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February 2018

ashoup
In Capitol Hill, Administration, News

This Week in the War on Health Care

This week, while Congress was on recess, the Trump Administration continued its unprecedented assault on the American health care system. Here’s what happened this week in the Republicans’ war on health care – and the extensive data showing that opposition to the GOP health care agenda is only growing:

SHORT-TERM PLANS? MORE LIKE LONG-TERM SCAMS

On Tuesday, the Trump Administration announced a proposal to let insurance companies sell short-term plans year-round. These plans skirt Affordable Care Act requirements to cover essential health benefits like cancer treatment, substance use treatment, and maternity care and can deny coverage altogether for those with pre-existing conditions.

What do these plans do?

  • Short-term health plans offer inadequate medical coverage and circumvent fundamental consumer protections
  • Short-term plans provide junk coverage which leaves those who get sick with thousands of dollars in unpaid bills
  • Short-term plans offer subpar coverage coverage which will raise premiums and destabilize markets

The negative reactions to this backdoor sabotage came fast and thick:

American Cancer Society Cancer Action Network, American Heart Association, American Liver Foundation, American Lung Association, Arthritis Foundation, Consumers Union, Crohn’s & Colitis Foundation, Cystic Fibrosis Foundation, Epilepsy Foundation, Leukemia And Lymphoma Society, Lutheran Services In America, March Of Dimes, National Health Council, National Ms Society, National Organization For Rare Disorders, United Way, World Wide Volunteers Of America: “The proposed rule released today would permit insurance companies to offer substandard insurance policies to millions of americans… as organizations committed to ensuring that coverage remains affordable, accessible, and adequate for all americans, we cannot support this proposal.” [Consumers Union, 2/20/18]

America’s Health Insurance Plans: “We remain concerned the expanded use of short-term plans could further fragment the individual market, which would lead to higher premiums for many consumers, particularly those with pre-existing conditions.”  [Twitter, 2/20/18]

Mike Kreidler, Washington State Insurance Commissioner: “If you get sick you may not be able to renew your coverage — there are no protections for people with pre-existing conditions. maternity care and mental-health benefits often are excluded.” [New York Times, 2/20/18]

Larry Levitt, Kaiser Family Foundation Senior Vice President: “Short-term insurance plans don’t cover pre-existing conditions, don’t cover the aca’s essential benefits, and can impose annual limits on coverage.” [Twitter, 2/20/18]

Rachel Sachs, Health Law Professor: “The government will spend millions more to provide fewer people with comprehensive coverage.” [Twitter, 2/20/18]

REPUBLICANS GO AFTER PRE-EXISTING CONDITIONS

The most popular provision of the Affordable Care Act is its ban on insurance company discrimination against people with pre-existing conditions. Short-term plans would once again force consumers to fill out medical history forms, and pay the price if they check the wrong boxes. Don’t believe us? Take a look at the headlines yourself:

NBC News: Trump pushes insurance that doesn’t cover pre-existing conditions

Vox: Trump’s quiet campaign to bring back preexisting conditions

Alaska Native News: Trump’s Latest Sabotage Targets Americans with Pre-existing Conditions

USA Today: Trump proposes 12-month insurance plans that don’t cover people, issues Obamacare requires

NPR: Trump Administration Wants To Let Insurers Offer Plans With Fewer Benefits

New York Times Editorial Board: Trump Tries to Kill Obamacare by a Thousand Cuts

CAUGHT IN A LIE

Also this week, top Administration health officials Secretary Alex Azar and Administrator Seema Verma directly contradicted their own short-term plan regulation as they desperately tried to spin away the damage which would be inflicted on Americans’ ability to access quality, affordable health care:

What They SaidWhat Their Reg Said
Individual market premiumsVERMA: “This shift will have will have virtually no impact on the individual market premiums.”HHS REG: “It would result in an increase in premiums for the individuals remaining in those risk pools. An increase in premiums for individual market single risk pool coverage would result in an increase in Federal outlays for APTC.”
Lower-quality coverageVERMA: “While in the past these plans have been a bridge, now they can be a lifeline.”HHS REG: “Consumers who purchase short-term, limited-duration insurance policies and then develop chronic conditions could face financial hardship as a result, until they are able to enroll in PPACA-compliant plans that would provide for such conditions.”
Fewer insurance optionsAZAR: “This is a group of people, they live in areas of the country where there’s one plan they might have access to, so they’re looking for other options.”HHS REG: “Individual market issuers could experience higher than expected costs of care and suffer financial losses, which might prompt them to leave the individual market.”
Short-term or not?AZAR: “We are proposing that these plans would be available up to 12 months for people … We are asking for comment on whether we have the legal authority to let people renew their plans.”HHS REG: “Short-term, limited-duration insurance is a type of health insurance coverage that was designed to fill temporary gaps in coverage that may occur when an individual is transitioning from one plan or coverage to another.”
Pre-existing conditionsAZAR: “These plans may have fewer benefits than we’re used to, they may have more restrictions, and also they may be able to limit who they insure for. That’s part of this.”HHS REG: “Short-term, limited-duration insurance policies would be unlikely to include all the elements of PPACA-compliant plans, such as the preexisting condition exclusion prohibition.”

CROCODILE TEARS FROM THE SWAMPIEST ADMINISTRATION

On Thursday, Axios reported that America’s largest pharmaceutical companies are using their windfall from the GOP tax scam to drive up their own stock prices to the tune of $50 billion, “a sum that towers over investments in employees or drug research and development.” Why is this so appalling?

  • The GOP cried crocodile tears over the cost of prescription drugs – and then gave Big Pharma a giant windfall through their tax scam.
  • The GOP has consistently voted to raise prescription drug costs, from the health care repeal that would get rid of Medicare’s prescription drug benefit to their confirmation of a Big Pharma executive who let drug prices skyrocket to lead HHS.
  • All the while, millions of Americans continue struggling to afford their prescription drugs, too often being forced to choose between their medication and a meal. And the GOP does nothing.

On prescription drugs, as well as their broader war on health care, however, the GOP’s actions, are finally catching up to them…

AMERICANS AGREE: KEEP YOUR HANDS OFF OUR HEALTH CARE

Four polls over six weeks have reached the same conclusion: the ACA has achieved lasting popularity, the electorate is angry about GOP sabotage, and health care is voters’ top priority. Here’s what the numbers say:

Last week, Public Policy Polling released its first national poll of the year, contrasting the rising popularity of the Affordable Care Act with the blame being leveled on President Trump’s sabotage:

  • Approval for the Affordable Care Act is 12 points above water (47% approval to 35% disapproval), a dramatic reversal from trends before Trump took office.
  • Over half of voters know Republicans are sabotaging health care, with 51% believing the Trump Administration is actively taking steps that will raise people’s health care costs.

Also last week, a Priorities USA memo found that President Trump’s handling of health care remains vastly unpopular, especially among independent voters:

  • On the policy of health care, Donald Trump has a 34/46 favorable/unfavorable message.
  • On his handling of drug pricing, 60% of voters have major concerns, including 71% among independents.

These polls came on the heels of a January Washington Post/ABC News poll asking Americans about President Trump’s time in office, which found that Americans are most united in opposition to the GOP’s health care agenda:

  • Asked if keeping “Obamacare” was a good thing for the country, 57 percent of respondents said yes – a significantly higher percentage than any other policy. The only policy underwater? The GOP tax scam, which kicked millions off of their insurance and was opposed 46% – 34%.

And all of these polls followed a Hart Research memo which found health care is the number one issue among voters, far exceeding anything else:

  • “Healthcare far exceeds any other issue as an important driver of voting preferences, with over half of all voters identifying healthcare as one of their top priorities in the 2018 congressional elections, with 54% of those surveyed choose health care as one of the two issues that will be the most important to them in deciding how to vote for Congress.”
  • Healthcare is the most frequently cited priority among Democrats (68%), independents (54%), and Republicans (38%). It is particularly important to African-American voters (66%) and to white women voters, whether they are college graduates (62%) or non-college graduates (59%).

One poll can be an outlier, two a coincidence – but four polls in six weeks independently highlighting the importance of health care and the contrast between the Affordable Care Act’s popularity and the GOP’s sabotage show just how important this issue is to the American people.

From coast to coast, constituents are making their view abundantly clear: it’s time for the GOP to stop its war on health care, and there will be significant consequences should President Trump and Congressional Republicans fail to heed this advice.

ashoup
In Capitol Hill, Administration, News

New Data: GOP Cries Crocodile Tears on Prescription Drugs as Big Pharma Reaps Rewards

Washington, DC – Axios is reporting that America’s largest pharmaceutical companies are using their windfall from the GOP tax scam to drive up their own stock prices to the tune of $50 billion, “a sum that towers over investments in employees or drug research and development.” Protect Our Care Campaign Director Brad Woodhouse responded:

“Every day millions of Americans struggle to afford their prescription drugs, too often being forced to choose between their medication and a meal. But while they cry crocodile tears over the cost of prescription drugs, President Trump and the GOP are giving Big Pharma an even bigger windfall through their tax bill. This isn’t about patients, it’s about profits.

“Everywhere you look, you can find Republicans voting to raise prescription drug costs, from the health care repeal that would get rid of Medicare’s prescription drug benefit to confirming a Big Pharma executive who let drug prices skyrocket to lead HHS. Now, it turns out, their tax plan is enriching Big Pharma at patients’ expense.

“It’s time for President Trump and his allies in Congress to work for patients instead of profiteers. Enough is enough – it’s time for Republicans to stop making health care more expensive.”

Pharma’s $50 billion tax windfall for investors

Axios // Bob Herman // February 22, 2018

The pharmaceutical industry is using a large portion of its windfall from Republicans’ corporate tax cuts to boost its stock prices. Nine drug companies are spending a combined $50 billion on new share buyback programs, a sum that towers over investments in employees or drug research and development.

The bottom line: All of those buybacks were announced during or after the passage of the Republican tax bill. That money is enriching hedge funds, other Wall Street investors and top drug company executives, but it isn’t necessarily helping patients.

That’s not all: Some drug companies also increased quarterly dividends following the tax overhaul. For example, AbbVie increased its cash dividend by 35% while at the same time committing to a new $10 billion share repurchase program.

  • Dividends dole out cash to existing investors, and share buybacks boost a company’s stock price by making shares scarcer.
  • The new tax law, which slashed the corporate tax rate and made it easier for companies to repatriate overseas cash, has made dividends and share buybacks quick and appealing options.
  • Several drug company buybacks are a lot larger than prior share repurchase programs.
  • Stock returns help people with 401k retirement accounts, but they mostly benefit wealthy investors and executives. And half of U.S. households don’t own any stock.

The big picture: The large buyback programs are rolling out while the same pharmaceutical companies raise drug prices and while Americans struggle to afford their prescriptions.

Pharmaceutical Research and Manufacturers of America, the main drug industry trade group, referred share buyback questions to employer groups.

ashoup
In Administration, News

Trump Officials’ Claims Contradict Their Own Short-Term Plan Proposal

Yesterday, top Trump health officials Secretary Alex Azar and Administrator Seema Verma directly contradicted their own short-term plan regulation as they desperately tried to spin away the damage their plan would inflict on Americans’ ability to access quality, affordable health care.

In their own words, here’s a roundup of Azar’s and Verma’s inconsistencies about the real impact of their “short-term” plan proposal:

Spiking individual market premiums

HHS REG: “It would result in an increase in premiums for the individuals remaining in those risk pools. An increase in premiums for individual market single risk pool coverage would result in an increase in Federal outlays for APTC.”

VERMA: “This shift will have will have virtually no impact on the individual market premiums.”

Lower-quality coverage

HHS REG: “Consumers who purchase short-term, limited-duration insurance policies and then develop chronic conditions could face financial hardship as a result, until they are able to enroll in PPACA-compliant plans that would provide for such conditions.”

VERMA: “While in the past these plans have been a bridge, now they can be a lifeline.”

Fewer real insurance options

HHS REG: “Individual market issuers could experience higher than expected costs of care and suffer financial losses, which might prompt them to leave the individual market.”

AZAR: “This is a group of people, they live in areas of the country where there’s one plan they might have access to, so they’re looking for other options.”

“Short term” or not?

HHS REG: “Short-term, limited-duration insurance is a type of health insurance coverage that was designed to fill temporary gaps in coverage that may occur when an individual is transitioning from one plan or coverage to another.”

AZAR: “We are proposing that these plans would be available up to 12 months for people … We are asking for comment on whether we have the legal authority to let people renew their plans.”

Bonus: A Pre-existing Predicament

Even Azar and Verma can’t find a way to sugarcoat the harm their proposal would inflict on the one in four Americans with a pre-existing condition. The Affordable Care Act’s protections for people with pre-existing conditions are among the law’s most popular provisions.

HHS REG: “Short-term, limited-duration insurance policies would be unlikely to include all the elements of PPACA-compliant plans, such as the preexisting condition exclusion prohibition.”

AZAR: “These plans may have fewer benefits than we’re used to, they may have more restrictions, and also they may be able to limit who they insure for. That’s part of this.”

 

ashoup
In Administration, News

Polling Roundup: The ACA Has Achieved Lasting Popularity & Republicans Have Been Hurt by Sabotage

Four polls over six weeks have reached the same conclusion: the Affordable Care Act has achieved lasting popularity, the electorate is aware of and angry about Republican health care sabotage, and these factors are making health care voters’ top priority. Here’s what the numbers say:

Last week, Public Policy Polling released its first national poll of the year, contrasting the rising popularity of the Affordable Care Act with the blame being leveled on President Trump’s sabotage:

  • Approval for the Affordable Care Act is 12 points above water (47% approval to 35% disapproval), a dramatic reversal from trends before Trump took office.
  • Over half of voters know Republicans are sabotaging health care, with 51% believing the Trump Administration is actively taking steps that will raise people’s health care costs.

Also last week, a Priorities USA memo found that President Trump’s handling of health care remains vastly unpopular, especially among independent voters:

  • On the policy of health care, Donald Trump has a 34/46 favorable/unfavorable message.
  • On his handling of drug pricing, 60% of voters have major concerns, including 71% among independents.

These two polls come on the heels of a January Washington Post/ABC News poll which asked Americans about the policies taking precedent during President Trump’s time in office and found that Americans are most united in opposition to the GOP’s health care agenda:

  • Asked if keeping “Obamacare” was a good thing for the country, 57 percent of respondents said yes – a significantly higher percentage than any other policy. Meanwhile, just one policy was underwater: the Republican tax scam, which kicked millions of people off of their insurance and was opposed 46% – 34%.

And all of these polls follow a Hart Research memo which found that health care is the number one issue among voters, far exceeding anything else in terms of driving voting preferences. A majority of those surveyed expressed strong disapproval for the health care policies pushed by the GOP:

  • “Healthcare far exceeds any other issue as an important driver of voting preferences, with over half of all voters identifying healthcare as one of their top priorities in the 2018 congressional elections, with 54% of those surveyed choose health care as one of the two issues that will be the most important to them in deciding how to vote for Congress.”
  • Healthcare is the most frequently cited priority among Democrats (68%), independents (54%), and Republicans (38%). It is particularly important to African-American voters (66%) and to white women voters, whether they are college graduates (62%) or non-college graduates (59%).

One poll can be an outlier, or two a coincidence, but four polls in six weeks independently highlighting the importance of health care and the contrast between the Affordable Care Act’s popularity and the GOP’s sabotage show just how important this issue is to the American people. From coast to coast, constituents are making their view abundantly clear: it’s time for the GOP to stop its war on health care, and there will be significant consequences should President Trump and Congressional Republicans fail to heed this advice.

ashoup
In Administration, News

“Short-Term Insurance Plans Don’t Cover Pre-Existing Conditions, Don’t Cover The ACA’s Essential Benefits, And Can Impose Annual Limits On Coverage”: A Reaction Roundup to the Trump Administration’s Latest Sabotage Attempt

Today, the Trump Administration announced a plan to let insurance companies sell short-term junk insurance year-round, ramping up its sabotage of the Affordable Care Act. These scam insurance plans don’t have to cover people with pre-existing conditions, re-impose lifetime caps, and don’t have to cover the essential medical benefits required by the Affordable Care Act, including maternity care and prescription drug benefits. Today’s proposal would weaken American health coverage, something nearly every major media outlet, health care expert, and stakeholder pointed out.

The coverage of President’s Trump’s latest effort to sabotage American health care is brutal. Take a look:

NBC News: “Trump Pushes Insurance That Doesn’t Cover Pre-Existing Conditions.” “The Trump administration announced Tuesday that it is moving to expand the use of low-budget temporary insurance, which could offer customers a cut-rate alternative to plans on the Affordable Care Act’s exchange, but undermine more comprehensive insurance for others… Unlike the ACA’s plans, they are not required to cover pre-existing conditions, cover specific treatments, or provide unlimited benefits. The plans are normally supposed to cover a brief lapse in coverage, but the order makes it easier to rely on them as primary insurance. Health experts say they’re likely to be cheaper, but they could raise premiums for patients who need comprehensive plans through Obamacare by siphoning away young and healthy customers into a separate market.” [NBC News, 2/20/18]

Washington Post: Short-Term Plans Next Part Of Trump Administration’s Plan To “Dismantle” Affordable Care Act. “The order is part of the administration’s strategy to circumvent parts of the sprawling 2010 health-care law — President Barack Obama’s primary domestic legacy — through executive actions. The moves are an alternate route given the Republican-led Congress’s inability last year to dismantle much of the law — although Trump is still urging lawmakers to try again, despite GOP Senate leaders’ reluctance.” [Washington Post, 2/20/18]

NPR: “Trump Administration Wants To Let Insurers Offer Plans With Fewer Benefits.” “The Trump administration wants to allow insurance companies to offer more policies that have limited health benefits and that can reject customers if they have pre-existing medical conditions.” [NPR, 2/20/18]

Kaiser Health News: Trump Administration Proposes Rule “That Can Reject People With Preexisting Medical Conditions.” “The new rule is expected to entice younger and healthier people from the general insurance pool by allowing a range of lower-cost options that don’t include all the benefits required by the federal law — including plans that can reject people with preexisting medical conditions.” [Kaiser Health News, 2/20/18]

Huffington Post: Plans Would Make “It More Difficult For People Who Need Or Want More Comprehensive Coverage To Get It.” “Taken together, the two steps ― getting rid of the mandate and then changing the rules on short-term plans ― could accelerate an evolution already underway for people buying insurance on their own, rather than through an employer… The new regulations would also render the law’s insurance reforms less effective, making it more difficult for people who need or want more comprehensive coverage to get it.” [Huffington Post, 2/20/18]

Reuters: “Another Trump Administration Move Aimed At Undercutting” The ACA. “The U.S. government on Tuesday proposed extending the availability of skimpy health insurance plans to millions of Americans in another Trump administration move aimed at undercutting the requirements of the Affordable Care Act, often called Obamacare…The plans will not include the benefits that define the insurance created under Democratic former President Barack Obama, including required health benefits such as maternity coverage and the guarantee of insurance regardless of health.” [Reuters, 2/20/18]

Wall Street Journal: Plans “Allow Insurers [To] Charge Higher Premiums Based On A Consumer’s Health Status.” “The plans are often sold only to people who qualify as healthy and they may have annual limits on the amount of care they will cover. The plans don’t have to cover people with pre-existing conditions, for example, and insurers can charge higher premiums based on a consumer’s health status. They also don’t have to include benefits mandated by ACA plans such as prescription-drug coverage… Health analysts say the more extensive short-term plans that would be allowed under the latest proposal could appeal to healthier customers seeking less-expensive alternatives to ACA plans. Higher-risk people would be likely to remain in traditional insurance coverage, however. That would cause their premiums to rise because healthier consumers are needed on the ACA’s exchanges to offset the costs of older and sicker people.” [Wall Street Journal, 2/20/18]

New York Times: Plans “Offer Significantly Less Protection To Consumers.” “Short-term policies are intended for people who are between jobs or need temporary coverage for other reasons. They are generally cheaper than insurance that meets the law’s requirements, but they offer significantly less protection to consumers. Insurers often deny short-term policies to people with pre-existing conditions and can charge higher premiums because of such conditions. Short-term policies do not have to provide the ‘essential health benefits’ that are required by the Affordable Care Act. They may, for example, omit coverage of maternity care, mental health care or addiction treatment. Short-term policies may impose limits on the amount the insurer will pay, but they do not have to cap the patient’s out-of-pocket costs.” [New York Times, 2/20/18]

USA Today: “Trump Proposes 12-month Insurance Plans That Don’t Cover People, Issues Obamacare Requires.” “The Trump administration proposed Tuesday that people be allowed to buy short-term insurance plans that don’t cover the benefits — or people — required to be covered by the Affordable Care Act (ACA)… The ACA was designed to prevent some of the situations the new plans would create, critics said. They could deny coverage based on pre-existing conditions, generally cover few benefits and can cap the benefits provided. The plans could also pull more healthy people out of the pool of people signing up for the ACA, and that could lead to higher premiums for those who remain and aren’t eligible for subsidies.” [USA Today, 2/20/18]

Bloomberg: “Trump Proposes Bigger Role for Skimpy Insurance, Undermining Obamacare.” “The Trump administration is proposing to expand the availability of short-term insurance plans, offering a cheaper health coverage option for consumers, while taking another step to undercut Obamacare… Combined with earlier moves by the Trump administration — such as ending the ACA requirement that all people buy health coverage or pay a fine — the latest proposals could result in higher costs or fewer options for individuals who still want to buy the more comprehensive Obamacare plans.” [Bloomberg, 2/20/18]

Politico: Trump Administration Pushing Plans “That Some Deride As ‘Junk Insurance.’” “The Trump administration is proposing to expand the availability of short-term health insurance plans that some deride as ‘junk insurance’ — an effort that could give consumers cheaper coverage options but undermine Obamacare’s marketplaces and popular protections for pre-existing medical conditions… Many health care experts fear expanding the availability of the health plans, which are exempt from Obamacare’s robust consumer protections, could further destabilize the law’s wobbly insurance markets. Critics say the plans offer just the illusion of coverage, and enrollees often don’t realize how limited their benefits are until it’s too late. Short-term plans maintain cheaper prices than traditional insurance by refusing coverage for pre-existing conditions, in some cases, and some medical services. Unlike Obamacare coverage, the short-term plans typically cap payouts, which could leave enrollees with catastrophic illnesses or injuries on the hook for huge medical bills.” [Politico, 2/20/18]

Talking Points Memo: Proposed Plans Represent “Further Gutting O’Care Market.” “Many health care experts and economists say the sale of these skimpy “junk insurance” plans will draw younger and healthier people out of Obamacare’s individual market, making the remaining risk pool older, sicker, less stable, and more expensive.” [Talking Points Memo, 2/20/18]

Vox: “Experts Anticipate [These] Changes Would Damage The Market.” By broadening the definition of short-term insurance, the Trump administration is opening more loopholes for more people to buy insurance outside the health care law’s marketplaces. In the eyes of the administration, this is fulfilling a campaign promise that President Trump made to give people relief from Obamacare… But experts anticipate those changes would damage the market for customers who are left behind. Because younger and healthier people are more likely to leave the markets and buy short-term insurance, leaving an older and sicker pool behind, the ACA markets are likely to face higher premiums. And some insurers might decide to leave the law’s markets altogether if the customers become too unhealthy and therefore too expensive.” [Vox, 2/20/18]

ThinkProgress: Trump Administration’s Latest Attack On Obamacare Would Cost Taxpayers Millions. “The administration is proposing to expand access to short-term health plans, which is intended to fill temporary gaps in coverage and provide some consumers with cheaper options because the plan’s coverage is limited. This is just the latest move to undermine the ACA, and it’ll cost the federal government anywhere between $96 to $168 million more every year.” [ThinkProgress, 2/20/18]

Stephanie Armour, Wall Street Journal: Short-Term Plans Will Mean Higher Premiums. “If the estimated 200,000 people leave exchanges for short term plans, average est. monthly premium goes from $649 to $718 on exchanges based on proposed rule.” [Twitter, 2/20/18]

Catherine Rampell, Washington Post: Short Term-Plans A “Recipe For Siphoning Off Health People And Unraveling The Individual Market.” [Twitter, 2/20/18]

Jonathan Cohn, Huffington Post:  “And Now, Another Effort To Undermine Aca Regulations.” [Twitter, 2/20/18]

Ana Marie Cox: “Another Awesome Thing To Be Doing In the Middle Of An Addiction Epidemic.” [Twitter, 2/20/18]

Norm Ornstein, American Enterprise Institute: “Disgraceful.” “Alex Azar at HHS now doing his part to sabotage Obamacare and cost taxpayers hundreds of millions, while taking healthy people out of risk pools and increasing premiums for others. Disgraceful.” [Twitter, 2/20/18]

Health care experts ripped the announcement, and previewed the extensive problems it would cause:

Mike Kreidler, Washington State Insurance Commissioner: “If You Get Sick You May Not Be Able To Renew Your Coverage — There Are No Protections For People With Pre-existing Conditions. Maternity Care And Mental-Health Benefits Often Are Excluded.” [New York Times, 2/20/18]

Larry Levitt, Kaiser Family Foundation Senior Vice President: “Short-Term Insurance Plans Don’t Cover Pre-Existing Conditions, Don’t Cover The ACA’s Essential Benefits, And Can Impose Annual Limits On Coverage.” “Short-term insurance plans don’t cover pre-existing conditions, don’t cover the ACA’s essential benefits, and can impose annual limits on coverage. The expansion of short-term health insurance plans is part of a strategy to create a parallel insurance market that does not comply with the ACA’s rules. Short-term insurance plans will cherry pick healthy people, leaving ACA-compliant plans to cover a sicker pool with higher premiums. With the expansion in short-term insurance plans, low-income people will be protected from higher premiums by subsidies. Middle-class people with pre-existing conditions will feel the full brunt of higher premiums.” [Twitter, 2/20/18]

Rachel Sachs, Health Law Professor: “The Government Will Spend Millions More To Provide Fewer People With Comprehensive Coverage.” “HHS projects this change will cost the government $96-$168 million more every year. So the government will spend millions more to provide fewer people with comprehensive insurance.” [Twitter, 2/20/18]

Loren Adler, Director of USC-Brookings Schaeffer Initiative for Health Policy:  “For Middle Class & Above, This Moves Individual Market Away From Providing Insurance, ↓ Costs For The Healthy, ↑ Them For The Sick. This Is A VERY Expensive Rule For Taxpayers.”  [Twitter, 2/20/18]

Robert Laszewski, Health Industry Consultant: Plans Will “Woe Unto Those Who Get A Condition And Have To Go Back Into Obamacare.” “If consumers think Obamacare premiums are high today, wait until people flood into these short-term and association health plans…The Trump administration will bring rates down substantially for healthy people, but woe unto those who get a condition and have to go back into Obamacare.” [Kaiser Health News, 2/20/18]

Robert Laszewski, Health Industry Consultant: “We’re Going To Have Two Different Markets, A Wild West Frontier Called Short-Term Medical…And A High-Risk Pool Called Obamacare.” [Kaiser Health News, 2/20/18]

Kevin Lucia, Georgetown University Health Policy Institute Project Director: “It Will Undermine The Individual Market Risk Pool.” [Kaiser Health News, 2/20/18]

Sarah Lueck, Center On Budget And Policy Priorities Health Policy Expert: Plans Mean “Making People With Pre-Existing Conditions Pay Premiums That Reflect Their Health Status.” “Something I learned from the proposed rule on short-term plans: ‘Actuarially fair’ apparently means, in this Administration, making people with pre-existing conditions pay premiums that reflect their health status.” [Twitter, 2/20/18]

Dania Palanker, Former National Women’s Law Center Senior Counsel For Health And Reproductive Rights: “Mental Health Crisis? Short-Term Plans Exclude Mental Health. Opioid Crisis? Short-Term Plans Exclude Substance Use Treatment. Maternal Mortality Crisis? Short-Term Plans Exclude Maternity Coverage.” [Twitter, 2/20/18]

Center On Budget And Policy Priorities: Short-Term Health Plans Would Raise Premiums In Individual Market, Undermine Market Reforms, And Expose More Consumers To Gaps And High Costs. “This would let a parallel market for skimpy plans operate alongside the market for comprehensive individual health insurance, exposing consumers to new risks and raising premiums for people seeking comprehensive coverage, especially middle-income consumers with pre-existing conditions.” [Center on Budget and Policy Priorities, 2/20/18]

The announcement was also criticized by stakeholders, who know first-hand what such a proposal will mean for Americans’ health:

American Cancer Society Cancer Action Network, American Heart Association, American Liver Foundation, American Lung Association, Arthritis Foundation, Consumers Union, Crohn’s & Colitis Foundation, Cystic Fibrosis Foundation, Epilepsy Foundation, Leukemia And Lymphoma Society, Lutheran Services In America, March Of Dimes, National Health Council, National Ms Society, National Organization For Rare Disorders, United Way, World Wide Volunteers Of America: “The Proposed Rule Released Today Would Permit Insurance Companies To Offer Substandard Insurance Policies To Millions Of Americans… As Organizations Committed To Ensuring That Coverage Remains Affordable, Accessible, And Adequate For All Americans, We Cannot Support This Proposal. “The proposed rule released today would permit insurance companies to offer substandard insurance policies to millions of Americans. As drafted, the rule could result in the proliferation of lower-premium plans, known as ‘short-term limited duration’ plans that could exclude coverage for critically important health care services, charge individuals with pre-existing health conditions higher rates, increase deductibles, and place strict limits on benefits. These lower-premium plans are designed to draw younger and healthier individuals away from the individual marketplace – leaving them with inadequate coverage if they become ill or injured. Older and less healthy individuals that remain in more comprehensive plans will likely see their insurance premiums increase dramatically, making it even more challenging to secure the care they need and deserve. It will also create confusion for the American public about which types  of plans will cover the services they need – creating an opportunity for consumers to purchase plans that would leave them unknowingly underinsured. As organizations committed to ensuring that coverage remains affordable, accessible, and adequate for all Americans, we cannot support this proposal.” [Consumers Union, 2/20/18]

America’s Health Insurance Plans: “We Remain Concerned The Expanded Use Of Short-Term Plans Could Further Fragment The Individual Market, Which Would Lead To Higher Premiums For Many Consumers, Particularly Those With Pre-Existing Conditions.”While we are reviewing the proposed rule to understand its impact on the people we serve, we remain concerned that expanded use of short-term policies could further fragment the individual market, which would lead to higher premiums for many consumers, particularly those with pre-existing conditions.” [Twitter, 2/20/18]

American Cancer Society-Cancer Action Network: Plans Represent A Roll Back of Critical Patient Protections. “Short-term plans can deny coverage based on pre-existing conditions, often cover very few benefits and can set caps on what limited benefits are provided. While these exemptions make these policies inexpensive, they also create plans with potentially inadequate coverage. Short-term plans are meant to be a bridge, not a substitute, for long-term meaningful coverage. Permitting plans to be renewed indefinitely would likely result in more people struggling with unexpected health care bills and insufficient insurance.” [ACS-CAN, 2/20/18]

Community Catalyst: Short-Term Plans Proposed by Trump Administration Would Roll Back Consumer Protections Enshrined in Affordable Care Act. “By giving insurance companies more leeway to sell plans that can skirt protections the ACA put in place specifically to ensure people with preexisting conditions such as cancer, asthma or diabetes wouldn’t be denied or priced out of coverage, President Trump is once again prioritizing politics over peoples’ health.” [Community Catalyst, 2/20/18]

Wisconsin Cancer Council: “Bottom Line: These Plans Do Not Have Protections Guaranteed.” “Bottom line: these plans do not have protections like guaranteed issue and bans on coverage limits, and may contribute to rising premiums for full coverage #ACA plans in the individual market, especially after the tax penalty goes away in 2019.” [Twitter, 2/20/18]

Today’s announcement represents the Administration’s latest salvo in their war on health care, and yet again it is the American people who will be the victims. These junk insurance plans would be another way for the Trump Administration and insurance companies to dismantle the Affordable Care Act and the benefits that millions of Americans have come to rely on. Enough is enough – it’s time for the Trump Administration to end its war on our health care.

ashoup
In Capitol Hill, Administration, News

This Week in the War on Health Care — February 12-16, 2018

This week, as the President announced his budget and the Senate debated various immigration proposals, the Trump Administration continued its unprecedented assault on the American health care system. Here’s what happened this week in Republicans’ war on health care, and why the American people stood up to this Administration – and the prominent GOP legislator who joined them:

ABOUT THAT BUDGET

On Monday, President Trump released his 2019 fiscal year budget blueprint, and its most prominent feature was a series of draconian cuts to the nation’s health care programs.

The Trump budget doubled down on Congressional Republicans’ previous failed repeal attempts, calling for the implementation of Graham-Cassidy, the GOP’s worst repeal bill, which would take away health insurance from 32 million Americans, raise costs, remove protections for pre-existing conditions, and end Medicaid as we know it. The budget also called for drastic cuts to Medicare and ending funding for Planned Parenthood, continuing to target everyday Americans in an attempt to balance costs after cutting taxes for the wealthiest and corporations.

President Trump and his Administration should be ashamed – and Congress should declare the budget dead on arrival.

THE ATTACKS ON WOMEN’S HEALTH CARE CONTINUE

The Administration also ratcheted up its war on women’s health care this week. In addition to a budget defunding Planned Parenthood and slashing Medicaid, denying millions of women access to basic health care, it came out that President Trump’s Health and Human Services Department last month instructed a Southern Poverty Law Center-designated hate group to write an official government letter providing a roadmap for state Medicaid programs to restrict women’s access to the health care provider of their choice.

Politico: “A conservative legal organization worked with the Trump administration to make it easier for states to defund Planned Parenthood.”

CNN: “The Trump administration relied on a right-wing anti-abortion rights group to draft the letter it sent to states reversing Obama-era guidance that it’s against the law to terminate Planned Parenthood as a Medicaid provider … the Alliance Defending Freedom calls itself a conservative Christian nonprofit organization … but the Southern Poverty Law Center has labeled it a hate group for its attacks on LGBT rights.”

A BLATANT VIOLATION OF FEDERAL LAW? MEH, SAYS ALEX AZAR

On Wednesday, Blue Cross of Idaho announced that it would follow Republican Governor Butch Otter’s lead and violate federal law by offering insurance plans that don’t conform to the consumer protections mandated by the Affordable Care Act, leading the charge to take people back to a time when insurance companies could decide whether they were taken care of when they got sick. In response, newly-confirmed HHS Secretary Alex Azar refused to say he will stop the measure, despite it being a blatant violation of federal law. Secretary Azar should read the letter fifteen patients’ rights groups sent him:

American Cancer Society Cancer Action Network, American Diabetes Association, American Heart Association, American Liver Foundation, American Lung Association, Cystic Fibrosis Foundation, Epilepsy Foundation, Hemophilia Federation of America, Leukemia & Lymphoma Society, Lutheran Services in America, March of Dimes, Mended Little Hearts, Muscular Dystrophy Association, National MS Society, National Organization for Rare Disorders: “The Federal Government Must Uphold The Requirements Of Federal Law.” “Idaho’s insurance bulletin would allow insurers to sell individual market plans that do not comply with federal law. Because the Idaho Bulletin purports to authorize the issuance of insurance coverage that is prohibited by federal law, it is legally invalid… The federal government must uphold the requirements of federal law that protect patients, their families, and the health system against these consequences. On behalf of our patients, and all Americans, we urge you to make clear that Idaho cannot authorize the issuance of health insurance coverage that violates federal law, and that any insurer that issues such plans risks enforcement action and serious penalties.” [American Cancer Society-Cancer Action Network, 2/14/18]

JOB OR NO JOB, REPUBLICANS CONTINUE SECRETLY ATTEMPTING TO REPEAL THE ACA

The Hill this week reported that Congressional Republicans, in a backdoor manner, are seeking to repeal yet another component of the Affordable Care Act: its requirement that employers with over 50 workers offer health insurance. The hypocrisy of encouraging states to cut working-age people off Medicaid, saying they should find a job if they want coverage, to telling employers they shouldn’t have to offer health coverage to their workers, is breathtaking. 151 million Americans are covered through employer-sponsored insurance, and such a move would be devastating. Unfortunately for the GOP, voters are on to their secret sabotage strategy…

POLLS CONFIRM AMERICANS ARE FED UP WITH GOP’S WAR ON HEALTH CARE

Two major polls were released this week, and both came to the same conclusion: voters are fed up with the GOP’s war on health care.

Public Policy Polling released its first national poll of the year, and offered some key findings about the state of health care:

  • Approval for the Affordable Care Act is 12 points above water (47% approval to 35% disapproval), a dramatic reversal from trends before Trump took office.
  • Over half of voters know Republicans are sabotaging health care, with 51% believing the Trump Administration is actively taking steps that will raise people’s health care costs.

Additionally, a Priorities USA memo found that independent voters continue to hold major concerns about President Trump’s war on health care, confirming that voters realize Republican sabotage is driving up insurance premiums and exacerbating the high health care costs burdening working families.

All in all, the results are clear: voters are fed up with the GOP’s posturing on health care and want real solutions that can expand coverage and lower premiums, and what they’re telling the GOP is simple: enough is enough, stop your war on our health care.

ashoup
In Administration, News

REACTION ROUNDUP: States Face Wave of Resistance to Trump-Inspired Medicaid Cuts

As states start to take advantage of the Trump Administration’s invitation to strip Medicaid coverage away from millions by imposing restrictions such as ‘work’ requirements designed to reduce access to coverage, these proposals face a wave of backlash from local editorial boards, lawmakers, health care providers, hospitals, and advocates:

Iowa (legislation to impose work requirements introduced in Feb. 2018)

Des Moines Register editorial: Medicaid bill demonizes low-income Iowans with delays, drug tests, work requirements. Iowa state Sen. Tom Greene, R-Burlington, is sponsoring Senate File 2158, a measure which “directs the Iowa Department of Human Services to seek federal approval to impose work requirements on Medicaid recipients.” The paper adds, “One would think Greene, who worked as a pharmacist for four decades, would understand the importance of ensuring Iowans get care needed to be productive members of society. Then again, the part-time lawmaker was not required to pee in a cup or wait six months to enjoy his taxpayer-subsidized family coverage.” [Des Moines Register, 2/14/18]

Louisiana (expected to propose work requirements in mid-Feb. 2018)

Republican state lawmaker skeptical: “Medicaid work requirements probably would not save much money as the state tries to close a looming $1 billion budget shortfall, he added. Louisiana legislators have expressed similar concerns. ‘I’m skeptical that it’s going to be any real savings,’ said Rep. Kirk Talbot, R-River Ridge.” [Louisiana Daily Comet, 2/6/18]

West Virginia (considering Medicaid work requirements as of Feb. 2018)

Charleston Gazette-Mail editorial: Work requirements don’t help people work. “Helping people achieve gainful employment and self-sufficiency is exactly the right goal. Disrupting people’s health coverage will not accomplish it. Medicaid recipients already struggle to maintain employment and support themselves. Otherwise, they wouldn’t qualify for Medicaid…A smarter, not to mention more humane, approach would be to remove as many barriers to health care access as possible for the state’s most challenged residents. The smarter approach would be to err on the side of inclusion. Cover more West Virginians, and don’t hassle them off of Medicaid month after month as their work status fluctuates.” [Charleston Gazette-Mail, 1/25/18]

Missouri (state has called for legislation to pursue work requirement)

St. Louis Post-Dispatch editorial: Job requirements for Medicaid recipients won’t work and might actually backfire. “Tracking down these people will require state governments to expand their staffing to police the work requirement and administer the paperwork. If the work requirement is similar to that required for coverage under the Temporary Assistance for Needy Families program, child care and transportation will have to be subsidized if it’s available. The cost savings for taxpayers is starting to look a little hazy…Ironically, researchers say that taking health insurance away from people makes it less likely they will be able to get and keep a job. This will be particularly true if, as expected, the burden of the work requirement falls most heavily on those with physical or mental impairments not yet certified as permanent disabilities.” [St. Louis Post-Dispatch, 1/15/18]

Missouri family medicine physician: Rolling back Medicaid will worsen Missouri’s opioid crisis. “For Missourians struggling with opioid addiction, Medicaid is the difference between life and death. The medications I prescribe can help 50 percent of patients begin recovery and stay healthy in the long term. With access to these medications, I see many of my patients rebuilding their lives, advancing in their careers and enjoying life with their families. But without Medicaid, many will lose access to the treatment and medications that we know are effective. Even for those with full-time jobs, many Missourians simply don’t make enough to afford private health insurance, and Medicaid is their only option to afford health care.” [Columbia Missourian, 1/31/18]

Maine (work requirement submitted for approval on 8/2/2017)

Portland Press-Herald editorial: Medicaid limits are not what Maine voters want. “MaineCare is health care, not welfare. People on the program don’t get a check every month that discourages them from working. But they do get a chance to go to see a doctor when they are sick, or fill prescriptions that keep chronic diseases at bay. Adding more hurdles to applying for benefits will inevitably result in eligible people failing to be enrolled. The bureaucratic nightmare of trying to figure out who has received how much coverage during their lifetimes would slow the process for everyone … Cutting off someone’s health care is not going to make them more likely to work — just the opposite is true. Illness is one of the main barriers that prevents people from working.” [Portland Press Herald, 2/8/18]

Bangor Daily News editorial: The contorted logic of allowing states to require work as a condition for Medicaid. “If work requirements in a food assistance program are likely to lead to a diminished state of health for thousands of low-income adults, it’s not hard to imagine the damaging health effects of imposing work requirements in a benefit program designed explicitly to ensure that the poorest among us can access health care.” [Bangor Daily News, 1/19/18]

South Dakota (Gov. Dennis Daugaard has called for Medicaid work requirements)

Yankton Daily Press & Dakotan editorial: Be wary of what’s lurking in the details of Medicaid work requirements. “The statement also feeds the long-held generalization embraced by some people that many of those receiving some form of low-income assistance are basically living off the government dole instead of working. However, a lot of low-income people who receive Medicaid are already working but aren’t able to make ends meet or afford basic health care, which Medicaid helps provide…If handled properly, the work requirement for Medicaid proposed by Daugaard — and pushed by the White House — may impact only a small segment of recipients. If this move becomes something more than that — which, unfortunately, could be vaguely implied by Verma’s blunt remarks — then the idea may be little more than subterfuge for something else.” [Yankton Daily Press & Dakotan, 1/20/18]

Kansas (work requirement submitted for approval on 12/20/2017)

Health execs: Don’t equate work requirements with job stability. “‘If the state is going to make further changes to the KanCare program, it will put a greater burden on the state’s general fund, hospitals and providers, said Brenda Sharpe, CEO of the REACH Healthcare Foundation. ‘The misconception of who is on Medicaid is rampant.’ Sharpe also said the proposed changes fail to account for the type of jobs most low-income workers hold. For example, a construction job may be seasonal, and a retail worker’s schedule may very week by week — then throw in the need for child care. ‘If they lose their job for three months because they work in an outdoor setting, are you going to kick them off benefits for three months?… The best thing you can do to get someone to keep a job is to give them health insurance.’” [Kansas City Business Journal, 1/24/18]

Arizona (work requirement submitted for approval on 1/4/2018)

Arizona Alliance for Healthcare Security: “They have no evidence of anyone taking advantage of the system, so this just becomes another obstacle for people to overcome in order to get Medicaid benefits.” [Inside Tucson Business, 1/19/18]

Arkansas (work requirement submitted for approval on 6/30/2017)

Arkansas Advocates for Children and Families: “Arkansas Works, the state’s Medicaid expansion program, has successfully provided hundreds of thousands of Arkansans with affordable health care coverage and has saved the state money in charity payments to providers for uncompensated care. But the proposed changes are designed to remove people from coverage without giving them a comparable alternative. This is not just bad policy – it runs counter to Medicaid’s core mission of providing health care coverage to low-income people.” [AACF report, 1/4/18]

Kentucky (work requirement approved on 1/12/2018)

Lexington Herald-Leader editorial: Cutting unemployment benefits won’t strengthen Ky. workforce. “The best hope for addiction treatment is Medicaid, but the state is getting ready to impose new work requirements and other hurdles to treatment and the chance at a responsible life.” [Lexington Herald-Leader, 2/14/18]

Policy analyst: “You’re spending more money to cover fewer people.” “Cost savings come from the assumption that nearly 100,000 people will drop out of Medicaid by the end of the five-year project recently approved by the federal government. For those who remain, the monthly cost of care increases faster than it would have had the state made no changes, according to the administration’s projections. ‘You’re spending more money to cover fewer people,’ said Dustin Pugel, a policy analyst for the Kentucky Center for Economic Policy in Berea and a critic of the Bevin plan. I’m not crazy about the idea of us spending more money to cover fewer people.'” [Louisville Courier Journal, 2/14/18]

Indiana Daily Student editorial: Kentucky’s Medicaid requirements hurt more than help. “There are patients on Medicaid who are disabled, need cancer treatment and have other situations that would make working impossible or incredibly difficult.” [Indiana Daily Student, 2/5/18]

Utah (work requirement submitted for approval on 8/16/2017)

Op-ed: Medicaid ‘work mandate’ is misguided policy. “The 1115 waiver’s “work requirement” is a fancy term for ‘work mandate’; it is in fact designed to provide less coverage overall.  Utah children and parents will be caught in a poverty cycle. Utahns will be far less healthy than they would be with full Medicaid expansion through the Utah Decides ballot initiative.” [Utah Policy, 1/11/18]

 

Wisconsin (work requirement submitted for approval on 6/15/2017)

Policy analyst: “Requiring you to work to get healthy — there’s something backwards there.” “‘If you’re not healthy, it’s difficult to work,’ said Mike Bare, research director for Community Advocates’ Public Policy Institute in Milwaukee. ‘Requiring you to work to get healthy — there’s something backwards there.’” [Wisconsin State Journal, 1/11/18]

Madison nonprofit: Work requirements only make lives harder. “‘This is targeted at the lowest-income folks that we have out there, people who have difficult lives already,’ said Bobby Peterson, executive director of ABC for Health, a nonprofit public interest law firm in Madison. ‘We’re just making it harder for them.’” [Wisconsin State Journal, 1/11/18]

Illinois (Rauner administration developing Medicaid work requirement)

Shriver National Center on Poverty Law: A Medicaid work requirement would be cruel — and costly. “Medicaid work requirements will largely be used to punish people in dire need for forces beyond their control…Ironically, by taking crucial medical assistance away from people who are already struggling, work requirements will make finding or maintaining employment much more difficult. The fact of the matter is that Medicaid, like most other major anti-poverty programs, serves as a work support.” [Chicago Tribune, 1/23/18]

Ohio (Kasich administration preparing to submit application)

Ohio Center for Community Solutions: “To suddenly remove these resources not only dis-benefits this huge area of employment and this huge area of economic impact for providers and others, it would have drastic impacts on things like the opioid epidemic, on chronic-disease management.” [Cleveland Scene, 2/12/18]

South Carolina (McMaster administration has directed Medicaid agency to submit application)

South Carolina Hospital Association VP: “If anything, we should help them get the care they need so they can return to work and lead more fulfilling lives.” “After all, most Medicaid beneficiaries in South Carolina are already working. Among those who are not, 52 percent are disabled or too sick, while another 32 percent act as caregivers. Community-engagement requirements shouldn’t punish the sick or discriminate against those with disabilities; if anything, we should help them get the care they need so they can return to work and lead more fulfilling lives.” [The State, 2/7/18]

Tennessee (House speaker has filed Medicaid work requirements bill)

TennCare Work Plan Would Affect 86K, Cost $18.7M. “A state analysis says legislation seeking to require certain able-bodied TennCare recipients to work, volunteer or attend school would affect 86,400 people and cost the state $18.7 million annually…The $18.7 million net cost notably includes $22.3 million more in anticipated case management state costs and $3.7 million in estimated state savings from disenrollments, assuming a 2020 program start.” [U.S. News & World Report, 2/14/18]

Chattanooga Times Free Press: Nearly 87,000 adult TennCare enrollees could be affected under work requirement plan. “As many as 86,400 able-bodied adult enrollees on Tennessee’s Medicaid program could be affected by a bill that seeks to require they work, attend school, volunteer or face losing their health benefits, according to a legislative analysis … Rep. John Ray Clemmons, D-Nashville, said ‘the data is clear’ with proponents’ ‘ultimate’ goal being ‘to kick people off’ of TennCare, the state’s Medicaid program.” [Chattanooga Times Free Press, 2/14/18]

… and 160 National, State, and Local Organizations Oppose Work Requirements in Letter to Secretary Azar: “CMS’s Medicaid work requirements policy is directly at odds with bipartisan efforts to curb the opioid crisis .. and will have a significant and disproportionately harmful effect on individuals with chronic health conditions, especially those struggling with substance use disorders (SUDs) and mental health disorders.”  [2/15/18]

ADAP Advocacy Association (aaa+)

Addiction Policy Forum

Advocacy Center of Louisiana

AIDS United

Alameda County Community Food Bank

American Association on Health and Disability

American Association of People with Disabilities

American Association for the Treatment of Opioid Dependence (AATOD)

American Civil Liberties Union

American Federation of State, County & Municipal Employees (AFSCME)

American Foundation for Suicide Prevention

American Group Psychotherapy Association

American Psychological Association

American Society of Addiction Medicine

Association for Ambulatory Behavioral Healthcare

Bailey House, Inc.

Board for Certification of Nutrition Specialists

Brooklyn Defender Services

CADA of Northwest Louisiana

California Consortium of Addiction Programs & Professionals

California Hepatitis Alliance

Caring Across Generations

Caring Ambassadors Program

CASES

Center for Civil Justice

Center for Employment Opportunities (CEO)

Center for Health Law and Policy Innovation

Center for Law and Social Policy (CLASP)

Center for Medicare Advocacy

Center for Public Representation

Charlotte Center for Legal Advocacy

CHOW Project

Coalition of Medication Assisted Treatment Providers and Advocates

Colorado Center on Law and Policy

Community Access National Network (CANN)

Community Catalyst

Community Health Councils

Community Legal Services of Philadelphia

Community Oriented Correctional Health Services

Community Service Society

Connecticut Legal Services

Consumer Health First

C.O.R.E. Medical Clinic, Inc.

Council on Social Work Education

CURE (Citizens United for Rehabilitation of Errants)

DC Coalition Against Domestic Violence

Desert AIDS Project

Disability Rights Arkansas

Disability Rights Wisconsin

Drug Policy Alliance

EAC Network (Empower Assist Care)

EverThrive Illinois

Facing Addiction with NCADD

Faces & Voices of Recovery

FedCURE

First Focus

Florida Health Justice Project, Inc.

Food & Friends

The Fortune Society

Forward Justice

Friends of Recovery – New York

Futures Without Violence

God’s Love We Deliver

Greater Hartford Legal Aid

Greenburger Center for Social and Criminal Justice

Harm Reduction Coalition

Health Law Advocates

Hep Free Hawaii

Hepatitis C Support Project/HCV Advocate

Heartland Alliance

HIV Medicine Association

Horizon Health Services

Hunger Free America

ICCA

Illinois Association of Behavioral Health

The Joy Bus

JustLeadershipUSA

Katal Center for Health, Equity, and Justice

The Kennedy Forum

Kentucky Equal Justice Center

Kitchen Angels

Justice in Aging

Justice Consultants, LLC

Lakeshore Foundation

Law Foundation of Silicon Valley

Legal Action Center

The Legal Aid Society

Legal Council for Health Justice

Life Foundation

Live4Lali

Liver Health Connection

Maine Equal Justice Partners

MANNA (Metropolitan Area Neighborhood Nutrition Alliance)

Massachusetts Law Reform Institute

McShin Foundation

Mental Health America

Mental Health Association in New York State, Inc. (MHANYS)

Michigan Poverty Law Program

Minnesota Recovery Connection

Mississippi Center for Justice

NAACP

The National Alliance to Advance Adolescent Health

National Alliance on Mental Illness

NAMI-NYS

National Alliance of State & Territorial AIDS Directors

National Association of Addiction Treatment Providers

National Association of County Behavioral Health & Developmental Disability Directors

National Association for Rural Mental Health

National Association of Social Workers

National Center for Law and Economic Justice

National Coalition Against Domestic Violence

National Council on Alcoholism and Drug Dependence, Phoenix

National Council for Behavioral Health

National Council of Churches

National Disability Rights Network

National Employment Law Project

National Federation of Families for Children’s Mental Health

National Health Care for the Homeless Council

National Health Law Program

National HIRE Network

National Juvenile Justice Network

National LGBTQ Task Force

National Low Income Housing Coalition

National Organization for Women

The National Viral Hepatitis Roundtable

NC Justice Center

New Haven Legal Assistance Association

New York Association of Alcoholism and Substance Abuse

New York Association of Psychiatric Rehabilitation Services

New York Lawyers for the Public Interest

New York State Council for Community Behavioral Healthcare

Open Hands Legal Services

Osborne Association

Outreach Development Corp.

The Partnership for Drug Free Kids

PICO National Network

The Poverello Center, Inc.

Project Inform

Public Justice Center

Root & Rebound

Ryan White Medical Providers Coalition

Safer Foundation

Sargent Shriver National Center on Poverty Law

School Social Work Association of America

Sea Island Action Network, South Carolina

The Sentencing Project

Shatterproof

Society of General Internal Medicine

Southern Center for Human Rights

Southern Poverty Law Center

Students for Sensible Drug Policy

TASC of the Capital District, Inc.

Tennessee Justice Center

Three Square Food Bank

Transitions Clinic Network

Treatment Action Group

Treatment Alternatives for Safe Communities (TASC) – Illinois

Treatment Communities of America

Virginia Poverty Law Center

Western Center on Law & Poverty

ashoup
In Capitol Hill, News

Americans Can’t Trust a Republican-Negotiated ACA Stabilization Bill

Washington, DC – In response to reports that Republicans in Congress have cut Democrats out of the discussion on how to fix the damage President Trump’s sabotage has inflicted on the health care markets, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Once again, Congressional Republicans are drafting partisan health care bills in secret behind closed doors. New reports indicate that Republicans are now writing a back-room Affordable Care Act ‘stabilization bill’ instead of working with Democrats like they promised. After a year of relentless Republican attacks on our care, Americans have no reason to trust another partisan, Republican-only, secret deal. Both parties must be at the table on stabilization discussions in order to protect Americans from skyrocketing premiums caused by Republican sabotage.

“We call on Senator Susan Collins, who has publicly expressed opposition to a partisan stabilization bill, to demand a bipartisan solution and recognize that the GOP leadership has repeatedly broken its health care promises to her.

“Congressional Republicans should listen to the American people, who are saying loud and clear that ‘enough is enough’ with partisan repeal and sabotage of our health care.”

BACKGROUND

Protect Our Care Outlines Market Stabilization Must-Haves [2/9/18]

ashoup
In News, Administration

Idaho Reactions: Will Secretary Azar Uphold His Oath or Allow State to Blatantly Violate Federal Law?

Today, Blue Cross of Idaho announced that it will follow Republican Governor Butch Otter’s lead and violate federal law by offering insurance plans that don’t conform to the consumer protections mandated by the Affordable Care Act. Blue Cross of Idaho is leading the charge to take people back to a time when insurance companies could decide whether they were taken care of when they got sick, and it’s now incumbent upon the Trump Administration, specifically Health and Human Services Secretary Alex Azar, to uphold the law of the land – just as he swore to do upon assuming his Cabinet position. How is this announcement being treated so far?

American Cancer Society Cancer Action Network, American Diabetes Association, American Heart Association, American Liver Foundation, American Lung Association, Cystic Fibrosis Foundation, Epilepsy Foundation, Hemophilia Federation of America, Leukemia & Lymphoma Society, Lutheran Services in America, March of Dimes, Mended Little Hearts, Muscular Dystrophy Association, National MS Society, National Organization for Rare Disorders: “The Federal Government Must Uphold The Requirements Of Federal Law.” “Idaho’s insurance bulletin would allow insurers to sell individual market plans that do not comply with federal law. Because the Idaho Bulletin purports to authorize the issuance of insurance coverage that is prohibited by federal law, it is legally invalid… The federal government must uphold the requirements of federal law that protect patients, their families, and the health system against these consequences. On behalf of our patients, and all Americans, we urge you to make clear that Idaho cannot authorize the issuance of health insurance coverage that violates federal law, and that any insurer that issues such plans risks enforcement action and serious penalties.” [ACS-CAN, 2/14/18]

Los Angeles Times: “Not A Good Sign For The Rule Of Law.” “If he is serious about his duty to uphold the Affordable Care Act, Azar has no real option other than to nip the Idaho venture in the bud. He could have taken a strong stand during his appearance on Capitol Hill Wednesday, but failed. That’s not a good sign for the rule of law.” [LA Times, 2/14/18]

Business Insider: “HHS Is Required By The ACA To Step In And Take Over Regulation Of Any State That Does Not Meet Regulatory Standards.” “Blue Cross of Idaho announced Wednesday it would take advantage of the state’s new loophole for Affordable Care Act regulations, prompting questions over how the Trump administration will respond… HHS is required by the ACA to step in and take over regulation of any state that does not meet regulatory standards, and the department has done so in four states already.” [Business Insider, 2/14/18]

The Hill: The Proposed Plans Contain Features “Not Allowed.” “[The] proposal is legally questionable and has drawn backlash from Democrats who say he is simply ignoring federal law. The [plans] would charge people with pre-existing conditions more and have a limit of $1 million in claims per year, according to the Idaho Statesman. Both of those features are not allowed under ObamaCare… Democrats have been pressuring Secretary of Health and Human Services Alex Azar to step in to stop Idaho’s plan and enforce the law.” [The Hill, 2/14/18]

Washington Examiner: Proposed Plans “Put Pressure On The Federal Government To Step In And Enforce Rules.” “Many experts have questioned whether this would survive a legal challenge, because Obamacare requires plans sold on the law’s insurance marketplaces, which offer coverage on the individual market, to meet certain benefit requirements… Idaho’s action has put pressure on the federal government to step in and enforce rules that the Trump administration has pushed to repeal.” [Washington Examiner, 2/14/18]

Bloomberg: Proposed Policies “Are Specifically Forbidden.” “[The policies proposed] are specifically forbidden by the 2010 law. The move sets up a potential conflict with the federal government. While President Donald Trump has said he opposes the law and has taken steps to undermine it, the administration will have to decide whether to enforce legal requirements that remain on the books.” [Bloomberg, 2/14/18]

Washington Times: The Trump Administration “Is Responsible For Enforcing [The Law].” “The Idaho situation is a key test for the Trump administration, which still wants to repeal and replace Obamacare but is responsible for enforcing the 2010 law while it remains on the books… Obamacare’s defenders say the Idaho plan skirts the law completely, however, so HHS must act to preserve hard-won consumer protections. ‘It’s cruel, and it’s an illegal attempt to repeal our health care,’ Save My Care, a pro-Obamacare coalition, says in new ads running in Boise, Idaho, and the nation’s capital. ‘Call Health and Human Services Secretary Alex Azar. Tell him to block Governor Otter’s attack on our health care.’” [Washington Times, 2/14/18]

As a reminder, here’s what legal experts are saying about Idaho:

Tim Jost, Washington and Lee University School of Law Emeritus Professor: “What They’re Doing Is Completely Illegal.” “Both in terms of federal penalties and in terms of potential private lawsuits, they are taking on tremendous liabilities here. What they’re doing is completely illegal. It’s kind of jaw-dropping.” [Bloomberg, 2/14/18]

Larry Levitt, Kaiser Family Foundation Senior Vice President: “This Is Simply Not Allowed.” “Idaho is allowing health insurance plans that charge sick people more than healthy people, have an annual limit on coverage, and don’t cover maternity care. That’s simply not allowed under the ACA. If a state like Idaho is not enforcing the ACA’s insurance protections, the federal government is obligated to step in and enforce the rules…. If HHS does not step in and enforce the ACA’s insurance rules in Idaho, it won’t just be about Idaho. Other conservative states will no doubt then start to allow insurance plans that don’t comply with the ACA.” [Twitter, 2/14/18]

Will Secretary Azar follow the oath he swore to uphold just weeks ago? Or will he allow states to violate the very laws he pledged to uphold?

ashoup
In Capitol Hill, Administration, News

3 Facts You Should Know After Sec. Azar’s Ways and Means Hearing

HHS Secretary Alex Azar appeared before the House Ways and Means Committee today and doubled down on the Trump Administration’s war on health care. His language may have been nuanced, but the policy results would be the same. Here are three key facts you should know after his testimony today.

FACT #1: THE TRUMP ADMINISTRATION’S OPIOID FUNDING WILL NOT BE EFFECTIVE IF IT CONTINUES PARTISAN EFFORTS TO REPEAL THE AFFORDABLE CARE ACT AND GUT MEDICAID

WHAT SEC. AZAR SAID: “The President’s Budget recognizes the devastation caused by this [opioid] crisis across America, by providing a historic new investment of $10 billion in HHS funding to address the opioid crisis and serious mental illness…”

THE FACTS: While the additional funding for opioids is welcomed, it will have little to no impact if the Administration continues its partisan push to repeal the Affordable Care Act (ACA) and gut Medicaid.

  • Vox: Trump’s budget could help fight the opioid crisis — if it didn’t try to repeal Obamacare. Vox: “Medicaid is particularly important in this area. A 2014 study by Truven Health Analytics researchers found that Medicaid paid for about 25 percent — $7.9 billion of $31.3 billion — of projected public and private spending for addiction treatment in 2014. That made it the second-biggest payer of addiction treatment after all local and state government programs. Yet not only would Trump’s budget plan end the Obamacare-funded Medicaid expansion, it would also make additional cuts to Medicaid.”

FACT #2: SEC. AZAR DOUBLED DOWN ON THE PARTISAN REPEAL ATTEMPT THAT WILL RIP COVERAGE AWAY FROM TENS OF MILLIONS, RAISE COSTS FOR MILLIONS MORE, AND GUT PROTECTIONS FOR PEOPLE WITH PRE-EXISTING CONDITIONS

WHAT SEC. AZAR SAID: “The Budget supports repealing Obamacare and replacing the law with flexibility for states to create free and open healthcare tailored to citizens’ needs. The two-part approach is modeled closely after the Graham-Cassidy-Heller-Johnson amendment to H.R. 1628, the American Health Care Act of 2017, and also includes additional reforms to put healthcare spending on a sustainable fiscal path.”

THE FACTS: The Graham-Cassidy legislation was the worst of all the partisan repeal efforts Congress considered last year that ripped coverage away from tens of millions of people, raised costs on millions more, gutted protections for pre-existing conditions, and slashed Medicaid.

  • Analysts Agree: Every State Loses Under Graham-Cassidy and Many Working and Middle Class Families See Their Costs Increase. Multiple independent analyses agree that the Graham-Cassidy repeal bill would cut federal funding to states. 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.
  • 32 Million Would Lose Health Coverage. As a result of zeroing out block grants for Marketplace tax credits and Medicaid expansion and additional cuts to Medicaid, the Graham-Cassidy bill is essentially repealing the Affordable Care Act without replacing it.
  • Graham-Cassidy Would Raise Costs For People With Pre-Existing Conditions. Graham-Cassidy would allow states to let insurance companies once again charge people with pre-existing conditions more, which could raise costs for the more than 134 million Americans that have a pre-existing condition. An individual with asthma, for example, would face a premium surcharge of $4,340. The surcharge for pregnancy would be $17,320, while it would be $142,650 more for patients with metastatic cancer.

FACT #3: SEC. AZAR DOUBLED DOWN ON THE TRUMP ADMINISTRATION’S WAR ON MEDICAID

WHAT SEC. AZAR SAID: “Our budget proposes a new future for Medicaid that will restructure Medicaid financing, provide states with new flexibilities to better serve our communities, improve the state plan and waiver processes, and provide the right incentives to preserve the program for future generations.”

THE FACTS: The Trump Administration is doubling down on its war on Medicaid by continuing to push for the Graham-Cassidy legislation that ended Medicaid expansion, which has given 15 million people access to care, and by slashing traditional Medicaid, putting the care of millions of seniors, children, and people with disabilities at risk. The Administration’s attempts to impose onerous work requirements are not about work, but about kicking people off their health care. The fact is most people on Medicaid who can work, are working. These requirements are the opposite of what we need to be doing to help people find and keep jobs.

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