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April 2018

ashoup
In News

The People Who Know Health Care the Best Say Short-Term Plans Are the Worst

Yesterday marked the deadline for comments to be submitted on the Trump Administration’s proposed short-term scam insurance. A wide variety of health care experts – including doctors, insurance exchange operators, insurance companies, analysts, and more than 100 patient groups – continue to make clear their strong opposition to the Administration’s proposal. Here’s what they had to say:

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

American Cancer Society Cancer Action Network, American Heart Association, American Liver Foundation, American Lung Association, Arthritis Foundation, Autism Speaks, Chron’s & Colitis Foundation, Cystic Fibrosis Foundation, Epilepsy Foundation, Family Voices, Hemophilia Federation of America, Leukemia & Lymphoma Society, Lutheran Services in America, March of Dimes, Mended Little Hearts, NAMI, National Health Council, National Multiple Sclerosis Society, National Organization for Rare Disorders, National Patient Advocacy Foundation, National Psoriasis Foundation: “Given The History Of Discrimination And Inadequate Coverage Within Short-term Limited-duration Plans, We Are Deeply Concerned That The Proposed Rule Could Seriously Undermine The Key Principles Of Access, Adequacy, And Affordability That Are The Underpinnings Of Current Law – And Put Those We Represent At Enormous Risk.” “Given the history of discrimination and inadequate coverage within short-term limited-duration plans, we are deeply concerned that the proposed rule could seriously undermine the key principles of access, adequacy, and affordability that are the underpinnings of current law – and put those we represent at enormous risk. We urge the Departments to withdraw the proposed rule until the needs of our populations are met and instead, to focus on stabilizing the individual insurance markets and lowering premiums for QHPs.” [ACS-CAN, 4/23]

American Academy Of Family Physicians: “Short-Term, Limited-Duration Plans Will Not Provide Meaningful Insurance Coverage.” “The AAFP strongly opposes the proposed rule since it allows plans to sell low-value insurance policies that could subject patients to catastrophic medical bills and medical bankruptcy. We oppose efforts to exempt short-term, limited-duration plans from consumer protections such as covering preexisting conditions or essential health benefits (EHBs). Furthermore, we oppose allowing any plans to establish caps on annual benefits since limiting benefits can expose patients to extraordinarily high out-of-pocket costs… The AAFP has significant concerns with these proposals since short-term, limited-duration plans will not provide meaningful insurance coverage. While these plans could increase the availability and affordability of services, we do not think doing so should come at the expense of meaningful insurance coverage.” [AFP, 4/18]

America’s Health Insurance Plans: “Not A Replacement For Comprehensive Coverage.” “‘We are concerned that this proposed rule will lead to more people being uninsured and under-insured, and to higher costs in the long run,’ AHIP chief executive Matt Eyles said. ‘Short-term plans can provide an important temporary bridge for Americans who are transitioning between plans. But they are not a replacement for comprehensive coverage.’” [Forbes, 4/23]

Alliance Of Community Health Plans: “The Proposed Rule Will Undermine Consumer Protections.” “The proposed rule will undermine consumer protections because short-term, limited duration plans do not require coverage of essential health benefits or coverage of pre-existing conditions. There is a substantial risk that consumers will not understand the coverage limitations that accompany short term plans. Contracts for medical coverage can be quite complex, and consumers may assume that essential health benefits are covered by short-term, limited duration plans, but for a shorter period of time. This could lead to consumers purchasing health insurance that is inadequate for their medical needs, potentially resulting in personal bankruptcy and an increase in uncompensated care for hospitals and other facilities. There is evidence of this connection between coverage and personal financial status: A Consumer Reports study found that increased health care coverage over the past several years was associated with a reduction by half in the number of personal bankruptcy filings. With the increased use of short-term, limited duration plans, we anticipate a troubling reversal of this trend.” [ACHP, 4/19/18]

American Cancer Society-Cancer Action Network: “We Believe That The Proposed Rule Should Be Withdrawn.” “We are very concerned about policies that would expand access to STLD policies because these products are exempt from important consumer protections, such as prohibitions on lifetime and annual dollar limits, limits on the use of pre-existing condition exclusions, and the prohibition on medical underwriting. These protections are key to ensuring that individuals with cancer (including those in active treatment and survivors) have access to quality health care needed to treat their disease. Without these protections, individuals could find themselves enrolled in policies that fail to provide coverage of medically necessary services. We believe this proposed rule should be withdrawn unless the needs of the patient community have been met.” [ACS CAN, 4/20/18]

American Hospital Association And Federation Of American Hosptials: “Concerned That The Result Will Be Increased Uncompensated Care.” “The American Hospital Association and the Federation of American Hospitals said the proposed rule, if finalized, would drain hospitals’ resources. The federation, which represents investor-owned hospitals, said its members ‘are concerned that the result will be increased uncompensated care, particularly for patients who need uncovered services or treatment for preexisting conditions.’” [Modern Health Care, 4/23]

Association for Community Affiliated Plans: Rule WIll Harm Consumers And Health Care Providers. “The Association for Community Affiliated Plans, a group representing safety-net plans that cover Medicaid, Medicare special-needs and marketplace members, warned that finalizing the rule as proposed would harm consumers and healthcare providers. The group warned that sellers of short-term plans have been known to rescind coverage as soon as an individual becomes ill and files a substantial claim. The space has been riddled with patient lawsuits over unpaid medical bills. ACAP pointed to the recent 42-state investigation into the business and marketing practices of Tokio Marine’s HCC Life subsidiary, a short-term medical insurer. Earlier this month, HCC Life reached a settlement to pay a fine of $5 million. The insurer is also prohibited from selling short-term plans for at least five years. ACAP also warned that skimpy short-term plan benefits would lead to increased uncompensated care.” [Modern Health Care, 4/23]

Heather Korbulic, Silver State Health Insurance Exchange Director: “Deeply Concerned” About Proposed Rule. “The head of Nevada’s health insurance exchange is ‘deeply concerned’ about a proposed federal rule change that would extend the length of short-term health plans, saying in a Friday letter to the Centers for Medicare and Medicaid Services that the policy will likely result in higher premiums for people who purchase insurance on the exchange… Korbulic is just one of many in the health-care field nationwide who has expressed concern that approving the federal rule will siphon off the healthiest individuals from the individual market, leaving behind a sicker, more expensive population. In the letter to CMS, Korbulic wrote that individuals with pre-existing conditions or who anticipate needing medical care will likely remain on the exchange where they can purchase plans with comprehensive health benefits but will likely face premium increases.” [Nevada Independent, 4/23]

American Heart Advocacy: Patients “Will Suffer If This Rule Becomes Law.” “Today is the deadline to tell HHS not to extend short-term health plans. The outcome is clear — Patients living with CVD, stroke survivors and others with pre-existing conditions will suffer if this rule becomes law.” [American Heart Advocacy, 4/23/18]

Matt Slonaker, Utah Health Policy Project Executive Director: Short-Term Plans Designed To Weaken ACA. “Matt Slonaker is the executive director of the Utah Health Policy Project. He said the new plans are a way to weaken the health law. ‘Unfortunately what is happening here is the short-term insurance idea is being used as a guise to erode some of the protections of the Affordable Care Act,’ Slonaker said.” [KUER, 4/23]

Tanji Northrup, Assistant Commissioner of the Utah Insurance Department: Short-Term Plans Could Increase Premiums By Double-Digits. “Tanji Northrup is the Assistant Commissioner of the Utah Insurance Department. She says these new plans will pull people out of ACA plans and make them more expensive. ‘There will definitely be increases because of pulling those healthy people out of the traditional market,’ Northrup said… Northrup says if these short-term plans go through, Affordable Care Act rates could increase by double-digits. She says no insurers in Utah have contacted her department yet to develop these new plans.” [KUER, 4/23]

Mario Molina, Former CEO of Molina Healthcare: Hopefully You Already Have Kids Because Maternity Care Won’t Be Covered. “Hopefully, you had kids already, because under the short-term health plan expansion encouraged by an executive order signed last year, covered maternity care vanishes in 100% of plans analyzed by [the Kaiser Family Foundation]” [Mario Molina, 4/23/18]

Blue Cross Blue Shield Association: Significant Concerns. “[BCBS] has significant concerns that allowing consumers to stay on these plans for a full year ‘would cause rates to increase for those who need or want comprehensive health insurance coverage.'” [Washington Post, 4/24/18]

Larry Levitt, Kaiser Family Foundation Senior Vice President: “These Short-Term Policy Brochures Read Like An Obstacle Course Of Exclusions.” [Washington Post, 4/23/18]

Kaiser Family Foundation: Analysis: Most Short-Term Health Plans Don’t Cover Drug Treatment or Prescription Drugs, and None Cover Maternity Care. “A new Kaiser Family Foundation analysis of short-term, limited duration health plans for sale through two major national online brokers finds big gaps in the benefits they offer. Through an executive order and proposed new regulations, the Trump Administration is seeking to encourage broader use of short-term, limited duration health plans as a cheaper alternative to individual market plans that comply with the Affordable Care Act’s requirements. Repeal of the individual mandate penalty – which currently applies to people buying short-term plans – is also expected to boost enrollment starting next year. The analysis examines 24 distinct short-term insurance products currently marketed in 45 states and the District of Columbia through eHealth or Agile Health Insurance. It finds: 43 percent do not cover mental health services; 62 percent do not cover substance abuse treatment; 71 percent do not cover outpatient prescription drugs; and none of the plans cover maternity care.” [Kaiser Family Foundation, 4/23]

Washington Post: Trump Proposal Could Mean Healthy People Save On Insurance While Others Get Priced Out. “The Trump administration’s proposal to build up short-term health insurance plans as a ‘lifeline’ for people who can’t afford Affordable Care Act coverage could split the insurance market in two, siphoning young, healthy people into cheaper, more minimal plans — while those who remain in ACA plans face premiums that spiral upward even faster… The effects of that policy change, combined with zeroing out the individual mandate’s financial penalty in 2019 will be harmful to the most vulnerable patients, according to more than 100 patient groups and many health policy wonks.” [Washington Post, 4/23]

Las Vegas Sun: Health Experts Concerned About Risks Of Limited-duration Health Plans. “People would be able to stay on a type of sub-par temporary health plan longer under a proposed Trump administration rule, sparking a concern that the plans won’t give consumers sufficient coverage. The proposal would lift the cap on short-term limited duration plans from six months to just under a year to give more options to consumers who cannot afford the rising cost of health care, according to the Department of Health and Human Services and other agencies involved. The plans can be much cheaper, but do not carry Obamacare-required benefits such as coverage for preexisting conditions.” [Las Vegas Sun, 4/23]

The Hill: Insurer Group Issues Warning On Trump Administration’s Short-Term Health Plan Proposal. “The nation’s largest trade group for health insurance companies is sounding the alarm on a proposal from the Trump administration that would expand the sale of plans that cover fewer services.  America’s Health Insurance Plans (AHIP) says the proposal could lead to more people being uninsured or underinsured and result in higher health-care costs in the long run.” [The Hill, 4/23]

Forbes: Health Insurers: Trump’s Short-Term Plans Will Trigger Loss Of Coverage. “The Trump administration’s proposed cheaper short-term plans may not provide adequate coverage and would trigger an increase in the number of uninsured and under-insured Americans, say health insurers that would be expected to sell such coverage. Through their lobby, America’s Health Insurance Plans, companies Monday were the latest to weigh in on the Trump administration’s proposed rule on short-term plans… Health insurance companies Monday morning issued their critique of the Trump administration’s proposal, joining a parade of doctor groups concerned about any effort to reduce coverage or pare benefits.” [Forbes, 4/23]

Healthcare Dive: Payer Trade Groups Slam Short-term Health Plan Proposal. “The Alliance of Community Health Plans (ACHP) and America’s Health Insurance Plans (AHIP) both slammed CMS’ proposal to expand short-term, limited duration (STLD) insurance plans, saying the proposed rule would undermine key consumer protections, lead to higher premiums in the individual market and jeopardize market stability.  The proposed rule, pushed by the Trump administration as a way to increase access to cheaper plan alternatives and sidestep the Affordable Care Act, would allow consumers to purchase plans for up to 12 months that do not adhere to federal rules for individual health insurance. STLD plans can charge those with pre-existing conditions more and may not cover ACA essential health benefits such as prescription drug coverage. The insurance lobbies argued that other policy mechanisms would be more effective at improving the individual health insurance market.” [Healthcare Div, 4/23]

Washington Times: Insurers’ Lobby Asks Trump To Curtail Short-term Insurance Plan. “Health insurers’ main lobbying group urged the Trump administration Monday to curtail its push to let Americans get around Obamacare by purchasing cheap ‘short-term’ plans for a full year, saying consumers will be left with skimpy coverage. Matt Eyles, the incoming president and CEO of America’s Health Insurance Plans, also said the plan — if it proceeds — should not be enacted until 2020, so insurers have time to plan for a reconfigured marketplace.” [Washington Times, 4/23]

Washington Examiner: Trump-Backed Short-Term Health Plans Have Big Gaps In Benefits, Analysis Finds. “Short-term health insurance plans that the Trump administration wants to expand don’t offer the same benefits of Obamacare plans, a new analysis found. A study from the health research firm Kaiser Family Foundation looked at how short-term plans cover the same benefits as Obamacare. The healthcare law requires plans sold on Obamacare’s insurance exchanges to cover 10 essential health benefits that include mental health services, prescription drug coverage, and maternity care. The Trump administration is seeking to expand the duration of the short-term plans from 90 days to nearly 12 months. These plans are cheaper than Obamacare plans because in part they do not have to cover as many benefits.” [Washington Examiner, 4/23]

Forbes: Doctors Attack Trump’s Short-Term Health Plans Ahead Of Comment Deadline. “An effort by the Trump administration to introduce cheaper short-term health insurance plans is under attack by physician groups who see the plans eliminating benefits and putting patient health at risk. The American Academy of Family Physicians and other doctor groups have unleashed detailed critiques of Trump’s effort to introduce cheaper health insurance with skimpier benefits ahead of a Monday deadline at 5 pm to provide public comments to the administration.” [Forbes, 4/22]

Vox: If You Need Prescriptions Or Maternity Care, You Won’t Like Trump’s Short-term Insurance Plans. “Short-term plans are much less likely to cover mental health and substance abuse treatment or prescription drugs — all of which must be covered by ACA plans. What is insurance, you might ask, if it doesn’t cover medications? This is also a setback for the ongoing effort to have mental health and substance abuse treated as equal to other physical health needs.” [Vox, 4/23/18]

Healthcare Dive: Report Finds Most Short-term Plans Don’t Cover Maternity, Substance Misuse Care. “A Kaiser Family Foundation report argues that recent efforts to promote short-term plans could have an adverse effect on the Affordable Care Act-compliant individual market, creating higher premiums for compliant plans and potentially leaving a greater number of people uninsured.  The expansion of short-term plans, along with the elimination of the individual mandate penalty, could also make it difficult for people who need behavioral health services and substance misuse treatment, which aren’t typically covered benefits under those plans. The Trump administration’s plans for short-term expansion would primarily impact the middle class, as lower-income people are protected from premium increases through the use of federal subsidies, KFF said.” [Healthcare Dive, 4/24]

Insurance News Net: Trump Administration Implored To Curtail Short-Term Plan. “Health insurers, patient groups and Senate Democrats implored the Trump administration Monday to curb or cancel its push to let Americans get around Obamacare by using cheaper, short-term health plans for a full year, saying the plan would destabilize the insurance markets and increase the number of uninsured… More than 100 patient-advocacy groups protested the proposal Monday, the final day to submit comments to HHS, noting the full-year plans could duck Obamacare rules requiring robust coverage or preventing insurers from denying sicker patients or charging them more than healthy ones.” [Insurance News Net, 4/24]

Modern Health Care: Insurers, Hospitals Warn Short-term Plans Aren’t The Answer. “Several health insurance and hospital associations urged HHS to spike the proposed rule to expand access to short-term, limited-duration health insurance, warning it would lead to higher premiums for Affordable Care Act-compliant plans and more uncompensated care delivered at hospitals. Meanwhile, stakeholders in the short-term insurance market encouraged HHS to finalize the proposed rule allowing the sale of short-term plans with durations of up to 12 months, saying the extension would lead to lower premiums and more options for consumers. It is clear those stakeholders would see more customers and higher revenue if the proposed rule is finalized.” [Modern Health Care, 4/23]

Washington Examiner: Healthcare Groups Plea With Trump Administration To Nix Short-Term Insurance Plan Rule.  “A wide array of doctor, insurer, and other major healthcare groups pleaded with the Trump administration to nix plans to expand short-term insurance plans… Healthcare groups say in comments to the proposed regulation, which were due Monday, the plans are no better than “junk insurance” that erode patient protections. The regulation would expand the duration of the short-term plans from 90 days to nearly 12 months.” [Washington Examiner, 4/23]

47 Senators: The Proposed Rule Will “Increase Costs And Reduce Access To Quality Coverage For Millions Of Americans, Harm People With Pre-Existing Conditions, And Force Premium Increases On Older Americans.” “If finalized, the rule could increase costs and reduce access to quality coverage for millions of Americans, harm people with pre-existing conditions, and force premium increases on older Americans. This rule expands the sale and marketing of “junk plans” that exclude basic benefits including hospitalization, prescription drugs, mental health services, substance abuse treatment, and maternity care. We urge you not to finalize the proposed rule and instead work with us to ensure that all American families have choices of affordable, meaningful health care coverage.” [State of Reform, 4/23]

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In Stories, News

Trump Admin Should Listen to Overwhelming Opposition & Scrap Its Junk Plan Proposal

Washington, D.C. – As an outpouring of public opposition marked today’s junk plan proposal comment deadline, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Over the past two months, Americans have clearly rejected the Trump Administration’s junk plan proposal because it would move our health care in exactly the wrong direction. We don’t want to go back to the days when insurance companies could charge more for pre-existing conditions or deny coverage altogether and when junk plans didn’t have to cover basic medical services. This rule has drawn criticism from over one hundred prominent disease groups, from the AARP, from doctors and providers, and from thousands of everyday Americans. The National Association of Insurance Commissioners has confirmed that it would raise rates on the one-in-four Americans with a pre-existing condition. The Trump Administration should listen to the experts, doctors, insurance commissioners, and individual advocates who have together formed a tidal wave of opposition to junk plans, and withdraw this dangerous proposal.”

EXPERTS REJECT PROPOSAL

113 Groups Plead For Congress To Block Trump Administration’s Expansion Of Short-Term Health Plans: “While short-term plans can offer less expensive coverage, they are not required to adhere to important standards, including the ten essential health benefit categories, guaranteed issue, out-of-pocket maximums, age-rating protections, and many other critical consumer protections,” the groups, including the American Heart Association, Susan G. Komen, and Justice in Aging, said in an April 17 letter (PDF) to congressional leaders. [Fierce Healthcare, 4/18/18]

AARP Warning: Short-Term Health Plans = Higher Premiums for Older Adults: You might have thought that efforts to unravel the Affordable Care Act (ACA) were over, but newly proposed regulations and legislation are once again threatening to have similar harmful effects for older adults ages 50-64 who rely on individual market coverage. [AARP Blog, 3/21/18]

National Association of Insurance Commissioners Report: “Risk pool segmentation has the obvious effect of driving up premiums in the health plans that protect individuals from health status discrimination.” [NAIC, 3/22/18]

American Academy of Family Physicians: “Insurers could reduce or eliminate certain essential health benefits to avoid vulnerable, expensive patients by excluding specific services.” [Forbes, 4/22/18]

American Medical Association: “We believe the proposed rule, however, would culminate in plans being offered that fall far short of maintaining crucial state and federal patient protections, disrupt and destabilize the individual health insurance markets, and result in substandard, inadequate health insurance coverage.” [Forbes, 4/22/18]

America’s Health Insurance Plans (AHIP): “Because many short-term plans are offered to consumers only after submitting information about their health status or prior medical conditions, we must also recognize that short-term plans will not meet the needs of many Americans with pre-existing health conditions.” [AHIP letter, 4/20/18]

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In News

Advocates Nationwide Highlight How Medicaid Supports Seniors and Older Adults

Throughout the third week of Medicaid Awareness Month, advocates across the country highlighted the significant role Medicaid plays supporting seniors and older adults, and spoke out against Republican proposals to weaken and cut Medicaid. Medicaid covers more than 15 million Americans over age 50.

In Arizona, the the Arizona Alliance for Retired Americans and Arizona Alliance for Healthcare Security joined state Reps. Daniel Hernandez and Cesar Chavez to discuss how Medicaid serves a lifeline to Arizona’s Seniors and older Americans.

How does Medicaid help seniors and older adults in the United States? Here are some of the many ways:

  • More Than 6.9 Million American Seniors Have Medicaid Coverage. 6,920,200 seniors, age 65 and older, are enrolled in Medicaid.
  • More Than 8.5 Million Adults Ages 50 To 64 Are Enrolled In Medicaid. More than 8.5 million Americans ages 50 to 64 have health coverage through Medicaid – many thanks to the Affordable Care Act’s Medicaid expansion.
  • Nearly 1 In 3 Seniors Live Below 200 Percent Of The Federal Poverty Line. For many of these seniors, Medicaid is a critical lifeline.
  • Medicaid Funds 53 Percent Of Long-Term Care Nationwide. As seniors age, long-term care services become more and more vital, serving half of seniors over age 75 and three in four seniors over age 85.
  • Medicaid Covers 6 In 10 Nursing Home Residents. The average annual cost of nursing home care is $82,000 – nearly three times most seniors’ annual income.
  • Over 1 In 5 Medicare Beneficiaries Also Have Medicaid Coverage. Most dual-eligibles are over age 65, and are more likely to have complex and chronic health needs.

In West Virginia, West Virginians Together for Medicaid, West Virginians for Affordable Health Care, West Virginia Citizen Action Group, and the West Virginia Center on Budget and Policy joined together to discuss the importance of Medicaid for seniors in the state and how cuts to the program be devastating for older West Virginians.

In the Daily Post-Athenian, Pam Weston of Sweetwater, Tennessee highlighted the benefits Medicaid provides for Tennessee residents:

In Tennessee alone, Medicaid provides coverage for 1,539,743 of our citizens, a number which includes children, senior citizens, and persons with severe disabilities. If Tennessee had implemented Medicaid expansion, the number eligible for coverage would have easily surpassed 2 million.

What many may not realize is that Medicaid provides $4 billion annually to support school-based health services. Sixty-eight percent of Tennessee’s schools use Medicaid funds to provide school nurses, counselors, and speech therapy. Outside the school setting, Medicaid covers 43 percent of all Tennessee’s children.

At a time when the opioid epidemic is a concern for most of Tennessee, it is important to note that 10 percent of all buprenorphine used to treat opioid addiction is paid for by Medicaid dollars.

Lastly, three out of five nursing home residents rely on Medicaid to cover their healthcare needs, and nearly a quarter of all seniors and individuals with disabilities are covered by Medicaid.

If $1.4 trillion is to be cut from Medicaid to offset the tax breaks provided to cororations under the recent “tax reform” plan, should the cuts be applied to medically fragile seniors, children, or to those with disabilities? It is said that a nation is judged by how it cares for it’s most vulnerable citizens. Cuts and per capita caps applied to Medicaid services will leave our most vulnerable without the care they require, and that does not speak well for what we have become.

In Tennessee, six Nashville residents, including small business owners, non-profit directors, and reverends, shared their personal stories of how Medicaid has benefitted their mother, fathers, and grandparents and grandparents.

Lindsey Copeland highlighted the work of Medicaid Awareness Month for the Medicare Rights Center.

And in The Hill, Max Ritchman, president and CEO of the National Committee to Preserve Social Security and Medicare, highlighted how just how important Medicaid is for older Americans’ health. Read his post:

April is Medicaid Awareness Month, but many Americans are truly unaware of what the program does for seniors. Medicaid is typically viewed as a health insurance program for the poor, which, of course, it is. But it also provides crucial supports for older Americans. Medicaid covers nearly 7 million seniors and more than 8.5 million “near seniors” aged 50-64. One in five Medicare beneficiaries (known as “dual eligibles”) also have Medicaid coverage to help pay premiums and co-pays.

Many people don’t realize that Medicaid helps millions of seniors to pay for long-term care  — in skilled nursing facilities as well as in-home and community-based care. In fact, Medicaid pays for more than 50 percent of long-term care nationwide. The program covers 6 in 10 nursing home residents. At an average annual cost of $82,000 (nearly three times most seniors’ annual incomes) long-term care would simply be out of reach for millions of elderly Americans if it weren’t for Medicaid.

“Seniors often need services from Medicaid that are not covered by Medicare,” says Rebecca Vallas, VP of the Poverty Program at the Center for American Progress. “These services include assistance with bathing and dressing, preparing meals, and many other activities of daily living.” Vallas explains that Medicaid “allows millions of seniors to age in place, to stay with their families and in their communities.”

In a Facebook Live interview this week, Rep. Joe Kennedy III (D-Mass.) told me that Medicaid is “the backbone for our healthcare infrastructure across the country.” But the Congressman isn’t confident that Americans sufficiently appreciate the crucial role that Medicaid plays. “So many [people] have heard of these programs,” said Rep. Kennedy, “But they don’t quite understand how integral they have become to preserving the dignity, the stability, the security of so many Americans.”

President Lyndon Johnson signed Medicaid and Medicare into law in 1965, and it’s no accident that the two were created simultaneously. Both programs were designed to provide health insurance to vulnerable members of society who previously went without medical coverage  — including the poor and the elderly. Over the past half a century, Medicare and Medicaid have been expanded to cover more people and more services.

Medicaid’s ability to cover older Americans at a time of their lives when chronic conditions and other health issues typically emerge took a big leap forward with passage of the Affordable Care Act (ACA). The ACA expanded Medicaid to cover people earning up to 138 percent of the poverty line. As a result, more than 15 million additional Americans received federal health coverage.

Many of those were in the 50-64 age group that typically has trouble buying private health insurance. According to the Center for Retirement Research, “The share of Americans ages 50-64 without insurance fell by 6.4 percentage points between 2012 and 2016 — due at least in part to increased Medicaid enrollment in the expansion states.”

Unfortunately, Medicaid has been under siege in Congress ever since the ACA was enacted. When the majority party took control of all branches of government in 2017, they tried relentlessly to gut the program  — starting with Obamacare repeal legislation all the way through President Trump’s first two budgets and various House GOP budget proposals.

The details vary in each dark scenario, but the commonalities included cutting more than $1 trillion from Medicaid, imposing per capita caps on payments to the states, or converting it into a block grant program. The Congressional Budget Office (CBO) estimated that these draconian measures would have resulted in 14 million Americans losing health coverage over the next ten years.

Even though those devastating proposals failed, Medicaid remains under assault from the right. The Trump/GOP tax cuts enacted last December will blow a $1.5 trillion hole in the national debt, inviting deep cuts to Medicaid (as well as Medicare and Social Security). Meanwhile, according to Americans for Tax Fairness, when the new tax law is fully phased in, 83 percent of the tax cuts will go to the wealthiest 1 percent.

Unsatisfied with the mere prospect of slashing Medicaid, the majority party offered a Balanced Budget Amendment (BBA) last week that would have triggered $114 billion in Medicaid cuts in a single year. The BBA attracted 233 votes (mostly along party lines), but fortunately failed to win the 2/3 of the House it would have needed to advance to the Senate.

The onslaught continues in the Trump administration, which is busy granting waivers for work requirements, drug testing, and other bureaucratic barriers that will result in Medicaid patients being kicked off the rolls.

“President Trump and his colleagues in Congress appear to have learned from their failed attempt to take away health insurance from tens of millions legislatively… that they need to do it in a back-door way, without the public catching on,” says Vallas.

Ironically, the right’s efforts to destroy the ACA and gut Medicaid have made Americans more aware of the program’s value. “They did something that Democrats couldn’t do for a long time. They made Medicaid popular,” says Rep. Kennedy.

Indeed, a Kaiser Health Tracking Poll conducted in March found that 74 percent of Americans have a positive opinion of Medicaid, including 65 percent of Republicans. In that same poll, 7 in 10 respondents said that they have a personal connection to Medicaid  — either because of their own medical coverage or their child’s, or indirectly through a family member or friend.

In a recent poll by the Center for American Progress, a whopping 80 percent of respondents (across party lines) said they oppose cutting Medicaid. “The Trump agenda of dismantling health care is the opposite of what the American people want,” says Vallas. “Americans want their policymakers to ensure that everyone has access to healthcare, not take away programs like Medicaid that make it possible for grandma to be in the nursing home.”

Our elected leaders need to understand that these Americans whose lives have been touched by Medicaid  — or likely will be by the time they are older — are people for whom Medicaid is a lifeline. They are not figures on a ledger, despite budget hawks’ tendency to view them that way. Even if our leadership isn’t sufficiently aware, it’s important that all of us  — their constituents — understand the myriad benefits that Medicaid provides seniors and everyone else who truly needs them. In fact, let’s make every month “Medicaid Awareness Month” until the program is safe from attack by budget slashers and properly fortified for the future.

ashoup
In Stories, News

This Week in the War on Health Care

While Americans paid up on Tax Day, Republicans continued their unprecedented assault on the American health care system. Here’s what happened this week in the war on health care – plus two stories you should be sure to read:

TRUMP’S TAX DAY: TAX BREAKS FOR THE RICH, HIGHER HEALTH CARE COSTS FOR YOU

On Tax Day, as millions of Americans worry that their health care costs are expected to increase by double digits because of the Republican tax bill, wealthy insurers were celebrating huge tax breaks thanks to President Trump and Congressional Republicans. As the Washington Post reported:

“The tax overhaul certainly unlocked more profits for the industry. It not only lowered the domestic corporate tax rate from 35 percent to 21 percent, a huge boon to insurers and pharmacy benefit managers, but it also enticed drug and biotech companies to bring home huge overseas cash reserves by slashing taxes on those earnings, too. Pfizer, which has been mentioned as a potential buyer of Shire, announced an extra $10.7 billion in reported income for 2017 because of the tax changes. Allergan, UnitedHealth and Anthem have also recorded a benefit from the tax overhaul, according to a recent analysis by Bloomberg. Indeed, all five major U.S. health insurers have announced the tax overhaul will increase their revenue this year.”

But, for people who work for a living, the TrumpTax means higher health care costs:

  • The nonpartisan Congressional Budget Office says that the premiums will go up 10% each year because of the TrumpTax.
  • A recent Urban Institute Urban study found that premiums are expected to rise 18.3% due to actions taken by the Trump Administration.
  • And an analysis from by Covered California projected that premiums could rise as much as 90% due to the Trump Administration’s sabotage campaign.
  • 20 Americans will lose their coverage for each millionaire’s tax break.

Every American who sees their health care costs go up should remember that their rising health care costs were brought to them courtesy of Donald Trump and the GOP.

PRESIDENT TRUMP VOWS HIS ADMINISTRATION WILL CONTINUE SABOTAGING ACA

On Monday in Florida, President Trump vowed to continue his sabotage campaign against the Affordable Care Act, saying the GOP’s tax bill brought about “the end of Obamacare” and expressing his support for proposed association health plans, calling them “tremendous insurance.”

He left out the fact that his war on our care already threatens millions of Americans’ insurance, is raising premiums double-digits for millions more, and has seriously damaged the individual market – and that his response has been to embrace junk insurance scams like association health plans, which have a history of fraud and have been condemned by experts across the country.

KOCH BROTHERS LAUNCH LATEST ANTI-CARE SALVO IN MONTANA

In Montana, Americans for Prosperity released a new, misleading ad against Sen. Jon Tester. They forgot to mention that because their Republican allies in Congress have been waging a war on health care that will raise costs, take away coverage, and gut protections for those with pre-existing conditions, Montana families will see their premiums go up an average of $2,100 this fall and 46,000 Montanans could lose coverage altogether.

LOS ANGELES TIMES: HOW TRUMP’S OBAMACARE ADMINISTRATOR IS TAKING A HATCHET TO OBAMACARE

Another Administration official responsible for Americans’ rising health care costs? CMS Administrator Seema Verma. Here’s the Los Angeles Times’ Michael Hilktzik:

It’s been well documented that the Trump White House has filled federal agencies with bureaucrats whose life work is destroying the very agencies they’ve been assigned to. But one is in a better position than her fellows to threaten the health of millions of Americans—and she’s been working at that assiduously. We’re talking about Seema Verma, who as administrator of the Centers for Medicare and Medicaid Services also is effectively the administrator of the Affordable Care Act. In the Trump administration, that has made her the point person for the Trump campaign to dismantle the act, preferably behind the scenes…

Verma never has concealed her hostility to Medicaid — especially Medicaid expansion, a provision of the ACA. Her animosity is fueled at least in part by ignorance (willful or otherwise) about the program. Back in November, on the very day that voters in Maine and Virginia were demonstrating full-throated support at the polls for expanding Medicaid in their states, Verma was unspooling a string of misleading statistics and suspect assertions about the program to support a policy of rolling back enrollment. Badmouthing Medicaid is pretty much the opposite of what a Medicaid administrator should be doing. It’s worse when there’s so little truth to the attack… Last month, after her superiors at the Department of Health and Human Services nixed an Idaho plan to eviscerate the ACA’s mandate of essential health benefits, she suggested to Idaho officials how they could circumvent the ACA’s mandate without being too obvious about it. She has cleared Kentucky to impose work requirements on Medicaid applicants, a historic first that is probably illegal and almost sure to drive as many as 300,000 enrollees out of the program in the very first year…

Republicans in Congress didn’t have the votes to repeal the Affordable Care Act, so they’ve taken to underhanded stunts to try to accomplish the same thing, with Trump’s help. Their actions include effectively eliminating the individual mandate, which will guarantee that the pool of ACA enrollees will be sicker next year than last year, driving up costs; and promoting cheaper, skimpier short-term health plans, which will leave their policyholders without crucial coverage or consumer protections just at the point they need these benefits for their health, while also draining healthier enrollees from full-benefit ACA plans.

These actions will almost certainly lead to a spike in premiums for 2019. “It’s just still a nasty soup right now that’s brewing,” Matt Eyles, a top executive at America’s Health Insurance Plans, the industry lobbying arm, warned at a Washington conference last week. Trump and his fellow Republicans will be entirely responsible for the fallout, but they’ll have Seema Verma to thank for running interference.

SPOKESMAN-REVIEW: MCMORRIS RODGERS HAS TROUBLES WITH THE TRUTH ON PRE-EXISTING CONDITIONS

And another Republican responsible for Americans’ rising health care costs? Washington Rep. Cathy McMorris Rodgers. Here’s the Spokesman-Review’s Shawn Vestal:

“If it’s April, it must be time for Cathy McMorris Rodgers to start telling whoppers about health care. A year ago at this time, McMorris Rodgers tied herself in knots trying to justify her vote for the American Health Care Act, the failed effort to replace Obamacare. Just a few months before that vote, after all, she had co-sponsored legislation that would have prohibited something that the AHCA would allow: charging sick people more for insurance… Three months later, she voted for the AHCA, which would have allowed insurers to do just that in some cases. She was against it before she was for it…

The AHCA is dead and buried, but McMorris Rodgers is sticking to her story. Last week, in an interview on KREM, she was asked, “And so you would not vote for legislation that did not have protection for those with pre-existing conditions? She said, “Right. And I haven’t.” Which seems like the wrong answer, given that she voted for a bill that would have allowed states to charge some sick people more money for being sick…

Health care politics is complicated. Politicians can mislead by simply saying the humane-sounding thing and hoping no one pays attention to the details. McMorris Rodgers has said all along that she supports protecting people with pre-existing conditions. It’s a top priority, she says. A fundamental principle. She has said all along: She opposes charging sick people more for health insurance. She said it when sponsoring a law to outlaw the practice. And she said it when voting to allow it.

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In Stories, News

Koch Brothers Launch Latest Salvo in the Republican War on Montanans’ Care

Washington, D.C. – In response to Americans for Prosperity releasing a new, misleading ad against Sen. Jon Tester, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“The Koch Brothers and their Republican allies in Congress have been waging a war on health care that will raise our costs, take away coverage, and gut protections for those with pre-existing conditions. Thanks to the Republican tax bill, pharmaceutical and insurance companies are getting billions of dollars in tax breaks while many Montana families will see their premiums go up an average of $2,100 this fall, and 46,000 Montanans could lose coverage altogether. Enough is enough: it’s time for the Koch brothers and their allies in Congress to stop their war on Montanans’ health care.”

BACKGROUND

INSURANCE COMPANIES AND PHARMACEUTICAL COMPANIES GET BILLIONS OF DOLLARS FROM THE REPUBLICAN TAX BILL

The Republican Tax Bill Is A $10 Billion Giveaway For Insurance Companies.  An Axios analysis found 21 health insurance companies collectively expected to gain $10 billion in tax breaks in 2018 alone. Most of the money is being used for buybacks, dividends, acquisitions and paying down debt — with just a sliver for one-time employee bonuses, research and internal investments. [Axios, 3/5/18]

The Republican Tax Bill Is A $50 Billion Windfall For Pharmaceutical Companies.  According to an Axios analysis, the pharmaceutical industry is using a large portion of its savings from the Republican corporate tax break to boost its stock prices. Nine drug companies are spending a combined $50 billion on new share buyback programs, far outstripping investments in employees or drug research and development. [Axios, 2/22/18]

THE REPUBLICAN TAX BILL WILL RAISE PREMIUMS AND TAKE COVERAGE AWAY FROM MONTANANS

The Republican Tax Bill Means Higher Costs, Especially for Older Montanans. A Center for American Progress estimate shows that in Montana, family premiums in the marketplace will increase on average by $2,100 in 2019. Older Montanans would not be spared. The AARP estimates a 64-year-old in Montana will have to pay $1,551 more in premiums because of health repeal, essentially an age tax for people over 50. [Center for American Progress, 11/16/17, AARP, 11/21/17]

The GOP Tax Bill Will Cost 46,000 Montanans Their Health Coverage. As a result of the tax bill, an estimated 46,000 Montanans will lose coverage by 2025. [Center for American Progress, 11/16/17]

REPUBLICAN SABOTAGE WILL RAISE THE COST OF HEALTH CARE FOR MONTANANS

Urban Institute: Premiums For Montanans Will Increase An Average Of 19.8 Percent Next Year. An Urban Institute study found that, “the actions President Trump and Congressional Republicans have taken to sabotage the health care markets will artificially inflate individual insurance premiums by an average of 19.8 percent in Montana for 2019.” [Urban Institute, 3/14/18]

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In News

Washington Post Report: Latest Example of GOP’s Health Care Winners and Losers

The Washington Post recently reported that “health industry giants get tax windfall” in a story about all the way big health insurance companies are benefiting from massive tax breaks in the TrumpTax.

Health industry giants get tax windfall. But it’s unclear how it will be used.

Washington Post // Paige Winfield Cunningham // April 18, 2018

[…] “One thing is for sure, however: the tax overhaul certainly unlocked more profits for the industry. It not only lowered the domestic corporate tax rate from 35 percent to 21 percent, a huge boon to insurers and pharmacy benefit managers, but it also enticed drug and biotech companies to bring home huge overseas cash reserves by slashing taxes on those earnings, too.

“Pfizer, which has been mentioned as a potential buyer of Shire, announced an extra $10.7 billion in reported income for 2017 because of the tax changes. Allergan, UnitedHealth and Anthem have also recorded a benefit from the tax overhaul, according to a recent analysis by Bloomberg.

“Indeed, all five major U.S. health insurers have announced the tax overhaul will increase their revenue this year.”

But, for people who work for a living, the TrumpTax means higher health care costs.

  • The nonpartisan Congressional Budget Office says that the premiums will go up 10% each year because of the TrumpTax.

  • A recent Urban Institute Urban study found that premiums are expected to rise 18.3% due to actions taken by the Trump Administration.

  • And an analysis from by Covered California projected that premiums could rise as much as 90% due to the Trump Administration’s sabotage campaign.

“Analysis after analysis and report after report all show the same thing: big pharmaceutical companies and health insurance companies are putting these tax breaks into their pockets while picking the pockets of working people through higher health care costs. This analysis only further underscores the most basic and predictable result of the TrumpTax: America’s largest health corporations are seeing huge profits while continuing to raise Americans’ health care costs,” said Brad Woodhouse, Protect Our Care Campaign Director.

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Trump’s Tax Day: Tax Breaks For the Rich, Higher Health Care Costs For You

Washington, D.C. – On Tax Day, as millions of Americans contend with health care premiums expected to increase an average of 18 percent, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“This Tax Day, wealthy health insurers and rich pharmaceutical companies get huge tax breaks thanks to Donald Trump and Congressional Republicans. Meanwhile, people who work for a living get higher health care costs.

“The TrumpTax will take health insurance away from 13 million people and raise premiums double-digits each year for millions more to fund a trillion-dollar tax break for the wealthiest individuals and corporations. 20 Americans will lose their coverage for each millionaire’s tax break.

“Every American who sees their health care costs go up should remember this Tax Day that their rising health care costs were brought to them courtesy of Donald Trump and the GOP.”

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In News

TrumpTax Bill Kicks 20 Americans Off Coverage Per Millionaire Tax Cut

To: Interested Parties
From: Brad Woodhouse, Campaign Director, Protect Our Care
Date: April 16, 2018
Re: TrumpTax Bill Kicks 20 Americans Off Coverage Per Millionaire Tax Cut

Last December, President Trump and Congressional Republicans passed a $1.5 trillion tax bill that disproportionately benefits wealthy Americans and big corporations. As a result, millionaires will receive $29.8 billion in tax cuts in 2021 alone. To partially pay for these massive tax cuts, Republicans repealed the Affordable Care Act’s individual shared responsibility provision, which requires most people to enroll in health insurance or pay a penalty. Repealing this provision means higher premiums for working families and 12 million more Americans without health care in 2021, according to the nonpartisan Congressional Budget Office (CBO).

THE PRICE OF ONE MILLIONAIRE’S TAX CUT IS TWENTY AMERICANS’ HEALTH INSURANCE

How are Republicans ‘paying for’ millionaires’ tax cuts? By stripping working Americans of their health insurance. Here’s how the numbers break down:

  • In 2021, tax cuts for millionaires due to the Republican tax bill will total $29.8 billion. Meanwhile, taxes for those earning between $10,000 and $20,000 a year will increase by $1.9 billion.
  • In 2021, 12 million Americans are expected to lose health insurance because of the tax bill’s repeal of the individual mandate. This is projected to save the federal government $30.6 billion.
  • For each American who loses health insurance in 2021, federal spending will be reduced by $2,550. Meanwhile, millionaires will be receiving an average tax transfer of $51,000.

The bottom line: The average millionaire’s tax cut will come at the cost of 20 Americans’ health insurance.

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In News

President Trump Vows to Keep Sabotaging Affordable Care Act

Washington, D.C. – Today in Florida, President Trump vowed to continue his sabotage campaign against the Affordable Care Act, saying the GOP’s tax bill brought about “the end of Obamacare” and expressing his support for proposed association health plans, calling them ‘tremendous insurance.’ Protect Our Care Campaign Director Brad Woodhouse released the following statement in response:

“President Trump today continued his crusade against the Affordable Care Act and Americans’ health care. Trump’s war on our care already threatens millions of Americans’ insurance, is raising premiums by double-digits for millions more, and has seriously damaged the individual market – and in response, the President has decided to embrace junk insurance scams like association health plans, which have a history of fraud and have been condemned by experts across the country. The new junk plan regulation that Trump today pledged to finalize within months is likely illegal, and will certainly cause even more turmoil in the insurance markets just before next year’s rates are finalized. Plans that can deny coverage based on pre-existing conditions and refuse to cover key services like hospitalization are the exact opposite of ‘tremendous insurance,’ and they join a long list of Trump Administration actions set to cause tremendous rate hikes this fall.

“While President Trump may say that ‘nobody remembers’ the Senate health care repeal bill, the truth is that Americans have not forgotten that Republicans threatened our care. We remember that Republicans tried to put insurance companies back in control; we remember they tried to leave the one-in-four Americans with a pre-existing condition out in the cold; and we remember that Republicans ignored our voices while pushing the most unpopular legislation in decades. Standing up to the war on health care is Americans’ top priority at the polls this year. As the Trump Administration continues to attack our care through harmful regulations and Republicans in Congress plot Medicare and Medicaid cuts, Americans will keep remembering, and the President and his party are right to fear the consequences of their destructive actions.”

TRANSCRIPT:

PRESIDENT TRUMP: So we have the biggest tax cut in history, bigger than the Reagan tax cut, bigger than any tax cut. But what else? The individual mandate is gone. That’s on Obamacare, which is about the end of Obamacare. So we had Obamacare beat and one senator decided to go thumbs down. Do you remember that evening? No, nobody remembers. Thumbs down.

It’s all right, because Alex Acosta has come up and this is the plan that a lot of people have wanted for a long time, associations. And we’re going any tremendous sign-ups. Alex, when is that going to be ready where people can start signing and doing it in groups and through cooperatives, et cetera?

LABOR SECRETARY ACOSTA: That’s right, Mr. President, we hope to have that by this summer.

PRESIDENT TRUMP: It’s going to be incredible, you’re going to get tremendous insurance at a very low cost.

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Advocates Nationwide Highlight Medicaid’s Role In Combating Opioid Crisis

Throughout the second week of Medicaid Awareness Month, advocates across the country highlighted the significant role Medicaid plays in combating the opioid crisis – most notable being that in 2014 Medicaid paid for one-fourth of addiction treatment nationwide – and spoke out against Republican proposals to weaken and cut Medicaid.

In Ohio, Chillicothe Mayor Luke Feeney, Cheryl Beverly, Operator of Cheryl’s House of Hope, and Michelle McAllister, Coordinator for the Heroine Partnership Project, held a press conference to discuss how changes to the state’s Medicaid program would leave over 150,000 Ohioans that suffer from substance abuse disorders and mental illness without care.

Protect Our Care released an opioid crisis fact sheet, showing how Medicaid provides access to treatment and gives states more resources in combating the epidemic.

In Tennessee, Chip Forrester, a father who lost his son to opioids, held a roundtable discussion about the crisis and how restricting access to Medicaid threatens lives and impedes states’ ability to respond to the epidemic.

The Center on Budget and Policy Priorities released a report analyzing how Better Integration of Medicaid and Federal Grant Funding Would Improve Outcomes for People with Substance Use Disorders.

ACA Medicaid Expansion Reduced Share of Opioid-Related Hospitalizations in Which Patient Was Uninsured

[CBPP]

In Ohio,  Jefferson County Commissioner Thomas Graham and health care leaders in Steubenville held a press conference to talk discuss how Medicaid benefits thousands of Ohioans suffering from substance abuse disorders.

And in Alaska and West Virginia, advocates held a virtual postcard sending party throughout the week to send notes thanking Sen. Lisa Murkowski for supporting Medicaid and encouraging her to continue doing so, culminating in a stand up event outside Sen. Murkowski’s Anchorage office emphasizing the role Medicaid plays in addressing the opioid crisis, and a press conference with faith leaders which focused on the opioid crisis and how West Virginia’s faith community can address substance abuse disorders in the state, respectively.

 

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