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ashoup
In Administration, News

Idaho Reactions: Will Secretary Azar Uphold His Oath or Allow State to Blatantly Violate Federal Law?

Today, Blue Cross of Idaho announced that it will follow Republican Governor Butch Otter’s lead and violate federal law by offering insurance plans that don’t conform to the consumer protections mandated by the Affordable Care Act. Blue Cross of Idaho is leading the charge to take people back to a time when insurance companies could decide whether they were taken care of when they got sick, and it’s now incumbent upon the Trump Administration, specifically Health and Human Services Secretary Alex Azar, to uphold the law of the land – just as he swore to do upon assuming his Cabinet position. How is this announcement being treated so far?

American Cancer Society Cancer Action Network, American Diabetes Association, American Heart Association, American Liver Foundation, American Lung Association, Cystic Fibrosis Foundation, Epilepsy Foundation, Hemophilia Federation of America, Leukemia & Lymphoma Society, Lutheran Services in America, March of Dimes, Mended Little Hearts, Muscular Dystrophy Association, National MS Society, National Organization for Rare Disorders: “The Federal Government Must Uphold The Requirements Of Federal Law.” “Idaho’s insurance bulletin would allow insurers to sell individual market plans that do not comply with federal law. Because the Idaho Bulletin purports to authorize the issuance of insurance coverage that is prohibited by federal law, it is legally invalid… The federal government must uphold the requirements of federal law that protect patients, their families, and the health system against these consequences. On behalf of our patients, and all Americans, we urge you to make clear that Idaho cannot authorize the issuance of health insurance coverage that violates federal law, and that any insurer that issues such plans risks enforcement action and serious penalties.” [ACS-CAN, 2/14/18]

Los Angeles Times: “Not A Good Sign For The Rule Of Law.” “If he is serious about his duty to uphold the Affordable Care Act, Azar has no real option other than to nip the Idaho venture in the bud. He could have taken a strong stand during his appearance on Capitol Hill Wednesday, but failed. That’s not a good sign for the rule of law.” [LA Times, 2/14/18]

Business Insider: “HHS Is Required By The ACA To Step In And Take Over Regulation Of Any State That Does Not Meet Regulatory Standards.” “Blue Cross of Idaho announced Wednesday it would take advantage of the state’s new loophole for Affordable Care Act regulations, prompting questions over how the Trump administration will respond… HHS is required by the ACA to step in and take over regulation of any state that does not meet regulatory standards, and the department has done so in four states already.” [Business Insider, 2/14/18]

The Hill: The Proposed Plans Contain Features “Not Allowed.” “[The] proposal is legally questionable and has drawn backlash from Democrats who say he is simply ignoring federal law. The [plans] would charge people with pre-existing conditions more and have a limit of $1 million in claims per year, according to the Idaho Statesman. Both of those features are not allowed under ObamaCare… Democrats have been pressuring Secretary of Health and Human Services Alex Azar to step in to stop Idaho’s plan and enforce the law.” [The Hill, 2/14/18]

Washington Examiner: Proposed Plans “Put Pressure On The Federal Government To Step In And Enforce Rules.” “Many experts have questioned whether this would survive a legal challenge, because Obamacare requires plans sold on the law’s insurance marketplaces, which offer coverage on the individual market, to meet certain benefit requirements… Idaho’s action has put pressure on the federal government to step in and enforce rules that the Trump administration has pushed to repeal.” [Washington Examiner, 2/14/18]

Bloomberg: Proposed Policies “Are Specifically Forbidden.” “[The policies proposed] are specifically forbidden by the 2010 law. The move sets up a potential conflict with the federal government. While President Donald Trump has said he opposes the law and has taken steps to undermine it, the administration will have to decide whether to enforce legal requirements that remain on the books.” [Bloomberg, 2/14/18]

Washington Times: The Trump Administration “Is Responsible For Enforcing [The Law].” “The Idaho situation is a key test for the Trump administration, which still wants to repeal and replace Obamacare but is responsible for enforcing the 2010 law while it remains on the books… Obamacare’s defenders say the Idaho plan skirts the law completely, however, so HHS must act to preserve hard-won consumer protections. ‘It’s cruel, and it’s an illegal attempt to repeal our health care,’ Save My Care, a pro-Obamacare coalition, says in new ads running in Boise, Idaho, and the nation’s capital. ‘Call Health and Human Services Secretary Alex Azar. Tell him to block Governor Otter’s attack on our health care.’” [Washington Times, 2/14/18]

As a reminder, here’s what legal experts are saying about Idaho:

Tim Jost, Washington and Lee University School of Law Emeritus Professor: “What They’re Doing Is Completely Illegal.” “Both in terms of federal penalties and in terms of potential private lawsuits, they are taking on tremendous liabilities here. What they’re doing is completely illegal. It’s kind of jaw-dropping.” [Bloomberg, 2/14/18]

Larry Levitt, Kaiser Family Foundation Senior Vice President: “This Is Simply Not Allowed.” “Idaho is allowing health insurance plans that charge sick people more than healthy people, have an annual limit on coverage, and don’t cover maternity care. That’s simply not allowed under the ACA. If a state like Idaho is not enforcing the ACA’s insurance protections, the federal government is obligated to step in and enforce the rules…. If HHS does not step in and enforce the ACA’s insurance rules in Idaho, it won’t just be about Idaho. Other conservative states will no doubt then start to allow insurance plans that don’t comply with the ACA.” [Twitter, 2/14/18]

Will Secretary Azar follow the oath he swore to uphold just weeks ago? Or will he allow states to violate the very laws he pledged to uphold?

ashoup
In Capitol Hill, Administration, News

3 Facts You Should Know After Sec. Azar’s Ways and Means Hearing

HHS Secretary Alex Azar appeared before the House Ways and Means Committee today and doubled down on the Trump Administration’s war on health care. His language may have been nuanced, but the policy results would be the same. Here are three key facts you should know after his testimony today.

FACT #1: THE TRUMP ADMINISTRATION’S OPIOID FUNDING WILL NOT BE EFFECTIVE IF IT CONTINUES PARTISAN EFFORTS TO REPEAL THE AFFORDABLE CARE ACT AND GUT MEDICAID

WHAT SEC. AZAR SAID: “The President’s Budget recognizes the devastation caused by this [opioid] crisis across America, by providing a historic new investment of $10 billion in HHS funding to address the opioid crisis and serious mental illness…”

THE FACTS: While the additional funding for opioids is welcomed, it will have little to no impact if the Administration continues its partisan push to repeal the Affordable Care Act (ACA) and gut Medicaid.

  • Vox: Trump’s budget could help fight the opioid crisis — if it didn’t try to repeal Obamacare. Vox: “Medicaid is particularly important in this area. A 2014 study by Truven Health Analytics researchers found that Medicaid paid for about 25 percent — $7.9 billion of $31.3 billion — of projected public and private spending for addiction treatment in 2014. That made it the second-biggest payer of addiction treatment after all local and state government programs. Yet not only would Trump’s budget plan end the Obamacare-funded Medicaid expansion, it would also make additional cuts to Medicaid.”

FACT #2: SEC. AZAR DOUBLED DOWN ON THE PARTISAN REPEAL ATTEMPT THAT WILL RIP COVERAGE AWAY FROM TENS OF MILLIONS, RAISE COSTS FOR MILLIONS MORE, AND GUT PROTECTIONS FOR PEOPLE WITH PRE-EXISTING CONDITIONS

WHAT SEC. AZAR SAID: “The Budget supports repealing Obamacare and replacing the law with flexibility for states to create free and open healthcare tailored to citizens’ needs. The two-part approach is modeled closely after the Graham-Cassidy-Heller-Johnson amendment to H.R. 1628, the American Health Care Act of 2017, and also includes additional reforms to put healthcare spending on a sustainable fiscal path.”

THE FACTS: The Graham-Cassidy legislation was the worst of all the partisan repeal efforts Congress considered last year that ripped coverage away from tens of millions of people, raised costs on millions more, gutted protections for pre-existing conditions, and slashed Medicaid.

  • Analysts Agree: Every State Loses Under Graham-Cassidy and Many Working and Middle Class Families See Their Costs Increase. Multiple independent analyses agree that the Graham-Cassidy repeal bill would cut federal funding to states. Over time, every state loses because Graham-Cassidy zeroes out its block grants and ratchets down its spending on the Medicaid per capita cap. This means people would not have access to the financial assistance to help lower their health care bills, and federal Medicaid funding would no longer adjust for public health emergencies, prescription drug or other cost spikes, or other unexpected increases in need.
  • 32 Million Would Lose Health Coverage. As a result of zeroing out block grants for Marketplace tax credits and Medicaid expansion and additional cuts to Medicaid, the Graham-Cassidy bill is essentially repealing the Affordable Care Act without replacing it.
  • Graham-Cassidy Would Raise Costs For People With Pre-Existing Conditions. Graham-Cassidy would allow states to let insurance companies once again charge people with pre-existing conditions more, which could raise costs for the more than 134 million Americans that have a pre-existing condition. An individual with asthma, for example, would face a premium surcharge of $4,340. The surcharge for pregnancy would be $17,320, while it would be $142,650 more for patients with metastatic cancer.

FACT #3: SEC. AZAR DOUBLED DOWN ON THE TRUMP ADMINISTRATION’S WAR ON MEDICAID

WHAT SEC. AZAR SAID: “Our budget proposes a new future for Medicaid that will restructure Medicaid financing, provide states with new flexibilities to better serve our communities, improve the state plan and waiver processes, and provide the right incentives to preserve the program for future generations.”

THE FACTS: The Trump Administration is doubling down on its war on Medicaid by continuing to push for the Graham-Cassidy legislation that ended Medicaid expansion, which has given 15 million people access to care, and by slashing traditional Medicaid, putting the care of millions of seniors, children, and people with disabilities at risk. The Administration’s attempts to impose onerous work requirements are not about work, but about kicking people off their health care. The fact is most people on Medicaid who can work, are working. These requirements are the opposite of what we need to be doing to help people find and keep jobs.

ashoup
In Capitol Hill, Administration, News

It’s Back: President Trump’s Budget Seeks to Revive Health Repeal

To: Interested Parties

From: Leslie Dach, Campaign Chairman, Protect Our Care

Subject: It’s Back: President Trump’s Budget Seeks to Revive Health Repeal

Date: February 13, 2018

——————————————————————————————————————————————–

President Trump’s fiscal year 2019 budget proposal calls for the passage of the so-called Graham-Cassidy bill, the worst of the partisan repeal bills Congress considered last year. If you forgot – and who can blame you, there were a lot of repeal bills! – Graham-Cassidy was deemed “crueler and more cynical” than previous repeal proposals, in large part due to its draconian Medicaid cuts, and garnered just 24% approval before it died in the Senate without a vote. It was opposed by the American Medical Association, AARP, the American Cancer Society, insurers, physicians, faith leaders, nearly every medical and patient’s rights organization, a coalition representing all 50 state Medicaid directors, and Jimmy Kimmel – who analysts said had a “better grasp of health care policy” than the GOP senators who pushed the proposal.

Specifically, the Graham-Cassidy bill Trump wants to bring back would:

  • Take away coverage from 32 million Americans by 2027, with 15 million Americans losing their insurance and premiums increasing by 20 percent in the first year.
  • Gut Medicaid by imposing severe cuts and per-capita caps, forcing states to either raise people’s taxes or make draconian cuts to schools and other vital programs.
  • Raise costs on working- and middle-class families by eliminating financial assistance that helps pay for care. Graham-Cassidy ends premium subsidies, which help 9 million Americans pay for coverage, and Medicaid expansion, which has helped 15 million people get the care they need. These programs would be converted into a block grant and eventually zeroed out.
  • Remove protections for those with pre-existing conditions, with the Congressional Budget Office finding that many people with pre-existing conditions “might not be able to purchase coverage at all.”
  • Harm women’s health by preventing Medicaid enrollees from accessing preventive health and family planning services through Planned Parenthood.

In short, Graham-Cassidy would irreparably harm the American health care system, and the fact that President Trump still considers it a good option shows just how out of touch he is with the American people. The negative reaction to its inclusion have been swift:

New York Times Editorial Board: “It calls for (yet again) the repeal of the Affordable Care Act… Medicare and Medicaid, which benefit one-third of Americans, are targeted for cuts of hundreds of billions of dollars. If Congress adopted Mr. Trump’s proposal, millions of people would stand to lose health insurance.”

Planned Parenthood: “This year’s budget plan proposes sweeping changes that, if implemented, would radically reduce people’s access to health care and information through vital programs, especially for women. Whether or not Congress subscribes to the president’s priorities, the entire proposal is a blueprint for policymaking that the administration will no doubt use to advance its agenda.”

American Cancer Society Cancer Action Network: “Eliminating the health insurance marketplace subsidies and transforming Medicaid funding into a per-capita cap or block-grant structure could leave millions of Americans unable to access critical health services. Medicaid serves as an essential safety-net for more than 2.3 million Americans with a history of cancer, including one-third of all pediatric cancer patients at the point of diagnosis.”

American Lung Association: “Over the past year, Americans have been hit by repeated public health crises, from devastating wildfires and deadly storms to an influenza epidemic. President Trump’s budget proposal would simply make things worse.”

Initial news coverage of the budget proposal also focused on the havoc it would wreak in the American health care system:

Los Angeles Times: “The White House is doubling down on the repeal effort, calling for massive cuts to healthcare assistance in its 2019 budget … Cuts of this magnitude – which parallel repeal legislation pushed unsuccessfully by GOP congressional leaders last year – would likely leave tens of millions more Americans without health coverage, independent analyses have indicated.”

Washington Post: “On healthcare for low-income Americans, Trump’s budget calls for cutting federal Medicaid funding by $250 billion over the next 10 years, as the administration envisions passing a law ‘modeled closely’ on a Senate Republican proposal that failed last fall to repeal the Affordable Care Act…  Experts say the overall reduction in government spending would cost millions of Americans their health insurance.”

Wall Street Journal: “The budget proposal includes $68.4 billion for the Department of Health and Human Services, a 21% drop from the funding level enacted last year. The proposal would also revive a repeal of the Affordable Care Act and cut spending on Medicare and Medicaid. It calls for enactment of a law to scrap the ACA and instead give block grants to states to establish their own health systems, a plan modeled after GOP legislation that failed to pass last year.”

CNBC: The new budget proposal also would seek a rollback of Obamacare’s expansion of Medicaid benefits to poor adults. Medicaid offers health coverage to primarily low-income people. Before Obamacare, most states either denied Medicaid coverage to people who did not have dependent children or set very low limits on how much a person could earn and still qualify for coverage.

Business Insider: “The budget contains cuts to funding for Medicare and other social safety net programs. During the presidential campaign, Trump repeatedly promised not to cut funding to these programs.”

USA Today: “The budget proposes repealing the ACA’s expansion of Medicaid and limiting the amount of money states receive for the jointly-funded health care program for the poor. It would also end after two years the private insurance subsidies for people who don’t get coverage through a government program or an employer, while giving states grants to develop their own programs.”

STAT News: “The proposals are a hodgepodge of relatively narrow policies that take aim at various parts of the Medicare and Medicaid programs. One would reduce the amount of money doctors and hospitals are reimbursed for hospital-administered drugs under Medicare Part B; another would let some states engage in more aggressive negotiation for drugs in their Medicaid programs. Others take aim at a drug discount program for hospitals and at seniors’ out-of-pocket spending.”

Since taking office last year, President Donald Trump and his Administration have carried out an unrelenting war on our health care with a goal of repealing the Affordable Care Act and gutting Medicaid. Trump has used his administrative powers to sabotage our health care and continue to beat the drum of partisan repeal of the increasingly-popular Affordable Care Act.

While the Trump Administration and Republicans in Congress want to keep up this war on health care in 2018, the American people are saying “Enough is Enough.” More than eleven million people signed up for coverage through HealthCare.gov despite all the sabotage efforts. The Affordable Care Act is more popular than it has ever been. And millions of people across the country made their voices heard at rallies, town halls and through calling their Member of Congress to fight these repeal efforts. The American people are right: enough IS enough – it’s time for President Trump and the GOP to end their war on our health care.

ashoup
In Administration, News

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.

ashoup
In Administration, News

This Week in the War on Health Care — February 5-9, 2018

While the budget showdown took up most of the oxygen this week in Washington, the Trump Administration continued its unprecedented assault on the American health care system.

Meanwhile, despite the relentless sabotage, 11.8 million people nationwide signed up for coverage through the Affordable Care Act marketplaces during this year’s open enrollment. Experts estimate that 1.1 million more could have signed up if Trump’s HHS hadn’t attacked outreach funding.

While most of us were focused on cars in space and the stock market, here’s a summary of what happened this week in sabotage – and how Americans are fighting back:

A NEW LOW IN THE WAR ON MEDICAID

On Monday reports emerged that the Trump Administration is considering a new low in their war on Medicaid: lifetime limits on coverage. The Affordable Care Act stopped insurance companies from imposing lifetime limits on coverage, freeing Americans from arbitrary limits on their care. The re-institution of these limits could punish Medicaid enrollees simply because their longtime employer doesn’t offer insurance or because they got sick or have a disability and lost their job, threatening the health and well-being of millions of Americans and leaving large swaths of the population with nowhere to turn.

And with Medicaid covering one-fifth of substance abuse treatment nationwide and playing a “central role,” in attempts to combat this crisis, this proposal could make things even worse.

MEANWHILE, SUPPORT FOR MEDICAID EXPANSION GROWS IN STATES

In stark contrast to the Administration’s near-constant attacks on Medicaid, medical professionals continue to assert the benefits of the popular program and states from coast to coast are moving forward with attempts to expand it.

In North Carolina, a children’s advocacy organization released a new report arguing that Medicaid expansion could reduce the state’s fetal and infant mortality rates, endorsing the bipartisan expansion proposal currently under consideration in the state legislature. Grassroots movements are underway in Nebraska, Utah, Missouri, and Idaho to put Medicaid expansion on state ballots in 2018. Just three weeks ago, Oregon voters supported a legislative package funding the state’s Medicaid program. And back in November, Maine voters overwhelmingly approved Medicaid expansion in the state.

All of which is to stay: people want expanded access to coverage. And if there were any doubts …

OPEN ENROLLMENT BLOWS EXPECTATIONS OUT OF THE WATER

Despite more than a year of sabotage from President Donald Trump, his Administration, and Congressional Republicans, 11.8 million Americans, including 2.5 million new enrollees, 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 the quality, affordable coverage they can get from the Affordable Care Act . Here’s how health care experts and media outlets described this year’s open enrollment period:

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

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.” [KHN, 2/7/18]

Los Angeles Times: The Numbers “Suggest Surprising Strength In Many Markets Across The Country.” [Los Angeles Times, 2/7/18]

The Hill: The Numbers “Show The Obamacare Remains Stable In The Face Of ‘National Uncertainty.’” [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.” [AP, 2/7/18]

Washington Post: “Enrollment Was Surprisingly Resilient.” [Washington Post, 2/7/18]

Washington Times: “Interest In The Exchanges Outpaced Last Year On A Day-To-Day Basis.” [Washington 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.” [Bloomberg, 2/718]

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.”  [AP, 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.” [Winston-Salem Journal, 2/7/18]

Trish Riley, National Academy For State Health Policy Executive Director: “This Shows Consumers Really Want And Need Coverage.”[Los Angeles Times, 2/7/18]

Allison O’Toole, MNSure Chief Executive: “We Had The Best Open Enrollment Period We Have Ever Had.” [Los Angeles Times, 2/7/18]

ashoup
In Stories, Administration, News

“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]

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In Capitol Hill, Stories, Administration, News

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.

ashoup
In Administration, News

Protect Our Care Statement on What Should Have Been the Last Day of Open Enrollment

After the states that stuck with the original Open Enrollment schedule wrapped up strong enrollment seasons last night, Protect Our Care Executive Director Brad Woodhouse released the following statement:

“If President Trump hadn’t sabotaged Open Enrollment by cutting the signup period in half for the 36 states using HealthCare.Gov, yesterday could have marked the end of the annual sign-up season nationwide. But here’s the good news: despite the Trump Administration’s sabotage, millions of Americans again signed up for comprehensive coverage. Before the final numbers come in, we have already reached 96% of last year’s enrollment total nationwide. This year’s enrollment season succeeded thanks to thousands of enrollment assisters, community activists, and volunteers who banded together to do what the Trump Administration refused to: help their fellow Americans get covered. It’s time for Republicans to stop their war on health care, which stopped even more people from signing up by driving up unsubsidized premiums, because it’s clearer than ever that Americans want and need quality, affordable coverage.”

 

 

ashoup
In Administration, News

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.”

ashoup
In Capitol Hill, News

Ted Cruz Vows to Continue the GOP War on Health Care. Will Other Republicans Go Along?

Washington, DC – Today, the Washington Examiner reported that Senator Ted Cruz (R-Texas) told the paper in an interview that Republicans need to “finish the job” and repeal the Affordable Care Act through reconciliation, and that he has been meeting with GOP senators previously opposed to repeal. Protect Our Care Campaign Director Brad Woodhouse issued the following statement in response: “Ted Cruz’s views on health care today are yet again wildly out-of-touch with the American public. Poll after poll has shown that the overwhelming majority of Americans prefer the Affordable Care Act over the GOP’s repeal agenda. Instead of listening to the American people and moving forward on bipartisan improvements to strengthen markets and lower premiums, however, Senator Cruz continues to push partisan repeal. It’s time to find out if other Republican senators agree with Ted Cruz that the GOP should continue its war on health care, the number one issue on voters’ minds – an effort that will result in millions more losing their coverage, and leave everyone else with higher costs and weaker protections – or if there is a better path forward. Will Senators like Susan Collins, Lisa Murkowski and John McCain succumb to pressure from the likes of Senator Cruz and lobbying from Senator Graham, further worsening the GOP’s standing with another secretive, partisan repeal process, or will they say enough is enough and call for an end to the GOP’s war on our health care?”

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