Adverse Selection And Unstable Health Insurance Markets.” “Under this proposal, the non-compliant policies would be exempt from consumer protections, such as guaranteed access to coverage, community rating (e.g. no, premium surcharges based on health-status), the ban on pre-existing condition exclusions, and the requirement to offer comprehensive benefits with appropriate limits on patient costsharing. Stable and well-functioning insurance markets require broad-based enrollment and a stable regulatory environment that facilitates fair competition and a level playing field. Unfortunately, this proposal would fracture and segment insurance markets into separate risk pools and create an un-level playing field that would lead to widespread adverse selection and unstable health insurance markets. This is particularly true for patients with pre-existing conditions — who would be most affected and potentially lose access to comprehensive coverage and/or have plans that were far more expensive, as premiums in the Exchange market would rise much faster than under existing market conditions and insurance options dwindle.” [Morning Consult, 7/10/17]

Blue Cross Blue Shield Of Massachusetts: “The Senate Bill Impedes The Meaningful Progress That Our State And Nation Have Made To Extend The Peace Of Mind And Security That Insurance Coverage Brings To Both The Sick And The Healthy.” “Blue Cross Blue Shield of Massachusetts remains opposed to the newly amended Senate health care bill (the Better Care Reconciliation Act or BCRA) because it would result in the loss of coverage for millions of Americans. While we recognize that the new version of the bill provides additional funding to help combat the opioid epidemic and contains certain provisions to stabilize health insurance markets, in the long term the bill’s deep Medicaid cuts would obstruct access to care for millions of families throughout the country. The bill could also create a new divide between those who are seriously ill and those who are healthy. A fair, stable health insurance system requires an adequate number of both sick and healthy people who contribute to the pool of funds available to pay medical claims. Whether for individuals or small businesses, provisions of the BCRA deepen this divide and would create an unfair and unstable market making coverage out of reach for those who need it most. This division would be further intensified with the inclusion of the “Consumer Freedom Option” because it undermines pre-existing condition protections. As a health insurance CEO, this is not an option that we want or need. We believe that the Senate bill impedes the meaningful progress that our state and nation have made to extend the peace of mind and security that insurance coverage brings to both the sick and the healthy. We encourage the Senate to work on bi-partisan solutions that support increased access to high quality and affordable care for all Americans.” [PR Newswire, 7/13/17]

Blue Cross Blue Shield Of Minnesota: “You Are Going To End Up Bifurcating The Individual Market Into Healthy And Unhealthy.” “‘If reimbursement levels continue to get cut back, it would be a huge concern for our ability to continue to participate in the program,” Guyette said… ‘There are job losses with these cuts,’ Wheeler said. ‘It becomes a domino effect.’ Wheeler and Guyette said the GOP legislation could also result in providers shifting costs to commercial insurers and insured consumers to offset losses from patients who lose insurance. ‘We can’t forget how highly connected all of the segments are,’ Guyette said… Guyette said Congress needs to address the individual market, where insurers have struggled to market attractive plans without losing money. He said the GOP bill includes changes that would help the individual market, but he criticized the introduction of new language that would allow insurers to sell low-cost policies that provide skimpy coverage — policies that were eliminated under Obamacare. ‘You are going to end up bifurcating the individual market into healthy and unhealthy,’ Guyette said.” [Star Tribune, 7/14/17]

Allina Health: “There Is Nothing In The Bill That Talks About System Reform, And In Fact It Actually Undercuts System Reform By Cutting So Many People Off Of Coverage.” “‘I have deep, deep concerns about where the federal framework is right now and where it is proposed to go,’ said Dr. Penny Wheeler, chief executive at Allina Health, a hospital and clinic system that is Minnesota’s fifth-largest employer. ‘There’s nothing in this bill that talks about system reform, and in fact it actually undercuts system reform by cutting so many people off of coverage… ‘There are job losses with these cuts,’ Wheeler said. ‘It becomes a domino effect.’” [Star Tribune, 7/14/17]

TEACHERS

American Federation of Teachers: “Now They Are Destabilizing The Entire Health Insurance Market.” “By revising their healthcare bill, Senate Republicans have only succeeded in making a bad bill worse. First they tried to rip healthcare away from millions to give tax breaks to the wealthy and decimate Medicaid as we know it — a lifeline for seniors, children with disabilities, and families — and now they are destabilizing the entire health insurance market. This new GOP leadership bill not only continues to strip healthcare away from those who need it, but structurally destroys private insurance by allowing those who think they are invincible to pay virtually nothing while driving up costs for everyone else… Nurses, educators, doctors, hospital leaders and the American people have been clear: Tear up this bill, stop the secrecy, and work to mend, not end, the Affordable Care Act. Nothing short of that will suffice.” [AFT, 7/13/17]

FAITH LEADERS

United States Conference Of Catholic Bishops: “We Do Not See Enough Improvement To Change Our Assessment That The Proposal Is Unacceptable.” “The USCCB is reviewing carefully the health care bill introduced by Senate leadership earlier today. On an initial read, we do not see enough improvement to change our assessment that the proposal is unacceptable. We recognize the incremental improvement in funding the fight against opioid addiction, for instance, but more is needed to honor our moral obligation to our brothers and sisters living in poverty and to ensure that essential protections for the unborn remain in the bill.” [USCCB, 7/13/17]