October 2018

“The Republican Agenda is the Same as it Ever Was, and the American People are Sick and Tired of It,” says Brad Woodhouse

Washington, DC – In response to Senator Mitch McConnell joining the pack of Republicans pledging to further slash Medicaid and Medicare to pay for deficit busting tax cuts for big corporations and the super rich.  Brad Woodhouse, executive director of Protect Our Care, issued the following statement in response:

“The Republican agenda is the same as it ever was: explode the deficit by trillions of dollars giving tax breaks to big corporations and the wealthy and then slash Medicare, Medicaid and Social Security which ordinary Americans rely on.  Mitch McConnell is a serial liar and only a fool would have believed him when he said that the tax scam they passed would pay for itself and only a fool would believe him or Republicans now when they say they care about getting the deficit they created under control. No, like always they have exploded the deficit by showering tax breaks on their friends and donors with the express purpose of turning around and slashing these programs which they have been out to dismantle for years. And we will all be damn fools if we let them get away with it.”

HERE ARE SOME OF THE OTHER REPUBLICANS PLEDGING TO SLASH HEALTH CARE TO PAY FOR THEIR TAX CUTS FOR THE WEALTHY:

• Last month, Larry Kudlow, Director of the National Economic Council, confirmed that he has his sights on cutting Medicare. Asked when programs like Social Security and Medicare will be looked at for reforms, Kudlow replied, “Everyone will look at that — probably next year.”
  

• Paul Ryan on Medicare: “It’s the biggest entitlement we’ve got to reform.” Paul Ryan, December 6, 2017: “We’re going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit…Frankly, it’s the health care entitlements that are the big drivers of our debt, so we spend more time on the health care entitlements…In- think the president is understanding that choice and competition works everywhere in health care, especially in Medicare…This has been my big thing for many, many years. I think it’s the biggest entitlement we’ve got to reform.”

• President Trump and Congressional Republicans are targeting Medicare and Medicaid to pay for tax cuts for the wealthiest. Last December, President Trump signed a $1.5 trillion tax bill that disproportionately benefits the wealthy. How do Republicans plan on paying for it? Speaker Ryan’s answer is clear: “Frankly, it’s the health care entitlements that are the big drivers of our debt.” In an attempt to pay for these tax cuts, in April, House Republicans passed a budget amendment that would slash Medicare funding by $537 billion over the next decade.

• Congressional Republicans proposed these cuts after passing a budget resolution last year that cut Medicare by $473 billion. The 2018 budget resolution passed by Republicans in December 2017 cut Medicare by $473 billion.

• Congressional Republicans Voted to Slash An Additional $1.3 Trillion From Medicaid and other Health Care Programs. The 2018 budget resolution passed by Republicans in December 2017 cut non-Medicare health programs, most notably Medicaid, by $1.3 trillion, a 20 percent cut over the course of 10 years, increasing to a 29.3 percent cut by 2027.

“Putting Mary Mayhew in charge of Medicaid is like handing Society Security over to Bernie Madoff,” said Brad Woodhouse, executive director of Protect Our Care

Yesterday, the Trump Administration announced that Mary Mayhew, a devoted Medicaid opponent, would be the new head of Medicaid and CHIP programs. Said Brad Woodhouse, executive director of Protect Our Care, about the announcement: “Putting Mary Mayhew in charge of Medicaid is like handing Social Security over to Bernie Madoff. The American people want Republican war on health care to end, but this is just more of the same Trump administration sabotage.”

People have noticed that Trump wants an anti-Medicaid head of Medicaid:

Bangor Daily News: Mayhew Was “The Face Of LePage’s Crusade Against Medicaid Expansion.”  “No member of the LePage administration except for the governor himself has been a more polarizing figure than Mayhew, whose arch-conservative six-year tenure in the often-embattled health department became a road map for Republicans after the inauguration of Trump in 2017. She was the face of LePage’s crusade against Medicaid expansion under the Affordable Care Act, which was approved by voters in 2017 but has languished unimplemented in a court fight with a pending expansion plan and a request for new Medicaid work requirements sitting before the agency where Mayhew will be a key official.” [Bangor Daily News, 10/15/18]

FierceHealthcare:  Mayhew Is “An Ardent Opponent Of Medicaid Expansion.”  “A former Maine health official and an ardent opponent of Medicaid expansion has been appointed to oversee Medicaid at the federal level.” [FierceHealthcare, 10/15/18]

Fiscal Times:  “Trump’s New Medicaid Chief Is a Medicaid Critic.”  [Fiscal Times, 10/15/18]

Healthcare Finance:  Mayhew “Opposed The Expansion Of Medicaid In Maine.” “Mayhew is a conservative who, under Maine Governor Paul LePage,  oversaw major changes to Maine’s public assistance programs, including MaineCare, its Medicaid program, according to the Press Herald report.   She opposed the expansion of Medicaid in Maine. LePage has fought a court order to expand Medicaid, saying the state does not have the financial means to pay for it. Voters in 2017 approved a ballot measure to expand Medicaid in the state.” [Healthcare Finance, 10/15/18]

AP:  Mayhew Is A “Strong Opponent” Of Expanding Medicaid.  “Mayhew and LePage are both strong opponents of expanding Medicaid under the Affordable Care Act. When she announced her run for governor last year, Mayhew said: ‘I adamantly reject that growing government is the answer to our challenges.'” [Associated Press, 10/15/18]

Modern Healthcare:  Mayhew “Staunchly Opposed The State’s Ballot Measure To Expand Medicaid.”  “Mary Mayhew, who as Maine Gov. Paul LePage’s top health official staunchly opposed the state’s ballot measure to expand Medicaid, will lead Medicaid policy at the federal level in her new position as new deputy administrator and director of the Center for Medicaid and CHIP Services.” [Modern Healthcare, 10/15/18]

Portland Press Herald:  Mayhew “Played A Major Role In Eliminating Nearly 70,000 People From The State’s Medicaid Program.”  “Mayhew is best known for her seven years as commissioner of the Maine Department of Health and Human Services under Gov. Paul LePage. During her tenure, she oversaw major changes to nearly all of Maine’s public assistance programs, including food stamps and the Temporary Assistance for Needy Families program. Mayhew also played a major role in eliminating nearly 70,000 people from the state’s Medicaid program and, like LePage, she was an ardent opponent of expanding Medicaid, which was made allowable at the state level under the Affordable Care Act.”  [Portland Press Herald, 10/15/18]

Politico:  Mayhew Was The “Architect” Of Maine’s “Aggressive” Cuts to Medicaid Enrollment. “The Trump administration has tapped Mary Mayhew — the architect of Maine’s aggressive conservative reforms to the social safety net — to oversee the national Medicaid program. She has been an ally of outgoing Maine Gov. Paul LePage, a Republican who has fought as hard as any governor against expanding Medicaid under Obamacare. CMS announced the move internally Monday, the day Mayhew began as the agency’s deputy administrator and director of Medicaid and the Children’s Health Insurance Program. Mayhew served as Maine’s health commissioner for six years under LePage, leading efforts to tighten the state’s Medicaid eligibility standards, add work requirements to the food stamp program and implement other conservative reforms. She supported LePage as he rejected efforts to expand the state’s Medicaid program — repeatedly vetoing legislation and then resisting after nearly 60 percent of Maine voters approved expansion on a ballot measure in 2017. ” [Politico, 10/15/18]

Vox:  Mayhew Is A “Strident Medicaid Critic.”  “The Trump administration’s choice to run the Medicaid program nationwide is Mary Mayhew, a strident Medicaid critic who has urged states not to join the Affordable Care Act’s Medicaid expansion.” [Vox, 10/15/18]

Washington Examiner:  Mayhew “Shepherded Work Requirements For Food Stamps” In Maine. “Mary Mayhew, a Maine official who shepherded work requirements for food stamps in the state, has been appointed to a top role at the Centers for Medicare and Medicaid Services, where she will be responsible for overseeing health programs for low-income people. Mayhew is joining the agency as the Trump administration is working to expand work requirements in the Medicaid program. Under the proposals, approved in a handful of states, certain low-income people who are covered by Medicaid would need to work, take classes, or volunteer as a condition of staying enrolled in the program. Mayhew oversaw the rollout of food stamp work requirements in 2014, when she was commissioner for Health and Human Services under GOP Gov. Paul LePage. Mayhew co-authored an opinion piece on Fox News earlier this year with former House Speaker Newt Gingrich praising the Trump administration’s push to add work requirements to more welfare programs and close exemptions.” [Washington Examiner, 10/15/18]

“This report is a call for change, yet the Trump Administration delivers more of the same sabotage” said Amanda Harrington

Washington, DC — At the same time as the release of a new report issued by the U.S. Government Accountability Office today finding a vast gulf in access to health care between people who live in states that have expanded Medicaid in contrast with those that have not, the Trump Administration announced that Governor Paul LePage’s former health-obstructer-in-chief Mary Mayhew has been tapped to lead Medicaid and CHIP.

The GAO report puts into sharp view the harm that can be done when officials like Mayhew block Medicaid expansion in their states. Among the report’s findings, low-income adults in states that expanded Medicaid were almost half as likely to have unmet medical needs, more than half as likely to forego medical care due to cost and nearly half as likely to report needing mental health care or prescription medication but not being able to afford it.

Amanda Harrington, spokeswoman for Protect Our Care, issued the following statement in response:

“The new GAO report is not only a call to action for states that haven’t expanded Medicaid yet, it’s a call for change in leadership. Medicaid expansion is front and center in many competitive governor’s races around the country, and this report shows why: Your ability to access medical care when you need it shouldn’t depend on who you are, how much money you make or what your ZIP code is, but unfortunately that’s the reality for far too many Americans living in states that refuse to expand Medicaid.

“Putting Mary Mayhew in charge of the critical Medicaid and CHIP programs, where she will actively be working to block people from the care they need, is just more Republican health care sabotage. Numerous times, Mary Mayhew and Governor Paul LePage have sought to obstruct the will of Mainers by blocking Medicaid expansion — and as this report shows, she did so at great cost to the people in her state.”

ADDITIONAL BACKGROUND

Key Findings from the GAO report, Access to Health Care for Low-Income Adults in States with and without Expanded Eligibility

• An estimated 5.6 million uninsured, low-income adults—those ages 19 through 64—had incomes at or below the income threshold for expanded Medicaid eligibility as allowed under the Patient Protection and Affordable Care Act (PPACA); of these, 3.7 million live in non-expansion states.
• Low-income adults in expansion states were less likely to report having any unmet medical needs compared with those in non-expansion states, and low-income adults who were insured were less likely to report having unmet medical needs compared with those who were uninsured.
• Among the low-income adults who were uninsured, those in expansion states were less likely to report having any unmet medical needs compared with those in non-expansion states.
• Low-income adults in expansion states were more likely to report having a usual place of care to go when sick or needing advice about their health and receiving selected health care services compared with those in non-expansion states.

As Medicaid’s Popularity Grows, It Has Become  a Key Issue in Competitive Governor’s Races

In Ohio, Cordray Blasts DeWine – Who Flip Flopped on Medicaid Expansion. “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 Targets 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 Maine, the Race For Governor Could “End Mediaid Standoff.” “Nearly 60 percent of voters said yes to the ballot initiative last November to approve expansion, but Republican Gov. Paul R. LePage — who is term limited  — has done everything he can to block its implementation, citing concerns over funding. Before it appeared on the ballot, he had vetoed bills to expand Medicaid five times, and now it’s tied up in an ongoing legal battle. Candidates who could follow LePage appear to be more open to implementing the ballot initiative. Democratic gubernatorial candidate Janet Mills has been a vocal supporter of Medicaid expansion. Independent candidates Terry Hayes and Alan Caron have also said they would implement it. The Republican candidate Shawn Moody previously seemed to follow LePage’s lead in opposing expansion, but now says he would implement the law as long as there is funding.” [Washington Post, 10/15/2018]

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 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 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]
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 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]