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NEW POLL: Overwhelming Majority of Americans Support Protections for People With Pre-Existing Conditions

Washington, D.C – This morning, a new poll was released which found that 94 percent of Americans want the Supreme Court to uphold protections for people with pre-existing conditions. Brad Woodhouse, executive director of Protect Our Care, released the following statement in response:

“More than nine in 10 Americans want the Supreme Court to stay away from Republican efforts to dismantle protections for people with pre-existing conditions, a finding that comes on the heels of last week’s Kaiser poll showing that upholding these protections is the top health care issue for voters. So when the Trump Administration teams up with Republican state attorneys general and governors to overturn protections for people with pre-existing conditions, and then nominates someone to the Supreme Court to side with them in that case, not only are they actively working against the interests of the 130 million Americans who live with pre-existing conditions, they are ignoring the clear and resounding wishes of the American people.”

ADDITIONAL BACKGROUND

July 2018 –  Kaiser Family Foundation’s July Tracking Poll Confirms That Protections For People With Pre-Existing Conditions Are The Most Important Health Care Issue To Voters.

  • A Candidate’s Position On Continuing Protections For People With Pre-Existing Health Conditions Is The Top Health Care Campaign Issue For Voters, Among A List Of Issues Provided. “This issue cuts across voter demographics with most Democratic voters (74 percent), independent voters (64 percent), and voters living in battleground areas (61 percent), as well as half of Republican voters (49 percent) saying a candidate’s position on continued protections for pre-existing health conditions is either the single most important factor or a very important factor in their 2018 vote.”
  • Nearly Two Thirds Of Those Polled Do Not Want Supreme Court To Overturn Protections For People With Pre-existing Conditions. “Nearly two-thirds (64 percent) do not want to see the Supreme Court overturn these protections compared to half (52 percent) who do not want to see the Supreme Court overturn the Affordable Care Act (ACA) more generally.”
  • Almost Six In Ten Americans Say They Think President Trump And His Administration Are Trying To Make The ACA Fail. “Almost six in ten (56 percent) Americans say they think President Trump and his administration are trying to make the ACA fail while one-third (32 percent) say they are trying to make the law work. Most of those who say they think the Trump administration is trying to make the law fail think this is a “bad thing” (47 percent of the public). In addition, most (58 percent) say since President Trump and Republicans in Congress have made changes to the ACA, they are responsible for any problems with it moving forward.”

June 2018 – Kaiser Tracking Poll Also Found That That ACA Protections For Sick Patients Still Overwhelmingly Popular Despite GOP’s Efforts To End Them. Key findings:

  • Health Care Is Top Issue For Voters. 25 percent of voters cited health care as the most important issue to them, compared to the next highest earner, the economy and jobs, which 23 percent of voters said was the most important issue. In total, 79 percent of voters considered health care to be the most important or a very important issue.
  • Candidates’ Continued Support For Protections For People With Pre-Existing Conditions Is The Single Most Important Health Position For Voters. 14 percent of voters said cited protections for people with pre-existing conditions as the most important factor. 66 percent of voters said it was very important, if not the most important, health care issue to them.
  • Nearly Three Quarters Of Those Polled Said It Was “Very Important” That ACA Provisions Protecting Those With Pre-Existing Conditions Remain Law. 76 percent of voters said it was very important to keep the provision of the ACA that prevents insurance companies from denying coverage because of a person’s medical history. 72 percent of voters said it was very important to preserve the ACA’s protection against charging sick people more. Majorities of all parties support these protections.
  • Nearly Six In Ten Say Someone In Their Household Has A Pre-Existing Condition. “Nearly six in ten (57 percent) say they or someone in their household suffers from pre-existing medical conditions such asthma, diabetes, or high blood pressure.”
  • Half Of The Public Continues To Have A Favorable View Of The Affordable Care Act. “Half of the public continue to hold favorable views of the 2010 health care law, known as the Affordable Care Act. This continues the more than a year-long trend of a larger share of the public viewing the law favorably (50 percent) than unfavorably (41 percent).

June 2018 – Hart Research Poll Finds That 66 Percent Of Voters Disapprove Of Trump Justice Department’s Actions To Overturn Protections For People With Pre-Existing Conditions. When asked about the Trump Justice Department’s decision to take to court to argue against protections for people with pre-existing conditions, voters polled by Hart Research disapproved by 66 to 34 percent.

One Year After Repeal Defeat, We’re 100 Days from Election Day and Health Care is Still #1

Health Care is Top Issue to Voters, Due to Opposition to GOP Sabotage

Coalition that Defeated Repeal One Year Ago Will #RememberInNovember

Washington, D.C. – One year ago today, the American people made possible what many said was impossible: they defeated the number one legislative priority of Republicans and President Trump dating back seven years, the repeal of the Affordable Care Act. Now, 100 days from Election Day, health care is still the issue that matters most to voters.

“Here we are, 100 short days from Election Day, and Americans are as strongly opposed Republicans’ attacks on our health care today as they were one year ago. Nevertheless, Republicans are carrying on their repeal-and-sabotage crusade, no matter the consequences for the American people — let alone their own political prospects. Now begins the time Americans work to hold their representatives accountable for the sabotage that’s raising our health care costs and cutting health care for millions,” said Brad Woodhouse, executive director of Protect Our Care.  

This week, Protect Our Care coalitions held events around the country throughout the week to commemorate the hard work that defeated ACA repeal:

In Arizona, health care advocates gathered at Senator John McCain’s office to commemorate the anniversary of his historic “thumbs down” vote against repeal of the Affordable Care Act.

…to highlight #WhatsAtStake for our health if Brett Kavanaugh is confirmed to the Supreme Court:

In Alaska, concerned residents with pre-existing conditions and a faith leader visited Senator Lisa Murkowski’s office to thank her for her vote one year ago to protect their care and urge her to stand up to protect Alaskans’ care again when considering Brett Kavanaugh’s nomination to the Supreme Court.

In Maine, health care advocates and residents with pre-existing conditions held a press conference outside the state capitol in Augusta to celebrate the ACA repeal failure one year ago and encourage Senator Susan Collins, who cast one of the consequential votes that helped kill repeal last year, to continue protecting access to affordable health care for all Mainers when considering Brett Kavanaugh for the Supreme Court.

In Nevada, health care advocates held a press conference to sound the alarm about the extensive campaign the Trump Administration has undertaken to sabotage healthcare, including the nomination of Brett Kavanaugh to the Supreme Court.

In Pennsylvania, health care advocates joined local residents with pre-existing conditions at a roundtable discussion about how the nomination of Brett Kavanaugh to the Supreme Court could harm the 5.3 million Pennsylvanians with pre-existing conditions.

In Washington, DC, health care advocates and people with pre-existing conditions were joined by U.S. Senators Ron Wyden, Debbie Stabenow and Chris Murphy at a press conference to highlight the threat Brett Kavanaugh’s nomination poses to health care, especially for the 130 million Americans living with pre-existing conditions.   

In West Virginia, health care advocates were joined by people with pre-existing conditions at a press conference highlighting ongoing health care sabotage and the threat that Brett Kavanaugh’s nomination to the Court poses for West Virginians.

In Wisconsin, health care advocates and people with pre-existing conditions held a press conference to highlight ongoing health care sabotage and the danger Brett Kavanaugh would pose for Wisconsinites.

… to call on state attorneys general and the Trump Administration to drop their lawsuit to overturn protections in the ACA for women, seniors and people with pre-existing conditions:

Outside Vice President Mike Pence’s closed appearances in North Dakota, health care advocates demonstrated in opposition to the Trump administration and Attorney General Wayne Stenjam’s lawsuit seeking to overturning the Affordable Care Act, as well as Brett Kavanaugh’s nomination to the Supreme Court.

In Tennessee, health care advocates and people with pre-existing conditions delivered an open letter to TN Attorney General Herbert Slatery signed by hundreds of Tennesseans, demanding that he drop the lawsuit against the ACA and instead work to protect the care of over 2.7 million Tennesseans with pre-existing condition.

In Indiana, a petition signed by more than 600 Hoosiers asked Indiana Attorney General Curtis Hill to withdraw from the federal lawsuit, Texas vs. HHS, which  could dismantle the consumer protections in the Affordable Care Act. Health care advocates held a press conference as they hand-delivered the petition to Attorney General Hill yesterday.

In Missouri, health care advocates held a press conference to spotlight the threat Attorney General Josh Hawley’s lawsuit to overturn health protections in the ACA poses for Missourians, as well as the dangers of Brett Kavanaugh’s nomination to the Court.  

…and to be sure that voters will #RememberinNovember:

In Ohio, health care experts and advocates hosted a community forum at the Lima Public Library to discuss what’s at stake for Ohioans’ health care in this year’s midterm election, the importance of protecting the Affordable Care Act and Ohio’s Medicaid expansion, and how the health care law has helped Ohio communities.

Why New Jerseyans’ Insurance Is Getting Even More Expensive: The Trump Administration and Washington Republicans Keep Sabotaging Health Care

Washington, D.C. – As preliminary New Jersey rate filings for 2019 individual-market health insurance indicated a potential near-double-digit average premium increase due to Washington Republicans’ repeal-and-sabotage agenda, Protect Our Care Executive Director Brad Woodhouse released the following statement:

“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 now families in New Jersey are being asked to pay the price. While insurance companies make huge profits and enjoy record tax breaks from Republicans, they are planning to charge working families even more. Until we stop Republicans’ war on health care, health care experts predict that rates will keep rising by double digits. 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 New Jerseyans.”

From the Insurance Commissioner and Insurance Companies:

Department Of Banking And Insurance: “Policies In Washington Aimed Aimed At Dismantling The Affordable Care Act Have Created Enormous Uncertainty In Insurance Markets Nationwide.” “Policies in Washington aimed at dismantling the Affordable Care Act have created enormous uncertainty in insurance markets nationwide. The repeal of the individual mandate as part of the federal Tax Cuts and Jobs Act has led to requested rate increases in states across the country. The federal government has also advanced rules to permit the sale of short-term limited duration plans and association health plans that do not comply with the ACA, stalled Risk Adjustment Payments to carriers and slashed funding for health care navigators that assist consumers with enrolling in coverage.” [State of New Jersey Department of Banking & Insurance, 7/27]

Department Of Banking And Insurance Commissioner Marlene Caride: Without State Actions Undertaken To Blunt GOP Sabotage, Rates Would Have Been Even Higher. “Carriers indicated that without the recent enactment of the law to continue an individual mandate in New Jersey, the average requested rate increase would have been 12.6 percent… ‘New Jersey is working aggressively to ensure that residents have access to affordable quality coverage, and actions taken by the state to improve the market are reflected in the rates submitted. Under the leadership of Governor Murphy, New Jersey is leading the nation in its efforts to create stability in the market and to combat the uncertainty created by Washington. Carriers were clear that without state action, the average increase requested in the individual market would have more than doubled,’ said Department of Banking and Insurance Commissioner Marlene Caride.” [State of New Jersey Department of Banking & Insurance, 7/27]

Horizon Blue Cross Blue Shield: Rate Increases Will Be As High As 9.8 Percent. “The requests from four insurers ranged from 0.8 percent for one of AmeriHealth of New Jersey’s plans to 9.8 percent for one offered by Horizon Blue Cross Blue Shield of New Jersey. Two insurers, Oscar and Oxford, are not active in southern New Jersey.” [Philadelphia Inquirer, 7/27]

Why New Jerseyans’ Insurance Is Getting Even More Expensive: The Trump Administration and Washington Republicans Keep Sabotaging Health Care

While spending most of last year trying to repeal the Affordable Care Act (ACA) and waging a war on our health care, President Trump and Republicans in Congress have also used their control of Washington to actively undermine the Health Insurance Marketplaces every chance they get – leading insurance companies to raise premiums for 2018 and 2019 and, in some cases, forcing them out of the individual market altogether. Washington Republicans’ goal is simple: sabotage and undermine the Affordable Care Act, then blame everyone but themselves for the consequences of their actions. President Trump keeps rooting for disaster, saying that “The best thing we can do…is let Obamacare explode” and “Let it be a disaster because we can blame that on the Democrats.

Now, initial rate filings in New Jersey forecast near-double-digit rate hikes again this fall because of Republican sabotage.

Republicans never ended their war on our health care. After Congress failed to repeal the Affordable Care Act, the Trump Administration is aggressively sabotaging our health care system and refusing to work to make coverage better and more affordable.

  • Experts from AARP, the Congressional Budget Office, and a wide range of other nonpartisan organizations agree that Republican actions are forcing up health care costs.
  • Republicans in Congress are supporting the Administration’s many actions to undermine health care, despite widespread opposition from patient and disease groups, doctors, nurses, hospitals, plus health care and consumer advocates.
  • The Trump Administration officials keep rewriting the rules to let big insurance companies cover fewer and fewer services while charging people more and more. The sabotage doesn’t stop there: last year the Administration fired many of the community assisters who help people enroll in health care; this year they are planning more enrollment cuts, making it even harder to sign up for coverage.
  • And now, Republicans are encouraging insurance companies to sell more junk plans that don’t have to cover basic care like hospitalization and prescription drugs, and that are allowed to charge people with pre-existing conditions more or even deny them coverage altogether.

This could have been avoided: if Republicans had stopped sabotaging health care, American families wouldn’t be facing another huge increase this fall.

  • Even the Trump Administration has admitted that the Affordable Care Act’s insurance marketplaces had been stabilizing prior to them coming into office.
  • The nonpartisan Congressional Budget Office had predicted only modest rate increases if Republicans hadn’t sabotaged the markets.
  • Even Senate Republicans admitted this fall’s upcoming rate hikes were “avoidable,” but then they torched bipartisan stabilization talks at the last minute, prioritizing partisan politics over their last opportunity to help American families afford health care next year.

The Trump Administration’s sabotage will punish Americans by jacking up premiums again, compounding the damage done last year, when Republican sabotage pushed rates up by a national average of 37 percent, and 18 percent in New Jersey.

  • The Republican tax bill’s repeal of a key Affordable Care Act provision and the Trump Administration’s junk plan proposal will increase individual market premiums in New Jersey by an average 10.9 percent this fall, according to a recent Urban Institute study.
  • This sabotage-driven rate hike will make the damage Republicans inflicted last year through repeal attempts and sabotage even worse.
  • Higher premiums will mean fewer working families can afford coverage: during the first year of the Trump Administration, millions more Americans joined the ranks of the uninsured – the highest increase since Gallup started tracking the uninsured rate.

Despite Republican sabotage, the Affordable Care Act has improved New Jerseyans’ care.

  • 274,782 New Jerseyans signed up for Marketplace coverage this year.
  • Thanks to the Marketplace and Medicaid expansion, New Jersey’s uninsured rate fell by 4.4 percent between 2013 and 2016 as New Jerseyans have gained access to affordable coverage.
  • Before today’s announcement, the Urban Institute predicted that New Jersey premiums for 2019 could rise 10.9 percent more because of the Trump Administration’s junk plan proposal and the Republican tax bill’s repeal of a key Affordable Care Act coverage incentive.
  • Even despite sabotage, Affordable Care Act subsidies help keep coverage affordable for 77 percent of New Jersey Marketplace consumers, whose average 2018 premium is $157 per month.
  • But because of the Republican sabotage agenda, many middle-income New Jerseyans could pay hundreds or thousands of dollars more than they would have otherwise.

New Jerseyans won’t forget that Republicans and the Trump Administration keep forcing up health care costs to score political points.

 

  • Health care costs are a top issue in nearly every major issue-ranked poll in 2018.
  • Voters overwhelmingly trust Democrats over Republicans on health care costs.
  • In poll after poll, voters resoundingly reject President Trump and Congressional Republicans’ repeal-and-sabotage campaign against the Affordable Care Act.

 

 

KEY QUOTES

America’s Health Insurance Plans: Trump Administration’s DOJ Decision Would “Cause Rates To Go Even Higher For Older Americans And Sicker Patients.” “Zeroing out the individual mandate penalty should not result in striking important consumer protections, such as guaranteed issue and community rating rules that help those with pre-existing conditions. Removing those provisions will result in renewed uncertainty in the individual market, create a patchwork of requirements in the states, cause rates to go even higher for older Americans and sicker patients, and make it challenging to introduce products and rates for 2019. Instead, we should focus on advancing proven solutions that ensure affordability for all consumers. [AHIP, 6/8/18]

Associated Press: Administration’s Decision Could “Nudge Premiums Even Higher.” “The Trump administration’s decision to stop defending in court the Obama health law’s popular protections for consumers with pre-existing conditions could prove risky for Republicans in the midterm elections — and nudge premiums even higher.” [CNBC, 6/8/18]

Timothy Jost, Washington & Lee University Law Professor: Administration’s Decision Could Leave Millions Of Americans Facing “Denial Of Coverage Or Higher Premiums.” “Yesterday, the Trump administration’s Department of Justice dropped a bombshell in a rural Texas federal courthouse. The administration stated in a court filing (and also in letters to Congressional leaders) that it would not defend three key provisions of the Affordable Care Act (ACA). If the judge in the case agrees, millions of Americans with preexisting conditions could face denial of coverage or higher premiums.” [Commonwealth Fund, 6/8/18]

Ceci Connolly, Alliance Of Community Health Plans: Administration’s Decision Decision Could Spark Fresh Market Instability. “Ceci Connolly, president of the Alliance of Community Health Plans, called the legal position ‘troubling’ and warned it could spark fresh market instability. ‘At the very least it adds uncertainty at exactly the moment when plans are trying to set rates for next year,’ Connolly said in a statement. ‘At the worst, it could strip away guaranteed coverage for those with pre-existing conditions. We don’t want to return to the days when people who needed the care the most could be turned away because of their health status.’” [Modern Healthcare, 6/8/18]

Fortune: If Administration’s Decision Is Implemented, “There’s A Strong Change Insurers Would Begin Charging Sicker People Significantly More.” “To date, many low-income people have been shielded from those increases since federal subsidies to help pay premiums rise in tandem with the spikes. Middle-class families who don’t qualify for the subsidies are left either swallowing the higher premiums or forgoing coverage. If the protections for people with pre-existing conditions are ultimately shot down, there’s a strong chance insurers would begin charging sicker people significantly more for their coverage while younger and healthier Americans would see lower prices.” [Fortune, 6/11/18]

America’s Health Insurance Plans: Administration’s DOJ Decision Would “Cause Rates To Go Even Higher For Older Americans And Sicker Patients.” “Zeroing out the individual mandate penalty should not result in striking important consumer protections, such as guaranteed issue and community rating rules that help those with pre-existing conditions. Removing those provisions will result in renewed uncertainty in the individual market, create a patchwork of requirements in the states, cause rates to go even higher for older Americans and sicker patients, and make it challenging to introduce products and rates for 2019. Instead, we should focus on advancing proven solutions that ensure affordability for all consumers. [AHIP, 6/8/18]

Associated Press: Administration’s Decision Could “Nudge Premiums Even Higher.” “The Trump administration’s decision to stop defending in court the Obama health law’s popular protections for consumers with pre-existing conditions could prove risky for Republicans in the midterm elections — and nudge premiums even higher.” [CNBC, 6/8/18]

Timothy Jost, Washington & Lee University Law Professor: Administration’s Decision Could Leave Millions Of Americans Facing “Denial Of Coverage Or Higher Premiums.” “Yesterday, the Trump administration’s Department of Justice dropped a bombshell in a rural Texas federal courthouse. The administration stated in a court filing (and also in letters to Congressional leaders) that it would not defend three key provisions of the Affordable Care Act (ACA). If the judge in the case agrees, millions of Americans with preexisting conditions could face denial of coverage or higher premiums.” [Commonwealth Fund, 6/8/18]

Ceci Connolly, Alliance Of Community Health Plans: Administration’s Decision Decision Could Spark Fresh Market Instability. “Ceci Connolly, president of the Alliance of Community Health Plans, called the legal position ‘troubling’ and warned it could spark fresh market instability. ‘At the very least it adds uncertainty at exactly the moment when plans are trying to set rates for next year,’ Connolly said in a statement. ‘At the worst, it could strip away guaranteed coverage for those with pre-existing conditions. We don’t want to return to the days when people who needed the care the most could be turned away because of their health status.’” [Modern Healthcare, 6/8/18]

Fortune: If Administration’s Decision Is Implemented, “There’s A Strong Change Insurers Would Begin Charging Sicker People Significantly More.” “To date, many low-income people have been shielded from those increases since federal subsidies to help pay premiums rise in tandem with the spikes. Middle-class families who don’t qualify for the subsidies are left either swallowing the higher premiums or forgoing coverage. If the protections for people with pre-existing conditions are ultimately shot down, there’s a strong chance insurers would begin charging sicker people significantly more for their coverage while younger and healthier Americans would see lower prices.” [Fortune, 6/11/18]

Former HHS Secretary Tom Price: GOP Actions Responsible For Premium Increases. “President Trump’s former top health official on Tuesday said the Republican tax law would raise the cost of health insurance for some Americans because it repealed a core provision of the Affordable Care Act. Tom Price, Trump’s first secretary of the Department of Health and Human Services, said people buying insurance on government-run marketplaces will face higher prices because the tax law repealed the ACA’s individual mandate. The mandate had forced most Americans to have health coverage or face a financial penalty. ‘There are many, and I’m one of them, who believes that that actually will harm the pool in the exchange market, because you’ll likely have individuals who are younger and healthier not participating in that market, and consequently that drives up the cost for other folks within that market,’ Price said at the World Health Care Conference in Washington.” [Washington Post, 5/1/18]

America’s Health Insurance Plans: Republican Sabotage Will “Drive Up The Rate Of Premium Increases.” “Policies that disproportionately draw healthy consumers away from the individual market, like expanding access to short-term plans, will likely have an even more devastating effect on affordability, choice and competition. This will further result in adverse selection, drive up the rate of premium increases, and exacerbate affordability issues for many other people.” [America’s Health Insurance Plans Letter to HHS, 4/20/18]

Cynthia Cox, Kaiser Family Foundation: “In The Absence Of Efforts To Undermine The Market, We Would Be Seeing A Period Of Relatively Small Premium Increases.” “‘In the absence of efforts to undermine the market, we would be seeing a period of relatively small premium increases, driven mostly by the underlying growth in health care costs,’ said Cynthia Cox, the lead author of the Kaiser Family Foundation report. ‘I wouldn’t be surprised if we’re in for another year of double-digit premium increases. And if that does happen, it would be in large part due to policy changes that are happening.’” [Huffington Post, 5/18/18]

Kris Haltmeyer, Blue Cross Blue Shield Association Vice President: “With The Repeal Of The Individual Mandate And The Failure Of Congress To Enact Stabilization Legislation, We Are Expecting Premiums To Go Up Substantially.” Kris Haltmeyer, a vice president at the Blue Cross Blue Shield Association, told reporters that the premium increases were in part due to the repeal of ObamaCare’s individual mandate in the Republican tax reform bill in December. He also cited lawmakers’ failure to pass a bill aimed at shoring up the market, which fell apart earlier this year amid a partisan dispute over abortion restrictions. ‘With the repeal of the individual mandate and the failure of Congress to enact stabilization legislation, we are expecting premiums to go up substantially,’ Haltmeyer said. He estimated that average premium increases nationwide will be in the ‘low teens,’ but that there will be major variation across areas, ranging from the low single digits to up to 70 or 80 percent.” [The Hill, 5/23]

New York Times Editorial Board: “The Administration’s Health Care Sabotage Efforts Have Already Had A Big Impact”: A 30-Percent Premium Increase. “The administration’s health care sabotage efforts have already had a big impact — but not the kind of impact officials promised. Insurance companies raised average premiums for 2018 A.C.A. policies by 30 percent. This has mostly hurt middle-class families who have to pay full freight for health insurance because they make too much money to qualify for subsidies and don’t get coverage through their employer. Few experts were surprised when the Commonwealth Fund found that the percentage of American adults who did not have health insurance jumped to 15.5 percent this year, from 12.7 percent before Mr. Trump took office. Experts say those numbers could climb higher still when the penalty for not having insurance goes away next year.” [NYT, 5/3/18]

Commonwealth Fund: Rollback Of Health Insurance Gains Spurred By “Actions By The Current Administration.” “The marked gains in health insurance coverage made since the passage of the Affordable Care Act (ACA) in 2010 are beginning to reverse, according to new findings from the latest Commonwealth Fund ACA Tracking Survey. The coverage declines are likely the result of two major factors: 1) lack of federal legislative actions to improve specific weaknesses in the ACA and 2) actions by the current administration that have exacerbated those weaknesses. These include the administration’s deep cuts in advertising and outreach during the marketplace open-enrollment periods, a shorter open enrollment period, and other actions that collectively may have left people with a general sense of confusion about the status of the law. Signs point to further erosion of insurance coverage in 2019: the repeal of the individual mandate penalty included in the 2017 tax law, recent actions to increase the availability of insurance policies that don’t comply with ACA minimum benefit standards, and support for Medicaid work requirements.” [Commonwealth Fund, 5/1/18]

Center For American Progress: “Combined, The Recent Tax Law’s Repeal Of The Individual Mandate And The Administration’s Short-Term Plan Rule Will Undermine The Individual Insurance Market And Increase Premiums For ACA-Compliant Coverage.” “Last year, as part of the tax law, Congress eliminated the Affordable Care Act’s individual mandate penalty. Given the mandate’s important role in encouraging healthier people to enroll in the marketplaces, the Congressional Budget Office (CBO) estimates that, in 2019, this will increase average premiums in the individual market by 10 percent. Furthermore, in February 2018, the Trump administration proposed a rule to expand short-term health insurance plans… Along with the repeal of the individual mandate penalty, this expansion of short-term plans will drive up average premiums for ACA-compliant coverage in the individual market. Recent preliminary rate filings in Virginia demonstrate that these actions are contributing to significant premium increases for marketplace coverage in 2019. In fact, some Virginia insurers specifically cited the individual mandate repeal and short-term plan rule as major factors in their rate filings… Combined, the recent tax law’s repeal of the individual mandate and the administration’s short-term plan rule will undermine the individual insurance market and increase premiums for ACA-compliant coverage.” [CAP, 5/18]

New York Times: “Rather Than Trying To Eliminate Obamacare In One Fell Swoop, [Republicans Are] Trying To Undermine It With Multiple Acts Of Sabotage – While Hoping Voters Won’t Realize Who’s Responsible For Rising Premiums And Falling Coverage.” “At the beginning of 2017, Republicans promised to release the kraken on Obamacare — to destroy the program with one devastating blow. But a funny thing happened: Voters realized that repealing the Affordable Care Act would mean taking health insurance away from tens of millions of Americans. They didn’t like that prospect — and enough Republicans balked at the backlash that Obamacare repeal fizzled. But Republicans still hate the idea of helping Americans get health care. So instead of releasing the kraken, they’ve brought on the termites. Rather than trying to eliminate Obamacare in one fell swoop, they’re trying to undermine it with multiple acts of sabotage — while hoping voters won’t realize who’s responsible for rising premiums and falling coverage.” [NYT, 5/8/18]

Washington Post Editorial Board: “The Numbers Suggest That [The ACA’s] Critics’ Sabotage Efforts Are To Blame. “The effects of the president’s underinformed instincts, enabled by the ideologues in his administration, are beginning to show up in some of the numbers, representing real pain that Americans are suffering for Mr. Trump’s deficient leadership… Obamacare critics regularly describe all problems as the inevitable result of a poorly designed law. But the numbers suggest that the critics’ sabotage efforts are to blame. After impressive declines during President Barack Obama’s second term, the fund found that the uninsured rate increased in both of the years Mr. Trump has been in office. During the campaign, Mr. Trump regularly complained that the Affordable Care Act (ACA) left too many Americans uncovered. The result of nearly a year and a half of Mr. Trump’s leadership is 4 million people added to that group.” [Washington Post, 5/8/18]

Horizon Blue Cross Blue Shield of New Jersey: 2018 Premium Increase Was Due To Federal Policy.Three factors connected to federal policy decisions are responsible for 14.7% of the 24.3% total average individual premium increase: Weakened enforcement of the Individual Mandate…Elimination of federal funding for Cost Sharing Reductions (CSR), [and] 2018 reinstatement of Health Insurance Tax…Were it not for the three factors within the control of the Federal Government, Horizon BCBSNJ’s individual premiums would have an average increase of 9.6%.” [Horizon Blue Cross Blue Shield of New Jersey, 10/17/17]

CEO of CareFirst Blue Cross Blue Shield: Things Are “Materially Worse” Under Trump. “Continuing actions on the part of the administration to systematically undermine the market and make it almost impossible to carry out the mission…If continued efforts at the federal level undermine the marketplaces, I would think the board would have to examine what they would want — that’s very much on their mind.” [Washington Post, 5/1/18]

Lindsey Graham: Republicans “Own The Outcome” On Health Care. “Sen. Graham told Breitbart News, ‘In October, premiums are going up. Obamacare cannot be fixed. It’s going to continue to collapse, and then, we own the outcome. By repealing the individual mandate, which is a step forward in the eyes of the public, we own the issue. We have a responsibility to do something about the collapsing Obamacare system. I believe that we’re going to get blamed more than Democrats because we stopped trying to repeal Obamacare, and to suggest that we don’t own it is just simply politically naive.’ Graham continued, ‘It can hurt us in 2018. It can hurt by our base feeling like we betrayed them. It can hurt us from people suffering from Obamacare, like we don’t have a solution. It will energize Democrats. It can undercut everything we did on the tax cut side.’” [Breitbart, 2/6/18]

Rep. Charlie Dent: “We, The Republican Party…Own” Health Care Now. “Rep. Charlie Dent (R-Pa.) argued Friday that President Trump was ‘ill-advised’ to end key ObamaCare payments, warning that the GOP now ‘owns’ whatever happens to ObamaCare. ‘I think the president is ill-advised to take this course of action because … we, the Republican Party, will own this,’ Dent, a key House moderate who is retiring from Congress at the end of his term, said on CNN. Asked about Trump’s previous comments blaming problems with ObamaCare on former President Barack Obama, Dent pointed out that Republicans currently control the White House and have majorities in both chambers of Congress. ‘Barack Obama is a former president. President Trump is the president and he’s a Republican, and we control the Congress,’ Dent said. ‘So we own the system now. We’re going to have to figure out a way to stabilize this situation … This is on us.’” [The Hill, 10/13/17]

Washington Post: “The Pottery Barn Rule Comes To Mind: You Break It, You Own It.” “This is not ‘letting’ Obamacare fail. Many nonpartisan experts believe that these active measures are likely to undermine the pillars of the 2010 law and hasten the collapse of the marketplaces. The Pottery Barn rule comes to mind: You break it, you own it. Yes, the plate you just shattered had some cracks in it. But if you dropped it on the ground, the store is going to blame you.” [Washington Post, 10/13/17]

Washington Post: “Trump’s Not Going To Be Able To Avoid Blame For Kneecapping Obamacare.” [Washington Post, 10/13/17]

“After Months Of Pinning The Blame For Obamacare’s Shortcomings On Democrats And Watching His Own Party Fail To Act, President Donald Trump Just Took Ownership Of A Struggle That’s Consumed Republicans For Seven Years.” “After months of pinning the blame for Obamacare’s shortcomings on Democrats and watching his own party fail to act, President Donald Trump just took ownership of a struggle that’s consumed Republicans for seven years. Trump’s decision late Thursday to end government subsidies to insurers to help lower-income Americans afford to use their coverage under the Affordable Care Act was the most drastic step he’s taken to undermine his predecessor’s signature achievement. It also lobbed a live bomb into the laps of Republicans lawmakers 13 months before congressional elections after he publicly berated the party’s Senate leadership for being unable to keep a longstanding promise to repeal the law.” [Bloomberg, 10/13/17]

The American People Agree: President Trump And Congressional Republicans Are Playing Politics With People’s Health Care.  A poll conducted last September found that 61 percent of voters believed President Trump was “trying to make the Affordable Care Act fail,” and 64 percent of voters said Trump is “playing politics with people’s health care.” The poll also found that the American people seriously disapprove of how Republicans in Congress are treating health care: 80 percent of voters disapprove while only 20 percent approve. [Hart Research, 9/5/17]

One Year Later, We Remember

Washington, D.C. – One year ago, a bipartisan majority defeated the repeal of the Affordable Care Act in the Senate. It was one of the first wins of the resistance and most defining moments of the Trump presidency. But the GOP has not stopped its attempts to sabotage our care – and we are all taking note.

Reporters remember:

Jeffrey Young, Huffington Post:

Jonathan Cohn, Huffington Post:

Steven Dennis, Bloomberg:

Dylan Scott, Vox:

Health Care experts remember:

Topher Spiro with the Center for American Progress:

Andy Slavitt, former acting administrator, Centers for Medicare and Medicaid Services:

Charles Gaba, independent health care analyst:

Senators remember:

Sen. Ron Wyden (D-OR):

Sen. Debbie Stabenow (D-MI):

Sens. Chris Murphy (D-CT), Brian Schatz (D-HI), and Cory Booker (D-NJ):

Health care activists remember:

Little Lobbyists:

Planned Parenthood Action Fund:

Health Care Voter:

And the public definitely remembers:

SHOT/CHASER: President Trump Doubles Down on Absurd Claims About Non-Existent Health Care Plans

During remarks given yesterday in Iowa and again today at the White House, President Donald Trump touted his junk association health plans (AHPs). There were just a few problems:

SHOT:  

Trump:  Association Health Plans Are Doing “Record Business.”  “Alex Acosta has come up with incredible healthcare plans through the Department of Labor — association plans where you associate, where you have groups and you get tremendous healthcare at a very small cost.  And it’s across state lines; you can compete all over the country. They compete. They want to get it. And, Alex, I hear it’s like record business that they’re doing. We just opened about two months ago, and I’m hearing that the numbers are incredible.  Numbers of people that are getting really, really good healthcare instead of Obamacare, which is a disaster.” [Donald Trump, Remarks at Workforce Development Roundtable, Peosta, IA, 7/26/18]

Trump Said “Associated Health Plans” Have “Just Opened” And “Millions Of People Are Going To Be Signing Up.”  “Through associated health plans we are giving Americans the ability — just opened — millions of people are going to be signing up. Millions and millions. Much better and more affordable healthcare, including bidding across state lines.” [Donald Trump, Press Availability, Washington, DC, 7/27/18]

CHASER:  

Association health plans won’t even go on sale until September and they’re already being described as “kind of a flop” as major associations decline to participate and 11 states filed suit to challenge the rule for undermining the protections of the Affordable Care Act.

HEADLINE:  “Trump Touts Demand For Healthcare Plans That Don’t Exist Yet.” [Washington Examiner, 7/27/18]

HEADLINE:  “Trump Celebrates ‘Record’ Sales of Nonexistent Health Insurance Policies” [Huffington Post, 7/27/18]

HEADLINE:  “States Sue Trump Administration Over Association Health Plans”  [Politico, 7/27/18]

HEADLINE:  “Trump Says New Health Plans, Not Available Until September, Already Doing ‘record Business’” [The Hill, 7/26/18]

HEADLINE:  “Trump’s Association Health Plans Are Kind Of A Flop” [Vox, 7/20/18]

HEADLINE:  “Trump Promised Them Better, Cheaper Health Care. It’s Not Happening.”  [Politico, 7/19/18]

Republicans At All Levels Face Fury from Their Constituents as the Coalition that Defeated Health Care Repeal Takes the Fight Local

As we head into the one-year anniversary of the Senate’s defeat of ACA repeal, Republicans are running scared of their own record, especially as Big Health Care CEO compensation soars on their watch.

Meanwhile, the coalition that defeated health care repeal is rising up to fight GOP sabotage at every level of government.

  • For a full month, Protect Our Care and its partners have continually sounded the alarm about Brett Kavanaugh, President Trump’s Supreme Court nominee, who is now opposed by 41 percent of Americans, the vast majority of whom do not want the Court to overturn protections for people with pre-existing conditions.
  • All week, the Protect Our Care coalition held events marking the anniversary of the Senate defeating repeal and highlighting continued threats to health care, and today Protect Our Care coalitions in Alaska, Arizona, Indiana, Maine, Nevada, Ohio, Pennsylvania, Tennessee, and West Virginia are holding actions to ask their Republican attorneys general and governors to drop their lawsuit to overturn protections for people with pre-existing conditions in the Affordable Care Act.
  • Looking ahead to August, Protect Our Care coalitions across the country are gearing up to confront House Republicans during recess about the numerous votes they have taken to repeal protections for people with pre-existing conditions, jack up premiums, reduce coverage, and give kickbacks to insurance companies, drug companies, and the wealthy – while doing nothing to bring down the cost of prescription drugs.

With an energized grassroots representing the will of the public, according to poll after poll after poll after poll, it’s no wonder why Democrats are rising up to fight for health care. Just yesterday:

  1. Senate Democrats redoubled their commitment to fight tooth-and-nail to protect health care for all Americans, while marking the one-year anniversary of their defeat of Republicans’ effort to repeal the ACA.
  2. House Democrats introduced a resolution that would intervene to protect the 130 million Americans with pre-existing conditions from the GOP-Trump Administration lawsuit working to overturn protections for them.
  3. A coalition of 12 Democratic attorneys general filed a lawsuit to fight back against the Trump Administration’s revival of junk plans that charge money for poor coverage.

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This Week in the War on Health Care: Repeal Defeat Anniversary Edition

One year ago, health care repeal was defeated. It was defeated because of the individuals across the country, from Alaska to Maine, who went to town halls and parades and protests to make their voices heard. It was defeated because of the numerous people with different backgrounds, from children with pre-existing conditions to seniors with disabilities, who traveled thousands of miles to the U.S. Capitol to make sure their representatives would listen to them. It was defeated because of the never-ending work done by everyday Americans who refused to let their care be taken away. And today, the health care fight is as urgent and energized as ever.

Health care is a top issue for voters, who are overwhelmingly backing Democrats on the issue:

Washington Post: Health Care Among Top Issues Motivating Voters, A “Clear Advantage” For Democrats. “Three months from the midterm elections, health care remains a gaping political vulnerability for the GOP… Recent polls have shown that health care is one of the top issues motivating voters, alongside jobs and the economy. A Washington Post-Schar School poll in July found that Democrats have a clear advantage among those voters who cite health care as their most important issue, and a Pew Foundation poll in June found that voters trust Democrats over Republicans on the issue by a 16-point margin.” [Washington Post, 7/25/18]

Kaiser Family Foundation: Protecting People With Pre-Existing Conditions Top Health Care Priority, Public Overwhelmingly Opposes Supreme Court Overturning Them. “A candidate’s position on continuing protections for people with pre-existing health conditions is the top health care campaign issue for voters, among a list of issues provided. This issue cuts across voter demographics with most Democratic voters (74 percent), independent voters (64 percent), and voters living in battleground areas (61 percent), as well as half of Republican voters (49 percent) saying a candidate’s position on continued protections for pre-existing health conditions is either the single most important factor or a very important factor in their 2018 vote. When it comes to the Supreme Court and possible future court cases, once again, continued protections for people with pre-existing conditions weighs heavy on the minds of the public. Nearly two-thirds (64 percent) do not want to see the Supreme Court overturn these protections.” [KFF, 7/25/18]

Forbes: Pre-Existing Condition Poll “Another Sign Of Mounting Political Problems For Republicans.” “By a 2-to-1 margin, U.S. voters disapprove of the U.S. Justice Department’s decision to support a lawsuit that would eliminate popular protections for patients with preexisting conditions under the Affordable Care Act, a new poll shows. The survey of likely voters by Hart Research Associates is another sign of mounting political problems for Republicans heading into the November mid-term elections, putting GOP candidates on the defensive for the Trump DOJ’s decision not to defend one of the most popular features of the ACA.” [Forbes, 6/24/18]

It’s a centerpiece of the Supreme Court fight:

Vox: The Fate Of The ACA Could Turn On Judge Kavanaugh’s Appointment. “The fate of the Affordable Care Act may hinge on the appointment of Judge Brett Kavanaugh to the Supreme Court — as Democrats have rightly been pointing out. But supporters of the health care law, if anything, underestimate the dangers to the law posed by conservative legal challenges and a rightward shift on the Court. Aspects of Kavanaugh’s jurisprudence as it relates to health care, especially his views about executive power, raise concerns that deserve more attention than they have been given so far —particularly because the president and his agencies have been using their powers to sabotage the ACA for more than a year. One highly politicized challenge to the ACA coming out of Texas has indeed received a lot of attention: It turns on the question of whether the entire health care law should be struck down now that Congress has eliminated the ACA’s penalty for failing to comply with the so-called ‘individual mandate’ to buy health insurance under the law. But the ACA is under attack on multiple legal fronts; anyone concerned needs to focus on more than just Texas. Taken together, these challenges threaten to end the ACA’s essential protections, including a minimum level of care for all and guaranteed access to quality health care regardless of preexisting conditions.” [Vox, 7/23/18]

Washington Post: Brett Kavanaugh Could Take An Ax To Obamacare. Kavanaugh is a polarizing figure in the health-care debate. Among the things that distinguish him from the other finalists on Trump’s list is his expansive view of executive power — he argued that a president could decline to enforce a statute such as Obamacare even if a court upholds its constitutionality — and his dissent in a 2011 case in which others on his appellate court upheld the constitutionality of the Affordable Care Act… In the long run, Kavanaugh could shape jurisprudence for decades on abortion, gay rights, voting rights, money in politics, guns, presidential authority and more. But his most immediate impact could be on health care.” [Washington Post, 7/9/18]

USA Today: Brett Kavanaugh Could Deal Death Blow To Obamacare. “With the nomination of Judge Brett Kavanaugh to the Supreme Court, President Donald Trump has now engaged all three branches of government in his fight to get rid of the Affordable Care Act and protections for people with pre-existing health conditions. Kavanaugh made clear last year in a speech at the Heritage Foundation that he thinks the court was wrong to uphold the ACA’s insurance mandate as constitutional. He has also said a president should be allowed to not enforce components of a law if he personally deems it unconstitutional (encouragement this president doesn’t need). There couldn’t be a more in-your-face threat to the ACA than from a Justice Kavanaugh.” [USA Today, 7/14/18]

It’s a driving force behind campaigns from coast to coast:

USA Today: Democratic Candidates Running On Health Care After GOP Attempts To Repeal Obamacare. “In one online ad, Democratic House candidate Angie Craig of Minnesota blasts GOP Rep. Jason Lewis for voting ‘to dramatically increase the cost of insurance and kick millions off health care.’ Rep. Jacky Rosen, a Democratic Senate candidate from Nevada, in another ad, highlights Sen. Dean Heller’s pledge to oppose a Republican attempt to repeal the Affordable Care Act, before ultimately backing the effort under pressure from President Trump. And Democratic House candidate Antonio Delgado of New York has an ad that points to GOP Rep. John Faso’s vote for repealing the ACA, known as Obamacare, after promising a woman with a brain tumor on video that he would not take away her health care… After years of playing defense on health care, Democratic candidates have made it a top issue this election cycle.” [USA Today, 5/2/18]

Seattle Times: “Her Experience [Over Repeal] Led Her To Do Something She’d Never Dreamed Of: Run For Congress.” “Last spring, Issaquah pediatrician Kim Schrier joined three other Virginia Mason doctors for a meeting with an aide to U.S. Rep. Dave Reichert, R-Auburn. On their minds: a Republican health-care bill aimed at dismantling the Affordable Care Act, also known as Obamacare. At Reichert’s Issaquah district office, Schrier and her colleagues argued against the GOP plan, pointing to estimates it would chop health-care access for tens of thousands of people in the 8th Congressional District… Within a week or so, Reichert voted to pass the health-care overhaul out of the House Ways and Means Committee. He later voted against the final version, but only after it was clear Republicans had enough votes to pass it without him. Her experience with Reichert led Schrier to do something she’d never dreamed of: run for Congress against a seven-term incumbent.” [Seattle Times, 7/26/18]

  • Kim Schrier, “If Congress Was Doing Its Job, I Would Not Have To Run For Office.” “‘I was ticked off. Frankly, if Congress was doing its job, I would not have to run for office. I would be back holding little babies. But times have changed,’ Schrier told volunteers at her campaign headquarters in Issaquah this month.” [Seattle Times, 7/26/18]

Bristol Herald Courier: “The Health Care Discussion Spurred Him Into Action.” “Dr. Marty Olsen was listening to the radio in 2017, when the health care debate was raging across the country. The discussion centered on repealing the Affordable Care Act. He had been contemplating what he could do to help take the country in a different direction. The health care discussion spurred him into action. ‘I recognized that my congressman was a physician who was going to vote to move 22 million people off their health care rolls, and these were the people I take care of,’ he said, referring to U.S. Rep. Phil Roe, R-1st, a retired physician. ‘I said, ‘Well, that’s wrong.’ And so, I just thought, ‘If you think it’s wrong, then go do something.’’ So the 59-year-old obstetrician/gynecologist decided to throw his hat in the race for the 1st District U.S. House seat.” [Bristol Herald Courier, 7/24/18]

And it’s not going away anytime soon:

Washington Post: Why Health Care Is Making Republicans’ Challenge In November Even Harder. “Unlike many issues, with health care, Democrats can make a persuasive argument no matter to whom they are talking. To their own base, they can say, ‘Republicans tried to repeal the Affordable Care Act and take away Medicaid from millions, and now they want to do even more to take away health security.’ And to swing voters, they can say, ‘Look what Republicans have done to you. Your premiums keep going up, your out-of pocket costs keep going up, and now the Trump administration even wants to take away protections for people with preexisting conditions. They said they’d fix everything, and they failed.’ Both arguments are correct. And in October, premium rates for 2019 will be announced, leading to a wave of stories about rising health-care costs.” [Washington Post, 7/19/18]

House Republicans Go Home After Doing Nothing to Lower Premiums, Bring Down Drug Costs or Protect People with Pre-Existing Conditions

Washington, D.C. – Following House Republicans’ failure to pass any legislation to address the real concerns of Americans — continuing protections for people with pre-existing health conditions, lowering premiums, or bringing down the cost of prescription drugs — during their so-called “Health Care Week,” Leslie Dach, chair of Protect Our Care, released the following statement:

“The events of this week show that Republicans are running scared because of the mess they are in with their constituents over health care. As they head home for recess, House Republicans are desperate to distract from the fact that every chance they get, they vote to repeal protections for people with pre-existing conditions, jack up premiums, reduce coverage, and give kickbacks to insurance companies, drug companies, and the wealthy. House Republicans may try to hide from it, but Americans know what they are doing to our health care — we are living with the consequences every day. That’s why today, the fight to protect our care is as urgent and as energized as it ever was.”

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On ADA Anniversary, Our Leaders Must Protect Health Care for Americans with Disabilities

On the twenty-eighth anniversary of the Americans with Disabilities Act, Leslie Dach, chair of Protect Our Care, released the following statement:

“Twenty-eight years ago the Americans with Disabilities Act was signed into law by Republican President George H.W. Bush, providing critical rights for the more than 57 million Americans with disabilities. Unfortunately, today’s Republicans seem hell bent on doing everything they can to harm these Americans’ health care through their constant attacks on Medicaid and the Affordable Care Act. Nearly nine million adults with disabilities depend on Medicaid for care, including the more than one in three adults under 65 enrolled in Medicaid who live with a disability, and the ACA provides a lifeline for these individuals by preventing insurance companies from discriminating against people with pre-existing conditions and removing annual and lifetime limits on coverage. On this important milestone, we urge leaders to advance bipartisan solutions to the health care concerns of Americans with disabilities, and stop meddling with the Medicaid and health care protections they rely on.”

The Affordable Care Act and Medicaid are Lifelines For People With Disabilities

BY THE NUMBERS:

57 million Americans have a disability. Thanks to the Affordable Care Act, insurance companies can no longer deny them coverage, drop their coverage for no reason, or charge them more because of a pre-existing condition.

8.7 million nonelderly adults with disabilities depend on Medicaid for care. Nearly 8.7 million adults enrolled in Medicaid have a disability. Of this group, only 43 percent qualify for social security income.

More than 1 in 3 adults under age 65 enrolled in Medicaid lives with at least one disability.

Nearly 45 percent of adults with disabilities have Medicaid coverage. Medicaid covers 45 percent of nonelderly adults with disabilities, including adults with physical disabilities, developmental disabilities, brain injuries, and mental illness.

Medicaid covers nearly a third of adults with disabilities. 31 percent of U.S. adults with disabilities have Medicaid coverage.

More than half of adults with disabilities covered through Medicaid earn less than 100 percent of the federal poverty line (FPL). A majority, 52 percent, of adults with disabilities who have Medicaid coverage earn annual incomes of less than 100 percent of the FPL, $12,060 for an individual, and could not afford needed care without the program.

Medicaid helps people who need long-term care to stay in their communities. Of nonelderly people with disabilities who rely on Medicaid for long-term care, 80 percent receive community-based care, while only 20 percent receive institutional care.

HOW PRESIDENT TRUMP & CONGRESSIONAL REPUBLICANS ARE TRYING TO DISMANTLE THE AFFORDABLE CARE ACT AND MEDICAID:

The Trump Administration’s Department of Justice went to court last month to argue that the Affordable Care Act and its protections for people with pre-existing conditions be overturned. This lawsuit could repeal the ACA and with it, its Medicaid expansion and protections for people with pre-existing conditions, including people with disabilities.

President Trump and his administration are pushing junk short-term health plans, that allow insurance companies to discriminate against people with pre-existing conditions. The Trump administration is bringing back health plans that are allowed to discriminate against people with pre-existing conditions, and designed to suck health people out of the individual market, thus raising premiums for people who depend on the individual market for comprehensive coverage.

President Trump and his Republican allies in Congress have repeatedly tried to slash funding for Medicaid and impose per-capita caps on coverage. Last year, the House of Representatives passed the American Health Care Act (AHCA) repeal bill, which included a per capita limit on federal Medicaid spending that would have resulted in huge cuts to Medicaid across states. After failing to pass the AHCA in the Senate, Republicans have continued to launch relentless attacks on Medicaid. Last December, the Trump Administration budget called for  $1.4 trillion in cuts to Medicaid.

The Trump Administration is encouraging states to impose work requirements and other bureaucratic restrictions on Medicaid enrollment in order to deny coverage. Experts warn that work requirements are fundamentally bureaucratic hurdles designed to restrict access to health care rather than increase employment. Previous examples show that requiring enrollees verify their employment or work-related activities will reduce enrollment among those eligible for Medicaid.

Requiring people to work to maintain Medicaid coverage is particularly burdensome for people with disabilities. Though some states are claiming to exempt people with disabilities from their work requirements, these exemptions are narrow and leave many behind. Among those who should qualify for exemptions, work requirements make it more difficult to keep coverage by requiring enrollees provide documentation, testimony, and records to prove they have disabilities.

President Trump and Congressional Republicans are targeting 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, last Thursday, House Republicans passed a balanced budget amendment that would slash Medicaid funding by $114 billion in a single year alone.

REPUBLICANS WANT TO REPEAL THE AFFORDABLE CARE ACT, WHICH PROVIDED AFFORDABLE COVERAGE AND HEALTH SECURITY TO PEOPLE WITH DISABILITIES

The Affordable Care Act Prevents Insurance Companies From Charging Americans With A Disability More, Or Denying Them Coverage Altogether. Prior to the ACA, insurance companies were allowed to charge people more or deny coverage simply because they had a pre-existing condition. The ACA banned this practice, requiring that insurance companies offer people coverage regardless of their health status.

Thanks To The Affordable Care Act, Insurance Companies Can No Longer Impose Annual And Lifetime Limits On Coverage. Before the ACA, insurance companies could restrict the amount of dollar amount of benefits someone could use per year or over a lifetime. At the time the ACA was passed, 91 million Americans had health care through their employers that imposed lifetime limits. Many such plans capped benefits at $1 million annually, functionally locking people with complex medical needs out of coverage.

Insurance Companies Can No Longer Practice Medical Underwriting, A Process That Let Insurers Make It Harder For People With Disabilities To Get The Coverage They Needed. Before the ACA, insurance companies could screen applicants for any conditions that might be costly to the company. If someone had condition that was predicted to cost the insurance company more, 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, or limit the applicant’s benefits (for instance, offer a policy that did not cover prescription drugs).

The ACA Requires Insurance Companies To Cover Basic Health Services. The Affordable Care Act established the ten essential health benefits, requiring insurance companies to cover rehabilitative or habilitative services, hospitalization, maternity care, prescription drugs, maternity care, and mental health services.

MEDICAID IS A VITAL SOURCE OF CARE FOR PEOPLE WITH DISABILITIES

Medicaid Helps People With Disabilities Receive Comprehensive, Consistent Care. “Nonelderly Medicaid adults with disabilities are four times as likely to receive nursing or other health care at home, more than 2.5 times as likely to have three or more functional limitations, and more than 1.5 times as likely to have 10 or more health care visits in a year compared to people with disabilities who are privately insured.” [Kaiser Family Foundation, 3/16/17]

Medicaid Covers A Broad Range Of Preventive And Medical Services. “Through Medicaid, nonelderly adults with disabilities have access to regular preventive care as well as medical care for illnesses and chronic conditions.  States must provide certain minimum services for adults, such as inpatient and outpatient hospital, physician, lab and x-ray, and nursing home services. States also can choose to provide a broad range of optional services, many of which are important to people with disabilities, such as prescription drugs, physical therapy, private duty nursing, personal care, rehabilitative services, and case management.” [Kaiser Family Foundation, 3/16/17]

Adults With Disabilities Are More Likely To Have Medicaid, And Less Likely To Have Private Insurance, Than Those Without Disabilities. “Those with disabilities are about three times as likely to be covered by Medicaid and about half as likely to have private insurance compared to those without disabilities. These differences are influenced by the greater health needs of people with disabilities and the fact that they are less likely to have access to employer-sponsored coverage.” [Kaiser Family Foundation, 3/16/17]

PEOPLE WITH DISABILITIES DEPEND ON MEDICAID FOR LONG-TERM CARE

Medicaid Provides Half Of Long-Term Care In U.S. “Medicaid provides half the nation’s long-term care. Over the decades, states, CMS, providers and consumers have worked to broaden access to care in home and community based settings, where many seniors and people with disabilities would prefer to live…In 2013, the Medicaid program reached a major milestone: for the first time, the majority of Medicaid spending on long term services and supports (LTSS) was for home and community based services (HCBS) rather than for institutional care.” [Centers For Medicare & Medicaid Services, January 2017]

Americans With Disabilities Depend On Medicaid For Community Based Care. Nearly 1.7 million nonelderly people with disabilities rely on Medicaid for long-term care. Medicaid helps the vast majority get the care they need in their communities, rather than an institution. In 2011, 80 percent of nonelderly people with disabilities who used Medicaid were served in their community; only 20 percent were served in institutions. [Kaiser Family Foundation, 3/16/17]

Julie Reiskin, Executive Director of ColoradoCross Disability Coalition: Medicaid Helps People With Chronic Disabilities To Access The Care They Need In Their Communities. “It is Medicaid that provides the in-home aid who helps get an adult with quadriplegia out of bed, dressed and able to go to work in the morning. It is Medicaid that provides the in-home occupational therapist who works with the autistic child so she can live at home with her family — not be pushed into an institution.” [Reiskin, The Hill, 6/21/17]

RESTRICTING MEDICAID THREATENS ACCESS TO CARE AND JOBS FOR FOR PEOPLE WITH DISABILITIES

Medicaid Work Requirements Make It Harder For People With Disabilities To Access The Care They Need. “Kentucky’s recently granted waiver does propose limited exemptions for people who are ‘medically frail’ and for those ‘diagnosed with an acute medical condition’ that prevents compliance, but these exemptions won’t keep beneficiaries from falling through the cracks…Arkansas, for example, estimates that just 10 percent of expansion enrollees are ‘medically frail’ — short of the third of non-SSI adult Medicaid enrollees nationwide unable to work because of a disability and far less than the 69 percent of Michigan Medicaid expansion enrollees who report serious chronic conditions that may sometimes prevent them from working.” [Center on Budget and Policy Priorities, 1/26/18]

The Arc: “Cutting Off Medicaid Won’t Help Anyone To Work.” Medicaid specifically covers services, such as attendant care, that are critical to enable people with significant disabilities to have basic needs met, to get to and from work, and to do their jobs. Requiring individuals to work to qualify for these programs would create a situation in which people cannot access the services they need to work without working – setting up an impossible standard.” [The Arc Statement, 1/11/18]

University of Kansas Report: “In Effect, Medicaid Expansion is Acting as an Employment Incentive for People with Disabilities. “People with disabilities are much more likely to be employed in states that have expanded Medicaid coverage as part of the Affordable Care Act, new research from the University of Kansas has found. Similarly, the number of those who report not working because of a disability has greatly declined in expansion states…’In effect, Medicaid expansion is acting as an employment incentive for people with disabilities,’ the researchers wrote.” [Healthcare Finance, 7/23/18]

President Trump’s Budget, Which Calls On Congress To Pass Graham-Cassidy, Would Strip Coverage Away From More Than 1.4 Million People With Disabilities. New analysis finds that, even according to conservative estimates, between 1.4 million and 1.8 million nonelderly adults with disabilities would lose vital Medicaid coverage as a result of the bill’s deep cuts, risking a return to widespread institutionalization and pushing people with disabilities—and their family members—out of the workforce.” [Center for American Progress, 9/25/17]

Republican Efforts To Repeal Medicaid Expansion Would Mean 64 Percent Of Medicaid Adults With Disabilities Would Lose Coverage. The Affordable Care Act’s Medicaid expansion covers 11 million people.  Many of them struggle with a chronic illness or a disability (such as a mental health condition) that wouldn’t, by itself, qualify them for Medicaid.  Only 36 percent of non-elderly Medicaid beneficiaries with disabilities receive Supplemental Security Income, which allows them to enroll in Medicaid even without the expansion.  While others may be eligible for Medicaid based on other criteria, many could lose Medicaid coverage under the House bill and wind up uninsured.” [Center on Budget and Policy Priorities, 8/29/17]

House Democrats Launch Historic Defense of Protections For People With Pre-Existing Conditions. Will Republicans Step Up?

Washington, D.C. – Following the Trump Administration’s decision to use a lawsuit brought by Republican attorneys general and governors in 20 states that would repeal the Affordable Care Act to attempt to strike down protections for people with pre-existing conditions, women, and people over 50, today House Democrats Jacky Rosen, Steny Hoyer, Richard Neal, Frank Pallone, Jr., Jerrold Nadler, and Bobby Scott introduced a resolution authorizing the House’s legal counsel to go to court and defend our health care law and protections for people with pre-existing conditions. Brad Woodhouse, executive director of Protect Our Care, released the following statement in response:

“House Republicans have repeatedly said they want to protect people with pre-existing conditions, but at every opportunity they’ve voted to repeal these protections or turned a blind eye to the Trump Administration’s campaign to get rid of them. Now, they have a chance to make it right. The Trump Administration has gone to court to try to strike down protections for the 130 million Americans with pre-existing conditions including cancer, diabetes and asthma — and passing this resolution would help defend these Americans’ care. If Republicans in the House won’t endorse and help pass this, they’ll once again show they’re on the side of insurance companies rather than everyday Americans. Thank goodness Democrats haven’t stopped fighting for the protections that prevent insurance companies from jacking up premiums for people with pre-existing conditions — or denying us care altogether — because if they had, these protections would be long gone.”

BACKGROUND:

Speaker Paul Ryan (R-WI): “We believe in giving everybody the ability and the resources to buy affordable health care coverage, including people with pre-existing conditions.” [Politico, 1/27/17]

Rep. Cathy McMorris Rodgers (R-WA): “Protecting people with pre-existing conditions isn’t just good policy, it’s a personal mission.”  [The Spokesman-Review, 6/13/18]

Rep. Greg Walden (R-OR): “We want to make sure that people with pre-existing conditions continue to get covered.” [The Hill, 1/26/17]

Rep. Martha McSally (R-AZ): “Committed to ensuring that individuals with pre-existing conditions have access to affordable coverage options and cannot be denied health insurance. [Tucson Weekly Dispatch, 3/1/17]

Rep. Mike Coffman (R-CO): “I will protect those with pre-existing conditions… I will maintain that commitment.”  [Politico, 4/13/17]

Rep. Fred Upton (R-MI): “I am committed to protecting patients living with pre-existing conditions. it’s only fair. [Holland Sentinel, 2/27/17]

Rep. Tom MacArthur (R-NJ): “I have never and will never support legislation” that does not cover pre-existing conditions.  [MacArthur Statement, 4/12/17]

Rep. Bruce Poliquin (R-ME): “I have pushed to make certain that those with pre-existing conditions would be covered.[Rep. Bruce Poliquin Press Release, 3/24/17]

Rep. Erik Paulsen (R-MN): “Rep. Paulsen has long supported protections for individuals with pre-existing conditions, and he continues to do so.” [Star Tribune, 6/23/18]

Rep. John Faso (R-NY): “I support keeping provisions of the ACA dealing with pre-existing conditions.” [Daily Freeman, 2/6/17]

Rep. Steve Knight (R-CA): “I will keep pre-existing conditions.” [Los Angeles Times, 4/18/17]

Rep. Mimi Walters (R-CA):  “I have been clear and unwavering in my strong support of ensuring those with pre-existing conditions cannot be denied health insurance coverage.” [Mimi Walters Tweet, 6/13/18]

Rep. Scott Tipton (R-CO):  “Ensuring that patients with pre-existing conditions have access to health insurance will continue to be one of my top priorities.” “[Rep. Scott Tipton Press Release, 1/27/17]

Rep. Brian Mast (R-FL): “We also need to ensure that patients with pre-existing conditions won’t be denied coverage.”  [Palm Beach Post, 3/9/17]

Rep. David Young (R-IA): “I have always believed patients with pre-existing conditions must have the ability to find safe, secure, and stable coverage.” [Rep. David Young Newsletter, 2/19/17]

Rep. Kevin Yoder (R-KS): People with pre-existing conditions ought to be protected. [Rep. Yoder Facebook Post, 2/21/17]

Rep. David Trott (R-MI): “Patients with pre-existing conditions need to be protected and have access to the coverage they need.” [Rep. Trott, Website, 4/20/17]

Rep. Leonard Lance (R-NJ): Pledged not to support legislation that rolls back coverage for people with pre-existing conditions. [The Hill, 4/12/17]

Rep. Scott Taylor (R-VA): “We will protect those with pre-existing conditions.”  [Republican Party of Virginia, 3/10/17]

Rep. Don Bacon (R-NE): “Supports coverage for those with pre-existing conditions.” [Omaha World Herald, 3/19/17]

Rep. John Culberson (R-TX): “Health care should be accessible for all, regardless of pre-existing conditions or past illnesses.” [Rep. Culberson Website, 4/20/17]