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February 2018

Second Study Confirms Trump Health Care Proposals A Disaster

Today, Avalere released a new study finding that the Trump Administration’s proposed Association Health Plans rule will increase premiums in the individual marketplace as much as 4% while reducing the enrollment in Affordable Care Act plans by 3 million. Protect Our Care Campaign Director Brad Woodhouse released the following statement in response:

“This is the second study in three days to conclude that the sabotage agenda being pushed by Donald Trump and his Administration will have massive negative consequences on Americans’ care,” said Woodhouse. “People will lose their coverage, premiums will rise across the board, and the marketplace will become even more jumbled, all while the Administration sits back and continues to play political games. It’s time for President Trump and Congressional Republicans to work with Democrats on real solutions to expand access and bring down costs for Americans rather than continuing to push their partisan sabotage efforts. Enough is enough – it’s time for the Trump Administration and Republicans in Congress to end their war on health care.”

As GOP Preaches Opioid Solutions, Medicaid Remains Key

Today, the Center on Budget and Policy Priorities released an analysis showing that states which expanded Medicaid saw higher rates of insurance coverage for people with opioid-use disorders. As the House Energy and Commerce Committee holds hearings and President Trump hosts a summit to address the opioid crisis, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“This analysis makes clear what we have been saying for months: Medicaid is a lifeline for those battling the scourge of opioid addiction, and Republican plans to gut the Medicaid program would have disastrous ramifications for the millions of Americans courageously doing so,” said Woodhouse. “This report undercuts false GOP claims and shows that Medicaid expansion increased access to substance abuse treatment, period. If they truly care about combating the opioid crisis, President Trump and GOP Members of Congress should end their partisan war on health care and immediately call for the expansion of Medicaid in states which have not done so.”

New Poll: Health Care Far-And-Away Top Issue Among Voters

A new poll from CNN finds that health care remains voters’ top priority, with 83% of those surveyed listing it as either extremely or very important, the highest percentage recorded in the poll dating back to 2002. The new numbers echo Protect Our Care/Hart Research polling conducted last month.

Key CNN results include:

  • 83% of voters said health care was extremely important or very important, the highest among all issues.
  • 53% of voters said health care was extremely important, the highest among all issues – a 20% increase from the CNN/USA Today/Gallup poll conducted in August of 2010, when health care supposedly dominated the midterm elections.
  • 78% of independent voters said health care was important, which tied with the economy as their top issue.
  • At least 70% of voters in every demographic category said health care was important – a trend that stretches across gender, age, income level, education level, ideology, and party affiliation.

“No matter how much the GOP wishes health care would go away, results like today make clear that this is the top issue for American voters,” said Protect Our Care Campaign Director Brad Woodhouse. “Health care is energizing voters of all backgrounds, the majority of whom are furious about the GOP’s sabotage attempts, and Republicans only have themselves to blame. Enough is enough: it’s time for Republicans to end their war on health care.”

Just last week, Save My Care launched a national “Enough is Enough” ad campaign with a six-figure national TV and digital ad buy. The campaign encourages Americans to call on Congress to end the partisan war on health care.

Across the Nation, Health Care Advocates Urge Senators to Stand Up Against President Trump’s Partisan War on Health Care

This week, health care advocates in Alaska, Arizona, Colorado, Maine, Nevada, Ohio, Tennessee and West Virginia launched the Enough is Enough campaign to tell their Senators that the GOP war on health care and attempts to repeal the Affordable Care Act must end.

The “Enough is Enough” effort is part of a multi-pronged national and local campaign to end the partisan war on health care with a clear message: protecting Medicaid and the Affordable Care Act is now a potent and positive issue in American politics. While Congress was in recess this week, health care advocates held Enough is Enough events across multiple states, featured TV, digital, and print advertising all along with a robust social media campaign and grassroots activity.  

From the polls that show health care is the number one issue for midterm voters, to the momentum in favor of Medicaid expansion in states like Maine and Virginia, to the success of candidates in race after race who are speaking out to defend the ACA, Medicaid, and CHIP – Americans are telling lawmakers: ”Enough is enough. Stop the partisan war on health care.”


Below is a sampling of activity in the states:









West Virginia

“Trump Will Drive Up Obamacare Premiums Nearly 20%”: Today’s Health Care Sabotage Headlines

This morning, the Urban Institute published a bombshell study outlining the the high price Americans will pay for Republican health care sabotage, which is set to artificially inflate premiums by double digits for millions of families this fall. The study forecasts an 18.2% increase in 2019 premiums for Affordable Care Act plans and millions of Americans losing their coverage. Here’s a roundup of today’s headlines:

Vox: Trump will drive up Obamacare premiums nearly 20%

Bloomberg: Trump’s Obamacare Changes to Push Up Premiums, Report Projects

Mic: Obamacare premiums could see double-digit increases thanks to Trump’s changes

CNN: 9 million fewer Americans expected to have health insurance in 2019

Axios: Millions of Americans won’t have health insurance next year

Huffington Post: These Are The Real-Life Effects Of Trump’s Obamacare Sabotage

The Hill: ObamaCare premiums to rise 18 percent from GOP-backed changes

“The Cost for their Rage Will be the Health of Millions”: Editorial Boards Respond to Trump’s Latest Sabotage

Last week, the Trump Administration announced its latest move to sabotage the Affordable Care Act: short-term, junk health plans. These plans will be allowed to discriminate against people with pre-existing conditions and eliminate guarantees that essential services like maternity and cancer care be covered. The new junk plans would leave people who get sick on the hook for substantial medical bills and destabilize the individual insurance marketplaces by encouraging insurers to cherry-pick who gets covered.

But don’t just take our word for it – here’s what the country’s leading editorial boards are saying:

Washington Post: This Trump Administration Health-Care Rule Would Return Us to the Bad Old Days. “The department’s plan would allow insurance companies to sell virtually unregulated health policies. This would signal a return to the bad old days when insurers could sharply limit benefits, impose caps on coverage and discriminate against people with preexisting conditions… Allowing healthy people to buy junk insurance plans is not worth risking sick and vulnerable people’s access to real coverage.” [2/26/18]

New York Times: Trump Tries to Kill Obamacare By a Thousand Cuts. “Not mentioned in the department’s talking points is the fact that these policies do not cover things like mental health services, substance abuse treatment, cancer drugs and maternity care. As a result, people who buy skimpy plans could end up being hit with exorbitant bills if they actually need medical care… If the administration were actually serious about reducing health care costs, it would try to improve the A.C.A., not dismantle it, [working with Congress to offer subsidies to middle-class families or pushing for the creation of a national reinsurance program that encourages insurers to offer policies at lower costs by protecting against steep losses]. But Mr. Trump and his Republican allies in Congress seem unwilling to pursue constructive health care policies because they are obsessed with undoing Obamacare. Regrettably, the cost for their rage will be the health care of millions of low-income and middle-class families.” [2/21/18]

Los Angeles Times: The Trump Administration Wants to Cut Premiums for the Healthy at the Expense of the Sick. Again. “These plans don’t have to comply with Obamacare’s insurance reforms, which means they typically provide much less coverage — and that they may not be as cheap, or as available, for people with preexisting conditions. Oh and yes, it would likely cost the taxpayers more. The vast majority of the people who shop in the Obamacare exchanges are low- to moderate-income Americans who receive federal subsidies; when premiums go up, their subsidies rise to cover the increase. That’s just one of the wrongheaded aspects of the proposal. The way to reduce premiums in that market is to pool risks more broadly by bringing more healthy people in. But seemingly every step the administration and Congress have taken lately has drawn healthy people out of the exchanges. This includes ending the requirement that virtually all Americans obtain insurance (as of 2019) and letting loosely defined associations offer plans that, like the temporary policies, don’t comply with Obamacare. This nasty trend is likely to continue until voters make it stop.” [2/26/18]

Baltimore Sun: Trump’s Latest Effort to Undermine the ACA Makes Maryland Action All the More Crucial. “If the Trump administration’s goal was to increase the ranks of the uninsured, it could scarcely have thought of a better policy than the one it announced Tuesday, in which it expands the short-term insurance plans that are exempt from Affordable Care Act standards. In one stroke, it found a way to make virtually useless plans more available for healthy people while making insurance that actually covers the treatments and services needed by people who are or could become sick more expensive. Coupled with the end of the federal requirement that most taxpayers buy insurance or pay a penalty, the administration has come up with a recipe for destabilizing individual insurance markets and putting coverage out of reach for those who really need it.” [2/20/18]

Bloomberg View: A New Way to Wreck Obamacare. “The Trump administration’s latest strike on the Affordable Care Act is to expand the availability of so-called short-term health insurance. Don’t be misled by the seeming modesty of this idea. It’s an impressive combination of bad policy and bad faith… If the courts fail to stop the change to short-term health insurance, states ought to step in, and should plan for this immediately by strengthening their own regulations. They should place their own time limits on short-term policies, and demand that such plans cover the health care people need. Sadly, people in states that won’t provide this protection will be left waiting for leaders in Washington who will.” [2/23/18]

Republican Sabotage Set to Spike Next Year’s Premiums Nationwide

As a new Urban Institute study pulls the alarm on dramatic double-digit rate hikes set to hit states because of President Trump and Congressional Republicans’ sabotage, which includes allowing the sale of junk plans that can discriminate against people with pre-existing conditions and the TrumpTax’s repeal of the individual mandate, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Today’s bombshell report shows the high price Americans will pay for Republican health care sabotage, which is set to artificially inflate premiums by double digits for millions of families this fall. Health care advocates warned President Trump over and over about the devastating economic toll his sabotage would take on American families, and now we have the numbers to prove it. This report shows that Republican sabotage is set not only to spike premiums, but also to drive millions of Americans off real coverage, leaving them underinsured or uninsured, meanwhile increasing federal spending by billions.

“Even though much of the damage is done, Trump and his Republican allies in Congress still have time to work with Democrats on a bipartisan stabilization bill to moderate these premium spikes, but that window of time is closing quickly as insurance companies start to lock in premiums for the fall. It’s past time for Republicans in Congress to stand up to Trump’s partisan war on health care and start cooperating with Democrats to protect our care.”

Find a summary of state-by-state impacts here.

Protect Our Care Fact Sheet: Stabilization Negotiators Must Reject High-Risk Pools

After USA Today reported that Senate health care stabilization negotiators are discussing bringing back high-risk pools, Protect Our Care is releasing a fact sheet detailing why this approach won’t work, as well as a statement from Protect Our Care Campaign Director Brad Woodhouse:

“Health care advocates continue to call for a bipartisan stabilization package to address the individual insurance market damage being caused by Trump Administration sabotage. Any serious proposal must reject bringing back high-risk pools, failed experiments that segregate sick people in worse coverage and that would further destabilize the markets.

“It’s time for Congressional Republicans to reject the partisan war on health care, stop pushing proposals that hurt people with pre-existing conditions, and start working with Democrats to come up with real solutions that bring down health care costs for American families.”


Stabilization Negotiators Must Reject Higher Costs & Coverage Restrictions for People With Pre-Existing Conditions

As Congressional negotiators consider health care stabilization proposals to include in next month’s Omnibus, overwhelming evidence shows that high-risk pools are one idea they should take off the table. This is a tool that has been tried and failed. Here’s why high risk pools would make challenges in American health care worse, not better:


Premiums For Coverage In High Risk Pools Were As Much As 200 Percent Higher Than The Average Rate But Covered Less Care. “High-risk pool enrollees faced substantially higher premiums than people in the normal individual market, often by as much as 150 percent to 200 percent, although some pools did offer subsidies to low-income enrollees…And stunningly, the overwhelming majority of state high-risk pools actually refused to pay for services associated with a patient’s pre-existing conditions in the first months of their enrollment.” [Center for American Progress, 2/16/17]

Deductibles For High Risk Pool Enrollees Were Well Above Maximum Allowed By ACA. ”Fourteen states had plans with deductibles of $10,000 per year or higher, substantially greater than the current maximum $7,150 deductible for catastrophic plans in the marketplaces. Thirty states imposed maximum lifetime limits; others had annual coverage limits as low as $75,000 per year.” [Commonwealth Fund, 3/29/17]

  Source: Commonwealth Fund, 3/24/17


Despite High Premiums, High Risk Pools Could Still Cost The American People Over $90 Billion Annually. “The U.S. Department of Health and Human Services (HHS) recently estimated that up to 17,875,000 people with preexisting conditions were uninsured in 2010. Had all of them been covered by high-risk pools, the cost would have been $194.8 billion in 2010 dollars, with premiums covering only $103.3 billion. Thus, states and the federal government would have needed to find $91.5 billion in additional funding to cover them all—much more than the up to $10 billion per year in federal assistance to states recently proposed by congressional Republicans.” [Commonwealth Fund, 3/29/17]

An Analysis Of High Risk Pools Under The ACHA Finds Such Pools Would Cost The Government Between $37 and $56 Billion Annually. “Government costs for supporting the high-risk pool using ACA-like coverage and subsidies would range from $37 to $56 billion in 2020 and $437 to $656 billion over 10 years (2020–2029), depending upon the eligibility rules used.” [The Urban Institute, May 2017]

Even Conservatives Estimated High Risk Pools Would Cost $15-$20 Billion Annually. “For comparison, conservative experts James Capretta and Tom Miller have estimated that $15 billion to $20 billion per year, or $150 billion to $200 billion over 10 years, would be needed to fully finance high-risk pools even if they covered only 2 million to 4 million people.” [Center For American Progress, 2/16/17]

Premiums For High Risk Pool Coverage Paid Just 53 Percent Of Program Costs. “Premiums ranged from 125 percent to 200 percent of average premiums in the individual market, yet covered only about 53 percent of claims and administrative costs nationally (Wisconsin allowed premiums up to 200 percent of average).” [Commonwealth Fund, 3/29/17]


High Risk Pools Typically Had Pre-Existing Condition Exclusions And Limited Benefits. Many such pools had pre-existing condition exclusion periods, limited benefits, and enrollment limits; all of these characteristics served to reduce the value of the coverage, creating high financial burdens for enrollees and limiting the number of people who could access the coverage.” [Health Affairs, 3/15/16]

Most State High Risk Pools Had Lifetime And Annual Limits On Coverage.  “Thirty-three pools [out of 35 states] imposed lifetime dollar limits on covered services, most ranging from $1 million to $2 million. In addition, six pools imposed annual dollar limits on all covered services while 13 others imposed annual dollar limits on specific benefits such as prescription drugs, mental health treatment, or rehabilitation.” [Kaiser Family Foundation, 2/22/17]

High Risk Pools Typically Had Waiting Periods. “There were 35 state high-risk pools before the Affordable Care Act passed. To control costs, they would often do things like charge higher premiums than the individual market. Most had waiting periods before they would pay claims on members’ preexisting conditions, meaning a cancer patient would need to pay premiums for six months or a year before the high-risk pool would cover her chemotherapy treatments.” [Vox, 5/3/17]

High Risk Pools Mean Delayed Or Forgone Care. “Even once they were in a high-risk pool, the high costs and limited benefits prompted some people to delay or forgo care, leading to poorer health outcomes and even more spending. And many families accrued substantial medical debt, even with the coverage.” [Stateline, 2/16/17]


Limited Coverage And High Costs Cause People To Remain Uninsured. Some patients also delayed care to save money, exacerbating their health conditions, and only entered the pools when their conditions became emergencies.” [Stateline, 2/16/17]

CMS: One-Third Of Uninsurable Were Unable To Afford High Risk Pool Coverage. A 2004-05 study by the Center for Medicare and Medicaid Services found that “nationally, high-risk pool premiums are above 25 percent of family income (i.e., are unaffordable) for 10 percent of all individuals, 18 percent of the uninsured, and 29 percent of the uninsurable. By these standards, almost one-third of the uninsurable are unable to afford high-risk pool coverage…” [CMS, Health Care Financing Review, Winter 2004-2005]


California High Risk Pool Led To Waiting Lists, High Premiums, And Lifetime Limits. “For example, California’s high-risk pool imposed a shorter-than-average, three-month waiting period before enrollees could receive treatment for pre-existing conditions—but also imposed a $75,000 annual limit on benefits along with a $750,000 lifetime limit. In addition, the state capped enrollment, resulting in long waiting lists of people unable to enroll; at the same time, the pool’s high premiums proved difficult for enrollees to afford, leading some to drop out.” [Center for American Progress, 2/16/17]

Premiums in Florida’s High Risk Pool Were Twice The Normal Rate. Many states starved high-risk pools of cash. Florida’s contained only about 200 people in 2011. Premiums were commonly twice the normal rate. Many states had enrolment caps, meaning that even people willing to fork over were not guaranteed coverage.” [The Economist, 1/16/17]

In Wisconsin, “Cancer Doesn’t Wait” For High Risk Pool Waiting Periods. “The benefit waiting periods used by Wisconsin’s and other states’ high-risk pools are a big concern for patient advocates and provider groups. ‘A six-month exclusionary period is a serious issue,’ said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, who also testified at the House hearing. ‘Cancer doesn’t wait.’” [Modern Healthcare, 2/13/17]

In Utah, High Risk Pools Were Limited In Size, And Offered Sub-Par, Delayed Coverage. “Stevenson said only 3,000 people signed up for Utah’s risk pool plan while 200,000 Utahns are signed up for insurance through Obamacare. ‘Utah’s past high risk pool plan had many limitations too,’ he said. People with pre-existing conditions had to wait six months before using their coverage. Pregnant women had a 10 month waiting period before they had any coverage for them or their baby. ‘The measure of success for a program is how many people it helps and if you are only covering 3,000 people and leaving tens of thousands uninsured, I don’t think that’s a good thing to go back to,’ he said.” [CBS KUTV, 3/9/17]

High Risk Pools Mean Higher Costs, Higher Uninsured, And Less Coverage. The reality is that high-risk pool coverage was prohibitively expensive and there is little evidence to suggest that the existence of such pools made coverage less costly for others in the individual insurance market. Without substantially more federal funding than currently proposed, these facts are not likely to change. People with preexisting conditions may have “access” to coverage, but most will not be able to afford it and those who can will face limited benefits and extremely high deductibles and out-of-pocket payments.” [Commonwealth Fund, 3/29/17]

Hours After Governors Release Proposal, Trump Stabs Bipartisan Health Care in the Back

Hours after bipartisan governors released a blueprint for moving on from Affordable Care Act repeal toward improving American health care, President Trump publicly recommitted to his death-by-a-thousand-cuts backdoor repeal agenda, saying he is wiping out the law “piece by piece.” Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“As bipartisan governors are in D.C. pleading with Washington Republicans to stop their destructive health care sabotage campaign and move on to productive solutions, President Trump is across the river at CPAC stabbing their efforts in the back by bragging about wiping out the Affordable Care Act piece by piece. It must be the height of frustration for Governors Kasich, Hickenlooper, and Walker to hear President Trump and his allies in Congress recommit to hurting the people they represent. Both Republican and Democratic Governors should speak out against against Trump’s partisan war on health care and his Administration’s sabotage campaign on behalf of their constituents’ coverage.”

Trump Brags About His War on Health Care at CPAC

Trump Header Background

In response to President Trump’s outrageous comments at CPAC, where he bragged that his Administration is “wip(ing) out” the Affordable Care Act “piece by piece,” Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“President Trump said loud and clear today that his Administration will stop at nothing to wage a war on our health care and sabotage the Affordable Care Act, confirming that recent HHS actions amount to nothing less than back-door health care repeal. Republicans on the ballot in 2018 will try to pretend they didn’t vote to repeal health care and endorse the sabotage of our health care. President Trump, the Saboteur-in-Chief,  just admitted that’s exactly what they’re trying to do.”


This Week in The War on Health Care [Protect Our Care, 2/22/18]