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Don’t Be Fooled: Chad Readler Wants to Repeal American Health Care

The Trump administration recently announced the renomination of 51 nominees to the federal bench, including Chad Readler for the Sixth Circuit Court of Appeals. In his role as Acting Assistant Attorney General, Readler overruled career attorneys at the Department of Justice and  filed a brief on behalf of the Trump administration in Texas v. United States arguing in favor of striking down the Affordable Care Act, including its protections for people with pre-existing conditions.

 

Let’s be clear, Readler’s anti-health care record speaks for itself:

 

READLER AUTHORED THE TRUMP ADMINISTRATION’S ASSAULT ON THE AFFORDABLE CARE ACT IN TEXAS V. UNITED STATES

Readler Filed The Trump Administration’s Brief In Texas V. United States To Strike Down The ACA.  In his role as Acting Assistant Attorney General, Raedler filed the Trump administration’s brief in Texas V. United States arguing that the court should enter “a declaratory judgment that the ACA’s provisions containing the individual mandate as well as the guaranteed issue and community-rating requirements will all be invalid beginning on January 1, 2019.” [Federal Defendants’ Memorandum in Response to Plaintiffs’ Application for Preliminary Injunction, Texas v. United States of America, 6/7/18]

Readler Was Nominated For A Judicial Seat The Same Day He Filed The Brief Calling For The ACA To Be Overturned.  “If confirmed, Chad A. Readler of Ohio will serve as a Circuit Judge on the U.S. Court of Appeals for the Sixth Circuit.  Chad Readler currently serves as the Principal Deputy and Acting Assistant Attorney General for the Civil Division at the U.S. Department of Justice, a position that he has held since 2017. In that role, Mr. Readler has lead and supervised the Department’s largest litigating division and has actively briefed and argued several cases on behalf of the United States in federal courts across the country.” [White House Press Release, 6/7/18]

  • Readler Was Renominated For The Bench In January 2019.  “Today President Donald J. Trump announced his intent to nominate the following judicial nominees:  […] Chad A. Readler, of Ohio, to be United States Circuit Judge for the Sixth Circuit.” [White House Press Release, 1/22/19]

Republicans And Career DOJ Officials Refused To Have Anything To Do With Readler’s Arguments

Republican Lamar Alexander Called Readler’s Argument “As Far Fetched As Any I’ve Ever Heard.”  “Sen. Lamar Alexander (R-Tenn.), the chairman of the Senate Health Committee, called the Trump administration’s argument against ObamaCare in a court case ‘as far-fetched as any I’ve ever heard.’  The Justice Department (DOJ) wrote in a filing Friday that it would not defend ObamaCare’s protections for people with pre-existing conditions, siding in large part with a challenge to the law brought by a coalition of Republican-led states. The states, and the DOJ, argue that Congress’s repeal of the tax penalty associated with ObamaCare’s individual mandate makes the law’s protections for people with pre-existing conditions unconstitutional Alexander said it wasn’t the intent to take away protections for people with pre-existing conditions when the mandate penalty was repealed late last year. ‘There’s no way Congress is going to repeal protections for people with pre-existing conditions who want to buy health insurance. The Justice Department argument in the Texas case is as far-fetched as any I’ve ever heard,’ Alexander said in a statement late Tuesday evening.” [The Hill, 6/12/18]

A 20 Year Veteran Of The DOJ Resigned In The Wake Of Readler’s Brief.  “A senior career Justice Department official has resigned in the wake of the Trump administration’s move to stop defending a key provision of the Affordable Care Act, a departure that highlights internal frustration generated by the decision, according to people familiar with the matter. Joel McElvain, who has worked at the Justice Department for more than 20 years, submitted his resignation letter Friday, the morning after Attorney General Jeff Sessions notified Congress that the agency will not defend the ACA — the 2010 law known as Obamacare — against lawsuits brought by Republican-led states challenging its requirement that most Americans carry health insurance.” [Washington Post, 6/12/18]

Two Career Attorneys At DOJ Asked To Be Withdrawn From Readler’s Brief.  “Just before the brief was filed, McElvain and two other career attorneys, Eric Beckenhauer and Rebecca Kopplin, filed a motion to withdraw from the case. Asked about the withdrawal of the attorneys, a Justice official said: ‘As is customary, the department decided to sub in a new legal team for a new legal position.’ The official said she was not aware of any indication that the other two attorneys were departing.” [Politico, 6/13/18]

An Ideologically Diverse Group Of  Legal Scholars Said Readler’s Arguments “Violate Basic Black-Letter Principles” Of Law.  “Under these circumstances, a court’s substitution of its own judgment for that of Congress would be an unlawful usurpation of congressional power and violate basic black-letter principles of severability. Yet that is what the plaintiff States and the United States invite this Court to do.” [Brief of Amici Curiae Jonathan H. Adler, Nicholas Bagley, Abbe R. Gluck, Ilya Somin, and Kevin C. Walsh in Support of Intervenors-Defendants’ Opposition to Plaintiffs’ Application for Preliminary Injunction, Texas v. United States of America, 6/14/18]

THE TEXAS CASE PUTS THE HEALTH CARE OF MILLIONS OF AMERICANS AT RISK

Republican officials — supported by the Trump administration in the brief authored by Chad Readler  — in 20 states went to federal court in the northern district of Texas to repeal the Affordable Care Act in its entirety. In a December 2018 ruling, U.S. Northern District Court Judge Reed O’Connor used  the courts to do what Republicans in Congress failed to do legislatively: strike down the Affordable Care Act. If O’Connor’s ruling is not overturned, it will rip coverage from millions of Americans, raise costs, end protections for people with pre-existing conditions, put insurance companies back in charge, and force seniors to pay more for prescription drugs. The result will be to — as the Trump Administration itself admitted in Court — unleash “chaos” in our entire health care system.

If The Texas Ruling Is Not Overturned, 17.1 Million People could Lose Their Coverage

If The Texas Ruling Is Not Overturned, Insurance Companies Could Be Put Back In Charge, Ending Protections For The 130 Million People With A Pre-Existing Condition

  • According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 130 million people, have a pre-existing condition. This includes:
    • 44 million people who have high blood pressure
    • 45 million people who have behavioral health disorders
    • 44 million people who have high cholesterol
    • 34 million people who have asthma and chronic lung disease
    • 34 million people who have osteoarthritis and other joint disorders
  • 17 million children. One in four children, or roughly 17 million, have a pre-existing condition.
  • 68 million women. More than half of women and girls nationally have a pre-existing condition.
  • 30 million people aged 55-64. 84 percent of older adults, 30.5 million Americans between age 55 and 64, have a pre-existing condition.

If The Texas Ruling Is Not Overturned, Insurance Companies Could Have the Power to Limit the Care You Get, Even If You Have Insurance Through Your Employer

 

  • Insurance Companies Do Not Have to Provide the Coverage You Need. The Affordable Care Act made comprehensive coverage more available by requiring insurance companies to include “essential health benefits” in their plans, such as maternity care, hospitalization, substance abuse care and prescription drug coverage. Before the ACA, people had to pay extra for separate coverage for these benefits. For example, in 2013, 75 percent of non-group plans did not cover maternity care, 45 percent did not cover substance abuse disorder services, and 38 percent did not cover mental health services. Six percent did not even cover generic drugs.

 

 

  • Reinstate Lifetime and Annual Limits. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage.

 

  • Large Employers Could Choose to Follow Any State’s Guidance, Enabling Them Put Annual and Lifetime Limits on Their Employees’ Health Care. Without the ACA’s definition of essential health benefits (EHB) in even some states, states could eliminate them altogether. Large employers could choose to apply any state’s standard, making state regulations essentially meaningless. Because the prohibition on annual and lifetime limits only applies to essential health benefits, this change would allow employers to reinstate annual and lifetime limits on their employees’ coverage.

AT HIS CONFIRMATION HEARING, READLER ATTEMPTED TO DOWNPLAY HIS INVOLVEMENT IN THE BRIEF CALLING FOR THE ACA TO BE STRUCK DOWN  

Readler Denied That He Was The “Primary Author” Of The Brief Calling For The ACA To Be Struck Down.  Mike Lee: Now, as acting assistant attorney general over the Civil Division or as the PDAG were you the primary author of briefs involving some of the cases that have been brought to the public’s attention in connection with your confirmation including the treatment of — in cases involving the treatment of pre-existing conditions under the Affordable Care Act, the separation of unaccompanied alien children from their parents, the so-called Entry Ban DACA litigation or sanctuary cities. Chad Readler: Senator, I wouldn’t call myself the primary author. As the head of the division my name would go on every single brief that the division would file. That could be 20 or 30 briefs a day. Depending on the case I may have had different levels of involvement with the case. I may not have looked at briefs, I may not have, but again it’s tradition at the department that the head of the division goes on every, name, goes on every single brief.” [Senate Judiciary Committee Hearing on Pending Nominations, 10/16/18]

Readler Defended The Brief:  “We Would Not Make An Argument If I Thought It Was Unethical Or Frivolous.”  “Pat Leahy: You do stand by those arguments today that the Affordable Care Act cannot be reasonably defended? Chad Readler: Senator, the position that the attorney general took is that the mandate was unconstitutional and… Leahy: Will you stand by those arguments today? Readler: Senator, it is my position to advocate for the United States. We would not make an argument if I thought it was unethical or frivolous.” [Senate Judiciary Committee Hearing on Pending Nominations, 10/16/18]

Readler On Whether Millions Of People With Pre-Existing Conditions Could Lose Health Coverage If His Position Prevailed:  “The Attorney General Was Clear About What The Legal Position For The Department Would Be. And We’ve Advocated That Position.”Maisie Hirono:  You’ve been asked a number of questions about your role in Texas versus United States. So if your argument – let me start with the protections of preexisting conditions under the ACA. If your argument on pre-existing condition prevails, would it mean that one in four people who have pre-existing conditions, millions of people in our country including women who have been pregnant possessing the pre-existing condition? Of course, people with asthma, diabetes, cancer. Doesn’t it mean that if your argument prevails that all of these people with pre-existing conditions will either lose their health insurance altogether or have to pay much, much more for health insurance? […] Chad Readler: So senator, healthcare is a very important policy issue in this country. I agree there are a lot of individuals and families facing very serious healthcare conditions. With respect to the legal issues, I’m not a policymaker, but with respect to legal issues in those cases, or in that case, the attorney general was clear about what the legal position for the department would be. And we’ve advocated that position.” [Senate Judiciary Committee Hearing on Pending Nominations, 10/16/18]

Thanks Donald: Trump Sabotage Leads To Highest Uninsured Rate Since 2014

Gallup’s quarterly health survey reveals that the uninsured rate has risen to the highest rate since the Affordable Care Act’s coverage expansion was completed. A major reason for this increase? Trump’s relentless health care sabotage. Take a look for yourself:

Gallup’s Own Release Cites Trump Administration Sabotage In Its Explanation Of The Rising Uninsured Rate: “The Open Enrollment Periods Since 2018 Have Been Characterized By A Significant Reduction In Public Marketing And Shortened Enrollment Periods Of Under Seven Weeks, About Half Of Previous Periods.” Among the factors Gallup cites as playing a role in the increase of the uninsured rate:

  • Increasing Premiums: “One may be an increase in the rates of insurance premiums in many states for some of the more popular ACA insurance plans in 2018 (although most states saw premiums stabilize for 2019).”  [Gallup, 1/23/19]
  • Major Cuts To Open Enrollment: “The open enrollment periods since 2018 have been characterized by a significant reduction in public marketing and shortened enrollment periods of under seven weeks, about half of previous periods.” [Gallup, 1/23/19]
  • Slashed Funding For Navigator groups: “Funding for ACA ‘navigators’ who assist consumers in ACA enrollment has also been reduced in 2018 to $10 million, compared with $63 million in 2016. Overall, after open enrollment in the ACA federal insurance marketplace (i.e., healthcare.gov) peaked in 2016 at 9.6 million consumers, it declined by approximately 12.5%, to 8.4 million in 2019, based on recently released figures.”  [Gallup, 1/23/19]
  • Trump’s Hostility To The ACA: “Other potential factors include political forces that may have increased uncertainty surrounding the ACA marketplace. Early in his presidency, for example, President Donald Trump announced, ‘I want people to know Obamacare is dead; it’s a dead healthcare plan.’ Congressional Republicans made numerous high-profile attempts in 2017 to repeal and replace the plan. Although none fully succeeded legislatively, the elimination of the ACA’s individual mandate penalty as part of the December 2017 Republican tax reform law may have reduced participation in the insurance marketplace in the most recent open enrollment period. Trump’s decision in October 2017 to end cost-sharing reduction could also potentially have affected the uninsured rate.” [Gallup, 1/23/19]

Los Angeles Times: Uninsured Rate Under Trump Surges To Highest Level Since Obamacare Began. “The percentage of American adults without health insurance surged upward in 2018, reaching levels not recorded since before President Trump took office, according to a new national survey that revealed widespread coverage losses over the last two years…The new number represents the highest uninsured rate since the beginning of 2014, when the Affordable Care Act began providing billions of dollars in aid to help low- and middle-income Americans get covered, according to the survey by Gallup. The new report also indicates that some 7 million American adults have likely lost or dropped coverage since 2016…Since taking office, however, Trump has repeatedly attacked the healthcare law and enthusiastically backed a 2017 effort by congressional Republicans to roll it back.” [Los Angeles Times, 1/23/19]

HuffPost: The Uninsured Rate Is The Highest It’s Been In Five Years. “About 7 million fewer Americans had health insurance at the end of last year compared with two years prior, and the share of people who are uninsured is the highest it’s been since 2014, according to a new survey…Since his first day in office, Trump has directed and overseen policies that undermine the health insurance exchanges. The administration has dramatically reduced funding for advertising, marketing and outreach to draw eligible customers to the exchanges during open enrollment and for programs that help consumers navigate the sign-up process. The Republican tax package Trump enacted in 2017 repealed the Affordable Care Act’s fines on people who didn’t obtain health coverage under the law’s individual mandate, freeing people to go uninsured without penalty and causing insurers to increase prices on the assumption that healthier people are less likely to buy coverage in the absence of fines. Perhaps most consequentially, Trump ended payments to health insurance companies serving the lowest-income customers, which led insurers to increase prices to make up for the lost revenue.” [HuffPost, 1/23/19]

Vox: Under Trump, The Number Of Uninsured Americans Has Gone Up By 7 Million.Certain demographic groups are experiencing a greater loss of coverage than others. Gallup data shows, for example, that Americans who are younger and lower-income have seen a greater decline in insurance coverage than those who are older and wealthier. Women have had insurance rates decline more quickly than men. This trend is especially surprising given that over the same time period, the unemployment rate has been declining. Usually, when more people have jobs, it means more people with access to employer-sponsored health insurance. But even during this period of job growth, America’s uninsured rate keeps climbing.” [Vox, 1/23/19]

Forbes: Uninsured Rate Hits Four-Year High Amid Trump’s Obamacare Attacks. “The rate of Americans without health insurance has ‘risen steadily’ to 13.7% from 10.9% in 2016 , data released Wednesday as part of Gallup’s national “health and well-being index,” which drew from a quarterly data sample of about 28,000 adults…Following his 2016 election, Donald Trump swept into the White House in January of 2017, promising to repeal and replace the ACA, also known as Obamacare. That effort was a failure because the Republican-led Congress of 2017 was unable to repeal the law nor did GOP lawmakers come up with a replacement plan. But the Trump White House has made several policy moves that the Gallup analysis indicates has contributed to fewer people having coverage. ‘The open enrollment periods since 2018 have been characterized by a significant reduction in public marketing and shortened enrollment periods of under seven weeks, about half of previous periods,’ Gallup’s analysis said.” [Forbes, 1/23/19]

CNBC: Rate Of Americans Without Insurance Rises To 4-year High As Trump Weakens Obama Health Law, Gallup Survey Finds. “The percentage of U.S. adults without health insurance reached a four-year high in the last quarter of 2018, but was still well below the peak level seen before Medicaid expansion under the Affordable Care Act in 2014, a new Gallup survey published Wednesday found. The national uninsured rate climbed to 13.7 percent in the fourth quarter of 2018, its highest level since the first quarter of 2014 when the rate reached 13.4 percent, according to data the compiled from Gallup. Women and adults under the age of 35 reported among the highest rates without insurance at 12.8 percent and 21.6 percent, respectively, the survey found.” [CNBC, 1/23/19]

Axios: “Gallup’s Quarterly Health Surveys Tell A Pretty Clear Story, Which It Attributes To The Trump Administration’s Handling Of The ACA.” “The number of Americans without health insurance has been creeping higher throughout the Trump administration, and it’s now the highest it’s been since the Affordable Care Act’s coverage expansion took effect in 2014, according to Gallup’s latest survey…Women, lower-income households and young people saw the biggest coverage losses, according to Gallup…Gallup’s quarterly health surveys tell a pretty clear story, which it attributes to the Trump administration’s handling of the ACA.” [Axios, 1/23/19]

New KFF Health Tracking Poll: More Trouble for Sabotage & Repeal Republicans

The 2018 midterms were a referendum on health care and voters rejected the sabotage and repeal approach of Donald Trump and Republicans in Congress.

According to the new Kaiser Family Foundation Health Tracking poll, opposition continues to grow against Republicans for putting the needs of their health insurance contributors ahead of the needs of people who work for a living.

TWO KEY FINDINGS FROM THE KFF HEALTH TRACKING POLL

  • People reject Trump’s lawsuit to overturn ACA. By 10 points (41-51%), voters disapprove of the right-wing TX judge backing the Trump administration’s lawsuit to overturn the Affordable Care Act. When people hear that the Trump administration lawsuit means “people with pre-existing conditions may have to pay more for coverage or could be denied coverage,” they shift to opposing it by 39 points (25-64%)
  • People want action to protect coverage for those with pre-existing conditions, lower the cost of prescription drugs, and protect consumers against surprise medical bills. 82% of voters say it’s either extremely (54%) or very important (28%) that this Congress take action to lower prescription drug costs. 73% say it’s either extremely (46%) or very important (27%) that this Congress take action to protect coverage of those with pre-existing conditions. 70% of voters say it’s either extremely (43%) or very important (27%) that Congress work to protect people with health insurance from surprise high out-of-pocket medical bills.

Federal Judge Puts The Breaks On Trump’s Birth Control Rules

Washington DC — Over the weekend, news broke that a federal judge blocked the Trump administration’s request to implement new rules that would make it easier for employers to deny women health insurance coverage for contraceptives. Anne Shoup, communications director of Protect Our Care issued the following statement in response to the Trump administration’s latest attempt to sabotage health care:

“There’s no doubt that the Trump administration will stop at nothing to prevent millions of Americans from gaining access to affordable health care. These new rules are just another desperate attempt by President Trump to rip away long-standing health care protections for women across the nation. But let’s be clear: millions of women have reliable access to reproductive care because of the Affordable Care Act. Under the ACA, contraception is covered as a preventive health service, meaning most employers and insurers are required to provide coverage at no charge. Because this ruling blocked Trump’s latest sabotage efforts, millions of women still have access to birth control — a critical piece of their reproductive care. But the fight isn’t over. We must remain vigilant and continue to block all attempts to take women back to the days when insurance companies had the power to deny, drop, or charge them more for coverage.”

Protect Our Care Praises House Democrats for Making Health Care a Top Priority in New Congress

On Day One, House Rules Package Includes

Provision to Oppose Texas Lawsuit to Overturn the Affordable Care Act

 

Washington DC – Today, it was reported that the House of Representatives will vote tomorrow on the Restoring Congress For The People Resolution, which takes direct aim at the relentless health care repeal and sabotage campaign waged by Republicans in Congress and President Trump. The Resolution specifically addresses the Texas, et. al. vs. United States, et. al. lawsuit that would strike down the Affordable Care Act. The resolution authorizes the House counsel to intervene in the lawsuit on behalf of the House of Representatives to protect the health care for millions of Americans, including 130 million with pre-existing conditions. Leslie Dach, chair of Protect Our Care, issued the following statement:

“Starting with their first action in the new Congress, House Democrats are once again showing the American people who is fighting for them on health care. This resolution takes direct aim at the disastrous Texas court decision, pushed by Republicans and President Trump, that would end all protections for people with pre-existing conditions, and raise health care costs for millions. This lawsuit must be overturned. If Republicans truly cared about keeping health care affordable and protecting people with pre-existing conditions, they would vote against this lawsuit and for protecting the tens of millions of Americans.”

BREAKING: Texas Judge Grants Motion To Stay Proceedings In GOP Lawsuit To Repeal ACA

Washington DC – Today, Judge Reed O’Connor, who sided with President Trump and Republicans to overturn the Affordable Care Act, issued a stay in the Texas, et. al. vs. United States, et. al. lawsuit and ruled that his ruling is immediately appealable. This decision will allow the Affordable Care Act to remain in place while the ruling is appealed. Brad Woodhouse, executive director of Protect Our Care issued the following statement in response:

“Today’s ruling should prevent the damage this lawsuit will cause to millions of Americans while the appeal process is underway. But despite the clear message from the November elections, that the American people want protections for pre-existing conditions and quality and affordable health coverage, Donald Trump and his Republican allies will continue to try and weaponize the courts to do what they couldn’t do legislatively or at the ballot box — repeal the ACA. If this misguided ruling isn’t overturned, Republicans will succeed at striking down the ACA and gutting key protections for millions of Americans. Make no mistake, this politically driven lawsuit remains an absolute disaster for Americans and their health care.”

BACKGROUND:

Due to Judge O’Connor’s ruling on December 14th, Republicans are one step closer to repealing the Affordable Care Act and eliminating key protections, unleashing — as the Trump Administration itself admitted in his court — “chaos” in our entire health care system. Under this ruling:

  • Marketplace tax credits and coverage for 10 million people: GONE.
  • Medicaid expansion currently covering 15 million people: GONE.
  • Protections for more than 130 million people with pre-existing conditions when they buy coverage on their own: GONE.
  • Allowing children to stay on their parents’ insurance until age 26: GONE.
  • Free annual wellness exams: GONE.
  • Ban on annual and lifetime limits: GONE.
  • Ban on insurance discrimination against women: GONE.
  • Contraception with no out-of-pocket costs: GONE.
  • Limit on out-of-pocket costs: GONE.
  • Requirement that insurance companies cover essential benefits like prescription drugs, maternity care, and hospitalization: GONE.
  • Improvements to Medicare, including reduced costs for prescription drugs: GONE.
  • Closed Medicare prescription drug donut hole: GONE.
  • Rules to hold insurance companies accountable: GONE.
  • Small business tax credits: GONE.

Santa Tell Me, Will I Have Health Care Next Year?

New Ad Shows How Court Ruling Helps Republicans Rip Away Protections for People with Pre-Existing Conditions

 

Washington DC – Late Friday night, conservative U.S. District Court Judge Reed O’Connor issued his ruling in Texas, et. al. vs. United States, et. al., striking down the Affordable Care Act (ACA). His decision to side with Republican attorneys general, governors, and the Trump Administration is being called into question by those who know the law and health care the best. In a new digital ad published on social media platforms, Protect Our Care points out that this decision to overturn the ACA, if allowed to take effect, will have a disastrous impact on the American health care system. Brad Woodhouse, executive director of Protect Our Care issued the following statement:

“With millions of lives at stakes, Republicans have once again turned their backs on the American people by asking the courts to do their bidding. The recent decision from Judge Reed O’Connor to strike down the ACA now puts Republicans dangerously closer to ripping away health care protections from people with pre-existing conditions like cancer, asthma, and diabetes. Given Republicans’ terrible track record on health care, this lawsuit is simply another desperate attempt to gut the ACA and undermine the American people.”

Watch Protect Our Care’s new ad here.

 

BACKGROUND:

Due to Judge O’Connor’s ruling on December 14th, Republicans are one step closer to repealing the Affordable Care Act and eliminating key protections, unleashing — as the Trump Administration itself admitted in his court — “chaos” in our entire health care system.  

  • Seventeen million more people could lose their coverage in a single year, leading to a 50 percent increase in the uninsured rate
  • Protections for 130 million people with pre-existing conditions, if they buy coverage on their own, are gone
  • The Medicaid expansion, currently covering 15 million people, could vanish.
  • Improvements to Medicare, including reduced costs for prescription drugs, are eliminated
  • No longer will kids be allowed to stay on their parents’ insurance until age 26
  • The ban on annual and lifetime limits are gone
  • The ban on insurance discrimination against women and people over age 50 is gone
  • Limits on out-of-pocket costs are eliminated
  • Small business tax credits are gone
  • Marketplace tax credits for up to 9 million people are gone

INVESTIGATION REVEALS: Trump Administration Tries to Rig Health Care Enrollment To Make Coverage Options Secret

Washington DC – This morning, a new Sunlight Foundation investigation revealed that the Trump Administration is sinking to new levels to sabotage the Affordable Care Act. Days before the open enrollment deadline, HHS removed information about ways to apply for coverage on HealthCare.Gov, which may cause confusion and could impede consumers ability to obtain health insurance coverage. According to Sunlight’s investigation, they are directing people to sign up for coverage through enrollment sites run by for-profit companies, and have removed the option of signing up for coverage by mail and phone. Brad Woodhouse, executive director of Protect Our Care, released the following statement in response:

“The Trump administration wants to make it as hard as possible for people to get the health care that they deserve and as easy as possible for the big health insurance companies to profit. Today, that means another round of health care sabotage. That sound you hear is the constant screech of a broken record, but it’s nothing in comparison to the real pain Americans are feeling from the Trump administration’s continued sabotage of our nation’s health care system. This administration’s relentless attacks on open enrollment, which include slashing the open enrollment period, dramatically cutting advertising, and instructing navigators to direct folks to junk plans, is now being punctuated by the removal of information explaining how to apply for coverage, serving no purpose other than to separate individuals from their health care coverage.”

 

In overhaul of HealthCare.gov webpage, information about ways to apply is gone

Sunlight Foundation// Rachel Bergman // December 11, 2018

A side-by-side of a previous version of the “Apply for Health Insurance” page from November 14, 2018, and a new version of the page from November 22, 2018. Snapshots captured by the Internet Archive’s Wayback Machine.

A few weeks after the start of the Open Enrollment period to sign up for Affordable Care Act (ACA) coverage, which runs from November 1 to December 15, 2018, HealthCare.gov’s “Apply for Health Insurance” webpage was altered. Information about two ways to apply is now missing and has been replaced by a new list of application options and links, including a link for “Help On Demand,” a third-party consumer assistance referral system, operated by a for-profit software company, BigWave Systems.

In today’s new report from the Web Integrity Project, we document the overhaul of the “Apply for Health Insurance” page, the portion of the ACA enrollment website that describes different ways consumers can apply for health coverage.

Previously, the page contained a table that listed five ways to apply, with links to pages that provided more information about each option: 1) online (using HealthCare.gov), 2) by phone, 3) with in-person help (from assisters), 4) through an agent or broker, and 5) by mail. Now, the page lists only four options: 1) Find and contact an agent, broker, or assister; 2) Have an agent or broker contact you; 3) Use a certified enrollment partner’s website; and 4) Use HealthCare.gov.

Two of the options — to enroll by phone and by mail — have been completely removed. These removals occurring well into the Open Enrollment period, after consumers may have already visited HealthCare.gov and decided to use one of these methods. The removals may cause confusion and could impede consumers’ ability to obtain health insurance coverage.

The third option, enabling users to get “in-person help” from assisters has been merged with the fourth option, to find an agent and broker. (Although these option were previously listed as distinct options, they both provided a link to the same page.) While the assister community is broad, and includes all individuals or organizations trained to provide free help to consumers and small businesses searching for and enrolling in health coverage, agents and brokers are part of narrower group of this community and usually receive commissions from health insurance companies for each plan they sell.

Some of the added links associated with new options may reflect policy changes at the Centers for Medicare and Medicaid Services (CMS) — the office that manages and funds HealthCare.gov. These policy changes are aimed at making it possible for consumers to bypass HealthCare.gov to find ACA coverage. The added links preceded CMS’s release of new guidance on enhanced direct enrollment, which allows websites of approved third-parties, including agents and brokers, to provide consumers with the same information and capacity to manage their coverage as is available through HealthCare.gov.

The new set of options includes third-party entities in three of the four options, listing agents and brokers twice and linking to information about using partner websites to enroll in coverage.

Specifically, a link listed as part of the new “Have an agent or broker contact you” option directs users to an “exit” webpage, warning “Once you leave HealthCare.gov, you’re subject to the privacy and security policies of the Help On Demand site, operated by BigWave Systems.” Clicking the “Go Now” button from this page directs users to the third-party website. According to CMS, the “Help on Demand” website, which is run by a for-profit, private software company, “connects consumers seeking assistance with Marketplace-registered, state-licensed agents and brokers in their area who can provide immediate assistance with Marketplace plans and enrollments.”

The page linked from the new “Use a certified enrollment partner’s website” option explains that certified partners may include online health insurance sellers, who will show you all the Marketplace coverage plans offered in your area, or insurance companies, whose websites may show you only the Marketplace plans they offer. Some certified partners let you shop for plans on their websites but require you to enroll on HealthCare.gov, and others allow you to shop, enroll, and manage your plan on their own websites, completely separate from HealthCare.gov.

Beyond including new options to use “Health On Demand” and partner websites, the order in which options appear on the page changed. The option to use HealthCare.gov — the website on which the “Apply for Health Insurance” page is hosted — is now last on the list of ways to apply. Before the change, it was listed as the first option. This change, in conjunction with options that direct consumers off of the HealthCare.gov website, demonstrates a de-emphasis by CMS of the very website it manages.

The shifts in information on the “Apply for Health Insurance” page are not a one off. This report on the overhaul comes on the heels of WIP’s recent report, describing the removal of an assister training guide for Latino outreach. Jodi Ray, who oversees an assister effort as director of Florida Covering Kids & Families at the University of South Florida, told the Washington Post about the importance of these training materials in enabling her work. “If you pull credible resources, make it less accessible, it does make our job more difficult,” said Ray. “You have to know your community, the population, the culture of who you’re trying to reach. If we’re not providing the resources to be able to do that effectively, we’re going to lose that population that needs this more than anyone.”

Indeed, the overhaul of the “Apply for Health Insurance” page and the removal of the Latino outreach training guide come amid an array of Trump administration efforts to undermine the Open Enrollment period. These efforts include cutting the advertising and promotional budget for the ACA last year and multiple budget cuts to federally-funded assister programs.

Through a de-emphasis of HealthCare.gov, the removal of information about some of the simple methods for applying for coverage under the ACA, and the addition of options directing users to insurance sellers outside of the Marketplace, the overhaul of the “Apply for Health Insurance” page reduces access to information and options for obtaining health insurance. This ultimately amplifies the many other efforts by this administration to undermine Open Enrollment and access to health coverage broadly.

More Proof: Trump Administration Targets Latinos In Its Open Enrollment Sabotage

Washington, DC – As part of its efforts to sabotage open enrollment, the Centers for Medicare and Medicaid Services removed a training guide for Latino outreach from a CMS website. This move is just one more part of the Administration’s sabotage efforts, including drastic cuts to outreach efforts and shortening the enrollment time period. Leslie Dach, Chair of Protect Our Care, issued the following statement in response:  

“From day one, Donald Trump has worked to sabotage health care for millions of Americans. Now, the Administration has targeted Latinos by deleting critical information from the HHS website that provides training for navigators as they assist Latino communities during the enrollment period. We all know open enrollment is a critical time for Americans to get the coverage they need. The Affordable Care Act is particularly important to Latinos, who are uninsured at a disproportionately high rate of 22 percent. There is no doubt in my mind that the Trump Administration is taking active steps to harm health care at the expense of the American people.”

 

BACKGROUND:

22 Percent Of Hispanic Americans Are Uninsured. The uninsured rate of Hispanic Americans is 22 percent, more than twice that of white Americans, 9 percent of whom are uninsured.

Between 2016 And 2018, The Trump Administration Has Cut Funding For Groups That Help People Sign Up For Coverage By 84 Percent. After cutting funding for navigator groups that help people sign up for coverage from $63 million in 2016 to $36 million in 2017, the Trump administration made yet another round of cuts in 2018, leaving just $10 million in funding for health navigator groups. Since 2016, Trump has cut navigator funding by 84 percent.

Health Navigators, Like Jodi Ray At The University Of South Florida, Say Cuts To Navigator Programs Prevent Them From Adequately Letting People Know That Open Enrollment Is Happening. Ray said, “We don’t have the people to provide the enrollment assistance nor to do the outreach and marketing to let people know what’s happening.”

This Year, 800 Counties Served By The Federal Marketplace Are Operating Without Any Federally Funded Navigators. This is more than six times as many counties served by the federal marketplace that operated without federally funded navigators in 2016, when 127 counties lacked such a navigator.  

The Trump Administration Wants Navigator Groups To Push Consumers To Sign Up For Junk Coverage That Is Exempt From Covering Prescription Drugs And Hospitalization Instead Of Comprehensive Plans. The Administration announced in July that it would encourage navigator groups to use their remaining funding to push consumers to sign up for junk health plans, which cover few benefits and notorious for the fraud they attract.

In 2017, The Trump Administration Cut The Open Enrollment Advertising budget By 90 Percent. As ABC News summarized, “In 2016, the Centers for Medicare & Medicaid Services spent $100 million on Obamacare advertising and outreach, but for [2017]’s open enrollment period, CMS plans on spending $10 million.” CMS chose not to increase the budget for 2019.

 

A full timeline of the Trump administration’s crusade to sabotage open enrollment is below:

October 2018

  • The Trump administration issues guidance that allows federal subsidies to be used to purchase junk plans that can deny coverage to people with pre-existing conditions, a move expected to worsen ACA risk pools.
  • Trump administration announces scheduled maintenance on the open enrollment website, preventing people from signing up for coverage on Sundays from 12:00 AM – 12:00 PM.

August 2018

  • Trump administration finalizes rule for bare-bones short-term plans that are exempt from key consumer protections, such as the requirement that insurance covers prescription drugs, maternity care, and hospitalization.

July 2018

  • Trump Administration slashes funding for non-profit health navigator groups that help people shop for coverage, from $36 million to $10 million. CMS encourages groups to use the remaining funds to push people to sign up for junk plans that skirt important consumer protections.

July 2018

  • Trump Administration limits access to assistance for consumers who want to enroll in marketplace coverage. This change removes the requirement that every area has at least two “navigator” groups to provide consumer assistance and that one be local. Now, just one group could cover entire states or groups of states.

December 2017

  • Congressional Republicans pass their tax scam, which doubles as a sneaky repeal of the Affordable Care Act by kicking 13 million people off of their insurance and raising premiums by double digits for millions more.

October 2017

  • The Trump Administration dramatically cuts in-person assistance to help people sign up for 2018 health coverage.

September 2017

  • The Administration orders the Department of Health and Human Services’ regional directors to stop participating in Open Enrollment events. Mississippi Health Advocacy Program Executive Director Roy Mitchell says, “I didn’t call it sabotage…But that’s what it is.”

August 2017

  • The Administration cuts the outreach advertising budget for Open Enrollment by 90 percent, from $100 million to just $10 million – which resulted in as many as 1.1 million fewer people getting covered.

July 2017

  • The Trump Administration uses funding intended to support health insurance enrollment to launch a multimedia propaganda campaign against the Affordable Care Act.

April 2017

  • The Trump Administration cuts the number of days people could sign up for coverage during open enrollment by half, from 90 days to 45 days.

January 2017

  • Also on January 20th, the Department of Health and Human Services begins to remove information on how to sign up for the Affordable Care Act.
  • The Trump Administration pulls funding for outreach and advertising for the final days of 2017 enrollment. This move is estimated to have reduced enrollment by nearly 500,000

Trump, GOP War on Health Care Throws Children Under the Bus Study Finds

Washington DC — For the first time in a decade, the number of uninsured children nationwide has increased, up to 5 percent from 4.7 percent in 2016, according to a recent report released by Georgetown University Center for Children and Families. This historic reversal of progress comes on the heels of the Trump Administration’s continued sabotage of health care, plus Republican state officials’ stubborn refusal to expand Medicaid, despite widespread support. In response to the study, Brad Woodhouse, executive director of Protect Our Care, said:

“President Trump has led a Republican war on health care that has claimed many victims, but most shocking and appalling of all is its impact on our nation’s most vulnerable Americans: our children. After decades of progress, last year more than a quarter million more children were uninsured than in 2016 due to President Trump and the GOP’s repeal and sabotage agenda.  This is an outrageous display of the Trump Administration’s total disregard for Americans’ health care. Whether by voting to expand Medicaid or by voting to replace pro-repeal Republicans with health care champions, the American people have made it crystal clear that they don’t want to give up an inch of progress on health care anymore and they are demanding an end to the Republican war on health care.”

 

Key Reasons for the decline in children’s coverage:

Divergent State Policies Have Led To Vastly Different Changes In The Children’s Uninsured Rate Across States — For Instance, The Uninsured Rate For Children Increased At Triple The Rate In States That Did Not Expand Medicaid As It Did In States That Expanded Medicaid. “In previous years, states have moved in similar but not uniform directions, reflecting the many ways state policy decisions can impact eligibility and enrollment in Medicaid and the Children’s Health Insurance Program (CHIP). The absence of significant progress across the country suggests that even states with the best intentions were unable to withstand strong national currents to protect children from losing health coverage…Three-quarters of the children who lost coverage between 2016 and 2017 live in states that have not expanded Medicaid coverage to parents and other low-income adults. The uninsured rates for children increased at almost triple the rate in non-expansion states than in states that have expanded Medicaid.”

Trump And His Republican Allies Have Repeatedly Tried To Repeal And Sabotage The Affordable Care Act And Have Slashed Funding For Outreach. “These national currents include a lengthy and ultimately unsuccessful congressional effort to repeal the Affordable Care Act (ACA) and cap federal Medicaid funding, as well as an unprecedented delay by Congress that allowed CHIP funding to lapse temporarily. In addition, Congress repealed the ACA’s individual mandate and the Trump Administration made numerous efforts to undermine the ACA Marketplaces, including dramatically cutting outreach and enrollment grants and shortening the open enrollment period.

Trump’s Punitive Immigration Policy Deter Children From Enrolling In Medicaid And CHIP. “Finally, one-quarter of all children under 18 living in the United States have a parent who is an immigrant. Several policies targeting immigrant communities are likely deterring parents from enrolling their eligible children in Medicaid or CHIP despite the fact that most of these children are U.S. citizens.

“All of these changes in the national political and policy realm mark a sharp reversal after many years of successful efforts to reduce the uninsured rate for children and families.”