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May 2018

ashoup
In News

House Farm Bill Becomes Latest Vehicle for Republicans’ War on Health Care

As the U.S. House prepares to vote on a farm bill that continues Republicans’ push to encourage subpar health plans, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“By including a provision encouraging association health plans, the House farm bill has become the latest vehicle for Republican attacks on health care and people with pre-existing conditions. The bill authorizes $65 million in taxpayer funding to set up association health plans, which can  exclude prescription drug coverage, mental health care, and maternity care. When these plans fail, they leave people who thought they had real coverage out in the cold. Hardworking Americans shouldn’t bet the farm on association health plan coverage.”

BACKGROUND

The National Association of Insurance Commissioners has warned that association health plans “provide inadequate benefits and insufficient protection to consumers” and “threaten the stability of the small group market.”

Subpar coverage and a lack of pre-existing condition protections pose a particularly large risk for agricultural workers because of the dangers of the profession. According to the U.S. Occupational Safety and Health Administration, the injury rate for agricultural workers is over 40 percent higher than the national workplace injury rate overall.

And as Roger Johnson, president of the National Farmers Union (NFU), wrote during last year’s repeal drive: “The Medicaid expansion has proven especially beneficial to rural communities, where the rate of enrollment is higher than in urban America, and the ACA’s system of tax credits and premium subsidies helps young farmers access insurance while enabling established farmers to maintain consistent coverage.”

 

ashoup
In News

GOP Health Care Sabotage In Dollars & Cents

This morning, Axios breaks down what Republicans’ continuing quest to undermine and sabotage health care is doing in dollars and cents.

SHOT: Health insurance and drug companies win big…

CHASER: People who work for a living pay more

ashoup
In Fact Sheet, News

Association Health Plans

By including a provision encouraging the proliferation of association health plans, the annual House farm bill has become the latest vehicle for Republican attacks on comprehensive coverage and pre-existing condition protections. The bill authorizes $65 million in taxpayer funding to set up association health plans, which would be allowed to exclude or limit basic services such as prescription drug coverage, mental health care, and maternity care. Before the Affordable Care Act, these kinds of plans had a long history of fraud and unpaid claims, because many states exempt them from key consumer protections. When these plans fail, they leave people who thought they had real coverage out in the cold.

ASSOCIATION HEALTH PLANS DON’T HAVE TO OFFER COMPREHENSIVE COVERAGE

Vox: Association Health Plans Could Allow Groups To Act As Large Employers Which Do Not Have To Cover Essential Benefits Under The ACA. “The result could in many cases be that these new association health plans would be considered large employers when it comes to health insurance. Large employers are not subject to the same rules as individual or small-group plans under Obamacare. Most notably, they do not have to cover all of the law’s essential health benefits or meet the requirement that insurance cover a minimal percentage of a person’s medical bills.” [Vox, 10/12/17]

Treating Association Health Plans Like Large Employers Would Exempt Them From Guaranteeing Essential Health Benefits And Allow Them To Charge People Based On Health Status And Gender. Treating Association Health Plans like large-employers would exempt them from key consumer protections under the Affordable Care Act. Large employers do not have to offer plans with the Essential Health Benefits like maternity care, prescription drug coverage or mental health and substance abuse services. Insurers for large employers can also charge more based on health status and gender. [Georgetown Center on Health Insurance Reforms, December 2017]

Katherine Hempstead, Robert Wood Johnson Foundation: “The Easier You Make It Not To Buy Comprehensive Coverage, The Harder You Make It Buy Comprehensive Coverage.” [New York Times, 10/11/17]

ASSOCIATION HEALTH PLANS HAVE A HISTORY OF FRAUD AND UNPAID CLAIMS

Former Insurance Fraud Investigator: “Fraudulent Association Health Plans Have Left Hundreds Of Thousands Of People With Unpaid Claims.” “Marc I. Machiz, who investigated insurance fraud as a Labor Department lawyer for more than 20 years, said the executive order was ‘summoning back demons from the deep.’ ‘Fraudulent association health plans have left hundreds of thousands of people with unpaid claims,’ he said. ‘They operate in a regulatory never-never land between the Department of Labor and state insurance regulators.’” [New York Times, 10/21/17]

2017: Labor Department Filed A Suit Against An AHP For 300 Employers In Washington State Alleging The AHP Had Charged Employers More Than $3 Million In Excessive Fees And Violating Its Fiduciary Duty By Using Assets For Personal Interests. “The problems are described in dozens of court cases and enforcement actions taken over more than a decade by federal and state officials who regulate the type of plans Mr. Trump is encouraging, known as association health plans. In many cases, the Labor Department said, it has targeted ‘unscrupulous promoters who sell the promise of inexpensive health benefit insurance, but default on their obligations.’ In several cases, it has found that people managing these health plans diverted premiums to their personal use. The department filed suit this year against an association health plan for 300 small employers in Washington State, asserting that its officers had mismanaged the plan’s assets and charged employers more than $3 million in excessive ‘administrative fees.’ Operators of the health plan violated their fiduciary duty by using its assets ‘in their own interest,’ rather than for the benefit of workers, the government said.” [New York Times, 10/21/17]

2016: A Labor Department Lawsuit Revealed An AHP Had Concealed Financial Problems And Left $3.6 Million In Unpaid Claims. “The Labor Department filed suit last year against a Florida woman and her company to recover $1.2 million that it said had been improperly diverted from a health plan serving dozens of employers. The defendants concealed the plan’s financial problems from plan participants and left more than $3.6 million in unpaid claims, the department said in court papers.” [New York Times, 10/21/17]

A Health Plan For New Jersey Small Businesses Collapsed With $7 Million In Unpaid Claims. “In another case, a federal appeals court found that a health plan for small businesses in New Jersey was ‘aggressively marketed but inadequately funded.’ The plan collapsed with more than $7 million in unpaid claims.” [New York Times, 10/21/17]

In Florida, A Man Pleaded Guilty To Embezzling $700,000 In Premiums From An AHP To Help Build A Home For Himself And Was Sentenced To 57 Months In Prison. “A Florida man was sentenced to 57 months in prison after he pleaded guilty to embezzling about $700,000 in premiums from a health plan that he had marketed to small businesses. The Labor Department and the Justice Department said he had used some of the plan premiums to build a home for himself.” [New York Times, 10/21/17]

In South Carolina, A Man Pleaded Guilty To Diverting Nearly $1 Million From An AHP For Churches And Small Businesses, Leaving $1.7 Million In Unpaid Claims. “A South Carolina man pleaded guilty after the government found that he had diverted more than $970,000 in insurance premiums from a health plan for churches and small businesses. ‘His embezzlement and the plan’s consequent failure left behind approximately $1.7 million in unpaid medical claims,’ the Labor Department said.” [New York Times, 10/21/17]

In Louisiana, Two People Pleaded Guilty To Using Money From The AHP For Spa Treatments, Diamond Cuff Links, Foreign Travel And Other Personal Expenses. “And in Louisiana, two people pleaded guilty to conspiracy charges after the government found that they had taken money from the medical benefit fund of a trade association and used it to pay for spa treatments, diamond cuff links, evening gowns, foreign travel and other personal expenses.” [New York Times, 10/21/17]

One AHP Scheme Shows How AHPs Can Move From State To State. Families USA chronicled an AHP scheme involving the American Trade Association, Smart Data Solutions, and Serve America Assurance. They found:

  • “Even after one state identifies a problem, the company may continue to operate for years in other states. North Carolina issued a cease and desist order to stop many of the players in this case from selling insurance in 2008.”
  • “But by June 2010, when Maryland issued a cease and desist order, the plans sold by these players had been identified in at least 23 states.2 „ Estimates of total premiums paid to these companies for unauthorized, unlicensed plans range from $14 million to $100 million.”
  • “This particular scheme operated through associations that went by many different names. (At least one of the players in this case was involved in a previous case concerned with fraudulent insurance sold through an association of employers in 2001-2002.”
  • “Consumers are often ill-protected when they buy coverage through an association, and the web of relationships among salespeople, associations, administrators, and actual insurers can be difficult for regulators to unravel and oversee. Consumers may be encouraged to join fake associations to buy health insurance so they have an illusion of coverage—and the insurers collect membership dues and premiums while illegally avoiding state oversight).” [Families USA, October 2010]

GAO Report In 1992 Showed Similar AHPs Left At Least 398,000 Participants With More Than $123 Million In Unpaid Claims And More Than 600 Plans In Almost Every State Failed To Comply With State Laws. “Back in 1992, the Government Accountability Office issued a scathing report on these multiple employer welfare arrangements (known as MEWAs; they’re pronounced “mee-wahs”) in which small businesses could pool funds to get the lower-cost insurance typically available only to large employers. These MEWAs, said the government, left at least 398,000 participants and their beneficiaries with more than $123 million in unpaid claims between January 1988 and June 1991. Furthermore, states reported massive and widespread problems with MEWAs. More than 600 plans in nearly every U.S. state failed to comply with insurance laws. Thirty-three states said enrollees were sometimes left without health coverage when MEWAs disbanded…’MEWAs have proven to be a source of regulatory confusion, enforcement problems and, in some instances, fraud,’ the GAO wrote at the time.” [Washington Post, 10/12/17]

Kentucky Experiment Showed AHPs Destabilize The Market And Caused Insurers To Leave Individual Market Or Not Sell New Policies Subject To Higher Standards. “In 1994, Kentucky passed a set of health insurance reforms (for the individual and small-group markets) that were very similar to the ACA’s market reforms.  These included a requirement for insurers to accept all applicants regardless of their health status, restrictions on exclusions of pre-existing health conditions, and a requirement that premiums be set without regard to health status, claims experience, or gender.  Premium variations for age, family size, and geographic factors were limited, and plan benefits were standardized. Insurers in the state resisted the reforms and lobbied to repeal parts of it. In 1996, Kentucky’s legislature passed legislation that repealed many of the market reforms.  Crucially, the law exempted associations of employers or individuals from the premium-rating and benefits requirements, a loophole that allowed associations to sell coverage under a much weaker regulatory scheme. In part because healthy individuals could buy association plans, the risk of adverse selection against the reformed individual market increased.  Nearly all insurers left Kentucky’s individual market or declined to sell new policies that were subject to the stronger rating and benefits standards. In 1998, the Kentucky legislature passed a bill that repealed many of the state’s remaining health insurance reforms.” [Center on Budget and Policy Priorities, 11/29/17]

KEY STAKEHOLDERS OPPOSE AHPs, SAYING THEY WOULD DESTABILIZE THE MARKETS, RAISE COSTS AND GUT PROTECTIONS FOR PEOPLE WITH PRE-EXISTING CONDITIONS

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

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

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

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

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

Small Business Majority: “These Changes Would Be Bad For Small Businesses And Their Employees Because They Could Lead To Higher Premiums, Unbalanced Risk Pools And Lower-Quality Insurance.” “We are extremely disappointed this administration continues to undermine the Affordable Care Act (ACA), as evidenced today when President Trump signed an executive order allowing insurance companies to sell health insurance products across state lines and making it easier for groups to establish association health plans (AHPs). These changes would be bad for small businesses and their employees because they could lead to higher premiums, unbalanced risk pools and lower-quality insurance. While President Trump’s order would make it easier for a few select small businesses with younger and/or healthier employees to purchase association health plans that might be cheaper in other states, the tradeoff is that this would result in the emergence of parallel insurance markets for small businesses, leading to major spikes in premiums for small firms that remain in the small-group market.” [SBA, 10/12/17]

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

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

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

ASSOCIATION HEALTH PLANS ALLOW PROVIDERS TO CHERRY PICK HEALTHIER PEOPLE, RAISING COSTS ON PEOPLE WITH PRE-EXISTING CONDITIONS AND DESTABILIZING THE MARKET

Tim Jost: “It Will Destroy The Small-Group Market…We’ll Be Back To Where We Were Before The Affordable Care Act.” “The result could in many cases be that these new association health plans would be considered large employers when it comes to health insurance. Large employers are not subject to the same rules as individual or small-group plans under Obamacare. Most notably, they do not have to cover all of the law’s essential health benefits or meet the requirement that insurance cover a minimal percentage of a person’s medical bills.If that change were made, association health plans would be freed to craft skimpier (and cheaper) health plans that appeal only to businesses with younger and healthier employees. Small businesses left in Obamacare’s marketplace would likely face higher costs and fewer options as the market became less attractive to insurers. ‘It will destroy the small-group market,’ Tim Jost, a law professor at Washington and Lee University who generally supports Obamacare, told me before the order was signed. ‘We’ll be back to where we were before the Affordable Care Act.’” [Vox, 12/29/17]

Georgetown Center on Health Insurance Reforms: Prior To ACA, AHPs Would Set Up Headquarters In A State With Fewer Regulations And Market To States With More Regulations. “Additionally, AHPs would often set up headquarters in one state with limited regulatory oversight and market policies to businesses and consumers in other states with more robust regulation, thereby bypassing those states’ more protective rating and benefit standards.” [Georgetown Center on Health Insurance Reforms, December 2017]

Deep Banerjee, S&P Global Ratings: “No One Healthy Is Now Going To Sign Up In The ACA Risk Pool, Because They Have This Cheaper Option.” “With associations, health care providers can effectively choose the most desirable participants, allowing the healthy to make the switch to save money — and potentially shutting out the less healthy. ‘No one healthy is now going to sign up in the ACA risk pool, because they have this cheaper option,’ Deep Banerjee, a health care analyst at S&P Global Ratings said.” [UPI, 10/12/17]

 

ashoup
In News

This Week in the War on Health Care

While a debate over Laurel and Yanny raged from coast to coast, Republicans continued their unprecedented assault on the American health care system. Here’s what happened this week in the war on health care, plus two more polls showcasing the massive unpopularity of the GOP sabotage campaign:

REPEAL AGAIN…REALLY?!

This week, Republican Senators once again started talking about reviving the worst of last year’s Republican repeal bills, Graham-Cassidy – apparently with the White House’s support. With the American people having rejected the GOP’s harmful repeal bills over and over again, Washington Republicans’ continued obsession with cutting Medicaid and ending protections for pre-existing conditions shows just how out of touch they are on the number one issue voters care about: health care.

THE COST OF SABOTAGE

On Monday, Protect Our Care launched Rate Watch, an educational campaign highlighting how Republican health care sabotage is forcing up health care costs across the country. As insurance companies’ preliminary rate filings point to Republican sabotage to justify hikes, Americans sat up and took notice:

The Hill: Premium Hikes Reignite The Obamacare Wars. “Democrats argue the price increases are the result of what they refer to as ‘Republican sabotage.’ They contend that, since the GOP controls Congress and the White House, the price hikes are their responsibility — and that’s the message they plan to take into the fall campaign… Protect Our Care, a pro-ObamaCare group, launched ‘Rate Watch’ on Tuesday, a media campaign and website aimed at getting out the Democrats’ message that Republicans are to blame for rate hikes..” [The Hill, 5/15]

Politico: Democrats Run On GOP Health Care ‘Sabotage.’ “Democrats are confidently running on Obamacare for the first time in a decade. They’ve got a unified message blaming Republicans for ‘sabotaging’ the health care law, leading to a cascade of sky-high insurance premiums that will come just before the November midterm elections. They’re rolling out ads featuring people helped by the law. And Tuesday, they’re starting a campaign to amplify each state’s premium increases — and tie those to GOP decisions… ‘Democrats need to prosecute the case against the Republican approach to health care,’ said Brad Woodhouse, campaign director at Protect Our Care and a longtime Democratic strategist.” [Politico, 5/15]

Washington Examiner: Obamacare Supporters Now Seizing On Rate Increases To Go After GOP. “The Obamacare advocacy group Protect Our Care announced its Rate Watch campaign Tuesday that will highlight proposed premium increases for Obamacare’s exchanges for 2019. The group said the goal of the campaign is to tie Republicans to the rate hikes because of moves such as the repeal of Obamacare’s individual mandate penalty that everyone have health insurance. ‘This is a purposeful, intentional campaign of sabotage that is making health insurance unaffordable,’ Sen. Chris Murphy, D-Conn., said on a call with reporters Tuesday.” [Washington Examiner, 5/16]

VERMONTERS AND OREGONIANS BECOME LATEST VICTIMS OF GOP SABOTAGE

Emphasizing the importance of Rate Watch, this week preliminary rate filings in Vermont and Oregon for 2019 plans were announced, and they included potential double-digit premium increases. Why? Here’s what insurance companies in the two states said:

“Recent federal legislation also eliminated the penalty associated with the individual mandate. As a result, it is expected that a number of healthy individuals will choose to forgo coverage and leave the single risk pool.” [BCBS Vermont, 5/14]

“These rate changes are necessary due to the increasing cost of medical care, the continued lack of funding for cost sharing reduction plans, and the expected reduction in the size of the Individual ACA market.” [BCBS Oregon, 5/14]

“The main drivers of the rate change are the increasing cost of medical care and the expected reduction in the size of the individual market. This filing reflects projected claim expenses increasing around 8.3% annually.” [BridgeSpan, 5/14]

For the past year and a half, President Trump and his Republican allies in Congress have engaged in a deliberate, aggressive campaign to undermine health care, and now families in Vermont and Oregon are being asked to pay the price. President Trump and Congressional Republicans should start working on bipartisan solutions to make coverage more affordable, instead of helping their friends in the insurance industry make another buck on the backs of hardworking Americans.

NEW STUDY FINDS PREMIUM INCREASES DUE TO GOP SABOTAGE CAMPAIGN

This morning, the Kaiser Family Foundation released a new study which attributed insurance companies’ premium increases to the GOP’s sabotage campaign, namely the repeal of the individual mandate and the embrace of short-term junk plans, and notes that:

However, absent any policy changes, it is likely that insurers would generally have required only modest premium increases in 2018 and in 2019 as well. Insurers are now beginning to file proposed rates for 2019.

As a reminder, the repeal of the individual mandate is expected to increase the uninsured rate by 13 million, and short-term plans have been estimated to raise premiums by 18.2%.

PRESIDENT’S PRESCRIPTION DRUG SPEECH NOT GETTING BETTER WITH AGE

Last Friday, President Trump gave a widely-panned speech on prescription drug pricing. The early reviews were not kind, and the coverage this week was no better. Here’s how the President’s remarks were covered this week:

Washington Post: Trump’s drug price retreat adds to list of abandoned populist promises

Washington Post: The health industry appears unfazed by Trump’s drug pricing speech

Bloomberg: Drug Industry Dodges Its Worst Fears in Trump’s Plan to Lower Prices

Pittsburgh Post-Gazette: Experts say Trump’s prescription to reduce drug prices is not what the doctor ordered

STAT News: Trump promised to bring pharma to justice. His speech sent drug stocks soaring

SEEMA VERMA ADMITS TRUMP ADMINISTRATION WILL LET UNINSURED RATE CONTINUE TO RISE

On Tuesday, Centers for Medicare & Medicaid Services Administrator Seema Verma admitted that the uninsured rate will continue to rise under her Administration’s watch.

Her remarks were only the latest example of the Trump Administration’s total disregard for Americans’ health care. During President Trump’s first year in office, the uninsured rate grew by 3 million – the largest increase since 2008. During President Trump’s second year in office, premiums are expected to increase double-digits across the country. The Trump Administration and Republicans in Congress have carried out a sabotage campaign designed to make the Affordable Care Act fail, and they have succeeded to the detriment of the American people. Administrator Verma’s admitting that the Administration has no plans to stop this suffering is disgraceful.

Enough is enough – it’s time for the GOP to end their war on health care. And if they don’t…

POLLS IN ARIZONA AND NEVADA CONFIRM: VOTERS SUPPORT THE ACA, OPPOSE GOP HEALTH CARE PLANS

This week, new polls were released in Arizona and Nevada. Most strikingly, the polls found that both Arizonans and Nevadans broadly support the Affordable Care Act over repeal.

From Arizona:

Republican candidates in Arizona running on the repeal of the Affordable Care Act do so at their own peril, according to a poll released Monday. The survey, conducted by the left-leaning Public Policy Polling, shows 33 percent of registered voters were more likely to vote for politicians who support scrapping ObamaCare compared to 46 percent who say they’re less likely. A majority of Arizonans also want to keep the current health law in place and would blame Republicans for health premiums increasing.

And Nevada:

In a poll released this week, most Nevada voters said they would hold Republicans “responsible” if ACA premiums increased this summer, and 53 percent favored fixing the law rather than repealing it and starting over.

Perhaps someone can bring these polls to the next Senate GOP caucus meeting.

ashoup
In News

Rate Watch Campaign Builds Momentum Against Republican Health Care Sabotage

Momentum is building against Republicans’ war on health care as families across the country start to count its consequences in dollars and cents. That’s why Protect Our Care’s ‘Rate Watch’ education and accountability campaign drew widespread attention yesterday:

The Hill: Premium Hikes Reignite The Obamacare Wars. “The cost of health insurance plans on the ObamaCare exchanges could jump in the coming weeks, some by double digits, inflaming the issue ahead of the midterm elections. Democrats argue the price increases are the result of what they refer to as ‘Republican sabotage.’ They contend that, since the GOP controls Congress and the White House, the price hikes are their responsibility — and that’s the message they plan to take into the fall campaign… Protect Our Care, a pro-ObamaCare group, launched ‘Rate Watch’ on Tuesday, a media campaign and website aimed at getting out the Democrat’s message that Republicans are to blame for rate hikes. Only a handful of states have released proposed premiums for next year, as insurers are largely still hammering out what their preliminary rates are going to be.” [The Hill, 5/15]

Circa News: Democrats Slam Trump, GOP Over Proposed Obamacare Rate Hikes. Protect Our Care, a coalition dedicated to preserving the ACA and opposing the GOP health care agenda, launched a campaign Tuesday to highlight proposed insurance rate increases and heap responsibility for them onto the Trump administration in advance of the November midterm elections. A ‘Rate Watch’ website, paid media, and coordinated educational efforts will aim to link high preliminary health insurance premiums to Trump’s policies as they are announced in the months ahead. ‘Families in every state in the nation are scared by the fallout of Washington Republicans’ repeal-and-sabotage war on health care, and with Rate Watch, we’re holding Republicans responsible for what they’ve done,’ said Protect Our Care Campaign Director Brad Woodhouse in a statement. ‘Every health care expert is confirming what ex-Secretary Tom Price just admitted: Republicans are responsible for hiking people’s premiums.’” [Circa, 5/15]

Politico: Democrats Run On GOP Health Care ‘Sabotage.’ “Democrats are confidently running on Obamacare for the first time in a decade. They’ve got a unified message blaming Republicans for ‘sabotaging’ the health care law, leading to a cascade of sky-high insurance premiums that will come just before the November midterm elections. They’re rolling out ads featuring people helped by the law. And Tuesday, they’re starting a campaign to amplify each state’s premium increases — and tie those to GOP decisions. That’s a big change from four election cycles of reluctance to talk about Obamacare on the stump… ‘Democrats need to prosecute the case against the Republican approach to health care,’ said Brad Woodhouse, campaign director at Protect Our Care and a longtime Democratic strategist. They will blame the next round of premium spikes on the GOP because Republicans repealed the individual mandate, eliminated a low-income subsidy, and let people enroll in health plans that don’t have the full range of ACA benefits and patient protections.” [Politico, 5/15]

Connecticut Mirror: Dems Predict ‘Eye-Popping’ Health Premium Hikes, Blame GOP. “Sen. Chris Murphy on Tuesday helped launch a Democratic initiative that blames Republicans for ‘sabotaging’ the Affordable Care Act, leading to sky-high health insurance premiums. Those sharp rate hikes — averaging more than 18 percent nationally for individual policies — will be announced just before November’s mid-term elections and will be an issue in many campaigns, the Democrats predict… Brad Woodhouse, campaign director at Protect Our Care and a longtime Democratic strategist, said Republicans had launched a ‘war on health’ that will result in ‘eye-popping rate increases.’” [CT Mirror, 5/15]

Washington Examiner: Obamacare Supporters Now Seizing On Rate Increases To Go After GOP. “A few years ago, Republicans would send out blaring alerts whenever an insurer proposed a double-digit rate increase for its Obamacare plans, putting Democrats on the defensive. Now Democrats and Obamacare supporters are hoping to do the same to the GOP, seizing on proposed rate hikes as evidence of GOP ‘sabotage’ of the law. The Obamacare advocacy group Protect Our Care announced its Rate Watch campaign Tuesday that will highlight proposed premium increases for Obamacare’s exchanges for 2019. The group said the goal of the campaign is to tie Republicans to the rate hikes because of moves such as the repeal of Obamacare’s individual mandate penalty that everyone have health insurance. ‘This is a purposeful, intentional campaign of sabotage that is making health insurance unaffordable,’ Sen. Chris Murphy, D-Conn., said on a call with reporters Tuesday… Protect Our Care is pointing to the proposals as evidence that the Trump administration is sabotaging the law. The Rate Watch campaign website lists a filing from Virginia insurer Cigna that stated a 15 percent increase is caused by the elimination of the individual mandate penalty and regulations to expand access to cheap, low-quality health plans. [Washington Examiner, 5/16]

Inside Health Policy: Protect Our Care Launches Campaign Blaming GOP For ACA Rate Hikes. “A pro-ACA group Wednesday launched a campaign that casts blame on the Trump administration and the GOP-led Congress for premium increases, holding up the GOP’s repeal of the individual mandate penalty, cutback of ACA advertising and outreach, and proposed non-ACA compliant plan options that could undermine the risk pools. Democrats say they want to work with the GOP on ways to reverse the rate hikes but see little hope for a way forward. Sen. Chris Murphy (D-CT) joined Protect Our Care, the left-leaning Center for American Progress and a Florida resident impacted by the rate hikes in announcing the co-called Rate Watch campaign. The Connecticut senator stressed that Democrats have spent the last 18 months fighting the GOP ‘sabotage’ of the Affordable Care Act.” [Inside Health Policy, 5/15]

ashoup
In News

NYT Report: Junk Plans Will Cause Bigger Dent in Health Care System, Cost Feds Almost $40 Billion

As the New York Times reported that an independent federal actuary has undercut Trump Administration claims its junk plan proposal would cause minimal damage to the health care system, Protect Our Care Campaign Director Brad Woodhouse said:

“The Trump Administration’s claims about how their junk plan proposal would impact people’s care never passed the smell test, and now we have solid proof that the fallout would be far worse than they originally claimed. In the wake of this new data, there’s simply no excuse for the Administration to move forward with a plan that does all of the things the American people don’t want to happen to health care. We don’t want to go back to the days when millions of people were stuck with junk plans that didn’t have to cover basic medical services. We don’t want to go back to the days insurance companies could charge more for pre-existing conditions or deny coverage altogether. This junk plan proposal has drawn criticism from over one hundred prominent disease advocates, from the AARP, from doctors and providers, and from thousands of concerned Americans. The Trump Administration should listen to the experts, doctors, insurance commissioners, and individual advocates who have together formed a tidal wave of opposition to junk plans, and withdraw this dangerous and damaging proposal.”

Trump’s Plan for Cheaper Health Insurance Could Have Hidden Costs
New York Times // Robert Pear

President Trump’s plan to expand access to skimpy short-term health insurance policies, as an alternative to the Affordable Care Act, would affect more people and cost the government more money than the administration estimated, an independent federal study says.

The study, by Medicare’s chief actuary, suggests that the new policies would appeal mainly to healthy people, including many who have had comprehensive coverage under the Affordable Care Act.

The administration estimated in February that a few hundred thousand people might sign up for the “short-term, limited-duration policies,” which would not have to provide the standard health benefits like preventive services, maternity care or prescription drug coverage.

But the chief actuary, Paul Spitalnic, estimates that 1.4 million people could sign up for the short-term policies in the first year, with enrollment reaching 1.9 million by 2022.

Under current rules, such short-term insurance cannot last for more than three months. Under a rule proposed by the Trump administration in February, the limit would be 364 days.

The new policies would probably attract people who do not need the full suite of benefits guaranteed by the Affordable Care Act, Mr. Spitalnic wrote in a recent memorandum.

Those remaining in Affordable Care Act marketplaces “would be relatively less healthy,” Mr. Spitalnic said, and as a result, the average premiums for those insurance policies would increase.

The federal government subsidizes premiums for most people who buy insurance in the marketplace. When premiums rise, the subsidy payments from the federal Treasury also increase.

The Trump administration estimated the extra cost to the federal government at $96 million to $168 million a year.

But the chief actuary, whose independence is protected by federal law, estimates that the rule proposed by the administration could increase federal spending by $1.2 billion next year and by a total of $38.7 billion over 10 years.

In its latest regulatory agenda, the administration said that a final rule expanding access to short-term policies could come next month. The rule would carry out an executive order signed by Mr. Trump with fanfare in October.

The executive order said the new policies would provide “an appealing and affordable alternative” because they would be “exempt from the onerous and expensive insurance mandates” in the Affordable Care Act.

When he signed the order, Mr. Trump said that short-term insurance would become “much more widely available” and that it would “cost us nothing.”

Mr. Spitalnic confirmed that the new policies would be cheaper for many consumers. He estimated that the full unsubsidized premium for a marketplace plan would be about $600 a month next year, on average — about 75 percent more than the premium of roughly $340 for short-term policies.

But the new short-term plans would also offer less protection to consumers.

Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, defended the president’s proposal.

“Because costs have gone up so much, there are a lot of individuals who can’t afford any coverage,” she said on Tuesday at a Washington Post event exploring the future of health care. For some of these people, she said, short-term plans “potentially could be a lifeline.”

Mr. Trump announced a major initiative last week to reduce consumers’ out-of-pocket costs for prescription drugs. But a new study by the Kaiser Family Foundation says that many short-term insurance plans do not cover prescription drugs outside the hospital, leaving consumers to pay the bills.

Short-term insurance policies were originally intended for people who were between jobs or needed temporary coverage for other reasons. Under the proposed rule, they could play a larger role.

“There is nothing in the proposed rule that would prevent companies from underwriting and issuing new policies to individuals at the end of the one-year coverage term,” Mr. Spitalnic said.

Under the Affordable Care Act, the most popular type of marketplace plans, so-called silver plans, cover 70 percent of health care costs for a typical population. By contrast, Mr. Spitalnic said, the new short-term plans would cover 50 percent of costs, on average.

Short-term plans can exclude coverage for pre-existing conditions and can omit some benefits deemed essential in the Affordable Care Act.

Thus, for example, some short-term plans offered by UnitedHealth Group do not provide prescription drug coverage and do not pay expenses related to a normal pregnancy or the treatment of mental disorders, according to a brochure from the company.

Another insurer, National General, says in a brochure that its short-term medical plans may not cover outpatient prescription drugs, normal pregnancy or childbirth, routine well-baby care or costs resulting from a pre-existing condition.

 

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Why Oregonians’ Insurance Is Getting Even More Expensive: The Trump Administration and Washington Republicans Keep Sabotaging Health Care

Washington, D.C. – As preliminary Oregon rate filings for 2019 individual-market health insurance indicated potential double-digit premium increases due to Washington Republicans’ repeal-and-sabotage agenda, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“For the past year and a half, President Trump and his Republican allies in Congress have engaged in a deliberate, aggressive campaign to undermine health care and now families in Oregon are being asked to pay the price. While insurance companies make huge profits and enjoy record tax breaks from Republicans, they are planning to charge working families even more. Until we stop Republicans’ war on health care, health care experts predict that rates will keep rising by double digits. Washington Republicans should start working on bipartisan solutions to make coverage more affordable, instead of helping their friends in the insurance industry make another buck on the backs of hardworking Oregonians.”

From the Insurance Companies

Regence Blue Cross Blue Shield of Oregon: “Continued Lack Of Funding For Cost Sharing Reduction Plans” And “Expected Reduction In The Size Of The Individual ACA Market” Responsible For Higher Premiums. “These rate changes are necessary due to the increasing cost of medical care, the continued lack of funding for cost sharing reduction plans, and the expected reduction in the size of the Individual ACA market.” [BCBS, 5/14]

BridgeSpan: “Expected Reduction In The Size Of The Individual Market” Driving Higher Premiums. “The main drivers of the rate change are the increasing cost of medical care and the expected reduction in the size of the individual market. This filing reflects projected claim expenses increasing around 8.3% annually.” [BridgeSpan, 5/14]

Why Oregonians’ Insurance Is Getting Even More Expensive: The Trump Administration and Washington Republicans Keep Sabotaging Health Care

While spending most of last year trying to repeal the Affordable Care Act (ACA) and waging a war on our health care, President Trump and Republicans in Congress have also used their control of Washington to actively undermine the Health Insurance Marketplaces every chance they get – leading insurance companies to raise premiums for 2018 and 2019 and, in some cases, forcing them out of the individual market altogether. Washington Republicans’ goal is simple: sabotage and undermine the Affordable Care Act, then blame everyone but themselves for the consequences of their actions. President Trump keeps rooting for disaster, saying that “The best thing we can do…is let Obamacare explode” and “Let it be a disaster because we can blame that on the Democrats.”

Now, initial rate filings in Oregon forecast double-digit rate hikes again this fall because of Republican sabotage.

Republicans never ended their war on our health care. After Congress failed to repeal the Affordable Care Act, the Trump Administration is aggressively sabotaging our health care system and refusing to work to make coverage better and more affordable.

  • Experts from AARP, the Congressional Budget Office, and a wide range of other nonpartisan organizations agree that Republican actions are forcing up health care costs.
  • Republicans in Congress are supporting the Administration’s many actions to undermine health care, despite widespread opposition from patient and disease groups, doctors, nurses, hospitals, plus health care and consumer advocates.
  • The Trump Administration officials keep rewriting the rules to let big insurance companies cover fewer and fewer services while charging people more and more. The sabotage doesn’t stop there: last year the Administration fired many of the community assisters who help people enroll in health care; this year they are planning more enrollment cuts, making it even harder to sign up for coverage.
  • And now, Republicans are encouraging insurance companies to sell more junk plans that don’t have to cover basic care like hospitalization and prescription drugs, and that are allowed to charge people with pre-existing conditions more or even deny them coverage altogether. In Oregon, no short-term plans available have to cover maternity care, and only 23 percent of plans cover prescription drugs.

The Trump Administration’s sabotage will punish Americans by jacking up premiums again, compounding the damage done last year, when Republican sabotage pushed rates up by a national average of 37 percent, and 20 percent in Oregon.

  • The Republican tax bill’s repeal of a key Affordable Care Act provision and the Trump Administration’s junk plan proposal will increase individual market premiums in Oregon by an average 9.1 percent this fall, according to a recent Urban Institute study.
  • This sabotage-driven rate hike will make the damage Republicans inflicted last year through repeal attempts and sabotage even worse.
  • Higher premiums will mean fewer working families can afford coverage: during the first year of the Trump Administration, millions more Americans joined the ranks of the uninsured – the highest increase since Gallup started tracking the uninsured rate.

This could have been avoided: if Republicans had stopped sabotaging health care, American families wouldn’t be facing another huge increase this fall.

  • Even the Trump Administration has admitted that the Affordable Care Act’s insurance marketplaces had been stabilizing prior to them coming into office.
  • The nonpartisan Congressional Budget Office had predicted only modest rate increases if Republicans hadn’t sabotaged the markets.
  • Even Senate Republicans admitted this fall’s upcoming rate hikes were “avoidable,” but then they torched bipartisan stabilization talks at the last minute, prioritizing partisan politics over their last opportunity to help American families afford health care next year.

Despite Republican Sabotage, the Affordable Care Act Has Improved Oregonians’ Care.

  • 156,105 Oregonians signed up for Marketplace coverage this year.
  • Thanks to the Marketplace and Medicaid expansion, Oregon’s uninsured rate fell by 8 percent between 2013 and 2016 as Oregonians have gained access to affordable coverage.
  • Before today’s announcement, the Urban Institute predicted that Oregon premiums for 2019 could rise 9.1 percent more because of the Trump Administration’s junk plan proposal and the Republican tax bill’s repeal of a key Affordable Care Act coverage incentive.
  • Even despite sabotage, Affordable Care Act subsidies help keep coverage affordable for 75 percent of Oregon Marketplace consumers, whose average 2018 premium is $138 per month.
  • But because of the Republican sabotage agenda, many middle-income Oregonians could pay hundreds or thousands of dollars more than they would have otherwise.

KEY QUOTES

Former HHS Secretary Tom Price: GOP Actions Responsible For Premium Increases. “President Trump’s former top health official on Tuesday said the Republican tax law would raise the cost of health insurance for some Americans because it repealed a core provision of the Affordable Care Act. Tom Price, Trump’s first secretary of the Department of Health and Human Services, said people buying insurance on government-run marketplaces will face higher prices because the tax law repealed the ACA’s individual mandate. The mandate had forced most Americans to have health coverage or face a financial penalty. ‘There are many, and I’m one of them, who believes that that actually will harm the pool in the exchange market, because you’ll likely have individuals who are younger and healthier not participating in that market, and consequently that drives up the cost for other folks within that market,’ Price said at the World Health Care Conference in Washington.” [Washington Post, 5/1/18]

Cigna: Policies Advocated By The Trump Administration Causing Premium Increases. “Two of Virginia’s ObamaCare insurers are requesting significant premium hikes for 2019, according to initial filings released Friday. Both Cigna and CareFirst BlueCross BlueShield cited policies advocated by the Trump administration, including the repeal of ObamaCare’s individual mandate, as part of its justifications for the increases. Cigna is proposing an average premium increase of 15 percent for its 103,264 customers in Virginia, with a range of increases from 6.4 percent to 40 percent. CareFirst is proposing a 64 percent increase for its approximately 4,500 customers in the commonwealth, citing an increase in sicker people entering the marketplace.” [The Hill, 5/4/18]

Commonwealth Fund: Rollback Of Health Insurance Gains Spurred By “Actions By The Current Administration.” “The marked gains in health insurance coverage made since the passage of the Affordable Care Act (ACA) in 2010 are beginning to reverse, according to new findings from the latest Commonwealth Fund ACA Tracking Survey. The coverage declines are likely the result of two major factors: 1) lack of federal legislative actions to improve specific weaknesses in the ACA and 2) actions by the current administration that have exacerbated those weaknesses. These include the administration’s deep cuts in advertising and outreach during the marketplace open-enrollment periods, a shorter open enrollment period, and other actions that collectively may have left people with a general sense of confusion about the status of the law. Signs point to further erosion of insurance coverage in 2019: the repeal of the individual mandate penalty included in the 2017 tax law, recent actions to increase the availability of insurance policies that don’t comply with ACA minimum benefit standards, and support for Medicaid work requirements.” [Commonwealth Fund, 5/1/18]

New York Times: “Rather Than Trying To Eliminate Obamacare In One Fell Swoop, [Republicans Are] Trying To Undermine It With Multiple Acts Of Sabotage – While Hoping Voters Won’t Realize Who’s Responsible For Rising Premiums And Falling Coverage.” “At the beginning of 2017, Republicans promised to release the kraken on Obamacare — to destroy the program with one devastating blow. But a funny thing happened: Voters realized that repealing the Affordable Care Act would mean taking health insurance away from tens of millions of Americans. They didn’t like that prospect — and enough Republicans balked at the backlash that Obamacare repeal fizzled. But Republicans still hate the idea of helping Americans get health care. So instead of releasing the kraken, they’ve brought on the termites. Rather than trying to eliminate Obamacare in one fell swoop, they’re trying to undermine it with multiple acts of sabotage — while hoping voters won’t realize who’s responsible for rising premiums and falling coverage.” [NYT, 5/8/18]

New York Times Editorial Board: “The Administration’s Health Care Sabotage Efforts Have Already Had A Big Impact”: A 30-Percent Premium Increase. “The administration’s health care sabotage efforts have already had a big impact — but not the kind of impact officials promised. Insurance companies raised average premiums for 2018 A.C.A. policies by 30 percent. This has mostly hurt middle-class families who have to pay full freight for health insurance because they make too much money to qualify for subsidies and don’t get coverage through their employer. Few experts were surprised when the Commonwealth Fund found that the percentage of American adults who did not have health insurance jumped to 15.5 percent this year, from 12.7 percent before Mr. Trump took office. Experts say those numbers could climb higher still when the penalty for not having insurance goes away next year.” [NYT, 5/3/18]

Washington Post Editorial Board: “The Numbers Suggest That [The ACA’s] Critics’ Sabotage Efforts Are To Blame. “The effects of the president’s underinformed instincts, enabled by the ideologues in his administration, are beginning to show up in some of the numbers, representing real pain that Americans are suffering for Mr. Trump’s deficient leadership… Obamacare critics regularly describe all problems as the inevitable result of a poorly designed law. But the numbers suggest that the critics’ sabotage efforts are to blame. After impressive declines during President Barack Obama’s second term, the fund found that the uninsured rate increased in both of the years Mr. Trump has been in office. During the campaign, Mr. Trump regularly complained that the Affordable Care Act (ACA) left too many Americans uncovered. The result of nearly a year and a half of Mr. Trump’s leadership is 4 million people added to that group.” [Washington Post, 5/8/18]

America’s Health Insurance Plans: Republican Sabotage Will “Drive Up The Rate Of Premium Increases.” “Policies that disproportionately draw healthy consumers away from the individual market, like expanding access to short-term plans, will likely have an even more devastating effect on affordability, choice and competition. This will further result in adverse selection, drive up the rate of premium increases, and exacerbate affordability issues for many other people.” [America’s Health Insurance Plans Letter to HHS, 4/20/18]

CEO of CareFirst Blue Cross Blue Shield: Things Are “Materially Worse” Under Trump. “Continuing actions on the part of the administration to systematically undermine the market and make it almost impossible to carry out the mission…If continued efforts at the federal level undermine the marketplaces, I would think the board would have to examine what they would want — that’s very much on their mind.” [Washington Post, 5/1/18]

Horizon Blue Cross Blue Shield of New Jersey: 2018 Premium Increase Was Due To Federal Policy. “Three factors connected to federal policy decisions are responsible for 14.7% of the 24.3% total average individual premium increase: Weakened enforcement of the Individual Mandate…Elimination of federal funding for Cost Sharing Reductions (CSR), [and] 2018 reinstatement of Health Insurance Tax…Were it not for the three factors within the control of the Federal Government, Horizon BCBSNJ’s individual premiums would have an average increase of 9.6%.” [Horizon Blue Cross Blue Shield of New Jersey, 10/17/17]

Lindsey Graham: Republicans “Own The Outcome” On Health Care. “Sen. Graham told Breitbart News, ‘In October, premiums are going up. Obamacare cannot be fixed. It’s 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. We have a responsibility to do something about the collapsing Obamacare system. I believe that we’re going to get blamed more than Democrats because we stopped trying to repeal Obamacare, and to suggest that we don’t own it is just simply politically naive.’ Graham continued, ‘It can hurt us in 2018. It can hurt by our base feeling like we betrayed them. It can hurt us from people suffering from Obamacare, like we don’t have a solution. It will energize Democrats. It can undercut everything we did on the tax cut side.’” [Breitbart, 2/6/18]

Rep. Charlie Dent: “We, The Republican Party…Own” Health Care Now. “Rep. Charlie Dent (R-Pa.) argued Friday that President Trump was ‘ill-advised’ to end key ObamaCare payments, warning that the GOP now ‘owns’ whatever happens to ObamaCare. ‘I think the president is ill-advised to take this course of action because … we, the Republican Party, will own this,’ Dent, a key House moderate who is retiring from Congress at the end of his term, said on CNN. Asked about Trump’s previous comments blaming problems with ObamaCare on former President Barack Obama, Dent pointed out that Republicans currently control the White House and have majorities in both chambers of Congress. ‘Barack Obama is a former president. President Trump is the president and he’s a Republican, and we control the Congress,’ Dent said. ‘So we own the system now. We’re going to have to figure out a way to stabilize this situation … This is on us.’” [The Hill, 10/13/17]

Washington Post: “The Pottery Barn Rule Comes To Mind: You Break It, You Own It.” “This is not ‘letting’ Obamacare fail. Many nonpartisan experts believe that these active measures are likely to undermine the pillars of the 2010 law and hasten the collapse of the marketplaces. The Pottery Barn rule comes to mind: You break it, you own it. Yes, the plate you just shattered had some cracks in it. But if you dropped it on the ground, the store is going to blame you.” [Washington Post, 10/13/17]

Washington Post: “Trump’s Not Going To Be Able To Avoid Blame For Kneecapping Obamacare.” [Washington Post, 10/13/17]

“After Months Of Pinning The Blame For Obamacare’s Shortcomings On Democrats And Watching His Own Party Fail To Act, President Donald Trump Just Took Ownership Of A Struggle That’s Consumed Republicans For Seven Years.” “After months of pinning the blame for Obamacare’s shortcomings on Democrats and watching his own party fail to act, President Donald Trump just took ownership of a struggle that’s consumed Republicans for seven years. Trump’s decision late Thursday to end government subsidies to insurers to help lower-income Americans afford to use their coverage under the Affordable Care Act was the most drastic step he’s taken to undermine his predecessor’s signature achievement. It also lobbed a live bomb into the laps of Republicans lawmakers 13 months before congressional elections after he publicly berated the party’s Senate leadership for being unable to keep a longstanding promise to repeal the law.” [Bloomberg, 10/13/17]

The American People Agree: President Trump And Congressional Republicans Are Playing Politics With People’s Health Care.  A poll conducted last September found that 61 percent of voters believed President Trump was “trying to make the Affordable Care Act fail,” and 64 percent of voters said Trump is “playing politics with people’s health care.” The poll also found that the American people seriously disapprove of how Republicans in Congress are treating health care: 80 percent of voters disapprove while only 20 percent approve. [Hart Research, 9/5/17]

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Seema Verma Admits Her Administration Will Let Uninsured Rate Continue to Rise

Washington, D.C. – This morning at the America’s Health Care Future event hosted by the Washington Post, Centers for Medicare & Medicaid Services Administrator Seema Verma admitted that the uninsured rate will continue to rise under their watch. Protect Our Care Campaign Director Brad Woodhouse released the following statement in response:

“Administrator Verma’s remarks this morning are only the latest example of the Trump Administration demonstrating their total disregard for Americans’ health care. During President Trump’s first year in office, the uninsured rate grew by 3 million – the largest increase since 2008. During President Trump’s second year in office, premiums are expected to increase double-digits across the country. The Trump Administration and Republicans in Congress have carried out a sabotage campaign designed to make  the Affordable Care Act fail, and they have succeeded to the detriment of the American people. Administrator Verma’s admitting that the Administration has no plans to stop this suffering is disgraceful. Enough is enough – it’s time for the GOP to end their war on health care.

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Protect Our Care Launches “Rate Watch” Campaign

Washington, D.C. – Protect Our Care today is launching “Rate Watch,” an educational campaign that will highlight how Republican health care sabotage is forcing up health care costs across the country through a coordinated earned and paid media effort and a flagship website. Recently, President Trump’s former HHS Secretary admitted that the GOP agenda is raising premiums, and a wide range of experts project that health care sabotage will raise 2019 premiums by double digits.

“Families in every state in the nation are scared by the fallout of Washington Republicans’ repeal-and-sabotage war on health care, and with Rate Watch, we’re holding Republicans responsible for what they’ve done. Every health care expert is confirming what ex-Secretary Tom Price just admitted: Republicans are responsible for hiking people’s premiums. Republicans gave record-breaking tax breaks to health insurance and drug companies and now they’re sabotaging the health care system, letting those companies raise rates and profit even more,” said Protect Our Care Campaign Director Brad Woodhouse.  

“On his first day in office, President Trump signed an Executive Order to undermine the health care system – no matter the consequences – and he’s been rooting for it to fail ever since. Now, people who work for a living are going to pay the price. Their latest sabotage scheme is these junk plans that discriminate against people with pre-existing conditions and cover almost nothing. As long as Republicans refuse to stop repeal and sabotage, they bear full responsibility for the costs working people have to pay. ”

This morning, leading health care voices, including Senator Chris Murphy (D-CT), held a press conference call with reporters and advocates to outline the new program, which will educate the public, stakeholders, and press in all 50 states and Washington, D.C. about the factors at play as insurance companies file preliminary individual market rates.

Check out the new Rate Watch website here.

Over the past week, Protect Our Care has highlighted insurance companies’ own statements about how Republican sabotage is raising rates in Virginia, Maryland, and Vermont, the first three states to announce proposed premiums for 2019.

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Why Vermonters’ Insurance Is Getting Even More Expensive: The Trump Administration and Washington Republicans Keep Sabotaging Health Care

Washington, D.C. – As preliminary Vermont rate filings for 2019 individual-market health insurance indicated potential double-digit premium increases due to Washington Republicans’ repeal-and-sabotage agenda, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“For the past year and a half, President Trump and his Republican allies in Congress have engaged in a deliberate, aggressive campaign to undermine health care and now families in Vermont are being asked to pay the price. While insurance companies make huge profits and enjoy record tax breaks from Republicans, they are planning to charge working families even more. Until we stop Republicans’ war on health care, health care experts predict that rates will keep rising by double digits. Washington Republicans should start working on bipartisan solutions to make coverage more affordable, instead of helping their friends in the insurance industry make another buck on the backs of hardworking Vermonters.”

From the Insurance Companies:

Blue Cross Blue Shield Vermont: Federal Actions Are Responsible For 2.2 Percent Premium Increases. Recent federal legislation also eliminated the penalty associated with the individual mandate. As a result, it is expected that a number of healthy individuals will choose to forgo coverage and leave the single risk pool. This is expected to exert an upward pressure of 2.2 percent on premium rates. [BCBS, 5/14]

Why Vermonters’ Insurance Is Getting Even More Expensive: The Trump Administration and Washington Republicans Keep Sabotaging Health Care

While spending most of last year trying to repeal the Affordable Care Act (ACA) and waging a war on our health care, President Trump and Republicans in Congress have also used their control of Washington to actively undermine the Health Insurance Marketplaces every chance they get – leading insurance companies to raise premiums for 2018 and 2019 and, in some cases, forcing them out of the individual market altogether. Washington Republicans’ goal is simple: sabotage and undermine the Affordable Care Act, then blame everyone but themselves for the consequences of their actions. President Trump keeps rooting for disaster, saying that “The best thing we can do…is let Obamacare explode” and “Let it be a disaster because we can blame that on the Democrats.”

Now, initial rate filings in Vermont forecast double-digit rate hikes again this fall because of Republican sabotage.

Republicans never ended their war on our health care. After Congress failed to repeal the Affordable Care Act, the Trump Administration is aggressively sabotaging our health care system and refusing to work to make coverage better and more affordable.

  • Experts from AARP, the Congressional Budget Office, and a wide range of other nonpartisan organizations agree that Republican actions are forcing up health care costs.
  • Republicans in Congress are supporting the Administration’s many actions to undermine health care, despite widespread opposition from patient and disease groups, doctors, nurses, hospitals, plus health care and consumer advocates.
  • The Trump Administration officials keep rewriting the rules to let big insurance companies cover fewer and fewer services while charging people more and more. The sabotage doesn’t stop there: last year the Administration fired many of the community assisters who help people enroll in health care; this year they are planning more enrollment cuts, making it even harder to sign up for coverage.
  • And now, Republicans are encouraging insurance companies to sell more junk plans that don’t have to cover basic care like hospitalization and prescription drugs, and that are allowed to charge people with pre-existing conditions more or even deny them coverage altogether.

The Trump Administration’s sabotage will punish Americans by jacking up premiums again, compounding the damage done last year, when Republican sabotage pushed rates up by a national average of 37%.

  • The Republican tax bill’s repeal of a key Affordable Care Act provision and the Trump Administration’s junk plan proposal will increase individual market premiums in Vermont by an average 12.2 percent this fall, according to a recent Urban Institute study.
  • This sabotage-driven rate hike will make the damage Republicans inflicted last year through repeal attempts and sabotage even worse.
  • Higher premiums will mean fewer working families can afford coverage: during the first year of the Trump Administration, millions more Americans joined the ranks of the uninsured – the highest increase since Gallup started tracking the uninsured rate.

This could have been avoided: if Republicans had stopped sabotaging health care, American families wouldn’t be facing another huge increase this fall.

  • Even the Trump Administration has admitted that the Affordable Care Act’s insurance marketplaces had been stabilizing prior to them coming into office.
  • The nonpartisan Congressional Budget Office had predicted only modest rate increases if Republicans hadn’t sabotaged the markets.
  • Even Senate Republicans admitted this fall’s upcoming rate hikes were “avoidable,” but then they torched bipartisan stabilization talks at the last minute, prioritizing partisan politics over their last opportunity to help American families afford health care next year.

Vermonters Won’t Forget That Republicans And The Trump Administration Keep Forcing Up Health Care Costs To Score Political Points.

  • Health care costs are a top issue in nearly every major issue-ranked poll in 2018.
  • Voters overwhelmingly trust Democrats over Republicans on health care costs.
  • In poll after poll, voters resoundingly reject President Trump and Congressional Republicans’ repeal-and-sabotage campaign against the Affordable Care Act.

Despite Republican Sabotage, The Affordable Care Act Has Improved Vermonters’ Care.

  • 28,763 Vermonters signed up for Marketplace coverage this year.
  • Thanks to the Marketplace and Medicaid expansion, Vermont’s uninsured rate fell by 2.6 percent between 2013 and 2016 as Vermonters have gained access to affordable coverage.
  • Before today’s announcement, the Urban Institute predicted that Vermont premiums for 2019 could rise 12.2 percent more because of the Trump Administration’s junk plan proposal and the Republican tax bill’s repeal of a key Affordable Care Act coverage incentive.
  • Even despite sabotage, Affordable Care Act subsidies help keep coverage affordable for 79 percent of Vermont Marketplace consumers, whose average 2018 premium is $192 per month.
  • But because of the Republican sabotage agenda, many middle-income Vermonters could pay hundreds or thousands of dollars more than they would have otherwise.

KEY QUOTES

Former HHS Secretary Tom Price: GOP Actions Responsible For Premium Increases. “President Trump’s former top health official on Tuesday said the Republican tax law would raise the cost of health insurance for some Americans because it repealed a core provision of the Affordable Care Act. Tom Price, Trump’s first secretary of the Department of Health and Human Services, said people buying insurance on government-run marketplaces will face higher prices because the tax law repealed the ACA’s individual mandate. The mandate had forced most Americans to have health coverage or face a financial penalty. ‘There are many, and I’m one of them, who believes that that actually will harm the pool in the exchange market, because you’ll likely have individuals who are younger and healthier not participating in that market, and consequently that drives up the cost for other folks within that market,’ Price said at the World Health Care Conference in Washington.” [Washington Post, 5/1/18]

Cigna: Policies Advocated By The Trump Administration Causing Premium Increases. “Two of Virginia’s ObamaCare insurers are requesting significant premium hikes for 2019, according to initial filings released Friday. Both Cigna and CareFirst BlueCross BlueShield cited policies advocated by the Trump administration, including the repeal of ObamaCare’s individual mandate, as part of its justifications for the increases. Cigna is proposing an average premium increase of 15 percent for its 103,264 customers in Virginia, with a range of increases from 6.4 percent to 40 percent. CareFirst is proposing a 64 percent increase for its approximately 4,500 customers in the commonwealth, citing an increase in sicker people entering the marketplace.” [The Hill, 5/4/18]

Commonwealth Fund: Rollback Of Health Insurance Gains Spurred By “Actions By The Current Administration.” “The marked gains in health insurance coverage made since the passage of the Affordable Care Act (ACA) in 2010 are beginning to reverse, according to new findings from the latest Commonwealth Fund ACA Tracking Survey. The coverage declines are likely the result of two major factors: 1) lack of federal legislative actions to improve specific weaknesses in the ACA and 2) actions by the current administration that have exacerbated those weaknesses. These include the administration’s deep cuts in advertising and outreach during the marketplace open-enrollment periods, a shorter open enrollment period, and other actions that collectively may have left people with a general sense of confusion about the status of the law. Signs point to further erosion of insurance coverage in 2019: the repeal of the individual mandate penalty included in the 2017 tax law, recent actions to increase the availability of insurance policies that don’t comply with ACA minimum benefit standards, and support for Medicaid work requirements.” [Commonwealth Fund, 5/1/18]

New York Times: “Rather Than Trying To Eliminate Obamacare In One Fell Swoop, [Republicans Are] Trying To Undermine It With Multiple Acts Of Sabotage – While Hoping Voters Won’t Realize Who’s Responsible For Rising Premiums And Falling Coverage.” “At the beginning of 2017, Republicans promised to release the kraken on Obamacare — to destroy the program with one devastating blow. But a funny thing happened: Voters realized that repealing the Affordable Care Act would mean taking health insurance away from tens of millions of Americans. They didn’t like that prospect — and enough Republicans balked at the backlash that Obamacare repeal fizzled. But Republicans still hate the idea of helping Americans get health care. So instead of releasing the kraken, they’ve brought on the termites. Rather than trying to eliminate Obamacare in one fell swoop, they’re trying to undermine it with multiple acts of sabotage — while hoping voters won’t realize who’s responsible for rising premiums and falling coverage.” [NYT, 5/8/18]

New York Times Editorial Board: “The Administration’s Health Care Sabotage Efforts Have Already Had A Big Impact”: A 30-Percent Premium Increase. “The administration’s health care sabotage efforts have already had a big impact — but not the kind of impact officials promised. Insurance companies raised average premiums for 2018 A.C.A. policies by 30 percent. This has mostly hurt middle-class families who have to pay full freight for health insurance because they make too much money to qualify for subsidies and don’t get coverage through their employer. Few experts were surprised when the Commonwealth Fund found that the percentage of American adults who did not have health insurance jumped to 15.5 percent this year, from 12.7 percent before Mr. Trump took office. Experts say those numbers could climb higher still when the penalty for not having insurance goes away next year.” [NYT, 5/3/18]

Washington Post Editorial Board: “The Numbers Suggest That [The ACA’s] Critics’ Sabotage Efforts Are To Blame. “The effects of the president’s underinformed instincts, enabled by the ideologues in his administration, are beginning to show up in some of the numbers, representing real pain that Americans are suffering for Mr. Trump’s deficient leadership… Obamacare critics regularly describe all problems as the inevitable result of a poorly designed law. But the numbers suggest that the critics’ sabotage efforts are to blame. After impressive declines during President Barack Obama’s second term, the fund found that the uninsured rate increased in both of the years Mr. Trump has been in office. During the campaign, Mr. Trump regularly complained that the Affordable Care Act (ACA) left too many Americans uncovered. The result of nearly a year and a half of Mr. Trump’s leadership is 4 million people added to that group.” [Washington Post, 5/8/18]

America’s Health Insurance Plans: Republican Sabotage Will “Drive Up The Rate Of Premium Increases.” “Policies that disproportionately draw healthy consumers away from the individual market, like expanding access to short-term plans, will likely have an even more devastating effect on affordability, choice and competition. This will further result in adverse selection, drive up the rate of premium increases, and exacerbate affordability issues for many other people.” [America’s Health Insurance Plans Letter to HHS, 4/20/18]

CEO of CareFirst Blue Cross Blue Shield: Things Are “Materially Worse” Under Trump. “Continuing actions on the part of the administration to systematically undermine the market and make it almost impossible to carry out the mission…If continued efforts at the federal level undermine the marketplaces, I would think the board would have to examine what they would want — that’s very much on their mind.” [Washington Post, 5/1/18]

Horizon Blue Cross Blue Shield of New Jersey: 2018 Premium Increase Was Due To Federal Policy. “Three factors connected to federal policy decisions are responsible for 14.7% of the 24.3% total average individual premium increase: Weakened enforcement of the Individual Mandate…Elimination of federal funding for Cost Sharing Reductions (CSR), [and] 2018 reinstatement of Health Insurance Tax…Were it not for the three factors within the control of the Federal Government, Horizon BCBSNJ’s individual premiums would have an average increase of 9.6%.” [Horizon Blue Cross Blue Shield of New Jersey, 10/17/17]

Lindsey Graham: Republicans “Own The Outcome” On Health Care. “Sen. Graham told Breitbart News, ‘In October, premiums are going up. Obamacare cannot be fixed. It’s 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. We have a responsibility to do something about the collapsing Obamacare system. I believe that we’re going to get blamed more than Democrats because we stopped trying to repeal Obamacare, and to suggest that we don’t own it is just simply politically naive.’ Graham continued, ‘It can hurt us in 2018. It can hurt by our base feeling like we betrayed them. It can hurt us from people suffering from Obamacare, like we don’t have a solution. It will energize Democrats. It can undercut everything we did on the tax cut side.’” [Breitbart, 2/6/18]

Rep. Charlie Dent: “We, The Republican Party…Own” Health Care Now. “Rep. Charlie Dent (R-Pa.) argued Friday that President Trump was ‘ill-advised’ to end key ObamaCare payments, warning that the GOP now ‘owns’ whatever happens to ObamaCare. ‘I think the president is ill-advised to take this course of action because … we, the Republican Party, will own this,’ Dent, a key House moderate who is retiring from Congress at the end of his term, said on CNN. Asked about Trump’s previous comments blaming problems with ObamaCare on former President Barack Obama, Dent pointed out that Republicans currently control the White House and have majorities in both chambers of Congress. ‘Barack Obama is a former president. President Trump is the president and he’s a Republican, and we control the Congress,’ Dent said. ‘So we own the system now. We’re going to have to figure out a way to stabilize this situation … This is on us.’” [The Hill, 10/13/17]

Washington Post: “The Pottery Barn Rule Comes To Mind: You Break It, You Own It.” “This is not ‘letting’ Obamacare fail. Many nonpartisan experts believe that these active measures are likely to undermine the pillars of the 2010 law and hasten the collapse of the marketplaces. The Pottery Barn rule comes to mind: You break it, you own it. Yes, the plate you just shattered had some cracks in it. But if you dropped it on the ground, the store is going to blame you.” [Washington Post, 10/13/17]

Washington Post: “Trump’s Not Going To Be Able To Avoid Blame For Kneecapping Obamacare.” [Washington Post, 10/13/17]

“After Months Of Pinning The Blame For Obamacare’s Shortcomings On Democrats And Watching His Own Party Fail To Act, President Donald Trump Just Took Ownership Of A Struggle That’s Consumed Republicans For Seven Years.” “After months of pinning the blame for Obamacare’s shortcomings on Democrats and watching his own party fail to act, President Donald Trump just took ownership of a struggle that’s consumed Republicans for seven years. Trump’s decision late Thursday to end government subsidies to insurers to help lower-income Americans afford to use their coverage under the Affordable Care Act was the most drastic step he’s taken to undermine his predecessor’s signature achievement. It also lobbed a live bomb into the laps of Republicans lawmakers 13 months before congressional elections after he publicly berated the party’s Senate leadership for being unable to keep a longstanding promise to repeal the law.” [Bloomberg, 10/13/17]

The American People Agree: President Trump And Congressional Republicans Are Playing Politics With People’s Health Care.  A poll conducted last September found that 61 percent of voters believed President Trump was “trying to make the Affordable Care Act fail,” and 64 percent of voters said Trump is “playing politics with people’s health care.” The poll also found that the American people seriously disapprove of how Republicans in Congress are treating health care: 80 percent of voters disapprove while only 20 percent approve. [Hart Research, 9/5/17]

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