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ashoup
In Administration, News

Protect Our Care Outlines Market Stabilization Must-Haves

As Congress begins to shape an omnibus after passing this morning’s spending bill, Protect Our Care Campaign Director Brad Woodhouse released the following statement outlining provisions that bill must include to stabilize the Affordable Care Act’s marketplaces and counteract cost increases caused by the Trump Administration and its Republican allies in Congress’s ongoing sabotage:

“If Congressional Republicans are serious about addressing the mounting mess they have created in the individual insurance market, they need to do far more than they are currently proposing. And the scale of those solutions must match the scope of the problems that Republican sabotage has created.

“While the Affordable Care Act marketplaces have shown remarkable stability in the face of this relentless sabotage, President Trump’s actions have already raised premiums this year, and the Republican tax bill will make things even worse next year by pushing premiums up double digits.

“A truly bipartisan market stabilization plan means making coverage more affordable,  not punishing people with pre-existing conditions, and not including anti-choice restrictions. The American people want affordable, high-quality health care, not even more restrictions on women’s health. And Republicans should not seek to revive high risk pools, failed experiments of the the past which would reverse the Affordable Care Act’s guarantees and once again allow states to segregate people with pre-existing conditions.

“The American people keep saying it loud and clear: enough is enough. It’s time for Republican lawmakers to do the right thing, leave politics at the door, reject their party’s war on health care, and develop real solutions to make coverage more affordable and accessible for more Americans.”

Policymakers Should Craft Reinsurance Proposals to Lower Premiums, Help More People
Center on Budget and Policy Priorities // Sarah Lueck // 2.8.18

The idea of reimbursing health insurers for some costs associated with their highest-cost enrollees, known as reinsurance, is gaining traction as policymakers seek ways to make states’ individual insurance markets more stable and reduce premiums. But some federal reinsurance proposals are likelier than others to reduce premiums, and reinsurance alone won’t help individual market consumers who qualify for subsidized coverage.

Reinsurance defrays insurers’ costs and reduces their risk, so insurers can reduce overall premiums compared to what they’d otherwise charge.

In the House, a bipartisan reinsurance bill from Reps. Ryan Costello and Collin Peterson is reportedly gaining support, including among insurers. It would provide up to $30 billion over three years for the Secretary of Health and Human Services (HHS) to allocate at his discretion. Meanwhile, Sen. Susan Collins is continuing to craft her bipartisan reinsurance bill (co-sponsored by Sen. Bill Nelson), which Senate Majority Leader Mitch McConnell promised to bring to the Senate floor. She’s proposing to make up to $10 billion over two years available to states, which they could then use to secure additional federal funding through waivers that HHS approves to let states experiment with new ways to deliver health care to their residents.

With reinsurance efforts potentially moving forward, policymakers should keep the following in mind:

Reinsurance funds should be targeted at reducing premiums, not diluted by other purposes. The Costello bill would let states use federal reinsurance for a number of purposes, not all of which focus on the individual market or on reducing premiums. For example, states could use the funding for “promoting participation” and “increasing health insurance options” in both the individual and small-group markets, or for promoting access to preventive services (especially dental and vision care) and maternity and newborn care, and preventing and treating mental or substance use disorders. While increasing access to these health services is important, it isn’t directly related to reducing premiums or stabilizing insurance markets. These provisions would probably also let states use federal funds to replace their own spending on activities they would have undertaken anyway — which would have no impact on individual-market premiums at all. The Costello bill also seems to let states create high-risk pools, an idea that House Speaker Paul Ryan has continued to talk up. But past high-risk pools worked by separating people with high-cost health needs into a different pool from less costly people. That approach has been tried and failed, and it shouldn’t be replicated. The Costello bill also includes new, unrelated policy dealing with abortion.

A federal reinsurance program is likely the fastest, most efficient way to mitigate premium increases in 2019. Insurers will have to finalize their decisions about individual-market premiums and about where they will offer plans by this fall, and they’ll begin making decisions well before that. And 2019 is shaping up to be a tough year in the individual market, particularly because the new tax law’s repeal of the Affordable Care Act’s (ACA) individual mandate to have health coverage or pay a penalty will take effect and because plans that don’t meet ACA standards are expected to proliferate under proposed Trump Administration regulatory changes. While a temporary reinsurance program is only a partial fix at best for the premium increases and other harmful effects of these changes, a federal reinsurance program could be implemented more quickly and efficiently than multiple state-level programs. The Collins-Nelson bill relies entirely on states to apply for funding. In a better approach, the Costello bill gives states the option to apply for funding and administer their own programs but includes a safeguard — to establish a federal program if states don’t act fast enough. The Costello bill, however, would also leave the amount that each state would receive up to the HHS Secretary’s discretion, creating unnecessary uncertainty and risk, particularly because the Trump Administration has been more focused on sabotaging the ACA-compliant insurance markets than shoring them up.

Provisions intended to offset reinsurance costs shouldn’t make people worse off. If policymakers seek to offset the federal cost of a reinsurance program through spending cuts or tax increases, those measures should not threaten the health of individuals. They should not, for instance, include cuts in other health care programs or changes that hurt modest-income people or those with pre-existing conditions.

Even well-designed reinsurance doesn’t make health care more affordable for low- or moderate-income people. Reinsurance reduces the sticker price of health insurance — i. e., the overall premiums that insurers charge. That means it benefits individuals and families who don’t qualify for premium tax credits that help low- and moderate-income people afford their insurance through the ACA health insurance marketplaces. That’s because the premium credits limit eligible people’s cost to no more than a given percentage of their incomes, so they pay about the same amount for coverage regardless of the sticker price. Most Americans who are uninsured and eligible for marketplace coverage could qualify for tax credits under current law. But some people who get tax credit — those with incomes up to four times the poverty level, or about $48,000 a year for an individual — also have trouble affording their premiums and out-of-pocket costs. Researchers estimate that modest improvements in the tax credits could meaningfully expand coverage. Increasing the tax credits or cost-sharing reductions (CSRs) for those already receiving them would also help shore up insurance markets and, if paired with reinsurance, broaden the benefits to all individuals and families buying health insurance on their own.

A bill that includes reinsurance funding and would reinstate CSR payments to insurers, such as the Costello bill, also should increase the tax credits or increase cost-sharing subsidies for people. Here’s why: As we and others have explained, the Trump Administration’s decision to halt CSR payments has had the effect of substantially raising tax credits, making coverage more affordable for many moderate-income consumers. (That’s because insurers raised premiums to account for the loss of CSR payments, which boosted the amount of federal premium tax credits available to eligible people.) Restoring CSR payments would reverse the tax credit increases and make coverage more expensive for this group. Thus, a bill funding reinsurance, restoring CSRs, and failing to increase tax credits or cost-sharing subsidies would make coverage more affordable for middle-income consumers but less affordable for many people at lower income levels.

 

ashoup
In Administration, News

As Trump Administration Undermines Medicaid, Some States Attempt to Expand It

Meta Capitol

It was revealed yesterday that the Trump Administration may allow lifetime coverage caps for people covered by Medicaid, an illegal move that would threaten the health and well-being of millions of Americans. But beyond the nation’s capital, states are instead looking at ways to expand Medicaid coverage.

Just today, a children’s advocacy organization in North Carolina released a new report arguing that Medicaid expansion could reduce the state’s fetal and infant mortality rates, bolstering the case for the bipartisan expansion proposal the state is currently considering.

Outside of North Carolina, grassroots movements are underway in Nebraska, Utah, Missouri and Idaho to put Medicaid expansion on state ballots in 2018. And just three weeks ago, Oregon voters supported a legislative tax package funding the state’s Medicaid program. Back in November, Maine voters overwhelmingly approved Medicaid expansion in the state.

“The Trump Administration and Congressional Republicans are doing the exact opposite of what the American people want, which is expanded access to coverage. It’s time for this Administration and its sabotage partners in Congress to get the message being sent to D.C. by countless states and take ACA repeal, Medicaid block grants, and administrative actions that diminish access off the table. Enough is enough: it’s time for the GOP to end its war on our health care,” said Protect Our Care Campaign Director Brad Woodhouse.

Groups: Medicaid expansion could lower baby-death rates

Winston-Salem Journal // Richard Craver // February 7, 2018

A state child advocacy group has added its voice to those urging the Republican-controlled legislature to expand Medicaid to more than 500,000 North Carolinians

States that have expanded Medicaid have a lower infant mortality rate than those who haven’t, NC Child said in a 2016 report.

An update of that report, which was scheduled to be released today, focuses on fetal mortality, which is defined as the death of a fetus that occurs at 20 or more weeks of gestation.

Both rates are affected by a wide range of factors, including tobacco use and substance use disorders, obesity, domestic violence, poverty, racism, education and access to pre-conception and prenatal healthcare.

In North Carolina, 58 percent of women between the ages of 18 and 44 are considered to be overweight or obese, while 16 percent have been diagnosed with hypertension and 20 percent are smokers.

In 2016, North Carolina had almost as many fetal deaths (818) as infant deaths (873).

From 2012 to 2016, there were 6.9 fetal deaths per 1,000 live births in North Carolina, compared with an infant mortality rate of 7.2 per 1,000 live births.

In Forsyth County, the rate of fetal deaths was 6.4 during that time span, while the infant mortality was 8.3. Forsyth’s highest infant mortality rate was 14.7 in 1997.

“By utilizing available federal funding to expand access to affordable health care for women of childbearing age, the state can influence both fetal and infant mortality simultaneously, effectively doubling the positive impact for North Carolina families,” said Whitney Tucker, research director at NC Child.

Statewide, premature birth and low birthweight are the leading causes of death for infants under 1 year old, causing 20.6 percent.

“These chronic conditions and risk factors can be addressed most effectively when women have access to health insurance,” NC Child said. “Unfortunately, 20 percent of North Carolina women of childbearing age (18 to 44) lacked health insurance in 2016.”

NC Child said 20.5 percent of Forsyth women of childbearing age do not have health insurance, while 31 percent do not receive prenatal care in their first trimester of their pregnancy.

“Newborns of mothers with no prenatal care are three times more likely to have a low birthweight and five times more likely to die than children born to mothers who do receive prenatal care,” according to the report.

NC Child spokesman Rob Thompson said “certain groups of non-citizens are eligible for Medicaid and Obamacare, but not undocumented immigrants.”

“I don’t know exactly what portion of the 20 percent is composed of undocumented immigrants. With children in N.C., 96 percent are insured and the general thinking is that somewhere between one-third and one-half of the remaining uninsured are undocumented.”

Most Republican legislative leaders argue that the federal government, first under the Obama administration and now under the Trump administration, may not be able to keep its pledge of covering 90 percent of the administrative costs of Medicaid expansion.

The advocacy group supports House Bill 662, titled “Carolina Cares,” that represents a bipartisan effort to expand Medicaid. The bill has Rep. Donny Lambeth, R-Forsyth, as its main sponsor.

The bill would require some people who get Medicaid to work, which has proven controversial. North Carolina is one of 10 states with federal regulatory permission to move forward with a work requirement, if legislatively approved.

However, HB 662 has not appeared on either chamber’s agenda for the current special session after not advancing out of committee during the regular 2017 session.

“While the proposal includes elements that will negatively impact enrollment — premiums and work requirements — it has the potential to provide currently unavailable health care options for women of childbearing age at high risk of experiencing fetal or infant mortality,” NC Child said.

“Whether it’s Carolina Cares or a different bill, the legislature should act quickly to close the health insurance coverage gap and support healthy pregnancies and healthy babies,” Tucker said.

Marlon Hunter, Forsyth’s health director, has said the county health department, along with its community and agency partners, encourage women of child-bearing age “to achieve optimal health before they become pregnant in order to improve birth outcomes.”

“Almost half of all pregnancies in our community are not planned.”

The county health department and county Infant Mortality Reduction Coalition are focusing on reducing pre-term birth, supporting and improving mental health services for women, and stressing the importance of women and men of reproductive ages to develop reproductive life plans.

The Kate B. Reynolds Charitable Trust and Novant Health Inc. launched Forsyth Connects in May 2016. Their initiative provides free in-home nurse visits to all mothers with newborn babies who are born and reside in Forsyth. The baby doesn’t have to be the mother’s first.

ashoup
In Administration, News

Protect Our Care Statement on 11.8 Million Final Open Enrollment Total

Meta Capitol

After final confirmation that 11.8 million people nationwide purchased 2018 health insurance through the individual insurance marketplaces created by the Affordable Care Act, meaning that despite a year of aggressive sabotage by the Trump Administration, overall enrollment equaled 96% of last year’s total, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“The American people are our own best health care advocates, and today’s enrollment total shows that we keep on beating the odds. This year’s open enrollment succeeded thanks to an untold number of enrollment assisters, community activists, health care professionals, and volunteers who did what their government refused to and helped their fellow Americans get covered.

“Despite everything the Trump Administration threw in their way, the high number of people who bought comprehensive insurance through the individual insurance marketplaces this year, 11.8 million, shows that the marketplaces are an essential component of the American health care system. Enrollment could have been even higher this year, but unfortunately, the cumulative effect of Trump’s year of sabotage was that too many Americans faced higher prices or fewer choices, as well as new hurdles to enrollment.

“The millions of people who bought coverage deserve a Congress that will protect and improve their access to care, but instead, their own Republican elected officials continue to sabotage the Affordable Care Act. They have already spiked next year’s premiums double digits by repealing the individual mandate and will do even more damage if they refuse to address and fix President Trump’s administrative sabotage.

“Along with Medicaid expansion, the marketplaces are how the Affordable Care Act succeeded in driving the American uninsured rate down to historic lows. Clearly Americans want and need to shop on their own for coverage in a marketplace where they can’t be denied for having a pre-existing condition or priced out based on their age, gender, or medical history.

“Despite the odds, this year’s enrollment total was 96% of last year’s. When you look at the numbers, it’s clear that with nurturing instead of sabotage, these marketplaces could keep expanding access to coverage and help reverse the increase in the uninsured rate that’s being caused by President Trump and his Republican allies’ war on our care.”

ashoup
In Administration, News

Protect Our Care Blasts Consideration of Medicaid Lifetime Limits

Washington, D.C. – In response to the news that the Trump Administration may allow states to impose arbitrary lifetime limits on Medicaid coverage, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“The appalling concept of lifetime Medicaid limits represents a new low for the Trump Administration, and it threatens the health and well-being of the millions of Americans who get their coverage through Medicaid. Allowing states to impose arbitrary time limits on access to health care would leave innocent Americans with nowhere to turn and fundamentally change and weaken the popular Medicaid program, which serves millions of American seniors, children, and people with disabilities.  

“The Affordable Care Act stopped insurance companies from imposing dollar lifetime limits on coverage, and as a result, 105 million Americans are now free from arbitrary limits on care. But the Trump Administration wants to take us back to the days of lifetime coverage caps, and they’re targeting our most vulnerable citizens as guinea pigs. The majority of Americans with Medicaid coverage live in working households, but the Trump Administration is now considering punishing people just because their longtime employer doesn’t offer insurance or because they got sick or have a disability and lost their job.

“Today’s news makes it clear that threats to the Affordable Care Act, Medicaid, and the health of millions of Americans will remain very much alive for as long as the Trump Administration and Congressional Republicans continue their war on Americans’ health care. The idea of arbitrary time limits on Medicaid eligibility is not only illegal, it is immoral, and the Trump Administration should be ashamed. Enough is enough – it’s time for the GOP to stop trying to kick Americans off their coverage and end its war on our health care once and for all.”

ashoup
In Administration, News

Trump’s Opioid Mess Keeps Getting Worse

New Report: Congressional Republicans Fed Up With Inaction

After new POLITICO reporting reveals mounting frustration among even Congressional Republicans about the Trump Administration’s failure to confront the national opioid crisis, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“When Republican Members of Congress are willing to go on record about your Administration’s continuing failure to confront a massive public health crisis, you have a problem. President Trump needs to wake up to reality and get serious about this out-of-control crisis instead of continuing his harmful efforts to gut the agency charged with fighting it and to sabotage Medicaid, which funds one-fifth of all substance abuse treatment nationwide.”

Kellyanne Conway’s ‘opioid cabinet’ sidelines drug czar’s experts

POLITICO // BRIANNA EHLEY and SARAH KARLIN-SMITH // 02/06/2018

President Donald Trump’s war on opioids is beginning to look more like a war on his drug policy office.

White House counselor Kellyanne Conway has taken control of the opioids agenda, quietly freezing out drug policy professionals and relying instead on political staff to address a lethal crisis claiming about 175 lives a day. The main response so far has been to call for a border wall and to promise a “just say no” campaign.

Trump is expected to propose massive cuts this month to the “drug czar” office, just as he attempted in last year’s budget before backing off. He hasn’t named a permanent director for the office, and the chief of staff was sacked in December. For months, the office’s top political appointee was a 24-year-old Trump campaign staffer with no relevant qualifications. Its senior leadership consists of a skeleton crew of three political appointees, down from nine a year ago.

“It’s fair to say the ONDCP has pretty much been systematically excluded from key decisions about opioids and the strategy moving forward,” said a former Trump administration staffer, using shorthand for the Office of National Drug Control Policy, which has steered federal drug policy since the Reagan years.

The office’s acting director, Rich Baum, who had served in the office for decades before Trump tapped him as the temporary leader, has not been invited to Conway’s opioid cabinet meetings, according to his close associates. His schedule, obtained under a Freedom of Information Act request, included no mention of the meetings. Two political appointees from Baum’s office, neither of whom are drug policy experts, attend on the office’s behalf, alongside officials from across the federal government, from HHS to Defense. A White House spokesperson declined to disclose who attends the meetings, and Baum did not respond to a request for comment, although the White House later forwarded an email in which Baum stressed the office’s central role in developing national drug strategy.

The upheaval in the drug policy office illustrates the Trump administration’s inconsistency in creating a real vision on the opioids crisis. Trump declared a public health emergency at a televised White House event and talked frequently about the devastating human toll of overdoses and addiction. But critics say he hasn’t followed through with a consistent, comprehensive response.

He has endorsed anti-drug messaging and tougher law enforcement. But he ignored many of the recommendations from former New Jersey Gov. Chris Christie’s presidential commission about public health approaches to addiction, access to treatment, and education for doctors who prescribe opioids. And he hasn’t maintained a public focus. In Ohio just this week, it was first lady Melania Trump who attended an opioid event at a children’s hospital. The president toured a manufacturing plant and gave a speech on tax cuts.

Much of the White House messaging bolsters the president’s call for a border wall, depicting the opioid epidemic as an imported crisis, not one that is largely home-grown and complex, fueled by both legal but addictive painkillers and lethal street drugs like heroin and fentanyl.

“I don’t know what the agency is doing. I really don’t,” said Regina LaBelle, who was the drug office’s chief of staff in the Obama administration. “They aren’t at the level of visibility you’d think they’d be at by now.”

Conway touts her opioids effort as policy-driven, telling POLITICO recently that her circle of advisers help “formalize and centralize strategy, coordinate policy, scheduling and public awareness” across government agencies.

That’s exactly what the drug czar has traditionally done.

Conway’s role has also caused confusion on the Hill. For instance, the Senate HELP Committee’s staff has been in touch with both Conway and the White House domestic policy officials, according to chairman Lamar Alexander’s office. But lawmakers who have been leaders on opioid policy and who are accustomed to working with the drug czar office, haven’t seen outreach from Conway or her cabinet.

“I haven’t talked to Kellyanne at all and I’m from the worst state for this,” said Sen. Shelley Moore Capito, a Republican from West Virginia, which has the country’s highest overdose death rate. “I’m uncertain of her role.” The office of Sen. Rob Portman (R-Ohio,) another leader on opioid policy, echoed that – although Portman’s wife, Jane, and Conway were both at the event with Melania Trump this week.

Some drug abuse experts and Hill allies find a silver lining, noting that Conway’s high-rank brings White House muscle and attention.

“If I want technical advice, I’m going to work with Baum,” said Rep. Tom MacArthur (R-NJ), a co-chair of the Bipartisan Heroin Task Force. “If I want to get a message to the president, Kellyanne is somebody that I know I can talk to.”

“It’s a really good sign that one of the president’s top advisers has been assigned to such an important topic,” said Jessica Hulsey Nickel, president and CEO of the Addiction Policy Forum.

Baum’s email called the drug office the “lead Federal entity in charge of crafting, publishing and overseeing the implementation of President Trump’s National Drug Control Strategy,” which multiple agencies review. He called Conway’s opioids cabinet an “interagency coordinating apparatus for public-facing opioids-related initiatives” and said that it was not overseeing national policy. But several administration officials did say her cabinet was indeed focused on a variety of policies.

Whatever Conway’s ties to the president, her career has been in polling and politics, not public health, substance abuse, or law enforcement.

Some of her “cabinet” participants do have a broad, general health policy background. But they don’t match the experience and expertise of the drug office’s professional staff. In her circle is Lance Leggitt, the deputy director of the White House’s Domestic Policy Council who was also chief of staff to former HHS Secretary Tom Price. Another top Price aide, Nina Schaefer, recently returned to the Heritage Foundation. The conservative think tank then touted her as having managed “the development of the HHS response to the opioid abuse crisis,” but when POLITICO recently tried to contact her, she said through a spokesperson she was not an expert on the topic.

Among the people working on the public education campaign that Trump promised is Andrew Giuliani, Rudy Giuliani’s 32-year-old son, who is a White House public liaison and has no background in drug policy, multiple administration sources told POLITICO. Nor has Conway spent her career in the anti-opioid trenches.

“Kellyanne Conway is not an expert in this field,” said Andrew Kessler, the founder of Slingshot Solutions, a consulting group that’s worked on substance abuse with many federal agencies.“She may be a political operative and a good political operative,” he added. “But look. When you appoint a secretary of Labor, you want someone with a labor background. When you appoint a secretary of Defense, you want someone with a defense background. The opioid epidemic needs leadership that ‘speaks’ the language of drug policy.”

The set-up befuddles other experts who’ve worked on substance abuse for prior administrations. Fresh ideas are fine, they say. But the drug office has a purpose.

“The whole reason we created ONDCP in 1988 was to be a coordinating force with power in the government and to bring together 20 agencies, many reluctant to be involved in drug control,” said Bob Weiner, who served in that office in both the George W. Bush and Clinton White Houses. “This is exactly when the agency should get maximum support from the White House,” he added.

An ONDCP spokesperson told POLITICO the office “works closely with other federal agencies and White House offices, including Kellyanne Conway’s office, to combat the opioid crisis” but declined to say whether the office’s career experts have attended any of her “opioids cabinet” sessions. The drug office is still crafting the annual drug control strategy, outside the Conway group, administration officials said.

A senior White House official confirmed that officials considered kicking off the media campaign with a big splash during the Super Bowl, but that fell through. Beyond that, many experts on drug policy and substance abuse say messaging alone won’t solve the problem anyway. People with addiction need treatment, and many people get addicted in the first place to painkillers their doctors have prescribed. An ad campaign won’t solve that.

One big test for the drug office will come when Trump releases his budget Monday, which is expected to slash the office’s budget, turning much of its work over to HHS and the Department of Justice. Both departments are developing their own opioid approaches; in past administrations, the drug czar would have coordinated. Lawmakers are already sounding the alarms over the budget plan.

A bipartisan group of senators last week wrote a letter to White House budget director Mick Mulvaney, urging him to reconsider and maintain the office’s programs that “prevent and fight against the scourge of drug abuse.”

Pushback to a similar proposal last year led the Trump administration to reverse the decision and maintain the office’s budget. Lawmakers hope that there will be a similar outcome this time — along with a smarter utilization of the drug policy office.

“What we haven’t seen is the kind of coordination of critical programs that ONDCP has traditionally done,” said Sen. Maggie Hassan, a Democrat from New Hampshire, another state with one of the highest overdose death rates in the country.

Trump officials say it was the Obama administration that began undermining the drug policy office, demoting the director from the Cabinet, shrinking the staff and stressing the health aspects more than a law enforcement-focused “war on drugs.” They say the emergency requires a new approach.

Bob Dupont, who served as the second White House drug czar under President Gerald Ford, before the formal drug policy office was created, and still informally advises the Justice Department on drug policy, believes the White House will eventually realize it needs the expertise that ONDCP has to offer.

The West Wing doesn’t “have the staff or capability” to carry out drug policy work like ONDCP does, Dupont told POLITICO. “I don’t think swashbuckling your approach is going to last very long.”

 

ashoup
In Capitol Hill, Administration, News

This Week In the War on Health Care — January 29 – February 2, 2018

While Washington focused on the State of the Union, the Trump Administration continued its unprecedented assault on the American health care system. Here’s what happened this week in Republicans’ war on health care – and why they’re losing battles to the American people:

LIES FROM THE LECTERN

During his State of the Union address, President Trump doubled down on the war on health care his administration and his Republican allies in Congress waged last year, saying he “repealed the core of disastrous Obamacare” — a widely debunked lie. He also failed to mention that:

The President then pivoted to the opioid crisis, attempting to take credit for addressing the epidemic. But in reality, Trump has done nothing to facilitate treatment for Americans struggling with addiction. In fact, his attacks on critical federal health care and opioid response programs stand to make the situation worse:

  • His public health emergency declaration speech freed up just $57,000, pathetically short of the billions experts say are desperately needed.
  • His Administration sabotaged Medicaid, which pays for one-fifth of all substance abuse treatment nationwide.
  • He proposed a 95% cut to the Office of National Drug Control Policy, which coordinates the federal opioid response – and he did so for the second year in a row.

Sadly, the Trump Administration is not only offering a pathetic response to the nation’s most urgent public health crisis, it’s actively sabotaging communities that are fighting to turn the tide on this deadly epidemic.

A NEW GENERAL TAKES HIS OATH

On Monday, former Big Pharma lobbyist Alex Azar was sworn in as the new secretary of Health and Human Services. Azar lied about the Trump Administration’s sabotage throughout his confirmation process, choosing to embrace the Republican agenda that takes coverage from millions of Americans, raises costs for millions more, and protections for people with pre-existing conditions.

Whether Azar upholds the oath he swore will soon be tested because of…

IDAHO’S ATTEMPT TO FLOUT FEDERAL LAW

Negative reactions continued as experts digested Idaho Governor Butch Otter’s illegal proposed assault on the Affordable Care Act. University of Michigan law professor and former Department of Justice attorney Nicholas Bagley called such an action “crazypants illegal,” noting that Idaho, “appears to be claiming they do not have to adhere to federal law.”

What Secretary Azar does with this will be an excellent indicator of whether he plans to truly support the health of the American people, like he claimed, of if he will merely be another foot soldier in the Administration’s war on health care.

COSTS FOR SENIORS CONTINUE TO RISE

A new report from the Kaiser Family Foundation highlights massive increases in out-of-pocket medical costs for Medicare beneficiaries – costs that are projected to keep skyrocketing.

While President Trump has claimed he wants to lower costs, the reality is the opposite: he has consistently supported proposals making health care more expensive, from repeal legislation allowing insurance companies to charge people over 50 an ‘age tax’ with rates five times higher to the GOP tax scam set to raise premiums double digits. Seniors should rightly be furious, as are…

HEALTH CARE PROTESTS IN WEST VIRGINIA

As GOP Members of Congress retreated to West Virginia, they were greeted by protesters furious about the ongoing war on health care:

OPEN ENROLLMENT NUMBERS BLOW EXPECTATIONS OUT OF THE WATER

And finally, yesterday was the scheduled final day of open enrollment. Despite the widespread attempts at sabotage by the Trump Administration, from cutting the sign-up period in half to dropping advertising by ninety percent, we have already reached 96% of last year’s enrollment total:

  • Nearly 8.8 million people signed up for coverage through HealthCare.gov.
  • Demand from new consumers outpaced new enrollments every single week of last year, with 2.5 million new people signing up for coverage.
  • Almost 6.3 million returning consumers actively renewed their coverage or were automatically re-enrolled compared to 6.2 million people last year.
ashoup
In Administration, News

Protect Our Care Statement on What Should Have Been the Last Day of Open Enrollment

After the states that stuck with the original Open Enrollment schedule wrapped up strong enrollment seasons last night, Protect Our Care Executive Director Brad Woodhouse released the following statement:

“If President Trump hadn’t sabotaged Open Enrollment by cutting the signup period in half for the 36 states using HealthCare.Gov, yesterday could have marked the end of the annual sign-up season nationwide. But here’s the good news: despite the Trump Administration’s sabotage, millions of Americans again signed up for comprehensive coverage. Before the final numbers come in, we have already reached 96% of last year’s enrollment total nationwide. This year’s enrollment season succeeded thanks to thousands of enrollment assisters, community activists, and volunteers who banded together to do what the Trump Administration refused to: help their fellow Americans get covered. It’s time for Republicans to stop their war on health care, which stopped even more people from signing up by driving up unsubsidized premiums, because it’s clearer than ever that Americans want and need quality, affordable coverage.”

 

 

ashoup
In Administration, News

State of American Health Care Threatened by Trump & GOP’s War on Health Care

To: Interested Parties

From: Leslie Dach, Campaign Chair, Protect Our Care

Date: January 29, 2018

Re: State of American Health Care Threatened by Trump & GOP’s War on Health Care

On Tuesday, President Trump will deliver his first official State of the Union address. We anticipate he will gloat about his efforts to undo the Affordable Care Act (ACA), take insurance away from millions of people in order to fund tax cuts for big corporations and the wealthiest , cut hundreds of billions of dollars from care for the elderly, children, and people with disabilities, and promise a continuation of his partisan approach to health care in 2018. But his agenda is overwhelmingly unpopular. The American people are saying “enough is enough.” We demand that the Trump Administration and Congress stop their war on our care.

The 2017 Republican War on Health Care

Last year, the Trump Administration and its Republican allies in Congress waged a war on our health care. Their attacks included five attempts to repeal the Affordable Care Act, proposing to end Medicaid as we know it, and sabotaging our health care system. Under their agenda, millions would lose coverage, costs would increase, especially for those with pre-existing conditions, and insurers would be able to skirt the tough rules that currently protect consumers thanks to the health care law. At the end of the first year of the Trump Administration, 3.2 million people have lost their health coverage, and premium rates spiked because of uncertainty President Trump injected into the individual insurance marketplaces. Here is what the first year of Trump’s partisan war on health care looked like:

January 2017

  • On his first day in office, President Trump signs an Executive Order directing the administration to identify every way it can unravel the Affordable Care Act.

February 2017

  • The Trump Administration proposes a rule to weaken Marketplace coverage and raise premiums for millions of middle-class families.

March 2017

  • The Trump Administration sends a letter to governors encouraging them to submit proposals which include provisions such as work requirements that make it harder for Medicaid beneficiaries to get affordable care and increase the number of people who are uninsured.

April 2017

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

May 2017

  • House Republicans vote for and pass a health care repeal bill that would cause 23 million people to lose coverage and gut protections for people with pre-existing conditions. It would have imposed an age tax and allowed insurers to charge people over 50 five times more for coverage and ended Medicaid as we know it, putting the care of seniors, children and people with disabilities in jeopardy.

June 2017

  • Senate Republicans embark on a monthslong failed attempt to pass BCRA, Skinny Repeal and Graham-Cassidy, all repeal bills that would have caused millions of Americans to lose their health coverage and raised premiums by double digits for millions more. They would have ended Medicaid as we know it, putting the care of children, seniors and people with disabilities at risk.

July 2017

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

August 2017

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

September 2017

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

October 2017

  • The Trump Administration takes direct aim at birth control by rolling back a rule that guaranteed women access to contraception. (A court has since questioned the legality of the action.)
  • President Trump signs an Executive Order to roll back key consumer protections that will result in garbage insurance, raise premiums, reduce coverage and again expose millions of Americans to discrimination based on pre-existing conditions.
  • The Trump Administration dramatically cuts in-person assistance to help people sign up for 2018 health coverage.
  • After threatening for months to stop funding cost-sharing reduction payments (CSRs) that help lower deductibles and out-of-pocket costs, the Trump Administration stops the payments altogether. The CBO finds that failing to make these payments will increase premiums by 20% and add nearly $200 billion to the debt.

November 2017

  • Republicans refuse to move forward on the bipartisan Alexander-Murray bill to address the CSR crisis even though it had a filibuster-proof majority in the Senate.

December 2017

  • The Trump Administration proposes a rule to expand association health plans, which would gut consumer protections, raise costs for people with pre-existing conditions and further destabilize the insurance markets.
  • Congressional Republicans pass their tax scam, which doubles as a sneaky repeal of the Affordable Care Act  by kicking 13 million people off of their insurance and raising premiums by double digits for millions more.

January 2018

  • The Trump Administration announces that it will support states that impose onerous work requirements on Americans covered by Medicaid, and approves Kentucky’s worst-in-the-nation waiver the next day.
  • The Trump Administration announces a move to allow providers to discriminate by allowing them to deny patient care for almost any reason.
  • The Trump Administration makes plans to announce even more exemptions from the requirement people have health coverage before this provision is repealed altogether.

Despite Attacks, the Affordable Care Act Continues to Help Americans

While the Trump Administration and its Republican allies in Congress had some success last year in their partisan war on health care, the Affordable Care Act is still here, and it is working. The reason the law survived is simple: the American people made their voices heard last year at town halls, rallies and the voting booth, thwarting the partisan repeal effort in Congress.

Despite Trump-led attacks, and because the American people spoke up, insurers still cannot deny or drop coverage because of a pre-existing condition; tax credits are still available to help people pay for coverage; young adults can still stay on their parents’ plan until age 26; the Medicare prescription drug donut hole is still closed; and Medicaid is still a lifeline for millions of seniors, children and people with disabilities. The recent open enrollment period saw nearly 9 million people sign up for coverage in the federal marketplaces, despite the Trump Administration’s decisions to cut the open enrollment period in half and refuse to promote it.  While any law can be improved, and the ACA is no exception, it continues to provide affordable health care and vital protections to millions of Americans.

Enough is Enough: Stop the Partisan War on Health Care

The Trump Administration and Republicans in Congress need to listen to the American people who are saying ‘enough is enough.’ It’s time to stop the partisan health care repeal effort and work on bipartisan solutions. If Republican politicians do not listen, they do so at their own peril. Recent polling by Protect Our Care showed that health care is far and away the number one issue on voters’ minds, and is one of the main reasons why voters disapprove of the job Republicans in Washington are doing.

Last week, Sen. Lisa Murkowski (R-Alaska) said, “I don’t think we should be spending time trying to do repeal and replace of Obamacare.” Her colleagues in Congress, and President Trump himself, would do well to listen to her.

ashoup
In Stories, Administration, News

Enough is Enough: the Trump Administration’s Sabotage of Our Health Care Must Stop

To: Interested Parties

From: Brad Woodhouse, Campaign Director, Protect Our Care

Subject: Enough is Enough: the Trump Administration’s Sabotage of Our Health Care Must Stop

Date: January 16,  2018

Since taking office last year, President Trump, his Administration, and allies in Congress have waged an unrelenting war against our health care. Their twin weapons have been repeal and sabotage: the innocent victims, the American people. Their agenda takes health care away from millions, raises premiums by double digits for millions more, guts protections for people with pre-existing conditions and attempts to destroy the insurance markets.

As research released today by Gallup shows, the consequences of the GOP agenda of sabotage are abundantly clear – President Trump has overseen the largest-ever one-year increase in the uninsured rate since Gallup began tracking:

The percentage of U.S. adults without health insurance was essentially unchanged in the fourth quarter of 2017, at 12.2%, but it is up 1.3 percentage points from the record low of 10.9% found in the last quarter of 2016. The 1.3-point increase in the uninsured rate during 2017 is the largest single-year increase Gallup and Sharecare have measured since beginning to track the rate in 2008, including the period before the Affordable Care Act (ACA) went into effect. That 1.3 point increase represents an estimated 3.2 million Americans who entered the ranks of the uninsured in 2017.

As the Obama Administration came to a close after the fourth quarter of 2016, the uninsured rate reached an all-time low. When the Trump Administration took over, it had all the tools it needed to continue that progress and keep driving down the uninsured rate. Instead, as last week’s bombshell report from POLITICO revealed, Trump’s HHS did the opposite:

Early last year, as an Obamacare repeal bill was flailing in the House, top Trump administration officials showed select House conservatives a secret road map of how they planned to gut the health care law using executive authority.

The March 23 document, which had not been public until now, reveals that while the effort to scrap Obamacare often looked chaotic, top officials had actually developed an elaborate plan to undermine the law — regardless of whether Congress repealed it.

Top administration officials had always said they would eradicate the law through both legislative and executive actions, but they never provided the public with anything close to the detailed blueprint shared with the members of the House Freedom Caucus, whose confidence — and votes — President Donald Trump was trying to win at the time. The blueprint, built off the executive order to minimize Obamacare’s “economic burden,” which Trump signed just hours after taking the oath of office, shows just how advanced the administration’s plans to unwind the law were — plans that would become far more important after the legislative efforts to repeal Obamacare failed.

President Trump famously said “the best thing we can do…is let Obamacare explode,” and “let it be a disaster because we can blame that on the Democrats.” But the newly revealed HHS document shows just how low this Administration is willing to go in order to sabotage the law – literally putting on paper a calculated plan to take away health insurance from Americans. The plan went high up: according to POLITICO, the document was “a key part” of a meeting with Speaker Paul Ryan and former HHS Secretary Tom Price, whose job was ostensibly to protect the health of the American people. President Trump and his Republican allies in Congress are not simply letting Obamacare fail – they are making Obamacare fail.

The increase in the uninsured rate is the most clear evidence yet that Republicans’ sabotage plan is having its intended effect: taking away Americans’ coverage. Here are some of the other ways the Trump Administration sabotaged health care in 2017:

  • On his first day in office, President Trump signed an Executive Order directing the administration to find any ways they could to unravel the Affordable Care Act.
  • 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.
  • House Republicans voted for and passed a health care repeal bill that causes 23 million people to lose coverage and guts protections for people with pre-existing conditions.
  • The Administration cut the outreach advertising budget for open enrollment by 90 percent, from $100 million to just $10 million – likely to result in 1.1 million fewer people getting covered. Advertising is a critical way for people to know when and how they can get covered.  
  • Republicans refused to move forward on the bipartisan Alexander-Murray bill even though it had a filibuster proof majority in the Senate.
  • Senate Republicans tried but failed to pass BCRA, Skinny Repeal and Graham-Cassidy, all of which would cause millions to lose their health coverage and raise premiums by double digits for millions more.
  • 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.”
  • The Administration dramatically cut in-person assistance that helped people sign up for 2018 coverage.
  • The Trump administration took direct aim at birth control by rolling back a rule that guaranteed women access to contraception. (A court has since delayed their effort.)
  • After threatening for months to stop funding cost-sharing reductions (CSRs) that help lower deductibles and out-of-pocket costs, the Trump Administration stopped CSR payments altogether in October. The CBO found failing to make these payments would increase premiums by 20 percent and add nearly $200 billion to the debt.
  • President Trump signed an Executive Order that would roll back key protections and result in garbage insurance, raise premiums, reduce coverage and expose millions of Americans again to discrimination based on pre-existing conditions.
  • House and Senate Republicans repealed the individual mandate in their tax bill in order to pay for massive tax breaks to the ultra wealthy and big corporations. CBO predicts millions will lose coverage and premiums will go up double digits.

And they aren’t done yet. Just last week the Trump Administration announced so-called “work requirements” to Medicaid, which will have the effect of removing millions of Americans – nearly all of whom are already working – from their health insurance. And Republicans have promised to go after Medicare, which insures 44 million Americans, and have their sights on the Affordable Care Act, too.

While the Trump Administration and Republicans in Congress want to keep up this war on health care in 2018, the American people are saying “Enough is Enough.” Nearly 9 million people just signed up for coverage through HealthCare.gov despite all the sabotage efforts. The Affordable Care Act is more popular than it has ever been. And millions of people across the country made their voices heard at rallies, town halls and through calling their Member of Congress to fight these repeal efforts.

The American people are right: enough IS enough.

ashoup
In Administration, News

Gallup Poll: Uninsured Rate Rose in Trump’s First Year

After a new Gallup poll showed that America’s uninsured rate jumped during Trump’s first year in office for the first time in a decade, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“This is what sabotage looks like. Today, Gallup confirmed that over 3 million Americans lost their insurance in 2017, becoming the first casualties of President Trump and Congressional Republicans’ war on health care. Today’s numbers also confirm that it’s exactly those Americans who the Trump administration targeted who are losing coverage: working families earning less than $36,000 a year, young adults, African-Americans, and Hispanics. On behalf of the 3 million who have already lost their coverage, and will now pay the price with their health — and the millions more whose insurance is under attack, we join the American people in saying: enough is enough. President Trump and his allies in Congress must stop their partisan war on health care before they take coverage from millions more and and drive up prices and weaken protections for everyone else.”

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