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This Week in the War on Health Care — January 22-26, 2018

This week, Washington was focused on shutdown drama, while in the background, the Trump Administration and Republicans across the country continued their unprecedented assault on the American health care system.

Here’s a what happened this week in Republicans’ war on health care – plus, read down to see how some states are fighting back.

SABERS RATTLE ON CAPITOL HILL

This week, Senator Ted Cruz (R-Texas) told reporters Republicans need to “finish the job” and repeal the Affordable Care Act through budget reconciliation, and that he has been lobbying GOP senators who opposed repeal in 2017.

Apparently those efforts aren’t bearing much fruit: when asked about Cruz’s call to action, Senator Lisa Murkowski (R-Alaska) told reporters, “I don’t think we should be spending time trying to do repeal and replace of ObamaCare” in 2018.

STATE SABOTAGE EFFORTS

Yesterday, Idaho Governor Butch Otter announced his (plainly illegal) intent to let insurance companies in Idaho sell bare-bone plans that don’t include the essential health benefits now required by the Affordable Care Act and again discriminate against people with pre-existing conditions. Experts were … confused:

And in Virginia, a State Senate committee rejected legislation to expand Medicaid on a party-line vote. Just two months ago, Virginians delivered sweeping victories to pro-Medicaid expansion candidates up-and-down the ballot, putting Ralph Northam in the governor’s mansion and flipping delegate seats across the state. A Washington Post exit poll found that 39% of Virginia voters listed health care as the number one issue in their vote. The Virginia GOP may have chosen to keep ignoring the will of the people, but thankfully, this week was only the beginning of Virginia’s fight for Medicaid expansion in 2018.

TROUBLE AT TRUMP’S HHS

On Wednesday, Alex Azar became the Trump Administration’s new HHS Secretary. Throughout his confirmation process, Azar refused to acknowledge the Trump Administration’s ongoing Affordable Care Act sabotage, let alone promise to stop it and stand up for Americans’ health care. Instead, he embraced the Republican agenda to take coverage from millions of Americans, raise costs for millions more, and gut protections for people with pre-existing conditions. Right out of the gate, newly-confirmed Secretary Azar faces a major test: will he block Idaho’s attack against the law of the land, or drive HHS even further away from its mission to protect Americans’ health?

Meanwhile, in the wake of HHS’s quiet renewal of its public health emergency declaration, with little to show for the first 90 days, a member of Trump’s Opioid Commission said the Administration’s efforts to address the epidemic are “tantamount to reshuffling chairs on the Titanic.” Other leading advocates joined him to speak out against the Administration’s failure to address to the nation’s most pressing public health crisis:

CNN: Opioid commission member: Our work is a ‘sham’

The Republican-led Congress has turned the work of the president’s opioid commission into a “charade” and a “sham,” a member of the panel told CNN. “Everyone is willing to tolerate the intolerable — and not do anything about it,” said former Democratic Rep. Patrick Kennedy, who was one of six members appointed to the bipartisan commission in March. “I’m as cynical as I’ve ever been about this stuff.”

Vox: Trump has had a year to confront the opioid epidemic. He’s done almost nothing.

There has been no move by Trump’s administration to actually spend more money on the opioid crisis. Key positions in the administration remain unfilled, even without nominees in the case of the White House’s drug czar office and the Drug Enforcement Administration (DEA). And although Trump’s emergency declaration was renewed last week, it has led to essentially no action since it was first signed — no significant new resources, no major new initiatives.

… AND THE STATES THAT ARE FIGHTING BACK

On Tuesday night, Oregon residents issued a stern rebuke to the GOP’s war on health care. Oregonians went to the polls to vote on Measure 101, an initiative Republicans worked to get on the ballot, which could have denied health care to thousands of their fellow citizens. Instead, Oregonians “overwhelmingly approved” continuing the state’s successful Medicaid expansion. Oregon sent a clear message to the rest of the country: Republicans who continue sabotaging health care should be wary.

And in a sign of how dramatically the politics around health care have shifted, Wisconsin Governor Scott Walker, once an outspoken foe of the Affordable Care Act, has embraced a plan he says will strengthen the law in his state. The about-face comes soon after a national Protect Our Care poll showed that health care is a top priority for most voters going into the 2018 election cycle.

Protect Our Care Blasts Alex Azar Confirmation as HHS Secretary

Washington, DC – After the Senate voted to confirm Alex Azar as the Trump Administration’s Secretary of Health and Human Services (HHS), Protect Our Care Campaign Director Brad Woodhouse issued the following statement:

“As the victims of the Trump Administration’s war on health care keep piling up, Senate Republicans just confirmed Big Pharma lobbyist Alex Azar to become President Trump’s sabotage sidekick at HHS. Throughout his confirmation process, Azar lied about the Trump Administration’s Affordable Care Act sabotage while embracing the Republican agenda to take coverage from millions of Americans, raise costs for millions more and gut protections for people with pre-existing conditions. Even as Donald Trump and the GOP install an anti-ACA Big Pharma lobbyist to lead HHS, the American people continue to reject their harmful agenda. Nearly 9 million people signed up for HealthCare.gov coverage despite every obstacle this Administration threw at them, and the ACA is more popular than ever. Enough is enough – it’s time for the GOP to come to the table and work with Democrats on bipartisan measures to stabilize the marketplace and expand coverage, just as the American people have said they want. It’s time for Donald Trump, Alex Azar and Congressional Republicans to end their war on America’s health care.”

Republicans Must Finally Confront Trump’s Disastrous Handling of Opioid Crisis

Inaction + Funding Cuts = Sabotage

Washington, DC – After former Congressman Patrick Kennedy, a member of President Trump’s Opioid Commission, said this Administration’s “efforts to address the epidemic are tantamount to reshuffling chairs on the Titanic,” and other leading advocates spoke out against the Administration’s nonresponse, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“With members of Trump’s own commission decrying the President’s non-response to the raging opioid epidemic, Republicans must finally face up to this Administration’s failure to confront the nation’s most urgent health care crisis. Despite his campaign-trail promises, Trump has done worse than nothing: his attacks on the Affordable Care Act, Medicaid, and the Office of National Drug Control Policy are actively sabotaging Americans’ access to addiction treatment. Enough is enough: Congressional Republicans need to end their partisan war on health care, stand up against President Trump’s sabotage, and put their money where their mouths are on the opioid epidemic – or else admit that they are making this crisis worse.”

Opioid commission member: Our work is a ‘sham’

CNN // Wayne Drash and Nadia Kounang // January 23, 2018

The Republican-led Congress has turned the work of the president’s opioid commission into a “charade” and a “sham,” a member of the panel told CNN. “Everyone is willing to tolerate the intolerable — and not do anything about it,” said former Democratic Rep. Patrick Kennedy, who was one of six members appointed to the bipartisan commission in March. “I’m as cynical as I’ve ever been about this stuff.”

Trump has had a year to confront the opioid epidemic. He’s done almost nothing.

Vox // German Lopez //  Jan 23, 2018, 8:00am

If you listen to President Donald Trump’s words about the opioid epidemic, he seems to understand it’s an emergency. He declared it as one late in 2017. And he has repeatedly promised, as president and on the campaign trail, that he will do something about it — that he would “spend the money,” and that “the number of drug users and the addicted will start to tumble downward over a period of years.” If you look at Trump’s actions, well, it’s a very different story. There has been no move by Trump’s administration to actually spend more money on the opioid crisis. Key positions in the administration remain unfilled, even without nominees in the case of the White House’s drug czar office and the Drug Enforcement Administration (DEA). And although Trump’s emergency declaration was renewed last week, it has led to essentially no action since it was first signed — no significant new resources, no major new initiatives.

President Trump’s First Year: A War on Women’s Health

TO: Interested parties

FROM: Marjorie Connolly, Communications Director, Protect Our Care

RE: President Trump’s First Year: A War on Women’s Health

DATE: January 19, 2018

A year after the historic Women’s March on Washington, the millions who mobilized against President Trump’s anti-women agenda have seen their worst fears justified. Over the past twelve months, the Trump Administration and its Republican allies in Congress have launched attack after attack on women’s access to health care in parallel with Republicans’ war on American health care.

The Republican war on women’s health care is real and ongoing. Over the past twelve months, the Trump Administration’s actions to undermine Affordable Care Act protections and the Republican Congress’s repeated attempts to roll back women’s right to make their own health care decisions have created a perfect storm of harmful anti-woman policies.

Here’s how Republicans worked to wind back the clock on American women’s health care during Trump’s first year in office:

Defunding Planned Parenthood: Just today, the Trump Administration rolled back Obama-era guidance that warned states not to carve Planned Parenthood out of their Medicaid providers, signaling support for state efforts to place even higher barriers in the way of women’s access to health care. The Republican health repeal bills in Congress also got rid of federal funding for Planned Parenthood.

Taking direct aim at birth control: The Trump Administration’s proposed rule to let any employer opt out of offering health insurance that covers birth control rolls back the Affordable Care Act’s guarantee that women may access copay-free contraception.

Pushing Medicaid cuts that hurt women the most: Women make up almost two-thirds of the Americans projected to lose Medicaid coverage because of the Trump Administration’s push for states to impose work requirements. That’s because women are more likely to hold jobs that do not offer health coverage or to take on primary caregiver duties for other family members.

Stacking federal courts with anti-choice judges: For the next generation, American women will face the threat posed by an increasingly anti-choice federal judiciary. 12 of Trump’s judicial nominees were appointed to circuit courts during his first year – more than any other first-year president in American history.

Reversing progress against breast cancer: Republicans’ repeated attempts to undermine the Affordable Care Act’s essential health benefits threaten landmark progress in women’s preventive health. New research this week finds that the Affordable Care Act requirement that plans (including Medicare) must cover recommended preventive care without a copay led to a significant increase in the number of women receiving mammography screenings.

Allowing insurers to once again charge women more: The Trump Administration’s recent proposed rule expanded Association Health Plans, which would allow plans to skirt some of the Affordable Care Act’s key protections. Under the rule, plans would be able to charge people more based on gender.

Raising costs on women for maternity care: The Republican health repeal bills allowed states to opt of covering “essential health benefits,” such as maternity care, prescription drugs, and substance abuse treatment. As a result, women would have had to purchase that care separately, and therefore pay more. The Congressional Budget Office estimated that maternity care, for example, would cost women $1,000 more per month.

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.”