Washington, DC — Tonight, President Trump addressed the nation at the State of the Union and told a series of blatant lies about his record on health care. In response, Brad Woodhouse, executive director of Protect Our Care, release the following statement:
“Another year of President Trump’s administration is in the books and it’s just more lies and broken promises. The president knows his abysmal health care record is an anvil weighing down his chances for reelection and that’s why he attempted to paint a rosy picture tonight, but voters know that Donald Trump’s war on health care is alive and well. President Trump has tried everything to destroy our health care from joining a lawsuit that would rip coverage from 20 million Americans to pushing junk insurance plans that don’t have to cover people with pre-existing conditions to giving his friends in the pharmaceutical industry big tax breaks while they continue to hike drug prices. President Trump’s actions speak louder than his empty rhetoric.”
BACKGROUND:
Pre-Existing Conditions
President Trump claimed he will “always” protect people with pre-existing conditions.
Facts:
Trump supported multiple House and Senate repeal bills that would have ended such protections.
He is pushing junk insurance plans that allow for insurance companies to discriminate against people with pre-existing conditions.
He is arguing that pre-existing condition protections for 135 million Americans should be eliminated in a lawsuit Trump himself claimed would “terminate” the Affordable Care Act and its consumer protections.
Prescription Drugs
President Trump claimed that he lowered drug prices.
He has repeatedly talked about lowering prices based on costs in other countries, but independent experts have said his proposals would be ineffective.
He opposes the single most important thing you can do to lower drug prices — giving Medicare the power to negotiate for lower prices.
Medicare, Medicaid and Social Security
President Trump claimed to protect Medicare and Social Security.
Facts:
As recently as January, President Trumpsignaled that he is open to slashing benefits for vital programs like Medicare, Medicaid and Social Security.
President Trump’s most recent budget proposed slashing Medicaid by $1.5 trillion and Medicare by $845 million.
Health Care Costs
President Trump claimed he made health care more affordable.
Facts:
Under the Trump presidency, the number of uninsured Americans has gone up by at least 7 million, in large part due to his policies to undermine the Affordable Care Act.
Trump’s war on health care is deeply unpopular, and polls have shown that Americans trust Democrats more to protect their health care and lower costs.
President Trump has continuously undermined health care by pushing harmful policies like junk insurance plans that don’t cover pre-existing conditions, and harmful work requirements on Medicaid that have resulted in thousands losing coverage and puts millions more Americans at risk of being kicked off the rolls.
Over the past two weeks Protect Our Care has launched a full-court press ahead of President Trump’s State of the Union Address to bring the conversation back to health care leading up to his speech tonight. In order to debunk the many false claims about health care Trump will likely make, we set out to make clear that his record on health care is as unpopular as it is disastrous. Through polling, press events, op-eds and a new ad, Protect Our Care led the charge to hold Trump accountable and remind Americans about his many lies and destructive policies, backed up by polling data in key battleground states that proves Trump’s health care agenda is deeply unpopular with voters.
Over the past two weeks, POC brought the conversation back to health care:
POC released a memo debunking Trump’s most egregious lies on health care he will likely repeat at his State of the Union Address.
POC conducted a new battleground poll showing Trump’s deep unpopularity on health care in key 2020 states of Florida, Michigan, North Carolina, Pennsylvania and Wisconsin.
POC launched a new ad highlighting Trump’s “Damnable Lie” that he “saved” protections for pre-existing conditions.
POC distributed Protect Our Care buttons to members of Congress and their guests to wear at the State of the Union.
POC hosted a press call with Senator Debbie Stabenow (MI), Representatives Donna Shalala (FL) and Susan Wild (PA) denouncing President Trump’s health care record ahead of the State of the Union and highlighting the disastrous impact on their constituents.
POC state teams in a dozen key states identified health care storytellers for members of Congress to bring as guests to the State of the Union, encouraged them to write op-eds and letters to the editor, and are lifting up their stories on social media and with local press.
And tonight, POC will be responding in real time to President Trump’s health care lies and false promises during his State of the Union Address. Follow @protectourcare and #protectourcare on Twitter throughout the night.
Washington, DC — The administration is signaling that President Trump may talk about drug prices and propose that HHS consider issuing a rule to bring U.S. drug prices more in line with international pricing. Independent experts have already described the proposal as weak and unlikely to have any real impact for consumers for years to come.
Protect Our Care Chair Leslie Dach issued the following statement:
“Once again, President Trump will likely lie about his health care record and make another false promise to the American people. His latest rumored announcement is nothing more than a proposal for a proposal for a proposal. Even under the most optimistic timeline, this policy wouldn’t take effect for years and Americans would likely only see a modest benefit if any at all. Meanwhile the president gave billions of dollars in tax breaks to drug companies and opposes giving Medicare the power to negotiate for lower drug prices, the one proven way to lower costs for millions.”
Although Trump campaigned on a promise to let Medicare “negotiate like crazy” for drug prices, he promised to veto House Democrats’ bill that would empower the federal health care program to do exactly that: directly negotiate with drug makers over the price of up to 250 drugs.
President Trump’s latest proposal lacks an enforcement mechanism and the potential savings are “murkier” than the administration claims.
President Trump’s plan would likely take years to go into effect. Per Politico: “even under the most favorable circumstances, the administration won’t be able to demonstrate any real change to consumers for years.”
“It’s not in his advantage for the 2020 elections to be a mandate on his performance on health care,” said William Howell, a professor of American politics at the University of Chicago.
A recent Kaiser Family Foundation survey showed that 54% of Americans disapprove of how Trump has handled the drug-cost issue, compared to just 30% who approve.
Republicans gave billions in tax breaks to the biggest drug companies in their 2017 tax overhaul.
Drug companies have already hiked the prices of 639 drugs since the beginning of 2020.
Washington, DC — Ahead of President Trump’s State of the Union Address tonight, Protect Our Care is launching a new digital ad highlighting his most absurd lie about health care: how he “saved” protections for pre-existing conditions. The ad, “A Damnable Lie,” launched today on digital platforms across several key 2020 battleground states, makes clear that Trump is lying when he claims to have saved protections for pre-existing conditions. A mountain of evidence to the contrary proves he’s repeatedly tried to strip these protections from 135 million Americans with pre-existing conditions. As it’s likely President Trump will repeat this lie during his State of the Union Address tonight, this ad sets the record straight about the absurdity of his claim and that his years-long war on Americans with pre-existing conditions is far from over.
The ad will run in the key battleground states of Florida, Michigan, North Carolina, Pennsylvania and Wisconsin where recent POC polling shows Trump is already deeply unpopular with voters when it comes to his record on health care.
“No matter how many times President Trump repeats his absurd claim to have ‘saved’ protections for pre-existing conditions, the American people know it’s a damnable lie,” said Protect Our Care Executive Director Brad Woodhouse. “The truth is that the president and his administration have done everything in their power, both in Congress and the courts, to strip protections from 135 million Americans with pre-existing conditions. Americans will be listening tonight when Trump will likely lie again about his record on health care, but his actions to repeatedly try and strip protections for pre-existing conditions and overturn the health care law speak louder than the empty rhetoric he will spout during his speech.”
Washington, DC — Today, the Centers for Medicare & Medicaid Services (CMS) issued the proposed annual Notice of Benefit and Payment Parameters (NBPP) for the 2021 benefit year, which outlines regulatory and financial guidelines applicable to exchange plans. According to reporting from Politico, “CMS is considering changing the automatic reenrollment process so people receiving tax subsidies covering their entire premium would instead be automatically signed up with reduced subsidies or no subsidies at all.” In response to the proposal, Protect Our Care Chair Leslie Dach release the following statement:
“In their latest act of sabotage, the Trump administration is trying to make it harder for people to keep their current marketplace coverage, potentially stripping their subsidies and enrolling them in plans they can no longer afford. Instead of trying to make coverage more accessible and affordable to all Americans, from day one of his administration, President Trump has been waging a war on our health care. HHS should abandon this proposed change and stop its ongoing efforts to make it harder for people to access or afford care.”
Yesterday, the Trump administration announced their new plan to encourage states to apply for so-called “block grants” that would gut Medicaid coverage and kick people off the rolls. Health care experts and patient groups swiftly denounced the plan, noting that the Trump administration’s plan is another “unlawful” attempt to strip health care from Americans after similar plans have been rejected by Congress time and again.
Vice President Pence was asked about the new guidance by Dr. Rob Davidson in Iowa last night. Dr. Davidson — an emergency room physician — explained that his patients depend on coverage through Medicaid expansion to receive emergency and primary care. The vice president claimed he “hadn’t heard” about cuts to Medicaid and told Dr. Davidson that he was “oversimplifying” the harmful impact of the administration’s block grant guidance.
See the interaction between Dr. Davidson and Vice President Pence below:
WHAT THE EXPERTS ARE SAYING:
Georgetown University Center for Children and Families Executive Director Joan Alker Said “The Misguided, Unlawful Guidance Issued By CMS Today Encourages States To Gamble With The Health And Well-Being Of Their Residents.” “The misguided, unlawful guidance issued by CMS today encourages states to gamble with the health and well-being of their residents and their budgets by trading in their guarantee of federal matching funds for a cap on federal funding on a portion of their programs. States already have a lot of flexibility in the Medicaid program. What this guidance does is to give states unprecedented new tools to make cuts to health care in their state. These cuts would also come with far less transparency and oversight.” [Georgetown Center For Children And Families, 1/30/20]
Center On Budget And Policy Priorities: Medicaid “Block Grant” Guidance Will Likely Encourage States To Undermine Coverage. “Weakening that guarantee — or eliminating the federal standards and oversight that ensure that states, health plans, and providers comply with it — would worsen access to care, health, and financial security for beneficiaries and likely increase providers’ uncompensated care costs. Meanwhile, capping federal funding would likely shift costs to states, since they would be solely responsible for unexpected costs above the cap instead of sharing those costs with the federal government as they do today.” [Center On Budget And Policy Priorities, 1/29/20]
Kaiser Family Foundation’s Larry Levitt Said “It’s Hard To See How This Could Help Patients.” “’The ‘opportunity’ here seems to be for states to limit benefits or drugs in Medicaid and pocket the savings,’ said KFF’s Larry Levitt. ‘It’s hard to see how this could help patients themselves.'” [Politico, 1/30/20]
Leo Cuello, Director Of Health Policy At The National Health Law Program, Said “Apparently Desperate To Cut Health Care Coverage, The Administration Is Seeking To Fund Harmful Block Grants” “‘This is an underhanded attempt by the President to do what even a Republican Congress refused to do as recently as the failed Affordable Care Act repeal effort in 2017. People across the country in both political parties called their legislators and stopped that attempt to slash Medicaid,’ said Leo Cuello, NHeLP’s director of health policy. ‘After that failure, the administration attempted to circumvent Congress and transform Medicaid through other means such as restrictive work requirements, which courts so far have found illegal. Apparently desperate to cut health care coverage, the administration is seeking to fund harmful block grants. And make no mistake, these block grants would be devastating for any state that attempts to implement them, and any irresponsible state leader that pursues this policy will be acting against his or her state’s interests – harming the state budget, rural hospitals, state health insurance coverage—and the people who depend on Medicaid for their health insurance coverage.’” [National Health Law Program, 1/30/20]
Joseph R. Antos, A Health Care Scholar At The Conservative American Enterprise Institute, Said That A Block Grant “Can’t Be Done.” “Joseph R. Antos, a health-care scholar at the conservative American Enterprise Institute, said the part of Medicaid law that allows states to get exceptions from the program’s usual rules does not allow federal health officials to waive the formula that defines the share of money the federal government and states provide. ‘Anything that sounds like a block grant,’ Antos said, ‘can’t be done.’” [Washington Post, 1/28/20]
Sara Rosenbaum, Professor Of Health Law And Policy At George Washington University, Said That She Assumes The Trump Administration Is “Trying To Look Like They Are Helping Poor People, Without In Any Way Extending The Entitlement.” “‘Trying to get to the bottom of the politics of this is hard,’ said Sara Rosenbaum, a professor of health law and policy at George Washington University. ‘I assume that they are trying to look like they are helping poor people, without in any way extending the entitlement. It’s one of these sleights of hand where you’re trying to figure out exactly what’s at work.’” [New York Times, 1/30/20]
WHAT THE PATIENT GROUPS ARE SAYING:
American Lung Association, American Heart Association, And 25 Other Patient Groups Said Trump’s Block Grants “Will Reduce Access To Quality And Affordable Health Care For Patients With Serious And Chronic Health Conditions And Are Therefore Unacceptable To Our Organizations.” “Per capita caps and block grants are designed to reduce federal funding for Medicaid, forcing states to either make up the difference with their own funds or make cuts to their programs that would reduce access to care for the patients we represent. As the gap between the capped allotment and actual costs of patient care increases over time, states will likely limit enrollment, reduce benefits, lower provider payments or increase cost-sharing for patients. States are already moving forward with deeply troubling proposals in anticipation of today’s guidance promoting these limiting financing arrangements. Simply put, block grants and per capita caps will reduce access to quality and affordable health care for patients with serious and chronic health conditions and are therefore unacceptable to our organizations.” [American Lung Association, 1/30/20]
The American Academy of Pediatrics, Children’s Defense Fund, Children’s Hospital Association, Family Voices, First Focus on Children, Georgetown University Center for Children and Families, March of Dimes and National Association of Pediatric Nurse Practitioners Said “At A Time When Child Uninsurance Is Already On The Rise, This Guidance Makes It Even Harder To Guarantee Children Can Get The Care They Need.” “Our organizations are united in opposition to any threat to Medicaid that would dismantle a pillar program millions of families rely on. At a time when child uninsurance is already on the rise, this guidance makes it even harder to guarantee children can get the care they need. We urge CMS to immediately rescind the guidance and keep Medicaid strong.” [American Academy Of Pediatrics, 1/30/20]
AARP: Block Grants “Could Put At Risk The Health Coverage For Millions Of Vulnerable Americans.” “AARP is deeply concerned that new guidance released today by CMS letting states cap funding in the Medicaid program could put at risk the health coverage for millions of vulnerable Americans. Capping the program’s funding structure and limiting benefits and services could leave millions without the coverage and care they need.” [AARP, 1/30/20]
American Academy Of Pediatrics: It Is “Baffling And Alarming That Such Drastic, Harmful Changes Are Being Proposed To A Program That Works So Well.” “Today’s guidance invites states to pursue policies that will leave patients worse off, including limiting how many prescription medications are available and cutting critical benefits, even before federal funding runs out. Children make up the single largest group of people who rely on Medicaid, including children with special health care needs and those from low-income families. Unlike many commercial insurance plans, Medicaid guarantees specific benefits designed especially for children. Simply put: Medicaid works. In fact, children in Medicaid are more likely to get check-ups, miss less school, graduate and enter the workforce than their uninsured peers.”It is therefore baffling and alarming that such drastic, harmful changes are being proposed to a program that works so well for such vulnerable groups. It is even more concerning that it was done in a way that does not allow those who would be impacted most to weigh in.” [American Academy Of Pediatrics, 1/30/20]
Rick Pollack, President and CEO Of The American Hospital Association, And Mark Parkinson, President and CEO Of The American Health Care Association, Said That “Entire Communities Could Lose Access To Care Under This Proposal.” “The presidents and CEOs of the American Hospital Association and American Health Care Association, Rick Pollack and Mark Parkinson, immediately criticized the Trump administration guidance Thursday, warning that it could lead to a $50 billion national Medicaid funding cut. ‘Entire communities could lose access to care under this proposal, especially in rural areas where 15 percent of hospital revenue and nearly two-thirds of nursing facility revenue nationwide depend on Medicaid funding,’ Pollack and Parkinson said in a joint statement. ‘The supplemental payment programs targeted in this rule are also a critical lifeline at hospitals, health systems and nursing facilities that serve some of the most vulnerable Americans.’” [Modern Healthcare, 1/30/20]
ASCO President, Howard A “Skip” Burris III, Said Transforming Medicaid Into A Block Grant Program Would Jeopardize Health And Outcomes For People With Cancer. “‘A transition to block grants could transform Medicaid from a safety net program, designed to meet basic health needs for low-income Americans, to a program with funding limits that drive care rationing for the most vulnerable,’ said ASCO President Howard A. “Skip” Burris, III, MD, FACP, FASCO…’ASCO recognizes that state and federal budgets are facing mounting financial pressures—including the rising cost of cancer care—but transforming Medicaid into a block grant program would jeopardize health and outcomes for people with cancer,’ said Dr. Burris. ‘Furthermore, reducing access to care such as recommended cancer screenings could actually end up increasing the cost of care when patients present to providers with more complex, late-stage illnesses.’” [American Society of Clinical Oncology, 1/28/20]
Charles N. “Chip” Kahn III, President Of The Federation Of American Hospitals, Said That Block Grants Are “Based On The Assumption You Can Control Costs,” But “You Can Get A Curveball In There, And It Can Throw The Whole Thing Off.” “Democrats and large swaths of the health-care industry have consistently opposed block grants, contending that such fixed payments could strand states financially when the economy deteriorates, expensive new therapies materialize or public health disasters arise. Such pressures, critics contend, would lead states to cut eligibility or services. ‘These are all the reasons you’ve got to be nervous about a block grant,’ said Charles N. “Chip” Kahn III, president of the Federation of American Hospitals. “’It’s based on the assumption you can control costs and the levels of services are the same from year to year. You can get a curveball in there, and it can throw the whole thing off.’” [Washington Post, 1/28/20]
Senator Debbie Stabenow (MI), Representatives Donna Shalala (FL) and Susan Wild (PA) Denounce President Trump’s Disastrous Health Care Agenda in Battleground States Highlighting the Devastating Impacts for Their Constituents
Washington, DC – Today, U.S. Senator Debbie Stabenow (MI), U.S. Representatives Donna Shalala (FL-27) and Susan Wild (PA-07), and Protect Our Care held a press call where they denounced President Trump’s health care record ahead of his State of the Union Address next week, including his ongoing efforts to sabotage and repeal the health care law. Also on the call, Jim Williams with Public Policy Polling, discussed a new poll from PPP in key battleground states (Florida, Michigan, North Carolina, Pennsylvania,Wisconsin) that found President Trump’s positions on health care issues are deeply unpopular among battleground voters.
“Health care is personal, not political — it’s personal for every one of us. During the State of the Union, we are going to be focused on the president’s dangerous record of trying to take away health care for tens of millions of Americans,” said U.S. Senator Debbie Stabenow. “Over and over again they talk about protecting people with pre-existing conditions while doing everything they can to make sure that’s not possible and not affordable.”
“My district has the largest enrollment in the ACA, and this president has tried to destroy their health care, because without coverage for pre-existing conditions you don’t have health insurance,” said Congresswoman Donna Shalala. “The president has no plan except to destroy the health care system as we know it. He’s absent on all major issues on health care — but more importantly, he’s making war on people’s health care. It’s going to drive costs up and destroy people’s lives.”
“Every single day, constituents from my community voice their concerns about healthcare – many can’t afford their prescriptions and those with pre-existing conditions are terrified of losing their coverage,” said Congresswoman Susan Wild. “For Pennsylvanians, the stakes could not be higher. That’s why I am focused on increasing access to care and lowering the cost of prescription drugs. I am proud to work alongside Protect Our Care to strive for healthcare that is both affordable and accessible for every American in every community.”
“As President Trump prepares for his State of the Union Address, his signature domestic issue, repealing and sabotaging American health care, is an anvil weighing down his job approval ratings and putting in grave doubt his prospects for reelection. And he knows it.” said Brad Woodhouse, executive director for Protect Our Care. “The president recently flew off the handle and berated his own Secretary of Health and Human Services reacting to abysmal health care numbers in his own polling.
“President Trump’s poor approval on health care is clearly of his own making, but it’s the American people who will pay the price if his war on Americans health care succeeds. Donald Trump has mounted a relentless war on American health care through trying to repeal the health care law – first in Congress and now in the courts – putting protections for 135 million people with pre-existing conditions and the insurance coverage of 20 million more at risk. Even this week, President Trump is proposing so-called block grants for Medicaid, a policy repeatedly rejected by Congress and is nothing more than a euphemism for slashing benefits for millions of Americans.”
Health care is the most important issue or a very important issue for a large majority of voters (68%) when deciding who to vote for in 2020. This issue is important to voters across party lines, including 66% of independents and 53% of Republicans.
The overwhelming majority (83%) support allowing Medicare to negotiate for lower prescription drug costs with drug companies, which Trump has promised to veto. Just 5% of voters oppose ending the ban on Medicare negotiating drug prices.
70% of voters oppose President Trump’s plan putting Medicare cuts on the table if he is re-elected—including by a plurality of Republicans, with 49% opposing his decision and only 38% in support.
Battleground voters in these states Trump won in 2016 trust Democrats more than President Trump on both the issue of pre-existing conditions (53-43) and prescription drugs (51-45), two of the most important issues on voters’ minds in 2020.
Only 27% agree with President Trump’s lawsuit to strike down the Affordable Care Act in the courts.
Trump’s effort to use the courts to eliminate protections for people with pre- existing conditions is a major concern for 72% of battleground state voters, including 73% of independents and 58% of Republicans.
Similarly, the fact that 20 million Americans would completely lose their health insurance coverage if President Trump’s lawsuit is successful is a major concern for 69% of voters, including 71% of independents.
Today, the Trump administration continued their quest to sabotage Medicaid by announcing new guidance encouraging states to apply for so-called “block grants” that will gut coverage and kick people off the rolls. Press reports quickly pointed out that millions will be hurt and that Congress has resoundingly rejected this proposal many times.
New York Times: Administration Offers Plan For Medicaid Block Grants, Long A Conservative Goal. “Republicans have proposed block grants in various forms for decades, going back to the Reagan administration…More recently, Republicans’ bills to repeal and replace the Affordable Care Act in 2017 proposed giving states a choice between a fixed annual sum per Medicaid recipient or a block grant, both of which would have almost certainly led to major cuts in coverage over time. Concerns from moderate House Republicans about the potential of deep cuts to Medicaid — which now serves more than 71 million people, or more than 1 in 5 Americans — helped doom the repeal effort.” [New York Times, 1/30/20]
Vox: Trump’s Audacious New Plan To Cut Medicaid, Explained. “Medicaid would no longer pay whatever is necessary to provide medical care to the people in or near poverty who qualify for its benefits. Instead, spending would be limited in states that got a waiver from the federal government, and they could impose cuts on benefits. Trump has already tried to fundamentally alter the Medicaid program through work requirements, though he’s been stopped in the courts. But the block grants represent an even more basic remaking of Medicaid on his watch, one that would lead to spending cuts and fewer benefits.” [Vox, 1/30/20]
Vox: Like Work Requirements, Trump’s Block Grants “A Roundabout Way To Roll Back Obamacare’s Expansion Of Medicaid Specifically.” “The block grants are also, like work requirements, a roundabout way to roll back Obamacare’s expansion of Medicaid specifically. Under the guidance released by CMS, it would be benefits for people newly eligible under the health care law — mostly childless adults and parents who are living in or near poverty — that would be subject to the block grants. In that context, despite Trump’s campaign promise not to cut Medicaid, these policies make sense as a means to an end for the conservatives whom Trump has put in charge of his health department.” [Vox, 1/30/20]
Vox: “Trump’s Record On Medicaid Is Quite Clear: His Administration Continues Pursuing Legally Dubious Changes That Would Scale Back The Program.” “ Trump’s record on Medicaid is quite clear: His administration continues pursuing legally dubious changes that would scale back the program. Before courts put them on hold, his work requirements led to 17,000 people in Arkansas losing Medicaid benefits, without any noticeable improvement in employment.” [Vox, 1/30/20]
Washington Examiner: Trump To Let States Overhaul Medicaid For The Poor, Seeking To Change Obamacare Without Legislation. “Thursday’s move is the latest example of Trump administration efforts to overhaul Obamacare after the Republican-controlled Senate failed to pass legislation to do so in 2017.” [Washington Examiner, 1/30/20]
Politico: “The Plan Is The Administration’s Boldest Step Yet To Curb Medicaid Spending And Shrink The Program.” “The plan is the administration’s boldest step yet to curb Medicaid spending and shrink the program covering about 1 in 5 low-income Americans. But the move is inciting fierce opposition from Democrats who say it’s the latest evidence President Donald Trump is trying to sabotage health coverage.” [Politico, 1/30/20]
Politico: “Congress Rejected A Similar Block Grant Proposal After Analysts Found It Would Result In Millions Losing Coverage.” “During the failed effort to repeal and replace Obamacare in 2017, Congress rejected a similar block grant proposal after analysts found it would result in millions of people losing coverage…The health care law — and in particular its Medicaid expansion — remains popular after the failed effort to replace it during Trump’s first year in office. Nearly three-quarters of states have expanded Medicaid since 2014, and support for the program has boosted Democratic candidates in conservative strongholds.” [Politico, 1/30/20]
Politico: “Block Grants Have Been A Regular Feature In Republican Health Plans Dating Back To The 1980s,” But “There’s Never Been Enough Support For The Idea From Congress.” “Block grants have been a regular feature in Republican health plans dating back to the 1980s. Republicans say that states can better manage the programs on a defined budget and fewer rules set by Washington. However, Medicaid advocates say a block grant would limit states’ ability to respond to economic downturns and expensive new drugs, forcing them to trim their programs. There’s never been enough support for the idea from Congress.” [Politico, 1/30/20]
The Hill: “The Move Is Likely To Kick Off A Furious Legal Fight.” “The move is likely to kick off a furious legal fight. Democrats have been arguing the administration doesn’t have the authority to approve such drastic changes, and Medicaid advocates argue the changes would hurt low-income people and invite states to cut costs and reduce coverage.” [The Hill, 1/30/20]
Block Grant Guidance Would Allow States To Impose Work Requirements And Cost Sharing And Premiums Without Additional Federal Approval. “States will have the ability to spend it however they see fit, without some federal guidelines. For example, the program will allow states to impose work requirements, cut provider payments, and require cost sharing and premiums without additional permission from the federal government. Notably, states will be able to adopt what is called a ‘closed formulary’ for certain drugs. This means a state can decide not to cover a Food and Drug Administration-approved drug if there is a cheaper alternative.” [The Hill, 1/30/20]
The Hill: Allowing States To Impose Block Grants “Would Be Extremely Controversial And Have Widespread Implications About The Use Of Executive Power.” “Congress already rejected block grants when the GOP’s ObamaCare repeal bill failed in 2017. Allowing states to impose those same changes by statutory waiver would be extremely controversial and have widespread implications about the use of executive power.” [The Hill, 1/30/20]
Modern Healthcare: Block Grants Could “Lead To Significant Coverage Losses And Reduce Access To Care For Some Of The Most Vulnerable Populations.” “Healthcare experts worry that under a block grant, states might have to slash their Medicaid rolls or payments to disproportionate-share hospitals to get program spending under control. That could lead to significant coverage losses and reduce access to care for some of the most vulnerable populations. It could also hurt doctors and hospitals by increasing the amount of uncompensated care that they provide.” [Modern Healthcare, 1/30/20]
Wall Street Journal: Trump Administration to Give States Wide Latitude in Medicaid Block-Grant Plan. “The Trump administration on Thursday released details for how states can apply to convert Medicaid to block grants that would let them impose changes such as eligibility requirements and prescription drug limits for millions of adults in the program…A legal row over the changes is likely. Democrats say the administration lacks the authority to approve structural changes to Medicaid that they say would hurt enrollment. Consumer advocates say the changes, including the limits on federal funding, hurt the poor.” [Wall Street Journal, 1/30/20]
Wall Street Journal: “A Republican-Led Push To Repeal The Affordable Care Act In 2017 Largely Failed Because It Included A Plan To Block-Grant Medicaid.” “Efforts to convert Medicaid to block grants have been contentious. A Republican-led push to repeal the Affordable Care Act in 2017 largely failed because it included a plan to block-grant Medicaid. Analysts said millions of people would lose health coverage. Democrats and consumer advocates say the new changes threaten enrollment gains seen under the former Obama administration and violate federal law.” [Wall Street Journal, 1/30/20]
Politico: ‘Block Grants’ No More: Trump’s Medicaid Overhaul Has New Name, Same Goals. “The forthcoming block grant program comes with a new name — ‘Healthy Adult Opportunity’ — but retains the original mission long sought by conservatives: allowing states to cap a portion of their spending on Medicaid, a radical change in how the safety net health program is financed. The block grant plan, which invites states to request capped funding for poor adults covered by Obamacare’s Medicaid expansion, also would let states limit health benefits and drugs available to some patients.” [Politico, 1/29/20]
Paul Waldman In The Washington Post: The Trump Administration’s Cruelty Knows No Limits. Here’s The Latest. “So states would be allowed to turn away qualified applicants, limit health benefits and deprive people access to medications they need. That’s ‘Healthy Adult Opportunity’ in the same sense that if I shoot you in the kneecap, I’ve given you ‘Mobility-Enhancing Pain Relief.'” [Washington Post, 1/29/20]
Paul Waldman In The Washington Post: “Verma Has Made No Secret Of The Fact That She’d Like To Have As Few People Getting Medicaid As Possible.” “Block-granting has long been a conservative goal, but Seema Verma, whom Trump named to run the Medicare and Medicaid programs, has taken to it with a particular relish. Verma has made no secret of the fact that she’d like to have as few people getting Medicaid as possible, and every time someone loses their coverage, as far as she’s concerned, it’s a victory.” [Washington Post, 1/29/20]
Paul Waldman In The Washington Post: “We Can Be Sure That Every Day This Administration Is In Office, It Will Try To Take Health Coverage Away From As Many Americans As It Can.” “We can’t know what the future of the ACA is (though my suspicion is that knowing what a catastrophe it would be for the Republican Party if they actually succeeded in their lawsuit, Chief Justice John G. Roberts Jr. will step in and vote with the liberal justices to save his party from itself). But we can be sure that every day this administration is in office, it will try to take health coverage away from as many Americans as it can.” [Washington Post, 1/29/20]
Washington, DC — President Trump’s rally in Des Moines, Iowa tonight comes after years of his relentless war on health care, and his own polling that shows his health care record is deeply unpopular. Ahead of Trump’s rally, Protect Our Care Executive Director Brad Woodhouse released the following statement:
“Iowans won’t hear about President Trump’s disastrous and unpopular health care record at his rally tonight. President Trump is lying when he claims that he has ‘saved’ protections for people with pre-existing conditions and would never take away Medicaid benefits. The fact of the matter is that the president’s disastrous Texas lawsuit would strip protections from nearly 1.3 million Iowans with pre-existing conditions and less than a week ago he indicated that he is open to cutting benefits for Medicare and Medicaid if he wins re-election. Voters in Iowa know the truth and are sick and tired of President Trump and Republicans playing politics with their health care.”
BACKGROUND:
Trump-Backed Texas Lawsuit Would Devastate Iowans
If Trump Gets His Way, Iowans Would Lose Their Coverage
187,000 Iowans could lose coverage. According to the Urban Institute, 187,000 Iowans would lose coverage by repealing the Affordable Care Act, leading to a 126 percent increase in the uninsured rate.
24,000 Iowa young adults with their parents’ coverage could lose care. Because of the Affordable Care Act, millions of young adults are able to stay on their parents’ care until age 26.
9,000 Iowa children could lose their coverage. Almost three million children nationwide gained coverage thanks to the ACA. If the law is overturned, many of these children will lose their insurance.
13,600 Iowa Latinos could lose coverage. The percentage of people gaining health insurance under the ACA was higher for Latinos than for any other racial or ethnic group in the country. According to a study from Families USA, 5.4 million Latinos nationwide would lose coverage if the lawsuit succeeds in overturning the ACA.
Iowans would lose important federal health care funding — an estimated reduction of $1.4 billion in the first year. The Urban Institute estimates that a full repeal of the ACA would reduce federal spending on Iowans’ Medicaid/CHIP care and Marketplace subsidies by $1.4 billion.
If Trump Gets His Way, Insurance Companies Would Be Put Back In Charge, Ending Protections For The 135 Million People Nationwide With A Pre-Existing Condition
According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 135 million people, have a pre-existing condition. This includes:
44 million people who have high blood pressure
45 million people who have behavioral health disorders
44 million people who have high cholesterol
34 million people who have asthma and chronic lung disease
34 million people who have osteoarthritis and other joint disorders
1,288,400 Iowans have a pre-existing condition, including 174,700 Iowa children, 643,000 Iowa women, and 324,100 Iowans between ages 55 and 64.
If Trump Gets His Way, Insurance Companies Would Have The Power To Charge You More, While Their Profits Soar
1,530,502 Iowans Could Once Again Have To Pay For Preventive Care. Because of the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no cost to consumers. This includes nearly 1,530,502 Iowans, most of whom have employer coverage.
39,039 Iowans in the Marketplaces Would Pay More for Coverage. If the Trump-GOP lawsuit is successful, consumers would no longer have access to tax credits that help them pay their marketplace premiums, meaning roughly nine million people who receive these tax credits to pay for coverage will have to pay more, including 39,039 in Iowa.
51,596 Iowa Seniors Could Have to Pay More for Prescription Drugs. If the Trump-GOP lawsuit is successful, seniors could have to pay more for prescription drugs because the Medicare “donut” hole would be reopened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 CMS report. In Iowa, 51,596 seniors each saved an average of $1,058.
Reinstate Lifetime and Annual Limits On 1,187,000 Privately Insured Iowans. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage for those insured through their employer or on the individual market.
If Trump Gets His Way, Medicaid Expansion Would Be Repealed
155,400 Iowans Enrolled Through Medicaid Expansion Could Lose Coverage. Seventeen million people have coverage through the expanded Medicaid program, including 155,400 in Iowa.
Access To Treatment Would Be In Jeopardy For 800,000 People With Opioid Use Disorder. Roughly four in ten, or 800,000 people with an opioid use disorder are enrolled in Medicaid. Many became eligible through Medicaid expansion.
Key Support For Rural Hospitals Would Disappear, leaving Iowa hospitals with $684 million more in uncompensated care.
Washington, DC – Tomorrow, the Trump administration is taking another step to sabotage Americans’ health care by issuing new guidance that could severely limit state funding for those enrolled in Medicaid expansion under the Affordable Care Act. A perennially unsuccessful conservative priority dating back to Ronald Reagan, block grants are a blatant attempt to gut coverage and kick people off the rolls. Block grants would reduce funding for states and have repeatedly been rejected by Congress. In response to the administration’s pending proposal, Protect Our Care Executive Director Brad Woodhouse issued the following statement:
“Once again, President Trump is taking cruel and unnecessary action to sabotage a program that is a lifeline to millions of Americans. The administration’s benefit-slashing block grants – which Congress has rejected time and time again – target Americans who have gained coverage through Medicaid expansion, one of the Affordable Care Act’s most successful and popular provisions. Medicaid has been in President Trump’s crosshairs since day one; with this new block grant guidance along with proposed budget cuts, onerous paperwork requirements, and his lawsuit that would overturn Medicaid expansion, President Trump is putting Medicaid on the chopping block and putting millions of Americans health care at risk.”
BACKGROUND
Experts, Patient Groups Confirm Block Grants Would Hurt Patients:
American Cancer Society Cancer Action Network, American Diabetes Association, And 25 Other Patient Groups Said Blocks Grants “Will Reduce Access To Quality And Affordable Health Care For Patients WIth Serious And Chronic Health Conditions.” “Per capita caps and block grants are designed to reduce federal funding for Medicaid, forcing states to either make up the difference with their own funds or make cuts to their programs that would reduce access to care for the patients we represent. As the gap between the capped allotment and actual costs of patient care increases over time, states will likely limit enrollment, reduce benefits, lower provider payments or increase cost-sharing for patients. States like Utah and Tennessee are already moving forward with deeply troubling proposals in anticipation of new federal guidance promoting these capped financing arrangements. Simply put, block grants and per capita caps will reduce access to quality and affordable healthcare for patients with serious and chronic health conditions and are therefore unacceptable to our organizations. We strongly oppose policies that would allow states to apply for block grants or per capita caps for their Medicaid programs.” [American Diabetes Association, 7/18/19]
Center On Budget And Policy Priorities: Medicaid Block Grant Guidance “Threatens The Well-Being Of Both Low-Income And Vulnerable Medicaid Beneficiaries And Those Who Provide Their Care.” “The combination of eligibility restrictions, weaker beneficiary protections, greater financial risk for states, and reduced federal oversight threatens the well-being of both low-income and vulnerable Medicaid beneficiaries and those who provide their care. Medicaid’s coverage guarantee means that coverage is there when it’s needed: people who lose their jobs or get sick can enroll when they qualify and receive a core set of health care services that all states must cover. Ending that guarantee — or eliminating the federal oversight that ensures that states, health plans, and providers comply with it — would worsen access to care, health, and financial security for Medicaid enrollees and very likely increase uncompensated care costs for hospitals and other providers.” [Center On Budget And Policy Priorities, 6/27/19]
Center For American Progress: Medicaid Block Grants “Would Not Only Critically Undermine The Federal Government’s Mandate To Provide Affordable Health Care For Low-Income, Vulnerable Populations, But They Would Also Reduce Overall Funding For The Program And Shift Medicaid Responsibility To The States.” “Efforts to implement Medicaid block grants and per-capita caps using Section 1115 waivers would not only critically undermine the federal government’s mandate to provide affordable health care for low-income, vulnerable populations, but they would also reduce overall funding for the program and shift Medicaid responsibility to the states. If state Medicaid costs were higher than expected due to increased enrollment as a result of economic shocks or natural disasters, states would be forced to either supplement their Medicaid program from other funding sources, increase taxes, or reduce services provided to enrollees.” [Center For American Progress, 8/7/19]
Rachel Sachs, Associate Professor Of Law At Washington University In St. Louis, And Nicole Huberfeld, Health Law Professor At Boston University School of Public Health, Said Block Grants “Would Very Likely Involve Disenrollment And Other Cost-Cutting Measures That Endanger The Lives Of The Most Vulnerable Patients.” “States already have significant flexibility within the Medicaid program, which always has been state specific. The administration’s desired policy change attempts to bypass the law, raising serious separation of powers concerns. And capped spending would very likely involve disenrollment and other cost-cutting measures that endanger the lives of the most vulnerable patients. Under a capped spending policy, it is foreseeable that states would face cost-cutting choices that harm the health of Medicaid beneficiaries of all kinds and especially those relying on access to care such as the medications necessary to manage chronic diseases and other life-threatening conditions.” [Health Affairs, 7/24/19]
Peter Edelman, Faculty Director Of The Georgetown Center On Poverty & Inequality, Said “Block Grants Create A Powerful Incentive For States To Reduce Assistance Even As Need Rises.” “With fixed funding levels, block grants create a powerful incentive for states to reduce assistance even as need rises. After all, they get to keep the ‘savings’ in what essentially becomes a slush fund. As has been seen in the TANF program created by the 1996 welfare law, states have used the malleability of the block grant to make it harder for people to receive benefits. As a result, the number of families experiencing poverty who receive TANF has fallen precipitously.” [Washington Post, 1/22/17]
