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Trump Effect: Tennessee Asks Trump Administration to Turn Medicaid Into A Block Grant

Washington, DC — Today, Tennessee formally asked the Trump administration to convert the state’s Medicaid program into a block grant. These so-called block grants being pushed by the Trump administration are seen by health care experts as blatant attempts to gut coverage and kick people off the rolls, and have repeatedly been rejected by Congress. In response, Protect Our Care executive director Brad Woodhouse issued the following statement:

“The multi-pronged attack on Medicaid by Tennessee Republicans and the Trump administration should tell you everything about the motives behind this latest proposal: kick people off the rolls, tear apart the foundations of the program, and watch Americans who rely on coverage through Medicaid suffer. This push to turn Medicaid into block grants, — along with promoting junk plans, working to repeal the ACA, and the reckless Texas lawsuit — is just another front in the Trump-Republican war on health care. Initiating block grants isn’t about improving or reforming health care; it’s about ripping coverage away from more Americans, plain and simple.”

BACKGROUND:

Experts And Health Advocates Warn That This Plan Would Wreak Havoc On Tennesseans’ Health Care: 

Michele Johnson, Executive Director Of The Tennessee Justice Center, Said That The Proposal Would Be “Devastating For Our Health Care Infrastructure, For The Tennessee Economy, And For Our Communities.” “Michele Johnson, executive director of the Tennessee Justice Center, a group representing vulnerable residents needing health care and other assistance, said the proposed changes to TennCare would be ‘devastating for our health infrastructure, for the Tennessee economy, and for our communities.” [Washington Post, 9/17/19

More Than Two Dozen Health Advocacy Groups Warned CMS That Block Grants “Will Reduce Access To Quality And Affordable Healthcare For Patients With Serious And Chronic Health Conditions.” “Moving to a block grant or per capita cap would also have widespread negative impacts on state economies. Cuts to Medicaid will not only impact those enrolled, but the entire healthcare system, as many critical healthcare entities, such as children’s hospitals, rely on Medicaid financing for their financial stability. The Affordable Care Act’s Medicaid expansion has led to significant reductions in uncompensated care costs and reduced the likelihood of hospital closures, especially in rural areas – progress that could be lost under block grant and per capita cap policies. Our organizations are concerned that CMS has not adequately considered these negative impacts. Finally, our organizations believe that the Administration does not have the authority to allow states to implement block grants or per capita caps through the 1115 waiver process. The Secretary is not permitted to waive Sections 1903 and 1905, where the financing structure of the Medicaid program is located, through these types of waivers. Such a change would require congressional authority, yet Congress has repeatedly declined to pass legislation on this issue, most recently during the debate over repealing and replacing the Affordable Care Act in 2017. Simply put, block grants and per capita caps will reduce access to quality and affordable healthcare for patients with serious and chronic health conditions and are therefore unacceptable to our organizations.” [American Lung Association et. al. letter to CMS Administrator Seema Verma, 7/18/19

Nashville Tennessean: Governor’s Plan To Implement Block Grant Proposal Would “Almost Certainly” Change Medicaid Coverage. “The whole point of the block grant proposal is that Tennessee officials think they can run their state Medicaid program better than the federal government. If the block grant proposal is enacted, the state government would likely gain control over who is eligible for TennCare and which medications and treatment are covered. State officials could potentially decide to stop paying for a medication that is now covered or start covering a procedure that is currently outside the scope of TennCare.”  [Nashville Tennessean, 8/25/19

Robin Rudowitz, A Medicaid Analyst At The Kaiser Family Foundation, Said Block Grants Run Counter To “Core Principles” Of Medicaid. “’There are two foundational things in Medicaid—an entitlement for all individuals eligible for coverage, and a guarantee to states of federal matching dollars,’ said Robin Rudowitz, a Medicaid analyst at the Kaiser Family Foundation. ‘Block grants run counter to both of those core principles.’”  [Modern Healthcare, 5/7/19

Two Major Tennessee Hospital Groups Expressed Concern That Block Grant Proposal Would Weaken Health Insurance For Families. “Two major Tennessee hospital companies say a plan to convert billions of federal Medicaid funding to a block grant may weaken health insurance for poor families or cause TennCare to run out of money during an economic recession. […] For this story, The Tennessean contacted about a dozen Tennessee hospital companies seeking comment from their executives about the block grant proposal. Interviews were conducted with experts at Saint Thomas Health in Nashville and Baptist Memorial Health Care in Memphis, both of whom expressed concerns, and with the CEO of Ballad Health in East Tennessee, which was supportive.” [Nashville Tennessean, 9/12/19

Republican State Senator And Cardiothoracic Surgeon Richard Briggs Said “A Straight Block Grant Could Be Very Dangerous.” “’A straight block grant could be very dangerous,’ said Briggs, who for the past few years has unsuccessfully pushed for Medicaid expansion under the Affordable Care Act. ‘If we go into a recession—and we’re due for one—there will be more people going into Medicaid, and the state would have to make up revenues to cover them.’” [Modern Healthcare, 5/7/19

SHOT/CHASER: PhRMA Rakes In Record High Revenue To Keep Drug Prices High While 58 Million Americans Say They Can’t Afford Their Prescriptions

SHOT: GALLUP Poll: 58 Million Adults Have Been Unable To Afford Prescribed Drugs At Least Once In The Last 12 months. “Dovetailing with these results is a rising percentage of adults who report not having had enough money in the past 12 months to ‘pay for needed medicine or drugs that a doctor prescribed’ to them. This percentage has increased significantly, from 18.9% in January 2019 to 22.9% in September. In all, the 22.9% represents about 58 million adults who experienced ‘medication insecurity,’ defined as the inability to pay for prescribed medication at least one time in the past 12 months.” [Gallup, 11/12/19] 

CHASER: AXIOS: “The drug industry lobbying group PhRMA registered $460 million of revenue in 2018, a shade more than 2017, according to its latest tax returns obtained by the Center for Responsive Politics.” [Axios, 11/18/19

NEW ADS: Ten New Districts Added to Protect Our Care’s Ad Campaign Thanking Members of Congress for Leading the Fight to Lower Prescription Drug Costs and Protect People With Pre-Existing Conditions

Ad Campaign Now Covers Twenty House Districts and Totals $4 Million

Watch New Ads HERE

Washington, DC — Protect Our Care (POC) added ten new districts to its digital advertising campaign in support of freshman members of Congress who are leading the fight to lower prescription drug costs and protect people with pre-existing conditions. POC’s $2 million expansion brings the organization’s investment in this campaign to $4 million covering 20 House districts of freshmen Democrats who ran and won on the issue of health care in 2018 and who have led the fight to improve American health care since joining the House earlier this year.

The districts added today are part of the House Education and Leadership Project (HELP), which Protect Our Care launched in September with an initial ten congressional districts. The campaign seeks to show constituents how their newly elected representative is delivering on their promises to protect care and lower costs in order to encourage the entire Congress to do the same. The latest round of ads begins with a focus on these Members’ work to lower prescription drug costs, specifically their support for giving Medicare the power to negotiate for lower prices (H.R 3) and efforts to rein in drug and insurance companies. The full campaign includes a series of 15- and 30-second ads. 

“Millions of Americans who worry about the rising costs of health care should know that these members of Congress are working to lower the costs of prescription drugs and end the rigged system created by big drug and insurance companies,” said Protect Our Care Chair Leslie Dach. “While the White House and Congressional Republicans oppose effective and popular solutions like giving Medicare the power to negotiate for lower drug prices, these members are delivering on their promise to lower costs and protect Americans’ health care.” 

The HELP campaign now includes these ten additional districts and kicks off with a 15 second ad on reducing drug prices:

Angie Craig (MN-02)

Sharice Davids (KS-03)

Antonio Delgado (NY-19)

Lizzie Fletcher (TX-07)

Jared Golden (ME-02)

Susie Lee (NV-03)

Elaine Luria (VA-02)

Lucy McBath (GA-06)

Chris Pappas (NH-01)

Susan Wild (PA-07)

The new ads will also run in districts included in the original campaign announcement:

Colin Allred (TX-32)

Cindy Axne (IA-03)

Abby Finkenauer (IA-01)

Andy Kim (NJ-03)

Katie Porter (CA-45)

Elissa Slotkin (MI-08)

Abigail Spanberger (VA-07)

Haley Stevens (MI-11)

Lauren Underwood (IL-14)

Ad Script:

Representative Elissa Slotkin is standing up to big drug companies.

She’s fighting to give Medicare the power to negotiate with drug companies for lower prices, reducing your costs by as much as 55%.

Thank her for leading the fight to lower your drug prices.

Louisiana Voters Reject Trump’s Sabotage Agenda

Washington, DC — Tonight, Louisiana voters went to the polls and rejected Trump’s sabotage agenda and the Republican candidate, Eddie Rispone. In response, Protect Our Care Executive Director Brad Woodhouse released the following statement:

“President Trump’s disastrous health care agenda was front and center this election and voters in Louisiana soundly rejected it by denying the governorship to a Republican who supports the president’s war on health care. In Virginia, Kentucky, and now Louisiana voters have sent a message that they support Medicaid expansion, ensuring protections for pre-existing conditions and want nothing to do with Republicans’ efforts to sabotage their health care. This election sends a warning to Trump and Republicans across the country that their repeated attacks on Americans’ health care will continue to cost them at the ballot box.”

Trump Administration’s New Rules Won’t Lower Prices For Patients

Washington, DC — Today, President Trump is rolling out new price transparency rules for insurers and hospitals. However, these rules won’t actually lower patients’ prices. In response to their announcement, Protect Our Care Chair Leslie Dach issued the following statement:

“Every person who has ever spent time in the hospital knows they have no ability to shop around or negotiate for a lower price. Meanwhile, the Trump administration opposes the single most powerful tool to reduce people’s health care costs — Medicare negotiating for lower prescription drug prices — which would save patients $158 billion. These new rules are nothing more than another attempt by this administration to mislead the American people about their relentless sabotage agenda.” 

SHOT/CHASER: Verma Claims Millions of Taxpayer Dollars Spent on Personal Brand Necessary to “Get on a Good Footing” While Spending Her First Year at CMS Sabotaging Americans’ Health Care

SHOT: CMS Administrator Seema Verma Spent Millions Of Taxpayer Dollars To “Get On A Good Footing” And Promote Personal Brand Early On In Trump Administration. [The Hill, 11/12/19]

CHASER: During Her First Year In Office, Verma: 

  • Cut the number of days people could sign up for coverage during open enrollment by half, from 90 days to 45 days.
  • Slashed the outreach advertising budget for Open Enrollment by 90 percent, from $100 million to just $10 million – which resulted in as many as 1.1 million fewer people getting covered.
  • Announced support for states imposing onerous work requirements and approved Kentucky’s worst-in-the-nation waiver the very next day.

LIME: CNBC: Rate Of Uninsured Americans Rises For The First Time Since Obamacare Took Effect In 2014. [CNBC, 9/10/19

For more on the Trump administration’s war on health care, see our sabotage tracker

SHOT/CHASER: People Can’t Afford Prescription Drugs, Trump Opposes Lower Costs

New GALLUP data today revealed that 58 million people were unable to afford medicine that they were prescribed in the past year. Sure enough, President Trump is siding with big drug companies to oppose the “Lower Drug Costs Act (H.R. 3)” which allows Medicare to negotiate lower drug prices for people on Medicare and people on private insurance. The nonpartisan CBO says it reduces the most expensive drugs by as much as 55 percent. 

SHOT: GALLUP: “The survey also found that 58 million people, roughly one-quarter of all U.S. adults, were unable to pay for drugs they were prescribed during the last 12 months.” [GALLUP, 11/12/19

CHASER: MARKETWATCH: “White House rejects Pelosi’s plan to lower drug prices” [Marketwatch, 11/5/19

LIME: POLITICO: “Federal health contract funneled hundreds of thousands of dollars to Trump allies” [POLITICO, 11/12/19

White House Puts Politics Over Popular and Effective Measures To Lower Drug Prices

Washington, DC — Speaking at a conference today, a senior White House official claimed House Democrats’ landmark bill giving Medicare the power to negotiate for lower drug prices is “unworkable” and “hyper-partisan.” In a recent poll by Hart Research for Protect Our Care, 77% of Americans, including 54% of Republicans supported giving Medicare the power to negotiate for lower drug prices for all Americans. In response, Protect Our Care Executive Director Brad Woodhouse released the following statement: 

“The only ones being ‘hyper-partisan’ in the debate over lowering drug prices are President Trump and his Republican allies who continue to put big pharma profits over patients. The American people overwhelmingly support the measures put forward in the House Democrats’ bill to lower drug costs, including giving Medicare the power to negotiate for lower drug prices, and reining in drug and insurance companies. It’s clear to the American people that the Trump administration hasn’t lifted a finger to tackle prescription drug costs. Their failure to even consider the effective and popular measures in the House bill proves the Trump administration has no interest in making progress or solving this problem.” 

BACKGROUND:

Recent national polling from Hart Research Associates for Protect Our Care of 1,000 voters confirms the provisions of H.R. 3 are supported by the majority of Americans across the political spectrum. 

  • 77% of Americans support giving Medicare the power to negotiate for lower drug prices for all consumers.
  • 77% of Americans support Democrats’ proposal to use the savings Medicare would achieve by negotiating for lower drug prices to provide vision, dental and hearing benefits for seniors. 
  • 97% of Americans support the H.R. 3 provision preventing drug companies from charging Americans more for the same drug than they charge people in other countries. 

 

Health Care Was The Winning Issue For Democrats In Kentucky And Virginia

Last night’s elections made clear that rejecting Trump’s sabotage agenda and protecting health care remain top priorities for voters. 

Washington Post Health 202: Medicaid Work Requirements “Clear Loser” In Last Night’s Elections. “There was a clear loser in last night’s elections: Medicaid work requirements in Kentucky and Virginia. To accomplish its goals for Medicaid, the Trump administration needs the help of state political leaders – and election results in Kentucky and Virginia yesterday made that less likely as Democrats widened their control in those states.” [Washington Post, 11/6/19

Axios: In Kentucky, The Trump Administration’s Health Care Agenda Lost One Of Its Closest Allies. “The Trump administration’s health care agenda appeared likely to lose one of its closest allies last night as Democrat Andy Beshear declared victory over Kentucky Gov. Matt Bevin, Axios health care editor Sam Baker notes. Driving the news: Beshear has pledged to reverse Kentucky’s plan for Medicaid work requirements — which took a backseat to national issues in the campaign, but was nevertheless one of Bevin’s most significant policy legacies.” [Axios, 11/6/19

Politico: Likely Governor-Elect Andy Beshear “Fully Embraced The Affordable Care Act In Kentucky” During Campaign. “Democrat Andy Beshear appears to eke out a win over Gov. Matt Bevin — Beshear, the son of the state’s previous Democratic governor who fully embraced the Affordable Care Act in Kentucky, made defending Medicaid expansion and Obamacare patient protections a central theme of his campaign against the unpopular Republican incumbent.” [Politico, 11/6/19

Politico: Virginia Democrats Flipped The State Legislature “Due In Part To The Party’s Promise To Protect The State’s Medicaid Expansion.” “Democrats flipped the state legislature — a victory that is due in part to the party’s promise to protect the state’s Medicaid expansion that’s covered more than 300,000 people.” [Politico, 11/6/19

Wall Street Journal: “Democrats Hailed The Election Gains As A Sign That Their Stance On Expanding Health Care Coverage Still Resonates With Voters.” “Democrats hailed the election gains as a sign that their stance on expanding health-care coverage still resonates with voters. Candidates had criticized their Republican challengers who opposed expanding Medicaid, a federal-state program for low-income and disabled people. The wins also thwart President Trump who has called for nationwide work requirements in Medicaid.” [Wall Street Journal, 11/6/19

The Atlantic: “Bevin Made It His Top Priority As Governor To Shred The ACA In Kentucky.” “Matt Bevin made it his top priority as governor to shred the ACA in Kentucky. He shifted 31,000 people off Medicaid and S-Chip, the state children’s health-insurance plan. He added work requirements for Medicaid, and other practical barriers to coverage. Bevin’s personal behavior may have been extreme, but his policy priorities as governor were squarely in the GOP mainstream. Squeezing the ACA has been Trump policy, too.” [The Atlantic, 11/6/19

Experts Confirm Health Care Was At The Center Of Democratic Wins In Kentucky And Virginia:

California Attorney General Xavier Becerra: “Congrats to Kentucky’s next Governor, @AndyBeshearKY! Democrats are fighting to #ProtectOurCare, uplift hardworking families, and strengthen our communities. Voters in Kentucky made the right choice today — and it won’t be their last. CC: @SenateMajldr. [AG Becerra Twitter, 11/5/19

Steve Schale: “One lesson from Kentucky – Protecting and building on the Affordable Care Act is both good policy and good politics. Beshear: I’m leading Kentucky’s fight to protect affordable health care for families.” [Steve Schale Twitter, 11/6/19

Alice Miranda Ollstein: “Beshear’s father implemented a Medicaid expansion in Kentucky that cut the state’s uninsured rate in half. Bevin fought for a work requirement that by his office’s own data would have dropped 90k+ people from the rolls.” [Alice Miranda Ollstein Twitter, 11/5/19

Joan Alker: “Fascinating and good night for Medicaid 1. KY Gov. Bevin losing – his own #’s showed his Medicaid work requirements/other punitive measures would cost 100k their coverage 2. VA D’s have run on Medicaid expansion and are winning; R’s there also pushed punitive work requirements.” [Joan Alker Twitter, 11/5/19

John Weaver: “Also a reminder tonight about the power of the health care debate and why Democrats must drive this home.” [John Weaver Twitter, 11/5/19

Joy Reid: “Matt Bevin ran in 2014 as a Trump before Trump, campaigning on getting rid of Obamacare in Kentucky. Then people found out Obamacare was “Kenect” — the healthcare they got when Dem Gov Steven Beshear expanded Medicaid under Obamacare. Beshear’s son just proved people noticed. [Joy Reid Twitter, 11/5/19

Matt McDermott: “Democrats have flipped the Virginia House and Senate, securing a legislative trifecta & with it can control redistricting, protect Medicaid expansion, institute universal gun background checks, and secure protections for LGBTQ people.” [Matt McDermott Twitter, 11/5/19

Anthony Wright: “Remarkable that the #KYGov– elect’s first week promise “I will rescind the Medicaid waiver” was the first on the list and got the biggest applause. #Kentucky. [Anthony Wright Twitter, 11/5/19]

New Poll From Hart Research and Protect Our Care Confirms Democrats’ Advantage On Health Care Heading Into 2020

One Year After Health Care Propelled House Democrats to Historic Victory in the House, Health Care Remains the Top Issue For Voters Heading Into 2020 

View findings from the poll HERE

Washington, DC — On a press call today, Hart Research President Geoff Garin and Protect Our Care unveiled findings from a new national survey showing that, among other things, health care remains the top priority for voters nationwide and across the political spectrum. Most importantly, the survey made clear that Democrats are well positioned to keep and expand their majority in the House if they continue to focus on lowering costs, improving and expanding access to health care and reversing the Trump-Republican sabotage agenda. Results also show that Trump’s sabotage agenda including his continued attacks on Medicaid, lawsuit to overturn the Affordable Care Act and repeated attempts to strip coverage from millions, is wildly unpopular with voters and stand to cost him at the ballot box next year. 

Coming off the heels of Democrats’ historic wins in Kentucky and Virginia where health care was a central campaign issue, the results of last night’s elections confirm our survey’s findings that health care is a winning issue for Democrats now, and will likely remain so heading into 2020. 

“Health care is now and will almost certainly remain the number one issue for voters across the country next November,” said Protect Our Care Executive Director Brad Woodhouse. “Americans are tired of Republican’s constant attacks on their health care and Democrats are well positioned to take advantage of that fact by making lowering costs, expanding access and reversing the Trump-GOP sabotage agenda their number one priority. Just as health care propelled Democrats to win a majority in the House one year ago, it remains the issue that will put Democrats in a position to maintain their majority and take back the Senate and White House next November.” 

Press call audio available HERE