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This Week in the War on Health Care

By April 12, 2018No Comments

While Facebook and confirmation hearings dominated Congress’ return to Washington this week, Republicans continued their unprecedented assault on the American health care system. Here’s what happened in the war on health care – and how five recent studies made clear the long- and short-term benefits of the Affordable Care Act:


On Monday, the Trump Administration finalized the “rules of the road” for next year’s ACA marketplaces, and they favor insurance companies over the American people, encouraging insurers to undermine protections for those with pre-existing conditions with a race-to-the-bottom approach while loosening restrictions on extreme rate hikes.

Moreover, despite the Administration’s own data showing that cuts to outreach and assistance dampened enrollment, especially among younger and healthier consumers, they pushed even further cuts to local assisters, ensuring it will be even more difficult for Americans to sign up for coverage next year.

This short-sighted, bad-faith rule is yet another brick in the wall that Republicans are building between the American people and access to good, affordable coverage.


Among those who know health care the best, the rules were not well received. Here’s a sampling of what the experts said:

Andy Slavitt, Former Acting CMS Administrator: “Andy Slavitt, who was acting CMS administrator during the Obama administration’s final two years, countered that the current administration ‘is making it clear that they’re implementing a law that they have no intention of making succeed.’ Slavitt called the revisions ‘a gift to the insurance companies by finding lots of ways for them to get around the standards Americans have come to expect.’” [Washington Post, 4/9/18]

Sam Berger, Senior Adviser, Center for American Progress: “This rule reduces protections for people with pre-existing conditions, increases the cost of health coverage, and makes it harder for consumers to sign up for coverage. This past year has shown just how much consumers value quality, affordable health care, but rather than encourage awareness, lower prices, and promote market stability, the administration is more concerned with trying to undermine the law. This is just the latest example of the Trump administration putting its ideological crusade against the Affordable Care Act ahead of the health and well-being of the American people.” [4/9/18]

Avalere: “The final NBPP … allows for greater essential health benefit flexibility, which could lead to less generous benefits and worse access for consumers.” [4/9/18]

Matt Eyles, Incoming AHIP President and CEO: “When you think about things like the individual mandate going away, some of the other proposed rules that are being put in place, whether it be around association plans, short-term policies — it’s just still a nasty soup right now that’s brewing… We’re looking ahead to 2019, and it’s not a really great picture right now, but I know a lot of companies are committed to the market.” [Washington Times, 4/10/18]

U.S. PIRG: “Together, these changes will make it easier for health insurance companies to raise rates and reduce the value of health coverage for consumers. This is a big step in the wrong direction.” [4/9/18]

AFT Nurses and Health Professionals: “CMS gives states more power to cut health benefits, more profits to insurance companies, with fewer safeguards for coverage.” [4/10/18]


On Tuesday, President Trump privately signed an executive order encouraging federal agencies and states to strengthen existing work requirements in Medicaid and in critical public assistance programs – and he was right to hide.

We’ve seen solid evidence that imposing work requirements on non-employment-related federal programs not only fail to help people find jobs, but actually push hard-working Americans through the cracks while costing more in wasteful administrative overhead. The reality is that 8 in 10 adults with coverage through Medicaid live in working families.

By pushing states and federal agencies to adopt short-sighted and inhumane tactics to force even more Americans off their insurance and out in the cold, President Trump is aggressively continuing his war on our health care.


Also on Tuesday, Sen. Cory Booker (D-NJ) released a major report confirming that none of the country’s ten biggest pharmaceutical companies have used any of their windfall from the GOP tax scam to lower drug prices for consumers, instead passing those benefits along to wealthy executives and shareholders.

The majority of Americans have always known the GOP tax scam was designed to enrich the wealthiest individuals and biggest corporations at the expense of everyday Americans and our health care, but this doesn’t make the findings any less distressing. Americans already pay a higher price for prescription drugs than consumers around the world, and big pharmaceutical companies have refused to lift a finger to provide relief from crippling prices.

It’s outrageous that pharmaceutical executives are further lining their own pockets instead of addressing the skyrocketing cost of prescription drugs, and it represents even further proof the GOP tax scam was never intended to help ordinary Americans.


On Wednesday, Administration officials unveiled an opioid crisis installation on White House grounds just hours after the President signed the executive order escalating his Administration’s relentless attacks on Medicaid, the most critical federal program for connecting Americans with opioid treatment, showing just how out-of-touch they are with the reality of this crisis: its HHS Secretary is holding photo-ops with art installations instead of taking real action.

Rather than waging a war on this crisis, the Administration continues to wage a war on our health care – and until they call off their war on Medicaid, which covers 25 percent of all addiction treatment nationwide, President Trump and Secretary Azar will have zero credibility in the opioid crisis fight.


And as we head into another weekend, it’s worth revisiting what happened last weekend. On Sunday, Sen. Susan Collins (R-Maine) appeared on CNN’s State of the Union and proceeded to give a version of the events surrounding the GOP stabilization bill failure that do not hold up to scrutiny. Here’s what Sen. Collins said about the stabilization effort  – and what actually happened:

What Collins says now:What really happened:
Asked whether she was lied to to get her vote for the GOP tax scam, Sen. Collins responded, “No, I really don’t.” Last December, Collins said that a failure to pass stabilization would be a “serious breach of a promise.” When discussing the possibility that stabilization might not become law, Collins said, “I’m counting on the administration to make sure that does not happen…I would consider it a very serious breach of a promise to me.”
Sen. Collins stated she believes Majority Leader McConnell kept his promise to her: “I had the opportunity just two weeks ago to bring a package to the Senate floor with Lamar Alexander, so the Majority Leader kept his promise to me.” In Sen. Collins’ own words, she cast a vote to pass the tax bill because she had secured “commitments to pass legislation to help lower health insurance premiums.” She secured a commitment to pass stabilization, not just hold a vote on legislation. Not only did stabilization never pass, but no vote was ever held on Collins’ or Alexander’s health care stabilization package.
Sen. Collins continued to push a false narrative about what happened during stabilization efforts, saying, “Much to my surprise, [stabilization] was blocked actually by Senators on the other side of the aisle.” Republicans bear 100% of the responsibility for failing to pass legislation that would stabilize the Affordable Care Act. House Republicans, such as Rep. Tom Cole, went on the record indicating they opposed stabilization. The White House then released a list of extreme, deal-breaking demands. Sen. Lindsey Graham told Breitbart News, “[Obamacare] is going to continue to collapse, and then, we own the outcome. By repealing the individual mandate, which is a step forward in the eyes of the public, we own the issue.”  And in an op-ed she penned for the Portland Press Herald, Sen. Collins herself admitted price increases were entirely avoidable: “This proposal was the last clear opportunity to prevent these health insurance rate increases, which will be announced Oct. 1. The most frustrating thing about these imminent price increases is that they were entirely avoidable. Much about health care is complicated.”


Ultimately, however, despite everything that Republicans continue to throw at it, the ACA continues to improve the lives of Americans from coast to coast. Over the past month, five studies looking at the impact of the Affordable Care Act have been released: three analyzing Medicaid expansion, and two analyzing marketplace coverage. These studies covered a broad scope of health care-related outcomes, from treatment for chronic conditions to jobs created in a local economy, and each came to the same conclusion: the ACA is providing clear benefits for Americans.

  • Louisiana Department of Health: Medicaid Expansion and the Louisiana Economy. An April report analyzed Louisiana’s Medicaid expansion, finding that expansion brought a $1.85 billion economic impact to the state; created 19,000 new jobs; and extended medical services to over 545,000 Louisianans, leaving Gov. John Bel Edwards to note, “It is costing us less to have more people insured.”
  • University of Montana Bureau of Business and Economic Research: Medicaid Expansion Has Boosted State’s Economy, Added Jobs, Improved Health Care. A March study examined Montana’s Medicaid expansion, finding that it created 5,000 new jobs and $280 million of personal income; saved the state $40 million in Medicaid benefits; and provided insurance to more than 94,000 Montanans. “Medicaid expansion is doing what it’s supposed to do, help Montanans live healthier lives and save the state money,” said State HHS Director Sheila Hogan.
  • America’s Health Insurance Plans: The Value of Medicaid: Providing Access to Care and Preventive Health Services. An April AHIP study compared coverage data for those under Medicaid, private insurance, and not covered, finding Medicaid enrollees to have access to care at levels comparable to private coverage and far better than those without insurance, leaving the authors to conclude the study’s findings “refute outdated, less rigorous studies that question the value of Medicaid.”
  • Health Affairs: Effects Of The ACA’s Health Insurance Marketplaces On The Previously Uninsured: A Quasi-Experimental Analysis. An April study compared adults who had gone through periods without insurance to those with continuous coverage, finding that the introduction of the ACA saw the uninsured rate decrease by 11 percentage points and the number of of individuals unable to access necessary care fall by two points, as well as more outpatient visits, more prescriptions being filled, and a higher probability of a hospital stay.
  • Health Affairs: The Affordable Care Act’s Marketplaces Expanded Insurance Coverage For Adults With Chronic Health Conditions. An April study examined the role the ACA marketplace had on non-elderly adults with chronic conditions, finding that far more Americans with chronic conditions obtained coverage through the marketplace, underscoring the law’s long-term benefits.