New Report is More Hot Air As the Trump-GOP War on Health Care Rolls On

Washington, DC – Today, the Trump Administration released a report that is nothing more than a bait-and-switch on health care from an Administration whose primary health care agenda is to take Americans’ coverage away. In response, Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

“No fancy report is going to change the fact that when it comes to health care, the Trump Administration’s real goals are crystal clear: to erode protections Americans depend on, like those for individuals with pre-existing conditions; to make people pay more money for less coverage; and to do whatever they can to get rid of or dismantle Medicare, Medicaid and the Affordable Care Act.”

Though they’re trying to distract from it, here’s the Trump Administration’s real health care record:

TRUMP AND REPUBLICANS ARE WORKING TO END PROTECTIONS FOR PRE-EXISTING CONDITIONS

If federal courts rule in favor of the Trump Administration and Republican attorneys general, protections for people with pre-existing conditions would vanish overnight, unleashing chaos in our entire health care system.

In addition to going to court to eliminate pre-existing conditions protections, the Trump Administration is urging states to skirt consumer protections in the Affordable Care Act through regulatory waivers.

TRUMP IS PUSHING JUNK PLANS THAT EXCLUDE COVERAGE OF PRE-EXISTING CONDITIONS

Short-Term Plans May Exclude Coverage For Pre-Existing Conditions. “Policyholders who get sick may be investigated by the insurer to determine whether the newly-diagnosed condition could be considered pre-existing and so excluded from coverage.” [Kaiser Family Foundation, 2/9/18]

Short-Term Junk Plans Can Refuse To Cover Essential Health Benefits and Prescription Drugs. “Typical short-term policies do not cover maternity care, prescription drugs, mental health care, preventive care, and other essential benefits, and may limit coverage in other ways.” [Kaiser Family Foundation, 2/9/18]

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

Junk Plans Are Notorious For The Scams They Attract. “Once the new rules were announced, vendors both fraudulent and legitimate adapted to market these short-term plans as the lines between the two became even more blurry. (The plans favored by our scam-happy president are also, unsurprisingly, historically scammy.)…As the administration promised, there are certainly more options, but there’s also not much by way of a filter. Since last summer, the federal budget for ‘insurance navigators’—the people you can call to parse your government-funded options, including Medicare and state healthcare—has been cut by 80%.” [Splinter, 11/21/18]

TRUMP’S HEALTH CARE SABOTAGE IS DRIVING COSTS UP FOR CONSUMERS

Larry Levitt, Senior Vice President Of Kaiser Family Foundation: Premiums Would Be Going Down If Not For Insurance Companies Compensating For Unstable Environment. “ACA premiums are stable for 2019 because they went up so much this year due to an uncertain environment and regulatory actions by the Trump administration. Premiums would be going down a lot if not for repeal of the individual mandate penalty and expansion of short-term plans.” [Levitt, 9/27/18]

Brookings Analysis Estimates That Individual Market Premiums Would Fall By 4.3 Percent In 2019 If Not For GOP Sabotage. [Brookings Institution, 8/1/18]

Health Care Analyst, Charles Gaba Has Calculated That Across The Country, Premiums Will Increase By An Average Of 2.8 Percent In 2019. The average premium increases indicate that premiums nationwide will be 8.1 percent higher than they would have been absent GOP sabotage. [Charles Gaba, Accessed 12/3/18]

TRUMP AND REPUBLICANS WANT TO UNDERMINE MEDICAID AND MEDICARE

President Trump’s FY 2019 budget proposed $1.4 trillion in cuts to Medicaid. In February, President Trump proposed a budget that would have gutted Medicaid by $1.4 trillion.

President Trump and Congressional Republicans are targeting Medicare and Medicaid to pay for tax cuts for the wealthiest. Last December, President Trump signed a $1.5 trillion tax bill that disproportionately benefits the wealthy. In an attempt to pay for these tax cuts, in April, House Republicans passed a budget amendment that would slash Medicare funding by $537 billion over the next decade.

Congressional Republicans proposed these cuts after passing a budget resolution last year that cut Medicare by $473 billion. The 2018 budget resolution passed by Republicans in December 2017 cut Medicare by $473 billion.

Larry Kudlow, Director of the National Economic Council, confirmed that he has his sights on cutting Medicare. Asked when programs like Social Security and Medicare will be looked at for reforms, Kudlow replied, “Everyone will look at that — probably next year.”

As the cost of drugs skyrocket, President Trump and his Republican allies in Congress will not allow Medicare to negotiate for better prescription drug prices. Under current law, the Secretary of the Department of Health and Human Services (HHS) is explicitly prohibited from negotiating directly with drug manufacturers on behalf of Medicare Part D enrollees. Although it would decrease both federal spending and beneficiaries’ out-of-pocket costs for prescription drugs, a policy allowing the federal government to negotiate drug prices for Medicare beneficiaries was noticeably absent from President Trump’s recent prescription drug announcement.  

Congressional Republicans repealed several components of the ACA designed to help keep Medicare’s costs down, effectively driving up costs for the program. By repealing the requirement that most people have insurance, Congressional Republicans knowingly voted for a measure expected to increase the number of uninsured. The 2018 Medicare Trustees Report predicts that this increase will increase the share of subsidies paid to hospitals via Medicare. Similarly, by repealing the Independent Payment Advisory Board, Congressional Republicans took away a mechanism that slowed Medicare cost growth.

TRUMP’S HRAs WILL FURTHER ERODE AMERICANS’ ACCESS TO AFFORDABLE HEALTH CARE

Standalone HRAs By Definition Contain An Annual Limit and Are Not Required to Cover Certain Preventive Services. “The ACA requires group health plans to meet certain standards that HRAs can’t meet, specifically the ban on annual and lifetime limits and the requirement to cover certain preventive services at no cost to plan enrollees. (HRAs by definition contain an annual limit on the amount of the employer’s contribution, and they are just accounts that do not cover any benefits.)” [Center on Budget and Policy Priorities, 11/29/17]

Increasing Access To Standalone HRAs Could Incentivize Businesses To Offer Limited Coverage HRAs Instead Of Full Health Coverage. “If the Administration attempts to broaden the availability of such “standalone” HRAs, that would likely prompt fewer businesses to offer health coverage to their employees.  Workers who now have good coverage and substantial contributions from an employer could see those benefits dropped and replaced with an HRA that leaves them paying higher premiums for less comprehensive coverage than what they have today.” [Center on Budget and Policy Priorities, 11/29/17]

HRAs Could Raise Premiums in the Individual Market By Drawing Healthy People Out Of Individual Market. “Depending on the specific proposals, and what employers do in response, HRAs could negatively affect the individual market by moving more high-cost people into that risk pool, raising overall premiums, and leaving other individual-market consumers and the federal government (through the premium tax credit) paying more.” [Center on Budget and Policy Priorities, 11/29/17]

American Cancer Society Cancer Action Network, American Heart Association, America’s Health Insurance plans, Blue Cross Blue Shield Association, Center on Budget and Policy Priorities, Crohn’s & Colitis Foundation, Epilepsy Foundation, Families USA, March of Dimes, The National Multiple Sclerosis Society Are Opposed to Expanding HRAs: “Expanding and extending short-term, limited-duration health plans, increasing enrollment in Association Health Plans (AHPs), and relaxing rules for employer Health Reimbursement Arrangements (HRAs) all increase adverse selection in insurance markets that serve millions of individuals and employers. We are concerned that this could create or expand alternative, parallel markets for health coverage, which would lead to higher premiums for consumers, particularly those with pre-existing conditions. Further, these actions destabilize the health insurance markets that guarantee access to comprehensive health coverage regardless of health status.” [Letter to State Departments of Insurance, 12/14/17]