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Sabotage

ashoup
In News

Association Health Plans Endanger Consumers

NATIONALLY, ASSOCIATION HEALTH PLANS HAVE A HISTORY OF FRAUD AND UNPAID CLAIMS

Between 2000 and 2002, AHPs Left 200,000 Policyholders with $252 Million In Unpaid Medical Bills. “There have been several documented cycles of large-scale scams. According to the GAO, between 1988 and 1991, multiple employer entities left 400,000 people with medical bills exceeding $123 million. The most recent cycle was between 2000 and 2002, as 144 entities left 200,000 policyholders with $252 million in unpaid medical bills.” [United Hospital Fund, 3/6/18]

  [GAO, February 2004]

Former Insurance Fraud Investigator: “Fraudulent Association Health Plans Have Left Hundreds Of Thousands Of People With Unpaid Claims.” “Marc I. Machiz, who investigated insurance fraud as a Labor Department lawyer for more than 20 years, said the executive order was ‘summoning back demons from the deep.’ ‘Fraudulent association health plans have left hundreds of thousands of people with unpaid claims,’ he said. ‘They operate in a regulatory never-never land between the Department of Labor and state insurance regulators.’” [New York Times, 10/21/17]

Dr. James Madara, CEO of the American Medical Association: Association Health Plans Have Potential To Threaten Health And Financial Stability. “Fraudsters prey upon areas of regulatory ambiguity and may challenge such authority in courts to further delay enforcement, which allows more time to increase unpaid medical claims…Without proper oversight to account for insolvency and fraud, AHPs have the potential to … (threaten) patients’ health and financial security and the financial stability of physician practices and other providers.” [Modern Healthcare, 3/7/18]

INSURANCE COMMISSIONERS AGREE THAT ASSOCIATION HEALTH PLANS ARE BAD FOR CONSUMERS

National Association of Insurance Commissioners: Association Health Plans Are Bad For Consumers. “AHPs would fragment and destabilize the small group market, resulting in higher premiums for many small businesses…AHPs would be exempt from state solvency requirements, patient protections, and oversight exposing consumers to significant harm.” [NAIC]

Pennsylvania Insurance Commissioner Concerned About Potential For Consumer Harm Under AHPs. “The proposed rule would also loosen existing commonality of interest requirements to allow associations to form simply based on membership in the same trade, industry or profession..If a self funded MEWA were permitted to form in a neighboring state and to sell to Pennsylvania association members under the metro area provision, Pennsylvania regulators would not have the ability to assist a Pennsylvania resident if problems arise with the other state’s association, including claim denials, or, worse yet, in the event of insolvency or fraud.” [PA Insurance Commissioner Jessica Altman, 3/6/18]

California Insurance Commissioner: “The Proposed Rule Is A Perfect Storm Of Bad Ideas.” “The AHPs proposed by this rule will harm consumers by degrading the individual and small group health insurance markets through adverse selection, and will impinge upon states’ rights while opening the door to fraud, insolvency and abuse…The proposed rule in no way limits the ability of states to regulate MEWAs, insurers offering coverage through MEWAs, and insurance producers marketing that coverage to employers. However, the checkered history of MEWAs instructs that unscrupulous actors will try and exploit any change which can be mischaracterized as constituting ERISA preemption.” [CA Insurance Commissioner Dave Jones, 3/6/18]

PATIENT GROUPS, HOSPITALS, AND KEY HEALTH STAKEHOLDERS CONDEMN AHPs

American Cancer Society Cancer Action Network: “We Are Also Concerned About The Proliferation Of AHPs Because Of Their History Of Fraud And Financial Instability.” “For a long time, these products were not traditionally subject to the same state insurance solvency and licensing requirements that allowed regulators to maintain necessary oversight.5 If an AHP lacked the financial resources to pay claims, then enrollees were left with no coverage and high out-of-pocket costs. Even in cases of well-meaning AHP sponsors, insolvencies led to millions of dollars in unpaid claims.” [ACS-CAN, 3/6/18]

American Hospital Association: AHPs “Ultimately Decreas[e] Access To Affordable Coverage.” “We are concerned that this rule fails to protect against discriminatory insurance practices and could contribute to instability in the individual and small group market, ultimately decreasing access to affordable coverage.” [American Hospital Association, 3/6/18]

Coalition Of 118 Patient And Community Organizations Urges Department Of Labor To Reconsider AHPs. “We believe that the proposed changes would negatively impact access to quality, affordable care for consumers, disrupt the individual and small business marketplace, and further strain the limited resources of state regulators…The intent of the President’s executive order was to increase consumer choice while curbing costs, however we believe that AHPs as proposed would invariably weaken the individual and small group markets leading to higher healthcare costs for all; higher premiums for those who stay in the marketplace, and high out of-pocket costs for those who are covered by AHPs for unexpected medical needs.” [Coalition Of 118 Patient And Community Organizations, 3/6/18]

AHPs ARE HOTSPOTS FOR FRAUD IN STATES:

Florida

A Labor Department Lawsuit Revealed An AHP Had Concealed Financial Problems And Left $3.6 Million In Unpaid Claims. “The Labor Department filed suit last year against a Florida woman and her company to recover $1.2 million that it said had been improperly diverted from a health plan serving dozens of employers. The defendants concealed the plan’s financial problems from plan participants and left more than $3.6 million in unpaid claims, the department said in court papers.” [New York Times, 10/21/17]

In Florida, A Man Pleaded Guilty To Embezzling $700,000 In Premiums From the AHP He Ran in 2004 To Help Build A Home For Himself And Was Sentenced To 57 Months In Prison. “A Florida man was sentenced to 57 months in prison after he pleaded guilty to embezzling about $700,000 in premiums from a health plan that he had marketed to small businesses. The Labor Department and the Justice Department said he had used some of the plan premiums to build a home for himself.” [New York Times, 10/21/17]

In 2004, A Florida Woman Was Left With $500,000 In Unpaid Medical Bills While She Was Covered By Association Health Plan. “Joan Piantadosi, a small business owner bought health insurance from Employers Mutual LLC through an association for herself, her family, and her employees. She was left with more than $500,000 in unpaid medical bills for her husband’s treatment during the time she was covered by Employers Mutual LLC. On top of that, her husband needed a liver transplant to live. In her own words, “[W]e were informed that since we lacked insurance coverage, we would have to pay a deposit of $150,000 before my husband could enter the hospital’s Liver Transplant Inpatient program. We simply did not have $150,000 to cover the deposit. Consequently, my husband was removed from the recipient list…We feared, among other things, that my husband might die while we were attempting to deal with the predicament of being uninsured despite having paid premiums to what appeared to be a legitimate health insurer.” [United Hospital Fund, 3/6/18]

Louisiana

In Louisiana, Two People Pleaded Guilty To Using Money From The AHP For Spa Treatments, Diamond Cuff Links, Foreign Travel And Other Personal Expenses. “And in Louisiana, two people pleaded guilty to conspiracy charges after the government found that they had taken money from the medical benefit fund of a trade association and used it to pay for spa treatments, diamond cuff links, evening gowns, foreign travel and other personal expenses.” [New York Times, 10/21/17]

Texas

In Texas, Patients Thought They Were Insured Until Told Otherwise In A Moment Of Crisis. “Robert Loiseau, who represented fraud victims in Texas, recalled their shock when they tried to receive care. ‘People bought insurance coverage because it was cheap and seemed to provide them with coverage they needed,’ he said. ‘It had a veneer of legitimacy. But when they went to the doctor, they found out all of a sudden that their insurance company, their perceived insurance company, was in receivership and that they had no coverage.’” [New York Times, 10/21/17]

Between 2001 And 2003, Texas Shut Down 129 Unauthorized Insurance Operations. “In the last two years, the Texas Insurance Department shut down 129 unauthorized insurance companies, affiliates, operators, and their agents whose illegal actions affected more than 20,000 Texans.” [The Commonwealth Fund, August 2003]

New Jersey

In 2002, An AHP Became Insolvent With $15 Million In Outstanding Claims. “For example, when a long-standing AHP in New Jersey that covered 20,000 people became insolvent in 2002, it had $15 million in outstanding medical bills. This left participating businesses and their employees’ claims unpaid even though employers paid premiums to the AHP.” [Commonwealth Fund, 10/10/17]

A Health Plan For New Jersey Small Businesses Collapsed With $7 Million In Unpaid Claims. “In another case, a federal appeals court found that a health plan for small businesses in New Jersey was ‘aggressively marketed but inadequately funded.’ The plan collapsed with more than $7 million in unpaid claims.” [New York Times, 10/21/17]

South Carolina

In South Carolina, A Man Pleaded Guilty To Diverting Nearly $1 Million From An AHP For Churches And Small Businesses, Leaving $1.7 Million In Unpaid Claims. “A South Carolina man pleaded guilty after the government found that he had diverted more than $970,000 in insurance premiums from a health plan for churches and small businesses. ‘His embezzlement and the plan’s consequent failure left behind approximately $1.7 million in unpaid medical claims,’ the Labor Department said.” [New York Times, 10/21/17]

Across State Lines: North Carolina, Maryland, And Beyond

One AHP Scheme Shows How AHPs Can Move From State To State. Families USA chronicled an AHP scheme involving the American Trade Association, Smart Data Solutions, and Serve America Assurance. They found:

  • “Even after one state identifies a problem, the company may continue to operate for years in other states. North Carolina issued a cease and desist order to stop many of the players in this case from selling insurance in 2008.”
  • “But by June 2010, when Maryland issued a cease and desist order, the plans sold by these players had been identified in at least 23 states.„ Estimates of total premiums paid to these companies for unauthorized, unlicensed plans range from $14 million to $100 million.”
  • “This particular scheme operated through associations that went by many different names. (At least one of the players in this case was involved in a previous case concerned with fraudulent insurance sold through an association of employers in 2001-2002.)”
  • “Consumers are often ill-protected when they buy coverage through an association, and the web of relationships among salespeople, associations, administrators, and actual insurers can be difficult for regulators to unravel and oversee. Consumers may be encouraged to join fake associations to buy health insurance so they have an illusion of coverage—and the insurers collect membership dues and premiums while illegally avoiding state oversight).” [Families USA, October 2010]

GAO Report In 1992 Showed Similar AHPs Left At Least 398,000 Participants With More Than $123 Million In Unpaid Claims And More Than 600 Plans In Almost Every State Failed To Comply With State Laws. “Back in 1992, the Government Accountability Office issued a scathing report on these multiple employer welfare arrangements (known as MEWAs; they’re pronounced “mee-wahs”) in which small businesses could pool funds to get the lower-cost insurance typically available only to large employers. These MEWAs, said the government, left at least 398,000 participants and their beneficiaries with more than $123 million in unpaid claims between January 1988 and June 1991. Furthermore, states reported massive and widespread problems with MEWAs. More than 600 plans in nearly every U.S. state failed to comply with insurance laws. Thirty-three states said enrollees were sometimes left without health coverage when MEWAs disbanded…’MEWAs have proven to be a source of regulatory confusion, enforcement problems and, in some instances, fraud,’ the GAO wrote at the time.” [Washington Post, 10/12/17]

ashoup
In Administration, News

Kaiser Poll Confirms Public Support for Affordable Care Act

This morning, on the 8th anniversary of the Affordable Care Act’s signing, the Kaiser Family Foundation’s March Health Tracking Poll finds that the law’s popularity remains above water, with half of Americans having a favorable opinion. The poll also confirms that Americans want Congress to improve the law, not to repeal it, with 63% saying Republicans in Congress should focus their efforts on improvements and only 32% supporting repeal.

“Today’s tracking poll confirms that after eight years, the Affordable Care Act has stood the test of time and is now woven into the fabric of the American health care system. Two-thirds of the public want to see the law improved and strengthened. Unfortunately, just this week, Republicans in Congress continued to ignore Americans’ desire to improve health care by refusing to pass bipartisan stabilization legislation to undo some of the rate hikes President Trump has caused with his relentless sabotage of the Affordable Care Act. It’s time for Republicans to listen to their constituents, who want Congress to put the partisan fight over the Affordable Care Act in the rearview mirror once and for all, and start working on bipartisan fixes and improvements. And it’s time for President Trump to face up to the facts and stop his Administration’s ongoing sabotage of our health care system,” said Protect Our Care Campaign Director Brad Woodhouse.

ashoup
In News, Administration, Capitol Hill

Protect Our Care on Eighth Anniversary of the Affordable Care Act: We Won’t Go Back

On the eighth anniversary of the Affordable Care Act being signed into law, Protect Our Care Campaign Chair Leslie Dach released the following statement:

“Eight years after the Affordable Care Act became law, twenty million people have gained coverage; the uninsured rate has been cut in half; and out-of-pocket spending has fallen double digits while medical bankruptcies are becoming more and more rare. Because of the ACA, insurers can no longer deny coverage to the one-in-four Americans with a pre-existing condition or drop coverage due to a yearly or lifetime limit; plans must cover essential health benefits; women cannot be charged more than men; and young adults can stay on their parent’s plan until age 26.

“Today, not only is the ACA more popular than ever, but health care has become a driving factor in elections across the country. The two times Medicaid expansion was on the ballot, in Maine and Oregon, it won overwhelmingly, and voters have cited health care as a top issue, powering Democratic victories in Virginia, New Jersey, Alabama, Wisconsin, and Pennsylvania. And despite almost a decade of attacks on the law, the American people are more united than ever in favor of expanding access to health care.

“Despite all this, Trump Administration and Congressional Republicans continue their relentless repeal-and-sabotage campaign, raising premiums and out of pocket costs for millions including demanding an age tax for older Americans, taking away protections for people with pre existing conditions, and gutting Medicaid.

“The past eight years have shown just how much progress has been made in the American health care system, and the past year has made clear just how much Americans value the quality, affordable care provided by the ACA. The Affordable Care Act made health care in America immensely better, and we won’t go back.”

ashoup
In News, Administration, Capitol Hill

The Republican War on Health Care: First They Sabotaged It, Then They Refused to Fix It, Now they Own It

Republicans Bear 100% of Responsibility for Avoidable Premium Increases Set to Hit Millions of Middle Class Families This Fall

BEFORE PRESIDENT TRUMP’S SABOTAGE, THE MARKETS WERE STABILIZING

Trump White House Today Admits The Marketplaces Were Stabilizing. “After an initial adjustment period, insurers’ financial health, as measured by their stock prices, surpassed earlier levels … While insurers initially incurred losses in the ACA marketplaces as they adjusted to new regulations and a relatively unhealthy risk pool, insurers are now profiting on the individual market as well.” [CEA, 3/18/18]

In 2017, Congressional Budget Office Reports: ACA Market Is Stable. “The subsidies to purchase coverage combined with the penalties paid by uninsured people stemming from the individual mandate are anticipated to cause sufficient demand for insurance by people with low health care expenditures for the market to be stable.”  [Congressional Budget Office, 3/13/17]

In 2017, S&P Global Reports: ACA Market Will Remain Stable So Long As The Trump Administration Is Not “Disruptive.” S&P Global repeatedly reports that “2016 results and the market enrollment so far in 2017 show that the ACA individual market is not in a ‘death spiral.’ However, every time something new (and potentially disruptive) is thrown into the works, it impedes the individual market’s path to stability.” [S&P Global, 4/7/17]

THEN REPUBLICAN REPEAL ATTEMPTS UNDERMINED THE MARKET

Ongoing Republican repeal attempts throughout 2017 created uncertainty that insurance companies said forced them to hike premiums: “Obamacare markets are undergoing a slow-motion meltdown as Republicans stoke a climate of uncertainty while struggling to agree on their own plan for overhauling American health care.” [Politico, 6/8/17]

AND IF THAT WASN’T ENOUGH, PRESIDENT TRUMP STARTED TO SABOTAGE THE MARKETS, WHILE REPUBLICANS ON THE HILL DID NOTHING TO STOP IT

On October 13, 2017, President Trump Ended Cost Sharing Reductions (CSRs), Payments To Insurers That Help Lower Income Americans Afford Health Coverage In The ACA Marketplace. [Washington Post, 10/13/17]

Kaiser Family Foundation: Lack Of CSR Payments Resulted In Surcharge In Premiums Of 7.1 To 38 Percent. “As shown in Table 1, among those insurers that specify the surcharge on silver plans for the discontinuation of CSR payments, the amount of the surcharge ranges from 7.1% to 38%.” [KFF, 10/27/17]

THEN CONGRESS PASSED A TAX CUT FOR THE WEALTHY AND CORPORATIONS THAT ALSO RAISED PREMIUMS AND WILL TAKE COVERAGE AWAY FROM MILLIONS OF PEOPLE

Last December, Congressional Republicans Passed A Tax Bill That Strips 13 Million Of Insurance And Raises Premiums By Double Digits. “The Senate bill’s repeal of the individual mandate (the requirement that most people get health coverage or pay a penalty) would cause 13 million more people to become uninsured, raising the uninsured rate among the non-elderly from 11 percent to about 16 percent, the Congressional Budget Office (CBO) estimates. It also would raise premiums by an average of 10 percent in the individual market by 2027, according to CBO.” [CBPP, 12/8/17]

Urban Institute Predicts Near 20 Percent Premium Increases Next Year And Millions Of Americans Losing Coverage Due To The Repeal Provision In The Tax Law And Trump Sabotage.  According to a study by the non-partisan Urban Institute, Republican health care sabotage is set to artificially inflate premiums by double digits for millions of families this fall. The study forecasts an 18.2% increase in 2019 premiums for Affordable Care Act plans and millions of Americans losing their coverage because the Trump and Congress repealed the individual mandate and the Trump Administration’s proposal to sell junk plans that do not meet ACA requirements. [Urban Institute, 3/14/18]

CONGRESSIONAL REPUBLICANS BROKE THEIR PROMISE TO PASS A STABILIZATION BILL IN 2017

After Being Promised To Have A Stabilization Bill As Part Of The Tax Bill, Sens. Alexander And Collins Issued A Statement Saying They Asked Sen. McConnell To Postpone Stabilization Until 2018. ‘Rather than considering a broad year-end funding agreement as we expected, it has become clear that Congress will only be able to pass another short-term extension to prevent a government shutdown and to continue a few essential programs,’ said the Senators.  ‘For this reason, we have asked Senator McConnell not to offer this week our legislation which independent analysts Avalere and Oliver-Wyman say would reduce premiums by about 20 percent for the 9 million Americans who have no government subsidies to help them buy insurance in the individual market. Instead, we will offer it after the first of the year when the Senate will consider the omnibus spending bill, the Children’s Health Insurance Program reauthorization, funding for Community Health Centers, and other legislation that was to have been enacted this week.’” [Alexander and Collins Statement, 12/20/17]

HOUSE REPUBLICANS INDICATED THEY WOULDN’T SUPPORT STABILIZATION

Speaker Ryan Opposed Efforts To Stabilize The ACA Dating Back To October 2017. Last October, Ryan spokesman, Doug Andres, said, “The speaker does not see anything that changes his view that the Senate should keep its focus on the repeal and replace of Obamacare.” [Matt Fuller, Huffington Post Reporter, 10/18/17]

House Conservatives Called Alexander-Murray Stabilization Bill A “Nonstarter.” “House conservatives appear united in opposition to the health care stabilization proposal crafted by Sens. Lamar Alexander and Patty Murray. ‘Right now it’s a nonstarter,’ House Freedom Caucus member Dave Brat said Tuesday during a Conversations with Conservatives press event.” [Roll Call, 10/24/17]

Rep. Tom Cole: “The Idea You’re Going To Vote For Billions Of Dollars To Stabilize A System You Never Supported In The First Place — Pretty Hard To Choke Down.”  “In addition to the dispute over abortion language, GOP lawmakers were reluctant to sign off on provisions that shored up the Affordable Care Act, a law they all opposed. ‘Nobody in that room voted for Obamacare, so the idea you’re going to vote for billions of dollars to stabilize a system you never supported in the first place — pretty hard to choke down,’ said Rep. Tom Cole (R-Okla.).” [Washington Post, 3/19/18]

PRESIDENT TRUMP AND SPEAKER RYAN REPEATEDLY TRIED TO DERAIL STABILIZATION NEGOTIATIONS BY ADDING MORE CONSERVATIVE DEMANDS

September 2017: “House Speaker Paul Ryan And The White House Have Informed Senate Republican Leaders That They Oppose A Bipartisan Plan To Stabilize Obamacare Being Written In The Senate.” “House Speaker Paul Ryan and the White House have informed Senate Republican leaders that they oppose a bipartisan plan to stabilize Obamacare being written in the Senate, according to Trump administration and congressional sources, in a clear bid to boost the Senate’s prospects of repealing the health law.” [Politico, 9/19/17]

March 2018: The White House Released A List Of Conservative, Deal-breaking Demands To Stabilization. In the middle of bipartisan negotiations on stabilization, the White House released a list of its conservative demands, including:

  • Expanding the Hyde abortion language
  • Codifying the Administration’s Short-Term proposal into law that undermine protections for people with pre-existing conditions
  • Expanding Health Savings Accounts (HSAs) that is essentially another tax cut for the wealthy
  • Imposing an age tax on older Americans by letting insurers charge people over 50 five times more than younger people. [White House Document, obtained by Politico, 3/8/18]

The Hill: White House pushes for conservative changes to ObamaCare fix

Politico: White House pitch to bolster Obamacare includes tough trade-offs for Democrats

Wall Street Journal: Trump Administration Pushes Conservative Goals in Health-Care Market Changes

Vox: The White House might have just blown up the last best hope to stabilize Obamacare

Talking Points Memo: White House Demands Threaten Bipartisan Effort To Bring Down Health Premiums

NOW, THE LATEST REPUBLICAN STABILIZATION PLAN THREATENS PRE EXISTING CONDITIONS AND ESSENTIAL HEALTH BENEFITS

           [AARP, 3/21/18]

AND, REPUBLICANS ADDED A  PARTISAN POISON PILL THEY KNEW WOULD TORPEDO BIPARTISAN STABILIZATION NEGOTIATIONS

Statements

Sen. Patty Murray: “They’re Moving Further And Further Away From Their Original Goal.” “We’re not going to give them an expansion of Hyde and say that’s a goal we all agree to…They’re moving further and further away from their original goal, which was to make sure people have lower costs and access.” [Washington Post, 3/8/18]

Sen. Patty Murray: “They Keep Throwing Obstacles In.” “If we would just go back to the basic premise here and do what we all agreed to do, we’d be able to get this done.” [Washington Post, 3/8/18]

Speaker Paul Ryan Refuses To Introduce Stabilization Without Restricting Women’s Access To Health Care. “House Speaker Paul Ryan (Wis.) told his GOP conference at a Tuesday meeting that he wouldn’t bring the measures to the floor without accompanying language known as the Hyde Amendment, ensuring taxpayer dollars can’t go toward plans that cover abortions.” [Washington Post, 3/8/18]

Headlines

  • Washington Examiner: House Republicans seek anti-abortion protections in Obamacare stabilization bills
  • Huffington Post: Another Obamacare Stabilization Bill Is In Trouble, This Time Because Of Abortion

BY REFUSING TO ADDRESS THEIR OWN SABOTAGE WITH BIPARTISAN STABILIZATION, REPUBLICANS NOW BEAR RESPONSIBILITY FOR THE CONSEQUENCES

Lindsey Graham: Republicans “Own The Outcome” On Health Care. “Sen. Graham told Breitbart News, ‘In October, premiums are going up. Obamacare cannot be fixed. It’s going to continue to collapse, and then, we own the outcome. By repealing the individual mandate, which is a step forward in the eyes of the public, we own the issue. We have a responsibility to do something about the collapsing Obamacare system. I believe that we’re going to get blamed more than Democrats because we stopped trying to repeal Obamacare, and to suggest that we don’t own it is just simply politically naive.’ Graham continued, ‘It can hurt us in 2018. It can hurt by our base feeling like we betrayed them. It can hurt us from people suffering from Obamacare, like we don’t have a solution. It will energize Democrats. It can undercut everything we did on the tax cut side.'” [Breitbart, 2/6/18]

Rep. Charlie Dent: Republicans “Own” Health Care Now.  “Rep. Charlie Dent (R-Pa.) argued Friday that President Trump was ‘ill-advised’ to end key ObamaCare payments, warning that the GOP now ‘owns’ whatever happens to ObamaCare. ‘I think the president is ill-advised to take this course of action because … we, the Republican Party, will own this,’ Dent, a key House moderate who is retiring from Congress at the end of his term, said on CNN. Asked about Trump’s previous comments blaming problems with ObamaCare on former President Barack Obama, Dent pointed out that Republicans currently control the White House and have majorities in both chambers of Congress. ‘Barack Obama is a former president. President Trump is the president and he’s a Republican, and we control the Congress,’ Dent said. ‘So we own the system now. We’re going to have to figure out a way to stabilize this situation … This is on us.'” [The Hill, 10/13/17]

Washington Post: “The Pottery Barn Rule Comes To Mind: You Break It, You Own It.” “This is not ‘letting’ Obamacare fail. Many nonpartisan experts believe that these active measures are likely to undermine the pillars of the 2010 law and hasten the collapse of the marketplaces. The Pottery Barn rule comes to mind: You break it, you own it. Yes, the plate you just shattered had some cracks in it. But if you dropped it on the ground, the store is going to blame you.” [Washington Post, 10/13/17]

Washington Post: “Trump’s Not Going To Be Able To Avoid Blame For Kneecapping Obamacare.” [Washington Post, 10/13/17]

“After Months Of Pinning The Blame For Obamacare’s Shortcomings On Democrats And Watching His Own Party Fail To Act, President Donald Trump Just Took Ownership Of A Struggle That’s Consumed Republicans For Seven Years.” “After months of pinning the blame for Obamacare’s shortcomings on Democrats and watching his own party fail to act, President Donald Trump just took ownership of a struggle that’s consumed Republicans for seven years. Trump’s decision late Thursday to end government subsidies to insurers to help lower-income Americans afford to use their coverage under the Affordable Care Act was the most drastic step he’s taken to undermine his predecessor’s signature achievement. It also lobbed a live bomb into the laps of Republicans lawmakers 13 months before congressional elections after he publicly berated the party’s Senate leadership for being unable to keep a longstanding promise to repeal the law.” [Bloomberg, 10/13/17]

The American People Agree: President Trump And Congressional Republicans Are Playing Politics With People’s Health Care. A poll conducted last September found that 61 percent of voters believed President Trump was “trying to make the Affordable Care Act fail,” and 64 percent of voters said Trump is “playing politics with people’s health care.” The poll also found that the American people seriously disapprove of how Republicans in Congress are treating health care: 80 percent of voters disapprove while only 20 percent approve. [Garin Poll, 9/5/17]

ashoup
In News

The Alexander-Collins Sham Stabilization Bill

Protect Our Care Campaign Chair Leslie Dach released the following statement on the sham, partisan Alexander-Collins health care stabilization bill:

“The Alexander-Collins legislation should be rejected. It is bad for Americans’ health care. This proposal would result in net coverage losses, higher out-of-pocket costs, and fewer coverage options for many Americans. Despite what Republicans may be publicly saying, Alexander-Collins is not a serious attempt to stabilize the marketplaces. House Republicans admit they oppose stabilization. And Republicans are insisting on a poison pill that would further their war on women’s health. This proposal is a partisan bill designed to fail, and it represents nothing more politics at its worst from elected officials who otherwise have voted to repeal Americans’ health care.”

BACKGROUND

  • The Republican “stabilization” bill includes expansive and restrictive new anti-abortion policy that would have far-reaching consequences for women’s health. Republicans claim they want to apply the existing ‘no federal funding for abortions’ Hyde Amendment to stabilization legislation, but are in fact proposing something entirely new: language that would result in an effective ban on private insurance coverage for abortion, including in plans purchased by private individuals using no federal money, which experts predict would coerce insurance companies into dropping abortion coverage from all plans, both on and off the Marketplace, in order to receive CSRs or reinsurance payments.
  • This proposal would ban a woman from using her own money to buy insurance that covers a medical service the Supreme Court says she has a constitutional right to access and represent a new frontier in Republicans’ war on women’s health. And it’s entirely hypocritical, because the Affordable Care Act was signed into law with restrictions that prohibit insurance companies from using public funds for abortion coverage, with President Obama even having signed an executive order emphasizing that none of its funds can be used to cover abortion services.
  • As Aviva Aron-Dine with the Center on Budget and Policy Priorities explains, the CBO finds that this legislation would result in net coverage losses, with larger losses for moderate-income consumers than gains for middle- and upper-income consumers. Ultimately, this legislation would result in net coverage losses between 500,000 and one million people.
  • Moreover, Aron-Dine notes that the CBO has confirmed that the federal savings from restoring CSRs come from coverage losses, higher premiums, and higher out-of-pocket costs for those with incomes below 400 percent of the federal poverty line, which would result in worse outcomes for consumers between 200 and 400 percent of the poverty line. In fact, the savings would come from a combination of consumers dropping coverage and those maintaining coverage being forced to pay more for doing so.
  • When Republicans’ constituents face double-digit premium increases in the fall because their Congressmen scuttled stabilization, they’ll know exactly who to blame.

Key Quote: ‘Nobody in that room voted for Obamacare, so the idea you’re going to vote for billions of dollars to stabilize a system you never supported in the first place — pretty hard to choke down,’ said Rep. Tom Cole (R-Okla).”

ashoup
In Administration, News

President Trump Ignores Real Opioid Solutions

Washington, D.C. – Today, President Trump spoke in New Hampshire about the opioid crisis. Protect Our Care Campaign Director Brad Woodhouse released the following statement in response:

“Heavy with rhetoric and short on solutions, President Trump’s speech today in New Hampshire was more of the same from a White House more committed to politicizing the opioid crisis than ending it. The Trump Administration has relentlessly attacked and sabotaged Medicaid, proposing to cut funding by hundreds of billions for the program that pays for one-fifth of all substance abuse treatment nationwide, and for two successive years has proposed a 95% cut to the Office of National Drug Control Policy, charged with coordinating the federal response to the nation’s raging opioid crisis.

“If the White House truly cared about combating the opioid epidemic, they would be calling for every state that hadn’t expanded Medicaid to do so. That they’re not tells you all you need to know.”

ashoup
In News

Meet the Press Guest: Republicans Could Lose the House in 2018 Because of Affordable Care Act Repeal Attempts

Washington, D.C. – This morning on Meet the Press, Cook Political Report National Editor Amy Walter told Chuck Todd: “Republicans could lose the House in 2018 by trying to repeal Obamacare.” Here are Walter’s full remarks:

“It was in Pennsylvania-18 where the generic ballot, when you ask that question right before the election, was 42-42 in a district that Trump carried by twenty points. The challenge for Republicans right now isn’t just that the President is unpopular and has lost popularity even in districts he won in 2016 – the Party’s unpopular, and the issues are unpopular. What Conor Lamb talked about, and Senator Brown raised this, about the issue of health care, is gonna be a big issue in this election. The irony is Democrats lost the House in 2010 on Obamacare, Republicans could lose the House in 2018 by trying to repeal Obamacare.”

Watch the full clip here.

ashoup
In News, Capitol Hill

After PA-18 Defeat, GOP Continues to Sabotage Health Care In So-Called Stabilization Bill

Washington, D.C. – Following the major role health care played in Democratic Congressman-elect Conor Lamb’s upset victory in PA-18, studies showing that Republican sabotage and repeal could raise premiums up to 94%, and despite all that, reports of ongoing Republican efforts to sabotage health care in the upcoming Omnibus,  Protect Our Care Campaign Chair Leslie Dach released the following statement:

“Despite Tuesday’s groundbreaking election in Pennsylvania, the clearest wake-up call yet that GOP health care sabotage is an albatross around the neck of anyone who supports it, Congressional Republicans continue to sabotage Americans’ health care, pushing a stabilization package that would not even begin to undo the damage they have done, and launching new attacks on women’s health.

“Because President Trump and his Republican allies in Congress have been trying to repeal and sabotage our health care for over a year, premiums are up twenty percent and millions of Americans have lost their coverage. But instead of addressing the very real damage they have caused in order to lower premiums, Republicans would rather attacks women’s health and encourage insurance companies to offer junk plans that can deny coverage to people with pre-existing conditions.

“Enough is enough. It’s time for the GOP to stop this war on our health care. If President Trump and Congressional Republicans think that grandstanding on a stabilization bill to fix their own wreckage will give them political cover, they are dead wrong.”

BACKGROUND

THE GOP HAS ATTEMPTED TO SABOTAGE AMERICANS’ HEALTH CARE AT EVERY TURN

From the moment that Donald Trump and Congressional Republicans took power, they’ve done everything they can to repeal and sabotage Americans’ health care. Now they’re claiming they want to stabilize the marketplaces and lower premiums. This false rhetoric is merely the latest ploy from Republicans who have seen the writing on the wall – Americans are furious about the Republican repeal-and-sabotage agenda.

For the better part of a year, President Trump and his Republican allies in Congress tried to repeal the Affordable Care Act legislatively, striving to kick 32 million Americans off of their coverage and returning to the days when insurers had the power to choose who to deny coverage to by removing protections for those with pre-existing conditions.

When this failed, they doubled down on their administrative sabotage, carrying out a closed-door campaign to undermine the law through administrative actions. These included cancelling cost-sharing reduction (CSR) payments designed to lower premiums; using funding for coverage enrollment to launch a propaganda campaign against the law; and attempting to gut open enrollment by reducing the advertising budget by 90% percent, costing an additional 1.1 million people coverage.

These repeal-and-sabotage attempts culminated in December, when the GOP voted to get rid of the individual mandate in their tax scam, ripping insurance away from ten million people and raising premiums double-digits for millions more in order to finance a tax cut for the wealthiest Americans and corporations.

In the time since, President Trump and his allies in Congress have promoted short-term health policies, which neglect key consumer protection provisions such as protections for those with pre-existing conditions and coverage mandates for essential benefits like maternity care; they have supported association health plans (AHPs), which raise costs for people with pre-existing conditions and further destabilize the insurance markets; and they have encouraged states to promote plans which violate the law, promoting and end-run around the ACA despite such procedures being labeled “wildly illegal.”

A study from the Urban Institute found that this sabotage will result in an increase in individual market premiums by an average of 18.2 percent for 2019.

THE GOP HAS REFUSED TO ACT ON MEASURES TO ACTUALLY STABILIZE THE MARKETS

What the GOP has not done through all of this, however, is undertake a genuine effort to actually stabilize the marketplaces.

Following the collapse of the legislative repeal bills in July, Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) began holding hearings on stabilization, bringing in insurance commissioners, governors, and health care experts of both parties. The GOP refused to act on their recommendations, however, instead pivoting to yet another attempt to repeal the ACA through the Graham-Cassidy legislation.

After Graham-Cassidy, which would have kicked twenty million Americans’ off of their insurance and raised premiums double-digits went down in flames, the GOP went through yet another charade on stabilization, refusing to move forward on the bipartisan Alexander-Murray bill to address stabilization despite it having a filibuster-proof majority in the Senate.

A STABILIZATION BILL MUST ACTUALLY STABILIZE THE MARKETPLACE

Now, the GOP says it wants to support stabilization measures. Where was this in the winter, when notices of skyrocketing premiums were going out across the country? Where was this in the fall, when experts were on Capitol Hill lamenting the damage being done to the marketplace? Where was this in the summer, when advocates were begging the GOP to do something rather than push forward yet another repeal bill?

Congressional Republican efforts to undo the damage they and President Trump have caused are wholly insufficient and often turn to failed ideas like high risk pools, which will leave Americans with higher costs and worse coverage. Any bill to stabilize the insurance marketplaces and reverse Republican-caused sabotage must:

  • Expand affordability by increasing the value of premium tax credits and cost-sharing reduction protections;
  • Ensure cost sharing protections fulfill their original purpose of improving affordability and Basic Health Plans are fully funded in order to protect coverage levels;
  • Apply the consumer protections of the Affordable Care Act – such as guaranteed issue, community rating, protections for preexisting conditions – to short term duration plans and protect the essential health benefits from being undermined;
  • Provide for a national meaningful reinsurance program that reduces current premium levels and stabilizes the market;
  • Adequately fund outreach and enrollment efforts;
  • Reject bringing back high-risk pools and Association Health Plans; two failed experiments that would have a destabilizing effect on the marketplace by incentivizing healthier individuals to leave the ACA compliant market, thereby negatively affecting the risk pool and increasing premiums; and
  • Reject punitive and duplicative new anti-choice restrictions on health centers.

Many of the above provisions are included in the recent bills introduced in the Senate by Senator Tammy Baldwin (D-WI) and in the House by Reps. Frank Pallone (D-NJ), Richard Neal (D-MA), and Bobby Scott (D-VA). If Republicans in Congress truly care about stabilization, they will work with Democrats to adopt these provisions and implement a bipartisan, common-sense package to lower premiums and expand coverage options. Anything else is just crocodile tears from elected officials more worried about partisan politics than about Americans’ health.

ashoup
In News

Health Care Voters Propel Lamb to Victory

Pennsylvania Voters Reject GOP Repeal & Sabotage Agenda

Washington, D.C. – As a PPP exit poll shows that dissatisfaction with Republicans’ war on health care drove voters to deliver a Democratic victory in a district that Donald Trump won by nearly twenty points in 2016, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Yesterday’s historic win in Pennsylvania should be the clearest message yet to Republicans that their war on health care is not just a political loser, but an albatross around the neck of any candidate who supports their destructive repeal-and-sabotage agenda.

“Rick Saccone has became the latest candidate to throw his lot in with President Trump’s war on health care and then suffer a once-unthinkable defeat. While Saccone called for a full repeal of the Affordable Care Act and backed the unpopular GOP repeal bills that would have thrown tens of millions of Americans off of their insurance and raised costs for millions more, Conor Lamb defended the Affordable Care Act and called for legislative action to improve the law and expand on its successes – and Pennsylvania voters responded by sending him to Washington.

“A PPP exit poll of PA-18 voters shows they broke for Lamb because of his commitment to improving the Affordable Care Act and opposition to the Republican repeal-and-sabotage agenda. In a district that voted Trump by almost 20 points, a majority of voters now support the Affordable Care Act, and last year’s repeal efforts were a drag on the Republican candidate, making 41% of voters less likely to support him.

“Last night’s exit poll makes it crystal clear that health care decided this race, echoing recent elections in Virginia, and across the country, as voters across the nation continue to say: enough is enough – it’s time to stand up to Republicans and stop the war on our care.”

BACKGROUND

Lamb: Congress Should Be Working Together To Build On ACA’s Progress, Fix What Isn’t Working, And Make The Law Better.

On his campaign website, Lamb writes, “I believe that every American has a right to go see a doctor when they’re sick, and that means every American has a right to health insurance they can afford. The Affordable Care Act has flaws, but it has provided affordable coverage to more than a million Pennsylvanians who were previously uninsured. Our representatives in Congress should be working together to build on that progress, fix what isn’t working, and make the law better. Instead, Republicans in Congress spent the past year trying to take health insurance away from people with no plan to replace it. Now, costs are likely to go up for many of us, especially those with preexisting conditions. That is unacceptable, and it’s a failure of leadership.”  Conor Lamb Campaign Website, Priorities, Affordable Health Care]

Lamb: GOP Leaders Have Not Even Allowed A Vote To Stabilize ACA Markets. 

On his campaign website, Lamb writes, “Republican leaders have not even allowed a vote on a bipartisan, common-sense effort to strengthen the ACA and stabilize the markets. And it took the threat of a government shutdown for both parties to come together and fund the children’s health program (CHIP), something they’d ignored for months while the program was forced to survive on week-to-week bailouts. These legislative failures show what is wrong with the status quo in Washington. I’ll work with anyone from either party who wants to help people with pre-existing conditions, improve the quality of care, and reduce premiums, out-of-pocket costs, and prescription drug prices.” [Conor Lamb Campaign Website, Priorities, Affordable Health Care]

Saccone Called For Full Repeal Of The ACA And Said AHCA Did Not Go Far Enough.

Saccone, in an interview on 790 WAEB, agreed that the AHCA does not go far enough. When the show’s host trashed AHCA as insufficiently right wing, Saccone said the host was “absolutely right.” Later, when asked if he favors full repeal of the ACA, Saccone replied, “absolutely; got to go.” [WAEB, 3/9/17]

Saccone Promised To “Fix” Obamacare By Utilizing “Free-Market Principles To Fix Our Healthcare Crisis.”

Under the heading “Fixing Obamacare,” Saccone’s website states, “Under Obamacare, health insurance has become unaffordable. Rick Saccone will utilize free-market principles to fix our healthcare crisis.” [RickSaccone.com, accessed 3/13/18]

Saccone Dismissed Concern About People Losing Health Coverage As “Typical Democrats Talking Points.”

“Conor Lamb, the Democratic candidate in the special election wasn’t available to speak on camera on Wednesday. On his campaign website, he claimed Republicans have been ‘trying to take health insurance away from people with no plan to replace it. Now, costs are likely to go up for many of us, especially those with preexisting conditions. That is unacceptable, and it’s a failure of leadership.’ Told of Lamb’s stand, Saccone said, ‘That’s typical Democrats talking points. Look, the price of health care was skyrocketing under Obamacare.’” [WTAE, 1/31/18]

Club For Growth Endorsed Saccone Because Of His Commitment To Repealing The ACA. 

“Today, the Club for Growth PAC announced its endorsement of Rick Saccone for the U.S. House of Representatives.  Saccone is running for the open seat vacated earlier this year by Tim Murphy (PA-18). ‘Club for Growth PAC is proud to endorse Rick Saccone in his run for Congress,’ stated Club for Growth PAC President David McIntosh.  ‘Rick is a constitutional conservative who supports lower taxes, repealing Obamacare, and limiting the size of government. In his time serving in the General Assembly, Rick has proven to be a strong conservative voice and been a strong advocate for Pennsylvania’s taxpayers.’” [Club for Growth Press Release, 12/19/17]

Saccone Applauded Repeal Of The Individual Mandate.

“I am pleased that the House and Senate have come together and passed a repeal of the onerous and punitive Obamacare mandate that was forced upon the country by the liberal wing of the Democratic Party led by Nancy Pelosi. The repeal was supported by 63% of Americans who agreed that the individual mandate tax was an excessive encroachment on taxpayers.  Alarmingly, the mandate disproportionately hurt low-income households – the very people Obamacare was to care for. According to the IRS, nearly 80 percent of households that pay the penalty make less than $50,000 annually. As a result, low-income families paid up to $2,085 this year not being able to afford health insurance. Obamacare premiums have skyrocketed so high that millions of Americans were forced to pay the penalty because they could not afford coverage.” [Rick Saccone for Congress Press Release, 12/21/17]

Saccone: “While Health Care Coverage Is Vital To All Of Us, The Government Should Not Involve Itself In Our Health Care Decisions.”

“While health care coverage is vital to all of us, the government should not involve itself in our health care decisions. We are all too aware of the inefficiencies of government bureaucracy, and the last thing that we need is for them to meddle with our health. I join the majority of Americans today in applauding Congress for repealing the Obamacare mandate penalty that will no longer burden taxpayers.” [Rick Saccone for Congress Press Release, 12/21/17]

ashoup
In News, Administration

“Premiums Could Increase 90 Percent”: The Trump Administration’s Effect on Future Premiums By the Headlines

Yesterday, Covered California released an analysis outlining the future of the individual market under the Trump Administration and its constant barrage of sabotage. Its findings were striking:

  • All states’ individual markets risk higher than normal premium increases — ranging from 35 to 90 percent over three years — due to continued uncertainty at the federal level.
  • Premium increases in the individual markets will likely range from 12 to 32 percent in 2019, and cumulative increases from 2019-2021 will range from 35 percent to more than 90 percent.
  • Increases are on average more than double the rate of medical inflation as a result of healthier consumers leaving the individual market.
  • 17 states are more likely — because of their historic risk mix and enrollment — to have cumulative premium increases of 90 percent or more and 19 additional states are at a higher risk of experiencing hikes of 50 percent.

All in all, the report makes clear in no uncertain terms just how much the repeal and sabotage campaign being carried out by the Trump Administration and its Republican allies in Congress is harming Americans. Here’s how the report was covered in headlines:

Washington Post: Premiums for ACA health insurance plans could jump 90 percent in three years

The Hill: Study: ObamaCare premiums could increase 90 percent over three years for some states

Insurance Business Magazine: Report: States could see average health premium increases up to 30%

Salon: Health care premiums set to spike highest in Trump country

San Francisco Chronicle: California health insurance premiums could soar, analysis projects

Berkshire Eagle: Premiums for plans could jump 90% in 3 years

Stamford Advocate: Study: Connecticut premiums could rise 35 percent

CT Post: Study: Connecticut premiums could rise 35 percent

KCRA: California health care exchange head says rates to increase

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