To: Interested Parties

From: Leslie Dach, Campaign Chairman, Protect Our Care

Subject: It’s Back: President Trump’s Budget Seeks to Revive Health Repeal

Date: February 13, 2018

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President Trump’s fiscal year 2019 budget proposal calls for the passage of the so-called Graham-Cassidy bill, the worst of the partisan repeal bills Congress considered last year. If you forgot – and who can blame you, there were a lot of repeal bills! – Graham-Cassidy was deemed “crueler and more cynical” than previous repeal proposals, in large part due to its draconian Medicaid cuts, and garnered just 24% approval before it died in the Senate without a vote. It was opposed by the American Medical Association, AARP, the American Cancer Society, insurers, physicians, faith leaders, nearly every medical and patient’s rights organization, a coalition representing all 50 state Medicaid directors, and Jimmy Kimmel – who analysts said had a “better grasp of health care policy” than the GOP senators who pushed the proposal.

Specifically, the Graham-Cassidy bill Trump wants to bring back would:

  • Take away coverage from 32 million Americans by 2027, with 15 million Americans losing their insurance and premiums increasing by 20 percent in the first year.
  • Gut Medicaid by imposing severe cuts and per-capita caps, forcing states to either raise people’s taxes or make draconian cuts to schools and other vital programs.
  • Raise costs on working- and middle-class families by eliminating financial assistance that helps pay for care. Graham-Cassidy ends premium subsidies, which help 9 million Americans pay for coverage, and Medicaid expansion, which has helped 15 million people get the care they need. These programs would be converted into a block grant and eventually zeroed out.
  • Remove protections for those with pre-existing conditions, with the Congressional Budget Office finding that many people with pre-existing conditions “might not be able to purchase coverage at all.”
  • Harm women’s health by preventing Medicaid enrollees from accessing preventive health and family planning services through Planned Parenthood.

In short, Graham-Cassidy would irreparably harm the American health care system, and the fact that President Trump still considers it a good option shows just how out of touch he is with the American people. The negative reaction to its inclusion have been swift:

New York Times Editorial Board: “It calls for (yet again) the repeal of the Affordable Care Act… Medicare and Medicaid, which benefit one-third of Americans, are targeted for cuts of hundreds of billions of dollars. If Congress adopted Mr. Trump’s proposal, millions of people would stand to lose health insurance.”

Planned Parenthood: “This year’s budget plan proposes sweeping changes that, if implemented, would radically reduce people’s access to health care and information through vital programs, especially for women. Whether or not Congress subscribes to the president’s priorities, the entire proposal is a blueprint for policymaking that the administration will no doubt use to advance its agenda.”

American Cancer Society Cancer Action Network: “Eliminating the health insurance marketplace subsidies and transforming Medicaid funding into a per-capita cap or block-grant structure could leave millions of Americans unable to access critical health services. Medicaid serves as an essential safety-net for more than 2.3 million Americans with a history of cancer, including one-third of all pediatric cancer patients at the point of diagnosis.”

American Lung Association: “Over the past year, Americans have been hit by repeated public health crises, from devastating wildfires and deadly storms to an influenza epidemic. President Trump’s budget proposal would simply make things worse.

Initial news coverage of the budget proposal also focused on the havoc it would wreak in the American health care system:

Los Angeles Times: “The White House is doubling down on the repeal effort, calling for massive cuts to healthcare assistance in its 2019 budget … Cuts of this magnitude – which parallel repeal legislation pushed unsuccessfully by GOP congressional leaders last year – would likely leave tens of millions more Americans without health coverage, independent analyses have indicated.”

Washington Post: “On healthcare for low-income Americans, Trump’s budget calls for cutting federal Medicaid funding by $250 billion over the next 10 years, as the administration envisions passing a law ‘modeled closely’ on a Senate Republican proposal that failed last fall to repeal the Affordable Care Act…  Experts say the overall reduction in government spending would cost millions of Americans their health insurance.”

Wall Street Journal: “The budget proposal includes $68.4 billion for the Department of Health and Human Services, a 21% drop from the funding level enacted last year. The proposal would also revive a repeal of the Affordable Care Act and cut spending on Medicare and Medicaid. It calls for enactment of a law to scrap the ACA and instead give block grants to states to establish their own health systems, a plan modeled after GOP legislation that failed to pass last year.”

CNBC: The new budget proposal also would seek a rollback of Obamacare’s expansion of Medicaid benefits to poor adults. Medicaid offers health coverage to primarily low-income people. Before Obamacare, most states either denied Medicaid coverage to people who did not have dependent children or set very low limits on how much a person could earn and still qualify for coverage.

Business Insider: “The budget contains cuts to funding for Medicare and other social safety net programs. During the presidential campaign, Trump repeatedly promised not to cut funding to these programs.”

USA Today: “The budget proposes repealing the ACA’s expansion of Medicaid and limiting the amount of money states receive for the jointly-funded health care program for the poor. It would also end after two years the private insurance subsidies for people who don’t get coverage through a government program or an employer, while giving states grants to develop their own programs.”

STAT News: “The proposals are a hodgepodge of relatively narrow policies that take aim at various parts of the Medicare and Medicaid programs. One would reduce the amount of money doctors and hospitals are reimbursed for hospital-administered drugs under Medicare Part B; another would let some states engage in more aggressive negotiation for drugs in their Medicaid programs. Others take aim at a drug discount program for hospitals and at seniors’ out-of-pocket spending.”

Since taking office last year, President Donald Trump and his Administration have carried out an unrelenting war on our health care with a goal of repealing the Affordable Care Act and gutting Medicaid. Trump has used his administrative powers to sabotage our health care and continue to beat the drum of partisan repeal of the increasingly-popular Affordable Care Act.

While the Trump Administration and Republicans in Congress want to keep up this war on health care in 2018, the American people are saying “Enough is Enough.” More than eleven million people signed up for coverage through HealthCare.gov despite all the sabotage efforts. The Affordable Care Act is more popular than it has ever been. And millions of people across the country made their voices heard at rallies, town halls and through calling their Member of Congress to fight these repeal efforts. The American people are right: enough IS enough – it’s time for President Trump and the GOP to end their war on our health care.