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Mitch Harle

Ohio Is The Next Stop On President Trump’s Medicaid Madness Tour

Washington, DC — Today, the Centers for Medicare and Medicaid Services approved Ohio’s request to implement work requirements on its Medicaid program. In their waiver request, Ohio officials predicted that roughly 18,000 people will lose their Medicaid eligibility. Brad Woodhouse, executive director of Protect Our Care, issued a statement in response:

“Ohio is the next stop on the Trump administration’s Medicaid sabotage tour. The work requirements approved by the administration will have disastrous effects on Ohioans. By Ohio’s own admission, nearly half of the people with coverage through Medicaid who will be subjected to work requirements will lose their health care; this is similar to the consequences we’ve seen in Arkansas where 18,000 people have already had their coverage stripped away from them. It’s high time for the administration to stop playing accomplice to states who are intent on denying people health care and start working on policies that will lower costs and improve care for all Americans.

NEW POLL: Voters Overwhelmingly Reject Cuts to Medicare and Medicaid in President Trump’s Budget Proposal

New Poll From PPP Found That Voters are Less Likely to Support President Trump’s Reelection After He Broke His Campaign Promise by Proposing Cuts to Medicare and Medicaid After Giving Tax Breaks to Big Corporations

Washington DC — Today, a new poll from Public Policy Polling (PPP) for Protect Our Care shows overwhelming voter rejection of President Trump’s newly released budget proposal because of its cuts to Medicare and Medicaid. Despite Trump’s campaign promise to oppose cuts to Medicare and Medicaid, he proposed a budget that makes these cuts after he already gave new tax breaks to big corporations. 60% of voters say they oppose Trump’s proposed Medicaid cuts, 72% say they oppose the Medicare cuts and 50% of voters say they’re less likely to vote for him because of these proposed cuts.

“This poll shows the Trump administration is acting against the will of the American people by proposing a budget that guts critical health care programs relied on by millions of Americans, especially impacting seniors and children,” said Brad Woodhouse, executive director of Protect Our Care. “These massive cuts to Medicare and Medicaid are even more egregious when considering the billions of dollars in tax breaks that the administration has showered on health insurance and drug companies. It’s way past time for the president and his Republican allies to wake up and stop their war on health care.”

Key findings from the survey include:

Voters overwhelmingly oppose the cuts to Medicare and Medicaid in Trump’s budget:

  • 72% oppose the Medicare Cuts in Trump’s Budget. By a 59-point margin (72% to 13%) voters oppose the proposed budget because it includes an $845-billion in cuts to Medicare. 81% of voters over the age of 65 say they oppose these cuts, and 70% of Independents also oppose the cuts to Medicare.
  • 60% oppose the Medicaid Cuts in Trump’s Budget. By a 36-point margin (60% to 24%) voters oppose the proposed budget because it includes a more than $1-trillion cut to Medicaid. 59% of Independents say they oppose the cuts to Medicaid.

Voters say the budget makes them less likely to support Trump for reelection:

  • 50% of voters say they’re less likely to support Trump because he broke his promise not to cut Medicare and Medicaid – including 54% with independents – while only 14% say they’re more likely to support him.
  • 54% of voters say they’re less likely to support Trump because he cut Medicare & Medicaid after giving away hundreds of billions of dollars in new tax breaks for big corporations, including 57% of voters people over age 65 and 51% of Independents. Just 15% say they’re more likely to support Trump due to the cuts.
  • 52% of voters say they’d vote for Trump’s Democratic opponent for President if the election were held today, compared to just 41% who say they’d vote for Trump.

Public Policy Polling surveyed 661 national voters by telephone on March 13th and 14th, on behalf of Protect Our Care. The survey’s margin of error is +/-3.8%.

Secretary Azar Admits That HHS Is Trying To Gut Medicaid Without Congressional Approval

Washington, DC — Today, Health and Human Services (HHS) Secretary Alex Azar answered questions from Senator Bob Casey (D-PA) during a Senate Finance Committee hearing on Trump’s FY20 budget about HHS having direct conversations with various states about block granting Medicaid, all without the approval of Congress. Leslie Dach, chair of Protect Our Care, released the following statement in response:

“The block grants that Secretary Azar and Trump’s Republicans are pushing are just a thinly veiled attempt to slash Medicaid funding and rip away people’s health care, which Americans vehemently oppose. Congress has repeatedly rejected this disastrous idea and so did voters just months ago in November. It’s time for Secretary Azar to come clean with the American people about his true intention to gut Medicaid and take health care away from millions of Americans.”

Five Things You Should Know Before Sec. Azar Testifies Today

Yesterday, Sec. Azar used his testimony before the Energy and Commerce Committee on the HHS FY20 budget to distract from the damage his agency has done and is going into overdrive to continue to do to Americans’ health care. Unfortunately for Azar, he can’t hide the truth. Here’s what you should know before he testifies today at the House Appropriations Labor-HHS Subcommittee:

  1. Trump’s Budget Would Repeal The Affordable Care Act And Its Protections For People With Pre-existing Conditions. In his testimony yesterday, Azar falsely claimed that Trump’s budget requires genuine protections for people with pre-existing conditions. The truth is just the opposite. Trump’s budget would repeal Affordable Care Act, completely eliminating its protections for those with pre-existing conditions.
  2. The Trump Administration Is Actively Pushing Consumers To Purchase Junk Plans That Can Discriminate Against People With Pre-existing Conditions. Though Azar said it was important that consumers be “fully aware” that junk plans do not cover pre-existing conditions, the truth is that his administration is pushing consumers to sign up for those very plans. In July, CMS announced that it would encourage health navigator groups that are intended to help consumers enroll in ACA-compliant health plans to instead direct consumers to junk plans that lack important consumer protections.
  3. Medicaid Work Requirements Inherently Increase Paperwork And Red Tape, Causing Eligible People To Lose Coverage. The Trump administration’s budget seeks to impose a national Medicaid work requirement, despite estimates that it would cause millions to lose coverage. Already, an Arkansas work requirement has led more than 18,000 to lose coverage. Yesterday Azar claimed that he did not have data on why so many lost coverage, but multiple studies and news reports have found high levels of confusion and lack of awareness among Medicaid enrollees. The truth is simple: work requirements add barriers and reduce access to health care for people who desperately need it.
  4. Republicans Are Not Trying To Give States More Choices, They Are Trying To Dismantle Medicaid. Azar has marketed a number of policies — block granting Medicaid, imposing work requirements, allowing partial expansion — as policies that give states more choices. Not coincidentally, these policies would all radically transform Medicaid and give states the power to restrict access to their Medicaid programs.
  5. Reminder: Republicans Are So Eager To End Pre-existing Condition Protections That Trump Held A Garden Party At The Prospect Of Signing Into Law A Bill That Would Let Insurance Companies Discriminate Against People With Pre-existing Conditions. When he claimed yesterday that Trump would never sign into law a bill that does not protect people with pre-existing conditions, Azar seemed to forget that Trump threw a party in the Rose Garden at the prospect of signing the House repeal bill, which would have let insurance companies charge people with pre-existing conditions significantly more, into law. Trump was so excited that NBC wrote, “Trump, GOP Leaders Take Victory Lap After House Passes ‘Trumpcare.’”

Trump’s Budget Reveals His True Agenda: Sabotage Americans’ Health Care

This morning, the Trump administration released its proposed FY20 budget, which revives the failed Graham-Cassidy repeal bill and calls for massive cuts to Medicaid, Medicare, and HHS. The administration’s budget reveals just how steadfast it remains in trying to take away Americans’ health care. Here’s a look at how it attempts to do so

  1. President Trump’s Budget Revives The Failed Graham-Cassidy Repeal Bill That Would Repeal Medicaid Expansion And ACA Subsidies Only To Replace Them With Inadequate Block Grants, Ultimately Cutting Medicaid By More Than $1 Trillion. By shifting to a block grant program and eliminating funding for Medicaid expansion, the administration would cut Medicaid by more than $1 trillion over 10 years.
  2. The Budget Would Impose Onerous Work Requirements On Medicaid Enrollees Nationwide, Which Is Estimated To Cause Up To 4 Million People To Lose Coverage. This unprecedented move would completely alter Medicaid as we know it, requiring people nationwide to meet onerous work and reporting requirements in order to maintain their Medicaid coverage. The Kaiser Family Foundation has estimated that a national Medicaid work requirement would cause up to 4 million people to lose coverage, most of them losing coverage due to paperwork and red tape.
  3. The President’s Budget Could Impose Premiums On Up To 4.2 Million Low-Income Uninsured People Who Are Currently Eligible For A Plan That Requires $0 In Premiums. As CQ’s Mary Ellen McIntire reports: “The budget proposes all exchange enrollees who are eligible for subsidies “contribute something” to their coverage, meaning people who currently pay $0 in premiums would have to make some sort of payment. Kaiser found that could apply to 4.2M uninsured.”
  4. The President’s Slashes HHS’s Operating Costs By 12 Percent. Trump’s budget would slash funding for the Department of Health and Human Services, the department responsible for administering the Affordable Care Act by 12 percent. As Politico reports, the budget request  “assumes that Congress will succeed in repealing and replacing Obamacare.”
  5. The Budget Proposes Cutting More Than $800 Billion From Medicare Over A Decade. Despite repeatedly promising not to cut Medicare, President Trump’s budget would cut roughly 10 percent of Medicare’s funding over the next ten years to help pay for tax cuts to insurance and big drug companies

Senate Republicans Make Chad Readler, Who Argued To Overturn Protections For People With Pre-existing Conditions, A Lifetime Federal Judge

Yesterday, in a near-party line vote, Senate Republicans confirmed Chad Readler to a lifetime appointment as a federal judge, despite Readler’s well-known history of fighting to strip protections from Americans with pre-existing conditions. Yesterday’s vote sends a clear message: Republicans remain intent on trying to take away Americans’ health care.

News outlets were quick to point out Readler’s health care history:

New York Times: Senate Confirms Trump Nominee Who As Justice Official Fought The Affordable Care Act. “The Senate on Wednesday confirmed Chad A. Readler of Ohio as President Trump’s 33rd federal appeals court judge despite bipartisan criticism that as a Justice Department official in the Trump administration he had shirked his official responsibility to defend the Affordable Care Act when it was challenged in court…The fight over Mr. Readler was intensified by his role in the legal struggle over the Affordable Care Act, which Democrats said he was obligated to defend as a top lawyer in the Justice Department’s civil division because it was existing law. Instead, he filed a brief in support of a lawsuit by Republican attorneys general aimed at gutting the Affordable Care Act, and argued that it, and its protections against denying coverage for pre-existing conditions, was unconstitutional.” [New York Times, 3/6/19]

HuffPost: Chad Readler Fought Obamacare Protections. Now He’s A Lifetime Federal Judge. “The Senate voted 52-47 to make Readler, 46, a lifetime federal judge. Every member of the chamber’s Democratic caucus opposed him with the exception of Sen. Joe Manchin of West Virginia, who did not vote. Every Republican but one, Sen. Susan Collins of Maine, voted for him. Democrats raised lots of concerns with Readler, who until recently was President Donald Trump’s acting assistant attorney general for the Justice Department’s civil division. In this role, Readler defended efforts to weaken voting rights, defended Trump’s ban on transgender people serving in the military, defended his ban on people from Muslim-majority countries visiting the United States and argued that a worker can be fired because of his or her sexual orientation. But most of the criticisms by Democrats centered on Readler’s role as a top attorney and policy advisor for the Justice Department when it declined to defend key provisions of the Affordable Care Act in response to a lawsuit filed by Republican state attorneys general. Readler made the legal argument that protections for pre-existing conditions are unconstitutional. The next day, Trump nominated him to be a federal judge.” [HuffPost, 3/6/19]

Wall Street Journal: Senate Confirms Readler “Over Objections About His Participation In The Trump Administration’s Decision To Stop Defending Major Parts Of The Affordable Care Act In Court.” “A divided Senate confirmed a top Justice Department lawyer to be a federal appeals judge Wednesday, over objections about his participation in the Trump administration’s decision to stop defending major parts of the Affordable Care Act in court. The 52-47 Senate vote confirmed Chad Readler for a seat on the Sixth U.S. Circuit Court of Appeals, which hears cases from Kentucky, Michigan, Ohio and Tennessee…Mr. Readler last year signed a Justice Department brief that declined to defend much of the Affordable Care Act against a challenge from a group of Republican-led states seeking to invalidate the health-care law. A Texas judge struck down the entire health-care law in December. That ruling is on hold for now and the case is on appeal.” [Wall Street Journal, 3/6/19]

Politico: Senate Confirms Trump’s Judicial Nominee Who Opposed Obamacare. “The Senate confirmed President Donald Trump’s controversial judicial nominee on Wednesday who supported a lawsuit challenging Obamacare. In a 52-47 vote, the Senate approved Chad Readler’s nomination to the Sixth Circuit Court of Appeals. Republican Sen. Susan Collins of Maine joined Democrats to vote against the nominee. In the lead-up to his confirmation vote, Senate Democrats framed Readler’s confirmation battle as a test for Republicans over whether they supported protecting individuals with pre-existing conditions.” [Politico, 3/6/19]

The Hill: Senate Confirms Controversial Trump Court Pick Who Backed A Lawsuit Challenging The Affordable Care Act. “The Senate on Wednesday confirmed a controversial federal circuit court pick who backed a lawsuit challenging the Affordable Care Act.  Senators voted 52-47 on Chad Readler’s 6th Circuit nomination, with GOP Sen. Susan Collins (Maine) siding with Democrats to oppose him. Readler, who previously worked as an assistant attorney general for the Civil Division at the Department of Justice, ran into controversy over a brief he filed last year supporting a lawsuit filed by Texas and other states seeking to strike down the Affordable Care Act.” [The Hill, 3/6/19]

And Democrats were clear:

Senate Minority Leader Chuck Schumer (D-NY): “Can You Imagine The Lack Of Compassion It Takes To Argue That 130 Million Americans, With Cancers, Respiratory Ailments, All The Way Down To Asthma, Don’t Deserve The Guarantee Of Affordable Health Care?” “‘Can you imagine the lack of compassion it takes to argue that 130 million Americans, with cancers, respiratory ailments, all the way down to asthma, don’t deserve the guarantee of affordable health care?’ asked Senate Minority Leader Chuck Schumer (D-N.Y.). ‘It’s going to be remembered, this vote, for a long time. A long, long time.’” [HuffPost, 3/6/19]

Sen. Joe Manchin (D-WV): Readler “Single-Handedly Tried To Rip Insurance Away From West Virginians And Americans.” “‘This is something I don’t do often,’ Mr. Manchin said. ‘I don’t take it lightly.’ But Mr. Readler, he said, had “single-handedly tried to rip insurance away from West Virginians and Americans” when his Justice Department responsibility was just the opposite. ‘This gentleman has basically shown it is not about the law; it is not about the Constitution; it is about his politics and himself and not a man who should be sitting on a higher court,’ Mr. Manchin said.” [New York Times, 3/6/19]

Sen. Sherrod Brown (D-OH): “Chad Readler Is A Clear And Immediate Threat To The Health Coverage Off Millions And Millions Of Americans Who Have Preexisting Conditions.” “The U.S. Senate on Wednesday confirmed Columbus attorney Chad Readler to be a judge on the Sixth Circuit Court of Appeals over objections from Democrats including U.S. Sen. Sherrod Brown of Ohio, who portrayed Readler as a right-wing idealogue who has ‘actively worked to strip Ohioans of their rights.’ ‘Chad Readler is a clear and immediate threat to the health coverage of millions and millions of Americans who have preexisting conditions,’ Brown said at a Tuesday press conference to decry Readler’s confirmation.” [Cleveland Plain Dealer, 3/6/19]

CMS Advocates Selling Insurance Across State Lines to Avoid Consumer Protections: A Blast from the GOP Past

Washington, DC — Today, the Centers for Medicare and Medicaid Services issued a request for information to gather recommendations on how to sell health insurance across state lines. Leslie Dach, chair of Protect Our Care, issued a statement in response:

“This move by the Trump administration is just another attempt to sabotage health care. The Trump Administration wants to let insurance companies pick the state with the least regulation, and allow insurers to bypass much needed consumer protections. This has nothing to do with choice, competition, or affordability for consumers; it is about increasing profitability for the insurance companies and guaranteeing worse coverage for the rest of us.”



CBO: Selling Across State Lines Would Result In People Living In States With More Consumer Protections To Be Offered Plans From States That Do Not Have Those Protections. “Under H.R. 2355, CBO expects that individual health insurance would be offered across state lines to individuals in states with relatively expensive coverage mandates and rate-setting rules that permit relatively little variation in the prices an insurer may charge. The insurers offering those policies would be licensed in, and regulated by, states that do not have those characteristics.” [Congressional Budget Office, 9/12/05]

Urban Institute: Insurers Would Domicile Firms In States With Lax Regulations And The Least Consumer Protections. “Pre-ACA proposals to permit sales of insurance across state lines would have allowed insurers to take advantage of the regulatory variation across states. The same is true for current proposals to permit such sales while simultaneously repealing all or most of the ACA. Under such a policy scenario, insurers would have powerful financial incentives to domicile firms in states that have little regulation of nongroup insurance markets, such as those without guaranteed issue, those with no limits on premium rating, those permitting liberal use of benefit riders, and so on.” [The Urban Institute, 6/29/16]

NAIC: Allowing The Sale Of Insurance Across State Lines Would “Preempt” Consumer Protections In States. “In the same vein, we strongly oppose legislation that would preempt state authority. We continue to see proposals that would preempt state licensing requirements and, thus, consumer protections by allowing sales across state lines by federal edict, without proper discretion for the states to form compacts between themselves. We also see proposals that would preempt state solvency requirements and regulations by creating federally licensed insurance pools called ‘association health plans.’ Such federal actions would strip states of the ability to protect consumers and create competitive markets and should be rejected.” [NAIC Letter to Reps. Walden, Brady, Pallone and Neal, 1/24/17]

Oregon Department Of Consumer And Business Services Director Pat Allen: “That Really Is A Race To The Bottom.” “Groups such as the National Association of Insurance Commissioners argue that insurers might flock to states with the most-limited requirements for the industry. That could result in some plans carrying cheaper premiums, though more limited coverage. ‘That really is a race to the bottom in terms of what the regulatory playing field looks like,’ said Pat Allen, director of the Department of Consumer and Business Services in Oregon.” [Wall Street Journal, 12/3/16]

Consumers Would Be More Vulnerable Because They Potentially Would Have Limited Ways To Hold Out Of State Insurers Accountable. “Health insurance sales across state lines raise the question of who would enforce the regulations of the state from which coverage is sold. Individuals may not even be aware that they are buying a policy not subject to the laws of their own state. Say an insurer violated the laws or regulations of the state of sale. Insurance regulators in the purchaser’s state would undoubtedly find it difficult, if not impossible, to enforce their laws on an insurer that may not even be licensed to sell coverage in their state. Regulators in the state in which the insurer is domiciled might have insufficient resources and insufficient incentives to protect the residents of another state. Consequently, it is unclear how consumers would have a path for redress if necessary.” [The Urban Institute, 6/29/16]

NAIC: “Allowing Insurance To Be Sold Across State Lines Would Eliminate The Ability Of Insurance Regulators To Assist Consumers.” “Interstate policies would for the first time allow insurers unlicensed in the purchaser’s state to sell health insurance, which would otherwise be a criminal offense. Licensure is the key that allows state regulators to take action to protect consumers. The regulators of one state have no authority to enforce the laws of another state. Instead, consumers will have to hope that the regulator in a distant jurisdiction has the ability and resources to assist consumers nationwide.” [NAIC, accessed 3/6/19]


NAIC: “Interstate Sales Would Allow Some Insurers To Cherry-Pick The Best Customers By Avoiding Consumer Protections.” “Interstate sales would allow some insurers to cherry-pick the best customers by avoiding consumer protections that require them to cover individuals with preexisting conditions and limit their ability to charge higher prices for older, sicker customers. In states with robust consumer protections, insurers could reap huge profits by skirting these rules. [NAIC, accessed 3/6/19]

NAIC: “Existing Risk Pools…Would Become Progressively Sicker And More Expensive Until They Ultimately Fail.” “Out-of-state insurers would be able to lure healthy enrollees away from existing risk pools, which would become progressively sicker and more expensive until they ultimately fail. Insurers that currently comply with state consumer protections would be forced by out-of-state competitors to evade them as well. Insurance policies would cover less and less, as insurers try to design policies that discourage the sickest customers from applying. [NAIC, accessed, 3/6/19]

Urban Institute: Selling Across State Lines Would Provide Strong Incentive For Healthy To Purchase Coverage From States With The Fewest Regulations. “Insurers doing so could then selectively sell insurance to just the healthiest, lowest-risk individuals living in states that regulate their markets more strictly. Healthier individuals living in states that require more sharing of health care risk between the healthy and the sick would have a strong financial incentive to buy coverage from these out-of-state insurers, who could charge them low premiums based on their particular characteristics and health experience.” [The Urban Institute, 6/29/16]

Premiums Will Increase For Those Who Purchase Insurance In More Regulated States, Which Would Most Likely Be The Sick. “Consequently, average health care costs would increase significantly for those enrolled in a product meeting the standards of a high-regulation state, making premiums unaffordable for those trying to buy more comprehensive coverage. Premiums would go up not just for sick people but also for relatively healthy people who prefer the more generous coverage in the more regulated market, that is, healthy older adults or families.” [The Urban Institute, 6/29/16]


CBO: Selling Across State Lines Would Result In 1 Million People Losing Their Employer Sponsored Coverage. “Some employers (especially smaller ones) would find it desirable to stop offering coverage to their employees because the insurance available in the individual market had become cheaper. In addition, some people with relatively low health care costs who, under current law, will obtain health insurance coverage through an employer, would choose instead to purchase individual health insurance coverage from an out-of-state insurer. That would increase the per-person cost of the employer’s group health insurance, and would result in additional employers deciding to drop the group coverage. Based on CBO’s analysis of research on the responses of individuals and firms to changes in the price of health insurance, CBO estimates that, if the full effect of H.R. 2355 were realized immediately, about 1 million people—including both employees and covered dependents—would lose employer-sponsored health insurance coverage.” [CBO, 9/12/05]

Heritage Foundation Senior Research Fellow Edmund Haislmaier: “No One Should Be Under The Illusion You Can Dramatically Lower The Cost Of Insurance In Los Angeles If You Buy An Arkansas Policy.” “‘No one should be under the illusion you can dramatically lower the cost of insurance in Los Angeles if you buy an Arkansas policy,’ said Edmund Haislmaier, a senior research fellow at the Heritage Foundation, a conservative think tank.” [Wall Street Journal, 12/3/16]

Senate Republican Support for Chad Readler is a Vote Against People With Pre-existing Conditions

Washington, DC — Today, Republicans in the United States Senate voted to confirm Chad Readler’s lifetime nomination to the Sixth Circuit of the US Court of Appeals. Readler led the effort in the Trump Justice Department to eliminate protections for pre-existing conditions by filing the brief on behalf of the Trump administration in Texas v. United States. Leslie Dach, chair of Protect Our Care, issued a statement in response to the vote:

“Make no mistake, the Republicans who voted to confirm Chad Readler were voting for full repeal of the Affordable Care Act. Republicans who voted for Chad Readler want to go back to the days where insurance companies could deny, drop or charge more for coverage for millions of people with pre-existing conditions. Readler tried to sabotage the ACA from within the administration, and now that he’s on the court, he will be able to sabotage your care from the bench. It’s clear that Republicans didn’t learn their lesson from the November election and they must be held accountable for giving a anti-health care nominee a lifetime appointment.”


As Acting Assistant Attorney General, Chad Readler filed a brief on behalf of the Trump administration in Texas v. United States arguing that protections for people with pre-existing conditions under the Affordable Care Act should be struck down. This put the full weight of the Department of Justice behind the Republican war on health care to overturn the entire Affordable Care Act (ACA).  In December, a federal judge ruled in favor of the Republican plaintiffs, striking down the entire ACA. If this ruling is allowed to stand:

  • 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.

House Energy & Commerce Committee Continues to Deliver On Their Promise to Americans With More Legislation Designed to Lower Costs, Improve Care, and End Trump Administration’s Sabotage

Democrats, Responding to the Mandate from Voters in November, Introduce Bills to Reverse the Trump Administration’s Harmful Cuts to the Navigator Program, Provide States More Funding to Establish State-Based Marketplaces, and Provide Funding for States to Set Up Their Own Reinsurance Programs

Washington, DC — Today, the Subcommittee on Health of the Committee on Energy and Commerce held a hearing announcing a second round of bills that are aimed at lowering costs, increasing access to care, and blocking the Trump administration’s sabotage of our health care system. The first round of bills considered by the committee would halt the administration’s harmful waivers, roll back junk plans that undermine protections for people with pre-existing conditions and provide insufficient coverage, and restore funding for open enrollment that has been slashed by President Trump in an act of deliberate sabotage.

This set of bills would reverse the Trump administration’s harmful cuts to the navigator program that denied people access to fair and impartial information on enrollment and financial assistance options; provide states more funding to establish state-based marketplaces giving states the ability to tailor the program to meet the particular needs of their residents; and provide funding for states to set up their own reinsurance programs that make health care more affordable for everyone throughout the individual market including those with serious medical conditions.

“Last November, voters rejected the Trump administration and their GOP allies’ repeal and sabotage agenda and scores of Republicans in Congress were shown the door as a result,” said Brad Woodhouse, executive director of Protect Our Care. “Democrats are continuing to turn the page on the willful sabotage by Republicans by doing what the American people asked of them – make health care more affordable and accessible to all. With this set of bills, Democrats are continuing to show us they’re serious about delivering on their promise to voters to lower costs and improve care for all Americans.”


The Health Subcommittee of the Committee on Energy and Commerce will consider the following bills:

H.R. 1425, the “State Health Care Premium Reduction Act” would provide $10 billion annually to states to establish a state reinsurance program or use the funds to provide financial assistance to reduce out-of-pocket costs for individuals enrolled in qualified health plans. The bill also requires the Centers for Medicare and Medicaid Services (CMS) to establish and implement a reinsurance program in states that do not apply for federal funding under the bill.

H.R.1386, the “Expand Navigators’ Resources For Outreach, Learning, And Longevity (ENROLL) Act” would provide $100 million annually for the Federally-facilitated Marketplace (FFM) navigator program. The bill would reinstate the requirement that there be at least two navigator entities in each state and would require the Department of Health and Human Services (HHS) to ensure that navigator grants are awarded to entities with demonstrated capacity to carry out the duties specified in the Affordable Care Act. The bill would also prohibit HHS from considering whether a navigator entity has demonstrated how it will provide information to individuals relating to association health plans or short-term, limited-duration insurance plans.

H.R.1385, the “State Allowance For A Variety Of Exchanges (SAVE) Act” would provide states with $200 million in federal funds to establish state-based Marketplaces. Under current law, federal funds are no longer available for states to set up state-based Marketplaces.  

The GOP Agenda: Worse Care, Higher Costs for Residents at Nursing Homes

Washington, DC — Ahead of the Senate Finance Committee’s hearing on nursing home neglect and abuse tomorrow, it’s important to remember just how the GOP’s health care policies have failed nursing home patients across America. Donald Trump and his Republicans in Congress worked to repeal the Affordable Care Act, block expansion and access to Medicaid, and fell into lock step with the nursing home industry to weaken penalties they may face for harming their own residents. The GOP Agenda has nothing to do with helping those in nursing homes and long-term care facilities–it only seeks to serve industry CEOs and gut access to care so many patients desperately need.

The GOP Agenda: Repeal the Affordable Care Act and Its Protections for People in Nursing Homes

The ACA Expanded Nursing Home Quality-Related Requirements for the First Time Since 1987. “The Affordable Care Act (ACA) is the first comprehensive legislation since the Nursing Home Reform Act, part of the Omnibus Budget Reconciliation Act of 1987 (OBRA ’87), to expand quality of care-related requirements for nursing homes that participate in Medicare and Medicaid and improve federal and state oversight and enforcement…the ACA incorporates the Nursing Home Transparency and Improvement Act of 2009, introduced because complex ownership, management, and financing structures were inhibiting regulators’ ability to hold providers accountable for compliance with federal requirements. The ACA also incorporates the Elder Justice Act and the Patient Safety and Abuse Prevention Act, which include provisions to protect long-term care recipients from abuse and other crimes.” [Kaiser Family Foundation, 1/28/13]

The GOP Agenda: Cutting Access to Nursing Home Care by Slashing Medicaid

Medicaid Pays for Most of the 1.4 Million People in Nursing Homes. “Medicaid pays for most of the 1.4 million people in nursing homes… It covers 20 percent of all Americans and 40 percent of poor adults…A combination of longer life spans and spiraling health care costs has left an estimated 64 percent of the Americans in nursing homes dependent on Medicaid. In Alaska, Mississippi and West Virginia, Medicaid was the primary payer for three-quarters or more of nursing home residents in 2015, according to the Kaiser Family Foundation.” [New York Times, 6/24/17]

Medicaid Covers 6 in 10 Nursing Home Residents, and Half of Seniors Using Medicaid Long-Term Care Services Were in Nursing Homes. [Kaiser Family Foundation, 6/20/17]

The Trump Administration and Republicans in Congress Pursued ACA Repeal Bill that Would Have Also Slashed Medicaid. “On Thursday, Senate Republicans joined their House colleagues in proposing steep cuts to Medicaid, part of the effort to repeal the Affordable Care Act. Conservatives hope to roll back what they see as an expanding and costly entitlement.” [New York Times, 6/24/17]

New York Times Headline: “Medicaid Cuts May Force Retirees Out of Nursing Homes” [New York Times, 6/24/17]

Associated Press Headline: “Medicaid cut in GOP health bill worries the nursing home set” [Associated Press, 7/8/17]

Senate GOP Repeal Bill Would Have Cut Medicaid by $2.6 Trillion by Second Decade. “The Congressional Budget Office (CBO) estimates that the Senate Republican health bill’s Medicaid cuts would deepen significantly in the second decade, with the cuts growing from 26 percent in 2026 to 35 percent in 2036, relative to current law. Now, based on CBO estimates and data, the Committee for a Responsible Federal Budget (CRFB) estimates that the Senate bill would cut Medicaid by roughly $2.6 trillion over the second decade (2027-36), on top of Medicaid cuts of $772 billion in the first decade.” [Center on Budget and Policy Priorities, 7/11/17]

The Trump Administration is Looking for Ways to Bypass Congress to Enact Medicaid Block Grants. “The Trump administration is quietly devising a plan bypassing Congress to give block grants to states for Medicaid, achieving a longstanding conservative dream of reining in spending on the health care safety net for the poor…Capping spending could mean fewer low-income people getting covered, or state-designated cutbacks in health benefits.” [Politico, 1/11/19]

In 2018, the Trump Administration Proposed Cutting Medicaid by $1.4 Trillion. “The Administration is proposing to cap federal Medicaid payments to states and to cut federal Medicaid spending by $1.439 trillion – that is trillion with a “t” – over the ten year period 2019 – 2028. That is about 26% of what the Administration projects federal Medicaid spending would otherwise be, and within shouting distance of the $1.455 trillion cost of the tax cuts enacted in December.” [Georgetown Center for Children and Families, 2/12/18]

The GOP Agenda: The Trump Administration Weakened Penalties Against Nursing Homes that Harm Patients at the Request of the Nursing Home Industry

The Trump Administration Scaled Back Fines Against Nursing Homes that Harm Residents, at the Request of the Nursing Home Industry. “The Trump administration is scaling back the use of fines against nursing homes that harm residents or place them in grave risk of injury, part of a broader relaxation of regulations under the president. The shift in the Medicare program’s penalty protocols was requested by the nursing home industry…The new guidelines discourage regulators from levying fines in some situations, even when they have resulted in a resident’s death. The guidelines will also probably result in lower fines for many facilities. [New York Times, 12/24/17]

New Guidelines Intended to Discourage Regulators from Levying Fines, Even When Violations Resulted in Resident’s Death. “The new guidelines discourage regulators from levying fines in some situations, even when they have resulted in a resident’s death. The guidelines will also probably result in lower fines for many facilities.” [Kaiser Health News, 12/31/17]

In November 2017, The Trump Administration Exempted Nursing Homes Violating Certain Rules from Penalties for 18 Months. “In November, the Trump administration exempted nursing homes that violate eight new safety rules from penalties for 18 months. Homes must still follow the rules, which are intended, among other things, to reduce the overuse of psychotropic drugs and to ensure that every home has adequate resources to assist residents with major psychological problems.” [New York Times, 12/24/17]

In October 2017, the Trump Administration Discouraged CMS Regional Offices from Levying Fines if the Error was a “One-Time Mistake.” “In October, CMS discouraged its regional offices from levying fines, even in the most serious health violations, if the error was a ‘one-time mistake.’ The centers said that intentional disregard for residents’ health and safety or systemic errors should still merit fines.” [Kaiser Health News, 12/31/17]
The Trump Administration Rolled Back Obama Administration Rule Making it Easier for Nursing Home Residents to Sue for Negligence or Abuse. “Another Obama-era regulation is on the Trump administration’s chopping block — this one about nursing homes. The Obama administration’s rule would’ve made it easier for nursing home residents to sue for negligence or abuse. But the Trump administration is proposing to replace that rule. And the new one could make it almost impossible for nursing home residents to get their day in court. That is because new nursing home residents are frequently handed an agreement to go to arbitration instead of suing if something goes wrong.” [NPR, 8/21/17]