House To Consider Package of Legislation that Fix None of the Health Care Problems They’ve Created, While Giving More Tax Cuts to the Wealthy
Washington, DC – Following the announcement from Leader Kevin McCarthy that next week will be “health care week” in the chamber that gloated about repealing protections for people with pre-existing conditions, jacking up premiums and reducing coverage, Brad Woodhouse, executive director of Protect Our Care released the following statement:
“Here’s what the Republican so-called ‘health care’ agenda has done: raised premiums, gutted protections for people with pre-existing conditions and handed billions of dollars in tax breaks to insurance companies and drug companies while they jacked up costs and raked in record profits. Republicans know that when they face their constituents this fall, they will be facing a political mess of their own making. Next week is a year to the day that Americans rose up to defeat health care repeal in the Senate, and all this time later, poll after poll shows health care to still be the top issue for American voters. These bills do nothing to fix the problems they created and are an obvious attempt to create political cover they know they desperately need. These bills are designed to distract from the fact that every chance they get, Republicans vote to repeal protections for people with pre-existing conditions, jack up premiums, reduce coverage and give kickbacks to insurance companies, drug companies and the wealthy.”
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.”
“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.”
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]
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]
Washington, D.C. – New data from America First Policies, compiled by President Trump’s own pollsters, found lowering the cost of health care to be the top issue voters want addressed in 2018, with these voters favoring fixes to the Affordable Care Act over repeal by a 47 to 34 percent margin. Protect Our Care Campaign Director Brad Woodhouse released the following statement in response:
“When President Trump’s own pollsters find that keeping and fixing the Affordable Care Act has a commanding double-digit advantage over repeal and that rising health care costs are the number-one issue on voters’ minds, it couldn’t be more clear that the Republican war on health care is failing. People across the country want to keep a health care system that stops insurance companies from discriminating against people with pre-existing conditions, imposing lifetime caps, or dropping coverage – and despite the rhetoric that Republicans have been pushing for nearly a decade, the law’s popularity only continues to rise.
“The GOP would do well to listen to the President’s own pollsters. No matter who conducts the polling, the results are clear: Americans continue to say they want Congress to lower their premiums and protect the ACA, repeating loudly and clearly: enough is enough – end the war on our health care.”
In honor of the Affordable Care Act being signed into law eight years ago, last week the Protect Our Care coalition celebrated ACA Anniversary Week, highlighting the health care achievements made across America under the ACA and making clear that we won’t go back and erode this progress.
SUPPORTERS STAND UP FOR THE ACA: WE WON’T GO BACK
All across the country, from Alaska to Tennessee to the nation’s Capitol, health care voters held rallies for the ACA Anniversary Week of Action to made their voices heard and tell elected officials we won’t go back on eight years of progress.
ALASKA
Protect Our Care and the Alaska Grassroots Alliance held a rally in Anchorage.
ARIZONA
Protect Our Care and Planned Parenthood Advocates of Arizona held a rally in Phoenix. They were joined by Dr. Wylie Carhartt of the Mountain Park Health Center Family Practice, Phil Pangrazio, CEO of Ability 360, Steve Gomez, whose child received a heart transplant under the ACA, and cancer survivors.
COLORADO
Protect Our Care held rallies in Denver and Grand Junction, visiting Sen. Cory Gardner’s Denver office and Rep. Scott Tipton’s Grand Junction office.
MAINE
Protect Our Care joined State Senator Dr. Geoff Gratwick and Nurse Practitioner State Rep. Anne Perry to hold a rally in Bangor. Rep Perry expressed her disappointment in Senator Susan Collins’ recent sponsorship of legislation which would weaken women’s care and her support for the ACA, saying, “Even though there may be complaints of more spent because of Medicaid, we will have a healthier population. And I don’t know of one business who doesn’t want a healthier workforce.”
Protect Our Care, OFA, Nevada Advocates for Planned Parenthood Affiliates, the Alliance for Healthcare Security, and Battle Born Progress held rallies in Las Vegas and Reno. They were joined by representatives from Positively Kids, the Children’s Advocacy Alliance, SmartBuy Insurance, and the Nevada Alliance for Retired Americans, as well as cancer survivors and health care advocates.
Protect Our Care and For Our Future joined with DeWayne Lee of Healing Heart, local pastors, and city councilmembers to hold rallies in Cincinnati, Mansfield, and Toledo, outside of Sen. Portman’s Toledo office.
Protect Our Care and the Southern Christian Coalition joined with physicians, registered nurses, local faith leaders, and Sara Scott, whose son has asthma and progressive heart disease and whose daughter has developmental disabilities, neither of whom would be insurable without the ACA, to hold rallies in Nashville and Chattanooga, outside Sen. Lamar Alexander’s office.
Protect Our Care, West Virginians for Affordable Health Care, the West Virginia Citizen Action Group, Our Children, Our Future, and West Virginians Together for Medicaid joined with staff from the office of Senator Joe Manchin to hold a rally in Charleston.
HOUSE DEMOCRATS JOIN HEALTH CARE GROUPS TO CELEBRATE ANNIVERSARY
Last Thursday, Leader Nancy Pelosi, Whip Steny Hoyer, Assistant Minority Leader Jim Clyburn, Rep. David Cicilline, and Rep. Brenda Lawrence joined Protect Our Care, Little Lobbyists, Health Care Voter, Doctors for America, and other health care advocates at a press conference celebrating the millions of lives which have benefited since the ACA was signed into law.
POLLING SHOWS: HEALTH CARE A TOP ISSUE, VOTERS BACKING PRO-ACA CANDIDATES Last week, Public Policy Polling released a series of polls which found that not only is health care a top issue for voters across the country, but in battleground states pro-repeal candidates are being rejected. The polls found the following results:
In Arizona, health care is a top issue for 68% of voters, with 21% saying it is the most important issue. In a hypothetical Senate election, Democrat Kyrsten Sinema leads pro-repeal candidate Martha McSally 46-41
In Nevada, health care is a top issue for 65% of voters, with 27% saying it is the most important issue. In a hypothetical Senate election, Democrat Jacky Rosen leads pro-repeal Dean Heller 44-39.
In Pennsylvania, health care is a top issue for 71% of voters, with 25% saying it is the most important issue. In a hypothetical Senate election, Democrat Bob Casey leads pro-repeal candidate Lou Barletta 54-36.
In Tennessee, health care is a top issue for 71% of voters, with 31% saying it is the most important issue. In a hypothetical Senate election, Democrat Phil Bredesen leads pro-repeal candidate Marsha Blackburn 46-41.
In Wisconsin, health care is a top issue for 72% of voters, with 25% saying it is the most important issue. In a hypothetical Senate election, Democrat Tammy Baldwin leads pro-repeal candidates Leah Vukmir and Kevin Nicholson 51-39 and 51-38, respectively.
Today, the Pew Research Center released a new survey that finds the number-one pocketbook issue for Americans of all income brackets is health care, confirming the vital importance of this issue to American families. The new data echoes a body of recent polling that indicates health care is a top issue heading into the 2018 midterm elections.
Key findings include:
More than half of those surveyed said that health care affects their household’s financial situation “a lot,” the only issue which more than half of Americans rated a key economic issue.
Health care is “a top household financial issue” across all income levels, with 53% of those earning more than $100,000 and 52% of those earning $30,000 or less saying it has a large effect.
This morning, on the 8th anniversary of the Affordable Care Act’s signing, the Kaiser Family Foundation’s March Health Tracking Poll finds that the law’s popularity remains above water, with half of Americans having a favorable opinion. The poll also confirms that Americans want Congress to improve the law, not to repeal it, with 63% saying Republicans in Congress should focus their efforts on improvements and only 32% supporting repeal.
“Today’s tracking poll confirms that after eight years, the Affordable Care Act has stood the test of time and is now woven into the fabric of the American health care system. Two-thirds of the public want to see the law improved and strengthened. Unfortunately, just this week, Republicans in Congress continued to ignore Americans’ desire to improve health care by refusing to pass bipartisan stabilization legislation to undo some of the rate hikes President Trump has caused with his relentless sabotage of the Affordable Care Act. It’s time for Republicans to listen to their constituents, who want Congress to put the partisan fight over the Affordable Care Act in the rearview mirror once and for all, and start working on bipartisan fixes and improvements. And it’s time for President Trump to face up to the facts and stop his Administration’s ongoing sabotage of our health care system,” said Protect Our Care Campaign Director Brad Woodhouse.
On the eighth anniversary of the Affordable Care Act being signed into law, Protect Our Care Campaign Chair Leslie Dach released the following statement:
“Eight years after the Affordable Care Act became law, twenty million people have gained coverage; the uninsured rate has been cut in half; and out-of-pocket spending has fallen double digits while medical bankruptcies are becoming more and more rare. Because of the ACA, insurers can no longer deny coverage to the one-in-four Americans with a pre-existing condition or drop coverage due to a yearly or lifetime limit; plans must cover essential health benefits; women cannot be charged more than men; and young adults can stay on their parent’s plan until age 26.
“Today, not only is the ACA more popular than ever, but health care has become a driving factor in elections across the country. The two times Medicaid expansion was on the ballot, in Maine and Oregon, it won overwhelmingly, and voters have cited health care as a top issue, powering Democratic victories in Virginia, New Jersey, Alabama, Wisconsin, and Pennsylvania. And despite almost a decade of attacks on the law, the American people are more united than ever in favor of expanding access to health care.
“Despite all this, Trump Administration and Congressional Republicans continue their relentless repeal-and-sabotage campaign, raising premiums and out of pocket costs for millions including demanding an age tax for older Americans, taking away protections for people with pre existing conditions, and gutting Medicaid.
“The past eight years have shown just how much progress has been made in the American health care system, and the past year has made clear just how much Americans value the quality, affordable care provided by the ACA. The Affordable Care Act made health care in America immensely better, and we won’t go back.”
Republicans Bear 100% of Responsibility for Avoidable Premium Increases Set to Hit Millions of Middle Class Families This Fall
BEFORE PRESIDENT TRUMP’S SABOTAGE, THE MARKETS WERE STABILIZING
Trump White House Today Admits The Marketplaces Were Stabilizing. “After an initial adjustment period, insurers’ financial health, as measured by their stock prices, surpassed earlier levels … While insurers initially incurred losses in the ACA marketplaces as they adjusted to new regulations and a relatively unhealthy risk pool, insurers are now profiting on the individual market as well.” [CEA, 3/18/18]
In 2017, Congressional Budget Office Reports: ACA Market Is Stable. “The subsidies to purchase coverage combined with the penalties paid by uninsured people stemming from the individual mandate are anticipated to cause sufficient demand for insurance by people with low health care expenditures for the market to be stable.” [Congressional Budget Office, 3/13/17]
In 2017, S&P Global Reports: ACA Market Will Remain Stable So Long As The Trump Administration Is Not “Disruptive.”S&P Global repeatedly reports that “2016 results and the market enrollment so far in 2017 show that the ACA individual market is not in a ‘death spiral.’ However, every time something new (and potentially disruptive) is thrown into the works, it impedes the individual market’s path to stability.” [S&P Global, 4/7/17]
THEN REPUBLICAN REPEAL ATTEMPTS UNDERMINED THE MARKET
Ongoing Republican repeal attempts throughout 2017 created uncertainty that insurance companies said forced them to hike premiums: “Obamacare markets are undergoing a slow-motion meltdown as Republicans stoke a climate of uncertainty while struggling to agree on their own plan for overhauling American health care.” [Politico, 6/8/17]
AND IF THAT WASN’T ENOUGH, PRESIDENT TRUMP STARTED TO SABOTAGE THE MARKETS, WHILE REPUBLICANS ON THE HILL DID NOTHING TO STOP IT
On October 13, 2017, President Trump Ended Cost Sharing Reductions (CSRs), Payments To Insurers That Help Lower Income Americans Afford Health Coverage In The ACA Marketplace. [Washington Post, 10/13/17]
Kaiser Family Foundation: Lack Of CSR Payments Resulted In Surcharge In Premiums Of 7.1 To 38 Percent. “As shown in Table 1, among those insurers that specify the surcharge on silver plans for the discontinuation of CSR payments, the amount of the surcharge ranges from 7.1% to 38%.” [KFF, 10/27/17]
THEN CONGRESS PASSED A TAX CUT FOR THE WEALTHY AND CORPORATIONS THAT ALSO RAISED PREMIUMS AND WILL TAKE COVERAGE AWAY FROM MILLIONS OF PEOPLE
Last December, Congressional Republicans Passed A Tax Bill That Strips 13 Million Of Insurance And Raises Premiums By Double Digits. “The Senate bill’s repeal of the individual mandate (the requirement that most people get health coverage or pay a penalty) would cause 13 million more people to become uninsured, raising the uninsured rate among the non-elderly from 11 percent to about 16 percent, the Congressional Budget Office (CBO) estimates. It also would raise premiums by an average of 10 percent in the individual market by 2027, according to CBO.” [CBPP, 12/8/17]
Urban Institute Predicts Near 20 Percent Premium Increases Next Year And Millions Of Americans Losing Coverage Due To The Repeal Provision In The Tax Law And Trump Sabotage. According to a study by the non-partisanUrban Institute, Republican health care sabotage is set to artificially inflate premiums by double digits for millions of families this fall. The study forecasts an 18.2% increase in 2019 premiums for Affordable Care Act plans and millions of Americans losing their coverage because the Trump and Congress repealed the individual mandate and the Trump Administration’s proposal to sell junk plans that do not meet ACA requirements. [Urban Institute, 3/14/18]
CONGRESSIONAL REPUBLICANS BROKE THEIR PROMISE TO PASS A STABILIZATION BILL IN 2017
After Being Promised To Have A Stabilization Bill As Part Of The Tax Bill, Sens. Alexander And Collins Issued A Statement Saying They Asked Sen. McConnell To Postpone Stabilization Until 2018. ‘Rather than considering a broad year-end funding agreement as we expected, it has become clear that Congress will only be able to pass another short-term extension to prevent a government shutdown and to continue a few essential programs,’ said the Senators. ‘For this reason, we have asked Senator McConnell not to offer this week our legislation which independent analysts Avalere and Oliver-Wyman say would reduce premiums by about 20 percent for the 9 million Americans who have no government subsidies to help them buy insurance in the individual market. Instead, we will offer it after the first of the year when the Senate will consider the omnibus spending bill, the Children’s Health Insurance Program reauthorization, funding for Community Health Centers, and other legislation that was to have been enacted this week.’” [Alexander and Collins Statement, 12/20/17]
HOUSE REPUBLICANS INDICATED THEY WOULDN’T SUPPORT STABILIZATION
Speaker Ryan Opposed Efforts To Stabilize The ACA Dating Back To October 2017. Last October, Ryan spokesman, Doug Andres, said, “The speaker does not see anything that changes his view that the Senate should keep its focus on the repeal and replace of Obamacare.” [Matt Fuller, Huffington Post Reporter, 10/18/17]
House Conservatives Called Alexander-Murray Stabilization Bill A “Nonstarter.” “House conservatives appear united in opposition to the health care stabilization proposal crafted by Sens. Lamar Alexander and Patty Murray. ‘Right now it’s a nonstarter,’ House Freedom Caucus member Dave Brat said Tuesday during a Conversations with Conservatives press event.” [Roll Call, 10/24/17]
Rep. Tom Cole: “The Idea You’re Going To Vote For Billions Of Dollars To Stabilize A System You Never Supported In The First Place — Pretty Hard To Choke Down.” “In addition to the dispute over abortion language, GOP lawmakers were reluctant to sign off on provisions that shored up the Affordable Care Act, a law they all opposed. ‘Nobody in that room voted for Obamacare, so the idea you’re going to vote for billions of dollars to stabilize a system you never supported in the first place — pretty hard to choke down,’ said Rep. Tom Cole (R-Okla.).” [Washington Post,3/19/18]
PRESIDENT TRUMP AND SPEAKER RYAN REPEATEDLY TRIED TO DERAIL STABILIZATION NEGOTIATIONS BY ADDING MORE CONSERVATIVE DEMANDS
September 2017: “House Speaker Paul Ryan And The White House Have Informed Senate Republican Leaders That They Oppose A Bipartisan Plan To Stabilize Obamacare Being Written In The Senate.” “House Speaker Paul Ryan and the White House have informed Senate Republican leaders that they oppose a bipartisan plan to stabilize Obamacare being written in the Senate, according to Trump administration and congressional sources, in a clear bid to boost the Senate’s prospects of repealing the health law.” [Politico, 9/19/17]
March 2018: The White House Released A List Of Conservative, Deal-breaking Demands To Stabilization. In the middle of bipartisan negotiations on stabilization, the White House released a list of its conservative 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
Imposing 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]
The Hill: White House pushes for conservative changes to ObamaCare fix
Politico: White House pitch to bolster Obamacare includes tough trade-offs for Democrats
Wall Street Journal: Trump Administration Pushes Conservative Goals in Health-Care Market Changes
Vox: The White House might have just blown up the last best hope to stabilize Obamacare
Talking Points Memo: White House Demands Threaten Bipartisan Effort To Bring Down Health Premiums
NOW, THE LATEST REPUBLICAN STABILIZATION PLAN THREATENS PRE EXISTING CONDITIONS AND ESSENTIAL HEALTH BENEFITS
AND, REPUBLICANS ADDED A PARTISAN POISON PILL THEY KNEW WOULD TORPEDO BIPARTISAN STABILIZATION NEGOTIATIONS
Statements
Sen. Patty Murray: “They’re Moving Further And Further Away From Their Original Goal.” “We’re not going to give them an expansion of Hyde and say that’s a goal we all agree to…They’re moving further and further away from their original goal, which was to make sure people have lower costs and access.” [Washington Post, 3/8/18]
Sen. Patty Murray: “They Keep Throwing Obstacles In.” “If we would just go back to the basic premise here and do what we all agreed to do, we’d be able to get this done.” [Washington Post, 3/8/18]
Speaker Paul Ryan Refuses To Introduce Stabilization Without Restricting Women’s Access To Health Care. “House Speaker Paul Ryan (Wis.) told his GOP conference at a Tuesday meeting that he wouldn’t bring the measures to the floor without accompanying language known as the Hyde Amendment, ensuring taxpayer dollars can’t go toward plans that cover abortions.” [Washington Post, 3/8/18]
Headlines
Washington Examiner: House Republicans seek anti-abortion protections in Obamacare stabilization bills
Huffington Post: Another Obamacare Stabilization Bill Is In Trouble, This Time Because Of Abortion
BY REFUSING TO ADDRESS THEIR OWN SABOTAGE WITH BIPARTISAN STABILIZATION, REPUBLICANS NOW BEAR RESPONSIBILITY FOR THE CONSEQUENCES
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]
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]
Washington Post: “Trump’s Not Going To Be Able To Avoid Blame For Kneecapping Obamacare.” [Washington Post, 10/13/17]
“After Months Of Pinning The Blame For Obamacare’s Shortcomings On Democrats And Watching His Own Party Fail To Act, President Donald Trump Just Took Ownership Of A Struggle That’s Consumed Republicans For Seven Years.” “After months of pinning the blame for Obamacare’s shortcomings on Democrats and watching his own party fail to act, President Donald Trump just took ownership of a struggle that’s consumed Republicans for seven years. Trump’s decision late Thursday to end government subsidies to insurers to help lower-income Americans afford to use their coverage under the Affordable Care Act was the most drastic step he’s taken to undermine his predecessor’s signature achievement. It also lobbed a live bomb into the laps of Republicans lawmakers 13 months before congressional elections after he publicly berated the party’s Senate leadership for being unable to keep a longstanding promise to repeal the law.” [Bloomberg, 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]
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.
