According to a new report, more than a half-million Floridians could lose their health care if Congress doesn’t make a tax credit included in the American Rescue Plan permanent.
Washington, D.C. – Today, Protect Our Care is kicking off the final week of Medicaid Awareness Month, which examines the critical role Medicaid has played in reducing disparities in health coverage and improving overall health outcomes for vulnerable communities. Research confirms that Medicaid expansion saves lives and drastically reduces racial health disparities. States that expanded their Medicaid programs saw a 51 percent reduction in the gap between uninsured white and Black adults after expansion, and a 45 percent reduction between white and Hispanic adults. Medicaid expansion is the single most important step Congress can take to reduce harmful inequities in our health care system, particularly for communities of color.
“Medicaid has played a vital role in improving equity in health insurance coverage and access to care. The program has increased coverage rates, reduced poverty and inequality, and boosted financial security for communities of color,” said Protect Our Care Executive Director Brad Woodhouse. “Democrats have worked hard to strengthen the program, which has resulted in record enrollment at a time it was needed most. President Biden and his allies in Congress are working hard to protect Medicaid for generations to come. Their success in the face of Republican sabotage speaks to the program’s success— Medicaid is stronger than ever.”
Throughout the month, Protect Our Care released fact sheets and hosted nationwide events with elected officials, storytellers, and health care advocates to highlight Medicaid’s critical role in America, discuss what needs to be done to expand and strengthen the program, and raise awareness of the consequences of Republican threats.
Medicaid Awareness Month 2022 theme weeks:
- Week 1: Medicaid is Working! Week one focused on how Medicaid has improved the lives of millions even amid the COVID-19 pandemic.
- Week 2: Close the Coverage Gap. Week two is bringing attention to the urgent need to close the Medicaid coverage gap.
- Week 3: Protect Medicaid Coverage. Week three will focus on how millions of Americans face losing their Medicaid coverage coverage when the COVID-19 public health emergency ends and how Republican officials across the country are waging a relentless war on Medicaid.
- Week 4: Medicaid & Health Equity. The final week will highlight how Medicaid is our most powerful tool in fighting for health equity.
FACT SHEET: Medicaid Works For Communities Of Color
Generations of structural racism have resulted in people of color experiencing lower rates of coverage, worst health outcomes, and staggering health inequities. As a result, Medicaid coverage remains a critical source of coverage, especially for Black, Hispanic, and Latino Americans who experience poverty at a higher rate than white Americans and remain less likely to have access to quality care. These groups also face higher rates of chronic conditions that make access to affordable health coverage even more essential.
Today, President Biden is attending an event in Seattle to discuss the importance of giving Medicare the power to negotiate prescription drug prices. Recent coverage and opinion pieces confirm that the American people are counting on Congress to pass legislation to drive down prescription drug prices. Giving Medicare the power to negotiate is overwhelmingly popular among voters, as it would drive down prices at the pharmacy counter and deliver long overdue relief to working families.
“President Biden is making clear that Democrats will deliver lower prescription drug prices,” said Protect Our Care Executive Director Brad Woodhouse. “Americans are sick and tired of choosing between paying the bills and affording the medications they need to survive. Congress must work quickly to meet the demands of American families and finally give Medicare the power to negotiate for lower drug prices. The President’s commitment to delivering lower costs for the American people is unwavering, and today’s event makes clear he won’t rest until he gets this done.”
RECENT HEADLINES
HuffPost: This Piece Of ‘Build Back Better’ Is Still A Political No Brainer. “Under the terms of the deal, Medicare would finally have some power to negotiate drug prices with manufacturers. There would also be “inflation caps” ― financial penalties on manufacturers that raise prices substantially from year to year. People with insurance would pay no more than $35 a month for insulin, and Medicare beneficiaries would finally have a hard limit ($2,000) on their out-of-pocket drug costs.” [HuffPost, 4/20/22]
The Hill: Opinion: Congress Must Pass Comprehensive Drug Pricing Reforms That Include Medicare Negotiation. “Right now, the Senate could follow the House of Representatives’ lead and pass the comprehensive reforms to deliver relief to all Americans with high drug prices. These historic reforms already have the necessary support to pass in the Senate – a clear path through reconciliation. But the Senate is dragging its feet on reconciliation, instead focusing on passing just one component of the broad package: capping monthly insulin copays. Meanwhile, Rep. Wild and her colleagues in the House have now passed the insulin provision twice — once in the comprehensive package last Fall and again last week as standalone legislation.” [The Hill, 4/8/22]
(AZ) AZ Mirror: Covid-19 Is Causing More Type 1 Diabetes In Kids, Who Will Be Saddled With High Insulin Prices — Unless Congress Acts. ”In America, around 1 in 4 diabetics have rationed their insulin due to high costs. With nearly 60% of Americans under 17 having been infected with COVID-19, some of them may develop type 1 diabetes. It is more important than ever to do something about insulin prices. By lowering the price of insulin and passing other federal prescription drug reforms, we can help existing diabetics and prevent newly diagnosed diabetics, especially kids, from being forced to ration life-saving medication.” [AZ Mirror, 4/11/22]
(KS) Kansas City Star: Kansas Seniors Like Me Have To Choose: My Medication Or My Mortgage? There Is A Fix. “I had eagerly anticipated the day I’d qualify for Medicare, believing I’d finally be able to afford my prescriptions. But to my surprise, the out-of-pocket cost of my medication was $3,000 a month. The price left me with few options: Skip my medication, seek donations or sacrifice my entire net worth to purchase the prescription. These should not be the only options in the American health care system. But President Joe Biden does have a solution that more than 80% of Americans agree with: Allow Medicare to negotiate drug costs and cap out-of-pocket spending on prescriptions at $2,000 a year. This would change my life. I wouldn’t have to choose between my mortgage or my medication.“ [Kansas City Star, 4/20/22]
(NV) Las Vegas Sun: Why I Turn To Mexico To Buy My Medications. “President Joe Biden has proposed an economic agenda that would allow Medicare to negotiate the cost of prescription drugs, limit the ability of drug companies to hike prices on life-sustaining medications, and cap insulin copays at $35 per month. The House has passed the Affordable Insulin Now Act but the Senate has not. We can’t let this issue fall by the wayside. These reforms would make my daily life much less stressful. Do you know what it is like to get up and spend an extra $1,500 a month just to stay alive? I often think of all the things I could have invested in to better my life if not for the financial weight of drug costs holding me down. If my costs are reduced, I can finally begin to spend my money on other things I’ve been dreaming of, like a mortgage for my own house.” [Las Vegas Sun, 4/17/22]
(NV) Nevada Current: Senate Dems Turn To Prescription Drug Reform Bill, But Will Need GOP Support. “U.S. Sen. Catherine Cortez Masto is optimistic the Senate could soon hear legislation on capping insulin costs and reigning in prescription drug prices, she said in Las Vegas Monday…’We should all be working to do it together,’ Cortez Masto said. ‘Nobody should be saying, ‘this doesn’t make sense.’ We all know this needs to be done. I don’t care if you’re a Republican or Democrat or independent. The focus is on lowering the costs for families and we should be doing it.’” [Nevada Current, 4/19/22]
(PA) The Morning Call: Your View By Monroe County Kidney Donor: Give Medicare Power To Negotiate Prescription Drug Prices. “Prescription drugs don’t work if people can’t afford them. As someone who is affected by the shockingly high cost of prescription drugs that is only getting higher, I’m grateful to see Congresswoman Susan Wild speaking out about this issue… Even since Rep. Wild wrote her letter in January, the prices of hundreds of medications have gone up. Drug companies have already raised prices on 804 drugs this year alone.” [The Morning Call, 3/22/22]
(WI) Wisconsin Examiner: Cutting Prescription Drug Costs Still Priority In US Senate, Baldwin Says. “[Sen. Tammy Baldwin] said she hopes that another provision she has advocated, allowing the federal Medicare program to negotiate drug prices with pharmaceutical manufacturers, can be revived this year as well… American patients pay two, three or four times what residents of other wealthy countries pay for medicine. Medicare negotiation would produce savings for taxpayers as well as patients, Baldwin said.” [Wisconsin Examiner, 3/28/22]
***MEDIA ADVISORY FOR FRIDAY, APRIL 22 AT 1:00 PM MST // 4:00 PM EDT***
Medicaid Is More Important Than Ever Before. Lawmakers Must Work To Strengthen the Program and Ensure Access to Quality, Affordable Care.
Phoenix, AZ — Today, April 22, 2022 at 1:00 PM MST // 4:00 PM EDT, Valle del Sol CEO Carmen Heredia and David Lujan, President & CEO of Children’s Action Alliance, will join Protect Our Care Arizona to highlight how Medicaid has provided Arizonans with access to quality, affordable health care, strengthened local economies, and improved health outcomes across the state.
Medicaid has served as a lifeline during the pandemic, providing health coverage to a record number of Americans at a time they need it most. As Republicans undermine Medicaid to throw people off coverage and we look to the end of the COVID-19 public health emergency, health care coverage for millions of Americans hangs in the balance, requiring a solution to prevent widespread coverage losses. Speakers will identify opportunities for lawmakers to strengthen Medicaid, and ensure ongoing access to care.
VIRTUAL PRESS CONFERENCE:
WHO:
Carmen Heredia, CEO, Valle del Sol
David Lujan, President & CEO, Children’s Action Alliance
Protect Our Care Arizona
WHAT: Virtual Press Conference
WHERE: Register for the Event Here
WHEN: Friday, April 22, 2022 at 1:00 PM MST // 4:00 PM EDT
***MEDIA ADVISORY FOR THURSDAY, APRIL 21 AT 11:00 AM CT // 12:00 PM ET***
Wisconsin — Thursday, April 21, 2022 at 11:00 AM CT // 12:00 PM ET, Wisconsin Assembly Democratic Leader Greta Neubauer and State Rep. Kristina Shelton will join Protect Our Care and Citizen Action of Wisconsin to highlight the critical role Medicaid plays in providing Wisconsinites with access to quality, affordable health care. During the call, speakers will also urge Republican lawmakers to finally expand Medicaid and close the coverage gap in the Badger State.
Medicaid expansion is essential to ensure every Wisconsinite has quality, affordable health coverage. Research shows that Medicaid coverage improves health outcomes, strengthens economies, and saves lives. Medicaid has been a lifeline for rural communities, providing crucial support for hospitals and health care providers, especially during the COVID-19 pandemic.
There has never been a better time for Wisconsin to expand Medicaid.
VIRTUAL EVENT:
WHO:
Assembly Democratic Leader Greta Neubauer
State Representative Kristina Shelton
Peggy M, retiree from Tomahawk
Citizen Action of Wisconsin
Protect Our Care Wisconsin
WHAT: Virtual Press Conference
WHERE: Register for the Event Here
WHEN: Thursday, April 21, 2022 at 11:00 AM CT // 12:00 PM ET
Washington DC — This week, Republicans on the House Ways & Means Committee released a series of bills proposing additional tax breaks for drug companies while rejecting measures to lower prices for patients. According to Inside Health Policy, if the GOP takes back the House, they “will focus on giving tax breaks to drug companies instead of Democrats’ goal of directing Medicare to negotiate drug prices.” In response, Protect Our Care Chair Leslie Dach issued the following statement:
“Republicans want to maintain the status quo where drug companies get to dictate whatever price they want to charge while millions of patients struggle to afford lifesaving medications. While Americans are cutting pills and skipping doses, drug companies continue to rake in record profits. The bills introduced by Republicans on the House Ways & Means Committee would do nothing to help patients at the pharmacy counter. Instead of coming to the table with meaningful solutions like giving Medicare the power to negotiate, Republicans would rather give in to Pharma’s demands.”
***MEDIA ADVISORY FOR WEDNESDAY, APRIL 20 AT 2:00 PM MST // 5:00 PM EDT***
Historic Legislation Would Cap Insulin Costs at $35 a Month, Saving Diabetics Who Struggle to Afford Their Insulin Hundreds of Dollars Every Month
Flagstaff, AZ — On Today, April 20 2022 at 2:00 PM MST // 5:00 PM EDT, Congressman Tom O’Halleran [AZ-01] will join Protect Our Care Arizona and Honest Arizona to discuss the recent passage of the Affordable Insulin Now Act by the House, and call on the Senate to act swiftly and deliver much-needed relief to millions of diabetics across the country. The Affordable Insulin Now Act caps out-of-pocket insulin costs for millions of diabetics with private insurance and Medicare coverage, and limits the out-of-pocket costs of insulin at $35 per month.
While all House Democrats voted for the legislation, 193 House Republicans — including Congressman David Schweikert [AZ-06]— voted against lowering the cost of insulin and against their constituents who struggle to afford their insulin to manage their diabetes. The rising cost of prescription drugs is a top concern among Arizonans, and House Democrats, including Congressman O’Halleran are helping families across the country find relief at the pharmacy counter.
PRESS CONFERENCE:
WHO:
Congressman Tom O’Halleran, (D-AZ-01)
Honest Arizona
Community Health Care Leaders
Protect Our Care Arizona
WHAT: Affordable Insulin Now Act Press Conference
WHERE: North Country HealthCare, 2920 N. Fourth St., Flagstaff, AZ 86004
WHEN: Wednesday, April 20 2022 at 2:00 PM MST // 5:00 PM EDT
Millions Are At Risk Of Losing Medicaid Coverage When The COVID-19 Public Health Emergency Ends
As part of week three of Medicaid Awareness Month, Protect Our Care is examining the consequences of ending the COVID-19 public health emergency, which could result in millions of people losing Medicaid coverage if states fail to act. Today, more than one in four Americans have health coverage through Medicaid or the Children’s Health Insurance Program (CHIP), making these programs undeniable pillars of the American health care system. During the COVID-19 pandemic, President Biden and Democrats in Congress have made historic investments to secure and expand Medicaid during a time of grave public health risks, sudden job loss, and economic upheaval. Thanks to their continued commitment to protecting health coverage access, 2022 saw more than 85 million Americans receiving their coverage through Medicaid or CHIP.
As America seeks a return to normal, it’s likely the public health emergency will end this summer. When that happens, for the first time in more than two years, all states will need to redetermine the eligibility for most people with Medicaid. This process — called the “PHE unwinding” — could result in more than 16 million people losing their Medicaid coverage, including more than six million children. It is imperative that Americans who continue to qualify for Medicaid coverage are not kicked off due to administrative hurdles and Americans who are no longer eligible are connected with affordable, quality coverage — not left to fall through the cracks. Far too many states who have been historically hostile to Medicaid care more about saving money than they care about peoples’ lives. Medicaid terminations prior to the COVID-19 pandemic have shown several states hostile to Medicaid have previously removed hundreds of thousands of Medicaid recipients due to administrative barriers and temporary income increases. It is essential that history not repeat itself, with the health of millions at risk.
President Biden has already taken the bold step of establishing an open enrollment period (OEP) for individuals with incomes below 150 percent of the federal poverty level that will continue until the end of 2022. This will ease the transition for Americans who are no longer eligible for Medicaid and ensure they have access to the coverage they need. States must also do everything within their power to protect the coverage of their residents, and respond to the worries and concerns of families. It is essential states follow the Centers for Medicare and Medicaid Services’ guidance to promote continuous coverage, and have a clear and proactive plan to implement every tool at their disposal, in order to protect millions of vulnerable Americans from losing their care.
Medicaid Landscape
Over 85 Million Americans Rely On Medicaid & CHIP. Nearly 15 million Americans were able to enroll in Medicaid during the COVID-19 pandemic, bringing the total of individuals covered by Medicaid and CHIP to more than 85 million, or one in four Americans. The pandemic has revealed the essential nature of the Medicaid program during America’s worst public health emergency. Since February 2020, there has been a 21 percent total increase in Medicaid and CHIP enrollment.
How The Pandemic Transformed Medicaid
Medicaid Served As A Lifeline During The Pandemic. Millions of Americans lost their jobs, and subsequently, their health coverage during the pandemic. The Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security Act (CARES) requires states to provide enrollees with continuous Medicaid coverage until the federal public health emergency (PHE) ends. The federal government provided additional funding to states during this period to support the increase of enrollees, which surged by 14.8 million over the course of the pandemic. Additionally, states streamlined their enrollment processes, allowing individuals to access their coverage as quickly as possible.
What’s At Stake When The Public Health Emergency Ends
Millions May Lose Coverage. In the 20 states able to report on potential Medicaid disenrollment, it is estimated that 13 percent of Medicaid recipients will be disenrolled at the end of the PHE. The majority of states report that a change in income will be the overwhelming reason people lose Medicaid coverage. However, many states have also indicated that missing documentation, incomplete renewals, or other administrative barriers are likely to be a primary reason for loss of coverage.
Restarting Medicaid Churn. The continuous coverage requirement in place during the PHE, has halted Medicaid churn — when enrollees are dis- and re-enrolled in Medicaid coverage over a short period of time. Churn happens for a number of reasons, including administrative barriers during the renewal or eligibility process. Churn can also occur when Medicaid recipients have brief periods of income fluctuation, which is common for enrollees. Most Medicaid recipients who are physically able to work are employed, frequently in low-wage, unpredictable sectors where their hours and income can adjust from month to month. The continuous coverage requirement protected these individuals from the constant cycle of gaining and losing coverage.
How States Can Prevent Coverage Loss
Renew Based On SNAP Eligibility. CMS’ unwinding guidance allows states to automatically renew Medicaid eligibility for non-elderly beneficiaries who receive SNAP. Nearly all SNAP beneficiaries, 97 percent, qualify for Medicaid. States would protect millions from losing coverage and reduce administrative burdens by renewing Medicaid eligibility based on SNAP enrollment.
Promote Coverage Through Waivers. States can opt to provide continuous coverage for a full year to adult Medicaid enrollees by submitting a Section 1115 waiver to CMS. This would allow individuals to undergo the eligibility determination process only once during a 12 month period, promoting coverage and lessening the administrative burden for states. CMS has also encouraged states to pursue Section 1902(e)(14) waivers, which would protect beneficiaries’ coverage, while allowing states with large administrative loads flexibility to process renewals.
Establish Plan To Promote Continuous Coverage. As of March 2022, only 27 states have developed their required plans for outstanding Medicaid eligibility and renewal when the PHE ends. While states are required to follow elements of CMS’ unwinding guidelines, they also have broad authority over this process. What states ultimately decide could mean the difference between smooth transitions and continuous health coverage and mass Medicaid disenrollment and spiking uninsurance rates.
Suspend Data Matching As Eligibility Tool. Electronic data matches — from a variety of data sources used to verify eligibility — are used to identify Medicaid enrollees for priority action who may lose their eligibility when the PHE ends. In practice, data matching can result in inaccurate information that causes states to begin the disenrollment process, even when the enrollee maintains eligibility. If the individual in question doesn’t follow up with the state when notified, they are likely to lose coverage due to this administrative error. Despite the recommendation from CMS that states suspend use of periodic data matching during the unwinding process, 15 states have indicated they will proceed with this practice and 16 states have yet to determine if they will move forward with electronic data matching. States that do utilize this tool are expected to see reduced coverage and increased churn.
Lengthen The Redetermination Process. CMS gives states 12 months to initiate and 14 months to complete the backlog of Medicaid redeterminations, which review enrollee eligibility at the end of the PHE. The longer the redetermination process, the more time states have to reach out to enrollees to confirm eligibility or assist in the transition process to another form of coverage. Currently, 41 states plan to take 9 to 12 months to conduct the redetermination process, four states plan to take six to nine months, and three states plan to take three to six months.
Follow Up With Enrollees. States are not required to follow up with Medicaid recipients during the redetermination process, they only need to send a renewal form and a termination notice if the enrollee does not respond. This is not adequate to ensure continuous coverage for millions of Americans. Currently 41 states plan on sending reminders and only 25 states plan on reaching out a minimum of two times. States can increase continuous coverage rates by allocating resources to reach out to enrollees multiple times and using multiple methods, such as mail, phone, text, and email.
Update Enrollee Contact Information. Because states are not required to do anything other than mail a renewal form and termination notice, it is essential that enrollee’s addresses are updated and correct. Currently, 46 states are planning on taking some form of action to update mailing addresses prior to the expiration of the PHE, but four states still have no plan to perform this critical service. Only 35 states have a plan to follow up when enrollee mail is returned to sender.
Increasing Staff Capacity. To complete the redetermination process in a timely manner that ensures continuous coverage, states will need additional resources. Currently, 30 states plan to increase staffing towards the end of the PHE, with 21 states planning to approve overtime work, 15 states planning to hire new workers, and 12 states intending to hire contract workers.
More information on Medicaid Awareness Month can be found here.
Protect Our Care Released Ads in the Following Districts: Reps. Cindy Axne (IA-03), Angie Craig (MN-02), Sharice Davids (KS-03), Andy Kim (NJ-03), Susie Lee (NV-03), Elissa Slotkin (MI-08), Abigail Spanberger (VA-07), and Susan Wild (PA-07)
Last week, Protect Our Care released new ads supporting health care champions from eight key districts who have fought to bring down health care costs for American families. Polling shows that health care costs remain a top priority as Americans from all walks of life overwhelmingly support reforms to bring down health care costs. The ads, released on April 13, highlighted Congressional members that delivered a ban on surprise medical bills and are fighting for reforms to lower health care costs, including capping the cost of insulin and giving Medicare the power to negotiate for lower drug prices. Coverage shows that addressing the cost of health care continues to be at the forefront of the Democrats’ agenda.
HEADLINES:
Politico Pulse: Health Campaign Supports House Dems. “The ads will highlight accomplishments — like passing a ban on surprise medical bills — and House-passed legislation that stalled in the Senate, including capping out-of-pocket insulin costs and allowing Medicare to negotiate drug prices, ” our Alice Miranda Ollstein writes. “The investment follows on the heels of recent polling showing health care costs remain among the top issues for Democratic voters.” [Politico Pulse, 4/13/22]
Kansas Reflector: Health Care Advocacy Group Spending $5 Million to Aid Davids, Seven Other Swing-District Democrats. “Protect Our Care, a Democratic leaning organization with former Gov. Kathleen Sebelius, as an advisory board member, made the investment in House swing districts in recognition of the bipartisan appeal of reform designed to control the cost of medical services. The commercial for Davids highlights her support for a law that went into effect this year banning surprise medical bills, her advocacy for a $35 per month cap on the cost of insulin that passed the U.S. House in March and her backing of legislation granting Medicare officials authority to negotiate lower medication prices.” [Kansas Reflector, 4/14/22]
Insider NJ: New Ad: Rep. Andy Kim Featured in New Ad Campaign Supporting His Efforts to Lower Health Care Costs for Working People. “Protect Our Care is releasing a new ad thanking Rep. Andy Kim (NJ-03) for his work to bring down health care costs for American families. The ad is part of a multi-million dollar campaign in support of health care champions like Rep. Kim, who helped ban surprise medical bills and is fighting for reforms to lower health care costs, including capping the cost of insulin and giving Medicare the power to negotiate for lower drug prices.” [Insider NJ, 4/15/22]
MIRS Newsletter: New Ad Thanks Slotkin. “Protect Our Care on Wednesday released a new ad thanking U.S. Rep. Elissa Slotkin of the state’s 8th Congressional District, which includes Ingham, Livingston, and North Oakland counties, for her work to bring down health care costs for American families. Just last month, Rep. Slotkin helped pass the Affordable Insulin Now Act, which caps insulin costs at $35. The new ad campaign comes as President Biden and Democrats are continuing their work to lower drug prices, further reduce premiums, and expand affordable coverage to working families.” [MIRS Newsletter, 4/13/22]
Virginia Political News: Protect Our Care Is Releasing a New Ad Thanking Rep. Abigail Spanberger for Her Work. “Protect Our Care is releasing a new ad this week thanking Rep. Abigail Spanberger (D-VA-07) for her work to try and bring down healthcare costs. As for the ad from Protect our Care, they are spreading the $5 million between Spanberger and seven members of Congress.” [Virginia Political News, 4/13/22]
Sean Golonka, The Nevada Independent: “Protect Our Care has launched a new $5 million ad campaign across eight congressional districts, including #NV03, highlighting Dem reps’ efforts to ‘bring down health care costs for American families.’ One ad highlights Rep. Susie Lee’s (D-NV) health care efforts in Congress.” [@s_golonka, 4/13/22]
A new report from the Robert Wood Johnson Foundation and Urban Institute shows that more than three million people – including 84,000 New Jerseyans would lose their coverage if Congress fails to make the American Rescue Plan’s enhanced premium tax credits permanent.