Category

Administration

Trump Administration Breaks Its Promise Again on Opioid Crisis

Following today’s news that the Trump Administration will propose a 95% cut to the Office of National Drug Control Policy charged with coordinating the federal response to the nation’s raging opioid crisis, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“For Americans fighting the opioid crisis who had hoped that President Trump might finally address this raging epidemic with the urgency it deserves, today’s proposed ONDCP cuts are yet another blow. This Administration has done nothing to facilitate treatment for Americans struggling with addiction, and its attacks on Medicaid and the ONDCP stand to make the situation worse. By trying to gut the office charged with coordinating the federal opioid response, the Trump Administration is not only continuing its pathetic response to the nation’s most urgent public health crisis: it is now actively sabotaging the communities that are fighting so hard to turn the tide on this deadly epidemic.”

Trump’s Year of Broken Health Care Promises

During his calamitous first year in office, President Trump broke his health care promises again and again, taking a hatchet to the American health care system. With enthusiastic cooperation from Congressional Republicans, Trump’s Administration embarked on a campaign to sabotage and weaken our care that has already driven 3 million Americans into the ranks of the uninsured and spiked premiums for millions more.

“If there’s one thing President Trump’s first year in office made clear, it’s that Americans cannot and should not trust Republicans to protect our care. President Trump has spent the past twelve months systematically breaking every health care promise he made to the American people. As President Trump and his Republican allies ratchet up their war on our care in 2018, Americans must stand up to their outrageous sabotage of the American health care system,” said Brad Woodhouse, Campaign Director for Protect Our Care.

 

TRUMP’S PROMISE: Everybody’s got to be covered.”

THE REALITY: Over 3 million Americans lost their insurance in 2017 because of Trump’s actions.

 

TRUMP’S PROMISE: “I’m not going to cut Medicare or Medicaid.”

THE REALITY: Trump supports dramatic cuts to Medicaid included in Republicans’ failed repeal bills and his Administration encourages states to embrace policies that reduce Medicaid enrollment.

 

TRUMP’S PROMISE: “Everybody’s going to be taken care of much better than they’re taken care of now.”

THE REALITY: The Trump Administration embarks on a campaign of systematic sabotage:

 

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 that 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.

June 2017

  • Senate Republicans embark on a monthslong failed attempt to pass BCRA, Skinny Repeal and Graham-Cassidy, all repeal bills that would cause millions of Americans to lose their health coverage and raise premiums by double digits for millions more.

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 – likely to result in 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 said, “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 reductions (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.

This Week in the War on Health Care — January 15-19, 2018

The week, as much of the focus in Washington shifted to DACA and negotiations in Congress over a continuing resolution, the Trump Administration continued its unprecedented assault on the American health care system.

While your attention was focused elsewhere, here’s a summary of what happened this week in sabotage:

ATTACKS ON MEDICAID

As the dust settled around the Trump HHS’s approval of Kentucky’s worst-in-the-nation Medicaid waiver, experts dug into the fundamental ways it signals an end to Medicaid’s legacy:

… and why we already know it won’t work, unless Governor Matt Bevin’s primary goal is to take away Kentuckians’ coverage (spoiler alert: it is):

As Margot Sanger-Katz notes: “Kentucky’s new Medicaid waiver will ask low-income people to jump over hurdles to keep their coverage. Evidence suggests that many will fail … Kentucky officials argue that the changes will give beneficiaries more dignity and promote personal responsibility. But they also estimate that around 100,000 fewer people will be enrolled in the program by the end of five years.”

Meanwhile, Republicans opened a new front in their war on Medicaid. Yesterday, Senator Ron Johnson held a sham hearing to try to smear Medicaid by blaming it for the opioid crisis — when in fact Medicaid is one of our most important tools to curb the epidemic. Fortunately, few were fooled:

  • Newsweek: “The Republican argument is flawed because the Medicaid expansion began in 2014, and opioid addiction was declared an epidemic by the Centers for Disease Control and Prevention in 2011.”
  • Washington Post: “While conservatives have noted that overdose deaths are much higher among people inside the program than those outside it, according to the Centers for Disease Control and Prevention, they’ve not been able to prove Medicaid actually leads to opioid abuse.”
  • Los Angeles Times: “The Republican campaign against Medicaid could only make the opioid crisis worse. That’s because Medicaid pays for a huge proportion of opioid treatments, covering fully one-third of those with addiction problems … Johnson and his fellow Republicans in Congress seem determined to impose cuts on the program, even though the benefits it renders are crystal-clear. Wednesday’s hearing did achieve one benefit, for all that: It showed how threadbare their arguments are.”

ATTACKS ON EMPLOYER COVERAGE

On Monday, New York Times reported that the GOP’s next health care sabotage scheme will remove the requirement that employers of over 50 workers offer health coverage for their employees. Such a move could yank care away from millions more Americans, while increasing government spending:

“The Affordable Care Act was built on a framework of shared responsibility … If you get rid of the employer mandate, you will see people lose coverage from their employers.”

ATTACKS ON CRITICAL HEALTH PROGRAMS

Congressional Republicans released a Continuing Resolution proposal that continues their heartless strategy of using children’s health insurance as a bargaining chip. Their bill also attempts to delay Affordable Care Act taxation provisions that benefit big corporations, while ignoring critical expired programs that support essential providers. These include community health centers and hospitals that serve lower-income communities. Some of these critical provider systems are facing threats of closure due to the ongoing uncertainty caused by the Republican Congress..

As Politico reported, GOP Congressional leaders considered including the badly-needed funding – then decided not to:

Knowing the vote is close, Ryan, House Majority Leader Kevin McCarthy of California and other GOP leaders debated on Wednesday morning whether to add more provisions to the package, such as funding for community health centers. In the end, they decided to move ahead with the package as is.

As this week’s CR brinksmanship showed, Republicans continue to prioritize partisan politics over their constituents’ health care.

SABOTAGE TAKES A TOLL

On Tuesday, Gallup found that America’s uninsured rate jumped during Trump’s first year in office for the first time in a decade, causing 3.2 million Americans to lose their care.

If this week’s news is any indication, that number could climb as the Republican war on health care continues into 2018.

Enough is Enough: the Trump Administration’s Sabotage of Our Health Care Must Stop

To: Interested Parties

From: Brad Woodhouse, Campaign Director, Protect Our Care

Subject: Enough is Enough: the Trump Administration’s Sabotage of Our Health Care Must Stop

Date: January 16,  2018


Since taking office last year, President Trump, his Administration, and allies in Congress have waged an unrelenting war against our health care. Their twin weapons have been repeal and sabotage: the innocent victims, the American people. Their agenda takes health care away from millions, raises premiums by double digits for millions more, guts protections for people with pre-existing conditions and attempts to destroy the insurance markets.

As research released today by Gallup shows, the consequences of the GOP agenda of sabotage are abundantly clear – President Trump has overseen the largest-ever one-year increase in the uninsured rate since Gallup began tracking:

The percentage of U.S. adults without health insurance was essentially unchanged in the fourth quarter of 2017, at 12.2%, but it is up 1.3 percentage points from the record low of 10.9% found in the last quarter of 2016. The 1.3-point increase in the uninsured rate during 2017 is the largest single-year increase Gallup and Sharecare have measured since beginning to track the rate in 2008, including the period before the Affordable Care Act (ACA) went into effect. That 1.3 point increase represents an estimated 3.2 million Americans who entered the ranks of the uninsured in 2017.

As the Obama Administration came to a close after the fourth quarter of 2016, the uninsured rate reached an all-time low. When the Trump Administration took over, it had all the tools it needed to continue that progress and keep driving down the uninsured rate. Instead, as last week’s bombshell report from POLITICO revealed, Trump’s HHS did the opposite:

Early last year, as an Obamacare repeal bill was flailing in the House, top Trump administration officials showed select House conservatives a secret road map of how they planned to gut the health care law using executive authority.

The March 23 document, which had not been public until now, reveals that while the effort to scrap Obamacare often looked chaotic, top officials had actually developed an elaborate plan to undermine the law — regardless of whether Congress repealed it.

Top administration officials had always said they would eradicate the law through both legislative and executive actions, but they never provided the public with anything close to the detailed blueprint shared with the members of the House Freedom Caucus, whose confidence — and votes — President Donald Trump was trying to win at the time. The blueprint, built off the executive order to minimize Obamacare’s “economic burden,” which Trump signed just hours after taking the oath of office, shows just how advanced the administration’s plans to unwind the law were — plans that would become far more important after the legislative efforts to repeal Obamacare failed.

President Trump famously said “the best thing we can do…is let Obamacare explode,” and “let it be a disaster because we can blame that on the Democrats.” But the newly revealed HHS document shows just how low this Administration is willing to go in order to sabotage the law – literally putting on paper a calculated plan to take away health insurance from Americans. The plan went high up: according to POLITICO, the document was “a key part” of a meeting with Speaker Paul Ryan and former HHS Secretary Tom Price, whose job was ostensibly to protect the health of the American people. President Trump and his Republican allies in Congress are not simply letting Obamacare fail – they are making Obamacare fail.

The increase in the uninsured rate is the most clear evidence yet that Republicans’ sabotage plan is having its intended effect: taking away Americans’ coverage. Here are some of the other ways the Trump Administration sabotaged health care in 2017:

  • On his first day in office, President Trump signed an Executive Order directing the administration to find any ways they could to unravel the Affordable Care Act.
  • The Trump Administration cut the number of days people could sign up for coverage during open enrollment by half, from 90 days to 45 days.
  • House Republicans voted for and passed a health care repeal bill that causes 23 million people to lose coverage and guts protections for people with pre-existing conditions.
  • The Administration cut the outreach advertising budget for open enrollment by 90 percent, from $100 million to just $10 million – likely to result in 1.1 million fewer people getting covered. Advertising is a critical way for people to know when and how they can get covered.  
  • Republicans refused to move forward on the bipartisan Alexander-Murray bill even though it had a filibuster proof majority in the Senate.
  • Senate Republicans tried but failed to pass BCRA, Skinny Repeal and Graham-Cassidy, all of which would cause millions to lose their health coverage and raise premiums by double digits for millions more.
  • The Administration ordered the Department of Health and Human Services’ regional directors to stop participating in open enrollment events. Mississippi Health Advocacy Program Executive Director Roy Mitchell said, “I didn’t call it sabotage…But that’s what it is.”
  • The Administration dramatically cut in-person assistance that helped people sign up for 2018 coverage.
  • The Trump administration took direct aim at birth control by rolling back a rule that guaranteed women access to contraception. (A court has since delayed their effort.)
  • After threatening for months to stop funding cost-sharing reductions (CSRs) that help lower deductibles and out-of-pocket costs, the Trump Administration stopped CSR payments altogether in October. The CBO found failing to make these payments would increase premiums by 20 percent and add nearly $200 billion to the debt.
  • President Trump signed an Executive Order that would roll back key protections and result in garbage insurance, raise premiums, reduce coverage and expose millions of Americans again to discrimination based on pre-existing conditions.
  • House and Senate Republicans repealed the individual mandate in their tax bill in order to pay for massive tax breaks to the ultra wealthy and big corporations. CBO predicts millions will lose coverage and premiums will go up double digits.

And they aren’t done yet. Just last week the Trump Administration announced so-called “work requirements” to Medicaid, which will have the effect of removing millions of Americans – nearly all of whom are already working – from their health insurance. And Republicans have promised to go after Medicare, which insures 44 million Americans, and have their sights on the Affordable Care Act, too.

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.” Nearly 9 million people just 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.

Health Care As A Defining Issue Of 2018

To: Interested Parties

From: Geoffery Garin

Subject: Health Care As A Defining Issue Of 2018

Date: January 12,  2018

——————————————————————————————————————————————-

Our newly completed survey among a representative national cross section of voters clearly shows that healthcare will be a defining issue in the 2018 elections and the healthcare policies of President Trump and the Republican Congress will be a very significant liability for GOP candidates.

These findings are based on 1,000 interviews nationwide conducted January 3 to 7, 2018, among a sample of 2016 voters, 49% of whom say they voted for Hillary Clinton and 46% of whom say they voted for President Trump.

1. Healthcare far exceeds any other issue as an important driver of voting preferences, with over half of all voters identifying healthcare as one of their top priorities in the 2018 congressional elections.

Fully 54% choose healthcare as one of the two issues that will be the most important to them in deciding how to vote for Congress, compared with 29% for the economy, 28% for taxes, 18% for immigration, 18% for education, 17% for government spending, 12% for national defense, and 11% for terrorism.

These results highlight the durability of healthcare as a powerful concern for voters, even when healthcare legislation is not front and center in the news. In our two previous readings in May 2017 and August 2017, 55% and 57% respectively selected healthcare as one of their top two issues.

Healthcare is the most frequently cited priority among Democrats (68%), independents (54%), and Republicans (38%). It is particularly important to African-American voters (66%) and to white women voters, whether they are college graduates (62%) or non-college graduates (59%).

2. Along with the tax bill, healthcare policies are a top-of-mind reason that many voters disapprove of the job Republicans are doing as the majority party in Congress. Indeed, there is widespread disapproval of Republicans in Congress with regard to their handling of healthcare, even among many rank-and-file Republican voters.

Even after the passage of the tax bill, fully 61% of voters disapprove of the job Republicans are doing as the majority party in Congress. When those who disapprove are asked to volunteer why, they most frequently mention Republican tax policies (43%), Republican healthcare policies (36%), and the Republicans’ general lack of concern for average Americans (11%).

While disapproval for the Republicans’ overall performance is high, disapproval for the GOP’s performance on healthcare is even higher (72%). Negative opinions about the way Republicans in Congress have handled healthcare cross party lines, with 93% of Democrats, 78% of independents, and 45% of rank-and-file Republicans expressing disapproval.

3. Republicans’ efforts to repeal and replace the Affordable Care Act are unpopular with voters and a political drag on them in this election year. Democrats increase their electoral advantage when they highlight their position of making improvements in the ACA while keeping what works. And it is clear that continued GOP efforts to repeal the ACA will exacerbate their political problems, given that two-thirds of voters agree on this issue that, “enough is enough.”

Just 35% of voters say they have a favorable opinion of the bills proposed by Republicans in Congress to repeal the Affordable Care Act, while 52% have an unfavorable opinion of them. By 47% to 38%, voters say they would be less likely to reelect their members of Congress if they voted for the bills by President Trump and Republicans in Congress to repeal and replace the ACA. Voters who are undecided on how to vote for Congress this year say by 12 points that they would be less likely to reelect someone who voted for repeal and replace.

Additionally, the poll results indicate that there is widespread frustration with Republicans’ repetitive efforts to repeal the Affordable Care Act. Fully 68% of voters agree with this statement: “Enough is enough—President Trump and the Republicans in Congress should stop trying to repeal and undermine the Affordable Care Act and start working across party lines on commonsense solutions that build on the current law.” Fifty-three percent (53%) strongly agree. There has been a 10-point increase in the share of voters who see President Trump as actively trying to make the Affordable Care Act fail (to 52%, with 28% saying he is not trying to make it fail and 20% not sure). By 55% to 45%, voters say problems with the Affordable Care Act are occurring mainly because Trump and Republicans in Congress are trying to sabotage the law rather than because it is a bad law.

As other polls have shown, Democrats head into the 2018 midterm elections with a clear advantage. In this poll, among all voters who cast ballots in the 2016 presidential election, Democrats have a seven-point margin (44% Democrat, 37% Republican) in a generic trial heat. The Democrats’ true advantage likely will be much greater, given that 75% of Clinton voters say they are certain to vote in 2018, compared with just 60% of Trump voters.

An election that focuses on healthcare and GOP repeal efforts would widen the Democrats’ margin. When given a choice between a Democrat who wants to keep what works in the Affordable Care Act and make improvements in it and a Republican who wants to repeal and replace Obamacare, voters prefer the Democrat by 18 points (59% to 41%). Those who are undecided in the generic trial heat prefer the Democrat in this
match-up by 68% to 32%.

4. The Republicans have a long list of severe vulnerabilities on healthcare that go beyond their repeated efforts to repeal the Affordable Care Act, and their healthcare policies on many fronts create very major concerns among large majorities of voters. These are the highest testing criticisms of the healthcare policies of President Trump and the Republicans in Congress.

These are the highest testing criticisms of the healthcare policies of President Trump and the Republicans in Congress.

Sixty-nine percent (69%) of women voters voice very major concerns about GOP policies that would allow insurance companies to charge women more than men for their health insurance. Other Trump policies are widely rejected by voters. The reaction is especially negative, for example, when voters are informed that, “the Trump administration is allowing insurance companies to sell plans that do not meet the requirements of the Affordable Care Act because they do not have to cover essential health benefits such as cancer treatments and maternity care and can deny coverage altogether for preexisting conditions.” Three quarters of all voters disapprove of this policy, including 53% who strongly disapprove.

5. The litany of bad Republican policies on healthcare ladders up to a very damaging overarching narrative for the GOP. Indeed, a large majority agree that the sum of the Trump-GOP policies shows that there is a “Republican war on healthcare.” Just as important, the healthcare issue focuses attention on two dominant weaknesses for the Republicans—their reputation for catering to special interests, and their support for a tax bill that gave huge cuts to the wealthy and large corporations.

Seventy-four percent (74%) of voters agree with the following statement, including 51% who strongly agree: “When you add it all up—taking away coverage from millions of people, weakening protections for people with preexisting conditions, allowing insurance companies to charge more if you are older or a woman, and making big cuts to Medicare and Medicaid—there is a Republican war on healthcare today.” Even 48% of Trump voters agree that there is a Republican war on healthcare.

The notion of a Republican war on healthcare is credible to voters because it speaks to two other important conclusions voters have about Republicans:

  • They take huge amounts of campaign funding from the insurance industry and the pharmaceutical industry, and they are catering to the special interests that give them money (77% say this is believable, including 51% who say it is very believable).

  • They want to cut funding for healthcare in order to pay for the huge tax cuts they passed for the wealthy and large corporations (72% say this is believable, including 48% who say it is very believable).

While voters also believe that Republicans in Congress are motivated by a desire to undo everything that President Obama did while he was in office, even more concerning to them are the GOP’s focus on cutting taxes for the wealthy and the large corporations and its desire to cater to the special interests that fund their campaigns.

Gallup Poll: Uninsured Rate Rose in Trump’s First Year

After a new Gallup poll showed that America’s uninsured rate jumped during Trump’s first year in office for the first time in a decade, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“This is what sabotage looks like. Today, Gallup confirmed that over 3 million Americans lost their insurance in 2017, becoming the first casualties of President Trump and Congressional Republicans’ war on health care. Today’s numbers also confirm that it’s exactly those Americans who the Trump administration targeted who are losing coverage: working families earning less than $36,000 a year, young adults, African-Americans, and Hispanics. On behalf of the 3 million who have already lost their coverage, and will now pay the price with their health — and the millions more whose insurance is under attack, we join the American people in saying: enough is enough. President Trump and his allies in Congress must stop their partisan war on health care before they take coverage from millions more and and drive up prices and weaken protections for everyone else.”

Newest Target of GOP Health Care Sabotage: Employer-Based Coverage

In response to the New York Times revealing  that the GOP’s next health care sabotage scheme would remove the requirement that ensures employers with over 50 employees provide health care to their employees, Protect Our Care Campaign Director Brad Woodhouse issued the following statement:

“Most Americans get their health insurance through their employer but Republicans want to let employers off the hook to provide it. The latest scheme from Congressional Republicans is to allow employers to no longer provide insurance and force people to deal with the consequences on their own.

“While they wait to force through their full health care repeal legislation, they continue to sabotage the system and employer-based coverage is the newest front. After they gave billions in tax breaks to wealthy corporations, maybe we shouldn’t be surprised that they want to let those same corporations cancel their health care policies for employees.

“Enough is enough is enough. It’s time for Republicans to stop their war on America’s health care.”

Protect Our Care Statement On Approval Of Kentucky Medicaid Waiver

In response to the news that the Trump Administration granted the approval of Kentucky’s waiver to implement work requirements for Medicaid recipients, Protect Our Care Campaign Director Brad Woodhouse issued the following statement:

“Today’s move from Republicans marks not just a shift in policy, but a shift in the fundamental decency of the United States. Medicaid has long been a lifeline for millions of hard-working Americans – our parents and grandparents, siblings and children. After more than fifty years and nine bipartisan administrations, it is Donald Trump who will cut Americans off from their health care.

“Despite the rhetoric pushed by this Administration and Republicans in Congress, the simple truth is that the majority of those covered by Medicaid who can work are working, largely in low-wage jobs or industries that don’t provide health care, and those who are not working overwhelmingly have chronic health conditions or are taking care of a sick family member. In Kentucky, where nearly 50 percent of all births are covered under Medicaid and nearly 10,000 veterans received the health care they deserve through Medicaid expansion, 20,000 people stand to lose coverage. This decision harms the most vulnerable among us, and abandons the next generation born into circumstances beyond their power.

“Changing Medicaid will do nothing to help Americans find jobs. It will merely take away their health care. It’s a cruel, short-sighted policy, and every Republican who goes along with it should be ashamed.”

“Today’s Announcement Isn’t About Work. It Is About Taking Away Health Insurance From Low-Income People”: Responses to the Trump Administration’s Medicaid Announcement

Today, the Trump Administration announced changes to Medicaid, the nation’s largest health insurance program. Issued to mandate work requirements to those receiving Medicaid, the proposed changes jeopardize health care for millions of Americans – nearly all of whom are already working. Responses to this announcement have focused on the amount of unnecessary suffering this could bring about, as well as the vast mistruths the Trump Administration is promoting. Don’t believe us?  Take a look for yourself…

Politico: “Independent studies have shown that most Medicaid enrollees who are eligible to work already do so.” [Politico, 1/11]

Washington Post: “Most health policy experts, including a few noted conservatives, have regarded the government insurance enabling millions of people to afford medical care as a right that should not hinge on individuals’ compliance with other rules.” [Washington Post, 1/11]

Vox: “Republicans argue that requiring work for Medicaid eligibility will lead to better health outcomes, because employment can be linked to improved health and help move people off Medicaid as they make more money. But many Medicaid recipients are already working. If they are not, then they are likely elderly, disabled, retired, sick, or caring for a loved one. These new bureaucratic hurdles could impede some Americans’ ability to access health insurance and the care they need.” [Vox, 1/11]

Los Angeles Times: “Critics of the Trump administration’s approach note that a growing body of evidence shows that Medicaid health coverage is helping many Americans improve their health and their finances, not holding them back, as Verma and other have suggested… There is little evidence that many working-age Medicaid enrollees are choosing the government coverage instead of seeking work.” [Los Angeles Times, 1/11]

CNN: “The Trump administration is about to start letting states require many Medicaid recipients to work for their benefits. But millions of Americans in the health care safety net program already have jobs. Some 60% of working age, non-disabled Medicaid enrollees are working, according to a new report from the Kaiser Family Foundation. That’s about 15 million people. Plus, nearly eight in 10 recipients live in families with at least one worker.” [CNN, 1/11]

Associated Press: “Most who are not working report reasons such as illness, caring for a family member or going to school. Some Medicaid recipients say the coverage has enabled them to get healthy enough to return to work.” [NBC News, 1/11]

Washington Examiner: “A Kaiser Family Foundation brief about work requirements in other programs, such as SNAP and TANF, raised questions about their effectiveness in getting people employed and said states spend a large amount of time and money making sure the requirements are followed.” [Washington Examiner, 1/11]

USA Today: “Health groups and advocates for the poor — including the National Center for Law and Economic Justice and the American Lung Association — dispute Verma’s contention that the Centers Medicare and Medicaid Service has the authority to grant such requests. Courts have said states can’t add additional requirements for Medicaid eligibility that are not in law, the coalition wrote. Some bills offered in Congress address such changes, but haven’t passed yet. ‘Most people on Medicaid who can work, do so,’ the coalition wrote, ‘and for people who face major obstacles to employment, harsh requirements won’t help them overcome them.’” [USA Today, 1/11]

Harold Pollock, University of Chicago: “Medicaid work requirements may hit Trump country hardest. They could hit underemployed early-retirees who now find themselves reliant on Medicaid.. They could hit surprising numbers of people with disabilities — including addiction to opioids — who are covered under the ACA Medicaid expansion but can’t fill the requirements. They could hit hospitals in low-income rural areas that provide services to people who have lost Medicaid and can’t pay.” [Washington Post, 1/11]

Jeff Grogger, University of Chicago: “Medicaid, unlike cash welfare payments, isn’t a disincentive to work, because it doesn’t provide people with funds they’d need to pay rent or buy food, said Jeff Grogger, an urban policy professor at the University of Chicago. He said it’s not clear what problem a Medicaid work requirement would solve, and that there are better ways to help people find jobs or reduce the number of people receiving Medicaid.”

Jeff Grogger, University of Chicago: “It’s not like Medicaid is providing some kind of alternative lifestyle that’s attractive and keeps people out of the workforce. If we had fewer sick people and fewer poor people, that’d lower the Medicaid rolls. Thinking in those terms is more productive.” [Bloomberg, 1/11]

Sara Rosenbaum, George Washington University: “‘It’s like the Wild West. Who knows what will come in the door?’ Sara Rosenbaum, a George Washington University professor who has followed Medicaid policy for decades, said. ‘Everything is couched as ‘you could,’ ‘you might,’ ‘you should think about.’ It’s like winking and nodding throughout the whole thing. They are not saying, ‘These are the limits on what we’ll approve.’” [Vox, 1/11]

Sara Rosenbaum, George Washington University: “There is a breathtaking lack of guardrails. Basically almost anything goes.. There’s really nobody who’s exempt.” [Vox, 1/11]

Elliot Fishman, Former CMS Administrator: “You’re going to lose not just the people who don’t meet the requirement but also those who can’t get through the new bureaucratic process.. Our experience over decades of research is that any time you require new documentation, you lose a lot of people who in principle shouldn’t be losing eligibility.” [Talking Points Memo, 1/11]

Elliot Fishman, Former CMS Administrator: “The requirement for Medicaid waivers is that they promote the objectives of the Medicaid program, and not just in the Obama administration, but in every previous administration, that was always understood to mean expanding coverage and strengthening the delivery of medical services. It has never been used to just cut back on coverage, which this is an effort to do.” [Talking Points Memo, 1/11]

Leonard Cuello, National Health Law Program National Policy Director: “Cuello said the argument that work promotes health is ‘totally contorted . . . It’s a little like saying that rain causes clouds. It’s more that people [with Medicaid] get care, which helps them be healthy and makes them able to work.’” [Washington Post, 1/11]

Mary Beth Musucemi, Kaiser Foundation Medicaid and the Uninsured Program Associated Director: This “will penalize individuals by having them lose health coverage, rather than incentivize them, as a voluntary program with adequately funded supportive services necessary to overcome barriers would.” [Washington Post, 1/11]

Mary Beth Musucemi, Kaiser Foundation Medicaid and the Uninsured Program Associated Director: “Conditioning Medicaid eligibility and coverage on work is a fundamental change to the 50 plus year history of the Medicaid program… There is a real risk of eligible people losing coverage due to their inability to navigate this process or miscommunication or other breakdowns in the administrative process.” [The Hill, 1/11]

Joan Alker, Georgetown Center for Children and Families Executive Director: The administration “has the ‘causality backwards’ and ‘you’re more likely to be able to work’ if you have health insurance such as Medicaid in the first place.” [The Hill, 1/11]

Matt Fiedler, Brookings Institution: “Documenting compliance will often not be trivial, and even small hassle costs can discourage people from signing up for insurance coverage… Higher hassle costs will likely cause meaningful reductions in Medicaid coverage even among people who are working.”  [Vox, 1/11]

Eliot Fishman, Families USA Senior Health Policy Director: “Unconscionable and illegal… Today’s announcement isn’t about work. It is about taking away health insurance from low-income people.” [Washington Post, 1/11]

Judy Solomon, Center on Budget and Policy Priorities Vice President for Health Policy:  “It is a very major change in Medicaid that for the first time would allow people to be cut off for not meeting a work requirement, regardless of the hardship they may suffer… There’s never been a work requirement in Medicaid, it’s only been in recent years that states have raised the possibility of having one. Medicaid is a health program that is supposed to serve people who don’t otherwise have coverage.” [NBC News, 1/11]

Judy Solomon, Center on Budget and Policy Priorities Vice President for Health Policy: “Don’t be fooled by the new [CMS] guidance saying will protect people with disabilities. It won’t. While people who get Medicaid because they meet strict Social Security disability criteria are exempt, there are lots of people who are ill or have a disability who get Medicaid. These people including people with cancer, mental illness and substance use disorders, will be subject to the work requirement and have to prove they are exempt with a doctor’s letter or other proof. Many won’t know to do that and some won’t be able to get the paperwork… The consequences will be harsh for many people. Losing critical care they need to stay healthy. This new policy won’t improve health outcomes but worsen them for many people and make it harder for them to work or stay employed.” [Twitter, 1/11]

Suzanne Wikle, Center for Law and Social Policy: “Access to Medicaid makes it easier for people to look for work and obtain employment. A so-called ‘work requirement’ does not support work, but instead puts a critical support for work at risk.” [National Public Radio, 1/11]

Jane Perkins, National Health Law Center Legal Director: “We know the upshot is people are going to be cut off… We are going to sweep in people who are working or trying to get work because they haven’t filled out the necessary paperwork. And cutting off people from Medicaid is certainly not going to improve their health.” [Los Angeles Times, 1/11]

Matt Salo, National Association of Medicaid Directors Executive Director: “This is going to go to court the minute the first approval comes out.” [Washington Post, 1/11]

Kicking You While You’re Down: 5 Facts You Need to Know About Medicaid & Why the Trump Administration’s New Proposal Would Hurt People

 

The Trump administration announced that it would allow states to deny Medicaid coverage to some low-income adults if they are not working or have a work-related activity, a move that could affect as many as 22 million people, with the stated goal that it would incentivize people to find a job. The facts speak otherwise. The truth is: the vast majority of people with Medicaid coverage who can work, are working. This policy ignores the reality that many who want to work can’t find a job and kicks people while they are down: targeting people with chronic health conditions, families with a sick child or a parent who needs care, and in particular women. If the goal here is to help people find a job, how does taking away their health care do that? It doesn’t. It only makes it harder. Here are five facts you should know about Medicaid and why the Trump administration’s policy would hurt people.

FACT –  The vast majority of people with Medicaid coverage who can work, are working.

  • 60 percent of nondisabled people with health coverage through Medicaid have a job and are working, including 42 percent working full-time.
  • 51 percent of working adult Medicaid enrollees have full-time jobs year-round, but their salaries are still low enough to qualify for Medicaid coverage, or have Medicaid because their employers do not offer insurance.  
  • Nearly 80 percent of nondisabled people with Medicaid coverage live in a family where at least one person is working, including 64 percent working full-time. The other adult family member may not be working because they have caregiving or other responsibilities at home.
  • A state by state breakdown can be found HERE

FACT – About half of working adults on Medicaid work for a small business and industries that typically do not provide health coverage, like farming.

  • Nearly half of adults who work and have Medicaid coverage work at businesses with fewer than 100 employees, including 42 percent in businesses with fewer than 50 employees.
  • 40 percent of adults who work with Medicaid coverage work in the the agriculture and service industries.

FACT – The Trump administration’s policy would hurt people with chronic health conditions or taking care of a family member.

  • More than one-third (36 percent) of adults with Medicaid are not working because they are ill or disabled but do not qualify for Supplemental Security Income (SSI).
  • 30 percent of adults on Medicaid without a job report they are taking care of a sick loved one or parent. 15 percent were in school; 9 percent were retired; and only 6 percent could not find work.

FACT – The Trump administration’s work requirement policy would hurt women, particularly women of color.

  • Almost two-thirds, or 62 percent, of those who would lose their Medicaid coverage as a result of work requirements are women, and disproportionately women of color.
  • One reason is women are more likely to be the caregivers for other sick family members, including children, or their parents. And women are more likely to be in jobs that do not provide health coverage.

FACT – The Trump administration’s policy may make it harder for Medicaid enrollees to find a job.

Research from Ohio and Michigan has shown that expanding Medicaid coverage makes it easier to find a job and keep a job. This policy does nothing to help people find work, and it may actually have the opposite effect.