Category

News

Industry Insiders Overwhelmingly Agree, The Price of Biogen’s Aducanumab Is “Borderline Fraud”

Survey Respondents Said “This is Not Science or Healthcare, This is Corporate Greed,” Called Biogen’s Actions “Highway Robbery for Snake Oil”

A new poll conducted by Endpoints News of more than 1,400 biotech and pharmaceutical industry workers found overwhelming consensus: the cost of Biogen’s new Alzheimer’s treatment, Aducanumab, is unjustified and will have major financial implications for patients, taxpayers, and the entire health care system. Nearly 75 percent of respondents found Aducanumab’s $56,000 cost to be “inequitable.”

Here is what industry workers had to say on the matter:

“Aducanumab priced at $56K with the efficacy of a sugar pill is taking advantage of patients, the health care system, and is ruthless.”

“Absolutely not. Unconscionable price for a drug with limited and questionable data, no clear clinical benefit, concerning tox profile and an immense population. 500,000 Alzheimer’s patients per year. 6M prevalent patients. This could devastate Medicare.”

“Since the drug has NOT been proven to be efficacious, the price is astounding[ly] ridiculous. This is not science or healthcare, this is corporate greed.”

“Highway robbery for snake oil.”

“How are [tax]payers going to focus on any other disease therapies (with far better efficacy) when they’re distracted with this giant line item? They’ve handed Biogen a gigantic blockbuster without them earning it.”

“Potentially dangerous to patients without any real indication of benefit.”

“Borderline fraud. I have an ethical obligation to my patients. I will never prescribe.”

“There is not enough proof of efficacy. Biogen will make a boat-load of profit selling an unproven drug at a high price based on the (false?) hopes of patients.”

“Data presented by Biogen is at the best weak, and at the worst totally irrelevant. This is coupled with high costs to consumers for, at best, modest improvements in therapeutic outcomes.”

HEADLINES: High Price of Unproven, Hugely Expensive Alzheimer Drug Demonstrates Urgent Need for H.R. 3 and Medicare Negotiation

This week, the FDA approved Biogen’s unproven and hugely expensive Alzheimer’s drug, Aducanumb, and experts have said that the drug’s $56,000 price tag will have major financial implications for patients, taxpayers, and the entire health care system. Even though the benefits of Aducanumb are uncertain, Biogen is putting profits over patients and taking advantage of a broken system that allows drugmakers to set outrageous prices without any limitations. The news only underscores the urgent need for Congress to take action and pass the Lower Drug Costs Now Act (H.R. 3) to give Medicare the power to negotiate for lower drug prices for all Americans, including launch prices.

Axios: New Alzheimer’s Drug Could Blow Up Health Spending. “The FDA’s decision this week paved the way for a free-for-all in which taxpayers foot most of the enormous bill for a drug that hasn’t been proven effective.” [Axios, 6/8/21]

CNBC: Biogen Faces Tough Questions Over $56K-A-Year Price Of Newly Approved Alzheimer’s Drug. “Analysts and advocacy groups immediately questioned how the company could justify the price — about five times higher than expected — especially as medical experts continue to debate whether there’s enough evidence that the drug actually works. [When executives were asked] how much Medicare will be expected to pay for the drug and how concerned executives are about the ‘backlash’ the industry will face over its pricing, Biogen executives [responded] the total price is ‘substantiated’ by the value it is expected to bring to patients, caregivers and society. They insisted the price was ‘responsible’.” [CNBC, 6/8/21]

STAT News: Biogen Isn’t Worried About Backlash To ‘Bewildering’ Price Of Alzheimer’s Drug. “Health policy experts have criticized Biogen and warned that the cost of Aduhelm, which will largely fall upon Medicare, could galvanize a political backlash and jump-start legislative efforts to constrain drug prices.” [STAT News, 6/8/21]

STAT News (Opinion): Bad Medicine: Aducanumab Is A Lackluster Drug With A High Price Tag. “Millions of US residents over age 65 will surely want [aducanumab]. This will only serve to emphasize the disparities in care accessibility that our system is already struggling with. Were Medicare to begin coverage, the projected costs of treating all eligible recipients would quickly overwhelm the resources of the system.” [STAT News, 6/8/21]

Bloomberg: Alzheimer’s Drug Approval Draws Fire On Treatment’s Effectiveness And Uses. “The approval could raise false hope in patients and ‘potentially bankrupt the Medicare program because of the drug’s projected exorbitant price.’” [Bloomberg, 6/7/21]

Quartz: The New Alzheimer’s Drug Is About $50,000 Too Expensive. “The majority of [Alzheimer’s] patients are covered by Medicare part B, which deals with treatments delivered in hospitals, and which until now has had a budget of about $35 billion a year. The new drug could easily double that budget, putting a severe strain on Medicare resources without clear benefits.” [Quartz, 6/8/21]

BACKGROUND:

More Than A Third Of Americans Have Forgone Medications To Pay For Essential Items And Bills. A recent survey found that 36% of Americans have forgone medications to pay for essential items and bills. The rate is higher for people of color, with nearly half (47%) of non-white respondents having forgone medications to pay for essential items.

H.R. 3 Would Save Taxpayers Nearly $500 Billion Over The Next 10 Years. Analyses from the nonpartisan Congressional Budget Office and the CMS Office of the Actuary confirmed the bill would reduce negotiated drug prices by as much as 55% – saving patients an estimated $158 billion over the next few years and decreasing deficits by $456 billion. 

H.R. 3 Could Save Patients Thousands Of Dollars On Costly Medications. The Center for American Progress calculated average savings for several drugs that would likely meet the criteria for negotiation under H.R. 3. In addition to achieving thousands of dollars in monthly savings on expensive treatments for conditions like cancer and multiple sclerosis, H.R. 3 would help lower the cost of insulin for some diabetics by more than $700 annually.

H.R. 3 Would Work To Create A Fair Standard For Drug Prices. The CommonWealth Fund found the bill would create a maximum price for any negotiated drug by tying it to the cost in other countries and penalizing manufacturers who fail to agree to prices set by HHS. 

For more information on the urgent need to lower drug prices, click here

IN THE NEWS: Biogen Poised To Earn Billions On New Alzheimer’s Treatment, Underscoring Big Pharma’s Power Over Medicare

For the first time in nearly 20 years, the Food and Drug Administration granted limited approval for a new Alzheimer’s treatment. This comes despite the FDA’s independent advisory committee’s recommendation not to approve the drug due to limited evidence of effectiveness. Despite the FDA’s requirement that Biogen verify the effectiveness of the treatment through an additional clinical trial, that did not deter Biogen from setting Aduhelm’s yearly cost at a staggering $56,000. The Institute for Clinical and Economic Review has estimated the treatment would be cost-effective only below $8,300. Biogen stands to make billions even as millions of older adults, many of whom are desperate for treatment options, are already struggling to pay for essential medications. More than 90% of those living with Alzheimer’s are over 65, creating a hazardous financial strain for Medicare.This hefty price tag for a drug with uncertain benefits underscores the urgent need for congress to pass the Lower Drug Costs Now bill to give Medicare the power to negotiate for lower drug prices.

Axios: Biogen Is Banking On Aducanumab. “Market analysts estimate Biogen could price aducanumab as high as $50,000 per year of treatment, if it’s approved. Independent experts have said that price is too high considering the clinical trial data doesn’t prove the drug is effective in combating the brain disorder. Even if only a small portion of the 6 million Alzheimer’s patients are able to obtain the drug, Biogen would net billions of dollars in new sales annually.” [Axios, 6/7/21]

Axios: Aduhelm’s Price To Squeeze Medicare And Patients. “Aduhelm could create massive strains on Medicare spending and could create financially ruinous prospects for patients and their families. If Medicare decides to cover the drug with no restrictions, it would pay almost $59,000 annually for a course of treatment. Biogen could easily fetch tens of billions of dollars every year if fewer than 10% of the 6 million Alzheimer’s patients get it.” [Axios, 6/8/21]

New York Times: Alzheimer’s Drug Is Bonanza For Biogen, Most Likely At Taxpayer Expense. “The drug is all but certain to unleash a gusher of profits for Biogen — the drug is expected to become one of the best-selling pharmaceutical products in the world within a few years. Those billions of dollars in anticipated costs are likely to be shouldered largely by Medicare. The drug’s approval could drive up insurance premiums, according to health care policy experts. And it could add new out-of-pocket costs for some families that are already facing years of staggering costs for caring for loved ones with Alzheimer’s. There is not strong evidence that the drug helps patients, and it comes with potentially serious side effects. Prominent experts, including the F.D.A.’s independent advisory committee and a professional society representing geriatricians and other health care providers for older adults, urged the agency not to approve the drug.” [New York Times, 6/8/21]

STAT News: ‘The Price Is Bewildering’: The Cost of Biogen’s Alzheimer’s Drug May Lead Payers To Erect Roadblocks. “At a wholesale price of $56,000 per year, the company exceeded some Wall Street expectations, and greatly surpassed the $8,300 threshold that a nonprofit determined was the price at which the medication could be considered cost-effective. The Centers for Medicare and Medicaid Services could [initially] let providers and patients make decisions about who gets the drug. But this has the potential to severely affect the Medicare budget, which affects taxpayers.” [STAT News, 6/7/21]

Bloomberg: Biogen’s Costly, Unproven Drug Feared As Health Budget Buster. “The approval of Biogen’s $56,000-a-year Alzheimer’s therapy creates an unprecedented challenge for the U.S. health system: a drug that many patients may get at a high price even though it may not slow their cognitive decline. With Monday’s FDA clearance of Aduhelm, the health system is taking on a treatment that as many as 1 million people might qualify at a total annual cost of as much $50 billion. Despite the large burden that represents, there is little certainty about whether patients will be better off.” [Bloomberg, 6/8/21]

Bloomberg (Opinion): Approving Biogen’s Alzheimer’s Drug Is A Big Mistake. “The price of the drug is just the beginning of the financial damage. Getting it will require doctor’s visits and scans to establish eligibility and monitor side effects, creating significant additional costs for Medicare, patients and their caregivers. Multiply those costs by even a fraction of the millions of Americans with Alzheimer’s, and you have a budget crisis.” [Bloomberg Opinion, 6/7/21]

Health Care Advocates and Elected Officials in Arizona, Delaware, New Jersey, West Virginia React to New Polls Showing Strong Support for Prescription Drug Reform

West Health Polls in Four States Show Voters’ Strong Support For Allowing Medicare to Negotiate Drugs Prices,  Rejection of Pharma’s Argument That Reform Would Harm Innovation

Protect Our Care hosted four virtual press conferences to discuss new polls conducted by Global Strategies Group on behalf of West Health showing health care is a top priority for Arizona, Delaware, New Jersey, and West Virginia voters.

Lowering prescription drug prices in particular remains a priority for voters in the four states, with an overwhelming majority reporting that they support giving Medicare the power to negotiate prescription drug prices for all Americans. The polls also show that voters reject drug companies’ arguments on innovation.

Protect Our Care recently launched The Campaign to Reduce Drug Prices, a seven-figure investment to demonstrate the urgent need for comprehensive legislation to lower drug prices. Protect Our Care will host events both nationally and in 13 key states, including Arizona, Delaware, New Jersey, and West Virginia throughout the summer.

ARIZONA: Thursday, June 3, 2021 — Rx Drug Reform Polling Event with AZ State Senator Engel, POC Executive Director Brad Woodhouse, and Local Storyteller

Key findings from the poll include:

  • Voters believe the benefit of reducing drug prices outweighs the negative impact on innovation and standards. 
      • Voters believe the benefit of reducing drug prices outweighs the negative impact on innovation and standards. Voters in Arizona are much more likely to agree with the statement we should allow Medicare to negotiate with drug companies to make drugs and medication more affordable to patients (72%) than the statement by letting Medicare dictate prescription drug prices, we will undercut drug companies’ ability to innovate and develop new drugs (13%). This sentiment to let Medicare negotiate with drug companies is consistently held across the partisan spectrum with Democrats (81%), independents (67%), and Republicans (66%).
  • More than half of voters in Arizona agree with the statement Americans pay too much for brand name prescription drugs – almost four times what people pay in Germany, France, and Japan.
    • Almost two thirds of voters in Arizona agree with the statement Americans pay too much for brand name prescription drugs — almost four times what people pay in Germany, France, and Japan (61%) —- rather than a statement by letting Medicare negotiate prescription drug prices based on international standards, we will be importing price controls from other countries that do not have health systems as strong as the United States (15%). The sentiment that Americans pay too much is consistent across the partisan spectrum with a majority of Democrats (63%), independents (52%), and Republicans (60%).
    • Voters are also more likely to support implementing stronger price controls for new drugs that are released into the market.

You can watch the press conference here. You can read the poll memo here and the slide presentation here. Learn more about how the Lower Drug Costs Now Act (H.R. 3) will make prescription drugs more affordable here.

DELAWARE: Monday, June 7, 2021 – Health Care Advocates and Storytellers React to New Poll Showing Delawareans’ Strong Support for Prescription Drug Reform

Key findings from the poll include

  • Voters strongly support giving Medicare the power to negotiate for lower drug prices and believe the benefit of reducing drug prices outweighs any negative impact on innovation. 
      • “An overwhelming majority of voters in Delaware support requiring drug companies to negotiate with Medicare for lower prescription drug prices for all Americans (88% support/5% oppose). This broad support is consistent across demographics and there is particularly strong support among voters 55 and older (92% support), and men 55 and older (93%). There is overwhelming support across the partisan spectrum with Democrats (91%), independents (82%), and Republicans (86%) all supporting this measure.”
      • “Voters in Delaware overwhelmingly agree with the statement we should allow Medicare to negotiate with drug companies to make drugs and medication more affordable to patients (76%) than the statement by letting Medicare dictate prescription drug prices, we will undercut drug companies’ ability to innovate and develop new drugs (14%).”
  • Reducing prescription drug prices is a top issue for Delaware voters, and majorities of all parties agree that drug prices are going up. 
    • “Prescription drug prices are a real priority for voters in Delaware (79% top/major priority) and a top priority for more than a third Delaware voters (34% top priority). Voters 65 and older (43%), Black voters (43%), and Democrats (40%) tend to rank prescription drug prices as a particularly high priority.”
    • “More than two-thirds of voters in Delaware voters say that they think drug prices are going up (67% going up). Those most likely to think that drug prices are going up include voters 65 and older (72%), men 55 and older (74%), non-college women (73%), and Black and Hispanic voters (78%). Across the partisan spectrum, Democrats (69%), independents (75%), and Republicans (63%) all believe that prescription drug prices are going up.”

You can read the polling memo here and slide presentation here, listen to the Protect Our Care Delaware press call here, and learn more about H.R. 3 here.

NEW JERSEY: Wednesday, June 2, 2021 — Rx Drug Reform Polling Event with State Senator Vin Gopal and Protect Our Care Executive Director Brad Woodhouse and Patient Storyteller

Key findings from the poll include:

  • Voters strongly support giving Medicare the power to negotiate for lower drug prices and believe the benefit of reducing drug prices outweighs any negative impact on innovation. 
      • “An overwhelming majority of voters in New Jersey support requiring drug companies to negotiate with Medicare for lower prescription drug prices for all Americans (88% support/5% oppose). This broad support is consistent across demographics and there is particularly strong support among voters 55 and older (92% support), and men 55 and older (93%). There is overwhelming support across the partisan spectrum with Democrats (91%), independents (82%), and Republicans (86%) all supporting this measure.”
      • “Voters in Delaware overwhelmingly agree with the statement we should allow Medicare to negotiate with drug companies to make drugs and medication more affordable to patients (76%) than the statement by letting Medicare dictate prescription drug prices, we will undercut drug companies’ ability to innovate and develop new drugs (14%).”
  • Reducing prescription drug prices is a top issue for Delaware voters, and majorities of all parties agree that drug prices are going up. 
    • “Prescription drug prices are a real priority for voters in Delaware (79% top/major priority) and a top priority for more than a third Delaware voters (34% top priority). Voters 65 and older (43%), Black voters (43%), and Democrats (40%) tend to rank prescription drug prices as a particularly high priority.”
    • “More than two-thirds of voters in Delaware voters say that they think drug prices are going up (67% going up). Those most likely to think that drug prices are going up include voters 65 and older (72%), men 55 and older (74%), non-college women (73%), and Black and Hispanic voters (78%). Across the partisan spectrum, Democrats (69%), independents (75%), and Republicans (63%) all believe that prescription drug prices are going up.”

You can watch the press conference here, and learn more about how the Lower Drug Costs Now Act (H.R. 3) will make prescription drugs more affordable here.

Coverage:

  • InsiderNJ: New Jersey State Senator Vin Gopal and Health Care Advocates React to New Poll Showing New Jerseyans’ Broad Support for Prescription Drug Reform

WEST VIRGINIA: Thursday May 6, 2021 — Lower Rx Drug Costs Virtual Event with West Virginians for Affordable Healthcare, WV Citizen Action Group, Storytellers, and Advocates

Key findings from the poll include:

  • Voters believe the benefit of reducing drug prices outweighs the negative impact on innovation and standards. 
      • Voters in West Virginia are much more likely to agree with the statement we should allow Medicare to negotiate with drug companies to make drugs and medication more affordable to patients (74%) than the statement by letting Medicare dictate prescription drug prices, we will undercut drug companies’ ability to innovate and develop new drugs (12%). This sentiment held across the partisan spectrum with the majority of Democrats (78%), independents (62%), and Republicans (74%) sharing it.
  • More than half of voters in West Virginia agree with the statement Americans pay too much for brand name prescription drugs – almost four times what people pay in Germany, France, and Japan.
    • Nearly sixty percent of voters in West Virginia agree with the statement Americans pay too much for brand name prescription drugs — almost four times what people pay in Germany, France, and Japan (58%)  — rather than a statement about letting Medicare negotiate prescription drug prices based on international standards, we will be importing price controls from other countries that do not have health systems as strong as the United States (21%). 
    • Voters are also more likely to support implementing stronger price controls for new drugs that are released into the market.

You can listen to the press call here, and learn more about how the Lower Drug Costs Now Act (H.R. 3) will make prescription drugs more affordable here.

Coverage:

Health Care Advocates and Storytellers React to New Poll Showing Delawareans’ Strong Support for Prescription Drug Reform

88 Percent of Delaware Voters Support Giving Medicare the Power to Negotiate for Lower Drug Prices

Watch the event here. 

DELAWARE — Today, State Senator Sarah McBride and a patient storyteller from Dover joined Protect Our Care to discuss a new poll conducted by Global Strategies Group on behalf of West Health showing health care is a top priority for Delaware voters.

Lowering prescription drug prices in particular remains a priority for Delaware voters, with an overwhelming majority of Delawareans reporting that they support giving Medicare the power to negotiate prescription drug prices for all Americans. The poll also shows that voters reject drug companies’ arguments on innovation. 

Protect Our Care recently launched The Campaign to Reduce Drug Prices, a seven-figure investment to demonstrate the urgent need for comprehensive legislation to lower drug prices. Protect Our Care will host events both nationally and in 13 key states, including Delaware, throughout the summer. 

Key findings from the poll include

  • Voters strongly support giving Medicare the power to negotiate for lower drug prices and believe the benefit of reducing drug prices outweighs any negative impact on innovation. 
      • “An overwhelming majority of voters in Delaware support requiring drug companies to negotiate with Medicare for lower prescription drug prices for all Americans (88% support/5% oppose). This broad support is consistent across demographics and there is particularly strong support among voters 55 and older (92% support), and men 55 and older (93%). There is overwhelming support across the partisan spectrum with Democrats (91%), independents (82%), and Republicans (86%) all supporting this measure.”
      • “Voters in Delaware overwhelmingly agree with the statement we should allow Medicare to negotiate with drug companies to make drugs and medication more affordable to patients (76%) than the statement by letting Medicare dictate prescription drug prices, we will undercut drug companies’ ability to innovate and develop new drugs (14%).”
  • Reducing prescription drug prices is a top issue for Delaware voters, and majorities of all parties agree that drug prices are going up. 
    • “Prescription drug prices are a real priority for voters in Delaware (79% top/major priority) and a top priority for more than a third Delaware voters (34% top priority). Voters 65 and older (43%), Black voters (43%), and Democrats (40%) tend to rank prescription drug prices as a particularly high priority.”
    • “More than two-thirds of voters in Delaware voters say that they think drug prices are going up (67% going up). Those most likely to think that drug prices are going up include voters 65 and older (72%), men 55 and older (74%), non-college women (73%), and Black and Hispanic voters (78%). Across the partisan spectrum, Democrats (69%), independents (75%), and Republicans (63%) all believe that prescription drug prices are going up.”

“Too many Delaware families continue to face the impossible choice between getting well and getting by,” said Sarah McBride, State Senator for Delaware’s 1st District. “And for patients across our state, the cost of care has been unbearable, and in many cases insurmountable. Delaware already spends more per capita on health care than almost every other state. But that spending is not leading to better outcomes, with Delaware actually ranked in the bottom half of states and health outcomes, according to one study, and indeed that spending is creating significant, often increasing barriers to care for Delaware families.” 

“Simply put, I cannot live the kind of life I want to live, I should be able to afford medication without so much worry on top of my illnesses and symptoms,” said Vanessa Ladson, Dover resident who faces high prescription drug costs. “My husband and I sacrificed a lot in order to be able to live. But I know other senior citizens who are much worse off than we are. Other countries help out their seniors by negotiating for fair drug prices. As the richest country in the world, the United States should be able to make our prescription drug affordable. That’s why we need Senators Carper and Coons to stand up for Delaware’s seniors, like me and my husband, by passing legislation to let Medicare negotiate for lower drug prices.”

“Politicians have every incentive to give Medicare the power to negotiate prescription drug costs. Polls show that Delawareans support prescription drug reform because they feel the impact of the high costs of their medications firsthand,” said Protect Our Care Executive Director Brad Woodhouse. “Giving Medicare the power to negotiate prescription drug prices will make medications more affordable for Delawareans and all Americans. It’s time for Congress to take action on soaring drug prices and help provide families some much-needed relief.”

You can read the polling memo here and slide presentation here, listen to Protect Our Care Delaware press call here, and learn more about H.R. 3 here.

HEADLINES: ACA Coverage Hits Record High of 31 Million People

Former President Obama Joined President Biden in a Video to Celebrate the Milestone

Over the weekend, the Biden administration announced that a record 31 million people now have coverage thanks to the Affordable Care Act. The news shines an even brighter spotlight on the Supreme Court’s pending decision on California v. Texas, former President Trump’s signature lawsuit seeking to overturn the entire health law, end its protections for 135 million Americans with pre-existing conditions and rip health care away from millions of Americans. Coverage makes clear that striking down the ACA would be especially devastating as Americans are relying on the law now more than ever. The ruling could come down as early as this week. 

Washington Post: Record 31 Million Americans Have Health-Care Coverage Through Affordable Care Act, White House Says. “About 31 million Americans now have health-care coverage through the Affordable Care Act, the White House announced Saturday, setting a record since the law, colloquially known as ‘Obamacare,’ was enacted in 2010 under President Barack Obama.” [Washington Post, 6/5/21

The Hill: Obama Joins Biden To Tout Record Obamacare Enrollment Numbers. “President Biden and former President Obama teamed up Saturday to tout a new record number of people enrolled in ObamaCare. The two reunited on Zoom to announce that more than 31 million Americans have gained access to health care through the Affordable Care Act (ACA).” [The Hill, 6/5/21

Health Affairs: Record High ACA Enrollment At 31 Million Americans. “The enrollment of 31 million people is a record high and shows an ongoing need for affordable coverage, especially for Americans without job-based coverage. This has been especially true during the pandemic—Medicaid and the marketplaces have served as an important source of coverage following job loss and economic instability. ASPE’s report also comes at a time when we are awaiting the Supreme Court’s decision in California v. Texas, a global challenge where the Court could invalidate all or parts of the ACA. The new ASPE data underscores just part of what is at stake in Texas—and the potential for coverage loss and chaos if the ACA is invalidated.” [Health Affairs, 6/7/21

HuffPost: 31 Million Now Get Coverage Through ‘Obamacare,’ Biden Administration Says. “More people than ever are getting health insurance through the Affordable Care Act, providing new proof of the law’s value even as its survival depends on a Supreme Court ruling that could come as soon as Monday.” [HuffPost, 6/5/21

Associated Press: Biden Turns To Obama To Help Boost Health Care Enrollment. “The White House effort to spotlight the expanded enrollment and claim strong numbers for the health law comes as the political world and the health care system await a Supreme Court ruling on the law’s constitutionality. ” [Associated Press, 6/5/21

Rolling Stone: Record 31 Million Americans Have Coverage Because of the Affordable Care Act, White House Says. “The White House announced the numbers in a report on Saturday and released a video featuring a conversation between President Joe Biden and Obama to celebrate the news and encourage more Americans to sign up. Expanded enrollment through the federal marketplace continues until August 15, due to the ongoing pandemic…But the ACA now faces the threat of a looming Supreme Court ruling on its constitutionality. The ACA survived an earlier challenge, but with more Trump-appointed judges now on the bench, its fate is less certain.” [Rolling Stone, 6/6/21

CNN: Biden Celebrates Health Care Milestone In Call To Obama. “The White House says that 31 million people are now covered by the Affordable Care Act. President Joe Biden called former President Barack Obama to celebrate the health care milestone.” [CNN, 6/5/21]

MSNBC: Biden, Obama Take Victory Lap as ACA Covers 31 Million Americans. “All of this coincides with the Democratic president’s special open-enrollment period, which more than a million Americans have already taken advantage of. They can continue to do so: the window doesn’t close until August. What’s more, this good news coincides with the expansive new ACA benefits included in the Democrats’ COVID relief package: some have seen their premiums cut in half, while millions have seen their premiums fall to literally zero, thanks entirely to the investments in the American Rescue Plan.” [MSNBC, 6/7/21

BREAKING NEWS: ACA Coverage Hits Record High of 31 Million People

Washington, DC — Today, the White House announced that a record 31 million people now have coverage thanks to the Affordable Care Act. In response, Protect Our Care Chair Leslie Dach issued the following statement:

“This is great news and further proof that the ACA works, is resilient, and that Americans want it and need it. President Obama and President Biden deserve America’s thanks. We need to continue to build on the law to reduce costs, expand Medicaid in Republican states that have refused to do the right thing, and extend the ACA’s success to the next frontier in health care — lowering the cost of prescription drugs. The news today of more than 30 million Americans covered by the ACA shines an even brighter spotlight on the Supreme Court’s pending decision on the future of the ACA in a case brought by right-wing partisans and which should be resoundingly rejected by the court.”

PRESS CALL: Health Care Advocates and Storytellers React to New Poll Showing Delawareans’ Broad Support for Prescription Drug Reform

***MEDIA ADVISORY FOR MONDAY, JUNE 7, AT 11:15AM ET***

PRESS CALL: Health Care Advocates and Storytellers React to New Poll Showing Delawareans’ Broad Support for Prescription Drug Reform

West Health Poll Shows Strong Support For Medicare Negotiation Among Voters in Delaware

DOVER, DE — On Monday, June 7, State Senator Sarah McBride and a patient storyteller from Dover will join Protect Our Care for a virtual press conference to discuss a new poll conducted by Global Strategies Group on behalf of West Health showing health care is a top priority for Delaware voters. 

Lowering prescription drug prices in particular remains a priority for Delaware voters, with an overwhelming majority of Delawareans reporting that they support giving Medicare the power to negotiate prescription drug prices for all Americans. The poll also shows that voters reject drug companies’ arguments on innovation. 

Protect Our Care recently launched The Campaign to Reduce Drug Prices, a seven-figure investment to demonstrate the urgent need for comprehensive legislation to lower drug prices. Protect Our Care will host events both nationally and in 13 key states, including Delaware, throughout the summer. 

PRESS CALL: 

WHO:

  • Sarah McBride, State Senator for Delaware’s 1st District
  • Brad Woodhouse, Executive Director of Protect Our Care
  • Vanessa Ladson, Dover resident who faces high prescription drug costs
  • Anne Shoup, Communications Director for Protect Our Care

WHAT:
Virtual Press Conference and Poll Briefing on Reducing Drug Prices for Delawareans

WHERE:
Register for the virtual press conference here.

WHEN: 

MONDAY, JUNE 7, at 11:15AM ET

PRESS CALL: Energy and Commerce Committee Chairman Pallone and Health Advocates Will Call on Congress to Give Medicare the Power to Negotiate for Lower Drug Prices

***MEDIA ADVISORY FOR MONDAY, JUNE 7 AT 10:30 AM ET***

PRESS CALL: Energy and Commerce Committee Chairman Pallone and Health Advocates Will Call on Congress to Give Medicare the Power to Negotiate for Lower Drug Prices

Congressman Frank Pallone, Jr. (D-NJ-06) Will Join Protect Our Care and Leaders from AARP and Little Lobbyists to Announce Summer Activities to Reduce Drug Prices for All Americans

New Jersey On Monday, June 7 at 10:30 AM ET, U.S. Representative and Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-NJ-06), Nancy LeaMond of AARP, and Elena Hung of Little Lobbyists will join Protect Our Care for a virtual press conference to kick off a summer of activities in support of congressional action to lower prescription drug prices for Americans. It is time to put an end to Big Pharma’s rigged system and put patients, not profits, first. 

In the coming months, President Biden and members of Congress have an unprecedented opportunity to finally take action to lower drug prices. In 2019, the House of Representatives passed the Lower Drug Costs Now Act (H.R. 3), bold legislation to give Medicare the power to negotiate for lower prices — the single most effective measure to bring down drug costs for patients. In April, Rep. Pallone reintroduced this legislation, giving Congress another opportunity to lower prescription drug prices and meet the demands of voters across the political spectrum. 

During the call, Protect Our Care will announce “Lower Rx Summer” as part of The Campaign to Reduce Drug Prices. Protect Our Care recently launched the seven-figure campaign to demonstrate the urgent need for comprehensive legislation to lower drug prices. Protect Our Care will continue to host events both nationally and in 13 key states throughout the summer.

PRESS CALL:

WHO:
U.S. Representative Frank Pallone, Jr. (D-NJ-06), Energy and Commerce Committee Chairman
Nancy LeaMond, AARP Executive Vice President and Chief Advocacy & Engagement Officer
Elena Hung, Executive Director & Co-Founder of Little Lobbyists
Leslie Dach, Chair of Protect Our Care

WHAT: Virtual Press Conference to Call for Action to Lower Prescription Drug Prices

WHERE: Register for the Event Here

WHEN: Monday, June 7 at 10:30 AM ET

Health Care Alert: What’s At Stake In Pending Supreme Decision On Affordable Care Act

This month, and as early as Monday, the Supreme Court is set to rule on California v. Texas, former President Trump’s signature lawsuit seeking to overturn the entire Affordable Care Act (ACA), end its protections for 135 million Americans with pre-existing conditions and rip health care away from more than 20 million Americans. Despite President Biden’s overwhelming support for the health care law, 18 red states remain on the lawsuit to finish the job and throw the entire health system into chaos. As we are still recovering from the health and economic fallout of the coronavirus pandemic, the future of our health care is at stake.

This ruling will come after President Biden signed the American Rescue Plan into law, which dramatically lowered health care costs for millions of people purchasing coverage on the ACA marketplaces. Experts say that as many as 25 million Americans stand to gain coverage or see their health care costs reduced under this historic legislation. In fact, nearly seven million uninsured people can now purchase an ACA plan with no monthly premium at all. And thanks to President Biden opening a special enrollment period, more than one million people have already been able to gain coverage since February. Striking down the health care law could be especially disastrous as Americans are relying on the ACA now more than ever. 

Special Online Resources:

State-specific fact sheets on impact of the Texas lawsuit

State-specific fact sheets on the American Rescue Plan

Fact Sheet On The Trump Lawsuit To Overturn ACA

What Abolishing The ACA Means: 

  • GONE: Protections for 135 million Americans with pre-existing conditions. The uninsured rate will increase by 69 percent. 
  • GONE: Medicaid expansion, which covers more than 15 million people. 
  • GONE: Nearly 12 million seniors will have to pay more for prescription drugs because the Medicare ‘donut hole’ will be reopened.
  • GONE: 2.3 million adult children will no longer be able to stay on their parents’ insurance. 
  • GONE: Insurance companies will be able to charge women 50 percent more than men.
  • GONE: Financial assistance that helps 9 million people purchase health care in the marketplace.
  • GONE: Key support for rural hospitals. 
  • GONE: Ban on insurance companies having lifetime caps on coverage.
  • GONE: Requirements that insurance companies cover prescription drugs and maternity care.
  • GONE: 60 million Medicare beneficiaries will face higher costs and disruptions to their medical care.

If Republicans Get Their Way, More Than 20 Million People Would Lose Their Coverage

  • 21 Million People Would Lose Coverage. Estimates from the Urban Institute show that 21.1 million people would lose coverage if the Supreme Court overturns the ACA. As the uninsured rate swells, so will the amount of uncompensated care, which Urban predicts will grow by at least 74 percent.
  • The Uninsured Rate Would Increase By 69 Percent. According to estimates from the Urban Institute, the number of uninsured Americans would increase from 30.8 million to 51.9 million without the ACA, representing a 69 percent increase in the uninsured rate. Americans of all ages would be impacted by coverage losses:
  • 1.7 million children would become uninsured, an increase of 48 percent. 
  • 4.9 million young adults aged 19 to 26 would become uninsured, an increase of 76 percent. 
  • 8.8 million adults aged 27 to 49 would become uninsured, an increase of 60 percent.  
  • 5.6 million million older adults aged 50 to 64 would become uninsured, an increase of 95 percent. 
  • States Would Lose Important Federal Health Care Funding — an estimated reduction of $152 billion in the first year. The Urban Institute estimates that a full repeal of the ACA would reduce federal spending on health care by $152 billion per year beginning in 2022.

Overturning The ACA Would Exacerbate Racial Disparities In Coverage

The uninsured rate for Black Americans would spike to 20 percent, 24 percent for American Indian/Alaska Natives, 19 percent for Asian/Pacific Islanders, and 30 percent for Hispanics — compared to 15 percent for white Americans. 

  • 3.1 Million Black Americans Would Lose Coverage. The Urban Institute estimates that 3.1 million Black Americans would become uninsured if the ACA were overturned. 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. 
  • 5.4 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.
  • 1.3 Million Asian/Pacific Islanders Would Lose Coverage. 1.3 million Asian/Pacific islanders would become uninsured if the ACA were overturned, according to estimates from the Urban Institute. Research shows the ACA cut uninsurance rates among Asian Americans by more than half–from nearly 20 percent to just under 8 percent– eliminating coverage disparities with white Americans.
  • 488,000 American Indians And Alaska Natives Would Lose Coverage. According to the Urban Institute, the uninsurance rate for American Indians and Alaska Natives would more than double in 10 states if the ACA is overturned. Nationwide, 488,000 would lose coverage. 

Republicans Want To Put Insurance Companies Back In Charge, Ending Protections For The 135 Million People With A Pre-Existing Condition

  • According to an analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 135 million people, have a pre-existing condition. This includes:
    • 44 million people who have high blood pressure
    • 45 million people who have behavioral health disorders
    • 44 million people who have high cholesterol
    • 34 million people who have asthma and chronic lung disease
    • 34 million people who have osteoarthritis and other joint disorders

Republicans Want To Give Insurance Companies The Power To Deny Or Drop Coverage Because Of A Pre-Existing Condition

Before the Affordable Care Act, insurance companies routinely denied people coverage because of a pre-existing condition or canceled coverage when a person got sick. Now insurance companies could have the license to do this again. 

  • A 2010 congressional report found that the top four health insurance companies denied coverage to one in seven consumers on the individual market over a three year period. 
  • A 2009 congressional report found that some of the largest insurance companies had retroactively canceled coverage for 20,000 people over the previous five year period.
  • The Kaiser Family Foundation estimates that 54 million people, or 27% of adults aged 18 to 64, have a condition that would have been grounds for coverage denial in the pre-ACA marketplace. 

Coronavirus Could Now Be Considered A Pre-Existing Condition. Without the ACA, millions of Americans who have contracted the coronavirus would likely be deemed as having a pre-existing condition and be at the mercy of their insurance companies who could refuse to pay for needed care. 

Conditions That Could Cost You Your Care:

  • AIDS/HIV
  • Alcohol/drug Abuse
  • Cerebral Palsy
  • Cancer
  • Heart Disease
  • Diabetes
  • Epilepsy
  • Kidney Disease
  • Epilepsy
  • Sleep Apnea
  • Pregnancy
  • Muscular Dystrophy
  • Depression
  • Eating Disorders
  • Bipolar Disorder
Jobs You Could Be Denied Coverage Because Of:

  • Active military personnel
  • Air traffic controllers
  • Body guards
  • Pilots
  • Meat packers
  • Taxi cab drivers
  • Steel metal workers
  • Law enforcement 
  • Oil and gas exploration
  • Scuba divers
Medications That You Could Be Denied Health Care For Taking:

  • Anti-arthritic medications
  • Anti-diabetic medications (including insulin)
  • Anti-cancer medications
  • Anti-coagulant and anti-thrombotic medications
  • Medication for autism
  • Anti-psychotics
  • Medications for HIV/AIDS
  • Growth hormone
  • Medication used to treat arthritis, anemia, and narcolepsy
  • Fertility Medication

Source: Kaiser Family Foundation

Republicans Want To Give Insurance Companies The Power To Charge You More, While Their Profits Soar

  • Premium Surcharges Could Once Again Be In The Six Figures. Without the ACA, insurance companies could once again charge people more because of a pre-existing condition. The House-passed repeal bill had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
  • Women Could Be Charged More Than Men For The Same Coverage. Prior to the ACA, women were often charged premiums on the nongroup market up to 50 percent higher than men were charged for the same coverage. 
  • People Over The Age of 50 Would Face A $4,000 “Age Tax.” Overturning the ACA means insurance companies could charge people over 50 more than younger people. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, according to the AARP.
  • Nine Million People In The Marketplaces Would Pay More For Coverage. Without the ACA, consumers would no longer have access to tax credits that help them pay their marketplace premiums, meaning roughly nine million people who receive these tax credits to pay for coverage would have to pay more.
  • Seniors Would Have To Pay More For Prescription Drugs. Without the ACA, seniors would have to pay more for prescription drugs because the Medicare “donut” hole would 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.
  • 60 Million Medicare Beneficiaries Could Face Higher Costs. In addition to paying more for preventive care and prescription drugs, Medicare beneficiaries could face higher premiums without the cost-saving measures implemented under the ACA. Without the ACA, seniors would also face less coordinated care. 
  • Insurance Companies Would Not Have To Provide The Coverage You Need. The Affordable Care Act made comprehensive coverage more available by requiring insurance companies to include “essential health benefits” in their plans, such as maternity care, hospitalization, substance abuse care and prescription drug coverage. Before the ACA, people had to pay extra for separate coverage for these benefits. For example, in 2013, 75 percent of non-group plans did not cover maternity care, 45 percent did not cover substance abuse disorder services, and 38 percent did not cover mental health services. Six percent did not even cover generic drugs.

Republicans Want To Give Insurance Companies The Power To Limit The Care You Get, Even If You Have Insurance Through Your Employer

  • Insurers Could Reinstate Lifetime And Annual Limits On 109 Million Privately Insured Americans. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage for those insured through their employer or on the individual market. In 2009, nearly 6 in 10 (59%) covered workers’ employer-sponsored health plans had a lifetime limit, according to the Kaiser Family Foundation. 
  • 138 Million Americans Could Once Again Have To Pay For Preventive Care. Because of the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no cost to consumers. This includes nearly 138 million Americans, most of whom have employer coverage.
  • Employers Could Eliminate Out-Of-Pocket Caps, Forcing Employees To Pay More For Care. Under the ACA, health insurers and employer group plans must cap the amount enrollees pay for health care each year. If the law is overturned, these cost-sharing protections would be eliminated. The ACA also barred employer plans from imposing waiting periods for benefits that last longer than three months.

Republicans Want To End Medicaid Expansion

  • More Than 15 Million People Enrolled Through Medicaid Expansion Would Lose Coverage. Before the coronavirus crisis, roughly 15 million people were enrolled through Medicaid expansion. 
  • Medicaid Plays A Critical Role In The Coronavirus Response. An estimated 14 million people have lost their employer-sponsored coverage as a result of the pandemic, and states are reporting steep increases in Medicaid enrollment. The Center on Budget and Policy Priorities found that roughly 6 million people enrolled in Medicaid between February and July 2020.  
  • Access To Treatment Would Be In Jeopardy For 800,000 People With Opioid Use Disorder. Roughly four in 10, or 800,000 people with an opioid use disorder are enrolled in Medicaid. Many became eligible through Medicaid expansion.
  • Key Support For Rural Hospitals Would Disappear, with uncompensated care costs for hospitals rising by $17.4 billion in 2022. 

Republicans Are Willing To Sacrifice Your Care For More Tax Cuts For The Wealthy

  • The Richest Americans Would See Tax Cuts Averaging $200,000. Overturning the ACA would cut taxes for the top 0.1 percent of earners by an average of $198,000.
  • Drug Companies Would Save Billions. If the ACA is struck down, pharmaceutical companies would pay $2.8 billion less in taxes each year.
  • Repeal Would Weaken The Medicare Trust Fund. A significant portion of the tax cuts resulting from ACA repeal would come “at the direct expense of the Medicare Trust Fund,” according to the Center on Budget and Policy priorities.