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Sabotage

ashoup
In Administration, News

REACTION ROUNDUP: Despite “Wildly Illegal” Affordable Care Act End-Run, Trump Administration Urges Idaho to Continue Sabotage

Yesterday, the Trump Administration confirmed that Idaho’s Affordable Care Act end-run is wildly illegal. Even so, CMS encouraged Idaho to explore other ways to sabotage the law.

Here’s a roundup of reactions to the Trump Administration’s continuing bad faith on protecting Idahoans’ health care:

Idaho Statesman: “With Some Modifications, The Noncompliant Plans Could Be Turned Into Short-term Plans For Customers.”

“Verma said her agency was sympathetic to Idaho officials’ concerns, and said President Trump is ‘committed to doing everything in his power to increase competition, choice, and access to lower-priced, high-quality health care options for all Americans.’ ‘As you know, the Patient Protection and Affordable Care Act (PPACA) is failing to deliver quality health care options to the American people and has damaged health insurance markets across the nation, including Idaho’s,’ Verma wrote, noting that premium rates for coverage through the Idaho health insurance exchange have increased by more than 91 percent from 2014 to 2018, while insurance companies continue to incur losses. Verma also outlined some options that she believes Idaho could legally take under a recently proposed federal rule. That rule would expand the availability of short-term, limited duration health insurance by allowing consumers to buy short-term plans that would cover them for just under a year. She said that with some modifications, the noncompliant plans could be turned into short-term plans for customers.” [Idaho Statesman, 3/8/18]

Sen. Ron Wyden: “While They Claim To Be Upholding The Law, They Are Explicitly Inviting Idaho And Other States To Sell Short-term, Junk Insurance — The Exact Opposite Of The Protections Put In Place By The Affordable Care Act.”

“ObamaCare supporters were pleased but not overly impressed by the CMS move. ‘The Trump administration is talking out of both sides of their mouth,’ said Sen. Ron Wyden (D-Ore.). ‘While they claim to be upholding the law, they are explicitly inviting Idaho and other states to sell short-term, junk insurance — the exact opposite of the protections put in place by the Affordable Care Act.’” [The Week, 3/8/18]

New York Times: “Verma Said That Idaho Had Other Options And Could Perhaps Achieve Much Of What It Wanted To Do Under A Regulation Proposed Last Month By Mr. Trump.”

“While rejecting the Idaho plan in its current form, Ms. Verma encouraged the state to keep trying, and she suggested that ‘with certain modifications,’ its proposal might be acceptable… Ms. Verma said that Idaho had other options and could perhaps achieve much of what it wanted to do under a regulation proposed last month by Mr. Trump.” [New York Times, 3/8/18]

Washington Post: “‘We Sincerely Appreciate Your Dedication To The People Of Idaho And Your Efforts To Address The Damage Caused By The [ACA],” Said The Letter.”

“The four-page letter to Idaho Gov. C. L. “Butch” Otter (R) and Cameron, made public early Thursday evening, straddles the Trump administration’s antipathy for the ACA with its need to enforce the sprawling 2010 health-care law that is a path to insurance coverage for millions of Americans. ‘We sincerely appreciate your dedication to the people of Idaho and your efforts to address the damage caused by the [ACA],” said the letter, signed by CMS Administrator Seema Verma. The letter said the president is eager to give states ‘as much flexibility as possible under the law to address the unique needs of their health insurance markets.’” [Washington Post, 3/8/18]

Rep Frank Pallone: “The Administration Continues Its Many Efforts To Undermine The Law And Chip Away At Its Protections, Including By Encouraging Idaho To Sell Junk Plans In Another Way.”

“Democrats cheered the Trump administration’s decision, but they still criticized other actions HHS has taken in recent months to weaken the law. ‘Make no mistake, however, while this is the right decision, the Administration continues its many efforts to undermine the law and chip away at its protections, including by encouraging Idaho to sell junk plans in another way,’ said Rep. Frank Pallone of New Jersey, the top Democrat on the House Energy and Commerce Committee.” [Politico, 3/8/18]

Talking Points Memo: “Verma Notes In The Letter That Enforcing The ACA Is ‘Certainly Not Our Preference.”

“Verma notes in the letter that enforcing the ACA is “certainly not our preference,” and encourages Idaho to find ways within the letter of the law to accomplish the same goals. She specifically advises the state to look into creating short-term health insurance plans—which recently received the Trump administration’s blessing to be sold in violation of the ACA’s regulations. [TPM, 3/8/18]

Bloomberg: “The White House Has Suggested To Congress That People Should Be Able To Renew Short-term Plans Without Being Subject To Medical Underwriting, The Process By Which Insurers Can Exclude Or Charge More For Pre-Existing Conditions.”

“Idaho’s proposal has put the Trump administration in a position it has found itself in before: charged with upholding a law it wants to get rid of, and that it has taken active steps to dismantle. Verma left open the possibility that plans like the state was proposing could be sold in a different form. If they were offered as short-term policies instead of annual coverage, they might be allowable, she said. The administration has pushed short-term plans as a way to offer consumers less expensive, less comprehensive options. In her letter to Idaho authorities, Verma said that ‘with certain modifications, these state-based plans could be legally offered’ as short-term plans. The White House has suggested to Congress that people should be able to renew short-term plans without being subject to medical underwriting, the process by which insurers can exclude or charge more for pre-existing conditions.” [Bloomberg, 3/8/18]

CNN: “Verma [Said] That She Wanted To Work With Idaho And Other States To Repair The ‘Damage’ Caused By The Affordable Care Act.”

“However, Verma did say that she wanted to work with Idaho and other states to repair the ‘damage’ caused by the Affordable Care Act. She suggested that Idaho could legally implement many of its proposals through short-term health insurance plans, which don’t have to adhere to all of Obamacare’s rules. The Trump administration is on course to allow insurers to offer these plans for up to a year, rather than just three months.” [CNN, 3/8/18]

Modern Health Care: “Secretary Alex Azar Told Insurers Thursday That The Trump Administration Will Do What It Can ‘Within The Law’ To Let Insurers Offer More Affordable Plans That Don’t Meet ACA Requirements.”

“The Trump administration on Thursday unexpectedly shot down Idaho’s effort to let insurers sell health plans that don’t comply with the Affordable Care Act’s coverage mandates, thwarting conservative efforts to unravel the law’s consumer protections directly for now. But CMS Administrator Seema Verma indicated that Idaho and other states could achieve the same goal by refashioning such noncompliant health plans as short-term products, which the administration would allow under a controversial proposed rule. HHS Secretary Alex Azar told insurers Thursday that the Trump administration will do what it can ‘within the law’ to let insurers offer more affordable plans that don’t meet ACA requirements. In a letter to Idaho Republican Gov. Butch Otter and state Insurance” [Modern Health Care, 3/8/18]

Washington Times: Verma: “This Is Certainly Not Our Preference.”

“‘If a state fails to substantially enforce the law, the Centers for Medicare & Medicaid Services (CMS) has a responsibility to enforce these provisions on behalf of the State,’ Ms. Verma added. ‘This is certainly not our preference.’ She said Idaho, with some tweaks, might be able to offer similar plans under Mr. Trump’s bid to offer short-term plans for up to a year. There is a GOP effort to codify this change and let people renew these plans, setting up a parallel market for healthier people that could siphon valuable enrollees from Obamacare’s exchanges.” [Washington Times, 3/8/18]

Business Insider: Verma: Idaho’s Attempt “Was Admirable.”

“Verma said that while Idaho’s desire to bring down costs — the stated reason for the policy — was admirable, it was also illegal. ‘CMS is committed to working with states to give them as much flexibility as permissible under the law to provide their citizens the best possible access to healthcare,’ Verma said.” [Business Insider, 3/8/18]

The Hill: “Verma’s Letter Offered Alternatives To The State.”

“Verma’s letter offered alternatives to the state, including embracing a Trump administration move to allow different kinds of cheaper, skimpier insurance plans, known as short-term plans.” [The Hill, 3/8/18]

Vox: “The CMS Letter Did Include A Caveat That Provides Some Consolation To Republican Officials – In Washington And Boise – Who Want To Unwind Obamacare.”

“It is a victory for the rule of law, given how openly Idaho was defying the ACA. But the CMS letter did include a caveat that provides some consolation to Republicans officials — in Washington and in Boise — who want to unwind Obamacare. The state could conceivably tweak its proposal, Verma noted, to align with the Trump administration’s own proposed regulations to expand short-term insurance plans — which also do not have to comply with the ACA’s insurance regulations. It would be a back door to achieve the same end (providing an escape hatch from Obamacare for healthier customers, one that is likely to lead to higher premiums for those left behind in the law’s markets) and would be more clearly in line with the administration’s agenda.” [Vox, 3/8/18]

ashoup
In Capitol Hill, News

The Barrasso Bill: Less Choices, Worse Outcomes, More Repeal and Sabotage

Washington, D.C. – In response to Sen. John Barrasso’s (R-WY) introduction of the latest Republican ACA repeal and sabotage bill, the Improving Choices in Health Care Coverage Act, which would codify the expansion of the Trump Administration’s proposed short-term, junk insurance plans, Protect Our Care Campaign Director Brad Woodhouse release the following statement:

“This legislation is nothing more than the GOP’s latest attack against Affordable Care Act, and it should be dead on arrival in the Senate. A permanent embrace of junk insurance plans would once again allow insurers to discriminate against those with pre-existing conditions and re-implement lifetime caps, eliminate essential health benefits, allowing maternity care and substance abuse treatment to be denied, and leave Americans holding the bill – often running into the hundreds of thousands of dollars.

“Like the many GOP sabotage legislative efforts before it, the Barrasso bill must be rejected. Congressional Republicans should instead be work with their Democratic counterparts to come up with commonsense, bipartisan solutions which actually stabilize the marketplace and provide relief to Americans. Enough is enough – it’s time for the GOP to end their war on health care.”

ashoup
In Administration, News

Trump’s Own Budget Experts Admit His Sabotage Inflated Premiums

Washington, D.C. – According to new reporting, President Trump’s own Office of Management and Budget has found that restoring the cost-sharing reduction payments (CSRs) that Trump unilaterally canceled last fall would lower premiums 15-20%. Protect Our Care Campaign Director Brad Woodhouse released the following statement in response:

“Donald Trump’s unilateral decision to end cost-sharing reduction payments triggered a massive and unnecessary increase in premiums. Now, Trump’s own Administration is admitting the damage that he caused. Once again, President Trump has slipped on a banana peel he threw on the floor himself. But Trump’s CSR sabotage was only the first strike in a deluge of Administration actions to damage and destabilize the health markets and drive up costs, and addressing the CSR issue alone is not sufficient to mitigate the harm ensuring Trump Administration sabotage actions are now set to drive up premiums by double digits again next year. That’s why any stabilization package worth its weight must match the scope of the damage inflicted by Trump and his Administration.”

OMB: Funding insurer subsidies will lower ACA premiums 15-20%

Axios // Caitlin Owens and Jonathan Swan // March 6, 2018

Funding the Affordable Care Act’s cost-sharing subsidies would lower premiums by 15-20%, according to an analysis being circulated around congressional offices from the Office of Management and Budget. OMB says those subsidies would be more cost-effective than a new reinsurance program.

Why it matters:

Reinsurance has been gaining steam on Capitol Hill, and Sen. Susan Collins is still owed a vote on a reinsurance bill. But the White House budget office is saying Congress could get a better deal by restoring a funding stream that President Trump cut off last year.

The numbers:

  • President Trump’s decision to quit making the cost-sharing payments this year caused premiums to rise by 15-20%, the analysis says, and funding them next year would undo that increase.
  • It also says that for every $1 billion spent on a reinsurance program — which would compensate insurers for their most expensive claims — individual market premiums would decrease by only 1%.

Key quote:

“We project funding CSRs would have a greater impact on reducing premiums than any of the reinsurance funding levels that have been proposed, and would have more bang for the buck in terms of Federal spending.”

ashoup
In Capitol Hill, Administration, News

Protect Our Care Outlines Must-Haves to Repair Trump-Inflicted Sabotage & Stabilize Health Markets

Washington, D.C. – As time runs out to repair the severe damage President Trump has inflicted on health care markets and stabilize them in order to protect American families from crippling rate hikes and coverage losses, Protect Our Care Campaign Director Brad Woodhouse released the following statement and the minimum policy prescriptions Republicans must include in any stabilization bill to roll back President Trump’s and the GOP’s sabotage of American health care:

“From the moment Donald Trump took the oath of office, his Administration and its Republican allies in Congress have waged an unrelenting war on our health care. In the last week, analyses have been published showing that Administrative sabotage through short-term junk plans will increase premiums eighteen percent and increase the number of uninsured by nine million people; sabotage through the expansion of association health plans will increase individual market premiums four percent and reduce enrollment in ACA plans by three million; and the sabotage campaign against the open enrollment period has eroded consumer confidence. Just yesterday, in fact, the Administration approved a Medicaid waiver from Arkansas designed to deny the most vulnerable  health care coverage.

“Current Congressional Republican efforts to undo the damage they and President Trump have caused are wholly insufficient and rely on failed ideas like high risk pools which will leave Americans with higher costs and worse coverage. Make no mistake, impending rate hikes and coverage losses are the responsibility of Republicans and President Trump, and they are the ones who will pay the price with the public and at the polls if they don’t do what is necessary to reverse the damage. 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 these provisions are included in the recent bills introduced in the Senate by Senator Tammy Baldwin (D-WI) and in the House by 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 will be mere crocodile tears from elected officials more worried about partisan politics than Americans’ health.”

ashoup
In Capitol Hill, Stories, Administration, News

Four Studies, Three Polls, One Conclusion: Americans Support the ACA, Are Fed Up With Trump’s Sabotage

It’s been a busy week for health care. Three polls – from CNN, the Kaiser Family Foundation, and then President Trump’s very own America First Policies – came out, all of which had similar and striking conclusions. Four studies – from the Urban Institute, Avalere, the Center on Budget and Policy Priorities, and the Commonwealth Fund – also came out, and too came to a similar conclusion. What did the analyses of the week show?

WHAT THE POLLS FOUND: ACA MORE POPULAR THAN EVER, VOTERS OVERWHELMINGLY OPPOSE ADMINISTRATION POLICIES

Last night, a new poll from President Trump’s own organization, America First Policies, confirmed that health care is the top issue to voters – and they don’t support the Trump Administration’s repeal and sabotage agenda. Trump’s polling found:

  • By 17 points, voters DISAPPROVE of Trump’s “handling of health care” with only 38% approving (16% strongly) and 55% disapproving (44% strongly).
  • A plurality of voters (41%) said the top priority for the President and Congress should be lowering health care costs.
  • Among those 41% who name lowering health care costs a the top priority, 68% want Congress to leave the ACA as is or work to fix it. Only 31% support the GOP repeal agenda.  

The America First poll followed the earlier release of the Kaiser February tracking poll, which found 54% of those surveyed holding a favorable view of the Affordable Care Act, the highest proportion supporting the ACA in the nine years the poll has been conducted. The poll also found:

  • The ACA favorable view rose from 50 percent in January 2018 to 54 percent this month, a change “largely driven by independents.”
  • More than twice as many voters mention health care costs (22 percent) as mention repealing/opposing the ACA (7 percent) as the top health care issue.
  • 74% of those surveyed had a favorable opinion of Medicaid, while 52% believed the Medicaid program is working well for most low-income people covered by the program.
  • 64% of independents oppose lifetime limits for Medicaid benefits.
  • A larger share of the public believes the proposed Medicaid changes are to reduce government spending (41 percent) than to help lift people out of poverty (33 percent).

And both of these followed a Tuesday CNN poll which found health care remains voters’ top priority, with 83% of those surveyed listing it as either extremely or very important. Other findings included:

  • 53% of voters said health care was extremely important, the highest among all issues – a 20% increase from the CNN/USA Today/Gallup poll conducted in August of 2010, when health care supposedly dominated the midterm elections.
  • 78% of independent voters said health care was important, which tied with the economy as their top issue.
  • At least 70% of voters in every demographic category said health care was important – a trend that stretches across gender, age, income level, education level, ideology, and party affiliation.

Americans support the Affordable Care Act because it works to bring down costs, expand coverage, and protect the most vulnerable among us. They oppose the GOP’s repeal and sabotage plan because it does the opposite. Four studies this week confirmed this.

WHAT THE STUDIES SHOW: COSTS UP, COVERAGE DOWN

Last week, the Trump Administration announced a proposal to move forward with short-term, junk insurance plans – the Administration’s latest form of sabotage.

  • On Monday, a bombshell Urban Institute study found that these short-term junk plans will cause an average premium increase of 18 percent in 43 states, making clear just how high the cost of the GOP’s sabotage efforts will be for Americans.

Last month, the Department of Labor proposed a rule promoting association health plans (AHPs).

  • On Wednesday, Avalere released a new study which found that this proposed rule would cause premiums for individual and small-group plans to rise 4% and reduce Affordable Care Act plans enrollment by as many as 4.3 million, further destabilizing the marketplace.

On Wednesday, President Trump hosted a White House summit to address the opioid crisis, just weeks after releasing a budget which called for vast cuts to Medicaid.

  • That day, the Center on Budget and Policy Priorities released an analysis showing that states which expanded Medicaid saw higher rates of insurance coverage for people with opioid-use disorders.

And throughout his time in office, President Trump and his GOP allies in Congress have been carrying out an extensive sabotage campaign designed to harm the ACA.

  • A new report from the Commonwealth Fund analyzed the effects on consumer confidence, finding that among those worried about maintaining their coverage in the future, “nearly half pointed to actions by the Trump administration and Congress as the main source of their unease.” Moreover, the report found that of the individuals who did not purchase insurance last year, 26 percent of those said they did not because they thought the law was going to be repealed, underscoring the effects this sabotage campaign has had.
  • The report did offer some steps to move forward: “As our findings suggest, policy changes could increase coverage, including greater outreach and advertising in all states and reforms to improve plan affordability.” The most specific suggestion: Medicaid expansion “remains the most obvious means for expanding coverage nationwide.”

All in all, Americans continued to make their voices heard loud and clear: they support the Affordable Care Act and want it to be improved and expanded, not undercut by a GOP sabotage effort from President Trump and Republicans in Congress. As for that sabotage effort? Study after study has found that its effects have been nothing short of disastrous for the American health care system. Will President Trump and Congressional Republicans ever get their act together on health care and finally embrace what the vast majority of Americans say they want? Well, there are a few polls they can read…

ashoup
In News

This Week in the War on Health Care

The Trump Administration continued its unprecedented assault on the American health care system this week. Here’s what happened this week in Republicans’ war on health care – and how polls and rallies across the country showed the Administration is fighting a losing battle with the American people:

SABOTAGE STRIKE ONE: 18% PREMIUM INCREASES AND “THE HEALTH OF MILLIONS” AT RISK

Last week, the Trump Administration announced a proposal to move forward with short-term, junk insurance plans – the Administration’s latest form of sabotage. On Monday, a bombshell Urban Institute study found that these short-term junk plans will cause an average premium increase of 18 percent in 43 states, making clear just how high the cost of the GOP’s sabotage efforts will be for Americans.

The Urban Institute wasn’t the only entity which questioned these plans, however. They were also savaged by the nation’s leading editorial boards:

Washington Post: This Trump Administration Health-Care Rule Would Return Us to the Bad Old Days. “The department’s plan would allow insurance companies to sell virtually unregulated health policies. This would signal a return to the bad old days when insurers could sharply limit benefits, impose caps on coverage and discriminate against people with preexisting conditions… Allowing healthy people to buy junk insurance plans is not worth risking sick and vulnerable people’s access to real coverage.” [2/26/18]

New York Times: Trump Tries to Kill Obamacare By a Thousand Cuts. “Not mentioned in the department’s talking points is the fact that these policies do not cover things like mental health services, substance abuse treatment, cancer drugs and maternity care. As a result, people who buy skimpy plans could end up being hit with exorbitant bills if they actually need medical care… The cost for [the Administration’s] rage will be the health care of millions of low-income and middle-class families.” [2/21/18]

Los Angeles Times: The Trump Administration Wants to Cut Premiums for the Healthy at the Expense of the Sick. Again. “These plans don’t have to comply with Obamacare’s insurance reforms, which means they typically provide much less coverage — and that they may not be as cheap, or as available, for people with preexisting conditions. Oh and yes, it would likely cost the taxpayers more.” [2/26/18]

Baltimore Sun: Trump’s Latest Effort to Undermine the ACA Makes Maryland Action All the More Crucial. “If the Trump administration’s goal was to increase the ranks of the uninsured, it could scarcely have thought of a better policy than the one it announced Tuesday… Coupled with the end of the federal requirement that most taxpayers buy insurance or pay a penalty, the administration has come up with a recipe for destabilizing individual insurance markets and putting coverage out of reach for those who really need it.” [2/20/18]

Bloomberg View: A New Way to Wreck Obamacare. “Don’t be misled by the seeming modesty of this idea. It’s an impressive combination of bad policy and bad faith… If the courts fail to stop the change to short-term health insurance, states ought to step in, [place] their own time limits on short-term policies, and demand that such plans cover the health care people need. Sadly, people in states that won’t provide this protection will be left waiting for leaders in Washington who will.” [2/23/18]

SABOTAGE STRIKE TWO: PREMIUM INCREASES AND FURTHER MARKET DESTABILIZATION

Last month, the Department of Labor proposed a rule promoting association health plans (AHPs). This week, Avalere released a new study which found that this proposed rule would cause premiums for individual and small-group plans to rise 4% and reduce Affordable Care Act plans enrollment by as many as 4.3 million, further destabilizing the marketplace.

It was the second study in three days to conclude the sabotage agenda being pushed by Donald Trump and his Administration will have massive negative consequences on Americans’ care.

SABOTAGE STRIKE THREE: LESS CONFIDENCE AND LESS COVERAGE

For more than a year, the Trump Administration and its GOP allies in Congress have been carrying out an extensive sabotage campaign designed to harm the Affordable Care Act. While many analyses have found the effect this has had on premiums and the open enrollment period, a new report from the Commonwealth Fund analyzed another aspect of this sabotage: its effect on consumer confidence.

“Among survey respondents who were extremely pessimistic about their ability to maintain their marketplace or Medicaid coverage going forward,” the report found, “nearly half pointed to actions by the Trump administration and Congress as the main source of their unease.”

Additionally, the report found that those with insurance through the ACA marketplace or Medicaid were “significantly less likely” to have confidence that they would be able to keep their insurance, with 32 responding it was because “they didn’t think the Trump administration would carry out the ACA” and 15 percent “[expecting] Congress to repeal the law.”

“Last year’s debate over the ACA likely affected some uninsured adults’ decisions not to shop for marketplace coverage,” the report continued, noting 26 percent of those asked said they did not because they thought the law was going to be repealed, underscoring the effects this sabotage campaign has had.

The report’s conclusion? “As our findings suggest, policy changes could increase coverage, including greater outreach and advertising in all states and reforms to improve plan affordability.” The most specific suggestion: Medicaid expansion “remains the most obvious means for expanding coverage nationwide.” We agree! Now if only President Trump and the GOP would listen…

STUDY CONFIRMS: MEDICAID A LIFELINE FOR OPIOID ADDICTION DESPITE FALSE RHETORIC

Yesterday, the Center on Budget and Policy Priorities released an analysis showing that states which expanded Medicaid saw higher rates of insurance coverage for people with opioid-use disorders.

As President Trump hosted a White House summit to address the opioid crisis, this analysis made clear that Medicaid is a lifeline for those battling the scourge of opioid addiction, further undercutting false GOP claims about the program and showing that Republican plans to gut the Medicaid program would have disastrous ramifications for the millions of Americans courageously doing so. If they truly care about ending this crisis, President Trump and GOP Members of Congress should end their partisan war on health care and immediately call for the expansion of Medicaid in states which have not done so.

POLLS CONFIRM: ACA MORE POPULAR THAN EVER, MEDICAID IS WORKING, HEALTH CARE TOP ISSUE ON VOTERS’ MINDS

This morning, the February Kaiser tracking poll came out, finding that 54% of those surveyed had a favorable view of the Affordable Care Act, the highest proportion supporting the ACA in the nine years the poll has been conducted. The poll also found that:

  • The ACA favorable view rose from 50 percent in January 2018 to 54 percent this month, a change “largely driven by independents.”
  • More than twice as many voters mention health care costs (22 percent) as mention repealing/opposing the ACA (7 percent) as the top health care issue.
  • 74% of those surveyed had a favorable opinion of Medicaid, while 52% believed the Medicaid program is working well for most low-income people covered by the program.
  • 64% of independents oppose lifetime limits for Medicaid benefits.
  • A larger share of the public believes the proposed Medicaid changes are to reduce government spending (41 percent) than to help lift people out of poverty (33 percent).

This follows a Tuesday poll from CNN, which found that health care remains voters’ top priority, with 83% of those surveyed listing it as either extremely or very important. Other findings included:

  • 53% of voters said health care was extremely important, the highest among all issues – a 20% increase from the CNN/USA Today/Gallup poll conducted in August of 2010, when health care supposedly dominated the midterm elections.
  • 78% of independent voters said health care was important, which tied with the economy as their top issue.
  • At least 70% of voters in every demographic category said health care was important – a trend that stretches across gender, age, income level, education level, ideology, and party affiliation.

ENOUGH IS ENOUGH: AMERICANS ACROSS THE COUNTRY FIGHT BACK

More than what polls can show, however, is the grassroots momentum sweeping the country against the Trump Administration’s sabotage. Over the past week, health care advocates of all backgrounds came together in Alaska, Arizona, Colorado, Maine, Nevada, Ohio, Tennessee and West Virginia to launch the Enough is Enough campaign. The campaign calls on voters to tell their Senators that the GOP war on health care and attempts to repeal the Affordable Care Act must end.

ashoup
In Administration, News

Despite Trump, GOP Agenda of Repeal and Sabotage, Kaiser Poll Finds ACA More Popular Than Ever

This morning, the Kaiser Family Foundation released its February Health Tracking Poll, which found that the Affordable Care Act has a 54% favorability rating, the highest since the poll started tracking the public’s views in 2010.  The increasing support for the Affordable Care Act comes in spite of the efforts of President Trump and Congressional Republicans to repeal and sabotage the law.  Protect Our Care Campaign Director Brad Woodhouse released the following statement in response:

“Today’s Kaiser tracking poll is the clearest evidence yet that the partisan war on health care of President Trump and Congressional Republicans has fallen flat with the American people and is a surefire political loser for the GOP,” said Woodhouse. “Congressional Republicans have spent eight years lying about the Affordable Care Act in attempts to repeal it, and President Trump has spent a year trying to repeal or sabotage it at every turn. Despite this, millions of people overcame the attempts to disrupt open enrollment and signed up for coverage, voters approved ballot measures supporting Medicaid expansion in Oregon and Maine, and when Democrats won big on election day in November health care was the major reason why.

“The reason for the ACA’s increased popularity is simple: it works. People support the ACA because it bars discrimination against those with pre-existing conditions and bans lifetime limits on care; they support the ACA because it covers essential medical care, like maternity care and prescription drug coverage; and they support the ACA because it gives them an opportunity to live their lives without fear that a medical emergency can come along and leave them at the whims of insurers, as was the case for far too long. Americans recognize the GOP’s health care sabotage is already expected to raise their premiums 20% next year. People want reforms that lower costs, not sabotage and repeal which raise them, and President Trump and Congressional Republicans would be well-served to finally listen to the Americans who continue to make their voices heard loud and clear. Enough is enough – it’s time for the GOP to end their war on health care.”

ashoup
In Administration, News

Medicaid Remains Key In Addressing Opioid Epidemic, Trump’s Repeal and Sabotage Agenda Sets Back Effort to Address the Crisis

As the White House continues to pay lip service regarding the need to address our nation’s growing opioid epidemic, its policy does the opposite — stripping resources from the very programs working to address the crisis.

The Trump Administration has relentlessly attacked and sabotaged Medicaid, which helps people with opioid addiction receive care, paying for one-fifth of all substance abuse treatment nationwide. Beyond slashing funds for Medicaid, Trump has also encouraged states to impose burdensome work requirements, mandating that Medicaid enrollees work a set amount of hours each week and jump through administrative hurdles to prove their employment status. Adding insult to injury, the Trump Administration has proposed a 95% cut to the Office of National Drug Control Policy, which is charged with coordinating the federal response to the nation’s raging opioid crisis – a cut proposed for the second year in a row.

These policies are counterproductive at best, cruel and life-threatening at worst. Medicaid has played a central role in responding to the opioid epidemic, and cutting access will only make it harder for states to address the crisis.

MEDICAID GIVES STATES MORE RESOURCES TO ADDRESS THE OPIOID EPIDEMIC

Medicaid Is A Sustainable Source Of Funding Compared To Short-Term Grants. “Now that more people with SUDs are eligible for Medicaid, states can significantly improve treatment for people with SUDs by improving Medicaid-covered services. Medicaid can be a sustainable funding source for providers, as opposed to capped, short-term grant funding.” [Center on Budget and Policy Priorities, 2/28/18]

Thanks To Medicaid Expansion, The Uninsured Rate For Opioid-Related Hospitalizations Dropped In Expansion States. “In Medicaid expansion states, the uninsured rate for opioid-related hospitalizations plummeted by 79 percent, from 13.4 percent in 2013 (the year before expansion implementation) to 2.9 percent in 2015.  The decline in non-expansion states was a much more modest 5 percent, from 17.3 percent in 2013 to 16.4 percent in 2015.” [Center on Budget and Policy Priorities, 2/28/18]

[Center on Budget and Policy Priorities, 2/28/18]

MEDICAID EXPANSION HAS INCREASED ACCESS TO TREATMENT

Medicaid Helps Make Buprenorphine And Naloxone, Drugs Used To Treat Opioid Use Disorder, Affordable. “These data are consistent with other evidence that Medicaid expansion is improving access to care for people with opioid use and other substance use disorders. Medicaid makes medications like buprenorphine and naloxone, which are prescribed to combat opioid use disorders, affordable for beneficiaries.“ [Center on Budget and Policy Priorities, 2/28/18]

Medicaid Expansion Has Improved Access To Substance Treatment Services. “Evidence also suggests that Medicaid expansion improved access to substance use treatment services more broadly. After expanding Medicaid, Kentucky experienced a 700 percent increase in Medicaid beneficiaries using substance use treatment services.  Use of treatment services rose nationally as well; one study found that expanding Medicaid reduced the unmet need for substance use treatment by 18.3 percent.” [Center on Budget and Policy Priorities, 2/28/18]

In Ohio, Medicaid Has Helped Those With Substance Use Disorders Access Mental Health Services. “An Ohio study found that 59 percent of people with opioid-use disorders who had gained Medicaid coverage under expansion reported improved access to mental health care. Nationwide, the share of people forgoing mental health care due to cost fell by about one-third as the ACA, including Medicaid expansion, took effect.” [Center on Budget and Policy Priorities, 2/28/18]

THE REPUBLICAN CLAIM THAT MEDICAID CONTRIBUTED TO THE OPIOID EPIDEMIC IS FALSE

PolitiFact: “No evidence to prove Medicaid expansion is fueling the opioid crisis.” [PolitiFact, 10/23/17]

CBPP: States That Have Expanded Medicaid Have Reduced Unmet Need For Substance Abuse Treatment. “Expansion states have reduced the unmet need for the treatment of substance use disorders by 18 percent. All states’ Medicaid programs cover at least one medically assisted treatment medication, and the Medicaid expansion has granted health coverage to an estimated 99,000 people with an opioid use disorder.” [Center on Budget and Policy Priorities, 10/5/17]

Opioid Deaths In Medicaid Expansion States Predates The Affordable Care Act.  “The opioid epidemic started decades before Medicaid expanded … Expansion states did have relatively more drug deaths than non-expansion states in 2015, but the upward trend in deaths in expansion states started in 2010, four years before the Medicaid expansion began. The results are the same if we exclude the six early expansion states. By the simplest criterion for causality, that causes must precede effects, these results cannot be taken as evidence of Medicaid expansion causing these deaths.” [Health Affairs, 8/23/17]

Medicaid Is Part Of The Solution To Curbing Opioid Epidemic. “Medicaid is the most powerful vehicle available to states to fund coverage of prevention and treatment for their residents at risk for or actively battling opioid addiction….The greatest opportunity to address this crisis is in those states that have elected to expand Medicaid, given the greater reach of the program, additional tools available, and the increased availability of federal funds.” [State Health Reform Assistance Network, 7/16]

CDC: “There Is No Evidence Medicaid Leads To Opioid Abuse.” “The Republican argument is flawed because the Medicaid expansion began in 2014, and opioid addiction was declared an epidemic by the Centers for Disease Control and Prevention in 2011. The federal science agency has also said there is no evidence that Medicaid leads to opioid abuse.” [Newsweek, 1/17/18]

Vox: “This Claim Runs Into A Basic Problem: The Concept Of Time.” “But this claim runs into a basic problem: the concept of time. Medicaid didn’t expand under Obamacare until 2014 — well after opioid overdose deaths started rising (in the late 1990s), after the Centers for Disease Control and Prevention in 2011 declared the crisis an epidemic, and as the crisis became more about illicit opioids, such as heroin and fentanyl, rather than conventional opioid painkillers. ‘It’s pretty ridiculous,’ Andrew Kolodny, an opioid policy expert at Brandeis University who’s scheduled to testify at the Senate hearing, told me.” [Vox, 1/17/18]

David Wyman, Georgetown University Law Center: “Just Because A Precedes B Doesn’t Mean That A Causes B. That’s Statistics 101.”  “The witnesses included one anti-Medicaid ideologue, two local prosecutors who testified that they’ve seen a lot of addicts in their work and lots of them seem to be on Medicaid, and two experts who, tactlessly, pointed out that the causes of the opioid epidemic are many and complex, that it started years before Medicaid expansion, and that it involves patients and doctors in Medicare and private insurance as well as the uninsured… Efforts to demonize Medicaid expansion because it was launched as the opioid crisis really took off confuse correlation with causation, David Hyman of the Georgetown University Law Center warned Johnson’s committee. ‘Just because A precedes B doesn’t mean that A causes B,’ he said. ‘That’s statistics 101.’” [Los Angeles Times, 1/17/18]

Katherine Baicker, University Of Chicago Harris School Of Public Policy Dean: “I Don’t Think Anybody Would Suggest Because Overprescribing Of Opioids Poses A Series Health Risk, People Shouldn’t Go See The Doctor.” “If [Republicans] argue against Medicaid based on the idea that it potentially allows more patients to get prescriptions for opioids, they could use that same reasoning to oppose expansion of private health insurance. Expanding health insurance of any variety increases people’s access to health care. Much of that care is beneficial; some may not be, Katherine Baicker, dean of the University of Chicago’s Harris School of Public Policy, told me. ‘I don’t think anybody would suggest because overprescribing of opioids poses a series health risk, people shouldn’t go see the doctor,’ Baicker said.” [Washington Post, 1/17/18]

THOSE WHO ARE MOST FAMILIAR WITH THE OPIOID CRISIS AGREE THAT MEDICAID IS CRUCIAL IN FIGHTING IT

A Panel Of Public Health Officials, Policy Experts, And Law Enforcement Officials Found Medicaid Among Most Important Programs In Combating Opioid Epidemic. Investing in Medicaid was the third most cited response when a panel of thirty experts were asked where they would put money to combat the opioid epidemic. [New York Times, 2/14/18]

Jay Unick, University Professor: Medicaid Expansion Is Most Important Intervention To Improve Opioid Epidemic. Medicaid expansion would be “the most important intervention for improving outcomes related to the opiate epidemic…all the other interventions discussed here only work if individuals have access to quality health care.” [New York Times, 2/14/18]

160 National, State, and Local Organizations Warn That Trump’s Medicaid Sabotage Will Hurt Those With Substance Use Disorders in Letter to Secretary Azar: “CMS’s Medicaid work requirements policy is directly at odds with bipartisan efforts to curb the opioid crisis…and will have a significant and disproportionately harmful effect on individuals with chronic health conditions, especially those struggling with substance use disorders (SUDs) and mental health disorders.”  [Letter, 2/15/18]

Signatories include: ADAP Advocacy Association (aaa+); Addiction Policy Forum, Advocacy Center of Louisiana; AIDS United, Alameda County Community Food Bank; American Association on Health and Disability; American Association of People with Disabilities; American Association for the Treatment of Opioid Dependence (AATOD); American Civil Liberties Union; American Federation of State; County & Municipal Employees (AFSCME); American Foundation for Suicide Prevention; American Group Psychotherapy Association; American Psychological Association; American Society of Addiction Medicine; Association for Ambulatory Behavioral Healthcare; Bailey House, Inc.; Board for Certification of Nutrition Specialists; Brooklyn Defender Services; CADA of Northwest Louisiana; California Consortium of Addiction Programs & Professionals; California Hepatitis Alliance; Caring Across Generations; Caring Ambassadors Program; CASES; Center for Civil Justice; Center for Employment Opportunities (CEO); Center for Health Law and Policy Innovation; Center for Law and Social Policy (CLASP); Center for Medicare Advocacy; Center for Public Representation; Charlotte Center for Legal Advocacy; CHOW Project; Coalition of Medication Assisted Treatment Providers and Advocates; Colorado Center on Law and Policy; Community Access National Network (CANN); Community Catalyst; Community Health Councils; Community Legal Services of Philadelphia; Community Oriented Correctional Health Services; Community Service Society; Connecticut Legal Services; Consumer Health First; C.O.R.E. Medical Clinic, Inc.; Council on Social Work Education; CURE (Citizens United for Rehabilitation of Errants); DC Coalition Against Domestic Violence; Desert AIDS Project; Disability Rights Arkansas; Disability Rights Wisconsin; Drug Policy Alliance; EAC Network (Empower Assist Care); EverThrive Illinois; Facing Addiction with NCADD; Faces & Voices of Recovery; FedCURE; First Focus; Florida Health Justice Project, Inc.; Food & Friends; The Fortune Society; Forward Justice; Friends of Recovery – New York; Futures Without Violence; God’s Love We Deliver; Greater Hartford Legal Aid; Greenburger Center for Social and Criminal Justice; Harm Reduction Coalition; Health Law Advocates; Hep Free Hawaii; Hepatitis C Support Project/HCV Advocate; Heartland Alliance; HIV Medicine Association; Horizon Health Services; Hunger Free America; ICCA; Illinois Association of Behavioral Health; The Joy Bus; JustLeadershipUSA; Katal Center for Health, Equity, and Justice; The Kennedy Forum; Kentucky Equal Justice Center ; Kitchen Angels ; Justice in Aging ; Justice Consultants, LLC; Lakeshore Foundation; Law Foundation of Silicon Valley; Legal Action Center; The Legal Aid Society; Legal Council for Health Justice; Life Foundation; Live4Lali; Liver Health Connection; Maine Equal Justice Partners; MANNA (Metropolitan Area Neighborhood Nutrition Alliance); Massachusetts Law Reform Institute; McShin Foundation; Mental Health America; Mental Health Association in New York State, Inc. (MHANYS); Michigan Poverty Law Program; Minnesota Recovery Connection; Mississippi Center for Justice; NAACP; The National Alliance to Advance Adolescent Health; National Alliance on Mental Illness; NAMI-NYS; National Alliance of State & Territorial AIDS Directors; National Association of Addiction Treatment Providers; National Association of County Behavioral Health & Developmental Disability Directors; National Association for Rural Mental Health; National Association of Social Workers; National Center for Law and Economic Justice; National Coalition Against Domestic Violence; National Council on Alcoholism and Drug Dependence, Phoenix; National Council for Behavioral Health; National Council of Churches; National Disability Rights Network; National Employment Law Project; National Federation of Families for Children’s Mental Health; National Health Care for the Homeless Council; National Health Law Program; National HIRE Network; National Juvenile Justice Network; National LGBTQ Task Force; National Low Income Housing Coalition; National Organization for Women; The National Viral Hepatitis Roundtable; NC Justice Center; New Haven Legal Assistance Association; New York Association of Alcoholism and Substance Abuse; New York Association of Psychiatric Rehabilitation Services; New York Lawyers for the Public Interest; New York State Council for Community Behavioral Healthcare; Open Hands Legal Services; Osborne Association; Outreach Development Corp.; The Partnership for Drug Free Kids; PICO National Network; The Poverello Center, Inc.; Project Inform; Public Justice Center; Root & Rebound; Ryan White Medical Providers Coalition; Safer Foundation; Sargent Shriver National Center on Poverty Law; School Social Work Association of America; Sea Island Action Network, South Carolina; The Sentencing Project; Shatterproof; Society of General Internal Medicine; Southern Center for Human Rights; Southern Poverty Law Center; Students for Sensible Drug Policy; TASC of the Capital District, Inc.; Tennessee Justice Center; Three Square Food Bank; Transitions Clinic Network; Treatment Action Group; Treatment Alternatives for Safe Communities (TASC) – Illinois; Treatment Communities of America; Virginia Poverty Law Center; Western Center on Law & Poverty

ashoup
In Administration, News

Second Study Confirms Trump Health Care Proposals A Disaster

Today, Avalere released a new study finding that the Trump Administration’s proposed Association Health Plans rule will increase premiums in the individual marketplace as much as 4% while reducing the enrollment in Affordable Care Act plans by 3 million. Protect Our Care Campaign Director Brad Woodhouse released the following statement in response:

“This is the second study in three days to conclude that the sabotage agenda being pushed by Donald Trump and his Administration will have massive negative consequences on Americans’ care,” said Woodhouse. “People will lose their coverage, premiums will rise across the board, and the marketplace will become even more jumbled, all while the Administration sits back and continues to play political games. It’s time for President Trump and Congressional Republicans to work with Democrats on real solutions to expand access and bring down costs for Americans rather than continuing to push their partisan sabotage efforts. Enough is enough – it’s time for the Trump Administration and Republicans in Congress to end their war on health care.”

ashoup
In Capitol Hill, Administration, News

As GOP Preaches Opioid Solutions, Medicaid Remains Key

Today, the Center on Budget and Policy Priorities released an analysis showing that states which expanded Medicaid saw higher rates of insurance coverage for people with opioid-use disorders. As the House Energy and Commerce Committee holds hearings and President Trump hosts a summit to address the opioid crisis, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“This analysis makes clear what we have been saying for months: Medicaid is a lifeline for those battling the scourge of opioid addiction, and Republican plans to gut the Medicaid program would have disastrous ramifications for the millions of Americans courageously doing so,” said Woodhouse. “This report undercuts false GOP claims and shows that Medicaid expansion increased access to substance abuse treatment, period. If they truly care about combating the opioid crisis, President Trump and GOP Members of Congress should end their partisan war on health care and immediately call for the expansion of Medicaid in states which have not done so.”

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