October 2018

Rep. Lou Barletta is claiming that Sen. Casey distorted his record on gutting protections for 5.3 million Pennsylvanians with pre-existing conditions using a Washington Post fact check as evidence.

However, Sen. Casey is correct. The American Health Care Act Barletta voted for would have gutted the protections for people with pre-existing conditions. And he repeatedly voted to repeal the entire Affordable Care Act.

The Washington Post fact check leaves out some important context.

• Sen. Casey said all 5.3 million Pennsylvanians with pre-existing conditions could be “at risk” of losing protections. He was right. While the Washington Post correctly claims the changes to protections for people with pre-existing conditions would mostly impact people in the individual market, it fails to measure who would be “at risk.” The Department of Health and Human Services releases a report citing up to 130 million Americans had a pre-existing condition. That includes as many as 5.3 million Pennsylvanians. The Fact Checker has cited these numbers before. If someone in the employer market were to lose their job, or decide to start a business, or had their employer drop their coverage, they would most likely find insurance on the individual market and would be subject to gutted protections under the AHCA.
• The AHCA impacted the employer market too. Another provision of the AHCA would have allowed states to allow insurers to waive the “essential health benefits” under the Affordable Care Act like maternity care, hospitalizations and prescription drugs, which apply to small business plans. Additionally, it would have allowed insurers to impose lifetime and annual limits on this coverage even for people in the employer based market, including for people with pre-existing conditions.
• Rep. Barletta has voted to repeal the entire Affordable Care Act. Rep. Barletta voted at least two times to repeal the entire Affordable Care Act which would have repealed protections for people with pre-existing conditions. In other words, he voted to allow insurance companies to deny coverage to people with pre-existing conditions.
• Rep. Barletta voted for the tax bill that is the basis of a lawsuit to take away protections for people with pre-existing conditions. He has refused to renounce the lawsuit. In addition, Barletta voted for the tax bill that essentially eliminated the penalty for the individual mandate. Republicans in 20 states have used this as a basis to ask the courts to overturn the entire Affordable Care Act, including the protections for people with pre-existing conditions. Barletta has refused to denounce the lawsuit.

Rep. Barletta can try to rewrite his record all he wants but it doesn’t change the fact that his vote to gut protections for people with pre-existing conditions put everyone at risk.

Washington, DC – In response to the breaking news that Idaho’s Republican Governor C.L. “Butch” Otter has endorsed the Medicaid Expansion ballot initiative before voters in his state, Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

“Governor Otter came out today to endorse Medicaid expansion in Idaho because it’s simply the right thing to do for the people of Idaho. As Republican politicians across the country and the Trump Administration have worked to dismantle and defund Medicaid — and smear the millions of children, families and seniors who rely on the program — Medicaid has only grown in popularity. Republicans who still stubbornly oppose Medicaid expansion — be those gubernatorial candidates like Scott Walker or Ron DeSantis, or Senate candidates like Mitt Romney — are on the wrong side health care, the wrong side of voters, and the wrong side of history.”

MEDICAID EXPANSION IS A DEFINING ISSUE IN GOVERNOR’S RACES ACROSS THE COUNTRY

In Georgia, Democratic Candidate Stacy Abrams Has Said The First Thing She Would Do Is Expand Medicaid. “Democratic candidate Stacey Abrams has said the first thing she would do as governor is expand Medicaid. That’s the decision each state can make to give more low-income people access to health care. States receive federal funding for it, though they, too, have to pay into the program. ‘And you’ll hear me talk about this ad nauseam because it’s the only answer to Georgia’s challenges,’ Abrams said at a health care policy press conference Monday. ‘We have an uncompensated care rate of $1.7 billion.’…Republican Gov. Nathan Deal has refused to expand the program in Georgia, and Republican candidate Brian Kemp said he wouldn’t expand it either. ‘Government programs that aren’t working now are not a reason to give them more money,’ Kemp said at an event last week. Kemp said, instead, he favors opening up the private sector market to more competition to lower health care costs.” [WABE, 9/12/18]

In Florida, Andrew Gillum is running on Medicaid Expansion, with polling showing Floridians want to expand Medicaid. “According to new data from the left-leaning think tank Data for Progress, an estimated 65 percent of Florida voters support expanding Medicaid across the state — and, amazingly, voters in every legislative or congressional district from the Keys all the way up to the Panhandle support the idea.” [Miami New Times, 5/25/18]

In Ohio, Cordray Blasts DeWine, Who Flip-Flopped on Medicaid Expansion because it is so Popular. “Cordray also dinged DeWine on Ohio’s Medicaid expansion, which provides health coverage to nearly 700,000 Ohioans. Republican Gov. John Kasich has ‘done some things that are very good for Ohio,’ Cordray said. ‘He had real courage on the Medicaid expansion, bringing that to Ohio and fighting the naysayers in his own party who said, ‘Gee, that’s part of Obamacare.’ And my opponent was part of those naysayers.’ DeWine now says he’ll keep the expansion. But Eck didn’t answer a question asking why, if he favored it, DeWine repeatedly sued to kill the law that made it possible.” [Columbus Dispatch, 9/20/18]

In Wisconsin, Democratic Challenger Tony Evers Targets Scott Walker For Not Taking Federal Medicaid Expansion. “Evers made health care the focus of his only television ad to date, faulting Walker for not taking the federal Medicaid expansion and pointing out that the cost of an average health insurance plan sold on the private market this year in Wisconsin was more expensive than in Minnesota. Walker argues the ad is misleading and health insurance costs will decrease in Wisconsin once a recently approved reinsurance program takes effect.” [Minneapolis Star Tribune, 9/7/18]

In Michigan, Candidates Gretchen Whitmer (D) and Bill Schuette (R) Spar Over Medicaid Expansion. “As attorney general, Schuette joined at least nine lawsuits fighting the Affordable Care Act. In a 2017 fundraising mailer, he said he opposed the law, ‘including the ‘free’ federal Medicaid dollars from Obama that leave Michigan taxpayers on the hook for more!’ ‘He has been the chief advocate against Healthy Michigan in our state ever since we started the bipartisan negotiations on it,” Whitmer told The Detroit News. ‘The biggest threat to health care in Michigan is Bill Schuette.’ But the Medicaid expansion program is threatened by declining federal aid, Schuette notes. The federal government fully funded the Medicaid expansion program the first three years, but the state began paying a share in 2017 and will be required to cover 10 percent of the costs by 2020. By then, it’s estimated to cost the state roughly $380 million a year.” [Detroit News, 9/18/19]

In Tennessee, Karl Dean is Running on Medicaid Expansion, with Polls Showing Voters Support it Strongly. “The poll, conducted by Mason-Dixon Polling & Research in April, showed 63 percent support Medicaid expansion with the use of federal funds to 21 percent against and 16 percent undecided.” [Nashville Tennessean, 5/7/18]

In Idaho, Democratic Candidate Paulette Jordan is a Supporter of Prop 2 (Medicaid Expansion). Her opponent, Lt. Gov. Brad Little has declined to say whether he will vote for the initiative but said if elected governor, he would respect the will of the voters if they pass Medicaid expansion. [KTVB, 10/29/18]

In Alabama, Democratic Challenger Walt Maddox Is Running On Medicaid Expansion. “The Democratic nominee began the tour in Tuscaloosa where he is mayor. Describing himself as the only candidate in the race talking about the state’s “big problems”, Maddox is running on a platform of establishing a state lottery to fund education programs and expanding Medicaid. Standing with his wife, Stephanie and his two children, Maddox said the race is about ensuring the state’s children have opportunities.” [Associated Press, 9/17/18]

As momentum builds to maintain protections for people with pre-existing conditions, Republicans have taken to covering up their records by trying to portray themselves as defenders of people with pre-existing conditions even as they continue efforts to demolish the very protections they claim to support. Across the country, the media have caught on to their plan.

Republicans’ claims have been fact-checked:

NBC News Fact Check Of Trump Claim That He Supports People With Pre-existing Conditions: “This Is False.” “‘We totally support people with pre-existing conditions,’ Trump said at the White House last week. This is false. The Trump administration is backing a Republican-led lawsuit that claims Obamacare’s protections for pre-existing conditions are illegal. If the suit succeeds, insurers would be able to start denying coverage to those people. The White House has not proposed alternative legislation that would offer those with pre-existing conditions the protections Obamacare gives consumers.” [NBC News, 10/23/18]

New York Times Fact Check: Trump Claims To Protect Pre-existing Health Conditions. That’s Not What The Government Says. “At a campaign rally in Las Vegas, President Trump said that he and Republicans “will protect patients with pre-existing conditions.” But his Justice Department has said that those provisions under the Affordable Care Act should be overturned.” [New York Times, 10/21/18]

And outlets have called out Republicans’ attempts to hide the truth:

Washington Post Editorial: “It’s The Height Of Free-Lunch Irresponsibility For Republicans To Suggest That Consumers Could Have Mandatory Coverage For Preexisting Conditions Otherwise.” “It’s the height of free-lunch irresponsibility for Republicans to suggest that consumers could have mandatory coverage for preexisting conditions otherwise. It was already the height of hypocrisy for them to render Obamacare’s individual market less stable — then pledge to keep the part of it everyone likes. As the saying goes, though, hypocrisy is the compliment vice pays to virtue.” [Washington Post, 10/22/18

Time Magazine on Trump’s Pre-existing Conditions Statements: “To Say That These Claims Are Fantastical Is Almost An Understatement.” “In recent days, Trump has responded by making two bold pronouncements that have little grounding in the facts: that Republicans will protect people with pre-existing conditions, and that he is working on a big middle-class tax cut that will be voted on soon. ‘We’re going to be putting in a 10 percent tax cut for middle-income families. It’s going to be put in next week,’ he told attendees at an Oct. 22 rally in Houston. ‘We’ve been working on it for a few months, a 10 percent brand-new — and that is in addition to the big tax cuts that you’ve already gotten.’ To say that these claims are fantastical is almost an understatement…In both cases, Trump is essentially admitting that his approach on two signature issues was not popular and may end up costing some Republican lawmakers their jobs in the midterms.” [Time, 10/24/18]

CNN: Republicans Engaged In Tactical Ducking And, At Times, Outright Lies“ Over Pre-existing Condition Protections. “After two years of trying to repeal Obamacare outright, the President and some GOP candidates are suddenly claiming they support the Affordable Care Act’s protections for those with pre-existing conditions — even though they voted for repeal bills that would weaken them, or are suing to eliminate Obamacare altogether…But Republicans’ tactical ducking and, at times, outright lies over their roles in efforts to unravel the current system either through legislation or in the courts has left some Democratic candidates exasperated — and led to a new wave of Democratic attacks over the GOP’s inconsistencies.” [CNN, 10/25/18]

Axios: “Trump’s Tweet Is Wrong On Pre-existing Conditions.” “Reality check: Democrats have been criticized for a lot of things about the Affordable Care Act, which they passed over GOP objections. But this may be the first time they’ve been accused of not protecting people with pre-existing conditions, since the ACA does that and Republicans have been on the defensive ever since they tried to repeal it.” [Axios, 10/24/18]

Bloomberg: “In The Real World, President Donald Trump’s Justice Department Is Arguing In Court That The Affordable Care Act’s Protections For Pre-existing Medical Conditions Are Unconstitutional And Should Be Nullified.” “In the real world, President Donald Trump’s Justice Department is arguing in court that the Affordable Care Act’s protections for pre-existing medical conditions are unconstitutional and should be nullified. On top of that, his administration explicitly supported a bill passed by House Republicans that would have weakened those protections…That gets at the heart of Republicans’ dilemma: It’s one thing to promise an end to Obamacare’s burdensome regulations while vowing to lower premiums and maintain patient protections. But it’s actually a phenomenally difficult policy problem, and the GOP hasn’t offered a proposal that solves it.” [Bloomberg, 10/19/18]

HuffPost On Trump’s Claim That Republicans Will Protect People With Pre-existing Conditions: “Anybody Even Dimly Aware Of Recent History…Should Recognize The Claim As A Lie.” “President Donald Trump on Wednesday sent out another tweet on health care. ‘Republicans will totally protect people with Pre-Existing Conditions,’ he wrote. ‘Democrats will not!’ By now, the fundamental dishonesty of that statement shouldn’t require explanation. Anybody even dimly aware of recent history ― specifically, the part where Democrats passed the Affordable Care Act, only to have Republicans spend eight years trying to repeal it ― should recognize the claim as a lie. And anybody unfamiliar with that saga could simply have paid attention this week, when the Trump administration announced a major reinterpretation of the Affordable Care Act’s insurance rules. The change means that states can undermine some of the law’s key provisions that help people with serious medical problems.” [HuffPost, 10/25/18]

Slate: “More Than Obfuscation Or Spin, This Is Outright Lying.” “Republicans still want to repeal Obamacare, but they’re telling voters the opposite. On the campaign trail, Republican candidates are stalwart defenders of the Affordable Care Act and its most popular provision: a regulation that prohibits insurers from discriminating on the basis of pre-existing conditions. More than obfuscation or spin, this is outright lying. And as they do it, Republicans are showing contempt for voters, and further fraying our ability to do electoral democracy…When the Affordable Care Act was unpopular, Republicans promised to repeal it. Now that it’s popular, Republicans are essentially promising to protect it—even as they plan to deliver the opposite if given the chance.” [Slate, 10/19/18]

ABC News: Republicans Trumpet Pre-existing Condition Protections Despite Votes To Repeal Obamacare. “According to data gathered by the Democratic Congressional Campaign Committee and confirmed by ABC News, the following Republicans in competitive races, Chabot included, all voted to repeal the Affordable Care Act and pass the ACHA, but have also, in the final months of their midterm campaigns, released ads targeted to people with pre-existing conditions: Rep. Rodney Davis, R-Ill.; Rep. Mario Diaz-Balart, R-Fla.; Rep. John Faso, R-N.Y.; Rep. Bob Gibbs, R-Ohio; Rep. George Holding, R-N.C.; Rep. French Hill, R-Ark.; Rep. Dana Rohrabacher, R-Calif.; Rep. Keith Rothfus, R-Pa.; Rep. Pete Sessions, R-Texas; Rep. Kevin Yoder, R-Kan.; Rep. David Young, R-Iowa.” [ABC News, 10/21/18]

Columnists were also taken aback by the lies:

Paul Krugman, New York Times Columnist: “Goodbye, Political Spin, Hello Blatant Lies.” “But Republicans no longer bother with deceptive presentations of facts. Instead, they just flat-out lie. What do they lie about? Lots of things, from crowd sizes to immigrant crime, from steel plants to the Supreme Court. But right now the most intense, coordinated effort at deception involves health care — an issue where Republicans are lying nonstop about both their own position and that of Democrats…Republicans don’t just hate the subsidies that help people buy insurance; they also hate the regulations that prevent insurers from discriminating against people with pre-existing conditions. Indeed, 20 Republican state attorneys general filed a lawsuit trying to eliminate protection for pre-existing conditions, and the Trump administration has declined to oppose the suit, in effect endorsing it.” [New York Times, 10/11/18]

Paul Waldman For Washington Post On Trump Claim That Republicans Will Protect Pre-existing Conditions: “It Simply A Lie.” “Let’s focus on the idea that “All Republicans support people with pre-existing conditions.” As our video shows, this has become a common refrain among Republican candidates, claiming that despite what Democrats are alleging, they would never, ever seek to take away protections from people with preexisting conditions. That is simply a lie. Here are the facts. Until the Affordable Care Act was passed in 2010, insurance companies routinely denied people coverage if they had a preexisting condition, or they said that they would cover you, but the insurance would not cover that condition or that part of your body. Or they would offer you coverage, but set the premiums so high that you couldn’t possibly afford them. The ACA outlawed that practice, mandating both ‘guaranteed issue’ (they have to cover you) and ‘community rating’ (everyone gets charged the same premium for the same plan regardless of whether they have a preexisting condition).The ACA was opposed by every single Republican in both houses of Congress, and they immediately began holding votes to repeal the law and filing lawsuits asking the courts to strike it down. So there’s no confusion: If they succeed in what they’re trying to do, there would be no more protection for preexisting conditions.” [Washington Post, 10/19/18]

Frank Bruni, New York Times Columnist: On Pre-existing Conditions, Republicans Are “Brazenly Denying The Past.” “Meanwhile, many Republican candidates who fought proudly and persistently to junk Obamacare without any suitable alternative are brazenly denying that past and fashioning themselves as the planet’s greatest champions of guaranteed health insurance for Americans with pre-existing conditions. That’s less an artful flip-flop than an extravagant fiction, and it’s of a piece with Republicans’ sudden complacency about deficits now that they’re ballooning under the party’s governance.” [New York Times, 10/23/18]

Dana Milbank For Washington Post: Republican Websites Continue To Cover Up Their Health Care Histories. “And they are vigorously scrubbing their records, according to archived versions of their websites reviewed by the Democratic Congressional Campaign Committee. Rep. Tom MacArthur’s (R-N.J.) site last year vowed: ‘Tom will work to repeal Obamacare, but won’t stop there.’ Now? ‘Tom opposed his own party’s efforts at a speedy Obamacare repeal.’ Rep. Ted Budd (R-N.C.), in 2016, had a pledge: ‘I will do everything I can to repeal every word of Obamacare.’ That passage is now repealed from his website. Rep. Leonard Lance’s (R-N.J.) website, in 2016, boasted that ‘Lance is on the front-lines in the fight to repeal and replace Obamacare.’ Now, that same passage has been rewritten: ‘Lance is leading the fight for real Health Care Reform.’ Their problem: Of the 73 incumbent House Republicans in competitive races, 67 voted at least once to eliminate Obamacare’s protections for those with preexisting conditions according to an analysis by the liberal Center for American Progress Action Fund.” [Washington Post, Milbank, 10/19/18]

Local media outlets have joined in taking on candidates’ lies:

Portland Press Herald Editorial Board Endorses Candidates On Health Care: “The Races In Maine’s Two Congressional Districts Are About Health Care, Taxes And Who Can Best Represent Our State In Washington.” “President Trump and other Republicans have demonstrated bad faith on health care, environmental policy and immigration. Pingree, however, has shown she’ll fight for the right side of those issues and others. She deserves another term…Where we think Golden would stand up for Mainers, Rep. Bruce Poliquin has, for the most part, let them down…Poliquin also voted to repeal the Affordable Care Act in ways that would have been devastating, stripping 24 million Americans of health insurance by 2026, including more than 100,000 Mainers. And while Poliquin has become an ardent supporter of protecting Americans with pre-existing conditions since he got on the campaign trail, his votes say otherwise.” [Portland Press Herald, 10/22/18]

Milwaukee Journal Sentinel: Leah Vukmir Claims To Support Pre-existing Condition Protections, But Only Offers Solutions Possible For Those Who Are Wealthy. “Leah Vukmir, the Republican candidate for U.S. Senate, also opposes the ACA but has said she supports covering people with pre-existing conditions. She hasn’t provided details on what she would support, but she has cited the state’s former Health Insurance Risk Sharing Plan of Wisconsin, known as HIRSP, as a model. HIRSP was an option, however, only for people who could afford health insurance.” [Milwaukee Journal Sentinel, 10/19/18]

Even Republicans are calling out their own:

Former Kasich Aide John Weaver: Republicans Lying About Pre-existing Conditions “Do Not Deserve Your Vote.” Just saw a clip of @RepMcSally flat out lying about her longstanding opposition to insurance for those with pre-existing health conditions. She & the other Republicans lying about this issue & giving cover to Trump on so many other fronts do not deserve your vote.” [The Hill, 10/26/18]

As President Trump repeats the lie that he is responsible for relatively low premium increases on the Affordable Care Act marketplaces this year, new Kaiser Family Foundation (KFF) analysis says otherwise. The analysis released this morning finds that President Trump has actually caused 2019 premiums to be 16 percent higher than they otherwise would have been absent GOP sabotage. Among the report’s key findings:

• On-exchange consumers’ premiums for 2019 are 16 percent higher than they should be because of GOP sabotage. The key drivers of these higher premiums are policies enacted by the Trump Administration and its Republican allies: “Altogether, on-exchange silver premiums in 2019 are therefore approximately 16% higher than would otherwise be the case if federal CSR payments had continued (the loss of which contributed approximately 10% to silver exchange premiums), the individual mandate penalty were still enforced, and more loosely-regulated plans were not expanding (the latter changes contributed an additional 6% to 2019 rates).”
• The repeal of the individual mandate and the expansion of junk plans has caused 2019 premiums to be  6 percent higher than they should be. Kaiser estimates that the repeal of the individual mandate penalty and the expansion of junk plans (association and short-term plans) will cause consumers to pay 6 percent more than they would absent these actions in their 2019 premiums.
• The administration’s decision to halt cost sharing reduction payments will cause on-exchange consumers to pay 10 percent more than they would have had CSRs not been stopped.
• Even consumers off the ACA exchange will pay 6 percent more because of Republican sabotage. Kaiser found, “Looking ahead to 2019, premiums in much of the country are holding flat or decreasing a bit, but unsubsidized off-exchange consumers on average will nonetheless pay an average of 6% more than they otherwise would have, if it were not for repeal of the individual mandate and expansion of more loosely regulated plans.”