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Sabotage

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

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 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]

ashoup
In News

Trump Administration Continues War On People With Pre-Existing Conditions By Suspending Billions In Risk Payments

This weekend, President Trump made another move in his war on health care. He suspended risk adjustment payments that help insurance companies offer more affordable coverage to everyone, regardless of if they are healthy or sick. By refusing to make risk adjustment payments — even though they don’t cost the taxpayer a single penny — President Trump and his Administration are making it harder for people with pre-existing conditions to access coverage, and driving up premiums for millions.

NATIONAL HEADLINES PAINT A TELLING STORY

  • Chicago Sun-Times Editorial: Trump Administration Yanks Health Care Away From Even More Americans. [7/10/18]
  • Wall Street Journal: Trump’s Latest Affordable Care Act Move Adds To Insurers’ Uncertainty. [7/8/18]
  • Los Angeles Times: Another Challenge For Obamacare — And A Bigger Bill For Taxpayers. [Los Angeles Times, 7/10/18]
  • Politico: Latest Obamacare Shake-up Could Fuel Rate Hikes. [Politico, 7/9/18]
  • New York Times: Health Insurers Warn Of Market Turmoil As Trump Suspends Billions In Payments. [7/7/18]
  • NPR: Trump Administration Freezes Payments Required By The Affordable Care Act. [NPR, 7/8/18]
  • Washington Post: Trump Administration Takes Another Major Swipe At The Affordable Care Act. [7/7/18]
  • Los Angeles Times: Trump Administration Freezes Billions Of Dollars In Payments To Obamacare Insurers. [7/8/18]
  • NPR: Why Health Insurance Premiums May Rise Next Year. [NPR, 7/9/18]
  • Associated Press: Trump Administration Takes Another Swipe At Obamacare.[Associated Press, 7/9/18]
  • USA Today: Trump Administration Freezes Payments Required By Affordable Care Act, Health Care Premiums Could Rise. [7/8/18]
  • Fortune: Trump Administration Freezes Payments To Affordable Care Act Insurers With Sicker Patients. [7/8/18]
  • Bloomberg: Trump Health Officials Toss Obamacare Insurers Another Curveball.[7/7/18]
  • Slate: It Sure Looks Like The Trump Administration Is Trying To Sabotage Obamacare Again. [7/8/18]
  • Bustle: What Does Trump’s Freeze On Obamacare Payments Mean? Premiums Could “Significantly Increase.” [7/9/18]

IN STATES, FEARS GROW AMONGST INSURANCE COMPANIES

  • Baltimore Sun: Maryland Insurers Say Trump Administration To Cut Health Payments Destabilizes Market. [7/9/18]
  • Chattanooga Times Free Press: Obamacare Payment Change Raises Worries For Individual Rates. [7/11/18]
  • Indianapolis Business Journal: Anthem Could Take Big Hit From Halt To Risk-Adjustment Payments. [7/10/18]
  • Star Tribune: Three Minnesota Health Plans Face Combined Hit Of $71.7 Million. [7/9/18]
  • Rutland Herald: ACA Changes Worry Vermont Health Care Officials. [7/9/18]
  • Georgia Health News: Insurers Caught Off Guard By Feds’ Freeze Of ACA ‘Sickness’ Payments. [7/9/18]
  • California Healthline: Health Insurers Struggle With Sudden Freeze On ACA Payouts. [7/10/18]
  • Associated Press: South Dakota Insurers May Take Hit After Payment Freeze. [7/10/18]

INSURANCE GROUPS, EXPERTS, AND PRESS CONDEMN ADMINISTRATION’S MOVE

America’s Health Insurance Plans: Decision To Halt Payments “Will Create More Market Uncertainty And Increase Premiums For Many Health Plans.” “We are very discouraged by the new market disruption brought about by the decision to freeze risk adjustment payments. This decision comes at a critical time when insurance providers are developing premiums for 2019 and states are reviewing rates. This decision will have serious consequences for millions of consumers who get their coverage through small businesses or buy coverage on their own. It will create more market uncertainty and increase premiums for many health plans – putting a heavier burden on small businesses and consumers, and reducing coverage options. And costs for taxpayers will rise as the federal government spends more on premium subsidies.” [AHIP, 7/7/18]

Sabrina Corlette, Health Policy Researcher At Georgetown: Administration Is Throwing Wrench Into Critical Program Whose Goal Is To Protect People With Pre-Existing Conditions Against Discrimination. “The government opted for ‘throwing a monkey wrench into a critical program whose primary goal is to protect people with pre-existing conditions from discrimination by insurers.’” [Minneapolis Star Tribune, 7/9/18]

Chicago Sun-Times: This Is Bad News For All Americans Who Believe Nobody Should Be Priced Out Of Basic Health Care To Save The Rest Of Us Buck. “That’s bad news for the chronically ill, the disabled, the elderly and all others whose health care costs can run considerably higher than average. It’s bad news, as well, for all Americans who believe that nobody should be priced out of basic health care just to save the rest of us a buck.” [Chicago Sun-Times, 7/10/18]

Blue Cross Blue Shield Association: “Without Quick Resolution On This Matter, This Action Will Significantly Increase 2019 Premiums For Millions.” “Without a quick resolution to this matter, this action will significantly increase 2019 premiums for millions of individuals and small business owners and could result in far fewer health plan choices. It will undermine Americans’ access to affordable coverage, particularly for those who need medical care the most…The action taken today will create turmoil not only for those in the individual market – particularly as insurers finalize their offerings for the next open enrollment that begins in November – but also for the millions of businesses that rely on the small group market to provide affordable insurance options for their employees.” [Blue Cross Blue Shield Association, 7/7/18]

Bill Wehrle, Kaiser Permanente Vice President Of Health Insurance Exchanges: Effective Risk Adjustment Program Is “Crucial,” Especially For Those With Pre-Existing Conditions. “An effective risk adjustment program is crucial to the sound operation of a health insurance marketplace in which individuals, families and small businesses with health needs have access to more affordable, high-quality coverage…It enables the country to move away from a market where plans compete to avoid covering or charge more to people with preexisting health conditions, to one where competition is based on quality, affordable care for everyone.” [Baltimore Sun, 7/9/18]

Larry Levitt, Senior Vice President of Kaiser Family Foundation: “This Is One Of Several Steps The Trump Administration Has Taken To Undermine The ACA.” “‘Insurers hate uncertainty, and when faced with it tend to raise premiums to hedge their bets,” says Larry Levitt, Senior Vice President at the Kaiser Family Foundation. He says halting the risk adjustment program will disrupt the individual markets, and might even cause insurers not to participate next year. ‘When the rules of the game change after the fact – insurers don’t necessarily see the federal government as a particularly reliable partner right now,’ Levitt says. ‘This is one of several steps the Trump administration has taken to undermine the ACA.'” [NPR, 7/8/18]

Rodney Whitlock, Vice President of Health Policy At ML Strategies And Former Republican Congressional Aide: Administration’s Goal Is To Make Marketplace As Inhospitable As Possible For Participating Plans. “‘What you have to keep in mind is ultimately the intent of the administration,’ Whitlock says. “The executive order the president signed, not long after he got to the White House after the [Inaugural] Parade was effectively, ‘We’re declaring war on the Affordable Care Act.'” Whitlock says, the goal has been to make the marketplace as inhospitable as possible for participating plans, and this is just one more step in that direction.” [NPR, 7/8/18]

Washington Post: “The Suspension Of These Payments Is The Most Recent Maneuver By The Trump Administration To Undercut The Health-Care Law That President Trump Has Vowed Since His Campaign To Demolish.” “The suspension of these payments is the most recent maneuver by the Trump administration to undercut the health-care law that President Trump has vowed since his campaign to demolish. A Republican-led Congress last year failed to repeal much of the ACA. The administration has been taking steps to dismantle it through executive powers.” [Washington Post, 7/7/18]

Nicholas Bagley, University of Michigan Law Professor: “This Is No Way To Run A Health Program, And No Way To Run A Government.” “In another sense, however, the needless suspension of the risk adjustment program is a signal that the Trump administration remains intent on sabotage. Already, insurers were stiffed on their risk corridor money. Then the cost-sharing payments evaporated. Now, even risk adjustment money may go up in smoke. What’s next? This is no way to run a health program, and no way to run a government.” [Nicholas Bagley, 7/9/18]

Los Angeles Times: Halted Risk Payments Will Burden Taxpayers. “But it will be painful for at least two groups of Americans. The first includes the people who aren’t covered by a large employer’s plan and who earn too much money to qualify for federal subsidies. They’d be facing higher premiums anyway, thanks to the rising cost of healthcare. But the increase will be larger than it should be courtesy of the Trump administration’s handling of this issue…Meanwhile, people who earn less than 400% of the federal poverty level — for a family of four, that’s about $100,000 — are eligible for subsidies under the ACA that hold their premiums to a percentage of their personal income. No matter how much premiums go up, the subsidies absorb the change. As a consequence, the higher premiums rise, the more the subsidies cost federal taxpayers. Those are people who’ll bear most of the cost of freezing the risk adjustment transfers.” [Los Angeles Times, 7/10/18]

Risk Adjustment Decision Fits With Broader Pattern Of Trump Administration Using Courts To Sabotage ACA. “It’s hard not to wonder, though, whether someone in the White House belatedly realized this case was another untapped opportunity to spook insurers into spiking premiums, finding creative ways to repel sick people or leaving the market altogether. That would fit neatly into the administration’s broader pattern of using court cases as excuses to undermine the Affordable Care Act, after all. The others include killing reimbursements to insurers for subsidies for lower-income people, and refusing to defend the law’s protections for those with preexisting conditions.” [Washington Post, 7/9/18]

NPR: Not Surprising Trump Sided With New Mexico Given Republicans Have Been “Trying To Kill The Affordable Care Act For Quite A Long Time.” “It’s a little bit confusing because the court ruling was back in February. There’s an order in – out of New Mexico that said the formula for making the payments was unfair. But there’s a second court order in Massachusetts that held the opposite. So HHS seems to have chosen which side to take. They chose the New Mexico ruling, which isn’t all that surprising because the Trump administration up until now – and even Republicans before Trump became president – have been trying to kill the Affordable Care Act for quite a long time.” [NPR, Kodjak, 7/9/18]

ashoup
In Fact Sheet, News

Short-Term Junk Plans

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

KEY HEALTH INSURANCE STAKEHOLDERS WARN AGAINST SHORT-TERM PLANS

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

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

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

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

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

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

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

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

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

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

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

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

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

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In News

CMS Report Confirms GOP Sabotage

Washington, D.C.  – Today, the Centers for Medicare and Medicaid Services released a trends report about last year’s open enrollment period, which saw decreased enrollment and rising premiums. Protect Our Care Executive Director Brad Woodhouse released the following statement in response:

“Today’s report confirms that Republican sabotage is directly responsible for rising premiums and fewer Americans obtaining health insurance, outcomes which were entirely avoidable. From the day he took office Donald Trump has worked with Congressional Republicans to sabotage the Affordable Care Act, and nowhere was this more evident than last year’s open enrollment period. The Administration cut in half the number of days people could sign up for coverage; reduced the outreach budget by ninety percent; and used funding to boost open enrollment to launch a propaganda campaign against the ACA. All told, these actions reduced enrollment by more than one million people – and as we look toward next year’s open enrollment period, the Trump Administration has already dramatically cut in-person assistance to help people sign up for 2018 health coverage, and we can expect more of the same. Unfortunately, it is the American people who will once again be left to suffer.”

BACKGROUND:

  • In April, the Trump Administration cut the number of days people could sign up for coverage during open enrollment by half, from 90 days to 45 days.
  • In July, the Trump Administration used funding intended to support health insurance enrollment to launch a multimedia propaganda campaign against the Affordable Care Act.
  • In August, the Administration cut 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.
  • In September, the Administration ordered 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.”
  • In October, the Trump Administration dramatically cut in-person assistance to help people sign up for 2018 health coverage.
  • Last week, it was reported that the Trump Administration proposed further massive cuts for health insurance navigators.
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In News, Stories

Trump Administration Escalates GOP War on Health Care, Attacks Protections for 130 Million Americans with Pre-Existing Conditions

Since January 2017, President Trump and his Republican allies in Congress have waged a relentless war on health care, trying anything and everything to undermine, sabotage, and repeal the Affordable Care Act (ACA). Last night, the Trump Administration launched its most egregious salvo yet: its lawyers are asking the courts to repeal key consumer protections that protect people with pre-existing conditions.

Overview of Texas v HHS and What the Trump Administration Just Did

Back in February, Republican state attorneys general from Texas and 19 other states filed a lawsuit arguing that the Affordable Care Act was unconstitutional now that Congress and President Trump repealed the individual mandate in their tax bill. The lawsuit argues the individual mandate, which required most people have health coverage or pay a fine, was crucial to making the Affordable Care Act work. Now that the individual mandate penalty has essentially been repealed, they argue the law is unworkable and should be struck down. Legal experts agree this argument is without merit.

Normally, the Department of Justice (DOJ) defends federal law in court. However, last night Attorney General Jeff Sessions said the DOJ will side with the Republican attorneys general and refuse to defend the constitutionality of the ACA. Moreover, the DOJ decided to specifically attack the ACA’s most popular reform, provisions banning insurance companies from denying coverage or charging people more because of a pre-existing condition.

The Trump Administration Wants to Put Insurance Companies Back in Charge to Deny Coverage and Charge More for People with Pre-Existing Conditions

While the courts and legal scholars debate these arguments, the real impact of the Trump Administration’s decision if they win the lawsuit is clear: overnight, Americans would once again be at the mercy of insurance companies, which could once again deny coverage or charge more because of a pre-existing condition. Roughly half of nonelderly American adults, or as many as 130 million people, have at least one pre-existing condition. Nationally, the most common pre-existing conditions were high blood pressure (44 million people), behavioral health disorders (45 million people), high cholesterol (44 million people), asthma and chronic lung disease (34 million people), and osteoarthritis and other joint disorders (34 million people).

The Trump Administration’s argument would also allow insurance companies to charge women more than men, and subject older Americans to an expensive “age tax” that would allows insurance companies to charge them much more.

DOJ Move Creates Uncertainty that Could Lead to Even Higher Rates

This all is happening at the same time as insurance companies in states across the country want to hike rates by double digits, pointing to Republican sabotage and uncertainty in the market as the reason. By creating even more uncertainty in the health care markets, the Trump Administration could raise health care costs even more for millions of people who are already facing double-digit hikes due to previous sabotage.

Our Health Care is at Stake

This dangerous lawsuit, now with the backing from the Trump Administration, threatens the care and coverage of tens of millions of Americans. If the courts rule in favor of the Republican attorneys general, critical Affordable Care Act protections would vanish overnight, unleashing chaos in our entire health care system. Our health care should not be at the mercy of partisan vendettas pushing “ludicrous” legal theories.

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In News, Stories

“The Justice Department Is Essentially Siding With Those Who Think That Health Insurance Companies Should Be Able to Sign Death Warrants For Sick People”: Trump Administration Launches Unprecedented Attack on Popular ACA Protections

Last night, the Trump Administration continued its historic sabotage of Americans’ health care when its Department of Justice said it will attack the Affordable Care Act’s popular provisions, including protections for those with pre-existing conditions, as unconstitutional. If the Supreme Court accepts their argument, insurance companies would be able to deny coverage for up to 130 million Americans with pre-existing conditions, and older Americans and women could once again face significant surcharges because of their or age gender.

Here’s how the shock news is being covered:

Los Angeles Times: Got A Preexisting Condition? The Trump Administration Wants Insurers To Deny You Coverage. “In its latest effort to undermine the Affordable Care Act — and in the process, raise premiums for many Americans — the Trump administration is urging a federal judge in Texas to throw out the law’s protections for people with preexisting conditions. In other words, the administration wants insurers to be able to deny coverage to the people most in need of it, or to charge them considerably higher premiums than they’re allowed to charge today. This is jaw-dropping. Even Republicans who’ve complained about Obamacare have been loath to undo the protections for people with preexisting conditions who are not covered by large employers’ health plans. That’s because the public supports them, and unequivocally so.” [Los Angeles Times, 6/8]

New York Times: “The Justice Department Said That The Protections For People With Pre-Existing Conditions Were Inseparable From The Individual Mandate And Must Also Be Struck Down.” “The Trump administration told a federal court on Thursday that it would no longer defend crucial provisions of the Affordable Care Act that protect consumers with pre-existing medical conditions. Under those provisions of the law, insurance companies cannot deny coverage or charge higher rates to people with pre-existing conditions… The Justice Department said that the protections for people with pre-existing conditions were inseparable from the individual mandate and must also be struck down.” [NYT, 6/7]

Talking Points Memo: Trump’s Midterm Gift To Dems: A War On Pre-Existing Condition Protections. “The Trump administration delivered an early midterms present to Democrats Thursday night when the Justice Department decided to side with 20 GOP states in a lawsuit seeking to gut the core protections of the Affordable Care Act for people with pre-existing conditions. The long-shot lawsuit argues that because Republicans repealed the ACA’s individual mandate penalty as part of their tax overhaul, all of the remaining law is unconstitutional. The Justice Department, in backing the state’s argument, is seeking to strike down two of Obamacare’s most popular provisions: the rule that insurance companies can’t turn someone away or charge them more based on a pre-existing condition, and the rule that limits how much insurers can charge older patients for their premiums.” [TPM, 6/8]

Bloomberg: Provisions DOJ Is Not Defending “Include Protecting People With Pre-Existing Medical Conditions From Being Charged More Or Being Denied Coverage.” “Since Congress repealed the penalty for not having insurance in its tax reform package last year, much of the rest of the insurance statute becomes unconstitutional in 2019 and must be ‘struck down,’ attorneys for the Justice Department said in a court filing Thursday. Such provisions include protecting people with pre-existing medical conditions from being charged more or being denied coverage.” [Bloomberg, 6/8]

USA Today: “The Brief Filed Thursday Night Is The Latest Attempt By His Administration To Weaken President Barack Obama’s Signature Health-Care Law.” “The Trump administration declared that it will no longer defend the Affordable Care Act from a challenge filed by 20 states because it agrees that the law’s individual mandate is unconstitutional and that key parts of the act — including the provisions protecting those with pre-existing conditions — are invalid. President Trump has long declared the ACA, also known as Obamacare, to be a ‘disaster’ and the brief filed Thursday night is the latest attempt by his administration to weaken President Barack Obama’s signature health-care law.” [USA Today, 6/8]

Huffington Post: Trump Administration Takes New Aim At Obamacare’s Pre-Existing Conditions. “The Trump administration on Thursday officially threw its support behind a new, seemingly far-fetched legal challenge to the Affordable Care Act, arguing that the law’s protections for people with pre-existing conditions are unconstitutional… The Trump administration’s contempt for Obamacare is no secret. And although the president and his supporters have sometimes said they believe in protections for people with pre-existing conditions, they have repeatedly taken action ― like trying to pass repeal legislation or rolling back the Affordable Care Act’s regulations on what plans must cover ― that seek to undermine or obliterate those protections entirely.” [Huffington Post, 6/7]

Donald Verrilli, Former United States Solicitor General: “I Find It Impossible To Believe That The Many Talented Lawyers At The Department Could Not Come Up With Any Arguments To Defend The ACA’s Insurance Market Reforms, Which Have Made Such A Difference To Millions Of Americans.” [St. Louis Dispatch, 6/8]

Nicholas Bagley, Former Department of Justice Attorney: The Administration Decided “Its Dislike For The Affordable Care Act Outweighed Its Respect For The Rule Of Law.”  Bagley, a former Justice Department attorney, said the DOJ has a ‘durable, longstanding, bipartisan commitment’ to defending the laws passed by Congress as long as there is a legitimate ‘non-frivolous’ argument to be made in its defense. ‘The Justice Department has an obligation to defend the law and it has refused to do so because it dislikes this particular law,’ Bagley told USA TODAY. The administration decided its ‘dislike for the Affordable Care Act outweighed its respect for the rule of law.’ Bagley said the brief reveals the ‘depth of institutional decay at the Department of Justice’ and he expressed profound concern about the precedent it sets. [USA Today, 6/8]

Mother Jones: Donald Trump Takes Aim At Pre-Existing Conditions. “The Trump administration’s desperate desire to deprive Americans of health care entered a new phase tonight when Donald Trump personally approved a decision by the Justice Department not to defend Obamacare against state lawsuits… The Justice brief and letter say many other aspects of the law can survive because they can be considered legally distinct from the insurance mandate and such consumer protections as a ban on charging more or refusing coverage to people with preexisting medical conditions.” [Mother Jones, 6/7]

Gizmodo: “If The DOJ Is Successful, Millions Of Americans Could Be Denied The Ability To Buy Health Insurance.” “The U.S. Justice Department made an unusual argument to a federal court last night, claiming that Obamacare’s protections for people with pre-existing medical conditions are unconstitutional. Roughly 1 in 4 Americans have pre-existing conditions that would make it difficult to buy insurance without those protections. If the DOJ is successful, millions of American could be denied the ability to buy health insurance. Under the Affordable Care Act, commonly called Obamacare, insurance companies can’t deny coverage to people with pre-existing medical conditions, and it puts limits on how much those companies can charge. But the Trump regime wants to change all that, arguing in federal court along with 20 states that protections for pre-existing conditions should be abolished.” [Gizmodo, 6/8]

Associated Press: Justice Department Says Heart Of Affordable Care Act Unconstitutional. “The Trump administration said in a court filing late Thursday that it will no longer defend key parts of the Affordable Care Act, including the requirement that people have health insurance and provisions that guarantee access to health insurance regardless of any medical conditions. The decision, announced in a filing in a federal court in Texas, is a rare departure from the Justice Department’s practice of defending federal laws in court.” [St. Louis Post-Dispatch, 6/8]

Splinter News: The Trump Administration Is Now Trying To Sabotage Obamacare In The Courts. “The GOP tried and failed to repeal the Affordable Care Act last year, so now it’s trying another strategy: deciding not to fight a legal effort to rule key parts of the law unconstitutional, including the ban on insurers denying coverage or charging an obscene amount to people who have ‘pre-existing conditions’ … Because the Justice Department is essentially siding with those who think that health insurance companies should be able to sign death warrants for sick people, a group of 16 state attorneys general will defend the law in court.” [Splinter News, 6/8]

Mic: Today In Trump’s America: Trump Admin Urges Courts To Throw Out Pre-Existing Condition Protections. “In a response to a lawsuit filed by a group of conservative states that seeks to end the ACA, Trump’s Justice Department said Congress’ repeal of the individual mandate invalidates other key provisions of the heath care law. This includes rules that forbid insurers both from charging sick customers more for coverage or denying coverage to people with pre-existing conditions. Those two provisions are some of the most popular aspects of the ACA, also known as Obamacare. And Republican attempts in 2017 to repeal Obamacare and those provisions were extremely unpopular and led to a backlash against Republican lawmakers.” [Mic, 6/8]

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Protect Our Care Praises Senate Democrats for Challenging Republicans to Address Health Care in August

Washington, D.C. – Today, Senate Democratic Leader Chuck Schumer (D-NY) sent Majority Leader Mitch McConnell (R-KY) a letter urging legislative proposals designed to lower Americans’ health care costs be taken up during August. Protect Our Care Campaign Director Brad Woodhouse released the following statement in response:

“Leader Schumer and Senate Democrats’ focus is precisely where it should be – on health care, the top issue for Americans of all backgrounds. President Trump and Republicans in Congress have carried out a devastating repeal and sabotage campaign from the first day President Trump was sworn into office, punctuated by the Republican Congress passing a tax bill that is now forcing double-digit premium increases. The bills Leader Schumer and Senate Democrats are championing would lower premiums and allow Medicare to negotiate for cheaper drug prices, priorities Republicans couldn’t possibly be against.  However, if Senate Republicans continue to ignore the health care of the American people, they will be doing so at their own peril.”

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As States Move to Expand Medicaid, GOP Keeps Pushing Repeal

Washington, D.C. – Today, “exclusive details” of the GOP’s new repeal bill were reported in the Washington Examiner, just a day after Virginia’s bipartisan expansion of Medicaid. Protect Our Care Campaign Chair Leslie Dach released the following statement in response:

“Less than 24 hours after Virginia moved to expand Medicaid, and as Idaho and Utah continue to move to place Medicaid expansion on the ballot this November, Washington Republicans are touting their latest health care repeal plan, taking health care away from millions of Americans and raising costs for millions more.Their newest effort is modeled after the worst of last year’s repeal bills, Graham-Cassidy, and guts the very Medicaid expansion that Virginia embraced yesterday, ends protections for people with pre-existing conditions, and imposes an age tax on older Americans. Enough is enough – it’s time for President Trump and Congressional Republicans to end their war on Americans’ health care.”

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