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ashoup
In News, Stories

Ex-Secretary Tom Price: Trump and GOP Responsible For Upcoming Rate Hikes

Washington, D.C. – In response to former Health and Human Services Secretary Tom Price’s comments this morning to the World Health Care Congress that Republicans’ TrumpTax bill and its individual mandate repeal will increase Americans’ health care costs, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Today, President Trump’s own former HHS secretary, Tom Price, admitted that the Republican tax bill’s sabotage of the Affordable Care Act will increase health care costs. Ex-Secretary Price has confirmed that President Trump and Congressional Republicans chose a trillion-dollar tax break for corporations and the wealthiest at the expense of hardworking Americans’ health care. Months ago when the nonpartisan Congressional Budget Office found that the TrumpTax would raise premiums by ten percent while kicking millions of Americans off of their coverage, Republican senators responded by accusing CBO of bias and dismissing their findings. Now, one of the Trump Administration’s lead saboteurs has admitted the truth. Americans now have it straight from Tom Price: Republicans are responsible for upcoming rate hikes.”

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In News

New Protect Our Care Ad: As Premiums Increase, Americans Should Thank Donald Trump & Congressional Republicans

Washington, D.C. – This year, Protect Our Care is kicking off May’s focus, Repeal and Sabotage Accountability Month, by releasing a web ad highlighting the consequences of Republicans’ deliberate health care repeal and sabotage campaign: a 20 percent rate hike set to hit working families while health insurance and pharmaceutical companies reap the windfalls of the GOP’s trillion-dollar tax break.

“From the moment he took office, President Trump has launched attack after attack on our health care, and Congressional Republicans have been eager to help. They tried to repeal the law; they attempted to undermine open enrollment; they promised to make the law fail; and they’ve proposed expanding junk insurance plans that would take us back to the days when insurance companies could impose sky-high rates on people with pre-existing conditions, or deny them coverage altogether. Now, Republican sabotage has left working people holding the bill. Every American who faces higher health care costs this year and next can thank Donald Trump and Congressional Republicans,” said Protect Our Care Campaign Director Brad Woodhouse.

Watch the ad here.

Ad script:

Are you sick and tired of Washington forcing your health care costs to go up? And up. And up.

For more than a year, Donald Trump and Republicans have sabotaged our health care…

… They ordered the government to dismantle the law.

… Then they made it harder for people to enroll.

… Then they proposed ways for insurance companies to deny care and discriminate against people with pre-existing conditions.

Doctors, patient groups, and health experts say the sabotage has a cost: higher premiums for you and your family – nearly 20% higher or more.

All this while their tax bill gave health insurance and pharmaceutical companies huge tax breaks.

Republicans and President Trump promised premiums would be lower but it’s their sabotage that is jacking up rates 20%.

People who work for a living? They just get higher costs.

And they keep going higher.

Enough is enough. Tell Republicans to stop the sabotage.  End the war on our health care.

ashoup
In News

Schumer Puts Trump, Republicans On Notice for Upcoming Rate Hikes

Washington, D.C. – Today on the Senate floor, Minority Leader Chuck Schumer (D-NY) put Republicans on notice: as preliminary rate hikes for next year begin to roll out, Democrats will speak out loudly and often about how  President Trump and Congressional Republicans’ repeal-and-sabotage campaign against Americans’ health care will leave working families holding the bill.

In response, Protect Our Care Campaign Director Brad Woodhouse said: “Sen. Schumer hit the nail on the head – President Trump and his Republican allies in Congress have undertaken a deliberate, aggressive campaign to sow chaos in the health insurance marketplace, and the consequences of their actions will soon become clear. Every American who sees rate hike announcements as soon as next week can thank one group of people: President Trump and Republicans in Congress.”

TRANSCRIPT

“Finally, on another matter, health care. Next week, health insurance companies will begin to announce their initial proposed rates for 2019 in each state across the country. And when they do, every American should remember that President Trump and Congressional Republicans have spent the past year and half trying to sabotage our health care system in a way that could increase costs and decrease access to quality health care.

“It’s true that last summer, the Senate Republican effort to repeal our current health care system and gut Medicaid — an effort that would have left tens of millions uninsured and raised costs on millions more — ended, thankfully for the American people, in failure.

“Despite that legislative failure, President Trump, his administration, and Congressional Republicans have committed several other acts of sabotage, raising premiums and hurting health care, all, it seems to me, for a political vendetta.

“For a long time, the president refused to guarantee that the administration will honor the cost-sharing program, which reduces premiums and out-of-pocket expenses for low-income Americans. He eventually cancelled payments for that program, causing major uncertainty and confusion in the markets.

“Then, Republicans repealed the health care coverage requirement as a part of their tax bill and put nothing in its place. The CBO projects that repealing the coverage requirement could cause rates to increase by as much as 10% and result in millions more people without insurance, so if you can’t get insurance, Mr. or Mrs. American, or if your premiums are going up you’ll know who caused it: the president, and Congressional Republicans by sabotaging a law that the majority of Americans want to see stay on the books.

“And making things worse, earlier this week, the comment period ended for a proposed Trump administration rule that is perhaps that most radical sabotage of our health care system yet — a rule that would expand the availability of junk insurance plans. These junk insurance plans would force higher premiums on people with pre-existing conditions, impose an “age tax” on older Americans, and once again could subject Americans to the devastating effects of medical bankruptcy, which too many people go through now. Many plans might not cover essential services like prescription drugs, maternity care, and mental health services.

“Each of these actions taken by President Trump and Republicans in Congress will raise costs and reduce access. We are truly living under “Trumpcare” today, with no effort by the president or Congressional Republicans to make it better.

“And, unfortunately, starting next week, the American people could see the devastating consequences of a year and half of health care sabotage reflected in the 2019 rates.”

ashoup
In News

The People Who Know Health Care the Best Say Short-Term Plans Are the Worst

Yesterday marked the deadline for comments to be submitted on the Trump Administration’s proposed short-term scam insurance. A wide variety of health care experts – including doctors, insurance exchange operators, insurance companies, analysts, and more than 100 patient groups – continue to make clear their strong opposition to the Administration’s proposal. Here’s what they had to say:

American Medical Association: Proposed Rule “Would Result In Substandard, 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]

American Cancer Society Cancer Action Network, American Heart Association, American Liver Foundation, American Lung Association, Arthritis Foundation, Autism Speaks, Chron’s & Colitis Foundation, Cystic Fibrosis Foundation, Epilepsy Foundation, Family Voices, Hemophilia Federation of America, Leukemia & Lymphoma Society, Lutheran Services in America, March of Dimes, Mended Little Hearts, NAMI, National Health Council, National Multiple Sclerosis Society, National Organization for Rare Disorders, National Patient Advocacy Foundation, National Psoriasis Foundation: “Given The History Of Discrimination And Inadequate Coverage Within Short-term Limited-duration Plans, We Are Deeply Concerned That The Proposed Rule Could Seriously Undermine The Key Principles Of Access, Adequacy, And Affordability That Are The Underpinnings Of Current Law – And Put Those We Represent At Enormous Risk.” “Given the history of discrimination and inadequate coverage within short-term limited-duration plans, we are deeply concerned that the proposed rule could seriously undermine the key principles of access, adequacy, and affordability that are the underpinnings of current law – and put those we represent at enormous risk. We urge the Departments to withdraw the proposed rule until the needs of our populations are met and instead, to focus on stabilizing the individual insurance markets and lowering premiums for QHPs.” [ACS-CAN, 4/23]

American Academy Of Family Physicians: “Short-Term, Limited-Duration Plans Will Not Provide Meaningful Insurance Coverage.” “The AAFP strongly opposes the proposed rule since it allows plans to sell low-value insurance policies that could subject patients to catastrophic medical bills and medical bankruptcy. We oppose efforts to exempt short-term, limited-duration plans from consumer protections such as covering preexisting conditions or essential health benefits (EHBs). Furthermore, we oppose allowing any plans to establish caps on annual benefits since limiting benefits can expose patients to extraordinarily high out-of-pocket costs… The AAFP has significant concerns with these proposals since short-term, limited-duration plans will not provide meaningful insurance coverage. While these plans could increase the availability and affordability of services, we do not think doing so should come at the expense of meaningful insurance coverage.” [AFP, 4/18]

America’s Health Insurance Plans: “Not A Replacement For Comprehensive Coverage.” “‘We are concerned that this proposed rule will lead to more people being uninsured and under-insured, and to higher costs in the long run,’ AHIP chief executive Matt Eyles said. ‘Short-term plans can provide an important temporary bridge for Americans who are transitioning between plans. But they are not a replacement for comprehensive coverage.’” [Forbes, 4/23]

Alliance Of Community Health Plans: “The Proposed Rule Will Undermine Consumer Protections.” “The proposed rule will undermine consumer protections because short-term, limited duration plans do not require coverage of essential health benefits or coverage of pre-existing conditions. There is a substantial risk that consumers will not understand the coverage limitations that accompany short term plans. Contracts for medical coverage can be quite complex, and consumers may assume that essential health benefits are covered by short-term, limited duration plans, but for a shorter period of time. This could lead to consumers purchasing health insurance that is inadequate for their medical needs, potentially resulting in personal bankruptcy and an increase in uncompensated care for hospitals and other facilities. There is evidence of this connection between coverage and personal financial status: A Consumer Reports study found that increased health care coverage over the past several years was associated with a reduction by half in the number of personal bankruptcy filings. With the increased use of short-term, limited duration plans, we anticipate a troubling reversal of this trend.” [ACHP, 4/19/18]

American Cancer Society-Cancer Action Network: “We Believe That The Proposed Rule Should Be Withdrawn.” “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. These protections are key to ensuring that individuals with cancer (including those in active treatment and survivors) have access to quality health care needed to treat their disease. Without these protections, individuals could find themselves enrolled in policies that fail to provide coverage of medically necessary services. We believe this proposed rule should be withdrawn unless the needs of the patient community have been met.” [ACS CAN, 4/20/18]

American Hospital Association And Federation Of American Hosptials: “Concerned That The Result Will Be Increased Uncompensated Care.” “The American Hospital Association and the Federation of American Hospitals said the proposed rule, if finalized, would drain hospitals’ resources. The federation, which represents investor-owned hospitals, said its members ‘are concerned that the result will be increased uncompensated care, particularly for patients who need uncovered services or treatment for preexisting conditions.’” [Modern Health Care, 4/23]

Association for Community Affiliated Plans: Rule WIll Harm Consumers And Health Care Providers. “The Association for Community Affiliated Plans, a group representing safety-net plans that cover Medicaid, Medicare special-needs and marketplace members, warned that finalizing the rule as proposed would harm consumers and healthcare providers. The group warned that sellers of short-term plans have been known to rescind coverage as soon as an individual becomes ill and files a substantial claim. The space has been riddled with patient lawsuits over unpaid medical bills. ACAP pointed to the recent 42-state investigation into the business and marketing practices of Tokio Marine’s HCC Life subsidiary, a short-term medical insurer. Earlier this month, HCC Life reached a settlement to pay a fine of $5 million. The insurer is also prohibited from selling short-term plans for at least five years. ACAP also warned that skimpy short-term plan benefits would lead to increased uncompensated care.” [Modern Health Care, 4/23]

Heather Korbulic, Silver State Health Insurance Exchange Director: “Deeply Concerned” About Proposed Rule. “The head of Nevada’s health insurance exchange is ‘deeply concerned’ about a proposed federal rule change that would extend the length of short-term health plans, saying in a Friday letter to the Centers for Medicare and Medicaid Services that the policy will likely result in higher premiums for people who purchase insurance on the exchange… Korbulic is just one of many in the health-care field nationwide who has expressed concern that approving the federal rule will siphon off the healthiest individuals from the individual market, leaving behind a sicker, more expensive population. In the letter to CMS, Korbulic wrote that individuals with pre-existing conditions or who anticipate needing medical care will likely remain on the exchange where they can purchase plans with comprehensive health benefits but will likely face premium increases.” [Nevada Independent, 4/23]

American Heart Advocacy: Patients “Will Suffer If This Rule Becomes Law.” “Today is the deadline to tell HHS not to extend short-term health plans. The outcome is clear — Patients living with CVD, stroke survivors and others with pre-existing conditions will suffer if this rule becomes law.” [American Heart Advocacy, 4/23/18]

Matt Slonaker, Utah Health Policy Project Executive Director: Short-Term Plans Designed To Weaken ACA. “Matt Slonaker is the executive director of the Utah Health Policy Project. He said the new plans are a way to weaken the health law. ‘Unfortunately what is happening here is the short-term insurance idea is being used as a guise to erode some of the protections of the Affordable Care Act,’ Slonaker said.” [KUER, 4/23]

Tanji Northrup, Assistant Commissioner of the Utah Insurance Department: Short-Term Plans Could Increase Premiums By Double-Digits. “Tanji Northrup is the Assistant Commissioner of the Utah Insurance Department. She says these new plans will pull people out of ACA plans and make them more expensive. ‘There will definitely be increases because of pulling those healthy people out of the traditional market,’ Northrup said… Northrup says if these short-term plans go through, Affordable Care Act rates could increase by double-digits. She says no insurers in Utah have contacted her department yet to develop these new plans.” [KUER, 4/23]

Mario Molina, Former CEO of Molina Healthcare: Hopefully You Already Have Kids Because Maternity Care Won’t Be Covered. “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]

Blue Cross Blue Shield Association: Significant Concerns. “[BCBS] has significant concerns that allowing consumers to stay on these plans for a full year ‘would cause rates to increase for those who need or want comprehensive health insurance coverage.'” [Washington Post, 4/24/18]

Larry Levitt, Kaiser Family Foundation Senior Vice President: “These Short-Term Policy Brochures Read Like An Obstacle Course Of Exclusions.” [Washington Post, 4/23/18]

Kaiser Family Foundation: Analysis: Most Short-Term Health Plans Don’t Cover Drug Treatment or Prescription Drugs, and None Cover Maternity Care. “A new Kaiser Family Foundation analysis of short-term, limited duration health plans for sale through two major national online brokers finds big gaps in the benefits they offer. Through an executive order and proposed new regulations, the Trump Administration is seeking to encourage broader use of short-term, limited duration health plans as a cheaper alternative to individual market plans that comply with the Affordable Care Act’s requirements. Repeal of the individual mandate penalty – which currently applies to people buying short-term plans – is also expected to boost enrollment starting next year. The analysis examines 24 distinct short-term insurance products currently marketed in 45 states and the District of Columbia through eHealth or Agile Health Insurance. It finds: 43 percent do not cover mental health services; 62 percent do not cover substance abuse treatment; 71 percent do not cover outpatient prescription drugs; and none of the plans cover maternity care.” [Kaiser Family Foundation, 4/23]

Washington Post: Trump Proposal Could Mean Healthy People Save On Insurance While Others Get Priced Out. “The Trump administration’s proposal to build up short-term health insurance plans as a ‘lifeline’ for people who can’t afford Affordable Care Act coverage could split the insurance market in two, siphoning young, healthy people into cheaper, more minimal plans — while those who remain in ACA plans face premiums that spiral upward even faster… The effects of that policy change, combined with zeroing out the individual mandate’s financial penalty in 2019 will be harmful to the most vulnerable patients, according to more than 100 patient groups and many health policy wonks.” [Washington Post, 4/23]

Las Vegas Sun: Health Experts Concerned About Risks Of Limited-duration Health Plans. “People would be able to stay on a type of sub-par temporary health plan longer under a proposed Trump administration rule, sparking a concern that the plans won’t give consumers sufficient coverage. The proposal would lift the cap on short-term limited duration plans from six months to just under a year to give more options to consumers who cannot afford the rising cost of health care, according to the Department of Health and Human Services and other agencies involved. The plans can be much cheaper, but do not carry Obamacare-required benefits such as coverage for preexisting conditions.” [Las Vegas Sun, 4/23]

The Hill: Insurer Group Issues Warning On Trump Administration’s Short-Term Health Plan Proposal. “The nation’s largest trade group for health insurance companies is sounding the alarm on a proposal from the Trump administration that would expand the sale of plans that cover fewer services.  America’s Health Insurance Plans (AHIP) says the proposal could lead to more people being uninsured or underinsured and result in higher health-care costs in the long run.” [The Hill, 4/23]

Forbes: Health Insurers: Trump’s Short-Term Plans Will Trigger Loss Of Coverage. “The Trump administration’s proposed cheaper short-term plans may not provide adequate coverage and would trigger an increase in the number of uninsured and under-insured Americans, say health insurers that would be expected to sell such coverage. Through their lobby, America’s Health Insurance Plans, companies Monday were the latest to weigh in on the Trump administration’s proposed rule on short-term plans… Health insurance companies Monday morning issued their critique of the Trump administration’s proposal, joining a parade of doctor groups concerned about any effort to reduce coverage or pare benefits.” [Forbes, 4/23]

Healthcare Dive: Payer Trade Groups Slam Short-term Health Plan Proposal. “The Alliance of Community Health Plans (ACHP) and America’s Health Insurance Plans (AHIP) both slammed CMS’ proposal to expand short-term, limited duration (STLD) insurance plans, saying the proposed rule would undermine key consumer protections, lead to higher premiums in the individual market and jeopardize market stability.  The proposed rule, pushed by the Trump administration as a way to increase access to cheaper plan alternatives and sidestep the Affordable Care Act, would allow consumers to purchase plans for up to 12 months that do not adhere to federal rules for individual health insurance. STLD plans can charge those with pre-existing conditions more and may not cover ACA essential health benefits such as prescription drug coverage. The insurance lobbies argued that other policy mechanisms would be more effective at improving the individual health insurance market.” [Healthcare Div, 4/23]

Washington Times: Insurers’ Lobby Asks Trump To Curtail Short-term Insurance Plan. “Health insurers’ main lobbying group urged the Trump administration Monday to curtail its push to let Americans get around Obamacare by purchasing cheap ‘short-term’ plans for a full year, saying consumers will be left with skimpy coverage. Matt Eyles, the incoming president and CEO of America’s Health Insurance Plans, also said the plan — if it proceeds — should not be enacted until 2020, so insurers have time to plan for a reconfigured marketplace.” [Washington Times, 4/23]

Washington Examiner: Trump-Backed Short-Term Health Plans Have Big Gaps In Benefits, Analysis Finds. “Short-term health insurance plans that the Trump administration wants to expand don’t offer the same benefits of Obamacare plans, a new analysis found. A study from the health research firm Kaiser Family Foundation looked at how short-term plans cover the same benefits as Obamacare. The healthcare law requires plans sold on Obamacare’s insurance exchanges to cover 10 essential health benefits that include mental health services, prescription drug coverage, and maternity care. The Trump administration is seeking to expand the duration of the short-term plans from 90 days to nearly 12 months. These plans are cheaper than Obamacare plans because in part they do not have to cover as many benefits.” [Washington Examiner, 4/23]

Forbes: Doctors Attack Trump’s Short-Term Health Plans Ahead Of Comment Deadline. “An effort by the Trump administration to introduce cheaper short-term health insurance plans is under attack by physician groups who see the plans eliminating benefits and putting patient health at risk. The American Academy of Family Physicians and other doctor groups have unleashed detailed critiques of Trump’s effort to introduce cheaper health insurance with skimpier benefits ahead of a Monday deadline at 5 pm to provide public comments to the administration.” [Forbes, 4/22]

Vox: If You Need Prescriptions Or Maternity Care, You Won’t Like Trump’s Short-term Insurance Plans. “Short-term plans are much less likely to cover mental health and substance abuse treatment or prescription drugs — all of which must be covered by ACA plans. What is insurance, you might ask, if it doesn’t cover medications? This is also a setback for the ongoing effort to have mental health and substance abuse treated as equal to other physical health needs.” [Vox, 4/23/18]

Healthcare Dive: Report Finds Most Short-term Plans Don’t Cover Maternity, Substance Misuse Care. “A Kaiser Family Foundation report argues that recent efforts to promote short-term plans could have an adverse effect on the Affordable Care Act-compliant individual market, creating higher premiums for compliant plans and potentially leaving a greater number of people uninsured.  The expansion of short-term plans, along with the elimination of the individual mandate penalty, could also make it difficult for people who need behavioral health services and substance misuse treatment, which aren’t typically covered benefits under those plans. The Trump administration’s plans for short-term expansion would primarily impact the middle class, as lower-income people are protected from premium increases through the use of federal subsidies, KFF said.” [Healthcare Dive, 4/24]

Insurance News Net: Trump Administration Implored To Curtail Short-Term Plan. “Health insurers, patient groups and Senate Democrats implored the Trump administration Monday to curb or cancel its push to let Americans get around Obamacare by using cheaper, short-term health plans for a full year, saying the plan would destabilize the insurance markets and increase the number of uninsured… More than 100 patient-advocacy groups protested the proposal Monday, the final day to submit comments to HHS, noting the full-year plans could duck Obamacare rules requiring robust coverage or preventing insurers from denying sicker patients or charging them more than healthy ones.” [Insurance News Net, 4/24]

Modern Health Care: Insurers, Hospitals Warn Short-term Plans Aren’t The Answer. “Several health insurance and hospital associations urged HHS to spike the proposed rule to expand access to short-term, limited-duration health insurance, warning it would lead to higher premiums for Affordable Care Act-compliant plans and more uncompensated care delivered at hospitals. Meanwhile, stakeholders in the short-term insurance market encouraged HHS to finalize the proposed rule allowing the sale of short-term plans with durations of up to 12 months, saying the extension would lead to lower premiums and more options for consumers. It is clear those stakeholders would see more customers and higher revenue if the proposed rule is finalized.” [Modern Health Care, 4/23]

Washington Examiner: Healthcare Groups Plea With Trump Administration To Nix Short-Term Insurance Plan Rule.  “A wide array of doctor, insurer, and other major healthcare groups pleaded with the Trump administration to nix plans to expand short-term insurance plans… Healthcare groups say in comments to the proposed regulation, which were due Monday, the plans are no better than “junk insurance” that erode patient protections. The regulation would expand the duration of the short-term plans from 90 days to nearly 12 months.” [Washington Examiner, 4/23]

47 Senators: The Proposed Rule Will “Increase Costs And Reduce Access To Quality Coverage For Millions Of Americans, Harm People With Pre-Existing Conditions, And Force Premium Increases On Older Americans.” “If finalized, the rule could increase costs and reduce access to quality coverage for millions of Americans, harm people with pre-existing conditions, and force premium increases on older Americans. This rule expands the sale and marketing of “junk plans” that exclude basic benefits including hospitalization, prescription drugs, mental health services, substance abuse treatment, and maternity care. We urge you not to finalize the proposed rule and instead work with us to ensure that all American families have choices of affordable, meaningful health care coverage.” [State of Reform, 4/23]

ashoup
In News, Stories

Trump Admin Should Listen to Overwhelming Opposition & Scrap Its Junk Plan Proposal

Washington, D.C. – As an outpouring of public opposition marked today’s junk plan proposal comment deadline, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Over the past two months, Americans have clearly rejected the Trump Administration’s junk plan proposal because it would move our health care in exactly the wrong direction. We don’t want to go back to the days when insurance companies could charge more for pre-existing conditions or deny coverage altogether and when junk plans didn’t have to cover basic medical services. This rule has drawn criticism from over one hundred prominent disease groups, from the AARP, from doctors and providers, and from thousands of everyday Americans. The National Association of Insurance Commissioners has confirmed that it would raise rates on the one-in-four Americans with a pre-existing condition. The Trump Administration should listen to the experts, doctors, insurance commissioners, and individual advocates who have together formed a tidal wave of opposition to junk plans, and withdraw this dangerous proposal.”

EXPERTS REJECT PROPOSAL

113 Groups Plead For Congress To Block Trump Administration’s Expansion Of Short-Term Health Plans: “While short-term plans can offer less expensive coverage, they are not required to adhere to important standards, including the ten essential health benefit categories, guaranteed issue, out-of-pocket maximums, age-rating protections, and many other critical consumer protections,” the groups, including the American Heart Association, Susan G. Komen, and Justice in Aging, said in an April 17 letter (PDF) to congressional leaders. [Fierce Healthcare, 4/18/18]

AARP Warning: Short-Term Health Plans = Higher Premiums for Older Adults: You might have thought that efforts to unravel the Affordable Care Act (ACA) were over, but newly proposed regulations and legislation are once again threatening to have similar harmful effects for older adults ages 50-64 who rely on individual market coverage. [AARP Blog, 3/21/18]

National Association of Insurance Commissioners Report: “Risk pool segmentation has the obvious effect of driving up premiums in the health plans that protect individuals from health status discrimination.” [NAIC, 3/22/18]

American Academy of Family Physicians: “Insurers could reduce or eliminate certain essential health benefits to avoid vulnerable, expensive patients by excluding specific services.” [Forbes, 4/22/18]

American Medical Association: “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]

America’s Health Insurance Plans (AHIP): “Because many short-term plans are offered to consumers only after submitting information about their health status or prior medical conditions, we must also recognize that short-term plans will not meet the needs of many Americans with pre-existing health conditions.” [AHIP letter, 4/20/18]

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In Stories, News

Koch Brothers Launch Latest Salvo in the Republican War on Montanans’ Care

Washington, D.C. – In response to Americans for Prosperity releasing a new, misleading ad against Sen. Jon Tester, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“The Koch Brothers and their Republican allies in Congress have been waging a war on health care that will raise our costs, take away coverage, and gut protections for those with pre-existing conditions. Thanks to the Republican tax bill, pharmaceutical and insurance companies are getting billions of dollars in tax breaks while many Montana families will see their premiums go up an average of $2,100 this fall, and 46,000 Montanans could lose coverage altogether. Enough is enough: it’s time for the Koch brothers and their allies in Congress to stop their war on Montanans’ health care.”

BACKGROUND

INSURANCE COMPANIES AND PHARMACEUTICAL COMPANIES GET BILLIONS OF DOLLARS FROM THE REPUBLICAN TAX BILL

The Republican Tax Bill Is A $10 Billion Giveaway For Insurance Companies.  An Axios analysis found 21 health insurance companies collectively expected to gain $10 billion in tax breaks in 2018 alone. Most of the money is being used for buybacks, dividends, acquisitions and paying down debt — with just a sliver for one-time employee bonuses, research and internal investments. [Axios, 3/5/18]

The Republican Tax Bill Is A $50 Billion Windfall For Pharmaceutical Companies.  According to an Axios analysis, the pharmaceutical industry is using a large portion of its savings from the Republican corporate tax break to boost its stock prices. Nine drug companies are spending a combined $50 billion on new share buyback programs, far outstripping investments in employees or drug research and development. [Axios, 2/22/18]

THE REPUBLICAN TAX BILL WILL RAISE PREMIUMS AND TAKE COVERAGE AWAY FROM MONTANANS

The Republican Tax Bill Means Higher Costs, Especially for Older Montanans. A Center for American Progress estimate shows that in Montana, family premiums in the marketplace will increase on average by $2,100 in 2019. Older Montanans would not be spared. The AARP estimates a 64-year-old in Montana will have to pay $1,551 more in premiums because of health repeal, essentially an age tax for people over 50. [Center for American Progress, 11/16/17, AARP, 11/21/17]

The GOP Tax Bill Will Cost 46,000 Montanans Their Health Coverage. As a result of the tax bill, an estimated 46,000 Montanans will lose coverage by 2025. [Center for American Progress, 11/16/17]

REPUBLICAN SABOTAGE WILL RAISE THE COST OF HEALTH CARE FOR MONTANANS

Urban Institute: Premiums For Montanans Will Increase An Average Of 19.8 Percent Next Year. An Urban Institute study found that, “the actions President Trump and Congressional Republicans have taken to sabotage the health care markets will artificially inflate individual insurance premiums by an average of 19.8 percent in Montana for 2019.” [Urban Institute, 3/14/18]

ashoup
In News

Trump’s Tax Day: Tax Breaks For the Rich, Higher Health Care Costs For You

Washington, D.C. – On Tax Day, as millions of Americans contend with health care premiums expected to increase an average of 18 percent, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“This Tax Day, wealthy health insurers and rich pharmaceutical companies get huge tax breaks thanks to Donald Trump and Congressional Republicans. Meanwhile, people who work for a living get higher health care costs.

“The TrumpTax will take health insurance away from 13 million people and raise premiums double-digits each year for millions more to fund a trillion-dollar tax break for the wealthiest individuals and corporations. 20 Americans will lose their coverage for each millionaire’s tax break.

“Every American who sees their health care costs go up should remember this Tax Day that their rising health care costs were brought to them courtesy of Donald Trump and the GOP.”

ashoup
In News

President Trump Vows to Keep Sabotaging Affordable Care Act

Washington, D.C. – Today in Florida, President Trump vowed to continue his sabotage campaign against the Affordable Care Act, saying the GOP’s tax bill brought about “the end of Obamacare” and expressing his support for proposed association health plans, calling them ‘tremendous insurance.’ Protect Our Care Campaign Director Brad Woodhouse released the following statement in response:

“President Trump today continued his crusade against the Affordable Care Act and Americans’ health care. Trump’s war on our care already threatens millions of Americans’ insurance, is raising premiums by double-digits for millions more, and has seriously damaged the individual market – and in response, the President has decided to embrace junk insurance scams like association health plans, which have a history of fraud and have been condemned by experts across the country. The new junk plan regulation that Trump today pledged to finalize within months is likely illegal, and will certainly cause even more turmoil in the insurance markets just before next year’s rates are finalized. Plans that can deny coverage based on pre-existing conditions and refuse to cover key services like hospitalization are the exact opposite of ‘tremendous insurance,’ and they join a long list of Trump Administration actions set to cause tremendous rate hikes this fall.

“While President Trump may say that ‘nobody remembers’ the Senate health care repeal bill, the truth is that Americans have not forgotten that Republicans threatened our care. We remember that Republicans tried to put insurance companies back in control; we remember they tried to leave the one-in-four Americans with a pre-existing condition out in the cold; and we remember that Republicans ignored our voices while pushing the most unpopular legislation in decades. Standing up to the war on health care is Americans’ top priority at the polls this year. As the Trump Administration continues to attack our care through harmful regulations and Republicans in Congress plot Medicare and Medicaid cuts, Americans will keep remembering, and the President and his party are right to fear the consequences of their destructive actions.”

TRANSCRIPT:

PRESIDENT TRUMP: So we have the biggest tax cut in history, bigger than the Reagan tax cut, bigger than any tax cut. But what else? The individual mandate is gone. That’s on Obamacare, which is about the end of Obamacare. So we had Obamacare beat and one senator decided to go thumbs down. Do you remember that evening? No, nobody remembers. Thumbs down.

It’s all right, because Alex Acosta has come up and this is the plan that a lot of people have wanted for a long time, associations. And we’re going any tremendous sign-ups. Alex, when is that going to be ready where people can start signing and doing it in groups and through cooperatives, et cetera?

LABOR SECRETARY ACOSTA: That’s right, Mr. President, we hope to have that by this summer.

PRESIDENT TRUMP: It’s going to be incredible, you’re going to get tremendous insurance at a very low cost.

ashoup
In News

Sabotage: Elected Officials, Stakeholders, Experts Pan Anti-Consumer Provisions in Trump Administration Marketplace Rule

Washington, D.C. – Consumer advocates spoke out quickly and loudly after the Trump Administration announced a final Notice of Benefit and Payment Parameters rule for plans offered through the Affordable Care Act’s individual marketplaces that will weaken benefits for millions of Americans, put those with pre-existing conditions at risk, and make it even harder for people to sign up for coverage – all while lining insurance company pockets through reduced review of rate hikes and overhead:

Elected Officials

Senator Ron Wyden (D-OR): “Instead of taking steps to prevent big premium increases this fall, the Trump Administration is watering down your health care and making it harder to get coverage. Projections already showed double digit premiums increases this year due to the Trump Administration’s attacks on families’ health care, and today’s new rules pour gasoline on the fire.” [4/9/18]

Senator Patty Murray (D-WA): “With this new rule, President Trump has issued an open invitation for insurance companies to raise premiums, skirt patient protections, and undermine families’ care. I’m very concerned about what these dramatic, harmful changes in policy could mean for women who don’t want to pay more than men for health care, for people with pre-existing conditions, for those struggling with mental illness and substance use, and for millions of peoples’ health costs. Republicans in Congress should join Democrats in condemning the President Trump’s latest politically-motivated effort to raise families’ costs and create health care chaos.” [4/9/18]

Stakeholders & Experts

Andy Slavitt, Former Acting CMS Administrator: “Andy Slavitt, who was acting CMS administrator during the Obama administration’s final two years, countered that the current administration ‘is making it clear that they’re implementing a law that they have no intention of making succeed.’ Slavitt called the revisions ‘a gift to the insurance companies by finding lots of ways for them to get around the standards Americans have come to expect.’” [Washington Post, 4/9/18]

Sam Berger, Senior Adviser, Center for American Progress: “This rule reduces protections for people with pre-existing conditions, increases the cost of health coverage, and makes it harder for consumers to sign up for coverage. This past year has shown just how much consumers value quality, affordable health care, but rather than encourage awareness, lower prices, and promote market stability, the administration is more concerned with trying to undermine the law. This is just the latest example of the Trump administration putting its ideological crusade against the Affordable Care Act ahead of the health and well-being of the American people.” [4/9/18]

Avalere: “The final NBPP … allows for greater essential health benefit flexibility, which could lead to less generous benefits and worse access for consumers.” [4/9/18]

Matt Eyles, Incoming President and CEO, America’s Health Insurance Plans: “When you think about things like the individual mandate going away, some of the other proposed rules that are being put in place, whether it be around association plans, short-term policies — it’s just still a nasty soup right now that’s brewing… We’re looking ahead to 2019, and it’s not a really great picture right now, but I know a lot of companies are committed to the market.” [Washington Times, 4/10/18]

U.S. PIRG: “Together, these changes will make it easier for health insurance companies to raise rates and reduce the value of health coverage for consumers. This is a big step in the wrong direction.” [4/9/18]

AFT Nurses and Health Professionals: “CMS gives states more power to cut health benefits, more profits to insurance companies, with fewer safeguards for coverage.” [4/10/18]

How It Played In The Headlines

​Wall Street Journal: Trump Administration Allows States to Narrow ACA Coverage

Reuters: Trump administration issues rule further watering down Obamacare

Washington Post: Trump administration rewrites ACA insurance rules to give more power to states

Washington Examiner: Trump administration releases new ways for states to skirt Obamacare rules

News Coverage Details Rule’s 529 Pages of Sabotage

Wall Street Journal: “Trump Administration Allows States to Narrow ACA Coverage.” “The Trump administration will give states leeway to winnow down the mandatory health benefits guaranteed to consumers who buy Affordable Care Act insurance plans, under a rule issued Monday… The changes to the ACA plans reflect the administration’s goal of dismantling former President Barack Obama’s signature health law and transferring more health-policy decisions to the states. Democrats and some consumer groups denounced the rule as another effort by the administration to undermine the ACA. They have said that weakening the scope of the benefits offered in ACA plans will hurt consumers by reducing coverage. The new rule will ‘undermine protections for people with pre-existing conditions with a race-to-the-bottom approach that fundamentally undermines the Affordable Care Act’s essential health-benefit coverage guarantee,’ said Brad Woodhouse, campaign director of Protect Our Care, a group that is an advocate for the ACA.” [Wall Street Journal, 4/9/18]

CNN: “The New Rule Is The Latest Effort By The Administration To Undermine The Affordable Care Act.” “The new rule is the latest effort by the administration to undermine the Affordable Care Act. Earlier this year, it proposed rules that would allow insurers to sell short-term insurance plans, which last just under a year but don’t have to comply with Obamacare’s regulations, and to make it easier for small businesses to band together to offer coverage that doesn’t adhere to all of the health reform law’s mandates. Both of these options could have lower premiums, but also cover fewer benefits.” [CNN, 4/9/18]

Health Care Dive: “The Sweeping Rule Is Just The Latest In The Trump Administration’s Steady Chipping Away” At The ACA. “The sweeping rule is just the latest in the Trump administration’s steady chipping away at the landmark health law, which has been coupled with a move to give states more control over their healthcare regulations. The administration cut off cost-sharing reduction payments to insurers in October, sparking backlash from payers. The Republican tax bill last year repealed the individual mandate penalty starting in 2019. And more is on the way. In February, the administration released a proposed rule to expand short-term health insurance availability, bumping up the allowance of coverage to 12 months. It is also promoting association health plans, which aren’t required to meet the EHB requirements or protect people with pre-existing conditions. The ACA requires payers to cover at least 10 specific benefits, including maternity care and prescription drugs.” [Health Care Dive, 4/9/18]

Reuters: “This Could Lead To Less Generous Coverage.” “The Trump administration took additional steps to weaken Obamacare on Monday, allowing U.S. states to relax the rules on what insurers must cover and giving states more power to regulate their individual insurance markets. The Centers for Medicare and Medicaid Services issued a final rule that allows states to select essential health benefits that must be covered by individual insurance plans sold under former President Barack Obama’s healthcare law. The 2010 Affordable Care Act requires coverage of 10 benefits, including maternity and newborn care and prescription drugs. Under the new rule, states can select from a much larger list which benefits insurers must cover. That could lead to less generous coverage in some states, according to Avalere Health, a research and consulting firm. [Reuters, 4/9/18]

Reuters: “Insurers Could Also Have An Easier Time Raising Their Rates Under The New Rule.” “Insurers could also have an easier time raising their rates under the new rule. Obamacare mandated that premium rate increases of 10 percent or more in the individual market be scrutinized by state regulators to ensure that they are necessary and reasonable. The new CMS rule raises that threshold to 15 percent.” [Reuters, 4/9/18]

CNN: The Rules “Make It Easier For Insurers To Spend Less Of The Premiums They Collect On Policyholders And Put More Toward Profits.” “The rule also allows states to make it easier for insurers to spend less of the premiums they collect on policyholders and put more toward profits and administrative costs. And the administration raised the default threshold that trigger state reviews of insurers’ proposed rate hikes to 15%, up from 10%.” [CNN, 4/9/18]

Washington Post: New Rules “Will Enable States To Allow Future Doctors Visits [Or Cover] Fewer Prescription Drugs.” “One of the most significant changes involves a set of 10 essential health benefits that the ACA requires of health plans sold through the federal insurance marketplace and separate state marketplaces. The new rules will not jettison any of the categories but will enable states to allow fewer doctors visits, for example, or to cover fewer prescription drugs.” [Washington Post, 4/9/18]

Washington Post: “The Government Will No Longer Require That Insurers Provide A Standardized Set Of Benefits, Urged By The Obama Administration As A Way To Help Consumers Comparison Shop.” “In another change, the government is turning over to the 39 states that rely on the federal insurance exchange, HealthCare.gov, responsibility for ensuring that marketplace plans have enough doctors and other providers of care in their networks. Similarly, the government no longer will require that insurers provide a standardized set of benefits, urged by the Obama administration as a way to help consumers comparison shop. [Washington Post, 4/9/18]

Washington Post: “In A Sharp Shift, The New Rules Further Weaken The Network Of Consumer Assisters.” “In ways both subtle and substantial, many of the past years’ rules were upgrades to help consumers with prices, benefits and shopping for coverage. Under a change effective in 2016, any insurer wanting to raise its premiums by 10 percent or more has been required to disclose the increase with a justification. Insurers also have had to publish up-to-date lists on drugs, including tiers of coverage and any restrictions on consumers’ ability to get them. The rules for 2017 started a rating system for the number of doctors and other providers in plans’ networks, so that customers could better compare marketplace insurers in areas that offer a choice. In a sharp shift, the new rules further weaken the network of consumer assisters, known as navigators, whose funding the Department of Health and Human Services slashed last year. The rules remove the requirement that every area has at least two navigator groups and that one be local.” [Washington Post, 4/9/18]

Washington Post: Insurers No Longer Must Devote 80 Percent Of Income To Customers’ Care. “In addition, insurers no longer will be required to devote 80 percent of their income to customers’ care, if they can show that a higher profile would improve their financial stability.” [Washington Post, 4/9/18]

The Hill: Ruling Gives Flexibility For States “To Change The Essential Health Benefits.” “Other changes announced Monday include additional flexibility for states to change the Essential Health Benefits, the list of health services that insurance plans must cover.” [The Hill, 4/9/18]

Washington Examiner: New Rules “Ease The Requirements” Plans Must Cover. “The new rules would ease the requirements on the health benefits that plans must cover, as well as quality control. Critics say the new rule will allow insurers to charge higher prices and skirt patient protections… The agency also is changing the requirements for how much money an insurer must provide toward medical services and quality improvement. Obamacare requires insurers to spend 80 percent of the money it takes in from premiums on health costs and quality improvements and 20 percent on administrative overhead or marketing. CMS would allow a state to change that ratio based on certain factors.” [Washington Examiner, 4/9/18]

Associated Press: “One Of The Ways To [Lower Costs] Is By Cutting Back On Benefits.” “The administration is under pressure from Republican-led states to reduce the cost of health insurance for consumers buying their own policies. One of the ways to do that is by cutting back on benefits.” [AP, 4/9/18]

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In News

Trump Administration Stacks Deck Against Next Year’s Health Care Shoppers

Washington, D.C. – After the Trump Administration finalized “rules of the road” for next year’s Affordable Care Act marketplaces that favor insurance companies over the American people, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“President Trump and Congressional Republicans have already set the stage for higher prices and more confusion next fall with laws and regulations that undermine the Affordable Care Act marketplaces. Now, the Trump Administration is compounding its attack by encouraging insurance companies to undermine protections for people with pre-existing conditions with a race-to-the-bottom approach that fundamentally undermines the Affordable Care Act’s essential health benefit coverage guarantee. Meanwhile, the Administration is sweetening the deal for insurance companies by loosening restrictions on extreme rate hikes.

“Today’s Trump Administration action will make it even harder for Americans to sign up for coverage next year, with further cuts to local assisters who help families navigate their options and enroll. The Administration’s own data from this year’s enrollment period shows that their cuts to outreach and assistance dampened enrollment – especially among younger and healthier consumers – while states that ran their own marketplaces did not see similar drop-off. Today’s sabotage will compound that problem.

“As we look ahead to this fall’s open enrollment period, when premiums are already expected to spike due to harmful actions by Trump and his Republican Congress, there is simply no excuse for setting rules of the road that allow insurance companies to chip away at benefit quality and hike rates with impunity, while at the same time stripping away resources that help Americans understand their insurance options. This short-sighted, bad-faith rule is yet another brick in the wall that Republicans are building between the American people and access to good, affordable coverage.”

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