All Posts By

Sean England

Medicaid Critical to Supporting America’s Rural Communities

Report: Trump’s War On Health Care, Obstruction of Medicaid Expansion Threatens Our Rural Communities
Washington, DC – Access to health care in rural communities is one of the most critical issues facing our country, and this Medicaid Awareness Month, it’s important to highlight the barriers many Americans living in rural communities face when it comes to receiving quality health care, and the significant role that Medicaid expansion has played in expanding coverage. In an updated annual report Protect Our Care (POC) is releasing today, A Tough Row to Hoe: How Washington Policies Are Leaving Rural Health Care in the Dust, POC looks at how important Medicaid is to rural communities and the myriad ways President Trump and Republicans are working to undermine and sabotage the program.Americans living in rural communities face unique obstacles when it comes to accessing health care, as many travel long distances to visit a doctor, and often live in low income communities. Medicaid expansion has been instrumental in providing health care to America’s rural populations. Yet the care of many still remains at risk due to the Trump administration’s war on Medicaid and the Trump Texas lawsuit, which would dismantle the entire health care system and strip care from more than 20 million Americans.

“Medicaid has played an essential role in providing quality, and affordable health care to America’s rural communities, a fact we are trumpeting during Medicaid Awareness Month. Yet the Trump administration’s continued war against Medicaid jeopardizes access to rural health care, and the Trump Texas lawsuit would strip coverage from millions of Americans and take away programs that are instrumental in providing health care for rural America. President Trump and Republicans who continue to attack Medicaid are putting the health care of millions at risk and are out of step with the vast majority of Americans who support this vital program.”



A Tough Row to Hoe: How Washington Policies Are Leaving 
Rural Health Care in the Dust

Read full report here

Rural Health At A Glance

Americans living in rural communities face unique barriers to accessing health care: they often have to travel longer distances to visit a doctor, have fewer options for doctors and other health care providers, and experience provider shortages more often. They also tend to be lower-income, but live in areas with higher-cost health care.

The Affordable Care Act (ACA) and its Medicaid expansion have been crucial in supporting rural communities, but the relentless war on health care being waged by President Trump and Republicans in Congress has reversed many of these gains, raised premiums, and threatened key components of the rural health care system, including rural hospitals.

Following the implementation of the ACA, the uninsured rate in rural areas droppedfrom 17 percent in 2013 to 12 percent in 2015. The ACA has expanded access to health care to nearly 1.7 million rural Americans who have gained coverage through the Medicaid expansion, not only playing a central role in improving rural communities’ health, but also supporting these communities’ economic well-being. Medicaid covers nearly 24 percent of rural Americans, 45 percent of rural children, 15 percent of rural seniors, and pays for 51 percent of rural births. The uninsured rate in rural areas in states that expanded Medicaid has dropped by a median of 44 percent since expansion. However, Republicans’ relentless war on Medicaid now threatens much of this progress.

In addition to expanding Medicaid, the Affordable Care Act has paved the way for people who are self-employed or work at small businesses to purchase health insurance in the state Marketplaces, which is particularly important given rising self-employment in rural areas. Between 2013 and 2015, the number of uninsured small business employees fell from 13.9 million to 9.8 million, and the uninsured rate for small business employees fell from 27.4 percent to 19.6 percent.


Read full report here

Especially at risk because of Republicans’ health care sabotage agenda are rural hospitals, which rural communities often depend on for both primary and specialized health care services. Since 2010, 104 rural hospitals have closed. The vast majority, 88 percent, were in states that had refused to expand Medicaid at the time of the hospital’s closure. As of 2016, 673 rural hospitals were at risk of closing. Republicans’ continued attacks on Medicaid threaten the financial stability of these hospitals.

Since January 2017, President Trump and his Republican allies have repeatedlyattempted to repeal the Affordable Care Act, end Medicaid expansion, and sabotagestates’ individual insurance markets. In December, a federal judge ruled in favor of conservative states to overturn the Affordable Care Act, its Medicaid expansion, and its protections for people with pre-existing conditions. In February, President Trump, whose administration joined conservative states in arguing that pre-existing condition protections should be overturned, boasted that because of the lawsuit, the ACA would be “terminated.”

Instead of building on the Affordable Care Act’s progress, Republican policies seek to walk back recent progress in rural health. The Republican health care agenda strips Americans of comprehensive health coverage and guts Medicaid.

These measures disproportionately impact rural areas, increase barriers in access to health care, lead to coverage losses, increase the likelihood that rural hospitals will close, threaten major sources of jobs in rural communities, and jeopardize access to health services. Simply put, the Republican health care agenda fails rural Americans.

The Affordable Care Act And Medicaid: Lifelines For Care In Rural Communities

Medicaid is critical to health coverage in rural communities, which generally have lower rates of employer-sponsored coverage than other areas. Nearly one in fourrural Americans have health coverage through Medicaid. As the Kaiser Family Foundation finds, rates of Medicaid coverage are generally higher in rural areas than in other areas of the country. In 41 of the 43 states that have both rural and non-rural areas, the rural areas have a higher Medicaid coverage rate than non-rural areas. For instance, in Kentucky, 32 percent of adults living in rural areas have health insurance through Medicaid compared to 24 percent of adults in urban areas.

Medicaid plays an especially important role in covering rural seniors and children. Nearly 15 percent of seniors living in rural areas have health coverage through Medicaid, and Medicaid pays for more than 50 percent of long-term care. Similarly, Medicaid provides health care for 45 percent of children in rural areas, and pays for 51 percent of rural births.

The Affordable Care Act opened the doors to Medicaid expansion, which has significantly expanded access to health care in rural communities, reduced rural hospitals’ uncompensated care costs, and helped rural health providers keep their doors open by allowing states to expand Medicaid coverage for adults up to 138 percent of the federal poverty line. Medicaid expansion allowed 1.7 million rural Americans to gain coverage who had not previously been eligible. Following Medicaid expansion, the uninsured rate in rural parts of expansion states decreased by a median of 44 percent. In rural states that expanded Medicaid, the uninsured rates dropped significantly after the ACA became law:

  • In Montana, the uninsured rate dropped from 19 to 8.5 percent between 2013 and 2016.

  • In Kentucky, the uninsured rate dropped from 16.3 to 7.2 percent between 2013 and 2016.

  • In Arkansas, the uninsured rate dropped from 17.8 to 9.1 percent between 2013 and 2016.

  • In West Virginia, the uninsured rate dropped from 14.2 to 8.8 percent between 2013 and 2016.

By increasing access to health care, Medicaid expansion also drastically reduced the amount of costs that a hospital absorbs for any treatment or service not paid for by an insurer or patient, known as uncompensated care. The Center on Budget and Policy Priorities finds that “states that expanded Medicaid to low-income adults under the ACA saw both larger coverage gains and larger drops in uncompensated care: a 47 percent decrease in uncompensated care costs on average compared to an 11 percent decrease in states that did not expand Medicaid.” CBPP concludes that these declines in uncompensated care were “almost certainly” the result of the ACA’s coverage gains.

A Commonwealth Fund study yielded similar findings: uncompensated care costs decreased substantially in states that expanded Medicaid. On average, uncompensated care costs in Medicaid expansion states decreased from 3.9 percentage points to 2.3 percentage points between 2013 and 2015. In expansion states with an especially high burden of uncompensated care, the share of uncompensated care costs fell from 6.2 percent to 3.7 percent between 2013 and 2015.

Community Health Centers Fare Better In States That Expanded Medicaid

Just as rural hospitals fare better in states that expanded Medicaid, so too do community health centers (CHCs). Community health centers, which provide comprehensive primary health services to underserved areas without regard for ability to pay, are particularly important in rural areas where people face increased barriers to care. A recent study in Health Affairs highlighted how Medicaid expansion strengthens community health centers in rural areas by reducing the number of uninsured patients they see, and improving their quality of care.

The study revealed that Medicaid expansion decreased the percentage of uninsured patients seen by community health centers. Expansion was associated with an 11.4 percentage point decrease in the proportion of uninsured patients a community health center received, and a 13.2 percent increase in patients with health coverage through Medicaid.

The report also found that expansion was associated with improved quality of care in rural areas. For instance, in rural areas that expanded Medicaid, patients with asthma were 3.5 percent more likely to receive appropriate pharmacologic treatment, adults were 6.7 percent more likely to receive a BMI treatment with follow-up if needed, and patients with hypertension were 2.1 percent more likely to receive blood pressure control.

Republicans Want to Slash Medicaid

Since taking office, the Trump administration and Republicans in Congress have tried time and again to slash funding to Medicaid. These efforts include:

  • Trump-GOP lawsuit: Arguing in court that the entire Affordable Care Act, including its Medicaid expansion, should be overturned

  • President Trump’s FY 2020 budget: $1.5 trillion in cuts to Medicaid

  • President Trump’s FY 2019 budget: $1.4 trillion in cuts to Medicaid

  • September 2017 – Graham-Cassidy: more than $1 trillion in cuts over 20 years

  • July 2017 – Senate’s repeal, “Better Care Reconciliation Act”: $842 billion cut by 2026

  • May 2017 – House repeal bill, “American Health Care Act”: $834 billion in cuts to Medicaid over 10 years

Following several failed attempts to slash Medicaid funding, President Trump and Congressional Republicans passed a massive $1.5 trillion tax cut in 2017. To pay for these tax cuts, Republicans have suggested they will need to decimate public health programs like Medicaid.

Speaker Paul Ryan made the GOP’s priorities clear: “Frankly, it’s the health care entitlements that are the big drivers of our debt, so we spend more time on the health care entitlements — because that’s really where the problem lies, fiscally speaking.” In his fiscal year 2010 budget, President Trump requested a $1.5 trillion cut to Medicaid — attempting to strip health care from millions of low-income Americans to pay for tax cuts for the rich.

Thom Tillis’ Bill On Pre-Existing Conditions Nothing More Than “Political CYA” For Vulnerable Republicans

Washington DC – This week, Senator Thom Tillis along with other Senate Republicans introduced legislation that amounts to nothing more than political cover for their repeated attempts to strip health care away from millions of Americans.

It is clear that this legislation is the GOP’s phony attempt at claiming support for protections for pre-existing conditions, as an LA Times editorial today put it bluntly, “The bill pretends to be about safeguarding Americans with preexisting health conditions. But it’s really about protecting Senate Republicans from the stink caused by the Trump administration’s efforts to repeal the Affordable Care Act…”

For years, Republicans like Tillis have promised to rip apart the nation’s health care laws, and this past year have seized on the opportunity to back Trump’s lawsuit that would strip health care away from millions of Americans and end those same protections for pre-existing conditions they claim to support.

On a press call this Thursday, Protect Our Care’s executive director Brad Woodhouse made clear the bill “is simply a piece of political CYA for Republican senators who are up,” in 2020:

“Republicans claim this is a piece of legislation to protect people with pre-existing conditions, but it does nothing of the kind. The bill’s sponsors like Senator Tills have repeatedly claimed that repealing the ACA are among their top priorities in the Senate and all support Trump’s Texas lawsuit that would not only rip up the nation’s health care laws, but strip away the same protections for people with pre-existing conditions that they claim to support. It’s clear that this legislation is nothing more than a piece of political CYA for endangered Republicans like Thom Tillis who are up for reelection in 2020.”

Senate Republicans Are Selling A Scam On Pre-Existing Conditions

Senate Republicans have spent ten years trying to eliminate the Affordable Care Act’s protections for people with pre-existing conditions. They support President Trump’s lawsuit to use the courts to gut these protections. They voted time and time again for repealing health care on the floor of the US Senate.

Now that voters have rejected these efforts, Senate Republicans have resorted to trying to deceive the American public by hiding behind a new bill they wrongly claim will protect people with pre-existing conditions. The only problem? Their bill is a scam. And we already have a comprehensive pre-existing conditions protection bill, it’s called the Affordable Care Act.

Their bill fails to protect people with pre-existing conditions and gives power back to insurance companies to charge women and older adults more and sell people plans that do not include coverage for prescription drugs, hospitalization, and maternity care. The bill claims to guarantee that people with pre-existing conditions would get the care they need and not be charged more. That is false.

Here is the Senate Republican vision for the 137 million Americans with a pre-existing condition:

Insurance companies would once again be able to refuse to cover essential health benefits like hospitalization and prescription drugs. If essential benefits such as hospitalization, mental health services, maternity care, and coverage for prescription drugs are not covered, consumers with pre-existing conditions are not adequately protected. Without this protection, someone with cancer may be sold a plan but denied prescription drug coverage. Before the ACA, these kinds of restrictions were common: 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.

Insurance companies would once again be allowed to charge people more because of their gender or age. The ‘Protect Act’ would let insurance companies charge women more than men and would let insurance companies charge older adults even more for care. Before the Affordable Care Act’s protections, women were often charged up to 50 percent morethan men for the same coverage, and insurance companies were able to charge older adults even more for care. An AARP analysis estimated that without the ACA’s protections, a 60-year-old in the individual market would be charged an ‘age tax’ of $4,124 more per year.

People with pre-existing conditions would once again face the prospect of bankruptcy and insurance companies would have the power to restrict the amount of care someone can receive per year. By eliminating the current protection against lifetime and annual limits, Republicans would let insurance companies cap the amount of care a patient may get. When annual and lifetime limits are imposed, people may be denied life-saving care simply because they have reached their limit.

Fact Sheet On Trump Lawsuit To Overturn ACA

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

If the Affordable Care Act is struck down:

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

Thanks To The Republican Lawsuit, Nearly 20 Million People Could Lose Their Coverage

  • According to the Urban Institute, 19.9 million people could lose coverage by repealing the Affordable Care Act, meaning the number of uninsured Americans would increase from 30.4 million to 50.3 million, representing a leading to a 65 percent increase in the uninsured rate. As the uninsured rate swells, so will the amount of uncompensated care, which Urban predicts will grow by at least 82 percent.

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

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

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

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

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

  • 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
  • Medication for autism
  • Anti-psychotics
  • Medications for HIV/AIDS
  • Growth hormone
  • Medication used to treat arthritis, anemia, and narcolepsy
  • Fertility Medication

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

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

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

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

Republicans Want To End Medicaid Expansion

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

Lower Costs, Better Care: House Dems Unveil Sweeping Health Bill

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

This bill is only the start for the Democrats’ agenda which will ultimately include further efforts to rein in prescription drug costs and end surprise hospital bills. Here’s how the proposed legislation will work for Americans:

Lower Health Care Costs. The House bill would reduce health care premiums and deductibles, expand eligibility for financial assistance that helps consumers afford coverage, and expand access to affordable health care by guaranteeing affordable care options.

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

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

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

End Sabotage. Since taking office, the Trump administration has worked relentlessly to sabotage Americans’ health care, expanding access to junk plans that allow insurance companies to deny coverage to patients with pre-existing conditions and slashing funding to help people sign up for comprehensive, affordable care.

  • Restoring funding for education. The House bill would restore marketing funding for heatlh care sold through the marketplace, which the Trump administration has cut by 90 percent since taking office.

Restoring funding for groups that help people sign up for coverage. Funding for health navigator groups that help people sign up for comprehensive care, which has been cut by 77 percent since the President Trump took office, would also be restored.

Bill Introduced By Thom Tillis, Senate Republicans A Desperate Attempt To Rewrite GOP’s History On Pre-Existing Conditions

Washington, DC – Legislation introduced by Senator Thom Tillis (R-NC) and Senate Republicans today is nothing more than an effort by the GOP to desperately disown their war on America’s health care and their repeated attempts to strip protections from millions of Americans with pre-existing conditions. Protect Our Care executive director Brad Woodhouse released the following statement in response:

“The American people aren’t idiots, and they know the Republican Party has spent ten years trying to rip up the health care laws and deny protections for Americans with pre-existing conditions. Republicans got clobbered in the midterms because of their constant attacks on people with pre-existing conditions, and the bill introduced by Senator Tillis today is just another desperate attempt by Senate Republicans to cover up their ongoing war on America’s health care. Let’s not forget, these are the same people who support Trump’s Texas lawsuit to rip apart our health care laws, slashing coverage for millions of Americans and gutting all protections for pre-existing conditions. Here’s an idea: if you want to save protections for people with pre-existing conditions, don’t support the Trump lawsuit to rip them apart.”

Idaho Places Burdensome Work Requirements On Voter-Approved Medicaid Expansion

Washington, DC – Today, Idaho Governor Brad Little signed a bill placing onerous work requirements on the Medicaid program that Idahoans voted to expand in November–just weeks after a federal judge struck down similar laws in other Republican-led states. In response, Protect Our Care executive director Brad Woodhouse released the following statement:

“Governor Little is defying the will of the people by imposing restrictive Medicaid work requirements after Idahoans overwhelmingly voted in favor of Medicaid expansion last November. Idaho Republicans are following the Trump administration’s lead imposing these dangerous requirements meant to kick people off the rolls. It’s clear that such requirements are not only harmful, but also illegal, given similar work requirements were struck down just weeks ago.”

Attorney General Barr Defends Trump’s Lawsuit, Gives Full-Throated Support For Taking Away Health Care From Millions Of Americans

Washington, DC — Today, Attorney General William Barr testified before the House Appropriations Subcommittee on Commerce, Justice and Science where he was grilled by Democrats on his defense of the Trump health care lawsuit, and failed to answer as to why the administration is trying to rip away health care from millions of Americans. Barr’s testimony follows a letter sent by House Democrats this morning demanding answers from the Barr about Trump’s refusal to enforce the nation’s health care laws while simultaneously trying to destroy them in the courts.

Following Barr’s defense of the disastrous Trump lawsuit today during his testimony and failure to provide sufficient answers about the administration’s ongoing sabotage of Americans’ health care, Protect Our Care executive director Brad Woodhouse released the following statement:

“Attorney General Barr made crystal clear today that the disastrous Trump lawsuit remains a top priority for the administration, and that Trump’s war on America’s health care is far from over. At the hearing today, Democrats seized on the opportunity to expose the hypocrisy of the man responsible for enforcing the nation’s health care laws while doing everything he can to rip them apart. It’s clear that Trump and his cabinet have made health care sabotage their utmost priority, and today’s testimony from the attorney general only confirms Trump’s desire to go to any lengths necessary take health care away from millions of Americans.”

Chairman Scott Takes Bold Action To Reverse Trump’s Health Care Sabotage, Stop The Spread Of Junk Insurance Plans

Washington, DC — Following the House Committee on Education and Labor markup of HR 1010, a bill to reverse the Trump administration’s expansion of short-term, junk health care plans, Protect Our Care executive director Brad Woodhouse released the following statement:

“Chairman Bobby Scott took much needed action today to block the spread of Trump’s disastrous short-term junk insurance plans that openly discriminate against millions of Americans with pre-existing conditions. If Republicans truly cared about protecting Americans with pre-existing conditions, they would have voted with their Democratic colleagues in support of this bill instead of blindly following Trump in his ongoing war on America’s health care.”


Junk Plans Hurt People with Pre-existing Conditions

Junk Plans Are Allowed To Discriminate Against People With Pre-Existing Conditions.“Policyholders who get sick may be investigated by the insurer to determine whether the newly-diagnosed condition could be considered pre-existing and so excluded from coverage.” [Kaiser Family Foundation, 2/9/18]

  • As Many As 130 Million Nonelderly Americans Have A Pre-Existing Condition. [Center for American Progress, 4/5/17]
  • One in 4 Children Would Be Impacted If Insurance Companies Could Deny Coverage Or Charge More Because Of A Pre-existing Condition. [Center for American Progress, 4/5/17]

Junk Plans Mean Higher Premiums For People With Pre-Existing Conditions. “By promoting short-term policies, the administration is making a trade-off: lower premiums and less coverage for healthy people, and higher premiums for people with preexisting conditions who need more comprehensive coverage.” [Washington Post, 5/1/18]

Junk Plans Can Refuse To Cover Essential Health Benefits. “Typical short-term policies do not cover maternity care, prescription drugs, mental health care, preventive care, and other essential benefits, and may limit coverage in other ways.” [Kaiser Family Foundation, 2/9/18]

Under Many Junk Plans, Benefits Are Capped At $1 Million Or Less. Short-term plans can impose lifetime and annual limits –  “for example, many policies cap covered benefits at $1 million or less.” [Kaiser Family Foundation, 2/9/18]

For more information, see Protect Our Care’s fact sheet on short-term junk plans.

Medicaid Expansion: Improves Health, Saves Lives And Gives Millions Access To Affordable Health Care

This April, Protect Our Care is Celebrating Medicaid Awareness Month, A Nationwide Push To Highlight the Importance of Medicaid for Millions of Americans, and What’s At Stake in the Texas Lawsuit and Trump’s Renewed Calls for Repeal

Washington, DC — April is Medicaid Awareness month, and this week we’re highlighting the success of Medicaid expansion and the positive impact that increasing access to Medicaid has had for millions of Americans across the country.

Years after the Affordable Care Act opened the doors for states to expand Medicaid, the results are piling in: Medicaid expansion works. It leads to healthier people, communities, and economies. Despite the increasing disparities between states that chose to expand Medicaid and those that did not, the Trump administration and its Republican allies remain intent on decimating Medicaid expansion, and jeopardizing the health of 12.7 million Americans who depend on Medicaid expansion for coverage.


Here’s a look at how Medicaid expansion is working:

Medicaid Expansion Saves Lives By Helping People Access Treatment, Preventive Care

Research Presented At American Heart Association’s Scientific Sessions Finds Medicaid Expansion Tied To Fewer Heart-Related Deaths. “Between 2010 and 2016, counties in states where Medicaid expanded had 4 fewer deaths per 100,000 residents each year from cardiovascular causes after expansion, compared with counties in non-expansion states, according to the research…’The overall results of this study are that after expansion of Medicaid in 2014, the areas in the country that did expand had a significantly lower mortality rate compared to if they had followed the same trajectory as the areas in the country that didn’t expand,’ said Dr. Sameed Khatana, a fellow in cardiovascular disease at the Hospital of the University of Pennsylvania in Philadelphia, who was first author of the new research.” [CNN 4/5/19]

Study Published In Health Affairs Finds Low-Income People More Able To Afford Diabetes Medications And Manage Disease In Expansion States. “Low-income people with diabetes are better able to afford their medications and manage their disease in states that expanded Medicaid under the Affordable Care Act, a new study suggests. The Health Affairs study, released Monday afternoon, found a roughly 40 percent increase in the number of prescriptions filled for diabetes drugs in Medicaid programs of the 30 states (including Washington, D.C.) that expanded eligibility in 2014 and 2015, compared with prior years.By contrast, states that didn’t embrace the Medicaid expansion saw no notable increase.” [Kaiser Health News, 8/6/18]

Drexel University Study: Medicaid Expansion Under The ACA Increased Low-Income Patient Access To Kidney Transplants. “After states expanded Medicaid to cover more low-income individuals under the Affordable Care Act (ACA), there was a significant boost in the number of chronic kidney disease patients with Medicaid coverage who were placed on the kidney transplant waiting list, according to a new study led by Drexel University researchers” [Drexel University, 6/21/18]

University of Michigan Study Finds Medicaid Expansion Improves Access To Family Planning. “Among 1,166 reproductive-age women who enrolled in the Healthy Michigan Plan, Michigan’s expansion of the Medicaid program for low-income adults, 1 in 3 said the expanded coverage improved access to birth control and family planning services…’Our findings suggest that the expansion provided an important service for populations with a high unmet need for family planning care,’ says lead author Michelle Moniz, M.D., M.Sc., an assistant professor of obstetrics and gynecology at Michigan Medicine. ‘Insurance coverage also means that women have access to more options if they do not want to become pregnant at the current time.’…Each dollar spent on contraception is estimated to save the health care system more than $7 in return, according to a recent study from the Guttmacher Institute. About 40 to 50 percent of the 4 million live births in the U.S. every year are paid for by Medicaid.” [University of Michigan, 8/31/18JAMA Publication]

Medicaid Expansion Improves Financial Security

The Chance Of Accruing Medical Debt Is 20 Percent lower In States That Have Expanded Medicaid. “A survey comparing expansion and non-expansion states finds that the chance of accruing medical debt is 20 percent lower in expansion states. It also finds that Medicaid coverage, by reducing enrollees’ unpaid medical bills, improves their credit, leading to lower-interest mortgage, auto, and credit card loans that save them an estimated $280 per year in interest.” [Center on Budget and Policy Priorities, 10/2/18]

National Bureau Of Economic Research Analysis Finds Medicaid Expansion Led To Nearly $6 Billion Decline In Unpaid Medical Bills And To Higher Credit Scores. “ In the context of the Medicaid expansion under the Affordable Care Act, we estimate that insurance provision led to a $5.89 billion decline in unpaid medical bills sent to collections, to higher credit scores, and to bet38 ter credit terms valued at $670 million annually.” [National Bureau Of Economic Research, 7/31/18]

An Ohio Report On The Impact Of Its Medicaid Expansion Found Vast Majorities Of Medicaid Enrollees Said Medicaid Expansion Helped Them Hold Down Jobs, Look For Work. “Over 83 percent of employed Ohioans who were continuously enrolled in Medicaid said the program helped enable them to hold down jobs; in many cases, Medicaid allowed them to obtain treatment for health conditions that would have otherwise made working difficult. Among unemployed but continuously enrolled beneficiaries, 60 percent said the program made it easier for them to look for work.” [Pacific Standard, 8/21/18]

University Of Kansas Research Finds Medicaid Boosts Employment For People With Disabilities. “People with disabilities are much more likely to be employed in states that have expanded Medicaid coverage as part of the Affordable Care Act, new research from the University of Kansas has found. Similarly, the number of those who report not working because of a disability has greatly declined in expansion states. Neither trend happened in states that chose not to expand Medicaid.” [Healthcare Finance News, 7/23/18]

Medicaid Expansion Is An Important Tool In Addiction Recovery

Health Affairs Study Finds Medicaid Expansion Aids Addiction Recovery. “The number of people diagnosed each month with opioid use disorder nearly tripled from 2014 to 2016, the authors found. And as more people were diagnosed, more people got treatment. About one-third of people diagnosed with opioid use disorder in 2014 were prescribed buprenorphine — the leading medication-assisted therapy for opioid dependence. By 2016, that was up to 75%.” [Axios, 4/2/19]

Urban Institute Report Finds Medicaid Expansion Increases Access To Treatment For Opioid Use Disorder. “Between 2013—before the major coverage provisions of the Affordable Care Act were implemented—and 2017, Medicaid spending on prescriptions for the Rapid Growth in Medicaid Spending and Prescriptions to Treat Opioid Use Disorder and Opioid Overdose from 2010 to 2017 treatment of OUD and overdose nearly tripled or more in states that expanded Medicaid by 2017, while spending in non-expansion states nearly doubled. Between 2013 and 2017, Medicaid-covered buprenorphine prescriptions nearly tripled from 1.79 million to 5.18 million, naltrexone prescriptions more than quadrupled from 99,000 to 444,000, and naloxone prescriptions rose nearly 25- fold from 5,000 to 125,000. Increases in all three prescriptions were far greater in states that had expanded their Medicaid programs before July 2016 than states that did not expand…Between 2013 and 2017, increases in per capita prescriptions were far greater in Medicaid expansion states than in non-expansion states. In addition, the highest levels of treatment prescriptions were in expansion states: more than 100 buprenorphine prescriptions per 1,000 Medicaid enrollees in 2017 compared with just over 30 prescriptions per 1,000 enrollees in non-expansion states.” [Urban Institute, February 2019]

Research Published In JAMA Confirms That Medicaid Expansion Increased Access To Opioid Treatment. “Medicaid expansion significantly increased buprenorphine with naloxone prescriptions per 100 000 county residents in expansion counties, suggesting that expansion improved access to opioid use disorder treatment. Expansion did not significantly increase the overall rate per 100 000 county residents of OPR prescriptions, but increased the population with OPRs paid for by Medicaid. This finding therefore suggests the growing importance of Medicaid in pain management and addiction prevention.” [JAMA, Saloner et. al, 8/17/18]