This Week

While Facebook and confirmation hearings dominated Congress’ return to Washington this week, Republicans continued their unprecedented assault on the American health care system. Here’s what happened in the war on health care – and how five recent studies made clear the long- and short-term benefits of the Affordable Care Act:

TRUMP ADMINISTRATION STACKS DECK AGAINST HEALTH CARE SHOPPERS

On Monday, the Trump Administration finalized the “rules of the road” for next year’s ACA marketplaces, and they favor insurance companies over the American people, encouraging insurers to undermine protections for those with pre-existing conditions with a race-to-the-bottom approach while loosening restrictions on extreme rate hikes.

Moreover, despite the Administration’s own data showing that cuts to outreach and assistance dampened enrollment, especially among younger and healthier consumers, they pushed even further cuts to local assisters, ensuring it will be even more difficult for Americans to sign up for coverage next year.

This short-sighted, bad-faith rule is yet another brick in the wall that Republicans are building between the American people and access to good, affordable coverage.

EXPERTS PAN NBPP RULES

Among those who know health care the best, the rules were not well received. Here’s a sampling of what the experts said:

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

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

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

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

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

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

ADMINISTRATION ENCOURAGES WORK REQUIREMENTS TO FURTHER HARM AMERICANS

On Tuesday, President Trump privately signed an executive order encouraging federal agencies and states to strengthen existing work requirements in Medicaid and in critical public assistance programs – and he was right to hide.

We’ve seen solid evidence that imposing work requirements on non-employment-related federal programs not only fail to help people find jobs, but actually push hard-working Americans through the cracks while costing more in wasteful administrative overhead. The reality is that 8 in 10 adults with coverage through Medicaid live in working families.

By pushing states and federal agencies to adopt short-sighted and inhumane tactics to force even more Americans off their insurance and out in the cold, President Trump is aggressively continuing his war on our health care.

NEW REPORT CONFIRMS GOP TAX SCAM BENEFITS DRUG COMPANIES WHILE AMERICANS PAY MORE

Also on Tuesday, Sen. Cory Booker (D-NJ) released a major report confirming that none of the country’s ten biggest pharmaceutical companies have used any of their windfall from the GOP tax scam to lower drug prices for consumers, instead passing those benefits along to wealthy executives and shareholders.

The majority of Americans have always known the GOP tax scam was designed to enrich the wealthiest individuals and biggest corporations at the expense of everyday Americans and our health care, but this doesn’t make the findings any less distressing. Americans already pay a higher price for prescription drugs than consumers around the world, and big pharmaceutical companies have refused to lift a finger to provide relief from crippling prices.

It’s outrageous that pharmaceutical executives are further lining their own pockets instead of addressing the skyrocketing cost of prescription drugs, and it represents even further proof the GOP tax scam was never intended to help ordinary Americans.

ADMINISTRATION STAGES OPIOID PHOTO-OP HOURS AFTER LATEST MEDICAID ATTACK

On Wednesday, Administration officials unveiled an opioid crisis installation on White House grounds just hours after the President signed the executive order escalating his Administration’s relentless attacks on Medicaid, the most critical federal program for connecting Americans with opioid treatment, showing just how out-of-touch they are with the reality of this crisis: its HHS Secretary is holding photo-ops with art installations instead of taking real action.

Rather than waging a war on this crisis, the Administration continues to wage a war on our health care – and until they call off their war on Medicaid, which covers 25 percent of all addiction treatment nationwide, President Trump and Secretary Azar will have zero credibility in the opioid crisis fight.

SEN. COLLINS’ SUNDAY SHOW DECEPTION ROUTINE

And as we head into another weekend, it’s worth revisiting what happened last weekend. On Sunday, Sen. Susan Collins (R-Maine) appeared on CNN’s State of the Union and proceeded to give a version of the events surrounding the GOP stabilization bill failure that do not hold up to scrutiny. Here’s what Sen. Collins said about the stabilization effort  – and what actually happened:

What Collins says now:	What really happened:
Asked whether she was lied to to get her vote for the GOP tax scam, Sen. Collins responded, “No, I really don’t.”	Last December, Collins said that a failure to pass stabilization would be a “serious breach of a promise.” When discussing the possibility that stabilization might not become law, Collins said, “I’m counting on the administration to make sure that does not happen…I would consider it a very serious breach of a promise to me.”
Sen. Collins stated she believes Majority Leader McConnell kept his promise to her: “I had the opportunity just two weeks ago to bring a package to the Senate floor with Lamar Alexander, so the Majority Leader kept his promise to me.”	In Sen. Collins’ own words, she cast a vote to pass the tax bill because she had secured “commitments to pass legislation to help lower health insurance premiums.” She secured a commitment to pass stabilization, not just hold a vote on legislation. Not only did stabilization never pass, but no vote was ever held on Collins’ or Alexander’s health care stabilization package.
Sen. Collins continued to push a false narrative about what happened during stabilization efforts, saying, “Much to my surprise, [stabilization] was blocked actually by Senators on the other side of the aisle.”	Republicans bear 100% of the responsibility for failing to pass legislation that would stabilize the Affordable Care Act. House Republicans, such as Rep. Tom Cole, went on the record indicating they opposed stabilization. The White House then released a list of extreme, deal-breaking demands. Sen. Lindsey Graham told Breitbart News, “[Obamacare] is 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.”  And in an op-ed she penned for the Portland Press Herald, Sen. Collins herself admitted price increases were entirely avoidable: “This proposal was the last clear opportunity to prevent these health insurance rate increases, which will be announced Oct. 1. The most frustrating thing about these imminent price increases is that they were entirely avoidable. Much about health care is complicated.”

STUDIES CONFIRM: ACA, MEDICAID IMPROVE HEALTH CARE ACCESS AND OUTCOMES, BOOST LOCAL ECONOMIES

Ultimately, however, despite everything that Republicans continue to throw at it, the ACA continues to improve the lives of Americans from coast to coast. Over the past month, five studies looking at the impact of the Affordable Care Act have been released: three analyzing Medicaid expansion, and two analyzing marketplace coverage. These studies covered a broad scope of health care-related outcomes, from treatment for chronic conditions to jobs created in a local economy, and each came to the same conclusion: the ACA is providing clear benefits for Americans.

• Louisiana Department of Health: Medicaid Expansion and the Louisiana Economy. An April report analyzed Louisiana’s Medicaid expansion, finding that expansion brought a $1.85 billion economic impact to the state; created 19,000 new jobs; and extended medical services to over 545,000 Louisianans, leaving Gov. John Bel Edwards to note, “It is costing us less to have more people insured.”
• University of Montana Bureau of Business and Economic Research: Medicaid Expansion Has Boosted State’s Economy, Added Jobs, Improved Health Care. A March study examined Montana’s Medicaid expansion, finding that it created 5,000 new jobs and $280 million of personal income; saved the state $40 million in Medicaid benefits; and provided insurance to more than 94,000 Montanans. “Medicaid expansion is doing what it’s supposed to do, help Montanans live healthier lives and save the state money,” said State HHS Director Sheila Hogan.
• America’s Health Insurance Plans: The Value of Medicaid: Providing Access to Care and Preventive Health Services. An April AHIP study compared coverage data for those under Medicaid, private insurance, and not covered, finding Medicaid enrollees to have access to care at levels comparable to private coverage and far better than those without insurance, leaving the authors to conclude the study’s findings “refute outdated, less rigorous studies that question the value of Medicaid.”
• Health Affairs: Effects Of The ACA’s Health Insurance Marketplaces On The Previously Uninsured: A Quasi-Experimental Analysis. An April study compared adults who had gone through periods without insurance to those with continuous coverage, finding that the introduction of the ACA saw the uninsured rate decrease by 11 percentage points and the number of of individuals unable to access necessary care fall by two points, as well as more outpatient visits, more prescriptions being filled, and a higher probability of a hospital stay.
• Health Affairs: The Affordable Care Act’s Marketplaces Expanded Insurance Coverage For Adults With Chronic Health Conditions. An April study examined the role the ACA marketplace had on non-elderly adults with chronic conditions, finding that far more Americans with chronic conditions obtained coverage through the marketplace, underscoring the law’s long-term benefits.

 

Despite the Congressional recess, this week, Republicans continued their unprecedented assault on the American health care system. Here’s what happened in the war on health care – and why, despite these efforts, the past seven days showed the Affordable Care Act is here to stay:

IOWA REPUBLICANS PRIORITIZE INSURERS’ PROFITS OVER IOWANS’ HEALTH

On Monday, Iowa Gov. Kim Reynolds signed legislation allowing for the sale of association health plans and ‘benefit plans’ which don’t meet Affordable Care Act requirements, taking Iowa back to the days when insurers could discriminate against those with pre-existing conditions and refuse to cover essential health benefits, paving the way for even higher premiums and further market destabilization.

In an editorial, “Elected officials undermine Iowans’ health insurance,” the Des Moines Register Editorial Board condemned the GOP’s efforts:

“The bill clears the way for the creation of unregulated, undefined health insurance exempted from ACA mandates. These mandates include requirements on insurers to cover hospitalization, prescriptions, preventive care and other health services people need. The new plans would not be considered ‘insurance’ and therefore would not be subject to state and federal rules… Sen. Mark Chelgren, R-Ottumwa, was among the biggest supporters of this insurance free-for-all. ‘We have tried this before,’ he said, referring to the days before the enactment of Obamacare. ‘This was how the system worked.’ Oh brother. Yes, senator, we have tried this before. This is how the system used to work. It was an unmitigated disaster and the driving force behind Congress crafting health reform.”

HIDDEN COSTS OF SABOTAGE – QUANTIFIED

On Tuesday, new Kaiser Family Foundation polling was released, confirming Americans’ mounting anxiety about ongoing GOP health care sabotage. Key takeaways included:

• About half the public believes ACA marketplaces are “collapsing,” including six in ten of those who purchased marketplace coverage. While this reflects the ongoing uncertainty caused by President Trump and Congressional Republicans, it contradicts what the President’s own economic advisors have confirmed about the stability and strength of the individual market.
  
• Because of Republican sabotage, the number of people who are “very worried” or “somewhat worried” that rate hikes will make coverage unaffordable has skyrocketed to 67%, compared with 38% in October 2017.
• One-third of  individual market shoppers say the individual mandate was a “major reason” they bought insurance, with one in ten saying they will not buy coverage without it. With research indicating those most likely to drop coverage are young people, the CBO forecasts average yearly premiums in the nongroup market will increase by 10% over the next decade.

Despite everything the GOP has thrown at it, the Affordable Care Act still protects every American with health insurance and provides millions of previously uninsured people with coverage – and Americans recognize and appreciate this.

TRUMP’S OWN POLLSTERS FIND ACA POPULAR, HEALTH CARE COSTS TOP VOTERS’ MINDS

New polling from America First, compiled by President Trump’s own pollsters, found lowering the cost of health care to be the top issue voters want addressed in 2018, and these voters favoring fixes to the Affordable Care Act over repeal by a 47 to 34 percent margin.

With President Trump’s own pollsters finding that keeping the ACA has a double-digit advantage over repeal and rising health care costs are the number-one issue on voters’ minds, it couldn’t be more clear that the Republican war on health care is failing. The GOP would do well to finally start listening to the American people who continue to say: enough is enough – end the war on our health care.

ENROLLMENT NUMBERS CONFIRM ACA’S STAYING POWER

This week also saw the Centers for Medicare and Medicaid Services release the final open enrollment numbers for 2018, which showed that 11.8 million people nationwide bought marketplace coverage.

For nearly a year, the Trump Administration carried out a rampant, unprecedented sabotage campaign against open enrollment, which included cutting the advertising budget by 90 percent, halving the enrollment time, and denying help for people trying to obtain coverage.

But millions of Americans rely on the ACA for quality, affordable coverage, and they made sure to obtain coverage in spite of partisan fear mongering and numerous obstacles placed in their way. The American people don’t want to go back to a time when insurers could deny them health care for having a pre-existing condition or be priced out of the market based on their age, gender, or medical history – and continued attempts to undermine the law will only be met with further resistance.

While much of Washington focused on the omnibus bill, the Trump Administration and Congressional Republicans continued their unprecedented assault on the American health care system this week. Here’s what happened this week in the GOP’s war on health care – and how as we approach the eighth anniversary of the Affordable Care Act being signed into law, the health care protections it provides Americans are more popular than ever.

GOP PRIORITIZES PARTISANSHIP OVER AMERICANS’ HEALTH, AGAIN…

Congressional Republican leaders left the bipartisan negotiating table and unilaterally released a “stabilization” bill riddled with poison pills designed to prevent Democrats from supporting its passage. The bill includes expansive anti-abortion language which effectively bans all private insurance from covering abortion services, and prevents states from  taking action against the Trump Administration’s proposed junk insurance plans that can deny coverage for pre-existing conditions and refuse to cover essential benefits.

Once again, Republicans chose to prioritize an extreme agenda over their constituents’ interests, continuing to go after pre-existing condition protections and women’s health while artificially inflating rates through their relentless sabotage of our care. As Rep. Tom Cole (R-OK) said, “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.”

…TO OFFER A SHAM STABILIZATION BILL

And what of the bill itself? Alexander-Collins is simply a terrible proposal for Americans’ health care. The proposed GOP stabilization legislation would result in net coverage losses, higher out-of-pocket costs, and fewer coverage options for many Americans – and an attack on a women’s right to choose.

So despite what Republicans may be publicly saying, Alexander-Collins is not a serious attempt to stabilize the marketplaces. It’s a partisan bill designed to fail, and it represents nothing more politics at its worst from Republican leaders in Congress who otherwise have voted to repeal Americans’ health care.

CONFIRMED: TRUMP’S JUNK PLAN RULE HARMS OLDER AMERICANS

According to a new study from AARP, the Trump Administration’s plot to let insurance companies sell junk plans would cause premiums for older Americans to jump by double digits next year, with the average 60-year-old paying an average of 16.6% more for individual-market coverage. If the proposal moves forward, older Americans would face an eye-popping annual premium increase of over $2,000 next year. Here are full state-by-state estimates:

WHITE HOUSE CONTINUES IGNORING REAL OPIOID SOLUTIONS

On Tuesday, President Trump spoke in New Hampshire about the opioid crisis. Once again, his speech was heavy with rhetoric and short on solutions – more of the same from a White House more committed to politicizing the opioid crisis than ending it.

As a reminder, 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.

HELLER RECEIVES HIS PAYOFF

Last summer, Senator Dean Heller (R-NV) supported the GOP’s repeal legislation, a bill he himself said ““takes insurance from tens of millions of Americans and hundreds of thousands of Nevadans.” This came just weeks after President Trump threatened Heller, sayings, “He wants to remain a senator, doesn’t he?” As CNN noted:

The subtle threat may have had an effect. Over the next several months, Heller aligned himself closely with the President, endorsing his efforts to repeal Obamacare, appearing right behind Trump at a White House event celebrating passage of the tax law, and avoiding direct criticism of Trump despite the seemingly endless string of controversies coming out of the West Wing.

This week, Sen. Heller received his final payoff: a tweet from President Trump.

Congrats to Sen. Heller! But he might want to take that endorsement with a grain of salt, because…

POLLING SHOWS: HEALTH CARE A TOP ISSUE, VOTERS BACKING PRO-ACA CANDIDATES

This week, Public Policy Polling released a series of polls which found that not only is health care a top issue for voters across the country, but voters are rejecting pro-repeal candidates in five battleground states. The polls found the following results:

• In Arizona, health care is a top issue for 68% of voters, with 21% saying it is the most important issue. In a hypothetical Senate election, Democrat Kyrsten Sinema leads Republica Martha McSally 46-41
• In Nevada, health care is a top issue for 65% of voters, with 27% saying it is the most important issue. In a hypothetical Senate election, Democrat Jacky Rosen leads Republican Dean Heller 44-39.
• In Pennsylvania, health care is a top issue for 71% of voters, with 25% saying it is the most important issue. In a hypothetical Senate election, Democrat Bob Casey leads Republican  Lou Barletta 54-36.
• In Tennessee, health care is a top issue for 71% of voters, with 31% saying it is the most important issue. In a hypothetical Senate election, Democrat Phil Bredesen leads Republican Marsha Blackburn 46-41.
• In Wisconsin, health care is a top issue for 72% of voters, with 25% saying it is the most important issue. In a hypothetical Senate election, Democrat Tammy Baldwin leads Republicans Leah Vukmir and Kevin Nicholson 51-39 and 51-38, respectively.

POLLING ALSO SHOWS: HEALTH CARE THE #1 POCKETBOOK ISSUE FOR AMERICAN FAMILIES

Today, the Pew Research Center released a new survey that finds the number-one pocketbook issue for Americans of all income brackets is health care, confirming the vital importance of this issue to American families. Key findings include:

• More than half of those surveyed said that health care affects their household’s financial situation “a lot,” the only issue which more than half of Americans rated a key economic issue.

• Health care is “a top household financial issue” across all income levels, with 53% of those earning more than $100,000 and 52% of those earning $30,000 or less saying it has a large effect.

THE ACA TURNS EIGHT, AND IS MORE POPULAR THAN EVER

Finally, today March 23, is the eight-year anniversary of the Affordable Care Act being signed into law. Since then, more than 20 million Americans have gained coverage; the uninsured rate fell to below 9 percent, the lowest-ever recorded rate; and health care prices rose at the slowest rate in more than half a century.

Yesterday morning, Leader Nancy Pelosi, Whip Steny Hoyer, Assistant Minority Leader Jim Clyburn, Rep. David Cicilline, and Rep. Brenda Lawrence joined Protect Our Care, Little Lobbyists, Health Care Voter, Doctors for America, and other health care advocates at a press conference celebrating the millions of lives which have benefited since the ACA was signed into law.

While there is countless work ahead, hundreds of millions of Americans are able to sleep easier at night knowing that insurers can no longer pick and choose who to cover, protecting from discrimination against those with pre-existing conditions, removing lifetime caps, and mandating essential coverage like maternity care and cancer treatment.

Today, the Affordable Care Act is more popular than it has ever been.