Intro: A Key 2020 Contrast 

The past two weeks have shown one of the most dramatic contrasts in priorities between Republicans and Democrats. On Monday, the House passed the Democrats’ bill to build on the ACA and improve and expand coverage for 17 million Americans. Just days prior, the Trump administration and Republicans submitted their opening briefs in their lawsuit to overturn the ACA, arguing in favor of ripping health care from 23 million Americans. One party has passed a bill to improve health care, while the other doubled down on their lawsuit to rip it away. That should tell you everything about where the Trump administration and Republicans’ priorities stand when it comes to health care, especially as the nation grapples with the coronavirus crisis. 

Coronavirus cases across the country continue to surge. As we enter the holiday weekend, states are grappling with record cases and overwhelmed hospitals. New polling from the Coronavirus War Room shows that Americans continue to prioritize people’s health over the economy, and they overwhelmingly disapprove of President Trump’s response to the crisis. 

This packet has resources to support your communications to constituents and the media on the disastrous implications on the Trump Texas lawsuit to repeal the Affordable Care Act, particularly in the middle of the coronavirus crisis. It also details how Trump’s actions are continuing to accelerate the spread of coronavirus and deepen the economic crisis. 

The House Passed Historic ACA Expansion Bill After the Trump Administration Filed Its Brief at the Supreme Court to Overturn the Affordable Care Act 

Just days after the Trump administration and Republican-led states filed briefs in support of their lawsuit to overturn the Affordable Care Act (ACA), the House passed the “Patient Protection and Affordable Care Enhancement Act” a landmark bill introduced and championed by House Democrats to improve health care for Americans by building on key provisions in the Affordable Care Act. 

The House bill lowers the costs of health insurance by offering increased financial assistance to more people, strengthens protections for pre-existing conditions and improves health care by incentivizing holdout states to expand Medicaid and expanding Medicaid eligibility for mothers 12 months postpartum. The bill will lead to coverage for 4 million additional people and lower health care costs for another 13 million, benefiting at least 17 million Americans at a time when expanded coverage and lower costs is paramount. 

As the Trump administration and red state Republicans present their case for ripping away people’s health care, Democrats put forth legislation to expand coverage and lower costs for Americans during this unprecedented health care crisis. The contrast of agendas could not be more stark. 

Taking Action on the Texas Lawsuit

The best way to highlight the threat is by explaining just how devastating this lawsuit is in the middle of a pandemic — ripping health care away from more than 23 million Americans would be disastrous when tens of millions have already lost their employer-based health coverage. 

Making matters worse, before the ACA, common conditions like asthma, diabetes, and cancer were grounds for insurance companies charging patients more or denying them coverage altogether. This also included HIV, a virus that has been the source of one of the most serious global health crises before the coronavirus pandemic. Without ACA protections, it is likely that everyone who contracts the coronavirus could similarly be deemed as having a pre-existing condition and be at the mercy of their insurance companies who could refuse to pay for needed care. 

Protect Our Care recently launched 12 days of action to sound the alarm on this lawsuit and make clear what’s at stake in the case by highlighting specific aspects of the ACA that would be ripped away if the Trump administration and Republicans are successful in overturning the law. 

As always, it’s critical to lift up voices of those who have benefited from the law and those who will suffer if it is overturned. Simply put, there has never been a more important time to protect and expand Americans’ health care, and never been a worse time to rip it away. No action would be more damaging to Americans’ health and safety than if the Trump administration achieves its desired goal of overturning the ACA in its entirety during this crisis. When the court hears this case, there will likely be no vaccine and no viable treatment for the virus. When millions of Americans have already lost health insurance due to the pandemic, it’s absurd that President Trump is arguing in court that another 23 million Americans should lose their health care. And when millions of Americans with the coronavirus join the 135 million Americans with a pre-existing condition, President Trump will also be arguing in court to allow insurance companies to deny them coverage or charge them more. 

If you’d like to work with Protect Our Care in your district, contact Anne Shoup at [email protected]. 

New Polling Shows That Even Economic Rebound Won’t Save Trump From His Ongoing Coronavirus Failures That Endanger Lives

While there has been a lot of attention paid to the political consequences of the weekly unemployment numbers, that conversation obscures a larger and far more perilous reality for President Trump. Polling just completed by Hart Research for Protect Our Care and its Coronavirus War Room clearly shows that months before the November election, Donald Trump’s failed coronavirus response is deeply unpopular and has put him in so deep a hole with voters that even a significant economic rebound will fail to win him the support he needs. 

Rather than basing their views on Trump and the economy, voters key to Trump’s re-election are primarily basing their decision on his mismanagement of a virus that has already killed more than 127,000 Americans. 

They are recoiling at the deadly consequences of Trump’s botched coronavirus response, particularly at his rush to reopen against the advice of medical experts, and reject trading off lives for economic gain. This includes those who actually approve of Trump’s handling of the economy. 

Voters see Trump’s calls to reopen too early as a ploy to boost his re-election chances by cynically juicing the economy at the expense of people’s health. They fundamentally reject this approach and by wide majorities are not willing to trade an economic rebound for more deaths.

The bottom line is this: Donald Trump’s failed coronavirus response and its consequences are so toxic with voters that they overwhelm any positive feelings some may have about his handling of the economy over the next several months. In other words, Trump’s re-election chances hinge on his getting the coronavirus under control; not forcing an economic comeback through rushed reopenings that further endanger people’s lives.

• Coronavirus is the number one issue on voters minds; bigger than the economy
• 59% say coronavirus (42%) and health care (17%) are more important than the economy (25%)
• Voters overwhelmingly prioritize people’s health over the well-being of the country’s economy or personal finances
• By a 64-36% margin, voters are more concerned about the impact of the coronavirus on people’s health than its impact on the economy and people’s financial well-being. Persuadable voters feel this way 60-40%. 
• By a 2-1 margin (68%-32%), voters are more concerned about the consequences to people’s health of reopening too quickly rather than the consequences to the economy and personal finances of waiting too long. Persuadable voters feel this way 65-35%.
• Voters overwhelmingly disapprove of how Trump has dealt with the coronavirus & blame him for the number of deaths
• A strong majority of voters (60%) disapprove of how Trump has handled the coronavirus.
• A strong majority of voters (57%) believe Trump is to blame for the deaths associated with coronavirus. 
• Even voters who approve of Trump’s handling of the economy care more about Trump’s botched response to the coronavirus
• Voters who approve of Trump’s handling of the economy but disapprove of his coronavirus response disapprove of his job performance 75% to 25%.
• Voters are much more concerned that Trump is making things worse, particularly by rushing to reopen
• 57% of voters believe that Trump’s policies are INCREASING the chances that many more people will die from the coronavirus. Only 17 percent believe they decrease the chance of death.
• 61% of voters disapprove of Trump’s policy of moving quickly to reopen the economy and get back to business as usual. Only 39% approve. 
• Voters reject Trump’s approach and are not willing to trade an economic rebound for people’s health
• By a 65%-35% margin, voters say it would not be worth it to reduce the number of unemployed to 8 or 9 percent by election day if it meant deaths reach 200,000.

Supreme Court Will Decide Fate of Trump-Texas Lawsuit in Upcoming Term

In March, the Supreme Court granted cert in the Trump-Republican lawsuit to overturn the Affordable Care Act. This means arguments will likely be held next fall–just as voters prepare to cast their 2020 ballots. If President Trump and his allies are successful, 135 million Americans with pre-existing conditions will lose protections and 23 million Americans will lose coverage. Every serious legal scholar agrees that this Trump-Republican lawsuit is entirely without merit. Every Republican who claims to care about health care should tell the president to drop this lawsuit.

April 2020 POC Poll Found That Less Than 30 Percent Of Voters Support Trump’s Lawsuit To Overturn The ACA. While more than half of voters oppose Trump’s lawsuit to strike down the ACA, only 29%–and just 44% of Republicans–support the lawsuit.

Fact Sheet On Trump Lawsuit To Overturn ACA

President Trump is trying to rip apart our health care by going to court to eliminate the Affordable Care Act in its entirety. If the Trump lawsuit is successful, it will strip coverage from millions of Americans, raise premiums, end protections for people with pre-existing conditions, put insurance companies back in charge, and force seniors to pay more for prescription drugs. The result will be to — as the Trump Administration itself admitted in Court — unleash “chaos” in our entire health care system. 

If the Affordable Care Act is struck down:

• GONE: Protections for 135 million Americans with pre-existing conditions. The uninsured rate will increase by 65 percent. 
• GONE: Medicaid expansion, which covers 17 million people. 
• GONE: Nearly 12 million seniors will have to pay more for prescription drugs because the Medicare ‘donut hole’ will be reopened.
• GONE: 2.3 million adult children will no longer be able to stay on their parents’ insurance. 
• GONE: Insurance companies will be able to charge women 50 percent more than men.
• GONE: Financial assistance that helps 9 million people purchase health care in the marketplace.
• GONE: Key support for rural hospitals. As Americans lose coverage, already struggling hospitals will be hit even harder as their costs increase.
• GONE: Ban on insurance companies having lifetime caps on coverage.
• GONE: Requirements that insurance companies cover prescription drugs and maternity care.

Thanks To The Republican Lawsuit, 23 Million People Could Lose Their Coverage

• According to the Urban Institute, 19.9 million people could lose coverage by repealing the Affordable Care Act, meaning the number of uninsured Americans would increase from 30.4 million to 50.3 million, representing a leading to a 65 percent increase in the uninsured rate. As the uninsured rate swells, so will the amount of uncompensated care, which Urban predicts will grow by at least 82 percent.
• States would lose important federal health care funding — an estimated reduction of $135 billion in the first year. The Urban Institute estimates that a full repeal of the ACA would reduce federal spending on Medicaid/CHIP care and Marketplace subsidies by $135 billion, or 34.6 percent in the first year.
• Millions of children could lose their coverage. Almost three million children nationwide gained coverage thanks to the ACA. If the law is overturned, many of these children will lose their insurance.
• The percentage of people gaining health insurance under the ACA was higher for Latinos than for any other racial or ethnic group in the country. According to a study from Families USA, 5.4 million Latinos would lose coverage if the lawsuit succeeds in overturning the ACA. 

Republicans Want To Put Insurance Companies Back In Charge, Ending Protections For The 135 Million People With A Pre-Existing Condition

• According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 135 million people, have a pre-existing condition. This includes:
  • 44 million people who have high blood pressure
  • 45 million people who have behavioral health disorders
  • 44 million people who have high cholesterol
  • 34 million people who have asthma and chronic lung disease
  • 34 million people who have osteoarthritis and other joint disorders

• More than 17 million children, 68 million women, and 32 million people aged 55-64 have a pre-existing condition.

Republicans Want To Give Insurance Companies The Power To Deny Or Drop Coverage Because Of A Pre-Existing Condition

Before the Affordable Care Act, insurance companies routinely denied people coverage because of a pre-existing condition or canceled coverage when a person got sick. Now insurance companies have license to do this again. 

• A 2010 congressional report found that the top four health insurance companies denied coverage to one in seven consumers on the individual market over a three year period. 
• A 2009 congressional report found that the of the largest insurance companies had retroactively canceled coverage for 20,000 people over the previous five year period
• An analysis by Avalere finds that “102 million individuals, not enrolled in major public programs like Medicaid or Medicare, have a pre-existing medical condition and could therefore face higher premiums or significant out-of-pocket costs” if the Trump-GOP lawsuit is successful.

Republicans Want To Give Insurance Companies The Power To Charge You More, While Their Profits Soar

• 138 Million Americans Could Once Again Have To Pay For Preventive Care. Because of the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no cost to consumers. This includes nearly 138 million Americans, most of whom have employer coverage.
• Premium Surcharges Can Once Again Be In The Six Figures. Thanks to the Republican lawsuit, insurance companies can charge people more because of a pre-existing condition. The House-passed repeal bill had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
• Women Can Be Charged More Than Men For The Same Coverage. Prior to the ACA, women, for example, were often charged premiums on the nongroup market of up to 50 percent higher than they charged men for the same coverage. 
• People Over The Age of 50 Can Face A $4,000 “Age Tax.” Thanks to the Republican lawsuit, insurance companies can charge people over 50 more than younger people. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, according to the AARP.
• Nine Million People In The Marketplaces Will Pay More For Coverage. Thanks to the Republican lawsuit, consumers no longer have access to tax credits that help them pay their marketplace premiums, meaning roughly nine million people who receive these tax credits to pay for coverage will have to pay more.
• Seniors Will Have To Pay More For Prescription Drugs. Thanks to the Republican lawsuit, seniors will have to pay more for prescription drugs because the Medicare “donut” hole got reopened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 Centers on Medicare and Medicaid Services report.

Republicans Want To Give Insurance Companies The Power To Limit The Care You Get, Even If You Have Insurance Through Your Employer

• Reinstate Lifetime and Annual Limits On 109 Million Privately Insured Americans. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage for those insured through their employer or on the individual market.
• Insurance Companies Do Not Have to Provide the Coverage You Need. The Affordable Care Act made comprehensive coverage more available by requiring insurance companies to include “essential health benefits” in their plans, such as maternity care, hospitalization, substance abuse care and prescription drug coverage. Before the ACA, people had to pay extra for separate coverage for these benefits. For example, in 2013, 75 percent of non-group plans did not cover maternity care, 45 percent did not cover substance abuse disorder services, and 38 percent did not cover mental health services. Six percent did not even cover generic drugs.
• Large Employers Could Choose to Follow Any State’s Guidance, Enabling Them Put Annual and Lifetime Limits on Their Employees’ Health Care. Without the ACA’s definition of essential health benefits (EHB) in even some states, states could eliminate them altogether. Large employers could choose to apply any state’s standard, making state regulations essentially meaningless. Because the prohibition on annual and lifetime limits only applies to essential health benefits, this change would allow employers to reinstate annual and lifetime limits on their employees’ coverage.

Republicans Want To End Medicaid Expansion

• Seventeen Million People Enrolled Through Medicaid Expansion Could Lose Coverage.
• Access To Treatment Would Be In Jeopardy For 800,000 People With Opioid Use Disorder. Roughly four in ten, or 800,000 people with an opioid use disorder are enrolled in Medicaid. Many became eligible through Medicaid expansion.
• Key Support For Rural Hospitals Would Disappear, leaving hospitals with $9.6 billion more in uncompensated care. 

Democrats’ Sweeping Health Care Bill Would Provide Lower Costs, Better Care for American Families

House Democrats are keeping their promise to reduce health care costs and improve care for millions by passing the Patient Protection and Affordable Care Enhancement Act (H.R. 1425). By putting an upper limit on how much insurance can cost a family, expanding the number of middle class families who can get financial support, and other cost reduction programs, millions of Americans will see their premiums reduced. The bill also improves health care by incentivizing holdout states to expand Medicaid and expanding Medicaid eligibility for mothers 12 months postpartum as well as increasing funding for outreach for open enrollment. The bill will lead to coverage for 4 million additional people and lower health care costs for another 13 million, benefiting at least 17 million Americans at a time when access to health care is paramount. 

While House Democrats take concrete steps to make our health care system work better for the American people, the Trump administration and its Republican allies are doing just the opposite: proposing to cut Medicare and Medicaid by billions of dollars, gutting protections for preexisting conditions, and throwing the full weight of the Justice Department behind overthrowing the Affordable Care Act in the Texas lawsuit. 

Lower Health Care Costs. The House bill would reduce health care premiums and deductibles, expand eligibility for financial assistance that helps consumers afford coverage, and expand access to affordable health care by guaranteeing affordable care options.

• Coverage for less than 8.5 percent of your income. Under the Underwood bill, nearly all Americans would be guaranteed an option to purchase health care for less than 8.5 percent of their income. A family of four earning $40,000 would save nearly $1,600 in annual premiums, and a 64-year-old earning $57,420 would save more than $8,700 in premiums each year.
• Financial assistance for more people. Premium tax credits would be made available to more middle class Americans, including those with incomes above 400 percent of the federal poverty line (roughly $100,400 for a family of four). It also expands the size of tax credits for people in all income brackets.
• Lower premiums. The House legislation would help further reduce premiums by providing $10 billion annually to states through a national reinsurance program. The CBO estimates that premiums for individual market coverage before subsidies would be 10 percent lower beginning in 2022.
• Negotiating prescription drug costs. The House bill includes important provisions from the Elijah E. Cummings Lower Drug Costs Now Act (H.R. 3), allowing Medicare to negotiate for lower drug prices for people enrolled through Medicare and private insurance. 

Better Care For More People. The House bill includes important provisions to expand health care to more people. In addition to lowering costs, the House bill would help more people access Medicaid and address racial disparities in health care coverage. 

• Expanding Medicaid. The House bill incentivizes holdout states to expand Medicaid by restoring the enhanced federal match rate. If all states expanded Medicaid, an additional 4.8 million people would be eligible for coverage.
• Reducing racial disparities in health care. The bill works to reduce racial disparities by addressing the maternal mortality crisis, expanding Medicaid to new mothers 12 months postpartum. It also ensures that children and families that enroll in Medicaid/CHIP receive 12 months of coverage to prevent coverage interruptions. 

End Sabotage. Since taking office, the Trump administration has worked relentlessly to sabotage Americans’ health care, expanding access to junk plans that allow insurance companies to deny coverage to patients with pre-existing conditions and slashing funding to help people sign up for comprehensive, affordable care. 

• Protecting people with pre-existing conditions. The legislation would stop the Trump administration’s plans to allow insurance companies to sell junk plans that deny people with pre-existing conditions coverage or charge them more. It also reverses the Trump administration’s efforts to allow states waive pre-existing condition protections.
• Guaranteeing that insurance companies cover basic health services. The bill would also prevent the Trump administration from weakening requirements that all insurance cover essential health benefits, such as prescription drug coverage, hospital care, and maternity coverage.
• Restoring funding for education. The House bill would restore all marketing funding for healthcare sold through the marketplace, which the Trump administration has cut by 90 percent since taking office.
• Restoring funding for groups that help people sign up for coverage. Funding for health navigator groups that help people sign up for comprehensive care, which has been cut by 77 percent since President Trump took office, would also be restored. The bill would provide $100 million annually to the federal navigator program. 

Top Ways the ACA Helps Fight Coronavirus 

The Affordable Care Act is a critical tool to help the U.S. coronavirus response. If Trump is successful in overturning the law in court, we will lose key protections: 

• Coverage for 20+ Million People. Because of the ACA, more than 20 million Americans gained health coverage. People with insurance are much more likely to see a doctor when they are sick and to get the treatment they need. 
• Protections For 135 Million People With Pre-Existing Conditions. Thanks to the ACA, insurers can no longer deny or drop coverage because of a pre-existing condition. Anyone who contracts the coronavirus will not be subject to future discrimination from their insurance companies. 
• Free Preventative Care. Because of the ACA, health plans must cover designated preventive services — including screening tests without cost-sharing. 
• Comprehensive Coverage. Because of the ACA, insurers have to cover what are known as “essential health benefits,” such as prescription drugs and hospitalization. Coronavirus testing and treatment are essential health benefits and must be covered by all ACA-compliant plans.
• Access To Critical Vaccinations Without Cost Sharing. The Affordable Care Act will almost certainly cover the coronavirus vaccine without cost-sharing, because it requires plans to cover all vaccinations recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP). 
• Increased CDC Funding. The Affordable Care Act established the CDC Prevention and Public Health Fund, which helps states prepare for disease outbreaks. The Washington Post reported that this fund “provides almost $1 billion annually to CDC, now about 12 percent of CDC’s budget. It includes prevention of bioterrorism and disease outbreaks, as well as money to provide immunizations and heart-disease screenings.”
• Medicaid Expansion. Because of the ACA, states can get additional federal money to expand Medicaid to vulnerable populations. More than 17 million Americans now have coverage through Medicaid expansion. Importantly, Medicaid’s funding structure allows funds to increase in response to a public health emergency like coronavirus. 
• Key Support For Rural Hospitals. The ACA led to a $12 billion reduction in uncompensated care costs. Between 2013 and 2015, hospitals’ uncompensated care costs decreased by $12 billion, or roughly 30 percent. As hospitals prepare for an influx in patients, it is critical that they are paid for the treatment they provide. 

Five Ways Trump’s Actions Are Accelerating the Spread of the Coronavirus and Deepening the Economic Crisis

1) Rush To Reopen: Trump’s Push For States To Reopen Prematurely Is Directly Responsible For Massive Spikes, But He Says U.S. Will Not Lock Down Again

• Pulitzer Prize Winning Science Journalist: “Where Social Distancing Policies Have Largely Been Observed, As In The NE, Cases Are Declining. But Where States Rushed To Reopen, Cases Are Soaring.” “The differences in #COVID19 trends by US region are stark. Where social distancing policies have largely been observed, as in the NE, cases are declining. But where States rushed to reopen, cases are soaring. It won’t be long, before the South surpasses NE’s mid-April peak.” [Twitter, Laurie Garrett, 6/24/20]
• Amanda M. Simanek, Associate Professor In Epidemiology At The University Of Wisconsin-Milwaukee’s Joseph J. Zilber School Of Public Health, Argued That Many States Eased Lockdown Measures Before Establishing Necessary Testing And Contract Tracing Infrastructure. “Simanek said many states eased lockdown measures before they had met the right criteria, including by building up the necessary infrastructure. That includes testing and contact tracing capabilities, which she said are ‘the primary means by which to prevent new cases from leading to wide-scale outbreaks.’” [Newsweek, 6/15/20]
• Trump On June 17, 2020: “We Won’t Be Closing The Country Again. We Won’t Have To Do That.” “‘We won’t be closing the country again. We won’t have to do that,’ Trump said in an interview with Fox News Channel.” [Reuters, 6/17/20]

2) Opposition To Testing: Trump Wants To Slow Testing Though Experts Agree Widespread Testing Is Vital To Stop The Spread Of The Virus And Reopen The Economy

• Harvard Global Health Institute Director Dr. Ashish Jha: “Testing Was The Fundamental Failure That Forced Our Country To Shut Down.” During the Select Subcommittee on the Coronavirus Crisis hearing on testing, tracing, and targeted containment Dr. Jha said: ‘Every expert on the left, right, and center agrees that we had to shut our economy down because the outbreak got too big because we didn’t have a testing infrastructure that allowed us to put our arms around the outbreak. And so testing was the fundamental failure that forced our country to shut down.’” [Twitter, Coronavirus War Room, 5/13/20]
• Yale University Professor Dr. Howard Forman: “Under Trump’s Leadership, Instead Of Increasing Testing Capacity, He’s Done The Opposite.” “Every time we miss an opportunity to test an individual, we are increasing the chance that someone will get infected or die, but under Trump’s leadership, instead of increasing testing capacity, he’s done the opposite. As a result, he’s only prolonging this crisis.” [Protect Our Care, Press Call, 6/23/20]
• During A Tulsa Rally On June 20, Trump Declared That He Told His Administration To “Slow The Testing Down Please.” “Trump had told supporters at the rally that Covid-19 testing was ‘a double-edged sword.’ ‘I said to my people, “Slow the testing down please,”’ the President had said.” [CNN, 6/22/20]
• The Trump Administration Has Withheld $14 Billion In Funding For Coronavirus Testing And Contact Tracing. “The Trump administration has been sitting on nearly $14 billion in funding that Congress passed for coronavirus testing and contact tracing, according to Democratic Sens. Chuck Schumer of New York and Patty Murray of Washington. The top Democrats said in a letter Sunday to Health and Human Services Secretary Alex Azar that the Trump administration has ‘still failed’ to distribute more than $8 billion out of $25 billion appropriated by Congress to expand testing and contact tracing. The letter indicated that Congress passed these funds as part of a coronavirus relief bill in April.” [NBC News, 6/21/20]
• As The United States Reached An All Time In New Reported Cases In A Day, The Trump Administration Announced That They Would Be Pulling Federal Funding For Coronavirus Testing Sites At The End Of June. “As the number of coronavirus infections continues to climb across the country — particularly now in the South and West — the Trump administration is planning to end its funding and support for coronavirus testing sites at the end of the month.” [NBC News, 6/24/29]

3) Refusal To Support Basic Safety Measures: Trump Has Flouted Mask Wearing Even Though It Is Proven To Effectively Slow The Transmission Of The Virus

• June 18, 2020: Trump Claimed That Americans Were Wearing Masks During The Coronavirus Pandemic To Show Disapproval Of Him. Trump Claimed “President Donald Trump told The Wall Street Journal that he believes that some Americans are wearing masks during the coronavirus pandemic not to protect others but simply to show that they disapprove of him.” [Business Insider, 6/18/20]
• May 7, 2020: Trump Said That Him Wearing A Mask Would “Send The Wrong Message.” “President Donald Trump has been mask averse for weeks. Within minutes of the CDC announcing its updated mask recommendations last month, the president said, ‘I don’t think that I’m going to be doing it.’ Trump has told advisers that he believes wearing one would ‘send the wrong message,’ according to one administration and two campaign officials not authorized to publicly discuss private conversations.” [Associated Press, 5/7/20]
• Former Trump FDA Commissioner Scott Gottlieb: “Universal Masking Is Most Obvious, Least Intrusive Intervention States With Large Epidemics Can Take.” “Universal masking is most obvious, least intrusive intervention states with large epidemics can take. But it won’t be enough at this stage. Many will also have to consider targeted mitigation steps to limit congregate settings that they identify as the sources of biggest spread.” [Twitter, Scott Gottlieb, 6/25/20]
• Researchers Found That Wearing Face Masks Prevented More Than 78,000 Infections In Italy And More Than 66,000 Infections In New York City. “The researchers calculated that wearing face masks prevented more than 78,000 infections in Italy between April 6 and May 9, and more than 66,000 infections in New York City between April 17 and May 9.” [CNN, 6/12/20]
• June 2020 Study: “We Conclude That Wearing Of Face Masks In Public Corresponds To The Most Effective Means To Prevent Interhuman Transmission.” “We conclude that wearing of face masks in public corresponds to the most effective means to prevent interhuman transmission, and this inexpensive practice, in conjunction with simultaneous social distancing, quarantine, and contact tracing, represents the most likely fighting opportunity to stop the COVID-19 pandemic.” [PNAS, Zhang et al., 6/11/20]

4) Holding Super Spreader Events: Experts Warn That Trump Holding Indoor Rallies With No Social Distancing Or Mask Wearing Will Accelerate The Spread The Virus

• According The CDC’s Guidelines, Trump’s June 20th Rally Would Fall Into The “Highest Risk” Category Of In-Person Gatherings. “The event would fall into the ‘highest risk’ category, according to the CDC’s own new guidelines issued on Friday, which characterizes those as ‘large in-person gatherings where it is difficult for individuals to remain spaced at least 6 feet apart and attendees travel from outside the local area.’” [NBC News, 6/13/20]
• Julie Fischer, An Associate Research Professor Of Microbiology And Immunology At Georgetown University, Warned That Trump’s Tulsa Rally Could Seed Outbreaks In Communities Across The Country. “Julie Fischer, an associate research professor of microbiology and immunology at Georgetown University, said the event could have wide repercussions for the country. ‘With a little bad luck, that scenario could end in the seeding of community outbreaks of COVID-19 across the U.S.,’ she said.” [Associated Press, 6/14/20]\
• Despite These Concerns, Trump Has Continued To Hold Rallies, Including One In Phoenix, AZ That Did Not Require Attendees To Wear Masks Or Have Their Temperatures Checked. “After a disappointing showing at his campaign rally over the weekend, President Donald Trump renewed his performance for a packed crowd of students on Tuesday, telling his Arizona audience that they were guardians in a cultural war over the heritage of the country… Images from the event showed a large crowd tightly packed together, with almost no one wearing protective masks. There were no temperature checks for the estimated 3,000 cheering attendees who, like many of Trump’s staunchest fans, ignored a new local ordinance requiring them to wear a mask, despite a public-health plea from the Democratic mayor on Monday.” [Politico, 6/23/20]

5) Refusal To Invoke Defense Production Act (DPA): Trump Is Refusing To Invoke The Full Powers Of The DPA To Ramp Up Production Of Testing And Protective Equipment

• For Weeks, The Trump Administration Delayed Invoking The Defense Production Act To Increase The Production Of Medical Supplies Necessary To Increase Testing. “President Donald Trump will use the Defense Production Act to compel an unnamed company to produce 20 million more coronavirus testing swabs every month — weeks after labs and public health officials started warning that shortages of these swabs were hurting efforts to ramp up testing nationwide… Asked why his administration waited for weeks to use the Defense Production Act on swabs, Trump alternately claimed that states have ‘millions coming in’ already, that states can procure them on their own, and that governors ‘don’t know quite where they are’ and need the federal government’s help.” [Politico, 4/19/20]
• Co-Founder Of Get Us PPE Val Griffith Has Argued That The DPA Could Be Used More Broadly To Increase Production Of Protective Gear. “Griffeth argues the Defense Production Act (DPA), which Trump has deployed selectively, could be used more broadly to increase production of essential protective gear.” [Vox, 6/17/20]
• National Nurses United President Zenei Cortez: “If There Is Concern That Our Nation’s Health Facilities Do Not Have Enough Disposable, Impermeable Gowns, The Presidential Administration Needs To Use The Defense Production Act.” “’Fluid impermeable gowns are an important part of the overall personal protective equipment ensemble. We must protect our health care workers, and if there is concern that our nation’s health facilities do not have enough disposable, impermeable gowns, the presidential administration needs to use the Defense Production Act to direct our manufacturing industries to immediately make them, in addition to the N95 respirator masks and other PPE gear we also need to fight this virus for the long term,’ Zenei Cortez, president of National Nurses United, said in a statement after the FDA deregulated the use of cloth gowns in medical settings in April.” [Roll Call, 6/9/20]
• Former CDC Director Dr. Tom Frieden Questioned Why The United States Had Not Been Able To Produce Enough Surgical Face Masks For The Public When Other Countries Had Been Able To Do So. “Surgical masks are more effective than cloth face coverings. Other countries have produced enough for the public as well as for health care workers and have kept prices low or given them out free to the public. Why can’t the United States do this?” [Twitter, Dr. Tom Frieden, 6/24/20]

How Trump’s Opposition To Testing Has Enabled COVID-19 To Spread

Trump’s Antagonism Toward Testing Is Not Limited To Rhetoric — Insufficient Testing Is Trump Administration Policy 

• The Trump Administration Has Withheld $14 Billion In Funding For Coronavirus Testing And Contact Tracing. “The Trump administration has been sitting on nearly $14 billion in funding that Congress passed for coronavirus testing and contact tracing, according to Democratic Sens. Chuck Schumer of New York and Patty Murray of Washington. The top Democrats said in a letter Sunday to Health and Human Services Secretary Alex Azar that the Trump administration has ‘still failed’ to distribute more than $8 billion out of $25 billion appropriated by Congress to expand testing and contact tracing. The letter indicated that Congress passed these funds as part of a coronavirus relief bill in April.” [NBC News, 6/21/20]
• HHS’ May Testing Plan Called For The Federal Government To Acquire So Few Testing Supplies That Experts Called It “Absurd.” “To ensure that States have the collection supplies that they need through December 2020, the Federal government plans to acquire 100 million swabs and 100 million tubes of viral transport media, and distribute these supplies to States as requested to meet their individual State plans. This large-scale acquisition reflects a significant expansion of current capacity and is a result of the broadening of available swab and media types authorized by the FDA and use of Title III of the Defense Production Act (DPA) to increase production of swabs.” [HHS, COVID-19 Strategic Testing Plan, 5/24/20]
• • Harvard Global Health Institute Director Dr. Ashish Jha Said Of The Trump Administration’s Testing Plan: “The Idea That 300,000 Tests A Day Is Enough For America Is Absurd.” “‘On the face of it, the idea that 300,000 tests a day is enough for America is absurd,’ said Dr. Ashish Jha, director of the Harvard Global Health Institute.” [New York Times, 5/25/20]

• For Weeks, The Trump Administration Delayed Invoking The Defense Production Act To Increase The Production Of Medical Supplies Necessary To Increase Testing. “President Donald Trump will use the Defense Production Act to compel an unnamed company to produce 20 million more coronavirus testing swabs every month — weeks after labs and public health officials started warning that shortages of these swabs were hurting efforts to ramp up testing nationwide… Asked why his administration waited for weeks to use the Defense Production Act on swabs, Trump alternately claimed that states have ‘millions coming in’ already, that states can procure them on their own, and that governors “don’t know quite where they are” and need the federal government’s help.” [Politico, 4/19/20]
• The Trump Administration Abandoned Talks Of Testing Most Workers Before Reopening The Economy, Citing A Lack Of Tests. “For the last several weeks, health and other administration officials had been discussing having most workers tested for the virus before they returned to work, both to protect businesses afraid of becoming the sites of large outbreaks and to quickly identify and isolate infected people to prevent another wave of cases. But in the last few days, the strategy has morphed to prioritizing four key groups: health-care workers, food safety workers, those in nursing homes and people with chronic diseases — which would still amount to testing millions of people. The new strategy was driven by a realization that it would be impractical to test everybody, as well as a lack of available tests, said a senior administration official involved in the strategy.” [Washington Post, 4/16/20]

Trump’s Refusal To Sufficiently Ramp Up Testing Has Had Disastrous Consequences 

• Trump’s Failure To Ramp Up Testing Allowed The Virus To Spread Undetected, Ultimately Contributing To More Than 120,000 US Deaths.
• By Failing To Sufficiently Test At The Outbreak Of The Coronavirus Crisis, Trump Allowed The Coronavirus To Spread Undetected. “It was not until 29 February, more than a month after the Journal article and almost six weeks after the first case of coronavirus was confirmed in the country that the Trump administration put that advice into practice. Laboratories and hospitals would finally be allowed to conduct their own Covid-19 tests to speed up the process. Those missing four to six weeks are likely to go down in the definitive history as a cautionary tale of the potentially devastating consequences of failed political leadership.” [The Guardian, 3/28/20]
• Today, There Have Been Nearly 2.3 Million Confirmed Cases And More Than 120,000 Coronavirus Deaths In The U.S. Despite accounting for only 4 percent of the world’s population, as of June 22nd, the US accounted for more than 25 percent of the world’s reported coronavirus cases and deaths. [Johns Hopkins University, Coronavirus Resource Center, Accessed 6/22/20]
• Trump’s Failure To Sufficiently Test Forced The Economy To Shut Down.
• Harvard Global Health Institute Director Dr. Ashish Jha: “Testing Was The Fundamental Failure That Forced Our Country To Shut Down.” “During the Select Subcommittee on the Coronavirus Crisis hearing on testing, tracing, and targeted containment Dr. Jha said: ‘Every expert on the left, right, and center agrees that we had to shut our economy down because the outbreak got too big because we didn’t have a testing infrastructure that allowed us to put our arms around the outbreak. And so testing was the fundamental failure that forced our country to shut down.’” [Twitter, Coronavirus War Room, 5/13/20]
• Trump’s Continued Failure To Adequately Test Has Made It More Dangerous For States To Reopen.
• As Trump First Considered Pushing States To Reopen, Johns Hopkins Center For Health Security Senior Scholar Amesh Adalja Emphasized The “Only Way” To Control The Spread Of Cases Was Testing. “It’s not a question of whether there’s going to be more cases after you lift social distancing. They are going to occur. We just want them to occur at a rate that is manageable. And the only way that’s going to happen is with testing.” [Vox, 4/10/20]
• Dr. Anthony Fauci Said Of States Reopening Without Robust Testing In Place: “You Can’t Just Leap Over Things And Get Into A Situation Where You’re Really Tempting A Rebound. That’s The Thing I Get Concerned About.” “‘We will get blips … there’s no doubt,’ Fauci told NBC’s ‘Today’ show. ‘When you pull back there will be cases, and what we need to do is make sure (states) have in place the capability of identifying, isolating and contact tracing individuals.’ Fauci urged states that don’t have that capability to go very slowly. ‘You can’t just leap over things and get into a situation where you’re really tempting a rebound. That’s the thing I get concerned about,’ he said.” [Associated Press, 4/30/20]
• Despite Those Concerns, Trump Pushed States To Reopen Without Adequate Testing In Place While Many Struggled To Conduct Urgent Testing Of Those With Symptoms Or In High-Risk Groups. “But as states begin to reopen, the nation is far from being able to conduct the kind of widespread surveillance testing that health experts say would be optimal. Many states are still struggling to conduct much more urgent testing of patients with symptoms, or those in high-risk groups. Few have the money or the personnel to also check on the presence of the virus in the general population or to reach out to people who have been in contact with those confirmed to be ill.” [New York Times, 4/25/20]
• Now, Cases Are Spiking In 29 States After Trump Pushed States To Reopen Prematurely. “A White House adviser said Sunday that the Trump administration is preparing for a possible second wave in the novel coronavirus pandemic this fall, as 29 states and U.S. territories logged an increase in their seven-day average of new reported cases after many lifted restrictions in recent weeks.” [Washington Post, 6/22/20]

Despite Trump’s Bragging, Testing Levels Remain Dangerously Below The Levels Experts Say Are Needed To Control The Virus’ Spread

• Harvard Global Health Institute Director Dr. Ashish Jha Believes We Will Need At Least “Two Or Three Times” More Tests Than The 40 To 50 Million Tests Adm. Giroir Estimates The U.S. Will Have Capacity For By September.  “Ashish Jha, director of the Harvard Global Health Institute, says Giroir’s prediction of 40 million to 50 million tests per month by September won’t be enough to tamp the virus down as the country returns to work and school. ‘I believe that we will need two or three times that number of tests, if not more, if we’re going to have a shot at keeping our economy open and keep our people protected during the fall and winter,’ he said.” [Politico, 6/17/20]
• Harvard Global Health Institute Director Dr. Ashish Jha Emphasized The Need To “Have Really Substantially Ramped-Up Testing And Isolation [Of New Cases]” To Actually Limit The Spread Of The Coronavirus. “To maintain a reproduction number that’s just over 1, or better yet, push it back to just under 1, even in the midst of further re-opening ‘would take a lot of work,’ Jha says. ‘You’d have to have really substantially ramped-up testing and isolation [of new cases].’ There’s also evidence emerging that widespread use of masks by people when they are out in public could help, Jha notes. Unfortunately, he says, it is hard to envision the U.S. adopting any of these practices to a sufficient degree ‘based on where we are today.’” [NPR, 6/12/20]
• Harvard Global Health Institute Director Dr. Ashish Jha: “If Things Stay Basically Status Quo And We Continue Doing What We’re Doing, We’re Going To Continue Seeing 25,000 To 30,000 Additional Deaths A Month For The Foreseeable Future.” “’If things stay basically status quo and we continue doing what we’re doing, we’re going to continue seeing 25,000 to 30,000 additional deaths a month for the foreseeable future,’ Jha says. Grim as it is, even this picture may be overly rosy, Jha adds. ‘I’m worried that the idea that we’re going to stay flat all summer is a very optimistic view of what is going to happen over the next three months,’ he says.” [NPR, 6/12/20]
• Harvard Safra Center For Ethics Director Danielle Allen Emphasized Multiple Models They Ran All Pointed To The U.S. Needing To Conduct More Than 3 Million Tests A Day. “The H.H.S. report noted that an analysis by the Safra Center at Harvard estimated the need at more than three million tests per day. But the federal report said that estimate was based on faulty assumptions. The Safra authors who crafted the estimate said that the federal report had cherry-picked one simple example from their analysis without considering other evidence. ‘We ran multiple models, all of which pointed to the same order of magnitude,’ said Danielle Allen, director of the Safra Center. ‘They’ve selected one non-primary model in an appendix and selectively adjusted assumptions to generate a different number.’” [New York Times, 5/25/20]

And Experts Say Trump’s Attempts To Downplay The Importance Of Testing Are Gravely Mistaken

• Amesh Adalja, An Infectious-Disease Expert At The Johns Hopkins Center for Health Security, Condemned Trump For Advocating For Slowing Down Testing And For Trying To Manipulate The Number Of Confirmed Coronavirus Cases. “The president’s comment, which came on the same day that eight states reported their highest-ever single-day case counts, drew a chorus of criticism from congressional Democrats and public health officials, who worry the president is more concerned with saving face than combating the pandemic. ‘Looking at it as a scoreboard is the wrong way to think about it,’ said Amesh Adalja, an infectious-disease expert at the Johns Hopkins Center for Health Security. ‘To think of it as something you can manipulate or slow down based on what the numbers look like speaks to a complete misunderstanding of what an infectious-disease response should be.’” [Washington Post, 6/21/20]
• Ashish Jha, Director Of The Harvard Global Health Institute: “We’re Still Really Early In This Pandemic And It Is Not Helpful To Create A Mind-Set That We’re Almost Done.” “‘We’re still really early in this pandemic and it is not helpful to create a mind-set that we’re almost done,’ said Ashish Jha, director of the Harvard Global Health Institute. ‘It’s part of what we’re seeing in terms of large outbreaks going on in Arizona, Texas and Florida, is people have gotten convinced the pandemic is over.’” [Washington Post, 6/21/20]