September 2023

Washington, DC — Today, a federal judge in Ohio denied the Chambers of Commerce’s request for a nationwide preliminary injunction in one of the cases that seeks to stop Medicare from negotiating lower drug prices for millions of seniors. This ruling allows Medicare to continue the process of negotiating lower drug prices as scheduled.

The Chambers’ case is one of eight meritless lawsuits seeking to overturn the Negotiation Program, which is overwhelmingly popular among voters of all parties across the country, to protect drug companies’ outrageous profits. While drug companies rake in billions and force seniors to skip doses of life-saving medicines, they charge up to four times more in the U.S. than in other countries. Read more about the lawsuits brought by big drug companies and their allies here. 

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

“This decision means that greed lost and hard-working Americans won. All these lawsuits are meritless and driven by nothing more than corporate greed. Seniors shouldn’t be forced to cut pills and skip doses of lifesaving medications while the drug companies rake in outrageous profits. For now, Judge Newman’s decision means that Medicare can move forward and negotiate with drug companies to make prescription drugs more affordable for millions, but we must remain vigilant. The drug companies will continue using every tool in their arsenal in all of these cases so that they can continue to charge whatever they want.”

Washington, DC — Yesterday, Republicans on the House Ways and Means Committee once again considered legislation to promote the use of health savings accounts (HSA), which overwhelmingly benefit high-income people while worsening racial and ethnic inequities in health care. This legislation incentivizes the expansion of HSAs through tax breaks, which would cost taxpayers more than $70 billion to reward the highest-paid workers. This comes as Republicans are working to repeal the Inflation Reduction Act, raise prescription drug prices, and throw millions off of Medicaid. In response, Leslie Dach issued the following statement: 

“Republicans are putting their priorities on full display: doling out more tax breaks to the wealthy while threatening to shut down the government. Republicans could join the Democrats to focus on making prescription drugs more affordable, expanding affordable health care, or fighting the maternal mortality crisis, but instead they are working to line the pockets of the wealthiest Americans while exacerbating harmful racial inequities in our health care system. Time and again, Republicans prove they are all in on their war on health care with no signs of letting up.” 

Background

HSAs Make Health Care Less Accessible And Affordable. Republican efforts to promote the use of HSAs directly undermines the ACA’s goals to make quality health care more accessible and affordable for all Americans. The promotion of employer-sponsored high-deductible health plans that use HSAs increases the cost of health care for employees and continues the difficult decisions low-income working families have to make between putting food on the table or paying for medical care. 

HSAs Benefit The Wealthy. HSAs largely benefit high-income individuals. Contributions to HSAs are not taxed, which helps wealthy people decrease their taxable income and avoid paying their fair share. These contributions can also be invested in stocks and bonds to accrue tax-free earnings that carry over year to year — further exacerbating the wealth gap.

HSAs Do Not Make Care More Affordable for Low-Income Individuals. HSAs do not benefit low-income individuals as they often do not have the ability to contribute to HSAs and need to use their available income to pay for medical bills and care upfront. Nearly 70 percent of adults under 200 percent of the poverty line would not have been able to pay a $1,000 medical bill within 30 days in 2022, let alone contribute to a HSA. Low-income individuals also do not benefit as much from tax-free earnings as high-income individuals due to the lower amount of tax deductions from being in a lower income tax bracket. Employers who offer high deductible health plans, where HSAs are necessary, typically contribute little to nothing to their employees’ HSAs. 

HSAs Exacerbate Racial And Ethnic Inequities In Health Care. Black and Latino people with private insurance are half as likely to have HSAs as white and Asian people. Per the Center on Budget and Policy Priorities: “Against a backdrop of long-standing racial disparities in wealth — a typical white family in 2019 had eight times the wealth of a typical Black family and five times the wealth of a typical Latino family — HSAs provide preferential tax treatment that is disproportionately out of reach for people of color.”

HSAs Cost The Government Billions. HSAs will cost the government $182 billion between 2023 and 2032. Meanwhile, the cost of President Biden’s plan for permanently closing the Medicaid coverage gap or permanently extending marketplace coverage premium tax credits over the next 10 years would cost roughly the same amount at $200 billion and $183 billion respectively. Unlike the bills to expand HSAs, Medicaid expansion and marketplace premium tax credits would allow millions of uninsured individuals to gain quality coverage.

As Republicans are on the verge of forcing a reckless government shutdown, they are once again considering legislation to promote the use of health savings accounts (HSA), which overwhelmingly benefit high-income people. This legislation incentivizes the expansion of HSAs through tax breaks, rewarding the highest-paid workers while worsening racial and ethnic inequities in health care. This comes as Republicans are working to repeal the Inflation Reduction Act, raise prescription drug prices, and throw millions off of Medicaid. Once again, Republicans prove they are dead set on prioritizing tax breaks for the wealthy over helping people get the health care they need. 

HSAs Make Health Care Less Accessible And Affordable. Republican efforts to promote the use of HSAs directly undermines the ACA’s goals to make quality health care more accessible and affordable for all Americans. The promotion of employer-sponsored high-deductible health plans that use HSAs increases the cost of health care for employees and continues the difficult decisions low-income working families have to make between putting food on the table or paying for medical care. 

HSAs Benefit The Wealthy. HSAs largely benefit high-income individuals. Contributions to HSAs are not taxed, which helps wealthy people decrease their taxable income and avoid paying their fair share. These contributions can also be invested in stocks and bonds to accrue tax-free earnings that carry over year to year — further exacerbating the wealth gap.

HSAs Do Not Make Care More Affordable for Low-Income Individuals. HSAs do not benefit low-income individuals as they often do not have the ability to contribute to HSAs and need to use their available income to pay for medical bills and care upfront. Nearly 70 percent of adults under 200 percent of the poverty line would not have been able to pay a $1,000 medical bill within 30 days in 2022, let alone contribute to a HSA. Low-income individuals also do not benefit as much from tax-free earnings as high-income individuals due to the lower amount of tax deductions from being in a lower income tax bracket. Employers who offer high deductible health plans, where HSAs are necessary, typically contribute little to nothing to their employees’ HSAs. 

HSAs Exacerbate Racial And Ethnic Inequities In Health Care. Black and Latino people with private insurance are half as likely to have HSAs as white and Asian people. Per the Center on Budget and Policy Priorities: “Against a backdrop of long-standing racial disparities in wealth — a typical white family in 2019 had eight times the wealth of a typical Black family and five times the wealth of a typical Latino family — HSAs provide preferential tax treatment that is disproportionately out of reach for people of color.”

HSAs Cost The Government Billions. HSAs will cost the government $182 billion between 2023 and 2032. Meanwhile, the cost of President Biden’s plan for permanently closing the Medicaid coverage gap or permanently extending marketplace coverage premium tax credits over the next 10 years would cost roughly the same amount at $200 billion and $183 billion respectively. Unlike the bills to expand HSAs, Medicaid expansion and marketplace premium tax credits would allow millions of uninsured individuals to gain quality coverage.

On August 29, the Biden administration announced the first round of high-cost drugs whose prices will come down as Medicare negotiates with the drug companies – a new power they have under the Inflation Reduction Act. This new program will lower prices for some of the highest-priced prescription drugs on the market used to treat conditions like diabetes, heart failure, blood clots, and autoimmune disorders – conditions that disproportionately impact women, communities of color, and people in rural areas. The Inflation Reduction Act was championed by President Biden and Democrats in Congress to lower health care costs for people across the nation. 

The first ten drugs selected for negotiation are taken by nearly 9 million people on Medicare and account for about 20 percent of annual Medicare Part D spending. CMS will negotiate lower prices with manufacturers of these drugs, and those prices will take effect in 2026. The drugs are:

1. Eliquis which is manufactured by Bristol Myers Squibb and Pfizer to treat blood clots
2. Enbrel which is manufactured by Amgen to treat rheumatoid arthritis, psoriasis, and psoriatic arthritis
3. Entresto which is manufactured by Novartis to treat heart failure 
4. Farxiga which is manufactured by AstraZeneca to treat diabetes, heart failure, and kidney disease
5. Fiasp, also known as NovoLog, which is manufactured by Novo Nordisk to treat diabetes
6. Imbruvica which is manufactured by AbbVie and Johnson & Johnson to treat leukemia and lymphoma 
7. Januvia which is manufactured by Merck to treat diabetes
8. Jardiance which is manufactured by Boehringer Ingelheim and Eli Lilly to treat diabetes
9. Stelara which is manufactured by Johnson & Johnson to treat psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis
10. Xarelto which is manufactured by Johnson & Johnson’s Janssen Pharmaceuticals and Bayer to treat blood clots

The Medicare Drug Price Negotiation Program advances health equity in two key ways: 

First, the Negotiation Program will lower drug prices for certain high-cost drugs, which will reduce out-of-pocket costs for Medicare enrollees. Since Black, Latino, women, LGBTQI+, and disabled people on Medicare are more likely to have lower incomes and less savings, reducing prescription drug costs will be especially impactful for their financial security and access to care. Lowering prices through negotiation is one of several ways the law reduces prescription drug costs for Medicare enrollees. Others include: capping monthly copays for insulin at $35, providing vaccines at no cost, limiting annual out-of-pocket spending in Part D to $2,000, which will save seniors with high drug costs over $400 per year, and making the Medicare Extra Help program available to more low-income seniors, reducing their premiums and copays for medication. 

Second, negotiating lower prices for the selected drugs will make drugs that are disproportionately needed by historically marginalized communities more affordable and accessible. The ten drugs selected by Medicare for lower negotiated prices treat a number of conditions that disproportionately impact people of color, and Medicare enrollees of color are more likely than the general Medicare population to take six of the ten selected drugs. Of the ten drugs selected by Medicare, eight treat conditions that disproportionately impact people of color including diabetes, heart failure, chronic kidney disease, blood clots, arthritis, and blood cancer (see Table 1). Additionally, six of the ten drugs are taken by a disproportionate number of Black, Latino, Asian, and/or American Indian/Alaska Native Medicare enrollees relative to the Medicare population as a whole (see Table 2), including

• Enbrel is taken by a higher percentage of Latino enrollees and American Indian/Alaska Native enrollees than their proportion of the Medicare population. 
• Entresto is taken by a higher percentage of Black enrollees than their proportion of the Medicare population. 
• Farxiga is taken by a higher percentage of Black enrollees, Latino enrollees, and Asian American enrollees than their proportion of the Medicare population.
• Fiasp/NovoLog is taken by a higher percentage of Black enrollees, Latino enrollees, and American Indian/Alaskan Native enrollees than their proportion of the Medicare population.
• Januvia is taken by a higher percentage of Black enrollees, Latino enrollees, and Asian American enrollees than their proportion of the Medicare population. 
• Jardiance is taken by a higher percentage of Black enrollees, Latino enrollees, Asian American enrollees, and American Indian/Alaskan Native enrollees than their proportion of the Medicare population.

Negotiating lower prices remains overwhelmingly popular among voters of all parties across the country. Unfortunately, big drug companies are suing the federal government to halt the program and protect their massive profits, and Republicans are attempting to repeal the Inflation Reduction Act in its entirety, placing these equity-advancing improvements at risk.

Table 1: Demographic Impact of Conditions Treated by Drugs Selected for Negotiation

Table 2: Drugs Selected for Negotiation Disproportionately Taken by Medicare Enrollees of Color

*the full drug name is Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen; NovoLog PenFill

Click here for a PDF of the tables and links.

Washington, DC — Today, the Biden administration announced that nearly 500,000 children and adults who were improperly disenrolled from Medicaid and CHIP will regain their coverage thanks to steps taken by the Biden administration. Last month, CMS sent letters to states directing them to assess their automatic renewal systems in order to ensure that eligible people did not lose coverage, to reinstate coverage for those who had been wrongly terminated, and to permanently fix renewal systems. New data released today shows 30 states attested to running automatic renewal systems that don’t comply with federal requirements, and approximately 500,000 children and adults wrongfully had their Medicaid or CHIP coverage terminated. Thanks to the Biden administration’s actions, those people will once again receive Medicaid coverage and any medical bills they incurred while they were disenrolled from the program will be covered. This action further protects eligible people from losing coverage through the auto-renewal system.

The data released today show states including Nevada, Virgina, and Georgia have kicked eligible children and adults off the Medicaid rolls through their automatic renewal systems. Nevada has reinstated coverage for over 100,000 children and adults, Virginia has reinstated coverage for up to 49,999 children, and Georgia is still determining how many people it wrongfully terminated from coverage. This is in addition to eligible children and adults who have been kicked off Medicaid for procedural – or paperwork – reasons. Georgia and Florida have ended coverage for hundreds of thousands of children; Texas has ended Medicaid coverage for between 500,000 and 750,000 children. Many of the states that are needlessly throwing people off the rolls have also failed to expand Medicaid, showing how some governors are using the redetermination process as another way to limit Medicaid enrollment. In response, Protect Our Care Chair Leslie Dach issued the following statement:

“This announcement shows that protecting quality, affordable health care remains front and center for the Biden administration. It is unacceptable for children and families to lose Medicaid coverage because their state’s renewal system is not properly run. The Biden administration’s actions to direct states to fix their systems permanently have immediately protected coverage for half a million people, and thousands more in the future. It’s no surprise that many of the states that are failing to keep people covered, like Georgia, Texas, and Florida are the same ones that have rejected Medicaid expansion, leaving families with no place to turn for basic health care. These governors need to ensure people who qualify for Medicaid are not being kicked off, period.” 

GOP War on Health Care Alive and Well

Republicans are at it again – attacking health care on multiple fronts. They want to hike costs and rip away care from millions of Americans in their latest budget proposal, including taking away Medicare’s power to negotiate lower drug prices for seniors. They are threatening a reckless government shutdown that would only make matters worse, and proposed a continuing resolution that would compound the growing health crises as it seeks to cut 8 percent of almost all federal spending. And the legislation they are championing in the House would send us back to the days when insurance companies could make the rules and weaken protections for preexisting conditions. If the GOP gets their way, they would throw millions of people off of Medicaid, reverse prescription drug savings for seniors under the Inflation Reduction Act, and make health care coverage more expensive for families purchasing coverage on their own through the Affordable Care Act. 

Here’s a closer look at what the GOP is proposing;

The Budget Details 

What The Republican Budget Proposal Means for Americans: 

• GONE: Medicare’s power to negotiate lower prices for the most expensive prescription drugs.
• GONE: Premium savings for 14.3 million Americans who buy insurance on their own — averaging $2,400 per family.
• GONE: Medicaid for millions of Americans including people with disabilities, new mothers, and children who can’t meet the bureaucratic paperwork burdens imposed by a work requirement. 
• GONE: Nearly $4 billion in funding for research on cancer, Alzheimers, and long COVID.
• GONE: Over $500 million in savings under the Affordable Care Act.

Medicare’s Price Negotiation Power Will Be Stripped Away by Republicans. Currently, negotiations are underway for ten drugs that make up around 20 percent of all Medicare Part D spending. Americans currently pay two to four times more for prescriptions than people in other countries and if Republicans have their way it will stay like that. The Arrington budget would slash Medicare’s power to negotiate and make sure prices stay high for Americans and federal spending is needlessly inflated.

Republicans Want to Make Health Care More Expensive For Millions By Repealing The Inflation Reduction Act’s Premium Subsidies. House Budget Chair Jodey Arrington’s budget proposal would scrap the Inflation Reduction Act’s premium subsidies, which has helped save over 13 million Americans an average of $2,400 per year on health care. It also ensures that no individuals making under $20,000 or families making around $41,000 will have to pay health care premiums at all. These subsidies have led a record breaking 14.3 million people to enroll in affordable health plans. The Republican plan will cause over 3 million people to lose coverage entirely. 

Medicaid Work Requirements Would Kick Millions of Americans, Including Mothers and Children, Off of Rolls. Despite all evidence and case studies showing that implementing work requirements on Medicaid kicks off people who do meet the work requirement but can’t jump through the additional bureaucratic reporting hoops and increases the program’s total costs due to increased administrative oversight, Republicans have proposed an 80 hour a month work requirement for Medicaid. Over 60 percent of Medicaid enrollees already work, so an additional work requirement will likely only kick off the 11 percent not able to work due to illness or disabilities, 13 percent not able to work due to caregiving, and 6 percent not able to work due to school attendance. This program will leave disabled Americans, those caring for families, the children of parents who have lost coverage, and those seeking education to better their job opportunities in the future without care.

Critical Research into Cancer, Alzheimers, Long COVID, and Other Diseases Will Be Halted. Republicans plan to cut over $3.8 billion in funding to the National Institute of Health and eliminate funding entirely for the Agency for Healthcare Research and Quality. With NIH funding accounting for 99.4 percent of all FDA approved drugs from 2010-2019, these cuts will significantly undermine novel pharmaceutical innovation and development.

Repealing Bans on Physician Self-Referral Will Increase Health Care Costs and Jeopardize Communities’ Access to Care. In the FY 2024 budget, House Republicans have proposed ending the Stark Law, which would allow physicians to self-refer patients to facilities and services in which they have a financial stake. Importantly, these controversial physician-owned hospitals provide limited or no emergency services, cherry pick the most potentially profitable patients, and incur significantly higher costs on the Medicare program. According to the HHS, up to one-third of these hospitals may violate Medicare requirements by relying on publicly funded services to stabilize patients while still charging the patients exorbitantly. The Affordable Care Act’s closing of the “whole hospital” exception loophole in the Stark Law reduced the federal deficit by half a billion dollars over ten years; Republicans repealing it will cost the federal government and the American people millions of dollars annually.

If Republicans Shut Down the Government Or Fail To Reauthorize Critical Health Programs

If Republicans don’t get their way to cut Medicaid, the Affordable Care Act, and the Inflation Reduction Act, it is more and more likely that they will shut down the entire federal government. Along with crucial federal programs not being funded during a shutdown, there are a range of other health initiatives that need to be reauthorized before the end of fiscal year 2023 on September 30, which Republicans are also neglecting to prioritize. Instead of governing, it seems the Republican party seeks to hold the entire American health care system hostage.

Over 300 Community Health Centers Will Be At Risk. The Community Health Center Fund provides around 70 percent of federal funding to over 300 grantees across the country running vital health centers which integrate local health equity efforts into broader health care. The funding for this program expires September 30th, and without additional resources the lapse in funding could cause a collapse in employment in these centers.

Federal Funding That Offsets Uncompensated Care Hospitals Provide Will Dry Up. In a letter sent by America’s Essential Hospitals, the group warned that the $8 billion cut to DSH payments, which would go into effect on October 1, could dramatically undermine America’s health and safety. As well without this funding, access to life-saving services could disappear for many low-income or otherwise marginalized Americans.

The Global Fight Against HIV/AIDS Will be Undermined. A government shutdown could cause The President’s Emergency Plan for AIDS Relief (PEPFAR) to not be reauthorized. This will sunset seven provisions at the end of fiscal year 2023 which involve how to allocate spending and U.S. contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Funding the Fight Against the Opioid Epidemic Would Dry Up. Without reauthorization, many programs launched in 2018 aimed at tackling the growing opioid crisis would lapse.

Pandemic Preparedness Would Collapse and Drug Shortages Continue. Due to an ongoing fight in the House, Republicans have held up reauthorizing the Pandemic and All Hazards Preparedness Act (PAHPA). Democrats have fought to address the growing drug shortages using the PAHPA, but Republicans have delayed the reauthorization, now causing it to potentially lapse out entirely due to a Republican shutdown.

The Republican Continuing Resolution Would Only Make Matters Worse

A Short Term CR Offered By Some Republicans Would Slash Federal Spending And Undermine Critical Research And Public Health Programs. Instead of shutting down the government, some Republicans have offered up a short-term funding bill which will keep the federal government running until October 31st. This continuing resolution will only compound the growing health crises as it seeks to cut 8 percent of almost all federal spending. Not only will these cuts increase wait times, slash public spending on disaster initiatives, and undermine critical pharmaceutical research, but it will also drastically decrease access to vital public health services as tens of thousands of Americans face obstacles in maintaining stable social determinants of health.

Republican Legislation Would Weaken Protections For Millions Of Americans With Pre-Existing Conditions

Legislation Offered By Republicans This Summer Would Promote “Junk” Insurance Plans And Undermine the ACA. The Association Health Plans Act and Self Insurance Protection Act passed by the Education & Workforce Committee this summer would expand access to association health plans (AHPs) and other non-ACA compliant health care plans, weakening protections for the over 135 million Americans with pre-existing conditions. AHPs are health plans that are offered to members of trade associations, professional groups, or other organizations. Compared to plans available on state marketplaces, AHPs provide weaker cost and protection coverage and are not required to hold up the same protections that plans under the ACA do. AHPs do not have to participate in the ACA’s single-risk pool rule and can set premiums lower for healthier people and higher for those with pre-existing conditions or who are at risk for health issues in the future.

Protect Our Care Along with Public Citizen, Senators and Leading Health Care Experts and Advocates File Briefs to Protect Medicare’s Power to Negotiate Lower Drug Prices

With Medicare slated to begin negotiating lower prescription drug prices with big drug companies in the coming weeks, drug companies and their mega lobbying group allies are desperately suing the federal government in an effort to protect their profits by halting the popular program. In one lawsuit, pharmaceutical company Merck has asked the court for a decision on their case without going to trial. In response, leading health care groups have filed briefs to deny the motion and protect the Inflation Reduction Act’s Medicare Drug Price Negotiation Program. Read more about the cases here. 

These meritless lawsuits are about one thing: protecting drug companies’ outrageous profits. Merck sells Januvia, a Type 2 diabetes drug that has been selected for negotiation. Januvia has been on the market without competition for 17 years and has grossed Merck $49.9 billion in sales since its launch. In 2021 alone, Medicare spent over $4 billion on the drug with an average of $4,343 per beneficiary while Merck CEO Robert Davis raked in $13.72 million. Since 2010, Medicare has spent nearly $28 billion on the drug. 

Medicare drug price negotiation is projected to lower costs for seniors and save taxpayers tens of billions of dollars, but big drug companies are eager to protect their outrageous prices and outsized profits. Drug companies that manufacture drugs that are likely to be eligible or were chosen for negotiation have a history of exploiting the patent system to protect their monopolies and keep competitor drugs off the market, spend millions on lobbying, and increase their list prices at rates that far exceed inflation.

Here are excerpts from the DOJ and health care expert and advocate briefs:

Department of Justice

Federal Government’s Opposition to Plaintiff’s Motion for Summary Judgment, and Cross-Motion: “For More Than 30 Years, Congress Has Imposed Limits on How Much Federal Agencies Pay for Prescription Drugs.” “Manufacturers who wish to sell their drugs to the Department of Defense and the Department of Veterans Affairs do so at statutorily defined ceiling prices, and both agencies have authority to negotiate prices further below those ceilings. […] Like other market systems, the Negotiation Program thus gives a manufacturer a choice: it can sell its products at prices a buyer is willing to pay, or it can take its business elsewhere. […] The IRA’s Negotiation Program is nothing more, and nothing less, than an example of Congress exercising its constitutional authority to control the use of federal funds. Such control fits squarely within the bounds of established precedent.” [Federal Government’s Opposition to Plaintiff’s Motion for Summary Judgment and Cross-Motion, 9/11/23]

Health Care Experts, Organizations, and Advocates

Protect Our Care, Public Citizen, et al.: “Merck’s Takings Clause claim rests on the flawed premise that ‘the whole point of the [IRA] Program is to take prescription drugs without paying their fair value.’” “Merck does not contest that it wants to sell brand-name drugs, including Januvia, to Medicare participants and beneficiaries. It does not contest that it will be paid for purchases of the drug. Instead, Merck argues that Medicare will pay less than the average amount that Merck prefers to charge in the United States – although not necessarily less than the amount that it charges other buyers in the United States or internationally. But Merck is wrong that its desire to impose a high monopolistic price on Medicare, the world’s largest drug purchaser, without negotiations, means that purchase below that price necessarily constitutes an unconstitutional taking.” [Protect Our Care, Public Citizen, et al. Amicus Brief, 9/13/23]

Sens. Amy Klobuchar, Peter Welch, Tammy Baldwin, Richard Blumenthal, Sherrod Brown, Catherine Cortez Masto, Richard J. Durbin, John Fetterman, John Hickenlooper, Jacky Rosen, Jeanne Shaheen, Debbie Stabenow, Chris Van Hollen, And Elizabeth Warren: “Congress Carefully Considered the Competing Interests at Stake in the Program and Struck an Appropriate Balance” “The Program was the culmination of ten years’ work examining the Medicare Part D system and escalating drug costs across the national economy. […] With the benefit of this long history and experience, Congress was fully prepared in 2021 to weigh and debate the negotiation provisions that would eventually win passage as part of the IRA. […] Naturally, Congress also heard from the Program’s opponents—and found their evidence and arguments wanting. […] The legislative record makes clear that Merck has simply repackaged the policy arguments it and its allies unsuccessfully advanced before Congress as constitutional arguments.” [Senators Amicus Brief, 9/19/23]

AARP and AARP Foundation: “Skyrocketing Drug Prices Have Stretched the Budgets of Older Adults to the Point Where They Are Forced to Make Impossible, Life-Altering Choices.” “The goal of the Negotiation Program is to end this public crisis and interject long-overdue fairness, transparency, and predictability into the drug pricing process. While prescription drugs are intended to treat illnesses and improve the quality of life, these benefits are meaningless if beneficiaries cannot afford them. […] Taken together, the IRA’s prescription drug provisions are designed to address high out-of-pocket costs, high taxpayer costs, and high drug prices. […] The other IRA provisions, though critical, cannot accomplish the goal of stopping escalating drug costs without the implementation of the Negotiation Program.” [AARP and AARP Foundation Amicus Brief, 9/18/23]

American Public Health Association et al.: “The Program Is A Vital First Step In Ensuring The Health Of Americans And The Medicare Program.” “Even without changing the price of new drugs, the public health benefits from lower drug prices for drugs that have been on the market for several years are likely to be orders of magnitude greater than the harm caused by this 1% reduction in new drugs: making existing drugs more affordable will enable more patients—especially low-income older people—to actually take and maintain existing necessary medication. […] Where funding for research and development comes from public programs, there is little reason to believe reduction in prices charged by manufacturers will result in substantially reduced effective and impactful innovation.” [American Public Health Association et al. Amicus Brief, 9/18/23]

Economists and Scholars of Health Policy: “The Inflation Reduction Act restores bargaining equity between manufacturers and consumers.” “These combined measures spur innovation and enable companies to recuperate their investment while protecting consumers from a market-wide overinflation of drug prices. The prescription-drug market has tipped in favor of manufacturers for decades, and the Inflation Reduction Act takes important steps to restore its balance.” [Economists and Scholars of Health Policy Amicus Brief, 9/18/23]

Nationally Recognized Healthcare and Medicare Experts: “Such rights do not apply to private parties’ relationships with the federal government.” “The [Drug Price Negotiation Program] is consistent with the federal government’s well-established ability to regulate the prices that the Medicare program pays for services by physicians, hospitals, and other providers. […] In claiming that the [Drug Price Negotiation Program] is an uncompensated taking of property in violation of the Constitution, Merck seeks to relitigate positions repeatedly rejected by courts in response to other challenges brought against federal healthcare programs.” [Nationally Recognized Healthcare and Medicare Experts Amicus Brief, 9/18/23]

Washington, D.C. — Today, House Budget Chair Jodey Arrington (R-TX) released a proposed budget for the next decade, which includes steep cuts to the Affordable Care Act, Medicaid, and Inflation Reduction Act, threatening health care for millions of seniors and families across the nation. Dismantling the Inflation Reduction Act would reverse prescription drug savings for seniors and make health care more expensive for families purchasing coverage on their own. This latest attack on health care comes at the same time House Republicans are threatening a government shutdown unless they get their way. The GOP budget resolution is slated for a committee markup tomorrow morning. 

In response, Protect Our Care Executive Director Brad Woodhouse issued the following statement:

“The GOP war on health care is alive and well. This is just the latest in a years-long effort to repeal the ACA, slash Medicaid and roll back any effort to make health care and prescription drugs more affordable for American families. The Republicans’ budget would do unspeakable harm to the progress made by the Biden-Harris administration through the Inflation Reduction Act. It’s a complete disgrace that while Democrats are working hard to lower health care costs for Americans, Republicans are trying to go backwards on progress.”

What Repealing the Inflation Reduction Act Means for American Health Care:

• GONE: Premium savings for over 13 million Americans covered under the ACA — averaging $2,400 per family.
• GONE: Medicare’s power to negotiate lower costs for the most popular and expensive prescription drugs.
• GONE: Prescription drug savings for seniors, including a $2,000 annual out-of-pocket cap and protections from Big Pharma’s price hikes.
• GONE: Free vaccines for seniors, including shingles and pneumonia.
• GONE: $35 monthly insulin caps for Medicare beneficiaries.

The CARE for Moms Act Includes Historic Investments to Strengthen Health Care Coverage During and After Pregnancy, Grow and Diversify the Doula Workforce, and Address Underlying Causes of Maternal Mortality

Watch the full event here.

Washington, DC — Today, U.S. Representative Robin Kelly (D-IL-02), National Medical Association President Dr. Yolanda Lawson, Maternity Care Coalition’s Sara Jann Heinze, and Vice Chair of the March of Dimes Board of Trustees Dr. Phyllis Dennery joined Protect Our Care to discuss her new legislation, the CARE for Moms Act, which is a comprehensive plan to combat the U.S. maternal mortality crisis. The bill includes critical steps to save lives, including by investing $35 million in state-based grants to improve perinatal care, mandating Medicaid coverage for new moms one year postpartum, extending Medicaid oral health coverage to pregnant and postpartum women, addressing implicit bias in the health care training, increasing and diversifying the doula workforce, and more. 

More than 1,000 women die annually due to complications of pregnancy or childbirth, making the U.S. maternal mortality rate three times higher than other wealthy nations. Black and Native women are at significantly greater risk of facing serious complications. Representative Kelly will introduce the CARE for Moms Act, which takes a multifaceted approach to promote the health of new mothers and their babies and the urgent need to stop the worsening maternal mortality crisis, on September 19. 

“I’m introducing the CARE For Moms Act because moms deserve better, Black moms deserve better,” said Congresswoman Robin Kelly, Chair of the CBC Health Braintrust. “When we take care of moms and prioritize prenatal and postpartum care, we can help entire families flourish. The reality is that too many moms, and particularly Black moms, are losing their lives. That’s why I’m pushing for change, supporting providers, and providing resources like mobile units and doulas. My goal is clear: to ensure that every mother has access to the care, empowerment, and resources necessary to be the best moms they can be.”

“The U.S. is lagging as a whole,” said National Medical Association President Dr. Yolanda Lawson. “Our country is faced with a shortage and a misdistribution of the maternal health care workforce which led to maternal health care deserts that are compounded by these hospital closures and closures of these obstetrical units. Then you look at black women in this country who are three to four times more likely to die and the disparity has increased and persisted for over 50 years. We talk about what we need to do to reduce these deaths and this bill is an important, useful, and substantive enhancement to these ongoing efforts to address and decrease maternal deaths.”

“We’re in a moment right now where folks are aware of the issues, and I don’t want us to miss the moment,” said Maternity Care Coalition’s Sara Jann Heinze. “This bill is investing in things that are already happening, work that we already know works that needs more resources. The health of our mothers is really one of the best measures to understand the health of our society, so investing in this work and having a broad-based coalition is important – we all need to be working together on these issues and helping people to understand the issue from multiple lenses.”

“After a premature birth, families face lifelong challenges, including economic, educational, and other things that impact their whole family,” said Vice Chair of the March of Dimes Board of Trustees’ Dr. Phyllis Dennery. “We have 900 maternal deaths each year and 80 percent of these are preventable, which is really a crisis. So I’m looking forward to this bill being passed because it is extremely important to all the mothers and babies in this country.”

“In the wealthiest nation on earth, it is unfathomable that our maternal mortality rate is three times higher than other nations,” said Communications Director for Protect Our Care Anne Shoup. “Our nation’s mothers are dying from fully preventable causes — with especially high risks for Black and Native mothers — and research shows that the problem is only getting worse. By making historic investments to strengthen health care coverage and address underlying causes of maternal mortality, the CARE for Moms Act is a critical step forward to improving the health and safety of families across the nation. We commend Representative Kelly for her leadership on this issue and urge Congress to do everything in its power to pass this legislation to save lives.” 

Dayton Area Chamber of Commerce et al. v. Becerra et al. Brings Meritless Challenge to Medicare, Threatening Billions in Savings for Seniors and Taxpayers 

Washington, DC — Today, a federal judge in Ohio held oral arguments in a lawsuit brought by the Chambers of Commerce to stop Medicare from negotiating lower drug prices for millions of seniors. The lawsuit was brought by a group of national, state, and regional Chambers of Commerce that asked for a nationwide preliminary injunction to halt the Biden administration’s implementation of the program and allow drug companies to continue to charge whatever they want for lifesaving medications. A ruling on the case is expected before October 1st.

The Chambers’ case is one of eight meritless lawsuits seeking to protect drug companies’ outrageous profits. While the drug companies rake in billions and force seniors to skip doses of their life saving medicines, they charge up to four times more in the U.S. than in other countries. Read more about the lawsuits brought by big drug companies and their allies here.

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

“This case has no legal merit. Drug companies and the Chambers of Commerce that are doing their bidding are basically asking a judge to protect their massive profits at the expense of millions of seniors. This case is just one of many in which drug companies and their mega lobbying group allies are desperately suing the federal government in an effort to protect their ability to charge whatever they want for drugs that millions rely on to stay alive. Meanwhile, seniors are cutting pills and skipping doses of lifesaving medications. Millions are depending on the savings from the Medicare negotiation program, and it is vital that Judge Newman reject this meritless lawsuit.”