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Protect Our Care Statement on Trump Sabotage of Health Care and Anthem Pulling Out of Maine

Anthem Cites Uncertainty over Cost-Sharing Reduction Payments, which President Trump Has Threatened to Cancel, Among other Reasons, in Decision to Leave Market

WASHINGTON, D.C. — Today, one day after the failure of GOP’s latest iteration of a partisan repeal bill which would have thrown the country’s health care system into chaos, the effects of President Trump’s intentional sabotage of health care were once again made clear when Anthem announced it would exit Maine’s individual insurance market next year. Why?

“‘A stable insurance market is dependent on products that create value for consumers through the broad spreading of risk and a known set of conditions upon which rates can be developed,’ said Anthem spokesman Colin Manning in a statement. ‘Today, planning and pricing for ACA-compliant health plans has become increasingly difficult due to a shrinking and deteriorating individual market, as well as continual changes and uncertainty in federal operations, rules and guidance, including the restoration of the health insurance tax on fully insured coverage and continued uncertainty around the future of cost sharing reduction subsidies.’”

As the Portland Press-Herald noted, however, actions taken by Congress — like the payment of cost-sharing reductions — could potentially bring Anthem back into the marketplace:

“Manning did not close the door on returning to the Maine marketplace if conditions stabilized. There are proposals in Congress to mandate that the cost-sharing reduction funding be paid to insurers, and other measures to stabilize the marketplace. ‘Our commitment to members has always been to provide greater access to affordable, quality healthcare, and we will continue to advocate solutions that will stabilize the market. As the marketplace continues to evolve and adjust to changing regulatory requirements and marketplace conditions, we will reevaluate whether a more robust presence in the exchange is appropriate in the future.’”

In response, Protect Our Care Campaign Director Brad Woodhouse issued the following statement:

“Anthem’s decision to pull out of Maine is the direct consequence of uncertainty created in the marketplace by Republicans pushing for partisan repeal of our health care and President Trump’s intentional efforts to sabotage the law,” said Woodhouse. “President Trump has been playing politics with cost-sharing reduction payments by continually threatening to cancel them even though they lower out-of-pocket costs for millions of Americans. This uncertainty has led to decisions like Anthem’s.

“President Trump and Republicans who have cheered him on and supported repeal are intentionally harming people’s health care for sheer politics. The American people know this and they will hold them accountable for undermining the health care of the American people. Instead of sabotaging America’s health care, Republicans should follow the example of Senator Susan Collins, who has called for Democrats and Republicans to work together to improve health care for the American people.”

President Trump Claims Alaska, Arizona, Maine and Kentucky Are “Big Winners” Under Graham-Cassidy…

SHOT:


CHASER:

Analysts Agree: Every State Loses Under Graham-Cassidy Affecting People’s Care. Multiple independent analyses — and even Trump’s own CMS — agree that states would be worse off if theGraham-Cassidy repeal bill passess. Over time, every state loses because Graham-Cassidy zeroes out its block grants and ratchets down its spending on the Medicaid per capita cap. This means people would not have access to the financial assistance to help lower their health care bills, and federal Medicaid funding would no longer adjust for public health emergencies, prescription drug or other cost spikes, or other unexpected increases in need.

  • Alaska stands to lose $2 billion from 2020–2027 and $14 billion over the next two decades.
  • Arizona stands to lose $19 billion from 2020–2027 and $133 billion over the next two decades.
  • Maine stands to lose $2 billion from 2020–2027 and $17 billion over the next two decades.
  • Kentucky stands to lose $11 billion from 2020–2027 and $81 billion over the next two decades.

And according to an AARP analysis, the bill’s age tax would lead to huge increases in total costs for a 60-year-old making $25,000 in each of these states:

  • $31,790 more in Alaska
  • $22,074 more in Arizona
  • $16,437 more in Maine
  • $13,118 more in Kentucky

Sad!

NEW: GOP’s Claim That Counties Won’t Have Health Care Has Evaporated

The Kaiser Family Foundation now confirms that 3,006 of the 3,007 counties in the United States have Affordable Care Act marketplace plans for next year. The one county that doesn’t, Ohio’s Paulding County, serves 334 people.

Republicans keep saying that many people will not have access to health care plans and make discredited claims about a non-existent death spiral. The claims have been debunked by the nonpartisan Congressional Budget Office and now by the facts in the 2018 coverage map from Kaiser Family Foundation.

Unfortunately, that hasn’t stopped the lies. Just last night, GOP Speaker Paul Ryan again made these debunked claims.

Here’s the truth from the Kaiser Family Foundation



Republicans Must Confront Trump’s Proposed Sabotage of Health Care

CBO: 20–25 Percent Premium Increase, Nearly $200 Billion Cost to Taxpayers, Coverage Losses, Market Uncertainty If Trump’s Cancels Health Care Payments

While Republicans are in the midst of responding to the fallout from Donald Trump’s latest comments on the events in Charlottesville, soon they may have to answer for the President’s continued efforts to sabotage health care for the American people. Yesterday, the nonpartisan Congressional Budget Office confirmed that a decision by President Trump to cancel critical health care payments, known as Cost-Sharing-Reductions, would inject substantial uncertainty in the insurance markets, force premiums to increase by 20% next year and 25% by 2020 and increase costs to the taxpayer by nearly $200 billion over ten years.

The headlines on the CBO report are bad enough for Republicans, whose partisan repeal efforts, along with Trump’s bluster, have injected uncertainty into the health care marketplace. Imagine the fallout they will face if Trump follows through with his threat to cancel payments which lowers the cost of health care for millions of Americans.

How do Republicans get out of this box canyon they’ve marched themselves into? Oppose Trump’s irrational sabotage of health care and join in a bipartisan process to improve health care for the American people. If not, these headlines will only get worse.

Associated Press: CBO: Higher premiums if Trump halts Obamacare subsidies

NBC 11 Baltimore: CBO: Deficit would spike, premiums would rise if Trump ends Obamacare subsidies

USA Today: CBO: Ending Obamacare subsidies would raise premiums and the deficit

The Courier-Tribune: CBO: Deficit, premiums would rise if Trump ends subsidies

Fox Business: Health Exchange Premiums Would Rise 20% in 2018 If Subsidies Ended, CBO Estimates — Update

NPR: CBO Predicts Rise In Deficit If Trump Cuts Payments To Insurance Companies

Arkansas Democrat-Gazette: Insurer subsidy cut seen as costly

The Guardian: Trump healthcare subsidy cut would raise premiums by 20%, CBO says

Marketwatch: CBO: Trump threat to scrap cost-sharing payments would increase federal deficits, premiums

New York Times: Trump Threat to Obamacare Would Send Premiums and Deficit Skyward

Wall Street Journal: Health Exchange Premiums Would Rise 20% in 2018 If Subsidies Ended, CBO Estimates

Politico: CBO: Pulling Obamacare subsidies would drive up premiums, reduce coverage

The Hill: CBO: ObamaCare premiums could rise 20 percent if Trump ends payments

Washington Examiner: CBO: Cutting off Obamacare payments would jack premiums up 20 percent

Bloomberg: Halting Obamacare Subsidies Would Increase Deficit, CBO Says

CBS: Premiums and deficit would rise if Trump ends Obamacare payments, CBO says

CNBC: If Trump sabotages Obamacare, premiums will spike 25 percent by 2020, CBO warns

San Francisco Chronicle: CBO: Ending health subsidies would raise premiums 20 percent

Los Angeles Times: Deficit would jump, premiums would rise if Trump ends Obamacare subsidies, CBO says

Business Insider: CBO: Trump could cause healthcare costs to soar for millions of Americans if he ends critical Obamacare payments

CBO Analysis: Trump’s Sabotage Will Force Even Higher Premium Hikes Than Previously Predicted…

Protect Our Care Campaign Director Leslie Dach released the following statement after the nonpartisan Congressional Budget Office confirmed that a decision by President Trump to cancel critical health care payments, known as Cost-Sharing-Reductions, would inject substantial uncertainty in the insurance markets, force premiums to increase by 20% next year and 25% by 2020 and increase costs to the taxpayer by nearly $200 billion over ten years.

“This is the latest confirmation that the Trump administration’s plans to sabotage our health care will hurt millions of middle class Americans — bringing substantial uncertainty to the health insurance markets and forcing even higher double digit premium hikes. President Trump seems to prefer playing political sabotage games over doing his job of lowering costs and improving our health care. Whether he tries to repeal health care by legislation or by sabotage it means higher costs and less coverage for American families — and he will be responsible for those results.

“It’s time for all Republicans in Congress to stand up to Trump’s sabotage agenda, work with Democrats and pass real market stabilization reforms to improve our health care system.”

Key Senate Republicans: Health Care Must be Bipartisan

Republicans Ignoring Trump’s Demands

Despite President Trump’s twitter threats demanding the GOP continue with partisan repeal efforts, Republican Senators — including many in leadership — are acknowledging what the American people have said all along: it’s time to abandon partisan repeal. With the announcement from Sens. Lamar Alexander and Patty Murray that bipartisan hearings will begin the first week of September, it’s clear the only path forward on health care is a bipartisan one.

Sen. Lamar Alexander, Senate HELP Committee Chairman:


Sen. John Cornyn, the number two Senate Republican:


Sen. Orrin Hatch, Senate Finance Committee Chairman: “There’s just too much animosity and we’re too divided on healthcare… I think we ought to acknowledge that we can come back to healthcare afterwards but we need to move ahead on tax reform.”

Sen. John Thune, the third-ranking Republican: “Until somebody shows us a way to get that elusive 50th vote, I think it’s over.

Sen. Roy Blunt, a member of GOP leadership: “Do I think we should stay on health care until we get it done? I think it’s time to move on to something else. Come back to health care when we’ve had more time to get beyond the moment we’re in and see if we can’t put some wins on the board.”

Seven in ten Americans want the Trump Administration and Congress to work across party lines to keep what works and fix what doesn’t in the current law. It’s time Republicans lived up to the promises they made and work with Democratic colleagues to improve our health care.

Trump Administration Would Be To Blame For Additional Double Digit Rate Hikes

Angry at the failure of his partisan effort to repeal health care and because of his hatred for former President Obama, Trump is threatening to cancel payments that help lower people’s deductibles and other out-of-pocket costs. Who will pay the price? Everyday people trying to afford health coverage. Trump’s efforts to sabotage health care have already caused costs to go up. Now, his latest scheme will mean people will have to pay 19% more for their coverage, and could mean that insurance companies are forced to leave some parts of the country altogether.

Republican Members of Congress have recognized that there needs to be swift bipartisan action. Independent experts, business leaders, insurers and insurance commissioners all agree that Trump’s threat is putting at risk people’s health coverage. And the American public — 74 percent — wants Trump and his Administration to do what they can to make the law work — not continue to do what they can to make it fail.

Will Trump listen to his own party, experts and voters? Or will he ignore the facts and punish the American people?

IN RECENT DAYS, TRUMP HAS UPPED HIS THREATS TO DESTABILIZE THE INDIVIDUAL MARKET IN RETALIATION FOR THE SENATE’S FAILED BID TO REPEAL HEALTH CARE



HOWEVER, TRUMP’S STANCE IS THE OPPOSITE OF A NUMBER OF REPUBLICAN SENATORS AND REPRESENTATIVES WHO ARE CALLING FOR BIPARTISAN ACTION TO STRENGTHEN THE INDIVIDUAL MARKET

Senate Majority Leader Mitch McConnell (R-KY): “Some Kind Of Action With Regard To The Private Health Insurance Market Must Occur. No Action Is Not An Alternative.” “‘If my side is unable to agree on an adequate replacement, then some kind of action with regard to the private health insurance market must occur,’ McConnell said. ‘No action is not an alternative. We’ve got the insurance markets imploding all over the country, including in this state.’” [Washington Post, 7/6/17]

Rep. Mark Meadows (R-NC): “I Don’t Think That Letting It Fail Is The Best Option, Even Though It Certainly Allows Additional Pressure To Happen.” “‘I don’t think that letting it fail is the best option, even though it certainly allows additional pressure to happen,’ said Rep. Mark Meadows, R-N.C., who is chairman of the House Freedom Caucus and close ties to the White House. ‘We can do better than that.’” [Washington Examiner, 7/31/17]

Rep. Mark Amodei (R-NV): Amodei Disagrees With President Trump, Believes The Individual Market Should Not Be Allowed To Fail. “Rep. Mark Amodei, R-Nev., rebuked Trump more directly. ‘No,’ he said when asked if he agreed with the president. ‘Clear-cut question — no.’” [Washington Examiner, 7/31/17]

Sen. John Thune (R-SD): “I Hope The President Will Continue To Make Those Payments.” [Kasie Hunt Tweet, 8/1/17]

Sen. Lisa Murkowski (R-AK): “The Senate Should Step Back And Engage In A Bipartisan Process To Address The Failures Of The ACA And Stabilize The Individual Markets.” “As I’ve been saying, the Senate should take a step back and engage in a bipartisan process to address the failures of the ACA and stabilize the individual markets. That will require members on both sides of the aisle to roll up their sleeves and take this to the open committee process where it belongs.” [Murkowski Statement, 7/18/17]

Sen. Lisa Murkowski (R-AK): “The Senate Should Take A Step Back And Engage In A Bipartisan Process To Address The Failures Of The ACA And Stabilize The Individual Markets.” “As I’ve been saying, the Senate should take a step back and engage in a bipartisan process to address the failures of the ACA and stabilize the individual markets. That will require members on both sides of the aisle to roll up their sleeves and take this to the open committee process where it belongs.” [Sen. Murkowski, 7/18/17]

Sen. Bill Cassidy (R-LA): “I Want To Stabilize The Insurance Market.” “Asked if a bipartisan stabilization bill would be needed if the current GOP bill fails, Sen. Bill Cassidy (R-La.) said, ‘I presume.’ He left the door open to supporting such a measure. ‘It depends on what it looks like, but I want to stabilize the insurance market,’ Cassidy said. ‘Families are paying too high premiums, so we’ve got to lower premiums.’” [The Hill, 7/13/17]

Sen. Bill Cassidy (R-LA): “Families Would Be Hurt” If Payments Not Made.” [Sahil Kapur Tweet, 8/1/17]

Sen. Ron Johnson (R-WI): The Senate Should “Bite The Bullet And Stabilize Those Markets.” “Sen. Ron Johnson (R-Wis.) has for months called for a bipartisan stabilization bill that would guarantee funding for ObamaCare payments, known as cost-sharing reductions, to insurers. Those payments are key to avoiding premium spikes and keeping insurers in the markets. Johnson said Tuesday that he hopes the GOP can pass something next week, but if not, ‘bite the bullet and stabilize those markets.’” [The Hill, 7/13/17]

Sen. John Hoeven (R-ND): “We Need To Stabilize The Health Insurance Market.” “Obamacare is failing and premiums continue to increase dramatically with some markets down to one or no insurance providers. That is why we need to make reforms to provide Americans with access to health care and affordable health insurance with more choice and competition. The CBO score of the Senate draft health care bill indicates that this legislation needs additional work to ensure that it meets this goal. Also, health care reform will be a process, not one bill. We need to stabilize the health insurance market to make it more competitive so consumers have access to better and more affordable health care policies. In addition, we want to ensure that low-income people have access to health care coverage either through Medicaid or a refundable tax credit that enables them to buy their own health insurance policy.” [Hoeven Statement, 6/27/17]

Sen. Lamar Alexander (R-TN): “The Senate Health Committee Has A Responsibility During The Next Few Weeks To Hold Hearings And Continue Exploring How To Stabilize The Individual Market.” “My main concern is doing all I can to help the 350,000 Tennesseans and 18 million Americans in the individual market who may literally have no options to purchase health insurance in 2018 and 2019. However the votes come out on the health care bill, the Senate health committee has a responsibility during the next few weeks to hold hearings to continue exploring how to stabilize the individual market. I will consult with Senate leadership and then I will set those hearings after the Senate votes on the health care bill.” [Alexander Statement, 7/18/17]

Sen. Lamar Alexander (R-TN): We Should “Approve The Temporary Continuation Of Cost-Sharing Subsidies For Deductibles And Co-Pays.” “‘While we build replacements, we want the 11 million Americans who now buy insurance on the exchanges to be able to continue to buy private insurance. Among the actions that will help are to… approve the temporary continuation of cost-sharing subsidies for deductibles and co-pays.’” [Politico Pro, 1/13/17]

INSURANCE COMPANIES AND STATE INSURANCE COMMISSIONERS HAVE WARNED THAT DEFAULTING ON COST SHARING PAYMENTS WILL INCREASE PREMIUMS, DESTABILIZE THE INDIVIDUAL MARKET, AND POTENTIALLY DISRUPT COVERAGE

National Association Of Insurance Commissioners: “Congress Must Act Quickly To Stabilize The Individual Health Insurance Marketplace Before They Adjourn For The District Work Period.” “As the latest attempt to repeal and replace the Affordable Care Act has failed, Congress must act quickly to stabilize the individual health insurance marketplace before they adjourn for the district work period. The window to act is rapidly closing, as rates must be finalized by mid-August and insurers are deciding whether to remain in this market or not. Without action, we anticipate more and more insurance companies pulling out across the country and significant premium rate increases in the majority of states. The National Association of Insurance Commissioners (NAIC) urges the Congress to take two immediate actions — fund CSR payments and market stability funding — to help shore up these markets. Cost-sharing reduction (CSR) payments are critical to the viability of the individual health insurance markets in a significant number of states and must be funded through 2018. Sufficient and sustained market stabilization funding for states to establish reinsurance programs or high-risk pool programs is also needed for long-term stability beyond 2018. These two actions alone would go a long way toward steadying the individual markets while ongoing debates over legislative replacement and reform options continue.” [NAIC, 7/28/17]

National Association of Insurance Commissioners: “We Write Today To Urge The Administration To Continue Full Funding For The Cost-Sharing Reduction Payments For 2017 And Make A Commitment That Such Payments Will Continue, Unless The Law Is Changed.” “On behalf of the nation’s state insurance commissioners, the primary regulators of U.S. insurance markets, we write today to urge the Administration to continue full funding for the cost-sharing reduction payments for 2017 and make a commitment that such payments will continue, unless the law is changed. Your action is critical to the viability and stability of the individual health insurance markets in a significant number of states across the country.” [Letter to Mick Mulvaney, 5/17/17]

Dan Hilferty, President and CEO, Independence Blue Cross: “We Firmly Believe Your Coverage Will Be There For 2018, If The Federal Government, Congress And President Commit To, Fund The Subsidies During An Interim Period Of Time.” “We firmly believe your coverage will be there for 2018, if the federal government, congress and president commit to, fund the subsidies during an interim period of time when we look at how we can fix the program long-term.” [CNN, 7/19/17]

Kurt Giesa, Practice Leader, Oliver Wyman Actuarial Consulting: “If payers do not gain clarity on funding of CSR payments soon, they will have to build that cost into their premiums.” “ … the current uncertainty regarding health reform and the ACA exchanges is making actuaries’ task as difficult as it has ever been … Two market influences, in particular, are complicating 2018 rate setting: the uncertainty surrounding continued funding of cost sharing reduction (CSR) payments and the question of how the relaxation of the individual mandate will impact enrollment and risk pools. Our modeling shows that this uncertainty, if it remains, could lead payers to submit rate increases between 28 and 40 percent, and more than two-thirds of those increases will be related to the uncertainty around CSR payments and individual mandate … If payers do not gain clarity on funding of CSR payments soon, they will have to build that cost into their premiums.” [Oliver Wyman Analysis, 6/14/17]

Dr. Mario Molina, Former CEO Of Molina Healthcare: ‘Don’t Let The Administration Fool You’ Into Thinking Insurers Are To Blame For Raising Premiums Instead Of Sabotage.” “The administration and Republicans in Congress want you to believe that insurers raising premiums for their plans or exiting the marketplaces all together are consequences of the design of the Affordable Care Act instead of the direct results of their own actions to sabotage the law. Don’t let them fool you.” [Op-Ed in US News & World Report, 5/30/17]

Dave Jones, California State Insurance Commissioner: “President Trump Appears On A Mission To Destroy Health-insurance Markets By Creating Instability Through His Own Actions And Thereby Depriving Millions Of Americans Of Health-care Coverage.” “President Trump’s first executive order directed federal agencies to ‘waive, defer, grant exemptions from, or delay’ ACA requirements. The IRS then announced reduced enforcement of the ACA health-insurance mandate, which in turn exposes health insurers to tremendous uncertainty as to who will be in the 2018 market. President Trump also threatens to cut the ACA assistance that consumers rely on to afford health care. In April Mr. Trump stated, ‘ObamaCare is dead next month if it doesn’t get that money.’ Just last month the nation’s insurance commissioners wrote to the Trump administration requesting assurances that cost-sharing reduction payments will continue, noting that this is critical to the ‘viability and stability of the individual marketplace.’ No such assurance has been provided. President Trump appears on a mission to destroy health-insurance markets by creating instability through his own actions and thereby depriving millions of Americans of health-care coverage.” [Letter to the Editor in Wall Street Journal, 6/27/17]

Marguerite Salazar, Colorado’s State Insurance Commissioner: The Trump Administration Threatens The Whole Market. “In Colorado, where most consumers continue to have multiple insurance choices, commissioner Marguerite Salazar said the Trump administration threatens the whole market. ‘My fear is it may collapse,’ she said.” [Los Angeles Times, 5/18/17]

John Naylor, CEO Of Medica In Iowa: “It Is Challenging To Stay Focused On Our Mission To Provide Access To High-quality Affordable Health Care When There’s Noise Around The System And A Lack Of Clarity Of Rules.” “‘It is challenging to stay focused on our mission to provide access to high-quality affordable health care when there’s noise around the system and a lack of clarity of rules,’ said John Naylor, chief executive of Medica, who called the amount of uncertainty being thrown at insurers at the moment unprecedented.” [Washington Post, 5/12/17]

Eric A. Cioppa, Superintendent of the Maine Bureau of Insurance: “If They Don’t Get A Subsidy, I Fully Expect Double-digit Increases For Three Carriers On The Exchanges Here.” “The uncertainty is extremely problematic. If they don’t get a subsidy, I fully expect double-digit increases for three carriers on the exchanges here.” [New York Times, 6/4/17]

Danielle Devine, Michigan Director of Operations, Meridian Health Plan: “The Uncertainty Over The Future Of The Subsidies Creates The Largest Reason For Significant Rate Increases.” “The political climate continues to make it difficult to price and the uncertainty over the future of the subsidies creates the largest reason for significant rate increases.” [Crain’s Detroit Business, 6/14/17]

Rick Notter, Director of Individual Business, Blue Cross Blue Shield of Michigan: “If We Don’t Have That Cost-sharing (Subsidy), We Have To Make Up The Difference And The Only Way For Us To Do That Is With A Higher Rate.” “If we don’t have that cost-sharing (subsidy), we have to make up the difference and the only way for us to do that is with a higher rate.” [Detroit Free Press, 6/14/17]

John Goodnow, CEO, Benefis Health System in Montana: Goodnow Said The Lifespan Of The Affordable Care Act Has Been Shortened Because Insurance Companies Are Pulling Out Of The Exchanges ‘because Of All The Fear That’s Been Created Over Funding.’ “Republicans are injecting instability into federal insurance marketplaces by suggesting lowering subsidies for people who buy coverage, and it’s a ‘slick trick’ to ensure the failure of the exchanges, the head of one of Montana’s largest hospitals said Thursday … Great Falls-based Benefis CEO John Goodnow said the lifespan of the Affordable Care Act has been shortened because insurance companies are pulling out of the exchanges ‘because of all the fear that’s been created over funding. ‘All you have to do is threaten to defund the subsidies,’ he said Thursday on a panel in Helena organized by the Montana Nurses Association to discuss the bill.” [Billings Gazette, 7/7/17]

Brad Wilson, CEO, Blue Cross Blue Shield of North Carolina: “The Failure Of The Administration And The House To Bring Certainty And Clarity By Funding CSRs Has Caused Our Company To File A 22.9 Percent Premium Increase, Rather Than One That Is Materially Lower.” “The failure of the administration and the House to bring certainty and clarity by funding CSRs has caused our company to file a 22.9 percent premium increase, rather than one that is materially lower. That will impact hundreds of thousands of North Carolinians.” [Washington Post, 5/26/17]

Teresa Miller, Pennsylvania Insurance Commissioner: “Instability Caused By Adverse Action From The Federal Government Will Do Nothing But Hurt Consumers Who Are Stuck In The Middle.” “Information provided by insurers shows the extent to which instability and changes would impact Pennsylvania’s 2018 health insurance rates. This proves what we already know — instability caused by adverse action from the federal government will do nothing but hurt consumers who are stuck in the middle. The 506,000 Pennsylvanians with Affordable Care Act-compliant plans in the individual market deserve single-digit rate increases like the ones most people will see if Congress and the Trump Administration choose not to risk consumers’ health and financial well-being by jeopardizing the stability of these markets.” [Press Release, 6/1/17]

Julie Mix McPeak, Tennessee State Insurance Commissioner: “Members Could Help Bring Immediate Stability And Potential Rate Relief For Our Consumers By Appropriating Cost-sharing Reduction Payments For The 2017 And 2018 Plan Years.” “As Congress continues to debate ACA reform efforts, Members could help bring immediate stability and potential rate relief for our consumers by appropriating cost-sharing reduction payments for the 2017 and 2018 plan years. Every dollar matters when Tennessee consumers are feeling like they need to choose between health insurance or groceries or mortgage payments and the Congress could take action that would pay immediate dividends.” [Statement, 7/7/17]

Julie Mix McPeak, Tennessee State Insurance Commissioner: “No One Feels Optimistic About The Market If CSRs Are Not Funded.” “I asked my colleagues at a meeting of insurance commissioners nationwide, and no one feels optimistic about the market if CSRs are not funded. We would prefer for funding of those cost-sharing reductions through ’19. Again figuring out who gets to make that decision has been tough for us as regulators …It’s that instability, that uncertainty, the insurers hate the most. They are going to price for that.” [The Tennessean, 5/12/17]

Kelly Paulk, Vice President, Product Strategy and Individual Markets, BlueCross BlueShield of Tennessee: Factoring In Whether The Cost-Sharing Reductions Are Paid And If The Coverage Mandate Will Be Enforced Will Raise Premiums By 21 Percent On Average. “Our 2017 rates are allowing us to earn a margin (profit) for the first time in four years and would have enabled us to propose only a small increase for 2018 to cover expected changes in medical and operating costs. However, we have to factor in two significant uncertainties — whether the federal government will fund cost-sharing reductions for low-income members and how the risk pool will change if the coverage mandate is not enforced … Combining those two factors leads to an average 21 percent rate increase.” [Blog Post, 6/30/17]

Mike Kreidler, Washington State Insurance Commissioner: “The Current Federal Administration’s Actions — Such As Not Committing To Reimburse Insurers For Cost-sharing Subsidies And Not Enforcing The Individual Mandate — Appear Focused Only On Destabilizing The Insurance Market.” “There is a great deal of uncertainty underlying our country’s health insurance system today and no state is immune. There are specific issues with our health insurance system that we need to address, such as the rising costs of prescription drugs and health care services. Yet, the current federal administration’s actions — such as not committing to reimburse insurers for cost-sharing subsidies and not enforcing the individual mandate — appear focused only on destabilizing the insurance market. Sadly, it’s the people in our communities and across the country who will pay the price.” [Statement, 6/19/17]

Breaking News: Trump WH Made Secret Promise that Health Care Repeal Will Include Cruz Amendment

According to FOX Business, the Trump Administration has made a secret promise that the final health care repeal WILL include the “Cruz Amendment” which, according to bipartisan analysts, guts protections for those with pre-existing conditions and completely destabilizes the health care markets.

The Trump Administration has now made it clear that any Republican who votes to proceed on repealing health care will be responsible for the damage the Cruz amendment does to people’s health care.

Here’s what you need to know about what health care repeal would mean with the Cruz amendment — it guts consumer protections, turns the health care market into a real death spiral and raise costs.

Look at what Republican Senators and health experts have to say about it…

THE CRUZ PROPOSAL WOULD GUT CONSUMER PROTECTIONS LIKE GETTING RID OF ANNUAL AND LIFETIME LIMITS

Sen. Chuck Grassley (R-IA): “There’s A Real Feeling That That’s Subterfuge To Get Around Pre-Existing Conditions.” “‘There’s a real feeling that that’s subterfuge to get around pre-existing conditions,’ says Grassley. ‘If it is subterfuge and it has the effect of annihilating the pre-existing condition requirement that we have in the existing bill, than obviously I would object to that.’” [Iowa Public Radio, 7/5/17]

Sen. Shelley Moore Capito (R-WV): Cruz Amendment “Would Make It Too Difficult For People With Pre-Existing Conditions To Get Coverage.” “‘I think that reopens an issue that I can’t support, that it would make it too difficult for people with pre-existing conditions to get coverage,’ she said.” [Charleston Gazette-Mail, 7/8/17]

THE CRUZ PROPOSAL WOULD DESTABILIZE THE MARKETPLACE AND LEAD TO A DEATH SPIRAL

Larry Levitt, Senior Vice President, Kaiser Family Foundation: Cruz Plan “The Perfect Recipe For Destabilizing The Market And Turning The Marketplaces Into High-Risk Pools.” “‘If there were a Joy of Cooking for insurance, this would be the perfect recipe for destabilizing the market and turning the marketplaces into high-risk pools,’ said Larry Levitt, senior vice president at the Kaiser Family Foundation.” [CNN Money, 7/6/17]

Douglas Holtz-Eakin, Former Director, Congressional Budget Office Director, And President, American Action Forum: “That’s A Recipe For A Meltdown.” “‘What that will do is allow insurers to offer cheap policy to young invincibles. And on the exchange you’re going to get all the sick people,’ said Douglas Holtz-Eakin, a former Congressional Budget Office director and president of the American Action Forum. ‘That’s a recipe for a meltdown. You’ve split the risk pool into two exchanges.’ And, he added: ‘I think it would end up being bad politics.’” [Politico, 7/1/17]

Tara O’Neill Hayes, Deputy Director Of Health Care Policy, American Action Forum: “I Think That Really Would Be The Definition Of A Death Spiral.” “‘I think that really would be the definition of a death spiral,’ said Tara O’Neill Hayes, deputy director of health care policy at the conservative American Action Forum. ‘I think it would no longer be a question of whether that’s happening.’” [Politico, 7/11/17]

Craig Garthwaite, Health Insurance Expert, Northwestern University: “The Sick Would Be Attracted To Cheaper Plans, With The Knowledge They Could Always Move Into More Generous Plans If They Got Sick.” “‘The sick would be attracted to generous plans, while the healthy would be attracted to cheaper plans, with the knowledge they could always move into more generous plans if they got sick,’ said Craig Garthwaite, a health insurance expert at Northwestern University. ‘That kind of adverse selection makes pricing and offering insurance very hard.’” [Modern Healthcare, 6/30/17]

Vox: “The Fundamental Problem Is Sicker People Would Be Drawn To The More Robust Obamacare Plans, While Healthier People Would Gravitate Toward The Skimpier Non-Obamacare Coverage.” “The fundamental problem is sicker people would be drawn to the more robust Obamacare plans, while healthier people would gravitate toward the skimpier non-Obamacare coverage. That’s a reality that even Cruz acknowledges. Then inside the Obamacare market, as more and more sick people buy coverage there, costs for health insurers go up and so they increase premiums. It has the makings of a classic death spiral. Because only sick people remain, premiums eventually increase to astronomic levels. It turns the Obamacare exchanges into a high-risk pool.” [Vox, 6/29/17]

THE CRUZ PROPOSAL WOULD RAISE COSTS FOR PEOPLE WITH PRE-EXISTING CONDITIONS

Ceci Connolly, CEO, Alliance Of Community Health Plans: “You Are Increasing The Likelihood That There Will Be Some Smaller, Sicker Group With Higher Rates.” “Separating the sick and the healthy is ‘not the best path forward,’ said Ceci Connolly, CEO of Alliance of Community Health Plans, a lobbying group for non-profit, community-based insurers. Instead, it’s better to spread the risk around in a larger pools of enrollees. The Cruz option would do the opposite. ‘You are increasing the likelihood that there will be some smaller, sicker group with higher rates,’ Connolly said. ‘That’s what you want to get away from.’” [CNN Money, 7/6/17]

Larry Levitt, Senior Vice President, Kaiser Family Foundation: “If They Have Pre-Existing Conditions, They’d Be Stuck In Plans With Escalating Premiums.” “Americans with higher incomes who wanted to buy an Obamacare-compliant plan, people likely to have high medical costs themselves, would have no protection from skyrocketing premiums. ‘If they’re healthy, they could buy inexpensive non-compliant plans. But if they have pre-existing conditions, they’d be stuck in plans with escalating premiums,’ Levitt said.” [Vox, 6/29/17]

Tim Jost, Law Professor, Washington And Lee University: “If This Were Adopted, Premiums Would Skyrocket For People Who Need Comprehensive Coverage.” “Health analysts said the amendment would cause premiums for that demographic to jump, resurrecting a thorny political issue that drew national attention earlier this year when House Republicans added a similar measure to their bill, known as the MacArthur amendment. ‘If this were adopted, premiums would skyrocket for people who need comprehensive coverage,’ said Timothy Jost, a law professor at Washington and Lee University in Lexington, Va.” [Wall Street Journal, 7/5/17]

Joe Antos, Health Policy Expert, American Enterprise Institute: People With Chronic Illness “Will End Up Paying More.” “‘Someone with chronic illness, they’re going to end up wanting to buy the more comprehensive coverage,’ says Joe Antos, a health policy expert with the conservative American Enterprise Institute. ‘This means that people with those kinds of illnesses will end up paying more. Even if they receive a federal subsidy, they will likely see higher cost sharing.’ … ‘The people who don’t know something will happen and come down with something, those are the ones at issue,’ Antos argues. ‘It’s not the people who planned ahead and bought the more expensive plan. It’s those who didn’t.’” [Vox, 7/10/17]

Wall Street Journal: “Middle-Income Earners With Pre-Existing Conditions Would Be The Hardest Hit.” “Such a bifurcation likely would mean increased costs for comprehensive plans, analysts said. People receiving the bill’s tax credits would be buffered from the price increases, but those who earn 350% of the poverty level and wouldn’t be eligible for the credits would pay more, they said. Middle-income earners with pre-existing conditions would be the hardest hit.” [Wall Street Journal, 7/5/17]

Larry Levitt, Senior Vice President, Kaiser Family Foundation: Getting Premiums Down “Comes Down To Relaxing Rules That Protect People With Pre-Existing Conditions.” “‘When it gets to crunchtime on these health bills, the discussion comes down to getting premiums down,’ said Larry Levitt, a senior vice president at Kaiser Family Foundation. ‘And that comes down to relaxing rules that protect people with pre-existing conditions.’” [Wall Street Journal, 7/5/17]

New Analysis: GOP’s Health Care Repeal Will Do More Harm To Trump’s “Obamacare Victims”

NEW ANALYSIS: GOP’S HEALTH CARE REPEAL WILL DO MORE HARM TO TRUMP’S “OBAMACARE VICTIMS”

President Trump highlighted the stories of four people who he claimed were “victimized” by the Affordable Care Act during a press stunt today.

Unfortunately for the Senate GOP, based on what’s known about the people President Trump highlighted, their health care repeal would do nothing for them. And could actually make things worse.

Uh oh.

PERSON #1

Trump Said: “After an excruciating series of events and complications, Melissa and her husband found themselves just before Christmas, emotionally and financially devastated, crying in a doctor’s office faced with yet another seemingly unpayable bill. When insurance wouldn’t cover the Ackisons’ care, they emptied out Melissa’s 401K to pay their bills.”

If GOP’s Repeal Passes: Under the Senate’s BCRA repeal effort, essential health benefits would be repealed, so routine doctor’s visits and hospitalizations may not even be covered by insurance plans.

PERSON #2

Trump Said:Democrats promised Americans like Steve Finn, a former police officer in West Virginia, that they would save $2,500 per year under Obamacare. Instead his premiums have more than tripled. That’s pretty bad. As a result of Obamacare’s skyrocketing costs, Steve and his family, and many of his employees, had no other option than going on Medicaid and giving up their existing coverage. For them Obamacare’s promise was a nightmare.”

If GOP’s Repeal Passes: Under the Senate’s BCRA repeal effort, premiums are projected to go up by 20% next year and deductibles would skyrocket to $13,000. Steve and his family could pay more out-of-pocket for their premiums and care because, unlike under current law, BCRA’s tax credits would not offset rising premiums. And if they are still Medicaid beneficiaries, the BCRA cuts over $700 billion from the program, so Steve and his family could lose their Medicaid coverage altogether.

PERSON #3

Trump Said: “Democrats promised families like the Weers that if they liked their doctor, they could keep their doctor — but now there is only one insurer left in the state exchange, and Marjorie says that every year she waits anxiously to learn if the doctors and hospitals which her son needs the most will remain in their network.”

If GOP’s Repeal Passes: Under the Senate’s BCRA repeal effort, insurance companies would be allowed to contract with hospitals and draw narrower networks than under what is permitted under current law. Under current law, consumers benefit from “network adequacy standards,” but the narrow networks of hospitals and doctors now could get even worse under the BCRA. In short, the Weers could still buy a plan where their doctor was out of network. But under the BCRA, the cost of coverage for people with pre-existing conditions would skyrocket.

PERSON #4

Trump Said: “Erin and Andy Witzig are small business owners from Illinois. They have six children. Their youngest daughter, Poppy, has a rare genetic condition. Children born with it are sometimes called Butterfly Children, because their skin is as fragile as the wings of a butterfly. Poppy has to wear special bandages all of the time. Unfortunately, under Obamacare, Poppy’s family insurance has been repeatedly discontinued and replaced with what Washington deems equivalent policies, but for Poppy these plans are not equivalent, and Poppy’s family has to spend precious time and tremendous resources fighting for exceptions for Poppy.”

If GOP Repeal Passes: Under BCRA, without insurance plans required to offer comprehensive coverage, people with complex medical needs such as the Witzig’s youngest daughter would be left to pay substantially more out-of-pocket for a similar level of coverage offered today. BCRA would also allow insurance companies to implement annual and lifetime limits. For someone with medical needs like Poppy, this could result in even higher out-of-pocket costs for her care.

Those Who Know Health Care the Best Say the Senate Repeal Bill Is Still the Worst

Every time Senate Republicans rework their devastating health care repeal bill, they promise us they’re going to make it better.

Every time they end up making it worse.

Their health care repeal is the least popular legislation in 30 years, with the support of only 12% of the public and opposition from bipartisan group of governors.

On top of that, the experts who know health care the best — doctors, nurses, disease advocates, seniors’ groups, etc. — all know the bill will make health care far worse with cuts to coverage, higher premiums and deductibles and fewer protections for people, including those with pre-existing conditions.

The question is — are Senate Republicans listening to everyone or only listening to themselves?

PATIENT GROUPS

33 Leading Cancer Organizations: “The Senate’s BCRA, Just As The House’s AHCA, Is A Direct Threat To America’s 16 Million Cancer Patients And Survivors Who Rely On Timely And Uninterrupted Access To Comprehensive And Affordable Health Care.” “The Senate’s BCRA, just as the House’s AHCA, is a direct threat to America’s 16 million cancer patients and survivors who rely on timely and uninterrupted access to comprehensive and affordable health care,” said NCCS CEO Shelley Fuld Nasso. “With an estimated 22 million losing coverage, severe cuts to Medicaid, and elimination of pre-existing condition protections, this bill is devastating for the American people, especially for anyone with a cancer diagnosis. It is time to end this threat that is causing fear and anxiety throughout the cancer community, and work towards bipartisan solutions to strengthen current law.” [NCSS, 7/13/17]

American Cancer Society Cancer Action Network: “The Latest Proposed Changes To The Senate Health Care Bill Would Make Access To Health Coverage Worse For Those With Pre-Existing Conditions Like Cancer.” “The latest proposed changes to the Senate health care bill would make access to health coverage worse for those with pre-existing conditions like cancer. The reluctance by senators to include patient feedback and other relevant stakeholder perspectives in the process is preventing the development of a reasonable, bipartisan consensus that could improve the law and pass the Senate.” [ACS CAN, 7/13/17]

American Society Of Clinical Oncology: “ASCO’s Core Mission Is To Ensure That Cancer Patients Have Meaningful Access To High Quality Cancer Care. The Better Care Reconciliation Act Runs Counter To This Goal.” “ASCO’s core mission is to ensure that cancer patients have meaningful access to high quality cancer care. The Better Care Reconciliation Act runs counter to this goal. ASCO’s guiding principles for health reform support improvements to the current health care system, and outline specific areas where people with cancer need protections. We shared these principles in January of this year and stand by them today. ASCO believes that any health system reform must ensure that all people affected by cancer receive high-quality care. We know Congress shares this belief and call on the Senate to work in a bipartisan manner to ensure access to high-quality cancer care, rather than move forward with H.R. 1628. As cancer care providers, we are especially concerned with provisions that would erode critical protections for patients with cancer by allowing insurers to sell products that do not meet their needs, including coverage for essential screening services. Additionally, a six-month waiting period for those that fail to obtain continuous coverage could leave many cancer patients and survivors without access to needed care. Reducing access to affordable health insurance will add costs to the system, decrease access to appropriate treatment and increase existing disparities in care. Removing protections from current federal law through state waivers or other means allows for a weakening of these critical provisions and a system of inequitable treatment across state lines for cancer patients. We urge policymakers to ensure that robust requirements are in place to ensure that all insurance products cover the full scope of services and therapies that cancer patients require. ASCO strongly opposes passage of the Better Care Reconciliation Act.” [ASCO, 7/13/17]

American Lung Association: “The Revised Better Care Reconciliation Act Does Not Address The Major Concerns About Quality And Affordable Healthcare Previously Outlined.” “The American Lung Association is very disappointed to see that the revised Better Care Reconciliation Act does not address the major concerns about quality and affordable healthcare previously outlined by the American Lung Association and therefore, our organization must still oppose this bill. The legislation would still make devastating cuts to Medicaid, which will harm many patients living with a lung disease. It would also still result in removing key patient protections, including for patients with pre-existing conditions. The American Lung Association is particularly troubled by the Cruz Amendment, which would result in higher, not lower, premiums for people with serious and chronic conditions. The American Lung Association has long stated that any healthcare legislation must be adequate, affordable and accessible. This bill still fails to meet this standard. The American Lung Association urges Senators to vote no on both the motion to proceed and the underlying bill. Instead, the Senate should start over with a bipartisan process aimed at improving healthcare for all Americans.” [ALA, 7/13/17]

PHYSICIANS, NURSES, SOCIAL WORKERS, PSYCHOLOGISTS

American Medical Association: “The Revised Bill Does Not Address The Key Concerns Of Physicians And Patients Regarding Proposed Medicaid Cuts And Inadequate Subsidies That Will Result In Millions Of Americans Losing Health Insurance Coverage.” “The revised bill does not address the key concerns of physicians and patients regarding proposed Medicaid cuts and inadequate subsidies that will result in millions of Americans losing health insurance coverage. The additional funding to address the opioid epidemic is a positive step, however, those suffering from substance use disorder have other health care needs that are not likely to be addressed if they lose coverage through a rollback of the Medicaid expansion. While stabilizing the individual market is an initial step, more bipartisan collaboration is needed in the months ahead to improve the delivery and financing of health care.” [AMA, 7/14/17]

American Congress Of Obstetricians And Gynecologists: “The BCRA Is Deeply Flawed, Cannot Be Fixed And Keeps Getting Worse.” “This most recent version of the Better Care Reconciliation Act is not “better” for patients. The BCRA is deeply flawed, cannot be fixed and keeps getting worse. Its original version deliberately stripped landmark women’s health gains made by the Affordable Care Act, turning back the clock on women’s health. This new version threatens to leave patients with preexisting conditions without care. Senators drafting these proposals still aren’t listening to America’s doctors. Yesterday, ACOG joined leaders representing 560,000 frontline physicians on Capitol Hill with one unified message to Senators: the BCRA is dangerous for patients and must be rejected. ACOG’s bottom line is simple: No legislation should take away coverage that patients have today. There’s only one solution. The Senate should put the BCRA where it belongs, in the circular file, not on the floor for a vote. Republican and Democratic senators should work with ob-gyns and other physicians on a new approach that will preserve women’s access to contraception and maternity care and improve the health care system for everyone. We stand ready to partner with the U.S. House and Senate and the White House on practical solutions to improve our nation’s health and reduce health care costs.” [ACOG, 7/14/17]

American Psychiatric Association: “Wordsmithing And Throwing Money At Certain Constituencies To Gain More Votes Highlights A Deeply Flawed Senate Proposal That Is Insufficient.” “Wordsmithing and throwing money at certain constituencies to gain more votes highlights a deeply flawed Senate proposal that is insufficient. The changed bill still rolls back access to care and allows for the removal of essential health benefits, such as treatment for mental illness and substance use disorders that will affect millions of patients and their families — from the young to the elderly to the most vulnerable in all our communities.” [APA, 7/13/17]

American College Of Physicians: “These Changes, Especially Title III, Will Make The Bill Even More Flawed And Therefore Even More Harmful To Our Patients.” “On behalf of the American College of Physicians (ACP), today ACP wrote Senate leaders to reaffirm our strongest possible opposition to the Better Care Reconciliation Act (BCRA) of 2017, despite the changes released today, as part of a revised bill. We believe these changes, especially Title III, will make the bill even more flawed and therefore even more harmful to our patients by creating new and perhaps insurmountable coverage barriers for patients with pre-existing conditions and by severely weakening or completely eliminating requirements that insurers cover essential health benefits (EHBs) and abide other protections like a community rating… The BCRA — even with modifications — will not preserve and improve essential coverage, benefits and consumer protections, and access to care for both currently insured and uninsured individuals, children and families.” [ACP, 7/13/17]

American Psychological Association: “More Damaging Than The Original Draft, Since It Would Support The Creation Of Bare-Bones Health Insurance Policies That Do Not Cover Mental Health And Substance-Use Treatment And Other Vital Services.” “The latest version of the Senate bill to repeal and replace the Affordable Care Act, the Better Care Reconciliation Act of 2017, is more damaging than the original draft, since it would support the creation of bare-bones health insurance policies that do not cover mental health and substance-use treatment and other vital services, according to the American Psychological Association. The new bill would also weaken current legal protections, making coverage much more expensive — and perhaps unaffordable — for people with pre-existing conditions, including mental health and substance-use disorders, according to the APA.” [APA, 7/13/17]

Association Of American Medical Colleges: “The Revised Bill Released Today Still Falls Woefully Short In Providing Americans With Comprehensive, Affordable Health Coverage, And Will Leave Millions Without Any Coverage At All.” “Notwithstanding the widespread concerns with the original Better Care Reconciliation Act, the revised bill released today still falls woefully short in providing Americans with comprehensive, affordable health coverage, and will leave millions without any coverage at all. As Congress has discussed repealing and replacing the Affordable Care Act, the nation’s medical schools and teaching hospitals have held steadfast that any replacement bill should at least maintain current levels of health coverage, not weaken Medicaid, and be the result of a deliberative and transparent process. The first version of the BCRA failed to meet these criteria, as does the revised version. The changes do nothing to address provisions that would cripple Medicaid and put added financial pressure on state budgets and health care providers. Additionally, allowing insurers to sell plans without meaningful coverage will hurt those with preexisting conditions and further destabilize insurance markets. Finally, providing time-limited money to help individuals purchase insurance does not give patients the long-term health security they need. The nation’s medical schools and teaching hospitals see firsthand that when our patients do not have sufficient coverage, they often delay seeking much-needed care, turning manageable conditions into dangerous and costly emergencies. We urge members of the Senate to reject this bill and work together to craft legislation that will protect Americans’ health care and will not result in millions more Americans uninsured. The AAMC stands ready to work with Congress to shape a solution that improves the health of all.” [AAMC, 7/13/17]

HOSPITALS

American Hospital Association: “The Unacceptable Flaws Of BCRA Remain Unchanged, And There Are No Significant Changes To The Massive Medicaid Reductions.” “Last month, we urged the Senate to go back to the drawing board after its original proposal included dramatic cuts to the Medicaid program and the loss of health care coverage for tens of millions of Americans. If enacted, BCRA would mean real consequences for real people — among them people with chronic conditions such as cancer, individuals with disabilities who need long-term services and support, and the elderly. Unfortunately, in the latest update released today, the unacceptable flaws of BCRA remain unchanged, and there are no significant changes to the massive Medicaid reductions. Instead of merely tweaking a proposal that would harm our most vulnerable, we again call on the Senate to advance a solution aimed at protecting coverage for all Americans who currently have it. Instead of merely putting forth an update, we again call on the Senate to put forth an upgrade.” [AHA, 7/13/17]

Catholic Health Association: “Today’s Release Of The Updated Senate Better Care Reconciliation Act Reinforces The Fact That This Bill Is So Flawed It Cannot Be Fixed.” “Today’s release of the updated Senate Better Care Reconciliation Act reinforces the fact that this bill is so flawed it cannot be fixed. The proposed changes do not amend the core issue that this bill will ultimately take health care away from millions of our nation’s most vulnerable populations. For this reason we continue to encourage Senators to oppose this bill and to work together towards improvements in our health care system that will stabilize the insurance market, improve affordability, and strengthen and expand the coverage gains already achieved. The latest version of the bill would still radically restructure the Medicaid program through per capita caps or block grants which would shift the cost burden onto local and state governments, providers and individual beneficiaries. States would be focused on ways to cut eligibility, benefits and provider payments rather than ways to improve care and lower costs over the long term by creating a better delivery system. Additionally, this bill will harm older Americans who will face significantly higher costs through age rating and undermine protections for people with pre-existing conditions by allowing insurance companies to waive essential health benefits and make coverage for pre-existing conditions unaffordable.” [CHA, 7/13/17]

America’s Essential Hospitals: “Senate Leaders Again Have Put Forward An Entirely Unacceptable Bill To Repeal And Replace The Affordable Care Act.” “Senate leaders again have put forward an entirely unacceptable bill to repeal and replace the Affordable Care Act. Their revised Better Care Reconciliation Act leaves untouched the most destructive provisions of the original bill: those that would gut the Medicaid program and strip affordable coverage from millions of low-income working Americans and others who face financial hardships. Making a bad bill worse, the Senate added measures that would destabilize the private market by creating a two-tiered system that funnels the sick and others most in need of affordable coverage into the highest-cost plans. The bill’s attempts to placate critics represent nothing more than token efforts. The additional dollars to combat the nation’s opioid crisis fall far short of replacing the treatment funds lost through the bill’s deep Medicaid cuts. Likewise, added spending to help low-income people pales in comparison to the hundreds of billions of dollars this bill would drain from Medicaid by ending expansion and imposing spending caps. The Senate must stop and accept that this deeply unpopular bill is bad for patients, bad for hospitals, and bad for the country. We urge lawmakers to reach across the aisle and work with all stakeholders for solutions that ensure everyone can afford high-quality care.” [AEH, 7/13/17]

Arizona Hospital And Healthcare Association: “The Better Care Reconciliation Act Remains A Bad Deal For Arizona Patients, Families And Health Care Providers.” “The latest Senate healthcare plan pays lip service to concerns regarding massive federal cuts to drug treatment and state budgets, but does not markedly alter an underlying proposal that continues to promise higher costs and reduced patient access to care. Most significantly, today’s amended proposal still slashes more than $800 billion from Medicaid — safety-net healthcare for nearly 2 million Arizonans, including thousands of veterans and 1 in 2 children in the state. As the Ducey administration has noted, these Medicaid cuts would result in a $7.1 billion financial hit to our state budget. An estimated 400,000 Arizonans are likely to fall off Medicaid as a result, leaving these families just one illness or injury away from financial catastrophe. “For months, the Arizona Hospital and Healthcare Association has called on Congress to deliver a responsible proposal that addresses shortcomings with the Affordable Care Act, especially regarding the health exchanges. This latest proposal falls short. The Better Care Reconciliation Act remains a bad deal for Arizona patients, families and health care providers.” [AZHHA, 7/13/17]

MENTAL HEALTH AND SUBSTANCE USE DISORDER GROUPS

Mental Health America: “This New Proposal Is Opposed By Insurance Companies, Providers, Advocates, And An Overwhelming Majority Of The Public. This Should Tell Us Something.” “If the American Health Care Act (AHCA) was worse than the Affordable Care Act (ACA), and the initial Better Care Reconciliation Act (BCRA) was worse than AHCA, then this new version of the BCRA — released yesterday — is worst of all. It retains all the provisions of the original BCRA that frightened so many people: significantly higher insurance costs for older people, huge cuts to Medicaid, penalties for those who lose their insurance when they try to sign up again, higher average deductibles for everyone, and no guarantees of minimum payouts by insurers for those with chronic conditions, including mental illnesses. It also reduces subsidies offered to the middle class to help offset the cost of insurance, and eliminates these tax credits entirely for individuals making more than $42,210 a year, or couples earning more than $56,840. Meanwhile, it retains tax cuts for tanning salons. Worst of all, it incorporates language from Senator Ted Cruz that could literally flood the market in every state with completely unregulated health insurance products. Marketed under the illusion of “lower insurance rates,” these plans would not have to cover mental illnesses, cancers, or any other chronic conditions — or people who have ever had one of these conditions. They would not have to reimburse providers at any reasonable rate. They could pay out as little in benefits as they wanted, and could be cancelled at any time. They would force people who signed up for them and thought they were getting a bargain to pay thousands more each year in out-of-pocket costs, while forcing everyone with a chronic condition into a single health insurance program. This new proposal is opposed by insurance companies, providers, advocates, and an overwhelming majority of the public. This should tell us something: it is time for Congress to act in a bipartisan way to address the health and mental health care needs of all of us, not just unrelated enterprises like tanning salons.” [MHA, 7/14/17]

National Alliance On Mental Illness: “The BCRA Will Further Worsen The Mental Health Crises Communities Across The Country Are Currently Facing.” “NAMI is deeply disappointed that the revised Better Care Reconciliation Act (BCRA), released today retains provisions that impose significant barriers to treatment and services for people with mental illness. The BCRA contains severe cuts to Medicaid benefits that would threaten access to critical mental health services millions of Americans rely on to lead healthy and productive lives. Medicaid is the largest funding source for public mental health services in our nation. One-third of people covered by Medicaid expansion lives with a mental health or substance use condition. Medicaid also covers 1.75 million American veterans — nearly 1 in 10 of the veteran population — who rely on this coverage for primary and mental health care. The BCRA will further worsen the mental health crises communities across the country are currently facing in homelessness, suicides, emergency room boarding and burdens on law enforcement. Rather than moving forward with a bill that threatens to destabilize our nation’s already struggling mental health system, NAMI urges Senators to reject the revised BCRA and to focus instead on small group and individual insurance market reforms needed in many states. This will ensure that Americans will receive the mental health care they need to lead healthy and productive lives.” [NAMI, 7/13/17]

PUBLIC HEALTH GROUPS

American Public Health Association: “A Public Health Catastrophe.” “The revised Senate plan to replace the Affordable Care Act is still irresponsible policy. Millions would lose insurance coverage, the sickest could still be denied access to critically needed care and far too many would pay even more for fewer benefits, creating an expanded class of underinsured. The bill, like previous versions, guts essential investments in public health by eliminating the Prevention and Public Health Fund. I urge our elected leaders to work together to find a bipartisan solution to fixing the Affordable Care Act. Let’s build on the successes we’ve seen when lawmakers keep the health of the population at the forefront. We all can agree that affordable, accessible health care is a right, not a privilege. Any legislation coming out of Congress should reflect that fact and avoid a public health catastrophe.” [APHA, 7/14/17]

CONSUMER GROUPS

AARP: “This Bill May Have Changed But The Results Are The Same: Higher Costs And Less Coverage For Older Americans.” “This bill may have changed but the results are the same: higher costs and less coverage for older Americans. We urge the Senate to vote ‘NO’ and start from scratch on a new health bill that lowers costs and maintains vital protections and coverage that millions of Americans count on. AARP reiterates our opposition to the Age Tax which would allow insurance companies to charge older Americans five times more than everyone else for the same coverage while reducing tax credits that help make insurance affordable, and we strongly oppose increasing costs for people with pre-existing conditions. AARP also remains alarmed at the Senate bill’s drastic Medicaid cuts. The proposed cuts would leave millions of Americans, including 17.4 million poor seniors and people with disabilities, at risk of losing the care they need and their ability to live independently in their homes and communities. AARP will hold all 100 Senators accountable for their votes on this harmful health care bill. Our members care deeply about their health care and have told us repeatedly that they want to know where their elected officials stand. We strongly urge the Senate to reject this bill.” [AARP, 7/13/17]

Consumers Union: “You Can’t Simply Put A Bandage On This Bill To Make It Better For Consumers, Because The Approach Is Fundamentally Flawed.” “If the goal is to improve healthcare coverage, this bill takes us further away from that goal — much further, not closer. Senators on both sides of the political aisle opposed the last version of this bill. This latest version is not a solution. You can’t simply put a bandage on this bill to make it better for consumers, because the approach is fundamentally flawed.” [Consumers Union, 7/13/17]

Medicare Rights Center: “This Tweaked BCRA Still Ends Medicaid As We Know It.” “Today’s release of the updated Better Care Reconciliation Act (BCRA) confirms what we already knew: this broken bill can’t be fixed. This tweaked BCRA still ends Medicaid as we know it, and it still yanks health coverage out from under millions of Americans, including older adults, people with disabilities, and those with pre-existing conditions. On Medicare, the amended bill includes one notable change. The revised BCRA leaves in place a modest tax on high earners that puts the program on stronger financial footing. But that doesn’t mean people with Medicare are safe. The bill’s deep cuts to Medicaid would devastate the 11 million people who rely on both programs to help pay their Medicare bills, for long-term care, and to stay in their homes. Most Americans oppose the BCRA’s untenable cuts to Medicaid and its disregard for the families who need guaranteed, affordable health coverage. In drafting the BCRA, Senate leaders have avoided public debate, hearings, and even their own constituents. That’s not how good bills get done. The BCRA puts access to needed health care at risk for every older adult, person with a disability, and American family. It’s past time to abandon this broken bill. The American people have asked for, and deserve, an open, bipartisan approach to making health care more affordable for everyone.” [MRC, 7/13/17]

INSURERS

Blue Cross Blue Shield/America’s Health Insurer Plans: Cruz Amendment Is “Simply Unworkable In Any Form And Would Undermine Protections For Those With Pre Existing Medical Conditions, Increase Premiums And Lead To Widespread Terminations Of Coverage For People Currently Enrolled In The Individual Market.” “As the U.S. Senate considers the Better Care Reconciliation Act, we are writing to urge you to strike the “Consumer Freedom Option” from the bill. It is simply unworkable in any form and would undermine protections for those with pre-existing medical conditions, increase premiums and lead to widespread terminations of coverage for people currently enrolled in the individual market.” [BCBSA/AHA, 7/14/17]

America’s Health Insurer Plans: “This Proposal Would Fracture And Segment Insurance Markets Into Separate Risk Pools And Create An Un-Level Playing Field That Would Lead To Widespread Adverse Selection And Unstable Health Insurance Markets.” “Under this proposal, the non-compliant policies would be exempt from consumer protections, such as guaranteed access to coverage, community rating (e.g. no, premium surcharges based on health-status), the ban on pre-existing condition exclusions, and the requirement to offer comprehensive benefits with appropriate limits on patient costsharing. Stable and well-functioning insurance markets require broad-based enrollment and a stable regulatory environment that facilitates fair competition and a level playing field. Unfortunately, this proposal would fracture and segment insurance markets into separate risk pools and create an un-level playing field that would lead to widespread adverse selection and unstable health insurance markets. This is particularly true for patients with pre-existing conditions — who would be most affected and potentially lose access to comprehensive coverage and/or have plans that were far more expensive, as premiums in the Exchange market would rise much faster than under existing market conditions and insurance options dwindle.” [Morning Consult, 7/10/17]

Blue Cross Blue Shield Of Massachusetts: “The Senate Bill Impedes The Meaningful Progress That Our State And Nation Have Made To Extend The Peace Of Mind And Security That Insurance Coverage Brings To Both The Sick And The Healthy.” “Blue Cross Blue Shield of Massachusetts remains opposed to the newly amended Senate health care bill (the Better Care Reconciliation Act or BCRA) because it would result in the loss of coverage for millions of Americans. While we recognize that the new version of the bill provides additional funding to help combat the opioid epidemic and contains certain provisions to stabilize health insurance markets, in the long term the bill’s deep Medicaid cuts would obstruct access to care for millions of families throughout the country. The bill could also create a new divide between those who are seriously ill and those who are healthy. A fair, stable health insurance system requires an adequate number of both sick and healthy people who contribute to the pool of funds available to pay medical claims. Whether for individuals or small businesses, provisions of the BCRA deepen this divide and would create an unfair and unstable market making coverage out of reach for those who need it most. This division would be further intensified with the inclusion of the “Consumer Freedom Option” because it undermines pre-existing condition protections. As a health insurance CEO, this is not an option that we want or need. We believe that the Senate bill impedes the meaningful progress that our state and nation have made to extend the peace of mind and security that insurance coverage brings to both the sick and the healthy. We encourage the Senate to work on bi-partisan solutions that support increased access to high quality and affordable care for all Americans.” [PR Newswire, 7/13/17]

Blue Cross Blue Shield Of Minnesota: “You Are Going To End Up Bifurcating The Individual Market Into Healthy And Unhealthy.” “‘If reimbursement levels continue to get cut back, it would be a huge concern for our ability to continue to participate in the program,” Guyette said… ‘There are job losses with these cuts,’ Wheeler said. ‘It becomes a domino effect.’ Wheeler and Guyette said the GOP legislation could also result in providers shifting costs to commercial insurers and insured consumers to offset losses from patients who lose insurance. ‘We can’t forget how highly connected all of the segments are,’ Guyette said… Guyette said Congress needs to address the individual market, where insurers have struggled to market attractive plans without losing money. He said the GOP bill includes changes that would help the individual market, but he criticized the introduction of new language that would allow insurers to sell low-cost policies that provide skimpy coverage — policies that were eliminated under Obamacare. ‘You are going to end up bifurcating the individual market into healthy and unhealthy,’ Guyette said.” [Star Tribune, 7/14/17]

Allina Health: “There Is Nothing In The Bill That Talks About System Reform, And In Fact It Actually Undercuts System Reform By Cutting So Many People Off Of Coverage.” “‘I have deep, deep concerns about where the federal framework is right now and where it is proposed to go,’ said Dr. Penny Wheeler, chief executive at Allina Health, a hospital and clinic system that is Minnesota’s fifth-largest employer. ‘There’s nothing in this bill that talks about system reform, and in fact it actually undercuts system reform by cutting so many people off of coverage… ‘There are job losses with these cuts,’ Wheeler said. ‘It becomes a domino effect.’” [Star Tribune, 7/14/17]

TEACHERS

American Federation of Teachers: “Now They Are Destabilizing The Entire Health Insurance Market.” “By revising their healthcare bill, Senate Republicans have only succeeded in making a bad bill worse. First they tried to rip healthcare away from millions to give tax breaks to the wealthy and decimate Medicaid as we know it — a lifeline for seniors, children with disabilities, and families — and now they are destabilizing the entire health insurance market. This new GOP leadership bill not only continues to strip healthcare away from those who need it, but structurally destroys private insurance by allowing those who think they are invincible to pay virtually nothing while driving up costs for everyone else… Nurses, educators, doctors, hospital leaders and the American people have been clear: Tear up this bill, stop the secrecy, and work to mend, not end, the Affordable Care Act. Nothing short of that will suffice.” [AFT, 7/13/17]

FAITH LEADERS

United States Conference Of Catholic Bishops: “We Do Not See Enough Improvement To Change Our Assessment That The Proposal Is Unacceptable.” “The USCCB is reviewing carefully the health care bill introduced by Senate leadership earlier today. On an initial read, we do not see enough improvement to change our assessment that the proposal is unacceptable. We recognize the incremental improvement in funding the fight against opioid addiction, for instance, but more is needed to honor our moral obligation to our brothers and sisters living in poverty and to ensure that essential protections for the unborn remain in the bill.” [USCCB, 7/13/17]