News

Washington, DC – The Trump administration is poised to take another step to sabotage Americans’ health care by issuing new guidance that would allow states to convert their Medicaid program into block grants that will specifically target those enrolled through Medicaid expansion under the Affordable Care Act. These so-called block grants are seen by health care experts as a blatant attempt to gut coverage and kick people off the rolls, and have repeatedly been rejected by Congress. In response to the administration’s proposal, Protect Our Care Executive Director Brad Woodhouse issued the following statement: 

“The president’s war on health care knows no bounds. In the same week President Trump said cuts to Medicare and Medicaid are on the table, we now learn that his administration is set to propose benefit-slashing block grants on Medicaid expansion, targeting the benefits of millions of Americans who have gained coverage through one of the Affordable Care Act’s most important, successful and popular provisions. President Trump blew his stack last week when he found out how poor his own polling is on the issue of health care and his response is to slash health care coverage for potentially millions of Americans? Seriously?”

Yesterday, President Trump made clear he is putting on the table slashing benefits for vital programs like Medicare, Medicaid and Social Security during an interview with CNBC at the World Economic Forum. The press quickly pointed out that Trump had made repeated promises to never cut these programs only to once again abandon that promise by threatening to cut Medicare and other benefits paid into by millions of Americans. Given President Trump’s latest remarks, it’s evident he has no problem cutting benefits from people who have worked a lifetime to earn them to fund his deficit-busting tax cuts for the wealthiest Americans.

Associated Press: Trump Suggests He May Be Open To Entitlement Cuts In Future. “Early in his presidential campaign, Trump said he was a different sort of Republican, one who would not cut Social Security, Medicare or Medicaid. The Medicaid promise was ultimately abandoned. The unsuccessful Republican drive to repeal ‘Obamacare’ would have also limited future federal spending on that federal-state health insurance program for low-income people. More recently, Trump’s 2020 budget called for deep cuts in Medicare payments to hospitals… the head of an advocacy group created to defend the Affordable Care Act said Trump tipped his hand with his comments in Davos. ‘The president has made it clear that he wants to make draconian cuts to both Medicare and Medicaid — something that the American people vehemently oppose — and today he said he’s going to try again,’ said Leslie Dach, chairman of Protect Our Care.” [Associated Press, 1/22/20]

New York Times: Trump Opens Door To Cuts To Medicare And Other Entitlement Programs. “The president has already proposed cuts for some safety-net programs. His last budget proposal called for a total of $1.9 trillion in cost savings from mandatory safety-net programs, like Medicaid and Medicare. It also called for spending $26 billion less on Social Security programs, the federal retirement program, including a $10 billion cut to the Social Security Disability Insurance program, which provides benefits to disabled workers.” [New York Times, 1/22/20]

USA Today: Trump Says He’d “Take A Look’ At Changing Entitlements Such As Medicare. “Trump promised early in his presidential campaign that he would not cut entitlement programs and lashed out at other GOP candidates over the issue. ‘The Republicans who want to cut SS & Medicaid are wrong,’ he wrote on Twitter in July 2015. ‘I’m not going to cut Social Security like every other Republican, and I’m not going to cut Medicare or Medicaid,’ Trump told The Daily Signal in May 2015, weeks before he launched his White House run…as president, Trump’s budgets have called for reductions in Medicare and Medicaid spending. He proposed cutting billions of dollars from Social Security disability programs but has not suggested reducing retirement benefits.” 

Axios: Trump Suggests Entitlement Cuts Could Come In His Second Term. “Trump said in his 2015 campaign launch speech that America needs to ‘save Medicare, Medicaid and Social Security without cuts.’ Asked by CNBC Wednesday if cuts to entitlements would now be something he’d consider, Trump responded: ‘At the right time, we will take a look at that.’ Asked directly about cuts to Medicare, Trump reiterated: ‘We’re going to look,’ but did not offer specifics. The big picture: The president’s latest budget proposal already called for $1.9 trillion in cost savings from mandatory safety-net programs like Medicare and Medicaid, as well as $26 billion less in spending on Social Security programs.” [Axios, 1/22/20] 

Business Insider: Trump Says Reforming Social Security And Medicare Is ‘the Easiest Of All Things’ As He Appears Open To Cutting Entitlement Spending. “In the interview, the president said entitlement reform could happen at the ‘right’ moment and appeared to credit the strength of the US economy for providing momentum to shrink spending on two of the nation’s biggest government programs…Any initiative to cut spending on Social Security and Medicare would be a break from his 2016 campaign pledge to protect funding for those programs.”  [Business Insider, 1/22/20] 

HuffPost: Trump Says He’s Willing To Tackle Entitlements ‘Toward The End Of The Year.’ “Trump’s comments to CNBC on Wednesday at the World Economic Forum in Davos, Switzerland, are a change from his past promises to Americans that he would leave those programs untouched, although his administration has pushed to downsize them. Given the enormous popularity of the programs, even hinting at entitlement cuts is typically the third rail of politics, particularly in an election year. Democrats have warned that Trump might do more to decrease the social safety net, and he just confirmed they’re right.“ [HuffPost, 1/22/20] 

Slate: Donald Trump Says He’s Willing to “Look” at Entitlements “Toward The End of This Year.” “When Donald Trump campaigned for president in 2016, one of his central promises was that he would not touch Medicare or Social Security benefits for the elderly, a vow that helped him come off as a relative centrist in the Republican field on economic issues. However, during a Wednesday interview at the World Economic Forum in Davos, Switzerland, Trump told CNBC host Joe Kernen that his administration would look into cutting federal entitlement programs at some point toward the end of the year, and that reforming them would be ‘the easiest of all things.’” [Slate, 1/22/20] 

Washington Examiner: ‘We Will Take A Look’: Trump To Consider Entitlement Cuts Toward End Of 2020. “President Trump said he will begin considering cuts to entitlement spending “toward the end of the year,” putting a politically perilous issue in play for 2020 that he had kept off the table in 2016, when he pledged to leave the programs alone.” [Washington Examiner, 1/22/20] 

Washington Post: Trump’s Comments About Entitlement Cuts Come After He Dismissed Concerns About The Budget Deficit. “The campaigns’ dispute reflects the political sensitivity of the Social Security issue. The budget deficit has soared under Trump, in part due to consecutive and significant increases to military spending under his administration. In recent private remarks to donors about the rising spending, Trump appeared unfazed by the ballooning deficit, saying: ‘Who the hell cares about the budget? We’re going to have a country.’ Trump also told CNBC the administration would look to cut taxes again in the second term. Trump claimed the 2017 Republican tax law had reduced rather than increased the deficit, a claim some nonpartisan budget experts said was not true.” [Washington Post, 1/22/20] 

Newsweek: Trump Said He’d Be Open To Entitlement Cuts “After Making Protecting Medicare, Social Security, And Other Social Programs Important Campaign Tentpoles.” “After making protecting Medicare, Social Security and other social programs important campaign tentpoles during his 2016 presidential campaign, President Donald Trump said during a CNBC interview with Joe Kernen on Wednesday that he’d be open to cutting funds to such programs in the future.” [Newsweek, 1/23/20] 

Protect Our Care’s Days of Action wrapped up just as the Supreme Court rejected House Democrats and Democrat state attorneys general’s request to fast-track consideration of the Trump-Republican lawsuit to overturn the Affordable Care Act, keeping the health care of millions of Americans in limbo.

Over the last two weeks, Protect Our Care organized 11 Days of Action to remind Americans how last month’s decision by the Fifth Circuit Court of Appeals in Texas vs. United States will impact every corner of the American health care system. Protect Our Care held events across the country with state attorneys general, state legislators and health care advocates to show how their communities will be impacted by this disastrous lawsuit if Trump and Republicans succeed in overturning the health care law. 

Protect Our Care’s Days of Action included:

Medicaid Expansion

Protections For People with Pre-Existing Conditions

Protection For Individuals with Disabilities

Key Protection For Seniors

LGBTQ Health Care

Children’s Coverage

Protection For Women

Prescription Drug Costs

Rural Health 

Marketplace Signups & Financial Assistance

Coverage For Communities of Color

Here’s a look at the events and some of the news coverage that took place over the Days of Action:

ARIZONA

Friday, January 17th – Letter Drop at AG Brnovich’s Office 

Protect Our Care Arizona was joined by patient advocates and the Arizona Alliance for Retired Americans at Attorney General Mark Brnovich’s office to deliver letters from Arizonans urging the attorney general to protect their health care amid legal challenges to the Affordable Care Act. Last month, the Fifth Circuit Court of Appeals ruled in favor of the Trump administration and Republicans in Texas vs. United States, a partisan lawsuit to dismantle the Affordable Care Act. The decision is a devastating blow to Arizonans, particularly seniors, who depend on the law to keep health care costs low. You can view the post-event release here. 

COLORADO

Wednesday, January 15th – Press Conference with Advocates

Protect Our Care Colorado was joined by patient advocates, health care experts, and Rocky Mountain Values at a press conference outside of Senator Cory Gardner’s office to denounce Senator Cory Gardner’s support for the Fifth Circuit Court of Appeals’ decision in Texas vs. United States, the partisan lawsuit seeking to dismantle the Affordable Care Act (ACA). Speakers described the devastating toll the lawsuit could take on their families, and health care experts explained why partisan efforts to throw our health care system into chaos are irresponsible and dangerous for Coloradans. View the post-event release here, and watch video of the event here. 

GEORGIA

Tuesday, January 14th – Press Conference with Women State Legislators

Protect Our Care Georgia was joined by a host of women state legislators, including State Sen. Jen Jordan, State Rep. Pat Gardner, State Sen. Nan Orrock, State Sen. Nikema Williams; Laura Simmons, NARAL state director; and Jarah Cotton, a native Georgian and Harvard freshman with a pre-existing condition who relies on the ACA to stay in her parents’ coverage. They discussed the consequences of the Texas lawsuit on women’s health care and called on new Senator Kelly Loeffler to stand up for her constituents. View the post-event release here, and watch video of the event here.

Georgia Recorder: Georgia Dems push new GOP U.S. Senator to oppose Obamacare repeal

CBS46: Women lawmakers concerned, call on Loeffler to push against lawsuit

The Newnan Times-Herald: Court: Part of ‘Obamacare’ invalid, more review needed

MAINE

Friday, January 17th – Press Conference on Pre-existing Conditions Protections

Protect Our Care Maine was joined by State Rep. Donna Doore, who is also a three-time cancer patient, and Whitney Parrish, Policy Director of Health Equity Alliance, to discuss how the decision in favor of the Trump administration in the Texas v. United States lawsuit would be devastating to Mainers with pre-existing conditions. They also condemned Sen. Susan Collins’ failure to sign on to a Senate resolution that would reverse the administration’s support of the lawsuit, and called on her to stand up for her constituents. View the post-event release here, and watch video of the event here.

MICHIGAN

Thursday, January 16th – Roundtable with AG Nessel and Advocates

Protect Our Care Michigan was joined by Attorney General Dana Nessel, the Michigan League for Public Policy, and patient advocates to discuss the disastrous ruling in favor of the Trump administration and Republicans in Texas vs. United States and its potential impact on seniors, patients with pre-existing conditions, and those who rely on the Healthy Michigan Plan. Participants emphasized the importance of the Affordable Care Act ensuring healthcare access for the seven percent of Michiganders using Medicaid, young people sharing their parents’ insurance, and those with pre-existing conditions both in Michigan and across the country. View the post-event release here.

WLNS: AG Nessel takes part in discussion on future of Affordable Care Act

Michigan Advance: Hospitals, economists join 20 AGs in ACA court fight

MIRS: Did Republicans Hitch Their Wagon To Political Loser With Anti-ACA Stance?

MINNESOTA

Friday, January 17th – Press Conference with State Legislators and Advocates

Protect Our Care Minnesota was joined by Planned Parenthood Minnesota, North Dakota, South Dakota Action Fund, and Reps. Laurie Halverson and Rep. Kelly Morrison to discuss the disastrous ruling in favor of the Trump administration and Republicans in Texas vs. United States, a partisan lawsuit to dismantle the Affordable Care Act (ACA), and its potential impact on women’s health. Speakers explained how the Affordable Care Act improved access to care for women in Minnesota and across the country, and described how the Fifth Circuit’s decision in favor of the partisan lawsuit could leave women without the care they depend on. View the post-event release here. 

NEVADA

Thursday, January 16th – Press Conference with Health Care Advocates

Healthcare advocates including Assemblywoman Michelle Gorelow, Healthcare Advocate Allison Stephens, Alex Camberos with the Children’s Advocacy Alliance, and Forrest Darby with the Nevada Alliance of Retired Americans denounced the Fifth Circuit Court of Appeals’ decision in the Trump administration and Republicans in Texas vs. United States, a partisan lawsuit to dismantle the Affordable Care Act at a press conference on Thursday. Participants called on Republican lawmakers to stand up to the lawsuit and for the Trump administration to stop its attempts to repeal the law. You can view the post event release here.

NEW HAMPSHIRE

Thursday, January 16th – Editorial Meeting with Brad Woodhouse and Laconia Daily Sun

Protect Our Care New Hampshire arranged a phone meeting between the managing editor and a reporter at the Laconia Daily Sun and Brad Woodhouse. They discussed what the Affordable Care Act has done for the state of New Hampshire, especially in rural areas, and the consequences for Granite Staters if the ACA were to be struck down in court.

NORTH CAROLINA

Friday, January 17th – Press Conference with Health Care Advocates

Protect Our Care North Carolina was joined by Piedmont Rising, Action NC, and Little Lobbyists   at a press conference outside Sen. Thom Tillis’ Charlotte office to condemn the Fifth Circuit Court of Appeals ruling in favor of the Trump administration in Texas vs. United States, a partisan lawsuit to dismantle the Affordable Care Act. Speakers criticized Senator Tillis for his support of the lawsuit, that could leave millions of North Carolinians without access to health care. Advocates shared their stories of obtaining health care through the Affordable Care Act, and described and what loss of coverage would mean for their families. Speakers called on Sen. Thom Tillis to stand up for his constituents, and urged the Supreme Court to take action on the case immediately. View the post-event release here.

WISCONSIN

Tuesday, January 14th – Doctors Press Conference

Ahead of Trump’s visit to Milwaukee, Protect Our Care and the Committee to Protect Medicare held a press conference with several doctors called attention to Trump’s broken promises on health care and warned of the impending danger of the Texas lawsuit winding its way through the courts. You can view the post-event release here. 

Tuesday, January 14th – Trump Bracketing Press Conference

In response to Trump’s visit to Milwaukee, the Democratic Party of Wisconsin and Milwaukee Mayor Tom Barrett held a press conference calling attention to the president’s attempts to eliminate the ACA. His most recent attack being the Texas lawsuit—which would overturn the ACA in its entirety—is still pending in the courts. You can view the post-event release here. 

Wisconsin Public Radio: Ahead Of Trump Rally, Milwaukee Streets Packed With Supporters

WITI: ‘An attack on Obamacare:’ Dems protest Pres. Trump’s ‘broken promises on health care’

Milwaukee Journal Sentinel: Trump sends a message to Democrats with a rally in Milwaukee, home of the 2020 DNC

Washington, DC — Today, the Supreme Court rejected House Democrats and Democrat state Attorneys General’s request to grant expedited consideration of cert for the Trump-Republican lawsuit to overturn the Affordable Care Act. This action all but guarantees that the court will not hear this case during the upcoming term, and the lawsuit will be remanded to a lower court judge who already ruled the entire law unconstitutional while millions of Americans’ health care will remain under attack. In response to their decision, Protect Our Care Chair Leslie Dach issued the following statement: 

“By likely getting their wish to postpone a Supreme Court decision on this destructive lawsuit until after the election, Donald Trump and the Republican Party have succeeded in their quest to spare themselves the political consequences of their effort to take away health care from 20 million Americans and protections for 135 million Americans with pre-existing conditions. Instead, the health care millions of Americans remains under attack and the same judge who already declared the entire law null and void will remain in the driver’s seat. It’s time Donald Trump ended his war on America’s health care and the terrible threat to the health care of millions of Americans.”

Last month, the Fifth Circuit Court of Appeals ruled in favor of the Trump administration and Republicans in Texas vs. United States, striking down as unconstitutional the ACA’s individual mandate and remanding to the lower court judge a final decision on what parts of the ACA should be eliminated – the very judge who has already ruled the entire law unconstitutional. If President Trump and Republicans have their way, 20 million Americans will lose their insurance coverage, 135 million Americans with pre-existing conditions will be stripped of their protections, and costs will go up for millions. 

“The Fifth Circuit’s disastrous decision on President Trump’s Texas lawsuit puts the health care of millions of Americans at risk. The court’s decision will impact every corner of the American health care system, including widening racial disparities in coverage rates and threatening health care access for communities of color across the country,” said Protect Our Care Executive Director Brad Woodhouse. “Over the course of these days of action, we will be reminding Americans what’s really at stake if the courts ultimately overturn the health care law.” 

Days of Action: Day 11 of 11 focuses on Coverage For Communities of Color. To learn more about our Days of Action, visit our website.

What’s At Stake: Coverage For Communities of Color

The ACA helped reduce longstanding racial disparities in coverage rates, improving health care access for communities of color across the board. 

The ACA helped lower the uninsured rate for African Americans by more than one third. Before the passage of the ACA, more than 16 percent of the nearly 50 million Americans lacking health insurance were African Americans. According to the Center on Budget and Policy Priorities, the ACA helped lower the uninsured rate for nonelderly African Americans by more than one third between 2013 and 2016 from 18.9 percent to 11.7 percent. 

Repealing Medicaid expansion would disproportionately harm communities of color. After the implementation of the ACA, gaps in insurance coverage narrowed the most in states that adopted Medicaid expansion. Moreover, communities of color make up significant proportions of the Medicaid population: Black Americans make up 13.4 percent of the U.S. population but 20 percent of Medicaid enrollees. Similarly, Latinos make up 30 percent of total Medicaid enrollees while only accounting for 18.3 percent of the U.S. population. 

Latinos stand to lose if the ACA is overturned. The percentage of people gaining health insurance under the ACA was higher for Latinos than for any other racial or ethnic group in the country. According to a study from Families USA, 5.4 million Latinos would lose coverage if the Texas lawsuit succeeds in overturning the ACA.  

Research confirms that the ACA improved health care access for communities of color: 

Commonwealth Fund Study Found That Medicaid Expansion Has Been Key To Improving Racial Equity In Health Insurance Coverage And Access To Care. “Uninsured rates for blacks, Hispanics, and whites declined in both expansion and nonexpansion states between 2013 and 2018. In addition, disparities in coverage between whites and blacks and Hispanics also narrowed over that time period in both sets of states… People living in Medicaid expansion states benefited the most in terms of coverage gains. All three groups reported lower uninsured rates in expansion states compared to nonexpansion states, and larger coverage improvements between 2013 and 2018. Coverage disparities in expansion states narrowed the most over the period, even though the disparities were smaller to begin with. The black–white coverage gap in those states dropped from 8.4 percentage points to 3.7 points, while the difference between Hispanic and white uninsured rates fell from 23.2 points to 12.7 points.” [Commonwealth Fund, 1/16/20] 

Washington Post: ACA Linked To Reduced Racial Disparities, Earlier Diagnosis And Treatment In Cancer Care. “Proponents of the embattled Affordable Care Act got additional ammunition Sunday: New research links the law to a reduction in racial disparities in the care of cancer patients and to earlier diagnoses and treatment of ovarian cancer, one of the most dangerous malignancies. According to researchers involved in the racial-disparity study, before the ACA went into effect, African Americans with advanced cancer were 4.8 percentage points less likely to start treatment for their disease within 30 days of being given a diagnosis. But today, black adults in states that expanded Medicaid under the law have almost entirely caught up with white patients in getting timely treatment, researchers said. Another study showed that after implementation of the law, ovarian cancer was diagnosed at earlier stages and that more women began treatment within a month. The speedier diagnoses and treatment were likely to have increased patients’ chances of survival, the researchers said.” [Washington Post, 6/2/19]

Black Women Were More Likely To Receive Care Because Of The ACA. “There has been an increase in the share of black women with a ‘usual source of care’—meaning a particular doctor’s office, clinic, or health center. In 2010, 83 percent of black women had a usual source of care. By 2014, the share had risen to 88.1 percent. Furthermore, black women have experienced a reduction among those who delayed or went without care due to cost. In 2010, 18.6 percent of black women ‘who had to delay or forgo care because of cost’; by 2014, only 15.1 percent of black women did so.” [Center for American Progress, 2/28/17] 

Bottom line: “Health coverage is especially important for African Americans and other racial and ethnic minorities because they often have worse health status than their white counterparts,” according to the Center on Budget and Policy Priorities. Coverage losses incurred by overturning the ACA would be devastating for communities of color and reverse the significant gains in health care access made by the law.

Last month, the Fifth Circuit Court of Appeals ruled in favor of the Trump administration and Republicans in Texas vs. United States, striking down as unconstitutional the ACA’s individual mandate and remanding to the lower court judge a final decision on what parts of the ACA should be eliminated – the very judge who has already ruled the entire law unconstitutional. If President Trump and Republicans have their way, 20 million Americans will lose their insurance coverage, 135 million Americans with pre-existing conditions will be stripped of their protections, and costs will go up for millions. 

“The Fifth Circuit’s disastrous decision on President Trump’s Texas lawsuit puts the health care of millions of Americans at risk. The court’s decision will impact every corner of the American health care system, eliminating both the individual marketplace and financial assistance that helps people purchase health insurance, while ripping coverage away from 20 million Americans across the country,” said Protect Our Care Executive Director Brad Woodhouse. “Over the course of these days of action, we will be reminding Americans what’s really at stake if the courts ultimately overturn the health care law.” 

Days of Action: Day 10 of 11 focuses on Marketplace Signups & Financial Assistance. To learn more about our Days of Action, visit our website.

What’s At Stake:  Marketplace Signups & Financial Assistance

If The Texas Lawsuit Succeeds, The Individual Marketplace And Financial Assistance That Helps Individuals Purchase Health Insurance Will Be Eliminated. 

• 11 Million People With Comprehensive Insurance Through The ACA Marketplace Could Lose Their Coverage. Without the ACA, more than 11 million people nationwide enrolled in the individual marketplace could lose coverage. 
• Nine Million People In The Marketplaces Would Pay More For Coverage. Nearly 9 million people would lose financial assistance that helps them purchase health care in the marketplace. In 2019, the average monthly premium tax credit was $514. 

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

• According to the Urban Institute, 19.9 million people could lose coverage by repealing the Affordable Care Act, meaning the number of uninsured Americans would increase from 30.4 million to 50.3 million, representing a leading to a 65 percent increase in the uninsured rate. As the uninsured rate swells, so will the amount of uncompensated care, which Urban predicts will grow by at least 82 percent.
• States would lose important federal health care funding — an estimated reduction of $135 billion in the first year. The Urban Institute estimates that a full repeal of the ACA would reduce federal spending on Medicaid/CHIP care and Marketplace subsidies by nearly $135 billion, or 34.6 percent in the first year.
• Millions of children could lose their coverage. Almost three million children nationwide gained coverage thanks to the ACA. If the law is overturned, many of these children will lose their insurance.
• More than 5 million Latinos would lose coverage. The percentage of people gaining health insurance under the ACA was higher for Latinos than for any other racial or ethnic group in the country. According to a study from Families USA, 5.4 million Latinos would lose coverage if the lawsuit succeeds in overturning the ACA.

Last month, the Fifth Circuit Court of Appeals ruled in favor of the Trump administration and Republicans in Texas vs. United States, striking down as unconstitutional the ACA’s individual mandate and remanding to the lower court judge a final decision on what parts of the ACA should be eliminated – the very judge who has already ruled the entire law unconstitutional. If President Trump and Republicans have their way, 20 million Americans will lose their insurance coverage, 135 million Americans with pre-existing conditions will be stripped of their protections, and costs will go up for millions. 

“The Fifth Circuit’s disastrous decision on President Trump’s Texas lawsuit puts the health care of millions of Americans at risk. The court’s decision will impact every corner of the American health care system including eliminating Medicaid expansion, which has served as a lifeline for rural Americans and has played a key role in fighting the opioid crisis in communities across the country,” said Protect Our Care Executive Director Brad Woodhouse. “Over the course of these days of action, we will be reminding Americans what’s really at stake if the courts ultimately overturn the health care law.” 

Days of Action: Day 9 of 11 focuses on Rural Health. To learn more about our Days of Action, visit our website.

What’s At Stake: Rural Health

Rural Americans Stand To Lose If The Texas Lawsuit Overturns The ACA.

• Nearly 1.7 million rural Americans gained coverage through Medicaid expansion under the ACA. 24 percent of Americans living in rural areas have health coverage through Medicaid.
• In 2017, nearly 1 in 5 marketplace enrollees (1.6 million people) lived in rural areas. 
• The uninsured rate for low-income adults dropped from 35 percent to 16 percent in rural areas and small towns in states that expanded Medicaid. 
• Rural Americans are more likely to be uninsured than Americans living in non-rural areas. 

Medicaid Is A Lifeline For Rural Hospitals: 

• The Affordable Care Act led to a $12 billion reduction in uncompensated care costs. Between 2013 and 2015, hospitals’ uncompensated care costs decreased by $12 billion, or roughly 30 percent. The majority of this reduction was concentrated in states that chose to expand Medicaid. 
• 430 rural hospitals are at a high financial risk of closing. This represents roughly 21 percent of the country’s rural hospitals. 
• 120 rural hospitals have closed since 2010. The vast majority closed in states that had not expanded Medicaid at the time of the hospital closure.

American Hospital Association, Federation Of American Hospitals, The Catholic Health Association Of The United States, And Association Of American Medical Colleges: “A Judicial Repeal Would Have Severe Consequences For America’s Hospitals, Which Would Be Forced To Shoulder The Greater Uncompensated-Care Burden That The ACA’s Repeal Would Create.” [American Hospital Association et. al, 6/14/18]

The ACA’s Medicaid Expansion Plays A Central Role In Fighting The Opioid Crisis

• More than half of people with an opioid use disorder earn incomes below 200 percent of the federal poverty line.
• In 2014, Medicaid paid for 25 percent of all addiction treatment nationwide.
• It is estimated that Medicaid expansion covers four in ten people with an opioid use disorder.
• Among those with opioid addiction, people covered through Medicaid are more than twice as likely as those with private insurance or no insurance to receive treatment.  In 2016, 43 percent of people who had substance use disorders received treatment when they were covered through Medicaid, significantly higher than the 21 percent of those privately insured who received treatment and 23 percent of those who were uninsured and received treatment.
• Medicaid expansion has reduced unmet need for substance use treatment by more than 18 percent. Recent research finds that Medicaid expanding reduced the unmet need for substance use treatment by 18.3 percent.

Last month, the Fifth Circuit Court of Appeals ruled in favor of the Trump administration and Republicans in Texas vs. United States, striking down as unconstitutional the ACA’s individual mandate and remanding to the lower court judge a final decision on what parts of the ACA should be eliminated – the very judge who has already ruled the entire law unconstitutional. If President Trump and Republicans have their way, 20 million Americans will lose their insurance coverage, 135 million Americans with pre-existing conditions will be stripped of their protections, and costs will go up for millions. 

“The Fifth Circuit’s disastrous decision on President Trump’s Texas lawsuit puts the health care of millions of Americans at risk. The court’s decision will impact every corner of the American health care system, making the high cost of prescription drugs even worse and threatening health care access for children, seniors, women, individuals with disabilities and LGBTQ Americans in communities across the country,” said Protect Our Care Executive Director Brad Woodhouse. “Over the course of these days of action, we will be reminding Americans what’s really at stake if the courts ultimately overturn the health care law.” 

Days of Action: Day 8 of 11 focuses on Prescription Drug Costs. To learn more about our Days of Action, visit our website.

What’s At Stake: Prescription Drug Costs

If the ACA is overturned, the high cost of prescription drugs would only get worse:  

• GONE: Rules that increase competition in the prescription drug market and help Americans access cheaper drugs. 
• GONE: Consumer protections that prohibit drug companies from paying off doctors behind closed doors to influence the drugs they prescribe to patients.
• GONE: Nearly 12 million seniors will have to pay more for prescription drugs because the Medicare ‘donut hole’ will be reopened.

ACA Repeal Means More Profits For Drug Companies And Higher Costs For Consumers. 

Consumers could be forced to pay more for drugs. The ACA’s Biologics Price Competition and Innovation Act paved the way for the Food and Drug Administration (FDA) to approve biosimilars, cheaper alternatives to expensive biologics. Without the ACA, approval of biosimilars will be in jeopardy, and drug companies may be less likely to invest in new biosimilar drugs. This change will make it harder for Americans to access low-cost alternatives to expensive biologic medications. It will also jeopardize the predicted $54 billion in savings that biosimilars are expected to produce between 2017 and 2026.

Drug companies would once again be allowed to pay doctors behind closed doors (to prescribe drugs you don’t necessarily need). Without the ACA’s Physician Payments Sunshine Act, Big Pharma will once again be allowed to make payments and offer gifts to doctors behind closed doors. When these payments are made with no transparency, they can create conflicts of interest and blur the line between objective and promotional research. The outcome of the Texas lawsuit has the potential to uproot the health care system all while giving drug companies even more power. 

Reopening the “donut hole” would make medications more expensive for 12 million seniors. If the entire ACA is overturned, seniors will have to pay more for prescription drugs because the Medicare “donut” hole will be reopened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 Centers on Medicare and Medicaid Services report. 

Last month, the Fifth Circuit Court of Appeals ruled in favor of the Trump administration and Republicans in Texas vs. United States, striking down as unconstitutional the ACA’s individual mandate and remanding to the lower court judge a final decision on what parts of the ACA should be eliminated – the very judge who has already ruled the entire law unconstitutional. If President Trump and Republicans have their way, 20 million Americans will lose their insurance coverage, 135 million Americans with pre-existing conditions will be stripped of their protections, and costs will go up for millions. 

“The Fifth Circuit’s disastrous decision on President Trump’s Texas lawsuit puts the health care of millions of Americans at risk. The court’s decision will impact every corner of the American health care system, endangering health care for women and access to care for seniors, children, individuals with disabilities and LGBTQ Americans in communities across the country,” said Protect Our Care Executive Director Brad Woodhouse. “Over the course of these days of action, we will be reminding Americans what’s really at stake if the courts ultimately overturn the health care law.” 

Days of Action: Day 7 of 11 focuses on Protections for Women. To learn more about our Days of Action, visit our website.

What’s At Stake: Protections for Women

If the ACA is overturned, key protections  for women would be ripped away overnight: 

• GONE: Insurance companies will be able to charge women 50 percent more than men.
• GONE: Contraception coverage for 60 million people who now have access to birth control with no out-of-pocket costs.
• GONE: A ban on discrimination for women, LGBTQ Americans, and individuals with disabilities in health care settings. 
• GONE: Essential protections for breastfeeding parents, including workplace standards and access to breast pumps with no out-of-pocket costs.   

Women Can Be Charged More Than Men For The Same Coverage. Prior to the ACA, women were often charged premiums on the nongroup market of up to 50 percent higher than men for the same coverage. Without the ACA, women would also lose guaranteed coverage of birth control and other preventive care services. Before the ACA, 1 in 5 women reported postponing or going without preventive care due to cost.

More than 60 million people could lose access to birth control with no out-of-pocket fees. The ACA guarantees that private health plans cover 18 methods of contraception and make them available to 62.4 million patients with no out-of-pocket costs. More than 99 percent of sexually-active women have used contraceptives at some point in their lifetimes, and approximately 60 percent of women of reproductive age currently use at least one birth control method. In addition to increasing access to this essential treatment, this ACA provision has saved money for women and their families: women saved $1.4 billion on birth control pills alone in 2013.

Women, LGBTQ Americans, and individuals with disabilities can face discrimination in health care settings. Section 1557 of the ACA prohibits discrimination the basis of race, color, national origin, sex, age, or disability by any health program or activity receiving federal assistance. It also prohibits these types of discrimination in health programs and activities administered by HHS as well as the ACA marketplaces. 

Nursing parents would lose breastfeeding support and critical workplace protections. The Affordable Care Act requires insurance companies to cover breastfeeding support and counseling, as well as breast pumps without cost-sharing for pregnant and nursing women. 

Today, President Trump tweeted a bizarre lie that he alone “saved” protections for pre-existing conditions in health care. The press quickly debunked President Trump’s claim and reminded Americans of the truth about Trump’s disastrous health care agenda. 

Associated Press: AP FACT CHECK: No, Trump Didn’t Save Preexisting Conditions. “People with preexisting medical problems have health insurance protections because of President Barack Obama’s health care law, which Trump is trying to dismantle. One of Trump’s major alternatives to Obama’s law — short-term health insurance, already in place — doesn’t have to cover preexisting conditions. Another major alternative is association health plans, which are oriented to small businesses and sole proprietors and do cover preexisting conditions. Neither of the two alternatives appears to have made much difference in the market. Meanwhile, Trump’s administration has been pressing in court for full repeal of the Obama-era law, including provisions that protect people with preexisting conditions from health insurance discrimination.” [Associated Press, 1/13/20] 

New York Times: To the Contrary, Trump Has Tried to Weaken Protections for Pre-Existing Conditions. “President Trump was not in Washington when the Affordable Care Act passed and established a right to health insurance for Americans with pre-existing health conditions. His first legislative priority as president was a bill that would have repealed key parts of Obamacare and weakened such protections. His Justice Department is arguing in court that the entire law should be overturned.” [New York Times, 1/13/20] 

Washington Times: Trump Misleads On Obamacare In Attacking Bloomberg. “Mr. Trump said he ‘saved Pre-Existing Conditions in your Healthcare,’ although the protections were written into the law that President Obama muscled to passage in 2010. He’s also rooting for a state-driven legal challenge that could upend those very protections.” [The Washington Times, 1/13/20] 

Politico Pro: “Trump’s Claim Monday That He ‘Saved Pre-Existing Conditions’ In Americans’ HealthCare Is A False One — The Latest Attempt By The President To Distort His Years-Long Record Of Trying To Strike Down The Affordable Care Act.” “Trump’s claim Monday that he ‘saved Pre-Existing Conditions’ in Americans’ health care is a false one — the latest attempt by the president to distort his years-long record of trying to strike down the Affordable Care Act. Backed by then-President Barack Obama and passed by Democrats in Congress in 2010, the landmark health care law included historic protections for millions of Americans with chronic illness and other health conditions.” [Politico Pro, 1/13/20] 

MSNBC: “It’s As Brazen A Lie As Trump As Ever Told – And To Know Anything About The President Is To Know The Competition In That Category Is Fierce.” “It’s as brazen a lie as Trump as ever told – and to know anything about the president is to know the competition in that category is fierce. In reality, Trump didn’t “save” protections for Americans with pre-existing conditions; he fought to take those protections away through a series of far-right repeal-and-replace proposals he couldn’t get through a Congress led by his own party. Trump, of course, is also helping champion an ongoing federal lawsuit which would – you guessed it – strip protections for Americans with pre-existing conditions.” [MSNBC, 1/13/20]

Business Insider: Trump Says He ‘Saved’ Protections For Pre-Existing Healthcare Conditions – But He’s Actually Tried Shredding Them For 3 Years. “President Trump sought to place himself as the guardian of a popular part of Obamacare in a series of Monday morning tweets, saying he protected insurance coverage for pre-existing conditions on behalf of millions of Americans. But that doesn’t align with his administration’s record on healthcare.” [Business Insider, 1/13/20] 

Yahoo News: Trump “Misrepresented His Administration’s Health Care Record” While Touting Court Case That Would Throw Millions Of Americans With Pre-Existing Conditions Off Of Their Insurance.  “Trump’s ‘win in court’ reference is about a lawsuit, backed by the Justice Department, that if successful would result in the overturning of the Affordable Care Act (the ACA, or Obamacare). If that happens, many Americans with preexisting conditions could lose their coverage entirely or face significantly higher premiums, unless and until an alternative is passed. Without protections for preexisting conditions provided by Obamacare, the Kaiser Family Foundation estimated in 2015 that up to 52 million people could be denied coverage. Others would lose insurance if the Medicaid expansion that was adopted by dozens of states and D.C. was killed.”” [Yahoo News, 1/13/20]

Vox: Trump Claiming To Be A Defender Of Preexisting Conditions Is Pretty Shameless. “Trump — who in 2017 pushed health care legislation that would’ve resulted in 23 million Americans losing coverage, and whose administration is currently fighting in federal court to strike down the Affordable Care Act (ACA), including its protections for people with preexisting conditions — nonetheless claimed in a tweet attacking Democratic presidential candidate Michael Bloomberg on Monday that ‘I was the person who saved Pre-Existing Conditions in your Healthcare, you have it now’…Trump’s tweet is either a big lie, illustrates his profound confusion about health care policy, or some combination thereof.” [Vox, 1/13/20] 

Esquire: Trump Debuts a New Claim That Is the Actual Diametric Opposite of Reality. “This is just unbelievably brazen lying, even by current Presidential Standards. The Trump administration is right now, this second, backing a lawsuit that would completely dismantle the Affordable Care Act. It would strip the guaranteed protection for preexisting conditions that is one of the law’s primary achievements and leave nothing in its place. This is real life: people will lose their coverage and go bankrupt if the decision goes that way. Funny enough, the people who want the law struck down have made it clear to the court that this can wait until after the 2020 election—when they might face some repercussions for their actions. 68 percent of respondents in a Kaiser Family Foundation poll last year said they wanted to maintain the protections.” [Esquire, 1/13/20]

Mother Jones: Don’t Let Trump Fool You Into Thinking He’s Improving Health Care. “President Donald Trump took to Twitter Monday morning with a brazenly false claim about his health care policy. Let’s break this down. First, Trump was not ‘the person who saved Pre-Existing Conditions in your Healthcare.’ All health plans on the Affordable Care Act marketplace are required by law, as enacted under Barack Obama, to cover treatment for preexisting conditions. A 2019 Kaiser Health News fact check found Trump’s repeated claims to protect patients with preexisting conditions false.” [Mother Jones, 1/13/20]