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Trump Administration Pushes Junk Plans, Cuts Enrollment Assistance for Navigators

Washington, D.C. – Following the announcement by the Centers for Medicare and Medicaid Services that the Trump Administration is slashing navigator funding and pushing enrollment for junk plans that charge people more money for less care, Leslie Dach, campaign chair for Protect Our Care, issued the following statement:

“After keeping one million Americans from gaining coverage by cutting last year’s open enrollment period in half and slashing advertising for affordable plans by ninety percent, the Trump Administration is once again taking quality, affordable health care away from people who need it through its latest act of sabotage. Defunding the navigator program and forcing the navigators who are left to push junk plans on the American people is a shocking and cynical move, even by this Administration’s standards.”

BACKGROUND:

Breaking: Trump Administration Slashes Grants To Help Americans Get Affordable Care Act Coverage. The Trump administration is eliminating most of the funding for grass-roots groups that help Americans get Affordable Care Act insurance and will for the first time urge the groups to promote health plans that bypass the law’s consumer protections and required benefits. The reduction, the second round of cuts that began a summer ago, will shrink the federal money devoted to groups known as navigators from $36.8 million to $10 million for the enrollment period that starts in November.” [The Washington Post, 7/10/2018].

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

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

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

Protect Our Care Statement on the Nomination of Judge Brett Kavanaugh to the Supreme Court by President Trump

Washington, D.C. – Following the nomination of Judge Brett Kavanaugh to the Supreme Court by President Trump, Brad Woodhouse, executive director of Protect Our Care, released the following statement:

“Make no mistake, President Trump had at least two litmus tests for Judge Kavanaugh to become his nominee for the Supreme Court: overturn Roe v. Wade and overturn America’s health care, by gutting protections for those with pre-existing conditions. Such a radical shift on these issues would be disastrous for women’s health and would put the health care of 130 million Americans with pre-existing conditions at risk. This extreme judicial agenda, of ripping health care away from millions of people and returning to an era when women and doctors are criminals, is opposed by the vast majority of the American people. This nomination must be stopped and, given the previous Republican votes against repeal of the Affordable Care Act, and support for the precedent of Roe v Wade, it can be.”

Shot/Chaser: Trump’s the Reason Drug Prices are Going Up

SHOT: On May 30, Trump promised that pharmacutical companies would voluntarily make big price cuts in “two weeks.” We’re still waiting, and in fact drug prices have gone up, as Trump acknowledged today:  

CHASER: Trump’s the reason drug prices going up so significantly.

 

White House Picks PhRMA Lobbyist to Guide Supreme Court Pick

Washington, D.C. – Following the White House’s announcement that former senator and current Big Pharma lobbyist Jon Kyl would be shepherding President Trump’s Supreme Court pick through the Senate, Brad Woodhouse, executive director of Protect Our Care, released the following statement:

“We already know that the biggest problem for Donald Trump’s Supreme Court pick would be their support for Trump’s position in favor of a lawsuit striking down health care protections, like those for people with pre-existing conditions. By making a Big Pharma lobbyist who has repeatedly called for repeal of the Affordable Care Act the representative of his nominee, President Trump is once again making clear where his priorities lie: with insurance and drug companies, not the 130 million Americans with a pre-existing condition.”

Health Care on the Line with Trump’s SCOTUS Pick

To: Interested Parties

From: Brad Woodhouse, executive director of Protect Our Care

Date: July 6, 2018

Re: Health Care on the Line with Trump’s SCOTUS Pick

—————————————————————————————————————————————————————-

For the last 18 months, President Trump and his Republican allies in Congress have been waging a relentless war on our health care, resulting in millions of people losing coverage, double digit premium rate increases, and weakened protections for people with pre-existing conditions. Now, with the retirement of Justice Anthony Kennedy, the President has an opportunity to tip the balance of the Supreme Court further in his favor and appoint a justice hostile to our health care, as he has repeatedly promised he would do. Make no mistake: our health care is on the line if Trump succeeds in appointing an extreme judge who will rubber stamp his anti-health care agenda.

Here’s why:

Trump’s Shortlist Includes Nominees Who Have Demonstrated Hostility to Health Care

Reportedly, President Trump has narrowed his list of potential justices to three people: Judges Brett Kavanaugh, Amy Coney Barrett and Raymond Kethledge. All three are on the Federalist Society-approved list of justices Trump released. The Federalist Society, as should be noted, has been fighting the Affordable Care Act (ACA) since before it was even signed into law and has consistently pushed judges very hostile toward women’s health.

Specifically, Judge Kavanaugh has argued that a president could declare a law unconstitutional and refuse to enforce it “even if a court has held or would hold the statute constitutional.”

Judge Barrett has already written that she believed the ACA should have been declared unconstitutional, that Roe v Wade was “erroneous,” and the ACA’s birth control benefit was “an assault on religious liberty.”

Consumer Protections, Including Prohibitions on Discriminating Against the 130 Million People with Pre-Existing Conditions, Are At Risk

Prior to the Affordable Care Act, insurance companies were able to cherry pick who they wanted to cover and would often discriminate against people with pre-existing conditions by charging them more, dropping coverage once people got sick, or denying coverage altogether. The ACA banned all of those practices, providing health security to millions.

  • Roughly half of nonelderly American adults, or up to 130 million people, have at least one pre-existing condition.
  • Nationally, the most common pre-existing conditions were high blood pressure (44 million people), behavioral health disorders (45 million people), high cholesterol (44 million people), asthma and chronic lung disease (34 million people), and osteoarthritis and other joint disorders (34 million people).

These protections have consistently been the most popular component of the law among not only Democrats, but Republicans and Independents as well.

Nevertheless, President Trump has taken every opportunity he has had to dismantle the consumer protections and market reforms in the ACA. Though he failed to enact legislation to repeal the ACA, on his first day in office, President Trump signed an executive order directing his administration to use whatever tools they could to undo as much of the ACA as it could. His administration has further taken actions to sabotage the law by allowing insurance companies to sell junk plans that do not have to cover people with pre-existing conditions, among other things.

Don’t forget: Trump campaigned on ending the ACA by any means necessary, and he had his sights on the Court from the very beginning. In fact, as a candidate Trump said he would have a “very strong test” for Supreme Court nominees, pointing to his “disappointment” in Chief Justice John Roberts, as “somebody that should have, frankly, ended Obamacare, and he didn’t.” As the leading coalition fighting against Republicans’ ongoing efforts to repeal and sabotage health care and working instead to protect coverage for millions of Americans, Protect Our Care knows that Trump’s meaning is clear: he has a litmus test for his Supreme Court nominees, and repealing the ACA is on that test.

After all, ending protections for people with pre-existing conditions is already the official policy of the Trump Administration. Normally, the Department of Justice (DOJ) defends federal law in court. However, the Trump Administration has taken the extraordinary step of joining the latest partisan lawsuit that seeks to invalidate the ACA and has argued the Court needs to take away the provisions in the law that prevent insurance companies from denying coverage or charging people more because of a pre-existing condition. If the Trump administration had its way, overnight the 130 million people with a pre-existing condition would once again be at the mercy of insurance companies.

This case should not be taken lightly three prior challenges to the Affordable Care Act (NFIB, et al. v. Sebelius, King v. Burwell, Hobby Lobby v. Burwell) have made their way to the Supreme Court, despite early doubts among legal scholars.  

Women’s Health Care is on the Line

President Trump’s campaign promise to appoint biased justices who will overturn Roe v. Wade and the dangerous consequences of making safe abortion a crime in this country have been widely reported. But many other women’s health services are under threat with this appointment. Among them:

Medicaid is Also at Risk

Medicaid is not only supported by three-quarters of Americans, it is a lifeline for one in five people, providing critical preventive care, substance use treatment, acute care, and more to more than 70 million people. Medicaid is the primary provider for long-term care in the country, covering 6 in 10 nursing home residents. It is also the primary provider to help people with disabilities stay in their homes, and pays for roughly half of the births in this country.

But the Trump Administration has launched a new assault on Medicaid enrollees by pushing states to adopt rigid rules (so-called “work requirements”) that are designed to be impossible for to be met and therefore prevent coverage. These new rules are just beginning to work their way through the courts, and while a federal district court judge recently blocked them in Kentucky, they could very well make their way to the high court soon.

THE BOTTOM LINE: All 100 Senators must reject a nominee that would take away, rather than protect, our care.

If Trump appoints an extreme nominee to the bench, and the Senate does not intervene, the balance of the court will turn against Americans’ right to health care. The Supreme Court should be a check on President Trump’s war on health care, not a rubber stamp on it.

After Trump Promised Prescription Drug Price Cuts, They Go Way Up

Just over a month ago, President Trump promised to lower drug prices.

MAY 30 2018 –

Bloomberg: Trump Says Drug Companies to Unveil Price Cuts in Two Weeks

“Major pharmaceutical companies will announce ‘voluntary, massive’ cuts in drug prices in two weeks, President Donald Trump said Wednesday, without providing details. ‘We’re also working very hard at getting the cost of medicine down, and I think people are going to start to see for the first time ever in this country a major drop in the cost of prescription drugs,’ Trump said while signing legislation making it easier for terminally ill patients to get access to experimental drugs.”

How’s that going?

JULY 2, 2018 –

Financial Times reports several U.S. drugmakers have raised their prices significantly:

  • The smoking cessation drug Chantix ”has gone up 17 percent this year.”
  • The multiple sclerosis drug Ampyra has been raised 9.5 percent, “taking a bottle of 60 to more than $3,000.”
  • The liver medication Ocaliva has been raised “7 percent to $263.48 per pill or nearly $8,000 for a pack of 30”

Read the Financial Times story here.

Short-Term Junk Plans

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

KEY HEALTH INSURANCE STAKEHOLDERS WARN AGAINST SHORT-TERM PLANS

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

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

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

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

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

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

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

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

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

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

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

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

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

Governor Matt Bevin Puts Partisanship Over Health of Kentuckians

Washington, D.C. – Days after a federal district court issued a scathing rebuke of the Bevin-Trump Administrations’ Medicaid scheme to impose rigid work requirements that would be impossible for many of those most in need of health care coverage to meet, Governor Bevin announced his Administration would retaliate by immediately cutting 500,000 Kentuckians enrolled in Medicaid off of critical and vision coverage. Brad Woodhouse, executive director of Protect Our Care, released the following statement in response:

“I have only one question for Governor Matt Bevin and President Donald Trump: why are you so hellbent on taking health care away from your constituents? Until the Bevin and Trump administrations teamed up to wage a war on health care, Kentucky was headed in the right direction: insurance coverage and access to quality care were going up — way up. But the GOP’s repeal-and-sabotage agenda is threatening these gains by driving people’s health care premiums up and kicking people off of health insurance by any means necessary, whether through so-called ‘work requirements’ or, now, by politically-motivated fiat.”

BACKGROUND:

Prior to the Bevin and Trump Administrations, Kentucky’s story was a successful case study of how the state and federal governments can work hand-in-hand to improve health care access and outcomes for people:

  • Kentucky experienced the largest uninsured rate drop among low-income adults, all while creating 40,000 jobs and harnessing a $30 billion economic impact.
  • Kentucky’s uninsured rate fell from 16.3% to 7.2% in 2016 following the implementation of Medicaid expansion.
  • Kentucky’s enrollment in Medicaid and CHIP increased 110% between 2013-2017, the largest increased of any state and nearly three-times the national average.
  • Low-wage workers made up the majority of Medicaid-eligible adults who gained coverage under the state’s expansion.
  • Medicaid is viewed favorably by 74 percent of Americans.

###

New TV Ad Warns About Danger from Supreme Court Pick for People with Pre-Existing Conditions

Washington, D.C. –  Protect Our Care will air a new TV ad sounding the alarm about the damage and devastation that could be done if the U.S. Senate confirms a Supreme Court Justice who will allow the Trump Administration and Congressional Republicans to overturn protections for more than 130 million Americans with pre-existing conditions.

Watch the ad here.

After failing to advance legislation in Congress, the Trump administration has already gone to court to overturn protections for people with pre-existing conditions and now, with Senator McConnell’s help, he plans to install a Supreme Court Justice who will vote to overturn them. The ad, called “Emergency,” urges people to call their Senators and ask them to reject a nominee who will once again allow insurance companies to strip health care from the very people who need it most.

“The Trump Administration has already gone to court to overturn protections for people with pre-existing conditions like asthma, diabetes and cancer. Now, Donald Trump is trying to install a Supreme Court Justice who will tip the balance in his favor. It’s an emergency,’” said Brad Woodhouse, executive director of Protect Our Care. “If you want to preserve protections for people with pre-existing conditions, and you want to protect and improve upon the Affordable Care Act, then you cannot let the Trump Administration have free reign to install a radical Supreme Court Justice who will do just that.”

The ad will run in Washington, D.C, Anchorage, and Bangor during cable morning shows this week in advance of Trump’s announcement on July 9th.

View the national ad: https://youtu.be/sDn8iVLO9S8

View the Alaska ad: https://youtu.be/RNpet40ulMg

View the Maine ad: https://youtu.be/9XMI5SmaucM

SCRIPT

“This is an emergency.

“Donald Trump has already gone to court to overturn health care protections for people with pre-existing conditions…

“One hundred thirty million Americans have pre-existing conditions like cancer, diabetes and asthma.

“Now, Trump and Mitch McConnell have a plan to install a Supreme Court Justice who will overturn those protections for people with pre-existing conditions,

“Who would take us back to a time when insurance companies could deny you coverage.

“It’s up to us to stop them.

“Call your senator. Tell them to stop any nominee who will support Trump’s lawsuit that overturns health care protections for people with pre-existing conditions.”

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New Rule Would Put Donald Trump Between Women And Their Doctors

Washington, D.C. – After the Trump Administration proposed to dramatically accelerate its attacks on women’s care, Protect Our Care Communications Director Marjorie Connolly released the following statement:

“Today’s rule would put Donald Trump between women and their doctors, and it signals a new phase in the Republican war on women’s health. By banning providers from giving women all the facts about their options and restricting them from getting any services at all from essential community health providers, including Planned Parenthood, this rule is designed to threaten women’s health care providers and restrict access to care. Courts blocked a similar proposal in the Reagan era, but now President Trump has gotten a record number of anti-choice judges confirmed, meaning this rule poses an even worse threat to women’s health than it did in the 80s. The Trump-Pence administration continues to pursue a radical anti-women’s health agenda, but today’s proposal will only strengthen the resolve of the millions of women who have been marching against these attacks since Day One.”

BACKGROUND: The Republican War on Women’s Care

Stacking Federal Courts With Anti-Choice Judges: The next generation of American women will face a growing threat posed by an increasingly anti-choice federal judiciary. Twelve of Trump’s judicial nominees were appointed to circuit courts during his first year – more than any other first-year president in American history.

Allowing States To Defund Clinics That Offer Abortion Care: Before today’s proposal, in early 2017, Trump signed a bill allowing states to withhold Title X family planning funds from health care providers that offer abortion-related care. Thirteen states used to withhold the Title X money from abortion providers before the Obama administration blocked them. (Because of the Hyde Amendment, federal funds can’t be used to pay for abortions, so the Title X money went to other health services at those clinics.) The legislation allows them to withhold the funds again and redirect them to providers that don’t offer abortion care.