News

President Biden is Driving Down Health Care Costs as GOP Threats Loom

Washington, D.C. — Tonight, President Biden delivered his State of the Union address, celebrating the administration’s accomplishments and outlining further action to lower costs and improve health care for people across the nation. During his speech, President Biden called on Congress to expand the Inflation Reduction Act’s drug savings for people with all types of insurance, permanently extend lower premiums for people who buy health insurance, and close the Medicaid coverage gap, among other priorities.

President Biden and Democrats in Congress are improving health care and making sure people can get the care they need by lowering prescription drug and premium costs for millions of seniors and families. This year, a record-breaking 21.3 million people signed up for coverage under the Affordable Care Act marketplaces – the most in history. The administration has also worked to stop surprise billing, strengthen maternal care, and reduce racial, rural, and other disparities in our health care system. 

At the same time, Republicans continue fighting to reverse all of the progress made by Democrats and the Biden-Harris administration. Trump is escalating his threats to repeal the ACA while Republican lawmakers and their allies are working overtime to dismantle reproductive care, hike premiums, slash Medicare and Medicaid, reverse recent coverage gains, and raise prescription drug costs for the American people.

Protect Our Care Chair Leslie Dach issued the following statement: 

“Health care continues to be a top-of-mind issue for the American people, and the Biden administration has fought tooth and nail to lower costs and improve care for seniors and hardworking families. Tonight, President Biden told the American people that driving down health care costs even further and expanding coverage for more Americans continues to be a top priority. By building on the Affordable Care Act and the Inflation Reduction Act, the president’s agenda would make a world of difference for our nation’s seniors, people of color, people with disabilities, rural communities, and countless others.

“On the other hand, Republicans have continued their unrelenting attack on health care. They have promised to repeal the ACA and the Inflation Reduction Act, slash Medicare and Medicaid, and hike drug costs for seniors, ripping away critical protections, coverage, and savings for millions. The contrast between the GOP and this administration could not be clearer.”

This evening, President Biden is expected to zero in on his plans to lower health care costs during his final state of the union address ahead of the election. This follows the agenda released yesterday by the Biden-Harris administration to build on the work of the Inflation Reduction Act and lower health care costs for even more Americans. Specifically, President Biden outlined a list of priorities to lower prescription drug prices, extend affordable health care coverage through the Affordable Care Act (ACA) and Medicaid, crack down on junk plans and surprise medical expenses, and protect health care for seniors and families for years to come. 

Meanwhile, the Republicans are dead set on raising the costs of health care, denying coverage to millions of people, and slashing funding for critical programs. Learn more about the MAGA-Republican plan for health care here.

HEADLINES:

Protect Our Care’s Leslie Dach Quoted in HuffPost: Joe Biden To Call For Expanding New Initiatives To Lower Drug Costs. “‘President Biden is doubling down on his efforts to lower drug prices, keep premium costs low, expand Medicaid, and put the health and well-being of families first,” Leslie Dach, chair of the advocacy group Protect Our Care, said in a prepared statement released Wednesday afternoon. Dach also called Biden “a health care president.’” [HuffPost, 3/6/24]

Axios: Biden Speech Again Seeks Credit On Drug Prices. “Drug prices still sync with the Biden campaign’s bigger theme around helping Americans make ends meet…  Biden tonight will try to build on the IRA by calling for expanded Medicare negotiations for at least 50 drugs each year, White House domestic policy adviser Neera Tanden told reporters… Biden will also call on Congress to expand a $2,000 cap on out-of-pocket spending for prescription drugs in Medicare to all private insurance plans, and to limit patient cost-sharing for high-value generic drugs to $2 in all Medicare plans, Tanden said.” [Axios, 3/7/24]

The Washington Post: In Third SOTU, Biden Will Urge Congress To Advance His Health Policies. “Biden is expected to urge lawmakers to increase the number of medications subject to annual Medicare price negotiations. He’ll push to extend penalties for drug price hikes to the commercial market. And he’ll advocate for expanding out-of-pocket price caps on prescription drugs.” [The Washington Post, 3/7/24]

CBS News: In State Of The Union Address, Biden To Urge Congress To Pass Measures To Lower Health Care Costs. “President Biden plans to urge Congress to focus on cost-saving ideas for prescription drugs in his State of the Union address Thursday night, including capping out-of-pocket prescription drug costs for all Americans and allowing the federal government to negotiate the prices of widely used medications… The White House also said the president on Thursday night is expected to tout his administration’s work on “surprise” costly medical bills from out-of-network providers and expanding health insurance through the Affordable Care Act.” [CBS News, 3/7/24]

The Hill: Biden To Focus On Drug Prices, Health Costs During State Of The Union. “Medicare will eventually be able to negotiate the prices of 20 drugs under the current law, but White House officials told reporters Wednesday that Biden will propose expanding that number to 50 and bringing more drugs into the program sooner. Biden will also propose extending Medicare’s $2,000 annual cap on out-of-pocket drug costs to people with commercial insurance… The policies that the president is set to pitch to Congress represent the Biden campaign’s effort to remind voters of the administration’s actions to lower health costs, even though many of the biggest wins won’t take effect this year, while also trying to showcase a path forward for the next four years.” [The Hill, 3/6/24]

STAT: Biden To Propose Expanding Medicare Drug Price Negotiation In State Of The Union. “The expansion is one of several appeals Biden will make to Congress to build on health care measures to lower prescription drug costs and protect patients from surprise medical bills, the White House said… It’s also a tightrope walk for Biden, who is simultaneously trying to build awareness that his administration passed drug pricing policies, even though the biggest ones haven’t gone into effect yet, and pitch a vision to go even further if voters reelect him for a second term.” [STAT, 3/6/24]

Roll Call: Biden To Renew Calls To Lower Health Costs At SOTU. “President Joe Biden will call on Congress to allow Medicare to increase its ability to negotiate drug prices and to expand caps on consumer prescription drug costs during his State of the Union address Thursday… the president will ask Congress to build on work from the 2022 health care and climate law that granted federal authority to negotiate the price of some drugs in Medicare, place caps on out-of-pocket prescription drug costs for seniors and charge drug companies if they raise prices at a rate higher than inflation.” [Roll Call, 3/6/24]

 ***MEDIA ADVISORY FOR FRIDAY, MARCH 8 AT 9:30 AM ET***

Washington, D.C. — On Friday, March 8, 2024, at 9:30 AM ET, U.S. Representatives Frank Pallone, Jr. (D-NJ-06) and Bobby Scott (D-VA-03) will join U.S. Senator Peter Welch (D-VT) and Protect Our Care for a virtual press conference to discuss President Biden’s State of the Union address. According to press reports the President will celebrate the administration’s health accomplishments and outline further action to lower costs and improve care for people across the nation. Republicans, on the other hand, are waging a full-blown war on health care by threatening to repeal the Affordable Care Act, upending reproductive care, raising premiums, ending Medicare and Medicaid as we know it, reversing recent coverage gains, and hiking prescription drug costs for the American people.

Democrats have delivered on health care promises, expanding affordable coverage, driving down prescription drug costs, strengthening Medicaid for moms and kids, and reducing inequities in care. This year, a record 21.3 million people signed up for coverage under the ACA marketplaces, seniors are saving on insulin and vaccine costs, and Medicare is negotiating lower prices for some of the costliest drugs on the market. 

PRESS CALL:

WHO:
U.S. Representative Frank Pallone, Jr. (D-NJ-06)
U.S. Representative Bobby Scott (D-VA-03)
U.S. Senator Peter Welch (D-VT)
Leslie Dach, Protect Our Care

WHAT: Virtual Press Conference

WHERE: Register for the Event Here

WHEN: Friday, March 8, 2024 at 9:30 AM ET

Washington, D.C. — Ahead of tomorrow’s State of the Union address, the Biden-Harris administration released an agenda to build on the work of the Inflation Reduction Act and lower health care costs for even more Americans. Specifically, President Biden outlined a list of priorities to lower prescription drug prices, extend affordable health care coverage through the Affordable Care Act (ACA) and Medicaid, crack down on junk plans and surprise medical expenses, and protect health care for seniors and families for years to come. 

Meanwhile, the Republicans are dead set on raising the costs of health care, denying coverage to millions of people, and slashing funding for critical programs. Learn more about the MAGA-Republican plan for health care here.

In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“Joe Biden is a health care president. From day one, this administration has fought tooth and nail to lower costs and make affordable health care a reality for seniors and families across the nation. In the face of so many attacks on health care from across the aisle, President Biden is doubling down on his efforts to lower drug prices, keep premium costs low, expand Medicaid, and put the health and well-being of families first. By releasing this bold plan to build on the administration’s health care victories, President Biden is addressing the top concern from voters of all parties.” 

Background:

State of the Union 2024: Biden is Bringing Down Health Care Costs as GOP Threats Loom

Tomorrow, President Biden will deliver his State of the Union address, which will underscore the contrast between his administration’s success in driving down health care costs and Republicans’ plans to take health care away from the American people. The Biden administration’s long list of accomplishments includes: expanding affordable coverage, lowering prescription drug costs, strengthening Medicaid for moms and kids, and reducing inequities in care. This year, a record 21.3 million people signed up for coverage under the Affordable Care Act (ACA) marketplaces, seniors are saving on insulin and vaccine costs, and Medicare is negotiating lower prices for some of the costliest drugs on the market. 

Last year, the GOP laid bare their plans for American health care: they are going to fight tooth and nail to raise costs even higher, deny coverage to millions of people, and slash funding for critical programs. In 2023 alone, Republicans tried to repeal the Inflation Reduction Act’s measures that make prescription drugs more affordable for seniors, impose burdensome Medicaid paperwork requirements designed to throw people off of coverage, and weaken protections for 135 million people with pre-existing conditions. Donald Trump has also reignited calls to repeal the ACA entirely, giving new life to Republicans’ longtime war on health care. 

Key points of the GOP health care plan include:

• Repealing the ACA
• Repealing the Inflation Reduction Act
• Hiking drug costs for seniors
• Slashing Medicare and Medicaid funding
• Putting drug and insurance companies back in charge

If Republicans are successful in enacting their health care plan, 46 million Americans across the country risk losing coverage, 15 million will see higher premiums, and 65 million people on Medicare will have to pay increased drug costs for lifesaving medications. 

Read more here: The Endless War: The MAGA Republican War on American Health Care

On Thursday, March 7, President Biden will deliver his final State of the Union address before the 2024 election, highlighting the stakes for American health care. According to press reports, President Biden will celebrate the administration’s health accomplishments and outline further action to lower costs and improve care for people across the nation. This builds on his work of expanding affordable coverage, lowering prescription drug costs, strengthening Medicaid for moms and kids, and reducing inequities in care. This year, a record 21.3 million people signed up for coverage under the Affordable Care Act (ACA) marketplaces, seniors are saving on insulin and vaccine costs, and Medicare is negotiating lower prices for some of the costliest drugs on the market. 

Republicans, on the other hand, are intensifying their war on health care. Trump is escalating his threats to repeal the ACA while Republican lawmakers and their allies are working overtime to dismantle reproductive care, hike premiums, slash Medicare and Medicaid, reverse recent coverage gains, and raise prescription drug costs for the American people. The contrast could not be more clear:

READ MORE: 

Biden Health Care Accomplishments Tracker 

The GOP Health Care Plan: It’s Worse Than You Think

Report: The MAGA Republican War on American Health Care

Washington, D.C.— Today, a federal court in Delaware dismissed AstraZeneca Pharmaceuticals LP v. Becerra et al for lack of standing. In the ruling against one of the pharmaceutical industry’s major claims against the Medicare Drug Price Negotiation Program, the judge disagreed with AstraZeneca’s claim that the program is coercive when it is voluntary. 

The decision is the Biden-Harris administration’s most recent win over the big drug companies and their mega lobbying groups that have filed meritless lawsuits against the federal government in an effort to stop Medicare from negotiating lower prescription drug prices — the most popular provision of the Inflation Reduction Act. Medicare drug price negotiation is projected to lower out-of-pocket drug costs for seniors and save taxpayers tens of billions of dollars, but big drug companies are desperately trying to protect their outsized profits at the expense of seniors. In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“Today’s decision is a win for patients and underscores drug companies’ greed and desperation to protect their profits by filing meritless lawsuits. While the drug companies are in court, the Biden administration is negotiating lower prices for some of the most expensive drugs on the market that have lacked competition for years. It’s time lifesaving drugs are affordable to people who need them.” 

Background

AstraZeneca Raked In More Than $45 Billion In Profits Last Year. AstraZeneca announced it raked in $45.5 billion in 2023 – a $1.46 billion increase over 2022 – during their earnings report in early February. While they make billions, drug companies charge Americans over four times more for prescription drugs than customers in other high-income countries. 

AstraZeneca Spent $4.5 Billion On Shareholders In 2023. Rather than make their lifesaving drugs affordable to patients, AstraZeneca rewarded shareholders by paying out $4.5 billion in dividends last year. AstraZeneca’s CEO, Pascal Soriot made over $120 million in total compensation over the past ten years, while the company hiked prices on lifesaving medication. 

AstraZeneca Has Earned About $20 Billion On Farxiga, A Diabetes Drug Selected For Medicare Negotiation. AstraZeneca charges U.S. customers more than seven times more for Farxiga than customers in other high-income countries, even when considering net prices in the U.S. 

Read more: AstraZeneca Is In Court To Stop Medicare From Negotiating Lower Prices In Order To Protect Sky-High Profits

On March 4, Fifth Circuit Court of Appeals to Hear Oral Arguments in Braidwood Case 

Extremists aiming to strike down a key portion of the Affordable Care Act (ACA) are scheduled to give oral arguments before a panel of judges at the Fifth Circuit Court of Appeals on March 4. The plaintiffs are challenging a provision of the ACA that requires insurers to cover lifesaving preventive services for free, and they are dissatisfied with a lower court’s ruling last year that overturned a narrow set of services recommended by the U.S. Preventive Services Task Force (USPSTF) after the passage of the ACA, blocked required coverage of USPSTF’s future recommendations, and allowed employers to refuse to cover certain preventive services on religious grounds. The plaintiffs now want the appeals court to go further and eliminate guaranteed free coverage of vaccines and women’s preventive services like cancer screenings, prenatal care, and contraception.

“Lifesaving preventive care under the ACA is at risk,” said Protect Our Care Chair Leslie Dach. “More than 150 million Americans rely on these benefits to get no-cost access to routine screenings for cancer, diabetes, mental health, and heart disease, recommended vaccinations, contraception and pregnancy-related care, and more. If the MAGA-backed plaintiffs get their way, it will put Americans at the mercy of insurance companies and employers once again, empowering them to charge high out-of-pocket costs and refuse to cover certain preventive benefits entirely. As a result, more Americans will suffer because their cancers will be detected too late or they won’t receive the mental health or prenatal care they need.” 

Background

Last March, District Judge Reed O’Connor – the same Federal District Court judge whose decision invalidating the entire ACA was reversed by the Supreme Court in 2021 – struck down a portion of the ACA’s preventive health services mandate, invalidating key, no-cost services recommended by the USPSTF after the ACA’s enactment. The government immediately appealed the decision, and the Fifth Circuit paused the ruling and temporarily reinstated the requirement that insurers cover those preventive services, but the Fifth Circuit could choose to revoke the stay at any time.

The ACA’s elimination of out-of-pocket costs for these lifesaving screenings and services has transformed how preventive care is delivered, saved countless lives, improved health outcomes, reduced disparities in care, and cut consumer health care costs. Guaranteed no-cost coverage of preventive services, including screenings for chronic disease, is a key factor in expanding access to these services – which together with actions to address other social and structural determinants of health – are advancing health equity. 

The Braidwood case is driven by extremist, longtime foes of the ACA, abortion rights and reproductive freedom, marriage equality, vaccination mandates, and diversity policies – but the stakes are even higher than before. The case, which was originally decided by the same judge whose decision invalidating the entire ACA was reversed by the Supreme Court in 2021, will now be decided by two extreme Trump appointees. These radical judges could strike down coverage for these essential preventive services at any time, removing the current stay on the lower court’s ruling and putting free preventive services on the chopping block for more than 150 million Americans covered through private health insurance. 

Here are just some of the lifesaving, no-cost benefits that could be invalidated by MAGA judges on the Fifth Circuit if the panel lifts the stay and allows the district court ruling to stand:

• GONE – Free, Guaranteed Cancer & Health Screenings. O’Connor’s ruling struck down ACA provisions requiring insurers to cover screenings for serious health issues including breast cancer, colorectal cancer, lung cancer, Hepatitis C, and HIV. 
• GONE – Free, Guaranteed Preventive Medication For Cardiovascular Disease. O’Connor’s ruling struck down ACA provisions requiring insurers to cover drugs that can lower cholesterol for certain adults at risk of developing cardiovascular disease.
• GONE – Free, Guaranteed Substance Use Screenings. O’Connor’s ruling struck down the ACA requirements that insurers cover screenings for unhealthy drug use. 
• GONE – Free, Guaranteed Preventive Treatment for Pregnancy Complications. O’Connor’s ruling struck down the ACA requirements that insurers cover medications used to prevent life-threatening complications in pregnancy like preeclampsia as well as mental health interventions for pregnancy-related depression. 
• GONE – Free, Guaranteed PrEP. O’Connor’s ruling struck down the ACA requirements that guarantee access to pre-exposure prophylaxis (PrEP), a drug proven to substantially reduce the risk of contracting HIV. PrEP has been associated with a significant decrease in the number of new HIV diagnoses.

If the Fifth Circuit agrees with the plaintiffs, they will eliminate the following additional services:

• GONE – Free, Guaranteed Vaccinations. The ACA requires that over a dozen vaccinations, ranging from meningitis and pneumonia to flu shots, be covered free of charge for adults and children.
• GONE – Free, Guaranteed Contraception & STI Counseling. The ACA guarantees women access to contraception without cost sharing, screenings for HIV, and counseling for sexually transmitted infections (STIs). Over 58 million women have benefited from free access to contraceptives, saving billions of dollars in out-of-pocket spending. 
• GONE – Free, Guaranteed Pregnancy Screenings & Treatments. The ACA requires free access to a variety of preventive services related to pregnancy, including preeclampsia screenings, breastfeeding equipment like pumps and bottles, folic acid, and screenings for perinatal diabetes, in order, to support healthy pregnancies and fight the maternal mortality crisis.
• GONE – Free, Guaranteed Routine Infant & Child Health Care. Under the ACA, all newborns have access to free, universal newborn screening and young children. As they grow, children are required to have free access to essential health screenings, behavioral assessments, growth measurements, behavioral assessments, routine childhood vaccinations, vision and dental screenings, and other essential preventive services.
• GONE – More Free, Guaranteed Health Screenings. The ACA requires plans to cover screenings and counseling for a wide array of health issues, including risk factors for heart disease – the leading cause of death in the U.S. – like high blood pressure, high cholesterol, diabetes, and obesity.
• GONE – Free, Guaranteed Mental Health & Substance Use Screenings. Under the ACA, insurers are required to cover a wide range of preventive assessments and treatments related to mental health and substance use, including depression, anxiety in adolescent and adult women, alcohol misuse, tobacco use, and adolescent drug use.

What Happens Next

The appeal is being made before the Fifth Circuit Court of Appeals, a circuit “where law goes to die” packed with MAGA appointees and ultra-conservative judges that have relentlessly chased an extreme agenda threatening health care access. If the Fifth Circuit approves a full reversal of the preventive services requirement, it would set off a massive disruption in the American health care system putting more than 150 million Americans at risk of losing access to no-cost preventive care when their insurance renews. 

Two of the three judges deciding the case, Don Willett and Cory Wilson, are extreme Trump appointees with long records of opposition to affordable health care, green-lighting abortion bans, medical misinformation campaigns, and anti-vaccine cases. Read more about these extreme MAGA judges here. Regardless of the outcome, the case will almost certainly end up at the Supreme Court.

Who Is Behind It?

The Braidwood v. Becerra Plaintiffs Have Repeatedly Sued To Overturn Parts Of The ACA. Plaintiff John Kelley filed an earlier and similar class action lawsuit against the ACA’s contraceptive mandate in DeOtte v. Azar. Kelley, his company Kelley Orthodontics, and Joel Starnes – all plaintiffs in Braidwood v. Becerra – brought a similar suit again in 2020 in Kelley v. Azar. Another plaintiff, Braidwood Management, owned by Dr. Steven Hotze, was also a plaintiff in DeOtte and has previously brought and lost challenges to other parts of the ACA. In addition to being a plaintiff in previous efforts to overturn the ACA, Hotze is a vocal advocate for multiple far-right conspiracy theories, claiming COVID-19 was an invention of the “deep state,” suggesting equal rights for LGBTQ+ individuals would lead to child molestation, and bankrolling election fraud vigilantism after making false claims regarding voter fraud in the 2020 election. 

The Lead Attorney For The Plaintiffs In Braidwood v. Becerra Is One of the Key Authors of SB8, Texas’ Vigilante Anti-Abortion Law. The lead attorney for the plaintiffs is Jonathan Mitchell, “who helped craft the Texas abortion law that was designed to evade judicial review by leaving enforcement to private citizens instead of government officials.”

• Mitchell Filed Briefs Arguing the Supreme Court Should Overrule its Decisions Protecting Marriage Equality and Invalidating Anti-Sodomy Laws. Mitchell filed a brief in the Dobbs case urging the Supreme Court to overturn Roe v. Wade–and criticized Mississippi for suggesting that the Court could leave in place its 2015 ruling in Obergefell v. Hodges, holding that same-sex couples have the right to marry in all states. He said that Obergefell and Lawrence v. Texas, the 2003 ruling that invalidated all remaining state anti-sodomy laws, “are judicial concoctions, and there is no other source of law that can be invoked to salvage their existence.” Mitchell has also referred to PrEP, a life-saving medication that prevents HIV infection as a drug that would “facilitate and encourage homosexual behavior, prostitution, sexual promiscuity, and intravenous drug use.” 

The Plaintiffs In Braidwood v. Becerra Are Also Represented By The Trump-Aligned America First Legal Foundation. The plaintiffs are “represented by America First Legal Foundation, a nonprofit led by senior members of President Donald Trump’s administration, including Trump senior adviser Stephen Miller.” 

• America First Legal Has Supported Suits To Overturn Vaccine Mandates And Block “Critical Race Theory.” America First Legal is involved in numerous hot-button conservative legal actions. AFL has supported suits seeking to overturn vaccine mandates and sued companies that have policies to increase diversity in their workforces. The group has also filed suits alleging that pandemic aid for minority farmers is “racist” and trying to force the Biden administration to stop allowing immigrant children into the country.
• America First Legal Was Established By Former Trump Aide Stephen Miller “To Make Joe Biden’s Life Miserable.” America First Legal was founded by former Trump aide and white nationalist Stephen Miller who was “looking to use it to make Joe Biden’s life miserable.” He was also the architect of the Trump administration’s harshest immigration policies and a supporter of the forced sterilizations committed by ICE in Georgia.

Why The Plaintiffs’ Legal Arguments Are Wrong

The plaintiffs make three primary legal arguments – all are wrong. The plaintiffs will likely raise these arguments as the case is appealed.

The Plaintiffs’ First Argument: Plaintiffs argue that the law violates the Appointments and Vesting Clauses of the Constitution because members of the United States Preventive Services Task Force (USPSTF), Advisory Committee on Immunization Practices (ACIP), and Health Resources and Services Administration (HRSA) have not been nominated by the President or confirmed by the Senate and, according to the plaintiffs, can “unilaterally determine” the preventive care that must be covered by insurers and plans. 

Why The Plaintiffs Are Wrong: Congress made a conscious decision to require coverage of preventive services — specifying bodies that utilized well-established standards to guide their decisions — and ensured each entity in question (USPSTF, ACIP, and HRSA) is overseen by federal agencies whose heads have been appointed by the President and who all report to a senior official appointed by the President and confirmed by the Senate (the Secretary of Health and Human Services [HHS]). USPSTF members are appointed by the head of the Agency for Healthcare Research and Quality, who reports to the Secretary of HHS. The HRSA Administrator reports to the Secretary of HHS. The members of ACIP are appointed by the CDC Director who reports to the Secretary of HHS. HRSA is a component of HHS.

The Plaintiffs’ Second Argument: The preventive services provision violates the nondelegation doctrine because it delegates legislative power to the USPSTF, ACIP, and HRSA without providing an “intelligible principle” to guide their exercise of discretion. 

Why The Plaintiffs Are Wrong: Congress required the coverage of evidence-based and preventive services, and it specified bodies that applied well-established standards to guide their decisions. By specifying those bodies, Congress plainly endorsed and incorporated the standards that they utilized, and those standards provide a sufficient “intelligible principle” to limit discretion and govern the recommendations and guidelines that must be covered under the ACA.

The Plaintiffs’ Third Argument: The plaintiffs claim they have religious objections to paying for one of the preventive services mandated by the ACA — PrEP, a drug essential to HIV prevention – and that requiring coverage of this medication is a violation of the Religious Freedom Restoration Act (RFRA).

Why The Plaintiffs Are Wrong: As the Department of Justice explains in its court filings, the plaintiffs have not shown that their religious beliefs are burdened because they failed to prove that the availability of PrEP medications encourages behavior inconsistent with their beliefs or that the PrEP requirement causes an increase in their cost for health insurance. In addition, preventing the spread of HIV, a potentially fatal, infectious disease, is a compelling government interest–which is a separate basis for rejecting the RFRA claim.

Here’s What Health Experts Have Said About The Case

• Over 100 Public Health Experts: If Successful, Plaintiffs’ Appeal “Would Result in Serious Illness and Deaths That Otherwise Would Have Been Prevented.” A coalition of 107 public health deans and professors—led by the American Public Health Association—urged the court not to end guaranteed preventive coverage because it “would result in serious illnesses and deaths that otherwise would have been prevented,” and, “would eliminate guaranteed cost-free access to preventive services in the other three statutory categories—immunizations; preventive treatments for infants, children, and adolescents; and preventive services for women.”
• American Medical Association et al.: Invalidating the Preventive Health Services Mandate “Will Result In Worse Health Outcomes And Impose Higher Costs On The Health System.” A coalition of 20 leading medical organizations—led by the American Medical Association—warned that striking no-cost coverage of preventive services would threaten public health: “[A]pproximately 233 million people are currently enrolled in health plans that must cover preventive services without cost-sharing. That means that, in addition to the preventive services for adults covered by the USPSTF recommendations…millions of people now have access to no-copay vaccinations. And women and children have access to the specific preventive care recommended for their populations, allowing these individuals to avoid acute illness, identify and obtain treatment for chronic conditions, and improve their health. These recommendations have been critical to improving public health. […] Deterring patients from receiving these vital services will result in worse health outcomes and impose higher costs on the health system.”
• The National Women’s Law Center: Millions of Women Who Rely on the ACA’s No-Cost-Sharing Coverage To Access Preventive Care Will Be Harmed. The National Women’s Law Center submitted an amicus brief in support of the government, writing, “[P]roviding these services without cost-sharing has helped to remedy discrimination in women’s health care and coverage and increased overall uptake of these services, improving women’s health and economic security and reducing racial disparities in both the use of these services and in health outcomes for populations facing multiple and intersecting forms of discrimination […] Further, the health and well-being of the millions of women who rely on the ACA’s no-cost- sharing coverage to access preventive care and who benefit from the resulting improvements to their health and economic security will be harmed.”
• American Cancer Society et al.: Reducing Insurance Coverage For Preventable Services Will Lead To Worsening Patient Outcomes, Preventable Deaths, and Higher Medical Costs. A coalition of 16 patient advocacy organizations—led by the American Cancer Society—urged the court not to end guaranteed preventive coverage because, “Detecting severe diseases early allows for less invasive, more effective, and lower-cost treatment options, and substantially improves patient outcomes. Reducing insurance coverage for preventive services will lead to the opposite result—worsening patient outcomes, leading to preventable deaths, and creating higher long-term medical costs.”
• American Lung Association et al.: Patients Could Discontinue Life-Saving Medications Despite Health Risks if Insurers Resume Cost-Sharing on Preventive Services. A coalition of 12 patient advocacy organizations–led by the American Lung Association–warned the court of “the demonstrated, severe public health effects of cost barriers” that invalidating guaranteed preventive coverage would “ameliorate,” writing: “If insurers impose cost-sharing requirements for patients to receive these life-saving medications, research suggests that patients could discontinue use despite the health risks.”

Watch the Full Event Here.

Washington, DC — Today, Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure joined Protect Our Care and the NAACP, in partnership with NAACP’s Howard University Chapter, the Howard University Graduate Student Assembly, and the Howard University Graduate Student Council, to discuss improving health outcomes for Black Americans. 

President Biden appointed Administrator Brooks-LaSure as the first African American to lead CMS. Under her leadership, the agency has built on the success of the Affordable Care Act and implemented the Inflation Reduction Act to make health insurance and prescription drugs more affordable for millions of Black families. 

Historically, Black Americans have faced barriers to achieving and maintaining optimal health. More than 65 percent of uninsured Black adults have become eligible for zero-dollar premium plans through enhanced premium savings. The Center on Budget Policy and Priorities estimates these increased savings will cause a sharp decline in the uninsured rate across every racial group, with a projected one in three uninsured Black adults gaining coverage. For people who have historically been marginalized and faced difficulty receiving the care they need, Black Americans in particular, these lower costs are translating to better access to care. Additionally, the Biden-Harris Administration is fighting the maternal health crisis by expanding Medicaid coverage for new mothers to one year postpartum, awarding millions of dollars to create a maternal mental health task force and other programs. Read our report on how the Inflation Reduction Act is helping Black Americans here. 

“The Biden-Harris Administration has and will continue to prioritize making health care coverage affordable,” said Chiquita Brooks-LaSure, CMS Administrator. “President Biden and Vice President Harris took the baton that President Obama handed to them, and this Administration continues to transform health care to change millions of people’s lives for the better. We’ve expanded coverage. We’ve expanded the number of Black and Brown people enrolled. What we seek for our country is for everyone eligible to be enrolled in one of CMS’ programs and for insurance not just to be a card in their pocket, but to mean that they have access to the care they need.”

“The fight to protect and advance the health of Black Americans is at the forefront of our mandate to improve Black lives,” said Dr. Chris T. Pernell, Director of the Center for Health Equity at the NAACP “The Inflation Reduction Act is a necessary tool to beat back the barriers to access to care and the cost of prescription drugs especially. Assuring optimal health for all communities, particularly those who have been saddled with higher rates of chronic disease and staggering costs, is exactly where the Biden-Harris Administration should be focused. This is what equity in action looks like – saving lives, preventing disease, and controlling costs.”

“Health care and eliminating inequities in health care is so important,” said Brad Woodhouse, Executive Director of Protect Our Care. “That is why we must have people at the wheel who want to drive in the right direction – getting affordable health care to every American. CMS led by Administrator Brooks-LaSure is getting the job done. It’s so important that Congress and the Biden-Harris Administration continue this historic work to preserve and expand health care.”

“In almost every indicator in which we measure health, Black Americans are lagging,” said Joi Chaney, Senior Health Equity Advisor at Protect Our Care. “But it’s not just about closing gaps, it’s also about making sure Black Americans can have a healthy life. Protect Our Care is dedicated to making high-quality, affordable, and equitable health care a right and not a privilege for everyone in America. The Biden-Harris Administration is doing the same – overcoming political opposition and obstruction to fight to close health disparities and improve health outcomes for Black Americans.”

Read the Report Here.

Washington, DC — Today, Protect Our Care and the NAACP are releasing a report detailing how the Inflation Reduction Act benefits Black Americans nationwide. Thanks to President Biden and Democrats in Congress, health care and prescription drugs are becoming more affordable for more people in the United States. 

According to the report, Black Americans disproportionately face adverse health outcomes such as higher rates of diabetes, heart disease, high blood pressure, and more affordability challenges when it comes to getting the care and prescriptions they need. The Inflation Reduction Act is working to lower costs nationwide by lowering premiums for people who buy health insurance on their own, capping the cost of insulin, limiting out-of-pocket spending for seniors’ prescriptions, providing no-cost vaccines, and empowering Medicare to negotiate lower drug prices. These lower costs translate to better access to care as a record number of Black Americans have enrolled in low- or no-cost Affordable Care Act Marketplace plans.

States with the highest Black populations like California, Georgia, Louisiana, Mississippi, New York, and Virginia benefit from the Inflation Reduction Act as six of the first ten drugs selected for negotiation treat conditions that disproportionately impact Black Americans:

• Black Americans are 60 percent more likely to be diagnosed with diabetes and twice as likely to die from the disease, which is treated by Januvia, Jardiance, Farxiga, and Fiasp/NovoLog. The negotiation program could lower costs for approximately 427,620 Black American enrollees taking Januvia, Jardiance, Farxiga, and Fiasp/NovoLog as of 2022.
• Black Americans are more than three times as likely to be diagnosed with end-stage renal disease related to diabetes. Farxiga treats kidney disease and diabetes. The negotiation program could lower costs for approximately 96,000 Black American enrollees taking Farxiga as of 2022.
• Black Americans are more likely to have activity limitations due to arthritis than their white counterparts. Enbrel treats arthritis. The negotiation program could lower costs for approximately 5,500 Black American enrollees taking Enbrel as of 2022.
• Black American Medicare beneficiaries have nearly 2.5 times higher rates of emergency department visits for hypertension and more than twice the emergency care rates for heart failure than their white counterparts. Farxiga and Entresto treat heart failure and high blood pressure can cause blood clots, which Eliquis and Xarelto treat. The negotiation program could lower costs for approximately 191,500 Black American enrollees taking Farxiga, Eliquis, and Entresto as of 2022.

Since the enactment of the Inflation Reduction Act, big drug companies have spent millions of dollars lobbying and filed meritless lawsuits to block the Negotiation Program from lowering drug prices. Medicare negotiation will save seniors and taxpayers tens of billions of dollars, and it’s the most popular provision of the Inflation Reduction Act. However, every Republican voted in Congress voted against the Inflation Reduction Act and Republicans have now introduced legislation to repeal it and are fighting to protect drug company profits. Read more on Republicans’ threats to health care here. 

Leslie Dach, Chair of Protect Our Care, issued the following statement: 

“The Inflation Reduction Act is making a difference, especially for families who need it most. Black Americans have faced too many barriers to accessing the care they need, leading to negative health outcomes. Our report finds that thanks to the Inflation Reduction Act, millions of Black families have more breathing room to see a doctor when they get sick and get the medicines they need to stay healthy without sacrificing other basic needs like food, housing, or saving for their future. But all this progress is under attack from Republicans. While Democrats lower costs for people, Republicans are doing the bidding of big drug companies, fighting to dismantle the Inflation Reduction Act and ban Medicare from negotiating lower drug prices, driving up costs for millions. We must celebrate the accomplishments of the Inflation Reduction Act, and continue to fight to ensure everyone has the health care they need, no matter who they are or where they live.”

Dr. Chris T. Pernell, Director of the Center for Health Equity at the NAACP issued the following statement:

“The fight to protect and advance the health of Black Americans is at the forefront of our mandate to improve Black lives. The Inflation Reduction Act is a necessary tool to beat back the barriers to access to care and the cost of prescription drugs especially. Assuring optimal health for all communities, particularly those who have been saddled with higher rates of chronic disease and staggering costs, is exactly where the Biden-Harris Administration should be focused. This is what equity in action looks like – saving lives, preventing disease, and controlling costs.”