Washington, DC — Following the news that Manny Sethi, a vocal supporter of repealing the entire Affordable Care Act, entered the Tennessee GOP Senate primary today, Protect Our Care chair Leslie Dach released the following statement:

“The voters have shown time and time again that running on an agenda of repealing and sabotaging health care is a political death wish, but Manny Sethi apparently didn’t get the memo when he entered the Tennessee GOP Senate primary today. Sethi’s brazen support for sabotaging our health care system, raising costs, and taking away people’s health care is as reckless as it is unpopular — especially for the millions of Tennesseans with pre-existing conditions.”

BACKGROUND:

If Sethi Gets His Way, 168,000 Tennesseans Would Lose Their Coverage

  • 168,000 Tennesseans could lose coverage. According to the Urban Institute, 168,000 Tennesseans would lose coverage by repealing the Affordable Care Act, leading to a 23 percent increase in the uninsured rate.
  • 47,000 Tennessee young adults with their parents’ coverage could lose care. Because of the Affordable Care Act, millions of young adults are able to stay on their parents’ care until age 26.

If Sethti Gets His Way, Insurance Companies Would Be Put Back In Charge, Ending Protections For The 130 Million People Nationwide With A Pre-Existing Condition

  • According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 130 million people, have a pre-existing condition. This includes:
    • 44 million people who have high blood pressure
    • 45 million people who have behavioral health disorders
    • 44 million people who have high cholesterol
    • 34 million people who have asthma and chronic lung disease
    • 34 million people who have osteoarthritis and other joint disorders
  • 2,718,800 Tennesseans have a pre-existing condition, including 355,200 Tennessee children, 1,382,000 Tennessee women, and 630,100 Tennesseans between ages 55 and 64.

If Sethi Gets His Way, Insurance Companies Would Have The Power To Charge You More, While Their Profits Soar

 

  • 2,745,436 Tennesseans Could Once Again Have To Pay For Preventive Care. Because of the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no cost to consumers. This includes nearly 2,745,436 Tennesseans, most of whom have employer coverage.
  • Insurance Companies Could Charge Premium Surcharges in the Six Figures. If the Trump-GOP lawsuit is successful, insurance companies would be able to charge people more because of a pre-existing condition. The health repeal bill the House passed in 2017 had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
  • Women Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women were often charged premiums on the nongroup market of up to 50 percent higher than they charged men for the same coverage.
  • People Over the Age of 50 Could Face a $4,000 “Age Tax,” Including $5,404 in Tennessee. Because Judge O’Connor sided with Republican lawmakers, insurance companies would be able to charge people over 50 more than younger people. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, including $5,404 in Tennessee, according to the AARP.
  • 181,218 Tennesseans in the Marketplaces Would Pay More for Coverage. If the Trump-GOP lawsuit is successful, consumers would no longer have access to tax credits that help them pay their marketplace premiums, meaning roughly nine million people who receive these tax credits to pay for coverage will have to pay more, including 181,218 in Tennessee.
  • 108,136 Tennessee Seniors Could Have to Pay More for Prescription Drugs. If the Trump-GOP lawsuit is successful, seniors could have to pay more for prescription drugs because the Medicare “donut” hole would be reopened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 CMS report. In Tennessee, 108,136 seniors each saved an average of $1,034.

 

 

 

 

 

 

 

If Sethi Gets His Way, Insurance Companies Would Have the Power to Limit the Care You Get, Even If You Have Insurance Through Your Employer

  • Insurance Companies Do Not Have to Provide the Coverage You Need. The Affordable Care Act made comprehensive coverage more available by requiring insurance companies to include “essential health benefits” in their plans, such as maternity care, hospitalization, substance abuse care and prescription drug coverage. Before the ACA, people had to pay extra for separate coverage for these benefits. For example, in 2013, 75 percent of non-group plans did not cover maternity care, 45 percent did not cover substance abuse disorder services, and 38 percent did not cover mental health services. Six percent did not even cover generic drugs.
  • Reinstate Lifetime and Annual Limits On 2,042,000 Privately Insured Tennesseans. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage for those insured through their employer or on the individual market.
  • Large Employers Could Choose to Follow Any State’s Guidance, Enabling Them Put Annual and Lifetime Limits on Their Employees’ Health Care. Without the ACA’s definition of essential health benefits (EHB) in even some states, states could eliminate them altogether. Large employers could choose to apply any state’s standard, making state regulations essentially meaningless. Because the prohibition on annual and lifetime limits only applies to essential health benefits, this change would allow employers to reinstate annual and lifetime limits on their employees’ coverage.

 

 

 

 

If Sethi Gets His Way, Medicaid Expansion Would Be Repealed

  • 381,000 Tennesseans who could gain coverage if Tennessee were to expand Medicaid will be denied that possibility. By not fully expanding Medicaid, Tennessee has restricted its Medicaid program, preventing 381,000 residents from gaining coverage.
  • Access To Treatment Would Be In Jeopardy For 800,000 People With Opioid Use Disorder. Roughly four in ten, or 800,000 people with an opioid use disorder are enrolled in Medicaid. Many became eligible through Medicaid expansion.
  • Key Support For Rural Hospitals Would Disappear, leaving Tennessee hospitals with $442 million more in uncompensated care.