Monthly Archives

September 2018

House Republicans Scramble To Rewrite History On Pre-existing Conditions

Republicans are scrambling to rewrite their history of opposing protections for pre-existing conditions now that they have been caught for their years of supporting health care repeal and sabotage. In addition to scrubbing their websites of mentions of repeal, House Republicans are trying to hide behind two figleafs — a bill (H.R. 1121) and a House resolution (H. Res. 1066) — that they falsely claim are evidence that they are on the right side of this issue. 

These pieces of legislation are nothing more than hollow promises that read well but in reality fail to protect people with pre-existing conditions from attacks by the Trump administration and their own earlier votes. Here’s what you need to know:

Two thirds of those who signed on to the House resolution (H.Res. 1066) voted to repeal the Affordable Care Act last summer. Of the 28 members of the House who have signed on to the resolution expressing support for pre-existing condition protections, 19 voted for the Republican repeal bill last summer. Last year’s repeal bill, the AHCA, would have dramatically weakened protections for 130 million Americans with a pre-existing condition, allowing insurance companies to charge people more when they get sick, for instance up to $140,510 more for people battling metastatic cancer.

All but eight co-sponsors of the House bill (H.R. 1121) voted to repeal the Affordable Care Act and weaken pre-existing condition protections last summer. Of the 75 cosponsors who voted on the AHCA last summer, 67 voted in favor of repealing the Affordable Care Act and weakening protections for 130 million Americans with a pre-existing condition. Their vote would have allowed insurance companies to charge people with pre-existing conditions more for coverage.

None of the co-sponsors of either the bill or the resolution have shown they oppose the Republican lawsuit backed by the Trump Administration that would completely gut protections for people with pre-existing conditions.

And, in reality, neither piece of legislation actually protects people with pre-existing conditions. The resolution’s language, intentionally vague, includes no specifics on exactly which protections should be preserved. Though H.R. 1121 prevents insurance companies from denying coverage to people with pre-existing conditions, it does nothing to prevent insurance companies from charging people with pre-existing conditions more for coverage or reinstating annual and lifetime limits that insurers use to restrict the amount of coverage someone can use, and it does not preserve the Affordable Care Act’s essential health benefits, essentially allowing insurers to sell plans exempt from covering basic services like maternity care, hospitalization, and prescription drugs. Absent such protections, an insurance company could sell coverage to a cancer patient, but charge them more and drop their coverage once they reach their lifetime limit.

If House members really wanted to defend people with pre-existing conditions, here are two concrete actions they could take:

  • Support the House Democrats’ resolution that would allow the House to defend pre-existing condition protections in court. This summer, the Trump Administration refused to defend against a lawsuit brought by 20 conservative states aimed at overturning the Affordable Care Act and its protections for people with pre-existing conditions. In July, House Democrats introduced a resolution that would authorize the General Counsel of the House of Representatives to intervene in the lawsuit and defend protections for people with pre-existing conditions. Not a single Republican has offered support.
  • Join the House effort to overturn Trump administration’s junk plan rule that lets insurance companies discriminate against people with pre-existing conditions. This summer, the Trump Administration finalized a rule that allows insurance companies to deny coverage to people with pre-existing conditions. Experts warn that this move will only increase the cost of comprehensive care, ultimately making it even harder for people with pre-existing conditions to get the care they need. House Democrats introduced legislation that would override Trump’s rule, but not a single Republican has signed on.

 

 

NEW POLL: More Evidence the Health Care Deficit for GOP is Deepening

“Every Republican should be worried,” said Leslie Dach

Washington, DCA new poll from Navigator Research is the latest showing that health care costs remain a top concern for voters and that the gap in perceptions of the two parties’ health care position is widening. Said Leslie Dach, chair of Protect Our Care, in response:

“The more people hear about Republican’s unrelenting war on our health care, the steeper their deficit with voters on this issue becomes. Every Republican who voted for health care repeal or stood by while the Trump administration and its allies have taken a sledgehammer to our health care should be worried. These Republicans have one thing in common: they have taken away Americans’ health care — and they’ll have to answer for this.”

Among the Navigator Research Findings:

“Health care remains a major issue continuing to drive conversation in Washington and around the country. What’s also clear is Democrats’ lead on the issue of health care has only grown.”

  • Navigator has tracked which party in Congress is more trusted to handle health care since June, and Democrats’ lead just reached a new high of 15 points.
  • Democrats in Congress now lead by 22 points among political independents (42% to 20%). Democrats also hold an 18 point advantage on health care when the sides are framed as “Democrats in Congress” versus “Donald Trump.”
  • By 46% to 32%, Americans prefer Democrats in Congress over Republicans in Congress to handle “keeping down health care costs,” up from a lead of just five points (39% to 34%) in June
  • Democrats lead by 26 points overall on protecting health care coverage for people with pre-existing conditions, including a 21-point lead among independents, a 33-point lead among college-educated whites and even a 9-point lead among whites without a college degree.

The Navigator Research Poll is the Latest Evidence that Health Care Will be a Major Liability for Republicans:

  • Morning Consult/POLITICO Poll Finds Voters Trust Democrats over Republicans on Pre-existing Conditions Protections. Eighty-one percent of voters say it should not be legal for insurance companies to deny coverage to people with pre-existing conditions, and 71 percent say it should not be legal for insurance companies to charge more for people with pre-existing conditions and on the question of pre-existing conditions, voters trust Democrats in Congress over Republicans in Congress by 22 points (42-20), including by 17 points among voters aged 65 and older (41-24). (September  2018)
  • Fox News Poll Finds Majority Of Americans Hold Favorable Opinion Of Affordable Care Act. The poll found that 51 percent of voters held favorable views the Affordable Care Act, compared to only 40 percent who held favorable views of the Republican tax bill. (August 2018)
  • NBC News/ Wall Street Journal Survey Finds Democrats Have 18 Point Advantage In Dealing With Health Care. The survey found that 45 percent of voters polled think democrats would do a better job dealing with health care, compared to only 27 percent of voters who say Republicans would do a better job. (August 2018)
  • Kaiser Tracking Poll Finds Almost Six In Ten Americans Say They Think President Trump And His Administration Are Trying To Make The ACA Fail, Most Say This Is A Bad Thing. “Almost six in ten (56 percent) Americans say they think President Trump and his administration are trying to make the ACA fail while one-third (32 percent) say they are trying to make the law work. Most of those who say they think the Trump administration is trying to make the law fail think this is a “bad thing” (47 percent of the public). In addition, most (58 percent) say since President Trump and Republicans in Congress have made changes to the ACA, they are responsible for any problems with it moving forward.” [Kaiser Family Foundation (July 2018)
  • Kaiser Tracking Poll Finds A Candidates’ Continued Support For Protections For People With Pre-Existing Conditions Is The Single Most Important Health Position For Voters. Fourteen percent of voters said cited protections for people with pre-existing conditions as the most important factor. Sixty-six percent of voters said it was very important, if not the most important, health care issue to them. (June 2018)

Sunday: Protect Our Care Kicks off 48 Stop Nationwide Bus Tour

Headlined by Sens. Chris Murphy and Richard Blumenthal and Cancer Survivor Laura Packard and Brad Woodhouse, Protect Our Care Kicks off 11,505 Mile Bus Tour on Sunday, September 23 in Bridgeport, Connecticut

Bus Rolls On to Portland, Maine for Appearance with Sen. Angus King, Rep. Chellie Pingree, State Representatives, and Mainers with Pre-Existing Conditions  

Washington, D.C. – This Sunday, Protect Our Care will kick off its nationwide bus tour, a 48-stop, 23-state bus tour highlighting the Republican war on health care and its impact on Americans from coast to coast. In its first week, “Care Force One” will travel from Connecticut to Maine, New York, Pennsylvania, and Ohio.

Check out protectourcare.org/bus-tour/ for the latest information on the tour.

What: Stand Up to Protect Our Care — Bridgeport, Connecticut

Who: Sen. Chris Murphy (D-CT)

Sen. Richard Blumenthal (D-CT)

Ned Lamont

State Rep. Chris Rosario (D-Bridgeport)

State Rep. William Tong (D-Stamford)

Laura Packard, cancer survivor

Leslie Dach, founder and chair of Protect Our Care

Brad Woodhouse, executive director of Protect Our Care

Where: Southwest Community Health Center

46 Albion Street, Bridgeport, CT, 06605

When: Sunday, September 23

1:00 PM ET

Livestream: Link available upon request

Following the kick-off event in Connecticut, Care Force One will host its second event the next day in Portland, Maine:

What: Stand Up to Protect Our Care — Portland, Maine

Who: Sen. Angus King (I-ME)

Rep. Chellie Pingree (ME-01)

State Rep. Heather Sanborn (D-Portland)

State Rep. Matt Moonen (D-Portland)

Laura Packard, cancer survivor

Brad Woodhouse, executive director of Protect Our Care

Where: Portland City Hall
389 Congress Street, Portland, ME, 04101

When: Monday, September 24

10:00 AM ET

Livestream: Link available upon request

After Portland, Care Force One will roll into Bangor:

What: Stand Up to Protect Our Care — Bangor, Maine

Who: State Rep. Ryan Tipping (D-Orono)

State Rep. Steve Stanley (D-Medway)

Former Bangor Mayor Joe Baldacci

Laura Packard, cancer survivor

Brad Woodhouse, executive director of Protect Our Care

Where: Waterfront Park
81 Railroad Street, Bangor, ME, 04401

When: Monday, September 24

2:00 PM ET

Livestream: Link available upon request

The full schedule of “Care Force One” appearances is below:

Bridgeport, CT on Sunday, September 23, 2018

Portland, ME on Monday, September 24, 2018

Bangor, ME on Monday, September 24, 2018

Kingston, NY on Tuesday, September 25, 2018

Binghamton, NY on Tuesday, September 25, 2018

Burlington County, NJ on September 26, 2018

Harrisburg, PA on Thursday, September 26, 2018

Pittsburgh, PA on Thursday, September 27, 2018

Erie, PA on Thursday, September 27, 2018

Cleveland, OH on Friday, September 28, 2018

Columbus, OH on Friday, September 28, 2018

Parkersburg, WV on Monday, October 1, 2018

Morgantown, WV on October 1, 2018

Charleston, WV on Monday, October 1, 2018

Cincinnati, OH on Tuesday, October 2, 2018

Indianapolis, IN on Tuesday, October 2, 2018

Lansing, MI on Wednesday, October 3, 2018

Kalamazoo, MI on Wednesday, October 3, 2018

South Bend, IN on Wednesday, October 3, 2018

Milwaukee, WI on Thursday, October 4, 2018

Green Bay, WI on Thursday, October 4, 2018

Madison, WI on Friday, October 5, 2018

Cedar Rapids, IA on Friday, October 5, 2018

Des Moines, IA on Monday, October 8, 2018

Minneapolis, MN on Monday, October 8, 2018

Fargo, ND on Tuesday, October 9, 2018

Minot, ND on Tuesday, October 9, 2018

Billings, MT on Wednesday, October 10, 2018

Butte, MT Thursday, October 11, 2018

Missoula, MT on Friday, October 12, 2018

Reno, NV on Monday, October 15, 2018

Las Vegas, NV on Tuesday, October 16, 2018

Phoenix, AZ on Wednesday, October 17, 2018

Tucson, AZ on Wednesday, October 17, 2018

Denver, CO on Friday, October 19, 2018

Kansas City, MO on Monday, October 22, 2018

Springfield, MO on Monday, October 22, 2018

St. Louis, MO on Tuesday, October 23, 2018

Memphis, TN on Tuesday, October 23, 2018

Nashville, TN on Wednesday, October 24, 2018

Richmond, VA on Thursday, October 25, 2018

Raleigh, NC on Thursday, October 25, 2018

Atlanta, GA on Friday, October 26, 2018

Sarasota, FL on Monday, October 29, 2018

Orlando, FL on Monday, October 28, 2018

Miami, FL on Wednesday, October 31, 2018

St. Lucie, FL on Thursday, November 1, 2018

West Palm, FL on Friday, November 2, 2018

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Kudlow Confirms: Republicans Intent On Dismantling Medicare

For weeks, Republicans have been misleading the American public — the truth is they have been trying to cut Medicare for years. Today, 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.”

Here are some ways they’ve already tried to undermine the program:

  1. Paul Ryan on Medicare: “It’s the biggest entitlement we’ve got to reform.” Paul Ryan, December 6, 2017: “We’re going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit…Frankly, it’s the health care entitlements that are the big drivers of our debt, so we spend more time on the health care entitlements…In- think the president is understanding that choice and competition works everywhere in health care, especially in Medicare…This has been my big thing for many, many years. I think it’s the biggest entitlement we’ve got to reform.”
  2. President Trump and Congressional Republicans are targeting Medicare and Medicaid to pay for tax cuts for the wealthiest. 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.” In an attempt to pay for these tax cuts, in April, House Republicans passed a budget amendment that would slash Medicare funding by $537 billion over the next decade.
  3. Congressional Republicans proposed these cuts after passing a budget resolution last year that cut Medicare by $473 billion. The 2018 budget resolution passed by Republicans in December 2017 cut Medicare by $473 billion.
  4. As the cost of drugs skyrocket, President Trump and his Republican allies in Congress will not allow Medicare to negotiate for better prescription drug prices. Under current law, the Secretary of the Department of Health and Human Services (HHS) is explicitly prohibited from negotiating directly with drug manufacturers on behalf of Medicare Part D enrollees. Although it would decrease both federal spending and beneficiaries’ out-of-pocket costs for prescription drugs, a policy allowing the federal government to negotiate drug prices for Medicare beneficiaries was noticeably absent from President Trump’s recent prescription drug announcement.  
  5. Congressional Republicans have repeatedly attempted to transform Medicare into a voucher program, which experts warn would lead to the “demise” of the program. Speaker Ryan has spoken about turning Medicare into a voucher system, and in Fall 2017, the Centers for Medicare and Medicaid services filed a Request for Information concerning a shift in a “new direction” for Medicare, which Senate Democrats worried might entail a voucher system. Experts warn, and Republicans including Newt Gingrich acknowledge, that such a shift would lead to the demise of traditional Medicare as premiums increase.
  6. Congressional Republicans repealed several components of the ACA designed to help keep Medicare’s costs down, effectively driving up costs for the program. By repealing the requirement that most people have insurance, Congressional Republicans knowingly voted for a measure expected to increase the number of uninsured. The 2018 Medicare Trustees Report predicts that this increase will increase the share of subsidies paid to hospitals via Medicare. Similarly, by repealing the Independent Payment Advisory Board, Congressional Republicans took away a mechanism that slowed Medicare cost growth.

Remember: GOP’s War On Medicaid and Pre-Existing Condition Protections Undermine the Opioid Fight

“Let’s be clear: Instead of waging a war on the opioid crisis, the GOP has waged a war on our health care,” says Brad Woodhouse

Washington, DC – While the Senate is advancing a package of legislation intended to address the opioid crisis, Republicans all levels have simultaneously 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, Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

“Let’s be clear: Instead of waging a war on the opioid crisis, the GOP has waged a war on our health care that has undermined the fight against the opioid crisis time and time again. Republicans must 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; drop its lawsuit to overturn the Affordable Care Act and reverse the damage it’s already done to pre-existing conditions protections by pushing junk insurance plans. After all, if there are two things Americans agree on, it’s that the opioid crisis is serious and that pre-existing conditions protections need to be upheld.”

REPUBLICAN SENATORS COULD SUPPORT PEOPLE WITH PRE-EXISTING CONDITIONS, INCLUDING OPIOID USE DISORDER, BY DOING THE FOLLOWING:

  1. Republican Senators can support the Senate Democrats’ resolution that would allow the Senate to defend pre-existing condition protections in court.
  2. Republican Senators can join the Senate Democrats’ effort to overturn Trump administration’s junk plan rule that lets insurance companies discriminate against people with pre-existing conditions.
  3. Republican Senators can stop working to repeal the Medicaid expansion, with Medicaid heralded by experts in the field as “the most powerful vehicle available to states to fund coverage of prevention and treatment for their residents at risk for or actively battling opioid addiction.”

PRESIDENT TRUMP AND HIS REPUBLICAN ALLIES WANT TO ROLL BACK COVERAGE THROUGH MEDICAID, A LIFELINE FOR PEOPLE SUFFERING WITH OPIOID USE DISORDER

  • Republicans Have Repeatedly Taken Aim At Medicaid. The GOP has attempted to restrict access to Medicaid by allowing states to impose onerous work requirements on Medicaid coverage, trying to impose per capita limits on Medicaid funding, and repeatedly proposing legislation that would end Medicaid expansion.
  • Restricting Access To Medicaid Threatens Lives And Impedes States’ Ability To Respond To The Opioid Epidemic. Four in 10 Americans with an opioid use disorder relies on Medicaid for access to treatment and life-saving overdose reversal medication. Restricting access to Medicaid puts people’s lives at risk and deprives states of funding and resources they depend on to fight the epidemic.

A TRUMP-GOP LAWSUIT COULD OVERTURN THE AFFORDABLE CARE ACT, WHICH PROTECTS PEOPLE WITH SUBSTANCE USE DISORDER

  • Because Of The Affordable Care Act, Insurance Companies Can No Longer Deny Coverage Or Charge More Because Of Pre-Existing Conditions. The Affordable Care Act prevents insurance companies from denying someone coverage or charging them more because of a health problem they had before the date that new health coverage starts. It also prevents insurance companies from rescinding or canceling someone’s coverage arbitrarily if they get sick.
  • The ACA Outlawed Medical Underwriting, The Practice That Let Insurance Companies Charge Sick People More. As the Brookings Institution summarizes, “The ACA outlawed medical underwriting, which had enabled insurance carriers to court the healthiest customers while denying coverage to people likely to need costly care. The ACA guaranteed that all applicants could buy insurance and that their premiums would not be adjusted for gender or personal characteristics other than age and smoking.”
  • The ACA Requires That Insurance Companies Cover Mental Health And Substance Use Disorder Services, And Paved The Way For Medicaid Expansion, Which Helps People Access Services For Substance Use disorders. The Affordable Care Act established ten essential health benefits, including mental health services, substance use disorder services, and prescription drug coverage, that insurance companies are required to cover. Without these protections, people in the individual market could be on their own — before the ACA, 45 percent of individual market plans did not cover substance use disorder services, and 38 percent of plans did not include mental health services.  The ACA also enabled states to expand Medicaid, which has helped people with substance use disorders and mental illness receive treatment. Recent research finds that Medicaid expanding reduced the unmet need for substance use treatment by 18.3 percent.

TRUMP-GOP JUNK INSURANCE PLANS OFTEN EXCLUDE COVERAGE FOR PRE-EXISTING CONDITIONS, MENTAL HEALTH CARE AND MORE

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 Have A Pre-Existing Condition. [Center for American Progress, 4/5/17]
  • 1 in 4 Children 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 [short-term (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]

FACT CHECK: SCOTT WALKER PUTS PRE-EXISTING CONDITIONS PROTECTIONS AT RISK

In response to a disingenuous new ad from the Scott Walker campaign, Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

“We know Scott Walker supports gutting protections for pre-existing conditions because he authorized a lawsuit that would eliminate these protections entirely. Scott Walker’s plan for health care would literally turn the clock backward by bringing back discrimination against pre-existing conditions through his lawsuit and by reviving Wisconsin’s high-risk pool, which has been panned by experts because it drives up costs and restricts coverage. In fact, in testimony before the U.S. House of Representatives, the chief medical officer of the American Cancer Society specifically criticized Wisconsin’s high risk pool for the deadly waiting periods it imposed on people who needed care when they got sick. I’ll say it again: if Scott Walker wants to show he stands up for people with pre-existing conditions, he’ll withdraw his lawsuit to take away the protections we have in current law away.”

SCOTT WALKER’S LAWSUIT WOULD REVERSE PRE-EXISTING CONDITIONS PROTECTIONS, THREATENING 2.4 MILLION WISCONSINITES’ CARE

2,435,700 Wisconsinites Live With A Pre-Existing Condition. About one in two Wisconsinites, 51 percent, lives with a pre-existing condition. [CAP, 4/5/17]

1,187,000 Wisconsin Women And Girls Have A Pre-Existing Condition. Approximately 1,187,000 women and girls in Wisconsin live with a pre-existing condition. [CAP & National Partnership For Women and Families, June 2018]

308,100 Wisconsin Children Already Have A Pre-Existing Condition. Roughly 308,000 Wisconsinites below age 18 live with a pre-existing condition. [CAP, 4/5/17]

616,900 Older Wisconsinites Live With A Pre-Existing Condition. 616,900 Wisconsin adults between the ages of 55 and 64 live with at least one pre-existing condition, meaning attacks on these protections significantly threaten Wisconsinites approaching Medicare age. [CAP, 4/5/17]

IT IS THE AFFORDABLE CARE ACT THAT OUTLAWS DISCRIMINATION BASED ON PRE-EXISTING CONDITIONS

Because Of The Affordable Care Act, Insurance Companies Can No Longer Deny Coverage Or Charge More Because Of Pre-Existing Conditions. Under current law, health insurance companies can’t refuse to cover you or charge you more just because you have a ‘pre-existing condition’ — that is, a health problem you had before the date that new health coverage starts.” [HHS]

The ACA Outlawed Medical Underwriting, The Practice That Let Insurance Companies Charge Sick People And Women More. As the Brookings Institution summarizes, “The ACA outlawed medical underwriting, which had enabled insurance carriers to court the healthiest customers while denying coverage to people likely to need costly care. The ACA guaranteed that all applicants could buy insurance and that their premiums would not be adjusted for gender or personal characteristics other than age and smoking.”

The ACA Stopped Companies From Charging Women More Than Men For The Same Plan. The Affordable Care Act eliminated “gender rating,” meaning American women no longer have to pay an aggregated $1 billion more per year than men for the same coverage.

Thanks To The Affordable Care Act, Insurance Companies Can No Longer Rescind Coverage Because of Illness. Because of the ACA, insurance companies can no longer rescind or cancel someone’s coverage arbitrarily if they get sick.

HIGH RISK POOLS IMPOSE HIGH PREMIUMS & DEDUCTIBLES …

Premiums For Coverage In High Risk Pools Were As Much As 200 Percent Higher Than The Average Rate But Covered Less Care. “High-risk pool enrollees faced substantially higher premiums than people in the normal individual market, often by as much as 150 percent to 200 percent, although some pools did offer subsidies to low-income enrollees…And stunningly, the overwhelming majority of state high-risk pools actually refused to pay for services associated with a patient’s pre-existing conditions in the first months of their enrollment.” [Center for American Progress, 2/16/17]

Deductibles For High Risk Pool Enrollees Were Well Above Maximum Allowed By ACA. ”Fourteen states had plans with deductibles of $10,000 per year or higher, substantially greater than the current maximum $7,150 deductible for catastrophic plans in the marketplaces. Thirty states imposed maximum lifetime limits; others had annual coverage limits as low as $75,000 per year.” [Commonwealth Fund, 3/29/17]

… COST TAXPAYERS MORE …

Despite High Premiums, High Risk Pools Could Still Cost The American People Over $90 Billion Annually. “The U.S. Department of Health and Human Services (HHS) recently estimated that up to 17,875,000 people with preexisting conditions were uninsured in 2010. Had all of them been covered by high-risk pools, the cost would have been $194.8 billion in 2010 dollars, with premiums covering only $103.3 billion. Thus, states and the federal government would have needed to find $91.5 billion in additional funding to cover them all—much more than the up to $10 billion per year in federal assistance to states recently proposed by congressional Republicans.” [Commonwealth Fund, 3/29/17]

An Analysis Of High Risk Pools Under The ACHA Finds Such Pools Would Cost The Government Between $37 and $56 Billion Annually. “Government costs for supporting the high-risk pool using ACA-like coverage and subsidies would range from $37 to $56 billion in 2020 and $437 to $656 billion over 10 years (2020–2029), depending upon the eligibility rules used.” [The Urban Institute, May 2017]

Even Conservatives Estimated High Risk Pools Would Cost $15-$20 Billion Annually. “For comparison, conservative experts James Capretta and Tom Miller have estimated that $15 billion to $20 billion per year, or $150 billion to $200 billion over 10 years, would be needed to fully finance high-risk pools even if they covered only 2 million to 4 million people.” [Center For American Progress, 2/16/17]

Premiums For High Risk Pool Coverage Paid Just 53 Percent Of Program Costs. “Premiums ranged from 125 percent to 200 percent of average premiums in the individual market, yet covered only about 53 percent of claims and administrative costs nationally (Wisconsin allowed premiums up to 200 percent of average).” [Commonwealth Fund, 3/29/17]

… AND RESTRICT COVERAGE

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’ pre-existing 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]

HIGH RISK POOL = MORE PEOPLE UNINSURED

Limited Coverage And High Costs Cause People To Remain Uninsured. Some patients also delayed care to save money, exacerbating their health conditions, and only entered the pools when their conditions became emergencies.” [Stateline, 2/16/17]

CMS: One-Third Of Uninsurable Were Unable To Afford High Risk Pool Coverage. A 2004-05 study by the Center for Medicare and Medicaid Services found that “nationally, high-risk pool premiums are above 25 percent of family income (i.e., are unaffordable) for 10 percent of all individuals, 18 percent of the uninsured, and 29 percent of the uninsurable. By these standards, almost one-third of the uninsurable are unable to afford high-risk pool coverage…” [CMS, Health Care Financing Review, Winter 2004-2005]

HIGH RISK POOLS HAVE BEEN TRIED & FAILED

In Wisconsin, “Cancer Doesn’t Wait” For High Risk Pool Waiting Periods. “The benefit waiting periods used by Wisconsin’s and other states’ high-risk pools are a big concern for patient advocates and provider groups. ‘A six-month exclusionary period is a serious issue,’ said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, who also testified at the House hearing. ‘Cancer doesn’t wait.’” [Modern Healthcare, 2/13/17]

California High Risk Pool Led To Waiting Lists, High Premiums, And Lifetime Limits. “For example, California’s high-risk pool imposed a shorter-than-average, three-month waiting period before enrollees could receive treatment for pre-existing conditions—but also imposed a $75,000 annual limit on benefits along with a $750,000 lifetime limit. In addition, the state capped enrollment, resulting in long waiting lists of people unable to enroll; at the same time, the pool’s high premiums proved difficult for enrollees to afford, leading some to drop out.” [Center for American Progress, 2/16/17]

Premiums in Florida’s High Risk Pool Were Twice The Normal Rate. Many states starved high-risk pools of cash. Florida’s contained only about 200 people in 2011. Premiums were commonly twice the normal rate. Many states had enrollment caps, meaning that even people willing to fork over were not guaranteed coverage.” [The Economist, 1/16/17]

In Utah, High Risk Pools Were Limited In Size, And Offered Sub-Par, Delayed Coverage. “Stevenson said only 3,000 people signed up for Utah’s risk pool plan while 200,000 Utahns are signed up for insurance through Obamacare. ‘Utah’s past high risk pool plan had many limitations too,’ he said. People with pre-existing conditions had to wait six months before using their coverage. Pregnant women had a 10 month waiting period before they had any coverage for them or their baby. ‘The measure of success for a program is how many people it helps and if you are only covering 3,000 people and leaving tens of thousands uninsured, I don’t think that’s a good thing to go back to,’ he said.” [CBS KUTV, 3/9/17]

High Risk Pools Mean Higher Costs, Higher Uninsured, And Less Coverage. The reality is that high-risk pool coverage was prohibitively expensive and there is little evidence to suggest that the existence of such pools made coverage less costly for others in the individual insurance market. Without substantially more federal funding than currently proposed, these facts are not likely to change. People with preexisting conditions may have “access” to coverage, but most will not be able to afford it and those who can will face limited benefits and extremely high deductibles and out-of-pocket payments.” [Commonwealth Fund, 3/29/17]

 

FACT CHECK: HERE ARE ALL THE WAYS KEVIN CRAMER DOESN’T STAND UP FOR PEOPLE WITH PRE-EXISTING CONDITIONS

Brad Woodhouse, executive director of Protect Our Care, issued the following statement in response to a bogus new ad from the Kevin Cramer campaign:

“Kevin Cramer’s new ad is another unbelievably desperate attempt to sweep his own record under the rug. Make no mistake, Cramer has voted numerous times to eliminate pre-existing conditions protections hundreds of thousands of North Dakotans rely upon, he’s refused to take action to oppose the Trump-GOP lawsuit that would eliminate pre-existing conditions protections and he’s done nothing to fight the junk insurance plans promoted by the Trump Administration that don’t have to cover pre-existing conditions and can drop coverage for people when they get sick. If Kevin Cramer thinks he can fool the people of North Dakota about his record against pre-existing conditions protections, he’s got another thing coming.”

REP. KEVIN CRAMER VOTED TO REPEAL THE ENTIRE AFFORDABLE CARE ACT WHICH WOULD HAVE ELIMINATED PROTECTIONS FOR PEOPLE WITH PRE-EXISTING CONDITIONS

2013:  Cramer Voted For A Total Repeal Of The ACA.  Cramer voted for HR 45, an act “to repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010.” [HR 45, Roll Call Vote #154, 5/16/13]

2015:  Cramer Voted For A Total Repeal Of The ACA.  Cramer voted for HR 596, an act “to repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010.”  The bill also ordered House committees to develop a replacement that would “provide people with pre-existing conditions access to affordable health coverage,” but provided no specifics. [HR 596, Roll Call Vote #58, 2/3/15]

 

  • Cramer Said The Bill Would “Repeal The Affordable Care Act In Its Entirety.” “Today Congressman Kevin Cramer voted with the U.S. House of Representatives to repeal the Affordable Care Act in its entirety.” [Cramer Website, 2/3/15]

 

What would full repeal of the Affordable Care Act eliminate?

    • Protections for 316,000 North Dakotans 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 20,000 North Dakotans.

REP. KEVIN CRAMER VOTED FOR THE HOUSE HEALTH REPEAL BILL WHICH WOULD GUT PROTECTIONS FOR PEOPLE WITH PRE-EXISTING CONDITIONS

2017: Cramer Voted For AHCA.  Cramer voted for passage of the American Health Care Act.  [HR 1628, Roll Call Vote #256, 5/4/17]

American Medical Association: “The Bill Passed By The House Today Will Result In Millions Of Americans Losing Access To Quality, Affordable Health Insurance And Those With Pre-Existing Conditions Face The Possibility Of Going Back To The Time When Insurers Could Charge Them Premiums That Made Access To Coverage Out Of The Question.” “The bill passed by the House today will result in millions of Americans losing access to quality, affordable health insurance and those with pre-existing health conditions face the possibility of going back to the time when insurers could charge them premiums that made access to coverage out of the question. Action is needed, however, to improve the current health care insurance system. The AMA urges the Senate and the Administration to work with physician, patient, hospital and other provider groups to craft bipartisan solutions so all American families can access affordable and meaningful coverage, while preserving the safety net for vulnerable populations.” [AMA, 5/4/17]

American College Of Physicians: “This Vote Makes Coverage Unaffordable For People With Pre-Existing Conditions.” “The American College of Physicians (ACP) is extremely disappointed that the U.S. House of Representatives passed the American Health Care Act (AHCA) today. This vote makes coverage unaffordable for people with pre-existing conditions,  allows insurers to opt-out of covering essential benefits like cancer screening, mental health, and maternity care, and cuts and caps the federal contribution to Medicaid while sunsetting Medicaid expansion…The House action is by no means the end of the story, however.  ACP will continue to do all that it can to ensure continued coverage and access for the millions of patients who have benefited from the Affordable Care Act. In a strongly worded letter to the United States Senate also sent today, ACP urged Senators to reject this harmful legislation and begin anew to craft bipartisan solutions to improve coverage and access for all Americans.” [ACP, 5/4/17]

American Association Of Family Physicians: AHCA “Allow[s] For Discrimination Against Patients Based On Their Gender, Age, And Health Status.” “The American Academy of Family Physicians is deeply disappointed with the U.S. House of Representatives passage of the American Health Care Act. This legislation will harm millions of their constituents. It will destabilize our health care system, cause 24 million Americans to lose their coverage, and allow for discrimination against patients based on their gender, age, and health status. Its inadequate and temporary high-risk pool funds are simply a band aid that does nothing to provide health security to the nearly one in three Americans who have a pre-existing condition. Its provision allowing annual and lifetime caps on benefits diminishes the value of every policy sold in the future.” [AAFP, 5/4/17]

American Cancer Society Cancer Action Network: AHCA “Would Create A Coverage Patchwork Whereby Patients With Pre-Existing Conditions Could Be Charged More For Their Coverage While Simultaneously Weakening The Rules For What Health Services Will Be Covered. “Today the House of Representatives passed a health care bill that could leave cancer patients, survivors and those at risk for the disease unable to access or keep quality health insurance. The bill would create a coverage patchwork whereby patients with pre-existing conditions could be charged more for their coverage while simultaneously weakening the rules for what health services will be covered.” [ACS CAN, 5/4/17]

AARP: AHCA “Now Puts At Risk The 25 Million Older Adults With Pre-Existing Conditions…Who Would Likely Find Health Coverage Unaffordable Or Unavailable To Them.” “AARP is deeply disappointed in today’s vote by the House to pass this deeply flawed health bill. The bill will put an Age Tax on us as we age, harming millions of American families with health insurance, forcing many to lose coverage or pay thousands of dollars more for health care.  In addition, the bill now puts at risk the 25 million older adults with pre-existing conditions, such as cancer and diabetes, who would likely find health care unaffordable or unavailable to them.” [AARP, 5/4/17]

Consumers Union: “In A Field Where ‘Do No Harm’ Is The Standard, This Bill Does Nothing But Harm American Families.” “Elizabeth Imholz, Special Projects Director for Consumers Union, the policy and mobilization arm of Consumer Reports, said, ‘The House of Representatives today failed their constituents and the American health system by passing the American Health Care Act. In a field where ‘do no harm’ is the standard, this bill does nothing but harm American families. Taking insurance away from 24 million people, devastating Medicaid, rolling back protections for preexisting conditions and older consumers, increasing out-of-pocket costs, encouraging junk insurance plans without any meaningful coverage, ​and even allowing the elimination of out-of-pocket cost caps and reinstating lifetime limits for the nearly half of all Americans who get their coverage through their employers — these are the real consequences of the AHCA. Each iteration has only made this bad bill worse.’” [Consumers Union, 5/4/17]

America’s Health Insurance Plans: “AHIP Believes That Every American Deserves Coverage And Care That Is Affordable And Accessible, Including Those With Pre-Existing Conditions.” “AHIP believes that every American deserves coverage and care that is affordable and accessible, including those with pre-existing conditions. The American Health Care Act needs important improvements to better protect low- and moderate-income families who rely on Medicaid or buy their own coverage. We stand ready to work with members of the Senate and all policymakers, offering our recommendations for how this bill can be improved to ensure the private market delivers affordable coverage for all Americans.” [AHIP, 5/4/17]

REP. KEVIN CRAMER SUPPORTS A CONSERVATIVE LAWSUIT TO REPEAL THE ACA ALONG WITH ITS PROTECTIONS FOR PEOPLE WITH PRE-EXISTING CONDITIONS

Cramer refuses to oppose a lawsuit designed to end protections for people with pre-existing conditions. This summer, the Trump Administration refused to defend against a lawsuit brought by twenty conservative states aimed at overturning the Affordable Care Act and its protections for people with pre-existing conditions. Cramer has come out in support of the lawsuit. [Politico, 8/17/18]

REP. KEVIN CRAMER WON’T WORK TO OVERTURN JUNK PLANS THAT ALLOW INSURERS TO DENY COVERAGE BECAUSE OF A PRE-EXISTING CONDITION

Cramer refuses to join the House effort to overturn Trump administration’s junk plan rule that lets insurance companies discriminate against people with pre-existing conditions. This summer, the Trump Administration finalized a rule that allows insurance companies to deny coverage to people with pre-existing conditions. Experts warn that this move will only increase the cost of comprehensive care, ultimately making it even harder for people with pre-existing conditions to get the care they need. House Democrats introduced legislation that would block Trump’s rule, but Cramer has not signed on.

Scott Walker: Drop Your Pre-ex Lawsuit

After Wisconsin Governor Scott Walker specifically “signed-off” on Attorney General Brad Schimel joining a partisan lawsuit to dismantle protections for pre-existing conditions protections and the other consumer consumer protections in the Affordable Care Act, today Scott Walker’s spokesperson reportedly said that Walker would call a special session if his own lawsuit is successful.

Said Amanda Harrington, communications director of Protect Our Care, in response:

“Scott Walker, no special session is needed. You authorized this lawsuit in the first place, and if you really want to protect Wisconsinites with pre-existing conditions, now you need to call it off.”

Advocates, Elected Officials Fight Trump’s Junk Plans on All Fronts

New Lawsuit Filed by Health Care Organizations Seeks to Invalidate Trump’s Harmful Junk Plan Rule

New House Resolution, Mirroring One in the Senate, Would Override The Trump Administration’s Rule To Stop Junk Plans

Washington, D.C. – On the heels of the Trump Administration expanding junk plans that can deny coverage to people with pre-existing conditions, that are not required to cover key benefits, such as cancer treatments and prescription drug coverage, and that can refuse to pay for costs after a person gets sick, health care advocates and Democrats in Congress are fighting back.

Today, the Association for Community Affiliated Plans (ACAP), National Alliance on Mental Illness (NAMI), Mental Health America, American Psychiatric Association (APA), AIDS United, National Partnership for Women & Families, and Little Lobbyists filed suit in the U.S. District Court for the District of Columbia to invalidate the Trump Administration’s short-term junk plan rule issued last month. This lawsuit comes just after Congresswoman Kathy Castor (D-FL-14) introduced a resolution that would override the Trump Administration’s rule to allow insurance companies to sell junk plans that charge people more money for less care. The Senate has a companion resolution that is awaiting any Republican support.

Brad Woodhouse, executive director of Protect Our Care issued the following statement in response to the multi-front fight against junk plans:

“The Trump Administration’s never-ending war on health care is not going unanswered. It is facing resistance on the Hill, resistance in the courts and — as poll after poll shows — resistance from the public. House and Senate Democrats have entered the arena to fight for hard-working Americans. Now, it’s time for Republicans to join them.”

House Republicans Who Claim to Support Pre-existing Conditions Protections Should Prove It and Join Castor’s Resolution:

Rep. Martha McSally (R-AZ): “Rep. McSally Is Committed To Ensuring That Individuals With Pre-Existing Conditions Have Access To Affordable Coverage Options And Cannot Be Denied Health Insurance.” “Rep. McSally is committed to ensuring that individuals with pre-existing conditions have access to affordable coverage options and cannot be denied health insurance. She will work to ensure the House reform package includes these protections.” [Tucson Weekly Dispatch, 3/1/17]

Rep. Carlos Curbelo (R-FL): “We’re Keeping The Things That Work, Like Guaranteed Coverage For Pre-Existing Conditions.” “We’re keeping the things that work, like guaranteed coverage for pre-existing conditions, allowing young people to remain on their parents’ plans until the age of 26, and prohibiting discrimination against women.” [Sunshine State News, 3/11/17]

Rep. Brian Mast (R-FL): “We Also Need To Ensure That Patients With Pre-Existing Conditions Won’t Be Denied Coverage.” “We also need to ensure that patients with pre-existing conditions won’t be denied coverage and that those who rely on Medicaid have access to quality care.” [Palm Beach Post, 3/9/17]

Rep. Bruce Poliquin (R-ME): Rep. Poliquin Would Only Support A Repeal Of The ACA If The Replacement Includes Coverage For Pre-Existing Conditions.” “Poliquin would support a repeal of the Affordable Care Act, but only if the alternative plan includes coverage for pre-existing conditions, allows young adults to remain on their parents’ plans until the age of 26, and doesn’t immediately end Obamacare exchange policies.” [WABI TV5, 1/24/17]

Rep. Erik Paulsen (R-MN): “Rep. [Erik] Paulsen has long supported protections for individuals with pre-existing conditions, and he continues to do so,” a spokesman for Paulsen, the Republican representing Minnesota’s Third Congressional District, said in a statement. [Star Tribune, 6/23/18]

Rep. John Culberson (R-TX): “Health Care Should Be Accessible For All, Regardless Of Pre-Existing Conditions Or Past Illnesses.” [Rep. Culberson Website Content Current as of 4/20/17]

Rep. Dave Brat (R-VA): Rep. Brat Stresses Care Would Continue For Those With Pre-Existing Conditions.” “He calmed nerves, for some, by stressing care would continue for those with preexisting conditions.” [CBS WTVR 6 News, 2/21/17]

Rep. Scott Taylor (R-VA): “We Will Protect Those With Pre-Existing Conditions.” “We will protect those with preexisting conditions, we will work help those who can’t help themselves, work to get more access and more people covered.” [Republican Party of Virginia, 3/10/17]

 

Shot/Chaser: Hawley, Stenehjem Hiding from Their Own Lawsuit to Overturn Pre-existing Conditions Protections

SHOT: For months, national patient groups, physicians, hospitals and insurers have emphasized how much the lawsuit could threaten care for people across the country. Health industry experts in the states involved in the lawsuit are making their concerns known, too.

USA Today: “Health Industry Experts Fear ‘Chaos’ if Texas Judge Suspends Affordable Care Act”

“The market would just be in chaos,” said Karen Bender, an actuary and president of Snowway Actuarial and Healthcare Consulting in Little Suamico, near Green Bay, Wisconsin, one of the states that has asked the judge to suspend the ACA.

Marty Anderson, chief marketing officer for Security Health Plan in Wisconsin, said the same.

“There would be chaos in the entire insurance market across the nation,” Anderson said. “That is the only way to describe it….I don’t understand what the end game is.”

CHASER: Feeling the heat not only from the medical community, but also from voters who strongly oppose ending protections for pre-existing conditions, the attorneys general who brought this case in the first place are trying and failing to duck and cover from it.

McClatchy: “Hawley Under Fire on Pre-existing Conditions as Pressure from Dems Mounts”

Missouri Attorney General Josh Hawley won’t offer details about his role in the Republican lawsuit that could strike down insurance protections for people with pre-existing conditions. […]

With pressure mounting, Hawley’s office has refused to clarify his role in the case after oral arguments took place in Texas last week. McClatchy first asked the office for an explanation of Hawley’s work on the case Monday.

[…] Hawley’s office already faces a Missouri Sunshine Law complaint from Protect Our Care, a liberal-leaning coalition of Missouri health care groups, for not turning over records related to his communications with President Donald Trump’s administration on the case.

HPR1 (North Dakota): “All Questions Go to Texas”

All questions related to the federal Texas lawsuit set to terminate current healthcare laws are still being referred to Texas, the North Dakota Attorney General’s office reported.

“We have no comments at this time,” Liz Brocker, public information officer for the Attorney General for North Dakota’s office stated when asked. The state, under Attorney General Wayne Stenehjem, joined the lawsuit along with 19 other Attorney’s General and two governors after the Tax Cuts and Jobs Act eliminated penalties for not obtaining insurance for health coverage.