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Indiana Waiver Approval Accelerates Trump Administration’s War on Medicaid

Washington, DC – As the Trump Administration accelerates its war on Medicaid today by approving Indiana’s waiver proposal, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“By announcing today’s approval, Secretary Azar is escalating the Republican war on health care and its effort to demolish Medicaid from the inside out. The Trump Administration is choosing to cause real pain in Indiana by letting the state make Mike Pence and Seema Verma’s cruel, failing Medicaid ‘experiment’ even worse. Hoosiers with Medicaid will face a 6-month lockout for a simple paperwork mistake, reversing Obama-era progress to streamline enrollment and reduce administrative hurdles. A person caring for a sick child or parent, someone working to control their opioid addiction, or someone who has chronic health conditions that make it impossible to work will now have the added worry of losing their health insurance. This is just cruel. The truth is that imposing work requirements will do nothing to help Hoosiers find or keep jobs. In fact, it most likely will have the opposite effect.

“With today’s announcement, Secretary Azar is also showing that he is a Trump foot soldier who’s happy to help distract from CMS Administrator Verma’s conflicts of interest in Indiana: the agency she leads has just signed off on an even worse version of a badly failing program she personally made millions of taxpayer money off of thanks to Vice President Pence while he was Governor.

“Today’s announcement is a direct affront to Medicaid’s stated mission of improving people’s health.  This is not about work. It’s about taking away people’s health care. All it does is kick people while they’re down.”

BACKGROUND:

In 2015, in order to expand Medicaid to over 350,000 Hoosiers, the Obama administration approved then-Indiana Governor Mike Pence’s experimental proposal to impose nominal “show” premiums (often $1) for people with Medicaid, and then take away their coverage with a “lockout” of at least 6 months if they missed a payment. Since then, 25,000 Hoosiers have been kicked off their coverage by lockouts.

CMS Administrator Verma’s Checkered Anti-Medicaid Past in Indiana & Beyond

Verma Created The “Healthy Indiana Plan 2.0” Under Pence, Which Put Restrictions On Medicaid Recipients That “Warranted A Six-Month Lockout From Coverage” If They Missed A Single Monthly Payment. According to the International Business Times, “Verma has an extensive history in the healthcare industry. Her consulting firm, SVC Inc., worked alongside Pence to reform Indiana’s Medicaid program following the induction of President Barack Obama’s Affordable Care Act (ACA). […]While Pence was governor of Indiana, Verma helped create Healthy Indiana Plan 2.0, which required users, including low-income recipients, to make monthly payments for their health insurance services with restrictions that warranted a six-month lockout from coverage if even a single payment was missed.” [International Business Times, 11/30/16]

A Mother Of Three In Indianapolis Was Kicked Out Of The Program For A Misplaced $1 Payment. According to NPR, “So how does it work in practice? For Amber Thayer, a mom of three who lives in a Volunteers of America family shelter in Indianapolis, it’s been a bit of a nightmare. Thayer is a recovering addict who has been clean for six months with the help of the medication Suboxone. And she’s training to be a nursing assistant. ‘It’s been quite, quite the struggle, but we’ve gotten there and we’re doing great, and we’re getting ready to get into our own home,’ she says. She pays $1 a month for her Medicaid insurance. In October, she got a bill for that $1 from a different company than the one she had been dealing with. She assumed the state had switched her. ‘It is only a dollar,’ she says. ‘I could pay a dollar a month, or I could pay $12 and that will cover me for the year. Unfortunately, at that time, I only had I believe it was like $2.38 on my card.’ So she called the company and used her bank card to pay the dollar. But the company, or perhaps the state, lost track of her dollar, and her insurance was cut off. She had her bank statement and a receipt from the insurer that proved she had paid. But she still spent six weeks, with multiple phone calls and visits to state health offices, trying to get her coverage restored.” [NPR via Houston Public Chronicle, 1/3/17]

Indiana Medicaid Recipients Could Be “Locked Out Of The Program” For Not Paying Their Premiums, “A Provision Even Commercial Insurance Does Not Impose.” According to The Guardian, “In Indiana, if people on Medicaid earning between $11,000 and $16,000 don’t pay their ‘premiums’, they can be locked out of the program for up to six months, a provision even commercial insurance does not impose. ‘If someone can’t scrape up the money for premiums for two months, they get dis-enrolled, and they get locked out for six months,’ said Kallow. ‘Then say they get cancer, they get hit by a truck, they have an accident. They have absolutely no place to turn for health coverage.’” [The Guardian, 12/4/16]

While Kicking People Off Of Medicaid, Verma’s Firm SVC, Inc. Was Contracted To Receive More Than $4.8 Million From The State Of Indiana Between 2014 And 2017. According to SVC’s contract with the Indiana Family and Social Services Administration, SVC Inc. was contracted to receive $4,851,400 between May 2014 and June 2017. [SVC Inc. Contract – Indiana Family and Social Services Administration, 6/17/16]

At The Same Time Verma Worked On The Redesign Of Indiana’s Medicaid Program Under A $3.5 Million State Contract She Was Working For “One Of The State’s Largest Medicaid Vendors,” Receiving More Than $1 Million.” According to the Indy Star, “Largely invisible to the public, Verma’s work has included the design of the Healthy Indiana Plan, a consumer-driven insurance program for low-income Hoosiers now being touted nationally as an alternative to Obamacare. In all, Verma and her small consulting firm, SVC Inc., have received more than $3.5 million in state contracts. At the same time, Verma has worked for one of the state’s largest Medicaid vendors — a division of Silicon Valley tech giant Hewlett-Packard. That company agreed to pay Verma more than $1 million and has landed more than $500 million in state contracts during her tenure as Indiana’s go-to health-care consultant, according to documents obtained by The Indianapolis Star. Verma’s dual roles raise an important question: Who is she working for when she advises the state on how to spend billions of dollars in Medicaid funds — Hoosier taxpayers or one of the state’s largest contractors?” [Indy Star, 8/26/14]

  • Indiana Lawmakers Were Unaware That Verma Was Working For The State And For HP Simultaneously. According to the Indy Star, “If Verma was a federal contractor, her dual roles ‘would certainly raise tremendous concern for regulators and purchasing officials,’ he said. ‘This is exactly the kind of thing that would land an agency in a hearing before a legislative oversight committee.’” [Indy Star, 8/26/14]

Verma’s Medicaid Reforms In Iowa Were “A Nightmare.” According to STAT News: “When President Donald Trump tapped policy consultant Seema Verma to run Medicaid and Medicare in his administration, he called her part of a health care ‘dream team.’ But the health policy changes she helped design in Iowa have felt more like a nightmare to providers serving poor and disabled residents across the state. Verma has helped several states revamp Medicaid, including Kentucky and Indiana. Here in Iowa, she worked on an aggressive effort to privatize the program, which provides health care to about 600,000 adults and children.” [STAT News, 1/24/17]

  • Ablekids Pediatric Therapy In Sioux Falls Reported Struggle to Keep Doors Open. According to a Des Moines Register editorial: “The Cedar Rapids Gazette has reported on billing problems experienced by outpatient rehabilitation clinics across the state. ‘We’re not even getting half of what we got with Iowa Medicaid,’ said Jessica McHugh, owner of AbleKids Pediatric Therapy in Sioux City, referring to the many years when the state administered Medicaid.” [Editorial – Des Moines Register, 7/16/16]

This Week In the War on Health Care — January 29 – February 2, 2018

While Washington focused on the State of the Union, the Trump Administration continued its unprecedented assault on the American health care system. Here’s what happened this week in Republicans’ war on health care – and why they’re losing battles to the American people:

LIES FROM THE LECTERN

During his State of the Union address, President Trump doubled down on the war on health care his administration and his Republican allies in Congress waged last year, saying he “repealed the core of disastrous Obamacare” — a widely debunked lie. He also failed to mention that:

The President then pivoted to the opioid crisis, attempting to take credit for addressing the epidemic. But in reality, Trump has done nothing to facilitate treatment for Americans struggling with addiction. In fact, his attacks on critical federal health care and opioid response programs stand to make the situation worse:

  • His public health emergency declaration speech freed up just $57,000, pathetically short of the billions experts say are desperately needed.
  • His Administration sabotaged Medicaid, which pays for one-fifth of all substance abuse treatment nationwide.
  • He proposed a 95% cut to the Office of National Drug Control Policy, which coordinates the federal opioid response – and he did so for the second year in a row.

Sadly, the Trump Administration is not only offering a pathetic response to the nation’s most urgent public health crisis, it’s actively sabotaging communities that are fighting to turn the tide on this deadly epidemic.

A NEW GENERAL TAKES HIS OATH

On Monday, former Big Pharma lobbyist Alex Azar was sworn in as the new secretary of Health and Human Services. Azar lied about the Trump Administration’s sabotage throughout his confirmation process, choosing to embrace the Republican agenda that takes coverage from millions of Americans, raises costs for millions more, and protections for people with pre-existing conditions.

Whether Azar upholds the oath he swore will soon be tested because of…

IDAHO’S ATTEMPT TO FLOUT FEDERAL LAW

Negative reactions continued as experts digested Idaho Governor Butch Otter’s illegal proposed assault on the Affordable Care Act. University of Michigan law professor and former Department of Justice attorney Nicholas Bagley called such an action “crazypants illegal,” noting that Idaho, “appears to be claiming they do not have to adhere to federal law.”

What Secretary Azar does with this will be an excellent indicator of whether he plans to truly support the health of the American people, like he claimed, of if he will merely be another foot soldier in the Administration’s war on health care.

COSTS FOR SENIORS CONTINUE TO RISE

A new report from the Kaiser Family Foundation highlights massive increases in out-of-pocket medical costs for Medicare beneficiaries – costs that are projected to keep skyrocketing.

While President Trump has claimed he wants to lower costs, the reality is the opposite: he has consistently supported proposals making health care more expensive, from repeal legislation allowing insurance companies to charge people over 50 an ‘age tax’ with rates five times higher to the GOP tax scam set to raise premiums double digits. Seniors should rightly be furious, as are…

HEALTH CARE PROTESTS IN WEST VIRGINIA

As GOP Members of Congress retreated to West Virginia, they were greeted by protesters furious about the ongoing war on health care:

OPEN ENROLLMENT NUMBERS BLOW EXPECTATIONS OUT OF THE WATER

And finally, yesterday was the scheduled final day of open enrollment. Despite the widespread attempts at sabotage by the Trump Administration, from cutting the sign-up period in half to dropping advertising by ninety percent, we have already reached 96% of last year’s enrollment total:

  • Nearly 8.8 million people signed up for coverage through HealthCare.gov.
  • Demand from new consumers outpaced new enrollments every single week of last year, with 2.5 million new people signing up for coverage.
  • Almost 6.3 million returning consumers actively renewed their coverage or were automatically re-enrolled compared to 6.2 million people last year.

Protect Our Care Statement on What Should Have Been the Last Day of Open Enrollment

After the states that stuck with the original Open Enrollment schedule wrapped up strong enrollment seasons last night, Protect Our Care Executive Director Brad Woodhouse released the following statement:

“If President Trump hadn’t sabotaged Open Enrollment by cutting the signup period in half for the 36 states using HealthCare.Gov, yesterday could have marked the end of the annual sign-up season nationwide. But here’s the good news: despite the Trump Administration’s sabotage, millions of Americans again signed up for comprehensive coverage. Before the final numbers come in, we have already reached 96% of last year’s enrollment total nationwide. This year’s enrollment season succeeded thanks to thousands of enrollment assisters, community activists, and volunteers who banded together to do what the Trump Administration refused to: help their fellow Americans get covered. It’s time for Republicans to stop their war on health care, which stopped even more people from signing up by driving up unsubsidized premiums, because it’s clearer than ever that Americans want and need quality, affordable coverage.”

 

 

Seniors’ Medical Expenses Rising as GOP War on Health Care Spikes Costs Nationwide

Meta Capitol

“Lost in the State of the Union coverage was yesterday’s new report from the Kaiser Family Foundation highlighting massive increases in out-of-pocket medical costs for seniors – and they’re projected to keep skyrocketing. While President Trump has claimed he wants to lower health care costs, including the prescription drug costs that drive seniors’ medical expenses, the reality is the opposite. President Trump has consistently supported proposals that make health care more expensive, from repeal legislation which would have allowed insurance companies to charge people over 50 an ‘age tax’ with rates five times higher to the tax scam that’s set to raise premiums double digits, and he recently put a Big Pharma executive in charge of HHS. The first step toward containing costs for American seniors and families is for Trump and the GOP to end their war on Americans’ health care and stop paying allegiance to Big Pharma.”

Seniors’ out-of-pocket medical costs are rising

Axios // Sam Baker // January 30, 2018

On average, Medicare beneficiaries are spending about 41% of their Social Security income on out-of-pocket health care costs, according to new research from the Kaiser Family Foundation. And half of all Medicare beneficiaries spent roughly 14% of their total income — not just from Social Security — on health care.

Why it matters: Health care is eating up more and more of everyone’s income — but that’s an especially difficult burden for seniors, who often live on fixed incomes.

The gritty details, per KFF:

  • These percentages are expected to grow.
  • Those expenses include premiums, cost-sharing, and spending on services Medicare doesn’t cover, such as long-term care.
  • Not surprisingly, older, sicker and poorer seniors were all more likely to spend a greater share of their income on health care expenses.

Don’t forget: This is also a good reminder that while “Medicare for all” polls well as a synonym for single payer, actual Medicare for all would still leave plenty of room for out-of-pocket spending and even privately administered benefits.

Go deeper: Corporate profits have dramatically outpaced wages and health benefits since the turn of the century.

President Trump Ignores Health Care Damage Caused By Year of Sabotage in 2018 State of the Union

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Washington, DC – In response to tonight’s State of the Union address, during which President Donald Trump falsely claimed to have repealed the Affordable Care Act, duplicitously claimed he is working to end the opioid crisis, and ignored the fact that under his watch, millions of Americans have lost coverage and millions more are facing skyrocketing health costs, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Tonight’s speech was a succinct summary of health care during the Trump Administration’s first year: full of lies, short on solutions and indifferent to the Americans who have been harmed by its policies. During last year’s speech, President Trump said he would lower premiums, protect those with pre-existing conditions, and protect Medicaid. Instead, he signed a bill which will raise premiums double-digits and deny coverage to millions, championed bills removing protections for pre-existing conditions and imposing an age tax, and implemented Medicaid requirements designed to deny coverage to people who need it the most. And 3.2 million Americans lost their health care in 2017 as a result of his sabotage.

“While President Trump and Republicans in Congress spent the year attempting to sabotage and repeal the Affordable Care Act, the American people refused to go along, voting out Republicans who supported sabotage and enrolling in Marketplace plans at near-record numbers. Today, the Affordable Care Act is more popular than ever. If Donald Trump truly cares about the state of the nation he leads, he will end his repeal and sabotage campaign. Enough is enough – it’s time for President Trump and Congressional Republicans to end their war on health care.”

Fact Check: President Trump Doubles Down On His War on Health Care In the State of the Union

During his State of the Union address, President Trump doubled down on the war on health care his administration and his Republican allies in Congress waged last year, saying he “repealed the core of disastrous Obamacare.” These relentless attacks and sabotage of our health care have real consequences for people across the country. Enough is enough. It it time to end partisan attempts to repeal and undermine health care.

ONE YEAR INTO THE TRUMP/GOP WAR ON HEALTH CARE: MORE UNINSURED & HIGHER COSTS

  • 3.2 million people have lost their health coverage.
  • Trump sabotage led to higher premiums this year because of uncertainty in the market.
  • Women may face higher costs after the Trump Administration took direct aim at birth control by rolling back a rule that guaranteed women access to copay-free contraception.
  • People with pre-existing conditions face higher costs because the Trump Administration’s rules rolling back key consumer protections that will result in garbage insurance.
  • Congress passed, and President Trump signed, a tax bill that repealed a key provision of the Affordable Care Act that will result in millions more losing health coverage and raising premiums by double digits.

Fact Check: Trump’s Massive Failure to Address the Opioid Crisis

Officer Ryan Holets is a true role model, one of the many dedicated Americans who work hard every day to fight our nation’s raging opioid crisis. Sadly, President Trump is not among them. For those Americans who had hoped that Trump might address this raging epidemic with the urgency it deserves, tonight’s hollow words echo last year’s broken promises. In reality, Trump has done nothing to facilitate treatment for Americans struggling with addiction, and his attacks on critical federal health care and opioid response programs threaten to make the situation worse:

  • The window-dressing public health emergency declaration the President touted in tonight’s speech freed up a fund worth only $57,000, falling pathetically short of the billions that experts say are desperately needed to combat the crisis.
  • The House repeal bill that President Trump supported would make the opioid crisis worse by eliminating parity requirements for mental health and addiction coverage, and through drastic Medicaid cuts that put states on the hook for the huge cost of dealing with the epidemic.
  • The Trump Administration has relentlessly attacked and sabotaged Medicaid, which helps people with opioid addiction receive care, paying for one-fifth of all substance abuse treatment nationwide.
  • This month, the Trump Administration proposed a 95% cut to the Office of National Drug Control Policy, which is charged with coordinating the federal response to the nation’s raging opioid crisis – for the second year in a row.

When you add it all up, the Trump Administration is not only offering a pathetic response to the nation’s most urgent public health crisis, it is actively sabotaging communities that are fighting to turn the tide on this deadly epidemic.

Protect Our Care State of the Union Resources

Ahead of tonight’s State of the Union address, here’s a roundup of helpful materials:

  • Protect Our Care State of the Union memo
  • Protect Our Care memo on Trump’s broken health care promises
  • Save My Care “Enough is Enough” campaign announcement
  • Save My Care “Enough is Enough” video
  • Roundup of State of the Union health care guests

Key Points:

Since coming into office last year, President Trump and Republicans in Congress have waged a war to repeal and sabotage our health care.

  • In his first year, Trump and the Republican Congress launched a war on the entire American health care system. They attacked the Affordable Care Act, Medicaid, and other critical health programs repeatedly with repeal bills and aggressive Administrative sabotage.
  • Trump made his war on health care the top domestic priority for his Administration from Day One. His first executive action as President directed his Administration to attack the ACA. Then, his HHS developed a secret plan to sabotage the American health care system from the inside, shared it with Republican leaders in Congress, and began launching attacks on the law from inside the Administration.
  • In Congress, Republicans tried five times to repeal the Affordable Care Act and kick millions off coverage. They ultimately passed a tax bill that will cause millions more Americans to go uninsured and drive up premiums by double digits, all so they can give massive tax breaks to big corporations and the wealthiest.

President Trump and Congressional Republicans’ sabotage is causing millions to lose insurance, driving up costs, and weakening protections.

  • 3.2 million Americans lost coverage during the first year of the Republican war on health care, and millions more stand to lose their insurance because of the Trump Administration’s health care agenda.
  • Trump’s decision to cancel cost-sharing reduction payments that help lower-income families’ out-of-pocket expenses was widely cited as the reason 2018 premiums increased more than predicted.
  • Now, Trump wants to let insurers charge Americans more for less. His Administration’s latest sabotage would take us back to the days when companies could force people with pre-existing health conditions to pay higher premiums, and would allow insurers to stop covering essential medical services like prescription drugs, hospitalization, and maternity care.

Enough is enough: The American people overwhelmingly reject President Trump’s war on health care. It’s time for Republicans in Congress to end their war on healthcare and move on from partisan repeal.

  • Last year, Americans rejected Republican repeal bills that would take coverage from as many as 23 million people, spike older Americans’ premiums with an “age tax,” and eliminate protections for millions of families with pre-existing conditions like cancer.
  • The American people made their opposition to this agenda clear at town halls, rallies, and at the polls.
  • National surveys now show that health care is the #1 most important issue to American voters. Trump’s war on health care has targeted his own base, exacerbating the opioid crisis and hurting rural America.
  • Republicans’ failed repeal drive stopped Congress from getting its work done last year. This year, Americans are asking for an end to partisan health care bills and, instead, bipartisan work to make health care more affordable for families.

Congressional Republicans must end their partisan repeal efforts and stand up to President Trump’s sabotage of our health care or face a powerful reaction from their constituents.

  • The failed Congressional repeal attempts of 2017 wasted Trump’s first 100 days in office, stoked public anger, spurred apolitical Americans to activism, and united a broad coalition of stakeholders.
  • Trump started 2018 by ramping up Administrative sabotage and declaring open war on Medicaid. By accelerating his war on health care, he will inflict even more damage on the American health care system.
  • Congress continues to ignore its constituents by aiding and abetting Trump’s health care sabotage, refusing to cooperate on the bipartisan solutions that Americans want.
  • Most Americans want Congress to keep and improve the Affordable Care Act and to say “enough is enough” to Trump’s war on health care.

A Year Later: President Trump’s Broken Health Care Promises

Enough Is Enough Graphic

Last year, in his first address to a joint session of Congress, President Donald Trump made several promises to the American people about what type of health care plan he would support. Tonight, as he makes his first official State of the Union address, we know he and his Republican allies in Congress broke those promises.

PRESIDENT TRUMP BROKE HIS PROMISE ON LOWERING HEALTH COSTS

WHAT TRUMP SAID: “The way to make health insurance available to everyone is to lower the cost of health insurance, and that is what we are going do.”

WHAT TRUMP DID: The health repeal plan House Republicans passed last year, and President Trump supported, ripped coverage away from 24 million people and raised premiums 20 percent. It imposed an age tax on older Americans by allowing insurers to charge people over 50 five times more.

PRESIDENT TRUMP BROKE HIS PROMISE ON PROTECTING PEOPLE WITH PRE-EXISTING CONDITIONS

WHAT TRUMP SAID:We should ensure that Americans with preexisting conditions have access to coverage, and that we have a stable transition for Americans currently enrolled in the healthcare exchanges.”

WHAT TRUMP DID: The health repeal plan that House Republicans passed, and President Trump supported, raised costs on people with pre-existing conditions by allowing states to let insurers charge them more. This surcharge could be in the six figures: up to $4,270 for asthma, $17,060 for pregnancy, $26,180 for rheumatoid arthritis and $140,510 for metastatic cancer. The Trump Administration has also proposed rules that, if finalized, will allow health insurers to skirt protections for pre-existing conditions.

PRESIDENT TRUMP BROKE HIS PROMISE ON MEDICAID

WHAT TRUMP SAID: “We should give our great state governors the resources and flexibility they need with Medicaid to make sure no one is left out.”

WHAT TRUMP DID: The health repeal bill House Republicans passed, and President Trump supported, ended Medicaid as we know it, slashing it to the tune of $839 billion, or 25 percent, and converting it into a “per capita cap”, thus ending guaranteed coverage for everyone who qualifies, chiefly seniors, children and people with disabilities. It also ended Medicaid expansion. As a result, 14 million people were estimated to lose their coverage under the plan.

PRESIDENT TRUMP BROKE HIS PROMISE ON WOMEN’S HEALTH

WHAT TRUMP SAID:My administration wants to work with members of both parties to … invest in women’s health…”

WHAT TRUMP DID: The Trump Administration and its Republican allies in Congress waged a war on women’s health last year, including efforts to defund Planned Parenthood; taking direct aim at birth control by rolling back the copay-free coverage requirement in the Affordable Care Act; proposing drastic cuts to Medicaid; putting anti-choice judges on the federal bench; and raising costs on women by making them pay more for maternity care.

PRESIDENT TRUMP BROKE HIS PROMISE ON OPIOIDS

WHAT TRUMP SAID:We will expand treatment for those who have become so badly addicted.”

WHAT TRUMP DID: The House repeal plan Republicans passed, and President Trump supported, would make the opioid crisis worse. The repeal bill eliminated the parity requirement that mental health and addiction services be covered under the Medicaid expansion, and the plan put states on the hook for the full cost of dealing with the crisis by proposing drastic Medicaid cuts.

PRESIDENT TRUMP BROKE HIS PROMISE ON PRESCRIPTION DRUGS

WHAT TRUMP SAID: “[We should] work to bring down the artificially high price of drugs, and bring them down immediately.”

WHAT TRUMP DID: Bringing down prescription drug prices has not been a priority for the Trump Administration this past year. Just yesterday, President Trump installed a former Big Pharma executive, Alex Azar, as the new secretary of Health and Human Services.

State of American Health Care Threatened by Trump & GOP’s War on Health Care

To: Interested Parties

From: Leslie Dach, Campaign Chair, Protect Our Care

Date: January 29, 2018

Re: State of American Health Care Threatened by Trump & GOP’s War on Health Care

On Tuesday, President Trump will deliver his first official State of the Union address. We anticipate he will gloat about his efforts to undo the Affordable Care Act (ACA), take insurance away from millions of people in order to fund tax cuts for big corporations and the wealthiest , cut hundreds of billions of dollars from care for the elderly, children, and people with disabilities, and promise a continuation of his partisan approach to health care in 2018. But his agenda is overwhelmingly unpopular. The American people are saying “enough is enough.” We demand that the Trump Administration and Congress stop their war on our care.

The 2017 Republican War on Health Care

Last year, the Trump Administration and its Republican allies in Congress waged a war on our health care. Their attacks included five attempts to repeal the Affordable Care Act, proposing to end Medicaid as we know it, and sabotaging our health care system. Under their agenda, millions would lose coverage, costs would increase, especially for those with pre-existing conditions, and insurers would be able to skirt the tough rules that currently protect consumers thanks to the health care law. At the end of the first year of the Trump Administration, 3.2 million people have lost their health coverage, and premium rates spiked because of uncertainty President Trump injected into the individual insurance marketplaces. Here is what the first year of Trump’s partisan war on health care looked like:

January 2017

  • On his first day in office, President Trump signs an Executive Order directing the administration to identify every way it can unravel the Affordable Care Act.

February 2017

  • The Trump Administration proposes a rule to weaken Marketplace coverage and raise premiums for millions of middle-class families.

March 2017

  • The Trump Administration sends a letter to governors encouraging them to submit proposals which include provisions such as work requirements that make it harder for Medicaid beneficiaries to get affordable care and increase the number of people who are uninsured.

April 2017

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

May 2017

  • House Republicans vote for and pass a health care repeal bill that would cause 23 million people to lose coverage and gut protections for people with pre-existing conditions. It would have imposed an age tax and allowed insurers to charge people over 50 five times more for coverage and ended Medicaid as we know it, putting the care of seniors, children and people with disabilities in jeopardy.

June 2017

  • Senate Republicans embark on a monthslong failed attempt to pass BCRA, Skinny Repeal and Graham-Cassidy, all repeal bills that would have caused millions of Americans to lose their health coverage and raised premiums by double digits for millions more. They would have ended Medicaid as we know it, putting the care of children, seniors and people with disabilities at risk.

July 2017

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

August 2017

  • The Administration cuts the outreach advertising budget for Open Enrollment by 90 percent, from $100 million to just $10 million – which resulted in as many as 1.1 million fewer people getting covered.

September 2017

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

October 2017

  • The Trump Administration takes direct aim at birth control by rolling back a rule that guaranteed women access to contraception. (A court has since questioned the legality of the action.)
  • President Trump signs an Executive Order to roll back key consumer protections that will result in garbage insurance, raise premiums, reduce coverage and again expose millions of Americans to discrimination based on pre-existing conditions.
  • The Trump Administration dramatically cuts in-person assistance to help people sign up for 2018 health coverage.
  • After threatening for months to stop funding cost-sharing reduction payments (CSRs) that help lower deductibles and out-of-pocket costs, the Trump Administration stops the payments altogether. The CBO finds that failing to make these payments will increase premiums by 20% and add nearly $200 billion to the debt.

November 2017

  • Republicans refuse to move forward on the bipartisan Alexander-Murray bill to address the CSR crisis even though it had a filibuster-proof majority in the Senate.

December 2017

  • The Trump Administration proposes a rule to expand association health plans, which would gut consumer protections, raise costs for people with pre-existing conditions and further destabilize the insurance markets.
  • Congressional Republicans pass their tax scam, which doubles as a sneaky repeal of the Affordable Care Act  by kicking 13 million people off of their insurance and raising premiums by double digits for millions more.

January 2018

  • The Trump Administration announces that it will support states that impose onerous work requirements on Americans covered by Medicaid, and approves Kentucky’s worst-in-the-nation waiver the next day.
  • The Trump Administration announces a move to allow providers to discriminate by allowing them to deny patient care for almost any reason.
  • The Trump Administration makes plans to announce even more exemptions from the requirement people have health coverage before this provision is repealed altogether.

Despite Attacks, the Affordable Care Act Continues to Help Americans

While the Trump Administration and its Republican allies in Congress had some success last year in their partisan war on health care, the Affordable Care Act is still here, and it is working. The reason the law survived is simple: the American people made their voices heard last year at town halls, rallies and the voting booth, thwarting the partisan repeal effort in Congress.

Despite Trump-led attacks, and because the American people spoke up, insurers still cannot deny or drop coverage because of a pre-existing condition; tax credits are still available to help people pay for coverage; young adults can still stay on their parents’ plan until age 26; the Medicare prescription drug donut hole is still closed; and Medicaid is still a lifeline for millions of seniors, children and people with disabilities. The recent open enrollment period saw nearly 9 million people sign up for coverage in the federal marketplaces, despite the Trump Administration’s decisions to cut the open enrollment period in half and refuse to promote it.  While any law can be improved, and the ACA is no exception, it continues to provide affordable health care and vital protections to millions of Americans.

Enough is Enough: Stop the Partisan War on Health Care

The Trump Administration and Republicans in Congress need to listen to the American people who are saying ‘enough is enough.’ It’s time to stop the partisan health care repeal effort and work on bipartisan solutions. If Republican politicians do not listen, they do so at their own peril. Recent polling by Protect Our Care showed that health care is far and away the number one issue on voters’ minds, and is one of the main reasons why voters disapprove of the job Republicans in Washington are doing.

Last week, Sen. Lisa Murkowski (R-Alaska) said, “I don’t think we should be spending time trying to do repeal and replace of Obamacare.” Her colleagues in Congress, and President Trump himself, would do well to listen to her.