February 2023

Washington DC — Today, President Biden made a speech in Virginia Beach, VA to call out Republicans for their recent threats to slash Medicaid and dismantle the Affordable Care Act (ACA). For months Republicans have openly stated their goal for their House majority – to gut health care programs rather than make companies and the wealthy pay their fair share.

Republicans have promised to defund Medicare and Medicaid, and to repeal the Affordable and the Inflation Reduction Act. Recent press reports indicate that GOP lawmakers have been meeting with Russ Vought, the Director of the Office of Management and Budget under former President Trump, as they begin to draft a budget to use as part of their threat to tank the economy and default on the nation’s debt if President Biden doesn’t agree to slash health care and other programs.

Vought’s plan cuts $2 trillion from Medicaid and guts the Affordable Care Act, eliminating protections for pre-existing conditions, ripping coverage from 20 million Americans who rely on Medicaid, and raising premiums for nearly 15 million Americans who receive premium tax credits that make coverage affordable. Vought’s plan would be catastrophic for the American people and disproportionately impact children, rural Americans, and people of color. People will lose their health insurance and important benefits like preventive services and maternity care, and pay more for prescription drugs and insurance premiums.

In response, Protect Our Care Chair Leslie Dach issued the following statement:

“President Biden made it clear in his remarks today that he and Congressional Democrats are not going to let Republicans hold our economy and the American people hostage. Republicans are doubling down on their long history of attacking ACA and Medicaid through their budget proposals, which disproportionately affects rural Americans, people with disabilities, and communities of color. The GOP plan would be disastrous for our country, effectively repealing the ACA, driving up costs for almost 15 million Americans and eliminating coverage altogether for more than 20 million people while also removing vital protections for millions of Americans with pre-existing conditions.

“President Biden won’t let the American people’s access to affordable health care be stripped away to justify an extreme right-wing budget. It’s the same old story, Democratic lawmakers want to expand health care while Republicans want to rip it away from the most vulnerable.”

BACKGROUND 

GONE: 2023 Republican Threat to the ACA

MEMO: Republican Threats to Health Care Are as Real as Ever

This week we highlight federal initiatives that are working to advance policies and programs that can make an impact on health and other outcomes and are taking an intersectional lens to our present challenges. These federal efforts, along with new research that showcases the importance of primary care to address our behavioral health crisis and other promising interventions, provide important insights on actions we can collectively take to achieve health equity throughout the country. While new research has shown areas of progress and opportunity, other studies demonstrate and reinforce where we have fallen short.

Protect Our Care is dedicated to making high-quality, affordable and equitable health care a right, and not a privilege, for everyone in America. We advocate for policies that lower health care costs and strengthen coverage, which are critical to expanding access to quality health care and, ultimately, achieving better health outcomes, particularly for people of color, rural Americans, LGBTQI+ individuals, people with disabilities, and more. Our strategies are driven by a broader commitment to tackling systemic inequities that persist due to racism and discrimination and the reality that multi-sector policies are needed to address basic conditions that affect health and related outcomes, particularly for marginalized communities.

INITIATIVES

Smart Cities Dive: President Biden Signs Executive Order on Promoting Racial Equity. “President Joe Biden signed an executive order on Thursday directing federal agencies to create annual, publicly-available Equity Action Plans that evaluate and ‘address the barriers underserved communities may face in accessing and benefitting from the agency’s policies, programs, and activities.’ Advocates for racial equality heralded the measure as a step in the right direction. As part of the federal initiative, the Department of Housing and Urban Development opened a portal allowing local governments to request technical assistance for its Thriving Communities program to help align their housing needs with their infrastructure investments under 2021’s bipartisan infrastructure law. Other initiatives include advancing equitable procurement, improving data equity and transparency, boosting economic development in rural communities and addressing emerging civil rights concerns such as biased algorithms in AI.” [Smart Cities Dive, 2/17/23]

American Hospital Association: HHS Hosts Black Health Matters Summit to Promote Racial Equity. “The Department of Health and Human Services today hosted the first daylong HHS Black Health Summit in Washington, D.C., where department officials highlighted federal, state and local efforts to eliminate health disparities and HHS resources to help advance health equity. Health and Human Services Secretary Xavier Becerra welcomed attendees and heralded the Biden Administration’s progress boosting Affordable Care Act enrollment and vaccine uptake among communities of color. Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure and Rep. Lauren Underwood, D-Ill., author of comprehensive maternal health legislation, discussed efforts to reduce Black maternal mortality and morbidity. Additionally, Miriam Delphin-Rittman, administrator of the Substance Abuse and Mental Health Services Administration, and Keisha Lance Bottoms, senior advisor to the president for public engagement, emphasized the importance of faith-based and other community partnerships in eradicating stigma and improving access to mental health treatment. The event concluded with a grants workshop featuring representatives from eight HHS agencies, including the National Institutes of Health, Administration for Children and Families, and Health Resources and Services Administration.” [AHA, 2/22/23]

Healthcare Finance News: Announcement of Medicare Benefit Expansion Mobility Devices will Help Address Disability Inequities. “The Centers for Medicare and Medicaid Services [CMS] has released a proposed National Coverage Determination on power seat elevation equipment on wheelchairs. This is the first National Coverage Determination to expand Medicare coverage for power seat elevation equipment on Group 3 power wheelchairs to allow individuals to have an easier transfer from the wheelchair to other surfaces. Group 3 power wheelchairs are designed to meet the needs of people with severe disabilities such as stroke, Amyotrophic Lateral Sclerosis and late-stage Parkinson’s or Multiple Sclerosis. The National Coverage Determination proposal incorporates feedback from interested parties, particularly those who are focused on eliminating health disparities for people with disabilities, CMS said. CMS encourages comments from all interested parties, but in particular, people with Medicare and their families, providers, clinicians, consumer advocates, healthcare professional associations and from individuals serving populations facing disparities in health and healthcare. Additionally, CMS is specifically interested in gathering additional scientific literature that provides evidence surrounding the medical necessity for seat elevation systems through studies that include measurable characteristics related to the performance of transfers.” [Healthcare Finance News, 2/16/23]

WRAL News: How Medicaid Expansion in North Carolina Will Help Rural Residents. “[R]ural Americans are more likely to die prematurely from heart disease, cancer, lung disease, and stroke, according to the National Institutes of Health (NIH). The NIH also reports that the risk of fatal car crashes, suicide, and drug overdoses is also higher in rural communities. Those trends are colliding with the rising number of rural hospitals closing their doors. North Carolina alone has lost 11 hospitals with between six and 70 inpatient beds since 2006, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill. Research from the 2019 Budget and Tax Center Report conducted by the North Carolina Justice Center indicates that Medicaid expansion would improve the physical and economic health of rural communities, as well as the hospitals that serve them. One study found that Medicaid expansion was associated with nearly 12 fewer deaths per 100,000 adults each year in states that have expanded Medicaid. In addition, according to the Commonwealth Fund, most Medicaid enrollees report higher rates of satisfaction than people with private insurance. Expanding Medicaid also helps rural hospitals by reducing the amount of uncompensated care they give. In Michigan, the cost of uncompensated care for uninsured people was cut in half after the state expanded Medicaid, a result seen across the country where states have adopted the program. By reducing that barrier to opening and growing a small business, the North Carolina Rural Center [also] projects that expanding Medicaid would create 83,000 jobs in North Carolina.” [WRAL News, 2/14/23]

Washington Post: Family Medicine May be a Factor in Improving Mental Health. “Primary care providers are at the forefront of the nation’s deepening behavioral health crisis because when patients walk into a doctor’s office, they bring all their needs with them. Asthma. Anxiety. Diabetes. Depression. Sniffles. Stress. A growing number of providers — like those at Charles Drew — are integrating behavioral health and primary care to improve the continuity of treatment and lower barriers to access. Now, the federal government is trying to bring down those barriers, too, by awarding 24 medical schools and hospitals a total of $60 million to train the next generation of primary care physicians — family medicine doctors, pediatricians, internists — to address behavioral health needs. Although behavioral and physical health are deeply intertwined, the two forms of care are often siloed in a poorly coordinated system. And patients often fall through the cracks of the disjointed system when they are referred to an outside specialist. The goal is to give people the space to share and to ensure they’re heard, [Sarah Abdelsayed] said, noting that it was common for appointments to last about an hour in her Buffalo offices after a racially motivated mass killing at a supermarket in a predominantly Black neighborhood in the city. If patients need support beyond what primary care providers can offer, they don’t have to go somewhere else to get it with an integrated care model, often on-site. In such a setting, there’s a behavioral health team, social workers, therapists or psychiatrists often. Experts say this helps foster discretion and dignity, because people could be sitting in a waiting room for myriad reasons.” [Washington Post, 2/10/23]

McDermott Plus: Select Telehealth Flexibilities Extended Under Act. “The Consolidated Appropriations Act, 2023 (2023 CAA) (Public Law 117-328), signed into law on December 29, 2022, funds US government operations for fiscal year 2023 and provides roughly $1.7 trillion in overall spending. The 2023 CAA extends certain key telehealth flexibilities instituted during the public health emergency (PHE) through December 31, 2024, effectively untying these flexibilities from the continued existence of the PHE. While the 2023 CAA decouples the extension of many telehealth flexibilities from the PHE and provides extended coverage through December 31, 2024, other telehealth policies remain tied to the PHE and will expire if additional legislative or regulatory action is not taken. The Administration announced on January 30, 2023, its intent to end the PHE on May 11, 2023.” [McDermott Plus, February 2023]

Futurity: The ACA Has Helped Farm Workers Get and Stay Healthy. “More than 2.5 million agricultural workers help maintain the United States’ abundant food supply. They play a vital role in the economy, but their job is hard and often dangerous. This low-income, largely immigrant workforce has some of the worst health outcomes in the US. Traditionally, farm workers have had difficulty getting routine preventive care because they’re often itinerant, working for a succession of employers who don’t provide health benefits. In the new paper, Donkor and colleagues conclude that Obamacare is helping farmworkers in a significant way—while also reducing economic stress on the health care system. The researchers found Obamacare has not only substantially raised the share of seasonal farm workers with medical insurance, it also has increased their use of preventive medical care and decreased their use of hospitals, including emergency care. The [Affordable Care Act] ACA also reduced the likelihood of a farm worker forgoing medical care. Medicaid-eligible farm workers were nearly 19% less likely to go without care; those eligible for an insurance subsidy under the law were nearly 9% less likely. Hospital use, including emergency room visits, decreased by 4.4% for Medicaid-eligible farm workers and 1.5% for those eligible for subsidies. These effects didn’t significantly differ between people with and without preexisting conditions, which suggests that the ACA has benefited farm workers’ health across the board.” [Futurity, 2/24/23]

CHALLENGES

Washington Post: CDC Finds Teenage Girls Are Experiencing Increasingly High Rates of Violence and Suicide. “Nearly 1 in 3 high school girls reported in 2021 that they seriously considered suicide — up nearly 60 percent from a decade ago — according to new findings from the Centers for Disease Control and Prevention. Almost 15 percent of teen girls said they were forced to have sex, an increase of 27 percent over two years and the first increase since the CDC began tracking it. Almost 3 in 5 teenage girls reported feeling so persistently sad or hopeless almost every day for at least two weeks in a row during the previous year that they stopped regular activities — a figure that was double the share of boys and the highest in a decade, CDC data showed. Girls fared worse on other measures, too, with higher rates of alcohol and drug use than boys and higher levels of being electronically bullied, according to the 89-page report. Thirteen percent had attempted suicide during the past year, compared with 7 percent of boys. Richard Weissbourd, a psychologist and senior lecturer at Harvard’s Graduate School of Education, said there is probably not a single cause to explain the data but rather interacting causes that vary by race, ethnicity, class, culture and access to mental health resources. In 2021, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry and the Children’s Hospital Association together declared ‘a national state of emergency’ in children’s mental health. A year later, the organizations sounded the alarm again.” [Washington Post, 2/13/23]

Los Angeles Times: Black Californians Hit Hardest for Health Disparities. “More than half of Black Californians said there was a time in the last few years when they thought they would have received better healthcare if they had belonged to a different racial or ethnic group, according to a report released Thursday. By comparison, 27% of Latinos, 12% of Asian people and 4% of white people responded the same way, the report said. The report from the California Health Care Foundation, a nonprofit organization focused on health issues in the state, summarized results from a survey that asked more than 1,700 Californians about their views on health equity, health costs, health access, housing, their experience in the health system and more. The results come as lawmakers, health providers and public health agencies grapple with how to explain and curb longtime racial health inequities. Overall, 54% of Californians had experienced at least one negative provider interaction, including 64% of Californians with low incomes and 50% of those with higher incomes, according to the report. But even when controlling for geographic region, income, gender, language and age, Black Californians were twice as likely as white Californians to report any negative experiences with healthcare providers in recent years.

Pharmacy Times: Lower Income Communities Have Worse Cardiovascular Health Disparities. “Rural counties with a higher percentage of Black residents have higher rates of heart disease, despite a general decline in heart disease between 2009 and 2018, according to a paper by researchers at the University of Georgia published in the Journal of the American Heart Association. Housing instability was an important factor that contributed to death from cardiovascular disease (CVD), as was food insecurity. This supports previous findings, which determined that having a low income can create stress that leads to inflammation and illness, thus providing an explanation as to why socioeconomic status can increase risk of death from CVD. In the current study, investigators collected data from this Department of Health survey. What they discovered is that counties with a higher incidence of CVD had a larger number of residents lived in mobile homes. Conversely, counties with higher household income and access to quality health insurance (Medicare) had lower rates of death from CVD. [Zhou] Chen explained that increasing food stamp availability could help address high rates of CVD in certain communities, although affordable housing and health care require more government action.” [Pharmacy Times, 2/23/23]

AP: Native Americans Are Facing Even More Barriers to Access Abortion Services Post-Roe. “Getting an abortion has long been extremely difficult for Native Americans….It has become even tougher since the Supreme Court overturned Roe v. Wade. New, restrictive state laws add to existing hurdles: a decades-old ban on most abortions at clinics and hospitals run by the federal Indian Health Service, fewer nearby health centers offering abortions, vast rural expanses for many to travel, and poverty afflicting more than a quarter of the Native population. Among the six states with the highest proportion of Native American and Alaska Native residents, four – South Dakota, Oklahoma, Montana and North Dakota – have moved or are poised to further restrict abortion. South Dakota and Oklahoma ban it with few exceptions. In some communities, the distance to the nearest abortion provider has increased by hundreds of miles, said Lauren van Schilfgaarde, a member of Cochiti Pueblo in New Mexico who directs the tribal legal development clinic at the University of California-Los Angeles. Many advocates worry that reduced abortion access will make things even worse for women already facing maternal death rates twice as high as their white peers, teen birth rates more than twice as high as whites, and the worst rates of sexual violence.” [AP, 2/14/23]

New York Times: Rural Hospitals Are Closing Their Maternity Units. “Astria Toppenish Hospital is one of a string of providers across the nation that have stopped providing labor and delivery care in an effort to control costs — even as maternal deaths increase at alarming rates in the United States, and as more women develop complications that can be life-threatening. From 2015 to 2019, there were at least 89 obstetric unit closures in rural hospitals across the country. By 2020, about half of rural community hospitals did not provide obstetrics care, according to the American Hospital Association. In the past year, the closures appear to have accelerated, as hospitals from Maine to California have jettisoned maternity units, mostly in rural areas where the population has dwindled and the number of births has declined. A study of hospital administrators carried out before the pandemic found that 20 percent of them said they did not expect to be providing labor and delivery services in five years’ time. Women in rural areas face a higher risk of pregnancy-related complications, according to a study by the Commonwealth Fund. Those living in so-called maternity care deserts are three times as likely to die during pregnancy and the critical year afterward as those who are closer to care, according to a study of mothers in Louisiana. The United States is already the most dangerous developed country in the world for women to give birth, with a maternal mortality rate of 23.8 per 100,000 live births — or more than one death for every 5,000 live deliveries. Recent figures show that the problems are particularly acute in minority communities and especially among Native American women, whose risk of dying of pregnancy-related complications is three times as high as that of white women. Their babies are almost twice as likely to die during the first year of life as white babies. Women of color are more likely to live in maternity care deserts or in communities with limited access to care. According to the March of Dimes, the maternal health nonprofit, seven million women of childbearing age reside in counties where there is no hospital-based obstetric care, no birthing center, no obstetrician-gynecologist and no certified nurse midwife, or where those services are at least a 30-minute drive away.” [New York Times, 2/26/23]

New York Times: Maternal Mortality Rates Have Stopped Falling Globally for the First Time. “Although maternal mortality rates declined worldwide from 2000 to 2020, almost 800 women still die of pregnancy-related complications every day, according to a grim report issued Wednesday by the World Health Organization and other agencies of the United Nations. Despite early improvements in maternal health during the 20-year period, progress has stalled in many regions, and in recent years maternal mortality rates have risen sharply in Latin America, the Caribbean and, perhaps surprisingly, in Europe and North America. In the United States, maternal deaths rose sharply during the pandemic. In 2021, hundreds of deaths resulted from pregnancy complications exacerbated by Covid infections, according to data from the U.S. Government Accountability Office. Among wealthy industrialized nations, the United States has the highest maternal mortality rate. According to the W.H.O., the rate almost doubled between 2000 and 2020, rising to 21 deaths per 100,000 live births in 2020, or one in 5,000, up from 12 deaths per 100,000 births in 2000, or 1 in 10,000. According to the Centers for Disease Control and Prevention, whose own figures put the U.S. maternal mortality rate for 2020 at 23.8 per 100,000, the risk is almost three times higher for Black women, at 55.3 per 100,000, than for white women, whose mortality rate is 19.1 per 100,000. Native American women also face a much higher risk of dying during and after pregnancy, compared with white women.” [New York Times, 2/22/23]

***MEDIA ADVISORY FOR WEDNESDAY, MARCH 1 AT 12:00 PM ET***

Washington, DC — On Wednesday, March 1, 2023, Senate Finance Committee Chairman Ron Wyden (D-OR), House Energy and Commerce Committee Ranking Member Frank Pallone, Jr. (D-NJ-06), and Representatives Tony Cárdenas (D-CA-29), and Debbie Dingell (D-MI-06) will join Protect Our Care for a press call following President Biden’s speech on the GOP’s real threats to slash Medicaid and dismantle the Affordable Care Act (ACA). For months Republicans have openly stated their goal for their House majority – to gut health care programs to fund tax breaks for the wealthy. During the call, speakers will discuss how the GOP remains committed to ripping away protections for pre-existing conditions, raising premiums, and throwing millions off their coverage.

Recent press reports indicate that GOP lawmakers have been meeting with Russ Vought, the Director of the Office of Management and Budget under former President Trump, as they begin to draft a budget to use as part of their threat to tank the economy and default on the nation’s debt if President Biden doesn’t agree to slash health care and other programs. 

Vought’s plan would cut $2 trillion from Medicaid alone and repeal Medicaid expansion, which covers 20 million people. This is the latest in a long line of Republican attacks on Medicaid. The plan also makes extensive cuts to the Affordable Care Act, eliminates protections for pre-existing conditions, and removes the premium tax credits that make coverage affordable for 15 million Americans. Vought’s plan would be catastrophic for the American people and disproportionately impact children, rural Americans, and people of color.

Read more here.

PRESS CALL:

WHO:
U.S. Senator Ron Wyden (D-OR)
U.S. Representative Frank Pallone, Jr. (D-NJ-06)
U.S. Representative Tony Cárdenas (D-CA-29)
U.S. Representative Debbie Dingell (D-MI-06)
Brad Woodhouse, Executive Director of Protect Our Care 

WHAT: Virtual Press Conference 

WHERE: Register for the Event Here

WHEN: Wednesday, March 1 at 12:00 PM ET

While They Air Television Ads Falsely Scaring Seniors They Are Bragging to Wall Street About Their Profits

The insurance industry and their Republican supporters in Congress are trying to scare seniors into believing the Biden administration is cutting Medicare. Insurance companies claims that they will have to cut benefits or increase premiums for seniors are just plain false. In fact, the Biden administration is proposing to increase spending on Medicare Advantage by $4 billion. And despite their dire advertising, the insurance companies have been busy telling Wall Street they expect Medicare Advantage to drive serious growth for their businesses.

Following Medicare’s Advance Notice payment update and during the industry’s multi-million dollar false advertising campaign, Humana announced they are doubling down on the Medicare Advantage business and only offering government-backed coverage. Humana announced in February 2023 that it will stop providing employer-sponsored commercial coverage as it focuses on bigger parts of its business, like Medicare Advantage. CEO Bruce Broussard said that the exit from employer-sponsored coverage lets Humana focus on its “greatest opportunities for growth.” After the announcement, shares of Humana Inc. climbed more than $4 to $507.91 Thursday.

Earlier in February, Humana shared with investors that they expect Medicare Advantage to drive their expected growth. In a Q4 2022 earnings call, Humana CFO Susan Diamond announced, “Our 2023 outlook reflects top-line growth above 11%, with consolidated revenues projected to be north of $103 billion…driven by growth in…Medicare Advantage.” 

UnitedHealthcare cites growth that is also driven by Medicare Advantage. In a Q4 2022 earnings call, UnitedHealthcare CFO John Rex announced, “Our strong 2023 Medicare Advantage member outlook is consistent with…serv[ing] up to 900,000 more people in ’23 across our individual, group, and dual special needs offerings, our 8th consecutive year of above-market growth.” 

In 2022, UnitedHealthcare showed double-digit revenue increases driven by Medicare Advantage. Their first quarter filing cited revenue growth of 14% in UnitedHealthcare and 19% in Optum. “The increases in revenues were primarily driven by growth in the number of people served through Medicare Advantage…”

We’ve heard these unfounded complaints from the industry before, and experts debunk them.
Mark Miller, who directed MedPAC for over 15 years, states: “This notion and threat thrown about from plans — ‘Touch one of my dollars, and all benefits will disappear’ — based on history and experience, that’s nonsense.” David Meyers, Assistant Professor of Health Services, Policy, and Practice at the Brown University School of Public Health, states: “I’m not really convinced we will see much movement in benefits or premiums with these proposed rules. Supp benefits are a huge marketing tool for plans and they won’t want to get rid of benefits benes like.”

U.S. Representatives James E. Clyburn and Lucy McBath Joined Protect Our Care to Call on Congress to Expand the Lifesaving Insulin Provision for Seniors in the Inflation Reduction Act to All Americans.

Over the past two weeks, Protect Our Care has been highlighting the importance of lowering insulin copay costs and calling for Congress to finish the job of the Inflation Reduction Act to make the $35 cap universal. Through nationwide events, resources, and social media, Protect Our Care has highlighted real stories of people currently saving hundreds, if not thousands of dollars on their insulin costs, as well as how a universal insulin copay cap would help all insulin users. For people of color, lowering insulin costs is especially important because they disproportionately suffer from diabetes and are more likely to skip, ration, or completely forgo insulin as a result of outrageous costs.

Last year, Republicans in Congress blocked a provision that would have extended the cap to people with private insurance which put Big Pharma’s profits over real people. Now, President Biden and Democrats in Congress are fighting to extend these savings to everyone. This would help an estimated 21 million patients afford this vital medication. 

Fact Sheets

• FACT SHEET: Inflation Reduction Act Helps Seniors of Color Afford Their Insulin
• FACT SHEET: Universal $35 Insulin Copay Cap Will Benefit Millions Of Americans

Videos

• NEW VIDEO: Georgia Health Care Storyteller Travels to DC to Call on Congress to Extend the Insulin Copay Cap to Everyone
• NEW VIDEO: Health Care Storyteller Shares Why Congress Must Extend the Inflation Reduction Act’s Insulin Cap to Everyone
• NEW VIDEO: Representative James E. Clyburn Discusses Expanding the Insulin Copay Cap to All

Opinion Pieces

• Arizona Physician: A Ray of Hope After the Inflation Reduction Act
• Bridge Magazine: Opinion | $35 insulin cap and free shingles vaccine a blessing for seniors
• Up North News: Nearly 60,000 Wisconsin Seniors on Medicare Need Insulin. So Why Did Republicans Oppose Biden’s $35-a-Month Insulin Cap?

Thursday, February 21 – Insulin Event with Representatives James E. Clyburn (D-SC-06) and Lucy McBath (D-GA-07): U.S. House Assistant Democratic Leader James E. Clyburn (D-SC-06) and U.S. Representative Lucy McBath (D-GA-07) joined Protect Our Care for a press call to discuss the ongoing efforts to expand the Inflation Reduction Act’s insulin savings to every American. During the call, speakers discussed how lowering insulin costs is especially important for people of color, who disproportionately suffer from diabetes and are more likely to skip, ration, or completely forgo insulin as a result of outrageous costs. “If there’s anything you cannot take shortcuts on, it’s the medicine that people need in order to maintain a good quality of life. … I know what families are going through with those children and not being able to afford the insulin. That’s not what this country is all about,” said U.S. House Assistant Democratic Leader James E. Clyburn. “This is about saving lives. We’re here today to continue this fight for those who sent us to Washington on their behalf and we’ll continue to do this work to expand savings for these life-saving drugs because the American people deserve it,” said U.S. Representative Lucy McBath. You can watch the event here, and view the post-event release here.

In The States

ARIZONA

Thursday, December 29, 2022—Arizona Physician Magazine Op-ed by Dr. Suganya Karuppana on the Inflation Reduction Act. Protect Our Care Arizona placed an opinion piece (pg. 14-16) in Arizona Physician magazine by Dr. Suganya Karuppan, chief medical officer at Valle Del Sol. In the piece, Dr. Karuppana highlights how the new Medicare benefits such as the $35 insulin cap and advanced premium tax credits improve health care costs for Arizonans. Krauppana writes, “Medicare beneficiaries will have more reasonable caps on out-of-pocket spending on medications, and my personal favorite, the Medicare $35 copay on insulin.” You can read the full op-ed here.

Thursday, February 9 – Post-SOTU/Insulin Event with Arizona Health Care Advocates. Saundra Cole, President of the Arizona Alliance for Retired Americans, and David Lucier, President of the Arizona Veterans and Military Leadership Alliance joined Protect Our Care Arizona to discuss how President Biden and Democrats in Congress have worked to pass historic health care measures, lower costs, and expand access to care in Arizona and across the country, including capping insulin costs for Medicare beneficiaries at $35 a month, and expanded coverage for certain vaccines. “When Medicare was introduced our lifespan increased because seniors were able to get their medical needs met,” said Cole. “Seniors are a vital part of the community and deserve to live with dignity and respect.” You can watch the event here.

GEORGIA 

Friday, February 10, 2023 – Senator Raphael Warnock SOTU Guest Lacy McGee Video. Senator Warnock was joined by Lacy McGee, an insulin user from Atlanta at President Biden’s State of the Union address. Lacy has struggled to afford her medication despite having private insurance and has been forced to ration her insulin or even rely on the black market to obtain the lifesaving drug. Lacy’s story demonstrates the importance of extending the Inflation Reduction Act’s monthly insulin cap to everyone. You can watch Lacy’s story here, and view an ICYMI on Lacy’s trip to Washington, DC here.

MICHIGAN

Thursday, January 26, 2023 – IRA Vaccines + Insulin Event with HHS Regional Director Joseph Palm and Michigan Health Care Advocates. Healthcare leaders joined Protect Our Care Michigan to celebrate a record-breaking enrollment of 322,273 Michiganders into the ACA marketplace for 2023. This year seniors in the state and across the country are saving on insulin costs and life-saving vaccines thanks to the Inflation Reduction Act. HHS Regional Director Joe Palm said record enrollment in Marketplace health coverage reflects the growing public awareness that health insurance is the lifeline that puts high-quality medical care within reach of middle-income families. “The 16.3 million people nationally – including 322,000 Michiganders – who enrolled in Marketplace health plans now have a way to deal with an unexpected illness or injury,” Palm said. “And thanks to the Inflation Reduction Act that was passed last year, they can continue to buy that insurance at an affordable price.” You can watch the event here.

• Detroit Free Press: Michigan sees highest Obamacare enrollment since 2016
• MLive: Record Michiganders seek health insurance through ACA marketplace in 2023
• WXMI-TV (FOX-Grand Rapids): Michigan Sees Record Open Enrollment Numbers
• Gongwer: Health Care Leaders Boast Record-Breaking Open Enrollment
• MIRS: Vaccines Are Free For Medicare Adults Under IRA

Thursday, February 2, 2023 – Bridge Magazine Op-ed by Linda Vail on New Medicare Benefits for Seniors. Protect Our Care Michigan placed an opinion piece in Bridge magazine by Ingham County health officer Linda Vail. In the piece, Vail highlights how the new Medicare benefits such as the $35 insulin cap and vaccine coverage are a blessing for seniors. Vail writes, “Under the Inflation Reduction Act, as of Jan. 1, monthly insulin costs are capped at $35 for Medicare recipients. This is nothing short of a lifesaving game changer for seniors in all corners of Michigan, and a major step toward reducing massive racial and geographical inequities in health care.” You can read the full op-ed here.

Thursday, February 16, 2023 – Post-SOTU/Insulin Event with Rep. Dan Kildee and Advocates. Congressman Dan Kildee and health care leaders joined Protect Our Care Michigan to discuss how President Biden and Democrats in Congress have worked to pass historic health care measures, lower costs, and expand access to care in Michigan and across the country. “I’ve worked to pass new laws to lower the costs of health care and prescription drugs for the American people,” said Congressman Dan Kildee. “Because of our work, Medicare will be allowed to negotiate drug prices with pharmaceutical companies, and we’ve capped the cost of insulin at $35 a month for seniors. Now Congress must build on this work and pass my bill to cap the cost of insulin for all Americans.” You can watch the event here.

• WNEM-TV (CBS Flint): Rep. Kildee Discusses Historic Health Care Measures
• WEYI-TV (NBC Flint): Event preview

NEVADA

Thursday, February 9, 2023 – Post-SOTU/Insulin Event with Rep. Susie Lee and Nevada Health Care Advocates. Congresswoman Susie Lee and advocates Barb Hartzell and Donna West joined Protect Our Care Nevada to discuss how President Biden and Democrats in Congress have worked to pass historic health care measures, lower costs, and expand access to care in Nevada and across the country. Congresswoman Susie Lee said, “As I sat in the House Chamber on Tuesday to hear directly from President Biden, it was clear that we’ve made huge strides in the fight to lower health care costs, but there is more work to do. With the Inflation Reduction Act, we’ve capped insulin costs at $35 per month for seniors on Medicare, we’ve expanded access to affordable care subsidies, we’ve capped out-of-pocket spending to $2,000 for more than 46.6 million Americans with Medicare Part D, and Medicare can finally negotiate to lower drug prices, putting money in back in your pockets. But we all know there is more to be done to ensure that these types of savings are extended to every American and that’s a fight I will continue to carry throughout this Congress.” You can watch the event here. 

• KSNV (NBC): Susie Lee highlights affordability of prescription drugs
• KSNV (NBC): Rep Susie Lee Joins Protect Our Care 
• KNPR (Radio): Rep Lee Highlights Healthcare Protections Through Inflation Reduction Act

PENNSYLVANIA

Wednesday, January 25, 2023 – Vaccine and Insulin Affordability Event with Senator Casey, HHS Regional Director Dr. Ala Stanford, and Pennsylvania Health Care Advocates. Senator Bob Casey, Dr. Ala Stanford, and health care advocates joined Protect Our Care Pennsylvania to highlight how seniors in Pennsylvania and across the country are saving on insulin costs and life-saving vaccines thanks to the Inflation Reduction Act. Senator Bob Casey said, “Because of the Inflation Reduction Act, an estimated 261,000 Pennsylvania seniors can now access life-saving vaccines at no cost and 87,000 Pennsylvanians are starting to see reduced costs for their insulin. These are huge milestones, and I’m proud to have fought for these provisions alongside Protect Our Care, which has been an incredible partner in protecting health care across the Nation. Dr. Ala Stanford said, “Thanks to President Biden’s leadership, millions of Americans are already seeing lower health care costs as they access the care they need. Key pieces of the law have already gone into effect or will go into effect very soon. As of January 1, millions of people with Medicare now have their insulin costs capped at $35 per month for each covered insulin they take.” You can watch the event here. 

• WOLF (Hazleton FOX): Senator Casey Highlights Inflation Reduction Act Savings 
• WOLF (Hazleton FOX): Senator Casey highlights savings from the Reduction Inflation Act
• WCAU (Philadelphia NBC): Medicare Patients to See Savings on Insulin & Vaccines
• WPVI (Philadelphia ABC): Inflation Reduction Act Benefits 
• KYW Newsradio: Inflation Reduction Act Savings on Insulin & Vaccines 
• KYW Newsradio: Medicare beneficiaries across Pa. can expect to see big savings on insulin and vaccines

VIRGINIA

Friday, February 10, 2023 – Sen. Mark Warner SOTU Health Care Guest ICYMI. On Tuesday night, President Biden delivered his State of the Union address, celebrating the administration’s accomplishments and outlining further action to lower costs and improve health care for Virginians and families across the country. As part of the event, Senator Mark Warner (D-VA) welcomed Marguerite Bailey Young from Fredericksburg, VA who demonstrated the importance of affordable and accessible health care for everyone. Marguerite is a 94-year-old type two diabetic and retired teacher from Fredericksburg, Virginia. The Inflation Reduction Act has allowed Marguerite, who is on a fixed income, to save around $2,000 a year on insulin.

• Fredricksburg Freelance-Star: Fredericksburg woman has ‘phenomenal experience’ at U.S. Capitol

WISCONSIN 

Thursday, January 12, 2023 – Shingles Vaccine and Insulin Affordability Roundtable with Senator Tammy Baldwin and Wisconsin Seniors. Senator Tammy Baldwin joined Protect Our Care Wisconsin alongside Seniors from Green Bay and Appleton to highlight how Medicare enrollees are already benefiting from the Inflation Reduction Act, which took effect this month and is lowering costs and improving health care for millions of Americans. “Too many Americans are seeing the costs of their prescription drugs increase and are struggling to afford the medications they need to survive,” says Senator Baldwin. “That’s why I was proud to support the Inflation Reduction Act last year, to finally provide some relief for Wisconsin families and hold drug companies accountable for prioritizing profits over people.” You can watch the event here. 

• City Pages: Baldwin Visits Green Bay to Speak on New Health Care Provisions
• WisPolitics: U.S. Sen. Tammy Baldwin highlights lower insulin costs, free vaccines for seniors in Green Bay

Thursday, January 19, 2023 – Senator Tammy Baldwin Joins Protect Our Care Wisconsin State Director Joe Zepecki on the Steve Scaffidi Show. Senator Tammy Baldwin joined Protect Our Care Wisconsin State Director Joe Zepecki on the Steve Scaffidi show to discuss key measures in the Inflation Reduction Act – including what the Senator described as “critical reforms” that are expected to save seniors in Wisconsin hundreds of dollars on their health care costs, keep millions of people healthy, and prevent dangerous complications associated with diabetes, shingles, and other serious diseases. During the segment, Senator Baldwin described how the soaring cost of insulin has put folks with diabetes in Wisconsin and across the country at risk and celebrated the Inflation Reduction Act’s $35 per month insulin copay cap for those on Medicare. “This is a huge reform that will make managing diabetes affordable – which is great news,” said Senator Baldwin. You can listen to the program here.

Tuesday, February 7, 2023 – State of the Union Preview Event with Senator Tammy Baldwin and Guest David Hovde. U.S. Senator Tammy Baldwin joined Protect Our Care to discuss how President Biden and Democrats in Congress have worked to pass historic health care measures, lower costs, and expand access to care across the country. “I was diagnosed with diabetes nearly 20 years and have been taking insulin for about 15 years and have watched as the costs have steadily risen,” said Mr. David Hovde. “I was fortunate, I had pretty good insurance but nonetheless, for two types of insulin, it was costing me several hundred dollars per month.” Senator Baldwin pledged to continue to fight to lower prescription drug costs for all Americans. “While the inflation reduction act is an extremely significant step, there is work yet to do (to lower health care costs),” said Senator Baldwin. Later, she referenced capping insulin costs at $35/month for all Americans and making the Advanced Premium Tax Credits permanent as top health care priorities. You can watch the event here. 

• WMTV (NBC): State of the Union Preview
• WMTV (NBC): Baldwin Speaks on Health Care
• WISC (CBS): Wisconsin Impact at State of the Union
• WSAW (CBS): Sen. Baldwin on President’s State of the Union
• WBAY (ABC): Appleton Man is Invited Guest to State of the Union
• Fox 11 News: Appleton Man to be Baldwin’s Guest at State of the Union
• KBJR (NBC): Senator Tammy Baldwin Bringing Appleton Man to State of the Union
• Wisconsin Examiner: Who’s on the Guest List for the State of the Union Speech
• Milwaukee Journal Sentinel: Baldwin to take cousin of potential GOP rival to State of the Union
• WisPolitics: U.S. Sen. Baldwin: Talks healthcare progress with her State of the Union guest ahead of President Biden’s Address to the nation 
• As Goes Wisconsin: David Hovde, Tammy Baldwin’s Guest for the State of the Union 

Wednesday, February 15, 2023 – Insulin and State of the Union Op-Ed by Senator Baldwin’s SOTU Guest David Hovde. Protect Our Care Wisconsin helped placed an opinion piece in UpNorthNews from Senator Tammy Baldwin’s State of the Union guest David Hovde, an Appleton resident who relies on insulin to manage his diabetes. In the piece, Hovde highlights how the Inflation Reduction Act is saving Wisconsinites money on care and expresses frustration over Republican lawmakers’ refusal to lower insulin costs for all Americans. “None of these provisions in the Inflation Reduction Act should have been controversial; it’s a historic bill that will make a difference in the lives of millions of Americans. Unfortunately, Republicans in Congress did not see it that way. Not a single Republican from Wisconsin voted to support this new law.” You can read David Hovde’s op-ed here.

• Up North News: Nearly 60,000 Wisconsin Seniors on Medicare Need Insulin. So Why Did Republicans Oppose Biden’s $35-a-Month Insulin Cap?

21 Million Americans Who Use Insulin Are Blocked From The $35 Insulin Cap As A Result Of Republicans In Congress

Watch Elise’s Story Here

Elise Oberdorfer-Douglas is a resident of Atlanta, GA, and a mother of two. Her 17-year-old daughter has lived with Type I diabetes for the past nine years. Elise and her husband are both self-employed, and despite having private insurance, they have been forced to ration supplies or rely on strangers to obtain the insulin her daughter needs to survive. Elise’s story is all too familiar and demonstrates why lawmakers must extend the Inflation Reduction Act’s $35 insulin cap to everyone.

Georgia Democrats, including Senator Reverend Raphael Warnock (D-GA) and Representative Lucy McBath (D-GA-07), have been leaders on lower insulin costs, sponsoring the Affordable Insulin Now Act, which would cap out-of-pocket insulin costs, not just for seniors on Medicare, but for millions of diabetics with private insurance. They are committed health care champions who are fighting for a future where quality, affordable health care is a reality for Georgians and all Americans.

Protect Our Care is highlighting the importance of lower insulin costs as part of the fortnight of action. The Inflation Reduction Act capped monthly insulin copays for seniors on Medicare — a game changer for more than three million people. But Republicans in Congress blocked a provision that would have extended the cap to people with private insurance. In a country where 80 percent of diabetics have had to go into debt in order to pay for insulin, this type of action by Republicans puts Big Pharma’s profits over real people. Now, President Biden and Democrats in Congress are fighting to extend these savings to everyone. Read Protect Our Care’s full fact sheet here. 

Washington DC — This week, news reports have indicated that Republican lawmakers have been leaning on Trump’s Office of Management and Budget Director, Russ Vought, as they navigate debt ceiling negotiations. Vought’s plan includes massive cuts to the Affordable Care Act (ACA), undermining protections for pre-existing conditions, eliminating premium tax credits that make coverage affordable for nearly 15 million Americans, and repealing Medicaid expansion, which covers 20 million people. These cuts would be disastrous for the American people, disproportionately impacting children, rural Americans, and people of color. In response, Protect Our Care Executive Director Brad Woodhouse issued the following statement: 

“As Republicans hold our economy hostage, they are returning to some of their greatest hits: attacking American health care. Behind closed doors, they are relying on a far-right Trump appointee to draft their budget. Vought’s plan would effectively repeal the ACA, driving up costs for almost 15 million Americans and eliminating coverage altogether for more than 20 million people. Vought is also advocating for removing vital protections for millions of Americans with pre-existing conditions by sending us back to the days when insurance companies could write the rules and deny coverage or charge more for people with pre-existing conditions. Make no mistake, Republican threats to health care are as real as ever, and we cannot let them get away with it.” 

BACKGROUND 

Trump’s Budget Director Russ Vought Is Working With Republicans To Slash Billions Of Dollars From Medicaid And The Affordable Care Act. Former Trump OMB Director Russ Vought now leads an influential think tank known as the Center for Renewing America where he has “quietly emerged as an intellectual leader of the GOP’s conservative flank” according to the Washington Post. Vought is in close contact with Republicans on Capitol Hill, briefing members of Congress at least three times about his budget plan and speaking to key lawmakers and staffers “at least once a week.” 

The Vought Plan Would Rip Medicaid Away From More Than 20 Million Americans. The Vought budget “repeals the authorizations created by Obamacare that permit states to expand their Medicaid programs.” The ACA’s expansion of Medicaid covers more than 21 million people who would have their care ripped away if Republicans were to enact this plan. 

The Vought Plan Raises Premiums For More Than 10 Million Americans. The Vought budget would fully repeal the Affordable Care Act’s tax credits that help millions of Americans afford quality health insurance. A record 16.3 million Americans signed up for coverage through the ACA marketplace this year, and with 80 percent of enrollees eligible for tax credits, over 13 million people could see their premiums soar if the Vought plan were enacted. 

The Vought Plan Puts Coverage For Tens Of Millions Of Americans With Pre-Existing Conditions At Risk. Vought’s plan lambastes the Affordable Care Act for providing “some subsidies to some people, only if they choose to purchase insurance the government defines in the way the government demands.” Removing the consumer protections enacted by the ACA would put insurance companies back in charge of your care and end protections for 54 million Americans with ‘declinable’ pre-existing conditions.

The Reality is Medicare Advantage Profits are Through the Roof, Especially for Plans That Serve Dual-Eligible Seniors

People who are on Medicare Advantage are disproportionately Black and Latino. The insurance industry is using this data point to suggest seniors of color will be disproportionately harmed by HHS’s proposed 2024 rate increase of $4 billion for Medicare Advantage plans. In reality, insurers are not doing enough to address the quality of Medicare Advantage plan offerings to these communities and are trying to hold onto their record profits.

Research Shows Plans Offered to Dual-Eligible Seniors are Among the Most Profitable. Medicare Advantage Plans are the most profitable part of the health insurance business by a factor of nearly two. Among Medicare Advantage plans, those that serve dual-eligible seniors are the most profitable. In 2022, MedPAC found that in 2020, special needs plans (SNPs) serving dual-eligible seniors (D-SNPs) had margins of 10.7 percent, and SNPs for enrollees with certain chronic conditions (C–SNPs) had margins of 11.2 percent. Even nonprofit D–SNPs had an average profit margin of 6.4 percent. Medicare Advantage plans have since received payment increases of 4.08% in 2022 and 8.5% in 2023.

Big Insurers are Threatening to Cut Benefits if They Don’t Receive a Larger Payment Increase. An industry-funded study claims Medicare Advantage plans could reduce annual benefits by $540 per senior if they don’t receive a larger payment increase. However, these plans make an average of $1,730 in annual gross margin per senior, so choosing to not invest more in seniors reflects their greed, not a lack of funding from CMS. Former MedPAC staff dismiss the claim that insurers will cut benefits as “nonsense” based on how plans have historically responded to payment updates.  

Medicare Advantage Doesn’t Serve Black And Latino Populations Well. Research shows that compared to white seniors, insurers offer plans with lower quality ratings to racial and ethnic minority groups, who enroll in these low-rated plans more frequently than white seniors. Even the top-rated plans perform worse for minority seniors. A December 2022 study found Black seniors enrolled in Medicare Advantage have higher rates of avoidable hospital admissions than white seniors. Furthermore, while Medicare Advantage plans provide additional benefits, a January 2023 GAO report highlights that plans refuse to report the extent to which seniors actually use the supplemental benefits provided by Medicare Advantage plans. 

The Biden Administration is Committed to Advancing Health Equity, Including Through Medicare Advantage. The Biden administration is improving Medicare Advantage for seniors of color by cracking down on deceptive marketing practices, establishing a health equity index in the Star Ratings program that incentivizes the highest quality care for underserved seniors, and strengthening access to behavioral health services by reducing wait times and improving care coordination and network adequacy. These improvements to Medicare Advantage for underserved populations are just one example of the administration’s commitment to advancing health equity stemming from an Executive Order President Biden issued on his first day in office and Health and Human Services’ subsequent Equity Action Plan to institutionalize and sustain a focus on equity over time.

Thanks to President Biden and Democrats in Congress, the Inflation Reduction Act capped insulin copays at $35 per month for seniors on Medicare. People of color are disproportionately affected by diabetes due to numerous systemic determinants of health that lead to barriers in accessing care. As a result, these communities are more likely to skip, ration, or delay insulin doses when compared to their white counterparts. The intersectionality of race and lack of care in rural areas especially leads to worse health outcomes for people of color. Making insulin more affordable is a lifeline for seniors of all backgrounds and economic status. Protect Our Care is highlighting the importance of lower insulin costs and calling for finishing the job of the Inflation Reduction Act to make the $35 cap universal.

BY THE NUMBERS

• Deaths related to diabetes are three times more likely among people of color than their white counterparts.
• More than 12 percent of Black adults, 11.8 percent of Hispanic adults, and 9.5 percent of Asian Americans are diagnosed with diabetes.
• Black Medicare beneficiaries are twice as likely as white beneficiaries to have health care cost-related challenges. 
• Americans of color spend upwards of $10,000 a year on diabetes-related costs.

Americans Of Color Are Disproportionately Affected By Diabetes. Over 12 percent of Americans of color experience diabetes due to a combination of genetic, socioeconomic, and environmental risk factors. In 2018, Black Americans were 2.5 times more likely than their white and Hispanic counterparts to be hospitalized due to diabetes complications. Hispanic adults are 50 percent more likely to develop type 2 diabetes over the course of their lifetime than their white counterparts. Racial and ethnic minority populations are also at a higher burden of diabetes-related complications, such as kidney disease, blindness, and worse glycemic control. Despite the higher risk of complications, Americans of color are less likely to receive recommended preventive care and annual screenings, largely as a result of systemic access barriers to this care.

Americans Of Color Skip, Ration, Or Delay Insulin Doses At Higher Rates Than Their White Counterparts. With rates of uninsurance also being highest among people of color, these insulin users are at a higher risk of skipping, rationing, or delaying insulin doses. Nearly 24 percent of Black Americans ration insulin compared to 16 percent of their white and Hispanic counterparts. Black adults also continue to be the hardest hit when it comes to affording their prescription drugs and paying medical bills.

Universal Insulin Copay Caps Will Help Insulin Dependent Americans Of All Ages. While there are 49 million seniors on Medicare who are eligible for the $35 insulin copay cap, 3.2 million were insulin users in 2020. If Congress passes legislation to make the $35 insulin copay cap universal, an additional 21 million insulin users of all ages would benefit, including the nearly 300,000 young people under 20 who are diagnosed with diabetes. 1 in 5 people with private insurance pays more than $35 per month and, for people who are uninsured or have poor coverage, insulin can cost up to $1,000 per month. A striking 14 percent of insulin users spend catastrophic amounts, or at least 40 percent of their income, on insulin.

Washington DC — One year ago today, Senator Rick Scott (R-FL) released a 12-point Republican plan that would sunset all federal legislation in five years. Not only would the Rick Scott plan put the Affordable Care Act in grave danger, but it threatens every federal health program, including Social Security, Medicare, and Medicaid. Tens of millions of Americans could face complete coverage loss and seniors could lose the benefits they’ve worked their entire lives to secure. In response, Protect Our Care Executive Director Brad Woodhouse issued the following statement: 

“One year later, Rick Scott’s plan is still bad news for American health care. Sunsetting all programs would put Social Security, Medicare, Medicaid, and the Affordable Care Act on the chopping block, threatening the health and well-being of tens of millions of families across the country. Some of these programs have been the bedrock of our nation for more than 50 years, and any effort to cut or privatize them would leave millions in the dust. As these threats have recently reemerged in debt ceiling negotiations, Rick Scott and other Republican leaders have only doubled down on their disastrous plans to rip away vital benefits from the American people — and we won’t let them get away with it.”   

Rick Scott’s Plan For America Would “Sunset” The Affordable Care Act, Medicare, and Medicaid.  One year ago today, as chair of the NRSC, Senator Scott proposed a 12-point Republican plan that would sunset all federal legislation in five years. Not only would the Rick Scott plan put the Affordable Care Act in grave danger, but it threatens every federal health program, including Medicare and Medicaid. When asked about the ACA’s protections for people with pre-existing conditions, Scott stated, “I don’t believe in grand bargains…We’ve got to reward people for caring for themselves.” As Governor of Florida, Rick Scott refused Medicaid expansion that would cover 833,000 Floridians and attempted to make it more difficult for Floridians to sign up for Medicaid, suggesting a reduction in the amount of time individuals have to enroll from 90 to 30 days. Scott wasn’t acting alone in his support for this radical plan. Many high-profile Republicans signaled their support, including Senator Ron Johnson, RNC Chairwoman Rona McDaniel, Senator Mike Braun, Senator Marco Rubio, Senator Tommy Tuberville, Congressman Matt Gaetz, and Senator Joni Ernst.     

Rick Scott Spent The Last Year Doubling Down On His Plan To Put The ACA, Medicaid, and Medicare At Risk.  Rick Scott has spent the last year repeatedly promoting his plan to put every health care program on the chopping block.  When President Biden pledged to protect Medicare during his State of the Union address, Scott tweeted, “In my plan, I suggested the following: All federal legislation sunsets in 5 yrs. If a law is worth keeping, Congress can pass it again” and then went on a media tour promoting his plan.  After Republican Senate candidates performed poorly in the 2022 elections, Scott insisted that he had no regrets about his scheme, writing, “Yes, I put out a plan of ideas, and I don’t regret it one bit. Yes, one of them suggested sunsetting laws after five years — noting that if a law is worth keeping, Congress can pass it again.”  Over the last year, Scott has tweeted countless times and made dozens of media appearances continuing to hammer his proposal to put the ACA, Medicaid, Medicare and health care for tens of millions of Americans at constant risk.