June 2019

New Report From Protect Our Care Highlights Overwhelming Benefits of Medicaid Expansion and the Consequences of GOP Sabotage to the Program

View the report HERE

Washington, DC – Protect Our Care is releasing a new report today detailing the benefits of Medicaid expansion in communities across America. From improving maternal health, reducing racial disparities in coverage, expanding access to treatment for opioid use disorder, and improving disease-specific diagnosis and treatment, Medicaid expansion has improved and expanded coverage for millions of Americans. The report also makes abundantly clear that the gains made under expanded Medicaid would be erased by the Republican sabotage agenda. Through the courts, Congress and legislatures across the country the Trump administration and its Republican allies will stop at nothing to undermine and sabotage American’s health care and gut Medicaid at every turn. Protect Our Care executive director Brad Woodhouse issued the following statement about the report:

“It’s undeniable that Medicaid expansion has enabled more Americans to receive coverage and improved access to vital health care services in communities across the country. Republicans who continue to wage a war against Medicaid do so at their own political peril, and as the program continues to improve the lives of millions, the GOP’s relentless sabotage efforts place even more Americans at risk of losing coverage – putting their health and even their lives at risk.”

Key passage from the report: As study after study has shown, expanding Medicaid means better health care for millions of people. It is one of the most successful components of an increasingly popular Affordable Care Act. Yet, Republicans continue their unwavering zeal to rip these benefits away. We have a choice: we can continue to find ways to expand and improve coverage and lower costs, or we can continue the Republican war on health care that threatens these benefits. For better health care, the choice is clear.

View the full report: Let’s Expand On That: Medicaid Expansion Has Made America Healthier But GOP Sabotage Threatens Those Gains

Washington, DC — One year ago today, Trump sent lawyers to back a lawsuit that would overturn our health care laws – striking down protections for people with pre-existing conditions. After failing repeatedly to overturn the Affordable Care Act in Congress, Trump went to the courts to try and dismantle it. If Trump’s Texas lawsuit is successful, health insurance companies could deny cover to 130 million Americans with pre-existing conditions like asthma, heart disease and cancer. In response, Protect Our Care chair Leslie Dach issued the following statement:

“Donald Trump and Republicans in Congress are waging a relentless war on health care, starting with their war against people with pre-existing conditions. Even after losing their majority in the 2018 midterm elections, Republicans have continued their sabotage agenda, putting the health care of virtually all Americans at risk. Poll after poll shows that health care continues to be the number one issue on voters’ minds, and there is no doubt Trump and Republicans will pay a heavy price for their ongoing sabotage at the ballot box again in 2020.”

BACKGROUND:

If the Affordable Care Act is struck down:

• GONE: Protections for 130 million Americans with pre-existing conditions. The uninsured rate will increase by 65 percent.
• GONE: Medicaid expansion, which covers 17 million people.
• GONE: Nearly 12 million seniors will have to pay more for prescription drugs because the Medicare ‘donut hole’ will be reopened.
• GONE: 2.3 million adult children will no longer be able to stay on their parents’ insurance.
• GONE: Insurance companies will be able to charge women 50 percent more than men.
• GONE: Financial assistance that helps 9 million people purchase health care in the marketplace.
• GONE: Key support for rural hospitals. As Americans lose coverage, already struggling hospitals will be hit even harder as their costs increase.
• GONE: Ban on insurance companies having lifetime caps on coverage.
• GONE: Requirements that insurance companies cover prescription drugs and maternity care.

Washington, DC – Today, the Office of Management and Budget announced that the Trump administration’s plan to overhaul state Medicaid programs through block grants is officially under review. Protect Our Care executive director Brad Woodhouse issued the following in response:

“After repeatedly being rejected by Congress, the Trump administration is now trying to push states to implement so-called block grants in a blatant attempt to avoid scrutiny in order to sabotage Medicaid. Congress has shut down prior proposals to slash Medicaid through so-called block grants because of the harm it would inflict on the health of so many Americans who rely on it. But since taking office, President Trump has been on a crusade to sabotage Americans’ health care and this attack on Medicaid is just the latest battle in this administration’s war on American health care.”    

BACKGROUND:

Joan Alker, Executive Director Of Georgetown University’s Center For Children And Families: Block-Granting Medicaid “Failed Through Legislation So They Are Trying Through The Administration.” “‘It’s clear that block-granting Medicaid is the Holy Grail,’ said Joan Alker, executive director of Georgetown University’s Center for Children and Families. ‘It failed through legislation so they are trying through the administration.’” [Wall Street Journal, 3/15/19]

Center On Budget And Policy Priorities: Medicaid Block Grant Would Slash Federal Funding, Shift Costs To States, And Leave Millions More Uninsured. “To compensate for the federal Medicaid funding cuts a block grant would institute, states would either have to contribute much more of their own funding or, as is far more likely, use the greater flexibility the block grant would give them to make draconian cuts to eligibility, benefits, and provider payments.  For example, Speaker Ryan’s ‘Better Way’ health plan would give states the choice of a block grant or a Medicaid per capita cap; both would appear to enable states to make sizeable cuts directly affecting beneficiaries that states can’t make now. This could include using waiting lists or capping enrollment; under current law, all eligible individuals who apply for Medicaid must be allowed to enroll.” [Center On Budget And Policy Priorities, 11/30/16]

Washington, DC — Following the news that Manny Sethi, a vocal supporter of repealing the entire Affordable Care Act, entered the Tennessee GOP Senate primary today, Protect Our Care chair Leslie Dach released the following statement:

“The voters have shown time and time again that running on an agenda of repealing and sabotaging health care is a political death wish, but Manny Sethi apparently didn’t get the memo when he entered the Tennessee GOP Senate primary today. Sethi’s brazen support for sabotaging our health care system, raising costs, and taking away people’s health care is as reckless as it is unpopular — especially for the millions of Tennesseans with pre-existing conditions.”

BACKGROUND:

If Sethi Gets His Way, 168,000 Tennesseans Would Lose Their Coverage

• 168,000 Tennesseans could lose coverage. According to the Urban Institute, 168,000 Tennesseans would lose coverage by repealing the Affordable Care Act, leading to a 23 percent increase in the uninsured rate.
• 47,000 Tennessee young adults with their parents’ coverage could lose care. Because of the Affordable Care Act, millions of young adults are able to stay on their parents’ care until age 26.

If Sethti Gets His Way, Insurance Companies Would Be Put Back In Charge, Ending Protections For The 130 Million People Nationwide With A Pre-Existing Condition

• According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 130 million people, have a pre-existing condition. This includes:
  • 44 million people who have high blood pressure
  • 45 million people who have behavioral health disorders
  • 44 million people who have high cholesterol
  • 34 million people who have asthma and chronic lung disease
  • 34 million people who have osteoarthritis and other joint disorders
• 2,718,800 Tennesseans have a pre-existing condition, including 355,200 Tennessee children, 1,382,000 Tennessee women, and 630,100 Tennesseans between ages 55 and 64.

If Sethi Gets His Way, Insurance Companies Would Have The Power To Charge You More, While Their Profits Soar

• 2,745,436 Tennesseans Could Once Again Have To Pay For Preventive Care. Because of the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no cost to consumers. This includes nearly 2,745,436 Tennesseans, most of whom have employer coverage.
• Insurance Companies Could Charge Premium Surcharges in the Six Figures. If the Trump-GOP lawsuit is successful, insurance companies would be able to charge people more because of a pre-existing condition. The health repeal bill the House passed in 2017 had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
• Women Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women were often charged premiums on the nongroup market of up to 50 percent higher than they charged men for the same coverage.
• People Over the Age of 50 Could Face a $4,000 “Age Tax,” Including $5,404 in Tennessee. Because Judge O’Connor sided with Republican lawmakers, insurance companies would be able to charge people over 50 more than younger people. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, including $5,404 in Tennessee, according to the AARP.
• 181,218 Tennesseans in the Marketplaces Would Pay More for Coverage. If the Trump-GOP lawsuit is successful, consumers would no longer have access to tax credits that help them pay their marketplace premiums, meaning roughly nine million people who receive these tax credits to pay for coverage will have to pay more, including 181,218 in Tennessee.
• 108,136 Tennessee Seniors Could Have to Pay More for Prescription Drugs. If the Trump-GOP lawsuit is successful, seniors could have to pay more for prescription drugs because the Medicare “donut” hole would be reopened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 CMS report. In Tennessee, 108,136 seniors each saved an average of $1,034.

If Sethi Gets His Way, Insurance Companies Would Have the Power to Limit the Care You Get, Even If You Have Insurance Through Your Employer

• Insurance Companies Do Not Have to Provide the Coverage You Need. The Affordable Care Act made comprehensive coverage more available by requiring insurance companies to include “essential health benefits” in their plans, such as maternity care, hospitalization, substance abuse care and prescription drug coverage. Before the ACA, people had to pay extra for separate coverage for these benefits. For example, in 2013, 75 percent of non-group plans did not cover maternity care, 45 percent did not cover substance abuse disorder services, and 38 percent did not cover mental health services. Six percent did not even cover generic drugs.
• Reinstate Lifetime and Annual Limits On 2,042,000 Privately Insured Tennesseans. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage for those insured through their employer or on the individual market.
• Large Employers Could Choose to Follow Any State’s Guidance, Enabling Them Put Annual and Lifetime Limits on Their Employees’ Health Care. Without the ACA’s definition of essential health benefits (EHB) in even some states, states could eliminate them altogether. Large employers could choose to apply any state’s standard, making state regulations essentially meaningless. Because the prohibition on annual and lifetime limits only applies to essential health benefits, this change would allow employers to reinstate annual and lifetime limits on their employees’ coverage.

If Sethi Gets His Way, Medicaid Expansion Would Be Repealed

• 381,000 Tennesseans who could gain coverage if Tennessee were to expand Medicaid will be denied that possibility. By not fully expanding Medicaid, Tennessee has restricted its Medicaid program, preventing 381,000 residents from gaining coverage.
• Access To Treatment Would Be In Jeopardy For 800,000 People With Opioid Use Disorder. Roughly four in ten, or 800,000 people with an opioid use disorder are enrolled in Medicaid. Many became eligible through Medicaid expansion.
• Key Support For Rural Hospitals Would Disappear, leaving Tennessee hospitals with $442 million more in uncompensated care.

Washington, DC – The Trump administration’s ongoing war on health care puts the entire LGBTQ community at risk. This Pride Month, it’s important to highlight the barriers to health care that LGBTQ Americans face every day and what’s at stake due to the GOP’s sabotage agenda. To highlight LGBTQ health care during Pride Month, Protect Our Care executive director Brad Woodhouse issued the following statement:

“Pride Month is an important time to recognize the many challenges gay, lesbian, bisexual, transgender, and queer Americans still face in receiving quality and affordable health care. With blatant attacks and discrimination from the Trump administration against trans people and same-sex parents, and their push to dismantle Medicaid through the Texas lawsuit, the GOP’s sabotage agenda would have devastating effects on the well-being and care of LGBTQ Americans across the country. During Pride Month, Americans should lift up and protect our nation’s most marginalized communities, work to ensure comprehensive coverage for LGBTQ medical needs, and continue working to defeat Trump and the Republican Party’s reckless assault on health care.”

Background:

MEMBERS OF THE LGBTQ COMMUNITY FACE DISCRIMINATION IN HEALTH CARE

The LGBTQ Community Faces Significant Barriers To Care. One study published in Health Affairs found that though the uninsured rate gap among members of the LGBTQ community has started to approach the uninsured rate among the non-LGBTQ community, “many continue to experience poorer access to high-quality care. Gay nonwhite men, bisexual white women, and bisexual and lesbian nonwhite women are disadvantaged in multiple aspects of access, compared to straight white men. Only some of these disparities are attributable to economic factors, which implies that noneconomic barriers to care are substantial.” [Health Affairs, October 2017]

Roughly One In Six LGBTQ People Say They Have Avoided Medical Care Due To Concern They Would Be Discriminated Against. “Overall, 18% of LGBTQ Americans say they have avoided going to a doctor or seeking health care out of concern that they would be discriminated against or treated poorly because of their LGBTQ identity.” [NPR, RWJF, & Harvard, November 2017]

Nearly A Quarter Of Transgender Americans Say They Have Avoided Doctors Or Health Care Out Of Fear Of Discrimination. In a survey conducted for NPR, Robert Wood Johnson Foundation, and The Harvard T.H. Chan School of Public Health, 22 percent of transgdender Americans report having avoided doctors or health care out of concern they would be discriminated against. Additionally, in the context of health care 10 percent of transgender people report being personally discrimiated against because they are transgender whem going to a doctor or health clinic. [NPR, RWJF, & Harvard, November 2017]

THE TRUMP ADMINISTRATION IS GREENLIGHTING EVEN MORE DISCRIMINATION

Now, The Trump Administraion Wants To Erode Rules That Protect LGBTQ Patients From Discrimination In The Health Care System. In May 2019, the Trump administration proposed rule change that allows doctors, hospitals, and health care companies to refuse to provide services to LGBTQ people and patients who have had abortions. While the Affordable Care Act’s Section 1557 protected LGBTQ patients against discrimination based on sex (defined to include gender identity and sex stereotypes), the Trump administration’s proposed rollback of this section grants a license to discriminate. [CBS News, 5/24/19]

The Williams Institute At UCLA Estimates That This Rollback Would Leave 1.4 Million Transgender Adults And 150,000 Transgender Teens Without The Help Of The Federal Government In Situations Of Discrimination. “The original rule was adopted ‘in response to an overwhelming record of anti-transgender discrimination and barriers to health care and health coverage,’ said Jocelyn Samuels, the former director of the HHS Office for Civil Rights and the current head of the Williams Institute at UCLA, in a statement. ‘A reversal of these protections would be contrary to the law and, if adopted, would seriously endanger the health and wellbeing of an especially vulnerable population.’ The Williams Institute, a think tank on LGBTQ rights, said that this rollback would leave 1.4 million transgender adults and 150,000 transgender teens without the help of the federal government in situations of discrimination.” [The Atlantic, 5/24/19]

Trump’s Discrimination Rule Is Part Of A Broader Effort By The Trump Administration To Reverse Progress In LGBTQ+ Rights. “The potential new HHS rule is part of a broader effort by social conservatives in the Trump administration to change the language around LGBTQ people in official documents, regulations and the law to represent more traditional views on relationships and rights. This includes adding references to ‘marriage between man and woman’ and removing terms such as gender rights.” [Washington Post, 4/24/19]

AND REPUBLICANS’ RELENTLESS REPEAL AND SABOTAGE AGENDA THREATENS TO TAKE COVERAGE AWAY FROM MANY IN THE LGBTQ COMMUNITY

Republicans’ Tireless Attempts To Overturn And Repeal The Affordable Care Act Jeopardize LGBTQ Americans’ Coverage. “A new study by the Center for American Progress, or CAP, finds that 15 percent of LGBT Americans across all income ranges are uninsured in 2017, compared to 7 percent of non-LGBT Americans. The ACA is closing this gap for those who most need financial help to afford coverage. In 2013, before the ACA’s coverage reforms came into effect, 1 in 3 LGBT people making less than $45,000 per year (34 percent) were uninsured. Just one year later, in 2014, uninsurance for this group had dropped by one-quarter to 1 in 4 (26 percent), and by 2017, CAP’s study finds that it was around 1 in 5 (22 percent). Conservative proposals to repeal and replace the ACA—such as the American Health Care Act, or AHCA—would undo these gains and hurt LGBT people, their families, and their neighbors.” [Center for American Progress, 3/22/17]

The Trump Administration Has Also Pushed Junk Plans, Which Are Exempt From Key Non-Discrimination Protections. “The Trump administration has sought to widen the availability of plans that may be exempt from key protections, including non-discrimination protections related to SOGI. Short-term limited duration (STLD) and association health plans in particular have been targeted as vehicles for this expansion.” [Kaiser Family Foundation, May 2018]

Research presented at the annual meeting of the American Society of Clinical Oncology this past weekend found the Affordable Care Act to be linked to a reduction in racial disparities in cancer care as well as earlier diagnosis and treatment. Here’s how these findings were covered:

Essence: While Republicans Work To Dismantle The Affordable Care Act, It’s Saving Black Cancer Patients’ Lives. “The Affordable Care Act (ACA), or Obamacare, does more than just make health care affordable to all, it’s also opening doors to life-saving treatment for Black cancer patients. New studies find that the ACA is linked to minimizing racial disparities within the care of cancer patients and earlier diagnoses for ovarian cancer patients, which often goes undetected until it spreads and becomes fatal, according to The Mayo Clinic.” [Essence, 6/3/19]

The Root: Affordable Care Act Reduces Racial Disparities In Cancer Treatment. “It turns out the Affordable Care Act may have acted to make care affordable and accessible to black folks. According to new research, the law has been linked to a reduction in racial disparities in the care of cancer patients and to earlier diagnoses and treatment for ovarian cancer, according to the Washington Post… Today, black adults in states with expanded Medicaid under the ACA are almost entirely caught up with white patients for early treatment.” [The Root, 6/2/19]

Washington Post: ACA Linked To Reduced Racial Disparities, Earlier Diagnosis And Treatment In Cancer Care. “Proponents of the embattled Affordable Care Act got additional ammunition Sunday: New research links the law to a reduction in racial disparities in the care of cancer patients and to earlier diagnoses and treatment of ovarian cancer, one of the most dangerous malignancies. According to researchers involved in the racial-disparity study, before the ACA went into effect, African Americans with advanced cancer were 4.8 percentage points less likely to start treatment for their disease within 30 days of being given a diagnosis. But today, black adults in states that expanded Medicaid under the law have almost entirely caught up with white patients in getting timely treatment, researchers said. Another study showed that after implementation of the law, ovarian cancer was diagnosed at earlier stages and that more women began treatment within a month. The speedier diagnoses and treatment were likely to have increased patients’ chances of survival, the researchers said.” [Washington Post, 6/2/19]

STAT: The Affordable Care Act Erased A Racial Disparity In Cancer Care, A New Study Says. “The expansion of Medicaid under the Affordable Care Act in 2010 nearly erased a key disparity in access to cancer care for white and African-American patients, according to a new study…Without Medicaid expansion, white patients received chemotherapy within a month of their cancer diagnosis 48.3% of the time. But African-American patients received chemotherapy within a month 43.5% of the time, 4.8-point difference. In states where Medicaid was expanded, this 4.8-point difference decreased to 0.8 points, a difference that was not statistically significant. In white patients, the Medicaid expansion increased the percent of patients who received chemotherapy in a month by two points; among African- Americans, there was a six-point change.” [STAT, 6/2/19]

CNN: Medicaid Expansion Tied To ‘Timely’ Treatment For Black Cancer Patients, Study Says. “‘The new findings came as no surprise to Dr. Georges Benjamin, executive director of the American Public Health Association, who was not involved in the research. ‘It tells you that insurance is important. Insurance matters,’ Benjamin said…So again you’re beginning to see more and more of this evidence that the states that did not expand are putting their citizens at extraordinary risk, which is preventable,’ Benjamin said. ‘They’re missing an opportunity to improve the health of their population and with this new cancer study, it shows that they’re also missing an opportunity to address issues around health equity.’” [CNN, 6/2/19]

Associated Press: More Blacks Got Timely Cancer Care Under ‘Obamacare.’ “New research suggests that states that expanded Medicaid coverage under the Affordable Care Act eliminated racial differences in being able to quickly start on treatment after a diagnosis of advanced cancer. The law that is often called “Obamacare” let states expand Medicaid eligibility and offer subsidies to help people buy health insurance.” [Associated Press, 6/2/19]

Wall Street Journal: One New Study Showed Earlier Diagnosis And Treatment Of Ovarian Cancer Under ACA. “One of the new studies concluded that the rates of diagnosis of earlier-stage ovarian cancer and start of treatment within 30 days improved after the implementation of the ACA. The study, led by researchers at Johns Hopkins University’s department of gynecology and obstetrics in Baltimore, used data on more than 70,000 patients from the National Cancer Database, which is run by medical groups and includes information about roughly 70% of newly diagnosed cancer patients…The study found a 1.7% relative improvement in early-stage ovarian-cancer diagnosis among women under 65, and a 1.6% gain in their start of treatment within 30 days of diagnosis. Dr. Anna Jo Smith, the lead study author, said the ACA improved patients’ access to primary-care doctors, which may have helped detect early-stage ovarian cancers.” [Wall Street Journal, 6/2/19]

The newest Republican talking point – from President Trump to Leaders McCarthy and McConnell to the RNC – that Democrats aren’t getting anything done on issues important to people…is a lie.

The reality is Democrats are setting a record-pace for actions to reduce health care costs, protect health care for pre-existing conditions and take on the big drug companies to curb the skyrocketing costs of prescription drugs.  

• In the last four months, Democrats have passed the “Protecting Americans with Preexisting Conditions Act of 2019” and the “Strengthening Health Care and Lowering Prescription Drug Costs Act,” despite near unanimous Republican opposition.
• House Democrats have joined the fight against Trump’s Texas lawsuit that would eliminate the entire Affordable Care Act. Republicans refused to join them.
• Democrats have held more than fifteen hearings on affordability and quality of care, and passed several bills to improve care and ensure protections for patients with pre-existing conditions.  

And they’re just getting started.

The problem is Republicans are blocking any reforms and keep pushing a repeal and sabotage agenda which analysts say will raise premiums, raise drug costs and gut protections for people with pre-existing conditions.

• The Trump administration and Republicans have gone to court in Texas to strike down our health care laws – gutting protections for people with pre-existing conditions and raising costs on millions of Americans.
• Trump has promised to repeal health care and repeatedly attacks the late Senator John McCain for voting against his repeal agenda.
• McConnell has become the grim reaper of the U. S. Senate and refuses to vote on any of the reforms that would lower drug prices or lower health care costs.  

See the comparison for yourself…

View the full side by side comparison here