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ashoup
In News, Administration

Federal Open Enrollment Comes to A Close Amid Unprecedented Republican Sabotage Campaign

Washington, D.C. – Following the devastating ruling from Judge Reed O’Connor to overturn the Affordable Care Act (ACA) during the final hours of open enrollment – one of the busiest times for sign-ups – we learned that a lot fewer people signed up for coverage through the federal exchange marketplace. Leslie Dach, chair of Protect Our Care, issued the following statement in response:

“Americans want and need the quality, affordable coverage provided by the Affordable Care Act. Open Enrollment sign-ups would be dramatically higher if not for the unprecedented Republican sabotage campaign, which included slashing advertising by 90 percent, dramatically cutting navigator assistance, and shortening the enrollment time period. Democrats ran on health care and were able to take back the House, and in the Majority these Democrats will work to fully fund open enrollment and end this sabotage, ensuring that Americans of all backgrounds are able to obtain the coverage they need. Will Republicans ever learn to do the same?”

BACKGROUND: THE TRUMP ADMINISTRATION AND REPUBLICANS DOUBLED DOWN ON OPEN ENROLLMENT SABOTAGE IN 2018

The Trump Administration Removed Information On Applying For Coverage From HealthCare.gov. The Trump Administration overhauled the “Apply for Health Insurance” section of HealthCare.gov, removing the options of signing up for coverage via mail and phone and directing people to sign up for coverage through enrollment sites run by private companies.

Between 2016 And 2018, The Trump Administration Cut Funding For Groups That Help People Sign Up For Coverage By 84 Percent. After cutting funding for navigator groups that help people sign up for coverage from $63 million in 2016 to $36 million in 2017, the Trump Administration made yet another round of cuts in 2018, leaving just $10 million in funding for health navigator groups. Since 2016, Trump has cut navigator funding by 84 percent.

Health Navigators, Like Jodi Ray At The University Of South Florida, Say Cuts To Navigator Programs Prevent Them From Adequately Letting People Know That Open Enrollment Is Happening. Ray said, “We don’t have the people to provide the enrollment assistance nor to do the outreach and marketing to let people know what’s happening.”

This Year, 800 Counties Served By The Federal Marketplace Are Operating Without Any Federally-Funded Navigators. This is more than six times as many counties served by the federal marketplace that operated without federally funded navigators in 2016, when 127 counties lacked such a navigator.  

The Trump Administration Wants Navigator Groups To Push Consumers To Sign Up For Junk Coverage That Is Exempt From Covering Prescription Drugs And Hospitalization Instead Of Comprehensive Plans. The Administration announced in July that it would encourage navigator groups to use their remaining funding to push consumers to sign up for junk health plans, which cover few benefits and notorious for the fraud they attract.

In December 2017, The Trump Administration Repealed The Requirement That Most People Have Insurance Despite The CBO Estimate That Doing So Would Increase The Number Of Uninsured By 13 Million. The Republican tax bill passed last December was estimated by the nonpartisan Congressional Budget Office to increase the number of uninsured by 13 million in 2027.

All Of This Comes After The Trump Administration Cut The Open Enrollment Advertising Budget By 90 Percent in 2017. As ABC News summarized, “In 2016, the Centers for Medicare & Medicaid Services spent $100 million on Obamacare advertising and outreach, but for [2017]’s open enrollment period, CMS plans on spending $10 million.” CMS chose not to increase the budget for 2019.

A full timeline of the Trump Administration’s crusade to sabotage open enrollment is below:

December 2018

  • Sunlight Foundation investigation finds that Trump Administration removed information about ways to apply for coverage on HealthCare.Gov and is directing people to sign up for coverage through enrollment sites run by for-profit companies.

October 2018

  • The Trump Administration issues guidance that allows federal subsidies to be used to purchase junk plans that can deny coverage to people with pre-existing conditions, a move expected to worsen ACA risk pools.
  • Trump Administration announces scheduled maintenance on the open enrollment website, preventing people from signing up for coverage on Sundays from 12:00 AM – 12:00 PM.

September 2018

  • Centers for Medicare and Medicaid Services removes a training guide for Latino outreach from a CMS website just over a month before the beginning of open enrollment. Latinos are at a disproportionately high risk of being uninsured compared to white non-hispanic Americans.

August 2018

  • Trump Administration finalizes rule for bare-bones short-term plans that are exempt from key consumer protections, such as the requirement that insurance covers prescription drugs, maternity care, and hospitalization.

July 2018

  • Trump Administration slashes funding for non-profit health navigator groups that help people shop for coverage, from $36 million to $10 million. CMS encourages groups to use the remaining funds to push people to sign up for junk plans that skirt important consumer protections.

July 2018

  • Trump Administration limits access to assistance for consumers who want to enroll in marketplace coverage. This change removes the requirement that every area has at least two “navigator” groups to provide consumer assistance and that one be local. Now, just one group could cover entire states or groups of states.

December 2017

  • Congressional Republicans pass their tax scam, which doubles as a sneaky repeal of the Affordable Care Act  by kicking 13 million people off of their insurance and raising premiums by double digits for millions more.

October 2017

  • The Trump Administration dramatically cuts in-person assistance to help people sign up for 2018 health coverage.

September 2017

  • The Administration orders the Department of Health and Human Services’ regional directors to stop participating in Open Enrollment events. Mississippi Health Advocacy Program Executive Director Roy Mitchell says, “I didn’t call it sabotage…But that’s what it is.”

August 2017

  • The Administration cuts the outreach advertising budget for Open Enrollment by 90 percent, from $100 million to just $10 million – which resulted in as many as 1.1 million fewer people getting covered. Emails obtained by Democracy Forward reveal that the administration chose to cut outreach despite having been warned that over 100,000 fewer people would enroll in coverage.

July 2017

  • The Trump Administration uses funding intended to support health insurance enrollment to launch a multimedia propaganda campaign against the Affordable Care Act.

April 2017

  • The Trump Administration cuts the number of days people could sign up for coverage during open enrollment by half, from 90 days to 45 days.

January 2017

  • Also on January 20th, the Department of Health and Human Services begins to remove information on how to sign up for the Affordable Care Act.
  • The Trump Administration pulls funding for outreach and advertising for the final days of 2017 enrollment. This move is estimated to have reduced enrollment by nearly 500,000.
protectourcare
In News, Administration, Capitol Hill

On The 19th Day Of Christmas, The GOP Gave America: A NO Vote On Stopping The Lawsuit To Overturn The Affordable Care Act

Washington DC – Today, Senate Democrats attempted to intervene on behalf of the American people and authorize the Senate legal counsel to defend the Affordable Care Act in the Texas, et. al. vs. United States, et. al lawsuit following the terrible ruling from conservative U.S. District Judge Reed O’Connor to overturn the Affordable Care Act (ACA). But in true sabotage fashion, the Republicans blocked the measure from moving forward. Brad Woodhouse, executive director of Protect Our Care issued the following statement in response:

“If anyone thought Republicans would end their war on health care after they were wallopped on the issue in November they were sadly mistaken. Republicans blocking the Senate from intervening in the Texas lawsuit confirms that they will do everything in their power to repeal and sabotage health care.  Americans do not want to roll back the clock and go back to the days where insurance companies could drop coverage or deny it altogether simply for having a pre-existing condition. Enough is enough. It’s time for the GOP to wake up and end this relentless war on health care.”

ashoup
In News, Capitol Hill

Good Riddance to the Least Successful, Most Anti-Health Care Speaker in American History

Washington, D.C. – This afternoon, Speaker Paul Ryan will give his farewell address at the Library of Congress. Brad Woodhouse, executive director of Protect Our Care, issued the following statement in response:

“Paul Ryan sat around a keg in college and dreamed of slashing Medicaid, tried to end Medicare as we know it as a Budget chairman, and tried to rip health care away from 23 million people by repealing the Affordable Care Act as Speaker of the House. As he leaves Washington, voters and legislatures across the country are expanding Medicaid; the public overwhelmingly rejected Ryan’s vouchers to upend Medicare, with the discussion today about how to strengthen and expand the program rather than end it; and despite his best efforts to repeal health care, kick tens of millions of people off of their coverage and end protections for those with pre-existing conditions, the ACA is more popular than ever, repeal went down in flames, and the Ryan-led effort to upend the American health care system swept his party from power in the House. There is no finer karma. Paul Ryan is perhaps the most anti-health care Speaker in American history – fortunately for the American people he was also the least successful and least competent. Good riddance.”

protectourcare
In News, Administration

“They May Have Bought More Than They Bargained For”: Republicans Thought They Had It Bad Before, But It’s Getting Clearer That It’s Even Worse Than They Thought

In the last twenty-four hours, it’s become clear that the Texas court decision overturning the Affordable Care Act is an even bigger problem for Republicans than originally reported. It goes beyond even the most outlandish of last year’s repeal bills by striking down some of the law’s most popular provisions, such as the prohibition on denying someone coverage because they’re sick and the requirement that adults under age 26 be allowed to stay on their parents’ plan.

Following Friday’s jarring decision by a conservative federal judge to overturn the Affordable Care Act, Democratic state attorneys general have submitted a request for a stay on the court’s order — ensuring that the Affordable Care Act remains in effect while the case makes it way through the appeals process. Should their request be denied, the American people will suffer, and the American health care system will be upended.

 

WHAT WOULD HAPPEN:

  • 12 million Americans who gained coverage through Medicaid expansion would become uninsured.
  • 8 million low-income residents will lose access to billions of dollars in tax credits.
  • 19 million Medicare Advantage beneficiaries could lose their plans because the ACA replaced the payment system previously in effect.
  • Insurance companies may once again be able to discriminate on the basis of health status by charging higher premiums or denying coverage altogether, jeopardizing the care of more than 130 million Americans with pre-existing conditions.
  • The prohibition of lifetime or annual limits on coverage would disappear.
  • The requirement that children under the age of 26 be allowed to stay on their parents’ coverage would be gone.
  • Insurance companies would no longer have to cover essential health benefits, including ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance abuse treatment, prescription drugs, laboratory services, preventative services and chronic disease management, and pediatric services, including oral and vision care.
  • States may lose their platforms for connecting residents to health care options — state marketplaces, federally facilitated exchanges, and hybrid options that use healthcare.gov would disappear.
  • Important initiatives to improve quality of care, reduce cost, and increase innovation would disappear. The Affordable Care Act’s initiatives holding hospitals accountable for quality and safety, allowing providers to receive Medicare payments based on quality and care coordination; and funding efforts to states, public health officials, educational institutions, and medical providers to improve treatment of chronic illnesses, reduce health disparities, improve efficiency and value, and to provide comprehensive care, including preventive care, and mental health and substance use disorder services could fall by the wayside.
  • Uncompensated care costs would increase by $1.1 trillion over the next decade because so many people would lose coverage.
  • And the Prevention and Public Health Fund (PPHF), a new funding stream created by the ACA that has sent over $3.9 billion to states since 2010 ($650 million for fiscal year 2017), would be eliminated.

THE KAISER FAMILY FOUNDATION: PRE-EXISTING CONDITION PROTECTIONS ARE NOT EVEN THE MOST POPULAR PROVISION THE RULING STRIKES DOWN

Kaiser Family Foundation President Drew Altman said:

“Democrats will now use the 2020 campaign to paint Republicans as threatening a host of popular provisions in the ACA And here’s the kicker: protections for pre-existing conditions, the provision that played such a big role in the midterms, is not even the most popular one.”

Overturning the Affordable Care Act means overturning its most popular provisions, which are supported by both Democrats and Republicans. According to the Kaiser Family Family Foundation’s November tracking poll:

  • Young adults can remain on their parents’ health insurance policies until age 26: 82% of the public supports this, including 66% of Republicans.
  • Subsidies for lower and moderate income people: 81% support this, including 63% of Republicans.
  • Closing the “donut hole” so there’s no gap in Medicare prescription drug coverage: 81% like this, as do 80% of Republicans.
  • Eliminating costs for many preventive services: 79% support this, as do 68% of Republicans.
  • Medicaid expansion: 77% like it, as do 55% of Republicans.
  • Protecting people with pre-existing conditions: 65% of the public supports this, including 58% of Republicans.

The bottom line from the Kaiser Family Foundation’s Drew Altman: “ [Republicans’] world has changed politically, with Democrats preparing to take control of the House next year, and Republicans may have been better off settling for the repeal of the mandate penalty that Congress already passed. The mandate was by far the least popular part of the law and gave them something to crow about. Now, they may have bought more than they bargained for.”

protectourcare
In News, Administration

Cory Gardner: The Grinch Who Stole Health Care

Washington DC – During a recent interview regarding conservative U.S. District Judge Reed O’Connor decision in the Texas, et. al. vs. United States, et. al. lawsuit, Senator Cory Gardner refused to denounce the efforts of Republican attorneys general, governors, and the Trump Administration. By siding with his GOP allies, Sen. Gardner is once again supporting the Republican war on health care to overturn the entire Affordable Care Act (ACA).  Brad Woodhouse, executive director of Protect Our Care issued the following statement in response:

 

“Don’t be fooled, Gardner voted to do what the court has just accomplished:  rollback the health care law, end people’s protections, and kick people off their life-saving coverage. If he feels differently now, he should denounce the lawsuit and sign on to the Senate resolution to intervene in opposition to it. Otherwise, you can count on Cory Gardner continuing to stand with the Trump administration and Republicans who want to repeal the law, kick kids off their parent’s policies and deny coverage to millions of Americans and Coloradans.  And in the end, if Gardner continues to be a soldier in the Republican war on American health care, voters will show him the door just as they did scores of his congressional colleagues in November.”

 

Background:

What’s at stake for Colorado:

  • The coverage that 419,000 Coloradans gained through the ACA by 2015.
  • Protections for 2,350,900 Coloradans who have a pre-existing health condition.
  • The health care of roughly 40,000 young adults in Colorado who have coverage because they can stay on their parents coverage until age 26.
  • 450,900 Coloradans who have coverage because of Medicaid expansion.
  • The nearly 2,519,638 Coloradans, most of whom have employer coverage, who can access free preventive care at no cost.
  • The 2,949,000 Coloradans with employer coverage who no longer have to worry about lifetime or annual limits.
  • Seniors’ drug savings — 56,531 Colorado seniors are saving $61.1 million on drugs in 2017, an average of $1,081 per beneficiary because the ACA closed the Medicare prescription drug donut hole.

Because Judge O’Connor Sided With Republicans, 17.1 Million People Could Lose Their Coverage

According to the Urban Institute, 17.1 million people would lose coverage in the first year by repealing the Affordable Care Act, leading to a 50 percent increase in the uninsured rate.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Be Put Back In Charge, Ending Protections For The 130 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 130 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
  • 17 million children. One in four children, or roughly 17 million, have a pre-existing condition.
  • 68 million women. More than half of women and girls nationally have a pre-existing condition.
  • 30 million people aged 55-64. 84 percent of older adults, 30.5 million Americans between age 55 and 64, have a pre-existing condition.

 

  • 2,350,900 Coloradans have a pre-existing condition.

 

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have 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.

  • 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
Conditions That Could Cost You Your Care:

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

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

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

 

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have The Power To Charge You More

 

  • More than 100 Million People With A Pre-Existing Condition Could Be Forced to Pay More. 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” thanks to the Republican lawsuit to repeal the Affordable Care Act.

 

 

 

  • Women Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women 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 Could Face a $4,000 “Age Tax,” Including $ 4,302 in Colorado. Because Judge O’Connor sided with Republican lawmakers, insurance companies could be able to 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, including $ 4,302 in Colorado, according to the AARP.

 

 

  • Nine Million People in the Marketplaces Would Pay More for Coverage, Including 102,628 Coloradans. If Judge O’Connor’s ruling is upheld, 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 102,628 in Colorado.

 

  • Seniors Would Have to Pay More for Prescription Drugs. Because Judge O’Connor sided with Republican lawmakers, seniors could 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 CMS report. In Colorado, 56,531 seniors each saved an average of $1,081.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have the Power to Limit the Care You Get, Even If You Have Insurance Through Your Employer

 

  • 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.

 

 

  • Reinstate Lifetime and Annual Limits. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage.

 

  • 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.

Because Judge O’Connor Sides With Republicans, Medicaid Expansion Could Be Repealed

  • Fifteen million people have coverage through the expanded Medicaid program, including 450,900 in Colorado.
ashoup
In Capitol Hill, News

Arizonans Have Rejected Martha McSally Before, and They Will Reject Her Again

Washington, D.C. – This morning, Arizona Governor Doug Ducey announced that defeated Senate candidate and health repealer Martha McSally will be appointed to the Senate seat previously held by Sen. John McCain. Brad Woodhouse, executive director of Protect Our Care, released the following statement:

“No one fought harder to repeal and sabotage health care than Martha McSally, who has spent years on the front lines of taking away protections for pre-existing conditions. When her colleagues expressed reservations about supporting a bill which would have kicked 23 million Americans off of their coverage, gutted protections for people with pre-existing conditions, and imposed an ‘age tax’ on people over 50, she implored them to, “Get this $#$$ thing done!” When confronted about her positions, she lied. When she faced the voters, she was sent home by the people of Arizona. It’s outrageous that Governor Ducey would now appoint her to a post the voters said she didn’t deserve. Arizonans rejected Martha McSally because of her relentless war on health care, and when they have another chance, they will reject her again.”

BACKGROUND:

Health Care Was A Top Issue For Voters, Who Overwhelmingly Backed Kyrsten Sinema On It, Propelling Her To Victory. A Public Policy Polling election day survey of Arizona voters found that health care was a top issue for voters in the state and that they overwhelmingly favored Democrats on it, propelling Kyrsten Sinema to victory. 62% of voters said that health care was either a very important issue, or the most important issue to them. Those voters supported Sinema over Martha McSally 68-29. Although the final result was close overall, voters said they trusted Sinema over McSally on the issue of health care by 10 points, 49-39.” [PPP, 11/6]

  • Arizona Republic: Health Care Was A “Defining Issue” In McSally’s Loss. “Especially for women — who tend to be primary caregivers for children and aging parents — health care was a defining issue. Sinema made it the centerpiece of her campaign from the outset. Everywhere she went, she reminded people of her votes to maintain the Affordable Care Act, the eight-year-old federal law commonly referred to as Obamacare, which Republicans have tried to repeal or roll back… In the weeks before the election, McSally found herself racing to reposition herself on health care. She was on the defensive when trying to explain her votes to both fully repeal the ACA and repeal and replace. And, she insisted that she was leading the fight to ‘force insurance companies to cover pre-existing conditions,’ a characterization rated ‘Mostly False’ by Politifact.” [Arizona Republic, 11/14]
  • KTAR: McSally Refused To Ask Mark Brnovich To Remove Arizona From Anti-Obamacare Lawsuit. “In February, Arizona became one of 19 Republican-led states to join Texas in the lawsuit. That was before Obamacare, and its protections for pre-existing medical conditions, became a key issue in the November elections. Across the nation, voters most concerned with health care supported Democrats overwhelmingly. In Arizona, Republican U.S. Rep. Martha McSally’s record of voting to repeal Obamacare is considered a major factor in her loss to Democrat Kyrsten Sinema in their Senate race.” [KTAR, 12/17/18]

McSally Backed The American Health Care Act, Encouraging Her GOP Colleagues To “Get This [Bleeping] Thing Done.” “Speaker Paul Ryan (R-Wis.) and his GOP leadership team held what amounted to a pep rally for rank-and-file members in the Capitol basement Thursday morning as they predicted victory in their push to repeal and replace ObamaCare. Leaders played the ‘Rocky’ theme song as lawmakers walked into the meeting. Majority Leader Kevin McCarthy (R-Calif.) put an image of George S. Patton on the screen and read inspirational quotes from the general. ‘Let’s get this f–king thing done!’ Rep. Martha McSally (R-Ariz.) told her colleagues, according to sources in the room.” [The Hill, 5/4/17]

  • What Did The So-Called Affordable Health Care Act Mean for Arizona?
    • In 2026, 465,200 Arizonans would have lost coverage.
    • The nonpartisan Congressional Budget Office found that the AHCA would have raised premiums 20 percent in 2018.
    • The negative economic impact of the AHCA would have caused 60,714 Arizonans to lose their jobs by 2022.

Martha McSally Lied About Voting To Support Protections For Pre-Existing Conditions, Repeatedly Voting To Repeal The Affordable Care Act.

  • When Confronted About Voting To Take Away Protections For Pre-Existing Conditions, McSally Lied To The Face Of A Voter. [Matt McDermott Twitter, 11/3]

  • Politifact: McSally’s Claims To Support Protections For Pre-Existing Conditions Were “Mostly False.” “McSally claimed she’s ‘leading the fight’ to ‘force insurance companies to cover pre-existing conditions.’ It was the Obama-era Affordable Care Act that forced insurance companies to cover pre-existing conditions. McSally in 2015 voted in favor of a full repeal of the law. The bill directed House committees to offer new proposals, including one that provided people with pre-existing conditions access to affordable health coverage. In 2017, McSally voted for the American Health Care Act, a Republican proposal that kept the Affordable Care Act’s pre-existing conditions coverage. Despite language in the bill to protect people with pre-existing conditions, it included provisions that undermined that coverage and increased premiums for certain people, making insurance unaffordable in some cases, experts said. McSally did support an amendment to help reduce over 5 years increased premiums and out-of-pocket expenses that people with pre-existing conditions might face due to a state waiver allowed in the bill. McSally’s statement contains an element of truth but ignores critical facts that would give a different impression. We rate it Mostly False.” [Politifcat Arizona, 10/30]
  • 2016:  McSally Attacked “The Failed Top-Down Approach Of Obamacare” And Claimed It Was “Only Getting Worse.” “The failed top-down approach of Obamacare is leaving patients with less choice, not more, and it’s only getting worse. Instead of a law that favors bureaucracy over doing what’s best for each family and individual, we need a better approach that actually ensures affordable, quality health care for all Americans.” [Martha McSally Facebook Post, 8/16/16]
  • 2015:  McSally Voted For A Total Repeal Of The ACA.  McSally voted for HR 596, an act “to repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010.”  The bill also ordered House committees to develop a replacement that would “provide people with pre-existing conditions access to affordable health coverage,” but provided no specifics. [HR 596, Roll Call Vote #58, 2/3/15]
  • 2012:  McSally Supported Repealing The ACA: “A Vote For Obamacare Is A Vote Against Small Business And A Vote Against Fiscal Responsibility.”  “The United States House of Representatives today passed the Repeal of Obamacare Act, 244-185, with bi-partisan support.  Arizona’s 8th Congressional District Representative and candidate in the newly drawn 2nd District, Ron Barber, voted against the Act and in support of Obamacare.   ‘Mr. Barber’s vote to save Obamacare is example number 1 of why he needs to be replaced in Congress. Obamacare is costing Americans jobs and driving up our debt. Ron Barber has only been in Washington for 3 weeks and has already become part of the problem. A vote for Obamacare is a vote against small businesses and a vote against fiscal responsibility.'” [Martha McSally for Congress Press Release, 7/11/12]

John McCain’s Former Chief Of Staff Endorsed Kyrsten Sinema Over McSally. “Grant Woods, the former Republican attorney general of Arizona who also served as the first congressional chief of staff for the late Sen. John McCain (R-AZ), backed Rep. Kyrsten Sinema (D-AZ) in a new ad released Friday. ‘Kyrsten Sinema is a tremendous public servant,’ Woods says in the video backing her in the Senate race over Rep. Martha McSally (R-AZ).” [Daily Beast, 9/28]

protectourcare
In News, Administration

Santa Tell Me, Will I Have Health Care Next Year?

New Ad Shows How Court Ruling Helps Republicans Rip Away Protections for People with Pre-Existing Conditions

 

Washington DC – Late Friday night, conservative U.S. District Court Judge Reed O’Connor issued his ruling in Texas, et. al. vs. United States, et. al., striking down the Affordable Care Act (ACA). His decision to side with Republican attorneys general, governors, and the Trump Administration is being called into question by those who know the law and health care the best. In a new digital ad published on social media platforms, Protect Our Care points out that this decision to overturn the ACA, if allowed to take effect, will have a disastrous impact on the American health care system. Brad Woodhouse, executive director of Protect Our Care issued the following statement:

“With millions of lives at stakes, Republicans have once again turned their backs on the American people by asking the courts to do their bidding. The recent decision from Judge Reed O’Connor to strike down the ACA now puts Republicans dangerously closer to ripping away health care protections from people with pre-existing conditions like cancer, asthma, and diabetes. Given Republicans’ terrible track record on health care, this lawsuit is simply another desperate attempt to gut the ACA and undermine the American people.”

Watch Protect Our Care’s new ad here.

 

BACKGROUND:

Due to Judge O’Connor’s ruling on December 14th, Republicans are one step closer to repealing the Affordable Care Act and eliminating key protections, unleashing — as the Trump Administration itself admitted in his court — “chaos” in our entire health care system.  

  • Seventeen million more people could lose their coverage in a single year, leading to a 50 percent increase in the uninsured rate
  • Protections for 130 million people with pre-existing conditions, if they buy coverage on their own, are gone
  • The Medicaid expansion, currently covering 15 million people, could vanish.
  • Improvements to Medicare, including reduced costs for prescription drugs, are eliminated
  • No longer will kids be allowed to stay on their parents’ insurance until age 26
  • The ban on annual and lifetime limits are gone
  • The ban on insurance discrimination against women and people over age 50 is gone
  • Limits on out-of-pocket costs are eliminated
  • Small business tax credits are gone
  • Marketplace tax credits for up to 9 million people are gone
ashoup
In Administration, News, Capitol Hill

Josh Hawley Gets His Wish: Texas Court Rips Health Care From Millions, Raises Premiums, and Guts Protections for People with Pre-Existing Conditions

Decision From Federal Judge Means:

Medicaid Expansion is Gone

Protections for Pre-Existing Conditions are Gone

Hundreds of Thousands of Missourians Will Lose Health Care

And Josh Hawley OWNS IT

Washington, D.C. –  On Friday night, conservative U.S. District Judge Reed O’Connor issued his ruling in Texas, et. al. vs. United States, et. al., siding with the Trump Administration and Republican governors and attorneys general, including Josh Hawley, arguably the most vocal and persistent proponent of overturning health care, to overturn the entire Affordable Care Act (ACA). Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

“Josh Hawley has led the charge to gut the ACA, championing a fraudulent lawsuit that would gut the protections Americans and Missourians depend on. If Josh Hawley has his way, 3 million Missourians with pre-existing conditions will lose their coverage; Missourians will once again be bankrupted by out-of-control medical bills; Missouri seniors will be subject to an age tax; and Missouri young adults will no longer be able to stay on their parents’ insurance until age 26. He falsely claimed throughout his campaign that he would protect these provisions, and his lies are now clear as day. Josh Hawley is the dog that caught the truck – unfortunately for Missourians, it is they who will be left to suffer accordingly.”

BACKGROUND:

Due to Judge O’Connor’s ruling on Friday, Republicans are one step closer to repealing the Affordable Care Act and eliminating key protections, unleashing — as the Trump Administration itself admitted in his court — “chaos” in our entire health care system. Under this ruling:

  • Marketplace tax credits and coverage for 10 million people: GONE.
  • Medicaid expansion currently covering 15 million people: GONE.
  • Protections for more than 130 million people with pre-existing conditions when they buy coverage on their own: GONE.
  • Allowing children to stay on their parents’ insurance until age 26: GONE.
  • Free annual wellness exams: GONE.
  • Ban on annual and lifetime limits: GONE.
  • Ban on insurance discrimination against women: GONE.
  • Contraception with no out-of-pocket costs: GONE.
  • Limit on out-of-pocket costs: GONE.
  • Requirement that insurance companies cover essential benefits like prescription drugs, maternity care, and hospitalization: GONE.
  • Improvements to Medicare, including reduced costs for prescription drugs: GONE.
  • Closed Medicare prescription drug donut hole: GONE.
  • Rules to hold insurance companies accountable: GONE.
  • Small business tax credits: GONE.

What’s at stake for Missouri:

  • The coverage that 103,000 Missourians gained through the ACA by 2015.
  • Protections for 2,495,900 Missourians who have a pre-existing health condition.
  • The health care of roughly 44,000 young adults in Missouri who have coverage because they can stay on their parents coverage until age 26.
  • The nearly 2,778,803 Missourians most of whom have employer coverage, who can access free preventive care at no cost.
  • The 2,148,000 Missourians with employer coverage who no longer have to worry about lifetime or annual limits.
  • Seniors’ drug savings — 102,643 Missouri seniors saved $108.2 million on drugs in 2017, an average of $1,054 per beneficiary because the ACA closed the Medicare prescription drug donut hole.

Because Judge O’Connor Sided With Republicans, 17.1 Million People Could Lose Their Coverage

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Be Put Back In Charge, Ending Protections For The 130 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 130 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
  • 17 million children. One in four children, or roughly 17 million, have a pre-existing condition.
  • 68 million women. More than half of women and girls nationally have a pre-existing condition.
  • 30 million people aged 55-64. 84 percent of older adults, 30.5 million Americans between age 55 and 64, have a pre-existing condition.
  • 2,495,900 Missourians have a pre-existing condition.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have 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.

  • 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.
Conditions That Could Cost You Your Care:

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

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

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

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have The Power To Charge You More

  • More than 100 Million People With A Pre-Existing Condition Could Be Forced to Pay More. 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” thanks to the Republican lawsuit to repeal the Affordable Care Act.
  • Insurance Companies Could Charge Premium Surcharges in the Six Figures. If Judge O’Connor’s ruling is upheld, insurance companies would be able to charge people more because of a pre-existing condition. The health repeal bill the House passed in 2017 had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
  • Women Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women were often charged premiums on the nongroup market of up to 50 percent higher than they charged men for the same coverage.
  • People Over the Age of 50 Could Face a $4,000 “Age Tax,” Including $4,554 in Missouri. Because Judge O’Connor sided with Republican lawmakers, insurance companies could be able to 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, including $4,554 in Missouri, according to the AARP.
  • Nine Million People in the Marketplaces Would Pay More for Coverage, Including 188,072 Missourians. If Judge O’Connor’s ruling is upheld, 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 188,072 in Missouri.
  • Seniors Would Have to Pay More for Prescription Drugs. Because Judge O’Connor sided with Republican lawmakers, seniors could 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 CMS report. In Missouri, 102,643 seniors each saved an average of $1,054.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have the Power to Limit the Care You Get, Even If You Have Insurance Through Your Employer

  • 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.
  • Reinstate Lifetime and Annual Limits. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage.
  • 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.
protectourcare
In News, Administration, Capitol Hill

The People Who Hate Obamacare the Most Think the Texas Decision is the Worst

Since Judge Reed O’Connor’s decision to overturn the Affordable Care Act on Friday night, Republicans and Democrats alike have condemned his ruling. Some of the strongest criticism has come from the columnists, editorial pages, and legal scholars that have led the opposition to the ACA.

Philip Klein, Executive Editor Of Washington Examiner: “I Hate Obamacare, But Texas Judge’s Decision On Its Constitutionality Is An Assault On The Rule Of Law.” “I hate Obamacare so much that it’s possible I’ve written more words criticizing it over the past decade than any person alive. I have supported multiple previous legal efforts against the legislation and its implementation. In the fall of 2012, after the Supreme Court upheld Obamacare, my Halloween costume depicted John Roberts turning into a chicken. If Congress repealed all of Obamacare tomorrow, I’d throw a party. Despite my policy preferences, I’d say the latest decision from U.S. District Court Judge Reed O’Connor of Texas declaring Obamacare unconstitutional is an assault on the rule of law… What’s happening here is an effort to short-circuit the normal process and implement policy preferences through judicial activism. Embracing unelected judges using shoddy reasoning to impose their policy preferences on the country just when they produce outcomes conservatives agree with would do significant long-term damage to everything conservatives hold dear.” [Washington Examiner, 12/17/18]

Wall Street Journal Editorial Board: “No One Opposes ObamaCare More Than We Do” But Federal Judge’s Decision “Is Likely To Be Overturned On Appeal And May Boomerang Politically On Republicans.” “No one opposes ObamaCare more than we do, and Democrats are now confirming that it was designed as a way-station to government-run health care. But a federal judge’s ruling Friday that the law is unconstitutional is likely to be overturned on appeal and may boomerang politically on Republicans.” [Wall Street Journal, 12/16/18]

Conservative Legal Scholar Jonathan Adler And Abbe Gluck, Professor Of Health Law At Yale Law School: “This Decision Makes A Mockery Of The Rule Of Law And Basic Principles Of Democracy.” “A ruling this consequential had better be based on rock-solid legal argument. Instead, the opinion by Judge Reed O’Connor is an exercise of raw judicial power, unmoored from the relevant doctrines concerning when judges may strike down a whole law because of a single alleged legal infirmity buried within…We were on opposing sides of the 2012 and 2015 Supreme Court challenges to the Affordable Care Act, and we have different views of the merits of the act itself. But as experts in the field of statutory law, we agree that this decision makes a mockery of the rule of law and basic principles of democracy — especially Congress’s constitutional power to amend its own statutes and do so in accord with its own internal rules.” [New York Times, 12/15/18]

Ilya Somin, George Mason University Law Professor: Judge Was “Badly Wrong” To Declare Entire Affordable Care Act Unconstitutional On Basis Of Individual Mandate. “Federal District Court Judge Reed O’Connor issued an important ruling in a case brought by twenty GOP-controlled state governments, arguing that the Obamacare individual health insurance mandate is now unconstitutional, because the tax reform bill Congress passed in December 2017 eliminates the monetary penalty for violation. Much more importantly, the states also claim that the rest of the Affordable Care Act must fall with the mandate because it cannot be “severed” from it. Judge O’Connor ruled in favor of the states on both counts. I think he was right on the first issue, but badly wrong on the second.” [Reason, 12/14/18]

Jonathan Adler, Professor Of Law At Case Western Reserve School Of Law: “This Is A Surprising Result, And One That Is Hard To Justify.” “This is a surprising result, and one that is hard to justify…And did I mention standing? The Justice Department somehow neglected to raise standing in its briefing, but Judge O’Connor addressed it nonetheless (as he should have, as Article III standing is jurisdictional). Despite recognizing the need to address standing, Judge O’Connor completely botched the relevant analysis, concluding the plaintiffs have standing to challenge a provision of a law that has no legal effect… However superficially plausible the plaintiff states’ claims initially appear, they melt upon inspection. The more one digs into them, the less substantial they appear.” [Reason, 12/14/18]

Jennifer Rubin, Conservative Blogger At Washington Post: “Susan Collins And Republicans Better Have Better Answers On Obamacare. “Republicans are the proverbial dog who caught the bus. They are to blame if the law, with no alternative, is not revived by a higher court; they are to blame if either by litigation or administrative action those with preexisting conditions are priced out of the market. We just had an election that turned on this precise issue. Democrats overwhelmingly carried the day by accusing Republicans of seeking to sabotage protection for preexisting conditions. Now that Collins, Blunt and others have made a mess, it is up to them to fix it — or face the wrath of the voters in 2020.” [Washington Post, 12/17/18]

ashoup
In Administration, Capitol Hill, News

Court Ruling Helps Kevin Cramer Rip Away Protections for People with Pre-Existing Conditions

Decision From Federal Judge Means:

Medicaid Expansion is Gone

Protections for Pre-Existing Conditions are Gone

Hundreds of Thousands of North Dakotans Will Lose Health Care

And Kevin Cramer OWNS IT

Washington, D.C. –  On Friday night, conservative U.S. District Judge Reed O’Connor issued his ruling in Texas, et. al. vs. United States, et. al., siding with Republican attorneys general, governors, the Trump Administration, and Senator Kevin Cramer  to overturn the entire Affordable Care Act (ACA). Whether it’s repealing the individual mandate to pay for tax cuts or ramming through partisan repeal legislation, repeal cheerleader Kevin Cramer has done nothing but support the GOP’s efforts to strip coverage from hundreds of thousands of North Dakotans. Brad Woodhouse, executive director of Protect Our Care issued the following statement:

“Like two sides of the same coin, Kevin Cramer and the Trump Administration have worked relentlessly to undermine the Affordable Care Act. Today, they are one step closer to ripping health care away from millions of North Dakotans with pre-existing conditions like cancer, diabetes, or asthma. If this ruling isn’t overturned, Kevin Cramer will roll back the clock and take North Dakotans back to the days where insurance companies had the power to once again deny, drop, or charge more for coverage. They will once again have the power to impose annual or lifetime limits and charge women and seniors more based on their age and gender. Make no mistake, these actions will hurt hundreds of thousands of North Dakotans.”

BACKGROUND:

Due to Judge O’Connor’s ruling yesterday, Republicans are one step closer to repealing the Affordable Care Act and eliminating key protections, unleashing — as the Trump Administration itself admitted in his court — “chaos” in our entire health care system. Under this ruling:

  • Marketplace tax credits and coverage for 10 million people: GONE.
  • Medicaid expansion currently covering 15 million people: GONE.
  • Protections for more than 130 million people with pre-existing conditions when they buy coverage on their own: GONE.
  • Allowing children to stay on their parents’ insurance until age 26: GONE.
  • Free annual wellness exams: GONE.
  • Ban on annual and lifetime limits: GONE.
  • Ban on insurance discrimination against women: GONE.
  • Contraception with no out-of-pocket costs: GONE.
  • Limit on out-of-pocket costs: GONE.
  • Requirement that insurance companies cover essential benefits like prescription drugs, maternity care, and hospitalization: GONE.
  • Improvements to Medicare, including reduced costs for prescription drugs: GONE.
  • Closed Medicare prescription drug donut hole: GONE.
  • Rules to hold insurance companies accountable: GONE.
  • Small business tax credits: GONE.

What’s at stake for North Dakota:

  • The coverage that 15,000 North Dakotans gained through the ACA by 2015.
  • Protections for 316,000 North Dakotans who have a pre-existing health condition.
  • Coverage for 21,400 North Dakotans enrolled through the state’s Medicaid expansion.
  • The health care of roughly 7,000 young adults in North Dakota who have coverage because they can stay on their parents coverage until age 26.
  • The nearly 359,052 North Dakotans most of whom have employer coverage, who can access free preventive care at no cost.
  • The 253,000 North Dakotans with employer coverage who no longer have to worry about lifetime or annual limits.
  • Seniors’ drug savings — 11,110 North Dakota seniors saved $11.5 million on drugs in 2017, an average of $1,037 per beneficiary because the ACA closed the Medicare prescription drug donut hole.

Because Judge O’Connor Sided With Republicans, 17.1 Million People Could Lose Their Coverage

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Be Put Back In Charge, Ending Protections For The 130 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 130 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
  • 17 million children. One in four children, or roughly 17 million, have a pre-existing condition.
  • 68 million women. More than half of women and girls nationally have a pre-existing condition.
  • 30 million people aged 55-64. 84 percent of older adults, 30.5 million Americans between age 55 and 64, have a pre-existing condition.
  • 316,000 North Dakotans have a pre-existing condition.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have 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.

  • 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
Conditions That Could Cost You Your Care:

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

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

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

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have The Power To Charge You More

  • More than 100 Million People With A Pre-Existing Condition Could Be Forced to Pay More. 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” thanks to the Republican lawsuit to repeal the Affordable Care Act.
  • Insurance Companies Could Charge Premium Surcharges in the Six Figures. If Judge O’Connor’s ruling is upheld, insurance companies would be able to charge people more because of a pre-existing condition. The health repeal bill the House passed in 2017 had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
  • Women Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women were often charged premiums on the nongroup market of up to 50 percent higher than they charged men for the same coverage.
  • People Over the Age of 50 Could Face a $4,000 “Age Tax,” Including $3,709 in North Dakota. Because Judge O’Connor sided with Republican lawmakers, insurance companies could be able to 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, including $3,709 in North Dakota, according to the AARP.
  • Nine Million People in the Marketplaces Would Pay More for Coverage, Including 18,139 North Dakotans. If Judge O’Connor’s ruling is upheld, 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 18,139 in North Dakota.
  • Seniors Would Have to Pay More for Prescription Drugs. Because Judge O’Connor sided with Republican lawmakers, seniors could 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 CMS report. In North Dakota, 11,110 seniors each saved an average of $1,037.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have the Power to Limit the Care You Get, Even If You Have Insurance Through Your Employer

  • 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.
  • Reinstate Lifetime and Annual Limits. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage.
  • 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.

Because Judge O’Connor Sides With Republicans, Medicaid Expansion Could Be Repealed

  • Fifteen million people have coverage through the expanded Medicaid program, including 21,400 in North Dakota.
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