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ashoup
In Fact Sheet, News

Short-Term Junk Plans

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

Short-Term Plans May Exclude Coverage For Pre-Existing Conditions. “Policyholders who get sick may be investigated by the insurer to determine whether the newly-diagnosed condition could be considered pre-existing and so excluded from coverage.” [Kaiser Family Foundation, 2/9/18]

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

Short-Term Junk Plans Can Refuse To Cover Essential Health Benefits. “Typical short-term policies do not cover maternity care, prescription drugs, mental health care, preventive care, and other essential benefits, and may limit coverage in other ways.” [Kaiser Family Foundation, 2/9/18]

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

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

Short-Term Junk Plans Can Retroactively Cancel Coverage After Patients File Claims. “Individuals in STLDI plans would be at risk for rescission. Rescissions are retroactive cancellations of coverage, often occurring after individuals file claims due to medical necessity. While enrollees in ACA coverage cannot have their policy retroactively cancelled, enrollees in STLDI plans can.” [Wakely/ACAP, April 2018]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

KEY HEALTH INSURANCE STAKEHOLDERS WARN AGAINST SHORT-TERM PLANS

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

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

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

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

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

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

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

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

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

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

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

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

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

ashoup
In News

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

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

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

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

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

ashoup
In News

Final Open Enrollment Numbers Confirm Staying Power of ACA

Washington, D.C. – As the Centers for Medicare and Medicaid Services released the final open enrollment numbers for 2018, which showed that 11.8 million people nationwide bought Affordable Care Act marketplace coverage, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Millions of Americans rely on the Affordable Care Act for quality, affordable coverage, and today’s confirmed enrollment numbers provide clear evidence of the law’s critical importance in American health care. But for over a year, the Trump Administration has been carrying out an unprecedented sabotage campaign designed to undermine the law and make it fail. Nowhere was this more apparent that the Administration’s attacks on open enrollment, which included cutting the advertising budget by 90 percent, halving the enrollment time, and denying help for people trying to get coverage. But the American people rejected this partisan scaremongering, and now we know that 11.8 million people signed up for marketplace coverage, almost matching last year’s total enrollment despite the many obstacles the Trump Administration placed in their way. While this is heartening news, these 11.8 million people and millions more are living in fear that the Republican war on health care will hike their rates and make care prohibitively expensive or unavailable to people with pre-existing conditions.

“The American people don’t want to go back to a time when insurers could deny them health care for having a pre-existing condition or be priced out of the market based on their age, gender, or medical history. The Affordable Care Act is a lifeline for millions of Americans, and Republicans’ continuing attempts to undermine the law are being met with resistance through enrollment, protests, and at the ballot box as the American continue to say: enough is enough – it’s time for Republicans to end their war on our care.”

ashoup
In News

New KFF Poll Confirms Hidden Cost of Sabotage

Anxiety About Health Care Mounts Due to Destructive Republican Rhetoric

Washington, DC – After new polling from the Kaiser Family Foundation confirmed Americans’ mounting anxiety about Republican health care sabotage, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Despite everything Republicans have thrown at it, the Affordable Care Act still protects every single American with health insurance and connects millions of previously uninsured people with coverage – but you wouldn’t know it listening to Trump and Republicans in Congress. Republicans need to realize that misleading the public, sabotaging the law and spreading fear has real and damaging consequences. Whether you’re a person with a pre-existing condition or the parent of a sick kid, you deserve elected officials who make life easier, not scarier. The constant anxiety Americans now face is yet another hidden cost of Republicans’ relentless repeal-and-sabotage campaign against our health care.”

Key takeaways from the survey:

  • About half the public overall believes the ACA marketplaces are “collapsing,” including six in ten of those with coverage purchased through these marketplaces. This belief reflects the ongoing uncertainty caused by Republican sabotage and Trump’s divisive rhetoric, but contradicts what the President’s own economic advisors have confirmed about the stability and strength of the individual market.
  • Because of Republican sabotage, the number of people who are “very worried” or “somewhat worried” that rate hikes will make coverage unaffordable has skyrocketed to 67%, compared with 38% in October 2017.
    • People are more worried about copays and deductibles – up from 42% to 69%.
    • People are more worried that insurance companies will stop selling plans – up from 34% to 49%.
    • People are more worried that there won’t be any plans in their area – up from 33% to 51%.
  • One-third (34 percent) of shoppers in the individual market say the individual mandate that Republicans repealed was a “major reason” why they chose to buy insurance, and one in ten say they will not buy coverage without it. Research indicates that those most likely to drop coverage are “young invincibles,” who balance the risk pool and act as a downward pressure on premiums. Because of Republicans’ individual mandate repeal, CBO forecasts that average premiums in the nongroup market will increase by 10% in most years of the coming decade.
ashoup
In Stories, News

Iowa Republicans Prioritize Insurance Company Profits Over Iowans’ Health

In response to Iowa Governor Kim Reynolds signing legislation which allows for the sale of association health plans and ‘benefit plans’ which don’t meet Affordable Care Act requirements, Protect Our Care Chair Leslie Dach released the following statement:

“The legislation takes Iowa back to the days when insurance companies could discriminate against people with pre-existing conditions and refuse to cover essential health benefits like maternity care and prescription drugs, paving the way for even higher premiums and further market destabilization. This legislation will allow insurance companies to sell junk plans without proper oversight – precisely the kind of abuses the Affordable Care Act was designed to stop.”

BACKGROUND

Protect Our Care [3/30/18]: Association Health Plans Endanger Consumers

Washington Post [4/2/18]: Iowa tries another end run around the Affordable Care Act
As a growing number of Republican-led states look for end runs around the Affordable Care Act, Iowa is embracing a strategy that contends not all health plans are actually health insurance. Gov. Kim Reynolds (R) is scheduled Monday to sign into law a bill allowing the century-old Iowa Farm Bureau to collaborate with the state’s dominant insurer to sell “health benefit plans,” which are expected to cost health customers less than ACA coverage because they will not have to comply with federal requirements.

ashoup
In News, Stories

Pew Poll: Health Care Is The #1 Pocketbook Issue for American Families

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.

 

ashoup
In News

The Republican War on Health Care: First They Sabotaged It, Then They Refused to Fix It, Now they Own It

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-partisan Urban 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

           [AARP, 3/21/18]

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]

Sean England
In News

The GOP Stabilization Sham

Let’s be clear about one thing, except for perhaps a handful of Republicans (and perhaps not even that many) Republicans don’t care one iota about stabilizing the Affordable Care Act (which only needs stabilizing because of their very own sabotage).  As a party, their operating theory has been to destroy the law for eight years and to believe that they now want to make it work better is pure fancy.

This whole thing has been a GOP led sham.  Remember, the whole notion of a stabilization bill was dead late last year until they needed Susan Collins’ vote for the tax scam bill which ripped away health care from millions to fund tax breaks for the wealthy and big corporations.  Collins is a Republican and was always going to vote for the tax bill – but she needed cover to vote for a bill that ripped away coverage and spiked premiums for millions of Americans.  She got it in the form of a promise to pass legislation to stabilize the markets – a promise we said from the beginning Republican’s would never keep.  We used to say that Collins got played by a desperate leadership which needed her vote for the only piece of major legislation they had a prayer of passing in 2017, but she’s been in Washington 30 years, she knew this was never going to happen – or, at a minimum, should have known.

Fast forward to today.  Republicans have seen the studies – they know their sabotage is going to massively spike premiums and threaten coverage – but they hate the ACA – always have – and broadly speaking have no interest in helping it survive.  They also know they need to provide cover to Collins because given the margins in the Senate they still need her vote on close bills.  So they put forward a bill that they know Democrats won’t support – which all but codifies junk plans, sets the stage for high risk pools and imposes unacceptable restrictions on abortion – a classic poison pill if there ever was one.  And they’ll force a vote on this bill separate from the omnibus because they know it will fail – which is what they want – and then they will blame Democrats for what ensues in the market and try to claim they would have fixed it.  That’s complete and utter horse manure and no reporter, editorial writer or voter should buy the GOP’s crocodile tears over the failure of their so-called stabilization bill.

My mother taught me growing up that when in doubt consider the source.  Republicans are going to claim that THEY are the ones who want to stabilize OBAMACARE and that Democrats stood in the way?  Give me a break.

Brad Woodhouse, Campaign Director

Protect Our Care

ashoup
In News

The Alexander-Collins Sham Stabilization Bill

Protect Our Care Campaign Chair Leslie Dach released the following statement on the sham, partisan Alexander-Collins health care stabilization bill:

“The Alexander-Collins legislation should be rejected. It is bad for Americans’ health care. This proposal would result in net coverage losses, higher out-of-pocket costs, and fewer coverage options for many Americans. Despite what Republicans may be publicly saying, Alexander-Collins is not a serious attempt to stabilize the marketplaces. House Republicans admit they oppose stabilization. And Republicans are insisting on a poison pill that would further their war on women’s health. This proposal is a partisan bill designed to fail, and it represents nothing more politics at its worst from elected officials who otherwise have voted to repeal Americans’ health care.”

BACKGROUND

  • The Republican “stabilization” bill includes expansive and restrictive new anti-abortion policy that would have far-reaching consequences for women’s health. Republicans claim they want to apply the existing ‘no federal funding for abortions’ Hyde Amendment to stabilization legislation, but are in fact proposing something entirely new: language that would result in an effective ban on private insurance coverage for abortion, including in plans purchased by private individuals using no federal money, which experts predict would coerce insurance companies into dropping abortion coverage from all plans, both on and off the Marketplace, in order to receive CSRs or reinsurance payments.
  • This proposal would ban a woman from using her own money to buy insurance that covers a medical service the Supreme Court says she has a constitutional right to access and represent a new frontier in Republicans’ war on women’s health. And it’s entirely hypocritical, because the Affordable Care Act was signed into law with restrictions that prohibit insurance companies from using public funds for abortion coverage, with President Obama even having signed an executive order emphasizing that none of its funds can be used to cover abortion services.
  • As Aviva Aron-Dine with the Center on Budget and Policy Priorities explains, the CBO finds that this legislation would result in net coverage losses, with larger losses for moderate-income consumers than gains for middle- and upper-income consumers. Ultimately, this legislation would result in net coverage losses between 500,000 and one million people.
  • Moreover, Aron-Dine notes that the CBO has confirmed that the federal savings from restoring CSRs come from coverage losses, higher premiums, and higher out-of-pocket costs for those with incomes below 400 percent of the federal poverty line, which would result in worse outcomes for consumers between 200 and 400 percent of the poverty line. In fact, the savings would come from a combination of consumers dropping coverage and those maintaining coverage being forced to pay more for doing so.
  • When Republicans’ constituents face double-digit premium increases in the fall because their Congressmen scuttled stabilization, they’ll know exactly who to blame.

Key Quote: ‘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).”

ashoup
In News

Dean Heller Traded Thousands of Nevadans’ Health Care for This One Trump Tweet

The tweet:

Heller’s political payoff:

Heller GOP Primary Challenger Tarkanian drops out of U.S. Senate race, jumps into 3rd Congressional District at Trump’s request [Nevada Independent, 3/16/18]

And the price Heller paid Trump?

Voting for a bill that HE HIMSELF said “takes insurance from tens of millions of Americans and hundreds of thousands of Nevadans” after Trump threatened: “He wants to remain a senator, doesn’t he?”

Trump rewards loyalty in Nevada and shows the power he wields over GOP [CNN, 3/17/18]

Last summer when Sen. Dean Heller was considering bucking President Donald Trump on health care, the president issued a not-so-subtle threat to the vulnerable Nevada Republican. “Look, he wants to remain a senator, doesn’t he?” Trump said at a meeting at the White House with GOP senators. Heller laughed off the comment, but GOP senators were alarmed. And the subtle threat may have had an effect. Over the next several months, Heller aligned himself closely with the President, endorsing his efforts to repeal Obamacare, appearing right behind Trump at a White House event celebrating passage of the tax law, and avoiding direct criticism of Trump despite the seemingly endless string of controversies coming out of the West Wing.

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