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CMS Proposal is the Trump Administration’s Latest Act Of Health Care Sabotage

The Payment Notice Cuts Premium Tax Credits By $1 Billion Annually, Slashes Coverage, Increases Out-Of-Pocket Costs, And Puts People With Pre-existing Conditions At Risk

 

Last night, the Centers for Medicare & Medicaid Services (CMS) issued the proposed annual Notice of Benefit and Payment Parameters (NBPP) for the 2020 benefit year, which outlines regulatory and financial guidelines applicable to exchange plans. The proposal from CMS would do the following:

  • Cut premium tax credits by $1 billion per year ($900M in 2020 and 2021, $1 billion in 2022 and 2023)
  • Cause 100,000 people to lose marketplace coverage annually starting in 2020
  • Increase annual premiums by $189 for a family of four at 300 percent of poverty
  • Increase the maximum out-of-pocket costs by $400 for a family (from $16,000 without the change to $16,400 with it) and $200 for an individual (from $8,000 annually to $8,200 annually).

“Despite the lessons of the 2018 midterm elections, the Trump administration is continuing its relentless efforts to sabotage health care for millions of Americans,” said Leslie Dach, chair of Protect Our Care. “They want to increase premiums, put protections for people with pre-existing conditions further at risk, and rip affordable coverage from countless Americans. It’s time they start improving our health care and stop ripping it apart.”

Here’s a look at what the Administration’s proposal would mean for people across the country, according to health care experts and CMS itself:

The Payment Notice Means Higher Premiums, Less In Subsides, And A Drop In Enrollment. “The Trump administration estimates that their proposed change to how ACA premium subsidies are calculated would increase consumer premiums by $181 million and decrease marketplace enrollment by 100,000. As a result, the government would save $900 million.” [Larry Levitt, 1/17/19]

The Provisions Of The Payment Notice Would Reduce Americans’ Premium Tax Credits By Roughly $1 Billion Annually, Leading A Family Of Four At 300 Percent Of The Federal Poverty Line To Pay $189 More Annually. As Matt Fielder, Fellow at the USC-Brookings Schaeffer Initiative for Health Policy concludes: “In dollar terms, single person at 300% of FPL would lose $92/year in [premium tax credits]; family of four at 300% of FPL would lose $189/year in [premium tax credits]. Smaller effects at lower income levels and larger effects at higher income levels. In the aggregate, CMS Actuary estimates proposed change would result in $900m less in tax credit payments and 100,000 fewer Marketplace enrollees in 2020.” [Matt Fiedler, 1/17/19]

The Rules Would Also Increase The Maximum Out Of Pocket Costs In All Private Insurance Plans, By $200 For Individuals And $400 For A Family. “A technical change proposed by the Trump administration would result in maximum consumer out-of-pocket costs in all private insurance plans going up to $8,200 per person in 2020 instead of $8,000. To be clear, either amount is out of reach for many people.” The rule would also increase the maximum out of pocket costs for families from $16,000 to $16,400. [Larry Levitt, 1/17/19; Centers on Medicare And Medicaid Services, 1/17/19

100,000 People Would Lose Marketplace Coverage Each Year Beginning In 2020. [CMS, 1/17/19]

The Administration Has Also Invited Public Comment On Two Parameters — Eliminating Silver-Loading And Automatic Reenrollment. “One change the Trump administration is inviting comment on could eliminate automatic renewal of ACA marketplace coverage and premium subsidies. This year 1.8 million people were automatically re-enrolled in states using the federal marketplace. Another change the Trump administration is inviting comment on could eliminate “silver loading,” where insurers increased premiums for silver plans to offset the termination of cost-sharing subsidy payments to those insurers by the administration. Prohibiting “silver loading” of premiums in the ACA marketplace would lower government costs, but it would increase out-of-pocket premiums for many subsidized enrollees and also increase premiums for middle-class consumers not eligible for subsidies.” [Larry Levitt, 1/17/19]

Andy Slavitt, Former Head Of CMS: “Undermining Obamacare Is The Only Conceivable Reason To Dismantle [Auto-reenrollment].” “Auto reenrollment is simple. It means that like most employer coverage, if you forget to sign up for coverage, yours won’t get taken away. With auto-reenrollment, you can still reject coverage by not paying the bill. 1.8 million use it every year to keep continuous coverage. What happens if it’s taken away? You forget to sign up by 12/15. Get a cancer diagnosis in January. Not covered. With auto-[reenrollment], covered. It’s already automated, and how people are used to operating. Undermining Obamacare is the only conceivable reason to dismantle this.” [Andy Slavitt, 1/17/19]

The Payment Notice Allows States To Select An Essential Health Benefits (EHB) Package Used By Another State, Making EHBs More Flexible And Making It Easier For States To Not Cover All Of The Needs Of People With Pre-existing Conditions. “In the 2019 Payment Notice, we finalized options for states to select new EHB benchmark plans starting with the 2020 benefit year. Under 45 CFR 156.111, a state may modify its EHB-benchmark plan by: (1) Selecting the EHB-benchmark plan that another state used for the 2017 plan year; (2) Replacing one or more EHB categories of benefits in its EHB-benchmark plan used for the 2017 plan year with the same categories of benefits from another state’s EHB-benchmark plan used for the 2017 plan year; or (3) Otherwise selecting a set of benefits that would become the state’s EHB-benchmark plan.” [CMS, 1/17/19]

Legislators are calling the changes out for what they are: sabotage.

Sen. Ron Wyden (D-OR), Ranking Member Of Senate Finance Committee: “Today’s Proposed Rule Deliberately And Needlessly Increases Premiums And Will Result In Too Many Americans Losing Coverage.” “Trump’s health care sabotage agenda is defined by higher premiums for families and bureaucratic barriers that make it harder to find health coverage. Today’s proposed rule deliberately and needlessly increases premiums and will result in too many Americans losing access to health coverage. It’s no wonder Americans are so fed up with America’s health care system when the Trump administration continues to fan the flames of uncertainty while families pick up the check.” [Wyden Statement, 1/17/19]

Sen. Patty Murray (D-WA), Ranking Member Of The Senate Health, Education, Labor, And Pensions (HELP) Committee: “Even 27 Days Into The Shutdown He Caused, President Trump Has Somehow Found Time To Further Sabotage Health Care For Patients, Families, And Women.” “Even 27 days into the shutdown he caused, President Trump has somehow found time to further sabotage health care for patients, families, and women — this time by proposing what would amount to a health care tax on patients and families across the country. President Trump is hurting families left and right and Democrats are going to keep holding him accountable.” [Murray Statement, 1/17/19

Protect Our Care Reacts to CMS Proposed Payment Notice For 2020

Washington, D.C. – Today, the Centers for Medicaid and Medicare Services (CMS) announced its proposed payment notice for the 2020 coverage year which includes a reduction in tax credits for millions of Americans and is additionally seeking public comments on potential changes to the ACA marketplaces — one which could eliminate the practice of silver loading and one that could eliminate the auto-enrollment of marketplace coverage.  In response, Leslie Dach, chair of Protect Our Care, issued the following statement:

“The proposed reduction in tax credits will raise health care premiums for millions of Americans and result in a minimum of 100,000 people losing their health care and are just another form of Trump administration sabotage.  In addition, any effort to eliminate silver loading or auto-enrollment would be a direct attack on our health care and would raise premiums and threaten coverage for millions. Once again, the Trump administration is sabotaging our health care system and asking the American people to foot the bill.”

Americans Want To Know: Will Attorney General Nominee William Barr Keep His Promise On The Texas Lawsuit?

Washington DC — Yesterday, during the Senate Judiciary Committee hearing on William Barr’s nomination to become the next U.S. Attorney General, Senator Kamala Harris pressed Barr to reconsider DOJ’s current position on the Texas, et. al. vs. United States, et. al. lawsuit which would strike down the Affordable Care Act and its protections if not overturned. Leslie Dach, chair of Protect Our Care, issued the following statement in response to Barr’s claims that he would like to review the department’s position if confirmed:

“Barr claimed he would review the department’s position on the Texas lawsuit, but that’s not enough. Let’s be clear, the Texas lawsuit is a politically motivated attack by Republican attorneys general, governors, and the Trump Administration to raise health care costs and take coverage away from millions of Americans. If confirmed, Barr must defend the law of the land and commit to protecting people with pre-existing conditions. We will hold Barr to his word and sound the alarm if yesterday’s comments prove to be empty promises meant to secure his confirmation.”

 

Background:

During The Senate Judiciary Committee Hearing, William Barr Claimed He Would Review The Department Of Justice Position On The Texas Lawsuit. Watch for yourself.  

(click here)

Due to Judge O’Connor’s ruling on December 14th, 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. 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.

Protect Our Care Statement On Senate Resolution To Protect Pre-Existing Conditions From GOP Lawsuit

Washington DC — Today, Senate Democrats reintroduced a resolution to defend the Affordable Care Act (ACA) and its protections for people with pre-existing conditions after a federal judge in Texas ruled to overturn the entire ACA. Similar to the House resolution passed last week, this resolution takes aim at Republican attorneys general lawsuit to overturn the entire Affordable Care Act and has the support of the Trump Administration. It also directs the Senate legal counsel to intervene on behalf of the American people. Brad Woodhouse, executive director of Protect Our Care, calls on the full Senate to support and pass this resolution:

“Now that Trump and his Republican allies have gotten a federal judge to do what they couldn’t do legislatively, overturn the ACA, Senate Democrats are once again fighting to protect people with pre-existing conditions and those who benefit from the law. This resolution takes direct aim at the Texas lawsuit and its dangerous ambitions of stripping health care away from millions of Americans. If this ruling isn’t overturned, Republicans will roll back the clock and take millions of people back to the days where insurance companies had the power to deny, drop, or charge more for coverage. It’s time for Senate Majority Leader Mitch McConnell and Republican Senators to step up to the plate and join their Democratic colleagues by bringing this resolution to the floor where it is sure to pass. Make no mistake, by refusing to bring this resolution to the floor, Senate Republicans are backing a full repeal of the Affordable Care Act.”

 

BACKGROUND:

Due to Judge O’Connor’s ruling on December 14th, 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. 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.

 

 

We Have 6 Questions For William Barr And They’re All About Health Care

Washington DC — Ahead of Tuesday’s scheduled Senate Judiciary Committee hearing on William Barr’s nomination to become the next U.S. Attorney General under President Trump, Leslie Dach, chair of Protect Our Care, issued the following statement:

“The Sessions’ Justice Department refused to defend the Affordable Care Act and its protections for millions of Americans with pre-existing conditions and even argued for them to be struck down. The result was the Texas Court’s decision to overturn the entire law. The American people need to know where Attorney General nominee William Barr stands. He should commit to reversing the Department’s previous inexplicable decision and commit to defending America’s health care. Now more than ever, the American people deserve answers and William Barr as well as the Justice Department he wants to lead have a lot to answer for. The American people deserve an Attorney General who is willing to fight for their health care.”

Six Questions for William Barr:

  1. Do you agree with the Administration’s decision for the Department of Justice to stop defending the Affordable Care Act in court?
  2. Who made the decision for the Department of Justice to stop defending the Affordable Care Act?
  3. What communication did the President, or White House senior staff, have with Department of Justice officials when DOJ decided to stop defending the Affordable Care Act?
  4. Do you agree with Judge Reed O’Connor’s December 2018 decision to strike down the entire Affordable Care Act?
  5. Even conservative legal analysts have said Judge O’Connor’s decision is wholly without merit. Are they wrong?
  6. Will you review and reverse the Department’s decision to refuse to defend protections for pre-existing conditions and the Affordable Care Act?  

Federal Judge Puts The Breaks On Trump’s Birth Control Rules

Washington DC — Over the weekend, news broke that a federal judge blocked the Trump administration’s request to implement new rules that would make it easier for employers to deny women health insurance coverage for contraceptives. Anne Shoup, communications director of Protect Our Care issued the following statement in response to the Trump administration’s latest attempt to sabotage health care:

“There’s no doubt that the Trump administration will stop at nothing to prevent millions of Americans from gaining access to affordable health care. These new rules are just another desperate attempt by President Trump to rip away long-standing health care protections for women across the nation. But let’s be clear: millions of women have reliable access to reproductive care because of the Affordable Care Act. Under the ACA, contraception is covered as a preventive health service, meaning most employers and insurers are required to provide coverage at no charge. Because this ruling blocked Trump’s latest sabotage efforts, millions of women still have access to birth control — a critical piece of their reproductive care. But the fight isn’t over. We must remain vigilant and continue to block all attempts to take women back to the days when insurance companies had the power to deny, drop, or charge them more for coverage.”

Here We Go Again: Trump Tries To End Medicaid As We Know It

Washington, D.C. — New reporting from Politico indicates that the Trump administration is trying to roll back protections for life-saving health care by ending Medicaid as we know it. Even in the midst of a federal government shutdown, President Trump is still working overtime to sabotage health care for millions by devising a plan that would impose limits on Medicaid spending. Leslie Dach, chair of Protect Our Care issued the following statement in response:

“By now, it should be abundantly clear that Donald Trump and his Republican allies will stop at nothing to rip apart our health care. While hundreds of thousands of Americans are going without their paychecks, the Trump administration is adding insult to injury by working to end Medicaid as we know it. Make no mistake, bypassing Congress to turn Medicaid into a block grant program would put the care of millions of children, families, and seniors who rely on the program at severe risk. Enough is enough. It’s time for Trump to call-off his relentless war on Medicaid.”

ADVISORY: Protect Our Care Hosts Press Calls Today in Seven States

Local Experts Offer Analysis On House GOP Vote to Repeal the ACA And Gut Protections for People with Pre-Existing Conditions

 

Washington DC — Representatives Diana DeGette, Ed Perlmutter, and Tom O’Halleran will join Protect Our Care Executive Director Brad Woodhouse in press calls today across the country to discuss a resolution passed by House Democrats on Wednesday that authorizes House Counsel to intervene in the Texas, et. al. vs. United States, et. al. lawsuit to defend the Affordable Care Act and its protections.

The resolution comes after a new poll from Public Policy Polling (PPP) for Protect Our Care found that more than half of voters oppose the recent court decision striking down the Affordable Care Act and sixty-nine percent of voters say it’s a major concern to them that the court case would eliminate protections for pre-existing conditions, such as cancer, diabetes, and asthma.

Below is the schedule of calls today (all times in EST):

10AM EST Maine: 877-229-8493; Pin: 114927

  • State Rep. Anne Perry, nurse practitioner
  • Rebecca London, state director of Protect Our Care Maine
  • Ron Green, former firefighter and Mainer

11AM EST North Carolina: 877-229-8493; Pin: 118274

  • Brad Woodhouse, Executive Director of Protect Our Care
  • State Senator Wiley Nickel (SD-16)
  • Tara Romano, Executive Director of NARAL North Carolina
  • Montica Talmadge, North Carolinian with a pre-existing condition

12PM EST Ohio: 877-229-8493; Pin: 118275

  • Zach Klein, Columbus City Attorney who filed suit against the Trump Administration to enforce the ACA
  • Danny O’Connor, attorney and Franklin County Recorder
  • Ethan Kissock, Ohioan with pre-existing condition

1PM EST Iowa: 877-229-8493; Pin: 118276

  • State Representative Beth Wessel-Kroeschell (HD-45)
  • Robin Stone, health care professional and advocate
  • Melissa Zapata, Des Moines University medical student

2:30 PM ET Colorado: 877-229-8493; Pin: 118277

  • Congresswoman Diana DeGette
  • Congressman Ed Perlmutter
  • Adam Fox, Colorado Consumer Health  Initiative

3:30 PM ET Arizona: 877-229-8493; Pin: 118278

  • Congressman Tom O’Halleran, Arizona’s 1st Congressional District
  • Toni Bannister, two-time cancer survivor
  • Morgan Tucker, Protect Our Care Arizona

4:30 PM ET Alaska: 877-229-8493; Pin: 118279

  • Alyse Galvin, health care advocate and former congressional candidate
  • Susanna Orr, Alaskan whose husband benefited from pre-existing conditions protections
  • David D’Amato, health care policy expert
  • Amber Lee, Protect Our Care Alaska

Protect Our Care Statement On House Republicans Refusal to Join Democrats On Resolution Opposing ACA Lawsuit and Instead Supported Full Repeal

“Nearly every Republican voted ‘no’ on this resolution, once again turning their backs on the millions of Americans whose access to life-saving care and benefits are in jeopardy,” says Brad Woodhouse

 

Washington DC — In response to House Democrats passing a stand-alone resolution that authorizes the House Counsel to intervene in the Texas, et. al. vs. United States, et. al. lawsuit to defend the Affordable Care Act and takes direct aim at the relentless repeal and sabotage campaign on health care by Republicans and President Trump, Brad Woodhouse, executive director of Protect Our Care issued the following statement:

“Under the leadership of Speaker Pelosi, the House took a crucial step to defend the Affordable Care Act and protect Americans with pre-existing conditions. By passing this resolution to intervene in the dangerous Texas lawsuit, Democrats stand in stark contrast with their repeal and sabotage Republican colleagues. Make no mistake, nearly every Republican voted ‘no’ on this resolution, once again turning their backs on the millions of Americans whose access to life-saving care and benefits are in jeopardy. Republicans are doubling down on their anti-health care agenda and ignoring the clear message sent by voters in November. If the Republicans had their way with this vote, the Affordable Care Act would be fully repealed and millions of people would lose their coverage. Clearly, Republicans haven’t learned the lesson of the 2018 elections and we’re here to remind them that elections have consequences.”

Background:

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

If The Texas Ruling Is Upheld, Protections For 130 Million People With A Pre-Existing Condition Could Disappear

  • 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.

If The Texas Ruling Is Upheld, Insurance Companies Would 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. Now insurance companies have a license to do this again.

  • A 2010 congressional report found that the top four health insurance companies denied coverage to one in seven consumers on the individual market over a three year period.
  • A 2009 congressional report found that the of the largest insurance companies had retroactively canceled coverage for 20,000 people over the previous five year period.

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.If The Texas Ruling Is Upheld, Insurance Companies Would Once Again Have The Power To Charge You More

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

If The Texas Ruling Is Upheld, Insurance Companies Will Have The Power To Limit The Care You Get, Even If You Have Insurance Through Your Employer

  • Reinstate Lifetime and Annual Limits. Thanks to the Republican lawsuit, insurance companies can once again impose annual and lifetime limits on coverage.
  • 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.

If The Texas Ruling Is Upheld, Medicaid Expansion Will End

  • Fifteen million people have coverage through the expanded Medicaid program.

Elections Have Consequences: State and Local Leaders are Protecting and Expanding Health Care Even as President Trump and Republicans Continue Their Repeal and Sabotage Agenda Nationally

Last year, health care was the number one issue that drove people to the polls and fueled the new Democratic majority in the U.S. House of Representatives.  And, even as President Trump and Republicans continue to pursue their repeal and sabotage agenda, elected leaders at the local and state level are fighting back and responding to voters by taking action to protect and expand coverage, and lower costs for their constituents. Elections do indeed have consequences.

(CA) Gov. Gavin Newsom Moves To Expand Access To Health Care In California. “Gov. Gavin Newsom proposed a broad overhaul of health care on his first day in office Monday, promising to throw the state’s financial power into an effort to lower prescription drug costs, expand Obamacare so middle-class families can receive subsidies to buy insurance, and offer Medi-Cal coverage to undocumented immigrants up to age 26. Newsom aides said the expansion of Affordable Care Act subsidies would be funded by a California version of the individual mandate, the former federal requirement that people either carry health insurance or pay a penalty on their taxes. Congressional Republicans and President Trump repealed the mandate in 2017, although the penalty does not disappear until the 2019 tax year. Newsom would reinstate it on the state level.” [San Francisco Chronicle, 1/7/19]

(CO) Colorado Democrats Introduce Public Option Health Care. “Creation of a public option health care plan is one of the most ambitious changes Colorado Democrats proposed Friday as they kicked off a new session of the General Assembly in control of both chambers for the first time in four years. The first five bills introduced in each chamber — indicators of lawmakers’ top priorities for the year — largely relate to health care and education costs. A Senate bill would create a public option health insurance plan that Coloradans who live in the highest-cost areas — mainly the Western Slope — could buy instead of their current insurance starting in the fall of 2019. A House bill would expand that program to the entire state by the fall of 2020.” [The Denver Post, 1/4/19]

(ME) On First Day In Office, Gov. Janet Mills Signs Executive Order Directing State To Implement Medicaid Expansion. “Medicaid expansion is finally advancing in Maine, more than a year after voters approved it at the ballot box. Newly sworn in Gov. Janet Mills, a Democrat who campaigned on broadening access to health insurance, used her first executive order to direct the Maine Department of Health and Human Services to begin implementation of Medicaid expansion.” [CNN, 1/3/19]

(NM) In New Mexico, Democrats Plan To Introduce A Bill To Create A Medicaid Buy-in Program. “New Mexico Democrats eye creating the nation’s first Medicaid buy-in program, one of many blue-state efforts expected this year to expand health insurance coverage.” [Politico, 1/9/19]

(WA) Gov. Jay Inslee Proposes Public Option For Washington. “Gov. Jay Inslee and Democratic lawmakers Tuesday announced proposed legislation for a new “public option” health-care plan under Washington’s health-insurance exchange. The proposal, which Inslee said is the first step toward universal health care, is geared in part to help stabilize the exchange, which has wrestled with double-digit premium increases and attempts by Republicans in Congress and President Donald Trump to dismantle the Affordable Care Act. ‘We are proposing to the state Legislature that we have a public option that is available throughout the state of Washington so that we can increase the ability to move forward on the road to universal health care in the state of Washington,’ said the governor, who is considering a run for president in 2020.” [The Seattle Times, 1/8/19]

(WI) Gov. Tony Evers Signs Executive Orders To Direct State To Develop Plan For Expanding Medicaid, Find Ways To Protect ACA’s Consumer Protections. “In his second day on the job, Gov. Tony Evers signed executive orders Tuesday to study expanding health coverage and providing insurance protections for people with pre-existing conditions…One order directs the state Department of Health Services to develop a plan to expand the state’s BadgerCare Plus health care program for low-income people under the Affordable Care Act, known as Obamacare. Republican lawmakers have fiercely opposed the idea. The issue is expected to come to a head this year as Evers and lawmakers work on a state budget that will determine whether the state taps into additional federal aid through Obamacare. The second order tells state agencies to prepare plans to find ways to protect coverage for people with pre-existing conditions, bolster consumer protections, improve the public’s understanding of insurance, and require insurers to make their costs and terms easily understandable. Evers has said the best way to protect coverage for those with pre-existing conditions is to keep the Affordable Care Act in place. He campaigned on getting Wisconsin out of a multistate lawsuit challenging the law.” [Milwaukee Journal-Sentinel, 1/8/19]

(NY) Governor Cuomo and the legislature to pursue reproductive rights protections. “Gov. Andrew Cuomo called Monday for including abortion rights in the New York Constitution, calling it an unprecedented opportunity to protect a woman’s right to choose… Cuomo took his call a step further, vowing to push an amendment that would enshrine a woman’s right to choose in the state Constitution. Such a move would make it more difficult for future governors and lawmakers to reverse: A constitutional amendment has to be approved by successively elected Legislatures and approved by a vote of the public. [Rochester Democrat and Chronicle, 1/7/19]

(NYC) New York City Mayor Bill de Blasio To Fund Health Care For All, Including Undocumented. “New York Mayor Bill de Blasio proposed a $100 million plan that he said would provide affordable ‘healthcare for all,’ reaching about 600,000 people, including undocumented immigrants, low-income residents not enrolled in Medicaid and young workers whose current plans are too expensive. The plan, which de Blasio dubbed ‘NYC Care,’ will offer public health insurance on a sliding price scale based on income, the mayor said during an interview Tuesday morning on MSNBC. It will begin later this year in the Bronx and will be available to all New Yorkers in 2021, and would cost at least $100 million once it reaches full enrollment, according to the mayor’s office.” [Bloomberg, 1/8/19]