Today, Secretary of Health and Human Services Alex Azar made yet another desperate attempt to hide the dirty truth about the Trump Administration’s new policies to expand junk health plans, cut Medicaid enrollment by pushing for burdensome work requirements, and sabotage health care at every turn. Said Leslie Dach, chair of Protect Our Care, in response:

“Today’s appearance officially makes Secretary Azar Donald’s Trump latest snake oil salesman. The simple fact is that Trump and Azar’s policies will kick people off their health insurance, allow insurance companies to sell junk insurance policies that discriminate against people with pre-existing conditions, charge women and older people higher premiums and kick people off when they get sick. What’s worse, the GOP relentless war on health care has raised health care costs for millions while giving billions in tax breaks to drug and insurance companies.”

Here’s the truth about the “stabilizing marketplace” Azar wrongly takes credit for:

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 Decrease If Not For GOP Sabotage. Among its key findings:

  • Estimates That Average Premium Would Fall By 4.3 Percent In 2019 In Stable Policy Environment. “I estimate that the nationwide average per member per month premium in the individual market would fall by 4.3 percent in 2019 in a stable policy environment.” [Brookings Institution, 8/1/18]
  • Insurance Companies’ Revenues Will Far Exceed Their Costs In 2018. “I project that insurers’ revenues in the ACA-compliant individual market will far exceed their costs in 2018, generating a positive underwriting margin of 10.5 percent of premium revenue. This is up from a modest positive margin of 1.2 percent of premium revenue in 2017 and contrasts sharply with the substantial losses insurers incurred in the ACA-compliant market in 2014, 2015, and 2016. The estimated 2018 margin also far exceeds insurers’ margins in the pre-ACA individual market. ” [Brookings Institution, 8/1/18]
  • Absent Republican Sabotage, Average Premiums For ACA-Compliant Plans Would Likely Fall In 2019. “In this analysis, I define a stable policy environment as one in which the federal policies toward the individual market in effect for 2018 remain in effect for 3 2019. Notably, this scenario assumes that the individual mandate remains in effect for 2019, but also assumes that policies implemented prior to 2018, like the end of CSR payments, remain in effect as well. Under those circumstances, insurers’ costs would rise only moderately in 2019, primarily reflecting normal growth in medical costs.” [Brookings Institution, 8/1/18]

Health Care Analyst, Charles Gaba Has Calculated That Across The Country, Premiums Will Increase By An Average Of 3.3 Percent In 2019. The average premium increases indicate that premiums nationwide will be 7.6 percent higher than they would have been absent GOP sabotage. [Charles Gaba, Accessed 9/27/18]

Here are the facts about Trump-Azar’s junk insurance plans:

JUNK PLANS HURT PEOPLE WITH COVERAGE IN THE ACA MARKETPLACES.

  • Healthy people will leave the individual market for these plans, causing everyone else’s premiums to go up. As the Center on Budget and Policy Priorities notes, these plans will divide the market between those who are sick and those who are healthy: “Short-term plans would be most likely to attract healthier people, leading to premium increases for ACA-compliant plans and destabilizing individual insurance markets across the nation. “

JUNK PLANS MAKE COMPREHENSIVE HEALTH CARE MORE EXPENSIVE.

  • Repealing the individual mandate and loosening short-term plan rules drive up premiums for everyone who needs comprehensive care. The Congressional Budget Office estimates that repealing the individual mandate will increase premiums by 10 percent annually for the next decade, and a report by Wakely Consulting Group estimates that short-term plans alone will cause premiums to increase by 1.4 percent in 2019.

JUNK PLANS MAKE IT HARDER FOR PEOPLE TO FIND COMPREHENSIVE COVERAGE.

  • Azar could be right if you don’t have a pre-existing condition, aren’t a woman or person over fifty, don’t need maternity care or prescription drug coverage, and will never have to use the hospital over the weekend. Junk plans are allowed to discriminate against people with pre-existing conditions by dropping or denying coverage, charge women more, impose annual limits on care, and exclude basic coverage, like hospitalization, prescription drug coverage, and maternity care. In an analysis of short-term plans conducted by the Kaiser Family Foundation, no short-term plans studied covered maternity care, 62 percent did not cover substance abuse treatment, and 71 percent did not cover outpatient prescription drug services. One plan won’t cover expenses if someone is admitted to a hospital on a Friday or Saturday.

Tennessee’s Own Insurance Commissioner, Julie Mix McPeak, Joined a Chorus of State Officials Warning Against Junk Plans. “‘We have to really make sure consumers know what they’re purchasing, and they’re aware of what’s covered and what’s not covered,’ Mix McPeak said. ‘The last thing we need is for consumers to have surprise bills.'” [The Hill, 8/12/18]

Here are the facts about Trump-Azar’s Medicaid work requirements:

TAKING SOMEONE’S HEALTH CARE AWAY DOES NOT HELP THEM TO WORK.

  • However, evidence suggests that such work requirements hurt, rather than help enrollees’ ability to find work. A study of Michigan’s Medicaid “illustrates the functional barriers to work that Medicaid beneficiaries face, and many of them result from physical and mental health challenges. This suggests to us that taking away their health coverage means that they are less likely to find work – not more so…a stable source of health coverage such as Medicaid is likely to assist people with their chronic mental and physical health conditions so that they they are better able to seek employment.” In both Ohio and Michigan, having access to health care made it easier for the unemployed to find work: “majorities said that gaining health coverage has helped them look for work or remain employed. Losing coverage — and, with it, access to mental health treatment, medication to manage chronic conditions, or other important care — could have the perverse result of impeding future employment.

ALREADY, ARKANSAS’ WORK REQUIREMENTS ARE NOT FUNCTIONING THE WAY THE STATE HAD SUPPOSEDLY HOPED THEY WOULD.

  • Early results in Arkansas confirm that Medicaid work requirements are fundamentally bureaucratic hurdles, threatening access to health coverage for thousands across the state. “The early results suggest that the incentives may not work the way officials had hoped. Arkansas officials, trying to minimize coverage losses, effectively exempted two-thirds of the eligible people from having to report work hours. Of the remaining third — about 20,000 people — 16,000 didn’t report qualifying activities to the state. Only 1,200 people, about 2 percent of those eligible for the requirement, told the state they had done enough of the required activities in August, according to state figures.” [New York Times, 9/24/18]

WORK REQUIREMENTS ARE SO DANGEROUS, THAT DOCTORS WORRY THEY WILL HAVE TO DECIDE BETWEEN “DOING HARM TO PATIENTS” AND “PROVIDING INACCURATE ASSESSMENTS.”

  • New England Journal Of Medicine: Medicaid Work Requirements Put Doctors In Difficult Position.  As outlined in the New England Journal of Medicine, “Along with creating new administrative burdens and costs for physicians and enrollees, work requirements may oblige physicians to be involved in determining whether patients maintain or lose insurance coverage. This expectation places physicians’ responsibility to provide honest documentation in stark tension with their primary obligation to serve patients’ interests. Without explicit state guidance on health circumstances that qualify patients for exemptions, physicians may face an ethical dilemma when choosing between two objectionable options: doing harm to patients and providing inaccurate assessments.”