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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.

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.

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.

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]

 

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]

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]

Association Health Plans Endanger Consumers

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

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

  [GAO, February 2004]

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

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

INSURANCE COMMISSIONERS AGREE THAT ASSOCIATION HEALTH PLANS ARE BAD FOR CONSUMERS

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

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

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

PATIENT GROUPS, HOSPITALS, AND KEY HEALTH STAKEHOLDERS CONDEMN AHPs

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

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

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

AHPs ARE HOTSPOTS FOR FRAUD IN STATES:

Florida

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

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

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

Louisiana

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

Texas

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

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

New Jersey

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

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

South Carolina

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

Across State Lines: North Carolina, Maryland, And Beyond

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

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

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

AARP Study: Trump’s Junk Plan Rule Punishes Older Americans

60-year-olds set to pay $2000 more in premiums next year after latest Trump sabotage

According to a new study by the AARP, the Trump Administration’s plot to let insurance companies sell junk plans would cause premiums for older Americans to jump by double digits next year, with the average 60-year-old paying an average of 16.6% more for individual-market coverage. In response, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Too many older Americans are already getting squeezed, and now a new AARP study proves that Trump’s new junk health insurance proposal would not only hurt those stuck with junk coverage, but would also drive up costs for people over age 50 who buy real insurance. If the Trump Administration’s junk plan proposal moves forward, older Americans will face an eye-popping average increase of over $2000 in annual premiums next year. This latest attack in the Trump Administration’s health care sabotage campaign must be stopped before it drives rates even higher, leaving older Americans struggling to pay the price.”

STATE-BY-STATE AARP ESTIMATES

The GOP Stabilization Sham

Let’s be clear about one thing, except for perhaps a handful of Republicans (and perhaps not even that many) Republicans don’t care one iota about stabilizing the Affordable Care Act (which only needs stabilizing because of their very own sabotage).  As a party, their operating theory has been to destroy the law for eight years and to believe that they now want to make it work better is pure fancy.

This whole thing has been a GOP led sham.  Remember, the whole notion of a stabilization bill was dead late last year until they needed Susan Collins’ vote for the tax scam bill which ripped away health care from millions to fund tax breaks for the wealthy and big corporations.  Collins is a Republican and was always going to vote for the tax bill – but she needed cover to vote for a bill that ripped away coverage and spiked premiums for millions of Americans.  She got it in the form of a promise to pass legislation to stabilize the markets – a promise we said from the beginning Republican’s would never keep.  We used to say that Collins got played by a desperate leadership which needed her vote for the only piece of major legislation they had a prayer of passing in 2017, but she’s been in Washington 30 years, she knew this was never going to happen – or, at a minimum, should have known.

Fast forward to today.  Republicans have seen the studies – they know their sabotage is going to massively spike premiums and threaten coverage – but they hate the ACA – always have – and broadly speaking have no interest in helping it survive.  They also know they need to provide cover to Collins because given the margins in the Senate they still need her vote on close bills.  So they put forward a bill that they know Democrats won’t support – which all but codifies junk plans, sets the stage for high risk pools and imposes unacceptable restrictions on abortion – a classic poison pill if there ever was one.  And they’ll force a vote on this bill separate from the omnibus because they know it will fail – which is what they want – and then they will blame Democrats for what ensues in the market and try to claim they would have fixed it.  That’s complete and utter horse manure and no reporter, editorial writer or voter should buy the GOP’s crocodile tears over the failure of their so-called stabilization bill.

My mother taught me growing up that when in doubt consider the source.  Republicans are going to claim that THEY are the ones who want to stabilize OBAMACARE and that Democrats stood in the way?  Give me a break.

Brad Woodhouse, Campaign Director

Protect Our Care

Exit Poll of PA-18 Shows Lamb Won Big On Health Care

Public Policy Polling conducted a telephone exit poll election survey of voters who cast ballots in Pennsylvania’s 18th Congressional District special election yesterday. Voters who voted in the contest were asked about the role of health care in their decision.

The exit poll shows that health care was a top priority issue to voters in this district and that voters believed Democrat Conor Lamb’s views were more in step with theirs.

In 2016, voters in this district backed Donald Trump by 20 points, but last night they backed a Democrat for Congress in a referendum on the health care plans of the Republican Congress:

-Health care was a top issue to voters. Health care was ranked as a top issue for 52% of voters (15% saying it was the most important issue and another 37% saying it was very important). Only 19% said it was not that important or not important at all.

– Conor Lamb won big especially among voters for whom health care was a top priority. Among voters who said health care was the most important issue for them, Lamb beat Rick Saccone 64-36 and among the broader group of voters who said it was either the most important or a very important issue Lamb beat Saccone 62-38.

– On health care, voters said Lamb better reflected their views by 7 points (45% to 38%) over Saccone. With independents, that gap widened to 16 points with 50% saying Lamb’s health care views were more in line with theirs to only 34% for Saccone.

– Voters were less likely to support Saccone because of the Republican health care agenda. Saccone’s support of the Republican health care agenda made 41% of voters less likely to vote for him and only 28% more likely to support him.

-Voters in this heavily Republican district disapproved of the Republican efforts to repeal the Affordable Care Act by 14 points (53% to 39%).

– 48% of voters believed Republicans are now trying to undermine and sabotage it since they failed to repeal it. Among independent voters, the disparity is even wider with only 33% supporting the GOP’s health care repeal efforts to 63% opposing them.

-In this deeply red district, 44% of voters support the Affordable Care Act while 42% oppose it.

– Only 38% of voters think the best path forward on health care is to repeal the Affordable Care Act, to 59% who think it should be kept in place with fixes made to it as necessary.

Read the full post-election survey here: PA18PostElectionSurvey