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May 2018

This Week in the War on Health Care

While celebrity pardons and TV cancellations dominated the headlines, Republicans continued their unprecedented assault on the American health care system. Here’s what happened this week in the war on health care – plus another major victory for the ACA:

IN THE FACE OF OVERWHELMING OPPOSITION, TRUMP DOUBLES DOWN ON SABOTAGE

On Tuesday, President Trump boasted about his Administration’s ongoing health care sabotage during a bill signing, saying that “we will have gotten rid of a majority of Obamacare” in relation to his Administration’s expected rules on short-term and association health plans – on the very same day a new analysis shows unprecedented opposition to both proposals, with over 90% of comments submitted opposing their implementation.And his boast came just days after

  • America’s Health Insurance Plans released a report stating that these rules “would likely increase premiums in the individual market by 1.7% in the near-term and up to 6.6% once these changes are fully implemented”;
  • the Congressional Budget Office released a report predicting that premiums for benchmark plans are expected to increase by 15 percent next year, and 7 percent per year between 2019 and 2028, with Republican sabotage to blame; and
  • the Center for American Progress released a report estimating that premium increases due to these acts of marketplace sabotage would raise benchmark premiums $1,013 nationally on average for a 40-year-old individual.

REPUBLICANS KEEP PUSHING REPEAL

Today, “exclusive details” of the GOP’s new repeal bill were reported in the Washington Examiner. Less than 24 hours after Virginia moved to expand Medicaid, Washington Republicans are touting their latest health care repeal plan, taking health care away from millions of Americans and raising costs for millions more.

Their newest effort is modeled after the worst of last year’s repeal bills, Graham-Cassidy, and guts the very Medicaid expansion Virginia embraced yesterday, ends protections for people with pre-existing conditions, and imposes an age tax on older Americans. Enough is enough – it’s time for President Trump and Congressional Republicans to end their war on Americans’ health care.

RHODE ISLANDERS FACE THE COST OF REPUBLICAN SABOTAGE

This morning, Rhode Islanders became the latest state to reap the costs of the Administration’s repeal and sabotage campaign, with preliminary rate filings for 2019 individual market plans indicating a nearly 10% increase. Why the leap?

Rhode Island Health Insurance Commissioner: Rates “made against the backdrop of continuing uncertainty over federal policy actions around the Affordable Care Act.” [Rhode Island Health Insurance Commissioner’s Office, 5/31]

Neighborhood Health Plan of Rhode Island: “Key drivers of the rate increase include” mandate repeal… “The repeal of the mandate penalty will result in approximately 1.9% increase of premiums.” [Neighborhood Plan of Rhode Island, 5/31]

For the past year and a half, President Trump and his Republican allies in Congress have engaged in a deliberate, aggressive campaign to undermine health care and now families in Rhode Island are being asked to pay the price. Republicans should start working on bipartisan solutions to make coverage more affordable, instead of helping their friends in the insurance industry make another buck on the backs of hardworking Rhode Islanders.

VIRGINIA EXPANDS MEDICAID, A SMACK IN THE FACE FOR WASHINGTON REPUBLICANS

This week wasn’t all bad, though!

Yesterday’s vote in Virginia to expand affordable health care access to 400,000 Virginians represents a tremendous step for Virginia’s health care system and its economy and a giant smack in the face to the Trump Administration and the Republicans in Congress who keep pushing an out-of-touch, anti-health-care agenda.

While Republicans keep voting for health care repeal and sabotaging the system, Virginia voters became the latest Americans to demand – and win – expanded coverage. In the four years since states began expanding Medicaid, more than fifteen million Americans have gained coverage, giving these individuals and families control of their health care and providing peace of mind that a medical emergency will no longer result in bankruptcy, or worse.

While it’s unfortunate that Virginia Republicans insisted on imposing work requirements as a precondition for this achievement, the vote highlights growing momentum across the country to expand access to health care. Virginia is the latest state to do the right thing, but it surely won’t be the last.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

As States Move to Expand Medicaid, GOP Keeps Pushing Repeal

Washington, D.C. – Today, “exclusive details” of the GOP’s new repeal bill were reported in the Washington Examiner, just a day after Virginia’s bipartisan expansion of Medicaid. Protect Our Care Campaign Chair Leslie Dach released the following statement in response:

“Less than 24 hours after Virginia moved to expand Medicaid, and as Idaho and Utah continue to move to place Medicaid expansion on the ballot this November, Washington Republicans are touting their latest health care repeal plan, taking health care away from millions of Americans and raising costs for millions more.Their newest effort is modeled after the worst of last year’s repeal bills, Graham-Cassidy, and guts the very Medicaid expansion that Virginia embraced yesterday, ends protections for people with pre-existing conditions, and imposes an age tax on older Americans. Enough is enough – it’s time for President Trump and Congressional Republicans to end their war on Americans’ health care.”

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

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

Here’s a roundup of reactions:

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

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

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

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

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

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

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

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

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

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

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

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

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

Why Rhode Islanders’ Insurance Is Getting Even More Expensive: The Trump Administration and Washington Republicans Keep Sabotaging Health Care

Washington, D.C. – As preliminary Rhode Island rate filings for 2019 individual-market health insurance indicated an almost 10% average premium increase due to D.C. Republicans’ repeal-and-sabotage agenda, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“For the past year and a half, President Trump and his Republican allies in Congress have engaged in a deliberate, aggressive campaign to undermine health care and now families in Rhode Island are being asked to pay the price. While insurance companies make huge profits and enjoy record tax breaks from Republicans, they are planning to charge working families even more. Until we stop Republicans’ war on health care, health care experts predict that rates will keep rising by double digits. Washington, D.C. Republicans should start working on bipartisan solutions to make coverage more affordable, instead of helping their friends in the insurance industry make another buck on the backs of hardworking Rhode Islanders.”

From The Insurance Commissioner And Insurance Companies:

Rhode Island Health Insurance Commissioner: Rates “Made Against The Backdrop Of Continuing Uncertainty Over Federal Policy Actions Around The Affordable Care Act.” “This year’s rate filings are made against the backdrop of continuing uncertainty over federal policy actions around the Affordable Care Act, such as the discontinuance of both Cost Sharing Reduction subsidies and penalties for not having insurance.” [Rhode Island Health Insurance Commissioner’s Office, 5/31]

Neighborhood Health Plan Of Rhode Island: “Key Drivers Of The Rate Increase Include” Mandate Repeal. “The range of rate changes, before reflecting changes in age, which consumers will experience, is approximately 7.9% to 9.6%. Key drivers of this rate increase, further described below, include: Repeal of the individual mandate penalty affecting medical service costs…  In 2018, the federal administration also repealed the individual mandate penalty which previously required all US citizens or permanent residents to obtain qualifying health insurance or pay a tax penalty greater than zero dollars. Repeal of the mandate penalty will result in approximately 1.9% increase of premiums, assuming healthy individuals will no longer purchase health insurance.” [Neighborhood Plan of Rhode Island, 5/31]

Why Rhode Islanders’ Insurance Is Getting Even More Expensive: The Trump Administration and Washington Republicans Keep Sabotaging Health Care

While spending most of last year trying to repeal the Affordable Care Act (ACA) and waging a war on our health care, President Trump and Republicans in Congress have also used their control of Washington to actively undermine the Health Insurance Marketplaces every chance they get – leading insurance companies to raise premiums for 2018 and 2019 and, in some cases, forcing them out of the individual market altogether. Washington Republicans’ goal is simple: sabotage and undermine the Affordable Care Act, then blame everyone but themselves for the consequences of their actions. President Trump keeps rooting for disaster, saying that “The best thing we can do…is let Obamacare explode” and “Let it be a disaster because we can blame that on the Democrats.

Now, initial rate filings in Rhode Island forecast rate hikes again this fall because of Republican sabotage.

Republicans never ended their war on our health care. After Congress failed to repeal the Affordable Care Act, the Trump Administration is aggressively sabotaging our health care system and refusing to work to make coverage better and more affordable.

  • Experts from AARP, the Congressional Budget Office, and a wide range of other nonpartisan organizations agree that Republican actions are forcing up health care costs.
  • Republicans in Congress are supporting the Administration’s many actions to undermine health care, despite widespread opposition from patient and disease groups, doctors, nurses, hospitals, plus health care and consumer advocates.
  • The Trump Administration officials keep rewriting the rules to let big insurance companies cover fewer and fewer services while charging people more and more. The sabotage doesn’t stop there: last year the Administration fired many of the community assisters who help people enroll in health care; this year they are planning more enrollment cuts, making it even harder to sign up for coverage.
  • And now, Republicans are encouraging insurance companies to sell more junk plans that don’t have to cover basic care like hospitalization and prescription drugs, and that are allowed to charge people with pre-existing conditions more or even deny them coverage altogether.

This could have been avoided: if Republicans had stopped sabotaging health care, American families wouldn’t be facing another huge increase this fall.

  • Even the Trump Administration has admitted that the Affordable Care Act’s insurance marketplaces had been stabilizing prior to them coming into office.
  • The nonpartisan Congressional Budget Office had predicted only modest rate increases if Republicans hadn’t sabotaged the markets.
  • Even Senate Republicans admitted this fall’s upcoming rate hikes were “avoidable,” but then they torched bipartisan stabilization talks at the last minute, prioritizing partisan politics over their last opportunity to help American families afford health care next year.

The Trump Administration’s sabotage will punish Americans by jacking up premiums again, compounding the damage done last year, when Republican sabotage pushed rates up by a national average of 37%.

  • The Republican tax bill’s repeal of a key Affordable Care Act provision and the Trump Administration’s junk plan proposal will increase individual market premiums in Rhode Island by an average 20.7 percent this fall, according to a recent Urban Institute study.
  • This sabotage-driven rate hike will make the damage Republicans inflicted last year through repeal attempts and sabotage even worse.
  • Higher premiums will mean fewer working families can afford coverage: during the first year of the Trump Administration, millions more Americans joined the ranks of the uninsured – the highest increase since Gallup started tracking the uninsured rate.

Despite Republican sabotage, the Affordable Care Act has improved Rhode Islanders’ care.

  • 33,021 Rhode Islanders signed up for Marketplace coverage this year.
  • Thanks to the Marketplace and Medicaid expansion, Rhode Island’s uninsured rate fell by 5 percent between 2013 and 2016 as Rhode Islanders have gained access to affordable coverage.
  • Before today’s announcement, the Urban Institute predicted that Rhode Island premiums for 2019 could rise 20.7 percent more because of the Trump Administration’s junk plan proposal and the Republican tax bill’s repeal of a key Affordable Care Act coverage incentive.
  • Even despite sabotage, Affordable Care Act subsidies help keep coverage affordable for 80 percent of Rhode Island Marketplace consumers, whose average 2018 premium is $144 per month.
  • But because of the Republican sabotage agenda, many middle-income Rhode Islanders could pay hundreds or thousands of dollars more than they would have otherwise.

Rhode Islanders won’t forget that Republicans and the Trump Administration keep forcing up health care costs to score political points.

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

KEY QUOTES

Former HHS Secretary Tom Price: GOP Actions Responsible For Premium Increases. “President Trump’s former top health official on Tuesday said the Republican tax law would raise the cost of health insurance for some Americans because it repealed a core provision of the Affordable Care Act. Tom Price, Trump’s first secretary of the Department of Health and Human Services, said people buying insurance on government-run marketplaces will face higher prices because the tax law repealed the ACA’s individual mandate. The mandate had forced most Americans to have health coverage or face a financial penalty. ‘There are many, and I’m one of them, who believes that that actually will harm the pool in the exchange market, because you’ll likely have individuals who are younger and healthier not participating in that market, and consequently that drives up the cost for other folks within that market,’ Price said at the World Health Care Conference in Washington.” [Washington Post, 5/1/18]

Cynthia Cox, Kaiser Family Foundation: “In The Absence Of Efforts To Undermine The Market, We Would Be Seeing A Period Of Relatively Small Premium Increases.” “‘In the absence of efforts to undermine the market, we would be seeing a period of relatively small premium increases, driven mostly by the underlying growth in health care costs,’ said Cynthia Cox, the lead author of the Kaiser Family Foundation report. ‘I wouldn’t be surprised if we’re in for another year of double-digit premium increases. And if that does happen, it would be in large part due to policy changes that are happening.’” [Huffington Post, 5/18/18]

America’s Health Insurance Plans: Republican Sabotage Will “Drive Up The Rate Of Premium Increases.” “Policies that disproportionately draw healthy consumers away from the individual market, like expanding access to short-term plans, will likely have an even more devastating effect on affordability, choice and competition. This will further result in adverse selection, drive up the rate of premium increases, and exacerbate affordability issues for many other people.” [America’s Health Insurance Plans Letter to HHS, 4/20/18]

Kris Haltmeyer, Blue Cross Blue Shield Association Vice President: “With The Repeal Of The Individual Mandate And The Failure Of Congress To Enact Stabilization Legislation, We Are Expecting Premiums To Go Up Substantially.” Kris Haltmeyer, a vice president at the Blue Cross Blue Shield Association, told reporters that the premium increases were in part due to the repeal of ObamaCare’s individual mandate in the Republican tax reform bill in December. He also cited lawmakers’ failure to pass a bill aimed at shoring up the market, which fell apart earlier this year amid a partisan dispute over abortion restrictions. ‘With the repeal of the individual mandate and the failure of Congress to enact stabilization legislation, we are expecting premiums to go up substantially,’ Haltmeyer said. He estimated that average premium increases nationwide will be in the ‘low teens,’ but that there will be major variation across areas, ranging from the low single digits to up to 70 or 80 percent.” [The Hill, 5/23]

Commonwealth Fund: Rollback Of Health Insurance Gains Spurred By “Actions By The Current Administration.” “The marked gains in health insurance coverage made since the passage of the Affordable Care Act (ACA) in 2010 are beginning to reverse, according to new findings from the latest Commonwealth Fund ACA Tracking Survey. The coverage declines are likely the result of two major factors: 1) lack of federal legislative actions to improve specific weaknesses in the ACA and 2) actions by the current administration that have exacerbated those weaknesses. These include the administration’s deep cuts in advertising and outreach during the marketplace open-enrollment periods, a shorter open enrollment period, and other actions that collectively may have left people with a general sense of confusion about the status of the law. Signs point to further erosion of insurance coverage in 2019: the repeal of the individual mandate penalty included in the 2017 tax law, recent actions to increase the availability of insurance policies that don’t comply with ACA minimum benefit standards, and support for Medicaid work requirements.” [Commonwealth Fund, 5/1/18]

Center for American Progress: “Combined, The Recent Tax Law’s Repeal Of The Individual Mandate And The Administration’s Short-Term Plan Rule Will Undermine The Individual Insurance Market And Increase Premiums For ACA-Compliant Coverage.” “Last year, as part of the tax law, Congress eliminated the Affordable Care Act’s individual mandate penalty. Given the mandate’s important role in encouraging healthier people to enroll in the marketplaces, the Congressional Budget Office (CBO) estimates that, in 2019, this will increase average premiums in the individual market by 10 percent. Furthermore, in February 2018, the Trump administration proposed a rule to expand short-term health insurance plans… Along with the repeal of the individual mandate penalty, this expansion of short-term plans will drive up average premiums for ACA-compliant coverage in the individual market. Recent preliminary rate filings in Virginia demonstrate that these actions are contributing to significant premium increases for marketplace coverage in 2019. In fact, some Virginia insurers specifically cited the individual mandate repeal and short-term plan rule as major factors in their rate filings… Combined, the recent tax law’s repeal of the individual mandate and the administration’s short-term plan rule will undermine the individual insurance market and increase premiums for ACA-compliant coverage.” [CAP, 5/18]

New York Times: “Rather Than Trying To Eliminate Obamacare In One Fell Swoop, [Republicans Are] Trying To Undermine It With Multiple Acts Of Sabotage – While Hoping Voters Won’t Realize Who’s Responsible For Rising Premiums And Falling Coverage.” “At the beginning of 2017, Republicans promised to release the kraken on Obamacare — to destroy the program with one devastating blow. But a funny thing happened: Voters realized that repealing the Affordable Care Act would mean taking health insurance away from tens of millions of Americans. They didn’t like that prospect — and enough Republicans balked at the backlash that Obamacare repeal fizzled. But Republicans still hate the idea of helping Americans get health care. So instead of releasing the kraken, they’ve brought on the termites. Rather than trying to eliminate Obamacare in one fell swoop, they’re trying to undermine it with multiple acts of sabotage — while hoping voters won’t realize who’s responsible for rising premiums and falling coverage.” [NYT, 5/8/18]

New York Times Editorial Board: “The Administration’s Health Care Sabotage Efforts Have Already Had A Big Impact”: A 30-Percent Premium Increase. “The administration’s health care sabotage efforts have already had a big impact — but not the kind of impact officials promised. Insurance companies raised average premiums for 2018 A.C.A. policies by 30 percent. This has mostly hurt middle-class families who have to pay full freight for health insurance because they make too much money to qualify for subsidies and don’t get coverage through their employer. Few experts were surprised when the Commonwealth Fund found that the percentage of American adults who did not have health insurance jumped to 15.5 percent this year, from 12.7 percent before Mr. Trump took office. Experts say those numbers could climb higher still when the penalty for not having insurance goes away next year.” [NYT, 5/3/18]

Washington Post Editorial Board: “The Numbers Suggest That [The ACA’s] Critics’ Sabotage Efforts Are To Blame. “The effects of the president’s underinformed instincts, enabled by the ideologues in his administration, are beginning to show up in some of the numbers, representing real pain that Americans are suffering for Mr. Trump’s deficient leadership… Obamacare critics regularly describe all problems as the inevitable result of a poorly designed law. But the numbers suggest that the critics’ sabotage efforts are to blame. After impressive declines during President Barack Obama’s second term, the fund found that the uninsured rate increased in both of the years Mr. Trump has been in office. During the campaign, Mr. Trump regularly complained that the Affordable Care Act (ACA) left too many Americans uncovered. The result of nearly a year and a half of Mr. Trump’s leadership is 4 million people added to that group.” [Washington Post, 5/8/18]

CEO of CareFirst Blue Cross Blue Shield: Things Are “Materially Worse” Under Trump. “Continuing actions on the part of the administration to systematically undermine the market and make it almost impossible to carry out the mission…If continued efforts at the federal level undermine the marketplaces, I would think the board would have to examine what they would want — that’s very much on their mind.” [Washington Post, 5/1/18]

Horizon Blue Cross Blue Shield of New Jersey: 2018 Premium Increase Was Due To Federal Policy.Three factors connected to federal policy decisions are responsible for 14.7% of the 24.3% total average individual premium increase: Weakened enforcement of the Individual Mandate…Elimination of federal funding for Cost Sharing Reductions (CSR), [and] 2018 reinstatement of Health Insurance Tax…Were it not for the three factors within the control of the Federal Government, Horizon BCBSNJ’s individual premiums would have an average increase of 9.6%.” [Horizon Blue Cross Blue Shield of New Jersey, 10/17/17]

Lindsey Graham: Republicans “Own The Outcome” On Health Care. “Sen. Graham told Breitbart News, ‘In October, premiums are going up. Obamacare cannot be fixed. It’s going to continue to collapse, and then, we own the outcome. By repealing the individual mandate, which is a step forward in the eyes of the public, we own the issue. We have a responsibility to do something about the collapsing Obamacare system. I believe that we’re going to get blamed more than Democrats because we stopped trying to repeal Obamacare, and to suggest that we don’t own it is just simply politically naive.’ Graham continued, ‘It can hurt us in 2018. It can hurt by our base feeling like we betrayed them. It can hurt us from people suffering from Obamacare, like we don’t have a solution. It will energize Democrats. It can undercut everything we did on the tax cut side.’” [Breitbart, 2/6/18]

Rep. Charlie Dent: “We, The Republican Party…Own” Health Care Now. “Rep. Charlie Dent (R-Pa.) argued Friday that President Trump was ‘ill-advised’ to end key ObamaCare payments, warning that the GOP now ‘owns’ whatever happens to ObamaCare. ‘I think the president is ill-advised to take this course of action because … we, the Republican Party, will own this,’ Dent, a key House moderate who is retiring from Congress at the end of his term, said on CNN. Asked about Trump’s previous comments blaming problems with ObamaCare on former President Barack Obama, Dent pointed out that Republicans currently control the White House and have majorities in both chambers of Congress. ‘Barack Obama is a former president. President Trump is the president and he’s a Republican, and we control the Congress,’ Dent said. ‘So we own the system now. We’re going to have to figure out a way to stabilize this situation … This is on us.’” [The Hill, 10/13/17]

Washington Post: “The Pottery Barn Rule Comes To Mind: You Break It, You Own It.” “This is not ‘letting’ Obamacare fail. Many nonpartisan experts believe that these active measures are likely to undermine the pillars of the 2010 law and hasten the collapse of the marketplaces. The Pottery Barn rule comes to mind: You break it, you own it. Yes, the plate you just shattered had some cracks in it. But if you dropped it on the ground, the store is going to blame you.” [Washington Post, 10/13/17]

Washington Post: “Trump’s Not Going To Be Able To Avoid Blame For Kneecapping Obamacare.” [Washington Post, 10/13/17]

“After Months Of Pinning The Blame For Obamacare’s Shortcomings On Democrats And Watching His Own Party Fail To Act, President Donald Trump Just Took Ownership Of A Struggle That’s Consumed Republicans For Seven Years.” “After months of pinning the blame for Obamacare’s shortcomings on Democrats and watching his own party fail to act, President Donald Trump just took ownership of a struggle that’s consumed Republicans for seven years. Trump’s decision late Thursday to end government subsidies to insurers to help lower-income Americans afford to use their coverage under the Affordable Care Act was the most drastic step he’s taken to undermine his predecessor’s signature achievement. It also lobbed a live bomb into the laps of Republicans lawmakers 13 months before congressional elections after he publicly berated the party’s Senate leadership for being unable to keep a longstanding promise to repeal the law.” [Bloomberg, 10/13/17]

The American People Agree: President Trump And Congressional Republicans Are Playing Politics With People’s Health Care.  A poll conducted last September found that 61 percent of voters believed President Trump was “trying to make the Affordable Care Act fail,” and 64 percent of voters said Trump is “playing politics with people’s health care.” The poll also found that the American people seriously disapprove of how Republicans in Congress are treating health care: 80 percent of voters disapprove while only 20 percent approve. [Hart Research, 9/5/17]

Protect Our Care Statement on Virginia Medicaid Expansion

After the Virginia Senate voted to approve Medicaid expansion, Protect Our Care Chair Leslie Dach released the following statement:

“Today’s vote in Virginia is a smack in the face to the Trump Administration and the Republicans in Congress who keep pushing an out-of-touch, anti-health-care agenda. While they keep voting for health care repeal and sabotaging the system, Virginia voters demanded – and won – expanded coverage. Up to four hundred thousand Virginians will gain coverage through today’s Medicaid expansion, a tremendous step for Virginia’s health care system and its economy. In the four years since states began expanding Medicaid, more than fifteen million Americans have gained coverage, giving these individuals and families control of their health care and providing peace of mind that a medical emergency will no longer result in bankruptcy, or worse. While it’s unfortunate that Virginia Republicans insisted on imposing work requirements as a precondition for this achievement, today’s vote highlights growing momentum across the country to expand access to health care. Virginia is the latest state to do the right thing, but it surely won’t be the last. Thanks to everyone who never gave up on this fight, from grassroots organizers across the Commonwealth to leaders in Richmond, who have today secured a landmark achievement for Virginia.”

 

Editorial Roundup: Across the Country, Standing Up to Health Care Sabotage

Across the country, editorial boards are speaking out against Republicans’ repeal-and-sabotage war on health care as rising costs and higher uninsurance rates take a toll on American communities:

San Antonio Express-News: Health Care Numbers Moving In The Wrong Direction. [5/27/18]

Los Angeles Times: CA Should Fight The Good Fight Against Bad Health Insurance Policies. [5/25/18]

Boston Globe: Repeal Failed, But The GOP’s ACA Attack Continues. [5/12/18]

Charlotte Observer: Get ready for Obamacare Sticker Shock. [5/9/18]

Valley News: Health-Care Sabotage Begins to Kick In. [5/7/18]

Washington Post: Americans Are Starting To Suffer From Trump’s Health Care Sabotage. [5/6/18]

Florida Times-Union: Obamacare has become Trumpcare. [4/12/18]

Des Moines Register: Elected officials undermine Iowans’ health insurance. [4/3/18]

Minneapolis Star Tribune: Sabotaging the Affordable Care Act will lead to pricier insurance. [3/27/18]

Portland Press Herald: Republicans responsible for looming chaos in health care marketplaces. [3/22/18]

Star-Ledger: State Lawmakers Must Rescue Obamacare. [3/11/18]

St. Louis Post-Dispatch: In Iron County, the rural health care catastrophe comes home. [3/8/18]

New York Times: Trump Tries to Kill Obamacare By A Thousand Cuts. [2/21/18]

Los Angeles Times: The Trump administration wants to cut premiums for the healthy at the expense of the sick. Again. [2/21/18]

President Trump Doubles Down on Health Care Sabotage at Bill Signing Ceremony

Washington, D.C. – After President Trump boasted about his Administration’s ongoing health care sabotage during a bill signing, saying that “we will have gotten rid of a majority of Obamacare” in relation to his Administration’s expected rules on short-term and association health plans, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“President Trump is bragging about his Administration’s continuing efforts to undermine and sabotage Americans’ health coverage through short-term junk and association health plans on the very same day that a new analysis shows unprecedented opposition to both proposals from over 90% of health care groups. Instead of forging ahead down this destructive path, Trump should listen to the vast majority of Americans, who oppose his repeal-and-sabotage agenda, and withdraw this harmful rule. It’s time for President Trump to end this partisan war on Americans’ health care.”

FACT SHEETS:

SHORT-TERM PLANS leave people who get sick with thousands of dollars in medical bills because they don’t have to cover basic medical services.

ASSOCIATION HEALTH PLANS may also refuse to cover basic medical services, and have a long history of fraud and unpaid claims.

Health Insurance Experts Confirm Rate Hikes Driven By Sabotage

New estimates from the health insurance industry trade group and other expert organizations are making it clear that Republican sabotage is dramatically increasing the premiums everyday Americans will be paying for health coverage in 2019. In a report that should shock every person struggling to afford health care, the health insurance companies expect rate hikes of up to 15.7% specifically because of Republican actions to undermine and sabotage the health care system.

AHIP: Factors Influencing 2019 Premiums in the Individual Market [5/25]

  • Short-term plan regulation: “Proposed rule would likely increase premiums in the individual market by 1.7% in the near-term and up to 6.6% once these changes are fully implemented.”
  • Association Health Plan regulation: “Could increase premiums in the individual market by up to 4 percent.”
  • Tax bill: Elimination of the individual mandate will increase premiums in 2019 … Recent regulatory guidance by the Administration expanded the list of hardship exemptions to the mandate for 2018, which could inject further uncertainty in the market ahead of 2019.”

AHIP, May 2018

Congressional Budget Office: Federal Subsidies for Health Insurance Coverage for People Under Age 65: 2018 to 2028 [5/23]

  • Significant hikes projected: Premiums for benchmark plans are expected to increase by 15 percent next year, and 7 percent per year between 2019 and 2028.
  • Republican sabotage to blame: CBO says these coverage losses and premium increases will happen “mainly because the penalty associated with the individual mandate will be eliminated and premiums in the nongroup market will be higher.”

CBO, May 2018

Center for American Progress: State-by-State Estimated Premium Increases due to Individual Mandate Repeal and Short-Term Plan Rule [5/18]

  • Four-figure rate hikesEstimated premium increases due to these acts of marketplace sabotage average $1,013 nationally for benchmark premiums for a 40-year-old individual.”
  • Cumulative sabotage impact: “After all, through previous acts of marketplace sabotage, the Trump administration has already unnecessarily driven up 2018 premiums for ACA-compliant coverage. For example, last year, CAP estimated that the Trump administration’s decisions to cancel cost-sharing reduction payments and to undermine enforcement of the individual mandate would increase average benchmark premiums for a 40-year-old by $1,061.”

Senator Bill Cassidy Won’t Stop Trying to Repeal Health Care

After Senator Bill Cassidy (R-LA), one of the chief architects of last year’s failed Senate Republican health repeal push, released a document urging Republicans to revisit Affordable Care Act sabotage and Medicaid cuts, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Senator Bill Cassidy, who infamously lied to Jimmy Kimmel last year about how his bill would hurt people with pre-existing conditions, is back with yet another plan that would force sick people to lose their coverage. His new proposal to sabotage the Affordable Care Act and cut Medicaid comes as Americans are already blaming Republicans for skyrocketing premiums. Cassidy wants to finalize the Trump Administration’s junk plan proposal to stick millions of Americans with skimpy plans that can discriminate against people with pre-existing conditions, refuse to cover essential services like hospitalization or prescription drugs and stick unsuspecting patients with enormous medical bills. Today’s proposal adds to a growing drumbeat of Republicans who are desperate to pass a health care repeal bill ahead of the November elections, even though Americans across the political spectrum overwhelmingly oppose their agenda and all they have to offer are reheated leftovers from last year’s mess.”