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AstraZeneca and Other Big Drug Companies Are Putting Greed Before Patients Once Again

On January 31, oral argument is scheduled in AstraZeneca’s lawsuit against the Biden administration seeking to block the implementation of the Medicare drug negotiation program. Over the past year, drug company giants and their mega lobbying groups have filed meritless lawsuits against the federal government in an effort to stop Medicare from negotiating for lower prescription drug prices — the most popular provision of the Inflation Reduction Act. Medicare drug price negotiation is projected to lower costs for seniors and save taxpayers tens of billions of dollars, but big drug companies are eager to protect their outsized prices and profits.

Since the enactment of the Inflation Reduction Act, AstraZeneca has announced massive, above-expectation profits, bringing in nearly $34 billion in revenue in the first nine months of 2023. Rather than make their lifesaving drugs affordable to patients, AstraZeneca spent over $5 billion on shareholder compensation, spending $859 million on stock buybacks and $4.5 billion on dividends. AstraZeneca, which has a long history of exploiting the patent system to maximize government funding and keep competitor drugs off the market, is suing to stop Medicare from negotiating lower prices in an effort to protect their massive profits. While they rake in billions, U.S. drug prices are up to four times higher than prices in other high-income countries, leading patients in America to cut pills and skip doses to make ends meet.

What’s At Stake? 

AstraZeneca is seeking to end Medicare’s new ability to negotiate lower prescription drug prices for Medicare beneficiaries. If they get their way, patients will pay more so the drug companies can make more money:

• GONE: Medicare’s power to negotiate lower prices for the most popular and expensive prescription drugs. Under the Inflation Reduction Act, Medicare is set to begin negotiating prices for 10 of the top 50 most expensive Part D drugs in 2026, adding another 15 drugs in 2027 and 2028, and another 20 in 2029 and subsequent years.
• GONE: $98.6 billion in Medicare savings over the next decade from the drug negotiation program, which translates into savings for patients and taxpayers.
• GONE: Lower Part D premiums and lower out-of-pocket drug costs for certain Medicare beneficiaries who rely on qualifying drugs.

Who Is Behind This Lawsuit? 

AstraZeneca is a UK-based multinational drug company, filing in the District of Delaware, that sells Farxiga, a drug used to treat diabetes, heart failure, and chronic kidney disease that was one of the first ten drugs selected for negotiation. Farxiga has cost Medicare nearly $6 billion as of 2022 and has made AstraZeneca more than $17.7 billion in global revenue since its launch. Farxiga costs around 88 percent less in other high-income countries.

Why AstraZeneca’s Legal Arguments Are Wrong

The plaintiffs assert multiple claims, including under the Fifth Amendment and the Administrative Procedure Act, but experts agree that these meritless arguments are merely an attempt to maintain the status quo where drug companies like AstraZeneca can protect their massive profits by charging whatever they want at the expense of patients and taxpayers.

AstraZeneca’s First Argument: The plaintiffs argue that the program violates the Fifth Amendment’s Due Process Clause. AstraZeneca argues “there is no actual negotiation involved.” They characterize the negotiation program as an arbitrary scheme of “price controls” in which companies have “no real choice but to accede to the agency’s unilaterally dictated price.” They argue that the Inflation Reduction Act deprives big drug companies of the “right to participate or be heard from beginning to end” in determining drug prices, supposedly depriving drug manufacturers of their “property interests in its patented drug products and the revenue it derives therefrom.”

The plaintiffs also argue that, by barring judicial review of some drug-price-negotiation items and allowing HHS to implement the program through guidance rather than rulemaking, the Inflation Reduction Act “purports to block AstraZeneca from seeking judicial review of the most critical implementation decisions,” providing no avenue for due process under the Fifth Amendment.

Why the Plaintiffs Are Wrong: The Inflation Reduction Act is not a price control statute. AstraZeneca is a private company, with enormous market power because it is the sole manufacturer of drugs that Americans depend on. The Act merely empowers HHS to negotiate–rather than blindly accept a price dictated by a drug company–the prices Medicare pays for a limited number of specified drugs. The Act does not set the market rate for drug prices. It establishes a mechanism by which drug manufacturers and the federal government mutually participate in a regulated market-driven process. 

The Negotiation Program in no way requires drug companies to sell selected drugs to Medicare at a specified price. First and foremost, Medicare is, and always has been, a voluntary program. Drug manufacturers – like physicians, hospitals, clinical labs, insurers, and other health care industry stakeholders – choose to participate in Medicare on a voluntary basis. If a manufacturer of a selected drug does not want to negotiate the price of a selected drug or cannot come to an agreement on a negotiated price, among other options, the manufacturer can withdraw from participation, just as they could have done at any point since the law has been debated and enacted.

Companies do not have any kind of property right to dictate the prices they pay while participating in a voluntary program. The notion that participating in market negotiation in a voluntary program somehow violates a company’s constitutional right is nonsensical. The Act lets companies decide whether they wish to participate or not–and leaves it to companies to decide which path makes the most economic sense for them. So far, the courts have found this claim dubious. As a federal judge in Ohio’s Southern District ruled in a separate case filed against the agency, “The law established in the Sixth Circuit and beyond is clear: participation in Medicare, no matter how vital it may be to a business model, is a completely voluntary choice…pharmaceutical manufacturers who do not wish to participate in the Program have the ability—practical or not—to opt out of Medicare entirely.” 

As to judicial review, Congress barring judicial review or administrative rulemaking is not a novel concept; There are at least 190 instances in federal code where Congress has barred judicial review. Medicare experts explain in an amicus brief that Medicare experts explain that courts have consistently upheld Congress’s decision to limit judicial review within Medicare, recognizing that “tremendously complex Medicare payment programs cannot function if they are continually burdened by litigation at every step of implementation.” Such experts also highlighted that the Medicare statute includes language barring judicial review of certain implementation decisions more than 60 times. 

Simply put, drug companies want to continue the status quo of having their greed unchecked by setting their own prices for their drugs and having Medicare be required to pay those prices. For too long, the industry has been able to exert its unparalleled power and deprive Americans of affordable drugs. The only reason they did not have to negotiate sooner is that Republicans included a provision in 2003 amendments to Medicare preventing negotiation in a concession to the powerful drug industry. 

AstraZeneca’s Second Argument: The plaintiffs argue that the drug negotiation program violates the Administrative Procedure Act in two ways. First, they argue that the Centers for Medicare & Medicaid Services (CMS) improperly defined the term “Qualifying Single Source Drug” to encompass two different drugs approved at different times, declaring the action to be impermissibly “arbitrary and capricious” by “fail[ing] to adequately explain a deviation from prior policy.” Second, the plaintiffs argue that CMS’ “bona fide” marketing test to determine if certain drugs with generic or biosimilar competition are eligible for negotiation “finds no support in the statutory text” of the Inflation Reduction Act, and they argue “contravenes the agency’s governing statute.” 

Why The Plaintiffs Are Wrong: CMS has followed the necessary procedure designed by Congress, outlining the process for selecting drugs for negotiation – including the identification of qualifying single source drugs and the assessment of generic or biosimilar competition – in its initial guidance on implementing the program. After releasing initial guidance, CMS allowed the document to be scrutinized for public comment, and released revised guidance responding to hundreds of comments from interested parties, providing detailed explanations for the definitions and procedures planned for implementation.

In its initial guidance, CMS explained that it identifies a drug’s eligibility for the negotiation program based on the drug’s active ingredient, and uses the earliest approval date to determine eligibility. CMS’ determination of qualifying single source drugs falls under the purview outlined by the Inflation Reduction Act, which explicitly directs CMS to “use data that is aggregated across dosage forms and strengths of the drug, including new formulations of the drug, such as an extended release formulation, and not based on the specific formulation or package size or package type of the drug.” The Act explicitly directs CMS to apply the negotiated price “across different strengths and dosage forms of a selected drug.” 

It is common practice for big drug companies to release multiple drugs with the same active ingredient, approved under separate applications by the Food and Drug Administration (FDA). If the negotiation program were limited to negotiating prices for a drug on a per application basis, drug companies could slightly modify their products and license them under new applications, circumventing the lower negotiated price. Congress anticipated this and required the negotiation program to apply broadly across a drug’s different strengths and dosages. Therefore, if CMS were to limit their determination of qualifying single source drugs to drugs under a single drug FDA application, CMS would be inconsistent with the statute. 

Additionally, Congress clearly granted CMS the authority to determine whether a generic or biosimilar drug meets the requirement of being “marketed” for the purposes of a product being exempt from selection for negotiation. CMS’s guidance explains that the agency will determine this via a “bona fide” marketing test. The “bona fide” standard outlined by CMS encompasses several factors, including sales and market availability, and requires periodic evaluation. 

AstraZeneca’s claims also lack merit because the company would not be impacted by either of these two portions of CMS’ guidance. As the Department of Justice noted, even if these definitions violated the APA, AstraZeneca’s drug selected for negotiation – Farxiga – only has one FDA-approved dosage form and lacks a generic competitor on the market.

What Happens Next

• January 31: Oral arguments
• March 1: AstraZeneca has asked the court to rule on the case by this date, though it remains unclear when the judge will rule.

Here’s What Legal & Health Experts Have Said About The Case

Amici

• Nine Nationally Recognized Health Care Experts, Including Three Former Medicare Administrators: “Drug Price Affordability Is Essential.” “The Amici, nationally recognized experts in healthcare, healthcare finance, and Medicare, submit this brief to explain: that ensuring prescription drug price affordability is essential to the financial stability of the Medicare program; that the authority conferred on CMS by the DPNP to negotiate drug prices for the Medicare program is consistent with the authority that Congress has given CMS to limit excessive prices of other Medicare services; that this authority is also consistent with that given to other agencies to limit drug prices in other federal government programs; that no court has ever found that an entity’s voluntary participation in Medicare creates a property interest, which would be necessary for AstraZeneca to prevail in arguing that the DPNP violates the Fifth Amendment’s Due Process Clause; and, finally, that courts regularly apply provisions precluding judicial review of features of the Medicare program similar to the provision in the DPNP.” [AstraZeneca Pharmaceuticals LP & AstraZeneca AB v. Becerra et al., Amicus Curiae Brief, 11/8/23]
• Seven Top Economists & Health Care Policy Scholars: AstraZeneca Presents “An Overly Simplistic And Misleading Account Of The Prescription-Drug Market.” A group of seven top health care policy scholars and economists hailing from Harvard, Yale, Johns Hopkins, Boston University, and Georgetown wrote: “This brief shows how AstraZeneca’s contention reflects an overly simplistic and misleading account of the prescription-drug market. […] [The Inflation Reduction Act] gives Medicare the authority to negotiate prices for drugs that have been on the market for at least 9-13 years. By doing so, it provides consumers a negotiating agent with enough clout to counter the pharmaceutical monopolist’s excessive prices. The law now gives consumers a negotiating agent that has enough clout to counter the pharmaceutical monopolist in establishing a price. The harm to true innovation is negligible because any drug eligible for negotiation will almost certainly have already recuperated its investment many times over. […] [C]ontrary to AstraZeneca’s contention, the Inflation Reduction Act pushes the drug market’s dynamics closer to competitive equilibrium, not further away.” [AstraZeneca Pharmaceuticals LP & AstraZeneca AB v. Becerra et al., Amicus Curiae Brief, 11/8/23]
• Protect Our Care, Public Citizen, Patients for Affordable Drugs Now, Doctors for America and Families USA: AstraZeneca Is Seeking To “Protect Its Ability to Charge Medicare Beneficiaries Exceedingly High Prices.” “Seeking to protect its ability to charge Medicare beneficiaries exceedingly high prices for its single-source drugs, plaintiffs AstraZeneca Pharmaceuticals LP and AstraZeneca AB (together, AstraZeneca) have challenged the IRA program, alleging a procedural due process claim and an Administrative Procedure Act (APA) claim. The procedural due process claim is based on the theory that “[t]he IRA deprives AstraZeneca of … property interests by compelling sales of its products at well-below- market prices.” AstraZeneca Mem. 29. Underlying this claim is the notion that the “market” price of a drug is whatever price AstraZeneca would otherwise charge Medicare absent negotiation; anything below that amount, AstraZeneca suggests, deprives the company of its property interests. AstraZeneca’s theory, however, is built on a faulty premise: that the price it prefers to charge is the “market” price. And absent any showing that the drug prices negotiated under the IRA program necessarily result in the deprivation of AstraZeneca’s property interests, AstraZeneca’s Due Process challenge must be rejected.” [AstraZeneca Pharmaceuticals LP & AstraZeneca AB v. Becerra et al., Amicus Curiae Brief, 11/2/23]
• AARP and the AARP Foundation: “Many Older People Lack The Resources To Pay Exorbitant And Escalating Drug Prices.” “Ever-escalating drug prices have hit older people particularly hard, forcing millions to make devastating decisions because they cannot afford the medications they need. More than 50 million people are enrolled in Medicare Part D, the federal government’s voluntary prescription drug benefit program for Medicare beneficiaries. Beneficiaries take, on average, between four and five prescription medications per month and have a median annual income of just under $30,000. The vast majority have chronic conditions requiring lifelong treatment. Many older people lack the resources to pay exorbitant and escalating drug prices. As a result, they are forced to choose between paying for their prescribed medication or paying for basic life essentials such as food, housing, or heat. Some older people skip doses, split doses, or forgo filling their prescriptions altogether to make ends meet.” [AstraZeneca Pharmaceuticals LP & AstraZeneca AB v. Becerra et al., Amicus Curiae Brief, 11/8/23]

Senate HELP Committee Chair Bernie Sanders Calls On Merck and J&J to Explain Sky-High Prices for American Patients 

Washington, D.C. — Today, U.S. Senator Bernie Sanders (I-VT) is holding a press conference calling on Merck and J&J CEOs to testify in front of the Senate HELP Committee about high drug prices. The news comes as the HELP Committee is scheduled to vote on a subpoena for both CEOs next week. To date, these companies have refused to testify despite producing some of the most expensive prescription drugs on the market. Both companies are suing the federal government to stop Medicare from negotiating lower drug prices for seniors in a blatant effort to protect their massive profits. In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“We commend Senator Sanders for his tireless efforts to bring down drug prices for patients. While companies like Merck and J&J are raking in billions, Americans are routinely skipping doses and cutting pills in half because of the outrageous cost of lifesaving medications. Merck and J&J’s Janssen are in court right now to stop Medicare from negotiating lower prices in order to keep prices high for patients. We are all sick and tired of being ripped off by big drug companies, and these CEOs owe it to the American people to testify.” 

Background:

GREED WATCH: Johnson and Johnson Touts Strong Earnings As They Sue to Protect Their Profits By Blocking Medicare From Negotiating Lower Prices

GREED WATCH: Merck Announces Over One Billion More Revenue This Quarter Than Last Year

“At a time when more Americans are enrolling in the ACA than ever before, it is outlandish that the likely GOP nominee is even considering another attempt at repeal,” said Brad Woodhouse, executive director of Protect Our Care.

Yesterday, the Biden administration announced that a record-breaking 21.3 million Americans have signed up for health care on the Affordable Care Act Marketplace for 2024 coverage. Thanks to the Biden-Harris administration’s Inflation Reduction Act, four out of five enrollees were able to find a plan for $10 or less per month. Even as more Americans are relying on the ACA than ever, presumptive GOP presidential nominee Donald Trump has continued his threats to repeal the Affordable Care Act and throw millions of families off their health care coverage.

HEADLINES

The Washington Post: Obamacare Enrollment Hits Record Level As Trump Vows Repeal. “‘At a time when more Americans are enrolling in the ACA than ever before, it is outlandish that the likely GOP nominee is even considering another attempt at repeal,’ Brad Woodhouse, executive director of Protect Our Care, a Democrat-aligned health-care advocacy group, said in a statement. About 3 in 5 voters — including 1 in 5 Republicans — trust Democratic politicians more than Republicans to handle the future of the Affordable Care Act, according to polling released last month by KFF.” [The Washington Post, 1/24/24]

CNN: Obamacare Sign-Ups Hit Record 21.3 Million As Biden Pushes His Efforts To Lower Health Care Costs. “Nearly 5 million more people signed up for Obamacare policies for this year compared with last year, the Centers for Medicare and Medicaid Services, which oversees the Affordable Care Act marketplaces, said Wednesday. Notably, about a quarter of people selecting plans were new consumers… The explosion in interest in Obamacare policies would make it harder for Trump to dismantle the health reform law, as he and congressional Republicans unsuccessfully tried to do after he took office in 2017. Only about 12.2 million people signed up for Affordable Care Act coverage during that open enrollment period.” [CNN, 1/24/24]

Modern Healthcare: Open Enrollment Breaks 21M For 2024. “Nearly 4.2 million people with incomes of less than 250% of the federal poverty level signed up for 2024 coverage, the agency said. Medicaid redeterminations that began last year helped push up the numbers. As of Dec. 31, about 15% of people who enrolled through the federal HealthCare.gov portal were previously enrolled in Medicaid or the Children’s Health Insurance Program.” [Modern Healthcare, 1/24/24]

Spectrum News: Record 21.3 Million Signed Up For Affordable Care Act Plans, Biden Announces. “The number represents a more than 30% increase from the previous year, when 16.3 million Americans signed up, according to the White House. In total, 9 million additional people have enrolled in plans through HealthCare.gov or state-based marketplaces since Biden took office three years ago… Health policy experts have attributed the increase in enrollments largely to federal subsidies for people purchasing plans. The subsidies were included in two pieces of major legislation spearheaded by Biden: the American Rescue Plan and the Inflation Reduction Act.” [Spectrum News, 1/24/24]

Axios: ACA Enrollment Surged In Red States This Year. “The 30.7% annual increase in ACA sign-ups comes as former President Trump’s renewed calls for repeal have again raised doubts about the law’s future. Enrollment figures released by federal health officials on Wednesday indicate that Republican-leaning states would be heavily affected by the law’s repeal. States with the largest year-over-year increase in sign-ups include West Virginia (80.2%), Louisiana (75.9%), Ohio (62.2%), Indiana (59.5%) and Tennessee (59.5%), according to data from the Centers for Medicare and Medicaid Services, which oversees the marketplaces.” [Axios, 1/24/24]

The Hill: Obamacare Marks Third Year of Record Enrollment With 5 Million More Sign-Ups. “Biden called for lowered premiums enacted through the Inflation Reduction Act to be made permanent. The president also went after Republicans in Congress for having ‘a different vision. … Their recent budget would get rid of the improvements I signed into law, raising costs for millions of people,” Biden said. “If the extreme Republicans in Congress get their way, millions of families would face skyrocketing health care costs or lose their health care altogether. I won’t let it happen on my watch, and I’ll keep fighting to bring down health care and prescription drug costs.’” [The Hill, 1/24/24]

Reuters: US Signs Up Record 21.3 Million People for 2024 Obamacare Plans. “‘For decades, when it came to federal programs we could depend on to keep Americans covered, three were always top of mind — Medicare, Medicaid and Social Security, but now it’s crystal clear that we need to add a fourth — the Affordable Care Act,’ said HHS Secretary Xavier Becerra.” [Reuters, 1/24/24]

MSNBC: ACA Enrollment Totals Soar as Republicans Renew Attacks. “For health care advocates, the data is encouraging on its own, and it reflects what’s possible when congressional Democrats lower premiums and an administration commits to covering as many Americans as possible.” [MSNBC, 1/25/24]

AlterNet: Trump’s Call To Repeal Obamacare Blasted As ‘Outlandish’ As Signups Hit New Record High. “‘At a time when more Americans are enrolling in the ACA than ever before, it is outlandish that the likely GOP nominee is even considering another attempt at repeal,’ Brad Woodhouse, who is executive director of the progressive nonprofit Protect Our Care, told the Post.” [AlterNet, 1/24/24]

PoliticoPro: Biden Touts Record Obamacare Numbers Ahead Of Reelection Campaign. “The record-breaking signups during the latest open enrollment mean that 9 million more people have gotten Obamacare coverage since Biden took office in 2021. One of the drivers for the signups are enhanced subsidies passed as part of the American Rescue Plan Act of 2021. Those premiums though expire after 2025.” [PoliticoPro, 1/24/24]

STATEMENTS

President Joe Biden: “The American people have made it clear: they don’t want the Affordable Care Act weakened and repealed – they want it strengthened and protected. We need to build on the progress we’ve made by making lower premiums permanent.  But Republicans in Congress have a different vision. … If the extreme Republicans in Congress get their way, millions of families would face skyrocketing health care costs or lose their health care altogether. I won’t let it happen on my watch, and I’ll keep fighting to bring down health care and prescription drug costs.” [President Joe Biden Statement, 1/24/24]

HHS Secretary Xavier Becerra: “For decades, when it came to federal programs we could depend on to keep Americans covered, three were always top of mind — Medicare, Medicaid, and Social Security, but now it’s crystal clear that we need to add a fourth — the Affordable Care Act. Once again, a record-breaking number of Americans have signed up for affordable health care coverage through the Affordable Care Act’s Marketplace, and now they and their families have the peace of mind that comes with coverage. The ACA continues to be a successful, popular, and important federal program to millions of people and their families.” [HHS Press Release, 1/24/24]

Democratic Leader Rep. Hakeem Jeffries: “Under the leadership of President Biden, Democrats have delivered on our promise to make health care more affordable and accessible for American families. Today’s announcement means more than 21 million people will have high-quality, affordable health care in 2024, shattering all previous Open Enrollment Period records.” [Rep. Hakeem Jeffries Statement, 1/24/24]

House Energy & Commerce Committee Ranking Member Frank Pallone Jr.: “While Trump vows to repeal the ACA, a historic 21 MILLION Americans have signed up for health care coverage already this year. That’s no coincidence. Democrats protected the law, lowered monthly premiums, and invested to help people sign up for coverage.” [@EnergyCommerce, 1/24/24]

House Education & Labor Committee Ranking Member Bobby Scott: “MAGA Republicans are intent on repealing the Affordable Care Act (ACA). Last Congress, @POTUS and Congressional Democrats strengthened the ACA by passing the American Rescue Plan and the Inflation Reduction Act. We will continue to build on this progress and #ProtectOurCare.” [X, 1/24/24]

Representative Kathy Castor: “We have just hit an all-time high in the number of Americans who have affordable health care coverage because of the Affordable Care Act. The Affordable Care Act is keeping people healthy and helping to keep money in their pockets at a time that they need it. Millions of Floridians and millions of Americans have peace of mind that a preexisting condition or medical diagnosis will not bankrupt them.” [Protect Our Care Press Conference, 1/24/24]

Representative Lauren Underwood: “Today is one of my favorite days in Congress because today is a health care day! This is the third straight year of record-breaking enrollment, with more than 23 million Americans signing up for coverage on the Affordable Care Act marketplaces. We’ve reached this milestone in part because of my Health Care Affordability Act, which has helped four out of five people find coverage for $10 or less. Congress must build on this progress and make these savings permanent.” [Protect Our Care Press Conference, 1/24/24]

As Trump Calls for ACA Repeal, Record Numbers of Americans Enroll in Affordable Coverage

Watch the Full Event Here.

Washington, DC — Today, Representatives Kathy Castor (D-FL-14) and Lauren Underwood (D-IL-14) joined Protect Our Care to discuss the release of the final record-breaking ACA open enrollment numbers from the Department of Health and Human Services. This morning the Biden Administration announced that a record 21.3 million Americans have signed up for health insurance through the Affordable Care Act (ACA) marketplaces – over nine million more than when President Biden took office. These numbers are nearly double the number of people enrolled when President Biden took office, including more than 5 million new signups. 

The Inflation Reduction Act’s cost-saving measures helped more Americans enroll in coverage than ever, with 80 percent of enrollees able to find a health plan through the Marketplace for $10 or less per month. However, we must protect this progress. These tax credits are set to expire in 2025 without congressional action.

Donald Trump has also fully reignited his war on health care as record numbers rely on the ACA for affordable coverage. Repealing the ACA means millions of Americans would lose coverage, costs would skyrocket, and people with pre-existing conditions would lose essential protections. 

“We have just hit an all-time high in the number of Americans who have affordable health care coverage because of the Affordable Care Act,” said Representative Kathy Castor (D-FL-14). “The Affordable Care Act is keeping people healthy and helping to keep money in their pockets at a time that they need it. Millions of Floridians and millions of Americans have peace of mind that a preexisting condition or medical diagnosis will not bankrupt them. But former President Trump is threatening to rip affordable coverage away and repeal the ACA if he is elected. He wants to take us backward and take away affordable health plans, so we must rally to prevent him from ever getting back to the White House.”

“Today is one of my favorite days in Congress because today is a health care day!” said Representative Lauren Underwood (D-IL-14). “This is the third straight year of record-breaking enrollment, with more than 23 million Americans signing up for coverage on the Affordable Care Act marketplaces. We’ve reached this milestone in part because of my Health Care Affordability Act, which has helped four out of five people find coverage for $10 or less. Congress must build on this progress and make these savings permanent.”

“I was diagnosed with cervical cancer on my 26th birthday,” said Kat Klawes, patient storyteller from Wisconsin. “However, my biggest concern with my diagnosis wasn’t the cancer but how I would be able to afford health care. Thankfully, I was able to register for ACA coverage online. The ACA saved my life and continues to do so by covering preventative care so I know if the cancer ever comes back, but there have been over 50 votes in Congress since 2011 to repeal the ACA. Trump’s repeated statements condemning the ACA and his promises to repeal and replace it, along with GOP policies that have consistently opposed expanding health care access, show the prioritization of political agendas over the well-being of the American people.”

“Democrats have led the charge to make quality, affordable health care a top priority, and as a result, millions more Americans are saving money on premiums and have the care they need to stay healthy,” said Leslie Dach, chair of Protect Our Care. “They continue to fight to lower health care costs for every American and protect those with pre-existing conditions. However, last night Donald Trump all but secured the Republican nomination, putting the ACA at risk once again of repeal and sabotage. It is unconscionable that Trump and his MAGA allies are promising to rip all of this progress away. With a record number of Americans signing up for coverage, it’s clear that Americans want and need the affordable, quality health care made possible through the ACA.”

As Trump Calls for ACA Repeal, Record Numbers of Americans Enroll in Affordable Coverage  

Washington, D.C. — Today, the Biden Administration announced that a record 21.3 million Americans have signed up for health insurance through the Affordable Care Act (ACA) marketplaces – over nine million more than when President Biden took office. Thanks to the Inflation Reduction Act lowering health insurance premiums, 80 percent of enrollees were able to find a health plan through the Marketplace for $10 or less per month. Additional sign-ups are still expected in state-based marketplaces with extended deadlines and HHS will update final enrollment numbers in the coming weeks. 

At the same time, Donald Trump’s victory in New Hampshire last night has laid the path for another Trump run for the presidency, putting the ACA in grave danger once again. In response, Protect Our Care Chair Leslie Dach issued the following statement:

“The Affordable Care Act is now woven into the fabric of America. More than 21 million people are enrolled in quality, affordable health coverage on the ACA exchanges today because of the tireless efforts of President Biden and Democratic lawmakers. Health insurance gives people peace of mind knowing they won’t go bankrupt over an injury or illness, and lower premiums means more money is in the pockets of hardworking families. 

President Biden lowered costs and invested in outreach, helping folks who have historically been left behind, like rural Americans, people of color, LGBTQ+ individuals, and people with disabilities. Importantly, Democrats lowered health insurance premiums through the Inflation Reduction Act, helping millions of people afford their coverage. It’s critical that those tax credits are made permanent. 

Unfortunately, this victory comes as Donald Trump has all but secured the Republican nomination, putting the ACA at risk once again of repeal and sabotage. It is unconscionable that Trump and his MAGA allies are promising to rip all of this progress away. The American people are sending a clear message: they want and need the affordable health care made possible by the ACA.” 

With Trump Marching Toward the GOP Nomination, Health Care is Once Again on the Chopping Block

Washington, D.C. — This evening, Donald Trump secured another victory in the 2024 primary, bringing him one step closer to the GOP nomination. Already, Trump has reignited his calls to repeal the Affordable Care Act (ACA), which would hike health care costs, throw millions of Americans off their coverage, and rip away vital protections from millions more. Once again, the issue is front and center leading up to this election. In response, Protect Our Care Executive Director Brad Woodhouse issued the following statement: 

“Trump’s victory in New Hampshire shows he is marching toward the GOP nomination, threatening the health and livelihoods of millions of households across the nation. We’re at a crossroads: While President Biden has delivered real relief to the American people by lowering costs and expanding affordable coverage, Trump has vowed to take all of this progress away and throw the health care system into chaos. Trump’s relentless calls for repealing the ACA demonstrate that the issue of health care will be front and center as voters head to the polls in November. Repealing the ACA would rip away protections for millions of Americans with pre-existing conditions, hike health care costs for working families, and throw millions of people off their health insurance. At a time when more Americans are enrolling in the ACA than ever before, it is outlandish that the likely GOP nominee is even considering another attempt at repeal. Sadly, the threat to American health care is as real as ever.” 

If the Affordable Care Act is repealed:

• 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 more than men.
• GONE: Ban on insurance companies having annual and lifetime caps on coverage.
• GONE: Requirements that insurance companies cover prescription drugs and maternity care.
• GONE: Protections for 135 million Americans with pre-existing conditions, including 54 million people with a pre-existing condition that would make them completely uninsurable.
• GONE: Medicaid expansion, which covers more than 22 million people. 
• GONE: Quality, affordable coverage that over 15.5 million people who buy insurance on their own.
• GONE: Premium tax credits that make premiums affordable for 80 percent of people who purchase health care on the marketplace.
• GONE: 50 million seniors will have to pay more for prescription drugs because the Medicare ‘donut hole’ will be reopened.
• GONE: Critical funding for rural hospitals. 
• GONE: 61.5 million Medicare beneficiaries will face higher costs and disruptions to their medical care. 

Johnson & Johnson announced it raked in $85.2 billion this past year – a $5.2 billion increase over 2022 revenue – during their earnings report today. While they make billions, Americans pay exorbitantly high prices for prescription drugs. Johnson & Johnson opposes the Biden administration reforms that lower prescription drug prices. 

• During the call, CEO Joaquin Duato bragged about the company’s unexpected revenue boosts and outlook on its pending lawsuits saying, “We have entered 2024 from a position of strength.”
• Johnson & Johnson announced it would spend $2 billion to acquire cancer drugmaker Ambrx Biopharma while seeking to use bankruptcy to get out of injury lawsuits filed by over 52,000 plaintiffs over their talcum baby powders causing cancer.
• Johnson & Johnson is suing the Biden administration to stop Medicare from negotiating lower drug prices for patients because it would endanger their massive profits. In 2023 alone, Johnson & Johnson took in $2.4 billion from sales of its heart disease drug Xarelto and $10.9 billion from Stelara sales. Over 64 percent of Johnson & Johnson’s revenue from Stelara came from sales to U.S. patients. All of the company’s revenue from sales of Xarelto came from U.S. patients.
• Johnson and Johnson charges U.S. customers 3 to 7 times more for Xarleto than customers in other high-income countries. 
• Johnson and Johnson charges U.S. customers 2 to 7 times more for Stelara than customers in other high-income countries. 
• On aggregate, drug companies charge Americans prices up to four times higher than prices in other countries, forcing patients to cut pills and skip doses. 
• Over 80 percent of voters support giving Medicare the power to negotiate, making it the most popular provision in the Inflation Reduction Act. 

The Inflation Reduction Act brings down prescription drug costs for everyday Americans, especially seniors, by capping the price of insulin at $35 per month and providing free vaccines including shingles, giving Medicare the power to negotiate lower drug prices, and limiting the amount people have to pay each year for prescription drugs to $2,000 annually starting in 2025.  

Read more:

REPORT: Why Medicare Needs the Power to Negotiate for Lower Drug Costs: the Five Drugs That Tell the Story

FACT SHEET: Big Drug Companies Are in Court to Stop Medicare Negotiation and Protect Their Sky-High Profits

***MEDIA ADVISORY FOR WEDNESDAY, JANUARY 24 AT 2:00 PM ET // 1:00 PM CT***

21.3 Million Have Enrolled in ACA Plans, According to Biden Administration

Washington, DC — On Wednesday, January 24, 2024, at 2 PM ET // 1:00 PM CT, Representatives Kathy Castor (D-FL-14) and Lauren Underwood (D-IL-14) will join Protect Our Care for a press call following the release of the final ACA open enrollment numbers from HHS. A record-breaking 21.3 million people across the nation have signed up for ACA coverage, according to a new report from HHS. These numbers are nearly double the number of people enrolled when President Biden took office and include more than 5 million new signups. 

Thanks to the Inflation Reduction Act’s reduction of health insurance premium costs, 80 percent of enrollees were able to find a health plan through the Marketplace for $10 or less per month. Representative Underwood is fighting to make these cost savings permanent by championing the Health Care Affordability Act. 

As record numbers are relying on the ACA for affordable coverage, Donald Trump has fully reignited his war on health care. Repealing the ACA means millions of Americans would lose coverage, costs would skyrocket, and people with pre-existing conditions would lose essential protections. 

PRESS CALL:

WHO:
U.S. Representative Kathy Castor (D-FL-14)
U.S. Representative Lauren Underwood (D-IL-14)
Kat Klawes, patient storyteller from Wisconsin
Leslie Dach, Chair of Protect Our Care

WHAT: Virtual Press Conference 

WHERE: Register for the Event Here.

WHEN: Wednesday, January 24 at 2:00 PM ET // 1:00 PM CT

January 23 is Maternal Health Awareness Day

Washington, D.C. — Today marks Maternal Health Awareness Day, an important reminder that the U.S. is facing a worsening maternal health crisis. This crisis is compounded by Republicans’ decades-long attacks on reproductive health and abortion care culminating in the Supreme Court’s decision to overturn Roe v. Wade. Pregnancy-related deaths have worsened over the last three decades, and Black and Native women are two to three times more likely than white women to die of pregnancy-related causes. Rates of maternal deaths are increasing most quickly for Hispanic women. Access to care is increasingly more difficult as one-third of U.S. counties are considered maternity care deserts. Complications related to pregnancy led to over 700 deaths in 2022, many of them preventable.

While Democrats have worked tirelessly to improve the health of mothers and their families, Republicans have rejected expanding affordable health care at every turn and instead fight to repeal advancements made. Despite these setbacks, the Biden-Harris administration is dedicated to expanding and protecting maternal health care. The White House released the Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis, a government-wide strategy to cut the rates of maternal mortality and morbidity and reduce disparities among maternal health outcomes. In addition, the Administration has worked to expand postpartum Medicaid coverage from 13 states in 2021 to 46 states and the District of Columbia that presently offer or plan to offer the coverage.

In response, Protect Our Care Director of Policy Programs Andrea Harris issued the following statement: 

“This Maternal Health Awareness Day we recognize the progress made by the Biden-Harris administration while also assessing the work that needs to be done. By working to eliminate Medicaid coverage gaps, diversifying the perinatal workforce, and strengthening social and economic supports for pregnant women and new parents, the Biden-Harris administration is saving lives and addressing the unacceptable inequities in maternal health outcomes. Meanwhile, Republicans have undermined access to contraception and preventive services and are fighting legislation to drive down health care costs and expand affordable care. With the federal right to a safe and legal abortion stripped, enacting strong measures to protect maternal health is more vital than ever.”

Background:

Biden-Harris Administration Has Expanded Medicaid Coverage Through 1 Year Postpartum. The Biden-Harris Administration, with Democrats in Congress, offered states incentives to expand Medicaid coverage for a full year postpartum first on a temporary basis through the American Rescue Plan and then permanently in the Consolidated Appropriations Act of 2022. President Biden is so committed to ensuring new mothers have the health care they need that he has proposed in his Budget to make 12 months of postpartum coverage mandatory for all Medicaid programs. The Biden-Harris administration announced that as of March 2023, an estimated 462,000 Americans have access to 12 months of postpartum coverage. 46 states and the District of Columbia have expanded or have made plans to expand Medicaid coverage to cover a full 12 months postpartum. Four states – Wisconsin, Arkansas, Iowa, and Idaho – have not made plans to expand postpartum Medicaid. 

HHS Awarded More Than $103 Million For A New Maternal Mental Health and Substance Use Disorder Task Force And A National Public Education Campaign On Postpartum Depression. This past fall, the Biden-Harris Administration announced new actions and funding to fight the maternal health crisis. More than $103 million has been awarded to create a maternal mental health and coexisting substance use disorder task force to improve federal data collection and health equity, and implement best practices for prevention, screening, diagnosis, intervention, treatment, community practices, communication, and community engagement. The focus of the task force will be to ensure mental health equity and promote trauma-informed practices. The funding is also going towards a national public education campaign, called Talking Postpartum Depression, which will increase awareness of postpartum depression symptoms, share reliable resources, and demonstrate the many ways to access care. 

• HHS Awarded Nearly $90 Million To Expand Maternal Health Resources and Services Administration (HRSA) Programs. The HRSA programs that have been awarded additional funding from HHS focus on expanding and diversifying the perinatal workforce, increasing access to maternal health services in underserved and rural communities, investing in maternal mental health research, and supporting patients and families postpartum by training additional OB/GYNs, midwives, and maternal health care providers.

CMS Launched ‘Birthing Friendly’ Designation On Comparing Care Tool. The Biden-Harris Administration and CMS launched the ‘birthing friendly’ designation on CMS’s online Care Compare tool. This designation allows patients to search for a hospital that participates in a perinatal quality improvement collaborative program and that implements evidence-based care to improve maternal health. More than 24 health plans agreed to use this designation on their consumer-facing websites, reaching more than 150 million people.

***MEDIA ADVISORY FOR MONDAY, JAN. 22 AT 9:30 AM PT // 12:30 PM ET***

Rep. Levin’s Health Insurance Premium Fairness Act would close loophole to save aging couples thousands of dollars. 

Legislation is latest effort to expand affordable health coverage.

WASHINGTON, D.C. – On Monday, January 22 at 9:30 AM PT // 12:30 PM ET, Congressman Mike Levin (CA-49) will join Protect Our Care California and health care advocate Ted DeBont to discuss their latest efforts to make health care premiums more affordable. This week, Rep. Levin and Rep. Linda Sanchez introduced the Health Insurance Premium Fairness Act, which closes a loophole in the Affordable Care Act (ACA) premium tax credit that penalizes households where one member ages into Medicare. The bill would adjust the ACA premium tax credit formula to account for any Medicare premiums paid by the household, saving dually enrolled American households thousands of dollars per year on healthcare premium costs and bills.

The Health Insurance Premium Fairness Act is the latest effort by Rep. Levin and Congressional Democrats to make health care more affordable for consumers. Thanks to the new measures in the Inflation Reduction Act, signed by President Biden, 80 percent of Californians can find coverage for $10 or less per month on the ACA marketplace. California residents can apply for coverage on Covered California, the state’s ACA marketplace, through the open enrollment period ending January 31. With Donald Trump and other Republican leaders promising to repeal the ACA, there has never been a more urgent time to make sure Californians can secure the best coverage for them. 

PRESS CALL

WHO:
Rep. Mike Levin
Ted and Carla DeBont, health care advocates
Matthew Herdman, Protect Our Care California state lead

WHAT: Virtual Press Conference

WHEN: Monday, January 22, 2024 at 9:30 AM PT // 12:30 PM ET

WHERE: Register for the Zoom here