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Virginia Archives — Protect Our Care

Protect Our Care Releases New Report Detailing the Threats Republican Policies Pose to Rural Health Care in Virginia

Senator Mark Warner’s SAME Act Would Help Expand Coverage and Benefit Rural Communities, Addressing the Unique Problems Outlined in New Report

Washington, DC — A day after Senator Warner introduced the SAME Act, a bill that would benefit rural communities by providing each state expanding its Medicaid program with the same levels of Federal matching funds regardless of when it chooses to expand the program, Protect Our Care released a new report, “A Tough Row to Hoe: How Republican Policies are Leaving Virginia’s Rural Health Care in the Dust.” The report looks at how Republican sabotage of the Affordable Care Act and relentless attacks on Medicaid expansion have done damage to rural residents of the state, who face both a lack of coverage and a lack of care in their communities.  


Read the report here.

“Our report shows how President Trump and his Republican allies in Congress have stopped at nothing to wreak havoc on our health care, resulting in especially devastating impacts in rural America,” said Brad Woodhouse, executive director at Protect Our Care. “Premiums have risen, coverage has been lost, and rural hospitals face constant uncertainty as rural health care is threatened. Medicaid expansion has been particularly crucial to expanding access to health care in rural communities and Senator Warner’s leadership on the SAME Act is a major step towards encouraging more states to expand Medicaid and ensuring rural Americans will have access to the health care coverage they so desperately need.”

By The Numbers: Rural Health In Virginia


19 percent of Virginians living in rural areas are uninsured, compared to 12 percent of Virginians living in nonrural areas.

Since the Affordable Care Act, the uninsured rate has fallen by 6 percent in rural parts of Virginia.

17 percent of Virginia living in rural areas have health coverage through Medicaid.

The Affordable Care Act led to a $78 million reduction in Virginia uncompensated care costs. Between 2013 and 2015, Virginia hospitals’ uncompensated care costs decreased by $78 million, or roughly 26 percent.

Since expanding Medicaid last fall, almost 200,000 Virginians have signed up for coverage. Since enrollment for Medicaid expansion began in November, nearly 200,000 Virginians have signed up for care. The Robert Wood Johnson Foundation (RWJF) and Urban Institute estimate that that number will continue to increase overtime, ultimately resulting in more than 400,000 people gaining coverage. Virginia’s decision to expand Medicaid is expected to reduce the uninsured rate by 3.3 points — from 14.2 percent to 10.9 percent.

In Virginia, where lawmakers refused to expand Medicaid until last year, two rural hospitals have closed since 2010. These hospitals include:
Pioneer Community Hospital of Patrick County (VA-09, closed in 2017)
Lee Regional Medical Center (VA-09, closed in 2013)

Protect Our Care Praises Effort Led by Senators Mark Warner (D-VA) and Doug Jones (D-AL) to Support Medicaid Expansion

The SAME Act Will Lead to Expansion of Coverage and Benefit Rural Communities

Washington, DC–Today, Senators Mark Warner (D-VA) and Doug Jones (D-AL), among others, introduced the States Achieve Medicaid Expansion (SAME) Act, which would provide each state expanding its Medicaid program with the same levels of Federal matching funds, regardless of when it chooses to expand the program. Brad Woodhouse, executive director of Protect Our Care, praised the legislation in a statement:

“Medicaid expansion has been one of the most successful facets of the Affordable Care Act, providing millions of Americans with the health care coverage they so desperately need. Medicaid expansion has been particularly crucial to expanding access to health care in rural communities and has helped rural hospitals keep their doors open. The SAME Act will not only give all states that enacted Medicaid expansion the same funding benefits, it will incentivize more states to follow suit. Under the leadership of Senators Mark Warner and Doug Jones, the SAME Act is a major step toward ensuring better access to care, lowering costs, and keeping rural hospitals open.”

BACKGROUND:

Medicaid Expansion Is A Lifeline To Rural Communities. The Affordable Care Act opened the doors to Medicaid expansion, which has significantly expanded access to health care in rural communities, reduced rural hospitals’ uncompensated care costs, and helped rural health providers keep their doors open by allowing states to expand Medicaid coverage for adults up to 138 percent of the federal poverty line. Medicaid expansion allowed 1.7 million rural Americans to gain coverage who had not previously been eligible.

Following Medicaid Expansion, The Uninsured Rate In Rural Parts Of Expansion States Decreased By A Median Of 44 Percent. In rural states that expanded Medicaid, the uninsured rates dropped significantly after the ACA became law:

  • In Montana, the uninsured rate dropped from 19 to 8.5 percent between 2013 and 2016.
  • In Kentucky, the uninsured rate dropped from 16.3 to 7.2 percent between 2013 and 2016.
  • In Arkansas, the uninsured rate dropped from 17.8 to 9.1 percent between 2013 and 2016.
  • In West Virginia, the uninsured rate dropped from 14.2 to 8.8 percent between 2013 and 2016.

By Reducing Uncompensated Care Costs, Medicaid Expansion Means Hospitals Have Greater Financial Security. Medicaid expansion also drastically reduced the amount of costs that a hospital absorbs for any treatment or service not paid for by an insurer or patient, known as uncompensated care.. The Center on Budget and Policy Priorities finds that “states that expanded Medicaid to low-income adults under the ACA saw both larger coverage gains and larger drops in uncompensated care: a 47 percent decrease in uncompensated care costs on average compared to an 11 percent decrease in states that did not expand Medicaid.” CBPP concludes that these declines in uncompensated care were “almost certainly” the result of the ACA’s coverage gains.

A June 2018 Protect Our Care Analysis Found That The Vast Majority Of Rural Hospital Closures Since 2010 Were In States That Had Refused To Expand Medicaid. Between 2010 and June 2018, 84 rural hospitals closed. The vast majority of those rural hospital closures, 77 percent, occurred in states that refused to expand Medicaid. Nearly 90 percent of the rural hospitals that have closed since 2010 were located in states that refused to expand Medicaid by the time of their closure. Only 10 out of 84 rural hospitals closed in states after they had expanded Medicaid; of hospital closures in states that expanded Medicaid, nine closed before the state expanded the program. Since Protect Our Care’s June report, even more hospitals have closed. The Scheps Center Rural Health Research Program tracks that 97 rural hospitals have closed since 2010.

Elections Matter: Virginia Medicaid Expansion Already Bringing Affordable Care to 200,000 Virginians

Washington, D.C. – Less than a year after Democrat Ralph Northam was sworn in as Virginia’s Governor, 200,000 people have already gained access to health care as a result of Medicaid expansion which officially took effect yesterday.  Brad Woodhouse, executive director of Protect Our Care, released the following statement in response:

“Elections matter, and nowhere is this more clear than in Virginia. Virginia Republicans spent years rejecting Medicaid expansion, but Virginia had its highest voter turnout in the past two decades in 2017, electing Democrats up and down the ballot, clearing a path for Medicaid expansion. Over the past two years, five states have voted to expand Medicaid, a clear and direct rebuke to the Trump Administration’s ongoing sabotage agenda on Medicaid and Americans’ health care. Make no mistake, from Virginia and Maine to Idaho, Nebraska and Utah, elections matter and hundreds of thousands of Americans are gaining access to life-saving coverage and rejecting the ongoing Republican war on health care which continues to this very day.”

What does Medicaid expansion mean for Virginians?

AP: More Than 200,000 People Have Already Been Enrolled. “Thousands of uninsured, low-income Virginians will have new health care coverage starting in the new year. Virginia is joining more than 30 states that have expanded Medicaid, a key part of former President Barack Obama’s health care overhaul… The state’s Medicaid office has been working with hospitals, advocates for the poor, insurance companies and others to help enroll the newly eligible into Medicaid. Coverage starts Jan. 1 and the state said Friday that more than 200,000 people have been enrolled.” [Bradenton Herald, 12/31/18]

WSLS: “More People In The Commonwealth Have Access To Health Coverage.” “More people in the commonwealth have access to health coverage starting today.  That’s because Virginia joins 32 other states in expanding Medicaid coverage. This will give more adults between the ages of 19 and 64 access to quality low-cost and no-cost health insurance.” [WSLS, 1/1/19]

Delegate Sam Rasoul: “It’s Been A Long Process But Is Fantastic.” “‘It’s been a long process but is fantastic. Over the past couple months, there’s been open enrollment. And 200,000 Virginians have already been signed up into Medicaid and have health care coverage and many others, for the first time ever, starting today. And we still have another couple hundred thousand to go,’ said Delegate Sam Rasoul.” [WSLS, 1/1/19]

Casey Thompson, 21-Year Old Virginian: “It’s Massive.” “Casey Thompson, a 21-year-old who has been uninsured for two years, said she lost all her savings when she had to go to a hospital in May for a ruptured cyst. She said she is thrilled she’ll be covered under Medicaid expansion starting in January and will no longer have to worry about unexpected medical costs. ‘It’s massive,’ she said.” [Bradenton Herald, 12/31/18]

What spurred this change?

AP: Expansion Occurred After 2017 Democratic Wave Election, GOP Repeal Attempts. “Opponents argued that Medicaid expansion was fiscally irresponsible because the long-term costs are unsustainable. Several factors contributed to Republicans switching position on the issue after years of opposition. They include a Democratic wave election in 2017 and the inability of President Donald Trump and congressional Republicans to repeal Obama’s signature health care law.” [Bradenton Herald, 12/31/18]

Was this mindset limited to just Virginia?

Lincoln Journal Star: After Republicans Refused, Nebraskans Voted To Expand Medicaid. “After seven years of legislative refusal to expand Medicaid in Nebraska, voters in November extended coverage to an estimated 90,000 adult Nebraskans who are working at low-wage jobs. That decision will bring a projected $1.3 billion in federal funding flowing into the state during the first three years of the new program.” [Lincoln Journal Star, 12/28/28]

Forbes: After Republicans Refused, Idahoans Voted To Expand Medicaid. “Idaho voted Tuesday to expand Medicaid under the Affordable Care Act via ballot initiative, overcoming conservative Republican state legislators who refused for years to pass additional coverage for the state’s poor. With nearly 60% support and two-thirds of the votes counted, voters in Idaho were following the lead of voters in Maine who last November voted to expand Medicaid under the Affordable Care Act in a public referendum at the ballot box. Supporters of Idaho’s Medicaid expansion put it on Tuesday’s midterm general election ballot after their Republican-controlled legislature for years balked at the idea.” [Forbes, 11/7/18]

Milwaukee Journal Sentinel: Medicaid Expansion Makes Sense “Both Fiscally And Socially.” “Experts and the evidence agree, increasing access to MAT is one of the most important policy changes we could implement to combat the opioid epidemic. They also agree that Medicaid expansion is a key move that could be made to improve access; it is the largest source of funding for treatment. Medicaid, which has broad public support, covers the poorest, most marginalized people in our communities who often have some of the most complicated health care needs. In the past, Wisconsin’s Medicaid program had a high-caliber reputation. Like all state Medicaid programs, BadgerCare is jointly financed by the state and federal government, which has a generous matching structure for any state dollars spent. As Wisconsin’s opioid mortality continues to skyrocket above the national average, expanding Medicaid here makes sense both fiscally and socially.” [Milwaukee Journal Sentinel, 1/2/19]

Elections Have Consequences

400,000 Virginians Now Eligible to Enroll in Medicaid

Washington DC – Today, hundreds of thousands of Virginians between the ages of 19 and 64 who earn less than 138 percent of the federal poverty level are now able to enroll in Medicaid, with the commonwealth having succeeded in enacting Medicaid Expansion earlier this year after the 2017 election during which health care was the number one issue to voters according to exit polls.  Brad Woodhouse, executive director of Protect Our Care, issued the following in response to today’s news:

“Today, hundreds of thousands of Virginians will gain access to quality health coverage, something only made possible because voters motivated by health care turned out in droves to elect pro-health care leaders in 2017. With only five days until the midterm elections, Americans across the country are gearing up to make their outrage about the Republican war on health care known because Republicans who still stubbornly oppose Medicaid expansion — be they Scott Walker, Ron DeSantis, Mitt Romney or Donald Trump — are on the wrong side health care, the wrong side of voters, and the wrong side of history.”  

MEDICAID EXPANSION IS A DEFINING ISSUE IN GOVERNOR’S RACES ACROSS THE COUNTRY

In Georgia, Democratic Candidate Stacy Abrams Has Said The First Thing She Would Do Is Expand Medicaid. “Democratic candidate Stacey Abrams has said the first thing she would do as governor is expand Medicaid. That’s the decision each state can make to give more low-income people access to health care. States receive federal funding for it, though they, too, have to pay into the program. ‘And you’ll hear me talk about this ad nauseam because it’s the only answer to Georgia’s challenges,’ Abrams said at a health care policy press conference Monday. ‘We have an uncompensated care rate of $1.7 billion.’…Republican Gov. Nathan Deal has refused to expand the program in Georgia, and Republican candidate Brian Kemp said he wouldn’t expand it either. ‘Government programs that aren’t working now are not a reason to give them more money,’ Kemp said at an event last week. Kemp said, instead, he favors opening up the private sector market to more competition to lower health care costs.” [WABE, 9/12/18]

In Florida, Andrew Gillum is running on Medicaid Expansion, with polling showing Floridians want to expand Medicaid. “According to new data from the left-leaning think tank Data for Progress, an estimated 65 percent of Florida voters support expanding Medicaid across the state — and, amazingly, voters in every legislative or congressional district from the Keys all the way up to the Panhandle support the idea.” [Miami New Times, 5/25/18]

In Ohio, Cordray Blasts DeWine, Who Flip-Flopped on Medicaid Expansion because it is so Popular. “Cordray also dinged DeWine on Ohio’s Medicaid expansion, which provides health coverage to nearly 700,000 Ohioans. Republican Gov. John Kasich has ‘done some things that are very good for Ohio,’ Cordray said. ‘He had real courage on the Medicaid expansion, bringing that to Ohio and fighting the naysayers in his own party who said, ‘Gee, that’s part of Obamacare.’ And my opponent was part of those naysayers.’ DeWine now says he’ll keep the expansion. But Eck didn’t answer a question asking why, if he favored it, DeWine repeatedly sued to kill the law that made it possible.” [Columbus Dispatch, 9/20/18]

In Wisconsin, Democratic Challenger Tony Evers Targets Scott Walker For Not Taking Federal Medicaid Expansion. “Evers made health care the focus of his only television ad to date, faulting Walker for not taking the federal Medicaid expansion and pointing out that the cost of an average health insurance plan sold on the private market this year in Wisconsin was more expensive than in Minnesota. Walker argues the ad is misleading and health insurance costs will decrease in Wisconsin once a recently approved reinsurance program takes effect.” [Minneapolis Star Tribune, 9/7/18]

In Michigan, Candidates Gretchen Whitmer (D) and Bill Schuette (R) Spar Over Medicaid Expansion. “As attorney general, Schuette joined at least nine lawsuits fighting the Affordable Care Act. In a 2017 fundraising mailer, he said he opposed the law, ‘including the ‘free’ federal Medicaid dollars from Obama that leave Michigan taxpayers on the hook for more!’ ‘He has been the chief advocate against Healthy Michigan in our state ever since we started the bipartisan negotiations on it,” Whitmer told The Detroit News. ‘The biggest threat to health care in Michigan is Bill Schuette.’ But the Medicaid expansion program is threatened by declining federal aid, Schuette notes. The federal government fully funded the Medicaid expansion program the first three years, but the state began paying a share in 2017 and will be required to cover 10 percent of the costs by 2020. By then, it’s estimated to cost the state roughly $380 million a year.” [Detroit News, 9/18/19]

In Tennessee, Karl Dean is Running on Medicaid Expansion, with Polls Showing Voters Support it Strongly. “The poll, conducted by Mason-Dixon Polling & Research in April, showed 63 percent support Medicaid expansion with the use of federal funds to 21 percent against and 16 percent undecided.” [Nashville Tennessean, 5/7/18]

In Idaho, Democratic Candidate Paulette Jordan is a Supporter of Prop 2 (Medicaid Expansion). Her opponent, Lt. Gov. Brad Little has declined to say whether he will vote for the initiative but said if elected governor, he would respect the will of the voters if they pass Medicaid expansion. [KTVB, 10/29/18]

In Alabama, Democratic Challenger Walt Maddox Is Running On Medicaid Expansion. “The Democratic nominee began the tour in Tuscaloosa where he is mayor. Describing himself as the only candidate in the race talking about the state’s “big problems”, Maddox is running on a platform of establishing a state lottery to fund education programs and expanding Medicaid. Standing with his wife, Stephanie and his two children, Maddox said the race is about ensuring the state’s children have opportunities.” [Associated Press, 9/17/18

Medicaid Expansion, Junk Plan Bans, and a Law to Shore Up the Marketplace: the ACA Has a Banner Week in the States

While congressional Republicans and their cheerleaders, like former U.S. Senator Rick Santorum, are on the verge of making another run at health care repeal, legislators and everyday citizens in states across the country this week took actions to expand health care access and shore up their marketplaces. Here’s what happened this week, from Virginia to California:

In Virginia, the state Senate joined with the House of Delegates, sending a measure to expand Medicaid to Gov. Ralph Northam to sign into law. The expansion will extend health insurance to 400,000 Virginians.

Richmond Times-Dispatch: Virginia Set To Expand Medicaid As Senate And House Back Budget Deal. “Six years after the U.S. Supreme Court left the decision to states on whether to expand their Medicaid programs under the Affordable Care Act, Virginia is about to extend health care coverage to hundreds of thousands of Virginians without it… [Republican State Senators Ben Chafin and Jill Vogel] defended their decisions as necessary to invest in core public services, while expanding health coverage to people who need it and the hospitals that provide it. ‘I came to the conclusion that ‘no’ just wasn’t an answer anymore,’ he said.” [Richmond Times-Dispatch, 5/31]

In New Jersey, the legislature acted to stabilize the state’s insurance marketplace by implementing a state-level individual mandate, following in the footsteps of Maryland, which passed stabilization measures last month. Congressional Republicans repealed the federal mandate in December’s tax bill, which, combined with the Trump Administration’s short-term plan regulations, had been projected to increase premiums in New Jersey by nearly 11%.

NJ.com: Phil Murphy Signs Law Protecting Obamacare From Trump With N.J. Mandate To Have Health Insurance. “Gov. Phil Murphy on Wednesday signed a law preserving a critical yet controversial part of the Affordable Care Act that President Donald Trump’s administration repealed last year… State Sen. Joseph Vitale, D-Middlesex, one of the prime sponsors of the law, said keeping the mandate ‘was needed to maintain a foundation for the insurance market and to allow the success of the ACA to continue.’ Trump’s actions ‘will usher in an era of higher health insurance costs for everyone and lower health coverage rates. We want to protect New Jersey from the negative impact,’ said state Sen. Troy Singleton, D-Burlington, also a sponsor. About 800,000 people obtained insurance coverage under the law — 500,000 through Medicaid and about 300,000 through a commercial plan.” [NJ.com, 5/30]

In Illinois, the state legislature is expected to implement a six-month limit on the Administration’s proposed short-term junk plans, restoring them to their original intention and protecting Illinoisans’ health and the state’s insurance marketplace. The move follows similar legislative actions in Hawaii and California, which is considering banning short-term plans entirely.

Chicago Tribune: Illinois Groups Push To Restrict Short-term Insurance, As Trump Administration Seeks To Expand It. “Dozens of Illinois advocacy groups, under the umbrella of the Protect Our Care Coalition, are supporting a bill that would impose a six-month limit on the use of short-term insurance plans — coverage originally meant to serve as a stopgap for consumers between health insurance plans, such as people changing jobs who can’t afford continued coverage under a previous employer’s plan or students taking a semester off school… Short-term plans can leave consumers in a lurch because they often don’t cover things like maternity care, pre-existing conditions, mental health or prescription medications. In addition to the six-month time limit, the bill would require warnings about what the plans do not cover to be read aloud to consumers buying the plans or featured on websites where they’re sold. The state Senate on Friday unanimously passed the bill.” [Chicago Tribune, 5/25]

Speaking of Medicaid expansion, Utah and Idaho both advanced ballot measures to expand Medicaid, too:

The Hill: Medicaid Expansion Qualifies For Ballot In Utah. “A measure to expand Medicaid under ObamaCare in Utah will appear on the ballot in November after it was certified as having enough signatures. Liberal groups hailed the announcement from the state’s lieutenant governor as they hope to make the deep-red state the 33rd to expand the health insurance program for the poor under the health law. Medicaid expansion would extend coverage to about 150,000 people in the state.” [The Hill, 5/30]

Associated Press: Medicaid Expansion Moves Closer To Possible Referendum. “A Medicaid expansion proposal has passed the signature threshold, officials confirmed on Thursday, but said further review is needed before it gets on the November ballot. Ada County Chief Deputy Clerk Phil McGrane says county clerks across the state have verified roughly 58,000 signatures that organizers submitted earlier this month.” [US News & World Report, 5/24]

In Maine, the Bangor Daily News Editorial Board called for the legislature to fund the state’s Medicaid expansion, which passed overwhelmingly in a referendum last fall:

Bangor Daily News: Lawmakers Must Fund Medicaid Expansion, Which Is The Law, ‘Not A Suggestion.’ “By expanding Medicaid, Maine will make insurance coverage available to as many as 80,000 Mainers. These are people who work but can’t afford health insurance or their employer doesn’t offer it. They are not poor enough or do not have a disability to qualify for Medicaid without an expansion. Under the Affordable Care Act, the federal government covers 90 percent of the cost. Maine is estimated to receive more than $525 million per year for a state investment of about $55 million annually, beginning in 2021, the first full year of implementation. Expanding Medicaid means thousands of Mainers who don’t have insurance will be able to access preventative care, vaccinations, addiction treatment, counseling and other needed care. It will also help stabilize the state’s hospitals, many of which are struggling financially.” [Bangor Daily News, 5/31]

And in Alabama, Jim Carnes, Policy Director of Alabama Rise, eloquently made the case for Medicaid expansion in an op-ed published by the Anniston Star:

Anniston Star: Expanding Medicaid Would Improve Alabama’s Health, Budgets And Economy. “The new Urban Institute report estimates that 314,000 Alabamians would enroll in Medicaid if Alabama extended eligibility to low-income workers. That would mean an additional $1.54 billion in federal funding surging into Alabama’s economy each year under the 9-to-1 federal match rate. It also would mean rural hospitals – like the one in Jacksonville that announced in May that it plans to close – would no longer be bleeding red ink through services to uninsured patients… In any other industry, the prospect of such gains would have political candidates of all stripes blowing trumpets and leading parades. And those other economic development plans wouldn’t have the added advantage that this one brings: giving people a new lease on life by helping them get the health care they need. Isn’t it time we broke the partisan gridlock on the coverage gap? Isn’t it time we demanded that anyone seeking to lead our state offer a vision of a healthier Alabama – and a path to getting there?” [Anniston Star, 5/29]

So while President Trump continued peddling lies about health care in Washington, D.C., states across the country continued the work of expanding health care access to hundreds of thousands of Americans. The ACA remains the law of the land, and its staying power shows it has become woven into the fabric of our nation’s health care system.

“Another Nail In the Coffin for Efforts to Repeal Obamacare”: Virginia Legislature Votes to Expand Medicaid for 400,000 Virginians

Yesterday afternoon, the Virginia Senate approved a bipartisan measure to expand Medicaid. Now Gov. Ralph Northam (D), who campaigned extensively on Medicaid expansion, is expected to sign expansion into law. Advocates secured expansion despite attempts from the White House and conservative activists to stop it, paving the way for Virginia to become the 34th state, including the District of Columbia, to expand Medicaid – with Utah, Idaho, and Nebraska seeking to follow suit through ballot measures this fall.

Here’s a roundup of reactions:

Washington Post: “It’s Another Nail In The Coffin For Efforts To Repeal Obamacare.” “As Joe Biden put it a little differently when Barack Obama signed the Affordable Care Act eight years ago, Virginia’s expansion of Medicaid on Wednesday is a big dang deal. And not just because 400,000 low-income citizens will now have access to government health insurance. It’s another nail in the coffin for efforts to repeal Obamacare… Years of obstruction in the commonwealth gave way because key Republicans from rural areas couldn’t bear to deny coverage for their constituents any longer, moderates wanted to cut a deal and, most of all, Democrats made massive gains in November’s off-year elections.” [Washington Post, 5/31]

Republican State Senator Ben Chafin: “I Came To The Conclusion That ‘No’ Just Wasn’t An Answer Anymore.” “In the final hours, Sen. Ben Chafin, a Republican lawmaker from Virginia’s economically depressed southwest coal country, announced his support for expansion on the Senate floor. He said his rural area needs expansion to bolster its hospitals and provide care for constituents. ‘I came to the conclusion that no just wasn’t the answer anymore,’ Chafin said.” [USA Today, 5/31]

Republican State Senator Frank Wagner: “It Is The Number One Issue On Our Voters’ Minds.” “‘This is not just about helping this group of people,’ said Sen. Frank Wagner (Virginia Beach), one of four Republicans in the Senate who split from their party to join Democrats and pass the measure by a vote of 23 to 17. ‘This is about getting out there and helping to bend the cost of health care for every Virginian. . . . It is the number one issue on our voters’ minds. By golly, it ought to be the number one issue on the General Assembly’s mind.’” [Washington Post, 5/30]

Richmond Times-Dispatch: GOP State Senators “Defended Their Decisions As Necessary,” Supported Expanding Coverage “To People Who Need It And Hospitals That Provide It.” “In the end, three other Republican senators — Frank Wagner of Virginia Beach, Ben Chafin of Russell County and Jill Vogel of Fauquier County — joined Hanger and the Senate’s 19 Democrats in adopting the pair of budget bills to end a standoff that has been watched closely by national bond-rating agencies and institutional investors who hold the state’s AAA-rated bonds… But Chafin and Vogel defended their decisions as necessary to invest in core public services, while expanding health coverage to people who need it and the hospitals that provide it.” [Richmond Times-Dispatch, 5/31]

Wall Street Journal: “The Growing Interest In Medicaid Expansion, Even In Some Conservative States, Suggests The Program Is Becoming More Accepted.” “Virginia is poised to expand Medicaid after a hard-fought legislative battle, making it one of a growing number of states where there is interest in expanding the program after Republicans failed to repeal the Affordable Care Act last year… Organizers who support Medicaid expansion in Utah learned this week that they had obtained enough signatures to put the initiative on the ballot in November, potentially expanding coverage to more than 100,000 people… A push is also under way to get expansion on the ballot in Idaho, where voters will select a new governor this fall. Democratic nominee Paulette Jordan supports an expansion and Lt. Gov. Brad Little, who claimed the GOP nomination in the primary, has said he would follow the will of the people if the initiative passes… The growing interest in Medicaid expansion, even in some conservative states, suggests the program is becoming more accepted as it appears less likely congressional Republicans will successfully revive efforts to repeal the ACA.” [Wall Street Journal, 5/30]

New York Magazine: “For A Health Care Law That Donald Trump Has Been Declaring ‘Dead’ Or ‘Dying’ Since 2013, Obamacare Seems To Have A Lot Of Life Left In It.” “One of the nation’s longest and bitterest battles over implementation of the Affordable Care Act looks likely to end very soon as the Virginia Senate approved a budget that included funds to expand Medicaid… For a health-care law that Donald Trump has been declaring ‘dead’ or ‘dying’ since 2013, Obamacare seems to have a lot of life in it yet, no thanks to his administration. Obama himself is probably sharing a bit of the good feelings among Democrats in Virginia.” [New York Magazine, 5/30]

CNN: “Despite Years Of Resistance, The State Will Become The Latest To Expand Access To Medicaid.” “Virginia lawmakers crossed an important hurdle Wednesday, ensuring that, despite years of resistance, the state will become the latest to expand access to Medicaid. The move to broaden the federal health care program for low-income Americans comes as a direct result of the political fallout from last November’s election.” [CNN, 5/31]

Los Angeles Times: Medicaid Vote “Serves As Something Of A Retort To President Trump And His Republican Allies In Congress.” “The breakthrough — made possible by a coalition of Democrats and a handful of Republicans in the statehouse — continues the expansion of the government safety net made possible by the 2010 healthcare law, often called Obamacare. Virginia’s move also serves as something of a retort to President Trump and his Republican allies in Congress, who have called for sweeping cuts in federal aid to states for Medicaid… Medicaid, the half-century-old government health plan for the poor, is a pillar of the 2010 healthcare law’s program for guaranteeing coverage, and it has helped drive a historic drop in the nation’s uninsured rate.” [Los Angeles Times, 5/30]

Business Insider: Medicaid Expansion “A Move That Shows The Resiliency Of The Landmark Healthcare Law.” “Virginia’s state Senate voted Wednesday in favor of a plan that would expand the state’s Medicaid program under the Affordable Care Act, or Obamacare, in a move that shows the resiliency of the landmark healthcare law. The Virginia Senate voted 23 to 17 to pass a budget that included Medicaid expansion, which could extend healthcare coverage to roughly 400,000 low-income Virginians. The House must re-vote on the Senate package, but a similar measure already made it through that chamber and the second vote is expected to follow suit.” [Business Insider, 5/31]

Politico: “Trump Administration Officials And Conservative Activists Had Tried To Derail” Expansion.” “Trump administration officials and conservative activists had tried to derail the Virginia plan. White House budget director Mick Mulvaney in March urged the state to reject Medicaid expansion, and White House health care aide Brian Blase joined phone calls with Americans for Prosperity as the Koch brothers-supported group tried to rally opposition. Former Sen. Rick Santorum, who is pushing for another Obamacare repeal vote in Congress this summer, was spotted in the Virginia Statehouse on Wednesday before the vote to brief Republicans on the status of that effort.” [Politico, 5/31]

Talking Points Memo: “Lobbying Against The Expansion By Trump Administration Officials” Was “Not Successful.” “After years of political battles and weeks of procedural delays, the Virginia House and Senate voted Wednesday to expand Medicaid to cover between 300,000 and 400,000 more low-income residents. Four Republicans joined every Senate Democrat in voting for the expansion Wednesday afternoon. Later Wednesday evening, the House followed suite, passing a multi-year budget including the expansion by an overwhelming majority. Last-minute lobbying against expansion by Trump administration officials, former Sen. Rick Santorum (R-PA) and the Koch brothers’ group Americans for Prosperity was not successful.” [TPM, 5/30]

The Daily Beast: Law To Be Signed By Gov. Ralph Northam, Who “Campaigned On Expansion.” “The Virginia Senate on Wednesday voted to approve Medicaid expansion, which would impact the lives of up to 400,000 citizens in the state. As such, Virginia becomes just the second state during the Donald Trump presidency to approve such a program, following only Maine. Yet even there, Republican Gov. Paul LePage faces a lawsuit for his refusal to actually implement the program. Virginia’s Democratic Gov. Ralph Northam, who handily won election last November sweeping in enough Democrats to nearly flip the state’s House of Delegates, campaigned on expansion and will undoubtedly sign it into law.” [Daily Beast, 5/30]

Vox: Medicaid Expansion “Top Item On The State’s Agenda.” “In political terms, expansion is a huge victory for the state’s Democratic governor, Ralph Northam, who made expansion a key campaign priority, and for the many Democrats who swept into the state legislature last November and came extraordinarily close to securing a majority in the House of Delegates… Even since Northam won the governor’s mansion in November and down-ballot Democrats narrowed the GOP’s House majority dramatically, Medicaid expansion became the top item on the state’s agenda.” [Vox, 5/30]

As Insurance Companies Cite “Policies Advocated By The Trump Administration,” Virginians Face Republican-Inflicted Rate Hikes

On Friday, preliminary Virginia rate filings for 2019 individual-market health insurance indicated a potential double-digit average premium increase due to Washington Republicans’ repeal-and-sabotage agenda. What’s behind this spike? In the words of the insurance companies themselves, “policies advocated by the Trump Administration” are driving the increases. It’s the latest consequence of the GOP’s repeal-and-sabotage campaign. Here’s some early coverage:

Senators Mark Warner And Tim Kaine: “These Proposed Price Increases Are A Painful Consequence Of The Trump Administration’s Efforts To Sabotage The Health Insurance Market And Dismantle The Affordable Care Act.” “These proposed price increases are a painful consequence of the Trump Administration’s efforts to sabotage the health insurance market and dismantle the Affordable Care Act. After a series of unsuccessful attempts to repeal the ACA, President Trump and Republicans in Congress settled for taking actions that will increase premium costs for American families, something even Trump’s former HHS Secretary admitted this week. Now, their irresponsible games are hurting Virginians by making it harder for families to afford health care. We hope our colleagues will take this seriously and pass bipartisan legislation to stabilize the market and make sure Virginians have affordable options for health insurance in 2019.” [Senator Tim Kaine, 5/4]

Rep. Don Beyer: “This Is A Scandal And A Disgrace And Virginians Are Going To Be Hurt Very Badly.” “Awful healthcare news for Virginia. Last year we stopped Trump/GOP attempts to repeal the ACA and strip health insurance from 23 million people. They responded by sabotaging the healthcare system. We just learned that this is going to cause Virginians’ premiums to skyrocket. ‘Skyrocket’ = double-digit increases, up to 64%, depending on your insurer and plan. There is no way to sugarcoat these health insurance premium hikes: they are across different insurers, they are devastating, and many will not be able to afford them. Why is this happening? The insurers themselves attribute it to Republican actions… This is a scandal and a disgrace and Virginians are going to be hurt very badly, especially those who can least afford it. It is so infuriating… Congress must act immediately to undo the Trump/GOP sabotage and take steps to rein in costs. It is still possible to help if we work together for solutions. Right now this is awful news for Virginians, but we will not be the only ones. Americans in other states will feel the same pain of health premium increases, and some may get hit even harder. The GOP did this on purpose. They have to let us fix it.” [Twitter, 5/4]

Virginian-Pilot: “Cigna And CareFirst Said Trump Administration Policies, Including The Repeal Of The Individual Mandate, Led To The Proposed Increases.” “Two of the insurance companies that participate in Affordable Care Act exchanges in Virginia are seeking clearance for large increases in premiums for next year…  Cigna and CareFirst BlueCross BlueShield are two of seven insurers that offer policies under what is known as Obamacare… Cigna and CareFirst said Trump administration policies, including the repeal of the individual mandate, led to their proposed increases. Cigna said it anticipates sicker people entering the market, a result of the individual mandate being repealed. Cigna also cited ‘anticipated changes to regulations’ involving short-term plans and association health plans as a reason for the requests.” [Virginian-Pilot, 5/4]

The Hill: Insurers “Cited Policies Advocated By The Trump Administration” As Justification For Increases. “Two of Virginia’s ObamaCare insurers are requesting significant premium hikes for 2019, according to initial filings released Friday. Both Cigna and CareFirst BlueCross BlueShield cited policies advocated by the Trump administration, including the repeal of ObamaCare’s individual mandate, as part of its justifications for the increases… The pro-ObamaCare group Protect Our Care Campaign was quick to attack the administration following the news. ‘Until we stop Republicans’ war on health care, health care experts predict that rates will keep rising by double digits,’ said the group’s director, Brad Woodhouse. ‘D.C. Republicans should start working on bipartisan solutions to make coverage more affordable, instead of helping their friends in the insurance industry make another buck on the backs of hardworking Virginians.’” [The Hill, 5/4]

Fierce Healthcare: Premiums Could Rise 64% “And Insurers Are Blaming President Donald Trump And Congressional Republicans.” “Premium increases for exchange plans could swell as much as 64% in Virginia next year if proposed rate hikes hold up. And insurers are blaming President Donald Trump and Congressional Republicans. According to preliminary filings submitted on Friday, two of Virginia’s largest ACA insurers, Cigna and CareFirst BlueCross BlueShield, are requesting significant premium hikes for next year in response to planned policy changes by the Trump administration and the GOP’s repeal of the individual mandate… The insurers cited repeal of the individual mandate and ‘anticipated changes to regulations’ to short-term health plans as reasons for the drastic increases. Congressional Republicans repealed the mandate last year as part of its tax overhaul, and the Trump administration has moved to extend the short-term health plan duration to 12 months. Both policies are projected to drive younger, healthier people from the markets, raising premiums for those who remain.” Fierce Healthcare, 5/6]

Politico: “This Time It’s Democrats Taking Advantage Of The Proposed Spikes To Blame President Donald Trump And Hill Republicans, Arguing They Have Taken Several Actions That Will Destabilize Insurance Markets.” “The initial glimpse of premium increases is predictably prompting political jockeying that will continue throughout the summer and fall as officials finalize next year’s prices. Unlike prior years, this time it’s Democrats taking advantage of the proposed spikes to blame President Donald Trump and Hill Republicans, arguing they have taken several actions that will destabilize insurance markets.” [Politico, 5/7]

Andy Slavitt, Former Acting CMS Administrator: “Trump Is Giving Insurance Companies Unfettered Ability To Charge What They Want, Deny What They Want, Cover What They Want, And Make Unlimited Profits.” [Twitter, 5/5]

Larry Levitt, Kaiser Family Foundation: “With Insurers Now Mostly Profitable In The ACA Individual Insurance Market, I Would Have Expected Single-Digit Premium Increases For 2019 Reflecting Health Cost Growth. With Repeal Of The Individual Mandate And Expansion Of  Short-Term Plans, Double-Digit Hikes Are Now Likely.” [Twitter, 5/7]

Joe Scarborough: “This Is A Coming Sign Of The Times That Will Haunt A Republican Party That Sabotaged America’s Health Care System Instead Of Replacing Or Reforming It.” [Twitter, 5/6]

Charles Gaba, ACA Signups: “For Anyone Who Doesn’t Believe The Latest Batch Of [Sabotage] By Trump Isn’t Gonna Jack Rates Up Next Year, I’ve Already Got Receipts Out Of Virginia.” [Twitter, 5/6]

Jon Favreau: “Enjoy Premium Hikes Of 64%, Brought To You By Republican Control Of Washington. And That Number Will Climb Even Higher If Republicans Keep Congress And Continue To Sabotage The Affordable Care Act In 2019.” [Twitter, 5/4]

David Certner, AARP: “Steps Could (And Should) Have Been Taken This Past Year To Hold Down Health Care Premiums. Instead, The Reverse Has Happened, And Now Insurers In Virginia Propose Major Premium Hikes For 2019.” [Twitter, 5/6]

Health Care Remains Top Issue Heading Into Midterms

To: Interested Parties

From: Brad Woodhouse, Protect Our Care Campaign Director

Date: May 3, 2018

Re: Health Care Remains Top Issue Heading Into Midterms


Throughout the Trump presidency, one issue has consistently stood out as the top priority for voters, critical to how Americans will cast their ballots in the midterm elections: health care.

  • Health care is a top issue in nearly every  major issue-ranked poll in 2018;
  • Voters overwhelmingly trust Democrats over Republicans on health care; and
  • Voters resoundingly reject President Trump and Congressional Republicans’ repeal-and-sabotage campaign against the Affordable Care Act and Medicaid.

These polls, conducted by nonpartisan news outlets and by research firms from a wide array of ideological backgrounds, have shown consistent results despite asking differently-framed questions amid a turbulent political landscape. Clearly, health care is a dominant issue that will remain potent through the midterm elections, and the consistent partisan trust divide indicates that it should be a major focus for Democratic candidates in virtually every race in the country.

HEALTH CARE REMAINS A TOP ISSUE FOR AMERICAN VOTERS

Throughout 2018, poll after poll has surveyed which issues are top-of-mind for voters and nearly every time health care has been at the top of the list.

For example, a February CNN poll found that health care was voters’ top priority. Among its findings:

  • 83% of voters said health care was extremely important or very important, the highest among all issues.
  • 53% of voters said health care was extremely important, the highest among all issues – a 20% increase from August of 2010, a year when health care played a major factor in midterm elections.
  • 78% of independent voters said health care was important, tied with the economy as their top issue.
  • At least 70% of voters in every demographic category said health care was important – a trend that stretches across gender, age, income level, education level, ideology, and party affiliation.

These results were echoed by a March Pew Research Center survey, which found health care is the number-one pocketbook issue for Americans across all income brackets:

  • More than half of those surveyed said that health care affects their household’s financial situation “a lot,” the only issue which more than half of Americans rated a key economic issue.

  • Health care is “a top household financial issue” across all income levels, with 53% of those earning more than $100,000 and 52% of those earning $30,000 or less saying it has a large effect.

An April HuffPost/YouGov poll found that health care was a top issue for voters, with, 28% of those surveyed listing health care as their top the top issue, leaving the Huffington Post to conclude:

“Heading into the midterm elections, American voters are more likely to say they’re focused about health care than any other issue.”

A March Gallup survey asked Americans about the issues they are most worried about and, 78% of those surveyed named health care as a worry, more than any other issue, leading Newsweek to frame its coverage of the poll, “Health Care Is A Bigger Concern Than Terrorism”:

“Americans are more concerned about health care than they are about terrorism, according to a poll released on Monday. The Gallup survey rated health care as the top concern among Americans, with 55 percent of respondents noting they were “a great deal” concerned about the availability and affordability of health care. Twenty-three percent were “a fair amount” concerned about the topic. It is the fifth year running that health care has topped Gallup’s list of concerns for  Americans. It’s the 13th time overall that the issue has been a top concern. Democrats were more concerned about health care than Republicans, although 39 percent of Republicans still expressed concerns about the issue.”

A survey leaked in March from America First Policies using President Trump’s own pollsters found that health care was the top issue for voters, with 41% saying lowering health care costs should be Congress’ top priority. On the other side of the spectrum, a February poll from Priorities USA also found that independent voters continue to hold major concerns about President Trump’s war on health care:

“Donald Trump’s policies are adding to the economic burdens of average families by raising the cost of health care and driving up insurance premiums. And Trump has broken his promise to crack down on excessive drug prices. Instead, he has given the big drug companies huge tax breaks while allowing them to charge as much as they want, without any controls or negotiation. 60% of voters have major concerns, including 71% among independents.”

HEALTH CARE IS DRIVING DEMOCRATIC SUPPORT

Health care is not just a top concern for voters – it’s also a deciding factor for voters, and drives widespread support of Democrats.

On March 13, voters in Pennsylvania’s eighteenth district went to the polls and selected Conor Lamb over pro-repeal candidate Rick Saccone in a district which had gone for Donald Trump by nearly twenty points. A telephone exit poll of those who cast ballots found that:

  • Health care was a top issue for voters, with 52% listing it as important and only 19% deeming it not important. Among voters who said health care was the most important issue, Lamb beat Saccone 64-36, and among voters who said it was either the most important or a very important issue, Lamb beat Saccone 62-38.
  • On health care, voters said Lamb better reflected their views by 7 points, 45-38. Among independents, that gap widened to 16 points, with 50% saying Lamb’s health care views were more in line with theirs to only 34% for Saccone.
  • Voters were less likely to support Saccone because of the Republican health care agenda. Saccone’s support of the Republican health care agenda made 41% of voters less likely to vote for him and only 28% more likely to support him.

On April 24, Hiral Tipirneni nearly upset Republican Debbie Lasko in Arizona’s eighth district, a “closer-than-expected” result in a district Donald Trump carried by 21 points. A telephone exit poll of those who cast ballots similarly found that:

  • Health care was a top issue to voters, and these voters favored Tipirneni. Health care was ranked as a top issue for 58% of voters, with only 17% saying it was not that important or not important at all. Among these voters, Tipirneni beat Lesko 65-33.
  • On health care, voters said Tipirneni better reflected their views. Overall, voters said Tipirneni better reflected their views by 2 points, 45-43, over Lesko. Among independents, the gap widened to 30 points, 57-27 in favor of saying Tipirneni.
  • Voters were less likely to support Lesko because of the Republican health care agenda. Lesko’s support of the Republican health care agenda made 40% of voters less likely to vote for her and only 33% more likely to support her.

These were not special occurrences, either. A March 21 PPP poll among voters in battleground states found voters supporting pro-health care candidates and rejecting those favoring repeal:

  • In Arizona, health care is a top issue for 68% of voters, with 21% saying it is the most important issue. In a hypothetical Senate election, Democrat Kyrsten Sinema leads pro-repeal candidate Martha McSally 46-41
  • In Nevada, health care is a top issue for 65% of voters, with 27% saying it is the most important issue. In a hypothetical Senate election, Democrat Jacky Rosen leads pro-repeal Dean Heller 44-39.
  • In Pennsylvania, health care is a top issue for 71% of voters, with 25% saying it is the most important issue. In a hypothetical Senate election, Democrat Bob Casey leads pro-repeal candidate Lou Barletta 54-36.
  • In Tennessee, health care is a top issue for 71% of voters, with 31% saying it is the most important issue. In a hypothetical Senate election, Democrat Phil Bredesen leads pro-repeal candidate Marsha Blackburn 46-41.
  • In Wisconsin, health care is a top issue for 72% of voters, with 25% saying it is the most important issue. In a hypothetical Senate election, Democrat Tammy Baldwin leads pro-repeal candidates Leah Vukmir and Kevin Nicholson 51-39 and 51-38, respectively.

And in November, in what analysts deemed the election most seen as a bellwether for the rest of the country, exit polling from Virginia, where Democrats had their best performance in decades, found health care to be far-and-away the most important issue:

  • Asked whether health care, immigration, gun policy, taxes, or abortion was the most decisive issue, 39% of voters said health care was the issue which mattered most.
  • Among those who selected health care, 77% backed Democrat Ralph Northam.

VOTERS REJECT THE REPUBLICAN HEALTH CARE AGENDA

Ultimately, Americans don’t support or trust the GOP when it comes to health care.

A February PPP poll found Americans placing blame for rising health care costs on President Trump’s sabotage of the law. Among its findings:

  • Over half of voters know Republicans are sabotaging health care, with 51% stating that the Trump administration is actively taking steps that will raise people’s health care costs.
  • 60% of voters want to keep the ACA in place and make fixes as necessary, with just 34% favoring repeal.

This rang true in Pennsylvania’s eighteenth district, with polling showing not just support for Conor Lamb based on his health care stance, but also a rejection of Rick Saccone for his pro-repeal views:

  • Voters in this heavily-Republican district disapproved of the Republican efforts to repeal the Affordable Care Act by 14 points, 53% to 39%.
  • 59% of those surveyed said the Affordable Care Act should be kept in place with fixes made to it as necessary, while just 38% of those surveyed said the best path forward on health care was to repeal the ACA.
  • Among independent voters, the disparity is even wider, with 63% of independent voters opposing the GOP’s health care efforts and just 33% supporting them.

This was also the case in Arizona’s eighth district. Although Tipirneni was not able to pull off the upset, polling showed health care was a boost for her, and once again showed the ACA’s growing popularity:

  • Voters in this heavily Republican district disapproved of the Republican efforts to repeal the Affordable Care Act by 5 points (49% to 44%).
  • Only 41% of voters think the best path forward on health care is to repeal the Affordable Care Act, to 54% who think it should be kept in place with fixes made to it as necessary.

In fact, even the Trump-backed poll finds that voters don’t trust the GOP’s health care agenda. The America First Policies poll also found:

  • By 17 points, voters disapprove of Trump’s “handling of health care and health insurance” with only 38% approving (16% strongly) and 55% disapproving (44% strongly).
  • Among the 41% of voters who say lowering health care costs should be the top priority, 68% want Congress to either leave the Affordable Care Act as it is or work to fix it, with just 31% backing repeal.

And let’s not forget – in direct opposition of the Republican health care agenda, the popularity of the ACA continues to rise:

  • In the PPP poll, approval for the Affordable Care Act 12 was points above water, 47% approval to 35% disapproval, a dramatic reversal from trends before Trump took office.
  • In the PA-18 exit polling, a deeply-red district, 44% of voters supported for the ACA while just 42% opposed it.
  • And in the latest Kaiser tracking poll, 50% of voters expressed their support for the ACA to just 43% who disapproved, reflecting the long-term upward trend of support for the ACA that reached an all-time high in February at 54-42 approve/disapprove.

Ultimately, the message could not be more explicit: voters from all backgrounds and in states across the country are telling the GOP that enough is enough – it’s time for Republicans to end their war on health care and cease their repeal and sabotage agenda. As polls and election results have made clear, if Republicans continue their war on health care and Democrats call them on it, the opposition party will continue to widen its advantage in the midterm elections.

This Week in the War on Health Care — January 22-26, 2018

This week, Washington was focused on shutdown drama, while in the background, the Trump Administration and Republicans across the country continued their unprecedented assault on the American health care system.

Here’s a what happened this week in Republicans’ war on health care – plus, read down to see how some states are fighting back.

SABERS RATTLE ON CAPITOL HILL

This week, Senator Ted Cruz (R-Texas) told reporters Republicans need to “finish the job” and repeal the Affordable Care Act through budget reconciliation, and that he has been lobbying GOP senators who opposed repeal in 2017.

Apparently those efforts aren’t bearing much fruit: when asked about Cruz’s call to action, Senator Lisa Murkowski (R-Alaska) told reporters, “I don’t think we should be spending time trying to do repeal and replace of ObamaCare” in 2018.

STATE SABOTAGE EFFORTS

Yesterday, Idaho Governor Butch Otter announced his (plainly illegal) intent to let insurance companies in Idaho sell bare-bone plans that don’t include the essential health benefits now required by the Affordable Care Act and again discriminate against people with pre-existing conditions. Experts were … confused:

And in Virginia, a State Senate committee rejected legislation to expand Medicaid on a party-line vote. Just two months ago, Virginians delivered sweeping victories to pro-Medicaid expansion candidates up-and-down the ballot, putting Ralph Northam in the governor’s mansion and flipping delegate seats across the state. A Washington Post exit poll found that 39% of Virginia voters listed health care as the number one issue in their vote. The Virginia GOP may have chosen to keep ignoring the will of the people, but thankfully, this week was only the beginning of Virginia’s fight for Medicaid expansion in 2018.

TROUBLE AT TRUMP’S HHS

On Wednesday, Alex Azar became the Trump Administration’s new HHS Secretary. Throughout his confirmation process, Azar refused to acknowledge the Trump Administration’s ongoing Affordable Care Act sabotage, let alone promise to stop it and stand up for Americans’ health care. Instead, he embraced the Republican agenda to take coverage from millions of Americans, raise costs for millions more, and gut protections for people with pre-existing conditions. Right out of the gate, newly-confirmed Secretary Azar faces a major test: will he block Idaho’s attack against the law of the land, or drive HHS even further away from its mission to protect Americans’ health?

Meanwhile, in the wake of HHS’s quiet renewal of its public health emergency declaration, with little to show for the first 90 days, a member of Trump’s Opioid Commission said the Administration’s efforts to address the epidemic are “tantamount to reshuffling chairs on the Titanic.” Other leading advocates joined him to speak out against the Administration’s failure to address to the nation’s most pressing public health crisis:

CNN: Opioid commission member: Our work is a ‘sham’

The Republican-led Congress has turned the work of the president’s opioid commission into a “charade” and a “sham,” a member of the panel told CNN. “Everyone is willing to tolerate the intolerable — and not do anything about it,” said former Democratic Rep. Patrick Kennedy, who was one of six members appointed to the bipartisan commission in March. “I’m as cynical as I’ve ever been about this stuff.”

Vox: Trump has had a year to confront the opioid epidemic. He’s done almost nothing.

There has been no move by Trump’s administration to actually spend more money on the opioid crisis. Key positions in the administration remain unfilled, even without nominees in the case of the White House’s drug czar office and the Drug Enforcement Administration (DEA). And although Trump’s emergency declaration was renewed last week, it has led to essentially no action since it was first signed — no significant new resources, no major new initiatives.

… AND THE STATES THAT ARE FIGHTING BACK

On Tuesday night, Oregon residents issued a stern rebuke to the GOP’s war on health care. Oregonians went to the polls to vote on Measure 101, an initiative Republicans worked to get on the ballot, which could have denied health care to thousands of their fellow citizens. Instead, Oregonians “overwhelmingly approved” continuing the state’s successful Medicaid expansion. Oregon sent a clear message to the rest of the country: Republicans who continue sabotaging health care should be wary.

And in a sign of how dramatically the politics around health care have shifted, Wisconsin Governor Scott Walker, once an outspoken foe of the Affordable Care Act, has embraced a plan he says will strengthen the law in his state. The about-face comes soon after a national Protect Our Care poll showed that health care is a top priority for most voters going into the 2018 election cycle.

The GOP War on Health Care Continues In Virginia

Richmond, VA – Following the news that a Virginia Senate committee rejected legislation to expand Medicaid on a party-line vote, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Just two months ago Virginians went to the polls and gave sweeping victories to pro-Medicaid expansion candidates up-and-down the ballot, with 39% of Virginia voters listing health care as the number one issue in their vote. Sadly, today eight Republican state senators in Richmond just ignored the will of their people, siding with party orthodoxy instead of Virginia values and voting against a plan to expand health care to hundreds of thousands of Virginians. The fight for Medicaid expansion in Virginia is far from over, but Virginia Republicans’ war on health care must end.”