Skip to main content
Monthly Archives

December 2018

protectourcare
In News

The People Who Hate Obamacare the Most Think the Texas Decision is the Worst

Since Judge Reed O’Connor’s decision to overturn the Affordable Care Act on Friday night, Republicans and Democrats alike have condemned his ruling. Some of the strongest criticism has come from the columnists, editorial pages, and legal scholars that have led the opposition to the ACA.

Philip Klein, Executive Editor Of Washington Examiner: “I Hate Obamacare, But Texas Judge’s Decision On Its Constitutionality Is An Assault On The Rule Of Law.” “I hate Obamacare so much that it’s possible I’ve written more words criticizing it over the past decade than any person alive. I have supported multiple previous legal efforts against the legislation and its implementation. In the fall of 2012, after the Supreme Court upheld Obamacare, my Halloween costume depicted John Roberts turning into a chicken. If Congress repealed all of Obamacare tomorrow, I’d throw a party. Despite my policy preferences, I’d say the latest decision from U.S. District Court Judge Reed O’Connor of Texas declaring Obamacare unconstitutional is an assault on the rule of law… What’s happening here is an effort to short-circuit the normal process and implement policy preferences through judicial activism. Embracing unelected judges using shoddy reasoning to impose their policy preferences on the country just when they produce outcomes conservatives agree with would do significant long-term damage to everything conservatives hold dear.” [Washington Examiner, 12/17/18]

Wall Street Journal Editorial Board: “No One Opposes ObamaCare More Than We Do” But Federal Judge’s Decision “Is Likely To Be Overturned On Appeal And May Boomerang Politically On Republicans.” “No one opposes ObamaCare more than we do, and Democrats are now confirming that it was designed as a way-station to government-run health care. But a federal judge’s ruling Friday that the law is unconstitutional is likely to be overturned on appeal and may boomerang politically on Republicans.” [Wall Street Journal, 12/16/18]

Conservative Legal Scholar Jonathan Adler And Abbe Gluck, Professor Of Health Law At Yale Law School: “This Decision Makes A Mockery Of The Rule Of Law And Basic Principles Of Democracy.” “A ruling this consequential had better be based on rock-solid legal argument. Instead, the opinion by Judge Reed O’Connor is an exercise of raw judicial power, unmoored from the relevant doctrines concerning when judges may strike down a whole law because of a single alleged legal infirmity buried within…We were on opposing sides of the 2012 and 2015 Supreme Court challenges to the Affordable Care Act, and we have different views of the merits of the act itself. But as experts in the field of statutory law, we agree that this decision makes a mockery of the rule of law and basic principles of democracy — especially Congress’s constitutional power to amend its own statutes and do so in accord with its own internal rules.” [New York Times, 12/15/18]

Ilya Somin, George Mason University Law Professor: Judge Was “Badly Wrong” To Declare Entire Affordable Care Act Unconstitutional On Basis Of Individual Mandate. “Federal District Court Judge Reed O’Connor issued an important ruling in a case brought by twenty GOP-controlled state governments, arguing that the Obamacare individual health insurance mandate is now unconstitutional, because the tax reform bill Congress passed in December 2017 eliminates the monetary penalty for violation. Much more importantly, the states also claim that the rest of the Affordable Care Act must fall with the mandate because it cannot be “severed” from it. Judge O’Connor ruled in favor of the states on both counts. I think he was right on the first issue, but badly wrong on the second.” [Reason, 12/14/18]

Jonathan Adler, Professor Of Law At Case Western Reserve School Of Law: “This Is A Surprising Result, And One That Is Hard To Justify.” “This is a surprising result, and one that is hard to justify…And did I mention standing? The Justice Department somehow neglected to raise standing in its briefing, but Judge O’Connor addressed it nonetheless (as he should have, as Article III standing is jurisdictional). Despite recognizing the need to address standing, Judge O’Connor completely botched the relevant analysis, concluding the plaintiffs have standing to challenge a provision of a law that has no legal effect… However superficially plausible the plaintiff states’ claims initially appear, they melt upon inspection. The more one digs into them, the less substantial they appear.” [Reason, 12/14/18]

Jennifer Rubin, Conservative Blogger At Washington Post: “Susan Collins And Republicans Better Have Better Answers On Obamacare. “Republicans are the proverbial dog who caught the bus. They are to blame if the law, with no alternative, is not revived by a higher court; they are to blame if either by litigation or administrative action those with preexisting conditions are priced out of the market. We just had an election that turned on this precise issue. Democrats overwhelmingly carried the day by accusing Republicans of seeking to sabotage protection for preexisting conditions. Now that Collins, Blunt and others have made a mess, it is up to them to fix it — or face the wrath of the voters in 2020.” [Washington Post, 12/17/18]

ashoup
In News

Court Ruling Helps Kevin Cramer Rip Away Protections for People with Pre-Existing Conditions

Decision From Federal Judge Means:

Medicaid Expansion is Gone

Protections for Pre-Existing Conditions are Gone

Hundreds of Thousands of North Dakotans Will Lose Health Care

And Kevin Cramer OWNS IT

Washington, D.C. –  On Friday night, conservative U.S. District Judge Reed O’Connor issued his ruling in Texas, et. al. vs. United States, et. al., siding with Republican attorneys general, governors, the Trump Administration, and Senator Kevin Cramer  to overturn the entire Affordable Care Act (ACA). Whether it’s repealing the individual mandate to pay for tax cuts or ramming through partisan repeal legislation, repeal cheerleader Kevin Cramer has done nothing but support the GOP’s efforts to strip coverage from hundreds of thousands of North Dakotans. Brad Woodhouse, executive director of Protect Our Care issued the following statement:

“Like two sides of the same coin, Kevin Cramer and the Trump Administration have worked relentlessly to undermine the Affordable Care Act. Today, they are one step closer to ripping health care away from millions of North Dakotans with pre-existing conditions like cancer, diabetes, or asthma. If this ruling isn’t overturned, Kevin Cramer will roll back the clock and take North Dakotans back to the days where insurance companies had the power to once again deny, drop, or charge more for coverage. They will once again have the power to impose annual or lifetime limits and charge women and seniors more based on their age and gender. Make no mistake, these actions will hurt hundreds of thousands of North Dakotans.”

BACKGROUND:

Due to Judge O’Connor’s ruling yesterday, Republicans are one step closer to repealing the Affordable Care Act and eliminating key protections, unleashing — as the Trump Administration itself admitted in his court — “chaos” in our entire health care system. Under this ruling:

  • Marketplace tax credits and coverage for 10 million people: GONE.
  • Medicaid expansion currently covering 15 million people: GONE.
  • Protections for more than 130 million people with pre-existing conditions when they buy coverage on their own: GONE.
  • Allowing children to stay on their parents’ insurance until age 26: GONE.
  • Free annual wellness exams: GONE.
  • Ban on annual and lifetime limits: GONE.
  • Ban on insurance discrimination against women: GONE.
  • Contraception with no out-of-pocket costs: GONE.
  • Limit on out-of-pocket costs: GONE.
  • Requirement that insurance companies cover essential benefits like prescription drugs, maternity care, and hospitalization: GONE.
  • Improvements to Medicare, including reduced costs for prescription drugs: GONE.
  • Closed Medicare prescription drug donut hole: GONE.
  • Rules to hold insurance companies accountable: GONE.
  • Small business tax credits: GONE.

What’s at stake for North Dakota:

  • The coverage that 15,000 North Dakotans gained through the ACA by 2015.
  • Protections for 316,000 North Dakotans who have a pre-existing health condition.
  • Coverage for 21,400 North Dakotans enrolled through the state’s Medicaid expansion.
  • The health care of roughly 7,000 young adults in North Dakota who have coverage because they can stay on their parents coverage until age 26.
  • The nearly 359,052 North Dakotans most of whom have employer coverage, who can access free preventive care at no cost.
  • The 253,000 North Dakotans with employer coverage who no longer have to worry about lifetime or annual limits.
  • Seniors’ drug savings — 11,110 North Dakota seniors saved $11.5 million on drugs in 2017, an average of $1,037 per beneficiary because the ACA closed the Medicare prescription drug donut hole.

Because Judge O’Connor Sided With Republicans, 17.1 Million People Could Lose Their Coverage

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Be Put Back In Charge, Ending Protections For The 130 Million People With A Pre-Existing Condition

  • According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 130 million people, have a pre-existing condition. This includes:
    • 44 million people who have high blood pressure
    • 45 million people who have behavioral health disorders
    • 44 million people who have high cholesterol
    • 34 million people who have asthma and chronic lung disease
    • 34 million people who have osteoarthritis and other joint disorders
  • 17 million children. One in four children, or roughly 17 million, have a pre-existing condition.
  • 68 million women. More than half of women and girls nationally have a pre-existing condition.
  • 30 million people aged 55-64. 84 percent of older adults, 30.5 million Americans between age 55 and 64, have a pre-existing condition.
  • 316,000 North Dakotans have a pre-existing condition.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have The Power To Deny Or Drop Coverage Because Of A Pre-Existing Condition

Before the Affordable Care Act, insurance companies routinely denied people coverage because of a pre-existing condition or canceled coverage when a person got sick.

  • A 2010 congressional report found that the top four health insurance companies denied coverage to one in seven consumers on the individual market over a three year period.
  • A 2009 congressional report found that the of the largest insurance companies had retroactively canceled coverage for 20,000 people over the previous five year period
Conditions That Could Cost You Your Care:

  • AIDS/HIV
  • Alcohol/drug Abuse
  • Cerebral Palsy
  • Cancer
  • Heart Disease
  • Diabetes
  • Epilepsy
  • Kidney Disease
  • Severe Epilepsy
  • Sleep Apnea
  • Pregnancy
  • Muscular Dystrophy
  • Depression
  • Eating Disorders
  • Bipolar Disorder
 Jobs You Could Be Denied Coverage Because Of:

  • Active military personnel
  • Air traffic controller
  • Body guard
  • Pilot
  • Meat packers
  • Taxi cab drivers
  • Steel metal workers
  • Law enforcement
  • Oil and gas exploration
  • Scuba divers
 Medications That You Could Be Denied Health Care For Taking:

  • Anti-arthritic medications
  • Anti-diabetic medications (including insulin)
  • Anti-cancer medications
  • Anti-coagulant and anti-thrombotic medications
  • Medications used to treat autism
  • Anti-psychotics
  • Medications for HIV/AIDS
  • Growth hormone
  • Medication used to treat arthritis, anemia, and narcolepsy
  • Fertility Medication

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have The Power To Charge You More

  • More than 100 Million People With A Pre-Existing Condition Could Be Forced to Pay More. An analysis by Avalere finds that “102 million individuals, not enrolled in major public programs like Medicaid or Medicare, have a pre-existing medical condition and could therefore face higher premiums or significant out-of-pocket costs” thanks to the Republican lawsuit to repeal the Affordable Care Act.
  • Insurance Companies Could Charge Premium Surcharges in the Six Figures. If Judge O’Connor’s ruling is upheld, insurance companies would be able to charge people more because of a pre-existing condition. The health repeal bill the House passed in 2017 had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
  • Women Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women were often charged premiums on the nongroup market of up to 50 percent higher than they charged men for the same coverage.
  • People Over the Age of 50 Could Face a $4,000 “Age Tax,” Including $3,709 in North Dakota. Because Judge O’Connor sided with Republican lawmakers, insurance companies could be able to charge people over 50 more than younger people. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, including $3,709 in North Dakota, according to the AARP.
  • Nine Million People in the Marketplaces Would Pay More for Coverage, Including 18,139 North Dakotans. If Judge O’Connor’s ruling is upheld, consumers would no longer have access to tax credits that help them pay their marketplace premiums, meaning roughly nine million people who receive these tax credits to pay for coverage will have to pay more, including 18,139 in North Dakota.
  • Seniors Would Have to Pay More for Prescription Drugs. Because Judge O’Connor sided with Republican lawmakers, seniors could have to pay more for prescription drugs because the Medicare “donut” hole got reopened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 CMS report. In North Dakota, 11,110 seniors each saved an average of $1,037.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have the Power to Limit the Care You Get, Even If You Have Insurance Through Your Employer

  • Insurance Companies Do Not Have to Provide the Coverage You Need. The Affordable Care Act made comprehensive coverage more available by requiring insurance companies to include “essential health benefits” in their plans, such as maternity care, hospitalization, substance abuse care and prescription drug coverage. Before the ACA, people had to pay extra for separate coverage for these benefits. For example, in 2013, 75 percent of non-group plans did not cover maternity care, 45 percent did not cover substance abuse disorder services, and 38 percent did not cover mental health services. Six percent did not even cover generic drugs.
  • Reinstate Lifetime and Annual Limits. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage.
  • Large Employers Could Choose to Follow Any State’s Guidance, Enabling Them Put Annual and Lifetime Limits on Their Employees’ Health Care. Without the ACA’s definition of essential health benefits (EHB) in even some states, states could eliminate them altogether. Large employers could choose to apply any state’s standard, making state regulations essentially meaningless. Because the prohibition on annual and lifetime limits only applies to essential health benefits, this change would allow employers to reinstate annual and lifetime limits on their employees’ coverage.

Because Judge O’Connor Sides With Republicans, Medicaid Expansion Could Be Repealed

  • Fifteen million people have coverage through the expanded Medicaid program, including 21,400 in North Dakota.
ashoup
In News

Court Ruling Helps Mike Braun Rip Away Protections for People with Pre-Existing Conditions

Decision From Federal Judge Means:

Medicaid Expansion is Gone

Protections for Pre-Existing Conditions are Gone

Hundreds of Thousands of Hoosiers Will Lose Health Care

And Mike Braun OWNS IT

Washington, D.C. –  On Friday night, conservative U.S. District Judge Reed O’Connor issued his ruling in Texas, et. al. vs. United States, et. al., siding with Republican attorneys general, governors, the Trump Administration, and Senator Mike Braun  to overturn the entire Affordable Care Act (ACA). Whether it’s repealing the individual mandate to pay for tax cuts or ramming through partisan repeal legislation, repeal cheerleader Mike Braun has done nothing but support the GOP’s efforts to strip coverage from hundreds of thousands of Hoosiers. Brad Woodhouse, executive director of Protect Our Care issued the following statement:

“Like two sides of the same coin, Mike Braun and the Trump Administration have worked relentlessly to undermine the Affordable Care Act. Today, they are one step closer to ripping health care away from millions of Hoosiers with pre-existing conditions like cancer, diabetes, or asthma. If this ruling isn’t overturned, Mike Braun will roll back the clock and take Hoosiers back to the days where insurance companies had the power to once again deny, drop, or charge more for coverage. They will once again have the power to impose annual or lifetime limits and charge women and seniors more based on their age and gender. Make no mistake, these actions will hurt hundreds of thousands of Hoosiers.”

BACKGROUND:

Due to Judge O’Connor’s ruling yesterday, Republicans are one step closer to repealing the Affordable Care Act and eliminating key protections, unleashing — as the Trump Administration itself admitted in his court — “chaos” in our entire health care system. Under this ruling:

  • Marketplace tax credits and coverage for 10 million people: GONE.
  • Medicaid expansion currently covering 15 million people: GONE.
  • Protections for more than 130 million people with pre-existing conditions when they buy coverage on their own: GONE.
  • Allowing children to stay on their parents’ insurance until age 26: GONE.
  • Free annual wellness exams: GONE.
  • Ban on annual and lifetime limits: GONE.
  • Ban on insurance discrimination against women: GONE.
  • Contraception with no out-of-pocket costs: GONE.
  • Limit on out-of-pocket costs: GONE.
  • Requirement that insurance companies cover essential benefits like prescription drugs, maternity care, and hospitalization: GONE.
  • Improvements to Medicare, including reduced costs for prescription drugs: GONE.
  • Closed Medicare prescription drug donut hole: GONE.
  • Rules to hold insurance companies accountable: GONE.
  • Small business tax credits: GONE.

What’s at stake for Indiana:

  • The coverage that 339,000 Hoosiers gained through the ACA by 2015.
  • Protections for 2,745,700 Hoosiers who have a pre-existing health condition.
  • Coverage for 412,700 Hoosiers enrolled through Indiana’s Medicaid expansion.
  • The health care of roughly 50,000 young adults in Indiana who have coverage because they can stay on their parents coverage until age 26.
  • The nearly 2,915,827 Hoosiers most of whom have employer coverage, who can access free preventive care at no cost.
  • The 2,259,000 Hoosiers with employer coverage who no longer have to worry about lifetime or annual limits.
  • Seniors’ drug savings — 121,432 Indiana seniors saved $135.2 million on drugs in 2017, an average of $1,114 per beneficiary because the ACA closed the Medicare prescription drug donut hole.

Because Judge O’Connor Sided With Republicans, 17.1 Million People Could Lose Their Coverage

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Be Put Back In Charge, Ending Protections For The 130 Million People With A Pre-Existing Condition

 

  • According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 130 million people, have a pre-existing condition. This includes:
    • 44 million people who have high blood pressure
    • 45 million people who have behavioral health disorders
    • 44 million people who have high cholesterol
    • 34 million people who have asthma and chronic lung disease
    • 34 million people who have osteoarthritis and other joint disorders
  • 17 million children. One in four children, or roughly 17 million, have a pre-existing condition.
  • 68 million women. More than half of women and girls nationally have a pre-existing condition.
  • 30 million people aged 55-64. 84 percent of older adults, 30.5 million Americans between age 55 and 64, have a pre-existing condition.
  • 2,745,700 Hoosiers have a pre-existing condition.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have The Power To Deny Or Drop Coverage Because Of A Pre-Existing Condition

Before the Affordable Care Act, insurance companies routinely denied people coverage because of a pre-existing condition or canceled coverage when a person got sick.

  • A 2010 congressional report found that the top four health insurance companies denied coverage to one in seven consumers on the individual market over a three year period.
  • A 2009 congressional report found that the of the largest insurance companies had retroactively canceled coverage for 20,000 people over the previous five year period
Conditions That Could Cost You Your Care:

  • AIDS/HIV
  • Alcohol/drug Abuse
  • Cerebral Palsy
  • Cancer
  • Heart Disease
  • Diabetes
  • Epilepsy
  • Kidney Disease
  • Severe Epilepsy
  • Sleep Apnea
  • Pregnancy
  • Muscular Dystrophy
  • Depression
  • Eating Disorders
  • Bipolar Disorder
 Jobs You Could Be Denied Coverage Because Of:

  • Active military personnel
  • Air traffic controller
  • Body guard
  • Pilot
  • Meat packers
  • Taxi cab drivers
  • Steel metal workers
  • Law enforcement
  • Oil and gas exploration
  • Scuba divers
 Medications That You Could Be Denied Health Care For Taking:

  • Anti-arthritic medications
  • Anti-diabetic medications (including insulin)
  • Anti-cancer medications
  • Anti-coagulant and anti-thrombotic medications
  • Medications used to treat autism
  • Anti-psychotics
  • Medications for HIV/AIDS
  • Growth hormone
  • Medication used to treat arthritis, anemia, and narcolepsy
  • Fertility Medication

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have The Power To Charge You More

  • More than 100 Million People With A Pre-Existing Condition Could Be Forced to Pay More. An analysis by Avalere finds that “102 million individuals, not enrolled in major public programs like Medicaid or Medicare, have a pre-existing medical condition and could therefore face higher premiums or significant out-of-pocket costs” thanks to the Republican lawsuit to repeal the Affordable Care Act.
  • Insurance Companies Could Charge Premium Surcharges in the Six Figures. If Judge O’Connor’s ruling is upheld, insurance companies would be able to charge people more because of a pre-existing condition. The health repeal bill the House passed in 2017 had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
  • Women Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women were often charged premiums on the nongroup market of up to 50 percent higher than they charged men for the same coverage.
  • People Over the Age of 50 Could Face a $4,000 “Age Tax,” Including $2,916 in Indiana. Because Judge O’Connor sided with Republican lawmakers, insurance companies could be able to charge people over 50 more than younger people. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, including $2,916 in Indiana, according to the AARP.
  • Nine Million People in the Marketplaces Would Pay More for Coverage, Including 102,375 Hoosiers. If Judge O’Connor’s ruling is upheld, consumers would no longer have access to tax credits that help them pay their marketplace premiums, meaning roughly nine million people who receive these tax credits to pay for coverage will have to pay more, including 102,375 in Indiana.
  • Seniors Would Have to Pay More for Prescription Drugs. Because Judge O’Connor sided with Republican lawmakers, seniors could have to pay more for prescription drugs because the Medicare “donut” hole got reopened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 CMS report. In Indiana, 221,432 seniors each saved an average of $1,114.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have the Power to Limit the Care You Get, Even If You Have Insurance Through Your Employer

  • Insurance Companies Do Not Have to Provide the Coverage You Need. The Affordable Care Act made comprehensive coverage more available by requiring insurance companies to include “essential health benefits” in their plans, such as maternity care, hospitalization, substance abuse care and prescription drug coverage. Before the ACA, people had to pay extra for separate coverage for these benefits. For example, in 2013, 75 percent of non-group plans did not cover maternity care, 45 percent did not cover substance abuse disorder services, and 38 percent did not cover mental health services. Six percent did not even cover generic drugs.
  • Reinstate Lifetime and Annual Limits. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage.
  • Large Employers Could Choose to Follow Any State’s Guidance, Enabling Them Put Annual and Lifetime Limits on Their Employees’ Health Care. Without the ACA’s definition of essential health benefits (EHB) in even some states, states could eliminate them altogether. Large employers could choose to apply any state’s standard, making state regulations essentially meaningless. Because the prohibition on annual and lifetime limits only applies to essential health benefits, this change would allow employers to reinstate annual and lifetime limits on their employees’ coverage.

Because Judge O’Connor Sides With Republicans, Medicaid Expansion Could Be Repealed

Fifteen million people have coverage through the expanded Medicaid program, including 412,700 in Indiana.

ashoup
In News

Court Ruling Helps Rick Scott Rip Away Protections for People with Pre-Existing Conditions

Decision From Federal Judge Means:

Medicaid Expansion is Gone

Protections for Pre-Existing Conditions are Gone

Hundreds of Thousands of Floridians Will Lose Health Care

And Rick Scott OWNS IT

Washington, D.C. –  On Friday night, conservative U.S. District Judge Reed O’Connor issued his ruling in Texas, et. al. vs. United States, et. al., siding with Republican attorneys general, governors, the Trump Administration, and Senator Rick Scott  to overturn the entire Affordable Care Act (ACA). Whether it’s repealing the individual mandate to pay for tax cuts or ramming through partisan repeal legislation, repeal cheerleader Rick Scott has done nothing but support the GOP’s efforts to strip coverage from hundreds of thousands of Floridians. Brad Woodhouse, executive director of Protect Our Care issued the following statement:

“Like two sides of the same coin, Rick Scott and the Trump Administration have worked relentlessly to undermine the Affordable Care Act. Today, they are one step closer to ripping health care away from millions of Floridians with pre-existing conditions like cancer, diabetes, or asthma. If this ruling isn’t overturned, Rick Scott will roll back the clock and take Floridians back to the days where insurance companies had the power to once again deny, drop, or charge more for coverage. They will once again have the power to impose annual or lifetime limits and charge women and seniors more based on their age and gender. Make no mistake, these actions will hurt hundreds of thousands of Floridians.”

BACKGROUND:

Due to Judge O’Connor’s ruling on Friday, Republicans are one step closer to repealing the Affordable Care Act and eliminating key protections, unleashing — as the Trump Administration itself admitted in his court — “chaos” in our entire health care system. Under this ruling:

  • Marketplace tax credits and coverage for 10 million people: GONE.
  • Medicaid expansion currently covering 15 million people: GONE.
  • Protections for more than 130 million people with pre-existing conditions when they buy coverage on their own: GONE.
  • Allowing children to stay on their parents’ insurance until age 26: GONE.
  • Free annual wellness exams: GONE.
  • Ban on annual and lifetime limits: GONE.
  • Ban on insurance discrimination against women: GONE.
  • Contraception with no out-of-pocket costs: GONE.
  • Limit on out-of-pocket costs: GONE.
  • Requirement that insurance companies cover essential benefits like prescription drugs, maternity care, and hospitalization: GONE.
  • Improvements to Medicare, including reduced costs for prescription drugs: GONE.
  • Closed Medicare prescription drug donut hole: GONE.
  • Rules to hold insurance companies accountable: GONE.
  • Small business tax credits: GONE.

What’s at stake for Florida:

  • The coverage that 1,597,000 Floridians gained through the ACA by 2015.
  • Protections for 7,810,300 Floridians who have a pre-existing health condition.
  • The health care of roughly 132,000 young adults in Florida who have coverage because they can stay on their parents coverage until age 26.
  • The nearly 7,289,873 Floridians most of whom have employer coverage, who can access free preventive care at no cost.
  • The 5,587,000 Floridians with employer coverage who no longer have to worry about lifetime or annual limits.
  • Seniors’ drug savings — 344,343 Florida seniors saved $367.8 million on drugs in 2017, an average of $1,068 per beneficiary because the ACA closed the Medicare prescription drug donut hole.

Because Judge O’Connor Sided With Republicans, 17.1 Million People Could Lose Their Coverage

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Be Put Back In Charge, Ending Protections For The 130 Million People With A Pre-Existing Condition

  • According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 130 million people, have a pre-existing condition. This includes:
    • 44 million people who have high blood pressure
    • 45 million people who have behavioral health disorders
    • 44 million people who have high cholesterol
    • 34 million people who have asthma and chronic lung disease
    • 34 million people who have osteoarthritis and other joint disorders
  • 17 million children. One in four children, or roughly 17 million, have a pre-existing condition.
  • 68 million women. More than half of women and girls nationally have a pre-existing condition.
  • 30 million people aged 55-64. 84 percent of older adults, 30.5 million Americans between age 55 and 64, have a pre-existing condition.
  • 7,810,300 Floridians have a pre-existing condition.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have The Power To Deny Or Drop Coverage Because Of A Pre-Existing Condition

Before the Affordable Care Act, insurance companies routinely denied people coverage because of a pre-existing condition or canceled coverage when a person got sick.

  • A 2010 congressional report found that the top four health insurance companies denied coverage to one in seven consumers on the individual market over a three year period.
  • A 2009 congressional report found that the of the largest insurance companies had retroactively canceled coverage for 20,000 people over the previous five year period
Conditions That Could Cost You Your Care:

  • AIDS/HIV
  • Alcohol/drug Abuse
  • Cerebral Palsy
  • Cancer
  • Heart Disease
  • Diabetes
  • Epilepsy
  • Kidney Disease
  • Severe Epilepsy
  • Sleep Apnea
  • Pregnancy
  • Muscular Dystrophy
  • Depression
  • Eating Disorders
  • Bipolar Disorder
 Jobs You Could Be Denied Coverage Because Of:

  • Active military personnel
  • Air traffic controller
  • Body guard
  • Pilot
  • Meat packers
  • Taxi cab drivers
  • Steel metal workers
  • Law enforcement
  • Oil and gas exploration
  • Scuba divers
 Medications That You Could Be Denied Health Care For Taking:

  • Anti-arthritic medications
  • Anti-diabetic medications (including insulin)
  • Anti-cancer medications
  • Anti-coagulant and anti-thrombotic medications
  • Medications used to treat autism
  • Anti-psychotics
  • Medications for HIV/AIDS
  • Growth hormone
  • Medication used to treat arthritis, anemia, and narcolepsy
  • Fertility Medication

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have The Power To Charge You More

  • More than 100 Million People With A Pre-Existing Condition Could Be Forced to Pay More. An analysis by Avalere finds that “102 million individuals, not enrolled in major public programs like Medicaid or Medicare, have a pre-existing medical condition and could therefore face higher premiums or significant out-of-pocket costs” thanks to the Republican lawsuit to repeal the Affordable Care Act.
  • Insurance Companies Could Charge Premium Surcharges in the Six Figures. If Judge O’Connor’s ruling is upheld, insurance companies would be able to charge people more because of a pre-existing condition. The health repeal bill the House passed in 2017 had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
  • Women Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women were often charged premiums on the nongroup market of up to 50 percent higher than they charged men for the same coverage.
  • People Over the Age of 50 Could Face a $4,000 “Age Tax,” Including $4,007 in Florida. Because Judge O’Connor sided with Republican lawmakers, insurance companies could be able to charge people over 50 more than younger people. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, including $4,007 in Florida, according to the AARP.
  • Nine Million People in the Marketplaces Would Pay More for Coverage, Including 1,508,784 Floridians. If Judge O’Connor’s ruling is upheld, consumers would no longer have access to tax credits that help them pay their marketplace premiums, meaning roughly nine million people who receive these tax credits to pay for coverage will have to pay more, including 1,508,784 in Florida.
  • Seniors Would Have to Pay More for Prescription Drugs. Because Judge O’Connor sided with Republican lawmakers, seniors could have to pay more for prescription drugs because the Medicare “donut” hole got reopened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 CMS report. In Florida, 344,343 seniors each saved an average of $1,068.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have the Power to Limit the Care You Get, Even If You Have Insurance Through Your Employer

  • Insurance Companies Do Not Have to Provide the Coverage You Need. The Affordable Care Act made comprehensive coverage more available by requiring insurance companies to include “essential health benefits” in their plans, such as maternity care, hospitalization, substance abuse care and prescription drug coverage. Before the ACA, people had to pay extra for separate coverage for these benefits. For example, in 2013, 75 percent of non-group plans did not cover maternity care, 45 percent did not cover substance abuse disorder services, and 38 percent did not cover mental health services. Six percent did not even cover generic drugs.
  • Reinstate Lifetime and Annual Limits. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage.
  • Large Employers Could Choose to Follow Any State’s Guidance, Enabling Them Put Annual and Lifetime Limits on Their Employees’ Health Care. Without the ACA’s definition of essential health benefits (EHB) in even some states, states could eliminate them altogether. Large employers could choose to apply any state’s standard, making state regulations essentially meaningless. Because the prohibition on annual and lifetime limits only applies to essential health benefits, this change would allow employers to reinstate annual and lifetime limits on their employees’ coverage.
protectourcare
In News

TODAY: Senator Murphy, Attorney General Herring, and Ranking Member Pallone Join Protect Our Care to Discuss District Court Ruling to Repeal the Affordable Care Act

Ruling Means:

Medicaid Expansion is Gone

Protections for Preexisting Conditions are Gone

Seniors Forced to Pay More for Prescription Drugs

Millions to Lose Health Care

Washington, DC – Today, Monday December 17, 2018 at 11:00 AM ET, Protect Our Care will hold a press conference call featuring U.S. Senator Chris Murphy (D-CT), Attorney General Mark Herring (D-VA), Ranking Member Pallone (D-NJ) to discuss the shocking decision by U.S. District Judge Reed O’Connor to unleash “chaos” in our health system by overturning critical Affordable Care Act protections. With this decision, Republicans have done through the courts what they couldn’t do in Congress: repeal the ACA, raise costs, end protections, and take health care away from millions of Americans with pre-existing conditions.

View Protect Our Care’s statement in response to the ruling here.

WHAT:

Press call to discuss Judge O’Connor’s ruling in Texas, et. al. vs. United States, et. al.

WHO:

U.S. Senator Chris Murphy

Attorney General Mark Herring

Ranking Member Frank Pallone, House Energy & Commerce Committee

Leslie Dach, chair, Protect Our Care

Brad Woodhouse, executive director, Protect Our Care

WHEN:        

Today, Monday, December 17, 2018

11:00 AM ET

CONTACT:

Please RSVP to [email protected]


CALL-IN NUMBER:
888-220-8474, code: 7916276

ADDITIONAL BACKGROUND:

If Judge O’Connor’s ruling takes effect, critical Affordable Care Act protections essentially vanish overnight, unleashing — as the Trump Administration itself admitted in his court — “chaos” in our entire health care system.

  • Seventeen million more people could lose their coverage in a single year, leading to a 50 percent increase in the uninsured rate
  • Protections for 130 million people with pre-existing conditions, if they buy coverage on their own, are gone
  • The Medicaid expansion, currently covering 15 million people, could vanish.
  • Improvements to Medicare, including reduced costs for prescription drugs, are eliminated
  • No longer will kids be allowed to stay on their parents’ insurance until age 26
  • The ban on annual and lifetime limits are gone
  • The ban on insurance discrimination against women and people over age 50 is gone
  • Limits on out-of-pocket costs are eliminated
  • Small business tax credits are gone
  • Marketplace tax credits for up to 9 million people are gone
protectourcare
In News, Stories

TOMORROW: Senator Murphy and Attorney General Herring Join Protect Our Care to Discuss District Court Ruling to Repeal the Affordable Care Act

Ruling Means:

Medicaid Expansion is Gone

Protections for Preexisting Conditions are Gone

Seniors Forced to Pay More for Prescription Drugs

Millions to Lose Health Care

 

Washington, DC – On Monday, December 17, 2018 at 11:00 AM ET, Protect Our Care will hold a press conference call featuring U.S. Senator Chris Murphy (D-CT) and Attorney General Mark Herring (D-VA) to discuss the shocking decision by U.S. District Judge Reed O’Connor to unleash “chaos” in our health system by overturning critical Affordable Care Act protections. With this decision, Republicans have done through the courts what they couldn’t do in Congress: repeal the ACA, raise costs, end protections, and take health care away from millions of Americans with pre-existing conditions.

View Protect Our Care’s statement in response to the ruling here.

 

WHAT:

Press call to discuss Judge O’Connor’s ruling in Texas, et. al. vs. United States, et. al.

 

WHO:

U.S. Senator Chris Murphy

Attorney General Mark Herring

Leslie Dach, chair, Protect Our Care

Brad Woodhouse, executive director, Protect Our Care

 

WHEN:        

Monday, December 17, 2018

11:00 AM ET

 

CONTACT:

Please RSVP to [email protected] for the call-in number

 

ADDITIONAL BACKGROUND:

If Judge O’Connor’s ruling takes effect, critical Affordable Care Act protections essentially vanish overnight, unleashing — as the Trump Administration itself admitted in his court — “chaos” in our entire health care system.

  • Seventeen million more people could lose their coverage in a single year, leading to a 50 percent increase in the uninsured rate
  • Protections for 130 million people with pre-existing conditions, if they buy coverage on their own, are gone
  • The Medicaid expansion, currently covering 15 million people, could vanish.
  • Improvements to Medicare, including reduced costs for prescription drugs, are eliminated
  • No longer will kids be allowed to stay on their parents’ insurance until age 26
  • The ban on annual and lifetime limits are gone
  • The ban on insurance discrimination against women and people over age 50 is gone
  • Limits on out-of-pocket costs are eliminated
  • Small business tax credits are gone
  • Marketplace tax credits for up to 9 million people are gone
ashoup
In News

“The Assurances Are Worthless”: Editorials From Coast to Coast Hammer Republicans Over Latest Attack on the Affordable Care Act

On Friday night, hand-picked, conservative, right-wing federal District Court Judge Reed O’Connor ruled the entire Affordable Care Act unconstitutional. His decision would end protections for people with pre-existing conditions, re-institute lifetime limits on coverage, implement an age tax on older Americans, end Medicaid expansion, and take away coverage from tens of millions of Americans. In short, an absolute disaster for Americans and their health care – and editorials across the country have been quick to note make this clear. Here’s a sampling:

The ruling has been criticized by editorial boards:

Los Angeles Times: “The Relentless, Wreck-It-Ralph Attacks On The Law In Congress And The Courts Should Have Ended Last Year.” “ By handing a victory to 18 Republican state attorneys general and two Republican governors, however, the judge has threatened to put healthcare out of reach for millions of lower-income Americans, undo important insurance reforms and toss out federal efforts to improve the cost and quality of care. The ruling will be appealed and has no immediate effect. Yet by issuing it before the end of open enrollment, Judge Reed O’Connor needlessly sowed confusion and, potentially, discouraged some people from obtaining coverage for 2019. That’s unforgivable. Worse yet, it could result in the entire law being tossed out by the courts. We get it — there are plenty of Republicans who don’t like major features of the ACA and resent the way it was enacted. But the relentless, Wreck-It-Ralph attacks on the law in Congress and the courts should have ended last year, when Republicans could get neither a pure repeal nor a repeal-and-replace plan through the Congress they controlled even on a simple majority vote.” [Los Angeles Times, 12/15]

Bloomberg: Republican Assurances On Pre-Existing Conditions “Were Worthless.” “‘Everybody I know in the Senate — everybody — is in favor of maintaining coverage for pre-existing conditions,’ Senate Majority Leader Mitch McConnell said in June. ‘All Republicans support people with pre-existing conditions, and if they don’t, they will after I speak to them. I am in total support,’ President Trump tweeted in October. This was during the midterm election campaign, when the Republicans were pedaling backward to convince America that they’d no intention of taking away the protections of the Affordable Care Act. Ignore the efforts in Congress to repeal the law, they told voters; don’t worry about the Justice Department joining a legal challenge to ACA, asking to strike down coverage of people with preexisting conditions at no extra cost. The assurances were worthless. A court has not only thrown out protections for preexisting conditions; it has ruled the ACA as a whole unconstitutional — including the Medicaid expansion, the requirement that large employers offer health-insurance benefits, the subsidies for low-income buyers of insurance on the health exchanges, even the exchanges themselves.” [Bloomberg, 12/16]

It has been assailed by legal experts:

Jonathan Adler and Abbe Gluck, New York Times: “This Decision Makes A Mockery Of The Rule Of Law And The Basic Principles Of Democracy.” “A ruling this consequential had better be based on rock-solid legal argument. Instead, the opinion by Judge Reed O’Connor is an exercise of raw judicial power, unmoored from the relevant doctrines concerning when judges may strike down a whole law because of a single alleged legal infirmity buried within. We were on opposing sides of the 2012 and 2015 Supreme Court challenges to the Affordable Care Act, and we have different views of the merits of the act itself. But as experts in the field of statutory law, we agree that this decision makes a mockery of the rule of law and basic principles of democracy — especially Congress’s constitutional power to amend its own statutes and do so in accord with its own internal rules.” [New York Times, 12/15]

Nicholas Bagley, Washington Post: “Don’t Mistake [This Ruling] For The Rule Of Law.” “To put it bluntly, [the ruling] makes zero sense… In perhaps the most remarkable passage in a remarkable opinion, he wrote that the 2017 Congress ‘intended to preserve the Individual Mandate because the 2017 Congress, like the 2010 Congress, knew that provision is essential to the ACA.’ Your jaw should be on the floor. On no account did Congress in 2017 ‘intend to preserve’ the individual mandate. It meant to get rid of the loathed mandate — and it did, by eliminating the penalty that gave it force and effect… So nothing changes for the time being. And nothing should change. The legal arguments in previous rounds of litigation over the ACA may have been weak, but they were not frivolous. This case is different; it’s an exercise of raw judicial activism. Don’t for a moment mistake it for the rule of law.” [Washington Post, 12/16]

Cristan Farias, New York Times: “Shocking Even Conservative Legal Experts, The Trump Administration Lent Its Support To The Texas Lawsuit.” “The ruling, issued late on Friday and only one day before the end of the law’s annual open enrollment period, is not a model of constitutional or statutory analysis. It’s instead a predictable exercise in motivated reasoning — drafted by a jurist with a history of ruling against policies and laws advanced by President Barack Obama… Shocking even conservative legal experts, the Trump administration fell for this spurious argument and lent its support to the Texas lawsuit — which, if successful, would render all of the marquee provisions of Obamacare, like protections for patients with pre-existing conditions, null… This all-out assault on health care is one reason Democrats did so well in the midterm elections, as voters rejected anti-Obamacare candidates at the polls. They included several lawmakers who had gleefully voted for Mr. Trump’s tax bill less than a year earlier.” [New York Times, 12/15]

And its drastic consequences have been made clear:

Jonathan Gruber, Boston Globe: “If This Law Is Struck Down, We Will Return To The Bad Old Days Where Insurers Could Deny Coverage To Individuals Who Are Ill.” “Even though the Trump administration has significantly weakened the ACA, 17 million Americans have gained coverage through the law. Perhaps more importantly, the estimated 133 million Americans with a pre-existing condition have access to affordable coverage should they need it. If this law is struck down, we will return to the bad old days where insurers could deny coverage to individuals who are ill, or charge them many times more than the healthy. That’s not all that will be lost with a repeal of the ACA. Children will no longer be protected by their parents’ insurance plans until age 26. Insurers will be able to once again limit how much healthcare spending they cover in any year, and there will no longer be a cap on what individuals have to spend out of pocket on their medical costs. Millions of Americans who don’t read the fine print of their insurance contracts could once again buy insurance that leaves them with tens of thousands of dollars in uncovered medical bills.” [Boston Globe, 12/15]

  • Gruber: “It Isn’t Just The Health Of Our Citizens That Is At Risk Here – It Is The Health Of Our Democracy.” “But it isn’t just the health of our citizens that is at risk here – it is the health of our democracy. We have a law that was first passed when Democrats controlled both houses of Congress and the presidency. It was then thoroughly reviewed, debated, and voted on when the Republicans controlled both houses of Congress and the presidency. The Republicans decided that the proper outcome was an ACA with no mandate, and the outcome of that process was a weaker but still functional ACA. If the courts overturn this outcome, it is an attack on the very process of representative government in the US.” [Boston Globe, 12/15]

Evan Mintz, Houston Chronicle: We’ll Wait To See Whether Insurance Companies Will Once Again Be Allowed To Discriminate Against People With Pre-existing Conditions Or Sell Plans That Don’t Cover Core Medical Needs.” “This district court didn’t issue an injunction, so the nation will have to wait for the inevitable appeals to see if we lose all the protections in the groundbreaking law. We’ll wait to see whether insurance companies will once again be allowed to discriminate against people with pre-existing conditions or sell plans that don’t cover core medical needs. Millions of Americans are left wondering if our nation is going to be thrust back into an age before the ACA, also known as Obamacare, when medical bankruptcies were skyrocketing and people were afraid to change their jobs for fear being denied coverage. If you’re one of these Americans, feel free to thank Texas Attorney General Ken Paxton, who led the plaintiffs in the lawsuit. Paxton — who is currently under indictment for fraud — now bears the burden of helping his fellow Texans understand what happens if the ACA is eventually struck down for good.” [Houston Chronicle, 12/16]

Derek Rapp, The Hill: This Ruling “Threatens Coverage Of Pre-Existing Conditions [And] Leaves MIllions In Jeopardy.” “Coverage for pre-existing conditions is critical for the millions of Americans living with chronic diseases, and it’s a matter of decency and existing law. Until the Affordable Care Act, people with pre-existing conditions were denied insurance coverage, charged higher premiums and offered limited benefits. Friday’s decision by a federal judge in Texas that threatens coverage of pre-existing conditions leaves millions in jeopardy a month after the topic dominated the midterm elections.” [The Hill, 12/15]

As millions of Americans go to bed tonight anxious about the future of their health care, whether this country will return to the days of discrimination against those with pre-existing conditions and denied coverage claims and surprise medical bankruptcies, Donald Trump and Congressional Republicans will continue to own every last worry.

ashoup
In News

Ignoring Clear Lessons of the Midterm Elections, Republicans Celebrate Decision Ending Protections for Pre-Existing Conditions and Ripping Health Care Away from Millions

On Friday, hand-picked, conservative, right-wing federal District Court Judge Reed O’Connor ruled the entire Affordable Care Act unconstitutional. His decision would end protections for people with pre-existing conditions, re-institute lifetime limits on coverage, implement an age tax on older Americans, end Medicaid expansion, and take away coverage from tens of millions of Americans. In short, an absolute disaster for Americans and their health care.

Despite this, Republicans are praising the decision:

CNN: President Trump “Immediately Tweeted In Celebration.” “President Donald Trump, who campaigned in 2016 on a promise to undo Obamacare, was thwarted in Congress last year by a lone vote from the late Arizona Republican Sen. John McCain. Trump immediately tweeted in celebration on Friday and called on Congress to act. ‘As I predicted all along, Obamacare has been struck down as an UNCONSTITUTIONAL disaster! Now Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions. Mitch and Nancy, get it done!’ Trump wrote. He later added, ‘Wow, but not surprisingly, ObamaCare was just ruled UNCONSTITUTIONAL by a highly respected judge in Texas. Great news for America!’” [CNN, 12/15]

Washington Examiner: Republicans Are Using The Ruling To Once Again Revive Repeal. “Republicans revived their calls to replace Obamacare in the wake of a federal judge declaring the healthcare law unconstitutional, but Democrats indicated they had no plans to abandon the legal battle ahead… Sarah Sanders, the White House press secretary, said Friday night that she expected it would land before the high court. ‘The judge’s decision vindicates President Trump’s position that Obamacare is unconstitutional,’ she said… The actions in the courts are another way that Republicans are aiming to undo the law. The latest ruling follows a slew of challenges Obamacare has faced both in Congress and in the courts since it passed.” [Washington Examiner, 12/15]

CMS Administrator Seema Verma: “Obamacare Has Been Struck Down.” “Obamacare has been struck down by a highly respected judge. The judge’s decision vindicates President Trump’s position that Obamacare is unconstitutional. Once again, the President calls on Congress to replace Obamacare and act to protect people with preexisting conditions…and provide Americans with quality affordable healthcare. We expect this ruling will be appealed to the Supreme Court. Pending the appeal process, the law remains in place.” [Seema Verma Twitter, 12/15]

House Energy and Commerce Chair Greg Walden: We Need New Health Care Legislation. “Energy and Commerce Committee Chairman Greg Walden, R-Ore., echoed the calls for new legislation. ‘We have a rare opportunity for truly bipartisan healthcare reform,’ he said.” [Washington Examiner, 12/15]

House Ways and Means Chair Kevin Brady: Ruling Was “No Surprise” Because ACA Was “Poorly Written, Crafted By Democrats Behind Closed Doors.” “No surprise. Poorly written, crafted by Democrats behind closed doors & stuffed with special interests that drove up health costs for millions of working Americans. Time to start over – both parties working together this time to LOWER costs.” [Kevin Brady Twitter, 12/15]

Texas Attorney General Ken Paxton: Ruling Lets Congress Replace “Failed Social Experiment” That Is The Affordable Care Act. “Meanwhile Texas Attorney General Ken Paxton is declaring victory. Paxton praised the ruling as halting an unconstitutional exertion of power by the federal government. ‘Our lawsuit seeks to effectively repeal Obamacare, which will give President Trump and Congress the opportunity to replace the failed social experiment with a plan that ensures Texans and all Americans will again have greater choice about what health coverage they need and who will be their doctor,’ said Paxton’s statement.” [Buzzfeed, 12/15]

The groundwork for the lawsuit was laid by the Trump Administration:

CNBC: While President Trump Was Unable To Repeal ACA, He Was “Able To Dismantle Key Parts Of It.” “While President Donald Trump was previously unable to repeal Obamacare, he was able to dismantle key parts of it that several health policy researchers are blaming for much of the drop in enrollment this year. He applauded the judge’s ruling in a tweet late Friday. White House Press Secretary Sarah Huckabee Sanders released a statement praising the ruling. ‘Obamacare has been struck down by a highly respected judge. The judge’s decision vindicates President Trump’s position that Obamacare is unconstitutional.’” [CNBC, 12/14]

Vice News: Lawsuit Only Possible Because Trump’s Department Of Justice “Made The Unusual Decision To Not Defend Existing Federal Law.” “The lawsuit to dismantle the program was led by political leaders from 20 conservative-leaning states that filed a complaint in February, arguing the law couldn’t constitutionally stand without the tax… The Justice Department made the unusual decision to not defend existing federal law, siding with the states instead. California’s attorney general, Xavier Becerra, is leading the defense of the health care law.” [Vice, 12/15]

Washington Times: The Trump Administration “Did Not Defend The Law In Court.” “The Trump administration did not defend the law in court, and sided with the states on some points. Yet it asked the judge to wait until open enrollment was complete, to avoid chaos in the markets. But that didn’t happen.” [Washington Times, 12/14]

And it is the American people would be left to suffer:

CBS News: Invalidated Law Would Mean The End Of Protections For People With Pre-Existing Conditions And The Ability Of Children To Stay On Their Parents’ Coverage Until Age 26. ““Democrats were able to retake the House in large part because they campaigned on health care issues, warning that Republicans would try to strip away some of the more popular provisions of the ACA, such as protection for pre-existing conditions. Around 130 million people in the United States have pre-existing conditions, and without the ACA, insurers would no longer be required to cover those conditions. If the law is invalidated, it could scrap other well-liked sections of the law, such as the part that allows parents to keep young adult children on their health care coverage until age 26.” [CBS News, 12/15]

Associated Press: Coverage For 20 Million Americans At Stake Under This Ruling. “About 20 million people have gained health insurance coverage since the law passed in 2010 without a single Republican vote. Currently, about 10 million have subsidized private insurance through the health law’s insurance markets, while an estimated 12 million low-income people are covered through its Medicaid expansion.” [AP, 12/15]

  • Fox News: Ruling “Could Suddenly Disrupt The Health Insurance Of Millions Of Americans.” “The Affordable Care Act, also known as Obamacare, was struck down by a Texas judge on Friday, a move that could suddenly disrupt the health insurance status of millions of Americans. The decision comes amid a six-week open enrollment period for the program.” [Fox News, 12/15]
  • CNN: Ruling “Throws Into Doubt The Future Of Health Coverage For Millions Of Americans.” “Legal experts say the ruling won’t immediately affect Americans’ health coverage, and a group of states led by California is already vowing to appeal. But the invalidation of the landmark health care law popularly known as Obamacare throws into doubt the future of health coverage for millions of Americans on the Obamacare exchanges and in Medicaid expansion.” [CNN, 12/15]

Politico: “Even The Trump Administration’s Own Plans To Lower Drug Prices” Would Be Illegal Under Ruling. “Expanded Medicaid for millions. Penalties for poorly performing hospitals. Even the Trump administration’s own plans to lower drug prices. Those and many other initiatives would all be illegal under a federal judge’s sweeping decision that the entire Affordable Care Act must be struck down — the latest shock to the nation’s health system after a decade of upheavals, including two fights over the ACA that reached the Supreme Court.” [Politico, 12/15]

ashoup
In News

Court Ruling Helps Lamar Alexander Rip Away Protections for People with Pre-Existing Conditions

Decision From Federal Judge Means:

Medicaid Expansion is Gone

Protections for Pre-Existing Conditions are Gone

Hundreds of Thousands of Tennesseans Will Lose Health Care

And Lamar Alexander OWNS IT

Washington, D.C. –  On Friday night, conservative U.S. District Judge Reed O’Connor issued his ruling in Texas, et. al. vs. United States, et. al., siding with Republican attorneys general, governors, the Trump Administration, and Senator Lamar Alexander  to overturn the entire Affordable Care Act (ACA). Whether it’s repealing the individual mandate to pay for tax cuts or ramming through partisan repeal legislation, repeal cheerleader Lamar Alexander has done nothing but support the GOP’s efforts to strip coverage from hundreds of thousands of Tennesseans. Brad Woodhouse, executive director of Protect Our Care issued the following statement:

“Like two sides of the same coin, Lamar Alexander and the Trump Administration have worked relentlessly to undermine the Affordable Care Act. Today, they are one step closer to ripping health care away from millions of Tennesseans with pre-existing conditions like cancer, diabetes, or asthma.  If this ruling isn’t overturned, Lamar Alexander will roll back the clock and take Tennesseans back to the days where insurance companies had the power to once again deny, drop, or charge more for coverage. They will once again have the power to impose annual or lifetime limits and charge women and seniors more based on their age and gender. Make no mistake, these actions will hurt hundreds of thousands of Tennesseans.”

BACKGROUND:

Due to Judge O’Connor’s ruling yesterday, Republicans are one step closer to repealing the Affordable Care Act and eliminating key protections, unleashing — as the Trump Administration itself admitted in his court — “chaos” in our entire health care system. Under this ruling:

  • Marketplace tax credits and coverage for 10 million people: GONE.
  • Medicaid expansion currently covering 15 million people: GONE.
  • Protections for more than 130 million people with pre-existing conditions when they buy coverage on their own: GONE.
  • Allowing children to stay on their parents’ insurance until age 26: GONE.
  • Free annual wellness exams: GONE.
  • Ban on annual and lifetime limits: GONE.
  • Ban on insurance discrimination against women: GONE.
  • Contraception with no out-of-pocket costs: GONE.
  • Limit on out-of-pocket costs: GONE.
  • Requirement that insurance companies cover essential benefits like prescription drugs, maternity care, and hospitalization: GONE.
  • Improvements to Medicare, including reduced costs for prescription drugs: GONE.
  • Closed Medicare prescription drug donut hole: GONE.
  • Rules to hold insurance companies accountable: GONE.
  • Small business tax credits: GONE.

What’s at stake for Tennessee:

  • The coverage that 266,000 Tennesseans gained through the ACA by 2015.
  • Protections for 2,718,800 Tennesseans who have a pre-existing health condition.
  • The health care of roughly 47,000 young adults in Tennessee who have coverage because they can stay on their parents coverage until age 26.
  • The nearly 2,745,436 Tennesseans, most of whom have employer coverage, who can access free preventive care at no cost.
  • The 3,369,000 Tennesseans with employer coverage who no longer have to worry about lifetime or annual limits.
  • Seniors’ drug savings — 108,136 Tennessee seniors are saving $111.8 million on drugs in 2017, an average of $1,034 per beneficiary.

Because Judge O’Connor Sided With Republicans, 17.1 Million People Would Lose Their Coverage

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Be Put Back In Charge, Ending Protections For The 130 Million People With A Pre-Existing Condition

  • According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 130 million people, have a pre-existing condition. This includes:
    • 44 million people who have high blood pressure
    • 45 million people who have behavioral health disorders
    • 44 million people who have high cholesterol
    • 34 million people who have asthma and chronic lung disease
    • 34 million people who have osteoarthritis and other joint disorders
  • 17 million children. One in four children, or roughly 17 million, have a pre-existing condition This includes 355,200 Tennessee children.
  • 68 million women. More than half of women and girls nationally have a pre-existing condition.
  • 30 million people aged 55-64. 84 percent of older adults, 30.5 million Americans between age 55 and 64, have a pre-existing condition. This includes 630,100 in Tennessee
  • 2,718,800 Tennesseans have a pre-existing condition.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have The Power To Deny Or Drop Coverage Because Of A Pre-Existing Condition

Before the Affordable Care Act, insurance companies routinely denied people coverage because of a pre-existing condition or canceled coverage when a person got sick. If Judge O’Connor rules in favor of Republicans, insurance companies will be able to do this again.

  • A 2010 congressional report found that the top four health insurance companies denied coverage to one in seven consumers on the individual market over a three year period.
  • A 2009 congressional report found that the of the largest insurance companies had retroactively canceled coverage for 20,000 people over the previous five year period
Conditions That Could Cost You Your Care:

  • AIDS/HIV
  • Alcohol/drug Abuse
  • Cerebral Palsy
  • Cancer
  • Heart Disease
  • Diabetes
  • Epilepsy
  • Kidney Disease
  • Severe Epilepsy
  • Sleep Apnea
  • Pregnancy
  • Muscular Dystrophy
  • Depression
  • Eating Disorders
  • Bipolar Disorder
 Jobs You Could Be Denied Coverage Because Of:

  • Active military personnel
  • Air traffic controller
  • Body guard
  • Pilot
  • Meat packers
  • Taxi cab drivers
  • Steel metal workers
  • Law enforcement
  • Oil and gas exploration
  • Scuba divers
 Medications That You Could Be Denied Health Care For Taking:

  • Anti-arthritic medications
  • Anti-diabetic medications (including insulin)
  • Anti-cancer medications
  • Anti-coagulant and anti-thrombotic medications
  • Medications used to treat autism
  • Anti-psychotics
  • Medications for HIV/AIDS
  • Growth hormone
  • Medication used to treat arthritis, anemia, and narcolepsy
  • Fertility Medication

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have The Power To Charge You More

  • More than 100 Million People With A Pre-Existing Condition Could Be Forced to Pay More. An analysis by Avalere finds that “102 million individuals, not enrolled in major public programs like Medicaid or Medicare, have a pre-existing medical condition and could therefore face higher premiums or significant out-of-pocket costs” thanks to the Republican lawsuit to repeal the Affordable Care Act.
  • Insurance Companies Could Charge Premium Surcharges in the Six Figures. If Judge O’Connor sides with Republican lawmakers, insurance companies would be able to charge people more because of a pre-existing condition. The health repeal bill the House passed in 2017 had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
  • Women Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women were often charged premiums on the nongroup market of up to 50 percent higher than they charged men for the same coverage.
  • People Over the Age of 50 Could Face a $4,000 “Age Tax,” Including $5,404 in Tennessee. If Judge O’Connor sides with Republican lawmakers, insurance companies would be able to charge people over 50 more than younger people. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, including $5,404 in Tennessee, according to the AARP.
  • Seniors Would Have to Pay More for Prescription Drugs. If Judge O’Connor sides with Republican lawmakers, seniors would have to pay more for prescription drugs because the Medicare “donut” hole got reopened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 CMS report. In Tennessee, 108,136 seniors saved $111.8 million on drugs in 2017, an average of $1,034 per beneficiary. .

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have the Power to Limit the Care You Get, Even If You Have Insurance Through Your Employer

  • Insurance Companies Do Not Have to Provide the Coverage You Need. The Affordable Care Act made comprehensive coverage more available by requiring insurance companies to include “essential health benefits” in their plans, such as maternity care, hospitalization, substance abuse care and prescription drug coverage. Before the ACA, people had to pay extra for separate coverage for these benefits. For example, in 2013, 75 percent of non-group plans did not cover maternity care, 45 percent did not cover substance abuse disorder services, and 38 percent did not cover mental health services. Six percent did not even cover generic drugs.
  • Reinstate Lifetime and Annual Limits. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage.
  • Large Employers Could Choose to Follow Any State’s Guidance, Enabling Them Put Annual and Lifetime Limits on Their Employees’ Health Care. Without the ACA’s definition of essential health benefits (EHB) in even some states, states could eliminate them altogether. Large employers could choose to apply any state’s standard, making state regulations essentially meaningless. Because the prohibition on annual and lifetime limits only applies to essential health benefits, this change would allow employers to reinstate annual and lifetime limits on their employees’ coverage.
ashoup
In News

Court Ruling Helps David Perdue Rip Away Protections for People with Pre-Existing Conditions

Decision From Federal Judge Means:

Medicaid Expansion is Gone

Protections for Pre-Existing Conditions are Gone

Hundreds of Thousands of Georgians Will Lose Health Care

And David Perdue OWNS IT

Washington, D.C. –  On Friday night, conservative U.S. District Judge Reed O’Connor issued his ruling in Texas, et. al. vs. United States, et. al., siding with Republican attorneys general, governors, the Trump Administration, and Senator David Perdue  to overturn the entire Affordable Care Act (ACA). Whether it’s repealing the individual mandate to pay for tax cuts or ramming through partisan repeal legislation, repeal cheerleader David Perdue has done nothing but support the GOP’s efforts to strip coverage from hundreds of thousands of Georgians. Brad Woodhouse, executive director of Protect Our Care issued the following statement:

“Like two sides of the same coin, David Perdue and the Trump Administration have worked relentlessly to undermine the Affordable Care Act. Today, they are one step closer to ripping health care away from millions of Georgians with pre-existing conditions like cancer, diabetes, or asthma.  If this ruling isn’t overturned, David Perdue will roll back the clock and take Georgians back to the days where insurance companies had the power to once again deny, drop, or charge more for coverage. They will once again have the power to impose annual or lifetime limits and charge women and seniors more based on their age and gender. Make no mistake, these actions will hurt hundreds of thousands of Georgians.”

BACKGROUND:

Due to Judge O’Connor’s ruling yesterday, Republicans are one step closer to repealing the Affordable Care Act and eliminating key protections, unleashing — as the Trump Administration itself admitted in his court — “chaos” in our entire health care system. Under this ruling:

  • Marketplace tax credits and coverage for 10 million people: GONE.
  • Medicaid expansion currently covering 15 million people: GONE.
  • Protections for more than 130 million people with pre-existing conditions when they buy coverage on their own: GONE.
  • Allowing children to stay on their parents’ insurance until age 26: GONE.
  • Free annual wellness exams: GONE.
  • Ban on annual and lifetime limits: GONE.
  • Ban on insurance discrimination against women: GONE.
  • Contraception with no out-of-pocket costs: GONE.
  • Limit on out-of-pocket costs: GONE.
  • Requirement that insurance companies cover essential benefits like prescription drugs, maternity care, and hospitalization: GONE.
  • Improvements to Medicare, including reduced costs for prescription drugs: GONE.
  • Closed Medicare prescription drug donut hole: GONE.
  • Rules to hold insurance companies accountable: GONE.
  • Small business tax credits: GONE.

What’s at stake for Georgia:

  • The coverage that 581,000 Georgians gained through the ACA by 2015.
  • Protections for 4,316,000 Georgians who have a pre-existing health condition.
  • The health care of roughly 74,000 young adults in Georgia who have coverage because they can stay on their parents coverage until age 26.
  • The nearly 4,187,077 Georgians, most of whom have employer coverage, who can access free preventive care at no cost.
  • The 5,240,000 Georgians with employer coverage who no longer have to worry about lifetime or annual limits.
  • Seniors’ drug savings — 138,291 Georgia seniors are saving $158.2 million on drugs in 2017, an average of $1,144 per beneficiary.

Because Judge O’Connor Sided With Republicans, 17.1 Million People Would Lose Their Coverage

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Be Put Back In Charge, Ending Protections For The 130 Million People With A Pre-Existing Condition

  • According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 130 million people, have a pre-existing condition. This includes:
    • 44 million people who have high blood pressure
    • 45 million people who have behavioral health disorders
    • 44 million people who have high cholesterol
    • 34 million people who have asthma and chronic lung disease
    • 34 million people who have osteoarthritis and other joint disorders
  • 17 million children. One in four children, or roughly 17 million, have a pre-existing condition.
  • 68 million women. More than half of women and girls nationally have a pre-existing condition.
  • 30 million people aged 55-64. 84 percent of older adults, 30.5 million Americans between age 55 and 64, have a pre-existing condition.
  • 4,316,000 Georgians have a pre-existing condition.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have The Power To Deny Or Drop Coverage Because Of A Pre-Existing Condition

Before the Affordable Care Act, insurance companies routinely denied people coverage because of a pre-existing condition or canceled coverage when a person got sick. If Judge O’Connor rules in favor of Republicans, insurance companies will be able to do this again.

  • A 2010 congressional report found that the top four health insurance companies denied coverage to one in seven consumers on the individual market over a three year period.
  • A 2009 congressional report found that the of the largest insurance companies had retroactively canceled coverage for 20,000 people over the previous five year period
Conditions That Could Cost You Your Care:

  • AIDS/HIV
  • Alcohol/drug Abuse
  • Cerebral Palsy
  • Cancer
  • Heart Disease
  • Diabetes
  • Epilepsy
  • Kidney Disease
  • Severe Epilepsy
  • Sleep Apnea
  • Pregnancy
  • Muscular Dystrophy
  • Depression
  • Eating Disorders
  • Bipolar Disorder
 Jobs You Could Be Denied Coverage Because Of:

  • Active military personnel
  • Air traffic controller
  • Body guard
  • Pilot
  • Meat packers
  • Taxi cab drivers
  • Steel metal workers
  • Law enforcement
  • Oil and gas exploration
  • Scuba divers
 Medications That You Could Be Denied Health Care For Taking:

  • Anti-arthritic medications
  • Anti-diabetic medications (including insulin)
  • Anti-cancer medications
  • Anti-coagulant and anti-thrombotic medications
  • Medications used to treat autism
  • Anti-psychotics
  • Medications for HIV/AIDS
  • Growth hormone
  • Medication used to treat arthritis, anemia, and narcolepsy
  • Fertility Medication

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have The Power To Charge You More

  • More than 100 Million People With A Pre-Existing Condition Could Be Forced to Pay More. An analysis by Avalere finds that “102 million individuals, not enrolled in major public programs like Medicaid or Medicare, have a pre-existing medical condition and could therefore face higher premiums or significant out-of-pocket costs” thanks to the Republican lawsuit to repeal the Affordable Care Act.
  • Insurance Companies Could Charge Premium Surcharges in the Six Figures. If Judge O’Connor sides with Republican lawmakers, insurance companies would be able to charge people more because of a pre-existing condition. The health repeal bill the House passed in 2017 had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
  • Women Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women were often charged premiums on the nongroup market of up to 50 percent higher than they charged men for the same coverage.
  • People Over the Age of 50 Could Face a $4,000 “Age Tax,” Including $4,183 in Georgia. If Judge O’Connor sides with Republican lawmakers, insurance companies would be able to charge people over 50 more than younger people. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, including $ 4,183 in Georgia, according to the AARP.
  • Nine Million People in the Marketplaces Would Pay More for Coverage, Including 368,795 Georgians. If Judge O’Connor sides with Republican lawmakers, consumers would no longer have access to tax credits that help them pay their marketplace premiums, meaning roughly nine million people who receive these tax credits to pay for coverage will have to pay more, including 368,795 in Georgia.
  • Seniors Would Have to Pay More for Prescription Drugs. If Judge O’Connor sides with Republican lawmakers, seniors would have to pay more for prescription drugs because the Medicare “donut” hole got reopened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 CMS report. In Georgia, 138,291 seniors each saved an average of $1,144.

Because Judge O’Connor Sided With Republicans, Insurance Companies Could Have the Power to Limit the Care You Get, Even If You Have Insurance Through Your Employer

  • Insurance Companies Do Not Have to Provide the Coverage You Need. The Affordable Care Act made comprehensive coverage more available by requiring insurance companies to include “essential health benefits” in their plans, such as maternity care, hospitalization, substance abuse care and prescription drug coverage. Before the ACA, people had to pay extra for separate coverage for these benefits. For example, in 2013, 75 percent of non-group plans did not cover maternity care, 45 percent did not cover substance abuse disorder services, and 38 percent did not cover mental health services. Six percent did not even cover generic drugs.
  • Reinstate Lifetime and Annual Limits. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage.
  • Large Employers Could Choose to Follow Any State’s Guidance, Enabling Them Put Annual and Lifetime Limits on Their Employees’ Health Care. Without the ACA’s definition of essential health benefits (EHB) in even some states, states could eliminate them altogether. Large employers could choose to apply any state’s standard, making state regulations essentially meaningless. Because the prohibition on annual and lifetime limits only applies to essential health benefits, this change would allow employers to reinstate annual and lifetime limits on their employees’ coverage.
Close Menu