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ACA Archives — Protect Our Care

In News

Lower Costs, Better Care: Ninth Anniversary of the Passage of the ACA is an Opportunity to Define Health Care Agenda

Washington, DC – Ahead of the ninth anniversary of the passage of the Affordable Care Act (ACA) this Saturday, March 23, Protect Our Care chair Leslie Dach released the following statement:

“As we mark the ninth anniversary of the Affordable Care Act, it’s important to remind ourselves what the law has accomplished and what President Trump and his allies in Congress want to take away. While the President doubles down on his efforts to repeal our health care and release a budget with nearly $2 trillion in devastating cuts to Medicaid and Medicare, Democrats are moving forward with an aggressive agenda to lower costs and improve care.

“The Democratic agenda will protect people with pre-existing conditions, lower drug costs, and make health care more affordable. It will stop surprise bills, end price gouging for everyday drugs like insulin, and give Medicare the ability to negotiate for lower drug prices. While Democrats take concrete steps forward, Republicans are dead-set on taking us backwards, doing everything they can to sabotage health care, and put the interests of drug and insurance companies ahead of the needs of the American people.”

BACKGROUND:  

Here is how the Affordable Care Act is working across the country:

More than 20 million Americans gained health coverage. Because of the ACA, more than 20 million Americans gained health coverage.

13 million people have coverage through the individual market. 13.3 million people are covered by marketplace or non-marketplace plans subject to ACA consumer protections. 82 percent of those enrolled through the marketplace are satisfied with their plans.

Insurers can no longer deny or drop coverage because of a pre-existing condition. Because of the ACA, insurers in the individual market can no longer drop or deny coverage, or charge you more because of a pre-existing condition. More than 130 million Americans have a pre-existing health condition.

Women no longer charged more than men. Because of the ACA, insurers can no longer charge women more than men for the same care, and insurers are now required to cover important health benefits like maternity care. Before the ACA, 75 percent of non-group plans refused to cover maternity care. 

Ended annual and lifetime limits. Because of the ACA, insurers can no longer put annual or lifetime limits on the care you receive.

Young adults can stay on their parents plan until age 26. Because of the ACA, roughly 2.3 million young adults have coverage because they can stay on their parents coverage until age 26.

Allowed states to expand Medicaid. Because of the ACA, states can get additional federal money to expand Medicaid. 17 million Americans have coverage through Medicaid expansion.

Free 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 137 million Americans, most of whom have employer coverage.

Comprehensive Coverage. Because of the ACA, insurers have to cover what are known as “essential health benefits,” such as maternity care, prescription drugs, and substance and mental health.

Tax credits are available to help people afford coverage. Because of the ACA, most people getting coverage on the marketplace qualify for tax credits to help pay for coverage. 8.9 million of the ACA’s 11.8 million marketplace enrollees receive premium tax credits.

Improved Access To Care And Financial Security. Between 2010 and 2018, the share of non-elderly adults with a problem paying a medical bill fell by 17 percent, the share who didn’t fill a prescription fell by 27 percent, the share who skipped a test or treatment fell by 24 percent, and the share who didn’t visit a provider when needing care fell by 19 percent.

Helping seniors afford prescription drugs. Because of the ACA, the Medicare prescription drug donut hole is closed. As a result, 4.9 million U.S. seniors are saving $5.7 billion on drugs in 2017, an average of $1,149 per beneficiary.

Helping increase access to employer-sponsored coverage. The Affordable Care Act’s individual and employer mandates are credited with helping increase rates of employer-sponsored health insurance. The Kaiser Family Foundation estimates that between 2013 and 2017, seven million more people gained employer coverage, nearly as many as gained coverage through the ACA marketplaces.

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In News

Protect Our Care Announces Plans for Nationwide Events to Highlight Agenda for Lower Costs and Better Care

To Mark 9th Anniversary of the ACA’s passage, Protect Our Care Will Hold Events in Key Battleground States this Week to Promote a Democratic Agenda for Lower Costs, Better Care and an End to GOP Sabotage

Washington, DC – Protect Our Care has announced plans for activities nationwide this week, during the Congressional recess, to promote an agenda for lower costs, better care and end to Republican health care sabotage in advance of the 9th anniversary of the passage of the Affordable Care Act (ACA), which was signed into law nine years ago this Saturday, March 23.

Activities will include press events in Alaska, Ohio, Colorado, Arizona, Iowa, Georgia, Maine and North Carolina as well as social media efforts nationwide.  At the events, health care professionals, elected officials, health care advocates, and people who have benefited from the ACA will talk about the benefits of the law and discuss the need to move forward with a health care agenda for lower costs and better care for all Americans. Participants will also urge Congress to take action to lower the cost of prescription drugs, rein in insurance companies, crack down on short-term junk plans and other steps necessary to improve our health care system. The events will also serve as an opportunity to call out Republicans in each state for their continued acts of health care sabotage and support for repeal.

“There is no doubt that the Democratic agenda on health care has changed the lives of millions of Americans for the better,” said Protect Our Care executive director Brad Woodhouse. “Across the country, Americans from all walks of life have been able to receive quality, affordable health care and coverage for pre-existing conditions thanks to Democrats’ actions to shape and strengthen the nation’s health care laws. On this important anniversary, it’s critical that we move forward with a bold agenda for lower costs and better care while continuing to call out Republican’s repeated attempts to undermine and sabotage our health care system at every turn.”

Events happening this week:

Iowa press event

When:    Tuesday, March 19 at 10:30am CDT

Where:   Iowa State Capitol (Room 116), 1007 E Grand Ave, Des Moines, IA 50319

Details:  Facebook event link

Alaska press event

When:   Tuesday, March 19 at 11:00am AKDT

Where:  1057 W Fireweed Ln, Anchorage, AK 99503

Details:  Facebook event link

Georgia press event

When:    Tuesday, March 19 at 3:00pm EST

Where:   Central Presbyterian Church, 201 Washington St. SW, Atlanta, Georgia 30303

Details:  Facebook event link

Arizona press event

When:    Wednesday, March 20 at 11:00am MST

Where:   Arizona State Capitol, 700 W Washington, Phoenix, Arizona 85007

Details:  Facebook event link

Ohio – Dayton press event

When:    Wednesday, March 20  

Where:   Dayton City Commission Office, 101 W Third St, Dayton, OH 45401

Maine press event

When:    Thursday, March 21 at 11:00am EST

Where:   State House Welcome Center, 210 State St, Augusta, ME 04333

Details:  Facebook event link

North Carolina press event

When:   Thursday, March 21 at 11:00am EST

Where:  North Carolina General Assembly, 16 W Jones St, Raleigh, NC 27601

Details: Facebook event link

Colorado rally outside Senator Cory Gardner’s office

When:   Friday, March 22 at 12:00pm MDT

Where:  Corner of 19th Street and Stout Street, Denver, CO 80202

Details: Facebook event link

Ohio – Cleveland press event

When:    Friday, March 22

Where:   Neighborhood Family Practice Pharmacy, 3569 Ridge Rd, Cleveland, OH 44102

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In News

Five Things You Should Know Before Sec. Azar Testifies Today

Yesterday, Sec. Azar used his testimony before the Energy and Commerce Committee on the HHS FY20 budget to distract from the damage his agency has done and is going into overdrive to continue to do to Americans’ health care. Unfortunately for Azar, he can’t hide the truth. Here’s what you should know before he testifies today at the House Appropriations Labor-HHS Subcommittee:

  1. Trump’s Budget Would Repeal The Affordable Care Act And Its Protections For People With Pre-existing Conditions. In his testimony yesterday, Azar falsely claimed that Trump’s budget requires genuine protections for people with pre-existing conditions. The truth is just the opposite. Trump’s budget would repeal Affordable Care Act, completely eliminating its protections for those with pre-existing conditions.
  2. The Trump Administration Is Actively Pushing Consumers To Purchase Junk Plans That Can Discriminate Against People With Pre-existing Conditions. Though Azar said it was important that consumers be “fully aware” that junk plans do not cover pre-existing conditions, the truth is that his administration is pushing consumers to sign up for those very plans. In July, CMS announced that it would encourage health navigator groups that are intended to help consumers enroll in ACA-compliant health plans to instead direct consumers to junk plans that lack important consumer protections.
  3. Medicaid Work Requirements Inherently Increase Paperwork And Red Tape, Causing Eligible People To Lose Coverage. The Trump administration’s budget seeks to impose a national Medicaid work requirement, despite estimates that it would cause millions to lose coverage. Already, an Arkansas work requirement has led more than 18,000 to lose coverage. Yesterday Azar claimed that he did not have data on why so many lost coverage, but multiple studies and news reports have found high levels of confusion and lack of awareness among Medicaid enrollees. The truth is simple: work requirements add barriers and reduce access to health care for people who desperately need it.
  4. Republicans Are Not Trying To Give States More Choices, They Are Trying To Dismantle Medicaid. Azar has marketed a number of policies — block granting Medicaid, imposing work requirements, allowing partial expansion — as policies that give states more choices. Not coincidentally, these policies would all radically transform Medicaid and give states the power to restrict access to their Medicaid programs.
  5. Reminder: Republicans Are So Eager To End Pre-existing Condition Protections That Trump Held A Garden Party At The Prospect Of Signing Into Law A Bill That Would Let Insurance Companies Discriminate Against People With Pre-existing Conditions. When he claimed yesterday that Trump would never sign into law a bill that does not protect people with pre-existing conditions, Azar seemed to forget that Trump threw a party in the Rose Garden at the prospect of signing the House repeal bill, which would have let insurance companies charge people with pre-existing conditions significantly more, into law. Trump was so excited that NBC wrote, “Trump, GOP Leaders Take Victory Lap After House Passes ‘Trumpcare.’”
In News, Administration

Trump Regime Launches Cover Up Of Its Health Care Sabotage


Washington DC — As reported by the Associated Press, the Trump White House is claiming it has done nothing to “sabotage” the Affordable Care Act. In a report expected to be released today, the Council of Economic Advisers is trying to claim that the administration’s relentless war on Americans’ health care does not constitute “sabotage.” This is blatantly false. Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

“We’re just over a month into 2019 but this whopper is already in the running for the lie of the year. The Trump administration’s relentless sabotage of our health care system is well-documented. In November, voters took to the polls and rejected the Republican war on health care, and the fact that this administration is launching a massive cover-up of their sabotage means that they’re already bracing themselves against the wrath of voters in 2020.”

Don’t believe us? Take a look at our sabotage tracker:

February 2019

  • Trump predicts the Affordable Care Act will be “terminated” through the Texas lawsuit seeking to overturn the law.
  • In an effort to restrict access to information about women’s reproductive health, the Trump administration removes web pages associated with the ACA and its contraceptive coverage from HHS’s Office of Population Affairs website.

January 2019

  • Thanks to GOP sabotage, the uninsured rate surges to the its highest level since 2014. Roughly seven million fewer people are estimated to have health care now than did two years ago.
  • The Centers for Medicare and Medicaid Services (CMS) proposes changes to the ACA’s benefit and payment parameters, reducing subsidies available to those who purchase health care through the exchange, increasing premiums, and raising the out-of-pocket maximum for people with employer-sponsored health care.
  • In a win for big Pharma, the Trump administration proposes changes to the rebate system that would raise premiums, benefit pharmaceutical companies, and contain no mandate to lower list prices of drugs.

December 2018

  • Hand-picked Federal Judge Reed O’Connor rules in favor of twenty conservative states to overturn the Affordable Care Act, jeopardizing coverage for 17 million people and ripping away the ACA’s vital consumer protections such as protections for people with pre-existing conditions.
  • Under the Trump administration’s relentless sabotage, the uninsured rate increases for the first time since 2010. As the Kaiser Family Foundation finds, “In 2017, the uninsured rate reversed course and, for the first time since the passage of the ACA, rose significantly to 10.2% [from 10%].”

November 2018

  • Trump administration issues new guidance urging states to “tear down basic pillars of the Affordable Care Act, demolishing a basic rule” that federal subsidies can only be used to purchase ACA-compliant plans. Experts warn against this move, saying it will push affordable, comprehensive care further out of reach for individuals with pre-existing conditions.
  • Under the Trump administration, the number of uninsured children grows for the first time in nearly a decade. After a decade of steady decreases in the number of uninsured children, in 2017 the number of uninsured children increased from 3.6 million to 3.9 million.

October 2018

  • Republicans appoint Brett Kavanaugh to the Supreme Court. Kavanaugh is known to be hostile to the Affordable Care Act.
  • The Trump administration issues guidance that allows federal subsidies to be used to purchase junk plans that can deny coverage to people with pre-existing conditions.

September 2018

  • The Trump administration’s Department of Justice joins twenty conservative states in court in opening arguments to argue that the Affordable Care Act’s protections for people with pre-existing conditions should be overturned.
  • Nearly 4,600 Arkansans are unable to meet Arkansas’ reporting requirements for the state’s Medicaid work requirements and lose Medicaid coverage.

August 2018

  • Trump administration finalizes rule for bare-bones short-term plans that are exempt from key consumer protections, such as the requirement that insurance covers prescription drugs, maternity care, and hospitalization.

July 2018

  • CMS halts risk adjustment payments, that enable insurance companies to cover everyone, regardless of whether they are healthy or sick.
  • Trump Administration slashes funding for non-profit health navigator groups, that help people shop for coverage, from $36 million to $10 million. CMS encourages groups to use the remaining funds to push people to sign up for junk plans that skirt important consumer protections.
  • President Trump nominates Brett Kavanaugh to the Supreme Court. Kavanaugh has previously forced a young woman to continue a pregnancy against her will and has criticized Justice Roberts for upholding the Affordable Care Act’s constitutionality.

June 2018

  • Department of Justice takes to the courts to argue that insurance companies should be able to discriminate against as many as 130 million Americans with a pre-existing condition.
  • Republican coalition, the Health Policy Consensus Group, released their latest proposal to repeal the Affordable Care Act, which would gut protections for people with pre-existing conditions, let insurance companies charge older people an age tax, and deny key coverage for basic services like maternity care.
  • Trump Administration finalizes proposal to expand access to association health plans that skirt key consumer protections.

May 2018

  • President Trump boasts about health care sabotage: “We will have gotten rid of a majority of Obamacare.”
  • Trump Administration enlists help of former drug lobbyist in writing its drug plan.
  • Congressional Republicans try to use annual farm bill to authorize $65 million in taxpayer funding to set up association health plans, which can  exclude prescription drug coverage, mental health care, and maternity care.

April 2018

  • House Republicans vote on a balanced budget amendment that would cut Medicaid by $700 billion over ten years, $114 billion in a single year alone.
  • Trump Administration limits access to assistance for consumers who want to enroll in marketplace coverage. This change removes the requirement that every area has at least two “navigator” groups to provide consumer assistance and that one be local. Now, just one group could cover entire states or groups of states.

March 2018

  • Republicans sabotage efforts to pass a bipartisan bill that would have stabilized Affordable Care Act marketplaces by insisting the bill restrict access to abortion.

February 2018

  • The Trump Administration announces that it will expand access to short-term health plans that do not have to comply with key consumer protection provisions required by the Affordable Care Act.
  • Urban Institute calculates that repeal of the individual mandate and expansion of short term plans will increase individual market premiums by an average 18.2 percent in 2019.
  • Trump Administration releases budget that calls for the Affordable Care Act to be replaced by Graham-Cassidy, in a move that experts predict would reduce health coverage for 32 million Americans.

January 2018

  • The Trump Administration announces that it will support states that impose onerous work requirements on Americans covered by Medicaid, and approves Kentucky’s worst-in-the-nation waiver the next day.
  • The Trump Administration announces a move to allow providers to discriminate by allowing them to deny patient care for almost any reason.
  • The Trump Administration makes plans to announce even more exemptions from the requirement people have health coverage before this provision is repealed altogether.

December 2017

  • The Trump Administration proposes a rule to expand association health plans, which would gut consumer protections, raise costs for people with pre-existing conditions and further destabilize the insurance markets.
  • Congressional Republicans pass their tax scam, which doubles as a sneaky repeal of the Affordable Care Act  by kicking 13 million people off of their insurance and raising premiums by double digits for millions more.

November 2017

  • Republicans refuse to move forward on the bipartisan Alexander-Murray bill to address the CSR crisis even though it had a filibuster-proof majority in the Senate.

October 2017

  • The Trump Administration takes direct aim at birth control by rolling back a rule that guaranteed women access to contraception. (A court has since questioned the legality of the action.)
  • President Trump signs an Executive Order to roll back key consumer protections that will result in garbage insurance, raise premiums, reduce coverage and again expose millions of Americans to discrimination based on pre-existing conditions.
  • The Trump Administration dramatically cuts in-person assistance to help people sign up for 2018 health coverage.
  • After threatening for months to stop funding cost-sharing reduction payments (CSRs) that help lower deductibles and out-of-pocket costs, the Trump Administration stops the payments altogether. The CBO finds that failing to make these payments will increase premiums by 20% and add nearly $200 billion to the debt.

September 2017

  • The Administration orders the Department of Health and Human Services’ regional directors to stop participating in Open Enrollment events. Mississippi Health Advocacy Program Executive Director Roy Mitchell says, “I didn’t call it sabotage…But that’s what it is.”

August 2017

  • The Administration cuts the outreach advertising budget for Open Enrollment by 90 percent, from $100 million to just $10 million – which resulted in as many as 1.1 million fewer people getting covered.

July 2017

  • The Trump Administration uses funding intended to support health insurance enrollment to launch a multimedia propaganda campaign against the Affordable Care Act.
  • President Trump, again, threatens to end cost-sharing reduction payments.

June 2017

  • Senate Republicans embark on a monthslong failed attempt to pass BCRA, Skinny Repeal and Graham-Cassidy, all repeal bills that would have caused millions of Americans to lose their health coverage and raised premiums by double digits for millions more. They would have ended Medicaid as we know it, putting the care of children, seniors and people with disabilities at risk.

May 2017

  • House Republicans vote for and pass a health care repeal bill that would cause 23 million people to lose coverage and gut protections for people with pre-existing conditions. It would have imposed an age tax and allowed insurers to charge people over 50 five times more for coverage and ended Medicaid as we know it, putting the care of seniors, children and people with disabilities in jeopardy.

April 2017

  • The Trump Administration cuts the number of days people could sign up for coverage during open enrollment by half, from 90 days to 45 days.
  • In an effort to convince Democrats to negotiate a repeal of the Affordable Care Act, President Trump threatens to cut off cost-sharing reduction payments (CSRs) that help low-income marketplace customers pay for out-of-pocket costs.

March 2017

  • The Trump Administration sends a letter to governors encouraging them to submit proposals which include provisions such as work requirements that make it harder for Medicaid beneficiaries to get affordable care and increase the number of people who are uninsured.

February 2017

  • The Trump Administration proposes a rule to weaken Marketplace coverage and raise premiums for millions of middle-class families.

January 2017

  • On his first day in office, President Trump signs an Executive Order directing the administration to identify every way it can unravel the Affordable Care Act.
  • Also on January 20th, the Department of Health and Human Services begins to remove information on how to sign up for the Affordable Care Act.
  • The Trump Administration pulls funding for outreach and advertising for the final days of 2017 enrollment. This move is estimated to have reduced enrollment by nearly 500,000.
In News

Ahead of Trump’s State Of The Union Address, Protect Our Care Releases Ad Outlining Health Care Agenda For Congress

View The Ad: An Agenda for American Health Care

Washington, D.C. — Ahead of President Trump’s State Of The Union address tonight, Protect Our Care released a new digital ad outlining a health care agenda that responds to Americans’ call for lower prescription drug costs, more affordable health care, and enhanced protections for patients like those with pre-existing conditions. During the 2018 midterm elections, Americans went to the polls to voice their outrage over Republican attacks on health care and the result was clear: voters elected a “Health Care Congress” to lower costs, improve care and expand coverage. The ad will run heavily on social media today and during the State of the Union address tonight targeting voters, members of congress and their staff, and reporters covering the address.

“No matter what the president says tonight, his record is clear. This administration had two years to find ways to lower costs and improve health care coverage for Americans but instead worked overtime to repeal and sabotage American health care,” said Brad Woodhouse, executive director of Protect Our Care. “This ad lays out the agenda for health care the American people voted for in November and serves as a blueprint for action in 2019. The time has come for Congress to lower costs, safeguard protections, and rein in the greed and abuses of insurance companies and the pharmaceutical industry. The American people rejected the anti-health care agenda that has defined the Republican Party for almost a decade now. If Donald Trump and his Republican allies truly care about the state of our union, they would heed the message voters sent in November and end their war on health care.”  

Watch Protect Our Care’s new ad here:

Background:

Read Protect Our Care’s full 2019 Agenda here. A summary of the agenda from the report can be found below.

Do Everything Possible to Overturn the Federal Court Decision that Struck Down the Affordable Care Act

  • Oppose the Texas ruling by a conservative federal judge in the Northern District of Texas that overturned the entire Affordable Care Act by passing a Senate Resolution to similar to the House measure that authorizes the House legal counsel to intervene in the lawsuit and oppose the Republican attorneys general, governors, and Trump Administration who are continuing the war on health care through the courts.

End the War on People with Pre-Existing Conditions

  • Stop insurance companies from selling junk health insurance that allows them to deny quality, affordable coverage to people with pre-existing conditions.  These kinds of short term plans should be limited to three-months with no option for renewal.
  • Guarantee protections for pre-existing conditions and essential health benefits. Require all health plans to cover the “essential health benefits” included in the law, ensure guaranteed issue and community rating, and prohibit insurance companies from imposing lifetime and annual limits on the amount of care a patient can receive.

Lower Costs

  • Lower the costs of prescription drugs. Pass legislation to allow Medicare to negotiate drug prices for all beneficiaries; end price gouging by requiring drug manufacturers to give notice and justify significant price increases; and require transparency of rebate amounts.
  • End surprise medical bills. 57 percent of Americans have received a surprise bill. Too many  people go to a hospital or Emergency Room that is in their network, but get billed for services provided out-of-network, subjecting them to huge bills, as much as six figures. Congress should pass legislation to end surprise medical bills and limit the amount a provider can charge to a negotiated rate.  
  • Expand financial assistance by expanding the eligibility for premium tax credits above 400 percent of the federal poverty limit and increase the size of the tax credit for all income brackets.
  • Expand services before deductibles, examples would include three primary care visits and one specialist visit that are not subject to a plan’s deductible.

End Republican Sabotage

  • Fully support Open Enrollment by restoring funding to the pre-Trump levels and making all information about ways to sign up for coverage easily accessible for everyone.
  • Oppose waivers that undermine the ACA and allow states to skirt key provisions of the law.

Strengthen Medicaid and Medicare

  • Improve Medicare’s affordability by adding an out-of-pocket maximum after which beneficiaries would be protected from additional costs; including prescription drugs in the limit on out-of-pocket spending; adding coverage for vision, hearing, and dental; and making cost-sharing more affordable.
  • Extend and increase federal funding for Medicaid expansion.

Conduct Oversight on Trump Administration Actions that Undermine The Affordable Care Act

  • Topics to conduct oversight on include the Trump Justice Department’s decision not to defend all of the Affordable Care Act in federal court, cuts to outreach and navigator funding, rules opening the door to junk insurance, 1332 guidance that allows federal funds to be used to purchase skimpy health plans, relationships between Administration political appointees and regulated industries, the administration’s push to encourage states to impose work requirements on Medicaid coverage, drug prices and pharmaceutical profits.
In News, Stories

State Leaders Praise Protect Our Care’s Agenda For “The Health Care Congress”

Health care activists and elected officials from across the country are praising Protect Our Care’s agenda for the 116th Congress that will lower costs and improve care for all Americans. Leaders in Arizona, Colorado, Iowa, North Carolina and Ohio are among those who have weighed in on the opportunity Congress has to build on the current health care law by making access to health care more affordable and accessible to all Americans.

 

Arizona Republic: Gallego, Kirkpatrick Call For ‘Health Care Congress’ To Fight For ACA. “The partisan battle over health care continued Tuesday as the liberal group ‘Protect Our Care Arizona’ demanded that Congress keep fighting for the Affordable Care Act amid ongoing attacks by President Donald Trump’s administration. Joined by Reps. Ruben Gallego and Ann Kirkpatrick, the Democratic coalition known for defending former President Barack Obama’s signature health-care-reform law — which critics on the right dubbed ‘Obamacare’ — called for the new 116th Congress to right the wrongs they say Republicans have done in the health-care realm. [AZCentral,1/30/19]”

Tucson Weekly: Reps. Gallego And Kirkpatrick Talk Health Care. “Ruben Gallego (CD-7) and Ann Kirkpatrick (CD-2), two Democratic representatives in U.S. Congress joined Alicia Held, an Arizona healthcare advocate, to talk about the state of health coverage in Arizona. They discussed what citizens can expect in the future during a press call hosted by Protect Our Care Arizona. Rep. Gallego said more than 20 million Americans have healthcare because of the Affordable Care Act, while Republicans have ‘waged a war’ against it. He said Democrats need to fight back in order to keep coverage for those who need it most. ‘Americans shouldn’t have to choose between paying for healthcare and buying groceries,’ he said.” [Tucson Weekly, 1/29/19]

Denver Westword: Attacking Outrageous Health-Care Costs In Colorado And Beyond. “A new report released today suggests ways for the U.S. Congress to fight rising health-care costs. Meanwhile, Colorado Governor Jared Polis just signed an executive order creating what’s been dubbed the Office of Saving People Money on Health Care. Anne Shoup, communications director for Protect Our Care, a coalition in Washington, D.C. (with staff assigned to Colorado), that put out the report, ‘The Health Care Congress: Cost, Coverage, Consumer Protections,’ sees these efforts as both timely and complementary. As Shoup notes, ‘We’re calling on Congress to enact cost-saving measures for people, but it’s hard to say what we can actually get done…it’s encouraging to see a state like Colorado step forward to find ways to lower costs for its constituents.’” [Westword, 1/24/19]

Daily Iowan, Iowa Starting Line, Iowa State Daily: This Must Be The Health Care Congress. “Iowans and Americans have demanded access to quality, affordable coverage at the ballot box and millions in our state and across the country deserve to have this year’s Congress be the ‘Health Care Congress. What would that mean, for this to be the Health Care Congress? First,Congress should do everything possible to overturn last year’s federal court decision that struck down the ACA, which President Trump has repeatedly celebrated and which has faced virtually no opposition from Senator Ernst and other Republican members of Congress…the Health Care Congress also has to end the Republican war on people with pre-existing conditions…the Health Care Congress can and should strengthen Medicaid and Medicare. Aside from extending and increasing federal funding for Medicaid expansion, they can improve Medicare’s affordability by adding an out-of-pocket maximum for older Americans.” [The Daily Iowan, 1/24/19]

BlueNC: Protect Our Care Announces Health Care Agenda for New Congress. “This week, Protect Our Care unveiled their health care agenda for the new Congress. The agenda is detailed in a new report, which calls for bold Congressional action to defend the Affordable Care Act against Republican attacks, strengthen Medicaid and Medicare, lower costs, and enact further protections for individuals with pre-existing conditions. Congressman David Price and State Sen. Jay Chaudhuri joined Protect Our Care North Carolina on a press call yesterday discussing the report – The Health Care Congress: Cost, Coverage, Consumer Protections – and what it means for North Carolina. ‘The voters want us to protect their health care,’ Representative David Price said. ‘They want us to protect the Affordable Care Act…and they want us to do whatever it takes to bring affordable, good health care to all of our people.’ ‘In November…affordable health care was the top issue for North Carolinians,’ State Sen. Jay Chaudhuri said. ‘Republicans…have two options for how they will govern – they can work with Democrats to find common ground, or they can continue to carry out a highly partisan agenda.’” [BlueNC, 1/25/19]

Gongwer News Service: Advocates Urge Congress To Expand Health Care Access. “During a Columbus press conference, representatives from Protect Our Care Ohio and several allied groups touted the organization’s January report laying out the group’s health care priorities for Congress. Titled ‘The Health Care Congress: Cost, Coverage, Consumer Protections,’ the paper outlines several steps advocates argue would shore up health care options and lower treatment costs for residents of the Buckeye State. The group’s report comes a day after Gallup found that the percentage of U.S. adults without health insurance increased 1.3 percentage points in the fourth quarter of 2017 compared to a year before, representing the largest single-year increase measured by the polling firm and Sharecare since they began tracking the rate in 2008. ‘There are many things this Congress could be doing to improve care and lower costs,’ Protect Our Care spokeswoman Amanda Wurst said. ‘Republicans in the Congress need to end their continued attack on the Affordable Care Act and join their Democratic colleagues in protecting our care.’” [Gongwer, 1/28/19]

Hannah Report: Groups Urge Congress to Protect the Affordable Care Act, Health Care. “Advocates who favor the Affordable Care Act (ACA), also known as Obamacare, urged Congress Friday to take steps to protect health care for Americans, including for those with pre-existing conditions and people who enrolled in Medicaid thanks to the ACA’s expanded requirements. The groups, which include For Our Future, Protect Our Care Ohio, ProgressOhio, and the Universal Health Care Action Network (UHCAN) Ohio, said the biggest threat to health care is a federal lawsuit originating in Texas that saw a federal judge rule the ACA was unable to stand on its own after Congress eliminated the tax penalty for not having health insurance. But they said there are other threats to the law as well, including efforts by the Trump administration to weaken it. Amanda Wurst, the Ohio director of Protect Our Care, said at a press conference held Friday in Columbus that Congress can take other steps to help lower the cost of health care in addition to preserving protections for those with preexisting conditions.” [Hannah Report, 1/25/19]

In News

NEW NYT Interview, Trump Reveals Goal of Texas Lawsuit: “Terminate” Health Care

Washington DC — According to the newly released transcript of President Trump’s interview with The New York Times, Trump boasted that his Texas lawsuit will “terminate” the Affordable Care Act and that was a political “victory” for him and Republicans in Congress. Brad Woodhouse, executive director of Protect Our Care, issued the following statement in response:

“President Trump confirmed what we all know to be true: he and Republicans are using the Texas lawsuit to overturn the entire Affordable Care Act – eliminating all the protections for people with pre-existing conditions – with no plans for a replacement. Voters overwhelmingly rejected Trump’s health care repeal and sabotage agenda back in November, yet President Trump and his allies in Congress are dead set on accomplishing through the courts what they couldn’t do legislatively: fully repeal the law, devastate American health care and leave millions of Americans at risk.”

In News, Administration

Breaking: State-based Exchanges Break Enrollment Record

Washington DC — As reported by health care analyst Charles Gaba, the state-based exchanges have broken an all-time enrollment record despite the Trump administration’s relentless attempts to sabotage access to coverage. Brad Woodhouse, executive director of Protect Our Care, issued the following statement in response:

“Millions of Americans rely on the Affordable Care Act for quality coverage and today’s announcement is evidence that the American people want and need coverage through the exchanges despite constant sabotage from the Trump administration. The fact that states who manage their own marketplaces saw record-breaking numbers this year while federal marketplaces saw a substantial decline is all the evidence one needs to prove that President Trump’s repeal-and-sabotage agenda is hurting millions of Americans.”

 

BREAKING: State-based exchanges collectively break all-time enrollment record!

ACA Signups // Charles Gaba // January 30, 2019

 

 

With Covered California releasing their final, official 2019 Open Enrollment Period data, and the latest updates from New York (which still has 2 days to go) and Massachusetts (which wrapped up last week), I now nearly all 2019 OEP data on hand.

I say nearly all because there are still three numbers missing:

  • Vermont has yet to release any 2019 enrollment data. This is the 3rd year in a row that they’ve been radio silent. Assuming they’re close to last year (28,763 QHP selections), they should add around 28,000 to the national total.
  • New York still has 2 days left for people to #GetCovered. I’m going to assume they’ll tack on perhaps 5,000 more people today and tomorrow.
  • The District of Columbia hasn’t posted any updates since December 11th, which means not only do they still have 2 days for people to sign up, they’re actually missing a whopping 51 days worth of enrollment data. Again, assuming they wrap up close to last year, that should mean another 1,400 or so from DC.

Between the three, I’d expect another ~34,000 QHP selections to be tacked onto the totals below.

However, even without that, the 12 state-based exchanges have collectively broken their all-time record for ACA Open Enrollment, racking up more than 3,018,000 QHP selections this season.

Here’s what that looks like visually…and the contrast between the Federal Exchange and the State-Based Exchanges is dramatic:

  • After a dramatic enrollment increase in 2015 and a lesser increase in 2016, the 39 states hosted by HC.gov have seen a gradual, steady decline each year since. They closed out the 2019 Open Enrollment Period with 1.3 million fewer people having signed up than at their peak in 2016. Perhaps 200,000 or so of this was due to Louisiana and Virginia expanding Medicaid in recent years, but that does nothing to explain the other 1.1 million drop-off, which is almost certainly due to having the HC.gov marketing & outreach budgets being slashed to the bone, the Open Enrollment Period being cut in half and so forth.
  • Meanwhile, the 12 states which operate their own full ACA exchanges (and which have their own marketing/outreach budgets) saw less-dramatic increases in 2015 & 2016…but they’ve collectively stayed virtual dead even for every year since then. In fact, when the dust settles on the 2019 Period, I expect the 12 state-based exchanges to reach around 3.05 million QHP selections, which would be 1.5% higher than last year and 1.3% higher than their collective all-time high in 2017.
In News, Administration

Calling BS on CMS: Seema Verma’s Medicaid Spin Is a Bald-Face Lie

Washington, DC — Today, Centers for Medicare & Medicaid Services Administrator Seema Verma gave a speech at the CMS Quality Conference in Baltimore, Maryland where she tried to affirm the administration’s commitment to Medicaid, despite the multiple efforts orchestrated by Verma to sabotage and undermine the program.

In response, Brad Woodhouse, executive director of Protect Our Care, released the following statement:

“Seema Verma’s comment today is, plain and simple, a bald-faced lie. This administration has worked against Medicaid at every turn. Indeed, not since Medicaid was signed into law more than 50 years ago has there been an administration or an Administrator more hostile to Medicaid than the Trump administration and Seema Verma. The Trump administration supports so-called work requirements like those in Arkansas which has already ripped coverage away from 18,000 people, opposed Medicaid expansion in states across the country, and advocated for the block granting of Medicaid which is a euphemism for slashing its budget and kicking people off the rolls.

Fortunately, the American people have a different view: Medicaid has never been more popular. The attacks on Medicaid by this administration and its Republican allies led in large part to the defeat of the ACA repeal effort. And, during the 2019 election, voters across the country rejected the Republicans’ sabotage agenda and either expanded Medicaid at the polls or elected pro-Medicaid politicians who promised to do so in office. The truth is, Medicaid is flourishing despite this administration’s efforts to undermine it and no type of Orwellian spin from Administrator Verma can change that.”

In News, Administration

“Higher Costs And More People Being Uninsured” How Trump’s Latest ACA Sabotage Targets Consumers

Last week, the Centers for Medicare and Medicaid Services (CMS) proposed changes to the Affordable Care Act’s benefit and payment parameters that would raise costs and reduce coverage for millions of Americans. On top of reducing subsidies available to those who purchase health care through the exchange and increasing premiums, the Trump administration’s proposed rule changes would also raise the out-of-pocket maximum for people with employer-sponsored health care.

Here’s what news outlets have to say about the proposed changes:

Axios: Consumers Would Pay More Under New ACA Rules. “Turns out the Trump administration’s big ACA regulation packs a bit more punch than we realized at first. Some of the rule’s technical changes will end up requiring people to pay more for their coverage, while rolling back the cost of federal premium subsidies, my colleague Sam Baker reports…The federal government would end up spending about $900 million less on premium subsidies, according to the proposed regulation. The same change would also slightly loosen limits on out-of-pocket costs. The ACA capped total out-of-pocket spending at $8,000 per year for an individual and $16,000 per year for a family plan.  The Trump proposal would raise those caps by $200 and $400, respectively, according to Brookings’ Matt Fiedler. That change would apply to people who get coverage through their jobs, not just the ACA’s insurance markets.” [Axios, 1/22/19]

Wall Street Journal: Trump’s Proposed ACA Rules Could Lift Costs For Millions Of People. “The Trump administration on Thursday proposed changes that could raise health insurance costs for millions of Americans who get coverage on the job or receive subsidies under the Affordable Care Act, a move that Republicans said is necessary to cut inflated subsidies but Democrats viewed as another GOP effort to sabotage the health law. The proposal, released by the Centers for Medicare and Medicaid Services, would raise the out-of-pocket maximum that people with employer-sponsored coverage pay in 2020. The individual maximum would increase by $200 to $8,200 annually, and the maximum for family coverage would increase by $400, analysts said. The plan would also change a calculation that determines how much people pay if they buy insurance from the ACA exchange and get credits to reduce their monthly premiums. The change could raise premiums next year for many of the roughly 9 million people who get the credit.” [Wall Street Journal, 1/17/19]

Los Angeles Times: Despite The Government Shutdown, Trump’s Efforts To Gut Obamacare Go Full Speed Ahead. “A good portion of the federal government may be shut down, but you can rest assured that the devoted Obamacare saboteurs at the Department of Health and Human Services are on the job. Late Thursday, they released proposed rule changes for the 2020 health insurance year — and requests for comments on further changes — that will drive up premiums for people on Affordable Care Act health plans, cut subsidies and discourage more Americans from enrolling. The proposals also could raise prescription costs for enrollees and raise costs even for families enrolled in employer plans. Longer-term changes proposed for 2021 and beyond could affect about 2 million ACA enrollees.” [Los Angeles Times, Hiltzik, 1/18/19]

Associated Press: White House Proposes To Increase Affordable Care Act Premiums. “The Trump administration Thursday announced proposed rule changes that would lead to a modest premium increase next year under the Affordable Care Act, potentially handing Democrats a new presidential-year health care issue. The roughly 1 percent increase could feed into the Democratic argument that the Trump administration is trying to ‘sabotage’ coverage for millions. The administration said the proposal is intended to improve the accuracy of a complex formula that affects what consumers pay for their premiums. Premiums under the health law were basically stable this year after several sharp annual hikes.”  [Associated Press, 1/17/19]

Politico: CMS Wants To Reduce Obamacare Subsidies Through Formula Change. “The administration is proposing a technical change in the 2020 marketplace rules that is expected to result in less premium assistance for low-income Obamacare customers, POLITICO’s Paul Demko reports…A decrease in financial assistance of $900 million and 100,000 fewer Obamacare customers in 2020 if the proposal is adopted, according to CMS. The agency is justifying the change as a way to reduce big increases in federal subsidies that resulted from the Trump administration’s decision to cut off cost-sharing reduction payments.” [Politico, 1/18/19]

Buzzfeed News: Administration’s Proposed Rule Would “Result In Higher Premiums And More People Being Uninsured.” “The Trump administration revealed this week that it could try to take one more shot at weakening the Affordable Care Act’s individual markets before the end of Trump’s first term. A request for comment on a proposed rule change posted late Thursday contemplates a series of changes that would save the government $1 billion per year or more, but result in higher premiums and more people being uninsured…But now the administration is signaling it may try to end silver loading. Doing this on its own would lead to a major jump in premium costs and could badly destabilize the markets. The administration says it wants to kill silver loading in concert with Congress voting to bring back the old subsidies. However, Congress has so far shown a complete inability to come together to pass a bill to improve the Obamacare markets. The administration did not specifically say it will act without Congress, but it did so with premiums in the past and is asking for feedback on how it should ‘address’ the issue of silver loading.” [Buzzfeed News, 1/18/19]