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September 2017

Protect Our Care Statement on Firing of HHS Secretary Tom Price

Washington, D.C. — Protect Our Care Campaign Director Brad Woodhouse released the following statement in response to the firing of Health and Human Services Secretary Tom Price:

“Tom Price was fired because he was more interested in spending taxpayer money on fancy air travel than helping people get health care. But for all the talk of his chartered flights, the most fireable offenses were his dishonesty in the pursuit of health care repeal and his efforts to put people’s lives at risk by sabotaging the law. Good riddance to Secretary Price — but what we really wish will go with him is the political spitefulness that has undermined the health care of the American people. This is an opportunity for President Trump and Republicans to turn the page, appoint someone untarnished by this administration’s repeal agenda and put people’s health above partisan politics.”

NEWEST POLLING: Could Health Care Repeal Be Any Worse?

The newest round of polling data is out from multiple sources but it all confirms the same thing — voters reject partisan health care repeal and disapprove of the leadership of those who keep up the relentless push.

New Quinnipiac University polling data shows only 19% support the Graham-Cassidy-Heller health care repeal, while 59% disapprove.

  • Support for repeal falls to only 14% among independents and is only 24% with white non-college educated voters.
  • Only 11% approve of how Republicans in Congress are handling health care with an overwhelming 81% disapproving, including 86% disapproval with independents.
  • Only 10% believe their health insurance costs would go down under the plan, while most voters think it will go up (44%) or stay the same (30%)
  • ⅔ (67%) of voters — as well as 63% of Republicans — approve of preventing health insurance companies from raising insurance rates for people with pre-existing conditions, a provision this repeal would take a way.

New national polling from FOX News shows a record-level of support for the Affordable Care Act with 51% saying they are glad it passed and 42% saying they wish it never had.

  • The poll showed voters prefer to make “minor changes to Obamacare while largely leaving the law in place” by a 33 point margin (63% to 30%).
  • Only 25% supported the Senate’s health care plan — known as Graham Cassidy — in this poll while 51% oppose it.

New data from Public Policy Polling confirms the trend with voters preferring the Affordable Care Act over Graham-Cassidy-Heller by 19 points (53% to 34%).

  • Only 27% support for the latest GOP health care repeal bill with 53% opposed.
  • Only 32% think the best path forward is repeal, while 62% prefer we keep what works and fix what doesn’t.

To: Interested Parties

To: Interested Parties

From: Brad Woodhouse, Protect Our Care Campaign Director

Date: September 29, 2017

Re: Trump and Republican Sabotage of Health Care

— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —

This week witnessed the defeat of the fifth Republican health care repeal attempt, the Graham-Cassidy-Heller-Johnson bill. Every attempt to repeal the Affordable Care Act (ACA) raised premiums and costs, increased the number of people without coverage, allowed insurance companies to gut protections for people with pre-existing conditions, imposed an age tax on older Americans, and ended Medicaid as we know it.

At the same time Republicans threaten to try repeal again in 2018 — despite the public’s repeated rejection of their partisan efforts — the Trump administration and Republicans in Congress are doing everything they can to sabotage our current system.

This memo exposes those sabotage efforts, outlines how this sabotage is already raising people’s costs, and shows how the American people will hold Republicans accountable for their actions.

Republicans are Taking Deliberate Actions to Sabotage Our Health Care

The most used Republican talking point is that Obamacare is “failing,” “imploding,” or “exploding.” President Trump said earlier this year, “the best thing we can do…is let Obamacare explode” and “let it be a disaster because we can blame that on the Democrats.

These statements are false for two reasons. First, independent analyses show that the Affordable Care Act is working. Standard’s & Poor said it expected insurers’ performance in the marketplaces to be better in 2016 than in 2015, and 2017 would be better than 2016. The nonpartisan Congressional Budget Office said it anticipated “the market to be stable” under the ACA. The average premium after tax credits increased by $1 dollar, from $100 in 2016 to $101 in 2017. Currently, 10.2 million people are signed up for coverage in the marketplaces.

Second, the President’s statements do not accurately reflect reality. Republicans are not “letting” the ACA fail, as though they were just mere onlookers watching it happen. No. They are taking deliberate actions to sabotage the health care system. For example, on day one, the Trump Administration issued an executive order demanding federal agencies begin dismantling the Affordable Care Act without protecting parts that are working and without regard to the damage it would cause. Whatever President Trump’s motivation — personal hostility toward President Obama or simply spitefulness — the result is clear: his administration is making it harder for people to sign up for coverage and taking steps that are raising people’s premiums and destabilizing the marketplace.

Making it Harder for People to Enroll — Meaning Fewer Will Sign Up

The Trump administration is making it much harder for people to enroll in the marketplaces. For the final days of open enrollment in January 2017, the Trump Administration cut 75% of television advertising and all digital advertising that helped people find out about their health care options- resulting in an estimated 500,000 fewer people getting coverage.

Then, the Trump administration announced it was cutting the number of days people could sign up for coverage in half for future enrollment periods, from 90 days to 45 days.

For the open enrollment period that begins on November 1, 2017, the Trump administration already said it was cutting the outreach ad budget by 90 percent, from $100 million to just $10 million. The administration will be shutting down for part of the day on most Sundays. Sens. Brian Schatz (D-HI), Elizabeth Warren (D-MA), Cory Booker (D-NJ) and Chris Murphy (D-CT) wrote to the Department of Health and Human Services demanding answers about why this is going to happen.

This week, BuzzFeed News reported that the Trump administration ordered the Department of Health and Human Services’ regional directors to stop participating in open enrollment events. Mississippi Health Advocacy Program Executive Director Roy Mitchell said, “I didn’t call it sabotage…But that’s what it is.”

Add to that cuts to in person assistance, call centers being closed and a new final deadline to sign up.

All of these actions will result in reducing the number of people who sign up in the marketplaces. What this will mean is that those people who do sign up are more likely to be sicker and older, since they have a higher incentive to sign up than younger, healthier people. That in turn will cause premiums to spike. In other words, the Trump administration’s direct actions will be responsible for fewer people signing up for health care and raising premiums for those who do — a clear case of sabotage if there ever was one.

CSRs: Raising Rates and Destabilizing the Marketplace

Another big part of Trump’s sabotage campaign is his repeated threats to stop funding the cost sharing reductions (CSRs), which lower people’s out of pocket costs. The result: an increase in deductibles and out-of-pocket costs for the majority of those covered through the ACA marketplaces. As Sen. Lamar Alexander (R-TN) said, “Without payment of these cost-sharing reductions, Americans will be hurt.

The proof is in the pudding. States that have finalized their rates for 2018 say they raised them even more because of the uncertainty over whether the Trump administration will pay these cost-sharing reductions. Experts agree, failing to make these payments will mean higher premiums and will explode the national debt.


  • Congressional Budget Office: Congressional Budget Office says that failure to make these payments would mean people’s health insurance premiums will go up 20 to 25 percent and add nearly $200 billion to the debt over the next decade.
  • Center for American Progress: “The Center for American Progress estimates that uncertainty around CSRs and mandate enforcement will raise 2018 premiums for benchmark coverage an extra $1,061 annually for a 40-year-old and $2,491 annually for a 64-year-old.”
  • Kaiser Family Foundation: “Benchmark premiums would increase by 19 percent on average if cost-sharing subsidies were unpaid.”
  • Urban Institute: “We find that premiums for silver marketplace plans would increase $1,040 per person on average.”
  • Urban Institute: “A precipitous drop in insurer participation is even more likely if the cost-sharing assistance is discontinued.”
  • Commonwealth Fund: “Eliminating cost-sharing reductions could destabilize insurance markets.”
  • Kurt Giesa, Practice Leader, Oliver Wyman Actuarial Consulting: “Our modeling shows that this uncertainty, if it remains, could lead payers to submit rate increases between 28 and 40 percent, and more than two-thirds of those increases will be related to the uncertainty around CSR payments and individual mandate.”

State Insurance Commissioners and Agencies

Health Care Industry

Americans Will Rightly Hold Republicans Accountable for Sabotage

President Trump and Republicans in Congress might hope that people will blame President Obama and Democrats for rising premiums and limited choices on the marketplace, but that is not the case. As the Wall Street Journal editorial board wrote, “Republicans run the government and that means they are responsible for what happens in health care.”

An April 2017 Kaiser Health tracking poll found that 64 percent of Americans, including ⅔ of independents and a majority of Republicans, said they would blame Republicans and President Trump for any future problems with health care and the Affordable Care Act (ACA) going forward. The same poll found that 74 percent want Trump and his Administration to do what they can to make the current law work — that includes 8 in 10 independents and over half of Republicans.

Moreover, a recent poll by Hart Research Associates found that “nearly two-thirds (64%) of voters believe it is true that Donald Trump is ‘undermining the Affordable Care Act’ and three-in-five (61%) voters believe that he is actively ‘trying to make the Affordable Care Act fail.’ Additionally, 64% say that Trump is ‘playing politics with people’s healthcare,’ including one-in-four (24%) of his own voters. Along similar lines, a 57% majority believe that the president is ‘sacrificing people’s health care in order to oppose Barack Obama.’”

Clearly, they are not fooling anybody. Take a look at some of the headlines this week after state’s announced their finalized insurance rates for next year:

  • Bloomberg: Obamacare Rates Rise in Markets Unsettled by Trump
  • USA Today: Obamacare rates soar as White House refuses to make long term commitment to subsidies
  • NBC News: Obamacare Repeal Failed, but the Damage Is Already Done

Stand Up to Sabotage

All of us need to play a role in standing up to the Trump administration and Republicans in Congress sabotaging our health care. Here are a few ways:

  1. Demand Bipartisan Talks and Action to Stabilize the Health Care Market: Republicans and President Trump have injected uncertainty into the health care market by pursuing secretive, partisan repeal and by refusing to commit to paying CSRs. A bipartisan deal to pay CSRs was nearly in place until Republican leaders and President Trump pulled the plug so they could again try to ram through partisan repeal in the form of Graham-Cassidy. It’s now on Republicans to return to the table and pass a stabilization bill immediately; unfortunately, a lot of the damage has already been done and they will hold the bag for higher premiums, lost coverage and higher debt.
  2. Demand Republicans Stand Up to Trump’s Sabotage of Open Enrollment and Shine a Light on What It Means: Republicans need to stand up to and speak out against the Administration’s effort to sabotage open enrollment and do their part to help get their constituents enrolled. Everyone must continue to shine a spotlight on every action (or inaction) along the way of the Trump Administration which undermines Open Enrollment through rapid response press, events in states, online activism and paid advertising so that we can hold people accountable.
  3. Hold Republicans Accountable: We should let lawmakers know that if they are not going to stand up to the Trump administration’s sabotage, they are complicit in it. We should be making our voices heard at town hall meetings and calls to our Representatives. We need to expose these sabotage efforts, demand answers and use every tool at our disposal, protests, ads and other forms of activism to hold Republican lawmakers accountable for participating in or turning a blind eye to sabotage.

Protect Our Care Statement on Trump Administration’s Continued Sabotage Following Legislative…

Today, BuzzFeed News reported that the Trump Administration is doubling down on its sabotage of the health care marketplace by ordering the Department of Health and Human Services’ regional directors to stop participating in open enrollment events. According to BuzzFeed News, all ten HHS regional directors “were told not to participate in state-based events promoting open enrollment — a significant change from years past,” and one that will surely be detrimental to enrolling people across the country. “I didn’t call it sabotage,” Mississippi Health Advocacy Program Executive Director Roy Mitchell said. “But that’s what it is.”

Earlier in the day Vox reported on the events in Mississippi being abruptly canceled, and it is now clear such a directive is part of a larger nefarious plan. This order comes on the heels of the Administration’s decision to limit the working period of and decrease open enrollment advertising by $90 million, and as the President continues to call for a partisan repeal bill. Protect Our Campaign Director Brad Woodhouse released the following statement in response to the Administration’s unprecedented sabotage efforts:

“What this Administration is doing is appalling,” said Woodhouse. “President Trump and Republicans who have cheered him on and supported repeal, and now sabotage, of our health care are intentionally harming people for sheer politics. The fact that they’re carrying these actions out the day after their heinous repeal bill fell through makes it all the more shameful. These actions are disgraceful, unprecedented and will ultimately have harmful effects on the very people they purport to serve — the American people know who to hold accountable for undermining their health care.”

Protect Our Care Statement on Trump Sabotage of Health Care and Anthem Pulling Out of Maine

Anthem Cites Uncertainty over Cost-Sharing Reduction Payments, which President Trump Has Threatened to Cancel, Among other Reasons, in Decision to Leave Market

WASHINGTON, D.C. — Today, one day after the failure of GOP’s latest iteration of a partisan repeal bill which would have thrown the country’s health care system into chaos, the effects of President Trump’s intentional sabotage of health care were once again made clear when Anthem announced it would exit Maine’s individual insurance market next year. Why?

“‘A stable insurance market is dependent on products that create value for consumers through the broad spreading of risk and a known set of conditions upon which rates can be developed,’ said Anthem spokesman Colin Manning in a statement. ‘Today, planning and pricing for ACA-compliant health plans has become increasingly difficult due to a shrinking and deteriorating individual market, as well as continual changes and uncertainty in federal operations, rules and guidance, including the restoration of the health insurance tax on fully insured coverage and continued uncertainty around the future of cost sharing reduction subsidies.’”

As the Portland Press-Herald noted, however, actions taken by Congress — like the payment of cost-sharing reductions — could potentially bring Anthem back into the marketplace:

“Manning did not close the door on returning to the Maine marketplace if conditions stabilized. There are proposals in Congress to mandate that the cost-sharing reduction funding be paid to insurers, and other measures to stabilize the marketplace. ‘Our commitment to members has always been to provide greater access to affordable, quality healthcare, and we will continue to advocate solutions that will stabilize the market. As the marketplace continues to evolve and adjust to changing regulatory requirements and marketplace conditions, we will reevaluate whether a more robust presence in the exchange is appropriate in the future.’”

In response, Protect Our Care Campaign Director Brad Woodhouse issued the following statement:

“Anthem’s decision to pull out of Maine is the direct consequence of uncertainty created in the marketplace by Republicans pushing for partisan repeal of our health care and President Trump’s intentional efforts to sabotage the law,” said Woodhouse. “President Trump has been playing politics with cost-sharing reduction payments by continually threatening to cancel them even though they lower out-of-pocket costs for millions of Americans. This uncertainty has led to decisions like Anthem’s.

“President Trump and Republicans who have cheered him on and supported repeal are intentionally harming people’s health care for sheer politics. The American people know this and they will hold them accountable for undermining the health care of the American people. Instead of sabotaging America’s health care, Republicans should follow the example of Senator Susan Collins, who has called for Democrats and Republicans to work together to improve health care for the American people.”

Protect Our Care Statement On Latest Failure of Health Care Repeal

Facing opposition from every health care organization, bipartisan opposition in the Senate and overwhelming opposition from the American people, Senate Republicans abandoned their latest health care repeal scheme today, known as Graham-Cassidy-Heller. This is at least the fifth attempt in 2017 at health care repeal by Republicans in Congress without any bipartisan or public support. Every version of health care repeal would have raised premiums, resulted in millions of people without coverage, allowed insurance companies to gut protections for people with pre-existing conditions, re-implement lifetime limits and charge an age tax, and ended Medicaid as we know it.

In response, Protect Our Care Campaign Director Brad Woodhouse issued the following statement:

“None of these health care repeal bills were ever about health care, they were about political wins for the Republican Congress and President Trump,” Woodhouse said. “No matter how hard they try to repeal our health care, the American people keep winning. Make no mistake, though, too many Republicans in Congress refuse to move on and are already promising to revive zombie repeal. The American people must remain vigilant.

“It’s past time for Republicans to abandon partisan repeal, stand up to President Trump’s sabotage of our health care system and work across party lines to improve our health care system. Senators Alexander and Murray had started that important work and it’s the path we need to take now.

“The Trump Administration and Republican leaders face a fork in the road — will they continue to be the party of partisan health care repeal and sabotage? Everyone is watching.”

Protect Our Care Statement After Another Awful Day for Graham-Cassidy

Today was perhaps the worst day yet for Graham-Cassidy, the GOP’s latest secret, partisan health care repeal bill which would raise costs, lower options, remove protection for pre-existing conditions and end Medicaid as we know it. A new poll found just one-fifth of voters supporting the bill; CBO analysis found “millions” would lose their insurance; and Sen. Susan Collins announced her opposition to the legislation, calling it “as deeply flawed as the previous iterations.” In response, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Today’s developments represent more major setbacks for the latest secretive, partisan effort to repeal the health care of the American people,” said Woodhouse. “A new CBS News poll this morning pegged support for the Graham-Cassidy repeal effort at a paltry 20 percent and terrible reviews of the latest draft poured in from expert voices and stakeholders across the country. And if all that wasn’t bad enough, the Congressional Budget Office released a partial analysis of the bill this afternoon which confirmed what every independent analysis has shown — that Graham-Cassidy repeal would strip millions of coverage and slash Medicaid. And to top it all off, Senator Susan Collins of Maine said she is a hard no on the bill.
“It should now be abundantly clear that partisan repeal is a loser both politically and substantively and that it’s time for Republicans to stop partisan repeal and return to bipartisan efforts to improve health care which were underway before Republicans pulled the plug. Until they do, the calls will continue, the ads will stay up and millions of Americans will write, email, tweet and protest until the effort to strip millions of health care and spike costs for millions more is dead, once and for all.”

The Reviews On Graham-Cassidy Are In: “The New Version of Cassidy-Graham May Be Crueler And More…

Today, the day of the only scheduled hearing on the GOP’s newest secret, partisan repeal bill, Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) released yet another version of their bill. Like previous iterations, this bill would raise costs, lower options and end Medicaid as we know it — and go even further removing protections for people with pre-existing conditions. If Sens. Graham and Cassidy thought releasing a new version of their bill would make it better, they were highly mistaken. Take a look for yourself:

“The new version of Cassidy-Graham may be crueler and more cynical than the last.”

“[T]he new version appears to go further in weakening protections for sick people, apparently to win over conservatives who continue to express reservations, such as senators Rand Paul, Ted Cruz, and Mike Lee.”

“The bill continues, however, to give states broad new authority to allow insurance companies to provide skimpier plans with far fewer benefits while charging higher premiums to the sick and the old.” [

The new draft attempts to win over skeptical conservatives by further weakening consumer protections for Americans in bad health.”

“States would have even more flexibility to roll back some of the Affordable Care Act’s insurance regulations — including the guarantees it provides for people with pre-existing conditions.”

“‘This is like legislating blind…It is really hard to find an example of something where Congress was this reckless.”

“Only a few Republican senators care about the substance of the bill.”

President Trump Claims Alaska, Arizona, Maine and Kentucky Are “Big Winners” Under Graham-Cassidy…



Analysts Agree: Every State Loses Under Graham-Cassidy Affecting People’s Care. Multiple independent analyses — and even Trump’s own CMS — agree that states would be worse off if theGraham-Cassidy repeal bill passess. Over time, every state loses because Graham-Cassidy zeroes out its block grants and ratchets down its spending on the Medicaid per capita cap. This means people would not have access to the financial assistance to help lower their health care bills, and federal Medicaid funding would no longer adjust for public health emergencies, prescription drug or other cost spikes, or other unexpected increases in need.

  • Alaska stands to lose $2 billion from 2020–2027 and $14 billion over the next two decades.
  • Arizona stands to lose $19 billion from 2020–2027 and $133 billion over the next two decades.
  • Maine stands to lose $2 billion from 2020–2027 and $17 billion over the next two decades.
  • Kentucky stands to lose $11 billion from 2020–2027 and $81 billion over the next two decades.

And according to an AARP analysis, the bill’s age tax would lead to huge increases in total costs for a 60-year-old making $25,000 in each of these states:

  • $31,790 more in Alaska
  • $22,074 more in Arizona
  • $16,437 more in Maine
  • $13,118 more in Kentucky


Fact Check: White House’s Marc Short Admits Graham-Cassidy Eliminates Protections For People With…

On Fox News Sunday this morning, White House legislative affairs director Marc Short admitted that the Graham-Cassidy health care repeal bill eliminates protections for people with pre-existing conditions.

Since the Affordable Care Act was passed, the most popular and essential provisions in the law has been coverage for pre-existing conditions. As many as half of all Americans have them, and Republicans have consistently paid lip service to continuing to ensure they will be covered. The GOP’s latest repeal bill, however, allows states to waive these protections — paving the way for insurance companies to once again discriminate against hundreds of millions of people. And as the bill heats up, so has the coverage highlighting the GOP’s plan…

Associated Press: Winners and losers in GOP’s last-ditch health overhaul

“Losers — People with health problems or with pre-existing medical conditions could be charged more if the state they live in obtains a waiver from current requirements that forbid insurers from charging higher premiums based on health status. States could also seek waivers from the current requirement that insurers cover 10 basic kinds of services, such as maternity and childbirth, or mental health and substance abuse treatment.”

The Hill: GOP takes heavy fire over pre-existing conditions

“The new ObamaCare repeal measure from Senate Republicans would give states a way to repeal protections for people with pre-existing conditions, a controversial move that opponents of the bill are denouncing.”

Vox: How Cassidy-Graham brings back preexisting conditions

“The new Republican plan to repeal Obamacare would bring preexisting conditions back to the individual market, allowing insurers to charge sick people higher premiums — or deny them coverage outright. ‘You can be charged more for a specific condition,’ says Chris Sloan, a senior manager at the health research firm Avalere, of the Cassidy-Graham plan that has begun to gain traction on Capitol Hill.”

Bloomberg: GOP Health Bill Would End Guarantee That Sick People Won’t Pay More

“Under the latest Republican bill, states could get a waiver allowing insurers to charge people more if they or a dependent have a pre-existing condition, or if they get sick and want to keep their insurance. The key provision in the bill has vague language requiring a state to first show how it ‘intends to maintain access to adequate and affordable health insurance coverage for individuals with pre-existing conditions.’”

Politico: Kimmel, not Cassidy, is right on health care, analysts say

“But experts say that Cassidy and Graham’s bill can’t guarantee those protections and that Kimmel’s assessment was basically accurate because of the flexibility the bill gives states to set up their own health care systems. For example, health insurers could hike premiums for patients with pre-existing conditions if their states obtain waivers from Obamacare regulations — as Kimmel said.

NPR: Latest GOP Effort To Replace Obamacare Could End Health Care For Millions

“But many experts say the bill would have an impact similar to earlier Republican proposals for repealing the Affordable Care Act. Graham-Cassidy would eliminate coverage for many low-income people who gained insurance through the Medicaid expansion and could gut protections for people with existing medical conditions because states would be encouraged to seek waivers from the federal government’s rules on what must be covered.

The Hill: Blue Cross warns GOP repeal bill ‘undermines’ pre-existing condition rules

“The Blue Cross Blue Shield Association warned against a new GOP ObamaCare bill on Wednesday, saying it would ‘undermine’ protections for pre-existing conditions. ‘The bill contains provisions that would allow states to waive key consumer protections, as well as undermine safeguards for those with pre-existing medical conditions,’ the association said in a statement.”

NBC News: New GOP Plan Could Sow Health Care Chaos

“Most notably, states could free up insurers to charge people more for pre-existing conditions or reduce their plan’s benefits, which could open up customers to annual or lifetime caps on coverage.”

New York Magazine: 4 Ways Graham-Cassidy Would Make the Health-Care System Far Worse

“Under Graham-Cassidy, insurers could not refuse to cover someone because of a preexisting condition, but they would be able to make coverage so exorbitantly expensive that sick people couldn’t afford it.”