Skip to main content
Monthly Archives

September 2018

ashoup
In News

Shot/Chaser: Drug Prices Go Up, So Do Drug Company Profits

Big Pharma Continues to be Big Winner in Trump’s America

Meanwhile, the GOP Slashes Health Care for the Rest of Us

SHOT: A new analysis by the Associated Press, released Monday of last week, showed that drug companies have announced “far more price hikes than cuts,” despite Trump’s promise to take action on prescription drug prices.

CHASER: A new analysis by CNBC, released Friday, showed that big drug companies are “having [their] best quarter in five years.” In fact, on Friday — the very same day that House Republicans passed massive tax cuts for the rich that they plan to pay for by cutting Medicare and Medicaid — big drug and insurance company profits “[surged] to an all-time high.”

ashoup
In News

About Last Night: At Senate Debate, Matt Rosendale Lies About His Record on Pre-existing Conditions Protections

Rosendale Changes Tune As New PPP Poll Shows Health Care and Pre-existing Conditions Protections Top Issue to Montana Voters, and Tester Up 4 Points — 49-45 — in Head-to-head

Washington, DC – At the Senate debate in Missoula last night, insurance commissioner Matt Rosendale became the latest Republican to lie to voters about his record on pre-existing conditions protections. Rosendale’s shameful effort to re-write his own record comes on the heels of a new poll from Public Policy Polling (PPP) for Protect Our Care showing that health care is a top issue to voters and that Montanans have “major concerns” with Matt Rosendale’s pro-repeal record. Said Brad Woodhouse, executive director of Protect Our Care, in response to the debate last night:

“Matt Rosendale is not being honest when he says he’s tried to make sure people with pre-existing conditions are always covered. What Matt Rosendale has actually done is work to allow insurance companies to charge you more if you have a pre-existing condition, if they will cover you at all. Rosendale’s health policies are a tough pill for voters to swallow and he knows it – that’s why he’s sugarcoating his record.”

ADDITIONAL BACKGROUND

What Rosendale Said:

“We are making sure people have options. We are making sure that other folks are being held accountable and we are trying to do it at the local level to make sure that pre-existing conditions are always covered.”

What Rosendale Has Done:

Rosendale Repeatedly, Consistently and Enthusiastically Supported Health Repeal Bills That Would Have Gutted Protections for Montanans With Pre-existing Conditions

  • Rosendale Supported A Straight Repeal Of The ACA. [KRTV, 7/18/17]
  • Rosendale:  “I Won’t Give Up On Repealing And Replacing Obamacare.” [Matt Rosendale for Montana, accessed 8/23/18]
  • 2017:  Rosendale Supported Allowing Insurers To Offer Plans That Don’t Cover Pre-Existing Conditions Or Offer Minimum Benefits Mandated By The ACA. “Rosendale said states should be allowed to let health insurers offer less-expensive plans that cover fewer things, instead of the minimum benefits mandated by the ACA. Those products could be priced lower for younger, healthier customers, he said – or people could use non-insurance products for their health coverage, such as agreements with primary-care providers. ‘If you give the consumer the ability to find something that fits their budget, that fits their health-care needs and meets their personal choices, then that will help us start bending the cost curve down,’ Rosendale said. Health insurers and others have said this approach would end up pricing certain people out of the market, such as older, sicker customers. However, Rosendale said the state and federal government can solve that problem by financing a high-risk insurance pool that would offer coverage to these more costly patients.” [KRTV, 7/18/17]

Rosendale Supports Junk Plans, Which Do Not Protect People with Pre-existing Conditions

  • Short-Term Plans May Exclude Coverage For Pre-Existing Conditions. “Policyholders who get sick may be investigated by the insurer to determine whether the newly-diagnosed condition could be considered pre-existing and so excluded from coverage.” [Kaiser Family Foundation, 2/9/18]
    • As Many As 130 Million Nonelderly Americans, Including 426,000 Montanans Have A Pre-Existing Condition. [Center for American Progress, 4/5/17]
    • One in 4 Children, Including 54,000 Montana Children With A Pre-Existing Condition, Would Be Impacted If Insurance Companies Could Deny Or Charge More Because Of A Pre-Existing Condition. [Center for American Progress, 4/5/17]
  • Short-Term Junk Plans Can Refuse To Cover Essential Health Benefits. “Typical short-term policies do not cover maternity care, prescription drugs, mental health care, preventive care, and other essential benefits, and may limit coverage in other ways.” [Kaiser Family Foundation, 2/9/18]
  • Under Many Short-Term Junk Plans, Benefits Are Capped At $1 Million Or Less. Short-term plans can impose lifetime and annual limits –  “for example, many policies cap covered benefits at $1 million or less.” [Kaiser Family Foundation, 2/9/18]
  • Short-Term Junk Plans Can Retroactively Cancel Coverage After Patients File Claims. “Individuals in STLDI plans would be at risk for rescission. Rescissions are retroactive cancellations of coverage, often occurring after individuals file claims due to medical necessity. While enrollees in ACA coverage cannot have their policy retroactively cancelled, enrollees in STLDI plans can.” [Wakely/ACAP, April 2018]
  • Association Health Plans Allow Insurers 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]

Rosendale Supports High Risk Pools, Which Do Not Protect People with Pre-existing Conditions

  • High Risk Pools Typically Had Pre-Existing Condition Exclusions And Limited Benefits. “Many such pools had pre-existing condition exclusion periods, limited benefits, and enrollment limits; all of these characteristics served to reduce the value of the coverage, creating high financial burdens for enrollees and limiting the number of people who could access the coverage.” [Health Affairs, 3/15/16]
  • Most State High Risk Pools Had Lifetime And Annual Limits On Coverage.  “Thirty-three pools [out of 35 states] imposed lifetime dollar limits on covered services, most ranging from $1 million to $2 million. In addition, six pools imposed annual dollar limits on all covered services while 13 others imposed annual dollar limits on specific benefits such as prescription drugs, mental health treatment, or rehabilitation.” [Kaiser Family Foundation, 2/22/17]
  • High Risk Pools Typically Had Waiting Periods. “There were 35 state high-risk pools before the Affordable Care Act passed. To control costs, they would often do things like charge higher premiums than the individual market. Most had waiting periods before they would pay claims on members’ preexisting conditions, meaning a cancer patient would need to pay premiums for six months or a year before the high-risk pool would cover her chemotherapy treatments.” [Vox, 5/3/17]
  • High Risk Pools Mean Delayed Or Forgone Care. “Even once they were in a high-risk pool, the high costs and limited benefits prompted some people to delay or forgo care, leading to poorer health outcomes and even more spending. And many families accrued substantial medical debt, even with the coverage.” [Stateline, 2/16/17]

Rosendale is Hiding His Record Because Polls of Montana Voters Show Health Care is a Top Issue and his Repeal Record is Unpopular:

  • Fifty-six percent of voters say health care is the most important or a very important issue for them this election.  
  • By a 20 point margin, 56-36, Montana voters oppose Republican efforts to repeal the Affordable Care Act and instead want to keep what works and fix what doesn’t.
  • Fifty-one percent of voters say the elimination of protections for people with pre-existing conditions, supported by Matt Rosendale, is “a major concern.”
  • Montana voters oppose the Trump administration’s lawsuit to eliminate protections for people with pre-existing conditions by a 49 point margin, 65 percent to 16 percent. A majority of Republicans (51 percent) oppose the administration’s lawsuit.
  • The survey finds Tester with a strong four point lead over Rosendale (49-45) similar to other surveys which have consistently shown Teste rahead. Six percent of respondents were undecided.

PPP surveyed 594 Montana voters on September 28, 2018.  The margin of error is +/- 4.02%. This poll was conducted by automated telephone interviews.

ashoup
In News

NEW POLL: Montanans Strongly Oppose Rosendale’s Repeal Crusade

New Poll Released Ahead of Senator Jon Tester and Matt Rosendale Debate Tonight Finds Health Care a Top Issue for Majority of Voters, and Strong Opposition to Repeal of ACA and Pre-existing Conditions Protections

Tester Up 4 points, 49-45, in Head-to-head

Washington, DC – Tonight, on the heels of a new poll from Public Policy Polling (PPP) for Protect Our Care showing Montanas have “major concerns” with Matt Rosendale’s pro-repeal record, health care champion Senator Jon Tester will debate Matt Rosendale. The poll also shows the importance and power of health care as an issue in a “red” state. Ahead of the debate, Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

“We know why Matt Rosendale recently started to pay lip service to protections for people with pre-existing conditions – because his voters vehemently oppose ripping those protections away. But the truth is Matt Rosendale has supported Republican bills to eliminate protections for people with pre-existing conditions in the past and his website says he’ll never ‘give up’ on repeal in the future. Rosendale even voted against the Medicaid expansion, which is a lifeline to thousands of Montanans.”  

Key Findings from the Protect Our Care-PPP Poll of Montana Voters:

  • Fifty-six percent of voters say health care is the most important or a very important issue for them this election.  
  • By a 20 point margin, 56-36, Montana voters oppose Republican efforts to repeal the Affordable Care Act and instead want to keep what works and fix what doesn’t.
  • Fifty-one percent of voters say the elimination of protections for people with pre-existing conditions, supported by Matt Rosendale, is “a major concern.”
  • Montana voters oppose the Trump administration’s lawsuit to eliminate protections for people with pre-existing conditions by a 49 point margin, 65 percent to 16 percent. A majority of Republicans (51 percent) oppose the administration’s lawsuit.
  • The survey finds Tester with a strong four point lead over Rosendale (49-45) similar to other surveys which have consistently shown Teste rahead. Six percent of respondents were undecided.

PPP surveyed 594 Montana voters on September 28, 2018.  The margin of error is +/- 4.02%. This poll was conducted by automated telephone interviews.

What Would Rosendale’s Repeal of the Affordable Care Act Mean for Montana?

  • Protections for 426,000 Montanans with pre-existing conditions, if they buy coverage on their own
  • Improvements to Medicare, including reduced costs for prescription drugs
  • Allowing kids to stay on their parents’ insurance until age 26
  • Ban on annual and lifetime limits
  • Ban on insurance discrimination against women
  • Limit on out-of-pocket costs
  • Medicaid expansion currently covering 15 million people
  • Rules to hold insurance companies accountable
  • Small business tax credits
  • Marketplace tax credits and coverage for up to 49,000 Montanans.

Rosendale Claims To Support Protecting Coverage For Pre-Existing Conditions, But Supported A Repeal That Would Have Gutted Protections

  • Rosendale Supported A Straight Repeal Of The ACA.  “Yet while Daines and Rosendale called for a straight repeal of the ACA, or “Obamacare,” that approach could be a political dead-end as well. […] Daines has never said publicly whether he would have supported the GOP proposal that was pulled Monday night, after two additional Republican senators came out against it. On Tuesday, however, he said it’s time to vote to get rid of ‘Obamacare,’ delay the effective date, and figure out the replacement before that date kicks in. Rosendale agreed, and said two years should be enough time to come up with a replacement.” [KRTV, 7/18/17]
  • Rosendale:  “I Won’t Give Up On Repealing And Replacing Obamacare.” “I won’t give up on repealing and replacing Obamacare. Montana families have been devastated with higher premiums and higher deductibles that have made health care completely unaffordable. President Trump has taken important steps to dismantle this disastrous law by removing the individual mandate and removing limits on health plan options. I’ll continue working to expand access and reduce health care costs because we must provide more affordable options and better care to all Montanans while also protecting those with pre-existing conditions.” [Matt Rosendale for Montana, accessed 8/23/18]
  • Rosendale Claimed The ACA Was In “A Death Spiral” And “Collapsing Under Its Own Weight.” “Obamacare is in a death spiral. Insurance premiums increased yet again by an average of 25 to 50 percent this year in Montana. As more insurers abandon the Affordable Care Act’s exchange, costs continue to skyrocket across the nation. These trends are unsustainable, and the system is collapsing under its own weight. As I’ve traveled across the state, Montanans have told me that reform is necessary. My role as Commissioner of Securities and Insurance is to advocate for the interests of average Montana insurance customers. I’m committed to fighting for health care policies that expand options, reduce costs, improve access, and respect personal choices.” [Matt Rosendale Op-Ed, Helena Independent Record, 3/20/17]
  • 2017: Rosendale Supported A Clean Repeal Bill, Which Would Have Gutted Protections For People With Pre-Existing Conditions.  “Montana’s two U.S. senators split down party lines Tuesday on the GOP’s failed attempts to do a clean repeal of the Affordable Care Act within two years and replace it, with one saying Montana’s current system is in dire straits and the other accusing Republicans of playing politics.  […] Matt Rosendale, the state securities and insurance commissioner, supported the repeal, saying Obamacare has been driving insurance prices up and limiting the choices people have to access health care. ‘It needs to be repealed, and Montana needs the flexibility to develop our own unique solutions to meet the needs of our most vulnerable citizens,’ he said. Rosendale said state lawmakers are ‘capable of crafting made-in-Montana policies to ensure transparency, bring down prices, and protect those with preexisting conditions.’  ‘I’m going to keep fighting for reform because the current system is broken and the people of Montana deserve better,’ Rosendale said.” [Great Falls Tribune, 7/18/17]
  • 2017:  Rosendale Supported Allowing Insurers To Offer Plans That Don’t Cover Pre-Existing Conditions Or Offer Minimum Benefits Mandated By The ACA.  “Rosendale said states should be allowed to let health insurers offer less-expensive plans that cover fewer things, instead of the minimum benefits mandated by the ACA. Those products could be priced lower for younger, healthier customers, he said – or people could use non-insurance products for their health coverage, such as agreements with primary-care providers. ‘If you give the consumer the ability to find something that fits their budget, that fits their health-care needs and meets their personal choices, then that will help us start bending the cost curve down,’ Rosendale said. Health insurers and others have said this approach would end up pricing certain people out of the market, such as older, sicker customers. However, Rosendale said the state and federal government can solve that problem by financing a high-risk insurance pool that would offer coverage to these more costly patients.” [KRTV, 7/18/17]

Rosendale Opposed Expanding Medicaid in Montana

Rosendale Voted Against Expanding Medicaid.  [SB 405, 4/18/15]

  • Thanks to the Medicaid expansion that Rosendale opposed, 58,100 Montana residents have gained coverage. 46 percent of Montana’s children rely on Medicaid coverage. Eliminating the Medicaid expansion would devastate Montana’s ability to address the opioid crisis as one in four adults battling addiction nationwide are covered through Medicaid.
ashoup
In News

Betsy Rader, Cleveland City Councilmembers, Columbus City Attorney Join “Care Force One” in Ohio Friday

https://lh6.googleusercontent.com/2V3N-hlYhMGAGUwERue_H09HrMw0Q8M4Cszixpo0uIZPU0GP2Bbyzd_dvPmwLZnhrgKWgx5A26-DwLCK46OYl6_6bUGrRiqCLwOkew1qyXgopWfsgM3quS8-1RULD9EvfWeLvTfK

Cleveland and Columbus Were Stops 10 and 11 on National Bus Tour

(Cleveland, OH & Columbus, OH) – Today, local officials, health care advocates, and Ohioans with pre-existing conditions spoke out against the devastating repercussions of health care repeal at events in Cleveland and Columbus.

You can watch the full Cleveland event here, and the full Columbus event here.

The events were part of Protect Our Care’s nationwide bus tour calling attention to Republicans’ attempts to sabotage health care, including a lawsuit that would gut protections for Ohioans with pre-existing conditions. Cleveland and Columbus were stops ten and eleven of the 48-stop tour.

The 4,830,900 Ohioans living with a pre-existing condition would be in jeopardy if a judge sides with President Trump and the GOP in their lawsuit.

In Cleveland, Betsy Rader and Cleveland City Councilmembers Blaine Griffin and Phyllis Cleveland joined Dr. Maria Phillis, Kat Schultz, Maya Brown-Zimmerman, who shared their personal health care stories. In Columbus, City Attorney Zach Klein and American Federation of Teachers President Randi Weingarten joined Ann Wightman and Laura Packard, who shared their personal stories.

Here’s what they had to say about health care and Republicans’ repeal-and-sabotage agenda:

Betsy Rader: “Republicans in Congress have waged a war on those in our community who live with pre-existing conditions, undermining their access to health care nearly every opportunity they had. It’s critical that we all stand up, take action, and fight for affordable healthcare.”

Columbus City Attorney Zach Klein: “Since President Trump took office, he has made very clear his intention to dismantle the Affordable Care Act – with not just his words, but his actions. His sabotage of health care for millions of Americans is both cruel and a true dereliction of his constitutional duty as President of the United States.”

Cleveland City Councilmember Blaine Griffin: “Republicans in Washington and the Ohio Statehouse aren’t sticking up for health care protections or working with Democrats to lower costs. Instead, they are ending protections for people with pre-existing conditions, driving up costs, and cutting coverage.”

Cleveland Councilmember Phyllis Cleveland: “Since day one of the Trump Administration, the agenda has been to eviscerate the Affordable Care Act. I am proud to stand here to say we here in Ohio and Cleveland have a strong contingent of individuals who care about people and their health care, so we will continue to fight.”

Randi Weingarten, President of the American Federation of Teachers: “Everyone is one pre-existing condition away from bankruptcy. This is about making sure there’s a basic level of health protection for every single of American. We have an obligation to stand up for everyone in this country.”

Local resident Maya Brown-Zimmerman: “I was born with a rare genetic disorder. One of my children inherited it, another is autistic, and another has a brain injury from in-utero. Protecting Americans with pre-existing conditions is not a Democratic or Republican issue. This is a human issue.”

Ohioan Kat Schultz: “I am one of the 4.8 million Ohioans who have a pre-existing condition. I’m deeply concerned that if protections for pre-existing conditions end, I’d be denied health insurance and unable to afford the treatments that keep my alive. Please protect my care, and protect my life.”

Dr. Maria Phillis, OB-GYN: “I went into medicine to help patients. As a physician, I’ve seen people who have benefited from good health care. To watch the ACA slowly become dismantled, piece by piece by politicians that are putting politics over patients, is heart-wrenching.”

Cancer survivor Laura Packard: “I am still here today thanks to the ACA. But I need to keep my health care, as do 130 million with pre-existing conditions. That’s why we’re here – to hold people like Senator Portman accountable for their votes to take away our care.”

Local resident Ann Wightman: “Thirteen years after I got sick and lost my health insurance, the ACA made it possible for my family to purchase real health insurance again. But now, Republicans are using every trick in the book to take it away. I am sick and I am tired. I am not going to take it anymore. I vow today to do everything that I can to fight this sabotage.”

 

You can watch the full Cleveland event here, and the full Columbus event here. The bus now travels to West Virginia before coming back to Cincinnati for an event on Tuesday. More details about upcoming stops can be found here.

protectourcare
In Capitol Hill

If Republicans Are Serious About Addressing the Opioid Crisis, Protecting Pre-Existing Conditions and Medicaid is Key

Washington, DC – Today, the House voted on a package of legislation to address the opioid crisis, while at the same time Republicans at all levels have doubled down on their attacks on people with pre-existing conditions, including opioid use disorder, in the courts, through legislation and through regulations that promote junk plans and restrict Medicaid. In response, Leslie Dach, chair of Protect Our Care, issued the following statement:

“It’s past time that Republicans do the things that would truly support the families suffering from this crisis: end its assault on Medicaid, upon which four in 10 Americans with opioid use disorder relies, and back down from its constant attacks on people people with pre-existing conditions.”

 

ADDITIONAL BACKGROUND: How Republican Health Care Sabotage Is Exacerbating The Opioid Crisis

 

BY THE NUMBERS

 

  • More than half of people with an opioid use disorder earn incomes below 200 percent of the federal poverty line.

 

 

 

  • In 2014, Medicaid paid for 25 percent of all addiction treatment nationwide.

 

 

 

  • It is estimated that Medicaid expansion covers four in 10 people with an opioid use disorder.

 

 

 

  • The opioid epidemic is now the most deadly drug overdose crisis in U.S. history. In 2016, roughly 64,000 Americans died of drug overdoses, meaning that more American lives were lost due to drug overdoses in 2016 than were lost in combat during the entirety of the Vietnam War. Two-thirds of 2016 drug overdoses involved opioids.

 

 

  • Medicaid expansion has reduced unmet need for substance use treatment by more than 18 percent. Recent research finds that Medicaid expanding reduced the unmet need for substance use treatment by 18.3 percent.

 

HOW PRESIDENT TRUMP & CONGRESSIONAL REPUBLICANS ARE WORKING TO DISMANTLE MEDICAID

  • President Trump and his Republican allies in Congress have repeatedly tried to slash Medicaid funding, including by imposing per-capita caps. Last year, the House of Representatives passed the American Health Care Act (AHCA), which included a per-capita limit on federal Medicaid spending and would have resulted in huge cuts to Medicaid across states. After failing to pass the AHCA in the Senate, Republicans have relentlessly continued their attacks on Medicaid. In December, the Trump Administration went so far as to propose a budget that called for  $1.4 trillion in cuts to Medicaid.

 

  • The Trump Administration is now encouraging new hurdles for Medicaid enrollees in order to keep their coverage. Experts warn that work requirements are fundamentally bureaucratic hurdles designed to restrict access to health care rather than increase employment. Previous examples show that requiring enrollees verify their employment or work-related activities reduces enrollment among those still eligible for Medicaid.

 

  • President Trump and Congressional Republicans are targeting Medicaid to pay for tax cuts to the wealthy. Last December, President Trump signed a $1.5 trillion tax bill that disproportionately benefits the wealthy. How do Republicans plan on paying for it? Speaker Ryan’s answer is clear: “Frankly, it’s the health care entitlements that are the big drivers of our debt.” Republicans’ approach is simple: cut programs like Medicaid that support working families.

 

  • Restricting access to Medicaid threatens lives and impedes states’ ability to respond to the opioid epidemic. Four in ten Americans with an opioid use disorder relies on Medicaid for access to treatment, and in cases of overdose, for life-saving overdose reversal medication. By cutting funding to Medicaid and restricting the eligibility of those who can enroll, the Trump Administration is people’s lives at risk and is depriving states of funding and resources they depend on to fight the opioid epidemic.

BY HELPING PEOPLE ACCESS TREATMENT AND OVERDOSE-REVERSAL MEDICATION, MEDICAID SAVES LIVES

In 2014, Medicaid Paid For 25 Percent Of Spending For Addiction Treatment. “A 2014 study by Truven Health Analytics researchers found that Medicaid paid for about 25 percent — $7.9 billion of $31.3 billion — of projected public and private spending for addiction treatment in 2014. That made it the second-biggest payer of addiction treatment after all local and state government programs.” [Vox, 2/13/18]

By Expanding Access To Naloxone, Medicaid Has Saved Lives. “We estimate that in Massachusetts 868 opioid-related deaths were averted in 2016 (13 per 100,000 population). By contrast in Tennessee, which did not expand its Medicaid program, only 11 opioid-related deaths were averted in 2016 (0.17 per 100,000 population). Both states have been hit particularly hard by the opioid epidemic: Opioid-related deaths in 2015 were 20.9 and 21.5 per 100,000 in Massachusetts and Tennessee, respectively.” [Commonwealth Fund, 7/5/17]

        [Commonwealth Fund, 7/5/17]

MEDICAID EXPANSION HAS INCREASED ACCESS TO TREATMENT

Medicaid Helps Make Buprenorphine And Naloxone, Drugs Used To Treat Opioid Use Disorder, Affordable. “These data are consistent with other evidence that Medicaid expansion is improving access to care for people with opioid use and other substance use disorders. Medicaid makes medications like buprenorphine and naloxone, which are prescribed to combat opioid use disorders, affordable for beneficiaries.“ [Center on Budget and Policy Priorities, 2/28/18]

Medicaid Expansion Has Improved Access To Substance Treatment Services. “Evidence also suggests that Medicaid expansion improved access to substance use treatment services more broadly. After expanding Medicaid, Kentucky experienced a 700 percent increase in Medicaid beneficiaries using substance use treatment services.  Use of treatment services rose nationally as well; one study found that expanding Medicaid reduced the unmet need for substance use treatment by 18.3 percent.” [Center on Budget and Policy Priorities, 2/28/18]

In Ohio, Medicaid Has Helped Those With Substance Use Disorders Access Mental Health Services. “An Ohio study found that 59 percent of people with opioid-use disorders who had gained Medicaid coverage under expansion reported improved access to mental health care. Nationwide, the share of people forgoing mental health care due to cost fell by about one-third as the ACA, including Medicaid expansion, took effect.” [Center on Budget and Policy Priorities, 2/28/18]

MEDICAID GIVES STATES MORE RESOURCES TO ADDRESS THE OPIOID EPIDEMIC

Medicaid Is A Sustainable Source Of Funding Compared To Short-Term Grants. “Now that more people with SUDs are eligible for Medicaid, states can significantly improve treatment for people with SUDs by improving Medicaid-covered services. Medicaid can be a sustainable funding source for providers, as opposed to capped, short-term grant funding.” [Center on Budget and Policy Priorities, 2/28/18]

There Is No Substitute For Comprehensive Health Care In Fighting The Opioid Epidemic. In response to the opioid epidemic, Republicans proposed creating a $45 billion fund. However, as the Center for American Progress analyzes, “The Senate opioid fund is no substitute for comprehensive health coverage.” Why? Because “Even if the entirety of the fund were available to cover low-income individuals being treated for OUD, $45 billion would provide only half of the $91 billion that would be available under the ACA for health coverage alone.” [Center for American Progress, 6/20/17]

Thanks To Medicaid Expansion, The Uninsured Rate For Opioid-Related Hospitalizations Dropped In Expansion States. “In Medicaid expansion states, the uninsured rate for opioid-related hospitalizations plummeted by 79 percent, from 13.4 percent in 2013 (the year before expansion implementation) to 2.9 percent in 2015.  The decline in non-expansion states was a much more modest 5 percent, from 17.3 percent in 2013 to 16.4 percent in 2015.” [Center on Budget and Policy Priorities, 2/28/18]

 

[Center on Budget and Policy Priorities, 2/28/18]

 

PUBLIC HEALTH, LAW ENFORCEMENT EXPERTS AGREE: MEDICAID IS KEY TOOL IN OPIOID FIGHT

A Panel Of Public Health Officials, Policy Experts, And Law Enforcement Officials Found Medicaid Among Most Important Programs In Combating Opioid Epidemic. Investing in Medicaid was the third most cited response when a panel of thirty experts were asked where they would put money to combat the opioid epidemic. [New York Times, 2/14/18]

Jay Unick, University Professor: Medicaid Expansion Is Most Important Intervention To Improve Opioid Epidemic. Medicaid expansion would be “the most important intervention for improving outcomes related to the opiate epidemic…all the other interventions discussed here only work if individuals have access to quality health care.” [New York Times, 2/14/18]

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

Signatories include: ADAP Advocacy Association (aaa+); Addiction Policy Forum, Advocacy Center of Louisiana; AIDS United, Alameda County Community Food Bank; American Association on Health and Disability; American Association of People with Disabilities; American Association for the Treatment of Opioid Dependence (AATOD); American Civil Liberties Union; American Federation of State; County & Municipal Employees (AFSCME); American Foundation for Suicide Prevention; American Group Psychotherapy Association; American Psychological Association; American Society of Addiction Medicine; Association for Ambulatory Behavioral Healthcare; Bailey House, Inc.; Board for Certification of Nutrition Specialists; Brooklyn Defender Services; CADA of Northwest Louisiana; California Consortium of Addiction Programs & Professionals; California Hepatitis Alliance; Caring Across Generations; Caring Ambassadors Program; CASES; Center for Civil Justice; Center for Employment Opportunities (CEO); Center for Health Law and Policy Innovation; Center for Law and Social Policy (CLASP); Center for Medicare Advocacy; Center for Public Representation; Charlotte Center for Legal Advocacy; CHOW Project; Coalition of Medication Assisted Treatment Providers and Advocates; Colorado Center on Law and Policy; Community Access National Network (CANN); Community Catalyst; Community Health Councils; Community Legal Services of Philadelphia; Community Oriented Correctional Health Services; Community Service Society; Connecticut Legal Services; Consumer Health First; C.O.R.E. Medical Clinic, Inc.; Council on Social Work Education; CURE (Citizens United for Rehabilitation of Errants); DC Coalition Against Domestic Violence; Desert AIDS Project; Disability Rights Arkansas; Disability Rights Wisconsin; Drug Policy Alliance; EAC Network (Empower Assist Care); EverThrive Illinois; Facing Addiction with NCADD; Faces & Voices of Recovery; FedCURE; First Focus; Florida Health Justice Project, Inc.; Food & Friends; The Fortune Society; Forward Justice; Friends of Recovery – New York; Futures Without Violence; God’s Love We Deliver; Greater Hartford Legal Aid; Greenburger Center for Social and Criminal Justice; Harm Reduction Coalition; Health Law Advocates; Hep Free Hawaii; Hepatitis C Support Project/HCV Advocate; Heartland Alliance; HIV Medicine Association; Horizon Health Services; Hunger Free America; ICCA; Illinois Association of Behavioral Health; The Joy Bus; JustLeadershipUSA; Katal Center for Health, Equity, and Justice; The Kennedy Forum; Kentucky Equal Justice Center ; Kitchen Angels ; Justice in Aging ; Justice Consultants, LLC; Lakeshore Foundation; Law Foundation of Silicon Valley; Legal Action Center; The Legal Aid Society; Legal Council for Health Justice; Life Foundation; Live4Lali; Liver Health Connection; Maine Equal Justice Partners; MANNA (Metropolitan Area Neighborhood Nutrition Alliance); Massachusetts Law Reform Institute; McShin Foundation; Mental Health America; Mental Health Association in New York State, Inc. (MHANYS); Michigan Poverty Law Program; Minnesota Recovery Connection; Mississippi Center for Justice; NAACP; The National Alliance to Advance Adolescent Health; National Alliance on Mental Illness; NAMI-NYS; National Alliance of State & Territorial AIDS Directors; National Association of Addiction Treatment Providers; National Association of County Behavioral Health & Developmental Disability Directors; National Association for Rural Mental Health; National Association of Social Workers; National Center for Law and Economic Justice; National Coalition Against Domestic Violence; National Council on Alcoholism and Drug Dependence, Phoenix; National Council for Behavioral Health; National Council of Churches; National Disability Rights Network; National Employment Law Project; National Federation of Families for Children’s Mental Health; National Health Care for the Homeless Council; National Health Law Program; National HIRE Network; National Juvenile Justice Network; National LGBTQ Task Force; National Low Income Housing Coalition; National Organization for Women; The National Viral Hepatitis Roundtable; NC Justice Center; New Haven Legal Assistance Association; New York Association of Alcoholism and Substance Abuse; New York Association of Psychiatric Rehabilitation Services; New York Lawyers for the Public Interest; New York State Council for Community Behavioral Healthcare; Open Hands Legal Services; Osborne Association; Outreach Development Corp.; The Partnership for Drug Free Kids; PICO National Network; The Poverello Center, Inc.; Project Inform; Public Justice Center; Root & Rebound; Ryan White Medical Providers Coalition; Safer Foundation; Sargent Shriver National Center on Poverty Law; School Social Work Association of America; Sea Island Action Network, South Carolina; The Sentencing Project; Shatterproof; Society of General Internal Medicine; Southern Center for Human Rights; Southern Poverty Law Center; Students for Sensible Drug Policy; TASC of the Capital District, Inc.; Tennessee Justice Center; Three Square Food Bank; Transitions Clinic Network; Treatment Action Group; Treatment Alternatives for Safe Communities (TASC) – Illinois; Treatment Communities of America; Virginia Poverty Law Center; Western Center on Law & Poverty

protectourcare
In Capitol Hill, News

House Republicans Pass More Tax Cuts for the Rich

“What this bill really means is more Republican health care cuts for the rest of us, and the American people are sick of it,” says Brad Woodhouse

Washington, DC – Today House Republicans passed a second set of tax cuts to benefit the wealthiest Americans and big corporations at the expense of working families. Their tax cuts have led to trillion dollar deficits, which Republicans are now using as an excuse to go after Social Security, Medicare and Medicaid. Brad Woodhouse, executive director of Protect Our Care, issued the following statement in response:

“What this bill really means is more Republican health care cuts for the rest of us, and the American people are sick of it. Since Paul Ryan and his allies have repeatedly made it plain that they will pay for these tax breaks for the wealthy by making deep cuts to Medicare and Medicaid, today’s vote calcifies the damage Republicans are doing to America’s working families and seniors all so they can give handouts to wealthiest. Thankfully, Americans see right through this Republican tax scam and are ready to give it a giant thumbs down at the polls in November.”

 

ADDITIONAL BACKGROUND:

President Trump and Congressional Republicans are targeting Medicaid and Medicare to pay for their tax cuts to the wealthy. Earlier this month, Larry Kudlow, Director of the National Economic Council, confirmed that they still have their sights set on Americans’ care. Asked when programs like Social Security and Medicare will be looked at for reforms, Kudlow replied, “Everyone will look at that — probably next year.” And last December, when President Trump signed the first round of $1.5 trillion tax bill that disproportionately benefits the wealthy, Speaker Paul Ryan made it clear they would cut programs like Medicaid that support working families. “Frankly, it’s the health care entitlements that are the big drivers of our debt.” Since that time:

Following Massive GOP Tax Cuts, Administration Predicts Medicare Trust Fund Will Be Depleted In 8 Years. “The financial outlook for Medicare’s Hospital Insurance Trust Fund deteriorated in the last year, and Social Security still faces serious long-term financial problems, the Trump administration said on Tuesday. The projections are the first from the administration since President Trump signed a $1.5 trillion tax cut into law in December. They show no sign that a burst of economic growth will significantly improve the finances of the government’s largest entitlement programs. The Medicare trust fund will be depleted in 2026, the administration said. By contrast, the government said last year that the trust fund would be exhausted in 2029.” [New York Times, 6/5/18]

protectourcare
In News

Health Care Repeal Crusader Matt Rosendale To Debate Health Care Champion Senator Jon Tester

Washington, DC – Tonight, health care champion Senator Jon Tester will debate Matt Rosendale, a rabid, pro-repeal and anti-Medicaid Republican who supports ending protections for people with pre-existing conditions. Ahead of the debate, Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

“Though Matt Rosendale recently started to pay lip service to protections for people with pre-existing conditions, the truth is he’s supported Republican bills to eliminate protections for people with pre-existing conditions in the past and his website says he’ll never ‘give up’ on repeal in the future. Rosendale even voted against the Medicaid expansion, which is a lifeline to thousands of Montanans.  Matt Rosendale is an Insurance Commissioner who wants to take away health coverage from thousands of Montanans while Jon Tester is a champion for health care and will always put the health of Montanans first. ”  

 

 

What Would Rosendale’s Repeal of the Affordable Care Act Mean for Montana?

  • Protections for 426,000 Montanans with pre-existing conditions, if they buy coverage on their own
  • Improvements to Medicare, including reduced costs for prescription drugs
  • Allowing kids to stay on their parents’ insurance until age 26
  • Ban on annual and lifetime limits
  • Ban on insurance discrimination against women
  • Limit on out-of-pocket costs
  • Medicaid expansion currently covering 15 million people
  • Rules to hold insurance companies accountable
  • Small business tax credits
  • Marketplace tax credits and coverage for up to 49,000 Montanans.


Rosendale Claims To Support Protecting Coverage For Pre-Existing Conditions, But Supported A Repeal That Would Have Gutted Protections

 

  • Rosendale Supported A Straight Repeal Of The ACA.  “Yet while Daines and Rosendale called for a straight repeal of the ACA, or “Obamacare,” that approach could be a political dead-end as well. […] Daines has never said publicly whether he would have supported the GOP proposal that was pulled Monday night, after two additional Republican senators came out against it. On Tuesday, however, he said it’s time to vote to get rid of ‘Obamacare,’ delay the effective date, and figure out the replacement before that date kicks in. Rosendale agreed, and said two years should be enough time to come up with a replacement.” [KRTV, 7/18/17]

 

  • Rosendale:  “I Won’t Give Up On Repealing And Replacing Obamacare.” “I won’t give up on repealing and replacing Obamacare. Montana families have been devastated with higher premiums and higher deductibles that have made health care completely unaffordable. President Trump has taken important steps to dismantle this disastrous law by removing the individual mandate and removing limits on health plan options. I’ll continue working to expand access and reduce health care costs because we must provide more affordable options and better care to all Montanans while also protecting those with pre-existing conditions.” [Matt Rosendale for Montana, accessed 8/23/18]

 

  • Rosendale Claimed The ACA Was In “A Death Spiral” And “Collapsing Under Its Own Weight.”  “Obamacare is in a death spiral. Insurance premiums increased yet again by an average of 25 to 50 percent this year in Montana. As more insurers abandon the Affordable Care Act’s exchange, costs continue to skyrocket across the nation. These trends are unsustainable, and the system is collapsing under its own weight. As I’ve traveled across the state, Montanans have told me that reform is necessary. My role as Commissioner of Securities and Insurance is to advocate for the interests of average Montana insurance customers. I’m committed to fighting for health care policies that expand options, reduce costs, improve access, and respect personal choices.” [Matt Rosendale Op-Ed, Helena Independent Record, 3/20/17]

 

  • 2017: Rosendale Supported A Clean Repeal Bill, Which Would Have Gutted Protections For People With Pre-Existing Conditions.  “Montana’s two U.S. senators split down party lines Tuesday on the GOP’s failed attempts to do a clean repeal of the Affordable Care Act within two years and replace it, with one saying Montana’s current system is in dire straits and the other accusing Republicans of playing politics.  […] Matt Rosendale, the state securities and insurance commissioner, supported the repeal, saying Obamacare has been driving insurance prices up and limiting the choices people have to access health care. ‘It needs to be repealed, and Montana needs the flexibility to develop our own unique solutions to meet the needs of our most vulnerable citizens,’ he said. Rosendale said state lawmakers are ‘capable of crafting made-in-Montana policies to ensure transparency, bring down prices, and protect those with preexisting conditions.’  ‘I’m going to keep fighting for reform because the current system is broken and the people of Montana deserve better,’ Rosendale said.” [Great Falls Tribune, 7/18/17]

 

  • 2017:  Rosendale Supported Allowing Insurers To Offer Plans That Don’t Cover Pre-Existing Conditions Or Offer Minimum Benefits Mandated By The ACA.  “Rosendale said states should be allowed to let health insurers offer less-expensive plans that cover fewer things, instead of the minimum benefits mandated by the ACA. Those products could be priced lower for younger, healthier customers, he said – or people could use non-insurance products for their health coverage, such as agreements with primary-care providers. ‘If you give the consumer the ability to find something that fits their budget, that fits their health-care needs and meets their personal choices, then that will help us start bending the cost curve down,’ Rosendale said. Health insurers and others have said this approach would end up pricing certain people out of the market, such as older, sicker customers. However, Rosendale said the state and federal government can solve that problem by financing a high-risk insurance pool that would offer coverage to these more costly patients.” [KRTV, 7/18/17]

Rosendale Opposed Expanding Medicaid in Montana

Rosendale Voted Against Expanding Medicaid.  [SB 405, 4/18/15]

  • Thanks to the Medicaid expansion that Rosendale opposed, 58,100 Montana residents have gained coverage. 46 percent of Montana’s children rely on Medicaid coverage. Eliminating the Medicaid expansion would devastate Montana’s ability to address the opioid crisis as one in four adults battling addiction nationwide are covered through Medicaid.
ashoup
In News

City Attorney Zach Klein & AFT President Randi Weingarten Join Ohioans with Pre-Existing Conditions to Demand that Republicans #ProtectOurCare

https://lh4.googleusercontent.com/PEBQzj6qdg38RP3nOjHRcEpvu3o4dEWx9sb1sFBKgJ-sCWV7CU7Z25KcTyQ8fIgt5quszAxLS_bqA_3Amemh_zeXWA56hEGMYdYUSlwe1I6YNXcB80uGSdrjC-SbLfkjzyLR_PhK

“Care Force One” Makes Stop in Columbus on National Bus Tour

(Columbus, Ohio) – Today, City Attorney Zach Klein and American Federation of Teachers President Randi Weingarten joined with Ohioans with pre-existing conditions at City Hall to speak out against the devastating repercussions of health care repeal.

The event was part of Protect Our Care’s nationwide bus tour calling attention to Republicans’ attempts to sabotage health care, including a lawsuit that would gut protections for Ohioans with pre-existing conditions.

The 4,830,900 Ohioans living with a pre-existing condition would be in jeopardy if a judge sides with President Trump and the GOP in their lawsuit.

“Since President Trump took office, he has made very clear his intention to dismantle the Affordable Care Act – with not just his words, but his actions, said Columbus City Attorney Zach Klein. “His sabotage of health care for millions of Americans is both cruel and a true dereliction of his constitutional duty as President of the United States.”

Randi Weingarten, President of the American Federation of Teachers, said, “Everyone is one pre-existing condition away from bankruptcy. This is about making sure there’s a basic level of health protection for every single of American. We have an obligation to stand up for everyone in this country.”

Klein and Weingarten were also joined by Laura Packard and Ann Wightman, Americans with pre-existing conditions, who shared their stories and talked about the protections provided to them under the Affordable Care Act.

Cancer survivor Laura Packard said, “I am still here today thanks to the ACA. But I need to keep my health care, as do 130 million with pre-existing conditions. That’s why we’re here – to hold people like Senator Portman accountable for their votes to take away our care.”

“Thirteen years after I got sick and lost my health insurance, the ACA made it possible for my family to purchase real health insurance again. But now, Republicans are using every trick in the book to take it away,” said local resident Ann Wightman. “I am sick and I am tired. I am not going to take it anymore. I vow today to do everything that I can to fight this sabotage.”

“The stakes have never been higher for Ohioans’ health care,” said TJ Helmstetter of Protect Our Care. “Since the enactment of the Affordable Care Act, almost 664,000 Ohioans have gained health insurance. This is all in jeopardy due to Republicans’ repeal and sabotage agenda, including their ludicrous lawsuit and Rep. Balderson’s mission to repeal health care. Ohioans want this Republican war on health care to end, plain and simple. That’s why we’re here today.”

You can watch the full video here. The bus now travels to West Virginia before coming back to Cincinnati for an event on Tuesday. More details about upcoming stops can be found here.

 

ashoup
In News

Betsy Rader Joins City Council Members and Local Residents to Demand that Republicans #ProtectOurCare

https://lh4.googleusercontent.com/kjWKrzQsmZIfg-YYaAEltlQvjBHPKf1dlkC_Rr6chk4YkzihgFT8sUzKFNDhA7feIhfUfo0QOgSo2YMuQ5MSGYPSd4-c5Hz_42WyTK88W-s9m7F9ovbSlSXRUqLwdoBCeopCPv4E

“Care Force One” Makes Stop in Cleveland on National Bus Tour

(Cleveland, Ohio) – Today, Betsy Rader and Cleveland City Council Members Blaine Griffin and Phyllis Cleveland joined Dr. Maria Phillis and Ohoioans with pre-existing conditions in Public Square to speak out against the devastating repercussions of health care repeal.

The event was part of Protect Our Care’s nationwide bus tour calling attention to Republicans’ attempts to sabotage health care, including a lawsuit that would gut protections for Ohioans with pre-existing conditions.

The 4,830,900 Ohioans living with a pre-existing condition would be in jeopardy if a judge sides with President Trump and the GOP in their lawsuit.

Cancer survivor Laura Packard kicked off the event, saying, “I am still here today thanks to the Affordable Care Act. But I need to keep my health care, as do 130 million with pre-existing conditions. That’s why we’re here – to hold people like Senator Portman accountable for their votes to take away our care.”

“Republicans in Congress have waged a war on those in our community who live with pre-existing conditions, undermining their access to health care nearly every opportunity they had,” Betsy Rader said. “It’s critical that we all stand up, take action, and fight for affordable healthcare.”

“Republicans in Washington and the Ohio Statehouse aren’t sticking up for health care protections or working with Democrats to lower costs. Instead, they are ending protections for people with pre-existing conditions, driving up costs, and cutting coverage,” Councilmember Blaine Griffin said.

“Since day one of the Trump Administration, the agenda has been to eviscerate the Affordable Care Act,” echoed Councilmember Phyllis Cleveland. “I am proud to stand here to say we here in Ohio and Cleveland have a strong contingent of individuals who care about people and their health care, so we will continue to fight.”

They were joined by Kat Schultz and Maya Brown-Zimmerman, Ohioans living with pre-existing conditions, and Dr. Maria Phillis, who shared their stories and talked about the importance of the Affordable Care Act.

Ohioan Kat Schultz, who has chronic mental and physical illness, said, “I am one of the 4.8 million Ohioans who have a pre-existing condition. I’m deeply concerned that if protections for pre-existing conditions end, I’d be denied health insurance and unable to afford the treatments that keep my alive. Please protect my care, and protect my life.”

“I went into medicine to help patients. As a physician, I’ve seen people who have benefited from good health care. To watch the ACA slowly become dismantled, piece by piece by politicians that are putting politics over patients, is heart-wrenching,” said Dr. Maria Phillis, OB-GYN.

“I was born with a rare genetic disorder. One of my children inherited it, another is autistic, and another has a brain injury from in-utero,” said local resident Maya Brown-Zimmerman. “Protecting Americans with pre-existing conditions is not a Democratic or Republican issue. This is a human issue.”

“The stakes have never been higher for Ohioans’ health care,” said TJ Helmstetter of Protect Our Care. “Since the enactment of the Affordable Care Act, almost 664,000 Ohioans have gained health insurance. This is all in jeopardy due to Republicans’ repeal and sabotage agenda, including their ludicrous lawsuit and Rep. Balderson’s mission to repeal health care. Ohioans want this Republican war on health care to end, plain and simple. That’s why we’re here today.”

You can watch the full video here. The bus now travels to Columbus then on to West Virginia before coming back to Cincinnati for an event on Tuesday. More details about upcoming stops can be found here.

ashoup
In News

Sec. Azar Sells Snake Oil in Tennessee

Today, Secretary of Health and Human Services Alex Azar made yet another desperate attempt to hide the dirty truth about the Trump Administration’s new policies to expand junk health plans, cut Medicaid enrollment by pushing for burdensome work requirements, and sabotage health care at every turn. Said Leslie Dach, chair of Protect Our Care, in response:

“Today’s appearance officially makes Secretary Azar Donald’s Trump latest snake oil salesman. The simple fact is that Trump and Azar’s policies will kick people off their health insurance, allow insurance companies to sell junk insurance policies that discriminate against people with pre-existing conditions, charge women and older people higher premiums and kick people off when they get sick. What’s worse, the GOP relentless war on health care has raised health care costs for millions while giving billions in tax breaks to drug and insurance companies.”

Here’s the truth about the “stabilizing marketplace” Azar wrongly takes credit for:

Larry Levitt, Senior Vice President Of Kaiser Family Foundation: Premiums Would Be Going Down If Not For Insurance Companies Compensating For Unstable Environment. “ACA premiums are stable for 2019 because they went up so much this year due to an uncertain environment and regulatory actions by the Trump administration. Premiums would be going down a lot if not for repeal of the individual mandate penalty and expansion of short-term plans.” [Levitt, 9/27/18]

Brookings Analysis Estimates That Individual Market Premiums Would Decrease If Not For GOP Sabotage. Among its key findings:

  • Estimates That Average Premium Would Fall By 4.3 Percent In 2019 In Stable Policy Environment. “I estimate that the nationwide average per member per month premium in the individual market would fall by 4.3 percent in 2019 in a stable policy environment.” [Brookings Institution, 8/1/18]
  • Insurance Companies’ Revenues Will Far Exceed Their Costs In 2018. “I project that insurers’ revenues in the ACA-compliant individual market will far exceed their costs in 2018, generating a positive underwriting margin of 10.5 percent of premium revenue. This is up from a modest positive margin of 1.2 percent of premium revenue in 2017 and contrasts sharply with the substantial losses insurers incurred in the ACA-compliant market in 2014, 2015, and 2016. The estimated 2018 margin also far exceeds insurers’ margins in the pre-ACA individual market. ” [Brookings Institution, 8/1/18]
  • Absent Republican Sabotage, Average Premiums For ACA-Compliant Plans Would Likely Fall In 2019. “In this analysis, I define a stable policy environment as one in which the federal policies toward the individual market in effect for 2018 remain in effect for 3 2019. Notably, this scenario assumes that the individual mandate remains in effect for 2019, but also assumes that policies implemented prior to 2018, like the end of CSR payments, remain in effect as well. Under those circumstances, insurers’ costs would rise only moderately in 2019, primarily reflecting normal growth in medical costs.” [Brookings Institution, 8/1/18]

Health Care Analyst, Charles Gaba Has Calculated That Across The Country, Premiums Will Increase By An Average Of 3.3 Percent In 2019. The average premium increases indicate that premiums nationwide will be 7.6 percent higher than they would have been absent GOP sabotage. [Charles Gaba, Accessed 9/27/18]

Here are the facts about Trump-Azar’s junk insurance plans:

JUNK PLANS HURT PEOPLE WITH COVERAGE IN THE ACA MARKETPLACES.

  • Healthy people will leave the individual market for these plans, causing everyone else’s premiums to go up. As the Center on Budget and Policy Priorities notes, these plans will divide the market between those who are sick and those who are healthy: “Short-term plans would be most likely to attract healthier people, leading to premium increases for ACA-compliant plans and destabilizing individual insurance markets across the nation. “

JUNK PLANS MAKE COMPREHENSIVE HEALTH CARE MORE EXPENSIVE.

  • Repealing the individual mandate and loosening short-term plan rules drive up premiums for everyone who needs comprehensive care. The Congressional Budget Office estimates that repealing the individual mandate will increase premiums by 10 percent annually for the next decade, and a report by Wakely Consulting Group estimates that short-term plans alone will cause premiums to increase by 1.4 percent in 2019.

JUNK PLANS MAKE IT HARDER FOR PEOPLE TO FIND COMPREHENSIVE COVERAGE.

  • Azar could be right if you don’t have a pre-existing condition, aren’t a woman or person over fifty, don’t need maternity care or prescription drug coverage, and will never have to use the hospital over the weekend. Junk plans are allowed to discriminate against people with pre-existing conditions by dropping or denying coverage, charge women more, impose annual limits on care, and exclude basic coverage, like hospitalization, prescription drug coverage, and maternity care. In an analysis of short-term plans conducted by the Kaiser Family Foundation, no short-term plans studied covered maternity care, 62 percent did not cover substance abuse treatment, and 71 percent did not cover outpatient prescription drug services. One plan won’t cover expenses if someone is admitted to a hospital on a Friday or Saturday.

Tennessee’s Own Insurance Commissioner, Julie Mix McPeak, Joined a Chorus of State Officials Warning Against Junk Plans. “‘We have to really make sure consumers know what they’re purchasing, and they’re aware of what’s covered and what’s not covered,’ Mix McPeak said. ‘The last thing we need is for consumers to have surprise bills.'” [The Hill, 8/12/18]

Here are the facts about Trump-Azar’s Medicaid work requirements:

TAKING SOMEONE’S HEALTH CARE AWAY DOES NOT HELP THEM TO WORK.

  • However, evidence suggests that such work requirements hurt, rather than help enrollees’ ability to find work. A study of Michigan’s Medicaid “illustrates the functional barriers to work that Medicaid beneficiaries face, and many of them result from physical and mental health challenges. This suggests to us that taking away their health coverage means that they are less likely to find work – not more so…a stable source of health coverage such as Medicaid is likely to assist people with their chronic mental and physical health conditions so that they they are better able to seek employment.” In both Ohio and Michigan, having access to health care made it easier for the unemployed to find work: “majorities said that gaining health coverage has helped them look for work or remain employed. Losing coverage — and, with it, access to mental health treatment, medication to manage chronic conditions, or other important care — could have the perverse result of impeding future employment.

ALREADY, ARKANSAS’ WORK REQUIREMENTS ARE NOT FUNCTIONING THE WAY THE STATE HAD SUPPOSEDLY HOPED THEY WOULD.

  • Early results in Arkansas confirm that Medicaid work requirements are fundamentally bureaucratic hurdles, threatening access to health coverage for thousands across the state. “The early results suggest that the incentives may not work the way officials had hoped. Arkansas officials, trying to minimize coverage losses, effectively exempted two-thirds of the eligible people from having to report work hours. Of the remaining third — about 20,000 people — 16,000 didn’t report qualifying activities to the state. Only 1,200 people, about 2 percent of those eligible for the requirement, told the state they had done enough of the required activities in August, according to state figures.” [New York Times, 9/24/18]

WORK REQUIREMENTS ARE SO DANGEROUS, THAT DOCTORS WORRY THEY WILL HAVE TO DECIDE BETWEEN “DOING HARM TO PATIENTS” AND “PROVIDING INACCURATE ASSESSMENTS.”

  • New England Journal Of Medicine: Medicaid Work Requirements Put Doctors In Difficult Position.  As outlined in the New England Journal of Medicine, “Along with creating new administrative burdens and costs for physicians and enrollees, work requirements may oblige physicians to be involved in determining whether patients maintain or lose insurance coverage. This expectation places physicians’ responsibility to provide honest documentation in stark tension with their primary obligation to serve patients’ interests. Without explicit state guidance on health circumstances that qualify patients for exemptions, physicians may face an ethical dilemma when choosing between two objectionable options: doing harm to patients and providing inaccurate assessments.”
Close Menu