Protect Our Care Campaign Director Leslie Dach released the following statement after the nonpartisan Congressional Budget Office confirmed that a decision by President Trump to cancel critical health care payments, known as Cost-Sharing-Reductions, would inject substantial uncertaintyin the insurance markets, force premiums to increase by 20% next year and 25% by 2020 and increase costs to the taxpayer by nearly $200 billion over ten years.
“This is the latest confirmation that the Trump administration’s plans to sabotage our health care will hurt millions of middle class Americans — bringing substantial uncertainty to the health insurance markets and forcing even higher double digit premium hikes. President Trump seems to prefer playing political sabotage games over doing his job of lowering costs and improving our health care. Whether he tries to repeal health care by legislation or by sabotage it means higher costs and less coverage for American families — and he will be responsible for those results.
“It’s time for all Republicans in Congress to stand up to Trump’s sabotage agenda, work with Democrats and pass real market stabilization reforms to improve our health care system.”
It looks like Tom “Tall Tales” Price has struck again.
While pretending to care about victims of the opioid epidemic yesterday, HHS Secretary Tom Price said “nobody is interested in cutting Medicaid.”
He must have forgotten that his own health care repeal bills would gut Medicaid by more than 25% and that the Trump administration budget cuts it even further.
This is just the latest Whopper of a lie from the man in charge of our health care but who seems incapable of telling the truth about it. See the rest here.
The FACTS:
Congressional Budget Office: The Senate BCRA bill cut Medicaid by $756 billion over the next decade compared to the ACA, or a 26 percent reduction.
From: Leslie Dach, Protect Our Care Campaign Director
Re: Health Care Debate: A Sea Change
Date: August 4, 2017
This past week represented a sea change in the effort to repeal health care that few would have predicted when President Trump and Republicans launched their partisan repeal campaign in January. While most observers believed Trump and Republicans in Congress would muscle through legislation to repeal Obamacare by hook or by crook, in the relative blink of an eye, repeal has been declared all but dead, Trump has become increasingly isolated on the issue and the grassroots energy to protect and improve the law has continued unabated.
Here are three things you need to know about the state of the Republican repeal attempts in Washington:
First, Congress’s push to repeal health care is on life support, if not completely dead, with more members urging bipartisan cooperation. The momentum in Congress continued to shift away from repeal this week, with Republicans in both the House and Senate signaling that they favor a bipartisan process to improve our health care system going forward. Senators Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) announced they are holding a series of bipartisan hearings in September to strengthen and stabilize the individual market.
Senate Majority Whip John Cornyn (R-TX): “And I Think, Frankly, Bipartisan Solutions Tend To Be More Durable.” “‘There’s a lot the American people expect of us, but we’ve seen with fragile majorities in the Senate that we are forced to work together to try to solve these problems. And I think, frankly, bipartisan solutions tend to be more durable,’ Cornyn said. Democrats have sent Republicans multiple letters on healthcare that asked, for example, for an all-Senate meeting and suggested a list of rooms where they could hold a public hearing.” [The Hill, 8/1/17]
Senate HELP Committee Chair Lamar Alexander (R-TN): “This Committee Will Hold Hearings…On The Actions Congress Should Take To Stabilize And Strengthen The Individual Health Insurance Market.” “This committee will hold hearings beginning the week of September 4th on the actions Congress should take to stabilize and strengthen the individual health insurance market so that Americans will be able to buy insurance at affordable prices in the year 2018. We will hear from state insurance commissioners, patients, Governors, health care experts and insurance companies. Committee staff will begin this week working with all of our committee members to prepare for these hearings and discussions.” [Alexander and Murray Statement, 8/1/17]
Senate Finance Committee Chair Orrin Hatch (R-UT) On Moving Forward On Health Care: “I Hope It’ll Be Bipartisan.” [Politico, 7/31/17]
The American people reject Republican partisan repeal and want Congress to work in a bipartisan way, and they are holding Republicans accountable for their votes.
Quinnipiac Poll: “Voters Disapprove 5–1 Of GOP Handling Of Health Care.” “American voters disapprove 80–15 percent of the way Republicans in Congress are handling health care. Even Republicans disapprove 60–32 percent. Voters disapprove 64–25 percent of Republican ideas to replace Obamacare.” [Quinnipiac Poll, 8/3/17]
And in states around the country, people held rallies, called their members of Congress, and showed they will not stop until Congressional Republicans, President Trump and HHS Secretary Tom Price quit their game of repeal and sabotage.
Second, President Trump and his administration are increasingly isolated on an island of their own making. Trump and HHS Secretary Tom Price continue to advocate for legislative repeal when Republicans in Congress have made clear they want to move on. Absent Congressional action, the administration continues to sabotage the marketplaces, threatening to torpedo the insurance markets by defaulting on cost-sharing reduction payments that lower out-of-pocket costs and deductibles for a majority of those enrolled on the marketplaces. Republicans in Congress strongly disagree and have directly said the administration should continue funding the payments.
Senate Majority Leader Mitch McConnell (R-KY): “Some Kind Of Action With Regard To The Private Health Insurance Market Must Occur. No Action Is Not An Alternative.” “‘If my side is unable to agree on an adequate replacement, then some kind of action with regard to the private health insurance market must occur,’ McConnell said. ‘No action is not an alternative. We’ve got the insurance markets imploding all over the country, including in this state.’” [Washington Post, 7/6/17]
Senate HELP Committee Chair Lamar Alexander (R-TN): “Without Payment Of These Cost-Sharing Reductions, Americans Will Be Hurt.” “And Tennessee Senator Lamar Alexander, a Republican who chairs the influential health committee, said this week that he urged the president to make the payments through September so Congress could work on stabilizing Obamacare in the short-term. That bipartisan solution ideally should also include funding for the subsidies through 2018, he said. ‘Without payment of these cost-sharing reductions, Americans will be hurt,’ Alexander said.” [CNN, 8/4/17]
Senate Finance Committee Chair Orrin Hatch (R-UT): “I Think We’re Going To Have To Do That.” “President Donald Trump has been urging lawmakers not to drop the matter, despite a series of failed votes last week. ‘There’s just too much animosity and we’re too divided on healthcare,’ Hatch said in an interview with Reuters. He said he would prefer Congress not appropriate cost-sharing subsidies that help make Obamacare plans affordable but added, ‘I think we’re going to have to do that.’” [Reuters, 7/31/17]
Sen. Ron Johnson (R-WI): The Senate Should “Bite The Bullet And Stabilize Those Markets.” “Sen. Ron Johnson (R-Wis.) has for months called for a bipartisan stabilization bill that would guarantee funding for ObamaCare payments, known as cost-sharing reductions, to insurers. Those payments are key to avoiding premium spikes and keeping insurers in the markets. Johnson said Tuesday that he hopes the GOP can pass something next week, but if not, ‘bite the bullet and stabilize those markets.’” [The Hill, 7/13/17]
House Ways And Means Chair Kevin Brady (R-TX): “Simply Letting Obamacare Collapse Will Cause Even More Pain For [People].” [Brady Statement, 7/28/17]
House Energy And Commerce Committee Chair Greg Walden (R-OR): “I Will Do Everything I Can To Make Sure That The Cost-Sharing Reduction Payments Get Made.” “Likewise, Mr. Walden said last month, ‘I will do everything I can to make sure that the cost-sharing reduction payments get made.’ That, he said, is ‘an obligation we have not only to the insurers,’ but also to consumers, and ‘we cannot leave them high and dry.’” [New York Times, 4/10/17]
House Appropriations Health Subcommittee Chair Tom Cole (R-OK) On Making CSR Payment: “My Personal Opinion Is Yes.” ‘’I don’t think anybody wants to disrupt the markets more than they already are,’ Mr. Cole said in an interview. ‘It’s a very unstable market.’ Asked if he thought Congress should provide the money, Mr. Cole said, ‘My personal opinion is yes.’” [New York Times, 4/10/17]
Rep. Charlie Dent (R-PA) On Not Paying CSR: “I Think That Would Be A Mistake.” “First, withholding that money would ultimately hurt a lot of people making between 150, 200 percent of the poverty level trying to afford insurance. So, I think that would be a mistake.” [Dent Interview on CNN’s New Day, 7/31/17]
Republican and Democratic governors, the chief executives of their respective states, do not agree with the Trump/Price approach:
National Governors Association: “The Administration Has The Opportunity To Stabilize The Health Insurance Market Across Our Nation And Ensure That Our Residents Can Continue To Access Affordable Health Care Coverage.” “The Administration has the opportunity to stabilize the health insurance market across our nation and ensure that our residents can continue to access affordable health care coverage. A first critical step in stabilizing the individual health insurance marketplaces is to fully fund CSRs for the remainder of calendar year 2017 through 2018. This is a necessary step to stabilize the individual marketplaces in the short term as Congress and the Administration address long-term reform efforts.” [NGA, 8/2/17]
And political analysts and journalists have noted Trump’s self-created isolation, too.
New York Times: “‘Time to Move On’: Senate G.O.P. Flouts Trump After Health Care Defeat” [New York Times, 8/1/17]
Associated Press: “Senate Republicans Slowly Turning Their Backs On Trump” [Associated Press, 8/2/17]
Wall Street Journal: “Senate Republicans Rebuff Donald Trump’s Health-Care Push” [Wall Street Journal, 8/1/17]
The HIll: Senate Republicans Brush Off Trump’s Healthcare Demands [The Hill, 8/1/17]
It’s clear that Trump and the administration will need to stop burning political capital on a failed gambit that will harm millions of Americans and that the legislative branch won’t get on board with.
Lastly, Americans who stood up and stopped repeal from happening aren’t letting up. Angry at the legislative failure to repeal the ACA, Trump and Price could respond by continuing their ongoing sabotage of people’s health care. They’ve threatened to default on paying cost-sharing reductions, which would raise premiums, spook insurers and hit the middle class hard. They might continue illegally using taxpayer funds to undermine the law. They could further curtail outreach and advertising efforts before Open Enrollment for HealthCare.gov, or continue producing misleading analysis of the ACA, or employ other sinister tactics to weaken current law and put people’s health care at risk.
But people are wise to what Trump and Price are trying to do.
This August recess, thousands of Americans will continue to make their voices heard.
They’ll attend local events across the country as part of Save My Care’s nationwide bus tour.
Los Angeles Times: “Protesters In L.A. And Across The Country Rally To Protect Healthcare From Future Threats.” [LA Times, 7/29/17]
Phoenix Fox 10: “‘Our Lives On The Line’ Rally In Phoenix Supports Affordable Health Care.” [Phoenix Fox 10, 7/29/17]
The Guardian: “Activists Refuse To Slow Resistance After Stymying Republican Healthcare Plan.” [The Guardian, 7/29/17]
They’ll canvass their neighborhoods, making sure their neighbors know how their Senators voted. They’ll continue to visit Congressional town halls across the country, asking their elected leaders to work on bipartisan ways to improve, not tear down, our health care system.
The sea change over the last seven days in how Republicans are approaching health care is significant. Let’s hope when they return from recess, they’ll be guided by the wishes of voters who depend on our health care system, not by the wishes of an increasingly isolated President who’s made clear he has little understanding of health care and equally little desire to remedy that.
Despite President Trump’s twitter threats demanding the GOP continue with partisan repeal efforts, Republican Senators — including many in leadership — are acknowledging what the American people have said all along: it’s time to abandon partisan repeal. With the announcement from Sens. Lamar Alexander and Patty Murray that bipartisan hearings will begin the first week of September, it’s clear the only path forward on health care is a bipartisan one.
Sen. Orrin Hatch, Senate Finance Committee Chairman: “There’s just too much animosity and we’re too divided on healthcare… I think we ought to acknowledge that we can come back to healthcare afterwards but we need to move ahead on tax reform.”
Sen. John Thune, the third-ranking Republican: “Until somebody shows us a way to get that elusive 50th vote, I think it’s over.”
Sen. Roy Blunt, a member of GOP leadership: “Do I think we should stay on health care until we get it done? I think it’s time to move on to something else. Come back to health care when we’ve had more time to get beyond the moment we’re in and see if we can’t put some wins on the board.”
Seven in ten Americans want the Trump Administration and Congress to work across party lines to keep what works and fix what doesn’t in the current law. It’s time Republicans lived up to the promises they made and work with Democratic colleagues to improve our health care.
Angry at the failure of his partisan effort to repeal health care and because of his hatred for former President Obama, Trump is threatening to cancel payments that help lower people’s deductibles and other out-of-pocket costs. Who will pay the price? Everyday people trying to afford health coverage. Trump’s efforts to sabotage health care have already caused costs to go up. Now, his latest scheme will mean people will have to pay 19% more for their coverage, and could mean that insurance companies are forced to leave some parts of the country altogether.
Republican Members of Congress have recognized that there needs to be swift bipartisan action. Independent experts, business leaders, insurers and insurance commissioners all agree that Trump’s threat is putting at risk people’s health coverage. And the American public — 74 percent — wants Trump and his Administration to do what they can to make the law work — not continue to do what they can to make it fail.
Will Trump listen to his own party, experts and voters? Or will he ignore the facts and punish the American people?
IN RECENT DAYS, TRUMP HAS UPPED HIS THREATS TO DESTABILIZE THE INDIVIDUAL MARKET IN RETALIATION FOR THE SENATE’S FAILED BID TO REPEAL HEALTH CARE
HOWEVER, TRUMP’S STANCE IS THE OPPOSITE OF A NUMBER OF REPUBLICAN SENATORS AND REPRESENTATIVES WHO ARE CALLING FOR BIPARTISAN ACTION TO STRENGTHEN THE INDIVIDUAL MARKET
Senate Majority Leader Mitch McConnell (R-KY): “Some Kind Of Action With Regard To The Private Health Insurance Market Must Occur. No Action Is Not An Alternative.” “‘If my side is unable to agree on an adequate replacement, then some kind of action with regard to the private health insurance market must occur,’ McConnell said. ‘No action is not an alternative. We’ve got the insurance markets imploding all over the country, including in this state.’” [Washington Post, 7/6/17]
Rep. Mark Meadows (R-NC): “I Don’t Think That Letting It Fail Is The Best Option, Even Though It Certainly Allows Additional Pressure To Happen.” “‘I don’t think that letting it fail is the best option, even though it certainly allows additional pressure to happen,’ said Rep. Mark Meadows, R-N.C., who is chairman of the House Freedom Caucus and close ties to the White House. ‘We can do better than that.’” [Washington Examiner, 7/31/17]
Rep. Mark Amodei (R-NV): Amodei Disagrees With President Trump, Believes The Individual Market Should Not Be Allowed To Fail. “Rep. Mark Amodei, R-Nev., rebuked Trump more directly. ‘No,’ he said when asked if he agreed with the president. ‘Clear-cut question — no.’” [Washington Examiner, 7/31/17]
Sen. John Thune (R-SD): “I Hope The President Will Continue To Make Those Payments.” [Kasie Hunt Tweet, 8/1/17]
Sen. Lisa Murkowski (R-AK): “The Senate Should Step Back And Engage In A Bipartisan Process To Address The Failures Of The ACA And Stabilize The Individual Markets.” “As I’ve been saying, the Senate should take a step back and engage in a bipartisan process to address the failures of the ACA and stabilize the individual markets. That will require members on both sides of the aisle to roll up their sleeves and take this to the open committee process where it belongs.” [Murkowski Statement, 7/18/17]
Sen. Lisa Murkowski (R-AK): “The Senate Should Take A Step Back And Engage In A Bipartisan Process To Address The Failures Of The ACA And Stabilize The Individual Markets.” “As I’ve been saying, the Senate should take a step back and engage in a bipartisan process to address the failures of the ACA and stabilize the individual markets. That will require members on both sides of the aisle to roll up their sleeves and take this to the open committee process where it belongs.” [Sen. Murkowski, 7/18/17]
Sen. Bill Cassidy (R-LA): “I Want To Stabilize The Insurance Market.” “Asked if a bipartisan stabilization bill would be needed if the current GOP bill fails, Sen. Bill Cassidy (R-La.) said, ‘I presume.’ He left the door open to supporting such a measure. ‘It depends on what it looks like, but I want to stabilize the insurance market,’ Cassidy said. ‘Families are paying too high premiums, so we’ve got to lower premiums.’” [The Hill, 7/13/17]
Sen. Bill Cassidy (R-LA): “Families Would Be Hurt” If Payments Not Made.” [Sahil Kapur Tweet, 8/1/17]
Sen. Ron Johnson (R-WI): The Senate Should “Bite The Bullet And Stabilize Those Markets.” “Sen. Ron Johnson (R-Wis.) has for months called for a bipartisan stabilization bill that would guarantee funding for ObamaCare payments, known as cost-sharing reductions, to insurers. Those payments are key to avoiding premium spikes and keeping insurers in the markets. Johnson said Tuesday that he hopes the GOP can pass something next week, but if not, ‘bite the bullet and stabilize those markets.’” [The Hill, 7/13/17]
Sen. John Hoeven (R-ND): “We Need To Stabilize The Health Insurance Market.” “Obamacare is failing and premiums continue to increase dramatically with some markets down to one or no insurance providers. That is why we need to make reforms to provide Americans with access to health care and affordable health insurance with more choice and competition. The CBO score of the Senate draft health care bill indicates that this legislation needs additional work to ensure that it meets this goal. Also, health care reform will be a process, not one bill. We need to stabilize the health insurance market to make it more competitive so consumers have access to better and more affordable health care policies. In addition, we want to ensure that low-income people have access to health care coverage either through Medicaid or a refundable tax credit that enables them to buy their own health insurance policy.” [Hoeven Statement, 6/27/17]
Sen. Lamar Alexander (R-TN): “The Senate Health Committee Has A Responsibility During The Next Few Weeks To Hold Hearings And Continue Exploring How To Stabilize The Individual Market.” “My main concern is doing all I can to help the 350,000 Tennesseans and 18 million Americans in the individual market who may literally have no options to purchase health insurance in 2018 and 2019. However the votes come out on the health care bill, the Senate health committee has a responsibility during the next few weeks to hold hearings to continue exploring how to stabilize the individual market. I will consult with Senate leadership and then I will set those hearings after the Senate votes on the health care bill.” [Alexander Statement, 7/18/17]
Sen. Lamar Alexander (R-TN): We Should “Approve The Temporary Continuation Of Cost-Sharing Subsidies For Deductibles And Co-Pays.” “‘While we build replacements, we want the 11 million Americans who now buy insurance on the exchanges to be able to continue to buy private insurance. Among the actions that will help are to… approve the temporary continuation of cost-sharing subsidies for deductibles and co-pays.’” [Politico Pro, 1/13/17]
INSURANCE COMPANIES AND STATE INSURANCE COMMISSIONERS HAVE WARNED THAT DEFAULTING ON COST SHARING PAYMENTS WILL INCREASE PREMIUMS, DESTABILIZE THE INDIVIDUAL MARKET, AND POTENTIALLY DISRUPT COVERAGE
National Association Of Insurance Commissioners: “Congress Must Act Quickly To Stabilize The Individual Health Insurance Marketplace Before They Adjourn For The District Work Period.” “As the latest attempt to repeal and replace the Affordable Care Act has failed, Congress must act quickly to stabilize the individual health insurance marketplace before they adjourn for the district work period. The window to act is rapidly closing, as rates must be finalized by mid-August and insurers are deciding whether to remain in this market or not. Without action, we anticipate more and more insurance companies pulling out across the country and significant premium rate increases in the majority of states. The National Association of Insurance Commissioners (NAIC) urges the Congress to take two immediate actions — fund CSR payments and market stability funding — to help shore up these markets. Cost-sharing reduction (CSR) payments are critical to the viability of the individual health insurance markets in a significant number of states and must be funded through 2018. Sufficient and sustained market stabilization funding for states to establish reinsurance programs or high-risk pool programs is also needed for long-term stability beyond 2018. These two actions alone would go a long way toward steadying the individual markets while ongoing debates over legislative replacement and reform options continue.” [NAIC, 7/28/17]
National Association of Insurance Commissioners: “We Write Today To Urge The Administration To Continue Full Funding For The Cost-Sharing Reduction Payments For 2017 And Make A Commitment That Such Payments Will Continue, Unless The Law Is Changed.” “On behalf of the nation’s state insurance commissioners, the primary regulators of U.S. insurance markets, we write today to urge the Administration to continue full funding for the cost-sharing reduction payments for 2017 and make a commitment that such payments will continue, unless the law is changed. Your action is critical to the viability and stability of the individual health insurance markets in a significant number of states across the country.” [Letter to Mick Mulvaney, 5/17/17]
Dan Hilferty, President and CEO, Independence Blue Cross: “We Firmly Believe Your Coverage Will Be There For 2018, If The Federal Government, Congress And President Commit To, Fund The Subsidies During An Interim Period Of Time.” “We firmly believe your coverage will be there for 2018, if the federal government, congress and president commit to, fund the subsidies during an interim period of time when we look at how we can fix the program long-term.” [CNN, 7/19/17]
Kurt Giesa, Practice Leader, Oliver Wyman Actuarial Consulting: “If payers do not gain clarity on funding of CSR payments soon, they will have to build that cost into their premiums.” “ … the current uncertainty regarding health reform and the ACA exchanges is making actuaries’ task as difficult as it has ever been … Two market influences, in particular, are complicating 2018 rate setting: the uncertainty surrounding continued funding of cost sharing reduction (CSR) payments and the question of how the relaxation of the individual mandate will impact enrollment and risk pools. Our modeling shows that this uncertainty, if it remains, could lead payers to submit rate increases between 28 and 40 percent, and more than two-thirds of those increases will be related to the uncertainty around CSR payments and individual mandate … If payers do not gain clarity on funding of CSR payments soon, they will have to build that cost into their premiums.” [Oliver Wyman Analysis, 6/14/17]
Dr. Mario Molina, Former CEO Of Molina Healthcare: ‘Don’t Let The Administration Fool You’ Into Thinking Insurers Are To Blame For Raising Premiums Instead Of Sabotage.” “The administration and Republicans in Congress want you to believe that insurers raising premiums for their plans or exiting the marketplaces all together are consequences of the design of the Affordable Care Act instead of the direct results of their own actions to sabotage the law. Don’t let them fool you.” [Op-Ed in US News & World Report, 5/30/17]
Dave Jones, California State Insurance Commissioner: “President Trump Appears On A Mission To Destroy Health-insurance Markets By Creating Instability Through His Own Actions And Thereby Depriving Millions Of Americans Of Health-care Coverage.” “President Trump’s first executive order directed federal agencies to ‘waive, defer, grant exemptions from, or delay’ ACA requirements. The IRS then announced reduced enforcement of the ACA health-insurance mandate, which in turn exposes health insurers to tremendous uncertainty as to who will be in the 2018 market. President Trump also threatens to cut the ACA assistance that consumers rely on to afford health care. In April Mr. Trump stated, ‘ObamaCare is dead next month if it doesn’t get that money.’ Just last month the nation’s insurance commissioners wrote to the Trump administration requesting assurances that cost-sharing reduction payments will continue, noting that this is critical to the ‘viability and stability of the individual marketplace.’ No such assurance has been provided. President Trump appears on a mission to destroy health-insurance markets by creating instability through his own actions and thereby depriving millions of Americans of health-care coverage.” [Letter to the Editor in Wall Street Journal, 6/27/17]
Marguerite Salazar, Colorado’s State Insurance Commissioner: The Trump Administration Threatens The Whole Market. “In Colorado, where most consumers continue to have multiple insurance choices, commissioner Marguerite Salazar said the Trump administration threatens the whole market. ‘My fear is it may collapse,’ she said.” [Los Angeles Times, 5/18/17]
John Naylor, CEO Of Medica In Iowa: “It Is Challenging To Stay Focused On Our Mission To Provide Access To High-quality Affordable Health Care When There’s Noise Around The System And A Lack Of Clarity Of Rules.” “‘It is challenging to stay focused on our mission to provide access to high-quality affordable health care when there’s noise around the system and a lack of clarity of rules,’ said John Naylor, chief executive of Medica, who called the amount of uncertainty being thrown at insurers at the moment unprecedented.” [Washington Post, 5/12/17]
Eric A. Cioppa, Superintendent of the Maine Bureau of Insurance: “If They Don’t Get A Subsidy, I Fully Expect Double-digit Increases For Three Carriers On The Exchanges Here.”“The uncertainty is extremely problematic. If they don’t get a subsidy, I fully expect double-digit increases for three carriers on the exchanges here.” [New York Times, 6/4/17]
Danielle Devine, Michigan Director of Operations, Meridian Health Plan: “The Uncertainty Over The Future Of The Subsidies Creates The Largest Reason For Significant Rate Increases.” “The political climate continues to make it difficult to price and the uncertainty over the future of the subsidies creates the largest reason for significant rate increases.” [Crain’s Detroit Business, 6/14/17]
Rick Notter, Director of Individual Business, Blue Cross Blue Shield of Michigan: “If We Don’t Have That Cost-sharing (Subsidy), We Have To Make Up The Difference And The Only Way For Us To Do That Is With A Higher Rate.” “If we don’t have that cost-sharing (subsidy), we have to make up the difference and the only way for us to do that is with a higher rate.” [Detroit Free Press, 6/14/17]
John Goodnow, CEO, Benefis Health System in Montana: Goodnow Said The Lifespan Of The Affordable Care Act Has Been Shortened Because Insurance Companies Are Pulling Out Of The Exchanges ‘because Of All The Fear That’s Been Created Over Funding.’ “Republicans are injecting instability into federal insurance marketplaces by suggesting lowering subsidies for people who buy coverage, and it’s a ‘slick trick’ to ensure the failure of the exchanges, the head of one of Montana’s largest hospitals said Thursday … Great Falls-based Benefis CEO John Goodnow said the lifespan of the Affordable Care Act has been shortened because insurance companies are pulling out of the exchanges ‘because of all the fear that’s been created over funding. ‘All you have to do is threaten to defund the subsidies,’ he said Thursday on a panel in Helena organized by the Montana Nurses Association to discuss the bill.” [Billings Gazette, 7/7/17]
Brad Wilson, CEO, Blue Cross Blue Shield of NorthCarolina: “The Failure Of The Administration And The House To Bring Certainty And Clarity By Funding CSRs Has Caused Our Company To File A 22.9 Percent Premium Increase, Rather Than One That Is Materially Lower.”“The failure of the administration and the House to bring certainty and clarity by funding CSRs has caused our company to file a 22.9 percent premium increase, rather than one that is materially lower. That will impact hundreds of thousands of North Carolinians.” [Washington Post, 5/26/17]
Teresa Miller, Pennsylvania Insurance Commissioner: “Instability Caused By Adverse Action From The Federal Government Will Do Nothing But Hurt Consumers Who Are Stuck In The Middle.” “Information provided by insurers shows the extent to which instability and changes would impact Pennsylvania’s 2018 health insurance rates. This proves what we already know — instability caused by adverse action from the federal government will do nothing but hurt consumers who are stuck in the middle. The 506,000 Pennsylvanians with Affordable Care Act-compliant plans in the individual market deserve single-digit rate increases like the ones most people will see if Congress and the Trump Administration choose not to risk consumers’ health and financial well-being by jeopardizing the stability of these markets.” [Press Release, 6/1/17]
Julie Mix McPeak, Tennessee State Insurance Commissioner: “Members Could Help Bring Immediate Stability And Potential Rate Relief For Our Consumers By Appropriating Cost-sharing Reduction Payments For The 2017 And 2018 Plan Years.” “As Congress continues to debate ACA reform efforts, Members could help bring immediate stability and potential rate relief for our consumers by appropriating cost-sharing reduction payments for the 2017 and 2018 plan years. Every dollar matters when Tennessee consumers are feeling like they need to choose between health insurance or groceries or mortgage payments and the Congress could take action that would pay immediate dividends.” [Statement, 7/7/17]
Julie Mix McPeak, Tennessee State Insurance Commissioner: “No One Feels Optimistic About The Market If CSRs Are Not Funded.” “I asked my colleagues at a meeting of insurance commissioners nationwide, and no one feels optimistic about the market if CSRs are not funded. We would prefer for funding of those cost-sharing reductions through ’19. Again figuring out who gets to make that decision has been tough for us as regulators …It’s that instability, that uncertainty, the insurers hate the most. They are going to price for that.” [The Tennessean, 5/12/17]
Kelly Paulk, Vice President, Product Strategy and Individual Markets, BlueCross BlueShield of Tennessee: Factoring In Whether The Cost-Sharing Reductions Are Paid And If The Coverage Mandate Will Be Enforced Will Raise Premiums By 21 Percent On Average. “Our 2017 rates are allowing us to earn a margin (profit) for the first time in four years and would have enabled us to propose only a small increase for 2018 to cover expected changes in medical and operating costs. However, we have to factor in two significant uncertainties — whether the federal government will fund cost-sharing reductions for low-income members and how the risk pool will change if the coverage mandate is not enforced … Combining those two factors leads to an average 21 percent rate increase.” [Blog Post, 6/30/17]
Mike Kreidler, Washington State Insurance Commissioner: “The Current Federal Administration’s Actions — Such As Not Committing To Reimburse Insurers For Cost-sharing Subsidies And Not Enforcing The Individual Mandate — Appear Focused Only On Destabilizing The Insurance Market.”“There is a great deal of uncertainty underlying our country’s health insurance system today and no state is immune. There are specific issues with our health insurance system that we need to address, such as the rising costs of prescription drugs and health care services. Yet, the current federal administration’s actions — such as not committing to reimburse insurers for cost-sharing subsidies and not enforcing the individual mandate — appear focused only on destabilizing the insurance market. Sadly, it’s the people in our communities and across the country who will pay the price.” [Statement, 6/19/17]
Once more the people who know health care the best think the latest Republican plan to repeal and delay is the worst
From the left to the right, from the expert to the voter, more and more people are coming out against the Senate Republicans’ latest health care repeal scheme — known as “Skinny Repeal” — which is just another name for repeal and delay. The nonpartisan Congressional Budget Office found that the plan would cut coverage for 16 million Americans next year and raise premiums by 20%.
Sure enough, last night, a bipartisan group of governors, including Nevada Governor Brian Sandoval, came out against the scheme — saying it would destabilize the markets, raise premiums and leave more people without insurance. They are not alone. More and more stakeholders — from the American Medical Association to the Blue Cross Blue Shield Association to AARP- and health experts agree that the skinny plan would be a disaster.
The support for “Skinny Repeal” is growing more and more thin by the day. Take a look for yourself…
REPUBLICAN AND DEMOCRATIC GOVERNORS: “SKINNY REPEAL” PLAN WOULD RAISE PREMIUMS AND LEAVE PEOPLE WITHOUT INSURANCE
Bipartisan Group Of Governors: “Skinny Repeal” “Is Expected To Accelerate Health Plans Leaving The Individual Market, Increase Premiums, And Result In Fewer Americans Having Access To Coverage.” “The Senate should also reject efforts to amend the bill into a ‘skinny repeal,’ which is expected to accelerate health plans leaving the individual market, increase premiums, and result in fewer Americans having access to coverage.” [Governors John Hickenlooper (D-CO), Steve Bullock (D-MT), Brian Sandoval (R-NV), Larry Hogan (R-MD), Tom Wolf (D-PA), John Bel Edwards (D-LA), Terry McAuliffe (D-VA), Charlie Baker (R-MA), John Kasich (R-OH), Phil Scott (R-VT), 7/26/17]
STAKEHOLDERS: THE SKINNY PLAN REPEAL WOULD DESTABILIZE THE MARKETS AND INCREASE PREMIUMS
American Medical Association: “Skinny Repeal” Will Lead “To Adverse Selection That Would Increase Premiums And Destabilize The Individual Market.” “There has been considerable speculation regarding a so-called “skinny package” that would primarily eliminate penalties related to the individual and employer mandates and provide tax cuts to device manufactures and the health insurance industry. Eliminating the mandate to obtain coverage only exacerbates the affordability problem that critics say they want to address. Instead, it leads to adverse selection that would increase premiums and destabilize the individual market.” [AMA, 7/26/17]
Blue Cross Blue Shield Association: “A System That Allows People To Purchase Coverage Only When They Need It Drives Up Costs For Everyone.” “If there is no longer a requirement for everyone to purchase coverage, it is critical that any legislation include strong incentives for people to obtain health insurance and keep it year-round. A system that allows people to purchase coverage only when they need it drives up costs for everyone.” [New York Times, 7/26/17]
American Academy Of Actuaries Health Practice Council: Repealing The Individual Mandate Would Raise Premiums And Costs To The Federal Government. “Eliminating the mandate, by lowering financial penalties or exempting particular categories of individuals from its requirements, would likely have significant implications for health insurance coverage and costs both to consumers and the federal government….Eliminating the individual mandate would lead to premium increases….Higher premiums could lead to increased federal government costs for premium subsidies.” [American Academy of Actuaries, 7/25/17]
AARP: “AARP Has Vigorously Opposed All Of The Measures That Would Increase Costs And Strip Away Needed Health Care Coverage From Older Americans — And Will Continue To Fight Against Any Bill That Would Increase Costs And Lower Benefits.” “Senate leaders now hope they can convince a majority of senators to vote for a scaled-back bill that is being called a ‘skinny’ repeal bill… The Congressional Budget Office (CBO) has not published a score for this specific measure. But actuaries and the CBO in the past have said that if the individual mandate were eliminated, 15 million fewer people would have insurance, and premiums for older adults would escalate because many healthy people would drop their coverage and insurers would be left covering older and sicker Americans… AARP has vigorously opposed all of the measures that would increase costs and strip away needed health care coverage from older Americans — and will continue to fight against any bill that would increase costs and lower benefits.” [AARP, 7/26/17]
HEALTH EXPERTS: THE SKINNY PLAN IS A TROJAN HORSE THAT WOULD RAISE PREMIUMS AND BE A DISASTER FOR THE INDIVIDUAL MARKET
Atul Gawande, Harvard School of Public Health: “‘Skinny Repeal’ Is A Known Disaster.” “‘Skinny repeal’ is a known disaster. 1995: WA state repealed mandate; kept guaranteed issue. 1999: no insurers left.” [Tweet, 7/26/17]
Los Angeles Times: When Washington State Repealed The Individual Mandate, Double-Digit Rate Increases Followed Before Insurers Pulled Out Of The Market. “When the new Legislature convened in 1995, GOP lawmakers set about pulling apart the law, bringing along Democrats who feared Republicans would repeal it through a ballot measure if they didn’t cooperate. The hastily crafted repeal — which the Legislature sent to the governor in three months — kept some popular parts of the law such as the guarantee that everyone could get coverage, even if they were sick. It scrapped parts voters didn’t like, including the requirement that state residents have health insurance. The state’s insurance market started teetering soon afterward. First, health insurers sought a series of double-digit rate hikes in 1995 and 1996. The health plans warned that with no requirement to have coverage, people were signing up for insurance only when they got sick, sending costs skyrocketing. Then, in November 1998, Premera Blue Cross, one of the state’s leading insurers, announced it would stop selling health plans, citing more than $100 million in losses. Regence and Group Health Cooperative, the state’s other two leading plans, quickly followed.” [LA Times, 5/31/17]
Robert Greenstein, Center On Budget Policies And Priorities: “In Short, The ‘Skinny Repeal’ Bill Is A Trojan Horse Designed To Resuscitate The Effort To Repeal Large Parts Of The ACA And Impose Big Medicaid Cuts That Would Jeopardize Coverage For Millions Of The Nation’s Neediest People.” “In short, the ‘skinny repeal’ bill is a Trojan horse designed to resuscitate the effort to repeal large parts of the ACA and impose big Medicaid cuts that would jeopardize coverage for millions of the nation’s neediest people. Indeed, when asked today whether Medicaid cuts would be in the “skinny repeal” bill, Senate Majority Whip John Cornyn replied, ‘No, I think people understand we’ll address the Medicaid issue when we conference with the House.’” [CBPP, 7/26/17]
Center For American Progress: “Skinny Repeal” Raises Premiums $1,238. [Center for American Progress, 7/25/17]
Larry Levitt, Kaiser Family Foundation: “20% Premium Spike And 15 Million Uninsured Increase.” “CBO on repealing the individual mandate (‘skinny repeal’): 20% premium spike and 15 million uninsured increase.” [Tweet, 7/25/17]
Josh Bevins, Economic Policy Institute: “Skinny Repeal” Would Bring System To “Almost Complete Collapse.” “But, [Josh Bevins, Research Director of the Economic Policy Institute] says, doing away with the mandates would bring the health-care system to ‘almost complete collapse.’ This is because letting people freely opt out of buying insurance creates prohibitive premiums for everyone else.” [QZ.com, 7/25/17]
Vox: “Repealing The Individual Mandate Risks Sending Obamacare’s Insurance Markets Into A Death Spiral.” “…repealing the individual mandate risks sending Obamacare’s insurance markets into a death spiral. Health insurers have long said that a compulsion for people to buy insurance is necessary in order for the law to work, after it required that insurers cover everyone and charge everyone the same premiums no matter their health.” [Vox, 7/25/17]
FLASHBACK 2015: SENATE REPUBLICANS RUBIO, LEE AND CRUZ OPPOSE “SKINNY REPEAL”
Sens. Marco Rubio (R-FL), Mike Lee (R-UT), Ted Cruz (R-TX): Repealing Only Parts Of Obamacare “Simply Isn’t Good Enough.” “On Friday the House of Representatives is set to vote on a reconciliation bill that repeals only parts of Obamacare. This simply isn’t good enough. Each of us campaigned on a promise to fully repeal Obamacare and a reconciliation bill is the best way to send such legislation to President Obama’s desk. If this bill cannot be amended so that it fully repeals Obamacare pursuant to Senate rules, we cannot support this bill.” [Joint Statement, 10/22/15]
FLASHBACK 2015: HERITAGE FOUNDATION OPPOSES “SKINNY REPEAL”
Heritage Action Opposed A “Skinny” Repeal And Included It As A Key Vote. “On Friday, the House is scheduled to vote on the so-called Restoring Americans’ Healthcare Freedom Reconciliation Act (H.R. 3762). The bill would not restore Americans’ health care freedom because it leaves the main pillars of Obamacare in place, nor would it actually defund abortion giant Planned Parenthood. This bill violates an explicit promise made in the budget, which ‘affirm[ed] the use of reconciliation for the sole purpose of repealing the President’s job-killing health care law.’…Heritage Action opposes H.R. 3762 and will include it as a key vote on our legislative scorecard.” [Heritage Action, 10/22/15]
SENATE REPUBLICANS ADMIT “SKINNY” REPEAL IS A BAIT AND SWITCH TO THE HOUSE REPEAL BILL THEY SAID THEY OPPOSED
Cornyn says the House Bill Would Be A “Template”
The latest Republican repeal scheme — the so-called skinny repeal plan — is nothing more than a bait and switch. It goes like this: pass a bill that can get 50 votes in the Senate, or the “lowest common denominator” as HHS Secretary Tom Price admitted this morning. Then, use that bill to hold more partisan secret backroom deals with the House, using the House repeal bill — which only one in five Americans supported, took coverage away from 23 million people, raised premiums by double digits, ended Medicaid as we know it and allowed insurers to charge more for people with pre-existing conditions — as a “template.”
A vote to pass the Senate’s “skinny” plan is in effect voting for the House repeal bill, a proposal that many senators said they opposed. In other words, a vote for the “skinny” plan will break their promises to oppose the House repeal bill.
SENATE REPUBLICANS ADMIT THE “SKINNY” REPEAL BILL IS A SCHEME TO NEGOTIATE WITH THE HOUSE REPEAL BILL AS A “TEMPLATE”
Senate Majority Whip John Cornyn (R-TX): “All We’re Looking At Is A Way To Get That To Conference Quick” And The House Bill Would Be A “Template” For Negotiations. “Senate Majority Whip John Cornyn (R-Texas) indicated Wednesday that is it likely the Senate will try to pass a scaled-down ObamaCare repeal bill as a way to move to negotiations with the House. …Republicans view the so-called skinny bill as a way to keep the repeal process alive, given the chamber’s apparent inability to get the votes for a more sweeping bill. Cornyn said the House-passed bill could be the ‘template’ for the negotiations in the conference committee.…’So I think all we’re looking at is a way to get to that conference quick,’ he added.” [The Hill, 7/26/17]
Cruz Amendment Gutting Protections For People With Pre-Existing Conditions Would Be On The Table In Conference. “Cornyn noted that new Senate ideas — such as Sen. Ted Cruz’s (R-Texas) amendment to let insurers sell plans outside of ObamaCare’s regulations and Sen. Rob Portman’s (R-Ohio) amendment to add $100 billion to help people losing Medicaid afford private coverage — could be included and could help pave the way for a deal in the conference committee.” [The Hill, 7/26/17]
Sen. John Cornyn (R-TX): “My Personal Goal Is To Make Sure That We Find Something That 50 Of Us Agree On, That We Can Then Pass As A Vehicle To Get To Conference To Do A More Comprehensive Bill.” [Roll Call, 7/25/17]
Sen. Corker (R-TN): “Skinny” Repeal Is “Forcing Mechanism” To Get To Conference With The House. “Corker says ‘content’ of skinny bill not the point, rather it is ‘forcing mechanism’ for conference with House.” [The Hill’s Peter Sullivan Tweet, 7/26/17]
Sen. Mike Rounds (R-SD) Said Skinny Repeal Is A Way To Get To Conference. “Sen. Mike Rounds (R-S.D.) likewise said Wednesday that passing the skinny bill would be a way to get to the conference committee, and would also buy time for the Congressional Budget Office to score the new proposals, including the Cruz and Portman amendments.” [The Hill, 7/26/17]
GOP SENATORS WOULD BE BREAKING THEIR PROMISE TO OPPOSE THE HOUSE REPEAL BILL
Sen. Dean Heller (R-NV): “I Am Opposed To The American Health Care Act.” “As I have stated previously, while I am in favor of repealing Obamacare, I am opposed to the American Health Care Act (AHCA) in its current form. This bill does not do enough to address Nevada’s Medicaid population or protect Nevadans with pre-existing conditions. The AHCA is a first step, but not the solution; now the Senate is doing its own work to put forth its own ideas that could work for states like Nevada. I remain engaged in discussions with my colleagues from Medicaid expansion states as well as Governor Sandoval, the Administration, and senators on both sides of the aisle to find a viable path forward.” [Sen. Heller Statement, 5/24/17]
Sen. Shelley Moore Capito (R-WV): On The House Repeal Bill’s Impact On Medicaid, “I’m Concerned About What The House Bill Might Do With That.” “Another concern West Virginia health care advocates brought up is the cut to Medicaid expansion. They said that throughout the next 10 years, the bill would cut $4 billion in funding to the state. U.S. Sen. Shelley Moore Capito, R-W.Va., said she isn’t willing to let that happen. ‘I’m concerned about what the house bill might do with that,’ Capito said Wednesday.” [WSAZ, 5/3/17]
Sen. Shelley Moore Capito (R-WV): “I’m Not Satisfied.” “I’m not satisfied. I’m worried about a lot of folks in West Virginia, of opioid and drug abuse issues, and the expanded Medicaid has helped with that.” [Washington Post, 3/23/17]
Sen. Rob Portman (R-OH): “I’ve Already Made Clear That I Don’t Support The House Bill As Currently Constructed.” “I’ve already made clear that I don’t support the House bill as currently constructed because I continue to have concerns that this bill does not do enough to protect Ohio’s Medicaid expansion population, especially those who are receiving treatment for heroin and prescription drug abuse. We have an opioid crisis in this country, and I’m going to continue to work with my colleagues on solutions that ensure that those who are impacted by this epidemic can continue to receive treatment.” [Portman Statement, 5/4/17]
Sen. Rand Paul (R-KY): “I Would Be A No In The Senate.” [Tweet, 3/21/17]
Sen. Marco Rubio (R-FL): “It’s Not Our Bill.” “That’s the House bill. The Senate bill is going to be the Senate bill. Obviously the CBO score is one data point and it’s instructive, but it’s not our bill.” [Roll Call, 5/26/17]
Sen. Mike Lee (R-UT): “I Am A No.” [Tweet, 3/21/17]
Sen. Tom Cotton (R-AR): “I Still Cannot Support The House Healthcare Bill.” “Despite the proposed amendments, I still cannot support the House healthcare bill, nor would it pass the Senate.” [The Hill, 3/21/17]
Sen. Tom Cotton (R-AR): “The House Should Continue Its Work On This Bill.” “The House should continue its work on this bill,” Cotton said Tuesday in a statement, adding that the changes offered Monday night don’t address rising premiums and deductibles. “It’s more important to finally get health-care reform right than to get it fast.” [Bloomberg Politics, 3/21/17]
Sen. Ron Johnson (R-WI): “I Will Not Vote To Support It Until I Have Enough Information That Whatever We’re Going To Pass Will Work.” “Let’s be honest. Not a whole lot of people are loving the (House bill) right now. I will not vote to support it until I have enough information that whatever we’re going to pass will work.” [Milwaukee Journal Sentinel, 3/21/17]
Sen. Cory Gardner (R-CO): “Concerned That Any Poorly Implemented Or Poorly Timed Change In The Current Funding Structure In Medicaid Could Result In A Reduction In Access To Life-saving Health Care Services.” [Letter to McConnell, 3/6/17]
Sen. Bill Cassidy (R-LA): Radically Reshape the House Bill. “Bill Cassidy of Louisiana says he wants to radically reshape the House bill so that it covers more people, not the 24 million fewer estimated by the Congressional Budget Office. [Bloomberg Politics, 3/21/17]
Sen. John McCain (R-AZ): “I’m Very Worried What The House Bill Would Do To Arizona.” [Talking Points Memo, 3/13/17]
Sen. Susan Collins (R-ME): “I Am Not At All Comfortable With The House-Passed Bill.” “I am not at all comfortable with the House-passed bill. And, indeed, I would oppose the House-passed bill. The Senate bill is still a work in progress. We haven’t seen the actual language. We’re trying to influence the direction of that. But a bill that results in 23 million people losing coverage is not a bill that I can support. So, we will see what the Senate comes up with. It’s still being drafted.” [CNN State of the Union, 6/11/17]
Sen. Susan Collins (R-ME): “There Does Seem To Be A Consensus That The House Bill Could Never Pass The Senate And I’m Certainly Of That Belief As Well.” “‘There does seem to be a consensus that the House bill could never pass the Senate and I’m certainly of that belief as well,’ said Sen. Susan Collins (R-Maine), who cited the CBO report’s finding that 23 million people would lose insurance under the House bill over the next decade.” [The Hill, 5/29/17]
Sen. Lisa Murkowski (R-AK): “I Want To Get Right Rather Than Get It Behind Us, And That’s Going To Take Time.” “Speaking to reporters after her lunchtime Chamber speech, she said that she’d rather see Congress ‘get it right’ when it comes to health care reform. ‘There are some who are very interested in moving it as quickly as possible to ‘get it behind us.’ I don’t think that’s the responsible path. I want to get right rather than get it behind us, and that’s going to take time,’ she said.” [Juneau Empire, 6/1/17]
Sen. Lisa Murkowski (R-AK) Wanted The Senate To Start With A “Clean Slate.” [Bloomberg, 5/4/17]
According to FOX Business, the Trump Administration has made a secret promise that the final health care repeal WILL include the “Cruz Amendment” which, according to bipartisan analysts, guts protections for those with pre-existing conditions and completely destabilizes the health care markets.
The Trump Administration has now made it clear that any Republican who votes to proceed on repealing health care will be responsible for the damage the Cruz amendment does to people’s health care.
Here’s what you need to know about what health care repeal would mean with the Cruz amendment — it guts consumer protections, turns the health care market into a real death spiral and raise costs.
Look at what Republican Senators and health experts have to say about it…
THE CRUZ PROPOSAL WOULD GUT CONSUMER PROTECTIONS LIKE GETTING RID OF ANNUAL AND LIFETIME LIMITS
Sen. Chuck Grassley (R-IA): “There’s A Real Feeling That That’s Subterfuge To Get Around Pre-Existing Conditions.” “‘There’s a real feeling that that’s subterfuge to get around pre-existing conditions,’ says Grassley. ‘If it is subterfuge and it has the effect of annihilating the pre-existing condition requirement that we have in the existing bill, than obviously I would object to that.’” [Iowa Public Radio, 7/5/17]
Sen. Shelley Moore Capito (R-WV): Cruz Amendment “Would Make It Too Difficult For People With Pre-Existing Conditions To Get Coverage.” “‘I think that reopens an issue that I can’t support, that it would make it too difficult for people with pre-existing conditions to get coverage,’ she said.” [Charleston Gazette-Mail, 7/8/17]
THE CRUZ PROPOSAL WOULD DESTABILIZE THE MARKETPLACE AND LEAD TO A DEATH SPIRAL
Larry Levitt, Senior Vice President, Kaiser Family Foundation: Cruz Plan “The Perfect Recipe For Destabilizing The Market And Turning The Marketplaces Into High-Risk Pools.” “‘If there were a Joy of Cooking for insurance, this would be the perfect recipe for destabilizing the market and turning the marketplaces into high-risk pools,’ said Larry Levitt, senior vice president at the Kaiser Family Foundation.” [CNN Money, 7/6/17]
Douglas Holtz-Eakin, Former Director, Congressional Budget Office Director, And President, American Action Forum: “That’s A Recipe For A Meltdown.” “‘What that will do is allow insurers to offer cheap policy to young invincibles. And on the exchange you’re going to get all the sick people,’ said Douglas Holtz-Eakin, a former Congressional Budget Office director and president of the American Action Forum. ‘That’s a recipe for a meltdown. You’ve split the risk pool into two exchanges.’ And, he added: ‘I think it would end up being bad politics.’” [Politico, 7/1/17]
Tara O’Neill Hayes, Deputy Director Of Health Care Policy, American Action Forum: “I Think That Really Would Be The Definition Of A Death Spiral.” “‘I think that really would be the definition of a death spiral,’ said Tara O’Neill Hayes, deputy director of health care policy at the conservative American Action Forum. ‘I think it would no longer be a question of whether that’s happening.’” [Politico, 7/11/17]
Craig Garthwaite, Health Insurance Expert, Northwestern University: “The Sick Would Be Attracted To Cheaper Plans, With The Knowledge They Could Always Move Into More Generous Plans If They Got Sick.” “‘The sick would be attracted to generous plans, while the healthy would be attracted to cheaper plans, with the knowledge they could always move into more generous plans if they got sick,’ said Craig Garthwaite, a health insurance expert at Northwestern University. ‘That kind of adverse selection makes pricing and offering insurance very hard.’” [Modern Healthcare, 6/30/17]
Vox: “The Fundamental Problem Is Sicker People Would Be Drawn To The More Robust Obamacare Plans, While Healthier People Would Gravitate Toward The Skimpier Non-Obamacare Coverage.” “The fundamental problem is sicker people would be drawn to the more robust Obamacare plans, while healthier people would gravitate toward the skimpier non-Obamacare coverage. That’s a reality that even Cruz acknowledges. Then inside the Obamacare market, as more and more sick people buy coverage there, costs for health insurers go up and so they increase premiums. It has the makings of a classic death spiral. Because only sick people remain, premiums eventually increase to astronomic levels. It turns the Obamacare exchanges into a high-risk pool.” [Vox, 6/29/17]
THE CRUZ PROPOSAL WOULD RAISE COSTS FOR PEOPLE WITH PRE-EXISTING CONDITIONS
Ceci Connolly, CEO, Alliance Of Community Health Plans: “You Are Increasing The Likelihood That There Will Be Some Smaller, Sicker Group With Higher Rates.” “Separating the sick and the healthy is ‘not the best path forward,’ said Ceci Connolly, CEO of Alliance of Community Health Plans, a lobbying group for non-profit, community-based insurers. Instead, it’s better to spread the risk around in a larger pools of enrollees. The Cruz option would do the opposite. ‘You are increasing the likelihood that there will be some smaller, sicker group with higher rates,’ Connolly said. ‘That’s what you want to get away from.’” [CNN Money, 7/6/17]
Larry Levitt, Senior Vice President, Kaiser Family Foundation: “If They Have Pre-Existing Conditions, They’d Be Stuck In Plans With Escalating Premiums.” “Americans with higher incomes who wanted to buy an Obamacare-compliant plan, people likely to have high medical costs themselves, would have no protection from skyrocketing premiums. ‘If they’re healthy, they could buy inexpensive non-compliant plans. But if they have pre-existing conditions, they’d be stuck in plans with escalating premiums,’ Levitt said.” [Vox, 6/29/17]
Tim Jost, Law Professor, Washington And Lee University: “If This Were Adopted, Premiums Would Skyrocket For People Who Need Comprehensive Coverage.” “Health analysts said the amendment would cause premiums for that demographic to jump, resurrecting a thorny political issue that drew national attention earlier this year when House Republicans added a similar measure to their bill, known as the MacArthur amendment. ‘If this were adopted, premiums would skyrocket for people who need comprehensive coverage,’ said Timothy Jost, a law professor at Washington and Lee University in Lexington, Va.” [Wall Street Journal, 7/5/17]
Joe Antos, Health Policy Expert, American Enterprise Institute: People With Chronic Illness “Will End Up Paying More.” “‘Someone with chronic illness, they’re going to end up wanting to buy the more comprehensive coverage,’ says Joe Antos, a health policy expert with the conservative American Enterprise Institute. ‘This means that people with those kinds of illnesses will end up paying more. Even if they receive a federal subsidy, they will likely see higher cost sharing.’ … ‘The people who don’t know something will happen and come down with something, those are the ones at issue,’ Antos argues. ‘It’s not the people who planned ahead and bought the more expensive plan. It’s those who didn’t.’” [Vox, 7/10/17]
Wall Street Journal: “Middle-Income Earners With Pre-Existing Conditions Would Be The Hardest Hit.” “Such a bifurcation likely would mean increased costs for comprehensive plans, analysts said. People receiving the bill’s tax credits would be buffered from the price increases, but those who earn 350% of the poverty level and wouldn’t be eligible for the credits would pay more, they said. Middle-income earners with pre-existing conditions would be the hardest hit.” [Wall Street Journal, 7/5/17]
Larry Levitt, Senior Vice President, Kaiser Family Foundation: Getting Premiums Down “Comes Down To Relaxing Rules That Protect People With Pre-Existing Conditions.” “‘When it gets to crunchtime on these health bills, the discussion comes down to getting premiums down,’ said Larry Levitt, a senior vice president at Kaiser Family Foundation. ‘And that comes down to relaxing rules that protect people with pre-existing conditions.’” [Wall Street Journal, 7/5/17]
To avoid a temper tantrum from President Trump, Senate Republicans are poised to take their first vote on health care repeal today — pushing forward on the same health care bill that passed the House of Representatives earlier this summer.
On top of the fact that the House bill will completely devastate people’s health care, voting for this House health care repeal bill would break the promise many Senators have made to oppose the House health care repeal.
Take a look at their promises…
Senator Susan Collins (R-ME): “I am not at all comfortable with the House-passed bill.” [CNN State of the Union, 6/11/17]
“There does seem to be a consensus that the House bill could never pass the Senate and I’m certainly of that belief as well.” [The Hill, 5/29/17]
“This is not a bill I could support in its current form.” [Press Herald, 3/17/17]
Senator Lisa Murkowski (R-AK): “Alaska’s Lisa Murkowski, who has been very critical of the House bill, said Thursday she hopes they start with ‘a clean slate’ in the Senate.” [Bloomberg, 5/4/17]
Senator Dean Heller (R-NV): “I agree with Governor Sandoval. I do not support the House bill in its current form.” [Associated Press, 3/17/17]
Senator Shelley Moore Capito (R-WV): “I’m not satisfied. I’m worried about a lot of folks in West Virginia, of opioid and drug abuse issues, and the expanded Medicaid has helped with that.” [Washington Post, 3/23/17]
Sen. Bill Cassidy (R-LA): “Bill Cassidy of Louisiana says he wants to radically reshape the House bill so that it covers more people, not the 24 million fewer estimated by the Congressional Budget Office.” [Bloomberg Politics, 3/21/17]
Senator Marco Rubio (R-FL): “That’s the House bill. The Senate bill is going to be the Senate bill. Obviously the CBO score is one data point and it’s instructive, but it’s not our bill.” [Roll Call, 5/26/17]
Senator Ted Cruz (R-TX): “The Senate bill will be significantly different from the House bill.” [The Hill, 5/26/17]
Senator Rob Portman (R-OH): “I continue to have concerns [the House bill] does not do enough to protect Ohio’s Medicaid population, especially those who are receiving treatment for heroin and prescription drug abuse.” [Portman Statement, 5/4/17]
Sen. Rob Portman (R-OH): “I could not support the current health legislation.” [Dayton Daily News, 3/23/17]
Sen. Rand Paul (R-KY): “I would be a no in the Senate.” [Tweet, 3/21/17]
Sen. Mike Lee (R-UT): “I am a no.” [Tweet, 3/21/17]
Sen. Tom Cotton (R-AR): “Despite the proposed amendments, I still cannot support the House health care bill, nor would it pass the Senate.” [The Hill, 3/21/17]
Sen. Ron Johnson (R-WI): “Let’s be honest. Not a whole lot of people are loving the (House bill) right now. I will not vote to support it until I have enough information that whatever we’re going to pass will work.” [Milwaukee Journal Sentinel, 3/21/17]
Sen. John McCain (R-AZ): “I’m very worried what the House bill would do to Arizona.” [Talking Points Memo, 3/13/17]
NEW ANALYSIS: GOP’S HEALTH CARE REPEAL WILL DO MORE HARM TO TRUMP’S “OBAMACARE VICTIMS”
President Trump highlighted the stories of four people who he claimed were “victimized” by the Affordable Care Act during a press stunt today.
Unfortunately for the Senate GOP, based on what’s known about the people President Trump highlighted, their health care repeal would do nothing for them. And could actually make things worse.
Uh oh.
PERSON #1
Trump Said: “After an excruciating series of events and complications, Melissa and her husband found themselves just before Christmas, emotionally and financially devastated, crying in a doctor’s office faced with yet another seemingly unpayable bill. When insurance wouldn’t cover the Ackisons’ care, they emptied out Melissa’s 401K to pay their bills.”
If GOP’s Repeal Passes: Under the Senate’s BCRA repeal effort, essential health benefits would be repealed, so routine doctor’s visits and hospitalizations may not even be covered by insurance plans.
PERSON #2
Trump Said: “Democrats promised Americans like Steve Finn, a former police officer in West Virginia, that they would save $2,500 per year under Obamacare. Instead his premiums have more than tripled. That’s pretty bad. As a result of Obamacare’s skyrocketing costs, Steve and his family, and many of his employees, had no other option than going on Medicaid and giving up their existing coverage. For them Obamacare’s promise was a nightmare.”
If GOP’s Repeal Passes: Under the Senate’s BCRA repeal effort, premiums are projected to go up by 20% next year and deductibles would skyrocket to $13,000. Steve and his family could pay more out-of-pocket for their premiums and care because, unlike under current law, BCRA’s tax credits would not offset rising premiums. And if they are still Medicaid beneficiaries, the BCRA cuts over $700 billion from the program, so Steve and his family could lose their Medicaid coverage altogether.
PERSON #3
Trump Said: “Democrats promised families like the Weers that if they liked their doctor, they could keep their doctor — but now there is only one insurer left in the state exchange, and Marjorie says that every year she waits anxiously to learn if the doctors and hospitals which her son needs the most will remain in their network.”
If GOP’s Repeal Passes: Under the Senate’s BCRA repeal effort, insurance companies would be allowed to contract with hospitals and draw narrower networks than under what is permitted under current law. Under current law, consumers benefit from “network adequacy standards,” but the narrow networks of hospitals and doctors now could get even worse under the BCRA. In short, the Weers could still buy a plan where their doctor was out of network. But under the BCRA, the cost of coverage for people with pre-existing conditions would skyrocket.
PERSON #4
Trump Said: “Erin and Andy Witzig are small business owners from Illinois. They have six children. Their youngest daughter, Poppy, has a rare genetic condition. Children born with it are sometimes called Butterfly Children, because their skin is as fragile as the wings of a butterfly. Poppy has to wear special bandages all of the time. Unfortunately, under Obamacare, Poppy’s family insurance has been repeatedly discontinued and replaced with what Washington deems equivalent policies, but for Poppy these plans are not equivalent, and Poppy’s family has to spend precious time and tremendous resources fighting for exceptions for Poppy.”
If GOP Repeal Passes: Under BCRA, without insurance plans required to offer comprehensive coverage, people with complex medical needs such as the Witzig’s youngest daughter would be left to pay substantially more out-of-pocket for a similar level of coverage offered today. BCRA would also allow insurance companies to implement annual and lifetime limits. For someone with medical needs like Poppy, this could result in even higher out-of-pocket costs for her care.
