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The GOP Agenda: Worse Care, Higher Costs for Residents at Nursing Homes

Washington, DC — Ahead of the Senate Finance Committee’s hearing on nursing home neglect and abuse tomorrow, it’s important to remember just how the GOP’s health care policies have failed nursing home patients across America. Donald Trump and his Republicans in Congress worked to repeal the Affordable Care Act, block expansion and access to Medicaid, and fell into lock step with the nursing home industry to weaken penalties they may face for harming their own residents. The GOP Agenda has nothing to do with helping those in nursing homes and long-term care facilities–it only seeks to serve industry CEOs and gut access to care so many patients desperately need.

The GOP Agenda: Repeal the Affordable Care Act and Its Protections for People in Nursing Homes

The ACA Expanded Nursing Home Quality-Related Requirements for the First Time Since 1987. “The Affordable Care Act (ACA) is the first comprehensive legislation since the Nursing Home Reform Act, part of the Omnibus Budget Reconciliation Act of 1987 (OBRA ’87), to expand quality of care-related requirements for nursing homes that participate in Medicare and Medicaid and improve federal and state oversight and enforcement…the ACA incorporates the Nursing Home Transparency and Improvement Act of 2009, introduced because complex ownership, management, and financing structures were inhibiting regulators’ ability to hold providers accountable for compliance with federal requirements. The ACA also incorporates the Elder Justice Act and the Patient Safety and Abuse Prevention Act, which include provisions to protect long-term care recipients from abuse and other crimes.” [Kaiser Family Foundation, 1/28/13]

The GOP Agenda: Cutting Access to Nursing Home Care by Slashing Medicaid

Medicaid Pays for Most of the 1.4 Million People in Nursing Homes. “Medicaid pays for most of the 1.4 million people in nursing homes… It covers 20 percent of all Americans and 40 percent of poor adults…A combination of longer life spans and spiraling health care costs has left an estimated 64 percent of the Americans in nursing homes dependent on Medicaid. In Alaska, Mississippi and West Virginia, Medicaid was the primary payer for three-quarters or more of nursing home residents in 2015, according to the Kaiser Family Foundation.” [New York Times, 6/24/17]

Medicaid Covers 6 in 10 Nursing Home Residents, and Half of Seniors Using Medicaid Long-Term Care Services Were in Nursing Homes. [Kaiser Family Foundation, 6/20/17]

The Trump Administration and Republicans in Congress Pursued ACA Repeal Bill that Would Have Also Slashed Medicaid. “On Thursday, Senate Republicans joined their House colleagues in proposing steep cuts to Medicaid, part of the effort to repeal the Affordable Care Act. Conservatives hope to roll back what they see as an expanding and costly entitlement.” [New York Times, 6/24/17]

New York Times Headline: “Medicaid Cuts May Force Retirees Out of Nursing Homes” [New York Times, 6/24/17]

Associated Press Headline: “Medicaid cut in GOP health bill worries the nursing home set” [Associated Press, 7/8/17]

Senate GOP Repeal Bill Would Have Cut Medicaid by $2.6 Trillion by Second Decade. “The Congressional Budget Office (CBO) estimates that the Senate Republican health bill’s Medicaid cuts would deepen significantly in the second decade, with the cuts growing from 26 percent in 2026 to 35 percent in 2036, relative to current law. Now, based on CBO estimates and data, the Committee for a Responsible Federal Budget (CRFB) estimates that the Senate bill would cut Medicaid by roughly $2.6 trillion over the second decade (2027-36), on top of Medicaid cuts of $772 billion in the first decade.” [Center on Budget and Policy Priorities, 7/11/17]

The Trump Administration is Looking for Ways to Bypass Congress to Enact Medicaid Block Grants. “The Trump administration is quietly devising a plan bypassing Congress to give block grants to states for Medicaid, achieving a longstanding conservative dream of reining in spending on the health care safety net for the poor…Capping spending could mean fewer low-income people getting covered, or state-designated cutbacks in health benefits.” [Politico, 1/11/19]

In 2018, the Trump Administration Proposed Cutting Medicaid by $1.4 Trillion. “The Administration is proposing to cap federal Medicaid payments to states and to cut federal Medicaid spending by $1.439 trillion – that is trillion with a “t” – over the ten year period 2019 – 2028. That is about 26% of what the Administration projects federal Medicaid spending would otherwise be, and within shouting distance of the $1.455 trillion cost of the tax cuts enacted in December.” [Georgetown Center for Children and Families, 2/12/18]

The GOP Agenda: The Trump Administration Weakened Penalties Against Nursing Homes that Harm Patients at the Request of the Nursing Home Industry

The Trump Administration Scaled Back Fines Against Nursing Homes that Harm Residents, at the Request of the Nursing Home Industry. “The Trump administration is scaling back the use of fines against nursing homes that harm residents or place them in grave risk of injury, part of a broader relaxation of regulations under the president. The shift in the Medicare program’s penalty protocols was requested by the nursing home industry…The new guidelines discourage regulators from levying fines in some situations, even when they have resulted in a resident’s death. The guidelines will also probably result in lower fines for many facilities. [New York Times, 12/24/17]

New Guidelines Intended to Discourage Regulators from Levying Fines, Even When Violations Resulted in Resident’s Death. “The new guidelines discourage regulators from levying fines in some situations, even when they have resulted in a resident’s death. The guidelines will also probably result in lower fines for many facilities.” [Kaiser Health News, 12/31/17]

In November 2017, The Trump Administration Exempted Nursing Homes Violating Certain Rules from Penalties for 18 Months. “In November, the Trump administration exempted nursing homes that violate eight new safety rules from penalties for 18 months. Homes must still follow the rules, which are intended, among other things, to reduce the overuse of psychotropic drugs and to ensure that every home has adequate resources to assist residents with major psychological problems.” [New York Times, 12/24/17]

In October 2017, the Trump Administration Discouraged CMS Regional Offices from Levying Fines if the Error was a “One-Time Mistake.” “In October, CMS discouraged its regional offices from levying fines, even in the most serious health violations, if the error was a ‘one-time mistake.’ The centers said that intentional disregard for residents’ health and safety or systemic errors should still merit fines.” [Kaiser Health News, 12/31/17]
The Trump Administration Rolled Back Obama Administration Rule Making it Easier for Nursing Home Residents to Sue for Negligence or Abuse. “Another Obama-era regulation is on the Trump administration’s chopping block — this one about nursing homes. The Obama administration’s rule would’ve made it easier for nursing home residents to sue for negligence or abuse. But the Trump administration is proposing to replace that rule. And the new one could make it almost impossible for nursing home residents to get their day in court. That is because new nursing home residents are frequently handed an agreement to go to arbitration instead of suing if something goes wrong.” [NPR, 8/21/17]

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In Stories, Administration, News

“Trump’s Former Top Health Official Just Broke With Him On The GOP’s Biggest Move To Undercut Obamacare”: Tom Price Admits That Trump, GOP Sabotage Responsible for Higher Costs

This morning, former HHS Secretary Tom Price admitted what every health policy expert, the Congressional Budget Office, state insurance commissioners – namely everyone other than repeal-supporting Republicans – has long said: the Trump Administration is responsible for the increase in premiums. Speaking of the repeal of the individual mandate, Price said, “And there are many, and I’m one of them, who believes that that actually will harm the pool in the exchange market, because you’ll likely have individuals who are younger and healthier not participating in that market, and consequently, that drives up the cost for other folks within that market.” Here’s how it played:

Washington Post: Trump’s Former Health Secretary: Americans Will Pay More Because GOP Weakened Obamacare. “President Trump’s former top health official on Tuesday said the Republican tax law would raise the cost of health insurance for some Americans because it repealed a core provision of the Affordable Care Act. Tom Price, Trump’s first secretary of the Department of Health and Human Services, said people buying insurance on government-run marketplaces will face higher prices because the tax law repealed the Affordable Care Act’s individual mandate. The mandate had forced most Americans to have health coverage or face a financial penalty.” [Washington Post, 5/1]

Business Insider: Trump’s Former Top Health Official Just Broke With Him On The GOP’s Biggest Move To Undercut Obamacare. “Tom Price, the former Health and Human Services Secretary under President Donald Trump, criticized a key Republican change to Obamacare during a speech Tuesday. Speaking at the World Health Care Congress, Price suggested the Republican Party’s repeal of Obamacare’s individual mandate — the requirement to buy insurance or face a penalty — was a faulty idea. He said it would drive up costs for people in the individual insurance marketplace.” [Business Insider, 5/1]

Vox: Trump’s Ex-Health Secretary Accidentally Told The Truth About Obamacare Repeal. “Repealing Obamacare’s individual mandate will hurt the law’s insurance marketplaces because fewer young and healthy people will buy coverage, leaving an older, sicker, and more expensive pool behind. Just ask, uh, former Trump health secretary Tom Price. Price, who was forced out of the US Health and Human Services Department last year after a scandal over luxurious charter jet travel, accurately described the pitfalls of the GOP’s decision to repeal the mandate in its tax bill in a speech to the World Health Care Congress in Washington, DC. This is, of course, exactly what health policy experts would tell you. The mandate didn’t quite work as well as planned, but the expectation is still that younger and healthier people are going to leave the Obamacare markets without it — especially with the Trump administration making cheaper, less comprehensive plans more available via regulation.” [Vox, 5/1]

Slate: Tom Price, Somewhat Belatedly, Starts Telling the Truth About Obamacare. “It took longer than expected, but disgraced former Health and Human Services Secretary Tom Price appears to have been welcomed back into polite society. Untethered from the political concerns that dictated what he could say either as a congressman or Cabinet member, Price is now able to tell certain truths about health care policy—though, in telling them now, he only confirms his own dishonesty about them when it mattered. Speaking at the World Health Care Congress on Tuesday morning, Price laid out the consequences of congressional Republicans’ decision to eliminate the individual mandate penalty in last year’s tax reform bill.” [Slate, 5/1]

Washington Times: Tom Price: Repeal Of Obamacare Mandate Will Drive Up Costs. “Former Health and Human Services Secretary Tom Price said Tuesday the GOP’s decision to repeal Obamacare’s individual mandate without a broader overhaul of the heath care system will likely increase costs on consumers who remain in the program. The comments from Mr. Price, who was ousted from HHS last fall over his pricey business travel, were remarkable, since he claimed the mandate was ineffective while in office. Also, Democrats have been making the same argument in accusing President Trump and his Republican allies of sabotaging the 2010 law’s marketplace.” [Washington Times, 5/1]

USA Today: Former HHS Sec. Price: Repealing The Individual Mandate ‘Will Harm’ People Insured Through Obamacare. “Former Health and Human Services Secretary Tom Price said Tuesday that repealing the requirement that all Americans have health insurance or face a tax penalty, may not have been such a good idea after all… Price’s comments come the same day the Commonwealth Fund, a foundation that studies health care and says it is focused on helping the most needy members of society, came out with a study that found since 2016 4 million working-age people no longer have insurance coverage. The foundation said the drop in coverage was not connected to a repeal in the individual mandate but instead due to  weaknesses with the current health care law that remain unfixed and the Trump Administration’s cuts to advertising and outreach related to getting people signed up for Obamacare.” [USA Today, 5/1]

CNBC: Trump’s Former Health Secretary, Tom Price, Now Thinks Repealing The Individual Mandate Will Increase Costs. “ormer Health and Human Services Secretary Tom Price used to say that Obamacare’s individual mandate increased health-care costs. Now he’s saying Congress’ decision to repeal it could actually increase costs. Lawmakers repealed the individual mandate, which penalized people who did not purchase health insurance, in the GOP tax reform bill President Donald Trump signed into law in December. The change goes into effect next year. Price argued Tuesday, in a speech at the World Health Care Congress in Washington, that the move amounts to ‘nibbling at the sides’ of the Affordable Care Act, long a target of the GOP and Trump – and that it would probably boost costs.” [CNBC, 5/1]

Splinter News: Tom Price, Disgraced Ex-Trump Official, Admits He’s Also a Huge Liar. “Price said he ‘believes [the repeal] actually will harm the pool in the exchange market, because you’ll likely have individuals who are younger and healthier not participating in that market, and consequently, that drives up the cost for other folks within that market.’ This is a very interesting development, given that last year, when he was actually in a position to influence whether or not this happened, he supported the repeal.” [Splinter News, 5/1]

The Hill: Tom Price: Obamacare Mandate Repeal Will Drive Up Costs. “Former Secretary of Health and Human Services Tom Price on Tuesday said that the repeal of ObamaCare’s individual mandate would drive up costs, a remark seized on by Democrats… Democrats immediately highlighted the remark from President Trump’s own former health secretary and fierce opponent of ObamaCare. They say his statement reinforces the argument that Republicans are to blame for coming premium increases in large part due to their repeal in the December tax bill of the mandate that most people obtain health insurance or pay a fine. ‘We couldn’t have said it any better ourselves,’ Matt House, spokesman for Senate Minority Leader Charles Schumer (D-N.Y.), said in email linking to Price’s comments. Added Sen. Patty Murray (D-Wash.), ‘I’m glad to see former Secretary Price admit the truth, which is that families’ premiums are going up because President Trump and Republicans in Congress have spiked prices with their relentless, partisan health care sabotage.’” [The Hill, 5/1]

Inside Health Policy: Price: Individual Mandate Repeal Will Drive Up Costs, Hurt Risk Pools. “Former HHS Secretary Tom Price, who was at the helm of HHS during the Trump administration’s 2017 efforts to repeal and replace Obamacare, told attendees at the 2018 World Health Care Congress that he is not a fan of the repeal of the federal individual mandate penalty and said the measure tucked into the new tax law will drive up costs and hurt the risk pools.” [Inside Health Policy, 5/1]

Talking Points Memo: Tom Price: Individual Mandate Repeal Will ‘Harm’ Insurance Exchanges. “Former Secretary of Health and Human Services Tom Price, now safely out of power, said Tuesday that Republicans’ repeal of Obamacare’s individual mandate will ‘harm’ the individual insurance marketplace… Price is making a mundane point to most health care policy experts: If, beginning in 2019, individuals on the non-group market are allowed to avoid choosing between paying for insurance or paying a penalty, many healthy people will simply drop their insurance. As a result, prices for individuals remaining in Obamacare’s individual insurance marketplaces will go up. The Congressional Budget Office estimated in 2016, and again in 2017, that repealing the individual mandate would increase the number of uninsured people in the United States.” [TPM, 5/1]

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In Stories, Administration, News

Republicans Knew Premiums Would Go Up When They Sabotaged Your Health Care, But They Did It Anyway

For the past year and a half, Republicans have waged a non-stop war against the Affordable Care Act. Throughout 2017, Republicans tried time after time to repeal the Affordable Care Act, slashed funding for outreach, ended cost-sharing reduction payments that helped low income Americans afford health care, and passed a tax bill that the Congressional Budget Office predicts will strip health care from 13 million Americans and raise premiums by double digits.  

Throughout their many layers of sabotage, Republicans have played ignorant, trying to cover up the fact that their votes will send Americans’ premiums skyrocketing. Just this morning, former HHS Secretary Tom Price called out Republicans’ lies, saying that the tax bill’s repeal of the individual mandate “will harm the pool in the exchange market, because you’ll likely have individuals who are younger and healthier not participating in that market, and consequently, that drives up the cost for other folks within that market.”

Just one month after voting for a tax bill that the CBO projected would raise insurance premiums by double digits, Sen. Ted Cruz acted as though he had wanted to lower premiums the whole time: “I think lowering premiums is a win-win for everybody…The number one reason people despise Obamacare is that premiums have skyrocketed.” As much as Republicans try to distance themselves from it, the fact of the matter is clear: they knew they were voting to raise premiums, and they chose to do it anyway.

EACH STEP OF THE WAY, EXPERTS WARNED THAT SABOTAGE WOULD DRIVE PREMIUMS UP

The Trump Administration Deliberately Tried To Reduce Enrollment Of Healthy Individuals By Halting Outreach, Despite Commonly Understood Consequence That This Would Increase Premiums.

  • January 2017: In “Transparent Effort To Damage Stability Of Health Insurance Marketplace,” President Trump Abruptly Halts Open Enrollment Ads. In the final week of open enrollment, President Trump ended ads that let people know they could sign up for the Affordable Care Act. As Politico notes, “The last five days of the open enrollment season are seen as critical because many individuals procrastinate and then join a last-minute sign-up surge. That’s particularly true for younger and healthier customers who are crucial to making insurance markets work.”
  • February 2017: Analysis Shows Trump’s Cuts To Outreach Prevent Nearly 500,000 People From Getting Coverage. Following Trump’s initial cuts to outreach, it was estimated that Trump’s cuts blocked nearly 500,000 people from getting coverage. When fewer healthy people are able to purchase care, experts agree that premiums increase.
  • August 2017: Trump Administration Cuts Aca Advertising Budget By 90 Percent, Despite Evidence That It Will Cause Premiums To Increase. [Vox, 8/31/17]
  • Because The Administration Still Refuses To Adequately Fund Outreach, Insurance Commissioners Warn That Premiums Will Continue To Increase. Peter Lee, the head of California’s ACA Marketplace wrote in a letter to HHS that premiums would go up because of the Administration’s failure to properly fund outreach: “The reality is clear: If the federal government maintains the current cuts in marketing and outreach, premiums will be higher than necessary, consumers will be hurt as a result and taxpayers will pay the price by supporting higher [than] necessary subsidies. This does not need to happen and can easily be avoided…Drops in new enrollment are a formula for a worse risk mix and higher premiums.” [Letter to HHS, 4/25/18]

Months Before The Trump Administration Ended Payments That Helped Lower Income Americans Afford Insurance, The CBO Warned That Doing So Would Raise Premiums By 20 Percent. President Trump Ended Them Anyway:

  • August 2017: CBO Warns That Premiums Will Increase By 20 Percent If Cost-Sharing Reduction Payments Are Terminated. “If President Trump follows through on his threat to stop paying billions of dollars of subsidies critical to insurance plans under the Affordable Care Act, insurance premiums for certain plans would rise by 20 percent next year, according to a new analysis by the nonpartisan Congressional Budget Office.” [Washington Post, 8/15/17]
  • October 2017: Trump Administration Decides To Halt Cost-Sharing Reduction Payments. Despite the CBO’s warning that ending cost-sharing reduction payments (CSRs) would cause premiums to rise by 20%, the Trump Administration decided to do so anyways. [Washington Post, 10/13/17]
  • After The Fact, Insurance Commissioners Did Exactly What The Cbo Said Would Happen — They Raised Premiums. Jessica Altman, Pennsylvania Insurance Commissioner: “This is not the situation I hoped we would be in, but due to President Trump’s refusal to make cost-sharing reduction payments for 2018 and Congress’s inaction to appropriate funds, it is the reality that state regulators must face and the reason rate increases will be higher than they should be across the country.” [CNN Money, 10/17/17]
  • Now, Research Confirms That Ending CSRs Caused Premiums To Jump, And Is Expected To Do So Again In 2019. RWJ’s interviews with ten insurance companies found that the loss of cost-sharing reduction plan reimbursements drove premium increases in 2018 ranging from 10 to 20 percent. [Robert Wood Johnson Foundation and Urban Institute, 3/19/18]

Republicans Knew That Repealing The Requirement That Most People Have Insurance Would Drive Up Premiums, And Rushed To Do So Without Public Comment:

  • November 2017: Congressional Budget Office (CBO) Estimates That Repealing The Individual Mandate Will Push Premiums Up By 10 Percent Annually. Last fall, the nonpartisan Congressional Budget Office released numbers that repealing the requirement that most people have insurance would increase premiums by roughly 10 percent each year for the next decade. [Congressional Budget Office, November 2017]
  • November 2017: Sen. Susan Collins Acknowledges That Repealing Individual Mandate Would Raise Premiums. “‘One of the major concerns I had was the impact on premiums of repealing the individual mandate,’ [Collins] said Tuesday, referring to government estimates that repealing the mandate would raise insurance premiums by at least 10 percent as healthier consumers leave the market.” [Talking Points Memo, 11/29/17]
  • December 2017: Republican Senate Hurries To Pass Final Gop Tax Bill, Which Repeals Individual Mandate Despite Cbo Analysis That It Will Drive Premiums Up, In The Dark Of The Night And Without Public Hearings. Senate Republicans were determined to stop discussion on their tax bill from ever seeing the light of day. In December, they passed their tax bill in a matter of weeks, without hearing any public hearings. The process was so rushed that entire pagers were crossed out of the final version of the bill, and amendments were handwritten and barely legible.

After Sen. Collins Exchanged Her Vote On The Tax Bill For A Promise To Pass ACA Stabilization, Republicans Sabotage Bipartisan Efforts To Pass Bill That Would Help Control Premium Hikes:

  • December 2017: To Counteract The Increase In Premiums That Would Follow Repealing The Individual Mandate, Sen. Susan Collins Exchanges Tax Bill Vote For Aca Stabilization Bill. Sen. In exchange for her vote on the GOP tax bill, Majority Leader Mitch McConnell, President Trump, and Vice President Trump committed to passing a health care stabilization measure. [Washington Post, 12/15/17]
  • March 2018: After Pushing The Stabilization Vote Into The Next Year, Republicans Refused To Vote On Stabilization Unless Democrats Agreed To A List Of Deal Breaking Demands. In the middle of bipartisan negotiations on stabilization, the White House released its list of demands, including: Expanding the Hyde abortion language, codifying the Administration’s Short-Term proposal into law that undermine protections for people with pre-existing conditions, expanding Health Savings Accounts (HSAs) that is essentially another tax cut for the wealthy, mposing an age tax on older Americans by letting insurers charge people over 50 five times more than younger people. [White House Document, obtained by Politico, 3/8/18]
  • March 2018: There Is No Vote On Stabilization. [New York Magazine, 3/26/18]

Ignoring Warnings From Health Insurers, Trump Administration Proposes Changes To Short-Term Health Plans That Would Drive Up Premiums For Americans In Individual Marketplace:

  • July 2017: In Letter To HHS, America’s Health Insurance Plans Warns That Allowing Short-Term Plans To Offer Coverage For More Than Three Months At A Time Will Drive Up Premiums. “A blanket extension of the permitted length of short term policies will draw lower risk people out of the individual market single risk pool and drive up premium costs for consumers.” [America’s Health Insurance Plans Letter To HHHS, 7/12/17]
  • October 2017: President Trump Signs Executive Order That Expands Access To Short-Term Health Plans. President Trump’s executive order allows short-term plans to last for 12 months and be renewable, a notable change from the previous rule, which limited these plans to three months and prevented them from being renewed. [The Atlantic, 10/12/17]
  • February 2018: Administration Releases Fact Sheet On Short-Term Rule That Would Allow Insurers To Sell Year-Long Plans. [Centers for Medicare & Medicaid Services, 2/20/18]
  • March 2018: Nonpartisan Urban Institute Says Premiums Will Increase By Nearly 20 Percent. Confirming what experts had warned of, the Urban Institute calculated that increasing the availability of short-term health plans, when combined with the repeal of the individual mandate, would lead premiums to increase by an average of 18.3 percent in 2019. [Urban Institute, March 2019]
  • March 2018: AARP Analysis Projects Short-Term Plans Will Cause Older Americans’ Premiums To Increase By 16.6 Percent. As a result of President Trump and his Republican allies’ pushing junk insurance plans, AARP expects premiums for older Americans buying marketplace health coverage to increase by an average of 16.6 percent in 2019.  [AARP, 3/21/18]

Each Of The Administration’s Decisions Is Designed Drive People Off Of Health Care And Increase Premiums:

  • Katherine Hempstead, health insurance expert at Robert Wood Johnson Foundation: Anything That Undermines The ACA-Compliant Risk Pool Is Bad For Premiums.  “Anything that undermines the ACA-compliant risk pool is bad for premiums in the ACA market…Every exit ramp makes that market more expensive and less competitive than it otherwise would be.” [Modern Healthcare, 4/26/18]

NOW, THE CONSENSUS IS IN: REPUBLICANS KNOWINGLY DROVE UP PREMIUMS

Vox: Republican Sabotage To Blame For Premium Hikes. “The Trump administration’s multifaceted crusade against the health care law — slashing outreach budgets and pulling the law’s cost-sharing reduction payments to insurers — were already to blame for a 20 percent premium hike this year. Then Congress repealed the individual mandate in their tax bill, a huge political victory given the GOP’s vehement opposition to the mandate but one that insurers have said would drive up premiums even more next year.” [Vox, 4/25/18]

Washington Post: “The Pottery Barn Rule Comes To Mind: You Break It, You Own It.” “This is not ‘letting’ Obamacare fail. Many nonpartisan experts believe that these active measures are likely to undermine the pillars of the 2010 law and hasten the collapse of the marketplaces. The Pottery Barn rule comes to mind: You break it, you own it. Yes, the plate you just shattered had some cracks in it. But if you dropped it on the ground, the store is going to blame you.” [Washington Post, 10/13/17]

The American People Agree: President Trump And Congressional Republicans Are Playing Politics With People’s Health Care. A poll conducted last September found that 61 percent of voters believed President Trump was “trying to make the Affordable Care Act fail,” and 64 percent of voters said Trump is “playing politics with people’s health care.” The poll also found that the American people seriously disapprove of how Republicans in Congress are treating health care: 80 percent of voters disapprove while only 20 percent approve. [Garin Poll, 9/5/17]

RECENT HEADLINES PAINT A TELLING PICTURE

EVEN REPUBLICANS ADMIT THEY’RE TO BLAME

Sen. Lamar Alexander: “Rates Will Go Up…They’re Going To Blame Every One Of Us, And They Should.” On the topic of failing to pass a stabilization bill, Sen. Alexander said: “Rates will go up. The individual market will probably collapse…There will be 11 million people who are between jobs, who are self-employed, who are working, who literally cannot afford insurance, and they’re not going to be very happy. And they’re going to blame every one of us, and they should.” [Vox, 4/25/18]

Lindsey Graham: Republicans “Own The Outcome” On Health Care. “Sen. Graham told Breitbart News, ‘In October, premiums are going up. Obamacare cannot be fixed. It’s going to continue to collapse, and then, we own the outcome. By repealing the individual mandate, which is a step forward in the eyes of the public, we own the issue. We have a responsibility to do something about the collapsing Obamacare system. I believe that we’re going to get blamed more than Democrats because we stopped trying to repeal Obamacare, and to suggest that we don’t own it is just simply politically naive.’ Graham continued, ‘It can hurt us in 2018. It can hurt by our base feeling like we betrayed them. It can hurt us from people suffering from Obamacare, like we don’t have a solution. It will energize Democrats. It can undercut everything we did on the tax cut side.'” [Breitbart, 2/6/18]

Rep. Charlie Dent: Republicans “Own” Health Care Now. “Rep. Charlie Dent (R-Pa.) argued Friday that President Trump was ‘ill-advised’ to end key ObamaCare payments, warning that the GOP now ‘owns’ whatever happens to ObamaCare. ‘I think the president is ill-advised to take this course of action because … we, the Republican Party, will own this,’ Dent, a key House moderate who is retiring from Congress at the end of his term, said on CNN. Asked about Trump’s previous comments blaming problems with ObamaCare on former President Barack Obama, Dent pointed out that Republicans currently control the White House and have majorities in both chambers of Congress. ‘Barack Obama is a former president. President Trump is the president and he’s a Republican, and we control the Congress,’ Dent said. ‘So we own the system now. We’re going to have to figure out a way to stabilize this situation … This is on us.'” [The Hill, 10/13/17]

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In Stories, Administration, News

Ex-Secretary Tom Price: Trump and GOP Responsible For Upcoming Rate Hikes

Washington, D.C. – In response to former Health and Human Services Secretary Tom Price’s comments this morning to the World Health Care Congress that Republicans’ TrumpTax bill and its individual mandate repeal will increase Americans’ health care costs, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Today, President Trump’s own former HHS secretary, Tom Price, admitted that the Republican tax bill’s sabotage of the Affordable Care Act will increase health care costs. Ex-Secretary Price has confirmed that President Trump and Congressional Republicans chose a trillion-dollar tax break for corporations and the wealthiest at the expense of hardworking Americans’ health care. Months ago when the nonpartisan Congressional Budget Office found that the TrumpTax would raise premiums by ten percent while kicking millions of Americans off of their coverage, Republican senators responded by accusing CBO of bias and dismissing their findings. Now, one of the Trump Administration’s lead saboteurs has admitted the truth. Americans now have it straight from Tom Price: Republicans are responsible for upcoming rate hikes.”

ashoup
In News

New Protect Our Care Ad: As Premiums Increase, Americans Should Thank Donald Trump & Congressional Republicans

Washington, D.C. – This year, Protect Our Care is kicking off May’s focus, Repeal and Sabotage Accountability Month, by releasing a web ad highlighting the consequences of Republicans’ deliberate health care repeal and sabotage campaign: a 20 percent rate hike set to hit working families while health insurance and pharmaceutical companies reap the windfalls of the GOP’s trillion-dollar tax break.

“From the moment he took office, President Trump has launched attack after attack on our health care, and Congressional Republicans have been eager to help. They tried to repeal the law; they attempted to undermine open enrollment; they promised to make the law fail; and they’ve proposed expanding junk insurance plans that would take us back to the days when insurance companies could impose sky-high rates on people with pre-existing conditions, or deny them coverage altogether. Now, Republican sabotage has left working people holding the bill. Every American who faces higher health care costs this year and next can thank Donald Trump and Congressional Republicans,” said Protect Our Care Campaign Director Brad Woodhouse.

Watch the ad here.

Ad script:

Are you sick and tired of Washington forcing your health care costs to go up? And up. And up.

For more than a year, Donald Trump and Republicans have sabotaged our health care…

… They ordered the government to dismantle the law.

… Then they made it harder for people to enroll.

… Then they proposed ways for insurance companies to deny care and discriminate against people with pre-existing conditions.

Doctors, patient groups, and health experts say the sabotage has a cost: higher premiums for you and your family – nearly 20% higher or more.

All this while their tax bill gave health insurance and pharmaceutical companies huge tax breaks.

Republicans and President Trump promised premiums would be lower but it’s their sabotage that is jacking up rates 20%.

People who work for a living? They just get higher costs.

And they keep going higher.

Enough is enough. Tell Republicans to stop the sabotage.  End the war on our health care.

ashoup
In News

Schumer Puts Trump, Republicans On Notice for Upcoming Rate Hikes

Washington, D.C. – Today on the Senate floor, Minority Leader Chuck Schumer (D-NY) put Republicans on notice: as preliminary rate hikes for next year begin to roll out, Democrats will speak out loudly and often about how  President Trump and Congressional Republicans’ repeal-and-sabotage campaign against Americans’ health care will leave working families holding the bill.

In response, Protect Our Care Campaign Director Brad Woodhouse said: “Sen. Schumer hit the nail on the head – President Trump and his Republican allies in Congress have undertaken a deliberate, aggressive campaign to sow chaos in the health insurance marketplace, and the consequences of their actions will soon become clear. Every American who sees rate hike announcements as soon as next week can thank one group of people: President Trump and Republicans in Congress.”

TRANSCRIPT

“Finally, on another matter, health care. Next week, health insurance companies will begin to announce their initial proposed rates for 2019 in each state across the country. And when they do, every American should remember that President Trump and Congressional Republicans have spent the past year and half trying to sabotage our health care system in a way that could increase costs and decrease access to quality health care.

“It’s true that last summer, the Senate Republican effort to repeal our current health care system and gut Medicaid — an effort that would have left tens of millions uninsured and raised costs on millions more — ended, thankfully for the American people, in failure.

“Despite that legislative failure, President Trump, his administration, and Congressional Republicans have committed several other acts of sabotage, raising premiums and hurting health care, all, it seems to me, for a political vendetta.

“For a long time, the president refused to guarantee that the administration will honor the cost-sharing program, which reduces premiums and out-of-pocket expenses for low-income Americans. He eventually cancelled payments for that program, causing major uncertainty and confusion in the markets.

“Then, Republicans repealed the health care coverage requirement as a part of their tax bill and put nothing in its place. The CBO projects that repealing the coverage requirement could cause rates to increase by as much as 10% and result in millions more people without insurance, so if you can’t get insurance, Mr. or Mrs. American, or if your premiums are going up you’ll know who caused it: the president, and Congressional Republicans by sabotaging a law that the majority of Americans want to see stay on the books.

“And making things worse, earlier this week, the comment period ended for a proposed Trump administration rule that is perhaps that most radical sabotage of our health care system yet — a rule that would expand the availability of junk insurance plans. These junk insurance plans would force higher premiums on people with pre-existing conditions, impose an “age tax” on older Americans, and once again could subject Americans to the devastating effects of medical bankruptcy, which too many people go through now. Many plans might not cover essential services like prescription drugs, maternity care, and mental health services.

“Each of these actions taken by President Trump and Republicans in Congress will raise costs and reduce access. We are truly living under “Trumpcare” today, with no effort by the president or Congressional Republicans to make it better.

“And, unfortunately, starting next week, the American people could see the devastating consequences of a year and half of health care sabotage reflected in the 2019 rates.”

ashoup
In Capitol Hill, News

After PA-18 Defeat, GOP Continues to Sabotage Health Care In So-Called Stabilization Bill

Washington, D.C. – Following the major role health care played in Democratic Congressman-elect Conor Lamb’s upset victory in PA-18, studies showing that Republican sabotage and repeal could raise premiums up to 94%, and despite all that, reports of ongoing Republican efforts to sabotage health care in the upcoming Omnibus,  Protect Our Care Campaign Chair Leslie Dach released the following statement:

“Despite Tuesday’s groundbreaking election in Pennsylvania, the clearest wake-up call yet that GOP health care sabotage is an albatross around the neck of anyone who supports it, Congressional Republicans continue to sabotage Americans’ health care, pushing a stabilization package that would not even begin to undo the damage they have done, and launching new attacks on women’s health.

“Because President Trump and his Republican allies in Congress have been trying to repeal and sabotage our health care for over a year, premiums are up twenty percent and millions of Americans have lost their coverage. But instead of addressing the very real damage they have caused in order to lower premiums, Republicans would rather attacks women’s health and encourage insurance companies to offer junk plans that can deny coverage to people with pre-existing conditions.

“Enough is enough. It’s time for the GOP to stop this war on our health care. If President Trump and Congressional Republicans think that grandstanding on a stabilization bill to fix their own wreckage will give them political cover, they are dead wrong.”

BACKGROUND

THE GOP HAS ATTEMPTED TO SABOTAGE AMERICANS’ HEALTH CARE AT EVERY TURN

From the moment that Donald Trump and Congressional Republicans took power, they’ve done everything they can to repeal and sabotage Americans’ health care. Now they’re claiming they want to stabilize the marketplaces and lower premiums. This false rhetoric is merely the latest ploy from Republicans who have seen the writing on the wall – Americans are furious about the Republican repeal-and-sabotage agenda.

For the better part of a year, President Trump and his Republican allies in Congress tried to repeal the Affordable Care Act legislatively, striving to kick 32 million Americans off of their coverage and returning to the days when insurers had the power to choose who to deny coverage to by removing protections for those with pre-existing conditions.

When this failed, they doubled down on their administrative sabotage, carrying out a closed-door campaign to undermine the law through administrative actions. These included cancelling cost-sharing reduction (CSR) payments designed to lower premiums; using funding for coverage enrollment to launch a propaganda campaign against the law; and attempting to gut open enrollment by reducing the advertising budget by 90% percent, costing an additional 1.1 million people coverage.

These repeal-and-sabotage attempts culminated in December, when the GOP voted to get rid of the individual mandate in their tax scam, ripping insurance away from ten million people and raising premiums double-digits for millions more in order to finance a tax cut for the wealthiest Americans and corporations.

In the time since, President Trump and his allies in Congress have promoted short-term health policies, which neglect key consumer protection provisions such as protections for those with pre-existing conditions and coverage mandates for essential benefits like maternity care; they have supported association health plans (AHPs), which raise costs for people with pre-existing conditions and further destabilize the insurance markets; and they have encouraged states to promote plans which violate the law, promoting and end-run around the ACA despite such procedures being labeled “wildly illegal.”

A study from the Urban Institute found that this sabotage will result in an increase in individual market premiums by an average of 18.2 percent for 2019.

THE GOP HAS REFUSED TO ACT ON MEASURES TO ACTUALLY STABILIZE THE MARKETS

What the GOP has not done through all of this, however, is undertake a genuine effort to actually stabilize the marketplaces.

Following the collapse of the legislative repeal bills in July, Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) began holding hearings on stabilization, bringing in insurance commissioners, governors, and health care experts of both parties. The GOP refused to act on their recommendations, however, instead pivoting to yet another attempt to repeal the ACA through the Graham-Cassidy legislation.

After Graham-Cassidy, which would have kicked twenty million Americans’ off of their insurance and raised premiums double-digits went down in flames, the GOP went through yet another charade on stabilization, refusing to move forward on the bipartisan Alexander-Murray bill to address stabilization despite it having a filibuster-proof majority in the Senate.

A STABILIZATION BILL MUST ACTUALLY STABILIZE THE MARKETPLACE

Now, the GOP says it wants to support stabilization measures. Where was this in the winter, when notices of skyrocketing premiums were going out across the country? Where was this in the fall, when experts were on Capitol Hill lamenting the damage being done to the marketplace? Where was this in the summer, when advocates were begging the GOP to do something rather than push forward yet another repeal bill?

Congressional Republican efforts to undo the damage they and President Trump have caused are wholly insufficient and often turn to failed ideas like high risk pools, which will leave Americans with higher costs and worse coverage. Any bill to stabilize the insurance marketplaces and reverse Republican-caused sabotage must:

  • Expand affordability by increasing the value of premium tax credits and cost-sharing reduction protections;
  • Ensure cost sharing protections fulfill their original purpose of improving affordability and Basic Health Plans are fully funded in order to protect coverage levels;
  • Apply the consumer protections of the Affordable Care Act – such as guaranteed issue, community rating, protections for preexisting conditions – to short term duration plans and protect the essential health benefits from being undermined;
  • Provide for a national meaningful reinsurance program that reduces current premium levels and stabilizes the market;
  • Adequately fund outreach and enrollment efforts;
  • Reject bringing back high-risk pools and Association Health Plans; two failed experiments that would have a destabilizing effect on the marketplace by incentivizing healthier individuals to leave the ACA compliant market, thereby negatively affecting the risk pool and increasing premiums; and
  • Reject punitive and duplicative new anti-choice restrictions on health centers.

Many of the above provisions are included in the recent bills introduced in the Senate by Senator Tammy Baldwin (D-WI) and in the House by Reps. Frank Pallone (D-NJ), Richard Neal (D-MA), and Bobby Scott (D-VA). If Republicans in Congress truly care about stabilization, they will work with Democrats to adopt these provisions and implement a bipartisan, common-sense package to lower premiums and expand coverage options. Anything else is just crocodile tears from elected officials more worried about partisan politics than about Americans’ health.

ashoup
In Administration, News

Backlash Against Proposed Medicaid Cuts Continues

As national backlash to the Trump Administration’s attacks against Medicaid continued, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“We continue to stand against the Trump Administration’s illegal plan to force people off their coverage. The American people want Congressional Republicans to stop stacking the deck against working Americans and for Congress to preserve Medicaid for generations to come.”

Kentucky Rushes to Remake Medicaid as Other States Prepare to Follow

New York Times // Abby Goodnough // February 10, 2018

LOUISVILLE, Ky. — With approval from the Trump administration fresh in hand, Kentucky is rushing to roll out its first-in-the-nation plan to require many Medicaid recipients to work, volunteer or train for a job — even as critics mount a legal challenge to stop it on the grounds that it violates the basic tenets of the program.

At least eight other Republican-led states are hoping to follow — a ninth, Indiana, has already won permission to do so — and some want to go even further by imposing time limits on coverage.

Such restrictions are central to Republican efforts to profoundly change Medicaid, the safety net program that has provided free health insurance to tens of millions of low-income Americans for more than 50 years. The ballooning deficits created by the budget deal that President Trump signed into law Friday and the recent tax bill are likely to add urgency to the party’s attempts to wring savings from entitlement programs.

House Speaker Paul D. Ryan, Republican of Wisconsin, said Thursday that addressing entitlement spending is “what you need to do to fully deal with this debt crisis,” though Senator Mitch McConnell, the Republican majority leader from Kentucky, said he has ruled out doing so this year.

As Kentucky pushes forward, many who work with the poor are worried that the thicket of new documentation requirements in Medicaid will be daunting for low-income people, who may have little education and struggle with transportation, paying for cellphone minutes and getting access to the internet. Not only that, they note, but the new rules will add the type of administrative costs and governmental burdens that Republicans tend to revile.

On a recent rainy Monday, Bill Wagner, who runs primary care clinics in poor neighborhoods here, listened tensely as a state health official explained how the state would enforce the complex and contentious new rules.

The 20 hours a week of work, job training or volunteering? Ten regional work force boards will monitor who complies, said the official, Kristi Putnam.

The monthly premiums of $1 to $15 that many will now owe? The managed care companies that contract with the state will collect them.

The “rewards dollars” that many will need to earn to get their teeth cleaned or their vision checked? They’ll be tracked through a new online platform, where Medicaid recipients will also be expected to upload their work, volunteer or training hours.

“I know it sounds a little bit complicated,” Ms. Putnam conceded as the group meeting with her, which has overseen efforts to enroll Louisville residents in health insurance in the Obamacare era, jotted notes. Someone heaved a sigh.

After four years of signing up thousands of people for coverage under the health law’s expansion of the Medicaid program, Mr. Wagner told the room, “We’re shifting our focus from helping people gain coverage to helping people keep it.”

The rationale of Gov. Matt Bevin and other supporters is that Medicaid was created for the most vulnerable citizens — those who aren’t only poor, but pregnant, elderly, children or disabled — and that for everyone else, working or otherwise engaging in their community will provide dignity and better health. About 500,000 Kentuckians have joined the Medicaid rolls under the Obamacare expansion, and the state estimates some 350,000 will be subject to the new work rules.

While the work requirement is unprecedented in the history of Medicaid, Mr. Wagner and others say they’re just as concerned about other new rules that will be confusing and hard to follow. For example, many adults who don’t pay their small premiums can be locked out of Medicaid for six months, unless they complete a financial or health literacy course. Others will lose access to dental and vision care.

Critics of the plan point to Indiana, which dropped about 25,000 adults from its Medicaid program from 2015 through 2017 for failing to pay premiums there. About half found other coverage, according to state surveys, typically through a job.

Mark Lee Coleman, a diabetic who was visiting a busy clinic run by Family Health Centers, the nonprofit network that Mr. Wagner heads, one recent morning, had heard next to nothing about the new rules. He needed refills on his medications; his blood sugar level had climbed so high without them that he risked falling into a diabetic coma. But first Mr. Coleman needed help figuring out why his Medicaid coverage had been canceled late last year, even before the new rules kicked in.

A counselor at the clinic called the state Medicaid office and found out Mr. Coleman, 49, had forgotten to report a change in income last July, when he switched from a higher-paying job at an Amazon warehouse to a less physically demanding job as a parts driver for Pep Boys, the automotive chain. After she helped him email a pay stub to the office, his coverage was set to be reinstated within a few days.

Once Kentucky’s new rules take effect this spring and summer, Mr. Coleman will also have to report a monthly tally of his work hours to keep his coverage.

Matt and Sarah Burress, and their children, at home in Mount Washington, Ky. Mr. Burress, who owns a small lawn care business and doesn’t work all winter, wonders how the new rules would affect seasonal, self-employed workers. Credit Aaron Borton for The New York Times
He now works 20 hours a week, but he has neuropathy, a numbness and tingling in his hands and feet, and sometimes has trouble walking. Should he cut back his hours, he’d either have to try to get classified as “medically frail,” which would exempt him from the work rule, or lose his coverage.

He hasn’t thought all that through yet. In concept, though, he supports work requirements — as do most voters, polls have found.

“That’s not bad, to tell you the truth,” he said. “If you’re working, that’s good for your health.

As he spoke, he gulped water from a bottle he kept refilling — his extreme thirst a sign of his health crisis. Kara Peers, a case worker at Family Health Centers, tried to gauge what other challenges he and his wife and four children might be facing that could interfere with his ability to manage his disease.

“What about food, sir?” she asked.

“Ah, we’re kind of low,” he replied.

“Utilities — are you able to pay the bill?”

“It can be tough.”

He left with a month’s worth of medications — three for diabetes, one for high blood pressure, paid for by the clinic — and the reassurance that his Medicaid would soon be reinstated. Melissa Mather, the communications director at Family Health Centers, said she worried that patients like him, who already stumble over Medicaid’s paperwork requirements, will be more lost under the new rules. She and Mr. Wagner are also worried about their homeless patients, who will be subject to the rules unless they meet the federal definition of “chronically homeless” and get an exemption.

“This is a very, very big concern from my perspective — talking about the complexity of these changes when a lot of the folks we deal with have lives that are in chaos already,” she said.

For now, there are more questions than answers, as state workers like Ms. Putnam hustle to iron out all the details, let alone explain them. Like Mr. Carter, Sarah and Matt Burress got Medicaid under the Affordable Care Act after going uninsured for years. The coverage may have saved Mr. Burress’s eyesight — though only 29, he was diagnosed with advanced glaucoma when he went for a routine eye check shortly after becoming insured in 2015.

Now he’s worried about keeping his coverage because he runs his own small lawn care business, working irregular hours with a hiatus that lasts all winter.

“We haven’t heard how it will work for seasonal self-employed workers,” said Ms. Burress, who works part time as an office manager. “Do his clients have to say, ‘Yeah, he mowed my grass this week?’ Part of it feels like they’re trying to catch you, by burying people in paperwork and making it a huge inconvenience.”

She added that she and her husband plan to remain on Medicaid only until his business starts turning a profit. “This was never meant to be our permanent fix,” she said, not the “dead-end entitlement trap” that Mr. Bevin rails against.

Most people on Medicaid do work, research has found; Those who don’t often are disabled, even though they may not qualify for Social Security Disability Insurance. Sheila Penney, 54, has cycled in and out of jobs for years with chronic depression and anxiety that started when she lost her father at 16. She has worked as a package handler, a boat reservations manager and even a health insurance enrollment counselor, helping patients at Family Health Centers sign up for Medicaid back in 2014.

But she has not worked at all for the last two years, focusing instead on getting her mental health problems under control and relying on her mother to pay her rent. Now she’s a plaintiff in a lawsuit filed last month to stop Kentucky’s new requirements from taking effect. With Medicaid, she is able to go weekly to a therapist and monthly to a psychiatric nurse practitioner who adjusts her medication, she said.

“I’m wanting to go back to work, but if I was told, ‘You have to go back,’ I do think that would step up my anxiety,” Ms. Penney said. “Volunteering would be less pressure, but you would still want to be consistent and reliable.”

Caring full time for a child or other family member can also count toward the work requirement, as can going to school full time, though neither will apply to Ms. Penney.

She expects she will find a way to pay the new premiums she’ll owe under the plan — $4 a month — but predicts it will mean going without other necessities at times. (She is poor enough under the new rules that if she fails to pay them, she will lose access to dental and vision coverage but not be dropped from coverage altogether.)

“I was at the store yesterday, looking in my wallet and going, ‘Do I have enough money for dog food?” she said. “The thought of taking on even one more expense feels overwhelming.”

For Kimberly Dandridge, who overcame breast cancer and addiction to crack cocaine earlier in her life, Medicaid is a bridge while she works toward a job that comes with benefits. Ms. Dandridge, 53, works 30 hours a week as an administrative assistant, and said she would have no trouble meeting the premium and work requirements — but could relate to those who might.

“I remember there was a time I was just down, in the gutter, so low and broken,” she said. “If people like that need medical attention, just let them get it.”

 

ashoup
In Administration, News

State of American Health Care Threatened by Trump & GOP’s War on Health Care

To: Interested Parties

From: Leslie Dach, Campaign Chair, Protect Our Care

Date: January 29, 2018

Re: State of American Health Care Threatened by Trump & GOP’s War on Health Care

On Tuesday, President Trump will deliver his first official State of the Union address. We anticipate he will gloat about his efforts to undo the Affordable Care Act (ACA), take insurance away from millions of people in order to fund tax cuts for big corporations and the wealthiest , cut hundreds of billions of dollars from care for the elderly, children, and people with disabilities, and promise a continuation of his partisan approach to health care in 2018. But his agenda is overwhelmingly unpopular. The American people are saying “enough is enough.” We demand that the Trump Administration and Congress stop their war on our care.

The 2017 Republican War on Health Care

Last year, the Trump Administration and its Republican allies in Congress waged a war on our health care. Their attacks included five attempts to repeal the Affordable Care Act, proposing to end Medicaid as we know it, and sabotaging our health care system. Under their agenda, millions would lose coverage, costs would increase, especially for those with pre-existing conditions, and insurers would be able to skirt the tough rules that currently protect consumers thanks to the health care law. At the end of the first year of the Trump Administration, 3.2 million people have lost their health coverage, and premium rates spiked because of uncertainty President Trump injected into the individual insurance marketplaces. Here is what the first year of Trump’s partisan war on health care looked like:

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.

February 2017

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

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.

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.

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.

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.

July 2017

  • The Trump Administration uses funding intended to support health insurance enrollment to launch a multimedia propaganda campaign against the Affordable Care Act.

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.

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.”

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.

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.

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.

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.

Despite Attacks, the Affordable Care Act Continues to Help Americans

While the Trump Administration and its Republican allies in Congress had some success last year in their partisan war on health care, the Affordable Care Act is still here, and it is working. The reason the law survived is simple: the American people made their voices heard last year at town halls, rallies and the voting booth, thwarting the partisan repeal effort in Congress.

Despite Trump-led attacks, and because the American people spoke up, insurers still cannot deny or drop coverage because of a pre-existing condition; tax credits are still available to help people pay for coverage; young adults can still stay on their parents’ plan until age 26; the Medicare prescription drug donut hole is still closed; and Medicaid is still a lifeline for millions of seniors, children and people with disabilities. The recent open enrollment period saw nearly 9 million people sign up for coverage in the federal marketplaces, despite the Trump Administration’s decisions to cut the open enrollment period in half and refuse to promote it.  While any law can be improved, and the ACA is no exception, it continues to provide affordable health care and vital protections to millions of Americans.

Enough is Enough: Stop the Partisan War on Health Care

The Trump Administration and Republicans in Congress need to listen to the American people who are saying ‘enough is enough.’ It’s time to stop the partisan health care repeal effort and work on bipartisan solutions. If Republican politicians do not listen, they do so at their own peril. Recent polling by Protect Our Care showed that health care is far and away the number one issue on voters’ minds, and is one of the main reasons why voters disapprove of the job Republicans in Washington are doing.

Last week, Sen. Lisa Murkowski (R-Alaska) said, “I don’t think we should be spending time trying to do repeal and replace of Obamacare.” Her colleagues in Congress, and President Trump himself, would do well to listen to her.

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