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March 2018

In News

Health Care Voters Propel Lamb to Victory

Pennsylvania Voters Reject GOP Repeal & Sabotage Agenda

Washington, D.C. – As a PPP exit poll shows that dissatisfaction with Republicans’ war on health care drove voters to deliver a Democratic victory in a district that Donald Trump won by nearly twenty points in 2016, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Yesterday’s historic win in Pennsylvania should be the clearest message yet to Republicans that their war on health care is not just a political loser, but an albatross around the neck of any candidate who supports their destructive repeal-and-sabotage agenda.

“Rick Saccone has became the latest candidate to throw his lot in with President Trump’s war on health care and then suffer a once-unthinkable defeat. While Saccone called for a full repeal of the Affordable Care Act and backed the unpopular GOP repeal bills that would have thrown tens of millions of Americans off of their insurance and raised costs for millions more, Conor Lamb defended the Affordable Care Act and called for legislative action to improve the law and expand on its successes – and Pennsylvania voters responded by sending him to Washington.

“A PPP exit poll of PA-18 voters shows they broke for Lamb because of his commitment to improving the Affordable Care Act and opposition to the Republican repeal-and-sabotage agenda. In a district that voted Trump by almost 20 points, a majority of voters now support the Affordable Care Act, and last year’s repeal efforts were a drag on the Republican candidate, making 41% of voters less likely to support him.

“Last night’s exit poll makes it crystal clear that health care decided this race, echoing recent elections in Virginia, and across the country, as voters across the nation continue to say: enough is enough – it’s time to stand up to Republicans and stop the war on our care.”

BACKGROUND

Lamb: Congress Should Be Working Together To Build On ACA’s Progress, Fix What Isn’t Working, And Make The Law Better.

On his campaign website, Lamb writes, “I believe that every American has a right to go see a doctor when they’re sick, and that means every American has a right to health insurance they can afford. The Affordable Care Act has flaws, but it has provided affordable coverage to more than a million Pennsylvanians who were previously uninsured. Our representatives in Congress should be working together to build on that progress, fix what isn’t working, and make the law better. Instead, Republicans in Congress spent the past year trying to take health insurance away from people with no plan to replace it. Now, costs are likely to go up for many of us, especially those with preexisting conditions. That is unacceptable, and it’s a failure of leadership.”  Conor Lamb Campaign Website, Priorities, Affordable Health Care]

Lamb: GOP Leaders Have Not Even Allowed A Vote To Stabilize ACA Markets. 

On his campaign website, Lamb writes, “Republican leaders have not even allowed a vote on a bipartisan, common-sense effort to strengthen the ACA and stabilize the markets. And it took the threat of a government shutdown for both parties to come together and fund the children’s health program (CHIP), something they’d ignored for months while the program was forced to survive on week-to-week bailouts. These legislative failures show what is wrong with the status quo in Washington. I’ll work with anyone from either party who wants to help people with pre-existing conditions, improve the quality of care, and reduce premiums, out-of-pocket costs, and prescription drug prices.” [Conor Lamb Campaign Website, Priorities, Affordable Health Care]

Saccone Called For Full Repeal Of The ACA And Said AHCA Did Not Go Far Enough.

Saccone, in an interview on 790 WAEB, agreed that the AHCA does not go far enough. When the show’s host trashed AHCA as insufficiently right wing, Saccone said the host was “absolutely right.” Later, when asked if he favors full repeal of the ACA, Saccone replied, “absolutely; got to go.” [WAEB, 3/9/17]

Saccone Promised To “Fix” Obamacare By Utilizing “Free-Market Principles To Fix Our Healthcare Crisis.”

Under the heading “Fixing Obamacare,” Saccone’s website states, “Under Obamacare, health insurance has become unaffordable. Rick Saccone will utilize free-market principles to fix our healthcare crisis.” [RickSaccone.com, accessed 3/13/18]

Saccone Dismissed Concern About People Losing Health Coverage As “Typical Democrats Talking Points.”

“Conor Lamb, the Democratic candidate in the special election wasn’t available to speak on camera on Wednesday. On his campaign website, he claimed Republicans have been ‘trying to take health insurance away from people with no plan to replace it. Now, costs are likely to go up for many of us, especially those with preexisting conditions. That is unacceptable, and it’s a failure of leadership.’ Told of Lamb’s stand, Saccone said, ‘That’s typical Democrats talking points. Look, the price of health care was skyrocketing under Obamacare.’” [WTAE, 1/31/18]

Club For Growth Endorsed Saccone Because Of His Commitment To Repealing The ACA. 

“Today, the Club for Growth PAC announced its endorsement of Rick Saccone for the U.S. House of Representatives.  Saccone is running for the open seat vacated earlier this year by Tim Murphy (PA-18). ‘Club for Growth PAC is proud to endorse Rick Saccone in his run for Congress,’ stated Club for Growth PAC President David McIntosh.  ‘Rick is a constitutional conservative who supports lower taxes, repealing Obamacare, and limiting the size of government. In his time serving in the General Assembly, Rick has proven to be a strong conservative voice and been a strong advocate for Pennsylvania’s taxpayers.’” [Club for Growth Press Release, 12/19/17]

Saccone Applauded Repeal Of The Individual Mandate.

“I am pleased that the House and Senate have come together and passed a repeal of the onerous and punitive Obamacare mandate that was forced upon the country by the liberal wing of the Democratic Party led by Nancy Pelosi. The repeal was supported by 63% of Americans who agreed that the individual mandate tax was an excessive encroachment on taxpayers.  Alarmingly, the mandate disproportionately hurt low-income households – the very people Obamacare was to care for. According to the IRS, nearly 80 percent of households that pay the penalty make less than $50,000 annually. As a result, low-income families paid up to $2,085 this year not being able to afford health insurance. Obamacare premiums have skyrocketed so high that millions of Americans were forced to pay the penalty because they could not afford coverage.” [Rick Saccone for Congress Press Release, 12/21/17]

Saccone: “While Health Care Coverage Is Vital To All Of Us, The Government Should Not Involve Itself In Our Health Care Decisions.”

“While health care coverage is vital to all of us, the government should not involve itself in our health care decisions. We are all too aware of the inefficiencies of government bureaucracy, and the last thing that we need is for them to meddle with our health. I join the majority of Americans today in applauding Congress for repealing the Obamacare mandate penalty that will no longer burden taxpayers.” [Rick Saccone for Congress Press Release, 12/21/17]

In News, Administration

Protect Our Care Coalition Highlights Women’s Health Gains, Trump Attempts to Diminish Them During Protect Women’s Care Week

In honor of International Women’s Day, last week the Protect Our Care coalition celebrated Protect Women’s Care week, outlining the achievements made in women’s care under the Affordable Care Act and highlighting the ongoing threats from the Trump Administration and its Republican allies in Congress to roll back this progress. Here are the biggest gains made under the ACA, the worst attacks from Trump, and the grassroots action standing up to the sabotage of women’s care:

WOMEN’S HEALTH HAS IMPROVED TREMENDOUSLY UNDER THE ACA

As study after study shows, the Affordable Care Act has increased women’s access to health care and improved women’s health outcomes. New data show the improved health and economic outcomes women are experiencing now that the Affordable Care Act has covered more women than ever before, improved breast cancer and maternity care, guaranteed copay-free access to birth control, and stopped insurance companies from charging women more. These are some of the gains in women’s health care that President Trump and his Republican allies want to reverse through repeal and sabotage:

Historic Gains in Women’s Coverage

ACA Brought Women’s Uninsured Rate To All-Time Low. “By 2016, the number of working-age women…lacking health insurance had fallen by almost half since 2010, from 19 million to 11 million.” [Commonwealth Fund, 8/10/17]

After Medicaid Expansion, More Women Of Reproductive Age Have Health Coverage. “ACA Medicaid expansions decreased uninsurance among women of reproductive age with incomes below 100% FPL by 13.2 percentage points.” [Women’s Health Issues Journal, 2/28/2018]

With Pre-Existing Discrimination Ban, More Women With Cancer Histories Now Have Coverage

Women With Gynecologic Cancer More Likely To Be Insured Following ACA. “Between 2011 and 2014…uninsured rates decreased by 50% for those diagnosed with uterine and ovarian cancer…and by 25% in cervical cancer.” [Gynecologic Oncology, June 2017]

Better Access to Contraception

Under ACA, Women Saved $1.4 Billion On Birth Control Pills Alone In 2013. “Prior to the ACA, co-pays as low as $6 deterred women from obtaining the health care that they needed, and some women chose to forgo birth control because of cost. But data on prescription drug use in 2013, after the birth control benefit went into effect, indicate a nearly five percent uptick in filled birth control pill prescriptions…The birth control benefit saved women $1.4 billion on birth control pills alone in 2013.” [National Women’s Law Center, 5/3/17]

Improved Maternity Care & Newborn Outcomes

Before The ACA, 75% Of Individual Market Plans Did Not Include Maternity Care. “Three in four health plans in the non-group insurance market did not cover delivery and inpatient maternity care in 2013, before the [ACA] essential health benefits requirement took effect.” [Kaiser Family Foundation, 6/14/17]

ACA Improved The Health Of Women And Their Babies. “The dependent coverage provision of the Affordable Care Act (ACA) that allowed young adults to stay on their parents’ insurance until they were 26 was associated with increased use of prenatal care, increased private insurance payment for births, and a modest reduction in preterm births.” [JAMA, 2/13/18]

Infant Mortality Decreased In States That Expanded Medicaid. “New data shows that infant mortality rates decreased in states that expanded Medicaid.” [Newsweek, 1/31/18]

Better Breast Cancer Care & Prevention

Medicaid Expansion Improves The Quality Of Breast Cancer Care. “[The study] found a connection between Medicaid expansion and improved quality of breast cancer care…The number of screening mammograms covered by Medicaid increased from 5.6 percent before expansion to 14.7 percent afterward.” [Daily Kos, 2/21/18]

Following ACA’s Lower Costs, Mammogram Screening Rates Increase. “After the [ACA] eliminated cost sharing for screening mammograms, their rate of use rose six percentage points among older woman for whom such screenings were recommended.” [Brown University, 1/17/18]

TRUMP’S 11 WORST ATTACKS ON WOMEN

From restricting women’s access to family planning services to allowing insurance companies to change women more than men for health insurance, the Trump Administration has tirelessly attacked American women’s health. Here are the top 11 ways Trump is setting American women’s health back:

  1. Letting Insurance Companies Charge Women More Than Men: Prior to the Affordable Care Act, 92 percent of plans in the market charged women up to 1.5 times as much as they charged men, in a practice known as gender rating. The Trump Administration is taking us back to the days when women could be charged more. Under the Trump Administration’s recent “short-term” rule, insurers would be able to skirt the ACA’s gender rating provision that banned insurers from charging different rates for men and women.
  2. Letting Insurance Companies Charge More For “Pre-Existing Conditions” Like Pregnancy & Being A Woman: The Affordable Care Act prevents insurers from denying, dropping, or charging more because of a pre-existing condition like cancer, or even, having a C-section. But, the Trump Administration’s new “short-term” plan rule allows insurers to deny coverage because someone has a pre-existing condition, and will raise costs and jeopardize coverage for nearly 30 million women who have a pre-existing condition.
  3. Making Maternity Care More Expensive: Before the Affordable Care Act, 75 percent of non-group plans did not cover delivery and inpatient care for maternity care. The ACA The Trump Administration and its Republican allies continue to advocate for policies, such as short-term and association health plans, that are not required to cover “essential health benefits,” and can thus force women to pay the nearly $20,000 it costs to give birth out of pocket.
  4. Defunding Planned Parenthood:  In January 2018, the Trump Administration announced it would roll back Obama Administration guidance that warned states not to carve Planned Parenthood out of their Medicaid providers, signaling its willingness to place even higher barriers in the way of women’s access to health care.
  5. Making Women Pay More For Birth Control: The Trump Administration’s proposed rule to let any employer opt out of offering health insurance that covers birth control rolls back the ACA’s guarantee that women may access copay-free contraception.
  6. Cutting Medicaid: President Trump’s calls to cut Medicaid put women’s lives and jobs at risk. The Trump Administration’s recent budget slashed Medicaid funding by more than $1 trillion over the next decade. These cuts will jeopardize the care of the nearly 13 million women of reproductive age who rely on Medicaid, including 31 percent of African-American women and 27 percent of Hispanic women in this age group. Moreover, 22.8 percent of women in the workforce are employed in the health industry, meaning their jobs may be at risk as well.
  7. Making New Moms Choose Between Working Or Losing Coverage: Almost two-thirds of those who would lose Medicaid coverage as a result of work requirements are women, and disproportionately women of color. This is in part because women are more likely to be caregivers for sick family members and children. Under these rules, a new mom would have 60 days to find health coverage after giving birth or risk their family’s health coverage.
  8. Stacking Federal Courts With Anti-Choice Judges: The next generation of American women will face a growing threat posed by an increasingly anti-choice federal judiciary. Twelve of Trump’s judicial nominees were appointed to circuit courts during his first year – more than any other first-year president in American history.
  9. Reversing Progress Against Breast Cancer: Republicans’ repeated attempts to undermine the Affordable Care Act’s essential health benefits threaten landmark progress in women’s preventive health. New research finds that the ACA requirement that plans (including Medicare) must cover recommended preventive care without a copay led to a significant increase in the number of women receiving mammography screenings.
  10. Cutting Funding For Teen Pregnancy Prevention Programs: The administration slashed two years off of five-year grants dedicated to teen pregnancy prevention research, which have already been promised to organizations across the country.
  11. Allowing States To Defund Clinics That Offer Abortion Care: Trump signed a bill allowing states to withhold Title X family planning funds from health care providers that offer abortion-related care. Thirteen states used to withhold the Title X money from abortion providers before the Obama administration blocked them. (Because of the Hyde Amendment, federal funds can’t be used to pay for abortions, so the Title X money went to other health services at those clinics.) The legislation allows them to withhold the funds again and redirect them to providers that don’t offer abortion care.

MEDICAID CUTS DISPROPORTIONATELY HURT WOMEN

Republicans are waging a war on Medicaid, and it’s hurting American women the most. Proposed cuts to Medicaid disproportionately impact women, who make up over two-thirds of adults with Medicaid coverage.

MEDICAID CUTS TAKE WOMEN’S ACCESS TO COVERAGE AND CARE

Millions of Women Rely on Medicaid for Health Care. More than 16.3 million women in the U.S. are enrolled in Medicaid. [Kaiser Family Foundation, 2017]

Medicaid Helps Pay For Long-Term Care, Mostly For Elderly Women. 69 percent of the 9 million people covered by both Medicare and Medicaid are women. [Center on Budget and Policy Priorities, 5/11/17]

MEDICAID CUTS RESTRICT REPRODUCTIVE & MATERNITY CARE FOR WOMEN

Medicaid Is The Largest Single Payer Of Pregnancy-Related Services. Medicaid financed 48 percent of all U.S. births in 2010. [Kaiser Family Foundation, 6/22/17]

Medicaid Is The Largest Financier Of Publicly Funded Family Planning Services. Medicaid accounts for 75 percent of all public expenditures on family planning services. [Kaiser Family Foundation, 6/22/17]

Women With Medicaid Are More Likely Than Those With Private Insurance To Have Discussed Sexual Health With Providers.  “In 2013, women with Medicaid coverage were more likely than women with private insurance to report they had spoken with a provider about sexual history, HIV, and intimate partner violence.” [Center on Budget and Policy Priorities, 5/11/17]

The Administration’s Attacks On Medicaid Jeopardize Women’s Access To Cancer Screening, Maternity Care, And Birth Control. “Fewer people on Medicaid means fewer women accessing health and reproductive services that do things like cover cancer screenings, improve access to birth control, and make sure moms and babies have health care throughout a pregnancy and in the months after a baby is born.” [Vox, 1/31/18]

NEW MEDICAID REQUIREMENTS MAKE IT HARDER FOR WOMEN TO GET COVERED

Nearly 2 In 3 People Who Would Lose Medicaid Coverage Because Of Work Requirements Are Women. “Almost two-thirds (62 percent) of those who could lose Medicaid coverage due to work requirements are women.” [Planned Parenthood, 1/11/18]

Work Requirements Punish Women Caring For Loved Ones. “It is already challenging for women with health conditions or who are caring for loved ones to work, and Medicaid work requirements will only make this harder…This means, for example, that a woman not covered by the FMLA who is enrolled in Medicaid could lose her job if she takes time away from work to get cancer treatment, and then lose her health coverage due to Medicaid work requirements. Losing Medicaid could be a death sentence for this woman.” [National Partnership for Women and Families, 2/28/18]

Medicaid Work Requirements Pose A Unique Burden On Women Of Color. “Due to racism and other systemic barriers that have contributed to income inequality, women of color are disproportionately likely to be insured through Medicaid: 31 percent of Black women and 27 percent of Hispanic women aged 15–44 were enrolled in Medicaid in 2015, compared with 16 percent of white women. Medicaid pays for nearly half of all U.S. births and is the largest payer of publicly funded family planning services.” [National Partnership for Women and Families, 2/28/18]

MEDICAID CUTS TAKE WOMEN’S JOBS

Medicaid Creates Jobs In The Health Industry, Which Employs Nearly 23% Of All Women In The American Workforce. “Women’s high participation in the health care industry, which employs more than 22.8% of all women in the workforce,4 means that Medicaid disproportionately creates jobs for women. This is especially true because Medicaid covers services that other payors typically do not cover and are more likely to be delivered by women, like long-term services and supports.” [National Women’s Law Center, June 2017]

Threats To Medicaid Are Threats To Women’s Livelihoods. “Women would be uniquely impacted by these changes, not only because women disproportionately are enrolled in Medicaid, but also because women occupy jobs whose funding relies on Medicaid. Such changes would threaten the livelihood of millions of women and families across the country.” [National Women’s Law Center, June 2017]

EXPERTS: CUTTING MEDICAID HURTS WOMEN

Black Women’s Health Imperative: Medicaid Work Requirements Threaten Health Care For Low-Income Black Women.  “There is a clear disconnect between this false and discriminatory narrative and the actual reality that Black women in poverty face every day. The truth is that over 70% of Black women on Medicaid already work hard everyday to support their families but, due to systemic inequalities, they earn less and face unfair barriers to health care. These jobs simply do not pay enough for women to afford health insurance.” [Black Women’s Health Imperative, 1/11/18]

Planned Parenthood: Women Lose The Most Under Trump’s Latest Attack On Medicaid. “With about one in five women of reproductive age relying on Medicaid for their health care and women accounting for approximately 62 percent of Medicaid enrollees who could lose coverage because of this enrollment restriction, this change will especially hurt women, particularly those who already face the highest barriers to care.” [Planned Parenthood, 1/11/18]

National Women’s Law Center: Medicaid Work Requirements Would Reduce Access To Care For Women Without Increasing Employment. “Many of the arguments underlying work requirements are designed to stoke racial resentment about entitlement programs, particularly playing upon harmful stereotypes of women of color…work requirements would endanger individuals’ health and economic security in many cases, with a particularly harsh impact on women.” [National Women’s Law Center, April 2017]

SEN. MURRAY JOINS LEADING WOMEN’S GROUP TO STAND UP FOR WOMEN’S CARE

But despite the rampant attacks coming from the Administration and Republicans in Congress, advocates have refused to back down. Last Thursday, on International Women’s Day, Sen. Patty Murray joined Protect Our Care, the National Partnership for Women & Families, the Black Women’s Health Imperative, and Planned Parenthood Federation of America to demand an end to the Trump administration’s attacks on women’s health and health care. As Kate Martin of the National Partnership wrote:

“‘Over and over again, President Trump and Vice President Pence have made clear they intend to interfere every way they can with a woman’s freedom to make health care decisions that are right for her,’ said Senator Murray. ‘People won’t stop resisting. Women who speak up for their rights are not going away. … We will continue to reject – loud and clear – the partisan, ideological Trump-Pence agenda that hurts women and families.’

The attacks include advancing policies that let insurance companies charge more for “pre-existing conditions” like pregnancy – or just being a woman. The Affordable Care Act (ACA) prevents insurers from denying, dropping or charging more because of a pre-existing condition like cancer, or even having a C-section. It also bans insurers from charging women higher rates than men (before the ACA, 92 percent of plans charged women up to 1.5 times as much as they charged men). But the Trump administration’s recent proposed “short-term” plan rule would allow insurance companies to sell more policies that skirt these protections, ultimately punishing women and all people with pre-existing conditions and destabilizing the health insurance marketplace. It’s just the latest in the administration’s ongoing attempt to sabotage the ACA…

These attacks are as unpopular as they are relentless, and they threaten the health, well-being and economic security of tens of millions of women and families. You can help fight back: Call your members of Congress and urge them to prioritize our health and health care, instead of a partisan political agenda. We all need to speak up now – and #pressforprogress on protecting our health care – before it’s too late!”

WOMEN (AND MEN) ACROSS THE COUNTRY STAND UP FOR WOMEN’S HEALTH

And in states across the country, women held rallies in honor of Protect Women’s Care Week and made their voices heard.

All in all, Protect Women’s Care Week was a smashing success – women, and men, across the country stood up together made their voices loud and clear in support of women’s health. Enough is enough – it’s time for the Trump Administration to end their war on women’s health care.

In News, Administration

“Premiums Could Increase 90 Percent”: The Trump Administration’s Effect on Future Premiums By the Headlines

Yesterday, Covered California released an analysis outlining the future of the individual market under the Trump Administration and its constant barrage of sabotage. Its findings were striking:

  • All states’ individual markets risk higher than normal premium increases — ranging from 35 to 90 percent over three years — due to continued uncertainty at the federal level.
  • Premium increases in the individual markets will likely range from 12 to 32 percent in 2019, and cumulative increases from 2019-2021 will range from 35 percent to more than 90 percent.
  • Increases are on average more than double the rate of medical inflation as a result of healthier consumers leaving the individual market.
  • 17 states are more likely — because of their historic risk mix and enrollment — to have cumulative premium increases of 90 percent or more and 19 additional states are at a higher risk of experiencing hikes of 50 percent.

All in all, the report makes clear in no uncertain terms just how much the repeal and sabotage campaign being carried out by the Trump Administration and its Republican allies in Congress is harming Americans. Here’s how the report was covered in headlines:

Washington Post: Premiums for ACA health insurance plans could jump 90 percent in three years

The Hill: Study: ObamaCare premiums could increase 90 percent over three years for some states

Insurance Business Magazine: Report: States could see average health premium increases up to 30%

Salon: Health care premiums set to spike highest in Trump country

San Francisco Chronicle: California health insurance premiums could soar, analysis projects

Berkshire Eagle: Premiums for plans could jump 90% in 3 years

Stamford Advocate: Study: Connecticut premiums could rise 35 percent

CT Post: Study: Connecticut premiums could rise 35 percent

KCRA: California health care exchange head says rates to increase

In News, Administration

REACTION ROUNDUP: Despite “Wildly Illegal” Affordable Care Act End-Run, Trump Administration Urges Idaho to Continue Sabotage

Yesterday, the Trump Administration confirmed that Idaho’s Affordable Care Act end-run is wildly illegal. Even so, CMS encouraged Idaho to explore other ways to sabotage the law.

Here’s a roundup of reactions to the Trump Administration’s continuing bad faith on protecting Idahoans’ health care:

Idaho Statesman: “With Some Modifications, The Noncompliant Plans Could Be Turned Into Short-term Plans For Customers.”

“Verma said her agency was sympathetic to Idaho officials’ concerns, and said President Trump is ‘committed to doing everything in his power to increase competition, choice, and access to lower-priced, high-quality health care options for all Americans.’ ‘As you know, the Patient Protection and Affordable Care Act (PPACA) is failing to deliver quality health care options to the American people and has damaged health insurance markets across the nation, including Idaho’s,’ Verma wrote, noting that premium rates for coverage through the Idaho health insurance exchange have increased by more than 91 percent from 2014 to 2018, while insurance companies continue to incur losses. Verma also outlined some options that she believes Idaho could legally take under a recently proposed federal rule. That rule would expand the availability of short-term, limited duration health insurance by allowing consumers to buy short-term plans that would cover them for just under a year. She said that with some modifications, the noncompliant plans could be turned into short-term plans for customers.” [Idaho Statesman, 3/8/18]

Sen. Ron Wyden: “While They Claim To Be Upholding The Law, They Are Explicitly Inviting Idaho And Other States To Sell Short-term, Junk Insurance — The Exact Opposite Of The Protections Put In Place By The Affordable Care Act.”

“ObamaCare supporters were pleased but not overly impressed by the CMS move. ‘The Trump administration is talking out of both sides of their mouth,’ said Sen. Ron Wyden (D-Ore.). ‘While they claim to be upholding the law, they are explicitly inviting Idaho and other states to sell short-term, junk insurance — the exact opposite of the protections put in place by the Affordable Care Act.’” [The Week, 3/8/18]

New York Times: “Verma Said That Idaho Had Other Options And Could Perhaps Achieve Much Of What It Wanted To Do Under A Regulation Proposed Last Month By Mr. Trump.”

“While rejecting the Idaho plan in its current form, Ms. Verma encouraged the state to keep trying, and she suggested that ‘with certain modifications,’ its proposal might be acceptable… Ms. Verma said that Idaho had other options and could perhaps achieve much of what it wanted to do under a regulation proposed last month by Mr. Trump.” [New York Times, 3/8/18]

Washington Post: “‘We Sincerely Appreciate Your Dedication To The People Of Idaho And Your Efforts To Address The Damage Caused By The [ACA],” Said The Letter.”

“The four-page letter to Idaho Gov. C. L. “Butch” Otter (R) and Cameron, made public early Thursday evening, straddles the Trump administration’s antipathy for the ACA with its need to enforce the sprawling 2010 health-care law that is a path to insurance coverage for millions of Americans. ‘We sincerely appreciate your dedication to the people of Idaho and your efforts to address the damage caused by the [ACA],” said the letter, signed by CMS Administrator Seema Verma. The letter said the president is eager to give states ‘as much flexibility as possible under the law to address the unique needs of their health insurance markets.’” [Washington Post, 3/8/18]

Rep Frank Pallone: “The Administration Continues Its Many Efforts To Undermine The Law And Chip Away At Its Protections, Including By Encouraging Idaho To Sell Junk Plans In Another Way.”

“Democrats cheered the Trump administration’s decision, but they still criticized other actions HHS has taken in recent months to weaken the law. ‘Make no mistake, however, while this is the right decision, the Administration continues its many efforts to undermine the law and chip away at its protections, including by encouraging Idaho to sell junk plans in another way,’ said Rep. Frank Pallone of New Jersey, the top Democrat on the House Energy and Commerce Committee.” [Politico, 3/8/18]

Talking Points Memo: “Verma Notes In The Letter That Enforcing The ACA Is ‘Certainly Not Our Preference.”

“Verma notes in the letter that enforcing the ACA is “certainly not our preference,” and encourages Idaho to find ways within the letter of the law to accomplish the same goals. She specifically advises the state to look into creating short-term health insurance plans—which recently received the Trump administration’s blessing to be sold in violation of the ACA’s regulations. [TPM, 3/8/18]

Bloomberg: “The White House Has Suggested To Congress That People Should Be Able To Renew Short-term Plans Without Being Subject To Medical Underwriting, The Process By Which Insurers Can Exclude Or Charge More For Pre-Existing Conditions.”

“Idaho’s proposal has put the Trump administration in a position it has found itself in before: charged with upholding a law it wants to get rid of, and that it has taken active steps to dismantle. Verma left open the possibility that plans like the state was proposing could be sold in a different form. If they were offered as short-term policies instead of annual coverage, they might be allowable, she said. The administration has pushed short-term plans as a way to offer consumers less expensive, less comprehensive options. In her letter to Idaho authorities, Verma said that ‘with certain modifications, these state-based plans could be legally offered’ as short-term plans. The White House has suggested to Congress that people should be able to renew short-term plans without being subject to medical underwriting, the process by which insurers can exclude or charge more for pre-existing conditions.” [Bloomberg, 3/8/18]

CNN: “Verma [Said] That She Wanted To Work With Idaho And Other States To Repair The ‘Damage’ Caused By The Affordable Care Act.”

“However, Verma did say that she wanted to work with Idaho and other states to repair the ‘damage’ caused by the Affordable Care Act. She suggested that Idaho could legally implement many of its proposals through short-term health insurance plans, which don’t have to adhere to all of Obamacare’s rules. The Trump administration is on course to allow insurers to offer these plans for up to a year, rather than just three months.” [CNN, 3/8/18]

Modern Health Care: “Secretary Alex Azar Told Insurers Thursday That The Trump Administration Will Do What It Can ‘Within The Law’ To Let Insurers Offer More Affordable Plans That Don’t Meet ACA Requirements.”

“The Trump administration on Thursday unexpectedly shot down Idaho’s effort to let insurers sell health plans that don’t comply with the Affordable Care Act’s coverage mandates, thwarting conservative efforts to unravel the law’s consumer protections directly for now. But CMS Administrator Seema Verma indicated that Idaho and other states could achieve the same goal by refashioning such noncompliant health plans as short-term products, which the administration would allow under a controversial proposed rule. HHS Secretary Alex Azar told insurers Thursday that the Trump administration will do what it can ‘within the law’ to let insurers offer more affordable plans that don’t meet ACA requirements. In a letter to Idaho Republican Gov. Butch Otter and state Insurance” [Modern Health Care, 3/8/18]

Washington Times: Verma: “This Is Certainly Not Our Preference.”

“‘If a state fails to substantially enforce the law, the Centers for Medicare & Medicaid Services (CMS) has a responsibility to enforce these provisions on behalf of the State,’ Ms. Verma added. ‘This is certainly not our preference.’ She said Idaho, with some tweaks, might be able to offer similar plans under Mr. Trump’s bid to offer short-term plans for up to a year. There is a GOP effort to codify this change and let people renew these plans, setting up a parallel market for healthier people that could siphon valuable enrollees from Obamacare’s exchanges.” [Washington Times, 3/8/18]

Business Insider: Verma: Idaho’s Attempt “Was Admirable.”

“Verma said that while Idaho’s desire to bring down costs — the stated reason for the policy — was admirable, it was also illegal. ‘CMS is committed to working with states to give them as much flexibility as permissible under the law to provide their citizens the best possible access to healthcare,’ Verma said.” [Business Insider, 3/8/18]

The Hill: “Verma’s Letter Offered Alternatives To The State.”

“Verma’s letter offered alternatives to the state, including embracing a Trump administration move to allow different kinds of cheaper, skimpier insurance plans, known as short-term plans.” [The Hill, 3/8/18]

Vox: “The CMS Letter Did Include A Caveat That Provides Some Consolation To Republican Officials – In Washington And Boise – Who Want To Unwind Obamacare.”

“It is a victory for the rule of law, given how openly Idaho was defying the ACA. But the CMS letter did include a caveat that provides some consolation to Republicans officials — in Washington and in Boise — who want to unwind Obamacare. The state could conceivably tweak its proposal, Verma noted, to align with the Trump administration’s own proposed regulations to expand short-term insurance plans — which also do not have to comply with the ACA’s insurance regulations. It would be a back door to achieve the same end (providing an escape hatch from Obamacare for healthier customers, one that is likely to lead to higher premiums for those left behind in the law’s markets) and would be more clearly in line with the administration’s agenda.” [Vox, 3/8/18]

In News

Trump Administration, Painted Into Legal Corner in Idaho, Doubles Down on Junk Plans

In reaction to the Trump Administration’s confirmation that Idaho’s Affordable Care Act end-run is wildly illegal, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“When painted into a corner, the Trump Administration was forced to agree with the lawyers that Idaho’s wildly illegal proposal was doomed to fail in the courts. But make no mistake: Trump’s HHS continues to sabotage the Affordable Care Act at every opportunity. In fact, in its letter to Idaho, the Trump Administration encourages Idaho insurance companies to instead sell junk plans that discriminate against patients with pre-existing conditions and ignore Affordable Care Act consumer protections. Unless this Administration stops pushing junk plans, cutting Medicaid, and trying to repeal the Affordable Care Act, President Trump, Secretary Azar, and Administrator Verma will continue to have zero credibility on health care.”

In News, Capitol Hill

The Barrasso Bill: Less Choices, Worse Outcomes, More Repeal and Sabotage

Washington, D.C. – In response to Sen. John Barrasso’s (R-WY) introduction of the latest Republican ACA repeal and sabotage bill, the Improving Choices in Health Care Coverage Act, which would codify the expansion of the Trump Administration’s proposed short-term, junk insurance plans, Protect Our Care Campaign Director Brad Woodhouse release the following statement:

“This legislation is nothing more than the GOP’s latest attack against Affordable Care Act, and it should be dead on arrival in the Senate. A permanent embrace of junk insurance plans would once again allow insurers to discriminate against those with pre-existing conditions and re-implement lifetime caps, eliminate essential health benefits, allowing maternity care and substance abuse treatment to be denied, and leave Americans holding the bill – often running into the hundreds of thousands of dollars.

“Like the many GOP sabotage legislative efforts before it, the Barrasso bill must be rejected. Congressional Republicans should instead be work with their Democratic counterparts to come up with commonsense, bipartisan solutions which actually stabilize the marketplace and provide relief to Americans. Enough is enough – it’s time for the GOP to end their war on health care.”

In News, Administration

Trump’s 11 Worst Attacks On Women’s Health

From restricting women’s access to family planning services to allowing insurance companies to change women more than men for health insurance, the Trump Administration has tirelessly attacked American women’s health. During Protect Women’s Care Week of Action, Americans are demanding an end to President Trump’s war on women’s health.

Here are the top 11 ways Trump is setting American women’s health back:

1. Letting Insurance Companies Charge Women More Than Men: Prior to the Affordable Care Act, 92 percent of plans in the market charged women up to 1.5 times as much as they charged men, in a practice known as gender rating. The Trump Administration is taking us back to the days when women could be charged more. Under the Trump Administration’s recent “short-term” rule, insurers would be able to skirt the ACA’s gender rating provision that banned insurers from charging different rates for men and women.

2. Letting Insurance Companies Charge More For “Pre-existing Conditions” Like Pregnancy & Being A Woman: The Affordable Care Act prevents insurers from denying, dropping, or charging more because of a pre-existing condition like cancer, or even, having a C-section. But, the Trump Administration’s new “short-term” plan rule allows insurers to deny coverage because someone has a pre-existing condition, and will raise costs and jeopardize coverage for nearly 30 million women who have a pre-existing condition.

3. Making Maternity Care More Expensive: Before the Affordable Care Act, 75 percent of non-group plans did not cover delivery and inpatient care for maternity care. The ACA The Trump Administration and its Republican allies continue to advocate for policies, such as short-term and association health plans, that are not required to cover “essential health benefits,” and can thus force women to pay the nearly $20,000 it costs to give birth out of pocket

4. Defunding Planned Parenthood:  In January 2018, the Trump Administration announced it would roll back Obama Administration guidance that warned states not to carve Planned Parenthood out of their Medicaid providers, signaling its willingness to place even higher barriers in the way of women’s access to health care

5. Making Women Pay More For Birth Control: The Trump Administration’s proposed rule to let any employer opt out of offering health insurance that covers birth control rolls back the ACA’s guarantee that women may access copay-free contraception.

6. Cutting Medicaid: President Trump’s calls to cut Medicaid put women’s lives and jobs at risk. The Trump Administration’s recent budget slashed Medicaid funding by more than $1 trillion over the next decade. These cuts will jeopardize the care of the nearly 13 million women of reproductive age who rely on Medicaid, including 31 percent of African-American women and 27 percent of Hispanic women in this age group. Moreover, 22.8 percent of women in the workforce are employed in the health industry, meaning their jobs may be at risk as well.

7. Making New Moms Choose Between Working Or Losing Coverage: Almost two-thirds of those who would lose Medicaid coverage as a result of work requirements are women, and disproportionately women of color. This is in part because women are more likely to be caregivers for sick family members and children. Under these rules, a new mom would have 60 days to find health coverage after giving birth or risk their family’s health coverage.

8. Stacking Federal Courts With Anti-Choice Judges: The next generation of American women will face a growing threat posed by an increasingly anti-choice federal judiciary. Twelve of Trump’s judicial nominees were appointed to circuit courts during his first year – more than any other first-year president in American history.

9. Reversing Progress Against Breast Cancer: Republicans’ repeated attempts to undermine the Affordable Care Act’s essential health benefits threaten landmark progress in women’s preventive health. New research finds that the ACA requirement that plans (including Medicare) must cover recommended preventive care without a copay led to a significant increase in the number of women receiving mammography screenings.

10. Cutting Funding For Teen Pregnancy Prevention Programs: The administration slashed two years off of five-year grants dedicated to teen pregnancy prevention research, which have already been promised to organizations across the country.

11. Allowing States To Defund Clinics That Offer Abortion Care: Trump signed a bill allowing states to withhold Title X family planning funds from health care providers that offer abortion-related care. Thirteen states used to withhold the Title X money from abortion providers before the Obama administration blocked them. (Because of the Hyde Amendment, federal funds can’t be used to pay for abortions, so the Title X money went to other health services at those clinics.) The legislation allows them to withhold the funds again and redirect them to providers that don’t offer abortion care.

 

In News, Administration

Protect Our Care Responds to White House’s Secret Stabilization Sabotage List

Washington, DC – In response to reports that President Trump’s White House is circulating a secret plan to sabotage bipartisan talks on mitigating the harm caused by President Trump’s destructive health care sabotage, Protect Our Care Campaign Chair Leslie Dach released the following statement:

“As if his disregard for America’s health care system wasn’t obvious enough already, President Trump is now trying to sabotage bipartisan Congressional efforts to fix Trump’s own sabotage. Trump just took Americans’ health insurance premiums as a hostage to his demands that insurance companies get to sell junk plans and charge five times more to people over 50. Democrats and moderate Republicans must stand firm against this outrageous anti-senior, anti-woman wish list.

“Congress needs to reject this bomb-throwing from the White House and take action on bipartisan solutions that contain costs for American families, not on extreme policies like junk plans that can discriminate against pre-existing conditions, an age tax, and anti-woman restrictions that people across the country rejected firmly during last year’s Affordable Care Act repeal debate. It’s outrageous that Trump continues to ignore the message Americans have sent loud and clear: enough is enough. Stop the war on our health care.”

In News, Administration

Trump’s Own Budget Experts Admit His Sabotage Inflated Premiums

Washington, D.C. – According to new reporting, President Trump’s own Office of Management and Budget has found that restoring the cost-sharing reduction payments (CSRs) that Trump unilaterally canceled last fall would lower premiums 15-20%. Protect Our Care Campaign Director Brad Woodhouse released the following statement in response:

“Donald Trump’s unilateral decision to end cost-sharing reduction payments triggered a massive and unnecessary increase in premiums. Now, Trump’s own Administration is admitting the damage that he caused. Once again, President Trump has slipped on a banana peel he threw on the floor himself. But Trump’s CSR sabotage was only the first strike in a deluge of Administration actions to damage and destabilize the health markets and drive up costs, and addressing the CSR issue alone is not sufficient to mitigate the harm ensuring Trump Administration sabotage actions are now set to drive up premiums by double digits again next year. That’s why any stabilization package worth its weight must match the scope of the damage inflicted by Trump and his Administration.”

OMB: Funding insurer subsidies will lower ACA premiums 15-20%

Axios // Caitlin Owens and Jonathan Swan // March 6, 2018

Funding the Affordable Care Act’s cost-sharing subsidies would lower premiums by 15-20%, according to an analysis being circulated around congressional offices from the Office of Management and Budget. OMB says those subsidies would be more cost-effective than a new reinsurance program.

Why it matters:

Reinsurance has been gaining steam on Capitol Hill, and Sen. Susan Collins is still owed a vote on a reinsurance bill. But the White House budget office is saying Congress could get a better deal by restoring a funding stream that President Trump cut off last year.

The numbers:

  • President Trump’s decision to quit making the cost-sharing payments this year caused premiums to rise by 15-20%, the analysis says, and funding them next year would undo that increase.
  • It also says that for every $1 billion spent on a reinsurance program — which would compensate insurers for their most expensive claims — individual market premiums would decrease by only 1%.

Key quote:

“We project funding CSRs would have a greater impact on reducing premiums than any of the reinsurance funding levels that have been proposed, and would have more bang for the buck in terms of Federal spending.”

In News, Administration, Capitol Hill

Protect Our Care Outlines Must-Haves to Repair Trump-Inflicted Sabotage & Stabilize Health Markets

Washington, D.C. – As time runs out to repair the severe damage President Trump has inflicted on health care markets and stabilize them in order to protect American families from crippling rate hikes and coverage losses, Protect Our Care Campaign Director Brad Woodhouse released the following statement and the minimum policy prescriptions Republicans must include in any stabilization bill to roll back President Trump’s and the GOP’s sabotage of American health care:

“From the moment Donald Trump took the oath of office, his Administration and its Republican allies in Congress have waged an unrelenting war on our health care. In the last week, analyses have been published showing that Administrative sabotage through short-term junk plans will increase premiums eighteen percent and increase the number of uninsured by nine million people; sabotage through the expansion of association health plans will increase individual market premiums four percent and reduce enrollment in ACA plans by three million; and the sabotage campaign against the open enrollment period has eroded consumer confidence. Just yesterday, in fact, the Administration approved a Medicaid waiver from Arkansas designed to deny the most vulnerable  health care coverage.

“Current Congressional Republican efforts to undo the damage they and President Trump have caused are wholly insufficient and rely on failed ideas like high risk pools which will leave Americans with higher costs and worse coverage. Make no mistake, impending rate hikes and coverage losses are the responsibility of Republicans and President Trump, and they are the ones who will pay the price with the public and at the polls if they don’t do what is necessary to reverse the damage. Any bill to stabilize the insurance marketplaces and reverse Republican-caused sabotage must:

  • Expand affordability by increasing the value of premium tax credits and cost-sharing reduction protections;
  • Ensure cost sharing protections fulfill their original purpose of improving affordability and Basic Health Plans are fully funded in order to protect coverage levels;
  • Apply the consumer protections of the Affordable Care Act – such as guaranteed issue, community rating, protections for preexisting conditions – to short term duration plans and protect the essential health benefits from being undermined;
  • Provide for a national meaningful reinsurance program that reduces current premium levels and stabilizes the market;
  • Adequately fund outreach and enrollment efforts;
  • Reject bringing back high-risk pools and Association Health Plans; two failed experiments that would have a destabilizing effect on the marketplace by incentivizing healthier individuals to leave the ACA compliant market, thereby negatively affecting the risk pool and increasing premiums; and
  • Reject punitive and duplicative new anti-choice restrictions on health centers.

“Many of these provisions are included in the recent bills introduced in the Senate by Senator Tammy Baldwin (D-WI) and in the House by Frank Pallone (D-NJ), Richard Neal (D-MA), and Bobby Scott (D-VA).  If Republicans in Congress truly care about stabilization, they will work with Democrats to adopt these provisions and implement a bipartisan, common-sense package to lower premiums and expand coverage options. Anything else will be mere crocodile tears from elected officials more worried about partisan politics than Americans’ health.”