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Sabotage

protectourcare
In News, Administration, Capitol Hill

New Census Report: Trump-GOP Halts Progress of Improved Health Coverage

Things Will Go From Bad to Worse as Trump-GOP Doubles Down on Its Repeal-and-Sabotage Agenda

Washington, D.C. – The Trump Administration and Congressional Republicans have remained consistent in their crusade against access to affordable health care, and the latest Census data confirms that after annual declines between 2013 and 2016, it has stopped hard-won progress in reducing the number of uninsured Americans in its tracks. And with GOP House Whip Steve Scalise today joining Vice President Mike Pence and Congressional Republicans in pledging to bring health care repeal back for a vote the minute they get a chance, it’s clear that Trump-GOP sabotage will only continue to wreak havoc on seniors, children, people with disabilities, women and working families across America.

Leslie Dach, chair of Protect Our Care, issued the following statement in response:

“Make no mistake, the Trump Administration and GOP have actively tried to rip health coverage away from millions of Americans and his alarming data will only get worse over time.  Republicans sabotaged open enrollment, created chaos in the insurance markets, and raised health care costs for millions.and pledge to continue to take health care away from millions moving forward. As long as the Trump-GOP war on health care continues, the American people will once again be left to suffer.”

ashoup
In Administration, News

Cities Sue Trump Administration Over ACA Sabotage

Yesterday, four cities — Baltimore, Chicago, Columbus, and Cincinnati— filed a lawsuit against the Trump Administration for intentionally sabotaging the Affordable Care Act.

Here’s how the lawsuit has been received nationally:

NBC News: Suit Seeks To Force Trump To Adopt Policies To Expand Rather Than Shrink Enrollment. “The suit seeks to force Trump to adopt policies intended to expand rather than shrink enrollment; reduce rather than increase premiums; and promote instead of attack the ACA. Among the specific rules plaintiffs seek to reverse are allowing exchanges to strip individuals of tax credits without notification and reducing oversight of insurance agents and brokers, as well as oversight of the law in general.” [NBC News, 8/2/18]

Fortune: “Trump Broke Constitutional Law By Attacking Obamacare, Lawsuit Says.” “Since Congress failed to repeal the Affordable Care Act last year, President Donald Trump has attempted to weaken the program through eliminating protections, discouraging enrollment, and driving up costs, the lawsuit argues. According to court filings, this directly violates a clause in the U.S. constitution, which states the president and their administration must ‘take care that the laws be faithfully executed.’” [Fortune, 8/2/18]

Esquire: “Consequences Be Damned.”: “[T]he administration’s ongoing attempt to sabotage the Affordable Care Act has led folks into interesting places. For example, four cities are now suing the president on the grounds that, in the case of the ACA, the president is in violation of his oath of office, and of Article II of the Constitution…The lawsuit got some ammunition on Thursday when the Brookings Institute released a study concluding that insurance premiums would have gone downhad the president and his party simply allowed the law to work.”

The Hill: Four Cities File Lawsuit Saying Administration’s Sabotage of ACA Violates Constitution. “The cities of Baltimore, Chicago, Columbus and Cincinnati filed the lawsuit in federal court in Maryland, arguing that Trump’s actions against the Affordable Care Act violate the Constitution’s provision that the president ‘shall take care that the laws be faithfully executed.’ The lawsuit points to a range of administration actions in arguing its case, including that it expanded insurance options that do not comply with the health-care law’s rules, that it cut funding for outreach to help people sign up for coverage, and that it shortened the sign-up period for ObamaCare.” [The Hill, 8/2/18]

Talking Points Memo: Cities Cite Trump Effort To Ways Trump Has “Depressed Health Insurance Enrollment And Driven Up Costs For Both Individuals And Taxpayers. “Cities filed a lawsuit on Thursday accusing the Trump administration of violating the “Take Care” clause of the Constitution and the Administrative Procedure Act by chipping away at the Affordable Care Act in ways that have depressed health insurance enrollment and driven up costs for both individuals and taxpayers.” [Talking Points Memo, 8/2/18]

What experts have to say:

Andy Slavitt, Former Administrator of CMS: The ACA Lawsuit Will Be Yet Another Test Of The Rule Of Law For A President Who Seems To Have Very Little Regard For Those Constraints.” “The ACA lawsuit will be yet another test of the rule of law for a president who seems to have very little regard for those constraints. It coincides with two major political events that highlight the issues at stake. First up is Supreme Court nominee Brett Kavanaugh’s Senate confirmation hearing, where he will be questioned extensively about his views on the limits of presidential authority. Then, fewer than 100 days away, are midterm elections that will put the ACA front and center; polls show access to health care is a top item on voters’ minds.” [USA Today, 8/2/18]

Abbe Gluck, Yale Law Professor: “If There’s Ever Going To Be A Violation Of The ‘Take Care’ Clause, This Is It.” “This case stands apart from all others, says Abbe Gluck, a Yale University law professor and expert on Article II, because it’s not about the extent to which Trump is “faithfully” implementing a law. Rather Trump has been frank that he is sabotaging the law, she said. ‘That’s what makes this case novel, first of its kind and really important,’ Gluck said. ‘No scholar or court has ever said the president can use his discretion to implement a statute to purposely destroy it…If there’s ever going to be a violation of the ‘take care’ clause, this is it,’ she said.” [NBC News, 8/2/18]

Abbe Gluck: “It Is Impossible To Recall A President Who Has Been As Clear About His Intent To Sabotage A Major Federal Law As This President Has Been About His Intent With Respect To The ACA.” “Historically, making the case for a violation of the take care clause has been a tall order because the executive is often vested with broad discretion to implement the law. But it is impossible to recall a president who has been as clear about his intent to sabotage a major federal law as this president has been about his intent with respect to the ACA.” [Vox, 7/23/18]

And here’s how cities have reported the news:

WCPO Cincinnati: Cincinnati Says Trump Administration Sabotage Is Costing City. “That’s costing the cities more money to pay for services that provide medical care to those who are uninsured or underinsured. In Cincinnati, for example, the city health department subsidizes various health centers with an annual budget of $23 million. The number of uninsured patients who visited those centers already increased by 11 percent from 2016 to 2017, according to the lawsuit.” [WCPO Cincinnati, 8/2/18]

Columbus Dispatch: Columbus Citing How Much Sabotage Is Costing City, Leads Suit Against Trump Administration Over Affordable Care Act. “Dismantling the Affordable Care Act will directly affect the city’s budget because it will result in more uninsured Americans, [Columbus City Attorney Zach Klein] said. The city provides about $4.3 million a year to Primary One, a federally qualified health center that Klein said has seen 3,000 more uninsured patients in the past year. It also will hit the city’s fire department, which takes about 132,000 medic runs a year. The city seeks to recoup costs from insurance companies if the patient has insurance, typically recovering about 40 to 80 percent of its costs, Klein said. For uninsured patients, the city sends a bill but doesn’t send unpaid bills to collections, he said. For uninsured patients, the recovery drops to an average of 4 percent.” [Columbus Dispatch, 8/2/18]

Columbus Resident, Denise Jacobs, Depends On ACA For Life Supporting Drugs. “Denise Jacobs is one of the people in Columbus that Klein says received help from the ACA. Jacobs was diagnosed with intersitial lung disease, and after many medical treatments and a lung transplant, she now uses anti-rejection drugs to help with her transplant. Jacobs says she’s worried about what the end of Obamacare may do to people like her. ‘Some people like me may have trouble affording their life supporting drugs,’ says Jacobs.” [WOOSU, 8/2/18]

Baltimore Mayor Emphasizes Cost Of Sabotage On Baltimore. “[Baltimore Mayor Catherine Pugh]  said the Baltimore City Fire Department treated 17,000 people last year who did not have health insurance. ‘As a result, you know, that’s uncompensated care and we’ve got to take care of individuals. We don’t turn people away from our hospitals, we try to take care of them. This is a cost the city cannot afford to bear,’ Pugh said.” [WBAL TV, 8/2/18]

Chicago Sun-Times: Chicago Joins Lawsuit, Highlights Burden Of Trump Sabotage On Chicago. “An increase in the number of uninsured or under-insured residents would ‘force Chicago to pay more to operate and subsidize’ public health clinics and put a greater strain and ‘unrecouped costs’ on the Chicago Fire Department’s newly-expanded fleet of 80 ambulances, the city contends.” [Chicago Sun-Times, 8/2/18]

ashoup
In Administration, News

New Lawsuit Seeks to Hold Trump Administration Accountable For Deliberate Sabotage and Higher Health Care Costs

Cities and Citizens Stuck with Higher Health Care Costs Maintain that the Trump Administration is Intentionally Violating its Constitutional Duty to “Faithfully Execute” the Affordable Care Act

Lawsuit Brings Danger of Kavanaugh on the Court into Sharper Focus

Washington, D.C. – Today, several cities stuck with higher health care costs and individuals saddled with astronomical premiums due to President Trump’s health care sabotage filed a lawsuit against the Trump Administration for violating its constitutional duty to “take care” that the Affordable Care Act be “faithfully executed.” The plaintiffs argue that the Trump Administration is actively and intentionally destabilizing the exchanges, decreasing enrollment and in turn driving up premiums and the uninsured rate, which leaves municipalities and families holding the bill.

“This lawsuit makes clear what we’ve known all along, that President Trump is violating his constitutional duties by intentionally sabotaging the Affordable Care Act. From day one President Trump has said he wants the Affordable Care Act to fail and each day since he has gloated about his efforts to destroy the law. His illegal actions are increasing the cost of health care and taking away coverage from millions, all while insurance companies’ profits skyrocket. Today’s lawsuit also brings into sharper view exactly why a vote to confirm Brett Kavanaugh is a vote to overturn our health care: Brett Kavanaugh has criticized previous Supreme Court decisions protecting the Affordable Care Act and has said he believes the president can disobey the law. President Trump must implement the law in good faith and be held accountable for his actions.”    

THE TRUMP ADMINISTRATION’S UNPRECEDENTED SABOTAGE CAMPAIGN

January 2017

  • On his first day in office, President Trump signs an Executive Order directing the administration to identify every way it can unravel the Affordable Care Act.
  • Also on January 20th, the Department of Health and Human Services begins to remove information on how to sign up for the Affordable Care Act.
  • The Trump Administration pulls funding for outreach and advertising for the final days of 2017 enrollment. This move is estimated to have reduced enrollment by nearly 500,000.

February 2017

  • The Trump Administration proposes a rule to weaken Marketplace coverage and raise premiums for millions of middle-class families.

March 2017

  • The Trump Administration sends a letter to governors encouraging them to submit proposals which include provisions such as work requirements that make it harder for Medicaid beneficiaries to get affordable care and increase the number of people who are uninsured.

April 2017

  • The Trump Administration cuts the number of days people could sign up for coverage during open enrollment by half, from 90 days to 45 days.
  • In an effort to convince Democrats to negotiate a repeal of the Affordable Care Act, President Trump threatens to cut off cost-sharing reduction payments (CSRs) that help low-income marketplace customers pay for out-of-pocket costs.

May 2017

  • House Republicans vote for and pass a health care repeal bill that would cause 23 million people to lose coverage and gut protections for people with pre-existing conditions. It would have imposed an age tax and allowed insurers to charge people over 50 five times more for coverage and ended Medicaid as we know it, putting the care of seniors, children and people with disabilities in jeopardy.

June 2017

  • Senate Republicans embark on a monthslong failed attempt to pass BCRA, Skinny Repeal and Graham-Cassidy, all repeal bills that would have caused millions of Americans to lose their health coverage and raised premiums by double digits for millions more. They would have ended Medicaid as we know it, putting the care of children, seniors and people with disabilities at risk.

July 2017

  • The Trump Administration uses funding intended to support health insurance enrollment to launch a multimedia propaganda campaign against the Affordable Care Act.
  • President Trump, again, threatens to end cost-sharing reduction payments.

August 2017

  • The Administration cuts the outreach advertising budget for Open Enrollment by 90 percent, from $100 million to just $10 million – which resulted in as many as 1.1 million fewer people getting covered.

September 2017

  • The Administration orders the Department of Health and Human Services’ regional directors to stop participating in Open Enrollment events. Mississippi Health Advocacy Program Executive Director Roy Mitchell says, “I didn’t call it sabotage…But that’s what it is.”

October 2017

  • The Trump Administration takes direct aim at birth control by rolling back a rule that guaranteed women access to contraception. (A court has since questioned the legality of the action.)
  • President Trump signs an Executive Order to roll back key consumer protections that will result in garbage insurance, raise premiums, reduce coverage and again expose millions of Americans to discrimination based on pre-existing conditions.
  • The Trump Administration dramatically cuts in-person assistance to help people sign up for 2018 health coverage.
  • After threatening for months to stop funding cost-sharing reduction payments (CSRs) that help lower deductibles and out-of-pocket costs, the Trump Administration stops the payments altogether. The CBO finds that failing to make these payments will increase premiums by 20% and add nearly $200 billion to the debt.

November 2017

  • Republicans refuse to move forward on the bipartisan Alexander-Murray bill to address the CSR crisis even though it had a filibuster-proof majority in the Senate.

December 2017

  • The Trump Administration proposes a rule to expand association health plans, which would gut consumer protections, raise costs for people with pre-existing conditions and further destabilize the insurance markets.
  • Congressional Republicans pass their tax scam, which doubles as a sneaky repeal of the Affordable Care Act  by kicking 13 million people off of their insurance and raising premiums by double digits for millions more.

January 2018

  • The Trump Administration announces that it will support states that impose onerous work requirements on Americans covered by Medicaid, and approves Kentucky’s worst-in-the-nation waiver the next day.
  • The Trump Administration announces a move to allow providers to discriminate by allowing them to deny patient care for almost any reason.
  • The Trump Administration makes plans to announce even more exemptions from the requirement people have health coverage before this provision is repealed altogether.

February 2018

  • The Trump Administration announces that it will expand access to short-term health plans that do not have to comply with key consumer protection provisions required by the Affordable Care Act.
  • Urban Institute calculates that repeal of the individual mandate and expansion of short term plans will increase individual market premiums by an average 18.2 percent in 2019.
  • Trump Administration releases budget that calls for the Affordable Care Act to be replaced by Graham-Cassidy, in a move that experts predict would reduce health coverage for 32 million Americans.

March 2018

  • Republicans sabotage efforts to pass a bipartisan bill that would have stabilized Affordable Care Act marketplaces by insisting the bill restrict access to abortion.

April 2018

  • House Republicans vote on a balanced budget amendment that would cut Medicaid by $700 billion over ten years, $114 billion in a single year alone.
  • Trump Administration limits access to assistance for consumers who want to enroll in marketplace coverage. This change removes the requirements that every area has at least two “navigator” groups to provide consumer assistance and that one be local. Now, just one group could cover entire states or groups of states.

May 2018

  • President Trump boasts about health care sabotage: “We will have gotten rid of a majority of Obamacare.”
  • Trump Administration enlists help of former drug lobbyist in writing its drug plan.
  • Congressional Republicans attempt to use annual farm bill to authorize $65 million in taxpayer funding to set up association health plans, which can  exclude prescription drug coverage, mental health care, and maternity care.

June 2018

  • Department of Justice takes to the courts to argue that insurance companies should be able to discriminate against as many as 130 million Americans with a pre-existing condition.
  • Republican coalition, the Health Policy Consensus Group, released their latest proposal to repeal the Affordable Care Act, which would gut protections for people with pre-existing conditions, let insurance companies charge older people an age tax, and deny coverage for basic services like maternity care.
  • Trump Administration finalizes proposal to expand access to association health plans that skirt key consumer protections

July 2018

  • CMS halts risk adjustment payments, that enable insurance companies to cover everyone, regardless of whether they are healthy or sick.
  • Trump Administration slashes funding for non-profit health navigator groups, that help people shop for coverage, from $36 million to $10 million. CMS encourages groups to use the remaining funds to push people to sign up for junk plans that skirt important consumer protections.
  • President Trump nominates Brett Kavanaugh to the Supreme Court. Kavanaugh has previously forced a young woman to continue a pregnancy against her will and has criticized Justice Roberts for upholding the Affordable Care Act’s constitutionality.

August 2018

  • Trump administration finalizes rule for bare-bones short-term plans that are exempt from key consumer protections, such as the requirement that insurance covers prescription drugs, maternity care, and hospitalization.
ashoup
In Administration, News

“Cheap for A Reason”: Outcry Against Trump’s Junk Plan Proposal

This morning the Trump administration announced its decision to allow junk plans that can deny coverage to people with pre-existing conditions, that are not required to cover key benefits, such as cancer treatments and prescription drug coverage, and that can refuse to pay for costs by claiming that you had a pre existing condition you didn’t tell them about.  

News coverage has called the administration’s actions out for what they are: a blatant move to dismantle protections for people with pre-existing conditions and undermine the Affordable Care Act.

Headlines paint a telling picture:

  • HuffPost: Horrible Health Insurance Now Legal Again, Thanks To Trump. [HuffPost, 8/1/18]
  • Bloomberg: Short-Term Health Plans Backed By Trump Are Cheap For A Reason. [Bloomberg, 7/31/18]
  • Associated Press: Officials Are Promoting Lower-Cost, Short-Term Health Plans. [Associated Press, 8/1/18]
  • New York Times: ‘Short Term’ Health Insurance? Up To 3 Years Under New Trump Policy. [New York Times, 8/1/18]
  • San Diego Union-Tribune: Trump Administration Widens Availability Of Skimpy, Short-Term Health Plans. [San Diego Times-Union, 8/1/18]
  • Politico: Trump Whacks Obamacare By Boosting Short-Term Health Plans. [Politico, 8/1/18]
  • Washington Post: Trump Administration Widens Availability Of Skimpy, Short-Term Health Plans. [Washington Post, 8/1/18]
  • Los Angeles Times: Trump Administration Moves To Further Expand Skimpy Health Plans. [Los Angeles Times, 8/1/18]
  • NPR: Under New Rules, Cheaper ‘Short-Term’ Health Care Plans Now Last Up To Three Years. [NPR, 8/1/18]
  • Governing: Trump Administration Loosens Restrictions On Skimpy, Short-Term Health Plans. [Governing, 8/1/18]
  • Kaiser Health News: Trump Administration Loosens Restrictions On Short-Term Health Plans. [Kaiser Health News, 8/1/18]
  • The Cut: Trump’s New Insurance Rules Put Women And Children At Risk. [The Cut, 8/1/18]

Reporters have been quick to note that these plans will hurt consumers…

Los Angeles Times: Expanding Short-Term Plans Is Opposed By Nearly Every Patient Advocacy Organization In The Country. “Expanding short-term plans also risks driving up costs for Americans with preexisting medical conditions who need more comprehensive benefits…Among the groups that have opposed the Trump administration’s moves are virtually every leading patient advocacy organization in the country, including the American Lung Assn., the American Heart Assn., the Cystic Fibrosis Foundation, the March of Dimes, the National Multiple Sclerosis Society, Susan G. Komen, AARP and the advocacy arm of the American Cancer Society.

HuffPost: Short-Term Plans Provide Junk Coverage And Drive Up Costs Of Comprehensive Care. “Meanwhile, those seeking out comprehensive plans because they want or need them will discover those policies have gotten more expensive, thanks to the way short-term plans will affect the rest of the insurance market. Some insurance shoppers will have serious, even life-threatening diseases, such as cancer, which will mean their insurance must have a full set of benefits. But those kinds of policies will become more expensive than they can afford. [HuffPost, 8/1/18]

Bloomberg: Cheaper Plans “Can Come At A Cost.” “For some people, though, the cheaper premiums can come at a cost, such as when insurers claim that a cancer treatment shouldn’t be covered because a patient had the disease before buying coverage, as Bloomberg reported in October.” [Bloomberg, 7/31/18]

Short-Term Plans Sometimes Impose Unexpected Rules, Like For Instance Refusing To Cover Hospitalizations During The Weekend. “There may be other strange rules. A review of some plan documents from Families USA found an Illinois plan that would cover only hospitalizations beginning during the week — inpatient stays that began on the weekend would not be allowed except in rare circumstances. Some plans had waiting periods for care. Cancer treatment, for example, is not covered in certain plans during the first month a person is enrolled in a plan, and no treatment for illness is covered in the first five days. That’s the kind of detail that might be easy to overlook when signing up for a plan if you aren’t expecting a cancer diagnosis.” [New York Times, 8/1/18]

….financially benefit insurance companies….

With Short-Term Plans, Insurance Companies Can Spend Less Money On Medical Care. “According to research from the National Association of Insurance Commissioners, the average short-term plan in 2017 spent less than 65 percent of premium dollars on medical care. Some of the short-term plans in the association’s analysis keep more than half of all premiums as overhead and profit.” [New York Times, 8/1/18]

Brokers Tend To Make Higher Commission On Short-Term Plans. “Brokers also tend to make higher commissions on the short-term plans, since the companies share a cut of their larger profits to get referrals. According to eHealth, a national online brokerage, a typical Obamacare-compliant plan pays a commission of around 5 percent, while short-term plans pay out commissions closer to 20 percent. Because short-term plans are currently limited to 90 days, brokers now make more money selling comprehensive plans that cover more benefits. But that math may shift as short-term plans expand their duration under the new rule, giving brokers a stronger financial incentive to sell short-term plans instead.” [New York Times, 8/1/18]

…and are designed to undermine access to affordable, comprehensive care.

Huffington Post: “The New Rules Represent One Of The Most Consequential Steps That President Donald Trump And His Republican Allies Have Taken In Their Campaign To Dismantle The 2010 Health Care Law Known As Obamacare.” [HuffPost, 8/1/18]

Washington Post: Making It Easier To Buy Plans That Circumvent The Law Part Of Trump’s Strategy To Undercut The ACA.“Making it easier to buy health plans that avoid the law’s protections is part of a strategy being employed by Trump and his aides of relying on executive powers to undercut aspects of the law, whose demolition has been one of Trump’s central goals since his 2016 campaign.” [Washington Post, 8/1/18]

San Diego Union-Tribune: Plans Are “Devised To Foster Low-Price Insurance That Circumvents The Affordable Care Act’s Coverage Requirements And Consumer Protections.” “The new rules are the second tool the administration has devised lately to foster low-price insurance that circumvents the Affordable Care Act’s coverage requirements and consumer protections. In June, the Labor Department issued rules that will make it easier for small companies to buy a type of insurance known as association health plans and, for the first time, allow them to be sold to people who are self-employed…Both can have bigger price differences between older customers and younger ones. But only the short-term plans can also charge higher prices to customers with medical conditions that require care, deny them coverage, or avoid covering health problems that a customer had before buying the insurance — all practices that the ACA bans.” [San Diego Times-Union, 8/1/18]

ashoup
In News, Administration

Experts Condemn Trump Move To Push Junk Short-Term Plans

This morning, the Trump Administration announced a rule that encourages consumers to ditch comprehensive health care in favor of junk short-term plans that will leave them with piles of bills and without coverage should they get sick. This announcement is just the latest attempt to undermine the Affordable Care Act, strip protections for people with pre-existing conditions, and drive up premiums. Here’s a look at what experts are saying:

Mary Dwight, Senior Vice President Of Cystic Fibrosis Foundation: Plans Will Split Market Into Plans For Healthy And Plans For Sick. “The new plans will no longer be just transition coverage. They will be an alternative to comprehensive insurance. They will split the market into plans for healthy people and plans for sick people.” [New York Times, 8/1/18]

Sabrina Corlette, Professor At Georgetown University Health Policy Institute: Short-Term Plans Are “Very Much A Buyer-Beware Situation.”  [Bloomberg, 7/31/18]

Larry Levitt, Senior Vice President of Kaiser Family Foundation: Trump Using Short-Term Plans To Create Parallel Insurance Market That Can Skirt ACA Consumer Protections. “The Trump administration cannot eliminate the ACA’s insurance rules. Instead, they are using short-term insurance plans to create a parallel market of insurance plans that do not have to follow any of the ACA’s rules.” [Levitt, 8/1/18]

Chris Hansen, President Of The American Cancer Society Cancer Action Network: People With Cancer Could “Face Astronomical Costs.” “People who buy the new policies and develop cancer could ‘face astronomical costs’ and ‘may be forced to forgo treatment entirely because of costs.'” [New York Times, 8/1/18]

Georgetown Center On Health Insurance Reforms: As Bills Start To Pile Up Under Short-Term Plans, Many Folks Would Realize “They’re Not Really Insured At All.” “If you are pregnant, you will have to find another way to pay for the cost of your pre-natal care and labor and delivery (maternity care charges for a normal birth average $32,093; $51,125 for an uncomplicated C-section). If you get cancer, your plan will not cover oncology drugs, which can cost an average of $10,000 per month. If you are hospitalized, you may find yourself owing hundreds of thousands of dollars for services that are not covered by your plan.” [Georgetown Center On Health Insurance Reforms, 7/26/18]

Blue Cross Blue Blue Shield Association: “The Broader Availability And Longer Duration Of Slimmed Down Policies That Do Not Provide Comprehensive Coverage Has The Potential To Harm Consumers.” “The broader availability and longer duration of slimmed-down policies that do not provide comprehensive coverage has the potential to  harm consumers, both by making comprehensive coverage more expensive and by leaving some consumers unaware of the risks of these policies.” [Politico, 8/1/18]

Erika Sward, Assistant Vice President Of The American Lung Association Describes Rule As “One More Blow Of An Ax To Stable State Marketplaces.” [New York Times, 8/1/18]

America’s Health Insurance Plans: We Remain Concerned That Consumers Will Face HIgh Medical Bills When They Need Care That Isn’t Covered. “We remain concerned that consumers who rely on short-term plans for an extended time period will face high medical bills when they need care that isn’t covered or exceed their coverage limits.” [Alice Ollstein, Talking Points Memo, 8/1/18]

New National Association of Insurance Commissioners Report Confirms That With Short-Term Plans, A Significantly Higher Percentage Of Money Goes Toward Administrative Costs And Profits Than Care. The NAIC report reveals that the largest seller of short-term plans, UnitedHealth, has a medical loss ratio, the ratio of money that goes toward care versus administrative costs and profits, of 43.7 percent, compared to the ACA-mandated minimum of 80 percent. [NAIC, July 2018]

ashoup
In News

Health Care Champions Take to Senate Floor to Call Out Ongoing Sabotage

Washington, D.C. – This afternoon, Senators Murphy, Murray, Coons, Menendez, Baldwin and Durbin took to the Senate floor to lay out the comprehensive repeal and sabotage campaign the Trump Administration and Congressional Republicans have undertaken in the year since the GOP’s repeal legislation failed. Among the highlights:

Sen. Chris Murphy:

“First, the President set an executive order saying that all of his agencies should take their own actions to unwind the protections of the Affordable Care Act. Then he stopped the marketing for the affordable care act so that less people would know about the options that were available to them. Then the President came to Congress and worked with Republicans to take away one of the most important pillars of the Affordable Care Act, a requirement that healthy people buy insurance — that action alone will result in 13 million people losing insurance and rates going up for 10 million Americans. Most recently the President authorized the junk insurance plans across the country, plans that don’t have to cover mental health, prescription drugs, or maternity care. He then cut funding even deeper for the personnel who help you find what insurance is right for you and instructed the people that remained to push Americans onto the junk plans. Then the President sent his lawyers to court to argue that congress can’t actually protect people with pre-existing conditions because it’s unconstitutional, which would wipe out all of the protections that people enjoy today. And so it’s really no mystery as to why, as the 2019 premium increases are coming out, they are catastrophic… The reason they are passing along enormous premium increases is because of the sabotage run by the President and this Congress.”

Sen. Patty Murray:


“During [the health care debate] I heard personal stories from patients and families all over my state of Washington who were concerned. I heard stories like Julie’s. Julie has a genetic condition, and as a result of that, she has had four different types of cancer. She has had four different organs removed during treatment and she has had her diet severely restricted and her life dramatically changed. But she is a fighter and she had excellent care and she ultimately won each of those four battles with cancer. However, without protections for people with pre-existing conditions, her health care costs could skyrocket. If President Trump had his way, Julie could not get the care she needed, and by the way, she’s not the only one.”

Sen. Chris Coons:

“[The Texas v. United States] lawsuit impacts every corner of America’s health care system and that [this] Administration is not defending the law of the land is a shocking development. It impacts not just those who get their health care through the ACA exchanges. It would impact 150,000,000 Americans who get their health insurance through their employer because it would eliminate protections against lifetime and annual limits on care. It would impact seniors on Medicare who would see increased prescription drug costs. It would impact Americans who depend on free preventive services, cancer screenings, and flu shots because those policies, components of the ACA, would be eliminated. And it impacts young people who would lose their right to stay on their parents’ health insurance until age 26. These are just a few of the devastating impacts if the Texas v. US lawsuit is successful in ripping out what is left of the protections of the ACA. It would have a real and tangible impact on families in my state of Delaware and across our country.”

Sen. Bob Menendez:

“Republicans’ reckless abandonment of families with pre-existing conditions is even more concerning given President Trump’s nomination of Judge Brett Kavanaugh to the Supreme Court. This is a judge with a long history of ruling against consumers, siding with corporate interests, and assailing the constitutionality of the Affordable Care Act. […] Without the Affordable Care Act, insurance companies could deny coverage to [children like] 4-year-old Ethan, who is more concerned about which dinosaur to play with than the pacemaker that’s keeping him alive. Before the Affordable Care Act, children like Ethan were blacklisted from insurance companies for life. How do you tell a 4-year-old that his president no longer believes in protecting children like him?”

Sen. Tammy Baldwin:

“The people of Wisconsin did not send me to Washington to take people’s health care coverage away. They have consistently sent a clear message that they want us to work across the party aisle to make things better and not worse. […] Last year the American people sent a loud message to Washington. I heard it, and they are sending the same simple message today: protect our care.”

Sen. Dick Durbin:

“My wife and I got married. I was in law school. God sent us a beautiful little girl and she had a serious medical problem. We were living here in Washington, D.C., and didn’t have health insurance. And I want to tell you, you never felt more helpless in your life than to be a new father with a brand-new baby who desperately needs medical care and not have health insurance. I’ll never forget it as long as I live. I lived in such fear from that point forward of not having health insurance coverage that I did crazy things like getting health insurance two different places of employment just to make sure I never lost it. It scared me that much. I still remember that fear, and I wonder if the people who are debating this issue about the Affordable Care Act ever lived through it themselves? Because if they did, they wouldn’t be standing here saying we can do away with the Affordable Care Act.”

###

ashoup
In News

New Report Shows Americans Will Spend Thousands of Dollars More on Health Care Premiums Due to GOP Sabotage

Washington, D.C. – New data released today by the Center for American Progress (CAP) shows a family of four will be paying an extra $3,000 for marketplace coverage due to Republican sabotage, while House Republicans gear up to advance politically-motivated legislation that will provide no relief for the higher health care costs Republicans have caused American families.

CAP’s analysis — and this shameless political posturing of House Republicans — comes nearly a year to the day after Americans rose up to stop the repeal of the Affordable Care Act in the Senate. All this time later, health care remains a top issue for voters because of the GOP’s ongoing campaign to sabotage health care and the higher costs and havoc it has caused all people, but especially those with pre-existing conditions, women, and people over age 50.  

“These bills do nothing to roll back the premium increases caused by the Republican tax bill, the Administration’s relentless sabotage campaign, and the uncertainty in the markets caused by Republicans’ repeated efforts at repeal. The premiums Americans will see next year will be too high by thousands of dollars, on top of the massive increases we are already paying this year because of the intentional, deliberate acts of Republican war on health care. We wish Republicans would work with us to advance bipartisan, popular reforms to reverse the damage they’ve done and bring costs back down for consumers. But as this week’s events show, they are only interested giving themselves political cover before they face their constituents this fall,” said Leslie Dach, chair of Protect Our Care.

ADDITIONAL BACKGROUND:

GOP Sabotage Has Persisted for 18 Months, and Has Caused Massive Premium Increases

  • Last year, Republican sabotage pushed 2018 insurance premiums up by a national average of 37 percent and this year GOP sabotage has resulted in 2019 premium increases in all but two states where the data is available.
  • Among the findings in CAP’s report released today, in 2019:
    • A typical family of four will see a marketplace premium that is $3,110 higher.
    • A 55-year-old couple will see a premium $3,330 higher on average.
    • An unsubsidized 40-year-old will pay an extra $970 on average.
  • Meanwhile, other acts of sabotage would eliminate protections for people with pre-existing conditions and raise costs. View a comprehensive list of acts of health care sabotage here.

A Year After Repeal Defeated in the Senate, Health Care is the Top Issue to Voters, and May be the Issue that Most Influences the Midterm Elections

  • A new Protect Our Care-PPP poll released yesterday found voters will support candidates who want to improve the ACA rather than repeal it, and strongly oppose the Trump Administration going to court to overturn protections for people with pre-existing conditions.
  • In June, the Kaiser Family Foundation tracking poll found health care to be the top issue for voters, ranked higher than all issues, including the economy and jobs.
  • A June NBC News poll found health care to be top midterm issue.
  • In a May CBS News poll, voters said health care is the most important issue in deciding who to vote for Congress in November.
  • A year ago, ACA repeal bills were among the least popular pieces of major legislation in history. When the House was considering the “American Health Care Act,” (AHCA) polls at the time showed it to be the most unpopular piece of major legislation Congress had considered in decades. Then, the so-called Graham-Cassidy repeal bill had a 24 percent approval, even more unpopular than the AHCA.

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ashoup
In News

Final Rates Confirm Oregonians’ Insurance Is Getting Even More Expensive

Commissioner Confirms Rate Hikes Due to Trump Administration and Washington Republicans Health Care Sabotage

Washington, D.C. – With final Oregon rate filings for 2019 individual-market health insurance indicating potential double-digit premium increases on top of last year’s 20 percent rate hike due to Washington Republicans’ repeal-and-sabotage agenda, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“For the past year and a half, President Trump and his Republican allies in Congress have engaged in a deliberate, aggressive campaign to undermine health care and families in Oregon are once again forced to pay the price. Until we stop Republicans’ war on health care, insurance companies will continue to make huge profits and enjoy record tax breaks from Republicans while they charge working families more and more. DC Republicans should start working on bipartisan solutions to make coverage more affordable, instead of helping their friends in the insurance industry make another buck on the backs of hardworking Oregonians.”

From the Insurance Commissioner

“[F]ederal actions […] continue to inject instability into our market,” Oregon Insurance Commissioner Andrew Stolfi said in a statement. “The positive effect of the Oregon Reinsurance Program provides relief for Oregonians and helps reverse some of the rate increases caused by actions at the federal level.” [Oregon DFR, 7/20]

From the Insurance Companies

Regence Blue Cross Blue Shield of Oregon: “Continued Lack Of Funding For Cost Sharing Reduction Plans” And “Expected Reduction In The Size Of The Individual ACA Market” Responsible For Higher Premiums. “These rate changes are necessary due to the increasing cost of medical care, the continued lack of funding for cost sharing reduction plans, and the expected reduction in the size of the Individual ACA market.” [BCBS, 5/14]

BridgeSpan: “Expected Reduction In The Size Of The Individual Market” Driving Higher Premiums. “The main drivers of the rate change are the increasing cost of medical care and the expected reduction in the size of the individual market. This filing reflects projected claim expenses increasing around 8.3% annually.” [BridgeSpan, 5/14]

ashoup
In News, Administration

Lamar Alexander Blames Democrats for Premiums, Ignoring Insurance Company Which Blames Republican Sabotage

Last night, Sen. Lamar Alexander once again lied about the rising premiums in his state, attempting to blame Democrats for problems caused by his party in Washington.

What did Sen. Alexander say? Per the Chattanooga Times Free Press, he blamed Democrats for Tennessee’s premiums:

“Since Democrats in Congress have elevated Obamacare to the 67th book of the Bible, and have blocked even minor changes to the law that could have lowered rates by up to 40 percent, it is up to the states and the administration to continue to help lower premiums.’”

What did BlueCross BlueShield of Tennessee say? That they were raising people’s premiums by $649.28 next year specifically because of the Trump Administration’s decision to freeze risk adjustment payments:

Sen. Alexander: stop denying that GOP sabotage is costing Tennesseans.

ashoup
In Administration, News

“This is How Health Care Disparities Are Exacerbated”: Trump Administration Slashes Funds To Navigators That Help People Purchase Health Care

On Tuesday, the Trump Administration escalated its war on Americans’ health care by announcing it would be slashing funding for navigators, who assist people in finding quality, affordable coverage, and directing these navigators to steer people to junk plans, which don’t have to provide consumer protections like those for pre-existing conditions.

Here’s what their decision means, and how Americans will be harmed by the Administration’s actions:

New York Times: Navigator Cuts Are Next Step In An “Escalating Attack” On The Affordable Care Act. “The Trump administration announced on Tuesday that it was slashing grants to nonprofit organizations that help people obtain health insurance under the Affordable Care Act, the latest step in an escalating attack on the law that threatens to destabilize its insurance markets.” [New York Times, 7/10/18]

HHS Slashes Funding Available For Groups That Help People Sign Up For Marketplace Coverage By $26 Million.”A total of just $10 million will be available nationwide for the next enrollment season — down from $36 million for this year, and $63 million for last year…In addition to slashing navigators’ funding, CMS is also pushing navigators to sign people up for the non-ACA options the Trump administration has expanded — association health plans and cheaper, skimpier short-term policies.” [Axios, 7/11/18]

We Have Already Seen How Much Of An Impact These Cuts Have. “Last year’s cut forced navigators to lay off staff, cancel events, and, in some cases, cease operations altogether. This new cut will leave navigators with just a fraction of the money they had available for the open enrollment periods that occurred during President Barack Obama’s administration ― in all likelihood hampering their ability to help consumers through the complicated process of choosing a health insurance policy and applying for financial assistance.” [Huffington Post, 7/10/18]

Trump Administration Claims Nonprofit Navigator Groups Do Worse Job Helping People Find Coverage Than Insurance Agents And Commercial Brokers. “Trump administration officials said the insurance counselors, known as navigators, did not enroll enough people to justify more spending. Insurance agents and brokers do much better, they said.” [New York Times, 7/10/18]

Administration Fundamentally Shifts Mission Of Navigator Groups, Instructing Them To Encourage People To Sign Up For Junk Plans That Are Exempt From Key Consumer Protections. “They will, for the first time, help people enroll in health insurance plans that do not comply with the consumer protection standards and other requirements of the Affordable Care Act. Since they began work in 2013, navigators have helped people enroll in health plans that comply with the Affordable Care Act. Now the Trump administration says they should also inform consumers of other options, like ‘association health plans’ and short-term, limited-duration insurance. Such plans do not have to provide the standard health benefits like preventive services, maternity care or prescription drug coverage, but administration officials say they will also be more affordable to consumers.” [New York Times, 7/10/18]

New York Magazine: “The Trump White House Has Been Busy Separating Migrant Families And Plotting The Demise Of Roe V. Wade In Recent Weeks, But Don’t Worry: They Haven’t Forgotten About Their Quest To Make It Harder For Americans To Obtain Adequate Health Insurance.” “But the administration isn’t just making it more difficult for people to enroll in Obamacare. Going forward, the administration wants navigators to steer clients into skimpier health coverage. While nonprofits operating under the navigator program were previously forbidden from recommending particular health plans, now groups that apply for the grants will be expected to encourage people to buy association health plans or short-term insurance plans.” [New York Magazine, 7/11/18]

Navigator Cuts Will Do More Than Just Suppress ACA Enrollment, They Will Likely Also Reduce Enrollment In Medicaid And CHIP. “Consumers who use navigators frequently end up enrolling in Medicaid, the Children’s Health Insurance Program or other special programs ― or simply enrolling on their own, at home, after long consultation with navigators. As a result, they don’t show up as enrolling in the private marketplace plans, which is the metric CMS is using to judge navigator performance. Navigators also target people with special needs, including those with complicated medical or financial situations that make eligibility for federal programs confusing. These are precisely the sorts of people who might not respond to routine advertising or find the help they need through commercial brokers.” [Huffington Post, 7/10/18]

NAVIGATOR GROUP LEADERS WARN THAT CUTS WILL HURT UNDERSERVED POPULATIONS

Fred Ammons, Supervises Insure Georgia Navigator Group: This Means Less Help To Underserved Populations. “This is a huge cut to navigator programs across the country. It will virtually eliminate face-to-face in-person assistance. It means less help, much less help, to underserved, hard-to-reach populations, people who live in rural areas or have low literacy or don’t speak English as their primary language.” [New York Times, 7/10/18]

Jodi Ray, Project Director For Florida Covering Kids And Families: We Will Be Put in Awful Position Of Pitting Populations Against Each Other. “This is pretty terrible, We will be put in the awful position of pitting populations that need assistance against each other, in order to prioritize how we can use the resources. This also does not take into account all the kinds of assistance navigators provide all year, such as helping with complex cases and issues and filing appeals. Florida will definitely be hit hard by this.” [Huffington Post, 7/10/18]

  • Ray: “This Is How Health Care Disparities Are Exacerbated.” [Kaiser Health News, 7/12/18]

Catherine Edwards, Executive Director Of Missouri Association Of Area Agencies On Aging: Administration Is “Strangling” Navigator Program. “They’re just strangling the program…They couldn’t kill the program in Congress, so they are cutting the money.” [Washington Post, 7/10/18]

William Hoagland, Bipartisan Policy Center Senior Vice President: “It Does Send A Signal Of Course That The Administration Is Not Promoting Enrollment.” “Combined with other recent actions by the Trump administration, the decision sets a negative tone, Hoagland said. ‘It does send a signal of course that the administration is not promoting enrollment,’ he said.” [Kaiser Health News, 7/12/18]

Elizabeth Hagen, Senior Health Consultant: Shifting Focus To Junk Plans Will Lead Consumers To Plans That Don’t Reflect THeir Needs. “CMS now wants the navigators to promote these policies in addition to steering people toward ACA-compliant plans and Medicaid. This adds to the concern about the lack of navigator funding. The availability of such new types of coverage will increase consumer demand for specially trained navigators, said Elizabeth Hagan, a senior consultant with Transform Health, a consulting firm. She said the problem with reducing consumer assistance is not so much that fewer people will buy coverage but that people will buy policies that don’t fit their needs.”  [Kaiser Health News, 7/12/18]

Mark Van Arnam, Director of North Carolina Navigator Consortium: Cuts Will Be Devastating To People Who Need Assistance To Find Coverage. “They are the public face of the Affordable Care Act in North Carolina for legions of residents stumped by the complexities of health insurance. But next year, ACA navigators — the trained instructors who explain health benefits and help people enroll — will be harder to find as a result of federal funding cuts. The Trump administration announced Tuesday it would could nationwide funding for navigators by 72 percent, from $36 million to $10 million. In North Carolina, which has consistently had the nation’s highest enrollments, the navigator budget will be cut by 85 percent — from $3.4 million to $500,000. ‘These are significant cuts,’ said Mark Van Arnam, director of the N.C. Navigator Consortium. ‘There’s a large portion of the population that we talk to that doesn’t understand the ACA and needs assistance.’” [News & Observer, 7/12/18]

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