Monthly Archives

April 2018

In News

GOP Blows Trillion-Dollar Hole in Budget, Responds by Attempting to Decimate Americans’ Health Care

In response to the House of Representatives voting on a balanced budget amendment, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“During the same week that the Congressional Budget Office found that the GOP’s Trump Tax will blow a trillion-dollar hole in the budget, Congressional Republicans have decided that fiscal prudence is of the utmost importance? Give me a break. By offering a proposal that would most likely mean devastating cuts in Medicare and Medicaid, Republicans are making their priorities clear: to pay for tax cuts for the wealthy and big corporations, they want to put the health security of millions of seniors, children, and people with disabilities on the chopping block. It is useless to pretend this vote is anything other than another salvo in their relentless war on health care. Thankfully, it will be going nowhere.”

In News

This Week in the War on Health Care

While Facebook and confirmation hearings dominated Congress’ return to Washington this week, Republicans continued their unprecedented assault on the American health care system. Here’s what happened in the war on health care – and how five recent studies made clear the long- and short-term benefits of the Affordable Care Act:

TRUMP ADMINISTRATION STACKS DECK AGAINST HEALTH CARE SHOPPERS

On Monday, the Trump Administration finalized the “rules of the road” for next year’s ACA marketplaces, and they favor insurance companies over the American people, encouraging insurers to undermine protections for those with pre-existing conditions with a race-to-the-bottom approach while loosening restrictions on extreme rate hikes.

Moreover, despite the Administration’s own data showing that cuts to outreach and assistance dampened enrollment, especially among younger and healthier consumers, they pushed even further cuts to local assisters, ensuring it will be even more difficult for Americans to sign up for coverage next year.

This short-sighted, bad-faith rule is yet another brick in the wall that Republicans are building between the American people and access to good, affordable coverage.

EXPERTS PAN NBPP RULES

Among those who know health care the best, the rules were not well received. Here’s a sampling of what the experts said:

Andy Slavitt, Former Acting CMS Administrator: “Andy Slavitt, who was acting CMS administrator during the Obama administration’s final two years, countered that the current administration ‘is making it clear that they’re implementing a law that they have no intention of making succeed.’ Slavitt called the revisions ‘a gift to the insurance companies by finding lots of ways for them to get around the standards Americans have come to expect.’” [Washington Post, 4/9/18]

Sam Berger, Senior Adviser, Center for American Progress: “This rule reduces protections for people with pre-existing conditions, increases the cost of health coverage, and makes it harder for consumers to sign up for coverage. This past year has shown just how much consumers value quality, affordable health care, but rather than encourage awareness, lower prices, and promote market stability, the administration is more concerned with trying to undermine the law. This is just the latest example of the Trump administration putting its ideological crusade against the Affordable Care Act ahead of the health and well-being of the American people.” [4/9/18]

Avalere: “The final NBPP … allows for greater essential health benefit flexibility, which could lead to less generous benefits and worse access for consumers.” [4/9/18]

Matt Eyles, Incoming AHIP President and CEO: “When you think about things like the individual mandate going away, some of the other proposed rules that are being put in place, whether it be around association plans, short-term policies — it’s just still a nasty soup right now that’s brewing… We’re looking ahead to 2019, and it’s not a really great picture right now, but I know a lot of companies are committed to the market.” [Washington Times, 4/10/18]

U.S. PIRG: “Together, these changes will make it easier for health insurance companies to raise rates and reduce the value of health coverage for consumers. This is a big step in the wrong direction.” [4/9/18]

AFT Nurses and Health Professionals: “CMS gives states more power to cut health benefits, more profits to insurance companies, with fewer safeguards for coverage.” [4/10/18]

ADMINISTRATION ENCOURAGES WORK REQUIREMENTS TO FURTHER HARM AMERICANS

On Tuesday, President Trump privately signed an executive order encouraging federal agencies and states to strengthen existing work requirements in Medicaid and in critical public assistance programs – and he was right to hide.

We’ve seen solid evidence that imposing work requirements on non-employment-related federal programs not only fail to help people find jobs, but actually push hard-working Americans through the cracks while costing more in wasteful administrative overhead. The reality is that 8 in 10 adults with coverage through Medicaid live in working families.

By pushing states and federal agencies to adopt short-sighted and inhumane tactics to force even more Americans off their insurance and out in the cold, President Trump is aggressively continuing his war on our health care.

NEW REPORT CONFIRMS GOP TAX SCAM BENEFITS DRUG COMPANIES WHILE AMERICANS PAY MORE

Also on Tuesday, Sen. Cory Booker (D-NJ) released a major report confirming that none of the country’s ten biggest pharmaceutical companies have used any of their windfall from the GOP tax scam to lower drug prices for consumers, instead passing those benefits along to wealthy executives and shareholders.

The majority of Americans have always known the GOP tax scam was designed to enrich the wealthiest individuals and biggest corporations at the expense of everyday Americans and our health care, but this doesn’t make the findings any less distressing. Americans already pay a higher price for prescription drugs than consumers around the world, and big pharmaceutical companies have refused to lift a finger to provide relief from crippling prices.

It’s outrageous that pharmaceutical executives are further lining their own pockets instead of addressing the skyrocketing cost of prescription drugs, and it represents even further proof the GOP tax scam was never intended to help ordinary Americans.

ADMINISTRATION STAGES OPIOID PHOTO-OP HOURS AFTER LATEST MEDICAID ATTACK

On Wednesday, Administration officials unveiled an opioid crisis installation on White House grounds just hours after the President signed the executive order escalating his Administration’s relentless attacks on Medicaid, the most critical federal program for connecting Americans with opioid treatment, showing just how out-of-touch they are with the reality of this crisis: its HHS Secretary is holding photo-ops with art installations instead of taking real action.

Rather than waging a war on this crisis, the Administration continues to wage a war on our health care – and until they call off their war on Medicaid, which covers 25 percent of all addiction treatment nationwide, President Trump and Secretary Azar will have zero credibility in the opioid crisis fight.

SEN. COLLINS’ SUNDAY SHOW DECEPTION ROUTINE

And as we head into another weekend, it’s worth revisiting what happened last weekend. On Sunday, Sen. Susan Collins (R-Maine) appeared on CNN’s State of the Union and proceeded to give a version of the events surrounding the GOP stabilization bill failure that do not hold up to scrutiny. Here’s what Sen. Collins said about the stabilization effort  – and what actually happened:

What Collins says now:What really happened:
Asked whether she was lied to to get her vote for the GOP tax scam, Sen. Collins responded, “No, I really don’t.” Last December, Collins said that a failure to pass stabilization would be a “serious breach of a promise.” When discussing the possibility that stabilization might not become law, Collins said, “I’m counting on the administration to make sure that does not happen…I would consider it a very serious breach of a promise to me.”
Sen. Collins stated she believes Majority Leader McConnell kept his promise to her: “I had the opportunity just two weeks ago to bring a package to the Senate floor with Lamar Alexander, so the Majority Leader kept his promise to me.” In Sen. Collins’ own words, she cast a vote to pass the tax bill because she had secured “commitments to pass legislation to help lower health insurance premiums.” She secured a commitment to pass stabilization, not just hold a vote on legislation. Not only did stabilization never pass, but no vote was ever held on Collins’ or Alexander’s health care stabilization package.
Sen. Collins continued to push a false narrative about what happened during stabilization efforts, saying, “Much to my surprise, [stabilization] was blocked actually by Senators on the other side of the aisle.” Republicans bear 100% of the responsibility for failing to pass legislation that would stabilize the Affordable Care Act. House Republicans, such as Rep. Tom Cole, went on the record indicating they opposed stabilization. The White House then released a list of extreme, deal-breaking demands. Sen. Lindsey Graham told Breitbart News, “[Obamacare] is going to continue to collapse, and then, we own the outcome. By repealing the individual mandate, which is a step forward in the eyes of the public, we own the issue.”  And in an op-ed she penned for the Portland Press Herald, Sen. Collins herself admitted price increases were entirely avoidable: “This proposal was the last clear opportunity to prevent these health insurance rate increases, which will be announced Oct. 1. The most frustrating thing about these imminent price increases is that they were entirely avoidable. Much about health care is complicated.”

STUDIES CONFIRM: ACA, MEDICAID IMPROVE HEALTH CARE ACCESS AND OUTCOMES, BOOST LOCAL ECONOMIES

Ultimately, however, despite everything that Republicans continue to throw at it, the ACA continues to improve the lives of Americans from coast to coast. Over the past month, five studies looking at the impact of the Affordable Care Act have been released: three analyzing Medicaid expansion, and two analyzing marketplace coverage. These studies covered a broad scope of health care-related outcomes, from treatment for chronic conditions to jobs created in a local economy, and each came to the same conclusion: the ACA is providing clear benefits for Americans.

  • Louisiana Department of Health: Medicaid Expansion and the Louisiana Economy. An April report analyzed Louisiana’s Medicaid expansion, finding that expansion brought a $1.85 billion economic impact to the state; created 19,000 new jobs; and extended medical services to over 545,000 Louisianans, leaving Gov. John Bel Edwards to note, “It is costing us less to have more people insured.”
  • University of Montana Bureau of Business and Economic Research: Medicaid Expansion Has Boosted State’s Economy, Added Jobs, Improved Health Care. A March study examined Montana’s Medicaid expansion, finding that it created 5,000 new jobs and $280 million of personal income; saved the state $40 million in Medicaid benefits; and provided insurance to more than 94,000 Montanans. “Medicaid expansion is doing what it’s supposed to do, help Montanans live healthier lives and save the state money,” said State HHS Director Sheila Hogan.
  • America’s Health Insurance Plans: The Value of Medicaid: Providing Access to Care and Preventive Health Services. An April AHIP study compared coverage data for those under Medicaid, private insurance, and not covered, finding Medicaid enrollees to have access to care at levels comparable to private coverage and far better than those without insurance, leaving the authors to conclude the study’s findings “refute outdated, less rigorous studies that question the value of Medicaid.”
  • Health Affairs: Effects Of The ACA’s Health Insurance Marketplaces On The Previously Uninsured: A Quasi-Experimental Analysis. An April study compared adults who had gone through periods without insurance to those with continuous coverage, finding that the introduction of the ACA saw the uninsured rate decrease by 11 percentage points and the number of of individuals unable to access necessary care fall by two points, as well as more outpatient visits, more prescriptions being filled, and a higher probability of a hospital stay.
  • Health Affairs: The Affordable Care Act’s Marketplaces Expanded Insurance Coverage For Adults With Chronic Health Conditions. An April study examined the role the ACA marketplace had on non-elderly adults with chronic conditions, finding that far more Americans with chronic conditions obtained coverage through the marketplace, underscoring the law’s long-term benefits.

 

In News

Research Roundup: Studies Confirm That ACA, Medicaid Improve Health Care Access and Outcomes, Boost Local Economies

Over the past month, five studies looking at the impact of the Affordable Care Act have been released: three analyzing Medicaid expansion, and two analyzing marketplace coverage. These studies covered a broad scope of health care-related outcomes, from treatment for chronic conditions to jobs created in a local economy, and each came to the same conclusion: the ACA is providing clear benefits for Americans.

Here’s a look at what these five studies found:

Louisiana Department of Health: Medicaid Expansion and the Louisiana Economy

A report released in April by the Louisiana Department of Health analyzed Louisiana’s Medicaid expansion, finding that expansion not only boosted the state’s economy but also save the state money, leaving Gov. John Bel Edwards to conclude, “It is costing us less to have more people insured.” Among its key takeaways:

  • The state saw a $1.85 billion economic impact due to Medicaid expansion, with Louisianans seeing $1.12 billion in personal earnings and local tax receipts totaling $746 million, with the economic impact “spread throughout the state.”
  • Louisiana saw 19,000 new jobs created under Medicaid expansion, making clear that “such healthcare can also positive affect the labor participation rate.”
  • Over 545,000 Louisianans have benefited under Medicaid expansion, including more than 180,000 Louisianans who visited a doctor and received new preventive services, more than 35,000 Louisianans who received breast cancer screenings, and more than 48,000 Louisianans who received mental health services.
  • Medicaid expansion saved the state $317 million, leading Gov. John Bel Edwards to note, “It was the easiest big decision I’ll ever make as governor.”
  • As the study’s authors concluded, the economic impact will continue “as long as the state maintains the program and as long as no major changes are instituted by the federal government, either through acts of the U.S. Congress or regulatory decisions made by the Center for Medicare & Medicaid Services.”

University of Montana Bureau of Business and Economic Research: Medicaid Expansion Has Boosted State’s Economy, Added Jobs, Improved Health Care

A March study from the University of Montana Bureau of Business and Economic Research examined the effects of Montana’s Medicaid expansion, and found that it has not only provided insurance to more than 94,000 Montanans, but had a major impact on the state’s economy. Among its key takeaways:

  • Montana’s Medicaid expansion was responsible for creating 5,000 new jobs,  in the health care, retail, construction and hospitality industries, and $280 million of personal income.
  • Labor-force participation has increased six points, from 58 to 64 percent, among those eligible for Medicaid expansion, Montanans aged 18-64 and earning up to 138 percent of the federal poverty level .
  • Medicaid expansion has saved $40 million in Medicaid benefits, in addition to providing $902 million worth of health care services. “The savings are enough to pay for the costs,” said Bryce Ward of the BBER.
  • Medicaid expansion accounts for an estimated $564 million per year on health care spending, with nearly 70% of this being “new money,” or an economic boost spurred only by expansion.
  • As Sheila Hogan, director of the state’s Department of Health and Human Services said, “Medicaid expansion is doing what it’s supposed to do, help Montanans live healthier lives and save the state money.”

America’s Health Insurance Plans: The Value of Medicaid: Providing Access to Care and Preventive Health Services

An April study from America’s Health Insurance Plans (AHIP) compared data from Americans covered by Medicaid, private insurance, and not covered, analyzing the access to care received under each, finding that Medicaid tremendously improves access to care. Among its key takeaways:

  • Adults (five-times as likely) and children (four-times) were significantly more likely to have access to “a usual source of care” than those without insurance.
  • Adults (four-times as likely) and children (two-to-three times) were significantly more likely to obtain preventative care than those without insurance.
  • Those enrolled in Medicaid had access to care at levels comparable to private coverage, and far better access to care than those without insurance.
  • As the authors concluded, “The findings from this study refute outdated, less rigorous studies that question the value of Medicaid, and add to the growing number of recent studies that demonstrate the value of having insurance coverage generally, and Medicaid more specifically.”

Health Affairs: Effects Of The ACA’s Health Insurance Marketplaces On The Previously Uninsured: A Quasi-Experimental Analysis

An April study published in Health Affairs, led by Harvard Medical School clinical fellow Anna Lise Goldman, MD, compared adults who had gone through periods without insurance to those with continuous coverage. It found that the ACA improved health care outcomes, especially among low-income adults. Among its key takeaways:

  • The introduction of the ACA saw the uninsured rate decrease by 11 percentage points and the number of of individuals unable to access necessary care fall by two points, as well as more outpatient visits, more prescriptions being filled, and a higher probability of a hospital stay.
  • Lower-income individuals, those with incomes of between 138 and 250 percent of the federal poverty level, saw even larger increases in the number of outpatient visits and prescriptions being filled.
  • As the study’s authors concluded, “The ACA led to a significant decline in the uninsurance rate, decreased barriers to medical care, increased the use of outpatient services and prescription drugs, and increased diagnosis of hypertension, compared to a control group with stable employer-sponsored insurance.”

Health Affairs: The Affordable Care Act’s Marketplaces Expanded Insurance Coverage For Adults With Chronic Health Conditions

An April study published in Health Affairs examined the role the ACA marketplace had on non-elderly adults with chronic conditions, finding that those far more Americans with chronic conditions obtained coverage through the marketplace. Among its key takeaways:

  • During the time period analyzed, 45% of marketplace enrollees aged 18-64 were treated for chronic conditions, compared to just 35% of those not enrolled in marketplace coverage and 38% of adults with employer insurance.
  • Those enrolled in marketplace coverage obtained more service use than those without it, underscoring the long-term benefits of the ACA.
In News

Trump Administration Stages Opioid Photo-Op Hours After Latest Medicaid Attack

As Trump officials unveiled an opioid crisis installation on White House grounds just hours after the President signed an Executive Order escalating his Administration’s relentless attacks on Medicaid, the most critical federal program for connecting Americans with opioid treatment, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“The Trump Administration is so out of touch with the reality of our nation’s out-of-control opioid crisis that its Secretary of Health and Human Services is holding photo-ops with art installations instead of taking real action. The Trump Administration isn’t waging war on this crisis, it’s waging war on our health care. President Trump and Secretary Azar will have zero credibility in the opioid crisis fight unless and until they call off their war on Medicaid, which covers 25 percent of all addiction treatment nationwide. This Administration could stage a million photo-ops and still fail to hide the fact that its anti-Medicaid agenda is leaving more Americans who need treatment with nowhere to turn.”

FACT SHEET: How Republican Health Care Sabotage Is Exacerbating The Opioid Crisis

In News

Protect Our Care Condemns Trump Executive Order Encouraging Medicaid & Other Critical Programs to Adopt Work Requirements

Administrative Hurdles Fail to Encourage Employment, Cost More & Escalate Trump’s War on Working Families

After President Trump privately signed an executive order encouraging federal agencies and states to strengthen existing work requirements in Medicaid and in critical public assistance programs, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“President Trump gave record-breaking tax breaks to people who inherited money from their parents and to corporations that contributed to Republican campaigns, and now he wants to take coverage from more working families who depend on Medicaid. Trump refused to publicly sign today’s brutal executive order, and he was right to hide. In early red-state experiments, we have seen solid evidence that imposing work requirements on non-employment-related federal programs not only fails to help people find jobs, but actually pushes hardworking people through the cracks while costing more in wasteful administrative overhead. Even worse, these administrative hurdles push a false stereotype about people who get coverage through Medicaid – the reality is that 8 in 10 adults with coverage through this critical program live in working families. By pushing states and federal agencies to adopt short-sighted and inhumane tactics to force even more Americans off their insurance and out in the cold, President Trump is continuing his war on our health care and threatening to fundamentally weaken our nation’s social fabric.”

In News

New Senate Report: GOP Tax Bill Benefits Drug Companies While Americans Pay More

Washington, D.C. – Today, Senator Cory Booker (D-NJ) released a major report confirming that none of the country’s ten biggest pharmaceutical companies have used any of their windfall from the GOP tax scam to lower drug prices for consumers, instead passing those benefits along to wealthy executives and shareholders. Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“From the moment the GOP’s tax scam proposal became public, the majority of Americans knew it was designed to enrich the wealthiest individuals and biggest corporations at the expense of everyday Americans and our health care, and today’s Senate report confirms it. Americans already pay a higher price for prescription drugs than consumers around the world, and big pharmaceutical companies have refused to lift a finger to provide relief from crippling prices. It’s outrageous that drug company executives are choosing to further line their own pockets instead of addressing the skyrocketing cost of prescription drugs, and it’s even further proof that the Republican tax bill was never intended to help ordinary Americans, and that it is only making health care more expensive for hardworking American families.”

In News

Sabotage: Elected Officials, Stakeholders, Experts Pan Anti-Consumer Provisions in Trump Administration Marketplace Rule

Washington, D.C. – Consumer advocates spoke out quickly and loudly after the Trump Administration announced a final Notice of Benefit and Payment Parameters rule for plans offered through the Affordable Care Act’s individual marketplaces that will weaken benefits for millions of Americans, put those with pre-existing conditions at risk, and make it even harder for people to sign up for coverage – all while lining insurance company pockets through reduced review of rate hikes and overhead:

Elected Officials

Senator Ron Wyden (D-OR): “Instead of taking steps to prevent big premium increases this fall, the Trump Administration is watering down your health care and making it harder to get coverage. Projections already showed double digit premiums increases this year due to the Trump Administration’s attacks on families’ health care, and today’s new rules pour gasoline on the fire.” [4/9/18]

Senator Patty Murray (D-WA): “With this new rule, President Trump has issued an open invitation for insurance companies to raise premiums, skirt patient protections, and undermine families’ care. I’m very concerned about what these dramatic, harmful changes in policy could mean for women who don’t want to pay more than men for health care, for people with pre-existing conditions, for those struggling with mental illness and substance use, and for millions of peoples’ health costs. Republicans in Congress should join Democrats in condemning the President Trump’s latest politically-motivated effort to raise families’ costs and create health care chaos.” [4/9/18]

Stakeholders & Experts

Andy Slavitt, Former Acting CMS Administrator: “Andy Slavitt, who was acting CMS administrator during the Obama administration’s final two years, countered that the current administration ‘is making it clear that they’re implementing a law that they have no intention of making succeed.’ Slavitt called the revisions ‘a gift to the insurance companies by finding lots of ways for them to get around the standards Americans have come to expect.’” [Washington Post, 4/9/18]

Sam Berger, Senior Adviser, Center for American Progress: “This rule reduces protections for people with pre-existing conditions, increases the cost of health coverage, and makes it harder for consumers to sign up for coverage. This past year has shown just how much consumers value quality, affordable health care, but rather than encourage awareness, lower prices, and promote market stability, the administration is more concerned with trying to undermine the law. This is just the latest example of the Trump administration putting its ideological crusade against the Affordable Care Act ahead of the health and well-being of the American people.” [4/9/18]

Avalere: “The final NBPP … allows for greater essential health benefit flexibility, which could lead to less generous benefits and worse access for consumers.” [4/9/18]

Matt Eyles, Incoming President and CEO, America’s Health Insurance Plans: “When you think about things like the individual mandate going away, some of the other proposed rules that are being put in place, whether it be around association plans, short-term policies — it’s just still a nasty soup right now that’s brewing… We’re looking ahead to 2019, and it’s not a really great picture right now, but I know a lot of companies are committed to the market.” [Washington Times, 4/10/18]

U.S. PIRG: “Together, these changes will make it easier for health insurance companies to raise rates and reduce the value of health coverage for consumers. This is a big step in the wrong direction.” [4/9/18]

AFT Nurses and Health Professionals: “CMS gives states more power to cut health benefits, more profits to insurance companies, with fewer safeguards for coverage.” [4/10/18]

How It Played In The Headlines

​Wall Street Journal: Trump Administration Allows States to Narrow ACA Coverage

Reuters: Trump administration issues rule further watering down Obamacare

Washington Post: Trump administration rewrites ACA insurance rules to give more power to states

Washington Examiner: Trump administration releases new ways for states to skirt Obamacare rules

News Coverage Details Rule’s 529 Pages of Sabotage

Wall Street Journal: “Trump Administration Allows States to Narrow ACA Coverage.” “The Trump administration will give states leeway to winnow down the mandatory health benefits guaranteed to consumers who buy Affordable Care Act insurance plans, under a rule issued Monday… The changes to the ACA plans reflect the administration’s goal of dismantling former President Barack Obama’s signature health law and transferring more health-policy decisions to the states. Democrats and some consumer groups denounced the rule as another effort by the administration to undermine the ACA. They have said that weakening the scope of the benefits offered in ACA plans will hurt consumers by reducing coverage. The new rule will ‘undermine protections for people with pre-existing conditions with a race-to-the-bottom approach that fundamentally undermines the Affordable Care Act’s essential health-benefit coverage guarantee,’ said Brad Woodhouse, campaign director of Protect Our Care, a group that is an advocate for the ACA.” [Wall Street Journal, 4/9/18]

CNN: “The New Rule Is The Latest Effort By The Administration To Undermine The Affordable Care Act.” “The new rule is the latest effort by the administration to undermine the Affordable Care Act. Earlier this year, it proposed rules that would allow insurers to sell short-term insurance plans, which last just under a year but don’t have to comply with Obamacare’s regulations, and to make it easier for small businesses to band together to offer coverage that doesn’t adhere to all of the health reform law’s mandates. Both of these options could have lower premiums, but also cover fewer benefits.” [CNN, 4/9/18]

Health Care Dive: “The Sweeping Rule Is Just The Latest In The Trump Administration’s Steady Chipping Away” At The ACA. “The sweeping rule is just the latest in the Trump administration’s steady chipping away at the landmark health law, which has been coupled with a move to give states more control over their healthcare regulations. The administration cut off cost-sharing reduction payments to insurers in October, sparking backlash from payers. The Republican tax bill last year repealed the individual mandate penalty starting in 2019. And more is on the way. In February, the administration released a proposed rule to expand short-term health insurance availability, bumping up the allowance of coverage to 12 months. It is also promoting association health plans, which aren’t required to meet the EHB requirements or protect people with pre-existing conditions. The ACA requires payers to cover at least 10 specific benefits, including maternity care and prescription drugs.” [Health Care Dive, 4/9/18]

Reuters: “This Could Lead To Less Generous Coverage.” “The Trump administration took additional steps to weaken Obamacare on Monday, allowing U.S. states to relax the rules on what insurers must cover and giving states more power to regulate their individual insurance markets. The Centers for Medicare and Medicaid Services issued a final rule that allows states to select essential health benefits that must be covered by individual insurance plans sold under former President Barack Obama’s healthcare law. The 2010 Affordable Care Act requires coverage of 10 benefits, including maternity and newborn care and prescription drugs. Under the new rule, states can select from a much larger list which benefits insurers must cover. That could lead to less generous coverage in some states, according to Avalere Health, a research and consulting firm. [Reuters, 4/9/18]

Reuters: “Insurers Could Also Have An Easier Time Raising Their Rates Under The New Rule.” “Insurers could also have an easier time raising their rates under the new rule. Obamacare mandated that premium rate increases of 10 percent or more in the individual market be scrutinized by state regulators to ensure that they are necessary and reasonable. The new CMS rule raises that threshold to 15 percent.” [Reuters, 4/9/18]

CNN: The Rules “Make It Easier For Insurers To Spend Less Of The Premiums They Collect On Policyholders And Put More Toward Profits.” “The rule also allows states to make it easier for insurers to spend less of the premiums they collect on policyholders and put more toward profits and administrative costs. And the administration raised the default threshold that trigger state reviews of insurers’ proposed rate hikes to 15%, up from 10%.” [CNN, 4/9/18]

Washington Post: New Rules “Will Enable States To Allow Future Doctors Visits [Or Cover] Fewer Prescription Drugs.” “One of the most significant changes involves a set of 10 essential health benefits that the ACA requires of health plans sold through the federal insurance marketplace and separate state marketplaces. The new rules will not jettison any of the categories but will enable states to allow fewer doctors visits, for example, or to cover fewer prescription drugs.” [Washington Post, 4/9/18]

Washington Post: “The Government Will No Longer Require That Insurers Provide A Standardized Set Of Benefits, Urged By The Obama Administration As A Way To Help Consumers Comparison Shop.” “In another change, the government is turning over to the 39 states that rely on the federal insurance exchange, HealthCare.gov, responsibility for ensuring that marketplace plans have enough doctors and other providers of care in their networks. Similarly, the government no longer will require that insurers provide a standardized set of benefits, urged by the Obama administration as a way to help consumers comparison shop. [Washington Post, 4/9/18]

Washington Post: “In A Sharp Shift, The New Rules Further Weaken The Network Of Consumer Assisters.” “In ways both subtle and substantial, many of the past years’ rules were upgrades to help consumers with prices, benefits and shopping for coverage. Under a change effective in 2016, any insurer wanting to raise its premiums by 10 percent or more has been required to disclose the increase with a justification. Insurers also have had to publish up-to-date lists on drugs, including tiers of coverage and any restrictions on consumers’ ability to get them. The rules for 2017 started a rating system for the number of doctors and other providers in plans’ networks, so that customers could better compare marketplace insurers in areas that offer a choice. In a sharp shift, the new rules further weaken the network of consumer assisters, known as navigators, whose funding the Department of Health and Human Services slashed last year. The rules remove the requirement that every area has at least two navigator groups and that one be local.” [Washington Post, 4/9/18]

Washington Post: Insurers No Longer Must Devote 80 Percent Of Income To Customers’ Care. “In addition, insurers no longer will be required to devote 80 percent of their income to customers’ care, if they can show that a higher profile would improve their financial stability.” [Washington Post, 4/9/18]

The Hill: Ruling Gives Flexibility For States “To Change The Essential Health Benefits.” “Other changes announced Monday include additional flexibility for states to change the Essential Health Benefits, the list of health services that insurance plans must cover.” [The Hill, 4/9/18]

Washington Examiner: New Rules “Ease The Requirements” Plans Must Cover. “The new rules would ease the requirements on the health benefits that plans must cover, as well as quality control. Critics say the new rule will allow insurers to charge higher prices and skirt patient protections… The agency also is changing the requirements for how much money an insurer must provide toward medical services and quality improvement. Obamacare requires insurers to spend 80 percent of the money it takes in from premiums on health costs and quality improvements and 20 percent on administrative overhead or marketing. CMS would allow a state to change that ratio based on certain factors.” [Washington Examiner, 4/9/18]

Associated Press: “One Of The Ways To [Lower Costs] Is By Cutting Back On Benefits.” “The administration is under pressure from Republican-led states to reduce the cost of health insurance for consumers buying their own policies. One of the ways to do that is by cutting back on benefits.” [AP, 4/9/18]

In News

Trump Administration Stacks Deck Against Next Year’s Health Care Shoppers

Washington, D.C. – After the Trump Administration finalized “rules of the road” for next year’s Affordable Care Act marketplaces that favor insurance companies over the American people, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“President Trump and Congressional Republicans have already set the stage for higher prices and more confusion next fall with laws and regulations that undermine the Affordable Care Act marketplaces. Now, the Trump Administration is compounding its attack by encouraging insurance companies to undermine protections for people with pre-existing conditions with a race-to-the-bottom approach that fundamentally undermines the Affordable Care Act’s essential health benefit coverage guarantee. Meanwhile, the Administration is sweetening the deal for insurance companies by loosening restrictions on extreme rate hikes.

“Today’s Trump Administration action will make it even harder for Americans to sign up for coverage next year, with further cuts to local assisters who help families navigate their options and enroll. The Administration’s own data from this year’s enrollment period shows that their cuts to outreach and assistance dampened enrollment – especially among younger and healthier consumers – while states that ran their own marketplaces did not see similar drop-off. Today’s sabotage will compound that problem.

“As we look ahead to this fall’s open enrollment period, when premiums are already expected to spike due to harmful actions by Trump and his Republican Congress, there is simply no excuse for setting rules of the road that allow insurance companies to chip away at benefit quality and hike rates with impunity, while at the same time stripping away resources that help Americans understand their insurance options. This short-sighted, bad-faith rule is yet another brick in the wall that Republicans are building between the American people and access to good, affordable coverage.”

In News

FACT CHECK: Sen. Collins’ Sunday Show Stabilization Deception

Yesterday, Sen. Susan Collins (R-Maine) appeared on CNN’s State of the Union and proceeded to give a version of the events surrounding the GOP stabilization bill failure that do not hold up to scrutiny. Here’s what Sen. Collins said – and what actually happened:

SEN. COLLINS BANKED ON DISINGENUOUS STABILIZATION PROMISE IN EXCHANGE FOR HER VOTE ON ON THE REPUBLICAN TAX BILL

What Collins says now:

When asked on CNN’s State of the Union whether she thought she was lied to to get her vote for the Republican tax bill, Sen. Susan Collins responded, “No, I really don’t.”

What really happened:

Last December, Collins said that a failure to pass stabilization would be a “serious breach of a promise.” When discussing the possibility that stabilization might not become law, Collins said, “I’m counting on the administration to make sure that does not happen…I would consider it a very serious breach of a promise to me.”

MITCH MCCONNELL BROKE HIS PROMISE TO SEN. COLLINS ON STABILIZATION

What Collins says now:

Sen. Collins reiterated that she believes Majority Leader McConnell kept his promise to her: “I had the opportunity just two weeks ago to bring a package to the Senate floor with Lamar Alexander, so the Majority Leader kept his promise to me.”

What really happened:

In Sen. Collins’ own words, she cast a vote to pass the tax bill because she had secured “commitments to pass legislation to help lower health insurance premiums.” She secured a commitment to pass stabilization, not just hold a vote on legislation. Not only did stabilization never pass, but no vote was ever held on Collins’ or Alexander’s health care stabilization package.

REPUBLICANS SABOTAGED EFFORTS TO STABILIZE THE AFFORDABLE CARE ACT

What Collins says now:

Sen. Collins continued to push a false narrative about what happened during stabilization efforts, saying, “Much to my surprise, [stabilization] was blocked actually by Senators on the other side of the aisle.”

What really happened:

In reality, Republicans bear 100% of the responsibility for failing to pass legislation that would stabilize the Affordable Care Act. House Republicans, such as Rep. Tom Cole, went on the record indicating they opposed stabilization: “Nobody in that room voted for Obamacare, so the idea you’re going to vote for billions of dollars to stabilize a system you never supported in the first place — pretty hard to choke down.”

The White House then released a list of extreme, deal-breaking demands, including: expanding Hyde restrictions to effectively prohibit all privately-purchased plans from covering abortion; codifying short-term health plans that undermine protections for people with pre-existing conditions; and imposing an age tax that allows insurers to change Americans over age 50 premiums over five times higher than they charge younger people. Republicans were quick to advocate for these changes, adding a partisan poison pill they knew would torpedo bipartisan stabilization efforts.

Even Sen. Collins’ Republican colleagues recognize that they now own the outcome on health care. Sen. Lindsey Graham told Breitbart News, “[Obamacare] is going to continue to collapse, and then, we own the outcome. By repealing the individual mandate, which is a step forward in the eyes of the public, we own the issue.”

In an op-ed she penned for the Portland Press Herald, Sen. Collins herself admitted that price increases were entirely avoidable: “This proposal was the last clear opportunity to prevent these health insurance rate increases, which will be announced Oct. 1. The most frustrating thing about these imminent price increases is that they were entirely avoidable. Much about health care is complicated.”

In News

Advocates Nationwide Highlight Medicaid’s Importance for Kids & Families

Throughout the first week of Medicaid Awareness Month, advocates stood up for the millions of kids and families who live healthy, happy lives thanks to this essential program — and spoke out against Republican proposals to weaken and cut Medicaid.

Medicaid advocates rally Friday in Charleston, West Virginia

Protect Our Care released state-by-state Medicaid fact sheets as a resource for advocates.

Alaskans rally for kids’ healthcare on Tuesday at Cuddy Family Park in Anchorage.

The Center on Budget and Policy Priorities released a brief on How Medicaid Work Requirements Will Harm Children as well as a blog: Medicaid Continues to Help Schools Help Children.


In Knoxville, advocates from the Tennessee Health Care Campaign, ForwardTN, Protect My Care, and Planned Parenthood shared stories about why Medicaid matters for Tennessee families and kids.

Tracy Nájera, the Executive Director for the Children’s Defense Fund-Ohio, highlighted how the program helps Ohio kids to succeed. Read her post:

Medicaid Protects America’s Children
Community Catalyst Blog

For more than a year, Congress has lobbied a variety of attacks at Medicaid. The challenge to defend the program has forced advocates to become very clear about why and how Medicaid is such a valuable program for children and families. And after a year of intensified study, the evidence is clear: Medicaid is saving the day for children and families all over this country.

Medicaid is protecting our babies.

Close to 45 percent of all U.S. births are covered by Medicaid: 52 percent in my home state of Ohio and as many as 72 percent of all births in New Mexico. Medicaid coverage is literally saving these infant’s lives. As the American Journal of Public Health’s study found, states that expanded Medicaid saw greater declines in their infant mortality rates between 2010 and 2016 than those that did not expand. The decline more than doubled for Black infant mortality rates compared to non-expansion states. Medicaid’s reach extends beyond infant care in our urban cores; Medicaid covers about 51 percent of rural births nationwide. Savvy states are leveraging Medicaid to address poor outcomes for infants in the wake of the opioid crisis by tackling Neonatal Abstinence Syndrome. As of February of this year, West Virginia became the first state to receive approval from the U.S. Centers for Medicare and Medicaid Services (CMS) to offer Neonatal Abstinence Syndrome (NAS) treatment services.

Medicaid is protecting our nation’s students, providing affordable and comprehensive health coverage for nearly 30 million children. Much of this care takes place directly inside of schools through school- based health services for low-income children. Services provided include preventive services and treatment as well as age-appropriate screening for vision, dental, and blood lead levels—a critical screening in places like Flint, Michigan and other high risk communities. And according to a recent survey of nearly 1,000 school and district leaders from around the country, 68 percent use Medicaid reimbursements to pay for school-based health professionals like nurses, counselors and psychologists for mental and behavior health, physical and occupational therapy, and speech pathology. Medicaid has been keeping our nation’s special education afloat for years by supplementing insufficient funding provided through the Individuals with Disabilities Education Act (IDEA).

Medicaid is a smart tool for tackling racial disparities and geographic inequity in our rural and Appalachian regions.

Between 2013 and 2016, the child uninsured rate fell from 7 percent to 4 percent, representing 2 million more insured children nationwide. At the same time, we experienced significant declines in racial disparities in children’s uninsured rates with the most significant movement towards gap-closing occurring between White and Hispanic children, where it declined from 7 percent to 4. The impact of Medicaid expansion on coverage in rural areas is also notable. Medicaid now covers 45 percent of rural children nationwide, and the rural child uninsured rate has dropped from 9 percent to just 6 percent. That means all the difference for a child whose family has delayed dental care for a cavity for few months to save up for the procedure or for a child in desperate need of speech therapy to be understood by her teacher and classmates.

Through this all, the Children’s Defense Fund-Ohio continues to push for progress on Medicaid enrollment and access to care for children and families by partnering with Ohio’s Medicaid department to close the remaining uninsured child gap and capitalize on opportunities to enroll children—especially immigrant children. We are growing access to physical, mental, and behavioral care by working to expand our state rules on telehealth and assisting schools in providing access to Medicaid-covered health services beyond the Medicaid in Schools Program. At the same time, we are working to protect Ohio’s children and families as Ohio adds itself to the list of states seeking an 1115 demonstration waiver from CMS place work requirements for Ohio’s Medicaid Expansion enrollees. We are raising the flag for children and families, defending against these measures which will push thousands of families out of needed health coverage in this critical time of economic recovery in Ohio. And as many other advocates in Ohio and around the country, we remain vigilant and alert to defend against any new federal Medicaid challenges.

Advocates can be proud to continue to protect Medicaid as we enter this year’s Medicaid Awareness Month. Medicaid is a game changer for children bringing tangible value in prevention and intangible value in the lives it is changing and saving. The need is growing and we must be relentless in our struggle to ensure all eligible children receive the care they need.