April 2023

Read the Report Here.

Washington, DC — Today, Protect Our Care is releasing an updated report detailing the disastrous implications of the medical abortion lawsuit in Texas aiming to ban the abortion medication mifepristone. A decision to ban mifepristone would threaten millions of women’s access to safe and legal abortions and open the door for the politically-motivated destruction of the entire drug approval process.

Last week, Judge Matthew Kacsmaryk issued a ruling to pull mifepristone from the market. Mifepristone is a safe and effective medication that is essential to abortion access across the nation. On Monday, legal and public health advocates joined Protect Our Care to discuss how the ruling has wider implications for the health care system and sets a precedent for any judge to be able to overrule the evidence-based and scientific FDA medication approval process. Watch the full event here.  

Protect Our Care Founder Leslie Dach issued the following statement: 

“Judge Kacysmaryk’s ruling threatens to throw the entire U.S. drug approval process into chaos,” said Protect Our Care Chair Leslie Dach. “It not only puts at risk the use of mifepristone for safe and legal abortions, but it opens the door for the politically-motivated removal of other safe and effective drugs from the market. If the ruling stands, millions of patients will suffer.”

Washington, DC – Last week, a federal judge in Texas issued a ruling revoking authorization for mifepristone, a safe and effective medication essential for abortion access that was approved by the FDA more than 20 years ago. Not only does this ruling risk barring the use of mifepristone for safe and legal abortions for millions of American women, but it opens the door for the politically-motivated removal of other safe and effective drugs from the market — throwing the entire U.S. drug approval process into chaos. Fierce opposition to the ruling has quickly emerged, with leaders in public health, former FDA and HHS officials, experts in the FDA, patient voices, and more than 400 top drug and biotechnology industry executives condemning the ruling. Read Protect Our Care’s new report on the case here. 

HEADLINES

New York Times: Drug Company Leaders Condemn Ruling Invalidating F.D.A. Approval of Abortion Pill. “The pharmaceutical industry plunged into a legal showdown over the abortion pill mifepristone on Monday, issuing a scorching condemnation of a ruling by a federal judge that invalidated the Food and Drug Administration’s approval of the drug and calling for the decision to be reversed. The statement was signed by more than 400 leaders of some of the drug and biotech industry’s most prominent investment firms and companies, none of which make mifepristone, the first pill in the two-drug medication abortion regimen. It shows that the reach of this case stretches far beyond abortion. Unlike Roe v. Wade and other past landmark abortion lawsuits, this one could challenge the foundation of the regulatory system for all medicines in the United States. ‘If courts can overturn drug approvals without regard for science or evidence, or for the complexity required to fully vet the safety and efficacy of new drugs, any medicine is at risk for the same outcome as mifepristone,’ said the statement.” [New York Times, 4/10/23]

The Hill: Drug Companies Slam Texas Judge’s Ruling On Abortion Pill. “Drug industry experts, current and former administration officials and abortion rights advocates have been sounding the alarm that U.S. District Court Judge Matthew Kacsmaryk’s ruling in favor of anti-abortion groups would have far-reaching consequences for FDA’s authority. The decision ‘undermines our nation’s entire system of drug approval. It opens the door for courts to overturn FDA’s evidence-based decisions for purely political or ideological reasons,’ Health and Human Services Secretary Xavier Becerra said in a statement Friday after the ruling. If the decision is upheld, it could open the door to any third party to challenge any medication or treatment that they disagree with, including vaccines for children, AIDS drugs, birth control or hormone therapy. […] William Schultz, a partner at Zuckerman Spaeder and former FDA deputy commissioner, told reporters during a briefing Monday that the ruling adds another barrier for bringing drugs and treatments to the market. ‘In order to get a drug approved, companies will not just have to survive literally often hundreds of millions of dollars and years of testing [and] FDA scientific review, but then they’ll have to survive challenges in court, which could be immediate, or as in this case, 20 years later, Schultz said.” [The Hill, 4/10/23]

The Washington Post: Justice Department Appeals Texas Abortion Pill Ruling. “The Justice Department on Monday appealed a Texas judge’s decision that would block access to a key abortion drug across the country, arguing that the challengers had no right to file the lawsuit since they were not personally harmed by the abortion pill. The 49-page appeal, filed in the right-leaning U.S. Court of Appeals for the 5th Circuit, landed less than one business day after Judge Matthew J. Kacsmaryk suspended Federal Drug Administration approval of mifepristone — one of the two medications used in more than half of all abortions in the United States. […] The judge’s ruling, Justice Department lawyers said, ‘upended decades of reliance by blocking FDA’s approval of mifepristone and depriving patients of access to this safe and effective treatment, based on the court’s own misguided assessment of the drug’s safety.’” [The Washington Post, 4/10/23]

Talking Points Memo: Upholding Kacsmaryk’s Decision Would Invite Challenges To Vaccines, Contraception. “These problems with the case make it an enormous risk — even beyond making mifepristone unavailable for the millions who need it — should Kacsmaryk’s ruling be upheld. It could fling wide the floodgates to those seeking to challenge the FDA’s approval in an attempt to get certain drugs removed from the market. This danger could also prove mifepristone’s salvation: Even a fundamentally anti-abortion Supreme Court majority might be less inclined to uphold Kacsmaryk’s decision, given the severity of the ramifications. ‘Allowing the courts to do this, to do this kind of searching inquiry and overturn FDA if the judge thinks FDA was wrong in combination with the court’s ruling on standing…could allow virtually anyone to challenge any FDA drug approval decision with a good chance at succeeding,’ William Schultz, former deputy FDA commissioner and HHS General Counsel, told reporters Monday.” [Talking Points Memo, 4/11/23]

New York Times (Opinion): I Worked at the F.D.A. The Abortion Pill Decision Is Dangerous. “A federal judge in Texas has taken a shocking and irresponsible action: invalidating the Food and Drug Administration’s approval of mifepristone, a medication used safely by hundreds of thousands of women each year to help terminate pregnancies as part of a two-pill regimen. For what appears to be the first time, a court has invalidated an agency drug approval — an approval that was based on extensive review of scientific evidence, earned the unanimous support of outside experts and retains, after two decades, the full backing of major professional medical organizations. The decision is so stunning that it is reasonable to ask whether courts should have any role in reviewing the F.D.A.’s scientific decision-making at all. In fact, judges do have an important job: protecting the ability of the agency to use science and expert judgment to support the health of the American people. The Texas decision is a perversion of this role and, by undermining the F.D.A., represents a threat to the safety of millions of Americans.” [New York Times (Opinion), 4/10/23]

Washington Post: Texas Abortion Pill Ruling Threatens FDA. “Friday’s dueling decisions over a key abortion drug thrust the Food and Drug Administration into an unprecedented legal bind, imperiling its authority to approve and regulate medications, legal scholars said. In Washington state, a federal judge ruled Friday that mifepristone is safe and effective, ordering the FDA to preserve access to the pill in the 17 states and D.C. that sued to protect medication abortion. But in Texas, another federal judge sided with antiabortion groups to block the agency’s approval of mifepristone, a decision that won’t go into effect for seven days, to give the federal government a chance to appeal. ‘It is totally unclear how FDA is supposed to resolve this because this isn’t the way FDA does its job,’ said Kirsten Moore, director of the advocacy organization Expanding Medication Abortion Access Project. ‘It shouldn’t have to say in these states the drug is approved, in these states the drug isn’t approved. That’s not tenable.’” [Washington Post, 4/7/23]

Politico: The Abortion Pill Rulings Are Scaring The FDA and Drugmakers. Here’s Why. “A Texas judge’s decision to rescind the FDA’s approval of the abortion pill could jeopardize access to the most popular method of terminating a pregnancy. And many in government and inside the pharmaceutical industry fear that it could also undermine the agency’s broader authority to regulate medicines, opening the door for courts to question approvals of anything from birth control pills to new treatments for debilitating diseases. […] William Schultz, former deputy commissioner for the FDA and former general counsel for HHS, said the decision ‘could allow virtually anyone to challenge any FDA drug approval decision with a good chance of succeeding.’ ‘Any FDA drug approval involves hundreds of judgments by the agency. If a court feels free just to kind of take a fresh look at each of those, there’s a chance that a court will find one of those judgments is wrong,’ Schultz said. HHS did not immediately respond to a request for comment on Monday.” [Politico, 4/10/23]

New York Times: Why Drugmakers’ Battle in Texas is Such a Big Deal. “The decision by a judge in Texas to overturn F.D.A. approval for the abortion pill mifepristone could have consequences far beyond the fraught area of reproductive health, throwing the regulatory regime for medicines into disarray and potentially upending the business of drug making. The ruling to reverse a green light given more than 20 years ago has sparked a furious response from pharmaceutical executives, and the Biden administration is pushing for the decision to be blocked. More than 400 pharmaceutical and biotech industry leaders slammed the ruling. ‘Judicial activism will not stop here,’ they warned in an open letter on Monday, after Matthew Kacsmaryk, a federal court judge, sided with anti-abortion groups who challenged the F.D.A. approval of mifepristone over ‘safety concerns.’ Medical organizations such as the American Medical Association and the American College of Obstetricians and Gynecologists say the drug is safe, and the pharmaceutical executives called for ‘the decision to disregard science’ to be reversed. The Justice Department said Mr. Kacsmaryk’s findings were incorrect and that he had engaged in an ‘extraordinary and unprecedented’ effort to usurp the F.D.A.’s authority. Retrospectively overturning F.D.A. decisions that are based on years of testing could also destabilize the industry. Dr. Jeremy Levin, C.E.O. of Ovid Therapeutics and the former chairman of BIO, a biotech trade association, told The Times that the ruling opened the door to ‘a political determination of what a medicine is and isn’t.’ The precedent could be ‘deeply harmful for vaccines, Alzheimer’s drugs, all the others,’ he added.” [New York Times, 4/11/23]

Watch the Event Here. 

Washington, DC — Today, Former Deputy FDA Commissioner and HHS General Counsel Williams Schultz and Dean of GWU’s Milken Institute School of Public Health Lynn Goldman joined Supreme Court and appellate lawyer Andy Pincus and Protect Our Care to discuss the disastrous implications of Judge Matthew Kacsmaryk’s ruling to invalidate the FDA’s approval of mifepristone. During the event, speakers discussed how Judge Kacysmaryk’s ruling has wider implications for the health care system and sets a precedent for any judge to be able to overrule the evidence-based and scientific FDA medication approval process. Read Protect Our Care’s new report on the case here. 

“In this case where the drug has been in use for decades, the harm to tens if not hundreds of thousands of women from removing its availability would be very significant,” said Andrew Pincus, Visiting Lecturer in Law at Yale Law School and experienced Supreme Court and appellate lawyer. “If this decision stands, then any group of doctors who are opposed to a particular drug or vaccine could bring a similar lawsuit, and that will really open the door to very broad instability in the drug approval process.” 

“Congress in the statute directed the FDA to evaluate the safety and effectiveness of drugs to determine whether the benefits of the drug outweigh the risks. This is a complex decision involving medicine, statistics, and sometimes epidemiology,” said William Schultz, Partner, Zuckerman Spaeder, former Deputy Commissioner, FDA, former General Counsel, Department of Health and Human Services. “If the decision were upheld, it could have a devastating effect on drug and vaccine development in this country. It would mean that in order to get a drug approved, companies will not just have to survive hundreds of millions of dollars and years of testing and FDA scientific review, but then they’ll have to survive challenges in court, which could be immediate, or as in this case, 20 years later.” 

“For doctors or patients and their families, it is critically important that we can trust the basis for the approval of a drug,” said Lynn R Goldman, MD, MS, MPH, Professor and Dean, Milken Institute School of Public Health, George Washington University. “There are reams of data that underlie every drug approval process and a multitude of decisions that must be made. For us to trust the consequences of that review, they need to be made by scientific experts who understand those data and can best evaluate them —  and those experts are not judges and they’re not courts of law.” 

“Judge Kacysmaryk’s ruling threatens to throw the entire U.S. drug approval process into chaos,” said Protect Our Care Chair Leslie Dach. “It not only puts at risk the use of mifepristone for safe and legal abortions, but it opens the door for the politically-motivated removal of other safe and effective drugs from the market. If the ruling stands, millions of patients will suffer.”

***MEDIA ADVISORY FOR TUESDAY, APRIL 11 AT 12:30 PM ET***

Washington, DC – On Tuesday, April 11, 2023, at 12:30 PM ET, Democratic Women’s Caucus Communications Task Force Co-Chairs Rep. Gwen Moore (D-WI-04) and Rep. Shontel Brown (D-OH-11), and President of the National Partnership for Women & Families Jocelyn Frye will join Protect Our Care for a press conference to discuss the ways Medicaid helps women and children across the nation stay healthy. The speakers will talk about how Medicaid is a lifeline for families and provides affordable, quality health care to people from all backgrounds.

April marks the 5th annual Medicaid Awareness Month. A record 92 million Americans have enrolled in Medicaid. Adult women comprise an estimated 40 percent of those enrolled in Medicaid, and over half (54 percent) of children across the country are enrolled in Medicaid/CHIP. Read Protect Our Care’s fact sheet on how Medicaid helps women and children here. 

Medicaid Awareness Month comes as Republicans in Congress are seeking serious cuts to the program and proposing bureaucratic work reporting requirements while GOP leaders in 10 states have failed to expand Medicaid under the Affordable Care Act, blocking millions of families from affordable coverage. Protections put into place by Congress to keep people enrolled in Medicaid during the public health emergency expired on April 1. It is predicted that approximately 15 million people may lose their coverage due to the unwinding with those in non-expansion states being particularly vulnerable. President Biden and Democrats in Congress, on the other hand, are working to strengthen Medicaid for years to come.

PRESS CALL:

WHO:
U.S. Representative Gwen Moore (D-WI-04), Democratic Women’s Caucus Communications Task Force Co-Chair
U.S. Representative Shontel Brown (D-OH-11), Democratic Women’s Caucus Communications Task Force Co-Chair
Jocelyn Frye, President, National Partnership for Women & Families
Kristin Volchansky, patient storyteller from Pennsylvania
Anne Shoup, Protect Our Care

WHAT: Virtual Press Conference 

WHERE: Register for the Event Here.

WHEN: Tuesday, April 11 at 12:30 PM ET

***MEDIA ADVISORY FOR MONDAY APRIL 10 AT 2:30 PM ET***

Devastating Ruling Threatens Essential Reproductive Care and Entire U.S. Drug Approval Process

Washington, DC — On Monday, April 10, 2023 at 2:30 PM ET, Williams Schultz, former deputy FDA commissioner and HHS General Counsel, Lynn Goldman, Dean of the Milken Institute School of Public Health at George Washington University, and experienced Supreme Court and appellate lawyer Andy Pincus will join Protect Our Care to discuss the disastrous implications of Judge Matthew Kacsmaryk’s ruling to invalidate the FDA’s approval of mifepristone. Judge Kacysmaryk’s ruling puts at risk not only the use of mifepristone for safe and legal abortions for millions of American women, but it opens the door for the politically-motivated removal of other safe and effective drugs from the market — throwing the entire U.S. drug approval process into chaos.

During the call, speakers will discuss how the Alliance for Hippocratic Medicine v. U.S. Food and Drug Administration lawsuit has wider implications for the health care system and sets a precedent for any judge to be able to overrule the evidence-based and scientific FDA medication approval process.

PRESS CALL:

WHO:
William Schultz, Partner, Zuckerman Spaeder, former Deputy Commissioner, FDA, former General Counsel, Department of Health and Human Services
Lynn R Goldman, MD, MS, MPH, Professor and Dean, Milken Institute School of Public Health, George Washington University
Andrew Pincus, Visiting Lecturer in Law at Yale Law School and experienced Supreme Court and appellate lawyer
Leslie Dach, Chair of Protect Our Care

WHAT: Virtual Press Conference 

WHERE: Register for the Event Here

WHEN: April 10, 2023 at 2:30 PM ET

April marks the 5th annual Medicaid Awareness Month. Medicaid is an essential pillar of coverage for women and children. Adult women comprise an estimated 40 percent of those enrolled in Medicaid, and over half (54 percent) of children are enrolled in Medicaid and the Children’s Health Insurance Program. Women of color who experience higher rates of poverty than white women and remain less likely to have access to quality care. For pregnant women, affordable health coverage is essential more than ever as the United States continues to experience the highest rates of maternal mortality among wealthy nations, deaths that Centers for Disease Control and Prevention (CDC) data show are largely preventable. 

Over 66 percent of Americans, including 55 percent of Republicans, have a favorable opinion of Medicaid. Voters agree that it is important to prevent harmful cuts to Medicaid that would reduce health care access for lower-income individuals and cut nursing home care funding. Even with the overwhelming support for Medicaid, Republicans across the country have made it their mission to slash its budget by billions. One budget plan offered by an influential former member of the Trump administration would cut over $2 trillion from Medicaid, ending Medicaid expansion entirely and kicking over 21 million Americans off of their health care plans. 

By The Numbers

• Medicaid Covers Over 30 Million Women Nationwide. 31 million adult women rely on Medicaid for coverage – an estimated 40 percent of the adults enrolled in Medicaid. In 2020, Medicaid covered 16 percent of nonelderly women in the United States. 
• Most Women On Medicaid Are Working Or Have Caretaking Responsibilities. According to the Kaiser Family Foundation, the vast majority of women enrolled in Medicaid work, including mothers on Medicaid. In 2019, 93 percent of women enrolled in Medicaid were either working, going to school, at home caring for young children or relatives, or experiencing an illness or disability that does not permit them to work. 
• Medicaid Is A Major Source Of Coverage For Women Of Color. Due to systemic inequality, women of color are disproportionately likely to be covered by Medicaid. Nearly 33 percent of Black Americans, 30 percent of Hispanic or Latino individuals, nearly 15 percent of Asian and Pacific Islanders, and 34 percent of American Indian and Alaska Native individuals are enrolled in Medicaid, compared with 15 percent of white individuals.
• Medicaid Covers Nearly Half Of Women With Disabilities. Medicaid covers more than 44 percent of nonelderly women with mental and physical disabilities. As of 2019, Medicaid was the source of health coverage for one in four American women with mental illness and 7.2 million American women with a substance use disorder.
• Over 50 Percent Of American Children Are Enrolled In Medicaid And CHIP. Over 40 million children in the United States are enrolled in Medicaid or CHIP. 
• More Than 2 Million People Would Gain Coverage If Remaining States Expanded Medicaid. Estimates from the Center on Budget and Policy Priorities found that roughly 2 million people, including children, would enroll in Medicaid and CHIP if the remaining 10 states implemented expansion. These states are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wyoming, and Wisconsin. 
• The Children’s Uninsured Rate In Medicaid Holdout States Is Double The Rate In Expansion States. In 2021, the child uninsured rate was 7.1 percent in holdout states, compared to 4 percent in states that adopted expansion.
• Almost Half Of Births Are Covered By Medicaid. Medicaid covers over 40 percent of births in the United States. Thanks to the American Rescue Plan, states were given the option to extend coverage to new mothers for one year postpartum, which improves maternal health outcomes. Congress subsequently made this option permanent as part of end-of-year legislation signed into law at the end of 2022. So far, 29 states have elected to extend postpartum coverage.

Medicaid Coverage Benefits Mothers And Women Of All Ages

Medicaid Is The Largest Payer Of Reproductive Health Care Coverage. Medicaid covers nearly 20,000,000 women of reproductive age, giving them access to reproductive health care services such as birth control, cancer screenings, and maternity care without cost-sharing. Medicaid for children also saves the government an estimated $200 billion when compared to the average cost of the program at $92 billion. These services are even more imperative now due to Dobbs v. Jackson Women’s Health Organization decision that overturned Roe v. Wade protections. Medicaid’s reproductive health coverage is especially important in states that have more restricted access to birth control and abortion.

• Expanding Access To Care At Every Stage. There is an urgent need for quality, affordable health coverage prior to, during, and after giving birth. While 48 percent of maternal deaths occur during pregnancy and delivery, more than half, 52 percent, occur in the year following the birth of a child. Recent CDC data show that 4 in 5 of maternal deaths are preventable. 12 percent of maternal deaths are deemed “late,” occurring between six weeks and one year following delivery, demonstrating the immense need for continuous health access and coverage for a minimum of one year following the birth of a child. The Biden-Harris Administration has established a pathway to coverage, providing states the opportunity to extend postpartum coverage under Medicaid from 60 days to 12 months following birth. Currently, 29 states have begun offering continuous Medicaid or CHIP coverage for 12 months after pregnancy.
• More Than Four In 10 Births Are Covered By Medicaid. More than 4 in 10 births were financed by Medicaid in 2021. Rates varied across the nation, with 61 percent of births financed by Medicaid in Louisiana, and 22 percent in Utah. In the 10 states that have refused Medicaid expansion, eight had more than 40 percent of births covered by Medicaid. Medicaid covers 65 percent of all births to Black mothers and 59 percent of all births to Latina mothers.
• Expanding Medicaid & Closing The Coverage Gap Is Critical To Improving Maternal Health. Women of color consistently experience higher rates of maternal mortality than white women, largely due to the intersection of health with race, gender, poverty, geography, and other social factors.
• Medicaid Helps Keep Families Out Of Debt. Out-of-pocket spending on health care pushed over 10.5 million Americans into poverty in 2016. Since the expansion, the program has covered the medical expenses of millions more poor and near-poor adults than it did previously, helping prevent households from becoming poor because of medical spending.

Medicaid Improves Access To Care For Women. Women with Medicaid are far more likely to receive care than uninsured women. According to the Kaiser Family Foundation, women with Medicaid coverage are less likely than women with private insurance to report delaying or forgoing care due to cost. Women with Medicaid coverage receive preventive care such as cancer screenings and well women services at roughly the same rates as women with private coverage and at a higher rate than women without insurance. 

Medicaid Helps Pay For Long-Term Care, Mostly For Elderly Women. Medicaid pays for roughly half of the nation’s long-term services and supports. In 2020, women accounted for 61 percent of the 12.3 million dual-eligibles, or people who rely on both Medicare and Medicaid for coverage. Most dual-eligibles are elderly, and many need Medicaid coverage for their long-term care needs.

Medicaid Creates Jobs In The Health Industry, Which Is Overwhelmingly Female. Kaiser Family Foundation estimates that there are 15.5 million frontline health care workers — 77 percent of which are women — establishing Medicaid as a major job creator for women. 

Medicaid Coverage Has Long-Term Benefits For Children

Research Shows Medicaid Prevents Child Deaths. A 2020 study found that children who received health insurance through Medicaid were less likely to die young, be employed in their adult life, and less likely to develop a disability as an adult. 

Medicaid Helps Children Stay Healthy, Leads To Long-Term Benefits For Children When They Grow Up. Medicaid eligibility during childhood lowers the high school dropout rate, raises college enrollment, and increases four-year college attainment. Medicaid for children also has a positive impact on employment opportunities later in life. For each additional year of Medicaid eligibility as a child, adults by age 28 had higher earnings and made $533 additional cumulative tax payments due to their higher incomes.

Thanks To Medicaid, Students Have Access To The Resources They Need To Focus In School. Medicaid’s Early Periodic Screening Diagnostic and Treatment benefit gives children under 21 years old access to comprehensive and preventive health services, such as yearly physicals, hearing, vision, and dental screenings, and physical, mental, and developmental disability treatments. The benefit also helps students gain access to medical supplies, such as hearing aids, glasses, and assistive technology, to help them succeed in school. 

The ACA’s Medicaid Expansion Helps Children Gain Access To Care

After the Affordable Care Act expanded access to Medicaid, the children’s uninsured rate fell to an all-time low. Research confirms expanding access to Medicaid for parents has had ripple effects for their children. At the same time, the 10 states that continue to reject expansion are limiting children’s health care access: 

Medicaid Expansion Led To Gains In Coverage For Children As Well As Parents. Parents enrolled in Medicaid are more likely to access the support they need to be a healthy and effective parent. When parents gain coverage they are more likely to enroll the whole family, so the family will be protected from the economic strains of medical debt and lay the groundwork for optimal child development. Children of parents who are enrolled in Medicaid are more likely themselves to have coverage, due to parents having a more straightforward experience adding their children than if they have never signed up for coverage before.

The Children’s Uninsured Rate In States That Have Rejected Expansion Is Twice The Rate In States That Expanded The Program — And That Gap Is Growing. The rate of uninsured children in states that have not expanded their Medicaid coverage grew at nearly three times the rate than that of states that have expanded Medicaid coverage. Texas and Florida, two non-expansion states, were responsible for 41 percent of coverage losses for children in a three-year period. 

When Parents Have Health Insurance, Children Are More Likely To Have Coverage. When parents are covered, their children are more likely to have access to health care and have long term benefits from that coverage. Adults who had health insurance as a child were more likely to have better health as adults, including fewer hospitalizations and emergency visits. Medicaid eligibility during childhood is also more linked to a higher likelihood of graduating from high school and college, as well as having higher wages in adulthood.

Devastating Ruling Threatens Access to Essential Reproductive Care and Entire U.S. Drug Approval Process

Washington DC — Today, Judge Matthew Kacsmaryk issued a ruling to pull mifepristone from the market. Mifepristone is a safe and effective medication that is essential to abortion access across the nation. This decision not only threatens access to vital reproductive care for millions of women, but it opens the door for the politically-motivated destruction of the entire drug approval process. In response, Protect Our Care Chair Leslie Dach issued the following statement:

“Today’s decision is a disaster for the American people. We are talking about a right-wing judge overruling the opinion of top scientists and other medical experts at the FDA. Taking away a safe, effective medication for abortion is dangerous, especially for rural women, people of color, and other vulnerable groups. This decision also means that judges now have the power to rip away other medications at the whim of their political motivations. This ruling must not stand.”

***MEDIA ADVISORY FOR THURSDAY, APRIL 6***

During Medicaid Awareness Month, Republicans’ Latest Attack on the ACA Targets Lifesaving Preventive Care for More than 150 Million Americans 

On Thursday, April 6th, U.S. Representative Jimmy Gomez, California Attorney General Rob Bonta, New York elected officials, and health care advocates will join Protect Our Care in California and New York to discuss U.S. District Judge Reed O’Connor’s devastating decision to strike down a major provision of the Affordable Care Act (ACA) that requires free coverage of lifesaving preventive health care services. During the call, speakers will highlight what this decision could mean for Americans’ access to lifesaving health care services, and discuss what is to come as the lawsuit moves through the court system.

Judge O’Connor’s decision in Braidwood Management v. Becerra would end the ACA’s guaranteed free access to essential preventive services including lifesaving cancer screenings, anxiety and depression screenings for children and adults, heart disease screenings, intimate partner violence screenings, and access to PrEP (pre-exposure prophylaxis), which can reduce the chance of contracting HIV. In 2020 alone, more than 150 million Americans benefited from these preventive services. Read more about the case here. 

The decision comes as Medicaid Awareness Month kicks off with groups across the country highlighting Republican threats to the program, including plans to slash funding, endangering care for millions of seniors, families, and children who rely on the program for coverage.

CALIFORNIA
WHO:
U.S. Representative Jimmy Gomez
California Attorney General Rob Bonta

WHEN: Thursday, April 6, 10 AM PT // 1 PM ET

WHERE: Register to join the Zoom event (Registration required)

NEW YORK
WHO:
Brad Hoylman, New York State Senator, 47th District
Erik Bottcher, New York City Council Member, 3rd District
Peter Meacher, Chief Medical Officer, Callen-Lorde Community Health Center
Jason Cianciotto, Vice President of Communications & Policy at Gay Men’s Health Crisis
Amanda Babine, Executive Director of Equality New York
Dr. Archie Jao, Medical Director at Housing Works
Paul Nagle, Executive Director of Stonewall Community Development Corporation

WHEN: Thursday, April 6 at 1:30 PM ET 

WHERE: Register to join the Zoom event (Registration required)

April marks the 5th annual Medicaid Awareness Month. With Medicaid currently serving over 92 million Americans, the largest enrollment in history, this program has never been more important to the lives of everyday Americans. Medicaid enrollment has increased by 61 percent nationally since 2013 and the program has been proven time and time again to save lives, increase coverage and – in turn – broaden access to needed care, and help reduce racial, rural, and other health disparities. Republican attacks on Medicaid are especially harmful for communities of color, rural Americans, people with disabilities, and low-income families. 

Even with Medicaid serving more Americans than ever before, Republicans across the country have made it their mission to slash its budget by billions. One budget plan offered by an influential former member of the Trump administration would cut over $2 trillion from Medicaid, ending Medicaid expansion entirely and kicking over 21 million Americans off of their health care plans. Whether it’s at the state level where Republican lawmakers in 10 states continue to refuse to expand Medicaid or in Congress where Speaker Kevin McCarthy recently released a plan that would impose work reporting requirements and other burdensome policies for new moms and families, this war on Medicaid will not stop.

By The Numbers

• Tens of Millions of Americans are at Risk of Losing Vital Parts of Their Health Care if Cuts to Medicaid Are Pushed Through. Over 92 million Americans are currently enrolled in Medicaid. Cuts to Medicaid would surely see considerable reductions in coverage leaving millions potentially uninsured with no pathway to get health coverage.
• More Than 50 Percent Of Children Could See Significant Reductions in Their Health Coverage. Nationally, 54 percent of American children are covered by Medicaid/CHIP. Slashing Medicaid funding would see many of these children become ineligible for low-cost health insurance with no pathway to finding affordable health care.
• Funding For Nearly Two-Thirds of Long-Term Residents in Nursing Homes Would Dry Up. Medicaid covers nursing home bills for over 60 percent of residents in nursing homes. In 2019, this totaled over $50 billion. The median private nursing home room can cost over $100,000 annually. Medicaid caps or cuts would see more seniors without the financial resources to afford long-term care.
• Marginalized Groups Are Disproportionately Harmed by Republican Attacks. Increasing Medicaid access is the single most important action available to expand coverage and reduce racial inequities in the American health care system. The ACA led to historic reductions in racial disparities in access to health care, but racial gaps in insurance coverage narrowed the most in states that adopted Medicaid expansion. 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. Cutting Medicaid and repealing the ACA’s Medicaid Expansion would result in coverage loss, and therefore inflame these disparities.
• Rural Americans Relying on Medicaid Would be Left Behind by Republicans. Nearly 14 million Medicaid enrollees reside in rural areas. Medicaid helps fund rural hospitals, which employ six percent of all employees in rural counties that report having any hospital employment. Rural hospitals in Medicaid expansion states are 62 percent less likely to close. In 2023, over 600 rural hospitals are at risk of closing in the near future.
• Nearly 45 Percent Of Adults With Disabilities Could See Reduced Health Coverage or Lose Coverage Entirely. Medicaid covers 45 percent of non-elderly adults with disabilities, including adults with physical disabilities, developmental disabilities, and brain injuries. Republican plans could leave many of these people and their families with little support and sometimes even no health coverage at all.
• Births Currently Covered by Medicaid Could be at Risk. Medicaid covers over 40 percent of births in the United States and Congress recently offered permanent federal funding to states that opt to expand Medicaid coverage to mothers for one year postpartum. All of these gains would be rolled back under Republican plans and maternal mortality, already a dire crisis in this country especially for Black and Indigenous mothers, would only be worsened.
• Medicaid’s Assistance for Those With Substance Use Disorders Would Substantially Diminish. Nationally, around 12 percent of Medicaid enrollees over 18 have some kind of substance use disorder (SUD) and Medicaid is crucial to building a system of comprehensive substance use care. These interventions have been vital and life saving, with one study finding that around 10,000 lives were saved from fatal opioid overdoses as a direct result of Medicaid expansion alone. Cutting Medicaid, put simply, would increase overdoses and decrease treatment options for thousands of Americans.
• Over a Quarter of Americans Living With a Serious Mental Health Condition Could See Their Coverage Cut Back. Medicaid is the single-largest payer for mental health services in America, serving 26 percent of all adults living with a serious mental health condition. Expanding Medicaid services, such as behavioral health benefits, also has led to improved access and better outcomes for low-income individuals. Simply having access to Medicaid has shown in some studies to reduce depression rates by over 3 percent among those with chronic health conditions. Capping or cutting Medicaid spending could see these achievements in mental health care rolled back.

Some Republicans Have Proposed Sunsetting Medicaid Programs. Republicans have a long history of targeting Medicaid for spending cuts and these threats have only grown more serious in recent weeks. Senator Rick Scott has famously proposed a budget that sunsets all federal programs, putting Medicaid in particular on the chopping block. Representative Barry Loudermilk called out Medicaid by name when pronouncing that “everything was on the table” when it came to spending cuts. At the same time, Representative Brett Guthrie called for an explicit cap on Medicaid spending, harkening back to the failed ACA replacement bill which led to Republicans losing the House of Representatives when Americans voted in the midterms. Speaker Kevin McCarthy recently released a plan that would impose work reporting requirements and other burdensome policies for new moms and families.

Speaker Kevin McCarthy Has Proposed Strict Work Requirements to Medicaid While Holding Debt Ceiling Deal as Leverage Over the Country. Kevin McCarthy gave up a significant amount of his power in order to take the title of Speaker. As such, it should be no surprise that his Medicaid proposals mirror that of the radical MAGA Freedom Caucus, proposing the addition of strict work requirements to Medicaid in order for eligible Americans to even have access to the program. Studies of states which have implemented work requirements have repeatedly found these barriers increase disenrollment rates, particularly among those with chronic illnesses (which has itself been increasing steadily since 2020). Other studies have found that even Medicaid beneficiaries who do work often struggle with the complex reporting requirements and risk losing coverage even if they fully comply with the work requirements.

The Proposed Vought Budget Plan Will Slash Medicaid and Rip Away Health Care from Millions of Americans. Former Trump budget director Russell Vought has been quietly tasked by House Republicans to craft a budget that will focus on cutting essential programs for millions of Americans. Although the party line is that Republicans want to reduce spending, choosing Vought is an interesting choice considering his direct role under Donald Trump in ballooning the national debt to a state which will weigh down the American economy for decades. Nevertheless, Vought has proposed a wide swath of austerity measures aimed at punishing the poorest and most vulnerable Americans. Vought’s plan would cut over $2 trillion from Medicaid alone and would also repeal the Affordable Care Act, which would end Medicaid Expansion entirely and kick over 21 million Americans off of their health care plans.

The House Freedom Caucus Budget Proposes Radical Medicaid Cuts. The House Freedom Caucus, to whom Speaker Kevin McCarthy ceded much of his official power as Speaker, has proposed a budget plan which will cut over $3 trillion in non-defense spending taking aim specifically at health care programs like Medicaid. One of the major plans for restructuring the program would be the institution of strict work requirements in order to even access Medicaid. All research on the subject shows that work requirements reduce dramatically the number of people who can access Medicaid. Almost two-thirds, or 62 percent, of those who would lose their Medicaid coverage as a result of work requirements are women, and disproportionately women of color. As well, even though the Freedom Caucus is claiming this is an attempt to cut spending on needless bureaucracy, time and time again Medicaid work requirements end up costing more money to implement and maintain than traditional Medicaid or Medicaid Expansion. Georgia’s new Medicaid work requirements require the state to develop “expensive administrative processes,” estimated to cost upwards of $270 million annually to implement, nearly 3 times more than Medicaid Expansion would cost.

Republicans in 10 States Continue to Fight Against Medicaid Expansion. While Republicans are fighting a war of ideology, the facts are clear, Medicaid expansion saves lives. According to the Center on Budget and Policy Priorities, Medicaid expansion saved the lives of 19,200 older adults aged 55 to 64 between 2014 and 2017. At the same time, 15,600 older adults died prematurely as a result of their state’s decision not to expand the program. A study published in the Journal of Health Economics found that Medicaid expansion reduced mortality in non-elderly adults by nearly four percent. Cancer deaths have dropped more in states that accepted Medicaid coverage under the ACA than in states that have held out, and expansion has also been tied to fewer heart-related deaths. Often Republicans know that Medicaid Expansion would be the best program for their state, but continue to refuse to expand it or, in some states, will try to implement a milquetoast replacement program.

• Republicans are Leaving Hundreds of Thousands of Georgians Behind With Their Sham Medicaid Waiver. Governor Brian Kemp’s Medicaid waiver program will likely increase coverage for 50,000 Georgians, costing taxpayers around the same amount of money it would cost to adopt Medicaid expansion and cover over 500,000 Georgians. Included in Kemp’s plan are strict work requirements aimed at punishing those who cannot afford health care which will cost taxpayers three times more simply to maintain than expanding Medicaid. Under the Republican waiver plan, almost 300,000 Georgians would have no pathway to any type of health insurance at all. Brian Kemp and Georgia Republicans are willing to leave these Georgians behind in the name of pure ideology.

Texas and Florida Are Cutting Staff While Millions Are At Risk of Losing Medicaid Coverage. Due to the Public Health Emergency (PHE), nearly 3 million Texans and 1 million Floridians were able to access and maintain Medicaid coverage for around three years. As the federal unwinding process begins , these 4 million people will likely see themselves kicked off of Medicaid, through no fault of their own. In 2022 Texas chose to purposefully cut staffing to their Medicaid program, making it even more difficult to enroll or renew coverage. Until April 1, this was not as large of an issue as Americans were protected from being booted off of Medicaid rolls, but now that Medicaid continuous coverage protections have been decoupled from the PHE eligibility for millions of Americans on Medicaid are being put into question. Even for people who are still eligible for Medicaid, the renewal process may be so difficult and burdensome that they cannot receive the coverage, with studies suggesting anywhere between 45 percent and 83 percent of those estimated to lose coverage will lose it purely for administrative reasons. In Florida, Republican lawmakers have made draconian cuts to hospitals specifically treating poor and marginalized Floridians amidst widespread protests from hospitals and staff throughout the state. These cuts have led to worse outcomes and patient care and the already fragile state of many hospitals in the state becoming dire. Since 2005, Florida has seen the 9th most rural hospital closures of any state in the country. Expanding Medicaid would increase funding to these hospitals, increase coverage of Floridians and Texans, and reduce the impacts of the PHE unwinding but both Republicans in Florida and Texas have no plans to move forward with expanding Medicaid programs.

***MEDIA ADVISORY FOR MONDAY, APRIL 3***

Phoenix, AZ — On Monday, April 3, 2023, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra will travel to Phoenix, Arizona for two press conferences. At the first event, Secretary Becerra will tour and hold a press conference at Melrose Pharmacy, where he’ll be joined by Phoenix Mayor Kate Gallego, Rep. Ruben Gallego (AZ-03), and local stakeholders. At the second event, Secretary Becerra will tour Ability 360, participate in a panel discussion, and hold a press conference with local stakeholders.

At 11:00 AM MST, the Secretary and Mayor Gallego will begin their visit by touring Melrose Pharmacy. Following the tour, Secretary Becerra will deliver remarks about the work of the Biden-Harris Administration to implement President Biden’s new lower cost prescription drug law (the Inflation Reduction Act), one of the most consequential health care laws since the Affordable Care Act was signed into law. Following remarks, the Secretary, Mayor, and Representative along with local stakeholders, will host a press availability from 11:33 AM MST – 11:45 AM MST.

Thanks to President Biden’s new lower cost prescription drug law, a month’s supply of each Medicare-covered insulin is capped at $35, and recommended, preventive vaccines are now free for people with Medicare prescription drug coverage. Furthermore, for the first time, the law allows Medicare to negotiate better prices for select prescription drugs. The Inflation Reduction Act is delivering lower prescription drug costs, making health insurance more affordable, and making the economy work for working families. 

At the second event, Secretary Becerra will tour Ability 360 and participate in a panel discussion with local stakeholders. The panel will discuss efforts to expand access to quality health care, strengthen Medicaid, and promote equity. Additionally, on site, Navigators will be updating contact information for community attendees. Following remarks, the Secretary along with local stakeholders will host a press availability from 2:50 PM- 3:00 PM.

Melrose Pharmacy Inflation Reduction Act Press Conference 

WHO:
HHS Secretary Becerra
Teresa Dickinson, Owner, Melrose Pharmacy
Kate Gallego, Mayor of Phoenix
Rep Ruben Gallego (AZ-03)
Marco Mendoza, Benefits Assistance Program Director, Area Agency on Aging, Region One
Laura Keller, Managing Director of Advocacy, American Diabetes Association
Dora Vasquez, Senior & Executive Director, Arizona Alliance for Retired Americans

WHERE: Melrose Pharmacy, 706 W. Montecito Ave, Phoenix, AZ 85013

WHEN: Monday, April 3, 2023 at 11:00 AM MST  

PRESS: RSVP to Adrian Eng ([email protected])

Arizona Public Health Emergency Medicaid Unwinding Press Conference

WHO:
HHS Secretary Becerra
Chris Rodriguez, President & CEO, Ability360
Matt Jewett, Health Policy Director, Children’s Action Alliance
Claudia Maldonado, Director of Outreach and Enrollment, Arizona Alliance for Community Health Centers
Carmen Heredia, Director, Arizona Health Care Cost Containment System (AHCCCS) 

WHERE: Ability360, 5025 E. Washington St., Conference Center, Phoenix, AZ 85034 

WHEN: Monday, April 3, 2023 at 1:30 PM MST  

PRESS: RSVP to Adrian Eng ([email protected])