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Momentum Builds Against Lifetime Limits on Medicaid Coverage

As critics speak out against the Trump Administration’s consideration of lifetime limits for people covered through Medicaid, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“One in five Americans has Medicaid coverage, most of them seniors, children, and people with disabilities. Every step the Trump Administration takes to roll back Medicaid coverage reveals that its true intention is to take away health insurance from Americans. But reactions to this week’s news about lifetime limits on Medicaid coverage make clear that this is an approach our nation rejects.

“The Affordable Care Act made it illegal for insurance companies to cut off care, preventing those going through extensive treatment like chemotherapy from having their coverage stopped. Allowing lifetime limits again would cast aside vulnerable Americans for no reason and under false pretenses – because despite the rhetoric coming from this Administration, studies show these proposals don’t incentivize people to work, they merely punish them for getting sick or having a disability and losing their job, or for working for a business that does not offer insurance.

“Implementing lifetime limits for those receiving coverage under Medicaid would work against the foundational goals of the program, which is why Americans are speaking up and fighting back.”

Another day, another stealth attack on Medicaid

Washington Post // Helaine Olen // February 8

Another day, another attack on Medicaid — and on the poor and working class.

According to a little-noticed McClatchy report this week, Arizona, Kansas, Utah, Maine and Wisconsin have appealed to the Trump administration to seek permission to put lifetime limits on Medicaid coverage for recipients they deem able-bodied. In other words, those five states want to time-limit or cap the total period of time an individual could receive Medicaid benefits over his or her lifetime.

There is no word on whether the administration will agree to this, but it is worth noting that it comes on the heels of its decision to allow Kentucky and Indiana to mandate that many of their able-bodied Medicaid recipients meet work requirements.

If successful, this push for lifetime limits will constitute another way to try to undermine the overall Medicaid program, including the Affordable Care Act’s coverage expansion. Arizona opted into the ACA’s Medicaid expansion, and voters in Maine approved a referendum to do the same, though that’s still up in the air. If the Trump administration signals that it will approve lifetime caps, other states that expanded Medicaid could follow. As a result, this could end up being a way to cut back on Medicaid both in states that didn’t expand the program as part of the ACA, and in states that did — further undermining the ACA’s historic coverage gains, just as work requirements will inevitably do.

As Jessica Schubel, a senior policy analyst at the Center on Budget and Policy Priorities, put it, the latest proposed change, when taken along with the work requirements, suggests the administration is “hell-bent on trying to keep people out of coverage.”

Direct attacks on Medicaid are not popular, as President Trump and Republicans learned last year during their efforts to repeal the Affordable Care Act. Polls have also found broad opposition to cutting Medicaid.

But that doesn’t mean Republicans are giving up. Both the work requirements and the proposed lifetime limits should be understood as using bureaucracy to facilitate a backdoor attack on Medicaid. As Rebecca Vallas, a vice president at the Center for American Progress, told me, work requirements ultimately are really about putting up “roadblocks and red-tape obstacles” in the way of access to health coverage. They discourage applicants from completing the process of getting benefits, usually to reduce spending by the states.

Work requirements — which have been championed by Seema Verma, the head of the Centers for Medicare and Medicaid Services — rest on a false premise.  It’s not true — despite myths claiming otherwise — that there are well-paying jobs out there for everyone who is willing and able to do them. Workers in the gig economy find temporary positions that come and go. Other low-wage workers can find their hours fluctuating enormously and with little notice. Medicaid is not simply there for people who are unemployed, or not a part of the workforce, but also as a support for people who are working, but not earning an adequate wage to afford health insurance.

Lifetime limits impose another hurdle on those who need Medicaid. Each state is proposing doing this in a different way. Utah’s proposed lifetime limit would be a total of five years. Wisconsinites would hit the limit at four years. In Kansas, at three years. Three of the states would count time working and not working while receiving Medicaid toward the limit, while two would only subject those receiving Medicaid while unemployed to the limit. Utah would only subject childless adults to it. All of these changes would be complex to navigate and, if they are green-lit, will not only push people out of the program when they hit the limits, but possibly discourage them from applying at all.

Medicaid lifetime limits and work requirements also function as cloaked attacks on the concept of universal health coverage. Medicaid functions as a guarantee of health coverage for people who do not have employer provided insurance, as well as the poor and working class. Lifetime limits — such as work requirements — throw more obstacles in the path of that idea, since they will, at some point, likely leave many without even that baseline access to health coverage.

If you believe universal health care is a right, lifetime limits are not the way to go. Caps on the time people can receive coverage would ultimately have the same effect as work requirements — a certain percentage of people who are ill, or will become ill, will not be able to easily access medical services when they need them.

Lifetime limits on Medicaid eligibility, like work requirements, take us backwards: they reestablish a principle that the ACA tried to abolish, albeit incompletely: that healthcare is not a right, but a privilege.

“Consumers Really Want Coverage”: Nearly 12 Million Americans Sign Up For Marketplace Plans Despite Rampant Obstacles

Meta Capitol

Despite more than a year of sabotage from President Donald Trump, his Administration, and Congressional Republicans, it was announced today that 11.8 million Americans purchased 2018 health insurance through Affordable Care Act marketplaces — 96% of last year’s total. These Americans did so in the face of rampant obstacles put in their way, from a shortened sign-up period to the President declaring the law ‘dead,’ and did so for one reason: they want and need quality, affordable coverage.

Overall, the open enrollment period this year was a resounding success that proved the skeptics wrong. Don’t believe us? Take a look for yourself…

NBC News: “Despite Trump, Obamacare Records Strong Enrollment.” [NBC News, 2/7/18]

Josh Peck, Former HealthCare.Gov CMO: “Without The Trump Administration’s Efforts To Undermine Enrollment, National Enrollment Would Have Exceeded 12.9 Million Enrollments Or Roughly 1.1 Million Additional People Would Have Enrolled.” [Get America Covered, 2/8/17]

Kaiser Family Foundation: 11.8 Million People Signed Up “Amid Steep Reductions In Federal Funding For Outreach In Navigators, An Enrollment Period Half As Long, And A Climate Of Political Uncertainty Surrounding The Law.” “11,760,418 people signed up for 2018 health insurance coverage on the ACA individual marketplaces, amid steep reductions in federal funding for outreach and navigators, an enrollment period half as long, and a climate of political uncertainty surrounding the law. The federal government also terminated cost-sharing subsidy payments to insurers in advance of the open enrollment period, leading to increases in premiums but also increased premium subsidies for many consumers that in some cases led to reductions in what they had to pay for coverage.” [KHN, 2/7/18]

Los Angeles Times: The Numbers “Suggest Surprising Strength In Many Markets Across The Country.” “Almost 12 million Americans signed up for 2018 health coverage through marketplaces created by the Affordable Care Act, according to a new tally that indicates nationwide enrollment remained virtually unchanged from last year despite President Trump’s persistent attacks on the 2010 health law. The new enrollment numbers — which include totals from California and other states that operate their own marketplaces, as well as states that rely on the federal HealthCare.gov marketplace — offer the most detailed picture to date of the insurance markets. And they suggest surprising strength in many markets across the country, with consumers steadily signing up for health plans even as Trump and his Republican congressional allies derided the markets as crumbling and unaffordable.” [Los Angeles Times, 2/7/18]

Bloomberg: “President Donald Trump Has Frequently Been Accused Of Trying To Undermine Obamacare, His Predecessor’s Signature Health Law. New Data Show That By At Least One Measure He Didn’t Do A Particularly Good Job Of It.” President Donald Trump has frequently been accused of trying to undermine Obamacare, his predecessor’s signature health law. New data show that by at least one measure he didn’t do a particularly good job of it. Enrollment in individual health-insurance plans under the Affordable Care Act fell 3.7 percent in 2018 to 11.8 million, from 12.2 million a year earlier, according to data compiled by the National Academy for State Health Policy, which calls itself a nonprofit, nonpartisan association of state health-policy makers. That’s a far smaller drop than some health-policy watchers had foreseen, after the Trump administration halved the enrollment season and cut marketing and enrollment-assistance efforts. Trump himself declared the law ‘dead.’” [Bloomberg, 2/718]

Trish RIley, National Academy For State Health Policy Executive Director: “This Shows Consumers Really Want And Need Coverage.” “‘This shows that consumers really want and need coverage,’ said Trish Riley, executive director of the National Academy for State Health Policy, which compiled the nationwide enrollment tally. ‘These are stable markets and a stable program,’ she said.”  [Los Angeles Times, 2/7/18]

Allison O’Toole, MNSure Chief Executive: “We Had The Best Open Enrollment Period We Have Ever Had.” “‘We had the best open enrollment period we have ever had,’ said Allison O’Toole, chief executive of Minnesota’s insurance marketplace, known as MNsure, which saw enrollment surge nearly 6% this year. Elected officials in Minnesota developed their own reinsurance system to help control premiums this year.” [Los Angeles Times, 2/7/18]

Washington Post: “Enrollment Was Surprisingly Resilient.” “With the Trump administration taking steps to undercut these marketplaces and congressional Republicans having spent much of last year trying unsuccessfully to dismantle large parts of the ACA, leaders of state insurance exchanges and other health-policy experts said that enrollment was surprisingly resilient.” [Washington Post, 2/7/18]

The Hill: The Numbers “Show The Obamacare Remains Stable In The Face Of ‘National Uncertainty.’” “Experts and advocates of ObamaCare had expected a bigger drop in enrollment, mainly due to attacks on the system from the Trump White House. The administration slashed the advertising budget for open enrollment by 90 percent and also cut funds for local groups that help people sign up for coverage.  Experts also worried that multiple attempts by congressional Republicans to repeal and replace the law could cause confusion and deter consumers from signing up… The final numbers released Wednesday, however, show the ObamaCare remains stable in the face of ‘national uncertainty,’ says the National Academy for State Health Policy (NASHP), the group that released the numbers. ‘For the first time we now have the full national picture of how the individual marketplaces did this year and it is a picture of remarkable stability,’ said Trish Riley, executive director of NASHP.” [The Hill, 2/7/18]

Associated Press: “Enrollment Remained Remarkably Stable Despite President Donald Trump’s Disdain For ‘Obamacare,’ And Repeated Efforts By The Republican-led Congress To Repeal The Program.” “Enrollment remained remarkably stable despite President Donald Trump’s disdain for ‘Obamacare,’ and repeated efforts by the Republican-led Congress to repeal the program. The Trump administration also cut the sign-up window in half, slashed the ad budget, and suddenly stopped a major subsidy to insurers, which triggered a jump in premiums.” [AP, 2/7/18]

Larry Levitt, Kaiser Family Foundation: “If You Had Asked Me A Year Ago Whether Enrollment For 2018 Would Be Almost Equal To 2017, I Would Have Laughed At You.” “‘If you had asked me a year ago whether enrollment for 2018 would be almost equal to 2017, I would have laughed at you,’ said Larry Levitt, who follows health law for the nonpartisan Kaiser Family Foundation. ‘So long as lots of people are still getting insurance it becomes much harder to take that away.’” [AP, 2/7/18]

Washington Times: “Interest In The Exchanges Outpaced Last Year On A Day-To-Day Basis.” “Based on its figures, the 11 states — plus D.C. — that ran their own exchanges matched last year’s signups. In fact, there was a tiny increase of 0.09 percent, compared to a 5.3-percent drop among the 34 states that solely relied on HealthCare.gov. Five states that run their own exchanges, yet use the federal website, saw a minuscule increase of 0.2 percent, according to the academy. Mr. Trump slashed the enrollment season in half this year, meaning consumers in HealthCare.gov states had to sign up by mid-December, though hurricane-battered areas got extra time. Interest in the exchanges outpaced last year on a day-to-day basis.” [Washington Times, 2/7/18]

San Diego Union Tribune: States “Generally Attributed The Reduction To The Trump Administration’s [Actions].” “States with larger enrollment declines have generally attributed the reduction to the Trump administration’s decision to cut back on marketing efforts and shorten the 2017 open-enrollment period which ended more than a month earlier than it did in California. Double-digit premium increases in many states are also blamed for decreasing enrollment in many locations. The president’s late 2017 executive order to eliminate special “cost sharing reduction” payments directly to health insurance companies are blamed for the price hikes.” [San Diego Union Tribune, 2/7/18]

Mark Hall, Wake Forest University Professor Of Law And Public Health: “Despite The Trump Administration’s Effort To Undermine The Affordable Care Act, Its Basic Structure Remains Solid.” “Mark Hall, a professor of law and public health at Wake Forest University, said the report ‘shows that, despite the Trump administration’s effort to undermine the Affordable Care Act, its basic structure remains solid. This is a testament to its fundamental soundness. In North Carolina, enrollment dipped, but not as much as some people feared.’” [Winston-Salem Journal, 2/7/18]

As Trump Administration Undermines Medicaid, Some States Attempt to Expand It

Meta Capitol

It was revealed yesterday that the Trump Administration may allow lifetime coverage caps for people covered by Medicaid, an illegal move that would threaten the health and well-being of millions of Americans. But beyond the nation’s capital, states are instead looking at ways to expand Medicaid coverage.

Just today, a children’s advocacy organization in North Carolina released a new report arguing that Medicaid expansion could reduce the state’s fetal and infant mortality rates, bolstering the case for the bipartisan expansion proposal the state is currently considering.

Outside of North Carolina, grassroots movements are underway in Nebraska, Utah, Missouri and Idaho to put Medicaid expansion on state ballots in 2018. And just three weeks ago, Oregon voters supported a legislative tax package funding the state’s Medicaid program. Back in November, Maine voters overwhelmingly approved Medicaid expansion in the state.

“The Trump Administration and Congressional Republicans are doing the exact opposite of what the American people want, which is expanded access to coverage. It’s time for this Administration and its sabotage partners in Congress to get the message being sent to D.C. by countless states and take ACA repeal, Medicaid block grants, and administrative actions that diminish access off the table. Enough is enough: it’s time for the GOP to end its war on our health care,” said Protect Our Care Campaign Director Brad Woodhouse.

Groups: Medicaid expansion could lower baby-death rates

Winston-Salem Journal // Richard Craver // February 7, 2018

A state child advocacy group has added its voice to those urging the Republican-controlled legislature to expand Medicaid to more than 500,000 North Carolinians

States that have expanded Medicaid have a lower infant mortality rate than those who haven’t, NC Child said in a 2016 report.

An update of that report, which was scheduled to be released today, focuses on fetal mortality, which is defined as the death of a fetus that occurs at 20 or more weeks of gestation.

Both rates are affected by a wide range of factors, including tobacco use and substance use disorders, obesity, domestic violence, poverty, racism, education and access to pre-conception and prenatal healthcare.

In North Carolina, 58 percent of women between the ages of 18 and 44 are considered to be overweight or obese, while 16 percent have been diagnosed with hypertension and 20 percent are smokers.

In 2016, North Carolina had almost as many fetal deaths (818) as infant deaths (873).

From 2012 to 2016, there were 6.9 fetal deaths per 1,000 live births in North Carolina, compared with an infant mortality rate of 7.2 per 1,000 live births.

In Forsyth County, the rate of fetal deaths was 6.4 during that time span, while the infant mortality was 8.3. Forsyth’s highest infant mortality rate was 14.7 in 1997.

“By utilizing available federal funding to expand access to affordable health care for women of childbearing age, the state can influence both fetal and infant mortality simultaneously, effectively doubling the positive impact for North Carolina families,” said Whitney Tucker, research director at NC Child.

Statewide, premature birth and low birthweight are the leading causes of death for infants under 1 year old, causing 20.6 percent.

“These chronic conditions and risk factors can be addressed most effectively when women have access to health insurance,” NC Child said. “Unfortunately, 20 percent of North Carolina women of childbearing age (18 to 44) lacked health insurance in 2016.”

NC Child said 20.5 percent of Forsyth women of childbearing age do not have health insurance, while 31 percent do not receive prenatal care in their first trimester of their pregnancy.

“Newborns of mothers with no prenatal care are three times more likely to have a low birthweight and five times more likely to die than children born to mothers who do receive prenatal care,” according to the report.

NC Child spokesman Rob Thompson said “certain groups of non-citizens are eligible for Medicaid and Obamacare, but not undocumented immigrants.”

“I don’t know exactly what portion of the 20 percent is composed of undocumented immigrants. With children in N.C., 96 percent are insured and the general thinking is that somewhere between one-third and one-half of the remaining uninsured are undocumented.”

Most Republican legislative leaders argue that the federal government, first under the Obama administration and now under the Trump administration, may not be able to keep its pledge of covering 90 percent of the administrative costs of Medicaid expansion.

The advocacy group supports House Bill 662, titled “Carolina Cares,” that represents a bipartisan effort to expand Medicaid. The bill has Rep. Donny Lambeth, R-Forsyth, as its main sponsor.

The bill would require some people who get Medicaid to work, which has proven controversial. North Carolina is one of 10 states with federal regulatory permission to move forward with a work requirement, if legislatively approved.

However, HB 662 has not appeared on either chamber’s agenda for the current special session after not advancing out of committee during the regular 2017 session.

“While the proposal includes elements that will negatively impact enrollment — premiums and work requirements — it has the potential to provide currently unavailable health care options for women of childbearing age at high risk of experiencing fetal or infant mortality,” NC Child said.

“Whether it’s Carolina Cares or a different bill, the legislature should act quickly to close the health insurance coverage gap and support healthy pregnancies and healthy babies,” Tucker said.

Marlon Hunter, Forsyth’s health director, has said the county health department, along with its community and agency partners, encourage women of child-bearing age “to achieve optimal health before they become pregnant in order to improve birth outcomes.”

“Almost half of all pregnancies in our community are not planned.”

The county health department and county Infant Mortality Reduction Coalition are focusing on reducing pre-term birth, supporting and improving mental health services for women, and stressing the importance of women and men of reproductive ages to develop reproductive life plans.

The Kate B. Reynolds Charitable Trust and Novant Health Inc. launched Forsyth Connects in May 2016. Their initiative provides free in-home nurse visits to all mothers with newborn babies who are born and reside in Forsyth. The baby doesn’t have to be the mother’s first.

PHOTOS: Health Care Protests at GOP Retreat in West Virginia

As Congressional Republicans retreated to West Virginia to discuss their plans for 2018, they were greeted by protesters who are furious about the GOP’s ongoing war on health care. Hundreds of protesters greeted Vice President Pence at the airport, lined up along the President’s motorcade route, and made sure every Member of Congress in attendance knew just how furious voters are about their party’s health care sabotage:

[Beckley Register-Herald]

The protesters made clear just how devastating the GOP’s health care attacks would be to West Virginia:

“An issue on the minds — and signs — of many of the protesters was health care. Hanno Kirk, 78, of Lewisburg, said his main concern as a health care provider is the 230,000 people in West Virginia who are in danger of losing health insurance if the GOP succeeds in dismantling the Affordable Care Act. ‘It’s totally misguided to attempt to do away with the ACA simply because it’s called ‘Obamacare,’ Kirk said, noting he used to be a ‘liberal Republican in Washington, D.C., back when there was such a thing as a liberal Republican.’ Stephen Josephine Fritsch of Harrisburg, Pa., the daughter of a combat veteran, said it appears the values her father fought for are slipping away. ‘This is America,’ she said. ‘It should be we the America, not me the America.’ Fritsch expressed concern about the state of U.S. health care under GOP leadership.”

“‘Well, we have a lot of issues in West Virginia,’ said psychotherapist and protester Hanno Kirk. ‘As a healthcare provider, I am acutely aware how many of my patients are reliant on Medicaid and Medicare and CHIPS. And if those two are eliminated, as there is a threat to that, we would have a huge number of uninsured people.’” [WVVA, 1/31]

[Beckley Register-Herald]

Protesters gathered at Senator Moore-Capito’s office ahead of Congressional Republicans’ arrival:

Protesters are hitting the streets in Charleston, a day ahead of the GOP retreat at The Greenbrier, to voice their concerns about cuts to health care and Medicaid. A rally Wednesday evening included people from all over the eastern U.S. gathering in Charleston, including one woman from as far away as Vermont. It is a test run for a bigger demonstration on Thursday in Greenbrier County. By the end of the night Wednesday, the group is expecting about 500 advocates in town — standing together against Medicaid and health care cuts. [WSAZ, 1/31]

They met Vice President Pence at the Charleston airport:

“‘We’re just ready for that change,’ Debbie Naeter says. She’s right outside the Greenbrier Valley Airport gates with protestors prepared to welcome Vice President Pence with their concerns. ‘It’s health care, and fracking, and equality, and being nice again,’ she says.” [WDBJ, 1/31]

Engaged activists traveled from all over the country to make their voices heard:

“Protesters came from all over the United States. WDBJ7’s Sara Machi spoke with protesters from West Virginia, New York City, Charlotte, and Arkansas. Many protesters present Thursday said they have decided to protest because of issues important to them. These issues include immigration, healthcare, the recent tax bill, clean water, and other issues.” [WDBJ, 2/1]

[Beckley Register-Herald]

As Paul Ryan raised the specter of “entitlement reform” inside, protesters at the gates of the five-star resort raised awareness about the GOP’s proposed cuts to Medicare and Medicaid:

“President Donald Trump’s address to Republican congressmen at The Greenbrier resort in southern West Virginia has drawn several hundred protesters with signs and chants criticizing him and calling for living wages, protecting Medicaid and Medicare, defending immigrants and decrying hate speech.” [AP, 2/1]

[Twitter]

The bottom line from protesters: Enough is enough. It’s time to stop the Republican war on our care.

“While President Donald Trump and Vice President Mike Pence plan to attend a GOP congressional retreat in West Virginia, some health care advocates plan to attend rallies to protest Medicaid and health care cuts… Organizers said in a news release that West Virginia health care advocates would join more than 500 people gathering to protest and send a message ‘that any cuts to health care — the issue expected to top the GOP’s agenda — will be met with a fierce nationwide fight.’” [WCHS, 1/31]

[Beckley Register-Herald]

Lest anyone be confused, they made clear what the protests were really about:

“Sammi Brown, the federal campaigns director for Our Children, Our Future, said this started after activists in Greenbrier County reached out to individual groups, and word of the action reached organizations in West Virginia and other states shortly afterward. ‘It is folks all along the East Coast that are standing in solidarity with West Virginia. We are expecting upwards of 600 people tomorrow to march with us,’ she said. Brown said the protest was not about Trump but rather the agenda of what she called ‘attacking health care.’” [West Virginia Metro News, 1/31]

And Vice President Pence found one special health care protester – West Virginia Senator Joe Manchin. After Pence chided him for not voting for the GOP tax scam, which kicked millions of Americans off of their coverage, Manchin hit back:

[Twitter]

As President Trump, Vice President Pence and GOP Members of Congress were shown upon their arrival in West Virginia, Americans, from local organizers to United States senators are furious about their repeal and sabotage memo. They’re furious over their weakening of the Affordable Care Act; they’re furious over their attempts to gut Medicare and Medicaid; and they’re furious over their unnecessary attacks on America’s health care system. And if they don’t stop, it’s only going to get worse.

Enough is enough – it’s time for the GOP to end their war on health care.

President Trump Ignores Health Care Damage Caused By Year of Sabotage in 2018 State of the Union

Trump Header Background

Washington, DC – In response to tonight’s State of the Union address, during which President Donald Trump falsely claimed to have repealed the Affordable Care Act, duplicitously claimed he is working to end the opioid crisis, and ignored the fact that under his watch, millions of Americans have lost coverage and millions more are facing skyrocketing health costs, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Tonight’s speech was a succinct summary of health care during the Trump Administration’s first year: full of lies, short on solutions and indifferent to the Americans who have been harmed by its policies. During last year’s speech, President Trump said he would lower premiums, protect those with pre-existing conditions, and protect Medicaid. Instead, he signed a bill which will raise premiums double-digits and deny coverage to millions, championed bills removing protections for pre-existing conditions and imposing an age tax, and implemented Medicaid requirements designed to deny coverage to people who need it the most. And 3.2 million Americans lost their health care in 2017 as a result of his sabotage.

“While President Trump and Republicans in Congress spent the year attempting to sabotage and repeal the Affordable Care Act, the American people refused to go along, voting out Republicans who supported sabotage and enrolling in Marketplace plans at near-record numbers. Today, the Affordable Care Act is more popular than ever. If Donald Trump truly cares about the state of the nation he leads, he will end his repeal and sabotage campaign. Enough is enough – it’s time for President Trump and Congressional Republicans to end their war on health care.”

Fact Check: President Trump Doubles Down On His War on Health Care In the State of the Union

During his State of the Union address, President Trump doubled down on the war on health care his administration and his Republican allies in Congress waged last year, saying he “repealed the core of disastrous Obamacare.” These relentless attacks and sabotage of our health care have real consequences for people across the country. Enough is enough. It it time to end partisan attempts to repeal and undermine health care.

ONE YEAR INTO THE TRUMP/GOP WAR ON HEALTH CARE: MORE UNINSURED & HIGHER COSTS

  • 3.2 million people have lost their health coverage.
  • Trump sabotage led to higher premiums this year because of uncertainty in the market.
  • Women may face higher costs after the Trump Administration took direct aim at birth control by rolling back a rule that guaranteed women access to copay-free contraception.
  • People with pre-existing conditions face higher costs because the Trump Administration’s rules rolling back key consumer protections that will result in garbage insurance.
  • Congress passed, and President Trump signed, a tax bill that repealed a key provision of the Affordable Care Act that will result in millions more losing health coverage and raising premiums by double digits.

Protect Our Care State of the Union Resources

Ahead of tonight’s State of the Union address, here’s a roundup of helpful materials:

  • Protect Our Care State of the Union memo
  • Protect Our Care memo on Trump’s broken health care promises
  • Save My Care “Enough is Enough” campaign announcement
  • Save My Care “Enough is Enough” video
  • Roundup of State of the Union health care guests

Key Points:

Since coming into office last year, President Trump and Republicans in Congress have waged a war to repeal and sabotage our health care.

  • In his first year, Trump and the Republican Congress launched a war on the entire American health care system. They attacked the Affordable Care Act, Medicaid, and other critical health programs repeatedly with repeal bills and aggressive Administrative sabotage.
  • Trump made his war on health care the top domestic priority for his Administration from Day One. His first executive action as President directed his Administration to attack the ACA. Then, his HHS developed a secret plan to sabotage the American health care system from the inside, shared it with Republican leaders in Congress, and began launching attacks on the law from inside the Administration.
  • In Congress, Republicans tried five times to repeal the Affordable Care Act and kick millions off coverage. They ultimately passed a tax bill that will cause millions more Americans to go uninsured and drive up premiums by double digits, all so they can give massive tax breaks to big corporations and the wealthiest.

President Trump and Congressional Republicans’ sabotage is causing millions to lose insurance, driving up costs, and weakening protections.

  • 3.2 million Americans lost coverage during the first year of the Republican war on health care, and millions more stand to lose their insurance because of the Trump Administration’s health care agenda.
  • Trump’s decision to cancel cost-sharing reduction payments that help lower-income families’ out-of-pocket expenses was widely cited as the reason 2018 premiums increased more than predicted.
  • Now, Trump wants to let insurers charge Americans more for less. His Administration’s latest sabotage would take us back to the days when companies could force people with pre-existing health conditions to pay higher premiums, and would allow insurers to stop covering essential medical services like prescription drugs, hospitalization, and maternity care.

Enough is enough: The American people overwhelmingly reject President Trump’s war on health care. It’s time for Republicans in Congress to end their war on healthcare and move on from partisan repeal.

  • Last year, Americans rejected Republican repeal bills that would take coverage from as many as 23 million people, spike older Americans’ premiums with an “age tax,” and eliminate protections for millions of families with pre-existing conditions like cancer.
  • The American people made their opposition to this agenda clear at town halls, rallies, and at the polls.
  • National surveys now show that health care is the #1 most important issue to American voters. Trump’s war on health care has targeted his own base, exacerbating the opioid crisis and hurting rural America.
  • Republicans’ failed repeal drive stopped Congress from getting its work done last year. This year, Americans are asking for an end to partisan health care bills and, instead, bipartisan work to make health care more affordable for families.

Congressional Republicans must end their partisan repeal efforts and stand up to President Trump’s sabotage of our health care or face a powerful reaction from their constituents.

  • The failed Congressional repeal attempts of 2017 wasted Trump’s first 100 days in office, stoked public anger, spurred apolitical Americans to activism, and united a broad coalition of stakeholders.
  • Trump started 2018 by ramping up Administrative sabotage and declaring open war on Medicaid. By accelerating his war on health care, he will inflict even more damage on the American health care system.
  • Congress continues to ignore its constituents by aiding and abetting Trump’s health care sabotage, refusing to cooperate on the bipartisan solutions that Americans want.
  • Most Americans want Congress to keep and improve the Affordable Care Act and to say “enough is enough” to Trump’s war on health care.

A Year Later: President Trump’s Broken Health Care Promises

Enough Is Enough Graphic

Last year, in his first address to a joint session of Congress, President Donald Trump made several promises to the American people about what type of health care plan he would support. Tonight, as he makes his first official State of the Union address, we know he and his Republican allies in Congress broke those promises.

PRESIDENT TRUMP BROKE HIS PROMISE ON LOWERING HEALTH COSTS

WHAT TRUMP SAID: “The way to make health insurance available to everyone is to lower the cost of health insurance, and that is what we are going do.”

WHAT TRUMP DID: The health repeal plan House Republicans passed last year, and President Trump supported, ripped coverage away from 24 million people and raised premiums 20 percent. It imposed an age tax on older Americans by allowing insurers to charge people over 50 five times more.

PRESIDENT TRUMP BROKE HIS PROMISE ON PROTECTING PEOPLE WITH PRE-EXISTING CONDITIONS

WHAT TRUMP SAID:We should ensure that Americans with preexisting conditions have access to coverage, and that we have a stable transition for Americans currently enrolled in the healthcare exchanges.”

WHAT TRUMP DID: The health repeal plan that House Republicans passed, and President Trump supported, raised costs on people with pre-existing conditions by allowing states to let insurers charge them more. This surcharge could be in the six figures: up to $4,270 for asthma, $17,060 for pregnancy, $26,180 for rheumatoid arthritis and $140,510 for metastatic cancer. The Trump Administration has also proposed rules that, if finalized, will allow health insurers to skirt protections for pre-existing conditions.

PRESIDENT TRUMP BROKE HIS PROMISE ON MEDICAID

WHAT TRUMP SAID: “We should give our great state governors the resources and flexibility they need with Medicaid to make sure no one is left out.”

WHAT TRUMP DID: The health repeal bill House Republicans passed, and President Trump supported, ended Medicaid as we know it, slashing it to the tune of $839 billion, or 25 percent, and converting it into a “per capita cap”, thus ending guaranteed coverage for everyone who qualifies, chiefly seniors, children and people with disabilities. It also ended Medicaid expansion. As a result, 14 million people were estimated to lose their coverage under the plan.

PRESIDENT TRUMP BROKE HIS PROMISE ON WOMEN’S HEALTH

WHAT TRUMP SAID:My administration wants to work with members of both parties to … invest in women’s health…”

WHAT TRUMP DID: The Trump Administration and its Republican allies in Congress waged a war on women’s health last year, including efforts to defund Planned Parenthood; taking direct aim at birth control by rolling back the copay-free coverage requirement in the Affordable Care Act; proposing drastic cuts to Medicaid; putting anti-choice judges on the federal bench; and raising costs on women by making them pay more for maternity care.

PRESIDENT TRUMP BROKE HIS PROMISE ON OPIOIDS

WHAT TRUMP SAID:We will expand treatment for those who have become so badly addicted.”

WHAT TRUMP DID: The House repeal plan Republicans passed, and President Trump supported, would make the opioid crisis worse. The repeal bill eliminated the parity requirement that mental health and addiction services be covered under the Medicaid expansion, and the plan put states on the hook for the full cost of dealing with the crisis by proposing drastic Medicaid cuts.

PRESIDENT TRUMP BROKE HIS PROMISE ON PRESCRIPTION DRUGS

WHAT TRUMP SAID: “[We should] work to bring down the artificially high price of drugs, and bring them down immediately.”

WHAT TRUMP DID: Bringing down prescription drug prices has not been a priority for the Trump Administration this past year. Just yesterday, President Trump installed a former Big Pharma executive, Alex Azar, as the new secretary of Health and Human Services.

This Week in the War on Health Care — January 22-26, 2018

This week, Washington was focused on shutdown drama, while in the background, the Trump Administration and Republicans across the country continued their unprecedented assault on the American health care system.

Here’s a what happened this week in Republicans’ war on health care – plus, read down to see how some states are fighting back.

SABERS RATTLE ON CAPITOL HILL

This week, Senator Ted Cruz (R-Texas) told reporters Republicans need to “finish the job” and repeal the Affordable Care Act through budget reconciliation, and that he has been lobbying GOP senators who opposed repeal in 2017.

Apparently those efforts aren’t bearing much fruit: when asked about Cruz’s call to action, Senator Lisa Murkowski (R-Alaska) told reporters, “I don’t think we should be spending time trying to do repeal and replace of ObamaCare” in 2018.

STATE SABOTAGE EFFORTS

Yesterday, Idaho Governor Butch Otter announced his (plainly illegal) intent to let insurance companies in Idaho sell bare-bone plans that don’t include the essential health benefits now required by the Affordable Care Act and again discriminate against people with pre-existing conditions. Experts were … confused:

And in Virginia, a State Senate committee rejected legislation to expand Medicaid on a party-line vote. Just two months ago, Virginians delivered sweeping victories to pro-Medicaid expansion candidates up-and-down the ballot, putting Ralph Northam in the governor’s mansion and flipping delegate seats across the state. A Washington Post exit poll found that 39% of Virginia voters listed health care as the number one issue in their vote. The Virginia GOP may have chosen to keep ignoring the will of the people, but thankfully, this week was only the beginning of Virginia’s fight for Medicaid expansion in 2018.

TROUBLE AT TRUMP’S HHS

On Wednesday, Alex Azar became the Trump Administration’s new HHS Secretary. Throughout his confirmation process, Azar refused to acknowledge the Trump Administration’s ongoing Affordable Care Act sabotage, let alone promise to stop it and stand up for Americans’ health care. Instead, he embraced the Republican agenda to take coverage from millions of Americans, raise costs for millions more, and gut protections for people with pre-existing conditions. Right out of the gate, newly-confirmed Secretary Azar faces a major test: will he block Idaho’s attack against the law of the land, or drive HHS even further away from its mission to protect Americans’ health?

Meanwhile, in the wake of HHS’s quiet renewal of its public health emergency declaration, with little to show for the first 90 days, a member of Trump’s Opioid Commission said the Administration’s efforts to address the epidemic are “tantamount to reshuffling chairs on the Titanic.” Other leading advocates joined him to speak out against the Administration’s failure to address to the nation’s most pressing public health crisis:

CNN: Opioid commission member: Our work is a ‘sham’

The Republican-led Congress has turned the work of the president’s opioid commission into a “charade” and a “sham,” a member of the panel told CNN. “Everyone is willing to tolerate the intolerable — and not do anything about it,” said former Democratic Rep. Patrick Kennedy, who was one of six members appointed to the bipartisan commission in March. “I’m as cynical as I’ve ever been about this stuff.”

Vox: Trump has had a year to confront the opioid epidemic. He’s done almost nothing.

There has been no move by Trump’s administration to actually spend more money on the opioid crisis. Key positions in the administration remain unfilled, even without nominees in the case of the White House’s drug czar office and the Drug Enforcement Administration (DEA). And although Trump’s emergency declaration was renewed last week, it has led to essentially no action since it was first signed — no significant new resources, no major new initiatives.

… AND THE STATES THAT ARE FIGHTING BACK

On Tuesday night, Oregon residents issued a stern rebuke to the GOP’s war on health care. Oregonians went to the polls to vote on Measure 101, an initiative Republicans worked to get on the ballot, which could have denied health care to thousands of their fellow citizens. Instead, Oregonians “overwhelmingly approved” continuing the state’s successful Medicaid expansion. Oregon sent a clear message to the rest of the country: Republicans who continue sabotaging health care should be wary.

And in a sign of how dramatically the politics around health care have shifted, Wisconsin Governor Scott Walker, once an outspoken foe of the Affordable Care Act, has embraced a plan he says will strengthen the law in his state. The about-face comes soon after a national Protect Our Care poll showed that health care is a top priority for most voters going into the 2018 election cycle.

Kaiser Health Tracking Poll: Voters Support ACA, Oppose Repeal, Want Bipartisan Solutions in 2018

Today’s Kaiser Health Tracking Poll echoes key findings from a recent Protect Our Care/Hart Research survey: American voters want President Trump and Congressional Republicans to stop partisan attempts to repeal and sabotage the Affordable Care Act and instead to work with Democrats on bipartisan priorities such as marketplace stabilization.

Key takeaways from today’s Kaiser poll:

  • The ACA remains popular in the wake of repeal & sabotage attempts: At the start of 2018, the public is more favorable in their views of the Affordable Care Act, with 50 percent saying they have a favorable view and 42 percent saying they have an unfavorable view. This continues the trend of a larger share of the public holding favorable views rather than unfavorable ones first measured during the Republican efforts to repeal the ACA during 2017.

  • Midterm voters are focused on health care: Health care is among the top issues American voters want 2018 candidates to talk about during their upcoming campaigns; one-third of independent voters (32 percent) say health care is the “most important issue” for congressional candidates to talk about.
  • Americans want Congress to work on bipartisan health care solutions: Respondents want Congress to stabilize the ACA Marketplaces (51 percent) and address the prescription painkiller addiction epidemic (48 percent). They’ve had enough with partisan Congressional attacks on the ACA – only 28 percent say repeal should be a top priority.

Republicans now own problems with health care: The majority of the public (61 percent) say since President Trump and Republicans in Congress have made changes to the ACA, they are responsible for any problems with it moving forward, compared to about three in ten (27 percent) who say that because President Obama and Democrats in Congress passed the law, they are responsible for any problems with it.