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Sen. Murkowski Should Keep Her Health Care Promises and Oppose Judge Kavanaugh’s Nomination to the Supreme Court

Judge Kavanaugh’s Record is at Odds with Sen. Murkowski’s Promises to Protect People with Pre-existing Conditions and Women’s Health

After President Trump announced he would nominate Brett Kavanaugh to the Supreme Court, Senator Lisa Murkowski assured constituents that she would hold him to a “rigorous and exacting” review. However, Sen. Murkowski is avoiding the fact that Kavanaugh stands in stark opposition to the commitments she made to her constituents — namely, to ensure protections for people with pre-existing conditions continue, protect access to birth control, and defend access to safe and legal abortion:

Sen. Lisa MurkowskiBrett Kavanaugh
On Pre-Existing Conditions:Murkowski: “We must continue to prohibit insurers from discriminating against pre-existing conditions.” Last year, Kavanaugh criticized Chief Justice Roberts for upholding the ACA, which protects people with pre-existing conditions.
On Access To Birth Control:In 2014, Sen. Murkowski was one of only three Republicans who voted to ban employers from denying their employees access to birth control coverage. In 2015, Kavanuagh sided with employers over women, arguing that they be able to deny women coverage for birth control.
On Safe And Legal Abortion:Murkowski: “I recognize that the Supreme Court, through Roe v. Wade, has said that a woman has the right, that reproductive right, to choose, and I have supported that.” In 2017, Kavanaugh tried to force a young woman to continue a pregnancy against her will.

 

Final Rates Confirm Delawareans’ Insurance Is Getting Even More Expensive

Washington, D.C. – Today, Delaware announced final rates for 2019 individual-market health insurance plans, which indicate a 3 percent premium increase, in contrast to the average nationwide 4.3 percent decrease that Brookings Institution analysts predicted would occur absent GOP sabotage, on top of last year’s 25 percent rate hike due to Washington Republicans’ repeal-and-sabotage agenda. Brad Woodhouse, executive director of Protect Our Care, released the following statement in response:

“For the past year and a half, President Trump and his Republican allies in Congress have engaged in a deliberate, aggressive campaign to undermine health care and families in Delaware are once again forced to pay the price. Until we stop Republicans’ war on health care, insurance companies will continue to make huge profits and enjoy record tax breaks from Republicans while they charge working families more and more. Washington Republicans should start working on bipartisan solutions to make coverage more affordable, instead of helping their friends in the insurance industry make another buck on the backs of hardworking Delawareans.”

From the Insurance Company:

Highmark: GOP Mandate Repeal And Short-Term Junk Plans Contributing To Rising Rates. “The rate development in this filing is based on certain assumptions we have had to make… We have assumed that the ACA health insurance coverage mandate is eliminated…. We have included an assumed [load] for expected adverse selection due to the Short Term limited Durational Insurance market expansion.” [Highmark, accessed 8/22]

Highmark: GOP Mandate Repeal Harmed Insurance Market, Leading To Higher Rates. “We applied [an adjustment] to reflect the anticipated changes in the average morbidity of the covered population… The morbidity factor was [increased] to reflect the market uncertainty from the elimination of the health insurance coverage mandate.” [Highmark, accessed 8/22]

From the Experts:

Brookings Analysis Estimates That Individual Market Premiums Would Decrease If Not For GOP Sabotage. Among its key findings:

  • Estimates That Average Premium Would Fall By 4.3 Percent In 2019 In Stable Policy Environment. “I estimate that the nationwide average per member per month premium in the individual market would fall by 4.3 percent in 2019 in a stable policy environment.” [Brookings Institution, 8/1/18]
  • Insurance Companies’ Revenues Will Far Exceed Their Costs In 2018. “I project that insurers’ revenues in the ACA-compliant individual market will far exceed their costs in 2018, generating a positive underwriting margin of 10.5 percent of premium revenue. This is up from a modest positive margin of 1.2 percent of premium revenue in 2017 and contrasts sharply with the substantial losses insurers incurred in the ACA-compliant market in 2014, 2015, and 2016. The estimated 2018 margin also far exceeds insurers’ margins in the pre-ACA individual market. ” [Brookings Institution, 8/1/18]
  • Absent Republican Sabotage, Average Premiums For ACA-Compliant Plans Would Likely Fall In 2019. “In this analysis, I define a stable policy environment as one in which the federal policies toward the individual market in effect for 2018 remain in effect for 3 2019. Notably, this scenario assumes that the individual mandate remains in effect for 2019, but also assumes that policies implemented prior to 2018, like the end of CSR payments, remain in effect as well. Under those circumstances, insurers’ costs would rise only moderately in 2019, primarily reflecting normal growth in medical costs.” [Brookings Institution, 8/1/18]

Setting the Record Straight on Kevin Cramer and the North Dakota GOP’s Attacks on People with Pre-Existing Conditions

For years, Republicans, including Congressman Kevin Cramer (R-ND), have waged a war on our health care trying to repeal the Affordable Care Act (ACA) and its protections for people with pre-existing conditions like cancer, diabetes or heart disease. Today, Republicans in North Dakota, in a scene out of Bizarro World, are holding a press conference to try to convince us that’s not really what they are doing.

They can’t change the facts. Republicans have repeatedly voted to repeal the ACA in its entirety. What that would mean is insurance companies could go back to denying or dropping coverage, or charging more, because of a pre-existing condition. They have tried to sabotage our health care at every turn which would make health coverage unaffordable for people with pre-existing conditions, essentially the same thing as repealing the protections all together. And they are now asking the court to do what they couldn’t do legislatively.

Here are the ways Republicans in North Dakota have attacked the 316,000 people in the state with a pre-existing condition:

NORTH DAKOTA REPUBLICAN LEADERS HAVE REPEATEDLY STOOD AGAINST PEOPLE WITH PRE-EXISTING CONDITIONS

Rep. Kevin Cramer voted multiple times to eliminate protections for people with pre-existing conditions:

2013: Cramer Voted For A Full Repeal Of The ACA. Cramer voted for HR 25, which created a reserve fund for the full repeal of the Affordable Care Act. [HR 25, House Vote #88, 3/21/13]

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

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

In fact, Cramer’s own website acknowledges his vote would “repeal the affordable care act in its entirety.” “Today Congressman Kevin Cramer voted with the U.S. House of Representatives to repeal the Affordable Care Act in its entirety.” [Cramer Website, 2/3/15]

Attorney General Wayne Stenehjem Filed a Lawsuit that Would Repeal The ACA And Its Protections For 316,000 North Dakotans With Pre-existing Conditions. North Dakota Attorney General Wayne Stenehjem joined conservatives in 19 other states in the Texas v. United States lawsuit to overturn the Affordable Care Act in its entirety. If the lawsuit were successful, here is how it would impact the people in the state:

  • Insurance companies would be able to deny, drop or charge more for coverage for people with pre-existing conditions. In North Dakota, 316,000 people have a pre-existing condition.
  • It would repeal provisions that lower prescription drugs for people on Medicare
  • It would repeal the provision allowing young adults to stay on their parents’ insurance until age 26
  • It would allow insurance companies to impose annual and lifetime limits again
  • It would allow insurance companies to charge women more for coverage
  • It would repeal tax credits that help  up to 17,000 North Dakotans purchase health coverage.
  • It would repeal Medicaid expansion, which has helped 21,400 North Dakotans get coverage.

Insurance Commissioner Jon Godfread Is “Extremely Supportive” of Stenjehm’s Lawsuit To Overturn Protections For People With Pre-existing Conditions, And Has Filed An Affidavit Of Support In The Case. “In a letter on Tuesday, North Dakota’s Democratic-NPL Party called for Stenehjem to withdraw from the 20-state lawsuit, citing consequences for the state’s Medicaid expansion and state residents afforded protections by the federal health care law. Godfread said his department has filed an affidavit in the case, outlining issues he sees in North Dakota. ‘In short order, we are extremely supportive of the attorney general continuing this lawsuit and have assisted him along the way,’ he said.” [Grand Forks Herald, 8/9/18]

State Senator Armstrong Agreed That AG Stenehjem Had An “Obligation” To Join The Suit To Overturn Protections For Pre-Existing Conditions.  “North Dakota Attorney General Wayne Stenehjem announced he would join Texas in the lawsuit. Stenehjem has ‘an obligation to pursue’ the lawsuit if he ‘thinks the law is unconstitutional,’ Armstrong said in a statement to the Herald. ‘We all agree that we must protect people with pre-existing conditions, but it is clear that Obamacare is a complete failure in North Dakota,’ Armstrong said. The Unaffordable Care Act is unpopular with providers and customers. It’s broken. Everyone knows it’s broken.’” [Grand Forks Herald, 8/3/18]

THOSE WHO KNOW BEST KNOW STENEHJEM’S LAWSUIT WOULD HURT NORTH DAKOTANS

Patient groups, physicians, and hospitals emphasize how much the lawsuit could threaten care for people across the country:

  • American Cancer Society, American Cancer Society Cancer Action Network, American Diabetes Association, American Heart Association, American Lung Association, and National Multiple Sclerosis Society: “Striking Down These Provisions Would Be Catastrophic And Have Dire Consequences For Many Patients With Serious Illnesses.” Invalidating the ACA in whole or in part “would be devastating for the millions of Americans who suffer from serious illness or have preexisting conditions and rely on those protections under current law to obtain life-saving health care. If either the plaintiffs’ or the administration’s position were adopted by the court, people with serious illness are likely to be denied coverage due to their preexisting conditions or charged such high premiums because of their health status that they will be unable to afford any coverage that may be offered. Without access to comprehensive coverage, patients will be forced to delay, skip, or forego care. Striking down these provisions would be catastrophic and have dire consequences for many patients with serious illnesses.” [American Cancer Society et. al, 6/14/18]
  • American Medical Association, The American Academy of Family Physicians, The American College of Physicians, The American Academy of Pediatrics, and the American Academy of Child and Adolescent Psychiatry: “​Invalidating The Guaranteed-issue And Community Rating Provisions—or The ​entire A​CA—would Have A Devastating Impact On Doctors, Patients, And The American Health Care System As A Whole.” “Congress declined to do what the Plaintiffs ask this Court to do for a reason: the consequences of repealing the ACA would be staggering…Plaintiffs’ proposed remedies . . . would strip health care from tens of millions of Americans who depend on the ACA; produce skyrocketing insurance costs; and sow chaos in the nation’s health care system​…The ACA’s ‘nationwide protections for Americans with pre-existing health conditions’ has played a ‘key role’ in allowing 3.6 million people to obtain affordable health insurance. Severing those vital insurance reforms would leave millions without much-needed insurance.” [AMA et. al, 6/14/18]
  • American Hospital Association, Federation of American Hospitals, The Catholic Health Association of the United States, and Association of American Medical Colleges: “A judicial repeal would have severe consequences for America’s hospitals, which would be forced to shoulder the greater uncompensated-care burden that the ACA’s repeal would create.” The relief sought by Texas and its allies “would have devastating consequences, kicking millions of Americans off of coverage and inflicting on them all the harms that come with being uninsured. These harms would fall on the low-income families least able to cope with them. ​And a judicial repeal would have severe consequences for America’s hospitals, which would be forced to shoulder the greater uncompensated-care burden that the ACA’s repeal would create.” [American Hospital Association et. al, 6/14/18]
  • Public Health Scholars and the American Public Health Association: “The Foreseeable Public Health Consequences Of The Injunction Are Nothing Short of Catastrophic.” “Without the ACA, the health of millions of Americans would be harmed. Consider the grim analyses of proposed legislation partially repealing the ACA: In 2017, the nonpartisan Congressional Budget Office (“CBO”) assessed the impact of a bill partially repealing the ACA and found (among other things) that it would, in “the first new plan year following enactment of the bill” alone, increase the number of uninsured Americans by 18 million. That number would grow to 27 million after the “year following the elimination of the Medicaid expansion,” and then to 32 million by 2026. Still more is at stake here: Unlike the injunctive relief plaintiffs seek, the bill analyzed by CBO would have staggered its partial repeal of the ACA to avoid catastrophic results. Here, plaintiffs ask the Court to eliminate, as preliminary injunctive relief, a complex statute in its eighth year of implementation—a statute whose repeal through democratic means has been attempted innumerable times but has never succeeded.” [Public Health Scholars et. al, 6/14/18]
  • AARP: Before ACA’s Protections, Discrimination Against Those With Pre-Existing Conditions, Age Rating, And Annual And Lifetime Caps Made Accessing Health Care Out Of Reach For Older Adults. “Uninsured pre-Medicare adults faced nearly insurmountable challenges to securing insurance because they were denied coverage based on preexisting conditions or offered costly policies that excluded coverage for needed care. Even without preexisting conditions, insurance premiums for older adults were as much as 11 times greater than their younger counterparts solely based on their age. Even a healthy person who was age 50 to 64 with no preexisting conditions faced markedly higher insurance premium rates than a younger person. Age rating put the cost of insurance out of reach for many pre-Medicare adults. Annual and lifetime caps—which were easily exceeded by treatment for a single illness such as cancer, heart disease, or diabetes—meant that many older adults either went without treatment until they became eligible for Medicare or incurred financially ruinous medical debt.” [AARP, 6/14/18]

Health insurance companies warn that the lawsuit could lead to mass coverage losses:

  • America’s Health Insurance Plans: “Abruptly threatening or even cutting off billions of federal dollars that allow individuals to purchase insurance and that fund benefits offered through Medicaid or Medicare would have devastating effects.” “The healthcare system, while constantly evolving, cannot pivot to a new (or, worse yet, non-existent) set of rules without consequences. Abruptly threatening or even cutting off billions of federal dollars that allow individuals to purchase insurance and that fund benefits offered through Medicaid or Medicare would have devastating effects.​ Enjoining enforcement of federal laws like the federally-facilitated marketplaces and the products sold on them would be similarly disruptive.” [AHIP, 6/14/18]
  • The Ability Of Millions Of Low-Income, Medically Vulnerable People To Access Necessary Treatments Would Be Cast Into Doubt. “The Medicaid program would likewise experience significant disruptions​. Stopping the funding for individuals made newly eligible for Medicaid under the ACA would harm the 34 states that have chosen to expand their Medicaid programs and potentially disrupt healthcare coverage for the 12 million people added as a result of that expansion​…The coverage of millions of low-income and medically-vulnerable patients—and their ability to receive necessary treatments and prescription drugs—would be cast into doubt. At the same time, state Medicaid programs would see drug costs increase considerably for all enrollees (including children, disabled, and elderly) due to the loss of the ACA’s enhanced prescription drug rebates​.” [AHIP, 6/14/18]

RATES GOING UP, DUE TO GOP SABOTAGE

In nearly every state where data is available, premium rates are higher because of Trump-GOP sabotage than they otherwise would be. In North Dakota, preliminary rates indicate proposed increases as high as 29.33 percent.

Recent research from the the Brookings Institute finds that premiums across the country are higher than they would be absent actions taken by the Trump administration and its Republican allies. It estimates that premiums would fall by an average of 4.3 percent nationwide, absent Republican efforts to sabotage the law, rather than improve it.

NEW POLL: A Vote To Confirm Kavanaugh Would Hurt Senator Collins’ Re-Election Prospects

Nearly Half of Mainers Think Collins Should Not Confirm Kavanaugh

(Portland, ME) – A new poll released by Public Policy Polling finds that a meager 42% of Maine voters think Sen. Susan Collins should vote to confirm Judge Brett Kavanaugh to the Supreme Court, and that voters are deeply concerned about his anti-health care record.

“Since Judge Kavanaugh was nominated, Mainers have gone to Senator Collins with our numerous concerns: that he’s hostile to our health care, that he believes the president is above the law, that he’s not been fully vetted, and that – if confirmed – he’d be a rubber stamp on President Trump’s dangerous anti-health care crusade,” said Rebecca London, State Director of Protect Our Care Maine.

“As this poll shows, Mainers remain concerned about Kavanaugh’s nomination and we want Senator Collins to vote ‘no’. This poll also makes clear to Senator Collins that if she votes to confirm Kavanaugh, and he in turn votes to take away our health care, we will remember where she stood.”  

POLL HIGHLIGHTS

  • When Mainers learn that Kavanaugh will support Trump’s lawsuit overturning protections for people with pre-existing conditions, they are 58% less likely to support him.
  • 62% of Maine voters want a complete review of Kavanaugh before his confirmation vote, including all documents from his time on the U.S. Court of Appeals and working in the Bush White House.
  • If Sen. Collins votes to confirm Kavanaugh, 47% of voters say they would be less likely to vote for her.

The full poll can be read here.

 

NEW POLL: A Vote To Confirm Kavanaugh Would Hurt Senator Collins’ Re-Election Prospects

Nearly Half of Mainers Think Collins Should Not Confirm Kavanaugh

A new poll released by Public Policy Polling finds that a meager 42% of Maine voters think Sen. Susan Collins should vote to confirm Judge Brett Kavanaugh to the Supreme Court, and that voters are deeply concerned about his anti-health care record.

“Since Judge Kavanaugh was nominated, Mainers have gone to Senator Collins with our numerous concerns: that he’s hostile to our health care, that he believes the president is above the law, that he’s not been fully vetted, and that – if confirmed – he’d be a rubber stamp on President Trump’s dangerous anti-health care crusade,” said Rebecca London, State Director of Protect Our Care Maine.

“As this poll shows, Mainers remain concerned about Kavanaugh’s nomination and we want Senator Collins to vote ‘no’. This poll also makes clear to Senator Collins that if she votes to confirm Kavanaugh, and he in turn votes to take away our health care, we will remember where she stood.”  

POLL HIGHLIGHTS

  • When Mainers learn that Kavanaugh will support Trump’s lawsuit overturning protections for people with pre-existing conditions, they are 58% less likely to support him.
  • 62% of Maine voters want a complete review of Kavanaugh before his confirmation vote, including all documents from his time on the U.S. Court of Appeals and working in the Bush White House.
  • If Sen. Collins votes to confirm Kavanaugh, 47% of voters say they would be less likely to vote for her.

The full poll can be read here.

 

The Truth About Patrick Morrisey’s Health Care Record

As President Trump prepares to campaign with Patrick Morrisey tonight, Morrisey is working overtime to conceal the role he has long played in the GOP repeal-and-sabotage agenda, including his own lawsuit to eliminate protections for people with pre-existing conditions. Here’s a closer look at his record:

Patrick Morrisey Supports Repealing The ACA And Its Protections For 737,000 West Virginians with Pre-Existing Conditions

Patrick Morrisey: “We Need To Repeal Obamacare.” “We need to repeal Obamacare and the onerous regulations that have cause premiums to skyrocket, while denying many West Virginia families the ability to choose their doctors and their health insurance plans. I support policies that will create more competition in the healthcare sector, so we can lower prices, improve access, and increase quality.” [Pineville Independent Herald, 3/27/18]

Morrisey Campaigned On His “Fight To Repeal And Replace Obama’s Government-controlled Health Care System.” “Obamacare has hurt West Virginians from all walks of life with higher premiums, fewer health care options, and one-size-fits-all government-run health care. Patrick Morrisey continues to fight to repeal and replace Obama’s government-controlled health care system in order to bring down premiums, foster choice and innovation in healthcare, and get government out of the doctor-patient relationship. Patrick is committed to protecting coverage for those who need it most, especially those with pre-existing conditions.” [Morrisey for Senate, accessed 8/20/18]

What would full repeal of the Affordable Care Act get eliminate?

  • Protections for 737,900 West Virginians with pre-existing conditions, if they buy coverage on their own
  • Improvements to Medicare, including reduced costs for prescription drugs
  • Allowing kids to stay on their parents’ insurance until age 26
  • Ban on annual and lifetime limits
  • Ban on insurance discrimination against women
  • Limit on out-of-pocket costs
  • Medicaid expansion currently covering 15 million people
  • Rules to hold insurance companies accountable
  • Small business tax credits
  • Marketplace tax credits and coverage for up to 29,000 West Virginians.

Patrick Morrisey Is A Party To The Trump-GOP Lawsuit To Roll Back Coverage For People With Pre-Existing Conditions

Although he claims to support protections for people with pre-existing conditions, Patrick Morrisey is a party to a lawsuit that would roll back that coverage and eliminate the protections for pre-existing conditions that exist in the ACA. Morrisey’s participation in the suit puts the health of the 737,900 West Virginians living with a pre-existing condition at risk and would take us back to the days when insurers routinely denied coverage or charged unaffordable premiums to people with pre-existing conditions, including cancer, asthma and hypertension.

2018: Morrisey Was One Of The First Attorney Generals To Sign On To A Lawsuit Challenging The Affordable Care Act. “Manchin is referring to a lawsuit filed in a U.S. district court in Texas on Feb. 26, 2018. The lawsuit was signed by 18 attorneys general and two governors, all of them Republicans. The suit challenges the Affordable Care Act, arguing that ‘the ACA is unlawful’ and seeking to enjoin, or block, its operation. One of the attorney generals who signed onto the lawsuit is Morrisey. He is listed as a signatory on a court document in the case dated as recently as June 20, 2018, or two days before Manchin’s tweet. We could not find any subsequent statement by Morrisey that he had withdrawn his support for the legal action.” [Politifact,  6/26/18]

Patrick Morrissey Said The Pre-Ex Lawsuit Would “Get Rid Of The Awful Policy Of Obamacare.” “Similarly, Morrisey said he supports pre-existing protection coverage despite being party to the lawsuit that would eliminate the law providing those protections. ‘You can believe that some of the pieces, helping those who need it most, are good but still have a lawsuit to get rid of the awful policy of Obamacare,’ Morrisey said.” [Politico, 8/17/18]  

Although Morrisey’s Campign Claimed He Supports Coverage For Pre-Existing Conditions — Despite His Lawsuit, Which Would Eliminate The ACA’s Protections For Those With Pre-Existing Conditions — Morrisey Himself Recently Called Concern About Coverage For People With Pre-Existing Conditions A “Scam” And A “Fake Issue.”  “A spokesman for Morrisey’s campaign said the attorney general doesn’t believe pre-existing condition protections should be eliminated and called the ad ‘false.’ ‘There is no debate over coverage for preexisting conditions,’ Nathan Brand said in a statement.” [The Hill, 8/17/18]

  • Morrisey, One Month Earlier: Called Concern About Coverage For People With Pre-Existing Conditions A “Scam” And A “Fake Issue.” “There’s no debate with respect to pre-existing conditions. People want to help those who need assistance the most, so he has come up with this fake issue, this scam.” [“Fox and Friends,” Fox News, 7/25/18]  

Morrisey Has Used His Position As Attorney General To Try To Dismantle Or Delay The ACA Before

Morrisey Unsuccessfully Sued To Block The ACA. “In October of [2014], he filed a lawsuit against the Department of Health and Human Services, contending the department did not have the authority to suspend Obamacare’s insurance mandate and accusing President Obama of ‘cherry-picking which laws his Administration will enforce.’ In July 2016, the D.C. circuit court ruled that West Virginia had not suffered an injury in fact and lacked standing.”  [National Review, 2/14/17]

Senate Republican Candidates Run From Their Record to Take Away Protections for People with Pre-existing Conditions

Today’s POLITICO story, “GOP’s Midterm Peril: What If They Win on Killing Obamacare?,” laid bare the confounding position Republican Senate candidates have put themselves in in the face of consistent, overwhelming public support for protections for people with pre-existing conditions and with health care remaining a top issue for voters. Even though they’ve voted numerous times to eliminate protections for people with pre-existing conditions, have filed a lawsuit to eliminate these protections, or said they support total repeal of these protections, they hypocritically declare their “support” of the very same protections their actions would take away.

Patrick Morrissey Is Party to the Trump-GOP Lawsuit That Would Get Rid of Protections for People with Pre-existing Conditions, But Wants Voters to Believe He Supports These Protections. “Similarly, Morrisey said he supports pre-existing protection coverage despite being party to the lawsuit that would eliminate the law providing those protections. ‘You can believe that some of the pieces, helping those who need it most, are good but still have a lawsuit to get rid of the awful policy of Obamacare,’ Morrisey said.” [Politico, 8/17/18]

Kevin Cramer Supports The Trump-GOP Lawsuit That Would Get Rid of Protections for People with Pre-existing Conditions and Voted Repeatedly to Eliminate Them But Wants Voters to Believe He Nevertheless Supports The Protections. “Both Missouri Attorney General Josh Hawley and Rep. Kevin Cramer (R-N.D.) say they support protecting pre-existing conditions, though Hawley is a party to the lawsuit and Cramer supports it, saying: ‘Who doesn’t want the constitutionality of something reviewed?'” [Politico, 8/17/18]

Mike Braun Supports “Anything” to Get Rid Of the Affordable Care Act, Including the Lawsuit, and Says Congress Should Then Pass the Very Same Protections (When All Four Major Senate GOP Repeal Bills Would Have Eliminated Them).  “‘Sure, anything that’s going to actually get rid of it, yes,’ said Indiana GOP Senate nominee Mike Braun of the GOP lawsuit to gut the law in an interview in Mishawaka. ‘And then be ready to come back and talk about what you’re ready to do about pre-existing conditions and no limits on coverage. That’s where you don’t hear much conservative talk.'” [Politico, 8/17/18]

Josh Hawley, Party To The Trump-GOP Lawsuit, Said The Senate Would Act to Protect People With Pre-Existing Conditions If His Suit Was Successful, Even Though All Four Major Senate GOP Repeal Bills Would Have Eliminated Them. “Hawley says he supports protecting pre-existing conditions as well as allowing children to stay on their parents’ plans until the age of 25. And he says if the lawsuit is successful and Obamacare is scuttled, the Senate must act to keep those provisions and rewrite healthcare laws. ‘The Senate is not doing its job. There’s no doubt about that. Claire McCaskill is a huge part of the problem,’ said Hawley. Next year, Hawley says replacing Obamacare ‘has got to be a top priority.'” [Politico, 8/17/18]

Dean Heller Refused To Talk About The Trump-GOP Lawsuit, While Also Declining to Join Senate Democrats in Defending the Law In Court.  “And vulnerable incumbent Sen. Dean Heller (R-Nev.) refused to talk about the lawsuit on Thursday, though his office said he support pre-existing condition protections.”  [Politico, 8/17/18]

Marsha Blackburn Refused To Talk About The Trump-GOP Lawsuit. “Several GOP candidates have not addressed the issue directly, wary that supporting the lawsuit will undermine Republicans’ stance that they stand to protect pre-existing conditions. Rep. Marsha Blackburn (R-Tenn.) said she still supports getting ‘the whole [Obamacare] thing off the books.’ but declined to weigh in on the lawsuit.” [Politico, 8/17/18]

Kevin Cramer’s Multiple Votes To Eliminate Protections For People with Pre-Existing Conditions

Facing a powerful new ad from Sen. Heidi Heitcamp, Rep. Kevin Cramer has become the latest Republican candidate to duck-and-cover from the GOP repeal-and-sabotage agenda, including his own votes to eliminate protections for people with pre-existing conditions. He cast two of them:

  1. 2013: Cramer Voted For A Total Repeal Of The ACA.  Cramer voted for HR 45, 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.” [HR 45, Roll Call Vote #154, 5/16/13]
  2. 2015: Cramer Voted For A Total Repeal Of The ACA.  Cramer 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]

In fact, Cramer’s own website acknowledges his vote would “repeal the affordable care act in its entirety.” “Today Congressman Kevin Cramer voted with the U.S. House of Representatives to repeal the Affordable Care Act in its entirety.” [Cramer Website, 2/3/15]

Three Things Sec. Azar Gets Wrong On Junk Plans

Yesterday, Secretary of Health and Human Services, Alex Azar, penned an op-ed for the Washington Post in which he is caught hiding the dirty truth about the Trump Administration’s new policy to expand short-term, limited duration junk health plans. These junk plans are designed to take us back to when insurance companies could discriminate against people with pre-existing conditions, exclude coverage for services like maternity care, and charge women and older people more.

Junk plans can exclude or deny medical services such as prescription drug coverage, hospitalization, and maternity care. Even when plans say they cover prescription drugs, the benefit is often capped at a limit, such as $3,000. Adding insult to injury, short-term plans have a history of finding ways to deny coverage after people become sick. This happened to Dawn Jones, who was diagnosed with breast cancer after buying a short-term plan when she was between jobs. Despite not knowing she had breast cancer when she bought the policy, the insurance company refused to pay for her treatment, leaving her with a $400,000 medical bill.

These plans are so awful that they are opposed by more than 98 percent of health groups that filed comments with HHS about Trump Administration’s plan make them more widely available.

Here are the facts:

1. JUNK PLANS HURT PEOPLE WITH COVERAGE IN THE ACA MARKETPLACES. Sec. Azar claims that junk plans “improves the exchange risk pools.”

Healthy people will leave the individual market for these plans, causing everyone else’s premiums to go up. As the Center on Budget and Policy Priorities notes, these plans will divide the market between those who are sick and those who are healthy: “Short-term plans would be most likely to attract healthier people, leading to premium increases for ACA-compliant plans and destabilizing individual insurance markets across the nation. “

2. JUNK PLANS MAKE COMPREHENSIVE HEALTH CARE MORE EXPENSIVE. Sec. Azar claims that repealing the individual mandate and expanding junk plans mean millions who couldn’t afford health insurance “will now be able to do so.”

Repealing the individual mandate and loosening short-term plan rules drive up premiums for everyone who needs comprehensive care. The Congressional Budget Office estimates that repealing the individual mandate will increase premiums by 10 percent annually for the next decade, and a report by Wakely Consulting Group estimates that short-term plans alone will cause premiums to increase by 1.4 percent in 2019.

3. JUNK PLANS MAKE IT HARDER FOR PEOPLE TO FIND COMPREHENSIVE COVERAGE. Sec. Azar says junk plans will “improve health-care choice and competition.”

Azar could be right if you don’t have a pre-existing condition, aren’t a woman or person over fifty, don’t need maternity care or prescription drug coverage, and will never have to use the hospital over the weekend. Junk plans are allowed to discriminate against people with pre-existing conditions by dropping or denying coverage, charge women more, impose annual limits on care, and exclude basic coverage, like hospitalization, prescription drug coverage, and maternity care. In an analysis of short-term plans conducted by the Kaiser Family Foundation, no short-term plans studied covered maternity care, 62 percent did not cover substance abuse treatment, and 71 percent did not cover outpatient prescription drug services. One plan won’t cover expenses if someone is admitted to a hospital on a Friday or Saturday.

DON’T TAKE OUR WORD FOR IT: STATE OFFICIALS WARN AGAINST JUNK PLANS

State Insurance Regulators Express Concern That Short-Term Plans Are Being Marketed To Consumers In Misleading Way. “State insurance regulators, gathered over the past three days for a meeting of the National Association of Insurance Commissioners, expressed deep concern that short-term plans were being aggressively marketed in ways likely to mislead consumers. Many said the plans, which need not comply with the Affordable Care Act’s coverage mandates, were a poor substitute for comprehensive insurance.” [New York Times, 8/6/18]

(AK) Lori Wing-Heier, Director Of Alaska Insurance Division: “I’m Concerned That People Will Buy These Policies, Show Up At The Hospital For A Condition They Did Not Expect, And Discover They Are Not Covered.” [HuffPost, 8/5/18]

(CA) California Insurance Commissioner, Dave Jones: “Of Course They’ll Be Less expensive…That’s Because It’s Junk Insurance And It Won’t Cover The Same Things.” [HuffPost, 8/5/18]

(CO) Colorado Interim Insurance Commissioner, Michael Conway: People May Read Warnings, But Not Understand How Bare-bones These Plans Really Are. “They may read [the warning], but that’s not the same as understanding it…Because of the ACA, now people think the baseline has changed ― that certain things are always covered.” [HuffPost, 8/5/18]

(NY) Deputy Superintendent At New York Department Of Financial Services, Troy Oechsner: “These Are Substandard Products.” “‘These are substandard products,’ sold on the premise that ‘junk insurance is better than nothing’ for people who cannot afford comprehensive coverage, Troy J. Oechsner, a deputy superintendent at the New York Department of Financial Services, told the insurers.” [New York Times, 8/6/18]

(PA) Pennsylvania Insurance Commissioner Jessica Altman Has Already Revoked The Licenses Of Eight Brokers Or Agents Misrepresenting Short-term Plans. “In Pennsylvania, Altman said she has already revoked the licenses of eight brokers or agents who had been misrepresenting short-term plans.” [The Hill, 8/12/18]

(TN) Tennessee Insurance Commissioner, Julie Mix McPeak Is Concerned About Whether Consumers Fully Understand The Plans They Buy. “‘We have to really make sure consumers know what they’re purchasing, and they’re aware of what’s covered and what’s not covered,’ Mix McPeak said. ‘The last thing we need is for consumers to have surprise bills.'” [The Hill, 8/12/18]

Protect Our Care Statement on Rep. Cramer’s Support of Trump-GOP Lawsuit to Eliminate Protects for North Dakotans with Pre-existing Conditions

“For the past 18 months, the Trump Administration and Republicans in Congress, including Rep. Kevin Cramer, have been waging a relentless war on our health care — undermining key protections for people with pre-existing conditions under the Affordable Care Act (ACA). The Trump Administration even went to court and asked a federal judge to overturn those protections. Last week, Kevin Cramer said he agreed with the suit. If Rep. Cramer has his way, insurance companies would have the power once again to deny, drop or charge more for coverage for people with pre-existing conditions like heart disease, cancer or diabetes. They would be able to impose annual or lifetime limits and charge women more. This is not a hypothetical debate. These actions could hurt hundreds of thousands of North Dakotans,” said Leslie Dach, chair of Protect Our Care.  

ADDITIONAL BACKGROUND

Trump Administration Attempts to Reverse Pre-Existing Condition Protections, Threatening 316,000 North Dakotans’ Care

The Trump Administration recently announced a dramatic escalation of its attempts to roll back protections for people with pre-existing conditions, saying its Department of Justice will ask the courts to eliminate these protections. The move comes after multiple attempts by Congress to repeal the Affordable Care Act and Administration proposals to encourage short-term ‘junk’ plans that can discriminate against people with pre-existing conditions.

316,000 North Dakotans Live With A Pre-Existing Condition. About one in two North Dakotans, 50 percent, lives with a pre-existing condition. [CAP, 4/5/17]

154,000 North Dakota Women And Girls Have A Pre-Existing Condition. Approximately 154,000 women and girls in North Dakota live with a pre-existing condition. [CAP & National Partnership For Women and Families, June 2018]

40,800 North Dakota Children Already Have A Pre-Existing Condition. Roughly 41,000 North Dakotans below age 18 live with a pre-existing condition. [CAP, 4/5/17]

73,700 Older North Dakotans Live With A Pre-Existing Condition. 73,700 North Dakota adults between the ages of 55 and 64 live with at least one pre-existing condition, meaning attacks on these protections significantly threaten North Dakotans approaching Medicare age. [CAP, 4/5/17]

THE AFFORDABLE CARE ACT OUTLAWED DISCRIMINATION BASED ON PRE-EXISTING CONDITIONS

Because Of The Affordable Care Act, Insurance Companies Can No Longer Deny Coverage Or Charge More Because Of Pre-Existing Conditions. Under current law, health insurance companies can’t refuse to cover you or charge you more just because you have a ‘pre-existing condition’ — that is, a health problem you had before the date that new health coverage starts.” [HHS]

The ACA Outlawed Medical Underwriting, The Practice That Let Insurance Companies Charge Sick People And Women More. As the Brookings Institution summarizes, “The ACA outlawed medical underwriting, which had enabled insurance carriers to court the healthiest customers while denying coverage to people likely to need costly care. The ACA guaranteed that all applicants could buy insurance and that their premiums would not be adjusted for gender or personal characteristics other than age and smoking.”

The ACA Stopped Companies From Charging Women More Than Men For The Same Plan. The Affordable Care Act eliminated “gender rating,” meaning American women no longer have to pay an aggregated $1 billion more per year than men for the same coverage.

Thanks To The Affordable Care Act, Insurance Companies Can No Longer Rescind Coverage Because of Illness. Because of the ACA, insurance companies can no longer rescind or cancel someone’s coverage arbitrarily if they get sick.

NOW, THE TRUMP ADMINISTRATION WANTS TO BRING BACK PRE-EXISTING CONDITION DISCRIMINATION

Since Assuming Office, President Trump And Congressional Republicans Have Repeatedly Attempted To Repeal The Affordable Care Act And With It, Protections For People With Pre-Existing Conditions.

  • The Trump Administration Just Asked Courts To Eliminate Protections For People With Pre-Existing Conditions. In early June, the Trump Administration’s Department of Justice decided to argue that courts should throw out the Affordable Care Act’s protections for people with pre-existing conditions.
  • Senate Republican Repeal Bill Would Have Allowed States To Waive ACA Protections, Allowing Insurance Companies To Charge Sick Patients More.
  • House Republican Repeal Bill Would Have Allowed Insurance Companies to Charge People With Pre-Existing Conditions “Prohibitively High Premiums.”

BEFORE THE AFFORDABLE CARE ACT, INSURANCE COMPANIES ROUTINELY DENIED COVERAGE BECAUSE OF PRE-EXISTING CONDITIONS

Before The Affordable Care Act, Insurance Companies Maintained Lists Of So-Called Deniable Medical Conditions. If someone had one or more ‘deniable’ conditions, they were automatically denied coverage. Common ‘deniable’ conditions included:

  • Pregnancy, alcohol or drug abuse with recent treatment, dementia, arthritis, cancer, cerebral palsy, epilepsy, hemophilia, hepatitis, diabetes, paralysis, severe obesity, sleep apnea, AIDS/HIV, kidney disease, multiple sclerosis, bipolar disorder, eating disorders, pending surgery or hospitalization, and muscular dystrophy. [Kaiser Family Foundation, December 2016]

Many Insurance Companies Also Maintained Lists Of Deniable Medications — Meaning That They Could Deny Coverage To Any Applicant With A Prescription For: Anti-arthritic medications, anti-diabetic medications, medications for HIV/AIDS or hepatitis, anti-cancer medications, anti-psychotics or other central nervous system medications, anti-coagulant medications, and other common drugs. [Kaiser Family Foundation, 12/12/16]

Insurance Companies Also Denied Coverage Based On People’s Jobs. For example, Preferred One Insurance Company used to deny coverage from people with the following professions: active military personnel, air traffic controllers, bodyguards, firefighters, law enforcement professionals, detectives, professional athletes, taxi cab drivers, window washers, security guards, scuba divers, miners, pilots, and offshore drillers.

Before The Affordable Care Act, 18 Percent Of Individual Market Applications Were Denied By Insurance Companies Because Of A Pre-Existing Condition. Experts believe this shocking statistic is actually an underestimate, because “many people with health conditions did not apply [for coverage] because they knew or were informed by an agent that they would not be accepted.” [Kaiser Family Foundation, 12/12/16]

If Someone Who Managed To Get Insurance Later Got Sick, Insurance Companies Could Find Ways To Charge Them More Or Rescind Coverage. Before the ACA, if someone had a condition expected to cost the insurance company more, such as acne, the insurance company would follow a practice called “medical underwriting” that allowed them to charge the applicant a higher premium, specifically exclude coverage for the condition that was expected to be costly, charge the applicant a higher deductible, and/or limit the applicant’s benefits (for instance, offer a policy that does not cover prescription drugs). Conditions that would trigger medical underwriting included: acne, allergies, anxiety, asthma, basal cell skin cancer, depression, ear infections, fractures, high cholesterol, hypertension, incontinence, joint injuries, kidney stones, menstrual irregularities, migraine headaches, being overweight, restless leg syndrome, tonsillitis, urinary tract infections, varicose veins, and vertigo.

This Foul Play Impacted Robin Beaton, Whose Insurance Company Denied Her Coverage For A Double Mastectomy Because She Had Previously Received Acne Treatment. “Robin Beaton found out last June she had an aggressive form of breast cancer and needed surgery — immediately. Her insurance carrier precertified her for a double mastectomy and hospital stay. But three days before the operation, the insurance company called and told her they had red-flagged her chart and she would not be able to have her surgery. The reason? In May 2008, Beaton had visited a dermatologist for acne. A word written on her chart was interpreted to mean precancerous, so the insurance company decided to launch an investigation into her medical history. Beaton’s dermatologist begged her insurance provider to go ahead with the surgery…Still, the insurance carrier decided to rescind her coverage. The company said it had reviewed her medical records and found out that she had misinformed them about some of her medical history. Beaton had listed her weight incorrectly. She also didn’t disclose medication she had taken for a pre-existing heart condition — medicine she wasn’t taking when she originally applied for coverage.” [CNN, 6/19/09]