News

Trump Administration and Washington Republicans’ Health Care Sabotage Raises Rates

Washington, D.C. – Yesterday, Colorado announced final rates for 2019 individual-market health insurance plans, which indicate that premiums will increase by an average of 5.6 percent statewide and as much as 21.6 percent in Denver, 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 double-digit 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 Colorado 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 Coloradans.”

From the Insurance Companies:

Colorado Insurance Commissioner Michael Conway: “Decisions At The Federal Level Continue to Make Life Interesting.” “In past years, challenges continue. Just last week, the Trump administration decided to freeze a key ACA program designed to discourage insurers from favoring healthy people over less healthy ones. ‘Decisions at the federal level continue to make life interesting,’ said Commissioner Conway. ‘But as we have in the past, we will find a solution to this most recent announcement. To that end, just this morning, I informed the insurance carriers that we will require that they account for their respective risk adjustment receivables or payables as they are reflected in the July 9, 2018 federal report. I will take any subsequent steps that are necessary to protect Coloradans and to maintain market stability.’” [Colorado Department of Regulatory Agencies, 7/13/18]

Office Of Colorado Insurance Commissioner Michael Conway: Individual Market Premiums Increasing An Average Of 5.94 Percent, Increasing As High As 12.3 Percent. “For 2019 individual plans, the average premium increase request is 5.94 percent across all companies and metal levels. In the small group market, the average premium increase request is 7.15 percent. Remember, these are averages across all plans from all companies, across all areas of the state where a company offers plans, for all ages. These averages are not representative of how one individual’s premium could change. Looking closer, the requested average premium increase for individual gold plans is 6.85 percent, and is 12.3 percent for silver plans. For bronze plans, the requested average premium increase is 0.9 percent.” [Colorado Department of Regulatory Agencies, 7/13/18]

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]

Minneapolis, MN—The debate today between Rep. Erik Paulsen and challenger Dean Phillips will make it very clear to voters where they stand on key issues, including health care. Health care remains among the top issues in MN03, with over 60% of voters saying it is either the top issue or very important this election. Polls also show that Paulsen has a steep hill to climb on this issue, with Democrats holding a decisive advantage on who voters trust more, what to do with the Affordable Care Act, and how to handle protections for the 2.3 million Minnesotans with preexisting conditions. Given Paulsen’s record on health care here are five things to watch for today:

1)    How will Paulsen try and claim he supports protections for people with preexisting conditions while actively trying to subvert them? Since 2011 Erik Paulsen has voted no less than five times to fully repeal or substantially alter the  Affordable Care Act (ACA), all of which would have taken away protections for 2.3 million Minnesotans with preexisting conditions and cut essential health care programs. These actions directly contradict his stated position that he has “long supported protections for people with preexisting conditions.”

2)    How will Paulsen try and distance himself from Donald Trump on health care when he’s supported him all the way on the issue?  When it comes to health care Erik Paulsen has supported Donald Trump 100% of the time, doubling down on attacks on people with pre-existing conditions, in the courts, through legislation and through regulations that promote junk plans and restrict Medicaid.

3)    Will Paulsen claim that he’ll protect Medicare, Medicaid and Social Security? Just Last week Erik Paulsen joined other House Republicans in passing a second set of tax cuts to benefit the wealthiest Americans and big corporations at the expense of working families. These tax cuts have led to trillion dollar deficits, which Republicans are now using as an excuse to go after Medicaid, Social Security and Medicare.

Earlier this month, Larry Kudlow, Director of the National Economic Council, confirmed that they still have their sights set on Americans’ care. Asked when programs like Social Security and Medicare will be looked at for reforms, Kudlow replied, “Everyone will look at that — probably next year.” And last December, when President Trump signed the first round of $1.5 trillion tax bill that disproportionately benefits the wealthy, Speaker Paul Ryan made it clear they would cut programs like Medicaid that support working families. “Frankly, it’s the health care entitlements that are the big drivers of our debt.”

4)    How will Paulsen claim he’s doing all he can to fight the opioid crisis? Medicaid and protections for preexisting conditions are the best tools in the policy toolbox to combat it, and Paulsen’s politically expedient votes to support legislation to confront the opioid crisis don’t change the damage he would do by eliminating those.

• In 2014, Medicaid paid for 25 percent of all addiction treatment nationwide.
• It is estimated that Medicaid expansion covers four in 10 people with an opioid use disorder.
• The opioid epidemic is now the most deadly drug overdose crisis in U.S. history. In 2016, roughly 64,000 Americans died of drug overdoses, meaning that more American lives were lost due to drug overdoses in 2016 than were lost in combat during the entirety of the Vietnam War. Two-thirds of 2016 drug overdoses involved opioids.
• Medicaid expansion has reduced unmet need for substance use treatment by more than 18 percent. Recent research finds that Medicaid expanding reduced the unmet need for substance use treatment by 18.3 percent.

5)    Will Paulsen claim to support MinnesotaCare?

Republican attacks on the Affordable Care Act have jeopardized MinnesotaCare, Minnesota’s twenty-five year old health care program for the working poor. The Trump Administration has threatened to cut hundreds of millions of dollars for this crucial program that helps low-income Minnesotans access affordable health coverage, and votes by Paulsen to repeal the Affordable Care Act would also lead to hundreds of millions in cuts. 

Additional Background

What would full repeal of the Affordable Care Act eliminate?

• Protections for 2,331,000 Minnesotans, including 310,200 of Paulsen’s constituents in MN-03, 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 120,000 Minnesotans

What would have the American Health Care Act (Republican ACA replacement bill Paulsen voted for) meant for Minnesota?

• In 2026, more than 254,000 Minnesotans would lose coverage under this bill, including 27,700 in Paulsen’s district.
• The nonpartisan Congressional Budget Office found that the American Health Care Act would have raised premiums 20 percent in 2018.
• AHCA imposed what the AARP calls an “age tax” on older Americans. In Minnesota, out-of-pocket costs for older people could increase by as much as $11,564  by 2026.
• The negative economic impact of the American Health Care Act would cause 24,785 Minnesotans to lose their jobs by 2022, including 1,062 in the 3rd congressional district

MN03 survey findings:

• A majority of voters (56%- 37%) – say they trust Democrats more than Republicans with their health care.
• MN03 voters oppose repealing the Affordable Care Act and instead want to keep what works and fix what doesn’t by a27-point margin.
• MN03 voters oppose the Trump Administration’s efforts to eliminate the health care law’s protections for people with preexisting conditions by a margin of 68% – 17%. 

You can read the full polling results for MN03 here

Washington, DC – Today, Senators sent to President Trump’s desk a package of legislation to address the opioid crisis while the Trump Administration has taken numerous, unprecedented steps to roll back progress in the fight, such as by enacting regulations that restrict Medicaid, upon which four in 10 Americans with opioid use disorder relies, attacking health care coverage for people with opioid use disorder through its lawsuit to end pre-existing conditions protections, and by promoting junk plans that don’t cover mental health care. In response, Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

“Okay, President Trump, you want to fight the opioid epidemic? End your administration’s assault on Medicaid and pre-existing conditions. Without doing that, signing this bill is like shutting the stable door after the horses have bolted.”

ADDITIONAL BACKGROUND:

PRESIDENT TRUMP AND HIS REPUBLICAN ALLIES WANT TO ROLL BACK COVERAGE THROUGH MEDICAID, A LIFELINE FOR PEOPLE SUFFERING WITH OPIOID USE DISORDER

• Republicans Have Repeatedly Taken Aim At Medicaid. The GOP has attempted to restrict access to Medicaid by allowing states to impose onerous work requirements on Medicaid coverage, trying to impose per capita limits on Medicaid funding, and repeatedly proposing legislation that would end Medicaid expansion.
• Restricting Access To Medicaid Threatens Lives And Impedes States’ Ability To Respond To The Opioid Epidemic. Four in 10 Americans with an opioid use disorder relies on Medicaid for access to treatment and life-saving overdose reversal medication. Restricting access to Medicaid puts people’s lives at risk and deprives states of funding and resources they depend on to fight the epidemic.

A TRUMP-GOP LAWSUIT COULD OVERTURN THE AFFORDABLE CARE ACT, WHICH PROTECTS PEOPLE WITH SUBSTANCE USE DISORDER

• Because Of The Affordable Care Act, Insurance Companies Can No Longer Deny Coverage Or Charge More Because Of Pre-Existing Conditions. The Affordable Care Act prevents insurance companies from denying someone coverage or charging them more because of a health problem they had before the date that new health coverage starts. It also prevents insurance companies from rescinding or canceling someone’s coverage arbitrarily if they get sick.
• The ACA Outlawed Medical Underwriting, The Practice That Let Insurance Companies Charge Sick People 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 Requires That Insurance Companies Cover Mental Health And Substance Use Disorder Services, And Paved The Way For Medicaid Expansion, Which Helps People Access Services For Substance Use disorders. The Affordable Care Act established ten essential health benefits, including mental health services, substance use disorder services, and prescription drug coverage, that insurance companies are required to cover. Without these protections, people in the individual market could be on their own — before the ACA, 45 percent of individual market plans did not cover substance use disorder services, and 38 percent of plans did not include mental health services.  The ACA also enabled states to expand Medicaid, which has helped people with substance use disorders and mental illness receive treatment. Recent research finds that Medicaid expanding reduced the unmet need for substance use treatment by 18.3 percent.

TRUMP-GOP JUNK INSURANCE PLANS OFTEN EXCLUDE COVERAGE FOR PRE-EXISTING CONDITIONS, MENTAL HEALTH CARE AND MORE

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]
• 1 in 4 Children Would Be Impacted If Insurance Companies Could Deny Or Charge More Because Of A Pre-Existing Condition. [Center for American Progress, 4/5/17]

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]

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]

Short-Term Junk Plans Can Retroactively Cancel Coverage After Patients File Claims. “Individuals in [short-term (STLDI)] plans would be at risk for rescission. Rescissions are retroactive cancellations of coverage, often occurring after individuals file claims due to medical necessity. While enrollees in ACA coverage cannot have their policy retroactively cancelled, enrollees in STLDI plans can.” [Wakely/ACAP, April 2018]

New Legislation Introduced by Senators Jeanne Shaheen and Maggie Hassan Would Ease Out-of-Pocket Costs

Washington, DC – Today, Senator Jeanne Shaheen (D-NH) introduced legislation to combat high out-of-pocket health care costs for uninsured patients and for patients in the individual health insurance market. U.S. Senator Maggie Hassan (D-NH) also announced that she will introduce companion legislation to help eliminate a related problem: surprise medical bills, where patients receive massive, unexpected medical bills, often for receiving care that they didn’t realize was considered out-of-network.

Said Leslie Dach, chair of Protect Our Care, in response to the legislation:

“We hear about it all the time – egregious surprise medical bills and astronomical out-of-network charges that bankrupt families – and it’s unacceptable. Insurance companies and providers could fix this, but they won’t. Any lawmaker who says they are serious about reducing health care costs for Americans should get behind these commonsense bills.”

ADDITIONAL BACKGROUND

Shaheen’s Reducing Costs for Out-of-Network Services Act of 2018 would cap the amount that hospitals and physicians could charge uninsured patients and out-of-network patients who have individual market coverage. These charge caps would also improve the ability of individual market health insurers to reduce premiums by lowering costs for in-network hospital and physician services. This legislation provides patients in the individual insurance market with similar protections to safeguards that Medicare Advantage beneficiaries have already benefitted from for years.

Hassan’s No More Surprise Medical Bills Act of 2018 would help eliminate surprise medical bills for people with employer-sponsored health plans. The bill will protect patients with medical emergencies from surprise billing by prohibiting hospitals and providers from charging more than the in-network amount. The bill also protects patients in non-emergency situations from surprise bills by requiring hospitals and providers to notify patients if services will be out-of-network and get their consent. Without proper notification and consent, a provider can only charge a patient the in-network amount.

Shaheen’s legislation protects patients who are uninsured or in the individual health insurance market, while Hassan’s legislation protects patients with employer-sponsored health plans.