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October 2017

Outrageous: Trump Sabotaging People’s Health Care for Leverage?!

“This is outrageous. We know Trump is hell bent on sabotaging the health care of the American people out of his hatred for President Obama and to curry favor with the most extreme elements of his political base, but now he’s also doing it as leverage to get a border wall? Americans are already seeing higher premiums as a result of Trump’s sabotage, the markets are being de-stabilized and as many as a million people will lose coverage next year next year because of his senseless, reckless, cold-hearted decision to end cost sharing reduction payments. It has always been a lie that the Affordable Care Act was in trouble and needed to be scrapped, and any problems with the law now lay squarely at the feet of Trump and Republicans for their blatant sabotage and focus on partisan repeal. If Republicans in Congress want to avoid the political fallout from Trump’s decision they can do one thing right now: pass legislation to restore CSR’s and dare Trump to veto it. Otherwise, when the fallout comes it will be coming their way, not just Trump’s.” -Brad Woodhouse, Campaign Director, Protect Our Care

“The president has said pretty clearly that he’s willing to talk to just about anybody about repealing and replacing [Obamacare],” Mulvaney continued. “But if the straight-up question is: Is the president interested in continuing what he sees as corporate welfare and bailouts for the insurance companies? No.”

The administration, however, opened the door to negotiations on the now-canceled payments. After speaking to Senate Minority Leader Chuck Schumer on Saturday, Trump said a temporary deal could be struck on shoring up the insurance markets. Mulvaney suggested the insurance payments could be a bargaining chip in a broader negotiation with Congress to either repeal former President Barack Obama’s signature health care law — or fund Trump’s long-stalled border wall with Mexico.

Trump opposes bipartisan Obamacare rescue plan

Politico // Burgess Everett, Rachael Bade and Josh Dawsey

October 13, 2017

https://www.politico.com/story/2017/10/13/trump-opposes-bipartisan-obamacare-rescue-plan-243752

President Donald Trump will oppose any congressional attempts to reinstate funding for Obamacare subsidies — unless he gets something in return, his budget director Mick Mulvaney said in an interview Friday morning.

The comments by the Office of Management and Budget chief delivered a severe blow to efforts by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) to strike a bipartisan deal on funding the subsidies. Trump canceled those payments to insurance companies on Thursday night, raising hopes among some Democrats and centrist Republicans that the Trump administration could accept a bill that would revive the subsides while offering states more flexibility to opt out of Obamacare.

But Mulvaney panned those efforts, calling the so-called cost-sharing reduction payments “corporate welfare and bailouts for the insurance companies.”

“Instead of saying what we might support, I’d say I’m pretty sure what we won’t support, which is just a clean Murray-Alexander bill,” Mulvaney said, sitting in his spacious Eisenhower Executive Office Building office Friday morning.

“The president has said pretty clearly that he’s willing to talk to just about anybody about repealing and replacing [Obamacare],” Mulvaney continued. “But if the straight-up question is: Is the president interested in continuing what he sees as corporate welfare and bailouts for the insurance companies? No.”

The administration, however, opened the door to negotiations on the now-canceled payments. After speaking to Senate Minority Leader Chuck Schumer on Saturday, Trump said a temporary deal could be struck on shoring up the insurance markets. Mulvaney suggested the insurance payments could be a bargaining chip in a broader negotiation with Congress to either repeal former President Barack Obama’s signature health care law — or fund Trump’s long-stalled border wall with Mexico.

Mulvaney is bullish about securing Trump’s priorities in a December funding bill, and he threatened — not for the first time — a government shutdown if Trump doesn’t get them.

“The president fully expects his priorities to be funded, and the wall is one of them,” Mulvaney said. “It would be highly unlikely for the president to sign a funding bill in December that does not fund his priorities.”

Mulvaney added that members of Congress he meets with probably “think that’s a credible threat.”

The government runs out of money on Dec. 8, a deadline that will trigger high-stakes negotiations with the White House over how to avoid a government shutdown. An immigration bill, debt ceiling increase or wall money could all be in the mix with the Obamacare payments.

“It depends on what else it’s attached to, right?” Mulvaney said of the administration’s position on the bipartisan health care payments proposal. “Take it on its own, I don’t know how you describe Murray-Alexander as anything other than a continuation of these subsidies and I don’t know how much interest there would be on that. If it’s part and parcel … of a larger discussion on health care, then maybe it’s something to look at.”

The tough talk from Mulvaney represents a hard line by the Trump administration toward Congress after months of frustration at the GOP-controlled Congress’ inability to repeal Obamacare. The president and his aides are foisting the issues of immigration, foreign policy and now Obamacare payments on Congress, hoping to extract conservative legislation out of a GOP legislative caucus consumed by infighting.

Republican leaders are worried that Trump’s move to end Obamacare subsidy payments could backfire on them in the 2018 midterms, inciting voters upset about skyrocketing insurance payments. But Mulvaney said voters are far more likely to punish congressional Republicans for failing to live up to a seven-year promise: repealing Obamacare.

“There’s a long list of reasons that Republicans could pay a price for something in the midterms, and my guess is at the top of the list is failure to repeal and replace Obamacare,” Mulvaney said. “So do I think [stopping subsidy payments] turns [into] an issue in a midterm election? Probably not.”

Democrats panned Trump’s Thursday evening decision as irresponsible and pleaded with GOP leaders not to cut off the bipartisan talks.

“I continue to be optimistic about our negotiations and believe we can reach a deal quickly — and I urge Republican leaders in Congress to do the right thing for families this time by supporting our work,” Murray said on Friday morning.

With the dour view from the administration, House and Senate Republicans are planning to unveil a proposal next week aimed at increasing GOP support for the cost-sharing payments, Sen. Ron Johnson (R-Wis.) said in an interview on Friday. The plan would mandate the sale of catastrophic health care plans, expand the use of health savings accounts and require insurers to reduce premiums if they accept the cost-sharing payments.

“I’ve always viewed the higher hurdles [to passage of a bill as being in] the House. Doesn’t do us a whole lot of good to come up with an agreement in the Senate that can’t pass the House,” Johnson said. He said the Senate has had “excellent discussions, but in the end we need to make sure we can get House members on board.”

Many Republicans, including GOP congressional leaders, have been urging Trump to continue the payments. But the White House viewed the failure of Obamacare repeal in the Senate as a breaking point, and saw no use in keeping up the payments without larger health care legislation on the horizon. The Justice Department also provided legal cover, pronouncing that the payments are unconstitutional.

That move by Trump also represents a significant internal win for Mulvaney, whose hard-line stances on spending and the debt ceiling have at times been spurned by the president. Mulvaney said he’d been trying to persuade Trump to end the payments since he was sworn in as budget director.

“I’ve been making the case from the beginning of the administration that we shouldn’t be making these payments,” said Mulvaney. “Not only are they bad policy, in terms of bailing out companies that don’t need to be bailed out, but №2, they’re unconstitutional.”

Trump Guts American Health Care In One Day — Time for Republicans Who Have Said They Support CSR…

In one day, between an Executive Order that will de-stabilize the insurance market and cutting off cost-sharing reduction (CSR) payments, President Trump has done what Congress repeatedly refused to — gut American health care. But, in slashing cost sharing reduction payments, not only is Trump out of step with the American people — he is out of step with many in his own party including key Senators, Governors and House members.

Now, the same Republicans who have spoken out in favor of efforts to stabilize the market and continue these payments which keep out of pocket costs low for millions of Americans, must step up and

immediately work to pass legislation to restore cost sharing reduction payments and stabilize the market or the political consequences associated with gutting people’s health care won’t just fall on Trump.

See what Republicans have said is support of continuing cost sharing reduction payments…

REPUBLICAN LEADERSHIP

Senate Majority Leader Mitch McConnell (R-KY): “If My Side Is Unable To Agree On An Adequate Replacement, Then Some Kind Of Action With Regard To The Private Health Insurance Market Must Occur.” “If my side is unable to agree on an adequate replacement, then some kind of action with regard to the private health insurance market must occur,’ McConnell said. ‘No action is not an alternative. We’ve got the insurance markets imploding all over the country, including in this state.” [Washington Post, 7/6/17]

Sen. John Thune (R-SD): “I Hope The President Will Continue To Make Those Payments.” [Kasie Hunt Tweet, 8/1/17]

House Deputy Majority Whip Rep. Tom Cole (R-OK): “Asked If He Thought Congress Should Provide The Money, Mr. Cole Said, ‘My Personal Opinion Is Yes.’” “I don’t think anyone wants to disrupt the markets more than they already are.” Asked if he thought Congress should provide the money, Mr. Cole said, “My personal opinion is yes.” [New York Times, 4/10/17]

REPUBLICAN COMMITTEE CHAIRS

Senate HELP Committee Chairman Lamar Alexander (R-TN): Sen. Alexander “Recommended The Trump Administration Find A Way, Either Through Administrative Action Or Legislation Or A Combination, To Extend Temporary Cost-Sharing Payments Under The Affordable Care Act At Least Through 2018 — And Probably Should Go Ahead And Do It Through 2019.’” He “recommended the Trump administration ‘find a way, either through administrative action or legislation or a combination, to extend temporary cost-sharing payments under the Affordable Care Act at least through 2018 — and probably should go ahead and do it through 2019.’” [Statement, 6/15/17]

Sen. Lamar Alexander (R-TN): “Without Payment Of These Cost-Sharing Reductions, Americans Will Be Hurt.” “‘Without payment of these cost-sharing reductions, Americans will be hurt. Up to half of the states will likely have bare counties with zero insurance providers offering insurance on the exchanges, and insurance premiums will increase by roughly 20%, according to America’s Health Insurance Plans (AHIP).” [Alexander Statement, 8/1/17]

Sen. Lamar Alexander (R-TN): We Should “Approve The Temporary Continuation Of Cost-Sharing Subsidies For Deductibles And Co-Pays.” “‘While we build replacements, we want the 11 million Americans who now buy insurance on the exchanges to be able to continue to buy private insurance. Among the actions that will help are to… approve the temporary continuation of cost-sharing subsidies for deductibles and co-pays.’” [Politico Pro, 1/13/17]

Senate Finance Committee Chair Orrin Hatch (R-UT): “I Think They’re Going To Have To Be Paid.” “I think they’re going to have to be paid.” “You can’t let people be without basic health care.” [Politico, 7/18/17]

House Ways And Means Committee Chairman Kevin Brady (R-TX): “We Should Act Within Our Constitutional Authority Now To Temporarily And Legally Fund Cost-Sharing Reduction Payments As We Move Away From Obamacare.” “We should act within our constitutional authority now to temporarily and legally fund cost-sharing reduction payments as we move away from Obamacare.” “Insurers have made clear the lack of certainty is causing 2018 proposed premiums to rise significantly.” [New York Times, 6/8/17]

House Energy And Commerce Committee Chair Greg Walden (R-WA): “I Will Do Everything I Can To Make Sure The Cost-Sharing Reduction Payments Get Made.” “I will do everything I can to make sure the cost-sharing reduction payments get made, especially this year where they were promised by the federal government under the contracts.” “That’s an obligation not only to insurers but also to the people who took on those plans. We cannot leave them high and dry.” [Bloomberg, 3/30/17]

Senate Homeland Security Committee Chair Ron Johnson (R-WI): The Senate Should “Bite The Bullet And Stabilize Those Markets.” “Sen. Ron Johnson (R-Wis.) has for months called for a bipartisan stabilization bill that would guarantee funding for ObamaCare payments, known as cost-sharing reductions, to insurers. Those payments are key to avoiding premium spikes and keeping insurers in the markets. Johnson said Tuesday that he hopes the GOP can pass something next week, but if not, ‘bite the bullet and stabilize those markets.’” [The Hill, 7/13/17]

OTHER REPUBLICANS

Rep. Ileana Ros-Lehtinen (R-FL): “Cutting Health Care Subsidies Will Mean More Uninsured In My District. @POTUS Promised More Access, Affordable Coverage. This Does Opposite.” [Tweet, 10/12/17]

Rep. Carlos Curbelo (R-FL): “Cost Sharing Reductions Are Critical To Low Income Americans. Congress Should Guarantee Their Funding Through The Appropriations Process.” [Tweet, 10/13/17]

Rep. Tom Reed (R-NY): “If Congress Doesn’t Get It Done The People Who Suffer Are The People Back Home.” “GOP Rep. Tom Reed calls for Congress to fund CSRs. ‘If Congress doesn’t get it done the people who suffer are the people back home.’” [Tweet, 10/13/17]

Rep. Leonard Lance (R-NJ): “Now Congress Must Act And Pass The Problem Solvers Caucus Health Care Plan That…Funds The Cost-Sharing Reduction Program.” “Now Congress must act and pass the Problem Solvers Caucus health care plan that I have endorsed. It funds the cost-sharing reduction program through the congressional appropriations process and implements free-market policies to improve our health care system and lower medical and insurance costs for all.” [Statement, 10/13/17]

Sen. Bill Cassidy (R-LA): “Families Would Be Hurt” If Payments Not Made.” [Sahil Kapur Tweet, 8/1/17]

Sen. Susan Collins (R-ME): “It Really Would Be Detrimental To Some Of The Most Vulnerable Citizens If Those Payments Were Cut Off.” “It would not affect my vote on health care, but it’s an example of why we need to act to make sure that those payments, which are not an insurance company bailout, but rather help people who are very low-income afford their out-of-pocket costs towards their deductibles and their co-pays. And that’s what we need to remember. So, it really would be detrimental to some of the most vulnerable citizens if those payments were cut off. They’re paid to the insurance companies, but the people that they benefit are people who make between 100 percent and 250 percent of the poverty rate. So, we’re talking about low-income Americans who would be devastated if those payments were cut off, though the threat to cut off those payments has contributed to the instability in the insurance market.” [Collins on CNN’s State of the Union, 7/30/17]

Sen. Susan Collins (R-ME): “Very Concerned” About Executive Order And Cutting CSR Funding.” “Susan Collins says she’s ‘very concerned’ with Trump’s new ACA EO and decision to do away with CSRs.” [10/12/17]

Susan Collins: “It Is Absolutely Essential That The CSR Payments Continue.” [Huffington Post’s Matt Fuller Tweet, 8/1/17]

Sen. Lisa Murkowski (R-AK): “The Senate Should Step Back And Engage In A Bipartisan Process To Address The Failures Of The ACA And Stabilize The Individual Markets.” “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.” [Murkowski Statement, 7/18/17]

Rep. Phil Roe (R-TN): “If We Pull The Subsidies … I Think There Would Be Nobody With A Health Insurance Plan Next Year.” “If we pull the subsidies … I think there would be nobody with a health insurance plan next year.” [Politico, 4/26/17]

Rep. Kevin Cramer (R-ND): “As Long As It’s [The Subsidies] Are Part Of The Law Of The Land, It’s Our Job To Appropriate The Money.” “As long as it’s [the subsidies] are part of the law of the land, it’s our job to appropriate the money.” [Politico, 4/5/17]

GOVERNORS, INCLUDING REPUBLICANS

National Governors Association: “The Federal Government Should Fully Fund The Cost-Sharing Reductions (CSRs) For The Remainder Of CY 2017 And CY 2018.” “The federal government should fully fund the cost-sharing reductions (CSRs) for the remainder of CY 2017 and CY 2018 and offer long-term certainty about the future of CSRs.” [NGA, 6/20/17]

Govs. Kasich, Hickenlooper, Sandoval, Wolf, Walker, McAuliffe, Edwards, Bullock: Trump Administration Should Make CSR Payments And Congress Should Explicitly Appropriate Funds Through 2019. “The Trump Administration should commit to making cost sharing reduction (CSR) payments. The National Association of Insurance Commissioners (NAIC), National Governors Association, and United States Chamber of Commerce have identified this as an urgent necessity…Also, Congress should put to rest any uncertainty about the future of CSR payments by explicitly appropriating federal funding for these payments at least through 2019. This guarantee would protect the assistance working Americans need to afford their insurance, give carriers the confidence they need to stay in the market, increase competition, and create more options for consumers.” [Letter, 8/31/17]

Asa Hutchinson, Governor of Arkansas: Calls Trump’s Threat To Withdraw Cost-Sharing Payments “Very Problematic.” “However, Hutchinson says he does have concerns about President Trump’s threat to withdraw cost-sharing from insurance companies if no healthcare bill is passed. Cost-sharing creates a healthcare fund that covers co-payments and deductibles for low-income enrollees. ‘That would be very problematic. That is like withdrawing one little element of the Affordable Care Act… without having a comprehensive reform,’ said Hutchinson.” [Arkansas Public Radio, 8/4/17]

Govs. McAuliffe And Baker On Behalf Of The Health And Human Services Committee, National Governors Association: “A First Critical Step In Stabilizing The Individual Health Insurance Marketplaces Is To Fully Fund CSRs For The Remainder Of Calendar Year 2017 Through 2018.” “The Administration has the opportunity to stabilize the health insurance market across our nation and ensure that our residents can continue to access affordable health care coverage. A first critical step in stabilizing the individual health insurance marketplaces is to fully fund CSRs for the remainder of calendar year 2017 through 2018. This is a necessary step to stabilize the individual marketplaces in the short term as Congress and the Administration address long-term reform efforts.” [NGA, 8/2/17]

Govs. Hickenlooper, Bullock, Sandoval, Hogan, Wolf, Edwards, McAuliffe, Baker, Kasich, And Scott: Instead Of Pursuing Health Care Repeal, “We Ask Senators To Work With Governors On Solutions To Problems We Can All Agree On: Fixing Our Unstable Insurance Markets.” “Instead, we ask senators to work with governors on solutions to problems we can all agree on: fixing our unstable insurance markets. Improvements should be based on a set of guiding principles, which include controlling costs and stabilizing the market, that will positively impact the coverage and care of millions of Americans, including many who are dealing with mental illness, chronic health problems, and drug addiction.” [Letter, 7/26/17]

Govs. Kasich, Bullock, Hogan, Edwards, Walker, Hickenlooper, Baker, Wolf, Scott, McAuliffe, And Sandoval: “Congress Should Work To Make Health Insurance More Affordable By Controlling Costs And Stabilizing The Market.” “Congress should work to make health insurance more affordable by controlling costs and stabilizing the market, and we are pleased to see a growing number of senators stand up for this approach.” [Letter, 7/18/17]

Trump’s CSR Sabotage In the Headlines

Trump’s CSR Sabotage In the Headlines

Late last night, President Trump announced he was cutting off the Affordable Care Act’s cost-sharing reduction payments, paving the way for massive premium increases and potentially sowing chaos in the country’s health care marketplace. How is this being described? Take a look for yourself…

Washington Post: Throwing a bomb into the insurance markets, Trump now owns the broken health-care system

NPR: Trump Administration To End Obamacare Subsidies For The Poor

Axios: ​Trump takes a sledgehammer to the ACA

Washington Post: Trump moves from firing shots at Obamacare to all-out war

Washington Post: Trump’s not going to be able to avoid blame for kneecapping Obamacare

Politico: Trump does more to undercut Obamacare in one day than Congress did all year

Vox: Trump will pull Obamacare subsidies in another attack on health law

Vox: Trump’s acting like Obamacare is just politics. It’s people’s lives.

New York Daily News: Trump to scrap Obamacare subsidies designed to help low-income Americans

New York Times: Trump to Scrap Critical Health Care Subsidies, Hitting Obamacare Again

Talking Points Memo: Trump Admin Ends Key O’care Payments In Latest Move To Undermine Law

Health Affairs: Administration’s Ending Of Cost-Sharing Reduction Payments Likely To Roil Individual Markets

Forbes: Trump’s End To Obamacare Subsidies Hurts Patients, Not Insurers

Vice: Trump just made healthcare more expensive for millions of people

Bloomberg: Trump Cuts Off Health-Insurer Subsidy, Threatening Obamacare Chaos

CNBC: Obamacare bombshell: Trump kills key payments to health insurers

MSNBC: Trump goes to war against his own country’s health care system

Slate: Trump Will Reportedly Cut Vital Obamacare Subsidy, Potentially Throwing Marketplaces into Upheaval

Salon: Donald Trump unwittingly admits he’s sabotaging health care

Politico: Trump will scrap critical Obamacare subsidies

Real Vail: Obamacare now Trumpcare as president moves on his own to gut Affordable Care Act

Cleveland Plain Dealer: Trump to stop paying insurers, putting Obamacare in limbo

NBC News: White House Says It Will End Key Obamacare Subsidies to Insurers

Reuters: Trump scraps key Obamacare subsidies, urges Democrats to fix ‘broken mess’

Protect Our Care Statement on Reports Trump is Canceling CSR Payments

In response to news reports tonight that the Trump administration plans to cancel funding the cost-sharing-reduction payments — a part of the Affordable Care Act — Protect Our Care Campaign Director Brad Woodhouse made the following statement.

“The President of the United States is now running a daily campaign to sabotage the health care of the American people. Nonpartisan analysts say canceling these payments means making people pay 20% higher premiums.

“The Trump administration and every Republican in Congress who lets him do this, is now responsible for every rate hike people see for the foreseeable future. They broke it, they own it.”

THOSE WHO KNOW HEALTH CARE THE BEST SAY TRUMP’S EXECUTIVE ORDER IS THE WORST

Patient groups, hospitals, doctors, industry experts, consumer groups, teachers and faith leaders have all come out against President Trump’s latest effort to sabotage our health care through Executive Order.

As eighteen patient groups wrote, “This order has the potential to price millions of people with pre-existing conditions and serious illnesses out of the individual insurance market and put millions more at risk through the sale of insurance plans that won’t cover all the services patients want to stay healthy or the critical care they need when they get sick.”

Read what the rest had to say here…

PATIENT GROUPS

American Cancer Society Cancer Action Network, American Diabetes Association, American Heart Association, American Liver Foundation, American Lung Association, Arthritis Foundation, Crohn’s And Colitis Foundation, Cystic Fibrosis Foundation, Epilepsy Foundation, Lutheran Services In America, March Of Dimes, Muscular Dystrophy Association, National Health Council, National Multiple Sclerosis Society, National Organization For Rare Disorders, United Way Worldwide, Volunteers Of America, Womenheart: “This Order Has The Potential To Price Millions Of People With Pre-Existing Conditions And Serious Illnesses Out Of The Individual Insurance Market And Put Millions More At Risk.” “This order has the potential to price millions of people with pre-existing conditions and serious illnesses out of the individual insurance market and put millions more at risk through the sale of insurance plans that won’t cover all the services patients want to stay healthy or the critical care they need when they get sick…Together, these actions would likely split the market between those who need the comprehensive benefits provided under current law and those who are currently healthy and can gamble with substandard coverage. Siphoning off healthy people into risky, low-value plans, could leave millions of Americans with chronic or serious illnesses in an unsustainable insurance pool with rising premiums and fewer choices. It could also leave those who are healthy seriously underinsured when they face an unexpected health crisis.” [Letter, 10/12/17]

American Cancer Society Cancer Action Network: “Health Care Changes Could Leave Millions Of Cancer Patients And Survivors Unable To Access Meaningful Coverage.” “Today’s executive order jeopardizes the ability of millions of cancer patients, survivors and those at risk for the disease from being able to access or afford meaningful health insurance. Exempting an entire set of health plans from covering essential health benefits like prescription drugs or specialty care and allowing expansion and renewability of bare-bones short-term plans will split the insurance market. If younger and healthier people leave the market, people with serious illnesses like cancer will be left facing higher and higher premiums with few, if any, insurance choices. Moreover, those who purchase cheap plans are likely to discover their coverage is inadequate when an unexpected health crisis happens leaving them financially devastated and costing the health care system more overall.” [ACS CAN, 10/12/17]

HOSPITALS

American Hospital Association: “These Provisions Could Destabilize The Individual And Small Group Markets, Leaving Millions Of Americans Who Need Comprehensive Coverage To Manage Chronic And Other Pre-Existing Conditions.” “Today’s Executive Order will allow health insurance plans that cover fewer benefits and offer fewer consumer protections…In addition, these provisions could destabilize the individual and small group markets, leaving millions of Americans who need comprehensive coverage to manage chronic and other pre-existing conditions, as well as protection against unforeseen illness and injury, without affordable options.” [AHA, 10/12/17]

DOCTORS

American Medical Association: “The Executive Order’s Proposal To Expand Access To Association Health Plans And Allow Short-Term Plans To Cover Longer Time Periods May Weaken Important Patient Protections And Lead To Instability In The Individual Health Insurance Market.” “The AMA supports patient choice and promoting market competition, and supports the concept of association health plans. We have concerns, however, the Executive Order’s proposal to expand access to association health plans and allow short-term plans to cover longer time periods may weaken important patient protections and lead to instability in the individual health insurance market.” [AMA, 10/12/17]

INDUSTRY EXPERTS

American Academy Of Actuaries: “These Effects Could Include Tilting The Market In Favor Of Entities With Weaker Benefits Or Solvency Standards And Weakening The Protections For Consumers With Pre-Existing Health Conditions.” “‘Creating exemptions from the Affordable Care Act (ACA) insurance market rules can have far-reaching and unintended effects,’ said Academy Senior Health Fellow Cori Uccello. ‘These effects could include tilting the market in favor of entities with weaker benefits or solvency standards and weakening the protections for consumers with pre-existing health conditions.’” [AAA, 10/12/17]

CONSUMER GROUPS

Consumers Union: “Executive Order On Health Plans Destabilizes Insurance Markets, Hurts Consumers, Drives Up Costs.” “While this executive order claims to help improve consumers’ access to affordable care, it would have the exact opposite effect. Allowing insurers to sell substandard association health plans that aren’t required to cover basic services and benefits will further fragment and destabilize the insurance markets as a whole. This action splits the market into two, pitting the healthy against those with preexisting conditions and life-threatening illnesses — but ultimately both groups lose in this new scheme.” [Consumers Union, 10/12/17]

TEACHERS

American Federation Of Teachers: [Donald Trump] “Is Ignoring The Rule Of Law, Refusing To Compromise, And Doing An End-Run Around Congress In Order To Strip People Of Their Healthcare.” “Donald Trump owns the unwinding of the Affordable Care Act. He is ignoring the rule of law, refusing to compromise, and doing an end-run around Congress in order to strip people of their healthcare. Millions of Americans will be worse off because of his actions. This is an ongoing pattern of the Trump administration’s callous sabotage of Obamacare, and it will cause real harm to American families, leading to increased premiums and loss of coverage for those most in need of healthcare and flooding markets with cheap, limited ‘junk’ insurance.” [AFT, 10/12/17]

FAITH LEADERS

NETWORK Lobby: “The Trump Administration Continues To Do As Much As Possible To Destabilize The American Healthcare System, Increase Costs For Families, And Prevent People From Accessing The Care They Need.” “The Trump Administration continues to do as much as possible to destabilize the American healthcare system, increase costs for families, and prevent people from accessing the care they need. Today’s executive order is the latest attack on our healthcare, following a long line of attempts to repeal and cripple the ACA. This executive order will drive up premiums for many — especially middle-class families and people with pre-existing conditions — to further undermine the ACA. It is morally reprehensible to hurt people through unjust policies for political gain.” [Statement, 10/12/17]

Protect Our Care Statement on President Trump’s Sabotage Executive Order

Washington, DC — In response to President Trump signing of an Executive Order this morning, which independent experts and state insurance commissioners agree will sabotage the country’s health care, raise health care premiums, deny access to coverage for millions of Americans and end affordable coverage for those with pre-existing conditions, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“President Trump’s Executive Order is a disaster for America’s health care which is exactly why he is doing it,” said Woodhouse. “Angry that Congress wouldn’t repeal the health care Americans depend on, President Trump is purposely trying to sabotage the law by creating garbage insurance which will undermine the market, raise premiums, reduce coverage and expose millions of Americans again to discrimination based on pre-existing conditions. If you were born with a health problem, or will ever get sick, you should be be very worried today. And to be clear, every dollar in premium increases, every denial of care you need and everyone discriminated against because of a prior illness will lay at the feet of President Trump and Republicans who support this approach or refuse to fight back.

“But even if they choose not to fight back we will. President Trump doesn’t get to have the final word on this — the courts, Congress and the American people will have the opportunity to be heard as well. This order is repeal of American health care by other means. Neither Congress nor the American people stood by for that failed legislative effort and there is no reason to stand by now and allow a president to sabotage the American health care system out of spite and pure politics.”

NEW VIDEO: Preview of Trump’s Health Care Sabotage Executive Order

At 11:15 am today, President Trump will sign an Executive Order to sabotage our health care. Having failed at health care repeal in Congress because of bipartisan opposition and overwhelming public rejection, the Trump administration is now doing everything it can to sabotage the country’s health care system and fulfill his promise to “Let it be a disaster.”

Protect Our Care is releasing this new video documenting how the elements of this Executive Order already reported by the press amount to government sabotage of our health care and how previous efforts at sabotage have already brought harm to people and their coverage, and urging Members of Congress to stand up to it.


The Trump administration’s sabotage agenda could end affordable coverage for those with pre-existing conditions, raise health care premiums and deny access to coverage for millions of Americans — and could result in the destabilization of the individual insurance market.


Trump and GOP Congress Force Health Care Rate Hike in California

As was just announced, California will impose an average 12.4 percent surcharge on health care premiums for the benchmark silver plan offered through Covered California because of efforts by President Trump and Republicans in Congress to sabotage our health care by threatening to withhold cost-sharing reduction payments. While they have been unable to repeal the health care law, they have been doing everything they can to sabotage the marketplace by:

  • Threatening to defund the law’s mandatory cost-sharing-reduction payments, which the nonpartisan Congressional Budget office said would increase rates by 20% in 2018 and 25% in 2020.
  • Slashing 90% of the funding to let people know when and how they can sign up for coverage.
  • Prohibiting Regional Directors from the Department of Health and Human Services from participating in efforts to help people enroll in coverage during open enrollment.
  • Shutting down HealthCare.gov during critical hours.
  • Cutting the number of days people can sign up for coverage in half.
  • On the first day of this administration, President Trump signed an Executive Order demanding that agencies dismantle as much of the law as they can.

Now people are facing the consequences.

“Everyone with the benchmark plan who gets a bill from their insurer for higher health care costs next year can thank President Trump and Republicans in Congress for the sabotage that led to this,” Protect Our Care Campaign Director Brad Woodhouse said. “Their repeated threats, uncertainty and sabotage of our health care system is taking a toll on real people’s lives in California. Your health care bills next year should say ‘brought to you by Donald Trump.’”

EXPERTS AND INSURANCE COMMISSIONERS AGREE THAT TRUMP’S SABOTAGE IS RAISING COSTS:

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.” [Center for American Progress, 8/16/17]

Kaiser Family Foundation: “Benchmark Premiums Would Increase By 19 Percent On Average If Cost-Sharing Subsidies Were Unpaid.” [KFF, 4/6/17]

Urban Institute: “We Find That Premiums For Silver Marketplace Plans Would Increase $1,040 Per Person On Average.” [Urban Institute, 1/16]

Commonwealth Fund: “Eliminating Cost-sharing Reductions Could Destabilize Insurance Markets.” [Commonwealth Fund, 4/28/17]

Urban Institute: “A Precipitous Drop In Insurer Participation Is Even More Likely If The Cost-sharing Assistance Is Discontinued.” [Urban Institute, 12/6/16]

Julie Mix Mcpeak, President-Elect Of The National Association Of Insurance Commissioners And Tennessee State Insurance Commissioner: “I Am Very Fearful That We’ll Have Insurers Make A Decision To Leave Markets As A Result Of The Uncertainty.” [New York Times, 8/7/17]

Teresa Miller, Pennsylvania Insurance Commissioner: “Failing To Make Payments To Insurers For Cost-sharing Reductions Would Force Insurers To Request A Statewide Average 20.3 Percent Increase Rather Than 8.8 Percent Statewide Average That Was Filed With The Department In May.” [Press Release, 7/31/17]

Mike Kreidler, Washington State Insurance Commissioner: “The Current Federal Administration’s Actions — Such As Not Committing To Reimburse Insurers For Cost-sharing Subsidies And Not Enforcing The Individual Mandate — Appear Focused Only On Destabilizing The Insurance Market.” [Statement, 6/19/17]

Lori Wing-Heier, Director, Alaska Division Of Insurance: “It Is Expected That Health Care Premiums Would Jump As High As 20 Percent If Trump Follows Through With His Threat To Cut Subsidies.” [Fairbanks News-Miner, 8/14/17]

Dave Jones, California State Insurance Commissioner: “President Trump Appears On A Mission To Destroy Health-Insurance Markets By Creating Instability Through His Own Actions And Thereby Depriving Millions Of Americans Of Health-care Coverage.” [Wall Street Journal, 6/27/17]

Marguerite Salazar, Colorado’s State Insurance Commissioner: “Commissioner Marguerite Salazar Said The Trump Administration Threatens The Whole Market. ‘My Fear Is It May Collapse.’” [Los Angeles Times, 5/18/17]

Craig Wright, Chief Actuary, Florida Office of Insurance Regulation: “If The Subsidies Are Not Funded, Carriers Would Face The Prospect Of Large Financial Losses.” [New York Times, 8/7/17]

Eric A. Cioppa, Superintendent Of The Maine Bureau Of Insurance: “If They Don’t Get A Subsidy, I Fully Expect Double-Digit Increases For Three Carriers On The Exchanges Here.” [New York Times, 6/4/17]

National Academy for State Health Policy: “The Federal Government Must Commit To Funding CSR Payments In Order To Lower Rates And Stabilize Carrier Participation.” [Letter from State-based Marketplace Directors, 8/30/17]

Dan Hilferty, President And CEO, Independence Blue Cross: “We Firmly Believe Your Coverage Will Be There For 2018, If The Federal Government, Congress And President Commit To, Fund The Subsidies During An Interim Period Of Time.” [CNN, 7/19/17]

Kelly Paulk, Vice President, Product Strategy And Individual Markets, Blue Cross Blue Shield Of Tennessee: “We Have To Factor In Two Significant Uncertainties…Combining Those Two Factors Leads To An Average 21 Percent Rate Increase.” [Blog Post, 6/30/17]

Danielle Devine, Michigan Director Of Operations, Meridian Health Plan: “The Political Climate Continues To Make It Difficult To Price And The Uncertainty Over The Future Of The Subsidies Creates The Largest Reason For Significant Rate Increases.” [Crain’s Detroit Business, 6/14/17]

Rick Notter, Director Of Individual Business, Blue Cross Blue Shield Of Michigan: “If We Don’t Have That Cost-Sharing (Subsidy), We Have To Make Up The Difference And The Only Way For Us To Do That Is With A Higher Rate.” [Detroit Free Press, 6/14/17]

Dr. Mario Molina, Former CEO, Molina Healthcare: “The Administration And Republicans In Congress Want You To Believe That Insurers Raising Premiums For Their Plans Or Exiting The Marketplaces All Together Are Consequences Of The Design Of The Affordable Care Act Instead Of The Direct Results Of Their Own Actions To Sabotage The Law. Don’t Let Them Fool You.” [U.S. News & World Report, 5/30/17]

Brad Wilson, CEO, Blue Cross Blue Shield Of North Carolina: “The Failure Of The Administration And The House To Bring Certainty And Clarity By Funding CSRs Has Caused Our Company To File A 22.9 Percent Premium Increase, Rather Than One That Is Materially Lower.” [Washington Post, 5/26/17]

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.” [Oliver Wyman, 6/14/17]

EARLY REVIEWS ARE IN: Trump’s Executive Order Will Sabotage Health Care

Based on what we know so far, the reviews of Trump’s health care sabotage Executive Order aren’t pretty.

In fact, they’re downright scary.

President Trump’s pledge to sign an Executive Order later this week will sabotage health care, achieving his dream of health care repeal that failed with bipartisan opposition in Congress and overwhelming opposition from the American people.

Trump has been rooting for health care to fail, saying “Let it be a disaster,” and his sabotage will end protections for those with pre-existing conditions, raise health care premiums and deny access to coverage for millions of Americans — and could result in the collapse of the individual insurance market.

But don’t take our word for it.

Look at the early reviews that have exposed the truth…

Larry Levitt, Kaiser Family Foundation: “If the executive order is as expansive as it sounds, it could severely destabilize the individual and small business insurance markets. Association plans exempt from the ACA can cherry pick healthy people and make coverage unaffordable for those with pre-existing conditions. If loosely regulated association plans are allowed, insurers will leave the ACA marketplaces as soon as they can or hike premiums a lot.”

Larry Levitt, Kaiser Family Foundation: “The executive order also reportedly envisions expanding the use of short-term health insurance plans. Short-term insurance plans can offer inexpensive coverage to currently healthy people, but they exclude people with pre-existing conditions. If healthy people can enroll in short-term plans and avoid the individual mandate penalty, the ACA marketplaces could collapse. Anything that creates a parallel insurance market for healthy people will lead to unaffordable coverage for sick people. Middle class people with pre-existing conditions ineligible for ACA subsidies could be especially vulnerable under the executive order. You can bet this executive order will get challenged in court, but it could also create lots of confusion going into open enrollment.”

Cori Uccello, American Academy of Actuaries: “Cori Uccello, senior health fellow at the American Academy of Actuaries, said that one aspect to watch in the order is when the changes will take effect. Insurers have already set their prices and made plans for 2018. ‘Anything that applied to 2018 would be incredibly destabilizing,’ she said. ‘It would still be destabilizing in 2019 but people would know ahead of time.’”

Matt Fiedler, Brookings Institute: “‘Associations would siphon many healthier people out of the ACA-compliant market, driving up premiums,’ said Matt Fiedler, a fellow with the Center for Health Policy at Brookings Institute. ‘Higher premiums in the ACA-compliant market would result in big cost increases for many sicker enrollees — since they would not have the option of switching to the association market — and likely for the federal government as well.’”

Joseph Antos, American Enterprise Institute: “Joseph Antos, a health policy scholar at the conservative American Enterprise Institute, agrees. ‘Trying to exempt these new associations from ACA rules that apply to all other plans doesn’t strike me as something that’s going to stand up in federal court,’ Antos says.”

National Association of Insurance Commissioners: “AHPs would fragment and destabilize the small group market, resulting in higher premiums for many small businesses. … AHPs would be exempt from state solvency requirements, patient protections, and oversight exposing consumers to significant harm.”

Commonwealth Fund: “If they do so, the health insurance sold via the AHP could become exempt from consumer protections such as the essential health benefits standard and the prohibition on charging higher premiums to people with preexisting conditions. The result would be increased risk for higher premiums and fewer plan options on the individual market, as well as fraud and insolvency.”

Craig Garthwaite, Northwestern University: “‘There’s a general belief that at every turn the federal government is going to create regulations to hurt rather than help the markets,’ said Craig Garthwaite, director of the health care program at Northwestern University’s Kellogg School of Management, referring to the Trump administration. ‘It unwinds the ability of people with pre-existing conditions to get insurance under the ACA,’ Garthwaite said.”

Gary Claxton, Kaiser Family Foundation: “‘If the market’s already fragile right now, this is going to make it much more fragile,’ said Gary Claxton, director of the health-care marketplace project at the Kaiser Family Foundation. ‘All of this would be the start of the end of the individual ACA market.’”

Linda Blumberg, Urban Institute: “‘The risks of trying to do the kinds of things we’re hearing about are really tremendous,’ said Linda Blumberg, senior fellow at the Health Policy Center at the Urban Institute.”

Associated Press: “Without those healthy customers, the cost might rise faster for people with medical conditions.”

The Hill: “President Trump’s planned executive order on ObamaCare is worrying supporters of the law and insurers, who fear it could undermine the stability of ObamaCare.”

Washington Post: “If at first you don’t succeed at repealing Obamacare, try, try again — with an executive order. President Trump, desperate for a health-care win that Congress couldn’t hand him, is pursuing a backdoor way of letting more Americans buy insurance plans free of the Obamacare regulations that Republicans have blamed for big premium hikes and costly deductibles.”

Washington Examiner: “Both association health plans and short-term plans are less expensive than Obamacare plans because they offer limited coverage. They don’t guarantee same-cost coverage, or any coverage, for people with pre-existing illnesses and they do not cover a broad range of medical care, from addiction treatment to maternity care.”