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Shelley Moore Capito Suddenly Supports the Affordable Care Act

Facing re-election, Sen. Shelley Moore Capito (R-WV) is now telling voters one thing while consistently having done the opposite. This morning, she told the Los Angeles Times she supports maintaining protections for people with pre-existing conditions and letting children stay on their parents’ insurance until age 26, two main provisions of the Affordable Care Act. Where has this been for the previous two years?

SHOT: “I think it would be in our best interest as Republicans to assure the public that [on] the issues like preexisting conditions, staying on your parents’ insurance until age 26 and things like that, we’re committed,” said Sen. Shelley Moore Capito, who is up for reelection in West Virginia in 2020.” [Los Angeles Times, 12/30/18]

CHASER: Sen. Capito voted to fully repeal the ACA as a House Member, which would have repealed provisions to protect people with pre-existing conditions and allow kids to stay on their parents’ coverage until age 26. And she voted to repeal the ACA as a Senator last summer.

In 2011, Rep. Shelley Moore Capito Voted For A Full Repeal Of The ACA, “Repealing the Job-Killing Health Care Law Act.” [House clerk, 1/19/11]

In 2012, Rep. Shelley Moore Capito Again Voted For A Full Repeal Of The ACA. [House clerk, 7/11/12]

In 2017, Sen. Shelley Moore Capito Voted For The Better Care Reconciliation Act, Which Would Kicked 22 Million Americans Off Of Their Insurance. [New York Times, 7/28/17; Congressional Budget Office, 6/26/17]

In 2017, Sen. Shelley Moore Capito Also Voted For The GOP’s Final Repeal Bill. [New York Times, 7/28/17]. As a reminder, under repeal:

  • 184,000 West Virginians would lose health coverage, a 208% increase in the number of uninsured. [Urban Institute]
  • West Virginians would lose $1.794 billion in federal financial assistance through the insurance marketplaces from 2019-2028, leading to a dramatic spike in the number of uninsured. [Urban Institute]
  • 29,163 West Virginians would lose an average monthly advanced premium tax credit of $388 which currently helps them pay for insurance [Kaiser Family Foundation]
  • West Virginia would lose $12.2 billion in federal Medicaid or Children’s Health Insurance Program (CHIP) funding, currently providing lifelines to 562,183 West Virginians. [Urban Institute, Kaiser Family Foundation]
  • Repealing the ACA would result in 16,000 West Virginia jobs lost, including 7,200 jobs in the healthcare sector. [Commonwealth Fund]

Federal Open Enrollment Comes to A Close Amid Unprecedented Republican Sabotage Campaign

Washington, D.C. – Following the devastating ruling from Judge Reed O’Connor to overturn the Affordable Care Act (ACA) during the final hours of open enrollment – one of the busiest times for sign-ups – we learned that a lot fewer people signed up for coverage through the federal exchange marketplace. Leslie Dach, chair of Protect Our Care, issued the following statement in response:

“Americans want and need the quality, affordable coverage provided by the Affordable Care Act. Open Enrollment sign-ups would be dramatically higher if not for the unprecedented Republican sabotage campaign, which included slashing advertising by 90 percent, dramatically cutting navigator assistance, and shortening the enrollment time period. Democrats ran on health care and were able to take back the House, and in the Majority these Democrats will work to fully fund open enrollment and end this sabotage, ensuring that Americans of all backgrounds are able to obtain the coverage they need. Will Republicans ever learn to do the same?”

BACKGROUND: THE TRUMP ADMINISTRATION AND REPUBLICANS DOUBLED DOWN ON OPEN ENROLLMENT SABOTAGE IN 2018

The Trump Administration Removed Information On Applying For Coverage From HealthCare.gov. The Trump Administration overhauled the “Apply for Health Insurance” section of HealthCare.gov, removing the options of signing up for coverage via mail and phone and directing people to sign up for coverage through enrollment sites run by private companies.

Between 2016 And 2018, The Trump Administration Cut Funding For Groups That Help People Sign Up For Coverage By 84 Percent. After cutting funding for navigator groups that help people sign up for coverage from $63 million in 2016 to $36 million in 2017, the Trump Administration made yet another round of cuts in 2018, leaving just $10 million in funding for health navigator groups. Since 2016, Trump has cut navigator funding by 84 percent.

Health Navigators, Like Jodi Ray At The University Of South Florida, Say Cuts To Navigator Programs Prevent Them From Adequately Letting People Know That Open Enrollment Is Happening. Ray said, “We don’t have the people to provide the enrollment assistance nor to do the outreach and marketing to let people know what’s happening.”

This Year, 800 Counties Served By The Federal Marketplace Are Operating Without Any Federally-Funded Navigators. This is more than six times as many counties served by the federal marketplace that operated without federally funded navigators in 2016, when 127 counties lacked such a navigator.  

The Trump Administration Wants Navigator Groups To Push Consumers To Sign Up For Junk Coverage That Is Exempt From Covering Prescription Drugs And Hospitalization Instead Of Comprehensive Plans. The Administration announced in July that it would encourage navigator groups to use their remaining funding to push consumers to sign up for junk health plans, which cover few benefits and notorious for the fraud they attract.

In December 2017, The Trump Administration Repealed The Requirement That Most People Have Insurance Despite The CBO Estimate That Doing So Would Increase The Number Of Uninsured By 13 Million. The Republican tax bill passed last December was estimated by the nonpartisan Congressional Budget Office to increase the number of uninsured by 13 million in 2027.

All Of This Comes After The Trump Administration Cut The Open Enrollment Advertising Budget By 90 Percent in 2017. As ABC News summarized, “In 2016, the Centers for Medicare & Medicaid Services spent $100 million on Obamacare advertising and outreach, but for [2017]’s open enrollment period, CMS plans on spending $10 million.” CMS chose not to increase the budget for 2019.

A full timeline of the Trump Administration’s crusade to sabotage open enrollment is below:

December 2018

  • Sunlight Foundation investigation finds that Trump Administration removed information about ways to apply for coverage on HealthCare.Gov and is directing people to sign up for coverage through enrollment sites run by for-profit companies.

October 2018

  • The Trump Administration issues guidance that allows federal subsidies to be used to purchase junk plans that can deny coverage to people with pre-existing conditions, a move expected to worsen ACA risk pools.
  • Trump Administration announces scheduled maintenance on the open enrollment website, preventing people from signing up for coverage on Sundays from 12:00 AM – 12:00 PM.

September 2018

  • Centers for Medicare and Medicaid Services removes a training guide for Latino outreach from a CMS website just over a month before the beginning of open enrollment. Latinos are at a disproportionately high risk of being uninsured compared to white non-hispanic Americans.

August 2018

  • Trump Administration finalizes rule for bare-bones short-term plans that are exempt from key consumer protections, such as the requirement that insurance covers prescription drugs, maternity care, and hospitalization.

July 2018

  • Trump Administration slashes funding for non-profit health navigator groups that help people shop for coverage, from $36 million to $10 million. CMS encourages groups to use the remaining funds to push people to sign up for junk plans that skirt important consumer protections.

July 2018

  • Trump Administration limits access to assistance for consumers who want to enroll in marketplace coverage. This change removes the requirement that every area has at least two “navigator” groups to provide consumer assistance and that one be local. Now, just one group could cover entire states or groups of states.

December 2017

  • Congressional Republicans pass their tax scam, which doubles as a sneaky repeal of the Affordable Care Act  by kicking 13 million people off of their insurance and raising premiums by double digits for millions more.

October 2017

  • The Trump Administration dramatically cuts in-person assistance to help people sign up for 2018 health coverage.

September 2017

  • The Administration orders the Department of Health and Human Services’ regional directors to stop participating in Open Enrollment events. Mississippi Health Advocacy Program Executive Director Roy Mitchell says, “I didn’t call it sabotage…But that’s what it is.”

August 2017

  • The Administration cuts the outreach advertising budget for Open Enrollment by 90 percent, from $100 million to just $10 million – which resulted in as many as 1.1 million fewer people getting covered. Emails obtained by Democracy Forward reveal that the administration chose to cut outreach despite having been warned that over 100,000 fewer people would enroll in coverage.

July 2017

  • The Trump Administration uses funding intended to support health insurance enrollment to launch a multimedia propaganda campaign against the Affordable Care Act.

April 2017

  • The Trump Administration cuts the number of days people could sign up for coverage during open enrollment by half, from 90 days to 45 days.

January 2017

  • Also on January 20th, the Department of Health and Human Services begins to remove information on how to sign up for the Affordable Care Act.
  • The Trump Administration pulls funding for outreach and advertising for the final days of 2017 enrollment. This move is estimated to have reduced enrollment by nearly 500,000.

Good Riddance to the Least Successful, Most Anti-Health Care Speaker in American History

Washington, D.C. – This afternoon, Speaker Paul Ryan will give his farewell address at the Library of Congress. Brad Woodhouse, executive director of Protect Our Care, issued the following statement in response:

“Paul Ryan sat around a keg in college and dreamed of slashing Medicaid, tried to end Medicare as we know it as a Budget chairman, and tried to rip health care away from 23 million people by repealing the Affordable Care Act as Speaker of the House. As he leaves Washington, voters and legislatures across the country are expanding Medicaid; the public overwhelmingly rejected Ryan’s vouchers to upend Medicare, with the discussion today about how to strengthen and expand the program rather than end it; and despite his best efforts to repeal health care, kick tens of millions of people off of their coverage and end protections for those with pre-existing conditions, the ACA is more popular than ever, repeal went down in flames, and the Ryan-led effort to upend the American health care system swept his party from power in the House. There is no finer karma. Paul Ryan is perhaps the most anti-health care Speaker in American history – fortunately for the American people he was also the least successful and least competent. Good riddance.”

Arizonans Have Rejected Martha McSally Before, and They Will Reject Her Again

Washington, D.C. – This morning, Arizona Governor Doug Ducey announced that defeated Senate candidate and health repealer Martha McSally will be appointed to the Senate seat previously held by Sen. John McCain. Brad Woodhouse, executive director of Protect Our Care, released the following statement:

“No one fought harder to repeal and sabotage health care than Martha McSally, who has spent years on the front lines of taking away protections for pre-existing conditions. When her colleagues expressed reservations about supporting a bill which would have kicked 23 million Americans off of their coverage, gutted protections for people with pre-existing conditions, and imposed an ‘age tax’ on people over 50, she implored them to, “Get this $#$$ thing done!” When confronted about her positions, she lied. When she faced the voters, she was sent home by the people of Arizona. It’s outrageous that Governor Ducey would now appoint her to a post the voters said she didn’t deserve. Arizonans rejected Martha McSally because of her relentless war on health care, and when they have another chance, they will reject her again.”

BACKGROUND:

Health Care Was A Top Issue For Voters, Who Overwhelmingly Backed Kyrsten Sinema On It, Propelling Her To Victory. A Public Policy Polling election day survey of Arizona voters found that health care was a top issue for voters in the state and that they overwhelmingly favored Democrats on it, propelling Kyrsten Sinema to victory. 62% of voters said that health care was either a very important issue, or the most important issue to them. Those voters supported Sinema over Martha McSally 68-29. Although the final result was close overall, voters said they trusted Sinema over McSally on the issue of health care by 10 points, 49-39.” [PPP, 11/6]

  • Arizona Republic: Health Care Was A “Defining Issue” In McSally’s Loss. “Especially for women — who tend to be primary caregivers for children and aging parents — health care was a defining issue. Sinema made it the centerpiece of her campaign from the outset. Everywhere she went, she reminded people of her votes to maintain the Affordable Care Act, the eight-year-old federal law commonly referred to as Obamacare, which Republicans have tried to repeal or roll back… In the weeks before the election, McSally found herself racing to reposition herself on health care. She was on the defensive when trying to explain her votes to both fully repeal the ACA and repeal and replace. And, she insisted that she was leading the fight to ‘force insurance companies to cover pre-existing conditions,’ a characterization rated ‘Mostly False’ by Politifact.” [Arizona Republic, 11/14]
  • KTAR: McSally Refused To Ask Mark Brnovich To Remove Arizona From Anti-Obamacare Lawsuit. “In February, Arizona became one of 19 Republican-led states to join Texas in the lawsuit. That was before Obamacare, and its protections for pre-existing medical conditions, became a key issue in the November elections. Across the nation, voters most concerned with health care supported Democrats overwhelmingly. In Arizona, Republican U.S. Rep. Martha McSally’s record of voting to repeal Obamacare is considered a major factor in her loss to Democrat Kyrsten Sinema in their Senate race.” [KTAR, 12/17/18]

McSally Backed The American Health Care Act, Encouraging Her GOP Colleagues To “Get This [Bleeping] Thing Done.” “Speaker Paul Ryan (R-Wis.) and his GOP leadership team held what amounted to a pep rally for rank-and-file members in the Capitol basement Thursday morning as they predicted victory in their push to repeal and replace ObamaCare. Leaders played the ‘Rocky’ theme song as lawmakers walked into the meeting. Majority Leader Kevin McCarthy (R-Calif.) put an image of George S. Patton on the screen and read inspirational quotes from the general. ‘Let’s get this f–king thing done!’ Rep. Martha McSally (R-Ariz.) told her colleagues, according to sources in the room.” [The Hill, 5/4/17]

  • What Did The So-Called Affordable Health Care Act Mean for Arizona?
    • In 2026, 465,200 Arizonans would have lost coverage.
    • The nonpartisan Congressional Budget Office found that the AHCA would have raised premiums 20 percent in 2018.
    • The negative economic impact of the AHCA would have caused 60,714 Arizonans to lose their jobs by 2022.

Martha McSally Lied About Voting To Support Protections For Pre-Existing Conditions, Repeatedly Voting To Repeal The Affordable Care Act.

  • When Confronted About Voting To Take Away Protections For Pre-Existing Conditions, McSally Lied To The Face Of A Voter. [Matt McDermott Twitter, 11/3]

  • Politifact: McSally’s Claims To Support Protections For Pre-Existing Conditions Were “Mostly False.” “McSally claimed she’s ‘leading the fight’ to ‘force insurance companies to cover pre-existing conditions.’ It was the Obama-era Affordable Care Act that forced insurance companies to cover pre-existing conditions. McSally in 2015 voted in favor of a full repeal of the law. The bill directed House committees to offer new proposals, including one that provided people with pre-existing conditions access to affordable health coverage. In 2017, McSally voted for the American Health Care Act, a Republican proposal that kept the Affordable Care Act’s pre-existing conditions coverage. Despite language in the bill to protect people with pre-existing conditions, it included provisions that undermined that coverage and increased premiums for certain people, making insurance unaffordable in some cases, experts said. McSally did support an amendment to help reduce over 5 years increased premiums and out-of-pocket expenses that people with pre-existing conditions might face due to a state waiver allowed in the bill. McSally’s statement contains an element of truth but ignores critical facts that would give a different impression. We rate it Mostly False.” [Politifcat Arizona, 10/30]
  • 2016:  McSally Attacked “The Failed Top-Down Approach Of Obamacare” And Claimed It Was “Only Getting Worse.” “The failed top-down approach of Obamacare is leaving patients with less choice, not more, and it’s only getting worse. Instead of a law that favors bureaucracy over doing what’s best for each family and individual, we need a better approach that actually ensures affordable, quality health care for all Americans.” [Martha McSally Facebook Post, 8/16/16]
  • 2015:  McSally Voted For A Total Repeal Of The ACA.  McSally voted for HR 596, an act “to repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010.”  The bill also ordered House committees to develop a replacement that would “provide people with pre-existing conditions access to affordable health coverage,” but provided no specifics. [HR 596, Roll Call Vote #58, 2/3/15]
  • 2012:  McSally Supported Repealing The ACA: “A Vote For Obamacare Is A Vote Against Small Business And A Vote Against Fiscal Responsibility.”  “The United States House of Representatives today passed the Repeal of Obamacare Act, 244-185, with bi-partisan support.  Arizona’s 8th Congressional District Representative and candidate in the newly drawn 2nd District, Ron Barber, voted against the Act and in support of Obamacare.   ‘Mr. Barber’s vote to save Obamacare is example number 1 of why he needs to be replaced in Congress. Obamacare is costing Americans jobs and driving up our debt. Ron Barber has only been in Washington for 3 weeks and has already become part of the problem. A vote for Obamacare is a vote against small businesses and a vote against fiscal responsibility.'” [Martha McSally for Congress Press Release, 7/11/12]

John McCain’s Former Chief Of Staff Endorsed Kyrsten Sinema Over McSally. “Grant Woods, the former Republican attorney general of Arizona who also served as the first congressional chief of staff for the late Sen. John McCain (R-AZ), backed Rep. Kyrsten Sinema (D-AZ) in a new ad released Friday. ‘Kyrsten Sinema is a tremendous public servant,’ Woods says in the video backing her in the Senate race over Rep. Martha McSally (R-AZ).” [Daily Beast, 9/28]

Josh Hawley Gets His Wish: Texas Court Rips Health Care From Millions, Raises Premiums, and Guts Protections for People with Pre-Existing Conditions

Decision From Federal Judge Means:

Medicaid Expansion is Gone

Protections for Pre-Existing Conditions are Gone

Hundreds of Thousands of Missourians Will Lose Health Care

And Josh Hawley OWNS IT

Washington, D.C. –  On Friday night, conservative U.S. District Judge Reed O’Connor issued his ruling in Texas, et. al. vs. United States, et. al., siding with the Trump Administration and Republican governors and attorneys general, including Josh Hawley, arguably the most vocal and persistent proponent of overturning health care, to overturn the entire Affordable Care Act (ACA). Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

“Josh Hawley has led the charge to gut the ACA, championing a fraudulent lawsuit that would gut the protections Americans and Missourians depend on. If Josh Hawley has his way, 3 million Missourians with pre-existing conditions will lose their coverage; Missourians will once again be bankrupted by out-of-control medical bills; Missouri seniors will be subject to an age tax; and Missouri young adults will no longer be able to stay on their parents’ insurance until age 26. He falsely claimed throughout his campaign that he would protect these provisions, and his lies are now clear as day. Josh Hawley is the dog that caught the truck – unfortunately for Missourians, it is they who will be left to suffer accordingly.”

BACKGROUND:

Due to Judge O’Connor’s ruling on Friday, Republicans are one step closer to repealing the Affordable Care Act and eliminating key protections, unleashing — as the Trump Administration itself admitted in his court — “chaos” in our entire health care system. Under this ruling:

  • Marketplace tax credits and coverage for 10 million people: GONE.
  • Medicaid expansion currently covering 15 million people: GONE.
  • Protections for more than 130 million people with pre-existing conditions when they buy coverage on their own: GONE.
  • Allowing children to stay on their parents’ insurance until age 26: GONE.
  • Free annual wellness exams: GONE.
  • Ban on annual and lifetime limits: GONE.
  • Ban on insurance discrimination against women: GONE.
  • Contraception with no out-of-pocket costs: GONE.
  • Limit on out-of-pocket costs: GONE.
  • Requirement that insurance companies cover essential benefits like prescription drugs, maternity care, and hospitalization: GONE.
  • Improvements to Medicare, including reduced costs for prescription drugs: GONE.
  • Closed Medicare prescription drug donut hole: GONE.
  • Rules to hold insurance companies accountable: GONE.
  • Small business tax credits: GONE.

What’s at stake for Missouri:

  • The coverage that 103,000 Missourians gained through the ACA by 2015.
  • Protections for 2,495,900 Missourians who have a pre-existing health condition.
  • The health care of roughly 44,000 young adults in Missouri who have coverage because they can stay on their parents coverage until age 26.
  • The nearly 2,778,803 Missourians most of whom have employer coverage, who can access free preventive care at no cost.
  • The 2,148,000 Missourians with employer coverage who no longer have to worry about lifetime or annual limits.
  • Seniors’ drug savings — 102,643 Missouri seniors saved $108.2 million on drugs in 2017, an average of $1,054 per beneficiary because the ACA closed the Medicare prescription drug donut hole.

Because Judge O’Connor Sided With Republicans, 17.1 Million People Could Lose Their Coverage

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Be Put 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. One in four children, or roughly 17 million, have a pre-existing condition.
  • 68 million women. More than half of women and girls nationally have a pre-existing condition.
  • 30 million people aged 55-64. 84 percent of older adults, 30.5 million Americans between age 55 and 64, have a pre-existing condition.
  • 2,495,900 Missourians have a pre-existing condition.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have 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.

  • 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.
Conditions That Could Cost You Your Care:

  • AIDS/HIV
  • Alcohol/drug Abuse
  • Cerebral Palsy
  • Cancer
  • Heart Disease
  • Diabetes
  • Epilepsy
  • Kidney Disease
  • Severe Epilepsy
  • Sleep Apnea
  • Pregnancy
  • Muscular Dystrophy
  • Depression
  • Eating Disorders
  • Bipolar Disorder
Jobs You Could Be Denied Coverage Because Of:

  • Active military personnel
  • Air traffic controller
  • Body guard
  • Pilot
  • Meat packers
  • Taxi cab drivers
  • Steel metal workers
  • Law enforcement
  • Oil and gas exploration
  • Scuba divers
Medications That You Could Be Denied Health Care For Taking:

  • Anti-arthritic medications
  • Anti-diabetic medications (including insulin)
  • Anti-cancer medications
  • Anti-coagulant and anti-thrombotic medications
  • Medications used to treat autism
  • Anti-psychotics
  • Medications for HIV/AIDS
  • Growth hormone
  • Medication used to treat arthritis, anemia, and narcolepsy
  • Fertility Medication

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have The Power To Charge You More

  • More than 100 Million People With A Pre-Existing Condition Could Be Forced to Pay More. 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” thanks to the Republican lawsuit to repeal the Affordable Care Act.
  • Insurance Companies Could Charge Premium Surcharges in the Six Figures. If Judge O’Connor’s ruling is upheld, insurance companies would be able to charge people more because of a pre-existing condition. The health repeal bill the House passed in 2017 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 Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women 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 Could Face a $4,000 “Age Tax,” Including $4,554 in Missouri. Because Judge O’Connor sided with Republican lawmakers, insurance companies could be able to 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, including $4,554 in Missouri, according to the AARP.
  • Nine Million People in the Marketplaces Would Pay More for Coverage, Including 188,072 Missourians. If Judge O’Connor’s ruling is upheld, consumers would 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, including 188,072 in Missouri.
  • Seniors Would Have to Pay More for Prescription Drugs. Because Judge O’Connor sided with Republican lawmakers, seniors could 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 CMS report. In Missouri, 102,643 seniors each saved an average of $1,054.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have the Power to Limit the Care You Get, Even If You Have Insurance Through Your Employer

  • 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.
  • Reinstate Lifetime and Annual Limits. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage.
  • 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.

Court Ruling Helps Kevin Cramer Rip Away Protections for People with Pre-Existing Conditions

Decision From Federal Judge Means:

Medicaid Expansion is Gone

Protections for Pre-Existing Conditions are Gone

Hundreds of Thousands of North Dakotans Will Lose Health Care

And Kevin Cramer OWNS IT

Washington, D.C. –  On Friday night, conservative U.S. District Judge Reed O’Connor issued his ruling in Texas, et. al. vs. United States, et. al., siding with Republican attorneys general, governors, the Trump Administration, and Senator Kevin Cramer  to overturn the entire Affordable Care Act (ACA). Whether it’s repealing the individual mandate to pay for tax cuts or ramming through partisan repeal legislation, repeal cheerleader Kevin Cramer has done nothing but support the GOP’s efforts to strip coverage from hundreds of thousands of North Dakotans. Brad Woodhouse, executive director of Protect Our Care issued the following statement:

“Like two sides of the same coin, Kevin Cramer and the Trump Administration have worked relentlessly to undermine the Affordable Care Act. Today, they are one step closer to ripping health care away from millions of North Dakotans with pre-existing conditions like cancer, diabetes, or asthma. If this ruling isn’t overturned, Kevin Cramer will roll back the clock and take North Dakotans back to the days where insurance companies had the power to once again deny, drop, or charge more for coverage. They will once again have the power to impose annual or lifetime limits and charge women and seniors more based on their age and gender. Make no mistake, these actions will hurt hundreds of thousands of North Dakotans.”

BACKGROUND:

Due to Judge O’Connor’s ruling yesterday, Republicans are one step closer to repealing the Affordable Care Act and eliminating key protections, unleashing — as the Trump Administration itself admitted in his court — “chaos” in our entire health care system. Under this ruling:

  • Marketplace tax credits and coverage for 10 million people: GONE.
  • Medicaid expansion currently covering 15 million people: GONE.
  • Protections for more than 130 million people with pre-existing conditions when they buy coverage on their own: GONE.
  • Allowing children to stay on their parents’ insurance until age 26: GONE.
  • Free annual wellness exams: GONE.
  • Ban on annual and lifetime limits: GONE.
  • Ban on insurance discrimination against women: GONE.
  • Contraception with no out-of-pocket costs: GONE.
  • Limit on out-of-pocket costs: GONE.
  • Requirement that insurance companies cover essential benefits like prescription drugs, maternity care, and hospitalization: GONE.
  • Improvements to Medicare, including reduced costs for prescription drugs: GONE.
  • Closed Medicare prescription drug donut hole: GONE.
  • Rules to hold insurance companies accountable: GONE.
  • Small business tax credits: GONE.

What’s at stake for North Dakota:

  • The coverage that 15,000 North Dakotans gained through the ACA by 2015.
  • Protections for 316,000 North Dakotans who have a pre-existing health condition.
  • Coverage for 21,400 North Dakotans enrolled through the state’s Medicaid expansion.
  • The health care of roughly 7,000 young adults in North Dakota who have coverage because they can stay on their parents coverage until age 26.
  • The nearly 359,052 North Dakotans most of whom have employer coverage, who can access free preventive care at no cost.
  • The 253,000 North Dakotans with employer coverage who no longer have to worry about lifetime or annual limits.
  • Seniors’ drug savings — 11,110 North Dakota seniors saved $11.5 million on drugs in 2017, an average of $1,037 per beneficiary because the ACA closed the Medicare prescription drug donut hole.

Because Judge O’Connor Sided With Republicans, 17.1 Million People Could Lose Their Coverage

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Be Put 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. One in four children, or roughly 17 million, have a pre-existing condition.
  • 68 million women. More than half of women and girls nationally have a pre-existing condition.
  • 30 million people aged 55-64. 84 percent of older adults, 30.5 million Americans between age 55 and 64, have a pre-existing condition.
  • 316,000 North Dakotans have a pre-existing condition.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have 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.

  • 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
Conditions That Could Cost You Your Care:

  • AIDS/HIV
  • Alcohol/drug Abuse
  • Cerebral Palsy
  • Cancer
  • Heart Disease
  • Diabetes
  • Epilepsy
  • Kidney Disease
  • Severe Epilepsy
  • Sleep Apnea
  • Pregnancy
  • Muscular Dystrophy
  • Depression
  • Eating Disorders
  • Bipolar Disorder
Jobs You Could Be Denied Coverage Because Of:

  • Active military personnel
  • Air traffic controller
  • Body guard
  • Pilot
  • Meat packers
  • Taxi cab drivers
  • Steel metal workers
  • Law enforcement
  • Oil and gas exploration
  • Scuba divers
Medications That You Could Be Denied Health Care For Taking:

  • Anti-arthritic medications
  • Anti-diabetic medications (including insulin)
  • Anti-cancer medications
  • Anti-coagulant and anti-thrombotic medications
  • Medications used to treat autism
  • Anti-psychotics
  • Medications for HIV/AIDS
  • Growth hormone
  • Medication used to treat arthritis, anemia, and narcolepsy
  • Fertility Medication

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have The Power To Charge You More

  • More than 100 Million People With A Pre-Existing Condition Could Be Forced to Pay More. 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” thanks to the Republican lawsuit to repeal the Affordable Care Act.
  • Insurance Companies Could Charge Premium Surcharges in the Six Figures. If Judge O’Connor’s ruling is upheld, insurance companies would be able to charge people more because of a pre-existing condition. The health repeal bill the House passed in 2017 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 Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women 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 Could Face a $4,000 “Age Tax,” Including $3,709 in North Dakota. Because Judge O’Connor sided with Republican lawmakers, insurance companies could be able to 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, including $3,709 in North Dakota, according to the AARP.
  • Nine Million People in the Marketplaces Would Pay More for Coverage, Including 18,139 North Dakotans. If Judge O’Connor’s ruling is upheld, consumers would 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, including 18,139 in North Dakota.
  • Seniors Would Have to Pay More for Prescription Drugs. Because Judge O’Connor sided with Republican lawmakers, seniors could 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 CMS report. In North Dakota, 11,110 seniors each saved an average of $1,037.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have the Power to Limit the Care You Get, Even If You Have Insurance Through Your Employer

  • 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.
  • Reinstate Lifetime and Annual Limits. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage.
  • 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.

Because Judge O’Connor Sides With Republicans, Medicaid Expansion Could Be Repealed

  • Fifteen million people have coverage through the expanded Medicaid program, including 21,400 in North Dakota.

Court Ruling Helps Mike Braun Rip Away Protections for People with Pre-Existing Conditions

Decision From Federal Judge Means:

Medicaid Expansion is Gone

Protections for Pre-Existing Conditions are Gone

Hundreds of Thousands of Hoosiers Will Lose Health Care

And Mike Braun OWNS IT

Washington, D.C. –  On Friday night, conservative U.S. District Judge Reed O’Connor issued his ruling in Texas, et. al. vs. United States, et. al., siding with Republican attorneys general, governors, the Trump Administration, and Senator Mike Braun  to overturn the entire Affordable Care Act (ACA). Whether it’s repealing the individual mandate to pay for tax cuts or ramming through partisan repeal legislation, repeal cheerleader Mike Braun has done nothing but support the GOP’s efforts to strip coverage from hundreds of thousands of Hoosiers. Brad Woodhouse, executive director of Protect Our Care issued the following statement:

“Like two sides of the same coin, Mike Braun and the Trump Administration have worked relentlessly to undermine the Affordable Care Act. Today, they are one step closer to ripping health care away from millions of Hoosiers with pre-existing conditions like cancer, diabetes, or asthma. If this ruling isn’t overturned, Mike Braun will roll back the clock and take Hoosiers back to the days where insurance companies had the power to once again deny, drop, or charge more for coverage. They will once again have the power to impose annual or lifetime limits and charge women and seniors more based on their age and gender. Make no mistake, these actions will hurt hundreds of thousands of Hoosiers.”

BACKGROUND:

Due to Judge O’Connor’s ruling yesterday, Republicans are one step closer to repealing the Affordable Care Act and eliminating key protections, unleashing — as the Trump Administration itself admitted in his court — “chaos” in our entire health care system. Under this ruling:

  • Marketplace tax credits and coverage for 10 million people: GONE.
  • Medicaid expansion currently covering 15 million people: GONE.
  • Protections for more than 130 million people with pre-existing conditions when they buy coverage on their own: GONE.
  • Allowing children to stay on their parents’ insurance until age 26: GONE.
  • Free annual wellness exams: GONE.
  • Ban on annual and lifetime limits: GONE.
  • Ban on insurance discrimination against women: GONE.
  • Contraception with no out-of-pocket costs: GONE.
  • Limit on out-of-pocket costs: GONE.
  • Requirement that insurance companies cover essential benefits like prescription drugs, maternity care, and hospitalization: GONE.
  • Improvements to Medicare, including reduced costs for prescription drugs: GONE.
  • Closed Medicare prescription drug donut hole: GONE.
  • Rules to hold insurance companies accountable: GONE.
  • Small business tax credits: GONE.

What’s at stake for Indiana:

  • The coverage that 339,000 Hoosiers gained through the ACA by 2015.
  • Protections for 2,745,700 Hoosiers who have a pre-existing health condition.
  • Coverage for 412,700 Hoosiers enrolled through Indiana’s Medicaid expansion.
  • The health care of roughly 50,000 young adults in Indiana who have coverage because they can stay on their parents coverage until age 26.
  • The nearly 2,915,827 Hoosiers most of whom have employer coverage, who can access free preventive care at no cost.
  • The 2,259,000 Hoosiers with employer coverage who no longer have to worry about lifetime or annual limits.
  • Seniors’ drug savings — 121,432 Indiana seniors saved $135.2 million on drugs in 2017, an average of $1,114 per beneficiary because the ACA closed the Medicare prescription drug donut hole.

Because Judge O’Connor Sided With Republicans, 17.1 Million People Could Lose Their Coverage

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Be Put 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. One in four children, or roughly 17 million, have a pre-existing condition.
  • 68 million women. More than half of women and girls nationally have a pre-existing condition.
  • 30 million people aged 55-64. 84 percent of older adults, 30.5 million Americans between age 55 and 64, have a pre-existing condition.
  • 2,745,700 Hoosiers have a pre-existing condition.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have 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.

  • 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
Conditions That Could Cost You Your Care:

  • AIDS/HIV
  • Alcohol/drug Abuse
  • Cerebral Palsy
  • Cancer
  • Heart Disease
  • Diabetes
  • Epilepsy
  • Kidney Disease
  • Severe Epilepsy
  • Sleep Apnea
  • Pregnancy
  • Muscular Dystrophy
  • Depression
  • Eating Disorders
  • Bipolar Disorder
Jobs You Could Be Denied Coverage Because Of:

  • Active military personnel
  • Air traffic controller
  • Body guard
  • Pilot
  • Meat packers
  • Taxi cab drivers
  • Steel metal workers
  • Law enforcement
  • Oil and gas exploration
  • Scuba divers
Medications That You Could Be Denied Health Care For Taking:

  • Anti-arthritic medications
  • Anti-diabetic medications (including insulin)
  • Anti-cancer medications
  • Anti-coagulant and anti-thrombotic medications
  • Medications used to treat autism
  • Anti-psychotics
  • Medications for HIV/AIDS
  • Growth hormone
  • Medication used to treat arthritis, anemia, and narcolepsy
  • Fertility Medication

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have The Power To Charge You More

  • More than 100 Million People With A Pre-Existing Condition Could Be Forced to Pay More. 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” thanks to the Republican lawsuit to repeal the Affordable Care Act.
  • Insurance Companies Could Charge Premium Surcharges in the Six Figures. If Judge O’Connor’s ruling is upheld, insurance companies would be able to charge people more because of a pre-existing condition. The health repeal bill the House passed in 2017 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 Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women 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 Could Face a $4,000 “Age Tax,” Including $2,916 in Indiana. Because Judge O’Connor sided with Republican lawmakers, insurance companies could be able to 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, including $2,916 in Indiana, according to the AARP.
  • Nine Million People in the Marketplaces Would Pay More for Coverage, Including 102,375 Hoosiers. If Judge O’Connor’s ruling is upheld, consumers would 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, including 102,375 in Indiana.
  • Seniors Would Have to Pay More for Prescription Drugs. Because Judge O’Connor sided with Republican lawmakers, seniors could 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 CMS report. In Indiana, 221,432 seniors each saved an average of $1,114.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have the Power to Limit the Care You Get, Even If You Have Insurance Through Your Employer

  • 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.
  • Reinstate Lifetime and Annual Limits. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage.
  • 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.

Because Judge O’Connor Sides With Republicans, Medicaid Expansion Could Be Repealed

Fifteen million people have coverage through the expanded Medicaid program, including 412,700 in Indiana.

Court Ruling Helps Rick Scott Rip Away Protections for People with Pre-Existing Conditions

Decision From Federal Judge Means:

Medicaid Expansion is Gone

Protections for Pre-Existing Conditions are Gone

Hundreds of Thousands of Floridians Will Lose Health Care

And Rick Scott OWNS IT

Washington, D.C. –  On Friday night, conservative U.S. District Judge Reed O’Connor issued his ruling in Texas, et. al. vs. United States, et. al., siding with Republican attorneys general, governors, the Trump Administration, and Senator Rick Scott  to overturn the entire Affordable Care Act (ACA). Whether it’s repealing the individual mandate to pay for tax cuts or ramming through partisan repeal legislation, repeal cheerleader Rick Scott has done nothing but support the GOP’s efforts to strip coverage from hundreds of thousands of Floridians. Brad Woodhouse, executive director of Protect Our Care issued the following statement:

“Like two sides of the same coin, Rick Scott and the Trump Administration have worked relentlessly to undermine the Affordable Care Act. Today, they are one step closer to ripping health care away from millions of Floridians with pre-existing conditions like cancer, diabetes, or asthma. If this ruling isn’t overturned, Rick Scott will roll back the clock and take Floridians back to the days where insurance companies had the power to once again deny, drop, or charge more for coverage. They will once again have the power to impose annual or lifetime limits and charge women and seniors more based on their age and gender. Make no mistake, these actions will hurt hundreds of thousands of Floridians.”

BACKGROUND:

Due to Judge O’Connor’s ruling on Friday, Republicans are one step closer to repealing the Affordable Care Act and eliminating key protections, unleashing — as the Trump Administration itself admitted in his court — “chaos” in our entire health care system. Under this ruling:

  • Marketplace tax credits and coverage for 10 million people: GONE.
  • Medicaid expansion currently covering 15 million people: GONE.
  • Protections for more than 130 million people with pre-existing conditions when they buy coverage on their own: GONE.
  • Allowing children to stay on their parents’ insurance until age 26: GONE.
  • Free annual wellness exams: GONE.
  • Ban on annual and lifetime limits: GONE.
  • Ban on insurance discrimination against women: GONE.
  • Contraception with no out-of-pocket costs: GONE.
  • Limit on out-of-pocket costs: GONE.
  • Requirement that insurance companies cover essential benefits like prescription drugs, maternity care, and hospitalization: GONE.
  • Improvements to Medicare, including reduced costs for prescription drugs: GONE.
  • Closed Medicare prescription drug donut hole: GONE.
  • Rules to hold insurance companies accountable: GONE.
  • Small business tax credits: GONE.

What’s at stake for Florida:

  • The coverage that 1,597,000 Floridians gained through the ACA by 2015.
  • Protections for 7,810,300 Floridians who have a pre-existing health condition.
  • The health care of roughly 132,000 young adults in Florida who have coverage because they can stay on their parents coverage until age 26.
  • The nearly 7,289,873 Floridians most of whom have employer coverage, who can access free preventive care at no cost.
  • The 5,587,000 Floridians with employer coverage who no longer have to worry about lifetime or annual limits.
  • Seniors’ drug savings — 344,343 Florida seniors saved $367.8 million on drugs in 2017, an average of $1,068 per beneficiary because the ACA closed the Medicare prescription drug donut hole.

Because Judge O’Connor Sided With Republicans, 17.1 Million People Could Lose Their Coverage

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Be Put 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. One in four children, or roughly 17 million, have a pre-existing condition.
  • 68 million women. More than half of women and girls nationally have a pre-existing condition.
  • 30 million people aged 55-64. 84 percent of older adults, 30.5 million Americans between age 55 and 64, have a pre-existing condition.
  • 7,810,300 Floridians have a pre-existing condition.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have 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.

  • 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
Conditions That Could Cost You Your Care:

  • AIDS/HIV
  • Alcohol/drug Abuse
  • Cerebral Palsy
  • Cancer
  • Heart Disease
  • Diabetes
  • Epilepsy
  • Kidney Disease
  • Severe Epilepsy
  • Sleep Apnea
  • Pregnancy
  • Muscular Dystrophy
  • Depression
  • Eating Disorders
  • Bipolar Disorder
Jobs You Could Be Denied Coverage Because Of:

  • Active military personnel
  • Air traffic controller
  • Body guard
  • Pilot
  • Meat packers
  • Taxi cab drivers
  • Steel metal workers
  • Law enforcement
  • Oil and gas exploration
  • Scuba divers
Medications That You Could Be Denied Health Care For Taking:

  • Anti-arthritic medications
  • Anti-diabetic medications (including insulin)
  • Anti-cancer medications
  • Anti-coagulant and anti-thrombotic medications
  • Medications used to treat autism
  • Anti-psychotics
  • Medications for HIV/AIDS
  • Growth hormone
  • Medication used to treat arthritis, anemia, and narcolepsy
  • Fertility Medication

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have The Power To Charge You More

  • More than 100 Million People With A Pre-Existing Condition Could Be Forced to Pay More. 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” thanks to the Republican lawsuit to repeal the Affordable Care Act.
  • Insurance Companies Could Charge Premium Surcharges in the Six Figures. If Judge O’Connor’s ruling is upheld, insurance companies would be able to charge people more because of a pre-existing condition. The health repeal bill the House passed in 2017 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 Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women 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 Could Face a $4,000 “Age Tax,” Including $4,007 in Florida. Because Judge O’Connor sided with Republican lawmakers, insurance companies could be able to 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, including $4,007 in Florida, according to the AARP.
  • Nine Million People in the Marketplaces Would Pay More for Coverage, Including 1,508,784 Floridians. If Judge O’Connor’s ruling is upheld, consumers would 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, including 1,508,784 in Florida.
  • Seniors Would Have to Pay More for Prescription Drugs. Because Judge O’Connor sided with Republican lawmakers, seniors could 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 CMS report. In Florida, 344,343 seniors each saved an average of $1,068.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have the Power to Limit the Care You Get, Even If You Have Insurance Through Your Employer

  • 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.
  • Reinstate Lifetime and Annual Limits. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage.
  • 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.

“The Assurances Are Worthless”: Editorials From Coast to Coast Hammer Republicans Over Latest Attack on the Affordable Care Act

On Friday night, hand-picked, conservative, right-wing federal District Court Judge Reed O’Connor ruled the entire Affordable Care Act unconstitutional. His decision would end protections for people with pre-existing conditions, re-institute lifetime limits on coverage, implement an age tax on older Americans, end Medicaid expansion, and take away coverage from tens of millions of Americans. In short, an absolute disaster for Americans and their health care – and editorials across the country have been quick to note make this clear. Here’s a sampling:

The ruling has been criticized by editorial boards:

Los Angeles Times: “The Relentless, Wreck-It-Ralph Attacks On The Law In Congress And The Courts Should Have Ended Last Year.” “ By handing a victory to 18 Republican state attorneys general and two Republican governors, however, the judge has threatened to put healthcare out of reach for millions of lower-income Americans, undo important insurance reforms and toss out federal efforts to improve the cost and quality of care. The ruling will be appealed and has no immediate effect. Yet by issuing it before the end of open enrollment, Judge Reed O’Connor needlessly sowed confusion and, potentially, discouraged some people from obtaining coverage for 2019. That’s unforgivable. Worse yet, it could result in the entire law being tossed out by the courts. We get it — there are plenty of Republicans who don’t like major features of the ACA and resent the way it was enacted. But the relentless, Wreck-It-Ralph attacks on the law in Congress and the courts should have ended last year, when Republicans could get neither a pure repeal nor a repeal-and-replace plan through the Congress they controlled even on a simple majority vote.” [Los Angeles Times, 12/15]

Bloomberg: Republican Assurances On Pre-Existing Conditions “Were Worthless.” “‘Everybody I know in the Senate — everybody — is in favor of maintaining coverage for pre-existing conditions,’ Senate Majority Leader Mitch McConnell said in June. ‘All Republicans support people with pre-existing conditions, and if they don’t, they will after I speak to them. I am in total support,’ President Trump tweeted in October. This was during the midterm election campaign, when the Republicans were pedaling backward to convince America that they’d no intention of taking away the protections of the Affordable Care Act. Ignore the efforts in Congress to repeal the law, they told voters; don’t worry about the Justice Department joining a legal challenge to ACA, asking to strike down coverage of people with preexisting conditions at no extra cost. The assurances were worthless. A court has not only thrown out protections for preexisting conditions; it has ruled the ACA as a whole unconstitutional — including the Medicaid expansion, the requirement that large employers offer health-insurance benefits, the subsidies for low-income buyers of insurance on the health exchanges, even the exchanges themselves.” [Bloomberg, 12/16]

It has been assailed by legal experts:

Jonathan Adler and Abbe Gluck, New York Times: “This Decision Makes A Mockery Of The Rule Of Law And The Basic Principles Of Democracy.” “A ruling this consequential had better be based on rock-solid legal argument. Instead, the opinion by Judge Reed O’Connor is an exercise of raw judicial power, unmoored from the relevant doctrines concerning when judges may strike down a whole law because of a single alleged legal infirmity buried within. We were on opposing sides of the 2012 and 2015 Supreme Court challenges to the Affordable Care Act, and we have different views of the merits of the act itself. But as experts in the field of statutory law, we agree that this decision makes a mockery of the rule of law and basic principles of democracy — especially Congress’s constitutional power to amend its own statutes and do so in accord with its own internal rules.” [New York Times, 12/15]

Nicholas Bagley, Washington Post: “Don’t Mistake [This Ruling] For The Rule Of Law.” “To put it bluntly, [the ruling] makes zero sense… In perhaps the most remarkable passage in a remarkable opinion, he wrote that the 2017 Congress ‘intended to preserve the Individual Mandate because the 2017 Congress, like the 2010 Congress, knew that provision is essential to the ACA.’ Your jaw should be on the floor. On no account did Congress in 2017 ‘intend to preserve’ the individual mandate. It meant to get rid of the loathed mandate — and it did, by eliminating the penalty that gave it force and effect… So nothing changes for the time being. And nothing should change. The legal arguments in previous rounds of litigation over the ACA may have been weak, but they were not frivolous. This case is different; it’s an exercise of raw judicial activism. Don’t for a moment mistake it for the rule of law.” [Washington Post, 12/16]

Cristan Farias, New York Times: “Shocking Even Conservative Legal Experts, The Trump Administration Lent Its Support To The Texas Lawsuit.” “The ruling, issued late on Friday and only one day before the end of the law’s annual open enrollment period, is not a model of constitutional or statutory analysis. It’s instead a predictable exercise in motivated reasoning — drafted by a jurist with a history of ruling against policies and laws advanced by President Barack Obama… Shocking even conservative legal experts, the Trump administration fell for this spurious argument and lent its support to the Texas lawsuit — which, if successful, would render all of the marquee provisions of Obamacare, like protections for patients with pre-existing conditions, null… This all-out assault on health care is one reason Democrats did so well in the midterm elections, as voters rejected anti-Obamacare candidates at the polls. They included several lawmakers who had gleefully voted for Mr. Trump’s tax bill less than a year earlier.” [New York Times, 12/15]

And its drastic consequences have been made clear:

Jonathan Gruber, Boston Globe: “If This Law Is Struck Down, We Will Return To The Bad Old Days Where Insurers Could Deny Coverage To Individuals Who Are Ill.” “Even though the Trump administration has significantly weakened the ACA, 17 million Americans have gained coverage through the law. Perhaps more importantly, the estimated 133 million Americans with a pre-existing condition have access to affordable coverage should they need it. If this law is struck down, we will return to the bad old days where insurers could deny coverage to individuals who are ill, or charge them many times more than the healthy. That’s not all that will be lost with a repeal of the ACA. Children will no longer be protected by their parents’ insurance plans until age 26. Insurers will be able to once again limit how much healthcare spending they cover in any year, and there will no longer be a cap on what individuals have to spend out of pocket on their medical costs. Millions of Americans who don’t read the fine print of their insurance contracts could once again buy insurance that leaves them with tens of thousands of dollars in uncovered medical bills.” [Boston Globe, 12/15]

  • Gruber: “It Isn’t Just The Health Of Our Citizens That Is At Risk Here – It Is The Health Of Our Democracy.” “But it isn’t just the health of our citizens that is at risk here – it is the health of our democracy. We have a law that was first passed when Democrats controlled both houses of Congress and the presidency. It was then thoroughly reviewed, debated, and voted on when the Republicans controlled both houses of Congress and the presidency. The Republicans decided that the proper outcome was an ACA with no mandate, and the outcome of that process was a weaker but still functional ACA. If the courts overturn this outcome, it is an attack on the very process of representative government in the US.” [Boston Globe, 12/15]

Evan Mintz, Houston Chronicle: We’ll Wait To See Whether Insurance Companies Will Once Again Be Allowed To Discriminate Against People With Pre-existing Conditions Or Sell Plans That Don’t Cover Core Medical Needs.” “This district court didn’t issue an injunction, so the nation will have to wait for the inevitable appeals to see if we lose all the protections in the groundbreaking law. We’ll wait to see whether insurance companies will once again be allowed to discriminate against people with pre-existing conditions or sell plans that don’t cover core medical needs. Millions of Americans are left wondering if our nation is going to be thrust back into an age before the ACA, also known as Obamacare, when medical bankruptcies were skyrocketing and people were afraid to change their jobs for fear being denied coverage. If you’re one of these Americans, feel free to thank Texas Attorney General Ken Paxton, who led the plaintiffs in the lawsuit. Paxton — who is currently under indictment for fraud — now bears the burden of helping his fellow Texans understand what happens if the ACA is eventually struck down for good.” [Houston Chronicle, 12/16]

Derek Rapp, The Hill: This Ruling “Threatens Coverage Of Pre-Existing Conditions [And] Leaves MIllions In Jeopardy.” “Coverage for pre-existing conditions is critical for the millions of Americans living with chronic diseases, and it’s a matter of decency and existing law. Until the Affordable Care Act, people with pre-existing conditions were denied insurance coverage, charged higher premiums and offered limited benefits. Friday’s decision by a federal judge in Texas that threatens coverage of pre-existing conditions leaves millions in jeopardy a month after the topic dominated the midterm elections.” [The Hill, 12/15]

As millions of Americans go to bed tonight anxious about the future of their health care, whether this country will return to the days of discrimination against those with pre-existing conditions and denied coverage claims and surprise medical bankruptcies, Donald Trump and Congressional Republicans will continue to own every last worry.

Ignoring Clear Lessons of the Midterm Elections, Republicans Celebrate Decision Ending Protections for Pre-Existing Conditions and Ripping Health Care Away from Millions

On Friday, hand-picked, conservative, right-wing federal District Court Judge Reed O’Connor ruled the entire Affordable Care Act unconstitutional. His decision would end protections for people with pre-existing conditions, re-institute lifetime limits on coverage, implement an age tax on older Americans, end Medicaid expansion, and take away coverage from tens of millions of Americans. In short, an absolute disaster for Americans and their health care.

Despite this, Republicans are praising the decision:

CNN: President Trump “Immediately Tweeted In Celebration.” “President Donald Trump, who campaigned in 2016 on a promise to undo Obamacare, was thwarted in Congress last year by a lone vote from the late Arizona Republican Sen. John McCain. Trump immediately tweeted in celebration on Friday and called on Congress to act. ‘As I predicted all along, Obamacare has been struck down as an UNCONSTITUTIONAL disaster! Now Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions. Mitch and Nancy, get it done!’ Trump wrote. He later added, ‘Wow, but not surprisingly, ObamaCare was just ruled UNCONSTITUTIONAL by a highly respected judge in Texas. Great news for America!’” [CNN, 12/15]

Washington Examiner: Republicans Are Using The Ruling To Once Again Revive Repeal. “Republicans revived their calls to replace Obamacare in the wake of a federal judge declaring the healthcare law unconstitutional, but Democrats indicated they had no plans to abandon the legal battle ahead… Sarah Sanders, the White House press secretary, said Friday night that she expected it would land before the high court. ‘The judge’s decision vindicates President Trump’s position that Obamacare is unconstitutional,’ she said… The actions in the courts are another way that Republicans are aiming to undo the law. The latest ruling follows a slew of challenges Obamacare has faced both in Congress and in the courts since it passed.” [Washington Examiner, 12/15]

CMS Administrator Seema Verma: “Obamacare Has Been Struck Down.” “Obamacare has been struck down by a highly respected judge. The judge’s decision vindicates President Trump’s position that Obamacare is unconstitutional. Once again, the President calls on Congress to replace Obamacare and act to protect people with preexisting conditions…and provide Americans with quality affordable healthcare. We expect this ruling will be appealed to the Supreme Court. Pending the appeal process, the law remains in place.” [Seema Verma Twitter, 12/15]

House Energy and Commerce Chair Greg Walden: We Need New Health Care Legislation. “Energy and Commerce Committee Chairman Greg Walden, R-Ore., echoed the calls for new legislation. ‘We have a rare opportunity for truly bipartisan healthcare reform,’ he said.” [Washington Examiner, 12/15]

House Ways and Means Chair Kevin Brady: Ruling Was “No Surprise” Because ACA Was “Poorly Written, Crafted By Democrats Behind Closed Doors.” “No surprise. Poorly written, crafted by Democrats behind closed doors & stuffed with special interests that drove up health costs for millions of working Americans. Time to start over – both parties working together this time to LOWER costs.” [Kevin Brady Twitter, 12/15]

Texas Attorney General Ken Paxton: Ruling Lets Congress Replace “Failed Social Experiment” That Is The Affordable Care Act. “Meanwhile Texas Attorney General Ken Paxton is declaring victory. Paxton praised the ruling as halting an unconstitutional exertion of power by the federal government. ‘Our lawsuit seeks to effectively repeal Obamacare, which will give President Trump and Congress the opportunity to replace the failed social experiment with a plan that ensures Texans and all Americans will again have greater choice about what health coverage they need and who will be their doctor,’ said Paxton’s statement.” [Buzzfeed, 12/15]

The groundwork for the lawsuit was laid by the Trump Administration:

CNBC: While President Trump Was Unable To Repeal ACA, He Was “Able To Dismantle Key Parts Of It.” “While President Donald Trump was previously unable to repeal Obamacare, he was able to dismantle key parts of it that several health policy researchers are blaming for much of the drop in enrollment this year. He applauded the judge’s ruling in a tweet late Friday. White House Press Secretary Sarah Huckabee Sanders released a statement praising the ruling. ‘Obamacare has been struck down by a highly respected judge. The judge’s decision vindicates President Trump’s position that Obamacare is unconstitutional.’” [CNBC, 12/14]

Vice News: Lawsuit Only Possible Because Trump’s Department Of Justice “Made The Unusual Decision To Not Defend Existing Federal Law.” “The lawsuit to dismantle the program was led by political leaders from 20 conservative-leaning states that filed a complaint in February, arguing the law couldn’t constitutionally stand without the tax… The Justice Department made the unusual decision to not defend existing federal law, siding with the states instead. California’s attorney general, Xavier Becerra, is leading the defense of the health care law.” [Vice, 12/15]

Washington Times: The Trump Administration “Did Not Defend The Law In Court.” “The Trump administration did not defend the law in court, and sided with the states on some points. Yet it asked the judge to wait until open enrollment was complete, to avoid chaos in the markets. But that didn’t happen.” [Washington Times, 12/14]

And it is the American people would be left to suffer:

CBS News: Invalidated Law Would Mean The End Of Protections For People With Pre-Existing Conditions And The Ability Of Children To Stay On Their Parents’ Coverage Until Age 26. ““Democrats were able to retake the House in large part because they campaigned on health care issues, warning that Republicans would try to strip away some of the more popular provisions of the ACA, such as protection for pre-existing conditions. Around 130 million people in the United States have pre-existing conditions, and without the ACA, insurers would no longer be required to cover those conditions. If the law is invalidated, it could scrap other well-liked sections of the law, such as the part that allows parents to keep young adult children on their health care coverage until age 26.” [CBS News, 12/15]

Associated Press: Coverage For 20 Million Americans At Stake Under This Ruling. “About 20 million people have gained health insurance coverage since the law passed in 2010 without a single Republican vote. Currently, about 10 million have subsidized private insurance through the health law’s insurance markets, while an estimated 12 million low-income people are covered through its Medicaid expansion.” [AP, 12/15]

  • Fox News: Ruling “Could Suddenly Disrupt The Health Insurance Of Millions Of Americans.” “The Affordable Care Act, also known as Obamacare, was struck down by a Texas judge on Friday, a move that could suddenly disrupt the health insurance status of millions of Americans. The decision comes amid a six-week open enrollment period for the program.” [Fox News, 12/15]
  • CNN: Ruling “Throws Into Doubt The Future Of Health Coverage For Millions Of Americans.” “Legal experts say the ruling won’t immediately affect Americans’ health coverage, and a group of states led by California is already vowing to appeal. But the invalidation of the landmark health care law popularly known as Obamacare throws into doubt the future of health coverage for millions of Americans on the Obamacare exchanges and in Medicaid expansion.” [CNN, 12/15]

Politico: “Even The Trump Administration’s Own Plans To Lower Drug Prices” Would Be Illegal Under Ruling. “Expanded Medicaid for millions. Penalties for poorly performing hospitals. Even the Trump administration’s own plans to lower drug prices. Those and many other initiatives would all be illegal under a federal judge’s sweeping decision that the entire Affordable Care Act must be struck down — the latest shock to the nation’s health system after a decade of upheavals, including two fights over the ACA that reached the Supreme Court.” [Politico, 12/15]