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“To get serious about opioids, Republicans need to stop their assault on Medicaid, quit pushing the sale of junk plans and end their relentless war on our health care,” says Leslie Dach

Washington DC – This week, President Trump and Congressional Republicans continue their campaign of deception, attempting to cloak themselves as caring about health care when instead they have waged a war on the Affordable Care Act and Medicaid. While the Trump administration claims the legislation they are signing will address the opioid epidemic sweeping the nation, their recent calls for cuts to Medicaid — which pays for one-fifth of all substance abuse treatments nationwide — and continual expansion and promotion of junk plans without substance use disorder coverage tells another story. Leslie Dach, chair of Protect Our Care, issued the following statement in response:

“Let’s be clear, President Trump and his Republicans are doing more to undermine efforts to address the opioid crisis than they doing to help those Americans who are suffering. In reality, Trump and his allies are undermining the fight against the opioid crisis by raiding Medicaid for hundreds of billions of dollars in cuts in order to pay for tax cuts for the wealthy and by making it easier for insurance companies to sell junk plans without mental health or substance use disorder treatment coverage. To get serious about opioids, Republicans need to stop their assault on Medicaid, quit pushing the sale of junk plans and end their relentless war on our health care.”  

ADDITIONAL BACKGROUND

MEDICAID GIVES STATES MORE RESOURCES TO ADDRESS THE OPIOID EPIDEMIC

Medicaid Is Part Of The Solution To Curbing Opioid Epidemic. “Medicaid is the most powerful vehicle available to states to fund coverage of prevention and treatment for their residents at risk for or actively battling opioid addiction….The greatest opportunity to address this crisis is in those states that have elected to expand Medicaid, given the greater reach of the program, additional tools available, and the increased availability of federal funds.” [State Health Reform Assistance Network, July 2016]

Thanks To Medicaid Expansion, The Uninsured Rate For Opioid-Related Hospitalizations Dropped In Expansion States. “In Medicaid expansion states, the uninsured rate for opioid-related hospitalizations plummeted by 79 percent, from 13.4 percent in 2013 (the year before expansion implementation) to 2.9 percent in 2015.  The decline in non-expansion states was a much more modest 5 percent, from 17.3 percent in 2013 to 16.4 percent in 2015.” [Center on Budget and Policy Priorities, 2/28/18]

Just This Week, An Associated Press Study Affirmed That “Medicaid Expansion States Had A Running Start On The Opioid Crisis.” “In states that expanded Medicaid, the insurance program already covers addiction treatment for nearly everyone who is poor and needs it. Medicaid allows states to go beyond the basics with the grant money, while non-expansion states have to fill in for basic needs with fewer dollars, said Brendan Saloner, an addiction researcher at Johns Hopkins Bloomberg School of Public Health. In effect, Medicaid expansion states had a running start on the opioid crisis, while states without the extra Medicaid funding hastened to catch up…States that did not expand Medicaid spent $2,645 per patient on opioid addiction treatment on average. Expansion states spent $1,581 per patient for treatment. States that did not expand Medicaid spent $1,170 per person served on recovery support services. Expansion states spent $446 per person served on recovery.” [Associated Press, 10/22/18]

(Center on Budget and Policy Priorities, 2/28/18)

In States Without Medicaid Expansion, Grant Funds Are Spent At A Faster Rate.  An analysis of state use of opioid grant money found states that have expanded Medicaid spend the grant funds at a slower pace than non-expansion states, because Medicaid already covers addiction treatment for the low-income population, allowing the state to direct the grant money to invest in new infrastructure. Non-expansion states spent 71 percent of their grant money in the first year, compared to 59 percent spent by expansion states. [AP, 10/22/18]

Medicaid Expansion Has Improved Access To Substance Treatment Services. “Evidence also suggests that Medicaid expansion improved access to substance use treatment services more broadly. After expanding Medicaid, Kentucky experienced a 700 percent increase in Medicaid beneficiaries using substance use treatment services.  Use of treatment services rose nationally as well; one study found that expanding Medicaid reduced the unmet need for substance use treatment by 18.3 percent.” [Center on Budget and Policy Priorities, 2/28/18]

Medicaid Helps Make Buprenorphine And Naloxone, Drugs Used To Treat Opioid Use Disorder, Affordable. “These data are consistent with other evidence that Medicaid expansion is improving access to care for people with opioid use and other substance use disorders. Medicaid makes medications like buprenorphine and naloxone, which are prescribed to combat opioid use disorders, affordable for beneficiaries.“ [Center on Budget and Policy Priorities, 2/28/18]

JUNK PLANS HURT PEOPLE WITH OPIOID USE DISORDER

Short-Term Junk Plans Can Refuse To Cover Essential Health Benefits, Like Mental Health Treatment. “Typical short-term policies do not cover maternity care, prescription drugs, mental health care, preventive care, and other essential benefits, and may limit coverage in other ways.” [Kaiser Family Foundation, 2/9/18]

Short-Term Plans May Exclude Coverage For Pre-Existing Conditions. “Policyholders who get sick may be investigated by the insurer to determine whether the newly-diagnosed condition could be considered pre-existing and so excluded from coverage.” [Kaiser Family Foundation, 2/9/18]

• As Many As 130 Million Nonelderly Americans Have A Pre-Existing Condition. [Center for American Progress, 4/5/17]
• One in 4 Children Would Be Impacted If Insurance Companies Could Deny Coverage Or Charge More Because Of A Pre-existing Condition. [Center for American Progress, 4/5/17]
  

Junk Plans Mean Higher Premiums For People With Pre-Existing Conditions. “By promoting short-term policies, the administration is making a trade-off: lower premiums and less coverage for healthy people, and higher premiums for people with preexisting conditions who need more comprehensive coverage.” [Washington Post, 5/1/18]

Under Many Short-Term Junk Plans, Benefits Are Capped At $1 Million Or Less. Short-term plans can impose lifetime and annual limits –  “for example, many policies cap covered benefits at $1 million or less.” [Kaiser Family Foundation, 2/9/18]

REPUBLICANS PLEDGE TO SLASH HEALTH CARE TO PAY FOR THEIR TAX CUTS FOR THE WEALTHY:

Last week, Mitch McConnell Blamed Medicare, Medicaid and Social Security for the massive increase in the debt, calling for cuts. Senate Majority Leader Mitch McConnell blamed “bipartisan reluctance” to reform federal entitlement programs for the rising federal deficit, which the Treasury Department said Monday reached $779 billion in 2018.  “There’s been a bipartisan reluctance to tackle entitlement changes because of the popularity of those programs,” McConnell told Bloomberg News. “Hopefully at some point here, we’ll get serious about this.”

Last month, Larry Kudlow, Director of the National Economic Council, confirmed that he has his sights on cutting Medicare. Asked when programs like Social Security and Medicare will be looked at for reforms, Kudlow replied, “Everyone will look at that — probably next year.”

Paul Ryan on Medicare: “It’s the biggest entitlement we’ve got to reform.” Paul Ryan, December 6, 2017: “We’re going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit…Frankly, it’s the health care entitlements that are the big drivers of our debt, so we spend more time on the health care entitlements…In- think the president is understanding that choice and competition works everywhere in health care, especially in Medicare…This has been my big thing for many, many years. I think it’s the biggest entitlement we’ve got to reform.”

President Trump and Congressional Republicans are targeting Medicare and Medicaid to pay for tax cuts for the wealthiest. Last December, President Trump signed a $1.5 trillion tax bill that disproportionately benefits the wealthy. How do Republicans plan on paying for it? Speaker Ryan’s answer is clear: “Frankly, it’s the health care entitlements that are the big drivers of our debt.” In an attempt to pay for these tax cuts, in April, House Republicans passed a budget amendment that would slash Medicare funding by $537 billion over the next decade.

Congressional Republicans proposed these cuts after passing a budget resolution last year that cut Medicare by $473 billion. The 2018 budget resolution passed by Republicans in December 2017 cut Medicare by $473 billion.

Congressional Republicans Voted to Slash An Additional $1.3 Trillion From Medicaid and other Health Care Programs. The 2018 budget resolution passed by Republicans in December 2017 cut non-Medicare health programs, most notably Medicaid, by $1.3 trillion, a 20 percent cut over the course of 10 years, increasing to a 29.3 percent cut by 2027.

Experts condemned the Trump Administration’s new federal policy to water down the guardrails ensuring health insurance plans sold in states that are seeking approvals of “1332 waivers” provide the full range of benefits and the cost-sharing protections in the Affordable Care Act. Here’s a look:

Larry Levitt, Senior Vice President Of Kaiser Family Foundation: Trump 1332 Waiver Guidance Gives States Much The Same Flexibility As Repeal Would. “Republicans couldn’t repeal and replace the ACA last year, but this guidance gives states the flexibility to shift the law in much the same way…It’s hard to overstate how much flexibility states will have under the Trump administration’s new guidance for ACA waivers,” he said. “This will likely widen the gap between red states and blue states for access, affordability, regulation, and protections for pre-existing conditions.” [Business Insider, 10/22/18]

HuffPost: 1332 Waiver Rule Change “Almost Certainly Means That, Overall, People With Serious Medical Problems Are Likely To Have A Harder Time Finding Coverage.” “But Monday’s rule change almost certainly means that, overall, people with serious medical problems are likely to have a harder time finding coverage ― and, ultimately, paying their medical bills. Under guidance from the Department of Health and Human Services that takes effect immediately but likely won’t affect insurance markets for another year, state governments will have new leeway to request waivers from some of the federal health care law’s core requirements…But this latest regulatory change is a reminder that the GOP has never given up on its goal of wiping ‘Obamacare’ off the books, and that people with serious medical problems are likely to suffer as a result.” [HuffPost, 10/22/18]

Axios: The Waiver Announced Yesterday “Could Add Up To One Of Its Most Substantive Blows Yet Against The Affordable Care Act.” “As in-the-weeds as a revised waiver process sounds, the practical effects of what the Trump administration announced yesterday could add up to one of its most substantive blows yet against the Affordable Care Act…Under the Obama administration, states seeking a waiver from the ACA’s rules had to show that their alternatives would cover just as many people as the ACA, with insurance that’s just as robust, for the same cost. That’s why only 8 waivers have ever been granted. But under the Trump administration’s approach, if the same number of people have access to ACA-level coverage, that’ll count — even if few of them actually choose it.” [Axios, 10/23/18]

Sabrina Corlette, Research Professor At Georgetown University: New Guidance Essentially Means That It’s Okay If Certain Subpopulations Are Harmed So Long As Things Work Out In Aggregate. “‘The guidance under Obama… meant that a state’s plan couldn’t result in fewer people enrolled in affordable, comprehensive coverage,’ Corlette explained. ‘This new guidance is saying that so long as people in the state have ‘access’ to [comprehensive] coverage, it doesn’t matter what they actually do… If un-insurance spikes or there’s a big movement to [less comprehensive plans] a state won’t get dinged for that.’ Corlette noted that the Obama administration insisted that state waivers not hurt certain vulnerable populations, including those with severe medical needs. ‘This is saying that so long as things work out in the aggregate, then it’s OK if certain subpopulations are harmed,’ she said.” [HuffPost, 10/22/18]

Waiver Could Allow States To Let Residents Use Subsidies Intended For Comprehensive Coverage To Cover Junk Plans. “Perhaps the biggest change states could enact would involve who would receive Obamacare’s federal premium subsidies, which have been critical to sustaining enrollment in recent years. Currently, subsidies can only be used to buy policies on the exchanges and can only go to those who earn less than 400% of the poverty level (just over $48,500 for a single person or $100,000 for a family of four). States could file waivers asking to provide subsidies to those buying short-term health plans, for instance, Verma said on a call with reporters. The Trump administration is pushing these policies, which have terms of less than a year, as a more affordable alternative to Obamacare. These plans typically have lower premiums so they could be more attractive to younger and healthier people who may not need all of the benefits required under Obamacare.” [CNN, 10/22/18]

New York Times: Timing Of The Announcement Was “Puzzling” Coming Just Before An Election In Which Protection Of People With Pre-existing Conditions Has Been Top Tier Issue. “Coming two weeks before Election Day, the new policy appeared to be a political gift to Democrats, who are making health care a potent campaign theme…The timing of the announcement, just before an election in which the protection of people with pre-existing conditions has been a top-tier issue, was puzzling.” [New York Times, 10/22/18]

Trump Administration Opening Door For States To Gut Protections For People With Pre-existing Conditions. “But the latest administration proposal to weaken insurance standards comes as President Trump and Republican congressional candidates are intensifying their bid to convince voters that the GOP backs patient protections in the 2010 law, often called Obamacare…The new proposal from the Department of Health and Human Services and the Treasury Department would not explicitly scrap the law’s protections, which bar health plans from denying coverage to people with preexisting medical conditions. But the administration plan would dramatically reshape rules established by the 2010 law that were designed to prevent states from weakening these protections.” [Los Angeles Times, 10/22/18]

“Trump’s ‘October Surprise’ is to prove once and for all that Republicans don’t care about protecting people with pre-existing conditions or making health care more affordable,” says Brad Woodhouse

Washington, DC – One year ago — after the American people rose up to defeat health care repeal — the Trump Administration issued an executive order outlining three ways that it would circumvent the will of the public and roll back health care protections in the Affordable Care Act. Today, the Trump administration has checked all three things off its list: this summer, it eased restrictions on junk plans (association health plans, or AHPs, and short-term health plans, or STLDIs); yesterday it made it easier for states to allow insurance companies to sell junk plans, and today it announced it has expanded health reimbursement arrangements (HRAs), over the overwhelming opposition of health care experts and advocates. In response, Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

“It’s the trifecta of health care sabotage: not satisfied with just undermining protections for people with pre-existing conditions or pushing junk plans for individuals, now the Trump Administration is working to undermine comprehensive employer coverage, as well. Trump’s ‘October Surprise’ is to prove once and for all that Republicans don’t care about protecting people with pre-existing conditions or making health care more affordable. If we know one thing to be true, it’s that the GOP’s ongoing war on America’s health care isn’t slowing down — in fact, it’s on overdrive as long as they have power.”

EXPANSION OF HRAs WILL FURTHER ERODE AMERICANS’ ACCESS TO AFFORDABLE HEALTH CARE

Standalone HRAs By Definition Contain An Annual Limit and Are Not Required to Cover Certain Preventive Services. “The ACA requires group health plans to meet certain standards that HRAs can’t meet, specifically the ban on annual and lifetime limits and the requirement to cover certain preventive services at no cost to plan enrollees. (HRAs by definition contain an annual limit on the amount of the employer’s contribution, and they are just accounts that do not cover any benefits.)” [Center on Budget and Policy Priorities, 11/29/17]

Increasing Access To Standalone HRAs Could Incentivize Businesses To Offer Limited Coverage HRAs Instead Of Full Health Coverage. “If the Administration attempts to broaden the availability of such “standalone” HRAs, that would likely prompt fewer businesses to offer health coverage to their employees.  Workers who now have good coverage and substantial contributions from an employer could see those benefits dropped and replaced with an HRA that leaves them paying higher premiums for less comprehensive coverage than what they have today.” [Center on Budget and Policy Priorities, 11/29/17]

HRAs Could Raise Premiums in the Individual Market By Drawing Healthy People Out Of Individual Market. “Depending on the specific proposals, and what employers do in response, HRAs could negatively affect the individual market by moving more high-cost people into that risk pool, raising overall premiums, and leaving other individual-market consumers and the federal government (through the premium tax credit) paying more.” [Center on Budget and Policy Priorities, 11/29/17]

American Cancer Society Cancer Action Network, American Heart Association, America’s Health Insurance plans, Blue Cross Blue Shield Association, Center on Budget and Policy Priorities, Crohn’s & Colitis Foundation, Epilepsy Foundation, Families USA, March of Dimes, The National Multiple Sclerosis Society Are Opposed to Expanding HRAs: “Expanding and extending short-term, limited-duration health plans, increasing enrollment in Association Health Plans (AHPs), and relaxing rules for employer Health Reimbursement Arrangements (HRAs) all increase adverse selection in insurance markets that serve millions of individuals and employers. We are concerned that this could create or expand alternative, parallel markets for health coverage, which would lead to higher premiums for consumers, particularly those with pre-existing conditions. Further, these actions destabilize the health insurance markets that guarantee access to comprehensive health coverage regardless of health status.” [Letter to State Departments of Insurance, 12/14/17]

1332 WAIVERS WITHOUT APPROPRIATE GUARDRAILS MAKES IT EASIER FOR INSURANCE COMPANIES TO SELL JUNK PLANS

• Protections for people with pre-existing conditions would be essentially meaningless. The American Cancer Society Cancer Action Network said allowing states to waive essential health benefits “could render those protections meaningless” for people with pre-existing conditions.
• It would be harder for people with pre-existing conditions to get affordable coverage. As Consumers Union stated, allowing states to waive essential health benefits would be “putting meaningful coverage out of reach for many Americans, especially those with chronic and pre-existing conditions.”
• You could pay more for the same coverage. 1332 waivers allow states to adjust the amount of premium tax credits and cost-sharing consumers receive to help lower their costs. Without the guardrail to ensure coverage is just as affordable, many consumers could end up paying more for the same care.
• Insurers would not have to cover essential benefits, like maternity care. Right now, every insurance plan must cover the 10 essential health benefits. Because states could opt out of covering these basic benefits, insurers would likely only offer policies that covered much less than they do now. The Kaiser Family Foundation found that the benefits most likely to no longer be covered would be maternity care, mental health or substance abuse coverage. According to the Brookings Institution, the result would be “that no one in a state’s individual market that waived EHBs would have access to comprehensive coverage. Insurers would likely sell separate policies for benefits not covered in their core plan offerings, but these supplemental policies would be subject to tremendous adverse selection, leading to very high premiums and enrollment almost exclusively by those with pre-existing conditions.” For example, a woman who purchases a separate insurance rider for maternity care would have to pay $17,320 more, according to the Center for American Progress. For states that no longer required substance use disorders or mental health to be covered, coverage for drug dependence treatment could cost an extra $20,450.
• Insurers could reimpose lifetime and annual limits. Allowing states to opt out of the essential health benefits coverage means that insurance companies could once again put lifetime and annual limits on the amount of care you receive. Moreover, as the Center on Budget and Policy Priorities notes, this would even impact people with coverage from their employer: “The ACA’s prohibition on annual and lifetime limits is tied to the definition of Essential Health Benefits. Thus, repeal of Essential Health Benefit standards could make this protection meaningless, putting almost all Americans with private health insurance coverage — not just those with individual or small-group market coverage — at risk.” The Center for American Progress estimates that 20 million people with health coverage through their employer would face lifetime limits on coverage, and 27 million would face annual limits.

JUNK PLANS HURT PEOPLE WITH PRE-EXISTING CONDITIONS PROTECTIONS

Short-Term Junk Plans Can Refuse To Cover Essential Health Benefits. “Typical short-term policies do not cover maternity care, prescription drugs, mental health care, preventive care, and other essential benefits, and may limit coverage in other ways.” [Kaiser Family Foundation, 2/9/18]

Short-Term Plans May Exclude Coverage For Pre-Existing Conditions. “Policyholders who get sick may be investigated by the insurer to determine whether the newly-diagnosed condition could be considered pre-existing and so excluded from coverage.” [Kaiser Family Foundation, 2/9/18]

• As Many As 130 Million Nonelderly Americans Have A Pre-Existing Condition. [Center for American Progress, 4/5/17]
• One in 4 Children Would Be Impacted If Insurance Companies Could Deny Coverage Or Charge More Because Of A Pre-existing Condition. [Center for American Progress, 4/5/17]
  

Junk Plans Mean Higher Premiums For People With Pre-Existing Conditions. “By promoting short-term policies, the administration is making a trade-off: lower premiums and less coverage for healthy people, and higher premiums for people with preexisting conditions who need more comprehensive coverage.” [Washington Post, 5/1/18]

Under Many Short-Term Junk Plans, Benefits Are Capped At $1 Million Or Less. Short-term plans can impose lifetime and annual limits –  “for example, many policies cap covered benefits at $1 million or less.” [Kaiser Family Foundation, 2/9/18]

With Health Care and Pre-existing Conditions Protections Called “Top Issues” by Texas Voters, Trump Joins GOP Candidates in Shamefully Trying to Hide their Repeal-and-Sabotage Record from View During Debates, Rallies

Houston, TX – Tonight President Donald Trump, the Repealer-in-Chief turned self-professed pre-existing conditions defender, stumps for Texas politicians who once bragged about working to repeal the Affordable Care Act and its protections for pre-existing conditions but are now trying to erase their repeal-and-sabotage record from memory, while health care champion Lizzie Fletcher and pro-repeal Republican John Culberson hold their first public debate. In response, Texans are telling their stories about how important maintaining protections for pre-existing conditions are to them. Ahead of the Fletcher-Culberson debate tonight, patients, providers and health care advocates in the Protect Our Care-Texas coalition will be speaking out against the Republican war on health care.   

Despite recent, empty promises and meaningless, “nonbinding” PR stunts to position themselves as protectors of people with pre-existing conditions, Ted Cruz, Pete Sessions and John Culberson and other Texas Republicans have worked for years to dismantle protections for pre-existing conditions. Recent polling by PPP for Protect Our Care shows nearly two-thirds of Texas voters statewide and in key House battlegrounds want to see protections for pre-existing conditions maintained in the law and nearly six in 10 are concerned about the consequences of GOP repeal efforts.

Here’s one Texan’s story about why Texas Republicans’ repeal-and-sabotage crusade is so personal:

“I’ve been living with my transplanted kidney for six years now. Thanks to the protections of pre-existing conditions rules in the Affordable Care Act, I am able to get insurance that allows me to get checkups that I need to make sure my kidney is doing well,” said Marc Pouhé, a Texan living with IgA nephropathy. “I’m able to get the medication that I need, daily, to keep me from rejecting the kidney — medication that would be thousands of dollars without the insurance that I have. So it’s gravely important that these protections stay in place.”

ADDITIONAL BACKGROUND

Ted Cruz’s Years-Long Campaign to Gut Pre-existing Conditions Protections for 11.5 Million Texans:

Cruz’s First Piece Of Legislation Was To “Fully Repeal Obamacare.” [Cruz.Senate.Gov, accessed 9/21/18]

2013: Cruz Led The Republican Government Shut Down Over ACA Implementation. [Vox, 1/22/18]

2015:  Cruz Voted To Repeal Most Of The ACA. [HR 3762, Roll Call Vote #114, 12/3/15]

2017:  Cruz Voted For The Senate “Repeal And Delay” Plan. [HR 1628, Roll Call Vote #169, 7/26/17]

2017: Cruz Voted For The Better Care Reconciliation Act.  

2017:  Cruz Voted For “Skinny Repeal” Of The ACA.  [HR 1628, Roll Call Vote #179, 7/28/17]

2018:  Ted Cruz: “We Need To Finish The Job” On Obamacare.  “Sen. Ted Cruz, R-Texas, on Wednesday said Republicans needed to ‘finish the job” on repealing and replacing Obamacare in 2018, and he is pushing his colleagues to use one last reconciliation bill before the midterms to deliver on their long-running promise.” [Washington Examiner, 1/24/18]

Ted Cruz Said It Was “Reasonable” for GOP to Argue ACA’s Preexisting Conditions Rules Are Now Unconstitutional.  “Sen. Ted Cruz (R-TX), as vociferous an Obamacare critic as you’ll find, sounds on board with the latest legal challenge to the health care law that could lead to protections for people with preexisting conditions being found unconstitutional. Cruz told Vox that he thought the Justice Department’s position in the lawsuit, that the law’s rules on preexisting conditions should be invalidated along with the individual mandate, was ‘reasonable’ and defended the foundation of the case being brought by his home state of Texas in a brief interview at the Capitol.” [Vox, 6/15/18]

John Culberson’s Years-Long Campaign to Gut Pre-existing Conditions Protections for 11.5 Million Texans:

2011:  Culberson Voted For A Total Repeal Of The ACA. [HR 2, Roll Call Vote #14, 1/19/11]

2011:  Culberson Voted To Repeal And Defund The ACA.[HCR 34, Roll Call Vote #277, 4/15/11]

2013:  Culberson Voted For A Total Repeal Of The ACA. [HR 45, Roll Call Vote #154, 5/16/13]

2015:  Culberson Voted For A Total Repeal Of The ACA. Culberson 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]

2017: Culberson Voted For AHCA, which would have gutted pre-existing conditions protections. [HR 1628, Roll Call Vote #256, 5/4/17]

Pete Sessions’s Years-Long Campaign to Gut Pre-existing Conditions Protections for 11.5 Million Texans:

Sessions has bragged that he has “voted more than 60 times to repeal, dismantle, and defund ObamaCare.” This includes:

2011: Sessions Voted For A Total Repeal Of The ACA. [HR 2, Roll Call Vote #14, 1/19/11]

2011:  Sessions Voted To Repeal And Defund The ACA. [HCR 34, Roll Call Vote #277, 4/15/11]

2013:  Sessions Voted For A Total Repeal Of The ACA. [HR 45, Roll Call Vote #154, 5/16/13]

2015:  Sessions Voted For A Total Repeal Of The ACA.  Sessions 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]

2017: Sessions Voted For AHCA, which would have gutted pre-existing conditions protections. [HR 1628, Roll Call Vote #256, 5/4/17]

…As New PPP-Protect Our Care Poll Shows Nevada Voters Oppose Heller’s Attacks On Health Care, and Support Rosen Instead

Washington DC – At the Senate debate in Las Vegas, Senator Dean Heller continued to run from his record of supporting massive tax cuts for large corporations and authoring repeal legislation to strip millions of Nevadans of their health care. Brad Woodhouse, executive director of Protect Our Care issued the following statement in response:

“What’s one thing that happened in Vegas and should stay there? Dean Heller, and his lies last night about health care. Let’s be clear, Dean Heller’s bill would have turned back the clock on pre-existing conditions protections. It would bring back what the AARP calls ‘the age tax’ for people over 50 and it would allow discrimination against women by insurance companies. What’s worse, he promised to give health repeal another go after the midterms. Dean Heller’s re-election campaign is all about getting another chance to strip health care away from millions of Americans and give wealthy corporations another massive tax cut. It’s no wonder more and more Nevadans are saying ‘no way.’”

What Heller Said:

“I wrote the bill, the repeal and replacement bill for Republicans that specifically added pre-existing conditions because that is how I feel about it.” [C-SPAN, 10/19/18]

The Truthl: Heller Authored Repeal Legislation That Would Have Jacked Up Premiums, Gutted Medicaid And Eliminated Protections For People With Pre-Existing Conditions

Graham-Cassidy-Heller Would Raise Costs For People With Pre-Existing Conditions. Graham-Cassidy-Heller would allow states to let insurance companies once again charge people with pre-existing conditions more, which could raise costs for up to 1,215,300 Nevadans that have a pre-existing condition. For example, an individual with asthma would face a premium surcharge of $4,340. The surcharge for pregnancy would be $17,320, while it would be $142,650 more for patients with metastatic cancer.

242,000 Nevadans Could See Lifetime And Annual Limits Again. Allowing states to opt out of the Essential Health Benefits coverage means that insurance companies could once again put lifetime and annual limits on the amount of care you receive, even impacting people with coverage from their employer. Up to 242,000 Nevadans with employer-sponsored coverage would lose these protections.

Graham-Cassidy-Heller Could Lead to An Age Tax, Meaning 60 Year Old Nevadans Could Pay Up To $16,458 More. The Graham-Cassidy-Heller bill would allow states to let insurers charge people over 50 high premiums without limits. The AARP said, “The Graham/Cassidy/Heller/Johnson bill would result in an age tax for older Americans who would see their health care costs increase under this bill.” AARP estimates that 60-year-old Nevadans could pay as much as a $16,458 more in higher premiums and out-of-pocket costs in 2020.

Millions of Women Could Face Higher Costs or Lose Access to Care. Graham-Cassidy-Heller would end Medicaid expansion, which has allowed 3.9 million women to gain access to care. It would end provisions that helped lower premiums and out-of-pocket costs for 9 million women. Graham-Cassidy-Heller slashes Medicaid, on which one in five women of reproductive age rely. The bill would defund Planned Parenthood and would allow states to let insurers forgo maternity coverage.

Analysts Agree: Every State Loses Under Graham-Cassidy-Heller Affecting People’s Care. Multiple independent analyses agree that the Graham-Cassidy-Heller repeal bill would cut federal funding to states. Over time, every state loses because Graham-Cassidy-Heller zeroes out its block grants and ratchets down its spending on the Medicaid per capita cap. This means people would not have access to the financial assistance to help lower their health care bills, and federal Medicaid funding would no longer adjust for public health emergencies, prescription drug or other cost spikes, or other unexpected increases in need.

• Avalere: $4 Trillion Cut To States Over Next Two Decades, Including $39 Billion Cut To Nevadans. Independent analysts at Avalere estimated that states collectively would lose $215 billion from 2020 to 2026 from the plans block grants and Medicaid cap, another $283 billion in 2027 when the block grant funding disappears altogether and $4 trillion over the next two decades. Nevada would see a $2 billion reduction from 2020 to 2026, another $5 billion reduction in 2027 and a $39 billion cut over two decades.

200,583 Nevadans Enrolled Through Medicaid Expansion At Risk. The Graham-Cassidy-Heller bill would eliminate Medicaid expansion, which has helped 200,583 Nevadans receive quality, affordable coverage, and put part of its funding into inadequate block grants. The bill would further punish states that expanded Medicaid by redistributing funds to states that did not expand Medicaid.

Premiums Will Increase 20 Percent in the First Year. According to the Congressional Budget Office, Graham-Cassidy-Heller includes provisions that would raise premiums up to 20 percent in the first year.

63,968 Nevadans Who Receive Marketplace Tax Credits Could Pay More. Because the Graham-Cassidy-Heller bill eliminates block grant funding in 2027 with no guarantee of any other funding to take its place, that means there would be no funding Marketplace tax credits that help people pay for their premiums, which currently benefits 63,968 Nevadans.

“The thing to know about Leah Vukmir is that she’s blocked health care and sided with insurance companies every chance,” says Brad Woodhouse

Washington DC – In response to last night’s third and final Senate debate between Leah Vukmir and Senator Tammy Baldwin, Brad Woodhouse issued the following statement:

“Third verse, same as the first: once again, Leah Vukmir repeated her tired old line about how she’d protect people with pre-existing conditions, which has been called out before. The thing to know about Leah Vukmir is that she’s blocked health care and sided with insurance companies over ordinary Wisconsinites every chance she’s gotten, whether by blocking Medicaid expansion, supporting junk insurance plans that don’t have to cover pre-existing conditions or prescription drugs or maternity care, or by voting against Wisconsin’s smoking ban.”

Additional background:

What Vukmir Said:

“I will fall in front of a truck before I let people go without coverage for pre-existing conditions.” [Wisconsin State Journal, 10/19/18]

What Vukmir Has Done:

Vukmir “Supports Full Repeal Of Obamacare. Period.” “Leah understands why people are upset with Republicans who promised to repeal Obamacare and didn’t deliver. She supports full repeal of Obamacare. Period. And she won’t stop pushing for full repeal in Congress.” [LeahVukmir.com, accessed 6/12/18]

Vice President Pence: ‘We Made An Effort To Fully Repeal And Replace Obamacare And We’ll Continue, With Leah Vukmir In The Senate.” [The Hill, 8/31/18]

Though Leah Vukmir claims she supports protections for people with pre-existing conditions, she has turned her back on Wisconsinites at every opportunity to do so.

• Vukmir refuses to stand against a lawsuit designed to end protections for people with pre-existing conditions. This summer, the Trump Administration refused to defend against a lawsuit brought by twenty conservative states aimed at overturning the Affordable Care Act and its protections for people with pre-existing conditions. Leah Vukmir refuses to speak against this lawsuit, instead calling it a “necessary step.”
• Vukmir refuses to take action at the state level against the Trump administration’s junk plan and association plan rules that let insurance companies discriminate against people with pre-existing conditions. This summer, the Trump Administration finalized a junk plan rule and an association plan rule that allow insurance companies to discriminate against people with pre-existing conditions. Experts warn that these moves will only increase the cost of comprehensive care, ultimately making it even harder for people with pre-existing conditions to get the care they need. Twenty-one states have taken or are taking action to limit the harmful effects of these junk plans, but Vukmir refuses to do the same for Wisconsin.

Vukmir Says High Risk Pools Would Be Her ‘Solution’ to Cover People With Pre-existing Conditions if the Affordable Care Act is Repealed. The statement itself acknowledges that she would give insurance companies back the power to deny coverage based on pre-existing conditions. Here are some other problems with high risk pools:

• High Risk Pools Typically Had Pre-Existing Condition Exclusions And Limited Benefits. [Health Affairs, 3/15/16]
• High Risk Pools’ Limited Coverage And High Costs Cause People To Remain Uninsured.  [Stateline, 2/16/17] Wisconsin’s previous high risk pool only covered 25,000 people, with estimates showing 2.4 million Wisconsinites live with pre-existing conditions.
• Premiums For Coverage In High Risk Pools Were As Much As 200 Percent Higher Than The Average Rate But Covered Less Care. [Center for American Progress, 2/16/17]
• Despite High Premiums, High Risk Pools Could Still Cost The American People Over $90 Billion Annually. [Commonwealth Fund, 3/29/17]

Vukmir Opposed Medicaid Expansion In Wisconsin.

• Medicaid is not only a lifeline for over one million Wisconsinites, it strengthens our communities and is supported by 74 percent of Americans. Wisconsin has restricted its Medicaid program such that only Residents earning up to 100 percent of the federal poverty line are eligible to enroll in Medicaid. If Wisconsin expanded its program, 119,000 more adults could gain coverage through Medicaid

Vukmir’s Extreme Health Care Record In The State Legislature Is Proof Of What She Would Do On The Federal Level.

• Vukmir Opposed An Indoor Smoking Ban, Calling It “Anti-Smoking Zealotry.”  [Associated Press, 5/14/09]
• Vukmir Opposed A Bipartisan Substance Abuse and Mental Health Parity Bill In The State Assembly. [Shepherd Express, 9/29/10]
• Vukmir Describes Stopping “Healthy Wisconsin,” A Health Plan That Would Have Covered Virtually Every Wisconsinite, As Her Proudest Legislative Achievement. [Milwaukee Magazine, 9/22/16]

“Let’s be clear: Cramer voted to gut pre-existing conditions protections,” said Brad Woodhouse

Washington DC – During last night’s Senate debate between repeal cheerleader Kevin Cramer and health care champion Heidi Heitkamp, Kevin Cramer continued his lie about health care, stating he “‘has not and would not’ support any legislation that cuts guaranteed coverage for pre-existing conditions.” Brad Woodhouse, executive director of Protect Our Care, issued the following statement in response:

“Kevin Cramer’s desperately trying to hide the facts from North Dakota voters because so many of them say health care care and protecting pre-existing conditions are their top issues. Let’s be clear: Cramer voted to gut pre-existing conditions protections. He voted to allow insurance companies to charge more for pre-existing conditions, a surcharge that could have been in the tens of thousands of dollars and even six figures: up to $4,270 for asthma, $17,060 for pregnancy, $26,180 for rheumatoid arthritis and $140,510 for metastatic cancer. Make no mistake: Cramer wants nothing more than to roll back the clock on health care.”

Here’s the truth:

2017: Cramer Voted For AHCA.  Cramer voted for passage of the American Health Care Act.  [HR 1628, Roll Call Vote #256, 5/4/17]

Cramer Claimed To Have Read The Entire AHCA Bill.  “I have read the 200-page bill in its entirety and debated nearly every section of it during a 27-hour hearing in the House Energy and Commerce Committee in March.” [Kevin Cramer Op-Ed, Dickinson Press, 5/18/17]  

…Then Cramer Falsely Claimed AHCA Protected People With Pre-Existing Conditions. But the American Health Care Act weakens key protections of the Affordable Care Act and allowed states to eliminate community rating, meaning insurers would be able to charge people with pre-existing conditions more. This surcharge could be in the tens of thousands of dollars and even six figures: up to $4,270 for asthma, $17,060 for pregnancy, $26,180 for rheumatoid arthritis and $140,510 for metastatic cancer.

What Would AHCA Mean for North Dakota?

• In 2026, 30,100 North Dakotans would lose coverage under this bill.
• The nonpartisan Congressional Budget Office found that the American Health Care Act would have raised premiums 20 percent in 2018.
• People in rural areas tend to face higher health costs, which is one of the reasons why the Affordable Care Act based the amount of premium tax credits in part on geographic location. The American Health Care Act does not, meaning people in rural areas would face higher costs. In North Dakota, 61 percent of marketplace consumers live in rural areas, and could see an average cost increase of $2,121.
• The negative economic impact of the American Health Care Act would cause 4,151 North Dakotans to lose their jobs by 2022.