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Affordable Care Act Archives — Protect Our Care

Protect Our Care Statement On Gallup Poll Showing The Uninsured Rate Jumping To The Highest Level In 5 Years

YEARS OF REPUBLICAN SABOTAGE RESULTS IN THE FEWEST PEOPLE COVERED SINCE THE PASSAGE OF THE ACA, HURTING WOMEN, LOWER-INCOME HOUSEHOLDS, AND YOUNG PEOPLE THE MOST

Washington DC — Today, according to a new Gallup Health and Wellbeing-Index, about 7 million fewer people had health care in 2018 compared to the previous year. The uninsured rate has steadily increased during the Trump administration from a low of 11 percent in 2016, the lowest since the passage of the Affordable Care Act (ACA). The rate was 14 percent in the last quarter of 2018. Brad Woodhouse, executive director of Protect Our Care, released the following statement:

“Years of Trump administration and Republican sabotage of the ACA continues to take its toll. The Trump administration regularly claims it’s making health care better, but the proof is in the pudding — he’s sabotaging the system and ripping coverage away from millions of families.  And Trump’s sabotage hits women, lower income households, and young people especially hard.

“President Trump and his allies in Congress must stop their partisan war on health care before they rip coverage away from millions more. Our focus should be on lowering costs and helping more people get coverage, but Republicans insist on taking us backwards – the exact approach voters rejected in November.  It’s past time for Congress to step in and put the brakes on Trump’s health care sabotage because millions of Americans are paying the price with less coverage and higher costs.”

“Our Lives on the Line” as Trump-GOP Work to Overturn Our Health Care

As Trump’s DOJ, GOP Attorneys General and GOP Governors Go to Court to Overturn Health Care Protections for Millions, Health Care Advocates in Their States Demand Their Leaders Protect the 130 Million Americans Living with Pre-Existing Conditions

Meanwhile, Advocates in Washington Urge Senators to Vote ‘No’ on Kavanaugh, Hand-picked to be a Rubber Stamp in this Case

Washington, DC – Today, as oral arguments will be held in the case Texas, et al. vs. United States, et al., a lawsuit that not only threatens protections for people with pre-existing conditions, but a whole host of provisions that tens of millions of Americans rely upon for their care and coverage, health care advocates around the country are uniting once again to demand that their Republican attorneys general and governors drop this dangerous lawsuit. At the same time, health care advocates living with pre-existing conditions have traveled to Washington, DC to urge Senators to reject Trump’s Supreme Court nominee Brett Kavanaugh. If the courts ultimately rule in favor of the Republican states and the Trump administration, critical health care protections would vanish overnight, unleashing chaos in our entire health care system.

“The court must uphold the law and protect our healthcare — and Republicans must end their dangerous political games with Americans’ health care. President Trump and the Republican attorneys general and governors pushing this lawsuit could bring us all back to a time when insures frequently denied the millions of Americans living with pre-existing conditions coverage or jacked up their premiums, making life-saving health care unaffordable for those who need it most,” said Brad Woodhouse, executive director of Protect Our Care.  

The American people have made it clear time and again that they do not support repeal, and poll after poll after poll shows Americans do not support rolling back critical coverage that would eliminate protections for pre-existing conditions that exist in the ACA. Today, Protect Our Care coalitions in Arizona, Indiana, Maine, Tennessee, Missouri, Montana, Florida, North Dakota, Wisconsin, and West Virginia are holding actions once more to ask their Republican attorneys general or governors to drop their lawsuit to overturn protections for people with pre-existing conditions in the Affordable Care Act.

While advocates with Protect Our Care coalitions stand up against the Trump-GOP lawsuit in states across the country, patients with pre-existing conditions are in Washington D.C. asking Senators to vote no on Kavanaugh’s nomination. “If confirmed, this judge will have the ability to overturn the Affordable Care Act and the power to dismantle the programs we now have,” said Kelly Gregory, an Air Force veteran from Nashville, Tennessee currently battling stage four breast cancer who sat in the hearing yesterday and was referenced by Senators Feinstein and Kloubuchar. “I’m here to fight for those people who will be in my shoes now and in the future,” said Jeff Jeans, a cancer survivor from Sedona, Arizona who switched political parties during cancer treatment when he realized he wouldn’t be alive if not for the Affordable Care Act. “This is my voice,” said Joseph Merlino, a survivor of cancer in his larynx, who met with Sen. Catherine Cortez Masto yesterday. “And I’m using it to make sure that my Senators know that as I fought a rare throat cancer, I relied on coverage that I got through the Affordable Care Act’s expansion of Medicaid. If it weren’t for that, I surely wouldn’t be here right now.”

Texas, et al. v. United States, et al. puts into sharp view just what is at stake for health care with Kavanaugh’s nomination. If the district court in Texas rules in favor of the Republicans and blocks the law — and Trump successfully installs Kavanaugh as his anti-health care ‘rubber stamp’ on the Supreme Court, it will have a devastating impact on health care. Here is what could be eliminated:

  • Seventeen million more people could lose their coverage in a single year, leading to a 50 percent increase in the uninsured rate
  • Protections for 130 million people with pre-existing conditions, if they buy coverage on their own
  • Improvements to Medicare, including reduced costs for prescription drugs
  • Allowing kids to stay on their parents’ insurance until age 26
  • Ban on annual and lifetime limits
  • Ban on insurance discrimination against women
  • Limit on out-of-pocket costs
  • Medicaid expansion currently covering 15 million people
  • Small business tax credits
  • Marketplace tax credits for up to 9 million people

For more information on the case, read Protect Our Care’s new report “The Relentless Republican War On People with Pre-existing Conditions: The Lone Star Edition.” You can also see what health care experts have to say by reading,  “Those Who Know Health Care The Best Say The Texas Lawsuit Is The Worst.”

Protect Our Care Releases New Report Highlighting Trump Administration’s “Summer of Sabotage”

After Failing to Get the Votes, Trump Administration is Sabotaging Health Care at Every Turn

Washington, D.C. – As the one-year anniversary of bipartisan defeat of Affordable Care Act repeal in the United States Senate approaches, Protect Our Care today released a detailed report, Summer of Sabotage, which comprehensively lays out the extensive campaign the Trump Administration has undertaken to sabotage health care just in the last few months. The report covers every act of administrative sabotage since May, from the proliferation of junk plans and slashing funding for enrollment assistance to the nomination of an anti-health care judge to the Supreme Court.

“Whether by pushing junk plans that don’t cover people with pre-existing conditions or destabilizing the  market, President Trump and his allies are directly responsible for the higher health care bills Americans are seeing,” said Brad Woodhouse, executive director of Protect Our Care. “This report makes clear the depth and breath of Republicans health care sabotage and how costs are rising because of it.”

Read the report here.

“The Summer of Sabotage report lays out exactly what the president has done and how it will hurt patients,” said U.S. Senator Chris Murphy. “This is a critical time in this fight because if the president and his backers get their way, insurance companies will once again be able to jack up prices or even deny care – to people with a pre-existing health condition. The American people need to know, so they can stand up and fight back.”

In addition to providing a status report on the premium increases insurance companies have filed this summer, the report analyzes a number of actions the Trump administration has undertaken to sabotage our care, including:

  • Arguing against protections for people with pre-existing conditions in federal court;
  • Encouraging Americans to sign up for junk plans, which would bring back discrimination against women, people with pre-existing conditions and people over age 50;
  • Nominating Brett Kavanaugh, an extreme anti-health care judge, to the Supreme Court;
  • Slashing funding for navigators that help Americans obtain insurance;
  • Restricting access to Medicaid;
  • Making it harder to find information about the ACA online, and
  • Freezing the risk adjustment program, which could unnecessarily drive up premiums.

“President Trump and his allies continue their campaign to sabotage health care at their own peril,” said Leslie Dach, campaign chair of Protect Our Care. “Health care is a top-ranked issue for voters because they care about it — deeply — and because the actions Republicans have taken to rip health care away from us are happening in plain view, for all to see.”

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Short-Term Junk Plans

SHORT-TERM JUNK PLANS OFFER INADEQUATE MEDICAL COVERAGE AND CIRCUMVENT FUNDAMENTAL CONSUMER PROTECTIONS

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]

  • As Many As 130 Million Nonelderly Americans Have A Pre-Existing Condition. [Center for American Progress, 4/5/17]
  • 1 in 4 Children Would Be Impacted If Insurance Companies Could Deny Or Charge More Because Of A Pre-Existing Condition. [Center for American Progress, 4/5/17]

Short-Term Junk Plans Can Refuse To Cover Essential Health Benefits. “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]

Under Many Short-Term Junk Plans, Benefits Are Capped At $1 Million Or Less. Short-term plans can impose lifetime and annual limits –  “for example, many policies cap covered benefits at $1 million or less.” [Kaiser Family Foundation, 2/9/18]

Commonwealth Fund: “Cost Sharing Designs In Short-Term Coverage Leave Members Facing Major, Unpredictable Financial Risk.” “The out-of-pocket maximum for each best-selling plan is higher than that allowed in individual or employer plans under the ACA, when adjusting for the shorter plan duration. When considering the deductible, the best-selling plans have out-of-pocket maximums ranging from $7,000 to $20,000 for just three months of coverage. In comparison, the ACA limits out-of-pocket maximums to $7,150 for the entire year.” [Commonwealth Fund, 8/11/17]

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]

Short-Term Junk Plan Currently Being Sold In Thirteen States Does Not Cover Services For Patients Admitted To Hospital On The Weekend. “That brings us to the short-term plan marketed by UnitedHealth’s Golden Rule subsidiary….To begin with, the Golden Rule plan excludes pregnancy and provides for a lifetime maximum benefit of only $250,000. Remarkably, it won’t cover hospital room, board or nursing services for patients admitted to a hospital on a Friday or Saturday, unless for an emergency or for necessary surgery the next day.” [Los Angeles Times, 4/26/18]

JUNK COVERAGE PROVIDED BY SHORT-TERM PLANS LEAVES THOSE WHO GET SICK WITH THOUSANDS OF DOLLARS IN UNPAID BILLS

Atlanta Woman With Short-Term Plan Was Diagnosed With Cancer And Left With $400,000 Medical Bill.Dawn Jones…bought a short-term plan from Golden Rule Insurance, a unit of UnitedHealth Group Inc., so she’d be covered between jobs, according to court documents. Then, she was diagnosed with breast cancer. Despite showing evidence she was unaware of the cancer when she bought the policy, the insurer didn’t pay for Jones’s treatment, leaving her with a $400,000 medical bill, according to a complaint she filed against the company in September 2016… the judge sided with Golden Rule and dismissed the case in August, finding the policy agreement clearly stated that preexisting conditions wouldn’t be covered, even if the customer was unaware of the condition. Jones wasn’t diagnosed until after she bought her policy.” [Bloomberg, 10/17/17]

San Antonio Man Paid Premiums To Short-Term Plan Company For Six Years, And Was Denied Coverage When He Developed Kidney Disease. “Pat’s decision to save some money by buying short-term insurance was a big mistake, says Karen Pollitz, project director of Georgetown University’s Health Policy Institute and a leading expert on the individual-insurance market. ‘These short-term policies are a joke,’ she says. ‘Nobody should ever buy them. It is false security that is being sold. It’s junk.’ That’s because diagnosing and treating an illness may not fall neatly into six-month increments. While Pat had been continuously covered since 2002 by the same company, Assurant Health, each successive policy treated him as a brand-new customer. In looking back over Pat’s medical records, the company noticed test results from December, eight months earlier. Though Pat’s doctors didn’t determine the precise cause of the problem until the following July, his kidney disease was nonetheless judged a ‘pre-existing condition’ — meaning his insurance wouldn’t cover it, since he was now under a different six-month policy from the one he had when he got those first tests.” [Time, 3/5/09]

In San Francisco, Woman Was Hit With $150,000 Charge After Short-Term Health Plan Refused Coverage. “Grace Wood, an instructor at a university in San Francisco, bought a short-term plan in 2013. When she had to have a heart procedure, her insurer, HCC Life, balked, leaving her with roughly $150,000 in unpaid medical bills.” [New York Times, 11/30/17]

Short-Term Insurance Plan Refuses To Pay For Man’s Triple Bypass Surgery, Leaving Family With $900,000 In Bills. “One case pending in federal court involves Kevin Conroy, who had a heart attack in 2014 and underwent triple bypass surgery, just two months after his wife, Linda, obtained a short-term policy over the telephone. Their insurer, HHC Life, refused to pay the bills. ‘We freaked out,’ Ms. Conroy said. ‘What were we going to do? It was $900,000.’ The insurer informed the Conroys the policy was ‘rescinded,’ to use the industry jargon. “[New York Times, 11/30/17]

SUBPAR COVERAGE OFFERED BY SHORT-TERM PLANS RAISES HEALTH COSTS FOR CONSUMERS WHILE RAKING IN PROFITS FOR INSURANCE COMPANIES

Short-Term Health Plans Rake In Profits For Insurance Companies While Leaving Consumers Unprotected. “That’s why they make up such a high-profit portion of the insurance industry: They are largely designed to rake in premiums, even as they offer little in return. And even when they do pay for things, they often provide confusing or conflicting protocols for making claims. Collectively, short-term plans can leave thousands of people functionally uninsured or underinsured without addressing or lowering real systemwide costs.” [The Atlantic, 4/25/18]

More Premium Dollars Can Go Toward Profit, Rather Than Coverage With Short-Term Plans. Short-term plans do not have to follow the Medical Loss Ratio, meaning that more premium dollars gan go toward administration and profit than under other plans. For instance, the largest seller of short-term insurance only requires 50% of premium dollars to pay for medical coverage, much less than the 80% required by ACA-compliant plans. [Wakely/ACAP, April 2018]

Junk Plans Lead To Higher Premiums For Those Enrolled In Full Coverage Plans. “While recent state-level and federal proposals differ in the details, they’d have a similar result: People who buy skimpy plans would face staggering costs when they get sick, and consumers who want comprehensive coverage could face drastic premium increases.” [Center on Budget and Policy Priorities, 2/5/18]

Short-Term Plans Divide Insurance Market Between Sick And Healthy. “Because short-term plans are not considered individual market coverage that must meet ACA standards, they can, and typically do, exclude coverage of pre-existing medical conditions, limit the amount of benefits that a person can receive from the plan in a year, and fail to include many of the essential health benefits, such as maternity care, mental health and substance-use disorder services, and prescription drugs…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.” [Center on Budget and Policy Priorities, 11/29/17]

Junk Plans Mean Higher Premiums For People With Pre-Existing Conditions. By promoting short-term policies, the administration is making a trade-off: lower premiums and less coverage for healthy people, and higher premiums for people with preexisting conditions who need more comprehensive coverage.” [Washington Post, 5/1/18]

JUNK PLANS DESTABILIZE THE INDIVIDUAL MARKET, DRIVING UP COSTS FOR MIDDLE CLASS FAMILIES

Gary Claxton, Kaiser Family Foundation Vice President: Short-Term Plans “Draw In Healthy People And Spit Them Back Into The Marketplace When They’re Sick.” “Short-term health plans, meanwhile, have the ability to charge sick people more than healthy people, to deny people with preexisting conditions, and kick people off the plans if they get sick. If federal agencies decided to lift the limits on the short-term plans, and to exempt people on them from the penalty for not buying health insurance, Obamacare’s individual market could become destabilized, Claxton says. Healthy people would join the short-term plans when they were healthy, stay on them for a year, and pay little for skimpier coverage. If they got sick, they would be kicked off those plans and onto the Obamacare exchanges, where coverage is expansive but prices would be higher than they are now.” [The Atlantic, 10/12/17]

Tim Jost, Health Law Expert: Short Term Health Plans Provide Subpar Coverage and Destabilize Market. “As their name suggests, short-term plans provide coverage for a limited period of time, often six months or less. They generally don’t cover such things as preexisting conditions, maternity services or prescription drugs. The policies typically have maximum coverage limits of about $1 million. Insurers can turn people down if they’re sick and may decide not to renew someone’s policy… ‘The big health insurance companies are really mixed on this,’ said Timothy Jost, emeritus professor at Washington and Lee University School of Law and an expert on the health law. ‘They see this as a seriously destabilizing force in the market, this crap coverage.’” [Kaiser Health News, 1/31/17]

When Healthy Individuals Opt For Short-Term Plans, Costs Go Up For Those Who Are Sick. To the extent that healthy individuals opt for cheaper short-term policies instead of ACA-compliant plans, such adverse selection contributes to instability in the reformed non-group market and raises the cost of coverage for people who have health conditions.” [Kaiser Family Foundation, 2/9/18]

Larry Levitt, Kaiser Family Foundation Senior Vice President: Short-Term Plans Will Raise Premiums for Middle Class Families. “‘The repeal of the mandate and expansion of association health plans and the rise of short-term plans will certainly send premiums rising for middle-class people with pre-existing conditions whose only option is the [ObamaCare]-regulated market,’ said Larry Levitt, a vice president at the Kaiser Family Foundation.” [The Hill, 1/7/18]

KEY HEALTH INSURANCE STAKEHOLDERS WARN AGAINST SHORT-TERM PLANS

98 Percent Of Health Groups That Submitted Comments To HHS Have Serious Concerns About The Short-Term Proposal.  “More than 98% — or 335 of 340 — of the healthcare groups that commented on the proposal to loosen restrictions on short-term health plans criticized it, in many cases warning that the rule could gravely hurt sick patients.” [Los Angeles Times, 5/30/18]

American Cancer Society Cancer Action Network: “Health Care Changes Could Leave Millions Of Cancer Patients And Survivors Unable To Access Meaningful Coverage.” “Today’s executive order jeopardizes the ability of millions of cancer patients, survivors and those at risk for the disease from being able to access or afford meaningful health insurance. Exempting an entire set of health plans from covering essential health benefits like prescription drugs or specialty care and allowing expansion and renewability of bare-bones short-term plans will split the insurance market. If younger and healthier people leave the market, people with serious illnesses like cancer will be left facing higher and higher premiums with few, if any, insurance choices.  Moreover, those who purchase cheap plans are likely to discover their coverage is inadequate when an unexpected health crisis happens leaving them financially devastated and costing the health care system more overall.” [ACS CAN, 10/12/17]

Blue Cross Blue Shield Officials Worry Short-Term Health Plans “Could Really Weaken The Efforts To Stabilize The Marketplace.” “Short-term plans can turn away people with pre-existing conditions, place caps on how much they’ll cover, and decline to cover services like maternity care. All of which means they could siphon healthy consumers out of the ACA’s marketplaces. ‘It could really weaken the efforts to stabilize the marketplace,’ says Kris Haltmeyer, BCBSA’s vice president of legislative and regulatory policy.” [Axios, 2/6/18]

American Academy of Family Physicians: STLD Plans Would Destabilize Individual Market. “We are troubled by how the proposed rule would further destabilize the individual market by drawing young, healthy people away from meaningful, comprehensive coverage…under the proposed rule, insurers could reduce or eliminate certain EHBs to avoid vulnerable, expensive patients by excluding specific services.” [Letter to HHS, 4/18/18]

ACS CAN: Short-Term Plans Are Exempt From Important Consumer Protections. “We are very concerned about policies that would expand access to STLD policies because these products are exempt from important consumer protections, such as prohibitions on lifetime and annual dollar limits, limits on the use of pre-existing condition exclusions, and the prohibition on medical underwriting…We are afraid that some consumers choose to enroll in STLD policies simply because of the lower premium and are unaware of the limitations of the coverage.” [ACS CAN letter to HHS, 4/20/18]

Alliance of Community Health Plans: Concerned It Will Leave Consumers With Fewer Coverage Options “ACHP is also concerned that the proposed rule will cause more insurers to flee the market, leaving consumers with fewer coverage options.” [Letter to HHS, 4/19/18]

American College of Rheumatology: Short-Term Plans Will Hurt Patients With Rheumatoid Arthritis. “We urge the agencies to consider how healthy individuals leaving the exchanges to purchase STLDI plans would affect market stability and premiums for those still in the health exchange. Potentially, our patients with diseases such as rheumatoid arthritis could see an upward swing in their premiums, causing further affordability and access issues” [American College of Rheumatology, 4/23/18]

AHIP: Short-Term Plans Should Not Be Offered As Replacement For Comprehensive Coverage.  “‘We recommend that short-term plans should not be offered as a full replacement for comprehensive coverage,’ AHIP says — because that could pull healthy customers out of the market for ACA coverage.” [Axios, 4/23/18]

Dr. David O. Barbe, president of American Medical Association: These Plans Would Result In “Inadequate Health Insurance Coverage.” “We believe the proposed rule, however, would culminate in plans being offered that fall far short of maintaining crucial state and federal patient protections, disrupt and destabilize the individual health insurance markets, and result in substandard, inadequate health insurance coverage.” [Forbes, 4/22/18]

Margaret Murray, CEO of Association for Community Affiliated Plans: Short Term Plans “strip every provision that might be of value to a patient.” “Not only do STLDI plans not cover pre-existing conditions, but what was covered when you bought the plan can be excluded three months later when you try to renew the plan. Rescissions are rampant in the STLDI market, leading to retroactive cancellation of policies that stick patients with enormous medical bills.” [Washington Examiner, 4/26/18]

Mario Molina, Former CEO of Molina Healthcare: Hopefully You Already Had Kids, Because Short-Term Plans Gut Maternity Care. “Hopefully, you had kids already, because under the short-term health plan expansion encouraged by an executive order signed last year, covered maternity care vanishes in 100% of plans analyzed by [the Kaiser Family Foundation]” [Mario Molina, 4/23/18]

California Department Of Insurance: “Trump Executive Order Will Create A Health Insurance Race To The Bottom.” “Increased sale of short-term policies that don’t cover essential health care needs or comply with most rules that apply to health insurance will harm consumers and create health insurance market instability.” [CDI, 10/12/17]

Sandy Praeger, Former Republican State Insurance Regulator In Kansas And Onetime President Of National Association Of Insurance Commissioners: “Basically anybody who knows anything about healthcare is opposed to these proposals.” [Los Angeles Times, 5/30/18]

Kaiser Health Tracking Poll Finds Health Care Remains a Top Issue to Voters

This morning’s Kaiser Family Foundation tracking poll finds that health care remains a top issue among voters, including Independents, and that one in four are “health care voters,” whose votes will be determined by candidates’ health care positions. Among the key findings:

  • 77% of those surveyed said health care was an important issue, with 30% of these voters listing health care costs as the reason why – just as premiums are rising due to GOP sabotage.

  • Health care is also a top issue for battleground voters, those in areas with competitive House, Senate, or Governor’s races.
  • 19 percent of Independents cited health care a top issue, second only to the economy at 22 percent.
  • Kaiser considers one in four Americans “health care voters,” who “say a candidate’s position on health care will be the ‘most important factor’ in their decision.”
  • Cutting Medicaid and Medicare remains deeply unpopular. As the poll found: “Few partisans – regardless of party identification – say they would be ‘more likely’ to vote for a candidate who wants to reduce government spending on health programs such as Medicare and Medicaid.”
  • The Affordable Care Act maintains a 6-point net-positive rating. As the poll’s author’s note, “This is similar to last month’s tracking poll and continues the nearly year-long trend of a larger share of the public holding favorable than unfavorable views.”
  • People are more likely to support candidates who support the Affordable Care Act, and less likely to support candidates who favor repeal.

The Kaiser survey follows numerous recent polls that find health care remains the top issue heading into midterms, including a new CBS poll released Tuesday that finds health care is the most important issue in deciding votes this November.

POLL: Voters Strongly Support Medicaid, Oppose Any Cuts

To: Interested Parties

From: Jim Williams, Public Policy Polling

Subject: Voters Strongly Support Medicaid,  Oppose Any Cuts

Date: 4-24-18

A new national Public Policy Polling survey finds that voters nationally strongly support Medicaid and are opposed to cutting it, especially to fund tax breaks. 66% of voters oppose cutting Medicaid, as opposed to just 19% who support cuts.  

  • 74% of Democrats and Independents oppose cutting Medicaid, while a plurality of Republicans, 49%,  also oppose cuts.
  • Only 34% of Republicans support cutting Medicaid.

71% of voters overall say they are opposed to cutting Medicaid to fund the Republican tax plan passed last year – including 82% of Democrats, 70% of Independents and 60% of Republicans. Rather than cut Medicaid, a majority of voters (52%) want to see it expanded, compared to just 35% who don’t.

  • Learning that Medicaid covers 6 in 10 nursing home residents, and 40 percent of costs for long-term care that seniors depend on, made voters 63% less likely to support cuts.
  • Voters were 53% less likely to support cuts after learning that if Medicaid funding is cut, 1 in 5 Americans—seniors, children, and individuals with disabilities—will be at risk of losing access to healthcare.

When it comes to the Affordable Care Act, 66% say they want to keep what works about the law and fix what doesn’t, while just 29% say they want to repeal it and start over with a new healthcare law. 82% of Democrats and 68% of Independents want to keep and fix the law and , 44% of Republicans want to keep what works about the ACA.  

Public Policy Polling interviewed 741 national registered voters on April 18-19, 2018. The margin of error for the survey is +/-2.1%. This survey was conducted using automated telephone interviews. The poll was conducted jointly for Protect our Care and SEIU.

Trump’s Tax Day: Tax Breaks For the Rich, Higher Health Care Costs For You

Washington, D.C. – On Tax Day, as millions of Americans contend with health care premiums expected to increase an average of 18 percent, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“This Tax Day, wealthy health insurers and rich pharmaceutical companies get huge tax breaks thanks to Donald Trump and Congressional Republicans. Meanwhile, people who work for a living get higher health care costs.

“The TrumpTax will take health insurance away from 13 million people and raise premiums double-digits each year for millions more to fund a trillion-dollar tax break for the wealthiest individuals and corporations. 20 Americans will lose their coverage for each millionaire’s tax break.

“Every American who sees their health care costs go up should remember this Tax Day that their rising health care costs were brought to them courtesy of Donald Trump and the GOP.”

Research Roundup: Studies Confirm That ACA, Medicaid Improve Health Care Access and Outcomes, Boost Local Economies

Over the past month, five studies looking at the impact of the Affordable Care Act have been released: three analyzing Medicaid expansion, and two analyzing marketplace coverage. These studies covered a broad scope of health care-related outcomes, from treatment for chronic conditions to jobs created in a local economy, and each came to the same conclusion: the ACA is providing clear benefits for Americans.

Here’s a look at what these five studies found:

Louisiana Department of Health: Medicaid Expansion and the Louisiana Economy

A report released in April by the Louisiana Department of Health analyzed Louisiana’s Medicaid expansion, finding that expansion not only boosted the state’s economy but also save the state money, leaving Gov. John Bel Edwards to conclude, “It is costing us less to have more people insured.” Among its key takeaways:

  • The state saw a $1.85 billion economic impact due to Medicaid expansion, with Louisianans seeing $1.12 billion in personal earnings and local tax receipts totaling $746 million, with the economic impact “spread throughout the state.”
  • Louisiana saw 19,000 new jobs created under Medicaid expansion, making clear that “such healthcare can also positive affect the labor participation rate.”
  • Over 545,000 Louisianans have benefited under Medicaid expansion, including more than 180,000 Louisianans who visited a doctor and received new preventive services, more than 35,000 Louisianans who received breast cancer screenings, and more than 48,000 Louisianans who received mental health services.
  • Medicaid expansion saved the state $317 million, leading Gov. John Bel Edwards to note, “It was the easiest big decision I’ll ever make as governor.”
  • As the study’s authors concluded, the economic impact will continue “as long as the state maintains the program and as long as no major changes are instituted by the federal government, either through acts of the U.S. Congress or regulatory decisions made by the Center for Medicare & Medicaid Services.”

University of Montana Bureau of Business and Economic Research: Medicaid Expansion Has Boosted State’s Economy, Added Jobs, Improved Health Care

A March study from the University of Montana Bureau of Business and Economic Research examined the effects of Montana’s Medicaid expansion, and found that it has not only provided insurance to more than 94,000 Montanans, but had a major impact on the state’s economy. Among its key takeaways:

  • Montana’s Medicaid expansion was responsible for creating 5,000 new jobs,  in the health care, retail, construction and hospitality industries, and $280 million of personal income.
  • Labor-force participation has increased six points, from 58 to 64 percent, among those eligible for Medicaid expansion, Montanans aged 18-64 and earning up to 138 percent of the federal poverty level .
  • Medicaid expansion has saved $40 million in Medicaid benefits, in addition to providing $902 million worth of health care services. “The savings are enough to pay for the costs,” said Bryce Ward of the BBER.
  • Medicaid expansion accounts for an estimated $564 million per year on health care spending, with nearly 70% of this being “new money,” or an economic boost spurred only by expansion.
  • As Sheila Hogan, director of the state’s Department of Health and Human Services said, “Medicaid expansion is doing what it’s supposed to do, help Montanans live healthier lives and save the state money.”

America’s Health Insurance Plans: The Value of Medicaid: Providing Access to Care and Preventive Health Services

An April study from America’s Health Insurance Plans (AHIP) compared data from Americans covered by Medicaid, private insurance, and not covered, analyzing the access to care received under each, finding that Medicaid tremendously improves access to care. Among its key takeaways:

  • Adults (five-times as likely) and children (four-times) were significantly more likely to have access to “a usual source of care” than those without insurance.
  • Adults (four-times as likely) and children (two-to-three times) were significantly more likely to obtain preventative care than those without insurance.
  • Those enrolled in Medicaid had access to care at levels comparable to private coverage, and far better access to care than those without insurance.
  • As the authors concluded, “The findings from this study refute outdated, less rigorous studies that question the value of Medicaid, and add to the growing number of recent studies that demonstrate the value of having insurance coverage generally, and Medicaid more specifically.”

Health Affairs: Effects Of The ACA’s Health Insurance Marketplaces On The Previously Uninsured: A Quasi-Experimental Analysis

An April study published in Health Affairs, led by Harvard Medical School clinical fellow Anna Lise Goldman, MD, compared adults who had gone through periods without insurance to those with continuous coverage. It found that the ACA improved health care outcomes, especially among low-income adults. Among its key takeaways:

  • The introduction of the ACA saw the uninsured rate decrease by 11 percentage points and the number of of individuals unable to access necessary care fall by two points, as well as more outpatient visits, more prescriptions being filled, and a higher probability of a hospital stay.
  • Lower-income individuals, those with incomes of between 138 and 250 percent of the federal poverty level, saw even larger increases in the number of outpatient visits and prescriptions being filled.
  • As the study’s authors concluded, “The ACA led to a significant decline in the uninsurance rate, decreased barriers to medical care, increased the use of outpatient services and prescription drugs, and increased diagnosis of hypertension, compared to a control group with stable employer-sponsored insurance.”

Health Affairs: The Affordable Care Act’s Marketplaces Expanded Insurance Coverage For Adults With Chronic Health Conditions

An April study published in Health Affairs examined the role the ACA marketplace had on non-elderly adults with chronic conditions, finding that those far more Americans with chronic conditions obtained coverage through the marketplace. Among its key takeaways:

  • During the time period analyzed, 45% of marketplace enrollees aged 18-64 were treated for chronic conditions, compared to just 35% of those not enrolled in marketplace coverage and 38% of adults with employer insurance.
  • Those enrolled in marketplace coverage obtained more service use than those without it, underscoring the long-term benefits of the ACA.

Sabotage: Elected Officials, Stakeholders, Experts Pan Anti-Consumer Provisions in Trump Administration Marketplace Rule

Washington, D.C. – Consumer advocates spoke out quickly and loudly after the Trump Administration announced a final Notice of Benefit and Payment Parameters rule for plans offered through the Affordable Care Act’s individual marketplaces that will weaken benefits for millions of Americans, put those with pre-existing conditions at risk, and make it even harder for people to sign up for coverage – all while lining insurance company pockets through reduced review of rate hikes and overhead:

Elected Officials

Senator Ron Wyden (D-OR): “Instead of taking steps to prevent big premium increases this fall, the Trump Administration is watering down your health care and making it harder to get coverage. Projections already showed double digit premiums increases this year due to the Trump Administration’s attacks on families’ health care, and today’s new rules pour gasoline on the fire.” [4/9/18]

Senator Patty Murray (D-WA): “With this new rule, President Trump has issued an open invitation for insurance companies to raise premiums, skirt patient protections, and undermine families’ care. I’m very concerned about what these dramatic, harmful changes in policy could mean for women who don’t want to pay more than men for health care, for people with pre-existing conditions, for those struggling with mental illness and substance use, and for millions of peoples’ health costs. Republicans in Congress should join Democrats in condemning the President Trump’s latest politically-motivated effort to raise families’ costs and create health care chaos.” [4/9/18]

Stakeholders & Experts

Andy Slavitt, Former Acting CMS Administrator: “Andy Slavitt, who was acting CMS administrator during the Obama administration’s final two years, countered that the current administration ‘is making it clear that they’re implementing a law that they have no intention of making succeed.’ Slavitt called the revisions ‘a gift to the insurance companies by finding lots of ways for them to get around the standards Americans have come to expect.’” [Washington Post, 4/9/18]

Sam Berger, Senior Adviser, Center for American Progress: “This rule reduces protections for people with pre-existing conditions, increases the cost of health coverage, and makes it harder for consumers to sign up for coverage. This past year has shown just how much consumers value quality, affordable health care, but rather than encourage awareness, lower prices, and promote market stability, the administration is more concerned with trying to undermine the law. This is just the latest example of the Trump administration putting its ideological crusade against the Affordable Care Act ahead of the health and well-being of the American people.” [4/9/18]

Avalere: “The final NBPP … allows for greater essential health benefit flexibility, which could lead to less generous benefits and worse access for consumers.” [4/9/18]

Matt Eyles, Incoming President and CEO, America’s Health Insurance Plans: “When you think about things like the individual mandate going away, some of the other proposed rules that are being put in place, whether it be around association plans, short-term policies — it’s just still a nasty soup right now that’s brewing… We’re looking ahead to 2019, and it’s not a really great picture right now, but I know a lot of companies are committed to the market.” [Washington Times, 4/10/18]

U.S. PIRG: “Together, these changes will make it easier for health insurance companies to raise rates and reduce the value of health coverage for consumers. This is a big step in the wrong direction.” [4/9/18]

AFT Nurses and Health Professionals: “CMS gives states more power to cut health benefits, more profits to insurance companies, with fewer safeguards for coverage.” [4/10/18]

How It Played In The Headlines

Wall Street Journal: Trump Administration Allows States to Narrow ACA Coverage

Reuters: Trump administration issues rule further watering down Obamacare

Washington Post: Trump administration rewrites ACA insurance rules to give more power to states

Washington Examiner: Trump administration releases new ways for states to skirt Obamacare rules

News Coverage Details Rule’s 529 Pages of Sabotage

Wall Street Journal: “Trump Administration Allows States to Narrow ACA Coverage.” “The Trump administration will give states leeway to winnow down the mandatory health benefits guaranteed to consumers who buy Affordable Care Act insurance plans, under a rule issued Monday… The changes to the ACA plans reflect the administration’s goal of dismantling former President Barack Obama’s signature health law and transferring more health-policy decisions to the states. Democrats and some consumer groups denounced the rule as another effort by the administration to undermine the ACA. They have said that weakening the scope of the benefits offered in ACA plans will hurt consumers by reducing coverage. The new rule will ‘undermine protections for people with pre-existing conditions with a race-to-the-bottom approach that fundamentally undermines the Affordable Care Act’s essential health-benefit coverage guarantee,’ said Brad Woodhouse, campaign director of Protect Our Care, a group that is an advocate for the ACA.” [Wall Street Journal, 4/9/18]

CNN: “The New Rule Is The Latest Effort By The Administration To Undermine The Affordable Care Act.” “The new rule is the latest effort by the administration to undermine the Affordable Care Act. Earlier this year, it proposed rules that would allow insurers to sell short-term insurance plans, which last just under a year but don’t have to comply with Obamacare’s regulations, and to make it easier for small businesses to band together to offer coverage that doesn’t adhere to all of the health reform law’s mandates. Both of these options could have lower premiums, but also cover fewer benefits.” [CNN, 4/9/18]

Health Care Dive: “The Sweeping Rule Is Just The Latest In The Trump Administration’s Steady Chipping Away” At The ACA. “The sweeping rule is just the latest in the Trump administration’s steady chipping away at the landmark health law, which has been coupled with a move to give states more control over their healthcare regulations. The administration cut off cost-sharing reduction payments to insurers in October, sparking backlash from payers. The Republican tax bill last year repealed the individual mandate penalty starting in 2019. And more is on the way. In February, the administration released a proposed rule to expand short-term health insurance availability, bumping up the allowance of coverage to 12 months. It is also promoting association health plans, which aren’t required to meet the EHB requirements or protect people with pre-existing conditions. The ACA requires payers to cover at least 10 specific benefits, including maternity care and prescription drugs.” [Health Care Dive, 4/9/18]

Reuters: “This Could Lead To Less Generous Coverage.” “The Trump administration took additional steps to weaken Obamacare on Monday, allowing U.S. states to relax the rules on what insurers must cover and giving states more power to regulate their individual insurance markets. The Centers for Medicare and Medicaid Services issued a final rule that allows states to select essential health benefits that must be covered by individual insurance plans sold under former President Barack Obama’s healthcare law. The 2010 Affordable Care Act requires coverage of 10 benefits, including maternity and newborn care and prescription drugs. Under the new rule, states can select from a much larger list which benefits insurers must cover. That could lead to less generous coverage in some states, according to Avalere Health, a research and consulting firm. [Reuters, 4/9/18]

Reuters: “Insurers Could Also Have An Easier Time Raising Their Rates Under The New Rule.” “Insurers could also have an easier time raising their rates under the new rule. Obamacare mandated that premium rate increases of 10 percent or more in the individual market be scrutinized by state regulators to ensure that they are necessary and reasonable. The new CMS rule raises that threshold to 15 percent.” [Reuters, 4/9/18]

CNN: The Rules “Make It Easier For Insurers To Spend Less Of The Premiums They Collect On Policyholders And Put More Toward Profits.” “The rule also allows states to make it easier for insurers to spend less of the premiums they collect on policyholders and put more toward profits and administrative costs. And the administration raised the default threshold that trigger state reviews of insurers’ proposed rate hikes to 15%, up from 10%.” [CNN, 4/9/18]

Washington Post: New Rules “Will Enable States To Allow Future Doctors Visits [Or Cover] Fewer Prescription Drugs.” “One of the most significant changes involves a set of 10 essential health benefits that the ACA requires of health plans sold through the federal insurance marketplace and separate state marketplaces. The new rules will not jettison any of the categories but will enable states to allow fewer doctors visits, for example, or to cover fewer prescription drugs.” [Washington Post, 4/9/18]

Washington Post: “The Government Will No Longer Require That Insurers Provide A Standardized Set Of Benefits, Urged By The Obama Administration As A Way To Help Consumers Comparison Shop.” “In another change, the government is turning over to the 39 states that rely on the federal insurance exchange, HealthCare.gov, responsibility for ensuring that marketplace plans have enough doctors and other providers of care in their networks. Similarly, the government no longer will require that insurers provide a standardized set of benefits, urged by the Obama administration as a way to help consumers comparison shop. [Washington Post, 4/9/18]

Washington Post: “In A Sharp Shift, The New Rules Further Weaken The Network Of Consumer Assisters.” “In ways both subtle and substantial, many of the past years’ rules were upgrades to help consumers with prices, benefits and shopping for coverage. Under a change effective in 2016, any insurer wanting to raise its premiums by 10 percent or more has been required to disclose the increase with a justification. Insurers also have had to publish up-to-date lists on drugs, including tiers of coverage and any restrictions on consumers’ ability to get them. The rules for 2017 started a rating system for the number of doctors and other providers in plans’ networks, so that customers could better compare marketplace insurers in areas that offer a choice. In a sharp shift, the new rules further weaken the network of consumer assisters, known as navigators, whose funding the Department of Health and Human Services slashed last year. The rules remove the requirement that every area has at least two navigator groups and that one be local.” [Washington Post, 4/9/18]

Washington Post: Insurers No Longer Must Devote 80 Percent Of Income To Customers’ Care. “In addition, insurers no longer will be required to devote 80 percent of their income to customers’ care, if they can show that a higher profile would improve their financial stability.” [Washington Post, 4/9/18]

The Hill: Ruling Gives Flexibility For States “To Change The Essential Health Benefits.” “Other changes announced Monday include additional flexibility for states to change the Essential Health Benefits, the list of health services that insurance plans must cover.” [The Hill, 4/9/18]

Washington Examiner: New Rules “Ease The Requirements” Plans Must Cover. “The new rules would ease the requirements on the health benefits that plans must cover, as well as quality control. Critics say the new rule will allow insurers to charge higher prices and skirt patient protections… The agency also is changing the requirements for how much money an insurer must provide toward medical services and quality improvement. Obamacare requires insurers to spend 80 percent of the money it takes in from premiums on health costs and quality improvements and 20 percent on administrative overhead or marketing. CMS would allow a state to change that ratio based on certain factors.” [Washington Examiner, 4/9/18]

Associated Press: “One Of The Ways To [Lower Costs] Is By Cutting Back On Benefits.” “The administration is under pressure from Republican-led states to reduce the cost of health insurance for consumers buying their own policies. One of the ways to do that is by cutting back on benefits.” [AP, 4/9/18]

Trump Administration Stacks Deck Against Next Year’s Health Care Shoppers

Washington, D.C. – After the Trump Administration finalized “rules of the road” for next year’s Affordable Care Act marketplaces that favor insurance companies over the American people, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“President Trump and Congressional Republicans have already set the stage for higher prices and more confusion next fall with laws and regulations that undermine the Affordable Care Act marketplaces. Now, the Trump Administration is compounding its attack by encouraging insurance companies to undermine protections for people with pre-existing conditions with a race-to-the-bottom approach that fundamentally undermines the Affordable Care Act’s essential health benefit coverage guarantee. Meanwhile, the Administration is sweetening the deal for insurance companies by loosening restrictions on extreme rate hikes.

“Today’s Trump Administration action will make it even harder for Americans to sign up for coverage next year, with further cuts to local assisters who help families navigate their options and enroll. The Administration’s own data from this year’s enrollment period shows that their cuts to outreach and assistance dampened enrollment – especially among younger and healthier consumers – while states that ran their own marketplaces did not see similar drop-off. Today’s sabotage will compound that problem.

“As we look ahead to this fall’s open enrollment period, when premiums are already expected to spike due to harmful actions by Trump and his Republican Congress, there is simply no excuse for setting rules of the road that allow insurance companies to chip away at benefit quality and hike rates with impunity, while at the same time stripping away resources that help Americans understand their insurance options. This short-sighted, bad-faith rule is yet another brick in the wall that Republicans are building between the American people and access to good, affordable coverage.”