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June 2018

Federal Court Protects Health Care for 97,000 Kentuckians

Washington, D.C. – Today, a federal district court issued a scathing rebuke of the Trump Administration’s approval of Kentucky’s Medicaid waiver putting health care for up to 97,000 Kentuckians at risk by imposing rigid work requirements that could be impossible for many of the people most in need to meet.  In response, Brad Woodhouse, executive director of Protect Our Care, released the following statement:

“This decision is a victory for the Kentuckians who need affordable health care the most — children, people with chronic health care conditions, and low-wage workers. Nearly 100,000 Kentuckians stood to lose coverage if this mean-spirited law was to take effect. But this fight isn’t over, since Governor Bevin made it plain he’d throw health care for 500,000 Kentuckians overboard if the court didn’t rule in his favor. We call on Governor Bevin to stand down from his crusade against Kentucky families who rely on Medicaid for coverage, and instead turn his focus to the urgent health needs confronting the people of his state, like the tragic opioid crisis.”

Said the Court in its ruling today: “[Secretary Azar] never adequately considered whether Kentucky HEALTH would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid. This signal omission renders his determination arbitrary and capricious. The Court, consequently, will vacate the approval of Kentucky’s project and remand the matter to HHS for further review.”

BACKGROUND:

  • 500,000 Kentuckians could lose coverage if Gov. Bevin ends the state’s Medicaid expansion,  according to Kentucky Health and Family Services Secretary Adam Meier.
  • Low-wage workers made up the majority of Medicaid-eligible adults who gained coverage under the state’s expansion.
  • Those currently covered by Medicaid in Kentucky include:
    • 561,326 children, composing 39 percent of all state Medicaid enrollees;
    • 9,500 veterans and 5,300 spouses of veterans, who gained coverage under expansion;
    • 44 percent of all births in the state;
    • 90,794 elder Americans aged 65 and older, and
    • 161,380 Medicaid enrollees who are disabled or require long-term care.
  • Medicaid is supported by 74 percent of Americans.

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

As preliminary Montana rate filings for 2019 individual-market health insurance indicated a potential double-digit average premium increase due to Washington Republicans’ repeal-and-sabotage agenda, Protect Our Care Executive 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 — today, hardworking families in Montana are being forced to pay the price. Insurance companies all around the country, and now in Montana, are proposing double-digit hikes that they directly attribute to D.C. Republicans’ deliberate actions to sabotage our health care system.

“Despite Insurance Commissioner Matt Rosendale’s claims, the Affordable Care Act’s protections and coverage expansions through the Marketplaces and Medicaid expansion continue to be a lifeline for many Montanans. A recent study from the University of Montana Bureau of Business and Economic Research found that Montana’s Medicaid expansion has covered more than 94,000 Montanans, created 5,000 new jobs, and saved the state $40 million. It’s time for Republicans like Commissioner Rosendale to stop working for their friends in the insurance industry and instead prioritize the working people of Montana and of the nation.”

 

From the Insurance Companies:

Premiums Could Increase By As Much As 10.6 Percent. “The other two companies selling policies on the online marketplace, PacificSource and the Montana Health Co-op, proposed average increases of 6.2 percent and 10.6 percent for individual policies, respectively, and lesser increases for small-group policies.” [KTVQ, 6/29]

From the University of Montana Bureau of Business and Economic Research:

  • Montana’s Medicaid expansion was responsible for creating 5,000 new jobs, in the health care, retail, construction and hospitality industries, and $280 million of personal income;
  • Labor-force participation has increased six points, from 58 to 64 percent, among those eligible for Medicaid expansion, Montanans aged 18-64 and earning up to 138 percent of the federal poverty level;
  • Medicaid expansion has saved $40 million in Medicaid benefits, in addition to providing $902 million worth of health care services. “The savings are enough to pay for the costs,” said Bryce Ward of the BBER;
  • Medicaid expansion accounts for an estimated $564 million per year on health care spending, with nearly 70% of this being “new money,” or an economic boost spurred only by expansion.
  • As Sheila Hogan, director of the state’s Department of Health and Human Services said, and “Medicaid expansion is doing what it’s supposed to do, help Montanans live healthier lives and save the state money.” [Great Falls Tribune, 3/8]

Why Montanans’ 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 Montana forecast double-digit rate hikes this fall because of Republican sabotage.

D.C. 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. In Montana, no short-term plans available cover maternity care, and none of the plans even cover prescription drugs.

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 percent, and 13 percent in Montana.

  • 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 Montana by an average 19.8 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 Montanans’ care.

  • 47,699 Montanans signed up for Marketplace coverage this year.
  • Thanks to the Marketplace and Medicaid expansion, Montana’s uninsured rate fell by 10.4 percent between 2013 and 2016 as Montanans have gained access to affordable coverage.
  • Before today’s announcement, the Urban Institute predicted that Montana premiums for 2019 could rise 19.8 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 84 percent of Montana Marketplace consumers, whose average 2018 premium is $111 per month.
  • But because of the Republican sabotage agenda, many middle-income Montanans could pay hundreds or thousands of dollars more than they would have otherwise.

KEY QUOTES

America’s Health Insurance Plans: Administration’s DOJ Decision Would “Cause Rates To Go Even Higher For Older Americans And Sicker Patients.” “Zeroing out the individual mandate penalty should not result in striking important consumer protections, such as guaranteed issue and community rating rules that help those with pre-existing conditions. Removing those provisions will result in renewed uncertainty in the individual market, create a patchwork of requirements in the states, cause rates to go even higher for older Americans and sicker patients, and make it challenging to introduce products and rates for 2019. Instead, we should focus on advancing proven solutions that ensure affordability for all consumers. [AHIP, 6/8/18]

Associated Press: Administration’s Decision Could “Nudge Premiums Even Higher.” “The Trump administration’s decision to stop defending in court the Obama health law’s popular protections for consumers with pre-existing conditions could prove risky for Republicans in the midterm elections — and nudge premiums even higher.” [CNBC, 6/8/18]

Timothy Jost, Washington & Lee University Law Professor: Administration’s Decision Could Leave Millions Of Americans Facing “Denial Of Coverage Or Higher Premiums.” “Yesterday, the Trump administration’s Department of Justice dropped a bombshell in a rural Texas federal courthouse. The administration stated in a court filing (and also in letters to Congressional leaders) that it would not defend three key provisions of the Affordable Care Act (ACA). If the judge in the case agrees, millions of Americans with preexisting conditions could face denial of coverage or higher premiums.” [Commonwealth Fund, 6/8/18]

Ceci Connolly, Alliance Of Community Health Plans: Administration’s Decision Decision Could Spark Fresh Market Instability. “Ceci Connolly, president of the Alliance of Community Health Plans, called the legal position ‘troubling’ and warned it could spark fresh market instability. ‘At the very least it adds uncertainty at exactly the moment when plans are trying to set rates for next year,’ Connolly said in a statement. ‘At the worst, it could strip away guaranteed coverage for those with pre-existing conditions. We don’t want to return to the days when people who needed the care the most could be turned away because of their health status.’” [Modern Healthcare, 6/8/18]

Fortune: If Administration’s Decision Is Implemented, “There’s A Strong Change Insurers Would Begin Charging Sicker People Significantly More.” “To date, many low-income people have been shielded from those increases since federal subsidies to help pay premiums rise in tandem with the spikes. Middle-class families who don’t qualify for the subsidies are left either swallowing the higher premiums or forgoing coverage. If the protections for people with pre-existing conditions are ultimately shot down, there’s a strong chance insurers would begin charging sicker people significantly more for their coverage while younger and healthier Americans would see lower prices.” [Fortune, 6/11/18]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

This Week in the War on Health Care

While the Supreme Court dominated the headlines , Republicans continued their unprecedented assault on the American health care system. Here’s a look back at what happened, plus highlights from three Senators who stood up for Americans’ care and two more polls that confirm Americans’ opposition to the GOP health care agenda.

NEW SUPREME COURT JUSTICE COULD HARM AMERICANS’ HEALTH CARE

Yesterday’s announcement that Justice Anthony Kennedy will retire at the end of this month came on the heels of Trump Department of Justice joining the lawsuit to overturn protections for the 130 million Americans with pre-existing conditions. Observers around the country took note, and pointed out that Trump’s next appointee, if confirmed, could tip the balance in terms of Americans’ access to affordable health care:

  • Modern Healthcare: Kennedy retirement could have “far-reaching consequences” on health care.
  • MedPage Today: Pre-existing condition case could swing due to Kennedy retirement.
  • Wall Street Journal: Some on Trump’s short list have already decided against Americans’ access to affordable health care.
  • New York Times: Kennedy retirement important due to “Trump Administration’s recent indication that it will use the courts to dismantle the law’s popular protections for people with pre-existing conditions.”

President Trump and Congressional Republicans already have voted to repeal health care protections and gone to court to overturn them. Senate Democratic Leader Chuck Schumer and House Democratic Leader Nancy Pelosi have called on their Congressional colleagues, as well as Americans of all stripes, to get involved in the fight to keep President Trump from from shoving another radical justice onto the Supreme Court who would side with insurance companies over the American people.

KENTUCKIANS AND FLORIDIANS BECOME THE LATEST VICTIMS OF GOP SABOTAGE

Relatedly, this week Kentuckians and Floridians became the latest Americans forced to bear the the cost of the GOP’s campaign to sabotage affordable health care, with preliminary rate filings for 2019 individual market plans indicating proposed increases as high as 30 percent. Why the leap?

CareSource Kentucky: Rates Going Up Because Of Individual Mandate Repeal. “Additionally, the removal of the individual mandate will increase the overall health risk of the Kentucky marketplace due to plan selection bias. Consumers with the greatest need for health insurance will tend to maintain coverage while healthier consumers may [forgo] coverage. Therefore CareSource will require an increase in premiums in order cover the expected increase in claims costs.” [CareSource, June 2019]

Cigna: “The Most Significant Factors Requiring The [30 Percent] Increase” Include “Elimination Of The Individual Mandate Penalties” And “Anticipated Changes To Regulations Regarding Short Term Medical And Association Health Plans That Will Impact The Affordable Care Act Risk Pool.”[Cigna, 6/20]

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 Kentucky and Florida 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 Americans.

ALEX AZAR TESTIFIES, DUCKS QUESTIONS ON AMERICANS’ HEALTH CARE PROTECTIONS

On Tuesday, Alex Azar testified before the Senate Finance Committee as his Department, attempting to defend junk plans and failing to address the skyrocketing cost of prescription drugs, all while his Administration argued in court that insurance companies should once again discriminate against people with pre-existing conditions. Among the questions he refused to answer:

  1. Why haven’t you spoken up to defend people with pre-existing conditions from the Justice Department’s threat?
  2. Will your reverse your stated opposition and support President Trump’s campaign-trail promise on drug cost negotiation?
  3. Insurance companies are citing your Administration’s sabotage as the reason for premium increases, the same argument Tom Price made. Isn’t the tax bill is driving up insurance costs?
  4. Can you estimate how many people with pre-existing conditions will be excluded from coverage under junk plans?
  5. If you finalize the junk plan rule, will you take action to ensure these products must cover essential health care services, such as hospitalization and maternity care?

There was one issue in particular Azar did take a stand on, however, and Senators did not miss it…

SENATE DEMOCRATS HAMMER AZAR OVER PRE-EXISTING CONDITION PROTECTIONS

While Azar re-affirmed his Administration’s support for eroding protections for the 130 million Americans who have pre-existing conditions, Senators Ron Wyden (D-OR), Bob Casey (D-PA), and Claire McCaskill (D-MO) were quick to make known just how much harm this decision would cause. Take a look:

TWO MORE POLLS AFFIRM AMERICANS’ OPPOSITION TO GOP HEALTH CARE AGENDA

And finally, two more polls underscoring Americans’ support for health care access and opposition to the GOP’s repeal and sabotage agenda were released this week.

Yesterday, the Kaiser Family Foundation released its June tracking poll, showing that health care remains a top issue among voters and that protecting provisions preventing discrimination against those with pre-existing conditions is one of their highest priorities. Among its key findings:

  • Seventy-nine percent of those surveyed say health care is an important issue in the midterms;
  • Three-fourths of those surveyed say continued protections for the 130 million Americans with pre-existing conditions is “very important” to them, including 88 percent of Democrats, 77 percent of Independents, and 58 percent of Republicans, and
  • Six in 10 say they or someone in their household suffers from a pre-existing medical condition, demonstrating just how important this issue is.

Additionally, new national survey found that the lawsuit filed by Republican state attorneys general seeking to invalidate key consumer protections in the Affordable Care Act is likely to be a serious and significant self-inflicted wound for the GOP. Among its key findings:

  • Two-thirds of all voters nationwide disapprove of the Trump Justice Department’s decision to support the lawsuit, with nearly half of all voters strongly disapproving;
  • Overwhelming majorities of both Democrats (87%) and independents (72%) disapprove of the Trump administration’s actions; and
  • When asked earlier in the survey which party is more likely to ‘make sure people with preexisting medical conditions can get affordable insurance coverage,’ respondents choose Democrats over Republicans by a 63-37 margin.

With Congress returning home for the July 4th recess, Americans are sure to continue to make their voices on health care clear.

“Justice Joins The Partisans”: Editorial Boards Across the Country Hammer Republicans’ Attack on Protections for 130 Million Americans With Pre-Existing Conditions

Earlier this month, the Trump Administration made the shocking decision to go to court to overturn protections allowing 130 million Americans with pre-existing conditions to buy affordable health insurance. Following Republicans in Congress voting to repeal these protections, Trump joined a partisan lawsuit filed by 18 Republican state attorneys general and two Republican governors that would do just that. The lawsuit is wildly unpopular with the American public, with a new poll showing voters reject the move by a 2-1 margin.

Here’s what editorial boards around the country have been saying about the ongoing lawsuit, Texas v. United States:

Houston Chronicle: Texas Lawsuit To Kill Obamacare Will Claim Other Victims. “Trump’s Justice Department is supporting efforts by 20 states, including Texas, to strangle the Affordable Care Act. Killing Obamacare would keep a promise Trump made to a constituency he believes will win him a second term. The millions who will lose health coverage if Obamacare dies would be collateral damage to him… People with pre-existing conditions not only include those with epilepsy, cancer and diabetes, it could include pregnant women who didn’t already have insurance. Denying coverage to cancer patients and pregnant women or charging them exorbitant rates would be despicable… Texans have a lot to lose in this fight over health care. We need to let [Attorney General Ken Paxton] and [Senator Ted Cruz] know they are on the wrong side of a deadly proposition.” [Houston Chronicle, 6/24]

Fort Wayne Journal Gazette: Obamacare Dismantling Would Hit Hoosiers Hard. “It wasn’t that long ago that people could lose their health insurance coverage or be denied the opportunity to purchase a new policy because of a pre-existing condition. The Affordable Care Act put an end to such often-devastating outcomes. Now it’s possible America could return to those bad old days. If that happens, the Indiana attorney general’s office will be among the entities responsible… If Hill and his colleagues prevail, it could take America back to the days when people with cancer, diabetes, asthma or other long-term illnesses could once again find themselves unable to obtain health insurance, at least at a price they could afford to pay. According to Kaiser, that could include at least 30 percent of our state’s non-elderly adults – 1.175 million Hoosiers.” [Journal Gazette, 6/17]

Orlando Sentinel: Florida’s Attorney General Puts Partisan Loyalty Over Health Care For 1.7 Million Floridians. “If the lawsuit prevails, Obamacare’s core guarantee — access to health insurance for Americans with pre-existing conditions — will disappear, along with other provisions in the law. This is a serious threat for Florida, where 1.7 million people enrolled in the federal health-insurance exchange last year to buy policies under the law. More than 90 percent of them received federal subsidies to lower their cost for premiums. Taking aim at the law, when there is no backup in place, is a reckless partisan act by Bondi that mocks the description of her in her official biography as ‘an advocate for Florida’s consumers’ who has ‘worked tirelessly to protect the rights and safety of Floridians.’ The lawsuit demonstrates more loyalty to her two dozen pals in the Republican Attorneys General Association than those 1.7 million Floridians.” [Orlando Sentinel, 6/20]

Akron Beacon Journal: Justice Joins The Partisans In Another Attack On The Affordable Care Act. “Polls consistently show that Republicans and Democrats agree about the need to protect the health coverage of those Americans with pre-existing conditions. For all the division over the Affordable Care Act, both sides favor its provision barring insurers from denying coverage based on a person’s health status or medical history… What Justice now has embraced is another partisan effort to weaken the Affordable Care Act, though Republicans failed to advance a workable alternative. Recall that President Trump described the protection for pre-existing conditions as one of the law’s ;strongest assets.’ Now he wants to see its demise? Recall, too, that there is bipartisan support for repairing flaws in the act, providing certainty for those with pre-existing conditions and others in need of adequate and affordable health coverage.” [Beacon Journal, 6/26]

Gainesville Sun: Fight Efforts To Sabotage Health Care. “In the upcoming federal and state elections, voters should cast their ballots like their health care depends on it. For those with preexisting conditions, that certainly is the case. The Trump administration is now arguing in court that the Affordable Care Act’s requirement that insurers cover preexisting conditions is invalid, along with other parts of the law. It is the latest move by the administration to sabotage the ACA, following the repeal of the individual mandate in last year’s tax-cut legislation. The repeal and other changes approved by the administration are driving up insurance costs, threatening the health coverage of the 1.7 million Floridians and others who have obtained coverage through the federal marketplaces… We need lawmakers that push back on the Trump administration’s efforts to dismantle the Affordable Care Act, not facilitate them further.” [Gainesville Sun, 6/17]

Minneapolis Star Tribune: States Launch Another Harmful Attack On The Affordable Care Act. “If courts eventually buy the case’s reasoning, then it is goodbye to the ACA components that have helped a lot of people. Among them: the premium assistance subsidies, the expanded eligibility for the publicly-run Medicaid program and the provision allowing young adults to stay on their parents’ health insurance until age 26. Also gone: the protections for those who have pre-existing medical conditions, though a few states like Minnesota may still have some state-level safeguards in place. Before the ACA, insurers on the individual market — which serves people who don’t have insurance through their jobs or a public program such as Medicare — didn’t have to cover people with asthma, diabetes, cancer or myriad other conditions. Returning to an era when sick people were priced out of coverage or barred by insurers from buying it is unacceptable.”[Star Tribune, 6/13]

Scranton Times-Tribune: Pre-Existing Misfeasance. “The Trump administration imperiled access to health care for millions of Americans last week when it declined to defend in court the Affordable Care Act’s provision that health insurers may not deny coverage based on pre-existing conditions… The Kaiser Family Foundation estimates that 27 percent of people younger than 65 (Medicare coverage age) have a pre-existing condition that would affect their insurance access or cost. Whatever the controversies that have plagued the ACA, coverage regardless of pre-existing conditions is its most popular feature. Kaiser polling consistently has shown it to have an 70 percent approval rating among all Americans, including 59 percent of Republicans. This is another case of the administration hewing to a narrow base, even at the expense of health care for millions… Americans want coverage regardless of pre-existing conditions, and Congress should ensure that they have access to it.” [Times-Tribune, 6/10]

St. Louis Post Dispatch: Health Care Issue Isn’t Dead, Though GOP Is Trying. “One of Obamacare’s most popular provisions says that the 52 million non-elderly American adults with pre-existing conditions can’t be denied coverage or charged more for it. In a 2017 Kaiser Family Foundation poll, 84 percent of Democrats, 68 percent of independents and 59 percent of Republicans favored guaranteed coverage for pre-existing conditions. However, the tax-cut bill enacted in December eliminated Obamacare’s penalty for failing to purchase health insurance. The end of the so-called individual mandate caused 20 Republican state attorneys general to again challenge the overall constitutionality of Obamacare’s consumer protections, including coverage of pre-existing conditions. The Justice Department chimed in to agree. A final court decision on the challenge could be years away. In the meantime, voters with pre-existing conditions might want to factor it into their decisions in November.” [Post Dispatch, 6/25]

Seattle Times: Affordable Care Act Is Worth Saving. “This month, the Justice Department announced it would stop defending the ACA’s pre-existing conditions protections in court. Insurance companies may start refusing to insure people who have already been diagnosed with cancer or diabetes, for example, and not worry about facing government legal action… [This] attack pushes the ACA further onto shaky ground — and for no good reason.” [Seattle Times, 6/18]

Supreme Court Vacancy Puts Pre-Existing Conditions on the Chopping Block

President Trump promised to have “a very strong test” for his Supreme Court nominees, and that test is whether they’re prepared to:

  • Allow insurance companies to deny coverage to people with pre-existing conditions;
  • Make the cost of premiums, copays, deductibles and prescription drugs higher; and
  • Charge people age 50 and older more for their plans by overturning the consumer protections and market reforms in the Affordable Care Act.

If the Senate does not intervene, the balance of the Court could turn against the 130 million Americans with pre-existing conditions, and millions more. Don’t believe us? Just take a look.

Modern Healthcare: Kennedy Retirement Could Have “Far-Reaching Consequences” On Health Care. “U.S. Supreme Court Justice Anthony Kennedy, 81, retired Wednesday, setting in motion a shakeup of the high court that could have far-reaching consequences on issues like abortion and healthcare.” [Modern Healthcare, 6/27]

WNPR: Pivotal Court Case Could Determine The Future Of The Affordable Care Act. “President Donald Trump has tried to fulfill a key campaign promise of repealing the ACA since he became president. So far, efforts to do that in Congress have largely been in vain. […] ‘The administration’s entire strategy is do whatever it can outside of Congress,’” a legal scholar points out. [WNPR, 6/28]

MedPage Today: Pre-Existing Condition Case Could Swing Due To Kennedy Retirement. “It’s possible that an ongoing Texas case questioning the viability of the Affordable Care Act may also make it to the court eventually.” [MedPage Today, 6/27]

ABC News: Kennedy Supported ACA, Subsidies Allowing Low-Income Americans To Obtain Insurance. “That same year, Kennedy voted to uphold a key component of the 2010 Affordable Care Act, also known as Obamacare, allowing the federal government to provide nationwide tax subsidies to help Americans buy health insurance.” [ABC News, 6/27]

Some On Trump’s Short List Have Already Decided Against Americans’ Access to Affordable Health Care. “In 2011, [Steven Colloton] voted[…] to side with religious nonprofits challenging the Affordable Care Act’s rules for contraceptive coverage.” [WSJ, 6/27]

New York Times: Kennedy Retirement Important Due To “Trump Administration’s Recent Indication That It Will Use The Courts To Dismantle The Law’s Popular Protections For People With Pre-Existing Conditions.” [NYT, 6/27]

Fortune: Retirement Could Affect The Future Of Abortion Rights, ACA. “Kennedy was seen as a firewall against efforts to dismantle abortion rights enshrined under the landmark Roe v. Wade decision in the 1970s—and anti-abortion groups are already gearing up to challenge abortion laws across the country in the wake of Kennedy’s retirement, which could potentially have an effect on other health care-related issues such as the future of the Affordable Care Act.” [Fortune, 6/27]

Kennedy Retirement Elevates Threat Against 130 Million Americans With Pre-Existing Conditions

Washington, D.C. – Protect Our Care Executive Director Brad Woodhouse released the following statement after the announcement of a vacancy on the Supreme Court. Last month, President Trump joined a lawsuit to overturn protections of health care for the 130 million Americans with pre-existing conditions.

“Donald Trump and Congressional Republicans have voted to repeal health care protections and gone to court to overturn them, but they must be stopped from shoving another radical right-wing justice onto the Supreme Court who will join in their crusade against our care. The Trump Administration is explicitly asking the court to overturn protections for the 130 million Americans with pre-existing conditions, and now it is every Senator’s responsibility to stand against any appointee who would vote to strip away these critical health protections for hundreds of millions of Americans.”

Post-DOJ Poll Finds Rock-Solid Support for Pre-Existing Protections

This morning’s Kaiser Family Foundation tracking poll finds that health care remains a top issue among voters and that protecting provisions preventing discrimination against those with pre-existing conditions is one of their highest priorities.

This poll is the third one released in recent weeks showing that health care remains the top issue for voters, and the second one released in a week’s time showing that efforts by the Trump administration and Republicans in Congress and in the states to reverse protections for people with pre-existing conditions are deeply unpopular.

Among the key findings in today’s Kaiser Family Foundation poll:

  • 79 percent of those surveyed say health care is an important issue in the midterms.
  • Fully three-fourths (76 percent) say continued protections for the 130 million Americans with pre-existing conditions is “very important” to them, including nine in 10 Democrats (88 percent), 77 percent of Independents, and 58 percent of Republicans – just as the Trump Administration made the shocking decision to join 18 Republican attorneys general and two Republican governors try to overturn these protections.

  • Six in 10 (57 percent) say they or someone in their household suffers from pre-existing medical conditions, demonstrating just how deeply motivating this issue is for voters.

This poll is the third one released in recent weeks showing that health care remains the top issue for voters.

  • A June 2018 Poll From Reuters Confirms That Americans Approve Of ACA, Are Concerned About Cost Of Health Care. Among its key findings:
    • 65 percent of Americans polled said they are “very concerned” about the overall cost of health insurance, including premiums, deductibles and copays. [Reuters, 6/15]
    • Nearly three in four Americans use prescription drugs, and 58 percent said they are “very concerned” about paying for them. [Reuters, 6/15]
    • 66 percent of those polled said they are concerned about their ability to see the doctor of their choice going forward. [Reuters, 6/15] 
  • A June 2018 NBC News Poll Finds Health Care To Be Top Midterm Issue. “Asked about their top issues for November, 22 percent of voters said health care was their first choice — followed by the economy and jobs at 19 percent, guns at 13 percent, taxes and spending at 11 percent and immigration at 10 percent.” [NBC News, 6/7] 
  • A May 2018 CBS News Poll Found that Health Care Is The Most Important Issue to Voters When Deciding Their Congressional Vote In November. In a May CBS poll, when asked which issue would be the most important in deciding a vote for Congress in November, more voters selected health care than any other issue. [CBS News, 5/6]

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

Washington, D.C. – As preliminary Florida rate filings for 2019 individual-market health insurance indicated potential double-digit premium increases due to Washington Republicans’ repeal-and-sabotage agenda, Protect Our Care Executive 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 Florida 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 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 Floridians.”

From the Insurance Companies:

Cigna: “The Most Significant Factors Requiring The [30 Percent] Increase” Include “Elimination Of The Individual Mandate Penalties” And “Anticipated Changes To Regulations Regarding Short Term Medical And Association Health Plans That Will Impact The Affordable Care Act Risk Pool.” [Cigna, 6/20]

Insurance Companies Cumulatively Requesting An 8.8 Percent Premium Increase. “In all, rate increases proposed by eight companies offering ACA-compliant plans on and off of the exchange, average 8.8 percent, according to a news release by the state office late Friday afternoon…Not yet known is how ongoing Trump Administration efforts will affect the future viability of the marketplace, such as repeal of the individual mandate, a requirement that nearly all individuals buy health insurance or face tax penalties.” [Sun Sentinel, 6/22]

Why Floridians’ 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 Florida forecast double-digit percent 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. In Florida, no short-term plans available have to cover maternity care, and only 33 percent of plans cover prescription drugs.

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 percent, and 41 percent in Florida.

  • 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 Florida by an average 16.9 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 Floridians’ care.

  • 1,715,227 Floridians signed up for Marketplace coverage this year.
  • Thanks to the Marketplace, Florida’s uninsured rate fell by 7.5 percent between 2013 and 2016 as Floridians have gained access to affordable coverage.
  • Before today’s announcement, the Urban Institute predicted that Florida premiums for 2019 could rise 16.9 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 91 percent of Florida Marketplace consumers, whose average 2018 premium is $70 per month.
  • But because of the Republican sabotage agenda, many middle-income Floridians could pay hundreds or thousands of dollars more than they would have otherwise.

Floridians 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

America’s Health Insurance Plans: Trump Administration’s DOJ Decision Would “Cause Rates To Go Even Higher For Older Americans And Sicker Patients.” “Zeroing out the individual mandate penalty should not result in striking important consumer protections, such as guaranteed issue and community rating rules that help those with pre-existing conditions. Removing those provisions will result in renewed uncertainty in the individual market, create a patchwork of requirements in the states, cause rates to go even higher for older Americans and sicker patients, and make it challenging to introduce products and rates for 2019. Instead, we should focus on advancing proven solutions that ensure affordability for all consumers. [AHIP, 6/8/18]

Associated Press: Administration’s Decision Could “Nudge Premiums Even Higher.” “The Trump administration’s decision to stop defending in court the Obama health law’s popular protections for consumers with pre-existing conditions could prove risky for Republicans in the midterm elections — and nudge premiums even higher.” [CNBC, 6/8/18]

Timothy Jost, Washington & Lee University Law Professor: Administration’s Decision Could Leave Millions Of Americans Facing “Denial Of Coverage Or Higher Premiums.” “Yesterday, the Trump administration’s Department of Justice dropped a bombshell in a rural Texas federal courthouse. The administration stated in a court filing (and also in letters to Congressional leaders) that it would not defend three key provisions of the Affordable Care Act (ACA). If the judge in the case agrees, millions of Americans with preexisting conditions could face denial of coverage or higher premiums.” [Commonwealth Fund, 6/8/18]

Ceci Connolly, Alliance Of Community Health Plans: Administration’s Decision Decision Could Spark Fresh Market Instability. “Ceci Connolly, president of the Alliance of Community Health Plans, called the legal position ‘troubling’ and warned it could spark fresh market instability. ‘At the very least it adds uncertainty at exactly the moment when plans are trying to set rates for next year,’ Connolly said in a statement. ‘At the worst, it could strip away guaranteed coverage for those with pre-existing conditions. We don’t want to return to the days when people who needed the care the most could be turned away because of their health status.’” [Modern Healthcare, 6/8/18]

Fortune: If Administration’s Decision Is Implemented, “There’s A Strong Change Insurers Would Begin Charging Sicker People Significantly More.” “To date, many low-income people have been shielded from those increases since federal subsidies to help pay premiums rise in tandem with the spikes. Middle-class families who don’t qualify for the subsidies are left either swallowing the higher premiums or forgoing coverage. If the protections for people with pre-existing conditions are ultimately shot down, there’s a strong chance insurers would begin charging sicker people significantly more for their coverage while younger and healthier Americans would see lower prices.” [Fortune, 6/11/18]

America’s Health Insurance Plans: Administration’s DOJ Decision Would “Cause Rates To Go Even Higher For Older Americans And Sicker Patients.” “Zeroing out the individual mandate penalty should not result in striking important consumer protections, such as guaranteed issue and community rating rules that help those with pre-existing conditions. Removing those provisions will result in renewed uncertainty in the individual market, create a patchwork of requirements in the states, cause rates to go even higher for older Americans and sicker patients, and make it challenging to introduce products and rates for 2019. Instead, we should focus on advancing proven solutions that ensure affordability for all consumers. [AHIP, 6/8/18]

Associated Press: Administration’s Decision Could “Nudge Premiums Even Higher.” “The Trump administration’s decision to stop defending in court the Obama health law’s popular protections for consumers with pre-existing conditions could prove risky for Republicans in the midterm elections — and nudge premiums even higher.” [CNBC, 6/8/18]

Timothy Jost, Washington & Lee University Law Professor: Administration’s Decision Could Leave Millions Of Americans Facing “Denial Of Coverage Or Higher Premiums.” “Yesterday, the Trump administration’s Department of Justice dropped a bombshell in a rural Texas federal courthouse. The administration stated in a court filing (and also in letters to Congressional leaders) that it would not defend three key provisions of the Affordable Care Act (ACA). If the judge in the case agrees, millions of Americans with preexisting conditions could face denial of coverage or higher premiums.” [Commonwealth Fund, 6/8/18]

Ceci Connolly, Alliance Of Community Health Plans: Administration’s Decision Decision Could Spark Fresh Market Instability. “Ceci Connolly, president of the Alliance of Community Health Plans, called the legal position ‘troubling’ and warned it could spark fresh market instability. ‘At the very least it adds uncertainty at exactly the moment when plans are trying to set rates for next year,’ Connolly said in a statement. ‘At the worst, it could strip away guaranteed coverage for those with pre-existing conditions. We don’t want to return to the days when people who needed the care the most could be turned away because of their health status.’” [Modern Healthcare, 6/8/18]

Fortune: If Administration’s Decision Is Implemented, “There’s A Strong Change Insurers Would Begin Charging Sicker People Significantly More.” “To date, many low-income people have been shielded from those increases since federal subsidies to help pay premiums rise in tandem with the spikes. Middle-class families who don’t qualify for the subsidies are left either swallowing the higher premiums or forgoing coverage. If the protections for people with pre-existing conditions are ultimately shot down, there’s a strong chance insurers would begin charging sicker people significantly more for their coverage while younger and healthier Americans would see lower prices.” [Fortune, 6/11/18]

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]

 

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]

 

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]

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]

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]

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]

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]

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]

CareFirst Blue Cross Blue Shield CEO: 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]

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]

Six Simple Questions For Secretary Azar on Health Care

Tomorrow, President Trump’s HHS chief, ex-pharmaceutical executive Alex Azar, will testify before the Senate Finance Committee amidst a swirl of controversy. With his Department pushing junk plans and failing to address the skyrocketing cost of prescription drugs, all while his Trump Administration argues in court that insurance companies should once again discriminate against people with pre-existing conditions, Secretary Azar has a lot answer for.

  1. The Trump Administration says it supports lowering prescription drug prices, despite its actions. The best way to keep drug prices down is to let Medicare directly negotiate with drug companies. Will Secretary Azar reverse his stated opposition and support President Trump’s campaign-trail promise on drug cost negotiation?

  2. The Department of Justice recently announced that it would no longer defend the Affordable Care Act in court and even argued that the courts should repeal the ACA’s protections for people with pre-existing conditions. Why hasn’t Secretary Azar spoken up to defend people with pre-existing conditions from the Justice Department’s threat?

  3. Insurance companies want to hike premium rates by double digits all across the country and they are citing your Administration’s sabotage as the reason. This is the same argument Azar’s predecessor, former HHS Secretary Tom Price made. Isn’t he right to say the tax bill is driving up insurance costs?

  4. Association health plans and short-term health plans allow insurance companies to discriminate against people with pre-existing conditions, and to charge sick people more for the same coverage. Can Secretary Azar estimate how many people with pre-existing conditions will be excluded from junk plans?

  5. HHS is now pushing junk plans that are often exempt from covering essential health benefits such as maternity care, substance abuse treatment, and prescription drugs. Experts warn these plans will drive up the cost of comprehensive care. If you finalize the junk plan rule, will you take action to ensure these products must cover essential health care services, such as hospitalization and maternity care?

  6. Your Department’s cuts to health care outreach were estimated to prevent more than 1 million Americans from signing up for care for 2018. Looking ahead to next year, will you commit the resources to make sure everyone has access to the support they need to sign up for health care this open enrollment period?

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

Washington, D.C. – As preliminary Kentucky rate filings for 2019 individual-market health insurance indicated another round of premium increases due to Washington Republicans’ repeal-and-sabotage agenda, Protect Our Care Executive 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 Kentucky are being asked to pay the price. Until we stop Washington Republicans’ attacks on health care, experts predict that rates will keep rising by double digits. Washington 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 Kentuckians.”

From the Insurance Companies:

CareSource Kentucky: Rates Going Up Because Of Trump/GOP Repeal Of Individual Mandate. “Additionally, the removal of the individual mandate will increase the overall health risk of the Kentucky marketplace due to plan selection bias. Consumers with the greatest need for health insurance will tend to maintain coverage while healthier consumers may forgoe coverage. Therefore CareSource will require an increase in premiums in order cover the expected increase in claims costs.” [CareSource, June 2019]

Why Kentuckians’ 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 Kentucky forecast double-digit 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. In Kentucky, no short-term plans available have to cover maternity care, and only 37 percent of plans cover prescription drugs.

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 percent, and 50 percent in Kentucky.

  • 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 Kentucky by an average 18.7 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 Kentuckians’ care.

  • 89,569 Kentuckians signed up for Marketplace coverage this year.
  • Thanks to the Marketplace and Medicaid expansion, Kentucky’s uninsured rate fell by 9.1 percent between 2013 and 2016 as Kentuckians have gained access to affordable coverage.
  • Before today’s announcement, the Urban Institute predicted that Kentucky premiums for 2019 could rise 18.7 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 76 percent of Kentucky Marketplace consumers, whose average 2018 premium is $124 per month.
  • But because of the Republican sabotage agenda, many middle-income Kentuckians could pay hundreds or thousands of dollars more than they would have otherwise.

Kentuckians 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

America’s Health Insurance Plans: Administration’s DOJ Decision Would “Cause Rates To Go Even Higher For Older Americans And Sicker Patients.” “Zeroing out the individual mandate penalty should not result in striking important consumer protections, such as guaranteed issue and community rating rules that help those with pre-existing conditions. Removing those provisions will result in renewed uncertainty in the individual market, create a patchwork of requirements in the states, cause rates to go even higher for older Americans and sicker patients, and make it challenging to introduce products and rates for 2019. Instead, we should focus on advancing proven solutions that ensure affordability for all consumers. [AHIP, 6/8/18]

Associated Press: Administration’s Decision Could “Nudge Premiums Even Higher.” “The Trump administration’s decision to stop defending in court the Obama health law’s popular protections for consumers with pre-existing conditions could prove risky for Republicans in the midterm elections — and nudge premiums even higher.” [CNBC, 6/8/18]

Timothy Jost, Washington & Lee University Law Professor: Administration’s Decision Could Leave Millions Of Americans Facing “Denial Of Coverage Or Higher Premiums.” “Yesterday, the Trump administration’s Department of Justice dropped a bombshell in a rural Texas federal courthouse. The administration stated in a court filing (and also in letters to Congressional leaders) that it would not defend three key provisions of the Affordable Care Act (ACA). If the judge in the case agrees, millions of Americans with preexisting conditions could face denial of coverage or higher premiums.” [Commonwealth Fund, 6/8/18]

Ceci Connolly, Alliance Of Community Health Plans: Administration’s Decision Decision Could Spark Fresh Market Instability. “Ceci Connolly, president of the Alliance of Community Health Plans, called the legal position ‘troubling’ and warned it could spark fresh market instability. ‘At the very least it adds uncertainty at exactly the moment when plans are trying to set rates for next year,’ Connolly said in a statement. ‘At the worst, it could strip away guaranteed coverage for those with pre-existing conditions. We don’t want to return to the days when people who needed the care the most could be turned away because of their health status.’” [Modern Healthcare, 6/8/18]

Fortune: If Administration’s Decision Is Implemented, “There’s A Strong Change Insurers Would Begin Charging Sicker People Significantly More.” “To date, many low-income people have been shielded from those increases since federal subsidies to help pay premiums rise in tandem with the spikes. Middle-class families who don’t qualify for the subsidies are left either swallowing the higher premiums or forgoing coverage. If the protections for people with pre-existing conditions are ultimately shot down, there’s a strong chance insurers would begin charging sicker people significantly more for their coverage while younger and healthier Americans would see lower prices.” [Fortune, 6/11/18]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]