Latest GOP Repeal Bill Hurts Seniors, Kids, People with Disabilities, Working Families, and Leaves States in Crisis on Their Own
The GOP has been consistent this year in its crusade against Medicaid, and the latest repeal proposal from Senate Republicans is no different. The Graham-Cassidy-Heller bill would end Medicaid as we know it, hurting seniors, children, people with disabilities, and working families, breaking key promises that the bill’s sponsors have made.
The Graham-Cassidy-Heller proposal would destroy Medicaid, turning it into a shrinking block grant that would not be able to support the nearly 75 million Americans who rely on Medicaid for their health care.
Here’s a look at just how damaging the latest repeal proposal is for Medicaid:
Graham-Cassidy-Heller would force states to raise taxes or make draconian cuts to schools and other priorities, and states would be left on their own when they need help the most in times of crisis and natural disasters.
The severe cuts to Medicaid would blow a hole in state budgets, forcing states to either raise people’s taxes or make draconian cuts to schools or other vital programs.
Medicaid funding helps schools support children with disabilities get individualized attention and therapy, and helps eligible kids get vision and dental screenings. Severe cuts to school funding will affect not only students on Medicaid, but will trigger a domino effect that leads to across-the-board education cuts, threatening extra-curricular programs and forcing schools to expand class sizes.
End Medicaid expansion, which has extended coverage to over 14 million low-income adults.
Graham-Cassidy-Heller ends the Medicaid expansion entirely, replacing it with a small, temporary block grant, and would threaten the health coverage of over 14 million Americans who currently rely on the program
The block grant would then disappear altogether after 2026, repealing the program altogether despite the major coverage gains as a direct result of allowing states to expand Medicaid.
Disproportionately harm states that chose to expand Medicaid coverage, like Alaska, Louisiana and Nevada.
States that expanded Medicaid are seeing record low uninsured rates according to the latest Census data. Under Graham-Cassidy-Heller, these same states would see the most significant cuts in federal funding.
Louisiana, for example, had an uninsured rate of nearly 15 percent in 2014, and after expanding Medicaid that number dropped 5 points to just 10 percent in 2016.
Louisiana would lose more than $3.2 billion in federal funding under Graham-Cassidy-Heller.
Sen. Cassidy’s own bill would wipe out the recent progress made due to Medicaid expansion, and cost his state more than $3 billion.
In a last-ditch effort to repeal the Affordable Care Act with only Republican votes before the September 30th deadline, Senators Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV) and Ron Johnson (R-WI) unveiled their latest proposal this week. While some may look at this effort as a Hail Mary pass with little chance to succeed, Sen. Cassidy said today that 48 or 49 Republican senators are on board with this bill, meaning they are only a couple of votes away from being able to pass the bill on the Senate floor.
The Graham-Cassidy-Heller-Johnson (GCHJ) bill would radically change our health care system — getting rid of the Affordable Care Act tax credits and Medicaid expansion and changing them into block grants with dramatically less funding for states. It would also convert traditional Medicaid into a per capita cap program. In short, this bill would slash coverage, raise costs, eliminate protections for millions of people across America, as well as gut Medicaid. In fact, it is potentially the worst of the repeal bills that we have seen to date.
Given Republicans will have to ram this partisan repeal bill through the Senate in the next two weeks in order to meet this September 30 deadline there will be no time for a regular process for the public to fully understand the impacts on their health care — with no time for adequate hearings, consultations with experts, constituent input, and amendments. Republicans in the Senate are resorting back to a secret, partisan process to force through health care repeal out of public view. — The American people need to know the facts about how this bill will impact them. Here are the top six (6) reasons why they should reject GCHJ just as they have rejected the previous repeal attempts.
GCHJ Cuts Funding to Most States & Punishes States that Expanded Medicaid
Overall, Graham-Cassidy-Heller-Johnson cuts spending on marketplace tax credits and Medicaid expansion and converts them into a block grant. Between 2020 and 2026, GCHJ would cut $239 billion from what was projected to be spent under current law for the tax credits and expansion. After 2026, the block grant funding is eliminated altogether. Moreover, GCHJ would convert traditional Medicaid into a per capita program and cut spending by another $175 billion from 2020 to 2026. This aspect is what makes GCHJ potentially the worst among all the partisan repeal bills.
The Center on Budget and Policy Priorities analyzed the latest Graham-Cassidy-Heller-Johnson proposal and found that all but twelve states would receive less federal funding. In 2026, Alaska would lose $255 million; Arizona, $1.6 billion; Louisiana, $3.2 billion; Maine, $115 million; Nevada, $639 million; Ohio, $2.5 billion; and West Virginia,
$554 million, just to name a few.
Source: Center on Budget and Policy Priorities, 9/13/17
Moreover, GCHJ’s state funding allocation redistributes funding to states that did not expand Medicaid at the expense of states that did. In other words, this bill punishes states that expanded Medicaid and chose to provide health coverage to more of their citizens. As the Center on Budget writes:
The block grant would not only cut overall funding for the Medicaid expansion and marketplace subsidies but also, starting in 2021, redistribute the reduced federal funding across states, based on their share of low-income residents rather than their actual spending needs. In general, over time, the plan would punish states that have adopted the Medicaid expansion or been more successful at enrolling low- and moderate-income people in marketplace coverage under the ACA. It would impose less damaging cuts, or even raise funding initially, for states that have rejected the Medicaid expansion or enrolled few low-income residents in marketplace coverage.
Source: Center on Budget and Policy Priorities, 9/13/17
GCHJ Would Slash Coverage
The billions of dollars in cuts to Medicaid and marketplace tax credits would result in millions of people losing health care coverage. For example, GCHJ ends Medicaid expansion, which has extended health coverage to 11 million low-income adults.
Another important point is that GCHJ ends block grant spending in 2026, or rather, spending for Medicaid expansion and marketplace tax credits. What that means is in 2026 GCHJ repeals the Affordable Care Act without a replacement. Earlier analyses showed a “repeal-without-replace” would result in 32 million people losing coverage and individual markets collapsing.
GCHJ Would Raise Health Care Costs
Graham-Cassidy-Heller-Johnson raises consumer health costs in a variety of ways. As discussed above, the bill would cut funding people get to help pay for premiums — through marketplace tax credits and by getting affordable coverage through Medicaid expansion.
According to the Brookings Institution, the result would be “that no one in a state’s individual market that waived EHBs would have access to comprehensive coverage. Insurers would likely sell separate policies for benefits not covered in their core plan offerings, but these supplemental policies would be subject to tremendous adverse selection, leading to very high premiums and enrollment almost exclusively by those with pre-existing conditions.” For example, a woman who purchases a separate insurance rider for maternity care would have to pay $17,320 more, according to the Center for American Progress. For states that no longer required substance use disorders or mental health to be covered, coverage for drug dependence treatment could cost an extra $20,450.
Allowing states to opt out of the essential health benefits coverage means that insurance companies could once again put lifetime and annual limits on the amount of care you receive. Moreover, this would even impact people with coverage from their employer. The Center for American Progress estimates that 20 million people with health coverage through their employer would face lifetime limits on coverage, and 27 million would face annual limits
GCHJ Would Gut Protections for People With Pre-Existing Conditions
The American Cancer Society Cancer Action Network said allowing states to waive essential health benefits “could render those protections meaningless” for people with pre-existing conditions.
The American College of Physicians called for regular order and wrote that “We believe that the substantial cuts to Medicaid authorized by this legislation would cause a significant increase in the number of uninsured patients and that it would undermine essential benefits provided for patients insured under current law.”
Consumers Unionsaid that allowing states to waive essential health benefits would be “putting meaningful coverage out of reach for many Americans, especially those with chronic and pre existing conditions.” Because states could opt out of covering these basic benefits, insurers would likely only offer policies that covered much less than they do now. The Kaiser Family Foundation found that the benefits most likely to no longer be covered would be maternity care, mental health or substance abuse coverage.
Key Stakeholders Oppose GCHJ
On Wednesday, key health care stakeholders — including the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, the American Congress of Obstetricians and Gynecologists, the American Osteopathic Association and the American Psychiatric Association — sent a letter to the Senate opposing the Graham-Cassidy-Heller-Johnson bill saying it would “have a negative impact on affordable coverage for patients across our nation.” The groups urged the Senate to go through a regular order to find bipartisan solutions on health care.
Last week, we saw Republicans and Democrats on the Senate Health, Education, Labor and Pensions (HELP) Committee, led by Senators Lamar Alexander (R-TN) and Patty Murray (D-WA), work together to find a solution to stabilize the individual market by making payments to help consumers lower out-of-pocket costs and deductibles. Insurers have cited the threat of defaulting on these payments-which the Trump administration has repeatedly threatened to do- as the main reason they would raise premiums or exit the markets. A bipartisan group of governors and insurance commissioners testified before the HELP Committee agreeing these payments needed to be made. The nonpartisan Congressional Budget Office concluded failure to make these payments would result in premiums skyrocketing 20 to 25 percent and adding nearly $200 billion to the federal debt.
The Graham-Cassidy-Heller-Johnson bill threatens this bipartisan work by once again injecting partisan repeal into the process for no reason.
Washington, D.C. — Today, GOP Senators Lindsey Graham, Bill Cassidy, Dean Heller and Ron Johnson introduced yet another bill to repeal the health care of the American people that would slash coverage, raise costs, eliminate protections and gut Medicaid. This desperate bill comes after three failed Senate repeal votes and a declaration from Senate Majority Leader Mitch McConnell that “it is time to move on,” and amidst the bipartisan hearings more than a dozen GOP senators have called for. The renewed partisan effort to repeal health care threatens the bipartisan efforts that began in earnest last week. In response to the GOP’s attempt to revive the least-popular piece of legislation in three decades, Protect Our Care Campaign Director Brad Woodhouse issued the following statement:
“Time and again, the American people have made explicitly clear that they do not want partisan health care repeal. The Graham-Cassidy-Heller bill is as bad or worse than the GOP’s previous efforts to repeal health care. It contains deep cuts to Medicaid, would eliminate payments to help lower out-of-pocket cost and deductibles and guts protections for people with pre-existing conditions, while disproportionately harming states that expanded Medicaid over those that did not. In short, it’s everything voters of both parties have said they don’t want.
“Attempting to jam a partisan repeal bill through the Senate at the eleventh hour is shameful and unnecessarily puts the bipartisan process underway in jeopardy for no reason. It’s time for Republicans to finally abandon their failed, partisan efforts and follow the lead of Senators Lamar Alexander and Patty Murray to focus on making the bipartisan, common sense fixes necessary to improve health care for millions of people.”
In the time since the House passed its partisan health care repeal, the vast majority GOP senators, including Sens. Bill Cassidy, Lindsey Graham and Dean Heller, have consistently called for bipartisan health care legislation. Take a look for yourself…
Sen. Bill Cassidy (R-LA) On His Bill With Sen. Graham: “I Think We’ll Have Hearings.” [The Advocate, 9/9/17]
Sen. Lindsey Graham (R-SC): “Any Bill…Not Scored? Needs To Be Viewed With Suspicion.” “‘Like y’all, I’m still waiting to see if it’s a boy or a girl,’ said Sen. Lindsey Graham (R-S.C.). ‘Any bill that has been posted less than 24 hours, going to be debated three or four hours, not scored? Needs to be viewed with suspicion.’” [Politico, 5/5/17]
Sen. Lindsey Graham (R-SC): “We’re Going To Do All These Things By September 30? Give Me A Break.” “‘We’re going to do all these things by Sept. 30? Give me a break. We’re going to cut taxes, pass health care, set aside sequestration?’ said Sen. Lindsey Graham, a South Carolina Republican.” [Politico, 6/2/17]
Sen. Lindsey Graham (R-SC): No Deal On Friday Signals “End Of [One-Party] Health Care Talks.” “[Graham] tells [Kasie Hunt] that if GOP doesn’t reach an agreement on health care by Friday it’ll be the end of the 1 party health care talks.” NBC News Frank Thorp Tweet, 6/28/17]
Senate Majority Whip John Cornyn (R-TX): “And I Think, Frankly, Bipartisan Solutions Tend To Be More Durable.” “‘There’s a lot the American people expect of us, but we’ve seen with fragile majorities in the Senate that we are forced to work together to try to solve these problems. And I think, frankly, bipartisan solutions tend to be more durable,’ Cornyn said. Democrats have sent Republicans multiple letters on healthcare that asked, for example, for an all-Senate meeting and suggested a list of rooms where they could hold a public hearing.” [The Hill, 8/1/17]
Senate Finance Committee Chair Orrin Hatch (R-UT) On Moving Forward On Health Care: “I Hope It’ll Be Bipartisan.” “‘It’s a constant battle. Health care is one of the most difficult things,’ said Sen. Orrin Hatch (R-Utah). ‘It has to come back before the end of the year. We have to face it.’ Hatch paused when asked if he’s referring to another party-line repeal effort. ‘Oh, I hope it’ll be bipartisan,’ he said.” [Politico, 7/31/17]
Sen. Lisa Murkowski (R-AK): “I Have Repeatedly Said That Healthcare Reform, And Especially Major Entitlement Reform, Should Go Through The Committee Process Where Stakeholders Can Weigh In And Ideas Can Be Vetted In A Bipartisan Forum.” “I have repeatedly said that healthcare reform, and especially major entitlement reform, should go through the committee process where stakeholders can weigh in and ideas can be vetted in a bipartisan forum. I voted ‘no’ today to give the Senate another chance to take this to the committee process.” [Murkowski Statement, 7/25/17]
Sen. Lisa Murkowski (R-AK): “The Senate Should Step Back And Engage In A Bipartisan Process To Address The Failures Of The ACA And Stabilize The Individual Markets.” “As I’ve been saying, the Senate should take a step back and engage in a bipartisan process to address the failures of the ACA and stabilize the individual markets. That will require members on both sides of the aisle to roll up their sleeves and take this to the open committee process where it belongs.” [Murkowski Statement, 7/18/17]
Sen. Lisa Murkowski (R-AK): “This Is Not For Republicans To Fix Or Democrats To Fix — This Is For Us As Americans To Fix.” “‘This is not for Republicans to fix or Democrats to fix — this is for us as Americans to fix,’ Sen. Lisa Murkowski, R-Alaska, said.” [MSNBC, 6/27/17]
Sen. Lisa Murkowski (R-AK): “We Should Be Working With Our Colleagues On The Other Side Of The Aisle.” ‘When did we get to the point where we said, ‘No, we’re not going to talk to Democrats about a fix?’ We should be working with our colleagues on the other side of the aisle,’ Sen. Lisa Murkowski, R-Alaska, told NBC News Tuesday.” [NBC News, 6/27/17]
Sen. Susan Collins (R-ME): “We Must Work In A Bipartisan Way To Fix The ACA’s Serious Flaws.” “I voted no on motion to proceed. When dealing with a complex issue that affects millions of Americans and 1/6th of our economy, we must proceed carefully. Making sweeping changes to the 50-year-old Medicaid program without a single Senate hearing is a mistake. We must work in a bipartisan way to fix the ACA’s serious flaws.” [Collins Tweet, 7/25/17]
Sen. Susan Collins (R-ME): “I Want To Work W/ My GOP & Dem Colleagues To Fix The Flaws In ACA.” “I want to work w/ my GOP & Dem colleagues to fix the flaws in ACA. CBO analysis shows Senate bill won’t do it.” [Collins Tweet, 6/26/17]
Sen. Susan Collins (R-Me): “Go Back To The Drawing Board” And Work With Democrats To “Correct” Problems In The ACA. [Bloomberg’s Sahil Kapur Tweet, 6/27/17]
Sen. John McCain (R-AZ): Writing Bill Behind Closed Doors And Forcing Passage Against A Unified Opposition Is Not “Going To Work In The End. And It Probably Shouldn’t.” “We’ve tried to do this by coming up with a proposal behind closed doors in consultation with the administration, then springing it on skeptical members, trying to convince them it’s better than nothing, asking us to swallow our doubts and force it past a unified opposition. I don’t think that is going to work in the end. And it probably shouldn’t.” [Sen. McCain Remarks, 7/25/17]
Sen. John McCain (R-AZ): Sen. McCain Calls For Return To Regular Order, Including “Input From Members Of Both Parties.” “The Congress must now return to regular order, hold hearings, receive input from members of both parties, and heed the recommendations of our nation’s governors so that we can produce a bill that finally provides Americans with access to quality and affordable health care.” [Sen. McCain Statement, 7/17/17]
Sen. Dean Heller (R-NV): “Republicans And Democrats Should Sit Down Together.” [Ralston Tweet, 6/27/17]
Sen. Bill Cassidy (R-LA): “I Wish We Weren’t Doing It One Party.” “Sen. Bill Cassidy (R-La.) said in an interview broadcast on Sunday that he wants the healthcare bill to be negotiated with both parties. ‘I wish we weren’t doing it one party. But that said, if you can lower premiums, that is common ground,’ Cassidy said on NBC’s ‘Meet The Press.’” [The Hill, 7/2/17]
Sen. Shelley Moore Capito (R-WV): “Collaborating With Democrats On The Other Side, To Me, Is Not An Exercise In Futility.” “‘Collaborating with Democrats on the other side, to me, is not an exercise in futility,’ Capito said, noting that she has spoken with Manchin and other Democrats about tackling health care together. ‘That may be where we end up, and so be it.’” [Politico, 7/9/17]
Sen. Shelley Moore Capito (R-WV): “It’s Never Good To Pass Major Legislation Without The Input Of Both Parties.” “It’s hard for me to see how we get there. I think a better approach would be to try to involve some moderate Democrats in the process and see if we can come up with a bipartisan bill. It’s never good to pass major legislation without the input of both parties.” [The Hill, 6/28/17]
Sen. Ron Johnson (R-WI): “I Wish We Were Doing This On A Bipartisan Basis.” “‘I wish we were doing this on a bipartisan basis,’ Johnson told CNN’s Chris Cuomo on “New Day.” ‘I think it was a mistake saying right away we were going to do this partisan, that’s where we’re out. Maybe what we’re going to have to do is our partisan bill, Democrats do theirs, we’re not going to fix all of these problems. Then maybe, maybe everybody will sit down and lets long-term fix the healthcare system, let’s start controlling healthcare costs,’ the Wisconsin senator continued.” [The Hill, 6/28/17]
Sen. Johnny Isakson (R-GA): “We’ve Got To Come Together, Republicans And Democrats And Deal With The Issues That Are Making Health Insurance So Expensive.” “The Affordable Care Act is the law of the land. As said by the majority leader and the minority leader Thursday night or Friday morning, neither party did anything to fix it. We’ve still got some things that need to be done. We’ve got to come together, Republicans and Democrats and deal with the issues that are making insurance so expensive. I think we will, and I think we’ll eventually get it done.” [Isakson Interview with Marietta Journal editorial staff, 8/1/17]
Sen. John Barrasso (R-WY): “For Big Things That Affect The Country, It Should Be Done In A Bipartisan Way.” “As lawmakers in Washington remain divided over the future of health care in the United States, Sen. John Barrasso, R-Wyoming, says there should be a bipartisan approach when it comes to legislation. ‘Should have been bipartisan when Obamacare was passed. It should be now as well,’ Barrasso said Sunday on ‘Face the Nation.’ ‘For big things that affect the country, it should be done in a bipartisan way,’ he added.” [CBS Face the Nation, 7/23/17]
Now Republicans Must Stop Trump’s Sabotage by Ensuring Cost Sharing Reduction Payments Are Made or Hold the Bag for Skyrocketing Premiums
Before it has even been introduced, the latest desperate attempt at health care repeal from Republicans is dead on arrival according to Republican Senators. The repeal proposal from Senators Graham, Cassidy and Heller was the most vicious bill yet and can’t seem to get the support from members of their own party. Sen. Hatch gave the possibility of a vote on the bill a firm, “No” on Monday. Sen. Rand Paul said the bill “sounds to me like a bad idea.” The bill proposes the same deeply unpopular provisions of previous repeal bills, including deep cuts to Medicaid, ending federal funding for Medicaid Expansion states, eliminating payments to help lower out-of-pocket costs and deductibles for lower-income individuals, and increasing out-of-pocket costs for people with pre-existing conditions. The bill would also disproportionately hurt states that expanded Medicaid over states that did not.
“The now dead Graham-Cassidy-Heller bill would have been the worst of all the partisan health care bills Senate Republicans have pursued to date — worse even than those that were already soundly rejected by the American people,” said Protect Our Care Campaign Director Brad Woodhouse. “Now is the time for Republicans to finally abandon these failed, partisan repeal efforts and work toward bipartisan solutions to improve health care like immediately making good on the cost-sharing reduction payments to prevent premiums from skyrocketing for Americans by twenty percent and provide much-needed certainty to the health care market. If Republicans don’t quickly stand up to Trump’s sabotage and ensure these payments are made, they will be to blame when the premiums rise, coverage lapses occur and the debt explodes by $200 billion.”
~The GOP Repeal Bill Would Cut Coverage, Raise Costs and Eliminate Protections~
With 3 weeks until the clock runs out on the GOP’s ability to repeal health care through partisan repeal, Republicans are scheming to ram through another secretly drafted plan — but this one might be their worst one yet. Senators have repeatedly promised an open process with “regular order” to allow for expert testimony, debate and amendments before passing a health care repeal, but this scheme was drafted in secret and may be rammed through at the last minute. In fact, Ohio Republican Governor John Kasich said last week that he opposes this plan, calling it an “eleventh hour” attempt at repeal, and in a bipartisan Senate hearing Massachusetts Republican Governor Charlie Baker said the plan would result in “dramatically negative” effects in his state.
Reports about the plan, known as Graham-Cassidy-Heller, suggest that it will include the same draconian cuts to Medicaid as the Senate’s previously introduced Better Care Reconciliation Act by eliminating the enhanced federal funding for the ACA’s Medicaid expansion and turning the remaining program into a block grant. But Graham-Cassidy-Heller would also eliminate the ACA’s marketplace subsidies. In their place, the proposal would give states a block grant that would shrink over time, ending entirely by 2027.
Source: Center on Budget and Policy Priorities, 8/24/17
The nonpartisan Congressional Budget Office has shown that every health care repeal means cutting coverage, increasing costs and gutting protections that people depend on. This is no different. In fact, Maine Republican Senator Susan Collins said she has “a lot of problems” with the way this plan guts Medicaid, and Nevada Republican Governor Brian Sandoval said he has “a problem” with the cuts to health insurance in Nevada.
“Anyone who thinks Republicans have been listening to voters who hated the first 5 health care repeal attempts is sorely mistaken — this latest scheme is even worse,” said Protect Our Care Campaign Director Brad Woodhouse. “Republicans are putting politics over people’s health care and are rushing through this partisan, harmful repeal bill in the final 3 weeks. Doing this puts in jeopardy the bipartisan, open process that’s begun in Senate Health Committee to strengthen our health care system.”
The American people have overwhelmingly rejected health care repeal time and again. In the latest polling from Hart Research released last week, voters have gone from neutral on health care repeal in March of 2017 (45% favor, 48% unfavor) to overwhelmingly opposed in the latest polling (25% favor, 60% unfavor). In fact, an analysis by MIT found the GOP effort to repeal health care to be the most unpopular legislation in 30 years.
KEY FACTS ABOUT GRAHAM-CASSIDY-HELLER
Includes the same cuts to Medicaid And Medicaid Expansion As Other Repeal Bills. This repeal scheme embrace the already-rejected Medicaid cuts in the Senate’s failed health care repeal bill (known as BCRA) with $180 billion in cuts over 10 years — gutting Medicaid coverage for seniors in nursing homes and kids with disabilities. In addition, this would effectively eliminate Medicaid expansion by 2027. [Center on Budget and Policy Priorities, 8/24/17]
Increases Out Of Pocket Costs And Weakens Protections For People With Pre-existing Conditions. As the Center on Budget and Policy Priorities found, “The proposal includes provisions of the Senate Republican leadership bill that would allow states to waive important consumer protections in the individual market. Under these waivers, which would be subject to near-automatic approval by the federal government, insurers could exclude crucial services such as maternity and mental health care from their plans, impose annual and lifetime limits, and dramatically raise deductibles and other out-of-pocket costs. According to CBO, states with about half of the population would take up these damaging waivers. In addition, Senators Cassidy and Graham are reportedly also considering adding to their plan the so-called ‘Cruz amendment,’ which would allow insurers to charge sharply higher premiums to people with pre-existing conditions or deny them coverage altogether.” [Center on Budget and Policy Priorities, 8/24/17]
Allows Insurers To Charge Older People Up To Five Times More For Coverage As Younger People. [Kaiser Family Foundation, 8/1/17]
Reduces And Eventually Eliminates Federal Funding For Tax Credits That Help People Afford Coverage. “Under current law, moderate-income individual market consumers are guaranteed tax credits to help them pay for meaningful coverage meeting certain standards, and low-income adults in expansion states are guaranteed the ability to enroll in Medicaid, which ensures a comprehensive array of benefits and financial protection. The Cassidy-Graham amendment would eliminate these guarantees and allow states to spend their federal funding on virtually any health care purpose. Faced with large federal funding cuts and exposed to enormous risk, most if not all states would be forced to use this ‘flexibility’ to eliminate or cut coverage and financial assistance for low- and moderate-income people.” [Center on Budget And Policy Priorities, 7/27/17]
Washington, D.C. — Protect Our Care Campaign Director Brad Woodhouse released the following statement in reaction to today’s Senate HELP Committee hearing on the health care marketplace:
“First and foremost, today’s hearing was a notable and welcome departure from the secretive, partisan and ultimately failed repeal effort which President Trump and Senate and House Republicans pursued for the first half of this year,” said Woodhouse. “The mere fact that these hearings are occurring and that bipartisan approaches to market stabilization are being discussed should send a strong signal to the partisan repeal holdouts that it is time to set aside that approach and instead work together to ensure more and more Americans have access to reliable, affordable care. It should also send an unmistakable signal to President Trump that his strategy to sabotage the law is wrong headed and faces bipartisan opposition.
“Substantively, there was broad agreement that Congress must ensure that cost sharing reduction payments continue to be made to lower out of pocket costs for millions of low-income Americans. Every insurance commissioner who testified agreed that ensuring these payments are made must be part of any stabilization plan and nearly all Senators on the panel agreed with that notion. As we have said before, these payments are an essential feature of the health care law, President Trump has been wrong to sow uncertainty in the market by threatening not to pay them and ensuring they continue is among the most important features of any stabilization bill. That there was broad agreement by the panel and the witnesses on the importance of these payments to make health care more affordable for millions of Americans was a welcome sign to say the least.”
According to news reports this morning, President Trump is again demanding that Congress deliver on health care repeal, despite the fact that it’s been overwhelmingly rejected by voters and repeated analysis has shown it would cut coverage, increase costs and eliminate protections. The latest vehicle for partisan repeal appears to be the so called Graham-Cassidy-Heller bill, which represents another partisan, secretive repeal effort which will gut coverage, slash Medicaid, raise out-of-pocket costs and weaken or eliminate protections for people with pre-existing conditions.
Senate Republicans have a choice to make: do they embrace the bipartisan committee hearings beginning today that focus on improving our health care system, reducing costs and stabilizing the markets OR do they follow Trump’s demand for another hyper-partisan health care repeal?
OPTION 1:POLITICO: “Trump wants one last Senate push on Obamacare repeal”
OPTION 2: Washington Post: “Senate panel begins bipartisan hearings to try to improve Affordable Care Act”
“The reality is clear: voters have rejected health care repeal because it guts our health care system, rips away coverage and raises costs. Graham-Cassidy-Heller is more of the same,” said Protect Our Care Campaign Director Brad Woodhouse. “Congress should listen to their constituents and reject the secret, partisan road to repeal. The American people expect Congress to work across the aisle and improve our health care system, not succumb to President Trump’s demands for a health care repeal.”
4 FACTS About The Latest Health Care Repeal Ploy (Graham-Cassidy-Heller)
I UNPOPULAR. New polling shows 60% of people oppose the GOP’s health care repeal bills while only 25% support it. That’s down from 48% unfavorable, 45% favorable back in March. The GOP health care repeal effort is the most unpopular legislation in over 30 years according to an analysis by MIT professors.
II SECRET. Despite commitments to oppose secretive processes on health care, the proposal still has had No public legislative language, section-by-section analysis or meaningful description; No public Congressional Budget Office estimates; No apparent consultation with experts; and No apparent inclusion of women Senators in the process.
III HARMFUL. The Center on Budget and Policy Priorities found the plan would “cause many millions of people to lose coverage, radically restructure and deeply cut Medicaid, increase out-of-pocket costs for individual market consumers, and weaken or eliminate protections for people with pre-existing conditions.”
IV WORSE. The latest analysis found this plan would be worse than the already-rejected health care repeal bills. Vox reports it would be “arguably be more disruptive, not less, to the current health care system. It would let money currently spent on health insurance go toward other programs, providing no guarantee that the Affordable Care Act programs individuals rely on today would continue into the future.”
RE: New Polling on Voters’ Priorities for Healthcare After the Failure of Repeal and Replace
From August 18 to 21, Hart Research Associates completed 1,017 online interviews with a representative national cross section of Americans who voted in the 2016 election. The selfreported presidential vote among the sample is 48% for Hillary Clinton, 45% for Donald Trump, 5% for Gary Johnson, and 2% for Jill Stein. The party identification of the survey respondents is 43% Democrat, 39% Republican, and 18% independent.
Overview
Our recent national survey of 1,017 voters, conducted August 18 to 21, 2017, confirms that the efforts of President Trump and Republicans in Congress to repeal and replace the Affordable Care Act already have put them very far at odds with the public and are a major political vulnerability for them. The poll results also clearly demonstrate that continued efforts by Trump and congressional Republicans to undermine the Affordable Care Act will be deeply unpopular with voters, including many rank-and-file Republican voters. Large majorities of voters recognize that President Trump is trying to make the Affordable Care Act fail and playing politics with people’s healthcare. This behavior is in direct contrast with the priorities of most voters; for example, two-thirds of voters agree that “President Trump and the Republicans in Congress need to put politics aside and take the necessary steps to make sure individuals have access to affordable health insurance under the Affordable Care Act.”
There is widespread disapproval of President Trump’s threats to cut off the funding that helps insurance companies reduce out-of-pocket costs for individuals, and these threats are one of the top sources of concern about Trump’s handling of healthcare. Voters react strongly to the fact that cutting off these funds would increase health insurance premiums for individuals by 19%, as well as to the uncertainty that these threats create for insurers and the resultant possibility that many Americans could be left without affordable healthcare options. If these outcomes occur and there are failures in the Affordable Care Act, voters will blame President Trump and the congressional Republicans who are complicit in his efforts to undermine the ACA. Healthcare stands out as the number-one issue for voters in the 2018 midterm elections, and large majorities say they will be less likely to reelect their senator or congressperson if he/she supports efforts by President Trump to destabilize the health insurance markets and sabotage the Affordable Care Act.
From a political perspective, these poll results underline one clear conclusion: Democrats and progressives should be playing offense on the issue of healthcare, and should keep the issue front and center for voters in the coming weeks and months. This poll and others show that healthcare is a priority voting issue across the electorate, and the threat to healthcare presented by the policies of President Trump and congressional Republicans is a matter of deep personal concern to many voters. There is an obvious high ground in the debate about what should happen next in healthcare policy: voters want a bipartisan effort to keep what works in the Affordable Care Act and make the necessary improvements so it can work better, and they want action to bring more stability to the health insurance markets to keep premiums down and make sure people continue to have affordable healthcare options. If President Trump and congressional Republicans fail on these objectives and outcomes, voters will hold them accountable for that, and Democrats and progressives should be aggressive in shining a spotlight on each and every action by Trump and the Republicans that contributes to higher premiums and greater instability in the healthcare system.
In making these points, Democrats and progressives should:
Remind voters of Trump’s frequent declarations of his intention to let the Affordable Care Act fail and the ways he has followed through on these threats — including his efforts to limit and subvert enrollment;
Blame Trump and congressional Republicans for rising premiums and insurer opt-outs in the health insurance marketplaces, as a direct result of policies and actions designed to promote uncertainty and instability;
Emphasize that Trump is deliberately sabotaging people’s healthcare because of his own egomania, political spitefulness, and personal hostility to the previous administration;
Hold congressional Republicans accountable for supporting Trump’s efforts to destabilize the health insurance markets and sabotage the Affordable Care Act, and for their lack of independence in standing up to these efforts;
Never let voters forget that Trump and the Republicans in Congress see the alternative to the Affordable Care Act as a system that weakens protections for pre-existing conditions, imposes an age tax through higher premiums on people over the age of 50, leaves 16 million to 32 million more Americans uninsured, and eviscerates Medicaid at the expense of children, people with serious disabilities, and people in need of nursing home care;
Remind voters that instead of sabotaging people’s healthcare, the better way is a bipartisan effort to keep what works in the Affordable Care Act and make the necessary improvements so all Americans have access to affordable, quality healthcare.
Discussion of Key Findings
1. The efforts of President Trump and Republicans in Congress to repeal and replace the Affordable Care Act already have put them in a very deep hole with the public on the issue of healthcare.
By 61% to 39%, voters disapprove of the way Donald Trump is handling the issue of healthcare as president — including fully half (50%) who strongly disapprove; only 21% strongly approve. Independent voters disapprove of Trump’s handling of the issue by 40 points (70% to 30%), and one-in-five (20%) Trump voters disapproves as well. Voters volunteer a variety of reasons for disapproving of Trump’s handling of healthcare: Democrats emphasize that Trump just wants to destroy former President Obama’s legacy, while Republicans focus on Trump’s lack of accomplishments on the issue and his failure to come up with a good plan to replace the Affordable Care Act.
Republicans in Congress get poor marks on this issue as well: eight-in-10 (80%) voters disapprove of the way congressional Republicans are handling the issue of healthcare, while only 20% approve. This “disapprove” number includes 91% of Democrats, 81% of independents, and, notably, 68% of Republicans themselves. These marks reflect the public’s dislike for Republicans’ legislative proposals over the course of this year: 60% of voters are unfavorable toward the bills proposed by the Republicans to repeal and replace the ACA, while only 25% are favorable. Among those with a strong opinion, negative attitudes outnumber positive ones by more than seven-to-one (6% very favorable, 43% very unfavorable). Independent voters oppose the GOP bills by a wide margin of 64% to 17%, while more than a third (35%) of Republicans are opposed as well. This represents significant erosion in support since our poll back in May, when voters expressed unfavorable views toward the House version of the Republican healthcare repeal bill (the AHCA) by a much smaller margin, 54% to 40% (with Republicans supportive by 71% to 22%). What’s more, our March poll — conducted at the outset of the healthcare fight — found voters to be essentially split on the issue, with 48% unfavorable and 45% favorable toward the Republicans’ efforts at that point.
2. Large majorities of voters recognize that President Trump is “trying to make the Affordable Care Act fail” and “playing politics with people’s healthcare.” This behavior is in direct contrast with the priorities of most voters.
There is a major disconnect between what voters want President Trump to do now that Congress has failed to repeal and replace the current healthcare law and what they believe he actually is doing, as the following table shows: Hart Research Associates
On a related set of questions, nearly two-thirds (64%) of voters believe it is true that Donald Trump is “undermining the Affordable Care Act” and three-in-five (61%) voters believe that he is actively “trying to make the Affordable Care Act fail.” Additionally, 64% say that Trump is “playing politics with people’s healthcare,” including one-in-four (24%) of his own voters. Along similar lines, a 57% majority believe that the president is “sacrificing people’s healthcare in order to oppose Barack Obama.” And when provided with a list of phrases describing potential actions Trump could take around healthcare, this idea — that Trump would hurt people purely out of his own personal animus toward his predecessor — scores as the most worrisome for voters, with onethird (32%) choosing it as their number-one concern.
Clear majorities of voters see each of the following statements about Trump’s approach to healthcare as true:
Trump is undermining the Affordable Care Act (64% true)
Trump is playing politics with people’s healthcare (64% true)
Trump is trying to make the Affordable Care Act fail (61% true)
Trump is sacrificing people’s healthcare in order to oppose Barack Obama (57% true)
3. There is widespread disapproval of President Trump’s threats to cut off the funding that helps insurance companies reduce out-of-pocket costs for individuals, and these threats are one of the top sources of concern about Trump’s handling of healthcare.
When asked to react to a variety of actions President Trump has taken on healthcare, several elicit widespread disapproval from voters.
He has frequently threatened to cut off the funding that helps insurance companies reduce out-of-pocket costs for individuals, which non-partisan analysis says can raise premiums by 19% (66% disapprove)
He has frequently threatened to cut off the funding that helps insurance companies reduce out-of-pocket costs for individuals, creating uncertainty for insurance companies when calculating next year’s premiums (66% disapprove)
He has cut in half the amount of time when people are able to sign up for health insurance under the Affordable Care Act (65% disapprove)
His budget makes deep cuts in funding for Healthcare.gov — the website people use to sign up for insurance under the Affordable Care Act — knowing that these cuts would make the website less reliable and less easy to use (63% disapprove)
He has publicly said several times that he will let the Affordable Care Act fail — signaling to insurance companies that they cannot rely on the Trump administration and creating uncertainty about what rules they will be operating under (61% disapprove)
Of these different actions taken by President Trump, many voters highlight his threat to cut off the CSR payments as one of the two items causing them the most concern (selected by 47%). Voters also emphasize Trump’s statements about letting the ACA fail as a top concern (selected by 43%), because these statements signal to insurance companies that they cannot rely on his administration and create uncertainty about the rules they will be operating under.
After hearing about what Trump has said and done on healthcare, voters overwhelmingly are convinced that his actions are destructive and will have negative consequences. For example, 70% of voters say it is true that Trump is “actively trying to undermine the Affordable Care Act and taking actions that are destabilizing health insurance markets,” while 65% say it is true that he is trying to “sabotage” the law. And more than three-in-five (61%) respondents concur with the conclusion that “on healthcare, Donald Trump is putting his ego and dislike for Barack Obama ahead of doing what is necessary to ensure that people have access to affordable health insurance” — exactly the petty, politically motivated approach they tell us bothers them the most.
4. After hearing the pros and cons of the issue, voters say by two to one that payments of the cost sharing reductions should continue — notwithstanding the GOP charge that these payments are bailouts of the insurance industry.
In total, we tested eight different arguments in favor of continuing and guaranteeing costsharing reduction payments for the next several years, all of which garnered majorities saying they were convincing — including three that were rated as convincing by 60% or more of voters. On the other side of the coin, we tested three arguments in support of cutting off these payments. Only one of these arguments — that these funds are used to bail out insurance companies so they can make a profit, and taxpayers should not subsidize insurance companies — was rated as convincing by a majority of voters. Fiftyseven percent (57%) of voters felt this was a convincing argument; while 43% said it was just somewhat or not convincing, including a third (32%) of Republicans.
Of the pro-CSR arguments we tested, the statement that “if these funds are cut off, more health insurance companies will decide not to offer health insurance to individuals and many Americans could be left without affordable healthcare options” tested strongly, with 64% saying this is a convincing argument in favor of continuing these payments, including 41% who say it is “very” convincing. Essentially tied was the argument that if these funds are cut off, non-partisan analysts say that premiums for individuals would be 19% higher each year; 63% of voters, including 66% of independent voters, rated this as convincing.
After hearing both sides, voters told us by 68% to 32% that they believe these payments should be continued, not cut off. Nearly all (94%) Democrats want to see these payments continued, as do 69% of independents and 38% of Republicans. Sixty-four percent (64%) of white non-college educated women and 41% of non-college educated Trump voters want to see these payments continue, as they are essential to keeping down healthcare costs for everyday people and ensuring access to affordable care.
Furthermore, when informed, nearly half (48%) of voters say that the idea that Trump is “sabotaging people’s healthcare” is one of their top concerns about what he would be doing if he cuts off these payments, and only one-in-five (21%) say that the idea of “sabotage” is not really believable to them as a way of describing what Trump would be doing. (Before learning about the effects of cutting off CSR payments, voters were more likely to see Trump as just playing politics with healthcare — but the additional information makes the idea of “sabotage” both highly concerning and broadly credible.)
5. Continued efforts by Trump and congressional Republicans to undermine the Affordable Care Act will be deeply unpopular with voters, and it is clear that voters will blame Trump and the Republicans for future premium increases and disruptions in the health insurance markets.
In terms of the path forward, 78% of voters agree (seven-to-10 ratings on a zero-to-10 scale) with the statement that “President Trump and the Republicans in Congress should take the necessary steps to make sure the health insurance markets are stable, in order to prevent large increases in insurance premiums,” including three-fourths (75%) of Republicans. Another 68% of voters agree that “President Trump and the Republicans in Congress need to put politics aside and take the necessary steps to make sure individuals have access to affordable health insurance under the Affordable Care Act.” Even in spite of its mentioning the ACA, nearly half (45%) of both Republicans and Trump voters agree with this statement as well.
Encouragingly, the poll indicates that — even if there is not universal agreement that the ACA is working well currently — there is a strong sense of optimism that it can work well with the proper support. In fact, 13% of all voters describe themselves as unfavorable toward the ACA, BUT say they believe it the law has the potential to work well in the future. This important target group is three-fifths female (61%) and is made up largely of Trump voters (69%), 70% of whom do not have a college degree.
Going forward, if there are still problems occurring a year from now in terms of premium increases and insurance companies no longer offering plans under the Affordable Care Act, 83% of voters tell us that Republicans in Congress will bear the responsibility, including 48% who say they will have “a lot” of the responsibility. And 71% believe that President Trump will be responsible, compared with only 51% who say the same about President Obama — suggesting that, despite being known as “Obamacare,” the onus to make the law work is now on the current occupant of the White House and leaders in Congress.
6. Healthcare stands out as the number one issue for voters in the 2018 midterm elections, and large majorities say they will be less likely to reelect their senator or congressperson if he/she supports efforts by President Trump to destabilize the health insurance markets and sabotage the Affordable Care Act.
Nearly six-in-10 (57%) voters chose healthcare as one of their top two most important issues heading into the 2018 elections, far and away the top choice (25 percentage points higher than any other issue) out of a list that spanned topics from the economy and taxes, to education, to immigration, to terrorism and national defense. Healthcare was the number-one choice among self-identified Democrats (71%), independents (58%), and Republicans (42%) alike. The issue is pertinent among key voting blocks, such as white non-college educated women, 53% of whom point to healthcare as one of their top issues, and voters across the 10 states Trump carried in 2016 but in which Democratic senators are defending seats next year (57% of voters in these states picked healthcare, compared to only 32% who picked the economy, their number-two choice).
Finally, this poll suggests that there are indeed electoral consequences to Republicans’ actions (or lack thereof) when it comes to improving the current law and stabilizing healthcare markets: 75% of voters tell us they would be more likely to support their senator or congressperson if he or she “supported a bipartisan effort to bring more stability to the health insurance markets in order to keep premiums down and make sure people continue to have affordable healthcare options,” including 85% of Democrats, 72% of independents, and 65% of Republicans. When framed explicitly in terms of the ACA (“supported a bipartisan effort to keep what works in the Affordable Care Act and make the necessary improvements so it can work better”), 68% of voters are supportive, with even Republican voters more likely to support their representative (47% to 38%). On the other side of the coin, however, voters tell us by 38 points that they would be less likely to vote for someone who “supported efforts by President Trump to destabilize the health insurance markets and sabotage the Affordable Care Act” (22% more likely, 60% less likely).
Washington, DC — Protect Our Care announced today that longtime democratic strategist and former Democratic National Committee (DNC) Communications Director Brad Woodhouse has been appointed Campaign Director for the health care coalition that has worked to stop repeal of health care and protect people’s health care. Leslie Dach, who served as the coalition’s founding Campaign Director will become Campaign Chair, focusing on longer term planning and strategy.
“President Trump continues to deliberately sabotage people’s health care out of his own spitefulness, and we are going to make sure the public is constantly aware of every move this Administration makes until Congressional Republicans stand up and make them stop,” said Woodhouse. “Health care continues to be the number one issue for the American people and we will make sure they have the facts to hold their representatives accountable for playing politics with their health care. I’m honored to lead a coalition devoted to protecting the gains we’ve made in health care for the American people but am daunted at the huge shoes Leslie is leaving me to fill.”
“Protect Our Care will maintain eternal vigilance when it comes to stopping health care repeal, protecting Medicaid, and preventing sabotage,” said Dach. “Brad is the perfect person to make sure that day in and day out we are shining a bright light on any attempt Congress or the Administration are making to harm people’s health care.”
Woodhouse has held leadership roles in multiple prominent progressive and political organizations including as President of Americans United for Change (AUFC), which for over a decade was one of the nation’s leading progressive issue advocacy organizations that was originally created to stop then-President Bush’s plan to privatize Social Security and later was integral in building the infrastructure on the progressive side to pass the Affordable Care Act (ACA). Woodhouse, as AUFC President, was a founding steering committee member of Health Care for America Now (HCAN) which laid the ground work in 2007 and 2008 for a post-Bush Administration push to pass health reform and later played an integral role in passing the ACA during President Obama’s first term.
During the campaign to pass the ACA in 2009 and 2010, Woodhouse was a senior adviser and Communications Director at the DNC, where he worked directly with the White House, Organizing for Action (OFA) and Congressional Democrats to pass the law. After leaving the DNC in 2013 and returning to Americans United for Change, Woodhouse and AUFC took the reins of Protect Your Care, an organization which had been established after the ACA was passed to promote and defend the law as it was being implemented. Under Protect Your Care’s banner, Woodhouse ran a field and rapid response communications effort nationally and in nearly a dozen states to push back on the efforts by, among others, the Koch Brothers, to undermine implementation of the law and to discourage people from enrolling in it.
In addition to his role as chair of POC, Dach will be working with the Rockefeller Foundation as a senior advisor, and be engaged in a number of other health care and foundation projects.
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