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ashoup
In News

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]

ashoup
In Administration, News

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

Sean England
In News, Administration, Capitol Hill

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

ashoup
In News

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

ashoup
In Administration, News

Protect Our Care Coalition Highlights Women’s Health Gains, Trump Attempts to Diminish Them During Protect Women’s Care Week

In honor of International Women’s Day, last week the Protect Our Care coalition celebrated Protect Women’s Care week, outlining the achievements made in women’s care under the Affordable Care Act and highlighting the ongoing threats from the Trump Administration and its Republican allies in Congress to roll back this progress. Here are the biggest gains made under the ACA, the worst attacks from Trump, and the grassroots action standing up to the sabotage of women’s care:

WOMEN’S HEALTH HAS IMPROVED TREMENDOUSLY UNDER THE ACA

As study after study shows, the Affordable Care Act has increased women’s access to health care and improved women’s health outcomes. New data show the improved health and economic outcomes women are experiencing now that the Affordable Care Act has covered more women than ever before, improved breast cancer and maternity care, guaranteed copay-free access to birth control, and stopped insurance companies from charging women more. These are some of the gains in women’s health care that President Trump and his Republican allies want to reverse through repeal and sabotage:

Historic Gains in Women’s Coverage

ACA Brought Women’s Uninsured Rate To All-Time Low. “By 2016, the number of working-age women…lacking health insurance had fallen by almost half since 2010, from 19 million to 11 million.” [Commonwealth Fund, 8/10/17]

After Medicaid Expansion, More Women Of Reproductive Age Have Health Coverage. “ACA Medicaid expansions decreased uninsurance among women of reproductive age with incomes below 100% FPL by 13.2 percentage points.” [Women’s Health Issues Journal, 2/28/2018]

With Pre-Existing Discrimination Ban, More Women With Cancer Histories Now Have Coverage

Women With Gynecologic Cancer More Likely To Be Insured Following ACA. “Between 2011 and 2014…uninsured rates decreased by 50% for those diagnosed with uterine and ovarian cancer…and by 25% in cervical cancer.” [Gynecologic Oncology, June 2017]

Better Access to Contraception

Under ACA, Women Saved $1.4 Billion On Birth Control Pills Alone In 2013. “Prior to the ACA, co-pays as low as $6 deterred women from obtaining the health care that they needed, and some women chose to forgo birth control because of cost. But data on prescription drug use in 2013, after the birth control benefit went into effect, indicate a nearly five percent uptick in filled birth control pill prescriptions…The birth control benefit saved women $1.4 billion on birth control pills alone in 2013.” [National Women’s Law Center, 5/3/17]

Improved Maternity Care & Newborn Outcomes

Before The ACA, 75% Of Individual Market Plans Did Not Include Maternity Care. “Three in four health plans in the non-group insurance market did not cover delivery and inpatient maternity care in 2013, before the [ACA] essential health benefits requirement took effect.” [Kaiser Family Foundation, 6/14/17]

ACA Improved The Health Of Women And Their Babies. “The dependent coverage provision of the Affordable Care Act (ACA) that allowed young adults to stay on their parents’ insurance until they were 26 was associated with increased use of prenatal care, increased private insurance payment for births, and a modest reduction in preterm births.” [JAMA, 2/13/18]

Infant Mortality Decreased In States That Expanded Medicaid. “New data shows that infant mortality rates decreased in states that expanded Medicaid.” [Newsweek, 1/31/18]

Better Breast Cancer Care & Prevention

Medicaid Expansion Improves The Quality Of Breast Cancer Care. “[The study] found a connection between Medicaid expansion and improved quality of breast cancer care…The number of screening mammograms covered by Medicaid increased from 5.6 percent before expansion to 14.7 percent afterward.” [Daily Kos, 2/21/18]

Following ACA’s Lower Costs, Mammogram Screening Rates Increase. “After the [ACA] eliminated cost sharing for screening mammograms, their rate of use rose six percentage points among older woman for whom such screenings were recommended.” [Brown University, 1/17/18]

TRUMP’S 11 WORST ATTACKS ON WOMEN

From restricting women’s access to family planning services to allowing insurance companies to change women more than men for health insurance, the Trump Administration has tirelessly attacked American women’s health. Here are the top 11 ways Trump is setting American women’s health back:

  1. Letting Insurance Companies Charge Women More Than Men: Prior to the Affordable Care Act, 92 percent of plans in the market charged women up to 1.5 times as much as they charged men, in a practice known as gender rating. The Trump Administration is taking us back to the days when women could be charged more. Under the Trump Administration’s recent “short-term” rule, insurers would be able to skirt the ACA’s gender rating provision that banned insurers from charging different rates for men and women.
  2. Letting Insurance Companies Charge More For “Pre-Existing Conditions” Like Pregnancy & Being A Woman: The Affordable Care Act prevents insurers from denying, dropping, or charging more because of a pre-existing condition like cancer, or even, having a C-section. But, the Trump Administration’s new “short-term” plan rule allows insurers to deny coverage because someone has a pre-existing condition, and will raise costs and jeopardize coverage for nearly 30 million women who have a pre-existing condition.
  3. Making Maternity Care More Expensive: Before the Affordable Care Act, 75 percent of non-group plans did not cover delivery and inpatient care for maternity care. The ACA The Trump Administration and its Republican allies continue to advocate for policies, such as short-term and association health plans, that are not required to cover “essential health benefits,” and can thus force women to pay the nearly $20,000 it costs to give birth out of pocket.
  4. Defunding Planned Parenthood:  In January 2018, the Trump Administration announced it would roll back Obama Administration guidance that warned states not to carve Planned Parenthood out of their Medicaid providers, signaling its willingness to place even higher barriers in the way of women’s access to health care.
  5. Making Women Pay More For Birth Control: The Trump Administration’s proposed rule to let any employer opt out of offering health insurance that covers birth control rolls back the ACA’s guarantee that women may access copay-free contraception.
  6. Cutting Medicaid: President Trump’s calls to cut Medicaid put women’s lives and jobs at risk. The Trump Administration’s recent budget slashed Medicaid funding by more than $1 trillion over the next decade. These cuts will jeopardize the care of the nearly 13 million women of reproductive age who rely on Medicaid, including 31 percent of African-American women and 27 percent of Hispanic women in this age group. Moreover, 22.8 percent of women in the workforce are employed in the health industry, meaning their jobs may be at risk as well.
  7. Making New Moms Choose Between Working Or Losing Coverage: Almost two-thirds of those who would lose Medicaid coverage as a result of work requirements are women, and disproportionately women of color. This is in part because women are more likely to be caregivers for sick family members and children. Under these rules, a new mom would have 60 days to find health coverage after giving birth or risk their family’s health coverage.
  8. Stacking Federal Courts With Anti-Choice Judges: The next generation of American women will face a growing threat posed by an increasingly anti-choice federal judiciary. Twelve of Trump’s judicial nominees were appointed to circuit courts during his first year – more than any other first-year president in American history.
  9. Reversing Progress Against Breast Cancer: Republicans’ repeated attempts to undermine the Affordable Care Act’s essential health benefits threaten landmark progress in women’s preventive health. New research finds that the ACA requirement that plans (including Medicare) must cover recommended preventive care without a copay led to a significant increase in the number of women receiving mammography screenings.
  10. Cutting Funding For Teen Pregnancy Prevention Programs: The administration slashed two years off of five-year grants dedicated to teen pregnancy prevention research, which have already been promised to organizations across the country.
  11. Allowing States To Defund Clinics That Offer Abortion Care: Trump signed a bill allowing states to withhold Title X family planning funds from health care providers that offer abortion-related care. Thirteen states used to withhold the Title X money from abortion providers before the Obama administration blocked them. (Because of the Hyde Amendment, federal funds can’t be used to pay for abortions, so the Title X money went to other health services at those clinics.) The legislation allows them to withhold the funds again and redirect them to providers that don’t offer abortion care.

MEDICAID CUTS DISPROPORTIONATELY HURT WOMEN

Republicans are waging a war on Medicaid, and it’s hurting American women the most. Proposed cuts to Medicaid disproportionately impact women, who make up over two-thirds of adults with Medicaid coverage.

MEDICAID CUTS TAKE WOMEN’S ACCESS TO COVERAGE AND CARE

Millions of Women Rely on Medicaid for Health Care. More than 16.3 million women in the U.S. are enrolled in Medicaid. [Kaiser Family Foundation, 2017]

Medicaid Helps Pay For Long-Term Care, Mostly For Elderly Women. 69 percent of the 9 million people covered by both Medicare and Medicaid are women. [Center on Budget and Policy Priorities, 5/11/17]

MEDICAID CUTS RESTRICT REPRODUCTIVE & MATERNITY CARE FOR WOMEN

Medicaid Is The Largest Single Payer Of Pregnancy-Related Services. Medicaid financed 48 percent of all U.S. births in 2010. [Kaiser Family Foundation, 6/22/17]

Medicaid Is The Largest Financier Of Publicly Funded Family Planning Services. Medicaid accounts for 75 percent of all public expenditures on family planning services. [Kaiser Family Foundation, 6/22/17]

Women With Medicaid Are More Likely Than Those With Private Insurance To Have Discussed Sexual Health With Providers.  “In 2013, women with Medicaid coverage were more likely than women with private insurance to report they had spoken with a provider about sexual history, HIV, and intimate partner violence.” [Center on Budget and Policy Priorities, 5/11/17]

The Administration’s Attacks On Medicaid Jeopardize Women’s Access To Cancer Screening, Maternity Care, And Birth Control. “Fewer people on Medicaid means fewer women accessing health and reproductive services that do things like cover cancer screenings, improve access to birth control, and make sure moms and babies have health care throughout a pregnancy and in the months after a baby is born.” [Vox, 1/31/18]

NEW MEDICAID REQUIREMENTS MAKE IT HARDER FOR WOMEN TO GET COVERED

Nearly 2 In 3 People Who Would Lose Medicaid Coverage Because Of Work Requirements Are Women. “Almost two-thirds (62 percent) of those who could lose Medicaid coverage due to work requirements are women.” [Planned Parenthood, 1/11/18]

Work Requirements Punish Women Caring For Loved Ones. “It is already challenging for women with health conditions or who are caring for loved ones to work, and Medicaid work requirements will only make this harder…This means, for example, that a woman not covered by the FMLA who is enrolled in Medicaid could lose her job if she takes time away from work to get cancer treatment, and then lose her health coverage due to Medicaid work requirements. Losing Medicaid could be a death sentence for this woman.” [National Partnership for Women and Families, 2/28/18]

Medicaid Work Requirements Pose A Unique Burden On Women Of Color. “Due to racism and other systemic barriers that have contributed to income inequality, women of color are disproportionately likely to be insured through Medicaid: 31 percent of Black women and 27 percent of Hispanic women aged 15–44 were enrolled in Medicaid in 2015, compared with 16 percent of white women. Medicaid pays for nearly half of all U.S. births and is the largest payer of publicly funded family planning services.” [National Partnership for Women and Families, 2/28/18]

MEDICAID CUTS TAKE WOMEN’S JOBS

Medicaid Creates Jobs In The Health Industry, Which Employs Nearly 23% Of All Women In The American Workforce. “Women’s high participation in the health care industry, which employs more than 22.8% of all women in the workforce,4 means that Medicaid disproportionately creates jobs for women. This is especially true because Medicaid covers services that other payors typically do not cover and are more likely to be delivered by women, like long-term services and supports.” [National Women’s Law Center, June 2017]

Threats To Medicaid Are Threats To Women’s Livelihoods. “Women would be uniquely impacted by these changes, not only because women disproportionately are enrolled in Medicaid, but also because women occupy jobs whose funding relies on Medicaid. Such changes would threaten the livelihood of millions of women and families across the country.” [National Women’s Law Center, June 2017]

EXPERTS: CUTTING MEDICAID HURTS WOMEN

Black Women’s Health Imperative: Medicaid Work Requirements Threaten Health Care For Low-Income Black Women.  “There is a clear disconnect between this false and discriminatory narrative and the actual reality that Black women in poverty face every day. The truth is that over 70% of Black women on Medicaid already work hard everyday to support their families but, due to systemic inequalities, they earn less and face unfair barriers to health care. These jobs simply do not pay enough for women to afford health insurance.” [Black Women’s Health Imperative, 1/11/18]

Planned Parenthood: Women Lose The Most Under Trump’s Latest Attack On Medicaid. “With about one in five women of reproductive age relying on Medicaid for their health care and women accounting for approximately 62 percent of Medicaid enrollees who could lose coverage because of this enrollment restriction, this change will especially hurt women, particularly those who already face the highest barriers to care.” [Planned Parenthood, 1/11/18]

National Women’s Law Center: Medicaid Work Requirements Would Reduce Access To Care For Women Without Increasing Employment. “Many of the arguments underlying work requirements are designed to stoke racial resentment about entitlement programs, particularly playing upon harmful stereotypes of women of color…work requirements would endanger individuals’ health and economic security in many cases, with a particularly harsh impact on women.” [National Women’s Law Center, April 2017]

SEN. MURRAY JOINS LEADING WOMEN’S GROUP TO STAND UP FOR WOMEN’S CARE

But despite the rampant attacks coming from the Administration and Republicans in Congress, advocates have refused to back down. Last Thursday, on International Women’s Day, Sen. Patty Murray joined Protect Our Care, the National Partnership for Women & Families, the Black Women’s Health Imperative, and Planned Parenthood Federation of America to demand an end to the Trump administration’s attacks on women’s health and health care. As Kate Martin of the National Partnership wrote:

“‘Over and over again, President Trump and Vice President Pence have made clear they intend to interfere every way they can with a woman’s freedom to make health care decisions that are right for her,’ said Senator Murray. ‘People won’t stop resisting. Women who speak up for their rights are not going away. … We will continue to reject – loud and clear – the partisan, ideological Trump-Pence agenda that hurts women and families.’

The attacks include advancing policies that let insurance companies charge more for “pre-existing conditions” like pregnancy – or just being a woman. The Affordable Care Act (ACA) prevents insurers from denying, dropping or charging more because of a pre-existing condition like cancer, or even having a C-section. It also bans insurers from charging women higher rates than men (before the ACA, 92 percent of plans charged women up to 1.5 times as much as they charged men). But the Trump administration’s recent proposed “short-term” plan rule would allow insurance companies to sell more policies that skirt these protections, ultimately punishing women and all people with pre-existing conditions and destabilizing the health insurance marketplace. It’s just the latest in the administration’s ongoing attempt to sabotage the ACA…

These attacks are as unpopular as they are relentless, and they threaten the health, well-being and economic security of tens of millions of women and families. You can help fight back: Call your members of Congress and urge them to prioritize our health and health care, instead of a partisan political agenda. We all need to speak up now – and #pressforprogress on protecting our health care – before it’s too late!”

WOMEN (AND MEN) ACROSS THE COUNTRY STAND UP FOR WOMEN’S HEALTH

And in states across the country, women held rallies in honor of Protect Women’s Care Week and made their voices heard.

All in all, Protect Women’s Care Week was a smashing success – women, and men, across the country stood up together made their voices loud and clear in support of women’s health. Enough is enough – it’s time for the Trump Administration to end their war on women’s health care.

ashoup
In Administration, News

“Premiums Could Increase 90 Percent”: The Trump Administration’s Effect on Future Premiums By the Headlines

Yesterday, Covered California released an analysis outlining the future of the individual market under the Trump Administration and its constant barrage of sabotage. Its findings were striking:

  • All states’ individual markets risk higher than normal premium increases — ranging from 35 to 90 percent over three years — due to continued uncertainty at the federal level.
  • Premium increases in the individual markets will likely range from 12 to 32 percent in 2019, and cumulative increases from 2019-2021 will range from 35 percent to more than 90 percent.
  • Increases are on average more than double the rate of medical inflation as a result of healthier consumers leaving the individual market.
  • 17 states are more likely — because of their historic risk mix and enrollment — to have cumulative premium increases of 90 percent or more and 19 additional states are at a higher risk of experiencing hikes of 50 percent.

All in all, the report makes clear in no uncertain terms just how much the repeal and sabotage campaign being carried out by the Trump Administration and its Republican allies in Congress is harming Americans. Here’s how the report was covered in headlines:

Washington Post: Premiums for ACA health insurance plans could jump 90 percent in three years

The Hill: Study: ObamaCare premiums could increase 90 percent over three years for some states

Insurance Business Magazine: Report: States could see average health premium increases up to 30%

Salon: Health care premiums set to spike highest in Trump country

San Francisco Chronicle: California health insurance premiums could soar, analysis projects

Berkshire Eagle: Premiums for plans could jump 90% in 3 years

Stamford Advocate: Study: Connecticut premiums could rise 35 percent

CT Post: Study: Connecticut premiums could rise 35 percent

KCRA: California health care exchange head says rates to increase

ashoup
In Administration, News

Protect Our Care Responds to White House’s Secret Stabilization Sabotage List

Washington, DC – In response to reports that President Trump’s White House is circulating a secret plan to sabotage bipartisan talks on mitigating the harm caused by President Trump’s destructive health care sabotage, Protect Our Care Campaign Chair Leslie Dach released the following statement:

“As if his disregard for America’s health care system wasn’t obvious enough already, President Trump is now trying to sabotage bipartisan Congressional efforts to fix Trump’s own sabotage. Trump just took Americans’ health insurance premiums as a hostage to his demands that insurance companies get to sell junk plans and charge five times more to people over 50. Democrats and moderate Republicans must stand firm against this outrageous anti-senior, anti-woman wish list.

“Congress needs to reject this bomb-throwing from the White House and take action on bipartisan solutions that contain costs for American families, not on extreme policies like junk plans that can discriminate against pre-existing conditions, an age tax, and anti-woman restrictions that people across the country rejected firmly during last year’s Affordable Care Act repeal debate. It’s outrageous that Trump continues to ignore the message Americans have sent loud and clear: enough is enough. Stop the war on our health care.”

ashoup
In Administration, News

Trump’s Own Budget Experts Admit His Sabotage Inflated Premiums

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

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

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

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

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

Why it matters:

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

The numbers:

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

Key quote:

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

ashoup
In Administration, News

Ahead of International Women’s Day, Coalition Mobilizes Against Trump’s War on Women’s Care

womenshealthcare

Washington, DC – Ahead of International Women’s Day, the Protect Our Care coalition is announcing the Protect Women’s Care Week of Action to fight back against President Trump’s war on women’s care. Throughout the week, Protect Our Care, its partners, and elected officials will highlight recent progress in women’s care achieved thanks to the Affordable Care Act and its Medicaid expansion, and mobilize American women to fight back against the Republican war on health care, which threatens all those gains and more.

“From Day One of this Administration, American women have been engaged in the fight of our lives against the Trump Administration’s radical anti-women’s health agenda,” said Protect Our Care Communications Director Marjorie Connolly. “Over the coming days, the Protect Women’s Care Week of Action will put President Trump and his Republican allies on notice: women know we have better care now thanks to the Affordable Care Act, and we are fighting ongoing Republican efforts to drag us back to the bad old days and worse.”

As study after study shows, the Affordable Care Act has increased women’s access to health care and improved women’s health outcomes. New data show the improved health and economic outcomes women are experiencing now that the Affordable Care Act has covered more women than ever before, improved breast cancer and maternity care, guaranteed copay-free access to birth control, and stopped insurance companies from charging women more.

Meanwhile, the Republican war on health care is using the twin tactics of repeal and sabotage to turn back the clock, making it harder for American women to access coverage and care.

These are some of the gains in women’s health care that Trump and his Republican allies want to reverse through their repeal and sabotage campaign:

Historic Gains in Women’s Coverage

ACA Brought Women’s Uninsured Rate To All-Time Low.

“By 2016, the number of working-age women…lacking health insurance had fallen by almost half since 2010, from 19 million to 11 million.” [Commonwealth Fund, 8/10/17]

After Medicaid Expansion, More Women Of Reproductive Age Have Health Coverage.

“ACA Medicaid expansions decreased uninsurance among women of reproductive age with incomes below 100% FPL by 13.2 percentage points.” [Women’s Health Issues Journal, 2/28/2018]

With Pre-Existing Discrimination Ban, More Women With Cancer Histories Now Have Coverage

Women With Gynecologic Cancer More Likely To Be Insured Following ACA.

“Between 2011 and 2014…uninsured rates decreased by 50% for those diagnosed with uterine and ovarian cancer…and by 25% in cervical cancer.” [Gynecologic Oncology, June 2017]

Better Access to Contraception

Under ACA, Women Saved $1.4 Billion On Birth Control Pills Alone In 2013.

“Prior to the ACA, co-pays as low as $6 deterred women from obtaining the health care that they needed, and some women chose to forgo birth control because of cost. But data on prescription drug use in 2013, after the birth control benefit went into effect, indicate a nearly five percent uptick in filled birth control pill prescriptions…The birth control benefit saved women $1.4 billion on birth control pills alone in 2013.” [National Women’s Law Center, 5/3/17]

Improved Maternity Care & Newborn Outcomes

Before The ACA, 75% Of Individual Market Plans Did Not Include Maternity Care.

“Three in four health plans in the non-group insurance market did not cover delivery and inpatient maternity care in 2013, before the [ACA] essential health benefits requirement took effect.” [Kaiser Family Foundation, 6/14/17]

ACA Improved The Health Of Women And Their Babies.

“The dependent coverage provision of the Affordable Care Act (ACA) that allowed young adults to stay on their parents’ insurance until they were 26 was associated with increased use of prenatal care, increased private insurance payment for births, and a modest reduction in preterm births.” [JAMA, 2/13/18]

Infant Mortality Decreased In States That Expanded Medicaid.

“New data shows that infant mortality rates decreased in states that expanded Medicaid.” [Newsweek, 1/31/18]

Better Breast Cancer Care & Prevention

Medicaid Expansion Improves The Quality Of Breast Cancer Care.

“[The study] found a connection between Medicaid expansion and improved quality of breast cancer care…The number of screening mammograms covered by Medicaid increased from 5.6 percent before expansion to 14.7 percent afterward.” [Daily Kos, 2/21/18]

Following ACA’s Lower Costs, Mammogram Screening Rates Increase.

“After the [ACA] eliminated cost sharing for screening mammograms, their rate of use rose six percentage points among older woman for whom such screenings were recommended.” [Brown University, 1/17/18]

 

ashoup
In Administration, News

Protect Our Care Statement on Arkansas’ Draconian Medicaid Plan

The Trump Administration just approved yet another damaging proposal to cut Medicaid, this time in Arkansas. The newly approved waiver, which imposes a red-tape-heavy work requirement that places first-in-the-nation burdens on Arkansas Medicaid enrollees with jobs and on those with disabilities, threatens 60,000 Arkansans and has been deemed even “more punitive” than Kentucky’s draconian waiver by the Arkansas Times.

Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Arkansas is the latest state to fall for the Trump Administration’s wrongheaded push to cut Medicaid and leave more vulnerable citizens without coverage. Analysis after analysis after analysis after analysis shows that these Medicaid requirements actually make it harder for lower-income people to find a job and stay at work, and really have only one aim: denying people coverage. By imposing onerous monthly paperwork requirements on working people and forcing Arkansans with disabilities to re-prove their exempt status every two months, today’s Arkansas plan breaks new ground in needless and ideologically-driven cruelty.

“In another dangerous precedent, the Trump Administration has refused to affirm what the Affordable Care Act says in black and white: Medicaid expansion dollars are only available to expand Medicaid, and Arkansas’ blatantly unacceptable proposal to kick those making between around $12,000 and $17,000 a year off the rolls is illegal and wrong. This cruel proposal should be rejected outright.

“Unfortunately, Arkansas is the latest state taking its cues from the Trump Administration’s relentless war on Medicaid and the Affordable Care Act. Unless President Trump and the Administration cease their attacks, states like Arkansas will keep following them down this dark path, and Americans across the country will keep losing their coverage. Enough is enough – it’s time for the GOP to end its war on Americans’ care.”

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