News

We have reached a critical point for the future of American health care and the fate of the Affordable Care Act (ACA). On June 25th, Trump’s Department of Justice (DOJ) and Republican-led states submitted their briefs in support of California v. Texas, the lawsuit seeking to strike down the ACA. If President Trump and Republicans have their way, more than 20 million Americans will lose their insurance coverage, 135 million Americans with pre-existing conditions will be stripped of their protections, and costs will go up for millions. The consequences of the lawsuit for America’s health care are particularly devastating at a time the country is gripped by the coronavirus crisis which threatens the health and safety of the entire nation.

No action would be more damaging to Americans’ health and safety than if the Trump administration achieves their desired goal of overturning the ACA in its entirety during this crisis. When the court hears this case, there will likely be no vaccine and no viable treatment for the virus. When millions of Americans have already lost health insurance due to the pandemic, it’s absurd that President Trump is arguing in court that 20 million more Americans should lose their health care. And when millions of Americans who contract the coronavirus join the 135 million Americans with a pre-existing condition, President Trump will also be arguing in court to allow insurance companies to deny them coverage or charge them more. The submission of these briefs from Republican states will put the Trump administration’s politically-motivated lawsuit on full display for the American people in front of the highest court.

Days of Action: Day 9 of 12 focuses on health care for Black Americans. To learn more about our Days of Action, visit our website.

What’s At Stake: Coverage for Black Americans

The ACA helped reduce longstanding racial disparities in coverage rates, improving health care access for communities of color across the board. Destroying the ACA would be especially harmful as the country is still reeling from the coronavirus pandemic, which has disproportionately devastated Black communities nationwide. 

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

Medicaid Expansion Played A Key Role In Increasing Coverage Rates For Black Communities. After the implementation of the ACA, gaps in insurance coverage narrowed the most in states that adopted Medicaid expansion. Today, a Black person living in an expansion state is more likely to be insured than a white person residing in a state that rejected Medicaid expansion. Per the Commonwealth Fund: “Five years after the ACA’s implementation, black adults living in states that expanded Medicaid report coverage rates and access to care measures as good as or better than what white adults in nonexpansion states report.”

Research Confirms That The ACA Improved Health Care Access For Black Americans: 

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

• Commonwealth Fund: The Black-White Disparity In Cost-Related Access Problems Shrank From 8.1 Percentage Points In 2013 To 4.7 Points In 2018. “Twenty-three percent of black adults reported avoiding care because of cost in 2013, compared to 17.6 percent in 2018…As a result, differences narrowed between white adults and black and Hispanic adults in cost-related access problems. The black–white disparity shrank from 8.1 percentage points in 2013 to 4.7 points in 2018, while the Hispanic–white difference fell from 12.7 points to 8.3 points.”  [Commonwealth Fund, 1/16/20] 

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

Georgetown University Center For Children And Families: “…Medicaid Expansion Is An Important Means of Addressing Persistent Racial Disparities In Maternal Health And Maternal Mortality.” “New research shows states that expand Medicaid improve the health of women of childbearing age: increasing access to preventive care, reducing adverse health outcomes before, during and after pregnancies, and reducing maternal mortality rates. While more must be done, Medicaid expansion is an important means of addressing persistent racial disparities in maternal health and maternal mortality. The uninsured rate for women of childbearing age is nearly twice as high in states that have not expanded Medicaid compared to those that have expanded Medicaid (16 percent v. 9 percent).” [Georgetown University Center for Children and Families, May 2019]

JAMA: Medicaid Expansion Tied To Positive Gains For Black Babies. “A major part of the Affordable Care Act — the expansion of the Medicaid program — may play a role in shrinking the gap in premature birth and low birth weight between black and white infants born in the United States, according to a new study…Black infants are about twice as likely to be born at low birth weight and 1.5 times as likely to be born prematurely than white infants. Yet the new study finds that Medicaid expansion was linked with closing that gap. Between 2011 and 2016, this expansion was associated with significant improvements in disparities among black and white infants, according to the study, published Tuesday in the medical journal JAMA.” [CNN, 4/23/19]

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

If The ACA Is Overturned, The Black Uninsured Rate Would Nearly Double: 

The Black Uninsured Rate Would Spike To 20 Percent. “Everything would go: protections for preexisting conditions, subsidies that help people purchase insurance, the Medicaid expansion…States that expanded Medicaid would get the worst of it: Urban projected their uninsured rates would nearly double if the law were overturned. The uninsured rate for black Americans would increase from 11 percent today to 20 percent without Obamacare; there would also be a dramatic spike in uninsurance among Hispanics.” [Vox, 3/2/20] 

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

Washington, DC — Last night, Oklahoma passed a ballot measure to implement Medicaid expansion, bringing health care to an additional 200,000 Oklahomans. Despite intense opposition by state Republicans, Oklahoma voters made clear that they wanted to expand Medicaid, a key provision of the Affordable Care Act that has already provided health care to 16 million Americans nationwide. In response to the vote, Protect Our Care Executive Director Brad Woodhouse issued the following statement:

“Oklahomans’ vote to expand Medicaid is a rebuke of Donald Trump’s war on health care. Voters in this deep red state passed Medicaid expansion, a key aspect of Obamacare, because they want expanded access to health care and are fed up with President Trump’s handling of the coronavirus crisis and his lawsuit that would rip their health care away. As a result of Medicaid expansion, more than 200,000 Oklahomans will now have access to lifesaving treatment and coverage, which has never been more important as Americans grapple with the worst public health crisis in a century.” 

HEADLINES:

Forbes: Medicaid Expansion Wins In Red State Oklahoma

Associated Press: Oklahoma Voters Narrowly Approve Medicaid Expansion

Politico: Oklahoma Voters Approve Medicaid Expansion as Coronavirus Cases Climb

The Oklahoman: Oklahoma Voters Approve Medicaid Expansion at the Ballot Box

Raw Story: ‘The People Have Spoken’: Thwarting GOP Push For Cuts, Oklahoma Voters Approve Medicaid Expansion

Courthouse News Service: Oklahoma Voters Approve Medicaid Expansion

HuffPost: Oklahoma Voters Approve Medicaid Expansion For 200,000

We have reached a critical point for the future of American health care and the fate of the Affordable Care Act (ACA). On June 25th, Trump’s Department of Justice (DOJ) and Republican-led states submitted their briefs in support of California v. Texas, the lawsuit seeking to strike down the ACA. If President Trump and Republicans have their way, 20 million Americans will lose their insurance coverage, 135 million Americans with pre-existing conditions will be stripped of their protections, and costs will go up for millions. The consequences of the lawsuit for America’s health care are particularly devastating at a time the country is gripped by the coronavirus crisis which threatens the health and safety of the entire nation.

No action would be more damaging to Americans’ health and safety than if the Trump administration achieves their desired goal of overturning the ACA in its entirety during this crisis. When the court hears this case, there will likely be no vaccine and no viable treatment for the virus. When millions of Americans have already lost health insurance due to the pandemic, it’s absurd that President Trump is arguing in court that 20 million more Americans should lose their health care. And when millions of Americans who contract the coronavirus join the 135 million Americans with a pre-existing condition, President Trump will also be arguing in court to allow insurance companies to deny them coverage or charge them more. The submission of these briefs from Republican states will put the Trump administration’s politically-motivated lawsuit on full display for the American people in front of the highest court.

Days of Action: Day 8 of 12 focuses on health care for young Americans. To learn more about our Days of Action, visit our website.

What’s At Stake: Coverage for Children & Young Adults

Health care for children and young adults is especially important as the nation continues to battle the coronavirus pandemic. As millions of families have lost their health care as a result of coronavirus-related job losses, the ACA and Medicaid expansion give them a place to turn to for comprehensive, affordable coverage. Research from Georgetown’s Center for Children and Families has already revealed an uptick in children’s Medicaid enrollment during the pandemic. 

The ACA made significant gains in children’s access to health care. If the health care law is struck down in court:

• Almost three million children nationwide gained coverage thanks to the ACA. If the law is overturned, many of these children will lose their insurance.
• More than 17 million children with pre-existing conditions could face discrimination. Insurance companies could once again exclude benefits, raise premiums, or deny all coverage altogether for children with conditions like asthma and diabetes. 
• More than 40 million children who have private insurance would lose guaranteed access to free preventive care and could once again face lifetime or annual limits.
• 2.3 million young adults will no longer be able to stay on their parents’ insurance. 

Medicaid Expansion Helps Children. 

Expanding access to Medicaid for parents has had ripple effects for their children. If the ACA is struck down, this progress could be reversed. 

When Parents Have Medicaid, Their Children Are More Likely To Have Regular Care. As summarized by Georgetown University’s Center on Children and Families, recent research finds that “Parents enrolled in Medicaid have children who are 29 percentage points more likely to receive a well-child visit. The relationship is strongest for families with household incomes between 100% and 200% [of the federal poverty line]. In these families, parents enrolled in Medicaid have children who are 45 percentage points more likely to receive a well-child visit.” [Georgetown University Center for Children and Families, 1/12/18]

Medicaid Expansion Led To Gains In Coverage For Children As Well As Parents. A study in Health Affairs found that “710,000 children gained public coverage when their parents enrolled in Medicaid between 2013 and 2015. If the remaining 19 non-expansion states expanded Medicaid, 200,000 additional children would gain health coverage through existing programs. The effect was largest among children whose parents gained Medicaid eligibility through the expansion.” [Georgetown University Center for Children and Families, 1/12/18]

Washington, DC — Today, Senator Bob Casey (D-PA) along with Senate Democrats introduced the Coronavirus Medicaid Response Act, a bill that expedites support for state Medicaid programs as more Americans are unemployed and more urgently need access to health care as a result of the coronavirus crisis. Specifically the bill will create an automated process to increase the Medicaid Federal Medical Assistance Percentage (FMAP) in states as unemployment levels increase, enabling states to receive federal assistance through a quicker process while providers get additional support as Medicaid rolls increase. In response to the bill, Protect Our Care Executive Director Brad Woodhouse released the following statement: 

“Senator Casey and Senate Democrats understand the dire situation so many Americans face when it comes to their health care and have taken much needed action to streamline the Medicaid process so that more people get access to critical care. With so many Americans unemployed as a result of the pandemic, Senate Democrats’ bill will automatically connect states’ Medicaid Federal Medical Assistance Percentage (FMAP) to its unemployment levels, prioritizing quicker Medicaid assistance to those who have lost their jobs. Democrats are making clear that their top priority when it comes to health care is to make it swifter and easier for Americans to access the care they need especially during this crisis, unlike President Trump and Republicans who are dead set on ripping it away.” 

Yesterday, the House of Representatives passed the “Patient Protection and Affordable Care Enhancement Act” a landmark bill introduced and championed by House Democrats to improve health care for Americans by building on key provisions in the Affordable Care Act. News coverage quickly pointed out that House Democrats kept their 2018 campaign promise to protect and build on the ACA just days after the Trump administration and Republican attorneys general filed briefs in support of California v. Texas, their lawsuit to overturn the ACA, rip health care from 23 million people and strip protections from 135 million people with pre-existing conditions in the middle of a pandemic. 

Headlines:

Washington Post: House Democrats Push Through First Bill in A Decade Expanding Affordable Care Act

The Hill: House Fires Back at Trump by Passing ObamaCare Expansion

Politico: House Democrats Approve Health Bill, Seeking Contrast with Trump’s Obamacare Assault

Associated Press: Dems Push Campaign-Season Health Care Bill Through House

Extended coverage of the House’s passage of the Patient Protection and Affordable Care Enhancement Act:

Washington Post: House Democrats Push Through First Bill in A Decade Expanding Affordable Care Act. “The House Monday passed the first significant expansion of the Affordable Care Act since its birth a decade ago, providing Democrats a high-wattage platform to castigate President Trump for his efforts to overturn the landmark law during a pandemic and an election year…the vote was laden with political implications. Less than five months before presidential and congressional elections, it forced Republicans to go on the record about the ACA and showed anew the parties’ highly charged ideological differences on health care — an issue that consistently polls as a prime concern among U.S. voters. Democrats portrayed themselves as champions of access to affordable care at a critical time.” [Washington Post, 6/29/20]

Politico: House Democrats Approve Health Bill, Seeking Contrast with Trump’s Obamacare Assault. “House Democrats on Monday approved a major expansion of Obamacare, underscoring the health care law’s central role in their campaign pitch and drawing sharp contrast with President Donald Trump’s efforts to eliminate the entire law…Democrats believe their defense of Obamacare — in particular, the law’s insurance protections for people with preexisting conditions — will again boost their electoral prospects. The bill approved Monday also targets the Trump administration’s expansion of short-term health insurance plans, which often exclude coverage of preexisting conditions.” [Politico, 6/29/20]

New York Times: House Votes to Limit Health Costs as Drug Maker Adds Price Tag to Virus Treatment. “House Democrats, moving to sharpen the distinction between themselves and Republicans as the coronavirus pandemic rages, passed legislation on Monday that would ensure that Americans paid no more than 8.5 percent of their income for health insurance and would allow the government to negotiate prices with drug makers…Democrats — who reclaimed the House majority in 2018 on a promise to lower health costs and expand access — intend to use it to reprise that playbook in November. The bill, unveiled last week, would expand the Affordable Care Act, President Barack Obama’s signature health care law, just as the Trump administration and Republican state attorneys general are asking the Supreme Court to overturn the 10-year-old law.” [New York Times, 6/29/20]

The Hill: House Fires Back at Trump by Passing ObamaCare Expansion. “Democrats timed the vote to contrast with the Trump administration’s legal brief filed with the Supreme Court last week calling for the ACA to be struck down, a move Democrats said would be even more harmful during the coronavirus pandemic…Defending the ACA was a key strategy used by Democrats in 2018, when they won back the House. The party is returning to the same playbook for the 2020 elections as it attempts to win back the White House and Senate as well.” [The Hill, 6/29/20]

Bloomberg Law: House Passes Obamacare Upgrades to Bolster Democratic Campaigns. “Legislation to boost Obamacare subsidies and direct the government to demand lower prices on certain drugs won House passage Monday, in an election-year reprise of earlier votes that Democratic leaders engineered to highlight differences with the Republican-controlled Senate and the Trump administration. The bill (H.R. 1425) would expand the Affordable Care Act’s tax credits, pressure states to expand Medicaid programs with the promise of more federal funds, and cap what any person may pay for coverage premiums at 8.5% of income. It would also let immigrants living in the U.S. under the Deferred Action for Childhood Arrivals program get access to subsidized insurance plans…Democratic leaders said they’re making good on a 2018 campaign promise to protect the Affordable Care Act.” [Bloomberg Law, 6/29/20]

Modern Healthcare: House Passes Tweaks to Shore Up ACA, Lower Premiums. “House Democrats on Monday passed a bill that would bolster the Affordable Care Act by hiking premium subsidies and incentivizing states to expand Medicaid…House Majority Leader Steny Hoyer (D-Md.) criticized Republicans’ lack of a detailed alternative healthcare plan if the ACA is struck down…House Democrats’ proposal also targets the Trump administration’s healthcare agenda, and would rescind the Trump administration’s rule expanding short-term, limited-duration insurance plans and revoke guidance on 1332 waivers.” [Modern Healthcare, 6/29/20]

Associated Press: Dems Push Campaign-Season Health Care Bill Through House. “Democrats pushed a package expanding ‘Obamacare’ coverage through the House on Monday, a measure that’s doomed to advance no further but spotlights how the coronavirus pandemic and President Donald Trump’s efforts to obliterate that law have fortified health care’s potency as a 2020 campaign issue…Democrats used Trump’s and the GOP’s failed 2017 efforts to erase Obama’s law as their chief issue in the 2018 elections, helping them capture House control by gaining 40 seats. They’ve talked ever since about reprising that theme in this year’s campaigns by focusing on curbing drug and health care costs and saying Republicans want to dismantle the Obama law’s patient protections…Democrats criticized Republicans for repeatedly claiming that after repealing Obama’s law they would pass legislation protecting patients, though they’ve never presented a viable replacement package.” [Associated Press, 6/29/20]

The Fiscal Times: House Dems Pass Obamacare Expansion, Seeking to Draw Contrast With Trump. “The Democratic-led House on Monday passed a bill to bolster Obamacare — and ramp up the political pressure on President Trump on the issue of health care as coronavirus cases surge across many U.S. states…the legislation gives Democrats another chance to attack Trump’s record on health care — an issue they hope to make central to this election much as they did in 2018, and it does so days after the administration filed a brief urging the Supreme Court to strike down Obamacare in its entirety, including the law’s protections for people with pre-existing medical conditions. Overturning the health care law would take away health insurance coverage from about 20 million people. The administration’s support for the legal challenge to the law has sparked strong condemnation from Democrats and criticism from some Republicans concerned that their party is once again being tied to the elimination of Obamacare, especially as Covid-19 case counts continue to rise.” [The Fiscal Times, 6/29/20]

NJ.com: House Votes to Strengthen Obamacare, Issue That Helped N.J. Democrats in Last Election. “Health care was the No. 1 issue two years ago…The House on Monday returned to that issue as lawmakers voted largely along party lines, 234-179, to strengthen the Affordable Care Act, known as Obamacare, even as President Donald Trump renewed his plea to the Supreme Court to kill it and threatened to veto this legislation…Trump and several Republican-run states have asked the Supreme Court to throw out the Affordable Care Act, including its protections for those with pre-existing conditions, the expansion of Medicaid, and the subsidies that make insurance affordable.New Jersey is one of the states that have asked the Supreme Court to uphold the law.” [NJ.com, 6/29/20]

We have reached a critical point for the future of American health care and the fate of the Affordable Care Act (ACA). On June 25th, Trump’s Department of Justice (DOJ) and Republican-led states submitted their briefs in support of California v. Texas, the lawsuit seeking to strike down the ACA. If President Trump and Republicans have their way, 20 million Americans will lose their insurance coverage, 135 million Americans with pre-existing conditions will be stripped of their protections, and costs will go up for millions. The consequences of the lawsuit for America’s health care are particularly devastating at a time the country is gripped by the coronavirus crisis which threatens the health and safety of the entire nation.

No action would be more damaging to Americans’ health and safety than if the Trump administration achieves their desired goal of overturning the ACA in its entirety during this crisis. When the court hears this case, there will likely be no vaccine and no viable treatment for the virus. When millions of Americans have already lost health insurance due to the pandemic, it’s absurd that President Trump is arguing in court that 20 million more Americans should lose their health care. And when millions of Americans who contract the coronavirus join the 135 million Americans with a pre-existing condition, President Trump will also be arguing in court to allow insurance companies to deny them coverage or charge them more. The submission of these briefs from Republican states will put the Trump administration’s politically-motivated lawsuit on full display for the American people in front of the highest court.

Days of Action: Day 7 of 12 focuses on protections for LGBTQ Americans. To learn more about our Days of Action, visit our website.

What’s At Stake: LGBTQ Health Care

The LGBTQ community has unique health care needs and has often experienced high rates of uninsurance and barriers to coverage and care, such as discrimination on the basis of gender identity and sexual orientation. A study by the Center for American Progress found that 15 percent of LGBTQ Americans were uninsured in 2017, compared to only seven percent of non-LGBTQ Americans.

Before the ACA came into effect, one in three (34 percent) LGBTQ people making less than $45,000 per year were uninsured. Just one year after the health care law was implemented, in 2014, the rate of uninsurance for this group dropped to 26 percent and by 2017, it was 22 percent. The ACA ensures that insurance companies cannot deny coverage, drop coverage for no reason, or charge LGBTQ people more because of a pre-existing condition. The ACA’s Medicaid expansion also plays a key role in ensuring LGBTQ adults are covered.

LGBTQ people are especially at risk during the coronavirus pandemic. They are more likely to suffer from chronic conditions that put them at higher risk for developing serious complications if they contract the coronavirus, and research shows LGBTQ Americans are extremely vulnerable to the economic impact of the pandemic. It’s critical that Americans understand just what’s at stake if this lawsuit succeeds as the nation is still reeling from the pandemic. 

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

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

LGBTQ adults covered under Medicaid expansion would lose coverage. The ACA expanded Medicaid to childless adults and increased income eligibility levels nationwide, helping many LGBTQ Americans gain coverage. Among all LGBTQ respondents in a 2017 Center for American Progress study, 18 percent had Medicaid coverage. By comparison, Medicaid covered eight percent of non-LGBTQ respondents. An estimated 1.8 million LGBTQ adults have Medicaid coverage. 

Protections for pre-existing conditions would be eliminated. Because of the ACA, insurance companies cannot deny coverage to individuals because of pre-existing conditions. This includes transgender-related medical history as well as substance use disorders, HIV, depression, and other conditions disproportiately affecting LGBTQ Americans. 

Legislation Builds on the Successes of the ACA to Lower Costs and Expand Coverage for Over 17 Million Americans

Washington, DC — Today the House of Representatives passed the “Patient Protection and Affordable Care Enhancement Act” a landmark bill introduced and championed by House Democrats to improve health care for Americans by building on key provisions in the Affordable Care Act. The bill lowers the costs of health insurance by offering increased financial assistance to more people, strengthens protections for pre-existing conditions and improves health care by incentivizing holdout states to expand Medicaid and expanding Medicaid eligibility for mothers 12 months postpartum. The bill will lead to coverage for 4 million additional people and lower health care costs for another 13 million, benefiting at least 17 million Americans at a time when expanded coverage and lower costs is paramount. The House has passed this landmark bill just days after the Trump administration and Republican-led states filed briefs in support of their lawsuit to overturn the ACA and rip health care from 23 million Americans in the middle of a pandemic and admitted they have no replacement plan if the court overturns the law. In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“House Democrats under the leadership of Speaker Pelosi have delivered on their promise to lower costs, expand coverage, and strengthen protections for pre-existing conditions at a time when access to affordable health care has never been more critical. Today’s bill will help provide affordable health care for over 17 million Americans just as President Trump and Republicans double down on their lawsuit to take health care away from 23 million Americans and gut protections for 135 million people with pre-existing conditions. Republicans want to rip coverage away from millions of Americans in the middle of a public health crisis while Democrats voted to make health care more accessible and affordable for the American people — the choice is clear. Now it’s time for Mitch McConnell and Senate Republicans to decide if they want to prioritize the health and well-being of Americans or side with the president and his disastrous lawsuit to take health care away.”

BACKGROUND:

Democrats’ Sweeping Health Care Bill Would Provide Lower Costs, Better Care For American Families

House Democrats are keeping their promise to reduce health care costs and improve care for millions by introducing the Patient Protection and Affordable Care Enhancement Act (H.R. 1425). By putting an upper limit on how much insurance can cost a family, expanding the number of middle class families who can get financial support, and other cost reduction programs, millions of Americans will see their premiums reduced. The bill also improves health care by incentivizing holdout states to expand Medicaid and expanding Medicaid eligibility for mothers 12 months postpartum as well as increasing funding for outreach for open enrollment. The bill will lead to coverage for 4 million additional people and lower health care costs for another 13 million, benefiting at least 17 million Americans at a time when access to health care is paramount. 

While House Democrats take concrete steps to make our health care system work better for the American people, the Trump administration and its Republican allies are doing just the opposite: proposing to cut Medicare and Medicaid by billions of dollars, gutting protections for preexisting conditions, and throwing the full weight of the Justice Department behind overthrowing the Affordable Care Act in the Texas lawsuit. 

Lower Health Care Costs. The House bill would reduce health care premiums and deductibles, expand eligibility for financial assistance that helps consumers afford coverage, and expand access to affordable health care by guaranteeing affordable care options.

• Coverage for less than 8.5 percent of your income. Under the Underwood bill, nearly all Americans would be guaranteed an option to purchase health care for less than 8.5 percent of their income. A family of four earning $40,000 would save nearly $1,600 in annual premiums, and a 64-year-old earning $57,420 would save more than $8,700 in premiums each year.
• Financial assistance for more people. Premium tax credits would be made available to more middle class Americans, including those with incomes above 400 percent of the federal poverty line (roughly $100,400 for a family of four). It also expands the size of tax credits for people in all income brackets.
• Lower premiums. The House legislation would help further reduce premiums by providing $10 billion annually to states through a national reinsurance program. The CBO estimates that premiums for individual market coverage before subsidies would be 10 percent lower beginning in 2022.
• Negotiating prescription drug costs. The House bill includes important provisions from the Elijah E. Cummings Lower Drug Costs Now Act (H.R. 3), allowing Medicare to negotiate for lower drug prices for people enrolled through Medicare and private insurance. 

Better Care For More People. The House bill includes important provisions to expand health care to more people. In addition to lowering costs, the House bill would help more people access Medicaid and address racial disparities in health care coverage. 

• Expanding Medicaid. The House bill incentivizes holdout states to expand Medicaid by restoring the enhanced federal match rate. If all states expanded Medicaid, an additional 4.8 million people would be eligible for coverage.
• Reducing racial disparities in health care. The bill works to reduce racial disparities by addressing the maternal mortality crisis, expanding Medicaid to new mothers 12 months postpartum. It also ensures that children and families that enroll in Medicaid/CHIP receive 12 months of coverage to prevent coverage interruptions. 

End Sabotage. Since taking office, the Trump administration has worked relentlessly to sabotage Americans’ health care, expanding access to junk plans that allow insurance companies to deny coverage to patients with pre-existing conditions and slashing funding to help people sign up for comprehensive, affordable care. 

• Protecting people with pre-existing conditions. The legislation would stop the Trump administration’s plans to allow insurance companies to sell junk plans that deny people with pre-existing conditions coverage or charge them more. It also reverses the Trump administration’s efforts to allow states waive pre-existing condition protections.
• Guaranteeing that insurance companies cover basic health services. The bill would also prevent the Trump administration from weakening requirements that all insurance cover essential health benefits, such as prescription drug coverage, hospital care, and maternity coverage.
• Restoring funding for education. The House bill would restore all marketing funding for healthcare sold through the marketplace, which the Trump administration has cut by 90 percent since taking office.
• Restoring funding for groups that help people sign up for coverage. Funding for health navigator groups that help people sign up for comprehensive care, which has been cut by 77 percent since President Trump took office, would also be restored. The bill would provide $100 million annually to the federal navigator program. 

Last week, the Trump administration and Republican attorneys general filed their opening Supreme Court briefs in California v. Texas, their lawsuit to eliminate the Affordable Care Act in the middle of a pandemic. Editorial boards across the country denounced President Trump and his Republican allies’ attempt to destroy the ACA and their lies about maintaining protections for people with pre-existing conditions, meanwhile calling on voters to make Republican elected officials “pay at the polling places” in November.  

Washington Post: Editorial: President Trump and Republicans Are the Radicals on Health Care. “The Trump Justice Department asked the Supreme Court on Thursday to kill Obamacare. This has long been a foolish, foolhardy obsession for President Trump. Even in the middle of a widening pandemic, he seeks to eliminate health-care coverage for some 23 million Americans…Mr. Trump claims that he would maintain protections for people with preexisting conditions and other popular elements of Obamacare. But he has no plan to do so. His position is for health-care chaos…Mr. Trump and Republicans, not Democrats, are the health-care radicals.” [Washington Post, 6/28/20]

New York Daily News: Editorial: The GOP’s Viral Obsession: One More Attempt to Kill Obamacare. “There’s a pandemic going on, and a related economic cataclysm has rendered millions jobless and without employer-provided health insurance. So, of course, the Trump administration is doubling down on its attempt to rip up the Affordable Care Act, aka Obamacare…For a decade now, Republicans repeatedly sought to repeal Obamacare without offering a serious replacement — the last attempt so reckless that John McCain provided the deciding vote against it. Biden rightly called this obsession a ‘heartless crusade.’ It was always immoral. It is now also obscene.” [New York Daily News, 6/29/20]

St. Louis Post-Dispatch: Editorial: The Virus and Unemployment Make Obamacare Crucial. The GOP Still Wants It Dead. “President Donald Trump has long publicly supported the effort to kill Obamacare while offering no specific program in its place for the millions of Americans who would lose their coverage…Trump, Hawley and most other elected Republicans say they want to protect people with preexisting conditions. Yet they’re barreling toward eviscerating the one such protection there is, while offering nothing to replace it. With a conservative-majority court in place, the danger is real that they could succeed. If so, America would return to a time when a diagnosis of serious illness could also become a sentence of bankruptcy. Every Republican candidate on the ballot this November who supports this twisted attack on American health care — which is virtually the whole party — should pay at the polling places.” [St. Louis Post-Dispatch, 6/27/20]

Kansas City Star: Editorial: Why Are Kansas and Missouri Trying to Kill Obamacare During the COVID-19 Pandemic? “The attorneys general in Missouri and Kansas are continuing their pointless campaign to invalidate the entire Affordable Care Act — in the middle of a pandemic that has claimed more than 1,200 lives in the two states…It isn’t clear why. Are residents in either state clamoring for an end to the Affordable Care Act in the middle of the COVID-19 pandemic? Save for a few on the very fringe, the answer is no. Most Kansans and Missourians have come to accept the ACA and rely on the benefits it provides…Derek Schmidt of Kansas and Eric Schmitt of Missouri are wrong to pursue this case: wrong on the facts, the law, logic, politics, and the needs of hundreds of thousands of people who live in their states. They should drop the case.” [Kansas City Star, 6/29/20]

Tribune-Star: Editorial: Americans Could Get Dealt Another Uncertainty If ACA Is Ended. “On Thursday, the federal government reported that 487,000 people had signed up for ACA (or Obamacare) coverage on Healthcare.gov, up 46% from the same time in 2019. Later Thursday night, the Trump administration filed a brief with the Supreme Court, asking the justices to end Obamacare completely. All of it. Such a decision would include erasing the protection of coverage for people with preexisting health conditions. The president keeps saying he wants such coverage to continue, but has given no clear way to make such a thing happen in the absence of Obamacare…Millions of idled American workers do not need another uncertainty, particularly one as worrisome as health care coverage, in the middle of a health crisis.” [Tribune-Star, 6/26/20]

Last week, the Trump administration filed their opening Supreme Court brief in their lawsuit to overturn the Affordable Care Act, which would rip health care from 23 million Americans and protections for 135 million with pre-existing conditions as the nation grapples with the coronavirus crisis. News coverage quickly pointed out the dangerous political consequences for the administration’s position in favor of overturning the law, particularly as President Trump continues to lie about how he would always protect Americans with pre-existing conditions. To make the administration’s abysmal weekend of press over their brief even worse, HHS Secretary Alex Azar made clear on Sunday that the administration does not have an ACA replacement plan, and will keep voters in the dark until after the election and potential decision by the Supreme Court. 

CNN: Trump’s Effort to Dismantle Obamacare During the Pandemic Might Be His Riskiest Move Yet. “President Donald Trump has made many questionable decisions in recent weeks as he looks ahead to his increasingly difficult reelection campaign. But his administration’s decision to forge ahead with its effort to invalidate the Affordable Care Act through the courts may go down as the decision that carried the most risk for Republicans up and down the ballot in 2020. The GOP has been fighting to eviscerate Obamacare since it was passed a decade ago. But the effort to strip Americans of health care has never appeared more out of touch and tone deaf than it has during a pandemic, when more than 125,000 Americans have died, more than 2.4 million have been infected and many have lost their employer-sponsored health insurance in the waves of layoffs that have decimated the economy.” [CNN, 6/27/20]

Washington Post: Bottomless Pinocchio: Trump’s Claim That He Will ‘Always’ Protect Those with Preexisting Conditions. “Trump says he will always protect people with preexisting health conditions who need to buy affordable insurance. But what is he actually doing with the powers of the presidency? In the middle of a pandemic, against the advice of many Republicans, the president is asking the Supreme Court to strike down the entire Affordable Care Act — including its coverage guarantee for patients with preexisting conditions…In addition to being a Four Pinocchio claim, this is a Bottomless Pinocchio — our worst rating — because Trump has repeated the falsehood more than 20 times.” [Washington Post, 6/29/20]

Mother Jones: Trump Rails Against Obamacare as Coronavirus Cases Surge. “Months into a global pandemic that has claimed the lives of more than 127,000 Americans, President Donald Trump still refuses to take responsibility for his administration’s underwhelming response. On Saturday, the president started off his weekend by railing against Obamacare—one of the few lifelines available to millions of people in this global health crisis…The Affordable Care Act, known as Obamacare, makes it illegal for insurance companies to deny coverage due to preexisting conditions. Trump has long claimed that he wants to protect people with preexisting conditions, but his actions have always been to pursue the opposite…as the country’s response to the coronavirus cripples the economy, Obamacare has offered an avenue for the millions of newly unemployed to maintain health insurance coverage. If the Supreme Court strikes down the law later this year, it could deprive those unemployed people of their health insurance too.” [Mother Jones, 6/27/20]

Bloomberg: Azar Suggests Voters Go on Faith on What Would Replace Obamacare. “The Trump administration doesn’t expect to release a detailed health care plan until the Supreme Court rules on the legality of the Affordable Care Act, said U.S. Health and Human Services Secretary Alex Azar. That would leave voters in November’s election in the dark about how their health care, typically ranked as among the most important issues, might be upended in 2021 and beyond…Democrats rode the health care issue in the 2018 midterm elections to retake control of the House and they’re planning to do it again in November, when the White House and both chambers of Congress will be on the line.” [Bloomberg, 6/28/20]

The Daily 202: Trump’s Legal Argument for Throwing Out All of the ACA Is A Nightmare for Senate Republicans. “President Trump insists on the campaign trail that he wants to protect insurance coverage for people with preexisting conditions. His legal team just told the Supreme Court otherwise. The 82-page brief submitted late Thursday night by Trump’s representatives states crisply that the president wants to get rid of every provision of the Affordable Care Act…From a political perspective, the timing of the Trump administration’s maneuver to get rid of the law, root and branch, is suboptimal for GOP candidates on the ballot this year. The justices are unlikely to make a final decision until after the November election on the legal challenge by Republican state attorneys general, ensuring that this looms as an issue in the fall campaign.” [Washington Post, 6/26/20] 

Newsweek: Trump Admin Won’t Announce ACA Replacement Plan Before Supreme Court Ruling. “The Trump Administration likely won’t announce a detailed health care plan until after the Supreme Court makes a decision on the legality of the Affordable Care Act (ACA), Health and Human Services Secretary Alex Azar suggested Sunday…CNN anchor Jake Tapper asked Azar in a live interview whether it was ‘unconscionable’ during a pandemic to take health insurance away from people without having a replacement plan ready to be implemented. Azar responded: ‘In terms of the Affordable Care Act, we have made very clear that if the Supreme Court strikes down all or a large part of Obamacare because its constitutionally or statutorily infirm, we will work with Congress to create a program that genuinely protects individuals with pre-existing conditions.’’ [Newsweek, 6/28/20]

USA Today: Pandemic, Politics Make Trump Administration’s Latest Attack on Health Care Law Perilous. “The Trump administration’s latest request that the Supreme Court strike down the Affordable Care Act comes at a perilous time for the president, amid a pandemic and just four months before Election Day…Some Republicans have acknowledged the timing of the Supreme Court battle isn’t ideal as the nation weathers a pandemic and the party looks ahead to November, when it will attempt to fend off Democrats eager to take control of the White House and Senate. Democrats have made health care a central fixture of their platform and credit the issue with helping them take control of the House in 2018.” [USA Today, 6/26/20]

Associated Press: Democrats Renew Health Care Attacks on GOP as Virus Builds. “Democrats are intensifying their attacks on President Donald Trump and his Republican allies over health care, hoping that an issue that helped lift the party during the 2018 midterms will prove even more resonant as the White House seeks to repeal the Affordable Care Act during a public health crisis…The health care law has been a flashpoint in American politics since its enactment a decade ago. Once a cudgel Republicans used against Democrats, the tables have turned as the law — and its protection for preexisting conditions — has become more popular. Democrats believe that their advantage on the issue will only grow as the Trump administration renews its push to nullify the law even as coronavirus infections surge.” [Associated Press, 6/26/20]

The Guardian: Covid-19 Survivors Could Lose Health Insurance If Trump Wins Bid to Repeal Obamacare. “Millions of Americans who have survived Covid-19 or face future infections could lose their insurance or be barred from getting coverage should the Trump administration successfully repeal Obamacare. The Trump administration asked the supreme court late Thursday to overturn the Affordable Care Act – a move that, if successful, would bring a permanent end to the health insurance reform law popularly known as Obamacare. Under the ACA, insurance companies cannot deny coverage for pre-existing conditions. Its abolition would mean millions of Americans who have had or have cancer, multiple sclerosis or other diseases would struggle to find insurance.” [The Guardian, 6/27/20]

We have reached a critical point for the future of American health care and the fate of the Affordable Care Act (ACA). On June 25th, Trump’s Department of Justice (DOJ) and Republican-led states submitted their briefs in support of California v. Texas, the lawsuit seeking to strike down the ACA. If President Trump and Republicans have their way, 20 million Americans will lose their insurance coverage, 135 million Americans with pre-existing conditions will be stripped of their protections, and costs will go up for millions. The consequences of the lawsuit for America’s health care are particularly devastating at a time the country is gripped by the coronavirus crisis which threatens the health and safety of the entire nation.

No action would be more damaging to Americans’ health and safety than if the Trump administration achieves their desired goal of overturning the ACA in its entirety during this crisis. When the court hears this case, there will likely be no vaccine and no viable treatment for the virus. When millions of Americans have already lost health insurance due to the pandemic, it’s absurd that President Trump is arguing in court that 20 million more Americans should lose their health care. And when millions of Americans who contract the coronavirus join the 135 million Americans with a pre-existing condition, President Trump will also be arguing in court to allow insurance companies to deny them coverage or charge them more. The submission of these briefs from Republican states will put the Trump administration’s politically-motivated lawsuit on full display for the American people in front of the highest court.

Days of Action: Day 6 of 12 focuses on protections for people with disabilities. To learn more about our Days of Action, visit our website.

What’s At Stake: Protections for Individuals with Disabilities

The Affordable Care Act (ACA) remains a lifeline for people with disabilities during this crisis. At a time when millions of people are facing the possibility of coronavirus and devastating health care bills, protecting coverage of our nation’s most vulnerable is more important than ever.  According to the Centers for Disease Control and Prevention, adults with disabilities are three times more likely to have chronic conditions, like heart disease, diabetes, and cancer, that put them at higher risk for severe illness if they contract the coronavirus. Additionally, data has shown that people with intellectual disabilities are both contracting and dying from coronavirus at higher rates than people without disabilities.. 

The ACA ensures that insurance companies cannot deny coverage, drop coverage for no reason, or charge people more because of a pre-existing condition. The ACA’s Medicaid expansion also plays a key role in ensuring adults with disabilities are covered. It’s critical that Americans understand just what’s at stake if this outrageous and irresponsible lawsuit succeeds.

Medicaid Is A Lifeline For People With Disabilities

If The Texas Lawsuit Succeeds, 17 Million People Covered By Medicaid Expansion—Including Individuals With Disabilities—Will Lose Coverage. 

• 61 million Americans have a disability. Without the Affordable Care Act, insurance companies could once again deny them coverage, drop their coverage for no reason, or charge them more because of a pre-existing condition. 
• 8.7 million nonelderly adults with disabilities depend on Medicaid for care. Of this group, only 43 percent qualify for supplemental security income (SSI). The remaining 5 million beneficiaries do not receive SSI and therefore do not qualify for coverage based on their disability status alone, meaning they rely on the ACA’s Medicaid expansion or eligibility as low-income parents. 
• More than 1 in 3 adults under age 65 enrolled in Medicaid lives with at least one disability. 
• 45 percent of adults with disabilities have Medicaid coverage. Medicaid covers 45 percent of nonelderly adults with disabilities, including adults with physical disabilities, developmental disabilities, brain injuries, and mental illness

Medicaid Expansion Increased Employment For People With Disabilities. “Individuals with disabilities are significantly more likely to be employed if they live in a state that has expanded Medicaid under the Affordable Care Act, a new study has found. Researchers at the University of Kansas co-authored a study that found a 6 percentage-point difference in employment rates among working-age adults with disabilities in states that expanded Medicaid and those that chose not to.” [The University Of Kansas, 12/21/16] 

Republican Efforts To Repeal Medicaid Expansion Would Mean 64 Percent Of Medicaid Adults With Disabilities Would Lose Coverage. “The Affordable Care Act’s Medicaid expansion covers 11 million people.  Many of them struggle with a chronic illness or a disability (such as a mental health condition) that wouldn’t, by itself, qualify them for Medicaid.  Only 36 percent of non-elderly Medicaid beneficiaries with disabilities receive Supplemental Security Income, which allows them to enroll in Medicaid even without the expansion.  While others may be eligible for Medicaid based on other criteria, many could lose Medicaid coverage under the House bill and wind up uninsured.” [Center on Budget and Policy Priorities, 8/29/17]

The Affordable Care Act Provided Affordable Coverage And Health Security To People With Disabilities: 

The Affordable Care Act Prevents Insurance Companies From Charging Americans With A Disability More Or Denying Them Coverage Altogether. Prior to the ACA, insurance companies were allowed to charge people more or deny coverage simply because they had a pre-existing condition. The ACA banned this practice, requiring that insurance companies offer people coverage regardless of their health status.

Thanks To The Affordable Care Act, Insurance Companies Can No Longer Impose Annual And Lifetime Limits On Coverage. Before the ACA, insurance companies could restrict the dollar amount of benefits someone could use per year or over a lifetime. At the time the ACA was passed, 91 million Americans had health care through their employers that imposed lifetime limits. Many such plans capped benefits at $1 million annually, functionally locking people with complex medical needs out of coverage. 

Under The ACA, Insurance Companies Can No Longer Practice Medical Underwriting, A Process That Let Insurers Make It Harder For People With Disabilities To Get The Coverage They Needed. Before the ACA, insurance companies could screen applicants for any conditions that might be costly to the company. If someone had condition that was predicted to cost the insurance company more, the insurance company would follow a practice called “medical underwriting” that allowed them to charge the applicant a higher premium, specifically exclude coverage for the condition that was expected to be costly, charge the applicant a higher deductible, or limit the applicant’s benefits (for instance, offer a policy that did not cover prescription drugs).

The ACA Requires Insurance Companies To Cover Basic Health Services. The Affordable Care Act established the ten essential health benefits, requiring insurance companies to cover rehabilitative or habilitative services, hospitalization, maternity care, prescription drugs, maternity care, and mental health services. Before the ACA, many people with disabilities had insurance that didn’t cover basic health care needs.