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Thanks Donald: Trump Sabotage Leads To Highest Uninsured Rate Since 2014

Gallup’s quarterly health survey reveals that the uninsured rate has risen to the highest rate since the Affordable Care Act’s coverage expansion was completed. A major reason for this increase? Trump’s relentless health care sabotage. Take a look for yourself:

Gallup’s Own Release Cites Trump Administration Sabotage In Its Explanation Of The Rising Uninsured Rate: “The Open Enrollment Periods Since 2018 Have Been Characterized By A Significant Reduction In Public Marketing And Shortened Enrollment Periods Of Under Seven Weeks, About Half Of Previous Periods.” Among the factors Gallup cites as playing a role in the increase of the uninsured rate:

  • Increasing Premiums: “One may be an increase in the rates of insurance premiums in many states for some of the more popular ACA insurance plans in 2018 (although most states saw premiums stabilize for 2019).”  [Gallup, 1/23/19]
  • Major Cuts To Open Enrollment: “The open enrollment periods since 2018 have been characterized by a significant reduction in public marketing and shortened enrollment periods of under seven weeks, about half of previous periods.” [Gallup, 1/23/19]
  • Slashed Funding For Navigator groups: “Funding for ACA ‘navigators’ who assist consumers in ACA enrollment has also been reduced in 2018 to $10 million, compared with $63 million in 2016. Overall, after open enrollment in the ACA federal insurance marketplace (i.e., healthcare.gov) peaked in 2016 at 9.6 million consumers, it declined by approximately 12.5%, to 8.4 million in 2019, based on recently released figures.”  [Gallup, 1/23/19]
  • Trump’s Hostility To The ACA: “Other potential factors include political forces that may have increased uncertainty surrounding the ACA marketplace. Early in his presidency, for example, President Donald Trump announced, ‘I want people to know Obamacare is dead; it’s a dead healthcare plan.’ Congressional Republicans made numerous high-profile attempts in 2017 to repeal and replace the plan. Although none fully succeeded legislatively, the elimination of the ACA’s individual mandate penalty as part of the December 2017 Republican tax reform law may have reduced participation in the insurance marketplace in the most recent open enrollment period. Trump’s decision in October 2017 to end cost-sharing reduction could also potentially have affected the uninsured rate.” [Gallup, 1/23/19]

Los Angeles Times: Uninsured Rate Under Trump Surges To Highest Level Since Obamacare Began. “The percentage of American adults without health insurance surged upward in 2018, reaching levels not recorded since before President Trump took office, according to a new national survey that revealed widespread coverage losses over the last two years…The new number represents the highest uninsured rate since the beginning of 2014, when the Affordable Care Act began providing billions of dollars in aid to help low- and middle-income Americans get covered, according to the survey by Gallup. The new report also indicates that some 7 million American adults have likely lost or dropped coverage since 2016…Since taking office, however, Trump has repeatedly attacked the healthcare law and enthusiastically backed a 2017 effort by congressional Republicans to roll it back.” [Los Angeles Times, 1/23/19]

HuffPost: The Uninsured Rate Is The Highest It’s Been In Five Years. “About 7 million fewer Americans had health insurance at the end of last year compared with two years prior, and the share of people who are uninsured is the highest it’s been since 2014, according to a new survey…Since his first day in office, Trump has directed and overseen policies that undermine the health insurance exchanges. The administration has dramatically reduced funding for advertising, marketing and outreach to draw eligible customers to the exchanges during open enrollment and for programs that help consumers navigate the sign-up process. The Republican tax package Trump enacted in 2017 repealed the Affordable Care Act’s fines on people who didn’t obtain health coverage under the law’s individual mandate, freeing people to go uninsured without penalty and causing insurers to increase prices on the assumption that healthier people are less likely to buy coverage in the absence of fines. Perhaps most consequentially, Trump ended payments to health insurance companies serving the lowest-income customers, which led insurers to increase prices to make up for the lost revenue.” [HuffPost, 1/23/19]

Vox: Under Trump, The Number Of Uninsured Americans Has Gone Up By 7 Million.Certain demographic groups are experiencing a greater loss of coverage than others. Gallup data shows, for example, that Americans who are younger and lower-income have seen a greater decline in insurance coverage than those who are older and wealthier. Women have had insurance rates decline more quickly than men. This trend is especially surprising given that over the same time period, the unemployment rate has been declining. Usually, when more people have jobs, it means more people with access to employer-sponsored health insurance. But even during this period of job growth, America’s uninsured rate keeps climbing.” [Vox, 1/23/19]

Forbes: Uninsured Rate Hits Four-Year High Amid Trump’s Obamacare Attacks. “The rate of Americans without health insurance has ‘risen steadily’ to 13.7% from 10.9% in 2016 , data released Wednesday as part of Gallup’s national “health and well-being index,” which drew from a quarterly data sample of about 28,000 adults…Following his 2016 election, Donald Trump swept into the White House in January of 2017, promising to repeal and replace the ACA, also known as Obamacare. That effort was a failure because the Republican-led Congress of 2017 was unable to repeal the law nor did GOP lawmakers come up with a replacement plan. But the Trump White House has made several policy moves that the Gallup analysis indicates has contributed to fewer people having coverage. ‘The open enrollment periods since 2018 have been characterized by a significant reduction in public marketing and shortened enrollment periods of under seven weeks, about half of previous periods,’ Gallup’s analysis said.” [Forbes, 1/23/19]

CNBC: Rate Of Americans Without Insurance Rises To 4-year High As Trump Weakens Obama Health Law, Gallup Survey Finds. “The percentage of U.S. adults without health insurance reached a four-year high in the last quarter of 2018, but was still well below the peak level seen before Medicaid expansion under the Affordable Care Act in 2014, a new Gallup survey published Wednesday found. The national uninsured rate climbed to 13.7 percent in the fourth quarter of 2018, its highest level since the first quarter of 2014 when the rate reached 13.4 percent, according to data the compiled from Gallup. Women and adults under the age of 35 reported among the highest rates without insurance at 12.8 percent and 21.6 percent, respectively, the survey found.” [CNBC, 1/23/19]

Axios: “Gallup’s Quarterly Health Surveys Tell A Pretty Clear Story, Which It Attributes To The Trump Administration’s Handling Of The ACA.” “The number of Americans without health insurance has been creeping higher throughout the Trump administration, and it’s now the highest it’s been since the Affordable Care Act’s coverage expansion took effect in 2014, according to Gallup’s latest survey…Women, lower-income households and young people saw the biggest coverage losses, according to Gallup…Gallup’s quarterly health surveys tell a pretty clear story, which it attributes to the Trump administration’s handling of the ACA.” [Axios, 1/23/19]

“Higher Costs And More People Being Uninsured” How Trump’s Latest ACA Sabotage Targets Consumers

Last week, the Centers for Medicare and Medicaid Services (CMS) proposed changes to the Affordable Care Act’s benefit and payment parameters that would raise costs and reduce coverage for millions of Americans. On top of reducing subsidies available to those who purchase health care through the exchange and increasing premiums, the Trump administration’s proposed rule changes would also raise the out-of-pocket maximum for people with employer-sponsored health care.

Here’s what news outlets have to say about the proposed changes:

Axios: Consumers Would Pay More Under New ACA Rules. “Turns out the Trump administration’s big ACA regulation packs a bit more punch than we realized at first. Some of the rule’s technical changes will end up requiring people to pay more for their coverage, while rolling back the cost of federal premium subsidies, my colleague Sam Baker reports…The federal government would end up spending about $900 million less on premium subsidies, according to the proposed regulation. The same change would also slightly loosen limits on out-of-pocket costs. The ACA capped total out-of-pocket spending at $8,000 per year for an individual and $16,000 per year for a family plan.  The Trump proposal would raise those caps by $200 and $400, respectively, according to Brookings’ Matt Fiedler. That change would apply to people who get coverage through their jobs, not just the ACA’s insurance markets.” [Axios, 1/22/19]

Wall Street Journal: Trump’s Proposed ACA Rules Could Lift Costs For Millions Of People. “The Trump administration on Thursday proposed changes that could raise health insurance costs for millions of Americans who get coverage on the job or receive subsidies under the Affordable Care Act, a move that Republicans said is necessary to cut inflated subsidies but Democrats viewed as another GOP effort to sabotage the health law. The proposal, released by the Centers for Medicare and Medicaid Services, would raise the out-of-pocket maximum that people with employer-sponsored coverage pay in 2020. The individual maximum would increase by $200 to $8,200 annually, and the maximum for family coverage would increase by $400, analysts said. The plan would also change a calculation that determines how much people pay if they buy insurance from the ACA exchange and get credits to reduce their monthly premiums. The change could raise premiums next year for many of the roughly 9 million people who get the credit.” [Wall Street Journal, 1/17/19]

Los Angeles Times: Despite The Government Shutdown, Trump’s Efforts To Gut Obamacare Go Full Speed Ahead. “A good portion of the federal government may be shut down, but you can rest assured that the devoted Obamacare saboteurs at the Department of Health and Human Services are on the job. Late Thursday, they released proposed rule changes for the 2020 health insurance year — and requests for comments on further changes — that will drive up premiums for people on Affordable Care Act health plans, cut subsidies and discourage more Americans from enrolling. The proposals also could raise prescription costs for enrollees and raise costs even for families enrolled in employer plans. Longer-term changes proposed for 2021 and beyond could affect about 2 million ACA enrollees.” [Los Angeles Times, Hiltzik, 1/18/19]

Associated Press: White House Proposes To Increase Affordable Care Act Premiums. “The Trump administration Thursday announced proposed rule changes that would lead to a modest premium increase next year under the Affordable Care Act, potentially handing Democrats a new presidential-year health care issue. The roughly 1 percent increase could feed into the Democratic argument that the Trump administration is trying to ‘sabotage’ coverage for millions. The administration said the proposal is intended to improve the accuracy of a complex formula that affects what consumers pay for their premiums. Premiums under the health law were basically stable this year after several sharp annual hikes.”  [Associated Press, 1/17/19]

Politico: CMS Wants To Reduce Obamacare Subsidies Through Formula Change. “The administration is proposing a technical change in the 2020 marketplace rules that is expected to result in less premium assistance for low-income Obamacare customers, POLITICO’s Paul Demko reports…A decrease in financial assistance of $900 million and 100,000 fewer Obamacare customers in 2020 if the proposal is adopted, according to CMS. The agency is justifying the change as a way to reduce big increases in federal subsidies that resulted from the Trump administration’s decision to cut off cost-sharing reduction payments.” [Politico, 1/18/19]

Buzzfeed News: Administration’s Proposed Rule Would “Result In Higher Premiums And More People Being Uninsured.” “The Trump administration revealed this week that it could try to take one more shot at weakening the Affordable Care Act’s individual markets before the end of Trump’s first term. A request for comment on a proposed rule change posted late Thursday contemplates a series of changes that would save the government $1 billion per year or more, but result in higher premiums and more people being uninsured…But now the administration is signaling it may try to end silver loading. Doing this on its own would lead to a major jump in premium costs and could badly destabilize the markets. The administration says it wants to kill silver loading in concert with Congress voting to bring back the old subsidies. However, Congress has so far shown a complete inability to come together to pass a bill to improve the Obamacare markets. The administration did not specifically say it will act without Congress, but it did so with premiums in the past and is asking for feedback on how it should ‘address’ the issue of silver loading.” [Buzzfeed News, 1/18/19]

Elections Have Consequences: State and Local Leaders are Protecting and Expanding Health Care Even as President Trump and Republicans Continue Their Repeal and Sabotage Agenda Nationally

Last year, health care was the number one issue that drove people to the polls and fueled the new Democratic majority in the U.S. House of Representatives.  And, even as President Trump and Republicans continue to pursue their repeal and sabotage agenda, elected leaders at the local and state level are fighting back and responding to voters by taking action to protect and expand coverage, and lower costs for their constituents. Elections do indeed have consequences.

(CA) Gov. Gavin Newsom Moves To Expand Access To Health Care In California. “Gov. Gavin Newsom proposed a broad overhaul of health care on his first day in office Monday, promising to throw the state’s financial power into an effort to lower prescription drug costs, expand Obamacare so middle-class families can receive subsidies to buy insurance, and offer Medi-Cal coverage to undocumented immigrants up to age 26. Newsom aides said the expansion of Affordable Care Act subsidies would be funded by a California version of the individual mandate, the former federal requirement that people either carry health insurance or pay a penalty on their taxes. Congressional Republicans and President Trump repealed the mandate in 2017, although the penalty does not disappear until the 2019 tax year. Newsom would reinstate it on the state level.” [San Francisco Chronicle, 1/7/19]

(CO) Colorado Democrats Introduce Public Option Health Care. “Creation of a public option health care plan is one of the most ambitious changes Colorado Democrats proposed Friday as they kicked off a new session of the General Assembly in control of both chambers for the first time in four years. The first five bills introduced in each chamber — indicators of lawmakers’ top priorities for the year — largely relate to health care and education costs. A Senate bill would create a public option health insurance plan that Coloradans who live in the highest-cost areas — mainly the Western Slope — could buy instead of their current insurance starting in the fall of 2019. A House bill would expand that program to the entire state by the fall of 2020.” [The Denver Post, 1/4/19]

(ME) On First Day In Office, Gov. Janet Mills Signs Executive Order Directing State To Implement Medicaid Expansion. “Medicaid expansion is finally advancing in Maine, more than a year after voters approved it at the ballot box. Newly sworn in Gov. Janet Mills, a Democrat who campaigned on broadening access to health insurance, used her first executive order to direct the Maine Department of Health and Human Services to begin implementation of Medicaid expansion.” [CNN, 1/3/19]

(NM) In New Mexico, Democrats Plan To Introduce A Bill To Create A Medicaid Buy-in Program. “New Mexico Democrats eye creating the nation’s first Medicaid buy-in program, one of many blue-state efforts expected this year to expand health insurance coverage.” [Politico, 1/9/19]

(WA) Gov. Jay Inslee Proposes Public Option For Washington. “Gov. Jay Inslee and Democratic lawmakers Tuesday announced proposed legislation for a new “public option” health-care plan under Washington’s health-insurance exchange. The proposal, which Inslee said is the first step toward universal health care, is geared in part to help stabilize the exchange, which has wrestled with double-digit premium increases and attempts by Republicans in Congress and President Donald Trump to dismantle the Affordable Care Act. ‘We are proposing to the state Legislature that we have a public option that is available throughout the state of Washington so that we can increase the ability to move forward on the road to universal health care in the state of Washington,’ said the governor, who is considering a run for president in 2020.” [The Seattle Times, 1/8/19]

(WI) Gov. Tony Evers Signs Executive Orders To Direct State To Develop Plan For Expanding Medicaid, Find Ways To Protect ACA’s Consumer Protections. “In his second day on the job, Gov. Tony Evers signed executive orders Tuesday to study expanding health coverage and providing insurance protections for people with pre-existing conditions…One order directs the state Department of Health Services to develop a plan to expand the state’s BadgerCare Plus health care program for low-income people under the Affordable Care Act, known as Obamacare. Republican lawmakers have fiercely opposed the idea. The issue is expected to come to a head this year as Evers and lawmakers work on a state budget that will determine whether the state taps into additional federal aid through Obamacare. The second order tells state agencies to prepare plans to find ways to protect coverage for people with pre-existing conditions, bolster consumer protections, improve the public’s understanding of insurance, and require insurers to make their costs and terms easily understandable. Evers has said the best way to protect coverage for those with pre-existing conditions is to keep the Affordable Care Act in place. He campaigned on getting Wisconsin out of a multistate lawsuit challenging the law.” [Milwaukee Journal-Sentinel, 1/8/19]

(NY) Governor Cuomo and the legislature to pursue reproductive rights protections. “Gov. Andrew Cuomo called Monday for including abortion rights in the New York Constitution, calling it an unprecedented opportunity to protect a woman’s right to choose… Cuomo took his call a step further, vowing to push an amendment that would enshrine a woman’s right to choose in the state Constitution. Such a move would make it more difficult for future governors and lawmakers to reverse: A constitutional amendment has to be approved by successively elected Legislatures and approved by a vote of the public. [Rochester Democrat and Chronicle, 1/7/19]

(NYC) New York City Mayor Bill de Blasio To Fund Health Care For All, Including Undocumented. “New York Mayor Bill de Blasio proposed a $100 million plan that he said would provide affordable ‘healthcare for all,’ reaching about 600,000 people, including undocumented immigrants, low-income residents not enrolled in Medicaid and young workers whose current plans are too expensive. The plan, which de Blasio dubbed ‘NYC Care,’ will offer public health insurance on a sliding price scale based on income, the mayor said during an interview Tuesday morning on MSNBC. It will begin later this year in the Bronx and will be available to all New Yorkers in 2021, and would cost at least $100 million once it reaches full enrollment, according to the mayor’s office.” [Bloomberg, 1/8/19]

Welcome To Washington’s 116th Congress

“The New Democratic House Of Representatives Will Be Relentless In Defending Protections For People With Pre-existing Conditions And Affordable Health Care For Every American.” – Speaker Nancy Pelosi

Since regaining control of the House, Democrats who ran and won the midterm election on protecting health care have wasted no time doing just that. On day one, under Speaker Pelosi’s leadership, Democrats voted to defend the Affordable Care Act and protect people with pre-existing conditions, and they are just getting started.

 

Speaker Nancy Pelosi: “The New Democratic House Of Representatives Will Be Relentless In Defending Protections For People With Pre-existing Conditions And Affordable Health Care For Every American.” “The new Democratic House of Representatives will be relentless in defending protections for people with pre-existing conditions and affordable health care for every American…Republicans should end their assault on health care and join us to do the right thing for the American people.” [The Hill, 1/3/19]

U.S. News & World Report: “The Chamber That Once Led The Fight To Undo Obamacare Will Now Be Fighting For Its Survival In The Courts.” “Democrats are making it brazenly clear they are back in power in the House of Representatives, providing a critical roadblock to the GOP agenda in an already-gridlocked government…The chamber that once led the fight to undo Obamacare will now be fighting for its survival in the courts. The old committee to examine global warming will be reconstituted – and renamed, more ominously, the Select Committee on the Climate Crisis.” [U.S. News & World Report, 1/4/19]

House Democratic Caucus Chairman Hakeem Jeffries (D-NY): In 116th Congress, “Nancy Pelosi will fight to lower healthcare costs, strengthen the affordable care act, protect people with pre-existing conditions.” “But Nancy Pelosi is just getting started. In the 116th Congress, she will continue to fight hard For The People. Nancy Pelosi will fight to lower healthcare costs, strengthen the affordable care act, protect people with pre-existing conditions, increase pay for everyday Americans, enact a real infrastructure plan, clean up corruption, defend the dreamers, fix the voting rights act and end the era of voter suppression once and for all.” [Hakeem Jeffries Website, 1/3/19]

Politico: “House Democrats In Power For The First Time In Nearly A Decade Are Opening A Sustained Campaign To Hammer Republicans On Obamacare.” “House Democrats in power for the first time in nearly a decade are opening a sustained campaign to hammer Republicans on Obamacare, seeking to force the GOP’s hand on popular policies like protecting patients with pre-existing conditions…Those votes are just opening salvos from House Democrats, who also plan to go after the Trump administration policies that they say have purposefully undermined Obamacare by depressing enrollment, cutting subsidies, promoting skimpy alternative health coverage, and even having the Department of Justice take the unusual move of supporting key elements of a lawsuit against the federal health law.” [Politico, 1/4/19]

Washington Post: “House Democrats Used Their New Majority On Thursday To Squeeze Republicans On Health Care.” “House Democrats used their new majority on Thursday to squeeze Republicans on health care, taking the first step to intervene in a court case in which a Texas judge has ruled the Affordable Care Act unconstitutional. That move will be followed by a vote next week designed to force GOP lawmakers into a political corner: agree to defend a law many members have spent years reviling or appear to oppose popular ACA protections for millions of Americans with preexisting medical conditions that many have pledged to uphold.” [Washington Post, 1/3/19]

CNN: “In Their First Hours In Control Of The House Of Representatives, Democrats Filed A Motion To Intervene In An Ongoing Lawsuit That Threatens To Bring Down The Affordable Care Act.” “In their first hours in control of the House of Representatives, Democrats filed a motion to intervene in an ongoing lawsuit that threatens to bring down the Affordable Care Act…As part of its rules package for the 116th Congress, the Democrats granted themselves authorization to intervene in the lawsuit that threatens to bring down the landmark health care law. It directed the House’s Office of General Counsel to represent lawmakers in any litigation involving the act and authorizes hiring of outside counsel. The House late Thursday voted in the rules package, which the majority party — now the Democrats — adopts at the start of a new Congress. The newly empowered Democratic leadership also scheduled a vote for next Wednesday on a standalone resolution affirming the House’s authorization to intervene in the lawsuit. This would put Republicans on the record voting specifically for or against defending Obamacare and its protections for those with pre-existing conditions.” [CNN, 1/4/19]

Rep. Jim McGovern (D-MA), Chairman On The Rules Committee: “We’re On Offense” On Health Care. “We’re on offense…The American people made it very clear in the last election that health care is important, and they don’t want Republicans screwing around with it. And we’re going to have their backs.” [Politico, 1/4/19]

CNN: “House Democrats Are Moving Quickly To Defend The Affordable Care Act Once They Retake Control Of The Chamber Thursday.” “House Democrats are moving quickly to defend the Affordable Care Act once they retake control of the chamber Thursday. As part of its rules package for the 116th Congress, the party is granting itself authorization to intervene in the lawsuit that threatens to bring down the landmark health reform law. It directs the House’s Office of General Counsel to represent lawmakers in any litigation involving the act and authorizes hiring of outside counsel…Supporting the Affordable Care Act, including its popular provisions that protect those with pre-existing conditions, helped Democrats retake the House in the midterm elections in November. Since then, the party’s leaders have repeatedly said they will swiftly work to uphold the law.” [CNN, 1/2/19]

CNBC: House Democrats Set Up Framework To Intervene In Federal Court Case Striking Down Obamacare. “Democrats about to take over control of the House of Representatives have moved to defend Obamacare from a court challenge that threatens to kill the landmark health-care reform law. In an action Tuesday night, Democratic leaders said they will authorize their next speaker, likely Nancy Pelosi, to intervene in a pending federal case, Texas v. United States, in which a judge has ruled Obamacare unconstitutional. Democrats regain control of the House when Congress returns for the 116th congressional session Thursday.” [CNBC, 1/2/19]

Washington Post: Democratic Wishlist Includes “Health Care (With A Focus On Prescription Drug Prices And Protecting People With Preexisting Conditions).” “At the top of the list is a sweeping political reform package linked to a new Voting Rights Act. Taking on the ‘special interests,’ she said, will ‘give people confidence’ in the rest of the Democratic wish list that includes health care (with a focus on prescription drug prices and protecting people with preexisting conditions), workforce training and ‘building the infrastructure of America in a green way.’ For the longer term, Democrats would be looking for ways to expand health coverage by strengthening the Affordable Care Act.” [Washington Post, Dionne Jr., 1/2/19]

The Hill: House To Vote Next Week On Intervening To Defend ObamaCare In Court. “A spokesman for House Minority Leader Nancy Pelosi (D-Calif.) said the vote on having the House formally intervene in court to defend ObamaCare will come next week, in addition to a vote on Thursday on intervening in the lawsuit as part of the larger package of rules for the new session of Congress. Holding the separate additional vote next week will put Republican lawmakers on record, highlighting the political pressure that Democrats hope to put on vulnerable GOP lawmakers who campaigned last year pledging to support protections for people with pre-existing conditions. Democrats say if GOP lawmakers vote against defending ObamaCare, they will be showing that they don’t actually support protections for people with pre-existing conditions contained in the health law.” [The Hill, 1/2/19]

Daily Mail: Nancy Pelosi’s First Move As Speaker Will Be A Public Stand On Saving Obamacare By Intervening In Court Case Where Judge Struck It Down As Unconstitutional. “Incoming likely speaker Nancy Pelosi is laying down a marker that newly-empowered Democrats will go to court to protect Obamacare, in one of the first acts of the Democratic-run House. Pelosi, who stands for election on Thursday, has assembled a new rules package that specifically commits the House to a legal case that has once again thrown President Obama’s signature health plan into jeopardy. Pelosi helped marshall through Obamacare during her first term as speaker. Now, the new rules package that the Democratic House will codify in their traditional first legislative action, will specifically authorize the House to intervene in the case.” [Daily Mail, 1/2/19]

Despite Democrats making monumental gains to become a pro-health care Congress, Republicans are touting a bill that would have ripped coverage from millions of Americans and decimated important consumer protections, continuing their tone-deaf message despite voters’ strong rejection of the GOP’s repeal and sabotage agenda:

In Her Speech Nominating Rep. Kevin McCarthy (R-CA) For Speaker Of The House, Rep. Liz Cheney (R-WY) Boasted About Republican Effort To Repeal The Affordable Care Act. “Leader McCarthy has led us through the 115th Congress in unmatched historic productivity, including passage of the historic Tax Cuts and Jobs Act, because we know, Madam Clerk, that the American people know better than the government how to spend their money…Leader McCarthy also led to ensure that we passed the American Health Care Act to expand access and options and put patients and families in the driver’s seat, not government bureaucrats.” [Cheney Floor Speech, 1/3/19]