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protectourcare
In Administration, News

New Poll: Trump Administration’s Sabotage Efforts Harm Open Enrollment  

Washington DC — The Kaiser Family Foundation released its November tracking poll and found that the Trump Administration’s ongoing sabotage campaign is preventing the American people from signing up for coverage. This isn’t surprising given the Trump Administration’s repeated sabotage of the open enrollment process by cutting outreach resources and shortening the enrollment time period. Brad Woodhouse, executive director of Protect Our Care, issued the following statement in response:

“The fact that people do not know they have until December 15th to sign up for coverage is another proof point in the Trump Administration’s sabotage of the Affordable Care Act. We all know open enrollment is a critical time for Americans to get the coverage they need. But Donald Trump and Republicans continue to do nothing to get the word out. We must redouble our efforts to let Americans know they only have until December 15th to sign up for coverage. In many cases, premiums are lower this year, making plans more affordable for millions of families across the nation. People who need insurance should sign up for coverage on HealthCare.gov before the December 15th deadline.”

The tracking poll showed that:

  • Only one in four Americans know the deadline to sign up for coverage during open enrollment.
  • The poll shows 77 percent of Americans said either they did not know, refused to answer, or gave the wrong date for the open enrollment deadline.
  • Only three in ten people who would buy coverage reported hearing or seeing information about how to do so in the past 30 days

 

BACKGROUND:

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.
protectourcare
In Administration, News

Seema Verma and Donald Trump Continue to Hide Behind Lies As Americans Continue to Worry About their Care

“Instead of a super secret so-called contingency plan which no one actually believes exists, just end the lawsuit,” said Brad Woodhouse.

Washington, D.C. – In response to CMS Administrator Seema Verma telling the Washington Examiner that the Trump Administration has a secret “contingency plan” should their lawsuit to upend the American health care system go through, Brad Woodhouse, executive director of Protect Our Care, released the following statement:

“The best contingency plan for protecting American health care – and especially for those with pre-existing conditions – is for the Administration to withdraw its support for this disastrous lawsuit and instead defend the law of the land. The American people have made their voices loud and clear: they support the Affordable Care Act, they want people with pre-existing medical conditions to be protected from discrimination by insurance companies, and they oppose any and all GOP efforts to undermine their health care. Instead of a super secret so-called contingency plan which no one actually believes exists, just end the lawsuit.”

 

THE CLAIM:

CMS Chief Seema Verma Claims That She And The Trump Administration Have A Contingency Plan If The Trump-GOP Lawsuit To End Protections For Pre-existing Conditions is successful [Washington Examiner]:

Seema Verma told reporters that “we do have contingency plans” if the healthcare law is struck down — specifically the provision aimed at ensuring people with pre-existing conditions, such as cancer or diabetes, have access to coverage.

But Chief Seema Verma declined to describe the backup plan, saying that “it wouldn’t be appropriate to share details because it may or may not be needed.”

 

THE REALITY:

If Judge Reed O’Connor rules in favor of the 20 Republican state officials and Trump’s Department of Justice, Seema Verma and Donald Trump will own the consequences to the American people. And those consequences are serious. Critical Affordable Care Act protections could vanish overnight, unleashing — as the Trump Administration itself admitted — “chaos” in our entire health care system.

  • 17 million 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, their own, could end.
  • Medicaid expansion, currently covering 15 million Americans, could vanish.
  • Improvements to Medicare, including reduced costs for prescription drugs, would be eliminated.
  • Children would no longer be allowed to stay on their parents’ insurance until age 26
  • Ban on annual and lifetime limits? Gone.
  • Ban on insurance discrimination against women and people over age 50? Nope.
  • Limits on out-of-pocket costs? Eliminated.
  • Small business tax credits? Done.
  • Marketplace tax credits for up to 9 million people? Not anymore.
protectourcare
In Administration, News

Wisconsinites Beware: Trump Administration Approves Walker’s Restrictive Medicaid Waiver

Washington DC – Today CMS approved Wisconsin’s plan to dramatically restrict Medicaid enrollment by taking coverage away from people who do not meet new burdensome work requirements or who cannot afford to pay new burdensome premiums. In response to the announcement, Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

“Let’s be clear: At a time when Scott Walker is in the political fight of his career — promising over and over again that he’ll protect people with pre-existing conditions — here he is teaming up with Donald Trump to rip health care away from the families who need it the most. Wisconsinites, the vast majority of whom want to ensure people with pre-existing conditions get the coverage they need, must judge Scott Walker by what he does, not what he says. Because despite all his recent talk about protecting people, all he really does is use his power as Governor to put barriers between the hardworking people in his state and the care and coverage they need.”

BACKGROUND

MEDICAID IS A LIFELINE FOR…

…CHILDREN & FAMILIES

…PEOPLE WITH DISABILITIES

  • Nearly 8.7 million adults enrolled in Medicaid have a disability. Of this group, only 43 percent qualify for social security income.

…SENIORS

  • More than 6.9 million American seniors have Medicaid coverage. 6,920,200 seniors, age 65 and older, are enrolled in Medicaid.
  • Medicaid funds 53 percent of long-term care nationwide. As seniors age, long-term care services become more and more vital, serving half of seniors over age 75 and three in four seniors over age 85.
  • Medicaid covers 6 in 10 nursing home residents. The average annual cost of nursing home care is $82,000 — nearly three times most seniors’ annual income.

…PEOPLE SUFFERING FROM OPIOID USE DISORDER

  • In 2014, Medicaid paid for 25 percent of all addiction treatment nationwide.

IN STATES WHERE SIMILAR RULES HAVE TAKEN EFFECT, THOUSANDS OF PEOPLE HAVE LOST CARE

  • Early results in Arkansas confirm that Medicaid work requirements are fundamentally bureaucratic hurdles, threatening access to health coverage for thousands across the state. “The early results suggest that the incentives may not work the way officials had hoped. Arkansas officials, trying to minimize coverage losses, effectively exempted two-thirds of the eligible people from having to report work hours. Of the remaining third — about 20,000 people — 16,000 didn’t report qualifying activities to the state. Only 1,200 people, about 2 percent of those eligible for the requirement, told the state they had done enough of the required activities in August, according to state figures.” [New York Times, 9/24/18]
  • This summer, a federal district court blocked Kentucky from imposing similar rules for the negative effects it would have on Kentuckians. Said the court in its ruling, “[Secretary Azar] never adequately considered whether Kentucky HEALTH would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid. This signal omission renders his determination arbitrary and capricious. The Court, consequently, will vacate the approval of Kentucky’s project and remand the matter to HHS for further review.”
  • In Indiana, 25,000 people with health insurance through Medicaid were dropped from coverage because they were unable to pay their premiums. The Washington Post reported, “About 25,000 adults were disenrolled from the program between its start in 2015 and October 2017 for failure to pay their premiums, according to state reports. Yet, state officials estimate that based on surveys of recipients, about half of those who were disenrolled found another source of coverage, most often through a job…In addition to those who were disenrolled, another 46,000 adults who signed up for Medicaid during 2016 and 2017 were not accepted because they did not pay their initial premium, the state reported.”

TAKING AWAY SOMEONE’S HEALTH CARE DOES NOT HELP THEM TO WORK

  • Evidence suggests that such work requirements hurt, rather than help enrollees’ ability to find work. A study of Michigan’s Medicaid “illustrates the functional barriers to work that Medicaid beneficiaries face, and many of them result from physical and mental health challenges. This suggests to us that taking away their health coverage means that they are less likely to find work – not more so…a stable source of health coverage such as Medicaid is likely to assist people with their chronic mental and physical health conditions so that they are better able to seek employment.” In both Ohio and Michigan, having access to health care made it easier for the unemployed to find work: “majorities said that gaining health coverage has helped them look for work or remain employed. Losing coverage — and, with it, access to mental health treatment, medication to manage chronic conditions, or other important care — could have the perverse result of impeding future employment.

WORK REQUIREMENTS ADD ADMINISTRATIVE HURDLES, MAKING IT HARDER FOR PEOPLE WHO ARE ELIGIBLE FOR CARE TO GET IT

  • Requiring People On Medicaid To Prove They Are Working Adds An Administrative Burden That Is Hardest On Low-Income Americans. “[Administrative hurdles] may be especially daunting for the poor, who tend to have less stable work schedules and less access to resources that can simplify compliance: reliable transportation, a bank account, internet access.  There is also a lot of research about the Medicaid program, specifically, that shows that sign-ups fall when states make their program more complicated.” [New York Times, 1/18/18]
  • Documentation Requirements Increase The Chances That People Will Lose Care, Simply Because They Have Trouble Navigating The Process. “There is a real risk of eligible people losing coverage due to their inability to navigate these processes, miscommunication, or other breakdowns in the administrative process. People with disabilities may have challenges navigating the system to obtain an exemption for which they qualify and end up losing coverage.” [Kaiser Family Foundation, 1/16/18]

THE VAST MAJORITY OF  PEOPLE WITH MEDICAID COVERAGE WHO WHO CAN WORK ARE WORKING

  • 60 percent of nondisabled people with health coverage through Medicaid have a job and are working, including 42 percent working full-time.
  • 51 percent of working adult Medicaid enrollees have full-time jobs year-round, but their salaries are still low enough to qualify for Medicaid coverage or have Medicaid because their employers do not offer insurance.  
  • Nearly 80 percent of nondisabled people with Medicaid coverage live in a family where at least one person is working, including 64 percent working full-time. The other adult family member may not be working because they have caregiving or other responsibilities at home.
  • A state by state breakdown can be found HERE
protectourcare
In Administration, News

Trump’s Speech: “A Desperate Attempt to Mask Republican Efforts to Gut Protections For Preexisting Conditions And Allow Insurance Companies to Deny Coverage for Prescription Drugs.”

Another PR Stunt that Will Do Little to Bring Down Costs for Americans

Remember: Health Repeal Bills and GOP’s ACA Lawsuit would Repeal Prescription Drug Coverage for Millions of Americans; Junk Plans Pushed by Trump Don’t Require Any Prescription Drug Coverage

 

Washington, D.C. – Ahead of President Trump’s latest effort to hide the truth of the Republican war on health care, Leslie Dach, chair of Protect Our Care, released the following statement:

 

“Donald Trump’s speech fails the one in four Americans struggling to afford the prescription drugs they need. Today’s speech flouts  Trump’s campaign promise to let Medicare negotiate drug pricing for drugs sold in pharmacies, and it does nothing to change the fact that Trump and Republicans called for, voted to, and are now suing to repeal the requirements in current law that prescription drugs are covered in insurance plans.

 

“Between their efforts to repeal prescription drug coverage in Congress and the courts and their work to push junk plans that don’t cover prescription drugs, Trump’s posturing on drug prices is as outrageous as Trump’s professed care and concern for people with pre-existing conditions. Making this announcement 13 days before an election where health care is the number one issue to voters just goes to show the desperation of a president who has led a GOP war on health care and who promised prescription drug price cuts, while drug costs go up for Americans at the same time drug company profits  skyrocket.”

BACKGROUND:

 

 

  • After Trump Promised Prescription Drug Price Cuts, Costs Went Way Up. In May, President Trump promised that prescription drug price cuts would be coming in “two weeks.” Months later, the Financial Times reported that several drugmakers raised their prices significantly, including double-digit increases in many cases, and an analysis by the Associated Press found “there were 395 price increases and 24 decreases” in the wake of the announcement and “the two dozen cuts were up from the 15 decreases in those same two months last year.”

 

 

  • Drug Prices Continue To Soar Under Trump. From January 1 to July 31 of this year, the Associated Press found there were 96 price hikes for every price cut this year. A recent report by Senate Democrats finds that the prices of the 20 most-prescribed drugs under Medicare Part D have increased substantially over the past five years, rising 10 times faster than inflation. Another report from the Pharmacy Benefits Consultants finds that over the past 14 months, 20 prescription drugs saw list-price increases of more than 200 percent.

 

 

  • Trump’s Previous Announcement Was Described As A “Big Win” For Big Pharma. In May, President Trump gave a speech billed as a major policy initiative to lower prescription drug costs. The phony speech was described as everything from a “big win” for pharmaceutical companies to him “[backing] out of his own plan to make drugs cheaper.” Said one drug lobbyist: “A lot of this [stuff] is meaningless to satisfy Trump.”

 

 

 

  • Drug Companies Using Windfall From GOP Tax Scam To Pad Investors’ Pockets. In February, Axios reported that America’s largest pharmaceutical companies were using their windfall from the GOP tax scam to drive up their own stock prices to the tune of $50 billion, “a sum that towers over investments in employees or drug research and development.”

 

 

 

  • Trump Installed Big Pharma Executives In Key Administration Posts. President Trump installed a former Eli Lily executive, Alex Azar, as his secretary of Health and Human Services and his appointment of Scott Gottlieb at FDA was described as “music to pharma’s ears.” Other pharma lobbyists writing Trump’s health policy include senior adviser at FDA, Keagan Lenihan, who joined the administration after lobbying for the drug distribution giant McKesson, former Gilead lobbyist, Joe Grogan, who reviews health care regulations at the Office of Management and Budget, and Deputy Assistant to the President for Domestic Policy Lance Leggitt, who has lobbied for a variety of drug-industry clients.

 

 

protectourcare
In Administration, News

Trump Administration Deals Devastating Blow to Pre-existing Conditions Coverage & Other Health Insurance Protections

“This is yet another blatant example of their repeal and sabotage agenda, and proof of their ongoing war on America’s health care,” says Leslie Dach

 

Washington, DC – In response to a new federal policy issued today that waters down the guardrails that ensure health insurance plans sold in states that are seeking approvals of “1332 waivers” provide the full range of benefits and the cost-sharing protections in the Affordable Care Act, Leslie Dach, chair of Protect Our Care, issued the following statement:

“The hypocrisy of Republicans rolling back protections for pre-existing conditions at a time when their candidates are campaigning as defenders of health care is outrageous. This is yet another blatant example of their repeal and sabotage agenda, and proof of their ongoing war on America’s health care.”

 

ADDITIONAL BACKGROUND:

Kaiser Family Foundation’s Larry Levitt Calls The Rule Out Today An “End Run” Around the ACA. Here is what 1332 waivers without appropriate guardrail protections could mean for consumers:

  • Protections for people with pre-existing conditions would be essentially meaningless. The American Cancer Society Cancer Action Network said allowing states to waive essential health benefits “could render those protections meaningless” for people with pre-existing conditions.
  • It would be harder for people with pre-existing conditions to get affordable coverage. As Consumers Union stated, allowing states to waive essential health benefits would be “putting meaningful coverage out of reach for many Americans, especially those with chronic and pre-existing conditions.”
  • You could pay more for the same coverage. 1332 waivers allow states to adjust the amount of premium tax credits and cost-sharing consumers receive to help lower their costs. Without the guardrail to ensure coverage is just as affordable, many consumers could end up paying more for the same care.
  • Insurers would not have to cover essential benefits, like maternity care. Right now, every insurance plan must cover the 10 essential health benefits. Because states could opt out of covering these basic benefits, insurers would likely only offer policies that covered much less than they do now. The Kaiser Family Foundation found that the benefits most likely to no longer be covered would be maternity care, mental health or substance abuse coverage. According to the Brookings Institution, the result would be “that no one in a state’s individual market that waived EHBs would have access to comprehensive coverage. Insurers would likely sell separate policies for benefits not covered in their core plan offerings, but these supplemental policies would be subject to tremendous adverse selection, leading to very high premiums and enrollment almost exclusively by those with pre-existing conditions.” For example, a woman who purchases a separate insurance rider for maternity care would have to pay $17,320 more, according to the Center for American Progress. For states that no longer required substance use disorders or mental health to be covered, coverage for drug dependence treatment could cost an extra $20,450.
  • Insurers could reimpose lifetime and annual limits. Allowing states to opt out of the essential health benefits coverage means that insurance companies could once again put lifetime and annual limits on the amount of care you receive. Moreover, as the Center on Budget and Policy Priorities notes, this would even impact people with coverage from their employer: “The ACA’s prohibition on annual and lifetime limits is tied to the definition of Essential Health Benefits. Thus, repeal of Essential Health Benefit standards could make this protection meaningless, putting almost all Americans with private health insurance coverage — not just those with individual or small-group market coverage — at risk.” The Center for American Progress estimates that 20 million people with health coverage through their employer would face lifetime limits on coverage, and 27 million would face annual limits.
protectourcare
In Administration, News

REALITY CHECK: ACA Marketplaces Experiencing Widespread Premium Increases Due to GOP Sabotage

Washington, D.C – On the heels of President Trump’s widely panned and highly deceptive health care op-ed, CMS issued a similarly misleading press release in a transparent effort to conceal how the Trump Administration has raised health care costs. Leslie Dach, chair of Protect Our Care, released the following statement in response:

 

“Another day, another set of lies from the Trump Administration, desperate to hide the truth about how they’ve jacked up health care costs for Americans. Here’s the simple truth: People buying health insurance in America today are paying more for it than they should because of the relentless sabotage campaign by the Trump Administration and its Republican allies in Congress and the states. People who are seeing substantial premium increases are paying more than they should and the people seeing small rate decreases should be paying even less. The fact that Americans are paying more because of Trump’s sabotage when insurance companies are getting massive tax breaks and their profits and CEO salaries are soaring — and projected to skyrocket even further — is outrageous, and underscores why millions are fed up with this Republican war on health care and preparing to take this anger out at the polls.”

 

FACT: ACROSS THE BOARD, AMERICANS ARE PAYING MORE DUE TO TRUMP ADMINISTRATION’S SABOTAGE CAMPAIGN

 

Brookings Analysis Estimates That Individual Market Premiums Would Decrease If Not For GOP Sabotage. Among its key findings:

  • Estimates That Average Premium Would Fall By 4.3 Percent In 2019 In Stable Policy Environment. “I estimate that the nationwide average per member per month premium in the individual market would fall by 4.3 percent in 2019 in a stable policy environment.” [Brookings Institution, 8/1/18]
  • Insurance Companies’ Revenues Will Far Exceed Their Costs In 2018. “I project that insurers’ revenues in the ACA-compliant individual market will far exceed their costs in 2018, generating a positive underwriting margin of 10.5 percent of premium revenue. This is up from a modest positive margin of 1.2 percent of premium revenue in 2017 and contrasts sharply with the substantial losses insurers incurred in the ACA-compliant market in 2014, 2015, and 2016. The estimated 2018 margin also far exceeds insurers’ margins in the pre-ACA individual market. ” [Brookings Institution, 8/1/18]
  • Absent Republican Sabotage, Average Premiums For ACA-Compliant Plans Would Likely Fall In 2019. “In this analysis, I define a stable policy environment as one in which the federal policies toward the individual market in effect for 2018 remain in effect for 3 2019. Notably, this scenario assumes that the individual mandate remains in effect for 2019, but also assumes that policies implemented prior to 2018, like the end of CSR payments, remain in effect as well. Under those circumstances, insurers’ costs would rise only moderately in 2019, primarily reflecting normal growth in medical costs.” [Brookings Institution, 8/1/18]

American Academy of Actuaries Point To Trump Administration Sabotage As Drivers Of 2019 Premium Increases. “Key drivers of 2019 premium changes include…Recent legislative and regulatory changes, including the elimination of the individual mandate penalty, the pending expanded availability of short-term limited duration plans and association health plans, and whether changes are made regarding how insurers are instructed to load premiums to account for cost-sharing reduction subsidies.” [American Academy of Actuaries, 6/13/18]

 

American Enterprise Institute Says Deregulating the Individual Market will not Lower Overall Health Costs. “When these proposed rules are made final, which is likely to occur in the coming months, many middle-class consumers will be able to exit the ACA-regulated markets for less expensive options. But overall costs will not decline. Insurers will simply shift higher premiums onto those who remain in the current market, which in turn will mean the federal government will pay higher subsidies for those eligible for premium assistance.” [American Enterprise Institute, 4/26/18]

 

FACT: TRUMP CAN’T TAKE CREDIT FOR STABILIZATION THAT WAS HAPPENING BEFORE HE CAME INTO OFFICE — AND ON A BETTER TRACK BEFORE HIS REPEAL-AND-SABOTAGE CAMPAIGN

 

Larry Levitt, SVP for Health Reform at Kaiser Family Foundation: Before Republican Sabotage, The Individual Marketplaces Were Stabilizing. “With insurers now mostly profitable in the ACA individual insurance market, I would have expected single-digit premium increases for 2019 reflecting health-cost growth…With repeal of the individual mandate and expansion of short-term plans, double-digit hikes are now likely.” [Rampell, Washington Post, 5/14/18]

  • Larry Levitt, SVP for Health Reform at Kaiser Family Foundation: If Not For Republican Sabotage, Premium Increases Would Be Modest. “If not for actions by Congress and the Trump administration, we’d be looking at very modest premium increases for next year.” [Larry Levitt, 5/17/18]

Analysis By The Kaiser Family Foundation Confirms what Experts Have Been Saying For Months, Before Sabotage Took Affect, The Individual Market Was Stabilizing. “Annual results from 2017 suggest the individual market was stabilizing and insurers in this market were regaining profitability. Insurer financial results through 2017 – after the Administration’s decision to stop making cost-sharing subsidy payments and before the repeal of the individual mandate penalty in the tax overhaul goes into effect – showed no sign of a market collapse.” [Kaiser Family Foundation, 5/17/18]

Kaiser Family Foundation: “Absent any policy changes, it is likely that insurers would generally have required only modest premium increases in 2018 and in 2019 as well.” [Kaiser Family Foundation, 5/17/18]

Between 2016 and 2017, Premiums Increased At A Much Faster Pace Than Claims Did. “Driving recent improvements in individual market insurer financial performance are the premium increases in 2017 and simultaneous slow growth in claims for medical expenses. On average, premiums per enrollee grew 22% from 2016 to 2017, while per person claims grew only 5%.” [Kaiser Family Foundation, 5/17/18]

 

FACT: CMS IS CHERRY PICKING. THEY IGNORE GIANT RATE INCREASES AND ONLY CITE THE AVERAGE OF SILVER PLANS BECAUSE, OVERALL, PLANS ARE GOING UP BY AN AVERAGE OF THREE PERCENT THIS YEAR (ON TOP OF 30 PERCENT INCREASES LAST YEAR)

In citing the decrease that some Tennesseans will experience next year, CMS completely neglects to mention that other Tennesseans will see increases as high as 10.84 percent on top of last year’s 36 and 21 percent rate hikes. Health insurance experts and analysts blame GOP sabotage.

 

Charles Gaba, Health Care Analyst: Tennessee Premiums Would Have Dropped By 23 Percent If Not For GOP Sabotage. “Regardless, the net effect of all this is that Tennessee premiums are now expected to drop by around 11.1% overall instead of 5.7%…but they still would have dropped even further (around 23% by my estimates) if not for ACA sabotage factors.” [ACASignups, 8/22/18]

Julie Mix McPeak, President of National Association of Insurance Commissioners and TN Insurance Commissioner: GOP Sabotage Could Raise Premiums Yet Again For Next Year. “Obamacare premiums for 2019 would go up 5 percent to 10 percent on top of rate increases that were previously expected because of uncertainty raised by the Trump administration’s suspension of payments among insurers to cover sick enrollees. That is what Tennessee Insurance Commissioner Julie Mix McPeak told me in an interview about the impact of the Department of Health and Human Services’ July 7 announcement that it was suspending $10.4 billion in transfer payments among insurers due to a ruling in February by the U.S. District Court for the District of New Mexico.” [Bloomberg Law, 7/20/18]

 

FACT: ON HIS FIRST DAY IN OFFICE, PRESIDENT TRUMP SIGNED AN EXECUTIVE ORDER DIRECTING THE ADMINISTRATION TO IDENTIFY EVERY WAY IT CAN UNRAVEL THE AFFORDABLE CARE ACT

 

…and he’s been sabotaging our health care each day since.

protectourcare
In Administration, News

HealthCare.Gov Sabotage, Version 2.0

Scheduled Site Maintenance During Open Enrollment Period is Latest Act of Trump-GOP Health Care Sabotage  

Washington, D.C. – The upcoming open enrollment period will share certain features of last year’s: a drastically shortened schedule, deep cuts to marketing and outreach budgets, and – according to media reports from today – the Trump administration will again be shutting down HealthCare.gov on the first day of open enrollment, as well as five out of the six Sundays during the upcoming open enrollment period (November 1, 2018 through December 15, 2018). In total, HealthCare.gov – which is used by millions of people in 38 states – will be down for more than three full days during a truncated open enrollment period. In response, Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

 

“There can be no doubt that the Trump Administration literally wants to stand in between people and the health care coverage they need, since they are once again purposely shutting down the website people need to use to sign up for coverage at the very time when they need it most. This cynical move comes after the Trump Administration cut the open enrollment period in half, slashed advertising by ninety percent, exacted drastic cuts to the Navigator program all while asking them to be mouthpieces for junk insurance plans. It’s shameful.”

 

HERE ARE ALL THE WAYS THE GOP HAS SABOTAGED OPEN ENROLLMENT

 

  • In July, the Trump Administration slashed 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.
  • In April, the Trump Administration limited access to assistance for consumers who want to enroll in marketplace coverage. This change removed 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.
  • In October 2017, The Trump Administration dramatically cut in-person assistance to help people sign up for 2018 health coverage.
  • Last September, the Administration ordered the Department of Health and Human Services’ regional directors to stop participating in Open Enrollment events. Mississippi Health Advocacy Program Executive Director Roy Mitchell said, “I didn’t call it sabotage…But that’s what it is.”
  • Last August, the Administration cut the outreach advertising budget for Open Enrollment by 90 percent, from $100 million to just $10 million.
  • Last July,the Trump Administration used funding intended to support health insurance enrollment to launch a multimedia propaganda campaign against the Affordable Care Act.
  • In April 2017, the Trump Administration cut the number of days people could sign up for coverage during open enrollment by half, from 90 days to 45 days.
  • On Trump’s first day in office, the Department of Health and Human Services began to remove information on how to sign up for the Affordable Care Act.
  • Also in January 2017, the Trump Administration pulled funding for outreach and advertising for the final days of 2017 enrollment. This move is estimated to have reduced enrollment by nearly 500,000.
protectourcare
In Administration

Seema Verma Continues to Spread Misinformation When Promoting Harmful Medicaid Work Requirements

Today, in defense of the Trump Administration’s indefensible work requirements that have kicked thousands of people off of their health care, Seema Verma, the Administrator of the Centers for Medicare and Medicaid Services, continued to argue  that these requirements help Medicaid enrollees attain “skills they need” and “jobs that are available.”

Say what?

Here’s the truth: TAKING AWAY SOMEONE’S HEALTH CARE DOES NOT HELP THEM TO WORK

  • Evidence suggests that such work requirements hurt, rather than help enrollees’ ability to find work. A study of Michigan’s Medicaid “illustrates the functional barriers to work that Medicaid beneficiaries face, and many of them result from physical and mental health challenges. This suggests to us that taking away their health coverage means that they are less likely to find work – not more so…a stable source of health coverage such as Medicaid is likely to assist people with their chronic mental and physical health conditions so that they they are better able to seek employment.” In both Ohio and Michigan, having access to health care made it easier for the unemployed to find work: “majorities said that gaining health coverage has helped them look for work or remain employed. Losing coverage — and, with it, access to mental health treatment, medication to manage chronic conditions, or other important care — could have the perverse result of impeding future employment.

 

  • In Michigan, Medicaid Work Requirements Hurt, Rather Than Help Enrollees’ Ability To Find Work: “The Michigan study illustrates the functional barriers to work that Medicaid beneficiaries face, and many of them result from physical and mental health challenges. This suggests to us that taking away their health coverage means that they are less likely to find work – not more so…a stable source of health coverage such as Medicaid is likely to assist people with their chronic mental and physical health conditions so that they they are better able to seek employment.” [Georgetown University Health Policy Institute, 12/15/17]

 

  • In Ohio, Health Coverage Made It Easier For The Unemployed To Look For Work: “In studies of adults who gained coverage in Ohio and Michigan under the Affordable Care Act’s Medicaid expansion, majorities said that gaining health coverage has helped them look for work or remain employed. Losing coverage — and, with it, access to mental health treatment, medication to manage chronic conditions, or other important care — could have the perverse result of impeding future employment. [CBPP, 1/11/2018]

 

WORK REQUIREMENTS ADD ADMINISTRATIVE HURDLES, MAKING IT HARDER FOR PEOPLE WHO ARE ELIGIBLE FOR CARE TO GET IT

  • Early results in Arkansas confirm that Medicaid work requirements are fundamentally bureaucratic hurdles, threatening access to health coverage for thousands across the state. “The early results suggest that the incentives may not work the way officials had hoped. Arkansas officials, trying to minimize coverage losses, effectively exempted two-thirds of the eligible people from having to report work hours. Of the remaining third — about 20,000 people — 16,000 didn’t report qualifying activities to the state. Only 1,200 people, about 2 percent of those eligible for the requirement, told the state they had done enough of the required activities in August, according to state figures.” [New York Times, 9/24/18]

 

  • Requiring People On Medicaid To Prove They Are Working Adds An Administrative Burden That Is Hardest On Low-Income Americans. “[Administrative hurdles] may be especially daunting for the poor, who tend to have less stable work schedules and less access to resources that can simplify compliance: reliable transportation, a bank account, internet access.  There is also a lot of research about the Medicaid program, specifically, that shows that sign-ups fall when states make their program more complicated.” [New York Times, 1/18/18]

 

  • Documentation Requirements Increase The Chances That People Will Lose Care, Simply Because They Have Trouble Navigating The Process. “There is a real risk of eligible people losing coverage due to their inability to navigate these processes, miscommunication, or other breakdowns in the administrative process. People with disabilities may have challenges navigating the system to obtain an exemption for which they qualify and end up losing coverage.” [Kaiser Family Foundation, 1/16/18]

 

ashoup
In News, Administration

Trump Administration Sabotages Open Enrollment, Pushes Junk Plans, Attacks Assistance for Navigators Yet Again

Washington, D.C. – This afternoon, the Trump Administration announced that it was slashing navigator funding designed to designed to help Americans obtain coverage by 84 percent and pushing enrollment for junk plans that charge people more money for less care and can deny coverage to people with pre-existing conditions. Brad Woodhouse, executive director of Protect Our Care, released the following statement in response:

“Last year, the Trump Administration cut the open enrollment period in half and slashed advertising by ninety percent. Now the Administration is once again doubling down on their sabotage of American health care by coupling further drastic cuts to the individuals who help Americans enroll with a cynical attempt to push Americans into junk plans which can deny coverage to those with pre-existing conditions. Yet again the Trump Administration is taking active steps to harm health care, and yet again it is the American people who will be left to suffer.”

BACKGROUND:

Junk Plans May Exclude Coverage For Pre-Existing Conditions. “Policyholders who get sick may be investigated by the insurer to determine whether the newly-diagnosed condition could be considered pre-existing and so excluded from coverage.” [Kaiser Family Foundation, 2/9/18]

  • As Many As 130 Million Nonelderly Americans Have A Pre-Existing Condition. [Center for American Progress, 4/5/17]
  • 1 in 4 Children Would Be Impacted If Insurance Companies Could Deny Or Charge More Because Of A Pre-Existing Condition. [Center for American Progress, 4/5/17]

Junk Plans Can Refuse To Cover Essential Health Benefits. “Typical short-term policies do not cover maternity care, prescription drugs, mental health care, preventive care, and other essential benefits, and may limit coverage in other ways.” [Kaiser Family Foundation, 2/9/18]

Under Many Junk Plans, Benefits Are Capped At $1 Million Or Less. Short-term plans can impose lifetime and annual limits –  “for example, many policies cap covered benefits at $1 million or less.” [Kaiser Family Foundation, 2/9/18]

Trump Administration Slashes Grants To Help Americans Get Affordable Care Act Coverage. “The Trump administration has distributed $10 million in grants to 39 organizations that help people enroll in Obamacare, a drop from the 90 organizations that received the awards last year when funding was nearly three times as high. The Trump administration slashed the budget for navigators from $100 million during the final open enrollment of former President Barack Obama’s term to $36 million, and slashed it even further to $10 million this year. Democrats have called the move another instance of ‘sabotage’ against the healthcare law.” [Washington Examiner, 9/12/10]

During The First Open Enrollment Period, 10.6 Million Americans Were Assisted By Navigators. “More than 4,400 Assister Programs, employing more than 28,000 full-time-equivalent staff and volunteers, helped an estimated 10.6 million people during the first Open Enrollment period.” [Kaiser Family Foundation, 7/15/14]

For Months, The Groups That Help People Sign Up For Marketplace Coverage Have Been In Limbo. “Local groups that help people sign up for ObamaCare and Medicaid have yet to hear from the Trump administration about their annual federal funding, leaving many in limbo and fearing the grants could be too small or might not come at all…The organizations typically hear from the federal government in April or early May with information about how much money will be available for grants, when key deadlines are and the expected award date. But several navigators contacted by The Hill said they have received no information from the Centers for Medicare & Medicaid Services..When asked about the navigator grants, a spokesperson for the Department of Health and Human Services (HHS) wrote in an email that HHS did not have any details to share at this time.” [The Hill, 6/20/18]

  • Dan Derksen, Doctor Who Oversees Navigator Program At University Of Arizona: “At a time when people have more questions, it’s very likely there will be fewer people to help them in person.” [USA Today, 6/21/18]
  • Last Year’s Cuts Led University Of Florida Navigator Program To Cut Staff. “Jodi Ray, director of Florida Covering Kids & Families navigator group at the University of South Florida, said her organization is bracing for changes. Last year’s cuts forced the Florida group to trim the number of employed navigators. She worries that further cuts and program changes could harm the state’s vulnerable residents who rely on the organization’s services.” [USA Today, 6/21/18]
  • Karen Egozi, CEO Of The Epilepsy Foundation Of Florida: We’re In The Dark. “We really haven’t gotten any update or any deadline to submit applications or any knowledge at all about what the future is going to bring.” [The Hill, 6/20/18]
  • Catherine Edwards, Executive Director For The Missouri Association Of Area Agencies On Aging: Administration Has No Incentive To Work With Community Groups. “We know this administration is not friendly to the ACA, and so they have no incentive to involve community-based groups in enrolling people.” [The Hill, 6/20/18]
  • Shelli Quenga, Director Of Programs For South Carolina-Based Palmetto Project: Restricting Support Is Bad For Consumers. “It’s very unfortunate for the consumer…We know that consumers still need in-person assistance — and especially consumers who are not native English speakers, consumers who are living just above the poverty line who don’t have a lot of experience with making big financial decisions like this that also have long-term implications to their financial future for themselves and their family members.” [The Hill, 6/20/18]
  • Cutting Funds To Navigator Groups Means They Must Significantly Cut Back On Outreach. “‘We have no expectation of any federal money being available to us,’ said Donna Friedsam, the director of Covering Wisconsin, a navigator program. Her organization received a 42 percent reduction last year because of the funding changes. It previously offered enrollment services in 23 counties, but had to scale down to 12.” [The Hill, 6/20/18]
  • Trump Administration Considering Cutting Funding For Health Care Navigator Groups. “The Trump administration is considering cutting funding for ObamaCare outreach groups that help people enroll in coverage, sources say. An initial proposal by the administration would have cut the funding for the groups, known as “navigators,” from $36 million last year to $10 million this year. Sources say that proposal now could be walked back, and it is possible funding could remain the same as last year, but it is unclear where the final number will end up.” [The Hill, 6/29/18]
  • Jodi Ray, Director Of Florida Covering Kids And Families: “Less Resources Means We Have Less Boots On The Ground To Provide That Enrollment Assistance.” [The Hill, 6/29/18]
ashoup
In Fact Sheet, Administration, News

Short-Term Junk Plans

SHORT-TERM JUNK PLANS OFFER INADEQUATE MEDICAL COVERAGE AND CIRCUMVENT FUNDAMENTAL CONSUMER PROTECTIONS

Short-Term Plans May Exclude Coverage For Pre-Existing Conditions. “Policyholders who get sick may be investigated by the insurer to determine whether the newly-diagnosed condition could be considered pre-existing and so excluded from coverage.” [Kaiser Family Foundation, 2/9/18]

  • As Many As 130 Million Nonelderly Americans Have A Pre-Existing Condition. [Center for American Progress, 4/5/17]
  • 1 in 4 Children Would Be Impacted If Insurance Companies Could Deny Or Charge More Because Of A Pre-Existing Condition. [Center for American Progress, 4/5/17]

Short-Term Junk Plans Can Refuse To Cover Essential Health Benefits. “Typical short-term policies do not cover maternity care, prescription drugs, mental health care, preventive care, and other essential benefits, and may limit coverage in other ways.” [Kaiser Family Foundation, 2/9/18]

Under Many Short-Term Junk Plans, Benefits Are Capped At $1 Million Or Less. Short-term plans can impose lifetime and annual limits –  “for example, many policies cap covered benefits at $1 million or less.” [Kaiser Family Foundation, 2/9/18]

Commonwealth Fund: “Cost Sharing Designs In Short-Term Coverage Leave Members Facing Major, Unpredictable Financial Risk.” “The out-of-pocket maximum for each best-selling plan is higher than that allowed in individual or employer plans under the ACA, when adjusting for the shorter plan duration. When considering the deductible, the best-selling plans have out-of-pocket maximums ranging from $7,000 to $20,000 for just three months of coverage. In comparison, the ACA limits out-of-pocket maximums to $7,150 for the entire year.” [Commonwealth Fund, 8/11/17]

Short-Term Junk Plans Can Retroactively Cancel Coverage After Patients File Claims. “Individuals in STLDI plans would be at risk for rescission. Rescissions are retroactive cancellations of coverage, often occurring after individuals file claims due to medical necessity. While enrollees in ACA coverage cannot have their policy retroactively cancelled, enrollees in STLDI plans can.” [Wakely/ACAP, April 2018]

Short-Term Junk Plan Currently Being Sold In Thirteen States Does Not Cover Services For Patients Admitted To Hospital On The Weekend. “That brings us to the short-term plan marketed by UnitedHealth’s Golden Rule subsidiary….To begin with, the Golden Rule plan excludes pregnancy and provides for a lifetime maximum benefit of only $250,000. Remarkably, it won’t cover hospital room, board or nursing services for patients admitted to a hospital on a Friday or Saturday, unless for an emergency or for necessary surgery the next day.” [Los Angeles Times, 4/26/18]

JUNK COVERAGE PROVIDED BY SHORT-TERM PLANS LEAVES THOSE WHO GET SICK WITH THOUSANDS OF DOLLARS IN UNPAID BILLS

Atlanta Woman With Short-Term Plan Was Diagnosed With Cancer And Left With $400,000 Medical Bill. “Dawn Jones…bought a short-term plan from Golden Rule Insurance, a unit of UnitedHealth Group Inc., so she’d be covered between jobs, according to court documents. Then, she was diagnosed with breast cancer. Despite showing evidence she was unaware of the cancer when she bought the policy, the insurer didn’t pay for Jones’s treatment, leaving her with a $400,000 medical bill, according to a complaint she filed against the company in September 2016… the judge sided with Golden Rule and dismissed the case in August, finding the policy agreement clearly stated that preexisting conditions wouldn’t be covered, even if the customer was unaware of the condition. Jones wasn’t diagnosed until after she bought her policy.” [Bloomberg, 10/17/17]

San Antonio Man Paid Premiums To Short-Term Plan Company For Six Years, And Was Denied Coverage When He Developed Kidney Disease. “Pat’s decision to save some money by buying short-term insurance was a big mistake, says Karen Pollitz, project director of Georgetown University’s Health Policy Institute and a leading expert on the individual-insurance market. ‘These short-term policies are a joke,’ she says. ‘Nobody should ever buy them. It is false security that is being sold. It’s junk.’ That’s because diagnosing and treating an illness may not fall neatly into six-month increments. While Pat had been continuously covered since 2002 by the same company, Assurant Health, each successive policy treated him as a brand-new customer. In looking back over Pat’s medical records, the company noticed test results from December, eight months earlier. Though Pat’s doctors didn’t determine the precise cause of the problem until the following July, his kidney disease was nonetheless judged a ‘pre-existing condition’ — meaning his insurance wouldn’t cover it, since he was now under a different six-month policy from the one he had when he got those first tests.” [Time, 3/5/09]

In San Francisco, Woman Was Hit With $150,000 Charge After Short-Term Health Plan Refused Coverage. “Grace Wood, an instructor at a university in San Francisco, bought a short-term plan in 2013. When she had to have a heart procedure, her insurer, HCC Life, balked, leaving her with roughly $150,000 in unpaid medical bills.” [New York Times, 11/30/17]

Short-Term Insurance Plan Refuses To Pay For Man’s Triple Bypass Surgery, Leaving Family With $900,000 In Bills. “One case pending in federal court involves Kevin Conroy, who had a heart attack in 2014 and underwent triple bypass surgery, just two months after his wife, Linda, obtained a short-term policy over the telephone. Their insurer, HHC Life, refused to pay the bills. ‘We freaked out,’ Ms. Conroy said. ‘What were we going to do? It was $900,000.’ The insurer informed the Conroys the policy was ‘rescinded,’ to use the industry jargon. “[New York Times, 11/30/17]

SUBPAR COVERAGE OFFERED BY SHORT-TERM PLANS RAISES HEALTH COSTS FOR CONSUMERS WHILE RAKING IN PROFITS FOR INSURANCE COMPANIES

Short-Term Health Plans Rake In Profits For Insurance Companies While Leaving Consumers Unprotected. “That’s why they make up such a high-profit portion of the insurance industry: They are largely designed to rake in premiums, even as they offer little in return. And even when they do pay for things, they often provide confusing or conflicting protocols for making claims. Collectively, short-term plans can leave thousands of people functionally uninsured or underinsured without addressing or lowering real systemwide costs.” [The Atlantic, 4/25/18]

More Premium Dollars Can Go Toward Profit, Rather Than Coverage With Short-Term Plans. Short-term plans do not have to follow the Medical Loss Ratio, meaning that more premium dollars gan go toward administration and profit than under other plans. For instance, the largest seller of short-term insurance only requires 50% of premium dollars to pay for medical coverage, much less than the 80% required by ACA-compliant plans. [Wakely/ACAP, April 2018]

Junk Plans Lead To Higher Premiums For Those Enrolled In Full Coverage Plans. “While recent state-level and federal proposals differ in the details, they’d have a similar result: People who buy skimpy plans would face staggering costs when they get sick, and consumers who want comprehensive coverage could face drastic premium increases.” [Center on Budget and Policy Priorities, 2/5/18]

Short-Term Plans Divide Insurance Market Between Sick And Healthy. “Because short-term plans are not considered individual market coverage that must meet ACA standards, they can, and typically do, exclude coverage of pre-existing medical conditions, limit the amount of benefits that a person can receive from the plan in a year, and fail to include many of the essential health benefits, such as maternity care, mental health and substance-use disorder services, and prescription drugs…Short-term plans would be most likely to attract healthier people, leading to premium increases for ACA-compliant plans and destabilizing individual insurance markets across the nation.” [Center on Budget and Policy Priorities, 11/29/17]

Junk Plans Mean Higher Premiums For People With Pre-Existing Conditions. “By promoting short-term policies, the administration is making a trade-off: lower premiums and less coverage for healthy people, and higher premiums for people with preexisting conditions who need more comprehensive coverage.” [Washington Post, 5/1/18]

JUNK PLANS DESTABILIZE THE INDIVIDUAL MARKET, DRIVING UP COSTS FOR MIDDLE CLASS FAMILIES

Gary Claxton, Kaiser Family Foundation Vice President: Short-Term Plans “Draw In Healthy People And Spit Them Back Into The Marketplace When They’re Sick.” “Short-term health plans, meanwhile, have the ability to charge sick people more than healthy people, to deny people with preexisting conditions, and kick people off the plans if they get sick. If federal agencies decided to lift the limits on the short-term plans, and to exempt people on them from the penalty for not buying health insurance, Obamacare’s individual market could become destabilized, Claxton says. Healthy people would join the short-term plans when they were healthy, stay on them for a year, and pay little for skimpier coverage. If they got sick, they would be kicked off those plans and onto the Obamacare exchanges, where coverage is expansive but prices would be higher than they are now.” [The Atlantic, 10/12/17]

Tim Jost, Health Law Expert: Short Term Health Plans Provide Subpar Coverage and Destabilize Market. “As their name suggests, short-term plans provide coverage for a limited period of time, often six months or less. They generally don’t cover such things as preexisting conditions, maternity services or prescription drugs. The policies typically have maximum coverage limits of about $1 million. Insurers can turn people down if they’re sick and may decide not to renew someone’s policy… ‘The big health insurance companies are really mixed on this,’ said Timothy Jost, emeritus professor at Washington and Lee University School of Law and an expert on the health law. ‘They see this as a seriously destabilizing force in the market, this crap coverage.’” [Kaiser Health News, 1/31/17]

When Healthy Individuals Opt For Short-Term Plans, Costs Go Up For Those Who Are Sick. “To the extent that healthy individuals opt for cheaper short-term policies instead of ACA-compliant plans, such adverse selection contributes to instability in the reformed non-group market and raises the cost of coverage for people who have health conditions.” [Kaiser Family Foundation, 2/9/18]

Larry Levitt, Kaiser Family Foundation Senior Vice President: Short-Term Plans Will Raise Premiums for Middle Class Families. “‘The repeal of the mandate and expansion of association health plans and the rise of short-term plans will certainly send premiums rising for middle-class people with pre-existing conditions whose only option is the [ObamaCare]-regulated market,’ said Larry Levitt, a vice president at the Kaiser Family Foundation.” [The Hill, 1/7/18]

KEY HEALTH INSURANCE STAKEHOLDERS WARN AGAINST SHORT-TERM PLANS

98 Percent Of Health Groups That Submitted Comments To HHS Have Serious Concerns About The Short-Term Proposal.  “More than 98% — or 335 of 340 — of the healthcare groups that commented on the proposal to loosen restrictions on short-term health plans criticized it, in many cases warning that the rule could gravely hurt sick patients.” [Los Angeles Times, 5/30/18]

American Cancer Society Cancer Action Network: “Health Care Changes Could Leave Millions Of Cancer Patients And Survivors Unable To Access Meaningful Coverage.” “Today’s executive order jeopardizes the ability of millions of cancer patients, survivors and those at risk for the disease from being able to access or afford meaningful health insurance. Exempting an entire set of health plans from covering essential health benefits like prescription drugs or specialty care and allowing expansion and renewability of bare-bones short-term plans will split the insurance market. If younger and healthier people leave the market, people with serious illnesses like cancer will be left facing higher and higher premiums with few, if any, insurance choices.  Moreover, those who purchase cheap plans are likely to discover their coverage is inadequate when an unexpected health crisis happens leaving them financially devastated and costing the health care system more overall.” [ACS CAN, 10/12/17]

Blue Cross Blue Shield Officials Worry Short-Term Health Plans “Could Really Weaken The Efforts To Stabilize The Marketplace.” “Short-term plans can turn away people with pre-existing conditions, place caps on how much they’ll cover, and decline to cover services like maternity care. All of which means they could siphon healthy consumers out of the ACA’s marketplaces. ‘It could really weaken the efforts to stabilize the marketplace,’ says Kris Haltmeyer, BCBSA’s vice president of legislative and regulatory policy.” [Axios, 2/6/18]

American Academy of Family Physicians: STLD Plans Would Destabilize Individual Market. “We are troubled by how the proposed rule would further destabilize the individual market by drawing young, healthy people away from meaningful, comprehensive coverage…under the proposed rule, insurers could reduce or eliminate certain EHBs to avoid vulnerable, expensive patients by excluding specific services.” [Letter to HHS, 4/18/18]

ACS CAN: Short-Term Plans Are Exempt From Important Consumer Protections. “We are very concerned about policies that would expand access to STLD policies because these products are exempt from important consumer protections, such as prohibitions on lifetime and annual dollar limits, limits on the use of pre-existing condition exclusions, and the prohibition on medical underwriting…We are afraid that some consumers choose to enroll in STLD policies simply because of the lower premium and are unaware of the limitations of the coverage.” [ACS CAN letter to HHS, 4/20/18]

Alliance of Community Health Plans: Concerned It Will Leave Consumers With Fewer Coverage Options “ACHP is also concerned that the proposed rule will cause more insurers to flee the market, leaving consumers with fewer coverage options.” [Letter to HHS, 4/19/18]

American College of Rheumatology: Short-Term Plans Will Hurt Patients With Rheumatoid Arthritis. “We urge the agencies to consider how healthy individuals leaving the exchanges to purchase STLDI plans would affect market stability and premiums for those still in the health exchange. Potentially, our patients with diseases such as rheumatoid arthritis could see an upward swing in their premiums, causing further affordability and access issues” [American College of Rheumatology, 4/23/18]

AHIP: Short-Term Plans Should Not Be Offered As Replacement For Comprehensive Coverage.  “‘We recommend that short-term plans should not be offered as a full replacement for comprehensive coverage,’ AHIP says — because that could pull healthy customers out of the market for ACA coverage.” [Axios, 4/23/18]

Dr. David O. Barbe, president of American Medical Association: These Plans Would Result In “Inadequate Health Insurance Coverage.” “We believe the proposed rule, however, would culminate in plans being offered that fall far short of maintaining crucial state and federal patient protections, disrupt and destabilize the individual health insurance markets, and result in substandard, inadequate health insurance coverage.” [Forbes, 4/22/18]

Margaret Murray, CEO of Association for Community Affiliated Plans: Short Term Plans “strip every provision that might be of value to a patient.” “Not only do STLDI plans not cover pre-existing conditions, but what was covered when you bought the plan can be excluded three months later when you try to renew the plan. Rescissions are rampant in the STLDI market, leading to retroactive cancellation of policies that stick patients with enormous medical bills.” [Washington Examiner, 4/26/18]

Mario Molina, Former CEO of Molina Healthcare: Hopefully You Already Had Kids, Because Short-Term Plans Gut Maternity Care. “Hopefully, you had kids already, because under the short-term health plan expansion encouraged by an executive order signed last year, covered maternity care vanishes in 100% of plans analyzed by [the Kaiser Family Foundation]” [Mario Molina, 4/23/18]

California Department Of Insurance: “Trump Executive Order Will Create A Health Insurance Race To The Bottom.” “Increased sale of short-term policies that don’t cover essential health care needs or comply with most rules that apply to health insurance will harm consumers and create health insurance market instability.” [CDI, 10/12/17]

Sandy Praeger, Former Republican State Insurance Regulator In Kansas And Onetime President Of National Association Of Insurance Commissioners: “Basically anybody who knows anything about healthcare is opposed to these proposals.” [Los Angeles Times, 5/30/18]

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