News

Yesterday, Donald Trump continued to play politics with Americans’ health care by signing an executive order that he claims will lower prescription drug prices in an effort to intentionally mislead voters ahead of Election Day. Reporters and experts were quick to point out that in reality, this stunt does nothing to actually lower drug prices, calling the order “toothless.” In order to lower prices, President Trump would need to put regulations into place — a process that takes considerable time and one that he has continually skipped. The New York Times also pointed out that the order relies on authority under the Affordable Care Act, which the Trump administration is actively trying to overturn in court. Since taking office, President Trump has broken his promise to stop drug prices from skyrocketing. Sunday’s executive order is more of the same.

The executive order requires additional regulations that would take months to go into effect, if the administration even puts them into place:

Washington Post:The Health 202: Trump Issued Another Toothless Executive Order on Drug Prices. “President Trump proclaimed yesterday that he’ll go even bigger and bolder on a long-touted effort to lower drug prices in the United States.But he has yet to put any teeth into the effort, nearly two years after first announcing it.In a move widely regarded as a political play seven weeks before the election, Trump announced via tweet he had signed an executive order aiming to lower drug prices in the Medicare program through what is known as ‘the most favored nation policy.'” [Washington Post, 9/14/20] 

NPR: “As With Most Executive Actions, This Only Just Begins What Will Be a Lengthy Bureaucratic Process That May or May Not Ultimately Result in the Promised Policy.” “President Trump signed an executive order Sunday that he says lowers prescription drug prices ‘by putting America first,’ but experts say the move is unlikely to have any immediate impact….The order calls on the Health and Human Services secretary to ‘immediately take appropriate steps to implement his rulemaking plan to test a payment model’ putting in place ‘most favored nations’ policy. Translated: As with most executive actions, this only just begins what will be a lengthy bureaucratic process that may or may not ultimately result in the promised policy.” [NPR, 9/13/20] 

Axios: “Given That [Trump’s] Had Four Years Already to Act On What Was Also a Big Issue In 2016, There’s Plenty of Reason to Be Skeptical Of This Ever Translating Into Official Policy.” “It’s September of an election year. That means that this executive order is, at best, a statement of Trump’s intention to keep trying to achieve something big on drug prices should he get a second term. But given that he’s had four years already to act on what was also a big issue in 2016, there’s plenty of reason to be skeptical of this ever translating into official policy.” [Axios, 9/14/20] 

CNN: The Latest Executive Orders Come as Most of Trump’s Actions on Drug Pricing “Remain in the Proposal Phase Or Have Been Rejected By The Courts.” “Unlikely to have any impact before the election, the executive orders come at a time when Trump is trying to fulfill his longstanding campaign promise to lower drug prices, though little movement has been made. Most of the administration’s actions — including the effort to import medication from Canada — remain in the proposal phase or have been rejected by the courts.” [CNN, 9/13/20] 

Stat: With Election Looming, Trump Releases Major, Last-Ditch Drug Pricing Order. “The Trump administration still hasn’t released formal regulations to implement the policy. That process typically takes months, if not years…It’s still unclear when the Trump administration will formally implement the new executive order. Drug industry lobbyists expect Trump to try and skip over most of the formal regulatory steps by issuing a so-called interim final rule, a rare regulatory maneuver that lets president’s skip most of the formal regulatory steps in certain emergencies. However, the drug industry has hinted it will sue if Trump tries to use that maneuver.” [Stat, 9/13/20] 

The executive order relies on authority given to the administration under the Affordable Care Act, which Trump is actively trying to overturn in court: 

New York Times: In An “Odd Twist,” the Administration Is “Relying on Its Authority Under the Affordable Care Act, Which Mr. Trump and His Fellow Republicans Are Trying to Overturn in the Supreme Court.” “But it is unclear whether the White House has the authority to put the expansive order into effect. And in an odd twist, in calling for the secretary to set up the model programs, the administration is relying on its authority under the Affordable Care Act, which Mr. Trump and his fellow Republicans are trying to overturn in the Supreme Court.” [New York Times, 9/13/20] 

House Democrats already passed legislation that would be more effective in lowering prescription drug prices: 

Wall Street Journal: “Drug Experts Say That the Best Way to Lower Drug Prices Under Medicare is to Grant the Agency the Legal Authority to Directly Negotiate Prices with Drug Companies. This Measure Wouldn’t Do That.” “The proposed executive order would appear to be of limited immediate effect. Experts see the order as the administration’s effort to show it is taking steps to lower drug pricing, as the president seeks reelection. Drug-pricing experts say that the best way to lower prices under Medicare is to grant the agency the legal authority to directly negotiate prices with drug companies. This measure wouldn’t do that.” [Wall Street Journal, 9/13/20] 

EXPERTS

The Kaiser Family Foundation’s Larry Levitt Said “President Trump’s Executive Order on Drug Pricing Does Not by Itself Do Anything.” “President Trump’s executive order on drug pricing does not by itself do anything. It has to be followed up by regulations, which will take time. Trump has a history of bold talk on drug prices, only to pull back when it comes to putting actual regulations in place,” the Kaiser Family Foundation’s Larry Levitt tweeted. [Axios, 9/14/20] 

Rachel Sachs, Associate Professor Of Law At Washington University in St. Louis, Noted That House Democrats Already Passed A Bill That Would Use International Reference Pricing, But “Trump Threatened to Veto That Bill.” “In addition, Rachel Sachs, an associate professor of law at Washington University in St. Louis who covers prescription drug policy, reminded her Twitter followers on Sunday that ‘in December 2019, the House (led by the Democratic caucus) passed a bill that would’ve used international reference pricing to lower the price of drugs in Medicare.’ ‘Trump threatened to veto that bill,’ she wrote.” [New York Times, 9/13/20] 

Dan Mendelson, Founder Of Avalere Health, Said Trump’s Order Would Not Affect Drug Prices Before the Election, Adding That Biden Has “A 20 Point Advantage Over Trump On Covid-19, So It’s Not Surprising to See the Administration Try to Change The Subject.” “Dan Mendelson, founder of consultancy Avalere Health, said Trump’s move would not affect drug prices for senior citizens before the Nov. 3 election, adding that polling shows Americans are more concerned with the coronavirus than drug prices. He said Democratic presidential candidate Joe Biden “has a 20 point advantage over the Trump on Covid19, so it’s not surprising to see the administration try to change the subject.” [Reuters, 9/13/20] 

Virtual 16-State Tour Featuring Elected Leaders, Health Care Advocates and Storytellers Will Take Place Throughout September and October 

Washington, DC — In the lead up to the 2020 election, Protect Our Care will be virtually hitting the road to make sure voters know health care is on the ballot in November. The virtual tour will start off with a national kick off event featuring House Speaker Nancy Pelosi (D-CA) and Senate Democratic Leader Chuck Schumer (D-NY) before moving onto 16 key states: Pennsylvania, Wisconsin, Minnesota, Michigan, New Hampshire, Maine, Iowa, Arizona, Montana, Colorado, Nevada, North Carolina, Georgia, Florida, Illinois and Texas to hold Trump and his Republican allies in Congress accountable for his relentless attacks on health care and his complete mismanagement of the coronavirus pandemic. The tour will also include other special events. One week after election day, on November 10, the U.S. Supreme Court will hear the Trump administration’s lawsuit to completely dismantle the ACA in the midst of the worst public health crisis in a century, which would throw America’s entire health care system into chaos.

This is Protect Our Care’s third national bus tour. The “Your Health, Your Vote” tour will feature important local voices, including elected leaders, health care advocates and storytellers, from each state in a virtual format to highlight the impact of Trump’s failed coronavirus leadership, his ongoing war on pre-existing conditions, Medicaid and Medicare and his failure to lower the cost of prescription drugs — and contrast them with the leadership of House and Senate Democrats and Vice President Biden. 

“As we battle the ever worsening coronavirus pandemic, voters know their health is at stake in the 2020 election,” said Protect Our Care Chair Leslie Dach. “Donald Trump refused to take decisive action early on to control the virus and still has no plan more than six months into the crisis. He has failed to protect Americans from coronavirus, and this virtual tour will highlight the ways Trump and his Republican enablers in Congress waged war on our health care and has made the pandemic worse.”

“President Trump and his Republican allies need to be held accountable for their relentless attacks on health care. From trying to remove protections for people with pre-existing conditions to causing prescription drug prices to skyrocket, Trump has taken every opportunity to sabotage Americans’ health care.” said Protect Our Care Executive Director Brad Woodhouse. “Voters know health care is on the ballot in November, and the contrast between Trump and Vice President Biden couldn’t be more clear. Another four years of Trump would be a disaster for Americans’ health.”

The Protect Our Care “Your Health, Your Vote” tour will make stops in: 

Pennsylvania on Tuesday, September 15, 2020
Wisconsin on Thursday, September 17, 2020
Minnesota on Monday, September 21, 2020
Michigan on Tuesday, September 22, 2020
New Hampshire on Thursday, September 24, 2020
Maine on Tuesday, September 29, 2020
Iowa on Thursday, October 1, 2020
Arizona on Tuesday, October 6, 2020
Montana on Thursday, October 8, 2020
Nevada on Thursday, October 15, 2020
North Carolina on Monday, October 19, 2020
Georgia on Tuesday, October 20, 2020
Florida on Thursday, October 22, 2020
*More dates will be added in coming days

Legislation Would Help Jobless Get Health Care Coverage

Washington, DC — Today, Senator Tammy Baldwin (D-WI) unveiled legislation to help people who lost a job during the coronavirus pandemic get comprehensive health care coverage as the nation faces the worst public health crisis in a century. The COVID Enrollment Response (COVER) Act would provide funding in every state to assist those who lost jobs or have been furloughed during the pandemic sign up for the health care coverage they need. Protect Our Care Executive Director Brad Woodhouse release the following statement in response:

“President Trump and his Republican enablers in Congress have done nothing to help people who have lost coverage as a result of their fumbled coronavirus response. With this legislation, Senator Baldwin is taking concrete steps to help more Americans get the health care coverage they need as coronavirus continues to ravage the nation. Instead of playing politics and taking every opportunity to rip health care away from Americans, Mitch McConnell and Senate Republicans should work with Senator Baldwin to ensure people can get health care coverage in the midst of a global pandemic.” 

New Post-Convention Polling Shows Voters Trust Vice President Biden Over Trump on Health Care Issues 

Call Audio Available Here

Washington, DC — Today, Protect Our Care held a press call with Sen. Amy Klobuchar (D-MN), former Acting Administrator of the Centers for Medicare and Medicaid Services Andy Slavitt and Jim Williams from Public Policy Polling to discuss new post-convention polling, President Trump’s failed coronavirus response, the Republican Senate’s failure to vote on critical coronavirus response legislation and the ongoing Republican war on pre-existing conditions.

“We can’t go back to a time when health insurers could deny coverage to people who are sick,” said Senator Klobuchar. “As we continue to face the challenges of the pandemic, we must maintain the protections in the Affordable Care Act, and make our health care system even stronger. Americans deserve the security of knowing that they will be covered whether they are healing a broken bone, battling cancer, or grappling with the uncertainty of a public health crisis.”

“Trump has woefully mismanaged the coronavirus pandemic. From downplaying the threat of the virus to discounting the advice of experts, Trump’s complete lack of decisive response has made the pandemic worse,” said former Acting Administrator of the Centers for Medicare and Medicaid Services Andy Slavitt. “This election is a job interview for who the American public wants to protect them and defeat this global pandemic.”

“This new polling shows health care is a top priority for voters, and they trust Vice President Joe Biden over Donald Trump on issues related to health care,” said Jim Williams of Public Policy Polling. “We see this response from voters on every health care issue from coronavirus response to protecting people with pre-existing conditions. Voters consistently choose Joe Biden on health care.”

“Trump has completely fumbled his coronavirus response and has taken every opportunity to undermine health care access during his presidency — including his lawsuit to completely dismantle the ACA and rip health care from 20 million people and remove protections for 135 million Americans with pre-existing conditions,” said Protect Our Care Chair Leslie Dach. “We know health care is on the ballot in 2020, and this poll confirms that voters trust Vice President Joe Biden over Donald Trump to handle the coronavirus pandemic and make health care more accessible and affordable.” 

Key Findings From the Poll: 

• 53% trust Joe Biden to protect Medicare, while just 40% trust President Trump.
• 52% trust Biden to protect healthcare for people with preexisting conditions, while just 41% say they trust Trump. 
• 51% trust Biden to have a plan to prevent future pandemics, compared to just 41% who say they trust Trump more. 
• 51% trust Biden to keep Americans safe during the coronavirus pandemic, while only 41% trust Trump.
• 51% trust Biden to lead the government-wide effort to develop and approve an effective coronavirus vaccine, while only 42% trust Trump more.
• 50% trust Biden more to make healthcare affordable, while just 41% trust Trump.
• 50% trust Biden more to have a plan to safely reopen schools, compared to just 40% who say they trust Trump more.

Democratic National Convention Speaker Will Be Leading Voice in Highlighting Stories of Those Lost to Coronavirus Pandemic Due to Trump’s Failure to Protect America

Washington, DC – Today, Protect Our Care and its Coronavirus War Room are announcing a partnership with Kristin Urquiza, who gained national attention after telling the powerful story of how she lost her father to COVID-19 at the Democratic National Convention earlier this month. Kristin will join Protect Our Care to help the organization highlight stories like her own and speak to the importance of protecting health care in the midst of the ongoing coronavirus pandemic. 

This Wednesday, Urquiza will lead a press event with other families who’ve lost loved ones to the pandemic in an effort to refocus attention on the very real impact of Donald Trump’s botched response. 

“Kristin has an unparalleled ability to powerfully tell the story of her loss and connect with others finding their voice to tell their own,” said Brad Woodhouse, Executive Director of Protect Our Care. “So much of our advocacy at Protect Our Care places people’s stories at the center of the health care debate. With the coronavirus pandemic still raging, it’s more important than ever that we’re centering the most important aspect of this issue: the thousands of Americans who’ve lost their lives to Trump’s negligence. Kristin will be an invaluable partner in helping us to that.”

“It has been overwhelming to see how my story of loss has resonated with so many people across the country,” said Kristin Urquiza. “While it’s difficult to tell these stories, it’s necessary to expose the overwhelming human toll that’s resulted from failed leadership on the coronavirus pandemic and health care. While I wish it was under different circumstances, it’s an honor to partner with Protect Our Care to continue telling my family’s story and help uplift stories of others experiencing their own unnecessary losses.”

This week at the RNC, President Trump and his Republican allies have been rewriting their disastrous health care record. Night after night, Trump and GOP leaders have lied about protecting people with pre-existing conditions, lowering drug prices and about the success of the Affordable Care Act. Here’s the truth: drug prices are still skyrocketing and one week after the election, the U.S. Supreme Court will hear oral arguments in California v. Texas — a lawsuit brought by the Trump administration to completely dismantle the Affordable Care Act. If successful, Trump’s lawsuit would rip away health care from more than 23 million Americans, end protections for more than 135 million people with pre-existing conditions and throw the entire American health care system into chaos as the nation faces the worst public health crisis in a century. 

Read Fact Checks on Trump and Republicans’ Lies About Health Care Below:

Pre-Existing Conditions

White House Press Secretary Kayleigh McEnany Claimed “I Can Tell You That This President Stands by Americans with Pre-Existing Conditions.”

New York Times: “This Is False…[Trump] Is Currently Trying to Dismantle The Affordable Care Act.” “This is false. While President Trump has paid lip service to protecting people who would have pre-existing medical conditions and may have provided support to Ms. McEnany during her recovery from a preventive mastectomy, he is currently trying to dismantle the Affordable Care Act. The federal law requires health insurers to cover people with pre-existing medical conditions and not charge them more when they have an expensive medical condition” [New York Times, 8/27/20] 

• “Mr. Trump’s First Legislative Priority Was to Repeal Parts of the Affordable Care Act. Although These Efforts Failed, His Justice Department Is Now Actively Trying to Overturn the Entire Law.” “Some 54 million Americans are estimated to have pre-existing conditions that would likely disqualify them from coverage without the protections from the Affordable Care Act. Mr. Trump’s first legislative priority was to repeal parts of the Affordable Care Act. Although those efforts failed, his Justice Department is now actively trying to overturn the entire law. The administration has also taken several steps to weaken the law by encouraging the sale of health plans that do not meet the standards of Obamacare. While Mr. Trump has repeatedly promised to introduce his own plan that would protect people with pre-existing conditions, he has not yet done so.” [New York Times, 8/27/20] 

CNN: “The Trump Administration and Congressional Republicans Have Repeatedly Put Forward Bills and Filed Lawsuits That Would Weaken Obamacare’s Protections for People with Pre-Existing Conditions.” “This needs context. Though the President has repeatedly asserted his support for covering individuals with preexisting conditions, his administration has consistently taken steps to undermine the Affordable Care Act without presenting alternative plans that would offer similar benefits. The Trump administration and congressional Republicans have repeatedly put forward bills and filed lawsuits that would weaken Obamacare’s protections for people with preexisting conditions. Trump is also supporting a Republican lawsuit that is seeking to declare all of Obamacare void. He has not issued a plan to reinstate the law’s protections for people with preexisting conditions if the suit succeeds. In early August, he promised he would issue an executive order to require health insurers to ‘cover all preexisting conditions for all customers,’ but has not yet done so.” [CNN, 8/27/20] 

NBC News: Trump Is “Supporting A Lawsuit That Would Wipe Out Current Safeguards for Pre-Existing Conditions Without Offering A Replacement Plan.” “Trump’s policy record on pre-existing conditions, however, tells a different story. He has fought for legislation that would undo the Affordable Care Act and weaken those protections. He is supporting a lawsuit that would wipe out current safeguards for pre-existing conditions without offering a replacement plan. The president has also used his executive authority to expand the use of short-term health plans, which are less expensive but aren’t required to cover pre-existing conditions.” [NBC News, 8/26/20] 

AP Fact Check: “No, people with preexisting medical problems have health insurance protections because of Obama’s health care law, which Trump is trying to dismantle. One of Trump’s alternatives to Obama’s law — short-term health insurance, already in place — doesn’t have to cover preexisting conditions. Another alternative is association health plans, which are oriented to small businesses and sole proprietors and do cover preexisting conditions….Meanwhile, Trump’s administration is pressing the Supreme Court for full repeal of the Obama-era law, including provisions that protect people with preexisting conditions from health insurance discrimination.” [Associated Press, 8/27/20] 

Washington Post: “Millions of Americans Could Lose Those Protections If the Supreme Court Strikes Down the [ACA].” “White House press secretary Kayleigh McEnany made a passing reference to people with preexisting conditions, roundly mischaracterizing the Trump administration’s approach to protecting them. In a speech where she spoke about testing positive for a genetic mutation linked to breast cancer, she claimed Trump ‘stands by Americans with preexisting conditions.’ Yet the Department of Justice, under Trump, is refusing to defend the Affordable Care Act from a lawsuit brought by GOP-led states. A landmark part of the ACA was its requirement that insurers cover people with preexisting conditions and not charge them more. Millions of Americans could lose those protections if the Supreme Court strikes down the law.” [Washington Post, 8/27/20] 

President Trump Claimed He Has “Strongly Protected Pre-Existing Conditions”

AP Fact Check: “People with Pre-Existing Medical Problems Have Health Insurance Protections Because of Obama’a Health Care Law, Which Trump Is Trying to Dismantle.” “TRUMP: ‘We protected your preexisting conditions. Very strongly protected preexisting … and you don’t hear that.’ THE FACTS: You don’t hear it because it’s not true. People with preexisting medical problems have health insurance protections because of Obama’s health care law, which Trump is trying to dismantle.” [Associated Press, 8/25/20] 

• The AP Highlighted Trump’s Promotion of Short-Term Plans and His Lawsuit to Overturn the ACA’s Protections for Pre-Existing Conditions. “One of Trump’s alternatives to Obama’s law — short-term health insurance, already in place — doesn’t have to cover preexisting conditions. Another alternative is association health plans, which are oriented to small businesses and sole proprietors and do cover preexisting conditions. Neither of the two alternatives appears to have made much difference in the market. Meanwhile, Trump’s administration is pressing the Supreme Court for full repeal of the Obama-era law, including provisions that protect people with preexisting conditions from health insurance discrimination.” [Associated Press, 8/25/20] 

NBC News: Fact Check: Trump Falsely Claims He ‘Protected Pre-Existing Conditions.’ “The president championed legislation in 2017 to undo the ACA and allow states to obtain waivers from rules that bar insurers from charging more to people with a prior illness. (The effort passed the House but stalled in the Senate.) Trump’s administration is currently backing a lawsuit led by Republican attorneys general that would wipe out the Affordable Care Act, including its pre-existing condition protections. He has not offered an alternative plan to restore them. And Trump has expanded the use of short-term plans that are cheaper and not required to cover pre-existing health conditions.” [NBC News, 8/25/20] 

MSNBC: On Health Care, There Are Some Lies Trump Just Can’t Shake. “Making matters worse, Trump’s efforts are ongoing: the White House is helping champion a federal lawsuit, which is currently pending at the U.S. Supreme Court, which would strip protections from Americans with pre-existing conditions. What’s more, Trump has also ‘expanded the use of short-term plans that are cheaper and that aren’t required to cover pre-existing conditions.’” [MSNBC, 8/25/20] 

Drug Prices

Kaiser Health News: Trump Again Claims He’s Bringing Down Drug Prices, But Details of How Are Skimpy. “During his afternoon speech Monday ― delivered on the first day of the Repubublican National Convention after delegates had unanimously renominated him to seek reelection ― he returned to this theme. ‘Now, I’m really doing it,’ he said, referring to a series of four executive orders he issued in July. These orders touched on a range of issues, including insulin prices and drug importation. He focused on two specifically. ‘But the fact is that we signed a favored nations clause and a rebate clause, and your numbers are going to come down 60, 70%,’ he said. However, those executive orders are far from being implemented, and multiple experts told us it’s unlikely the measures would pass along drug-pricing discounts to a majority of Americans. And the text of one, the favored nation executive order, has not yet been made public ― making it hard to know how exactly the initiative would work.” [Kaiser Health News, 8/26/20] 

• Harvard Professor Aaron Kesselheim Said Trump “Promised to Lower Drug Prices as Part of His Campaign In 2016 and Has Done Absolutely Nothing of Substance About Drug Prices At All While He’s Been In Office.” “‘He promised to lower drug prices as part of his campaign in 2016 and has done absolutely nothing of substance about drug prices at all while he’s been in office,’ Aaron Kesselheim, a professor of medicine at Harvard, wrote in an email.” [Kaiser Health News, 8/26/20] 

Kaiser Health News: Tiffany Trump Claimed Trump Has Taken Several Actions to Lower Drug Prices, But In Reality “He Has Made Little Progress…Outside of Issuing Several Executive Orders That Have Yet to Be Enacted.” “‘And if you believe in expanding quality and affordable health care, only President Trump, my father, signed Right to Try into law, the favored nations clause, and other actions to lower drug prices and keep Americans from getting ripped off.’ — Tiffany Trump This is somewhat misleading. The Right to Try law that Trump signed in 2018 allows individuals with life-threatening conditions who have tried all approved treatment options and cannot participate in clinical trials to access unapproved treatments. It did not, however, lower drug prices…While Trump has long talked about lowering drug prices as one of his top health care goals, he has made little progress in doing so, outside of issuing several executive orders that have yet to be enacted.” [Kaiser Health News, 8/26/20] 

Affordable Care Act

Washington Post: Trump Falsely Claimed He “Knocked Out” the ACA. “Trump claimed his administration had eliminated the Affordable Care Act. That’s not true, but as part of its 2017 tax overhaul the administration did with Congress’s stamp of approval get rid of the penalty that comes with the individual mandate, a requirement for all Americans to have health insurance. ‘We eliminated Obamacare’s horrible and very unfair individual mandate, which basically knocked out Obamacare. We knocked out Obamacare,’ Trump said.” [Washington Post, 8/25/20] 

Washington Post: Senator Rand Paul Touted Expansion of Association Health Plans, But In Reality “the Plans Are Generally Considered to Be Cheaper Because They Provide Skimpier Coverage.” “Trump signed an executive order expanding the availability of Association Health Plans, which are geared at small businesses and associations, but the plans are generally considered to be cheaper because they provide skimpier coverage. These plans are not required to cover the 10 essential benefits that insurance policies under the Affordable Care Act must cover, such as hospitalizations, emergency care and prescription drugs. Health-care experts say insurers selling these plans may limit the services covered, though the plans allow groups of similar businesses to band together to negotiate lower insurance prices for their employees.” [Washington Post, 8/26/20] 

Last night at the Republican National Convention, Republicans continued to lie about their health care record, this time on protections for pre-existing conditions. In a speech, White House Press Secretary Kayleigh McEnany falsely claimed that President Trump “stands by Americans with pre-existing conditions.” The truth is that one week after the election the U.S. Supreme Court will hear oral arguments in California v. Texas, a lawsuit brought by the Trump administration to completely dismantle the Affordable Care Act. If successful, Trump’s lawsuit would rip away health care from more than 23 million Americans, end protections for more than 135 million people with pre-existing conditions and throw the entire American health care system into chaos as the nation faces the worst public health crisis in a century. 

What’s At Stake: Protections For People With Pre-Existing Conditions

Without the ACA, protections for 135 million Americans with pre-existing conditions will be eliminated overnight, and the uninsured rate will increase by 65 percent. Making matters worse, if the ACA is struck down, everyone who contracts the coronavirus could be deemed as having a pre-existing condition and be at the mercy of their insurance companies who could refuse to pay for needed care. It’s critical that Americans understand just what’s at stake if this outrageous and irresponsible lawsuit succeeds.

The ACA included four key provisions that protect people with pre-existing conditions. If the law is overturned in the Texas lawsuit: 

• GONE: Rule that forbids insurance companies from denying coverage to people with pre-existing conditions.
• GONE: Rule that prevents insurers from charging people with pre-existing conditions more.
• GONE: Requirements that insurance companies cover essential health benefits, such as prescription drugs and maternity care.
• GONE: Ban on insurance companies having lifetime caps on coverage.

Premium Surcharges Can Once Again Be In The Six Figures. Thanks to the Republican lawsuit, insurance companies can charge people more because of a pre-existing condition. The House-passed repeal bill had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.

More Than 140 Million Americans Could Once Again Have To Pay For Preventive Care. Because of the ACA, private health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no cost to consumers. More than 140 million Americans are enrolled in plans that provide free preventive services, including 133 million people with employer coverage. 

Insurance Companies Would Not Have To Provide The Coverage You Need. The Affordable Care Act made comprehensive coverage more available by requiring insurance companies to include “essential health benefits” in their plans, such as maternity care, hospitalization, substance abuse care and prescription drug coverage. Before the ACA, people had to pay extra for separate coverage for these benefits. For example, in 2013, 75 percent of non-group plans did not cover maternity care, 45 percent did not cover substance abuse disorder services, and 38 percent did not cover mental health services. Six percent did not even cover generic drugs.

Reinstate Lifetime and Annual Limits On 109 Million Privately Insured Americans. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage for those insured through their employer or on the individual market. In 2009, prior to the implementation of the ACA, 59 percent of workers covered by employer-sponsored health plans had a lifetime limit. 

Before the Affordable Care Act, insurance companies routinely denied people coverage because of a pre-existing condition or canceled coverage when a person got sick.

Republicans Want To Put Insurance Companies Back In Charge, Ending Protections For The 135 Million People 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
• More than 17 million children, 68 million women, and 32 million people aged 55-64 have a pre-existing condition.

American Cancer Society, American Cancer Society Cancer Action Network, American DIabetes Association, American Heart Association, American Lung Association, and National Multiple Sclerosis Society: “Striking Down These Provisions Would Be Catastrophic And Have Dire Consequences For Many Patients With Serious Illnesses.” [American Cancer Society et. al, 6/14/18]

Ahead of the Republican Senator’s RNC Speech, Protect Our Care Sets the Record Straight on Her Health Care Sabotage

Tonight, Sen. Joni Ernst (R-IA) will take the stage at the Republican National Convention to spread lies about what Trump and Senate Republicans have accomplished in the last four years, but what she won’t talk about is her continuous attacks on Americans’ health care coverage. 

Sen. Ernst refuses to condemn Trump’s lawsuit to completely dismantle the Affordable Care Act, even if it means more than 185,000 Iowans will lose health care coverage as the country is still reeling from the coronavirus pandemic. Sen. Ernst has continually downplayed the threat of coronavirus and praised Trump for his failed response to the pandemic. Time and again, she has voted to repeal the ACA with no viable plan to replace it, a disastrous move for her constituents. Repealing the ACA would mean removing protections for 1.3 million Iowans with pre-existing conditions, kicking 150,000 Iowans off Medicaid and eliminating marketplace tax credits that help nearly 40,000 Iowans afford coverage. Joni Ernst is wrong on health care and wrong for Iowa. 

BACKGROUND:

Read More About Sen. Joni Ernst’s Health Care Record Here

Ernst Supports Repealing The ACA And Its Protections For 1.2 Million Iowans with Pre-Existing Conditions

2014: Ernst Campaigned For The Senate With An Ad Where She “Unloads” On Obamacare By Shooting It With A Handgun. “Republican U.S. Senate candidate Joni Ernst of Iowa has released a new TV ad vowing to ‘unload’ on Obamacare, in which she takes target practice at a shooting range with a handgun. [Washington Post, 5/4/14] 

2015: Ernst Voted To Repeal Most Of The ACA. Ernst voted for legislation that gutted the Affordable Care Act by eliminating the insurance exchanges and subsidies, and repealing the Medicaid expansion accepted by 30 states, including Nevada. [HR 3762, Roll Call Vote #114, 12/3/15] 

2017: Ernst Voted For The Senate “Repeal And Delay” Plan. Ernst voted for Obamacare Repeal and Replacement Act was a Republican effort to repeal the ACA without a replacement. Known as “repeal and delay,” the bill repealed major sections of the ACA, including the Medicaid expansion and premium tax credits, in 2020. [HR 1628, Roll Call Vote #169, 7/26/17] 

2017: Ernst Voted For “Skinny Repeal” Of The ACA. Ernst voted for “Skinny Repeal” of the ACA, which repealed the individual mandate and delayed the employer mandate while leaving most of the rest of the law in place. [HR 1628, Roll Call Vote #179, 7/28/17] 

2017: Ernst Refused To Give Up On Repealing The Affordable Care Act After The Failure Of The Senate Bills. “Ernst said Friday she’s also not ready to give up on repealing the Affordable Care Act. ‘We don’t have the option to sit back and do nothing; Iowans are demanding relief from Obamacare,’ she wrote in a statement released by her staff.” [Des Moines Register, 7/28/17] 

Ernst Claims To Support Coverage For People With Pre-Existing Conditions But Sponsors Legislation That Would Gut Those Protections 

In Response To The Court Ruling Striking Down All Of The ACA, Ernst Said It Was “Important That We Protect People With Preexisting Conditions, As We Repeal And Replace Obamacare.” “Republicans are facing a moment of reckoning on health care after a federal judge struck down the Affordable Care Act, imperiling the landmark law the GOP has struggled against for eight years. […] One of the Republican senators facing a potentially competitive reelection campaign is Joni Ernst of Iowa. Ernst issued a statement Saturday saying that it was ‘important that we protect people with preexisting conditions, as we repeal and replace Obamacare.’” [Washington Post, 12/15/18] 

2018: Ernst Co-Sponsored Legislation That She Claimed Would “Guarantee Americans Have Equal Health Care Coverage, Regardless Of Their Health Status Or Pre-Existing Condition.” “Yesterday, Senators Thom Tillis (R-NC), Lamar Alexander (R-TN), Chuck Grassley (R-IA), Dean Heller (R-NV), Bill Cassidy, M.D. (R-LA), Lisa Murkowski (R-AK), Joni Ernst (R-IA), Lindsey Graham (R-SC), John Barrasso (R-WY), and Roger Wicker (R-MS) introduced the Ensuring Coverage for Patients with Pre-Existing Conditions Act, legislation that would guarantee Americans have equal health care coverage, regardless of their health status or pre-existing conditions. Oral arguments in Texas v. United States will begin on September 5th, and if the judge rules in favor of the plaintiffs, protections for patients with pre-existing conditions could be eliminated. This legislation amends the Health Insurance Portability and Accountability Act (HIPAA) to guarantees the availability of coverage in the individual or group market, for all Americans, including those with pre-existing conditions, regardless of the outcome in Texas v. United States. The legislation prohibits discrimination against beneficiaries based on health status, including the prohibition against increased premiums for beneficiaries due to pre-existing conditions.” [Sen. Thom Tillis Press Release, 8/24/18] 

2019: Ernst Co-Sponsored The Protect Act That She Claimed Would Protect Americans With Pre-Existing Conditions. “Senate Republicans believe in patient-centered health care that delivers the choices they want, the affordability and protections they need, and the quality they deserve. That is why Senator Thom Tillis (R-NC) and his colleagues today introduced the Protect Act, legislation that protects Americans with pre-existing conditions, ensuring that Americans have the peace of mind knowing that they and their loved ones will never be denied health care coverage or be charged more because of a pre-existing condition. Joining Senator Tillis as co-sponsors of the Protect Act are Senators Lamar Alexander (R-TN), Chuck Grassley (R-IA), Bill Cassidy, M.D. (R-LA), Rob Portman (R-OH), David Perdue (R-GA), Joni Ernst (R-IA), John Cornyn (R-TX), Kevin Cramer (R-ND), Johnny Isakson (R-GA), Roger Wicker (R-MS), Shelley Moore Capito (R-WV), John Barrasso (R-WY), Rick Scott (R-FL), John Kennedy (R-LA), Todd Young (R-IN), Tom Cotton (R-AR), and Richard Burr (R-NC).’” [Sen. Thom Tillis Press Release, 4/10/19]

Ernst Refuses To Condemn The Texas Lawsuit That Would Rip Coverage Away From More Than 185,000 Iowans

2019: Ernst On The Texas Lawsuit: “I Am Not Going To Make A Determination On That.” Joni Ernst: In today’s day and age, we do see a lawsuit moving forward that could potentially dismantle the ACA. If that happens, we need to make sure that we are reiterating that preexisting conditions will be covered in any future insurance actions. […] Anchor: Do you support that lawsuit that is going forward that would dismantle the Affordable Care Act all together? Ernst: I am not going to make a determination on that. I am not an attorney. But I would say that, yes, I would like to see different forms of health care coverage that exist out there that will bring costs down. I do want to see that addressed” [WHBF, 4/28/19] 

2018: Ernst Refused To Discuss The Texas Lawsuit Threatening The ACA. “Sen. Joni Ernst (R-Iowa), who faces a potentially tough reelection bid in 2020, declined to discuss the ruling with a reporter in a Senate hallway on Monday, instead referring to her written statement.” [The Hill, 12/17/18]

Ernst Voted For The Tax Bill Which Forms The Basis For The Trump-Republican Lawsuit. Ernst was a key vote for the Republican tax bill, which repealed a key provision of the Affordable Care Act that required most people to have health coverage and which is the basis of the Trump-Republican lawsuit seeking to overturn the Affordable Care Act. 

Trump’s Lawsuit to Overturn the Entire ACA Will Be Argued Before the Supreme Court One Week After Election Day

As Trump and his Republican allies spin lies about health care during the Republican National Convention, he and his administration are actively plotting more health care sabotage. One week after the election, on November 10, the U.S. Supreme Court will hear oral arguments in California v. Texas, a lawsuit brought by the Trump administration to completely dismantle the Affordable Care Act. If successful, Trump’s lawsuit would rip away health care from more than 23 million Americans, end protections for more than 135 million people with pre-existing conditions and throw the entire American health care system into chaos — in the midst of a pandemic. This is Trump’s real health care agenda. 

Fact Sheet On Trump Lawsuit To Overturn ACA

President Trump is trying to rip apart our health care by going to court to eliminate the Affordable Care Act in its entirety. If the Trump lawsuit is successful, it will strip coverage from millions of Americans, raise premiums, end protections for people with pre-existing conditions, put insurance companies back in charge, and force seniors to pay more for prescription drugs. The result will be to — as the Trump Administration itself admitted in Court — unleash “chaos” in our entire health care system. 

If the Affordable Care Act is struck down:

• GONE: Protections for 135 million Americans with pre-existing conditions. The uninsured rate will increase by 65 percent. 
• GONE: Medicaid expansion, which covers 16 million people. 
• GONE: Nearly 12 million seniors will have to pay more for prescription drugs because the Medicare ‘donut hole’ will be reopened.
• GONE: 2.3 million adult children will no longer be able to stay on their parents’ insurance. 
• GONE: Insurance companies will be able to charge women 50 percent more than men.
• GONE: Financial assistance that helps 9 million people purchase health care in the marketplace.
• GONE: Key support for rural hospitals. As Americans lose coverage, already struggling hospitals will be hit even harder as their costs increase.
• GONE: Ban on insurance companies having lifetime caps on coverage.
• GONE: Requirements that insurance companies cover prescription drugs and maternity care.

Thanks To The Republican Lawsuit, 20 Million People Could Lose Their Coverage

• According to the Urban Institute, 19.9 million people could lose coverage by repealing the Affordable Care Act, meaning the number of uninsured Americans would increase from 30.4 million to 50.3 million, representing a leading to a 65 percent increase in the uninsured rate. As the uninsured rate swells, so will the amount of uncompensated care, which Urban predicts will grow by at least 82 percent.
• States would lose important federal health care funding — an estimated reduction of $135 billion in the first year. The Urban Institute estimates that a full repeal of the ACA would reduce federal spending on Medicaid/CHIP care and Marketplace subsidies by $135 billion, or 34.6 percent in the first year.
• Millions of 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.
• The percentage of people gaining health insurance under the ACA was higher for Latinos than for any other racial or ethnic group in the country. According to a study from Families USA, 5.4 million Latinos would lose coverage if the lawsuit succeeds in overturning the ACA. 

Republicans Want To Put Insurance Companies Back In Charge, Ending Protections For The 135 Million People 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
• More than 17 million children, 68 million women, and 32 million people aged 55-64 have a pre-existing condition.

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

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

• A 2010 congressional report found that the top four health insurance companies denied coverage to one in seven consumers on the individual market over a three year period. 
• A 2009 congressional report found that the of the largest insurance companies had retroactively canceled coverage for 20,000 people over the previous five year period
• An analysis by Avalere finds that “102 million individuals, not enrolled in major public programs like Medicaid or Medicare, have a pre-existing medical condition and could therefore face higher premiums or significant out-of-pocket costs” if the Trump-GOP lawsuit is successful.

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

• 138 Million Americans Could Once Again Have To Pay For Preventive Care. Because of the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no cost to consumers. This includes nearly 138 million Americans, most of whom have employer coverage.
• Premium Surcharges Can Once Again Be In The Six Figures. Thanks to the Republican lawsuit, insurance companies can charge people more because of a pre-existing condition. The House-passed repeal bill had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
• Women Can Be Charged More Than Men For The Same Coverage. Prior to the ACA, women, for example, were often charged premiums on the nongroup market of up to 50 percent higher than they charged men for the same coverage. 
• People Over The Age of 50 Can Face A $4,000 “Age Tax.” Thanks to the Republican lawsuit, insurance companies can charge people over 50 more than younger people. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, according to the AARP.
• Nine Million People In The Marketplaces Will Pay More For Coverage. Thanks to the Republican lawsuit, consumers 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.
• Seniors Will Have To Pay More For Prescription Drugs. Thanks to the Republican lawsuit, seniors will have to pay more for prescription drugs because the Medicare “donut” hole got reopened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 Centers on Medicare and Medicaid Services report.

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

• Reinstate Lifetime and Annual Limits On 109 Million Privately Insured Americans. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage for those insured through their employer or on the individual market.
• Insurance Companies Do Not Have to Provide the Coverage You Need. The Affordable Care Act made comprehensive coverage more available by requiring insurance companies to include “essential health benefits” in their plans, such as maternity care, hospitalization, substance abuse care and prescription drug coverage. Before the ACA, people had to pay extra for separate coverage for these benefits. For example, in 2013, 75 percent of non-group plans did not cover maternity care, 45 percent did not cover substance abuse disorder services, and 38 percent did not cover mental health services. Six percent did not even cover generic drugs.
• Large Employers Could Choose to Follow Any State’s Guidance, Enabling Them Put Annual and Lifetime Limits on Their Employees’ Health Care. Without the ACA’s definition of essential health benefits (EHB) in even some states, states could eliminate them altogether. Large employers could choose to apply any state’s standard, making state regulations essentially meaningless. Because the prohibition on annual and lifetime limits only applies to essential health benefits, this change would allow employers to reinstate annual and lifetime limits on their employees’ coverage.

Republicans Want To End Medicaid Expansion

• Sixteen Million People Enrolled Through Medicaid Expansion Could Lose Coverage.
• 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 hospitals with $9.6 billion more in uncompensated care.