September 2018

Trump Administration and Washington Republicans’ Health Care Sabotage Raises Rates

Washington, D.C. – Today, North Dakota announced final rates for 2019 individual-market health insurance plans, which indicate that premiums will increase by as much as 25.9 percent, in contrast to the average nationwide 4.3 percent decrease that Brookings Institution analysts predicted would occur absent GOP sabotage, on top of last year’s comparable rate hike due to Washington Republicans’ repeal-and-sabotage agenda. Brad Woodhouse, executive director of Protect Our Care, released the following statement in response:

“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 families in North Dakota are once again forced to pay the price. Until we stop Republicans’ war on health care, insurance companies will continue to make huge profits and enjoy record tax breaks from Republicans while they charge working families more and more. 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 North Dakotans.”

From the Insurance Companies:

Sanford: GOP Repeal Of Individual Mandate Driving Up Rates. “A rate change is needed to account for medical trend as well as revisions to the following pricing assumptions… Removal of the individual coverage mandate penalty in 2019.”[Sanford, accessed 8/1/18]

Medica: Rate Increases Driven By “Unprecedented Amount Of Uncertainty” In Marketplace. “The significant factors driving the proposed rate increase primarily include: Unprecedented amount of uncertainty and risk inherent in the marketplace.” [Medica, accessed 8/1/18]

From the Experts:

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]

Kavanaugh’s Positions on Health Care, Roe v Wade, Executive Power and Repeated Evidence of Lack of Veracity Require Nomination To Be  Withdrawn

White House Should Honor the Three Women Who Bravely Stepped Forward by Initiating an FBI Investigation

Washington, DC – Ahead of the scheduled Senate Judiciary Committee hearing on Dr. Christine Blasey Ford’s testimony that Donald Trump’s Supreme Court nominee Brett Kavanaugh sexually assaulted her, Leslie Dach, chair of Protect Our Care, issued the following statement:

“Brett Kavanaugh is unfit to serve on the Supreme Court, his nomination should be withdrawn and every Senator must speak out and oppose his confirmation. Kavanaugh’s record, previous testimony on pre-existing conditions and Roe v. Wade, and his repeated lack of truthfulness disqualify him from a seat on the Supreme Court.

“Kavanaugh now faces serious and highly credible accusations of sexual assault from three courageous survivors. The White House should withdraw his nomination and immediately initiate the FBI investigations Dr. Christine Blasey Ford, Deborah Ramirez, and Julie Swetnick have so bravely requested and Kavanaugh has resisted. The Court and the American people deserve a Supreme Court Justice who isn’t afraid of the truth.”

Voters Disapprove of Republican Attacks on Pre-Existing Conditions and Incumbent Dave Brat’s Pro-Repeal Record

Washington, DC – As a new poll out of Monmouth University Polling Institute finds that Democrat Abigail Spanberger holds a narrow lead over pro-repeal incumbent Republican Dave Brat, new polling from Protect Our Care and Public Policy Polling (PPP) shows one reason why: health care is the top issue for voters in VA-07. Said Brad Woodhouse, executive director of Protect Our Care, in response to the poll findings:

“Voters are willing to throw their support behind Democrats to ensure protections for pre-existing conditions remain intact, it’s just that simple. That’s why Republicans like David Brat are finding themselves in hot water.”

Key Findings from PPP-Protect Our Care Poll in VA-07

• Health care is a very important issue to voters when deciding who to vote for. 60% say it is either the most important issue or a very important issue when deciding who to vote for.
• Virginians are very concerned about the possible consequences of repealing the ACA. 62% of voters think charging people 50+ years old, five times more than younger people for health insurance is a major concern. Eliminating protections for people with pre-existing conditions is a major concern for 63% of voters.
• 59% oppose the Trump administration’s lawsuit to overturn protections for people with pre-existing conditions, including nearly half (49%) of Republicans. Virginians are also less likely to vote for Republicans who stayed silent on this lawsuit. A plurality of voters (42%) say they are less likely to vote for Congressman Brat because of his silence on the lawsuit.

The PPP-Protect Our Care Poll Mirrors Data from Google Trends Showing that Searches for Health Care Dominate across the State — including in VA-07.

• In VA-07, between 43 and 82 percent of all issue searches were on health care; in every county, the second highest search trailed by 8 percentage points or more.

Voters Disapprove of Repealing the Affordable Care Act and Eliminating protections for people with pre-existing conditions. Health Care is The Top Voting Issue Making Voters More Likely to Support Democrats

“Pre-existing Conditions Create Headaches for Ohio Republicans,” writes the Cleveland Plain Dealer

Washington, DC – New Public Policy Polling (PPP) surveys commissioned by Protect Our Care find that health care may be a decisive issue for voters in the Ohio battlegrounds of OH-12 and OH-14. Brad Woodhouse, executive director of Protect Our Care, issued the following statement in response to the poll findings:

“Try as they might to hide it, make no mistake:  Troy Balderson and Dave Joyce want to roll back protections for 4.8 million Ohioans with pre-existing conditions and you don’t have to look any further than their own record on health care for proof.”

Key Findings from PPP-Protect Our Care Poll OH-12

• Health care is an important issue to voters when deciding who to vote for. 61% say it is either the most important issue or a very important issue when deciding who to vote for.

• Ohioans are very concerned about the possible consequences of repealing the ACA. 59% of voters think charging people 50+ years old, five times more than younger people for health insurance is a major concern. Eliminating protections for people with pre-existing conditions is a major concern for 64% of voters.
• 64% oppose the Trump administration lawsuit to eliminate the health care law’s protections for people with pre-existing conditions, including a 46% plurality of Republicans.

Key Findings from PPP-Protect Our Care Poll OH-14

• Health care is an important issue to voters when deciding who to vote for. 64% say it is either the most important issue or a very important issue when deciding who to vote for.
• Ohioans are very concerned about the possible consequences of repealing the ACA. 65% of voters think charging people 50+ years old, five times more than younger people for health insurance is a major concern. Eliminating protections for people with pre-existing conditions is a major concern for 60% of voters.
• 63% oppose the Trump administration lawsuit to eliminate the health care law’s protections for people with pre-existing conditions, including a 51% majority of Republicans.

The PPP-Protect Our Care Polls Mirror Data from Google Trends Showing that Searches for Health Care Dominate across the State — including in OH- 12 and OH-14.

• In OH-12, health care is far and away the top issue in searches, with the next most popular issue, immigration, trailing by 17-29 percentage points in Delaware, Monroe and Licking counties.
• In OH 14, health care is also the top issue by a 19-27 percentage point spread in Ashtabula, Lake and Gauga counties.

Here’s how the PPP-Protect Our Care polls were covered locally:

Pre-existing Conditions Create Headaches for Ohio Republicans

Years of pushing for Obamacare repeal have created an unpleasant side effect for Republicans seeking re-election to Congress: Their Democratic opponents are pounding the message that Republicans voted to let insurance companies refuse coverage to people with pre-existing medical conditions.

Democrats ranging from Betsy Rader in Ohio’s northeast to Aftab Pureval in the southwest are running ads that accuse Republicans in Congress of  voting to end the law’s protections for people with ailments that might disqualify them from buying health insurance. Across the country, Democrats are running similar ads in hopes of winning enough seats to gain control of Congress.

[…] Nowadays, Ohio Republicans who once highlighted their Affordable Care Act opposition are instead stressing their support for its provisions that keep insurance companies from discriminating against sick customers.
Rader’s opponent, Bainbridge Township GOP Rep. Dave Joyce, has even erased boasts on his campaign website about his more than 30 votes to repeal the Affordable Care Act.

“Mitt Romney, it’s actually not that complicated. Medicaid Expansion is a good thing. That’s why it’s popular and that’s why the people will vote for it — and not for you — in November,” said Brad Woodhouse, executive director of Protect Our Care

SHOT: Mitt Romney opposes Medicaid expansion, and believes that the issue is too complicated for the people to decide in an initiative to appear on November’s ballot. “Medicaid expansion is a very complex issue. It requires extensive research and analysis and I think is generally done best by elected representatives of the people.”

CHASER: Medicaid expansion has been studied, and it’s been found to provide numerous benefits for Americans. That’s why Utah’s proposed initiative to enact the Medicaid Expansion is enjoying support from 60 percent of residents.

Here are a few of the studies Mitt Romney must have willfully ignored:

• Research From Georgetown University Center For Children And Families Confirms That Rural Populations Are Especially Hurt When States Do Not Expand Medicaid. “The uninsured rate for low-income adult citizens (below 138 percent FPL) has come down since 2008/09 in nearly all states, but small towns and rural areas of states that have expanded Medicaid have seen the sharpest declines. The uninsured rate for this population dropped sharply from 35 percent to 16 percent in rural areas and small towns of Medicaid expansion states compared to a decline from 38 percent to 32 percent in non-expansion states between 2008/09 and 2015/16.” [Georgetown University Center for Children and Families, 9/25/18]
• Rural, Low-Income Voters Less Likely To Have Health Insurance In Than Urban Poor States That Did Not Expand Medicaid. “Rural, low-income voters who helped propel President Trump to victory in 2016 are less likely to have health insurance than the urban poor in states that didn’t expand Medicaid under the Affordable Care Act. A new study compared uninsured rates from 2008-2009 and 2015-2016 by the the Georgetown University Center for Children and Families and the University of North Carolina Rural Health Research Program. It examined insurance coverage in 46 states with significant rural populations and found a disparity between low-income adults living in rural areas and small towns versus those living in metropolitan areas.” [Washington Post, 9/25/18]
• Georgetown Report Emphasizes That Medicaid Expansion Plays Significant Role In Coverage Gains Given Difficulty Getting Insurance Companies To Cover Rural Communities. “There are several reasons cited in the Georgetown/University of North Carolina report that Medicaid expansion could be part of the solution:  It’s difficult to get insurance company to offer plans in sparsely populated rural towns; areas with more insured residents draw clinics and providers to operate there; and rural hospitals are less likely to close in places where they can depend on Medicaid payments.” [Washington Post, 9/25/18]
• University of Michigan Study Finds Medicaid Expansion Improves Access To Family Planning. “Among 1,166 reproductive-age women who enrolled in the Healthy Michigan Plan, Michigan’s expansion of the Medicaid program for low-income adults, 1 in 3 said the expanded coverage improved access to birth control and family planning services…’Our findings suggest that the expansion provided an important service for populations with a high unmet need for family planning care,’ says lead author Michelle Moniz, M.D., M.Sc., an assistant professor of obstetrics and gynecology at Michigan Medicine. ‘Insurance coverage also means that women have access to more options if they do not want to become pregnant at the current time.’…Each dollar spent on contraception is estimated to save the health care system more than $7 in return, according to a recent study from the Guttmacher Institute. About 40 to 50 percent of the 4 million live births in the U.S. every year are paid for by Medicaid.” [University of Michigan, 8/31/18, JAMA Publication]
• Northwestern University Research Heart Attack Patients Had Higher Rates Of Health Coverage In Medicaid Expansion States.“In a boost for cardiovascular care in the U.S., new research shows those suffering heart attacks and strokes were less likely to be uninsured for their hospital stays after states expanded Medicaid under the Affordable Care Act…Research led by Dr. Ehimare Akhabue from Northwestern University’s Feinberg School of Medicine showed Medicaid expansion states had a ‘significant reduction in the proportion of uninsured hospitalizations for major cardiovascular events within 1 year of Affordable Care Act Medicaid expansion compared with nonexpansion states.’ Researchers looked at more than 3 million ‘non-Medicare’ hospitalizations from hospital databases from 30 states.” [Forbes, 8/26/18]
• Ohio Medicaid Expansion Study Found That People Continuously Enrolled Through Medicaid Were Less Likely To Have Medical Debt. “People continuously covered by Medicaid were substantially less likely to have medical debt than eligible people who were still uninsured or people who churned on and off of Medicaid.That aligns with prior studies published in Health Affairs and elsewhere. If the purpose of Medicaid is to provide people with health care and a certain level of basic economic security, it seems to be succeeding.” [Vox, 8/24/18]
• Following Medicaid Expansion, The Percentage Of Uninsured Ohioans With Income At Or Below 138 Percent Of FPL Dropped Drastically. See chart below. [Vox, 8/24/18]

• Researched Published In JAMA Confirms That Medicaid Expansion Increased Access To Opioid Treatment. “Medicaid expansion significantly increased buprenorphine with naloxone prescriptions per 100 000 county residents in expansion counties, suggesting that expansion improved access to opioid use disorder treatment. Expansion did not significantly increase the overall rate per 100 000 county residents of OPR prescriptions, but increased the population with OPRs paid for by Medicaid. This finding therefore suggests the growing importance of Medicaid in pain management and addiction prevention.” [JAMA, Saloner et. al, 8/17/18]
• Health Affairs Study Finds Low-Income People More Able To Afford Diabetes Medications And Manage Disease In Expansion States. “Low-income people with diabetes are better able to afford their medications and manage their disease in states that expanded Medicaid under the Affordable Care Act, a new study suggests. The Health Affairs study, released Monday afternoon, found a roughly 40 percent increase in the number of prescriptions filled for diabetes drugs in Medicaid programs of the 30 states (including Washington, D.C.) that expanded eligibility in 2014 and 2015, compared with prior years.By contrast, states that didn’t embrace the Medicaid expansion saw no notable increase.” [Kaiser Health News, 8/6/18]
• University Of Kansas Research Finds Medicaid Boosts Employment For People With Disabilities. “People with disabilities are much more likely to be employed in states that have expanded Medicaid coverage as part of the Affordable Care Act, new research from the University of Kansas has found. Similarly, the number of those who report not working because of a disability has greatly declined in expansion states. Neither trend happened in states that chose not to expand Medicaid.” [Healthcare Finance News, 7/23/18]