August Recess

Driving the Point Home: This Is A Health Care Emergency

The core message for Democrats is a simple and persuasive one — President Trump and Republicans have created a health care emergency; they want to take away your health care, raise your costs, and give more power to insurance and drug companies. Democrats want to lower costs, improve care and give power back to you. This August recess is a critical opportunity to hold the President and Republicans accountable for supporting this disastrous Texas lawsuit to destroy health care and highlight the positive Democratic agenda of lower costs and better care. 

To drive this message home, Protect Our Care is will be running a nationwide bus tour throughout August highlighting the health care emergency created by the Trump-Texas lawsuit. The “Health Care Emergency Tour” will travel throughout key 2020 battleground states in the Southwest, Midwest and up and down the East Coast. Across the country, POC will host press events with Members of Congress, local elected officials, health care advocates and storytellers to highlight the Trump-Republican sabotage and repeal agenda, and the never-ending Republican war on health care.

The “Health Care Emergency Tour” has planned stops in 22 cities in 14 states including Arizona, Colorado, Georgia, Iowa, Maine, Michigan, Minnesota, New Mexico, Nevada, North Carolina, Ohio, Pennsylvania, New Hampshire, and Virginia.

Message Guidance

According to two recent polls, health care is the most important issue to voters and is the most compelling reason for voters to oppose President Trump. In the past month, the contrast between Democrats and Republicans’ health care priorities has become even more clear. Since taking the majority in January, House Democrats have tirelessly fought to enact their agenda to lower costs and improve care while Republicans have doubled down on their attempts to strip health care away from millions of Americans. 

As Democrats have advanced proposals that voters in both parties overwhelmingly support, Republicans have dug in deeper on their efforts to sabotage the Affordable Care Act. In July, the Trump administration appeared in court to argue in support of the disastrous Texas lawsuit, released a budget that slashes funding for Medicare and Medicaid, and ramped up their efforts to throw people off Medicaid by allowing states to implement so-called work requirements. 

Democrats Are Fighting For Lower Costs, Better Care & To End Health Care Sabotage 

In May, Democrats in the U.S. House of Representatives voted to overturn Trump administration regulations that encourage junk plans, began the effort to reduce the cost of prescription drugs, and strengthened health care by taking steps to reverse Trump’s sabotage agenda. In June, they voted to prevent the Department of Justice from using federal funds for litigation that undermines the Affordable Care Act. The House passed H.R. 986, the “Protecting Americans With Pre-existing Conditions Act;” H.R. 987, the “Strengthening Health Care and Lowering Prescription Drug Costs Act;” and H.Amdt. 424 to H.R. 3055. These bills have several key components:

• Ending Trump’s expansion of junk plans that discriminate against people with pre-existing conditions. The House bill overturns the Trump administration’s rule to allow expanded new junk plans that allow insurance companies to deny coverage completely to people with pre-existing conditions or not cover essential treatments like prescription drugs (HR 1010). The House will also ban the federal government from using taxpayer money to push consumers into these junk plans (HR1386). 

A new report from the American Cancer Society showed that typical patients with cancer who bought junk plans would be stuck with devastating health care bills because the junk plans they bought purposefully did not adequately cover the treatments they needed to survive. Many people did not know of these gaps and limits on coverage when they signed up. 

A recent PPP poll showed nearly 70 percent of people support ending junk plans.

• Ending Trump sabotage of open enrollment. The House bill restores $100 million in funds for education, outreach and assistance to make it easier for people to find and buy health insurance that is right for them (HR987 and HR1386). The House bill also provides $200 million to states to set up state health insurance marketplaces (HR1385) so they can provide better health care for their residents. 

Since taking office, the Trump administration has slashed the marketing budget for health care plans sold through the marketplace by 90 percent and funding for health navigator groups that help people sign up for comprehensive care by 77 percent. These cuts are estimated to have reduced enrollment by nearly 500,000 people.

• Lowering prescription drug costs. The House bill will stop big drug companies from purposely delaying cheaper generic drugs from getting to market (HR965 and HR1499). The bill will also increase competition in the generic drug market (HR938), helping lower costs for patients.

A recent PPP poll showed 82 percent of people support making it harder for big drug companies to block new, cheaper generic drugs.

• Preventing DOJ from using federal funds to argue against the ACA in court. Amendment 424 to HR3055  prevents the Department of Justice from using federal funds for litigation that undermines the Affordable Care Act.

These bills are only the start for the Democrats’ agenda which will ultimately include further efforts to rein in prescription drug costs, end surprise hospital bills, and increase financial assistance that can be used to purchase insurance.

Meanwhile, Republicans Are Working To Take Health Care Away From Millions

Since President Trump was sworn into office, he and Republicans have waged a relentless war on American health care. Against the loud objections of the American people, Trump and his allies have repeatedly tried to repeal and sabotage the health care law in Congress, administratively and in the courts. This strategy was resoundingly rejected by the American people in November when they voted out scores of pro repeal Republicans and put Democrats in charge of a Health Care Congress.

Trump’s lawsuit means higher costs for worse care

President Trump’s lawsuit to completely overthrow the Affordable Care Act would rip insurance away from millions of Americans, gut protections for pre-existing conditions and raise costs. It would give insurance companies power to charge as much as they want and cover as little as they want, while paying their CEOs more and padding their profits. If Trump overturns health care, it would:

• Gut protections for every American with a pre-existing condition
• Hike premiums for millions of Americans
• No longer allow children the ability to stay on their parents health care plan until 26
• Allow insurance companies to not cover drug costs and to charge women more than men
• Increase the number of uninsured by 65%
• Let insurance companies use premiums for unlimited executive bonuses instead of paying for care

Voters loudly rejected health care repeal in 2018, and now Donald Trump is going to court to overrule them. Health care repeal was the #1 issue in the midterms and is the #1 issue the American people want Congress to address. 

Every Republican owns this lawsuit. Republicans have tried for years to repeal the Affordable Care Act and the Trump administration has actively tried to sabotage it. 18 states led by Republican state officials are supporting Trump’s lawsuit and Republicans in the House voted for it. 

And if that wasn’t enough, Republicans continue their larger war on health care…

In addition to Trump’s lawsuit, the Republican repeal and sabotage agenda raises costs, weakens protections, reduces coverage, and puts drug and insurance company profits first.

• Trump’s newly proposed budget includes nearly $1 trillion in Medicare cuts and $1.5 trillion in cuts to Medicaid, and repeats his call for repeal of the Affordable Care Act. Trump promised to never cut Medicare and Medicaid when he ran for president.
• The Trump and Republican tax bill gave hundreds of billions of dollars in tax cuts to insurance and drug companies. Their profits and CEO salaries soar while you pay more. 
• Republicans continue their relentless sabotage efforts. They want insurance companies to sell you junk plans that don’t cover pre-existing conditions and charge you more when you get sick.  And they want to require ridiculous paperwork requirements as a way of kicking you off Medicaid.

Fact Sheet On Trump Lawsuit To Overturn ACA

President Trump is trying to rip apart our health care by going to court to eliminate the Affordable Care Act in its entirety. If the Trump lawsuit is successful, it will strip coverage from millions of Americans, raise premiums, end protections for people with pre-existing conditions, put insurance companies back in charge, and force seniors to pay more for prescription drugs. The result will be to — as the Trump Administration itself admitted in Court — unleash “chaos” in our entire health care system. 

If the Affordable Care Act is struck down:

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

Thanks To The Republican Lawsuit, 17 Million People Could Lose Their Coverage

• According to the Urban Institute, 19.9 million people could lose coverage by repealing the Affordable Care Act, meaning the number of uninsured Americans would increase from 30.4 million to 50.3 million, representing a leading to a 65 percent increase in the uninsured rate. As the uninsured rate swells, so will the amount of uncompensated care, which Urban predicts will grow by at least 82 percent.
• An estimated 689,077 veterans would become uninsured by 2026 if the ACA is overturned. Veterans benefited immensely from Medicaid expansion and the ACA’s subsidies for purchasing insurance in the marketplaces. Ultimately, the ACA reduced the number of uninsured veterans by more than one third. 
• States would lose important federal health care funding — an estimated reduction of $135 billion in the first year. The Urban Institute estimates that a full repeal of the ACA would reduce federal spending on Medicaid/CHIP care and Marketplace subsidies by $135 billion, or 34.6 percent in the first year.

Republicans Want To Put Insurance Companies Back In Charge, Ending Protections For The 130 Million People With A Pre-Existing Condition

• According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 130 million people, have a pre-existing condition. This includes:
  • 44 million people who have high blood pressure
  • 45 million people who have behavioral health disorders
  • 44 million people who have high cholesterol
  • 34 million people who have asthma and chronic lung disease
  • 34 million people who have osteoarthritis and other joint disorders
• 17 million children, 68 million women, and 30 million people aged 55-64 have a pre-existing condition.

Republicans Want To Give Insurance Companies The Power To Deny Or Drop Coverage Because Of A Pre-Existing Condition

Before the Affordable Care Act, insurance companies routinely denied people coverage because of a pre-existing condition or canceled coverage when a person got sick. Now insurance companies have license to do this again. 

• A 2010 congressional report found that the top four health insurance companies denied coverage to one in seven consumers on the individual market over a three year period. 
• A 2009 congressional report found that the of the largest insurance companies had retroactively canceled coverage for 20,000 people over the previous five year period
• An analysis by Avalere finds that “102 million individuals, not enrolled in major public programs like Medicaid or Medicare, have a pre-existing medical condition and could therefore face higher premiums or significant out-of-pocket costs” if the Trump-GOP lawsuit is successful.

Republicans Want To Give Insurance Companies The Power To Charge You More, While Their Profits Soar

• 138 Million Americans Could Once Again Have To Pay For Preventive Care. Because of the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no cost to consumers. This includes nearly 138 million Americans, most of whom have employer coverage.
• Premium Surcharges Can Once Again Be In The Six Figures. Thanks to the Republican lawsuit, insurance companies can charge people more because of a pre-existing condition. The House-passed repeal bill had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
• Women Can Be Charged More Than Men For The Same Coverage. Prior to the ACA, women, for example, were often charged premiums on the nongroup market of up to 50 percent higher than they charged men for the same coverage. 
• People Over The Age of 50 Can Face A $4,000 “Age Tax.” Thanks to the Republican lawsuit, insurance companies can charge people over 50 more than younger people. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, according to the AARP.
• Nine Million People In The Marketplaces Will Pay More For Coverage. Thanks to the Republican lawsuit, consumers no longer have access to tax credits that help them pay their marketplace premiums, meaning roughly nine million people who receive these tax credits to pay for coverage will have to pay more.
• Seniors Will Have To Pay More For Prescription Drugs. Thanks to the Republican lawsuit, seniors will have to pay more for prescription drugs because the Medicare “donut” hole got reopened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 Centers on Medicare and Medicaid Services report.

Republicans Want To Give Insurance Companies The Power To Limit The Care You Get, Even If You Have Insurance Through Your Employer

• Reinstate Lifetime and Annual Limits On 109 Million Privately Insured Americans. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage for those insured through their employer or on the individual market.
• Insurance Companies Do Not Have to Provide the Coverage You Need. The Affordable Care Act made comprehensive coverage more available by requiring insurance companies to include “essential health benefits” in their plans, such as maternity care, hospitalization, substance abuse care and prescription drug coverage. Before the ACA, people had to pay extra for separate coverage for these benefits. For example, in 2013, 75 percent of non-group plans did not cover maternity care, 45 percent did not cover substance abuse disorder services, and 38 percent did not cover mental health services. Six percent did not even cover generic drugs.
• Large Employers Could Choose to Follow Any State’s Guidance, Enabling Them Put Annual and Lifetime Limits on Their Employees’ Health Care. Without the ACA’s definition of essential health benefits (EHB) in even some states, states could eliminate them altogether. Large employers could choose to apply any state’s standard, making state regulations essentially meaningless. Because the prohibition on annual and lifetime limits only applies to essential health benefits, this change would allow employers to reinstate annual and lifetime limits on their employees’ coverage.

Republicans Want To End Medicaid Expansion

• Seventeen Million People Enrolled Through Medicaid Expansion Could Lose Coverage.
• Access To Treatment Would Be In Jeopardy For 800,000 People With Opioid Use Disorder. Roughly four in ten, or 800,000 people with an opioid use disorder are enrolled in Medicaid. Many became eligible through Medicaid expansion.
• Key Support For Rural Hospitals Would Disappear, leaving hospitals with $9.6 billion more in uncompensated care. 

The Trump Administration’s Talk is Cheap, But Drug Prices Aren’t

Health care is prohibitively expensive for many Americans, causing many who have insurance to skip or delay care and prohibiting many who lack insurance from signing up for care. 

• A Protect Our Care poll found that 84 percent of Americans support requiring drug companies to notify the government in advance when they plan to significantly raise drug prices and create a mechanism to identify and stop unjustified increases; 82 percent support allowing Medicare to negotiate directly with drug companies to get lower prices on prescription drugs.
• 15.5 percent of those who have insurance either skipped or delayed care because of cost or trouble paying bills in 2017.
• Roughly one in four, or 26.2 percent of non-elderly people struggle with insurance affordability problems. 
• Cost is of particular concern to those in fair or poor health — 46.5 percent of those in fair or poor health are uninsured or have problems affording care despite having coverage. This includes 13.5 percent who are uninsured and 32.9 percent who have insurance but had a problem affording care in the last year.
• Cost is the most cited reason for being uninsured — 45 percent of uninsured nonelderly adults in 2017 said they were uninsured because the cost is too high.

Americans pay more for drugs than do people in any other country. At $1,208 per capita, people in the U.S. spend more on pharmaceuticals per capita than do people in any other country in the world. British researchers found that U.S. prices were consistently higher than in other European markets, six times higher than in Brazil, and 16 times higher than in the lowest-price country, which was usually India.

Drug Prices Continue to Soar Under Trump. A report by Senate Democrats finds that the prices of the 20 most-prescribed drugs under Medicare Part D have increased substantially over the past five years, rising 10 times faster than inflation. Another report from the Pharmacy Benefits Consultants finds that over the past 14 months, 20 prescription drugs saw list-price increases of more than 200 percent. A June 2019 report from AARP found that the prices of widely used specialty drugs grew more than three times faster than general inflation in 2017.

Drug companies are engaging in the dangerous practice of price-gouging — pursuing massive profits to the detriment of people who need their medication to survive. In September 2018, Nostrum chief executive Nirmal Mulye defended his choice to raise the price of an antibiotic from $474.75 to $2,392 a bottle, saying he had “moral requirement…to sell the product for the highest price.” In 2017, Mylan, the company that made the EpiPen, came under fire for charging $609 for a box of two devices even though each only contained about $1 worth of the drug epinephrine. Between 2012 and 2016, the price of insulin, which 7.5 million Americans depend on, nearly doubled from $344 to $666. A Wells Fargo analysis found evidence for severe price hikes in June 2019. Most notably, the price of a generic anti-diuretic was hiked by 909 percent. 

…Pharmaceutical Companies Are Raking It In…

Pharmaceutical Companies Have Reaped Huge Benefits From The Trump Tax Bill. The Trump tax scam means billions of dollars in tax breaks for pharmaceutical companies. An Axios study found that 21 health care companies collectively expect to gain $10 billion in tax savings during 2018 alone. Most of the tax break windfall for health care companies is going toward share buybacks, dividends, acquisitions and paying down debt. According to Axios, nine pharmaceutical companies are are spending a combined $50 billion on new share buyback programs. All of the buybacks were announced during or after passage of the tax bill. Some drug companies are also increasing dividends for shareholders, with AbbVie increasing its cash dividend by 35 percent while also announcing a new $10 billion share repurchase program.

Massive Profits And Price Increases. Pharmaceutical companies raked in more than $30 billion in profits in the third quarter of 2018, with Pfizer alone bringing in $4.1 billion — the highest of any publicly traded health care company. Of the 19 companies that tallied at least $1 billion of third-quarter profit, 14 were drug companies.  Meanwhile, pharmaceutical companies continue to increase prices. In January 2019 alone, Pfizer and Novartis announced price increases on dozens of drugs, including increasing the cost of a breast cancer medication to $12,000 for 21 pills.  All in all, nearly 30 drugmakers are expected to raise prices in 2019.  

Soaring CEO Pay. According to an Axios study, the CEOs of 70 of the largest U.S. health care companies cumulatively have earned $9.8 billion since 2010. CEOs took home nearly 11 percent more money on average every year since 2010 — far more than the wage growth of nearly all other workers. In 2017 alone, 30 health care executives made a combined $976 million. 

…And Republicans Are Making it Worse

Republicans refuse to let Medicare negotiate for lower drug prices. Though 92 percent of Americans support allowing the federal government to negotiate drug prices for Medicare beneficiaries, Republicans refuse to let Medicare negotiate drug prices. A 2018 Senate Homeland Security and Governmental Affairs Democratic Committee report found that Medicare Part D could save $2.8 billion in a single year if it were allowed to negotiate drug prices.

Trump Installed Big Pharma Executives In Key Administration Posts. President Trump installed a former Eli Lily executive, Alex Azar, as his secretary of Health and Human Services and his appointment of Scott Gottlieb at FDA was described as “music to pharma’s ears.” Other pharma lobbyists writing Trump’s health policy include senior adviser at FDA, Keagan Lenihan, who joined the administration after lobbying for the drug distribution giant McKesson, former Gilead lobbyist, Joe Grogan, who reviews health care regulations at the Office of Management and Budget, and Deputy Assistant to the President for Domestic Policy Lance Leggitt, who has lobbied for a variety of drug-industry clients.

Pharma Executives Maintain Grip On Trump And Republican Allies During Drug Pricing Negotiations. As Trump and his Republican allies worked on proposals supposedly aimed at lowering drug costs, Trump invited four top Pharma executives for a private meeting in the White House. Record-breaking lobbying by PhRMA has also resulted in Republicans watering down their proposals in addition to abandoning some altogether. 

Trump’s Proposals Always Fall Far Short Of His Promises. President Trump promised that he would allow Medicare to use its buying power to negotiate drug prices directly with suppliers, but after meeting with pharmaceutical executives early in 2017, Trump abandoned that pledge, calling it “price fixing” that would hurt “smaller, younger companies.” Trump has also rolled back promises made in his “blueprint” for bringing down drug costs, including a rebate proposal that would have redirected savings toward patients.

Because Washington Republicans Repealed The Requirement That Most People Have Insurance And Encouraged People To Sign Up For Junk Plans, 2019 Premiums Are Higher Than They Should Be. Charles Gaba, health care analyst, calculates that individual marketplace premiums are increasing by an average of 2.8 percent nationally. However, Gaba estimates that if not for Republican sabotage, premiums would decrease by an average of 5.4 percent.

The Administration Has Consistently Advocated For The Repeal Of The Affordable Care Act, Including Eliminating The Requirement That Insurance Companies Cover Prescription Drugs. After the Trump administration tried and failed to repeal the ACA legislatively, it took to the courts in hopes of eliminating the health law. In 2018, the Justice Department decided not to defend the Affordable Care Act in court against a lawsuit seeking to overturn it. Since, a federal judge has ruled to overturn the law, including its requirement that insurance companies cover patients’ prescription drugs. 

Lower Costs, Better Care: House Dems To Continue Fighting For More Affordable Care

After winning the midterm elections by vowing to fight for Americans’ health care, Democrats in the House of Representatives are making good on their promises by introducing sweeping legislation to achieve lower costs and better care. While House Democrats take concrete steps to make our health care system work better for the American people, the Trump administration and its Republican allies are doing just the opposite: proposing to cut Medicare and Medicaid by $2 trillion, gutting protections for preexisting conditions, and throwing the full weight of the Justice Department behind overthrowing the Affordable Care Act in the Texas lawsuit.

Democrats’ recent bill (H.R. 987) is only the start for the Democrats’ agenda which will ultimately include further efforts to rein in prescription drug and insurance costs and end surprise hospital bills. Here’s a look at what’s next:

Lower Health Care Costs. The “Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019” (H.R. 1884) would reduce health care premiums and deductibles, expand eligibility for financial assistance that helps consumers afford coverage, and expand access to affordable health care by guaranteeing affordable care options.

• Coverage for less than ten percent of your income. Under the bill, nearly all Americans would be guaranteed an option to purchase health care for less than 10 percent of their income. 
• Financial assistance for more people. H.R 1884 would make premium tax credits available to more middle class Americans, including those with incomes above 400 percent of the federal poverty line or roughly $100,400 for a family of four.
• Lowering premiums. By creating a national reinsurance program the House legislation would help further reduce premiums. 

Better Care For More People. The bill would restrict insurance companies’ ability to sell plans that gut circumvent important consumer protections. By helping to lower costs, the House bill would also expand access to comprehensive, affordable care for even more people.

• Lowering premiums, deductibles, or both for more than 13 million people currently insured and providing lower cost options for 12 million uninsured people. In all, the bill’s extended tax credits, reinsurance programs and premium assistance would cut premiums for all ACA-compliant plans sold on the individual market, reducing premiums or deductibles for 13 million with individual market coverage and creating lower cost options for 12 million uninsured people eligible for coverage through the marketplace. 
• Guaranteeing that insurance companies cover basic health services. The bill would also prevent the Trump administration from weakening requirements that all insurance cover essential health benefits, such as prescription drug coverage, hospital care, and maternity coverage. 
• Taking power away from insurance companies and gives it back to patients. While the Trump administration gives insurance companies the power to flood the market with junk plans and rewards them with massive tax breaks, this bill reinstates important protections for American consumers, giving power back to patients.