March 2020

Surrounding the 10th anniversary of the passage of the Affordable Care Act (ACA) on March 23, Protect Our Care is holding 10 days of action to raise awareness of the most critical components of the law which has improved the lives of millions of Americans. Working with partner organizations and health care advocates, Protect Our Care will highlight a different aspect of the law each day while making clear what’s at stake if the Trump administration is successful in overturning the law through the courts.  

“The Affordable Care Act has been an incredibly positive force for Americans over the last 10 years, especially in implementing protections for people with pre-existing conditions,” said Protect Our Care Executive Director Brad Woodhouse. “Over the course of these 10 days of action, Protect Our Care will remind Americans how the ACA has improved the lives of millions while making clear that President Trump and Republicans’ lawsuit to overturn the law poses an existential threat to Americans’ health care.” 

Days of Action: Day 8 of 10 focuses on Protections For Pre-Existing Conditions. To learn more about our days of action, visit our website

The Affordable Care Act implemented key protections for people with pre-existing conditions. Ten years later, these protections are some of the most popular provisions in the health care law. 

• According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 135 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
• More than 17 million children, 68 million women, and 32 million people aged 55-64 have 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.

The ACA Includes Four Key Provisions That Protect People With Pre-Existing Conditions: 

• COVERAGE GUARANTEE: Rule that forbids insurance companies from denying coverage to people with pre-existing conditions. 
• COST: Rule that prevents insurers from charging people with pre-existing conditions more. 
• ESSENTIAL HEALTH BENEFITS: Requirements that insurance companies cover essential health benefits, such as prescription drugs and maternity care.
• LIFETIME CAPS: Ban on insurance companies having lifetime caps on coverage.

Republicans Want To Put Insurance Companies Back In Charge, Ending Protections For The 135 Million People With Pre-Existing Conditions.

Repeated attempts to undermine and sabotage the ACA puts protections for 135 million Americans with pre-existing conditions at risk. Moreover, the Trump administration is backing a lawsuit seeking to overturn the entire health care law. WIthout the ACA, protections for pre-existing conditions would be eliminated overnight and the uninsured rate would increase by 65 percent. 

More Than 140 Million Could Once Again Have To Pay For Preventative Care. Because of the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no cost to consumers. More than 140 million Americans are enrolled in plans that provide free preventive services, including 133 million people with employer coverage. 

Premium Surcharges Could Once Again Be In The Six Figures. Thanks to the Republican lawsuit, insurance companies can charge people more because of a pre-existing condition. The House-passed repeal bill 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.

Reinstate Lifetime And Annual Limits On 109 Million Privately Insured Americans. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage for those insured through their employer or on the individual market. In 2009, prior to the implementation of the ACA, 59 percent of workers covered by employer-sponsored health plans had a lifetime limit. 

Insurance Companies Would 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.

Washington, DC — Today, on the eve of the 10-year anniversary of the passage of the Affordable Care Act, President Trump reaffirmed his commitment to pursuing the lawsuit that would overturn the ACA in the courts saying, “what we want to do is terminate it.” If successful, this lawsuit would rip coverage away from 20 million Americans and end protections for 135 million people with pre-existing conditions. This comes at a time when America faces an unprecedented health care crisis and it’s more important than ever that people have access to affordable, quality health care. Protect Our Care Chair Leslie Dach released the following statement in response: 

“It’s outrageous that President Trump would reaffirm his commitment to the lawsuit that would rip coverage away from 20 million Americans during a briefing about an ongoing unprecedented health crisis. No one should have to worry about the status of their health care, particularly during a time when Americans are more concerned than ever about their health and safety. To effectively fight the coronavirus, we need to ensure that people are getting the care and treatment they need. Instead, President Trump wants to rip coverage and vital protections away from the most vulnerable among us at a time when they need it the most.”

BACKGROUND:

View the full fact sheet on Trump-Republican lawsuit to overturn the ACA HERE.

If the Affordable Care Act is struck down:

• GONE: Protections for 135 million Americans with pre-existing conditions. The uninsured rate will increase by 65 percent. 
• GONE: Medicaid expansion, which covers 17 million people. 
• GONE: Nearly 12 million seniors will have to pay more for prescription drugs because the Medicare ‘donut hole’ will be reopened.
• GONE: 2.3 million adult children will no longer be able to stay on their parents’ insurance. 
• GONE: Insurance companies will be able to charge women 50 percent more than men.
• GONE: Financial assistance that helps 9 million people purchase health care in the marketplace.
• GONE: Key support for rural hospitals. As Americans lose coverage, already struggling hospitals will be hit even harder as their costs increase.

POC Also Highlights How the ACA Helps Fight the Coronavirus and the Devastating Consequences of Overturning the Law in the Midst of the Crisis

March 23 is the 10-year anniversary of the passage of the Affordable Care Act and there has never been a more important time to highlight the benefits of the law and the ongoing Trump Republican efforts to sabotage and repeal the law, particularly in light of the coronavirus crisis. 

This month, the Supreme Court announced it would hear the Trump-Republican lawsuit to repeal the ACA in its upcoming term, which if successful would strip coverage from 20 million Americans and eliminate protections for 135 million with pre-existing conditions. During a time when Americans face unprecedented threats to their health as a result of President Trump’s failure to prepare America for the coronavirus, Republicans remain dead set on ripping away their health care. 

“There is no question that the Affordable Care Act has been an incredibly positive force for Americans over the last 10 years, yet so much is at stake as Republicans try to overturn it in the midst of America grappling with the coronavirus pandemic,” said Protect Our Care Executive Director Brad Woodhouse. “President Trump and Republicans need to understand just how devastating their war on health care has been and will continue to be especially as Americans’ health care is threatened more than ever with the spread of coronavirus.” 

“Thanks to the Affordable Care Act, more than 20 million Americans have health coverage and 135 million Americans with pre-existing conditions are guaranteed health insurance that they can afford,” said Protect Our Care Chair, Leslie Dach. “It is unimaginable that President Trump wants to take that coverage away from millions of people when they need them the most.” 

In the lead up to the anniversary Protect Our Care Our’s work has highlighted the ACA’s achievements, the devastating consequences of overturning the law, and the specific ways in which those consequences are amplified as America grapples with coronavirus including a series of memos, and fact sheets. We have also held press calls in key battleground states with elected officials and health care advocates to bring attention to how the Trump-Republican war on health care is affecting people in communities across the country. 

Here are some resources that make the connection between the Trump-Republican sabotage efforts and how the damage of their war on health care is amplified during this crisis: 

MEMO: ACA at 10 Successes and Ongoing Threats on the 10th Anniversary of Its Passage

Key points: During a time when Americans face unprecedented threats to their health as a result of President Trump’s failure to contain the virus, Republicans are still trying to rip away their health care and leave 20 million of Americans uninsured and 135 million with pre-existing conditions without protections.

Trump’s Sabotage Of The ACA Leaves The U.S. Less Prepared For Coronavirus

Key points: Trump is backing a lawsuit that could rip way coverage from 20 million Americans during the middle of the outbreak. He is also pushing short-term junk plans that would not need to cover coronavirus treatment and continues to undermine Medicaid expansion, leaving more Americans uninsured. 

Top Ways The ACA Helps Fight Coronavirus

Key points: From free preventative care, to coverage for 20 million Americans, protections for pre-existing conditions and access to critical vaccinations without cost sharing, along with so many other important areas of coverage, there’s no question the ACA plays an essential role in providing affordable health care to Americans during this crisis. 

Fact Sheet On Trump’s Lawsuit To Overturn The ACA
Key points: President Trump is trying to rip apart our health care by going to court to eliminate the Affordable Care Act in its entirety. If the Trump lawsuit is successful, it will strip coverage from 20 million Americans, raise premiums, end protections for 150 million people with pre-existing conditions, put insurance companies back in charge, and force seniors to pay more for prescription drugs.

ACA at 10 Fact Sheets

Key points: Ahead of the 10th anniversary of the passage of the Affordable Care Act (ACA) on March 23, Protect Our Care is holding 10 days of action to raise awareness of the most critical components of the law which has improved the lives of millions of Americans. 

Fact sheets found here: 

1. Affordability
2. Children’s Coverage
3. Expanded Coverage 
4. Protections For Individuals With Disabilities 
5. Prescription Drug Costs
6. Medicaid Expansion
7. Protections For Pre-Existing Conditions
8. Rural Health
9. Seniors
10. Women’s Health

Ahead of the 10th anniversary of the passage of the Affordable Care Act (ACA) on March 23, Protect Our Care is holding 10 days of action to raise awareness of the most critical components of the law which has improved the lives of millions of Americans. Working with partner organizations and health care advocates, Protect Our Care will highlight a different aspect of the law each day while making clear what’s at stake if the Trump administration is successful in overturning the law through the courts.  

“The Affordable Care Act has been an incredibly positive force for Americans over the last 10 years, particularly in improving coverage and health care access for millions of people with disabilities across the country,” said Protect Our Care Executive Director Brad Woodhouse. “Over the course of these 10 days of action, Protect Our Care will remind Americans how the ACA has improved the lives of millions while making clear that President Trump and Republicans’ lawsuit to overturn the law poses an existential threat to Americans’ health care.” 

Days of Action: Day 7 of 10 focuses on Protections For Individuals With Disabilities. To learn more about our days of action, visit our website

The Affordable Care Act Provided Affordable Coverage And Health Security To People With Disabilities: 

The Affordable Care Act Prevents Insurance Companies From Charging Americans With Disabilities More, Or Denying Them Coverage Altogether. Prior to the ACA, insurance companies were allowed to charge people more or deny coverage simply because they had a pre-existing condition. The ACA banned this practice, requiring that insurance companies offer people coverage regardless of their health status.

Thanks To The Affordable Care Act, Insurance Companies Can No Longer Impose Annual And Lifetime Limits On Coverage. Before the ACA, insurance companies could restrict the dollar amount of benefits someone could use per year or over a lifetime. At the time the ACA was passed, 91 million Americans had health care through their employers that imposed lifetime limits. Many such plans capped benefits at $1 million annually, functionally locking people with complex medical needs out of coverage. 

Under The ACA, Insurance Companies Can No Longer Practice Medical Underwriting, A Process That Lets Insurers Make It Harder For People With Disabilities To Get The Coverage They Needed. Before the ACA, insurance companies could screen applicants for any conditions that might be costly to the company. If someone had condition that was predicted to cost the insurance company more, the insurance company would follow a practice called “medical underwriting” that allowed them to charge the applicant a higher premium, specifically exclude coverage for the condition that was expected to be costly, charge the applicant a higher deductible, or limit the applicant’s benefits (for instance, offer a policy that did not cover prescription drugs).

The ACA Requires Insurance Companies To Cover Basic Health Services. The Affordable Care Act established the ten essential health benefits, requiring insurance companies to cover rehabilitative or habilitative services, hospitalization, maternity care, prescription drugs, maternity care, and mental health services. Before the ACA, many people with disabilities had insurance that didn’t cover basic health care needs.

Medicaid Is A Lifeline For People With Disabilities:

• 61 million Americans have a disability. The Affordable Care Act ensures that insurance companies cannot deny coverage, drop coverage, or charge them more because of a pre-existing condition. 
• 8.7 million nonelderly adults with disabilities depend on Medicaid for care. Nearly 8.7 million adults enrolled in Medicaid have a disability. 
• More than 1 in 3 adults under age 65 enrolled in Medicaid lives with at least one disability. 
• Nearly 45 percent of adults with disabilities have Medicaid coverage. Medicaid covers 45 percent of nonelderly adults with disabilities, including adults with physical disabilities, developmental disabilities, brain injuries, and mental illness.

Medicaid Expansion Increased Employment For People With Disabilities. “Individuals with disabilities are significantly more likely to be employed if they live in a state that has expanded Medicaid under the Affordable Care Act, a new study has found. Researchers at the University of Kansas co-authored a study that found a 6 percentage-point difference in employment rates among working-age adults with disabilities in states that expanded Medicaid and those that chose not to.” [The University Of Kansas, 12/21/16] 

If The Texas Lawsuit Succeeds, 17 Million People Covered By Medicaid Expansion—Including Individuals With Disabilities—Will Lose Coverage:

Republican Efforts To Repeal Medicaid Expansion Would Mean 64 Percent Of Medicaid Adults With Disabilities Would Lose Coverage. “The Affordable Care Act’s Medicaid expansion covers 11 million people. Many of them struggle with a chronic illness or a disability (such as a mental health condition) that wouldn’t, by itself, qualify them for Medicaid. Only 36 percent of non-elderly Medicaid beneficiaries with disabilities receive Supplemental Security Income, which allows them to enroll in Medicaid even without the expansion. While others may be eligible for Medicaid based on other criteria, many could lose Medicaid coverage under the House bill and wind up uninsured.” [Center on Budget and Policy Priorities, 8/29/17]

Veteran Group Will Drive POC’s Coronavirus Accountability, Advocacy Work

Washington, DC — Protect Our Care today is launching a Coronavirus War Room with a veteran group of operatives to drive its accountability and advocacy efforts on the coronavirus crisis with a focus on President Trump’s ongoing failure to prepare the nation for this pandemic.

Zac Petkanas, a former communications adviser to Hillary Clinton and Senate Majority Leader Harry Reid who has been involved in a host of other political and advocacy campaigns, will serve as Coronavirus War Room Director.

Patrick Devlin, a former Communications Director to Majority Whip James Clyburn who has three decades of experience as senior aide on both sides of Capitol Hill, will serve as Senior Communications Adviser to the war room.

Sarah Chase, a former Research Associate on Elizabeth Warren’s campaign for president and a former Deputy Research Director for Protect Our Care, will serve as Research Director for the Coronavirus War Room.

“Today’s launch marks an important effort in Protect Our Care’s work to inform the American people about the science and facts about the coronavirus and to educate the public on the Trump’s administration’s ongoing failure to provide honest information and listen to the experts and the science,” said Leslie Dach, Chair of Protect Our Care. “As a result America does not have the testing it needs, our health care workers don’t have the equipment they need, and our hospitals are not prepared.”

“This team has a wealth of know-how, experience and expertise and with the coronavirus crisis, which has been exacerbated by President Trump’s failure to prepare, we need the best in the business working on advocacy efforts to hold President Trump accountable for his failure to lead,” said Brad Woodhouse, Executive Director of Protect Our Care.

More personnel announcements are expected in the coming days including in key states around the country beginning with Wisconsin, Michigan and Pennsylvania.

The Coronavirus War Room will work closely with partners in the health care and progressive communities and will benefit from and partner with the full resources of Protect Our Care’s current operations.

Ahead of the 10th anniversary of the passage of the Affordable Care Act (ACA) on March 23, Protect Our Care is holding 10 days of action to raise awareness of the most critical components of the law which has improved the lives of millions of Americans. Working with partner organizations and health care advocates, Protect Our Care will highlight a different aspect of the law each day while making clear what’s at stake if the Trump administration is successful in overturning the law through the courts.  

“The Affordable Care Act has been an incredibly positive force for Americans over the last 10 years, especially for seniors and older adults nationwide,” said Protect Our Care Executive Director Brad Woodhouse. “Over the course of these 10 days of action, Protect Our Care will remind Americans how the ACA has improved the lives of millions while making clear that President Trump and Republicans’ lawsuit to overturn the law poses an existential threat to Americans’ health care.” 

Days of Action: Day 6 of 10 focuses on Lower Costs and Better Care For Seniors. To learn more about our days of action, visit our website.

In Addition To Making Health Care More Affordable, The ACA Saved Lives:

Medicaid Expansion Saved The Lives Of At Least 19,200 Older Adults. A report by the Center On Budget And Policy Priorities found that “The Affordable Care Act’s (ACA) expansion of Medicaid to low-income adults is preventing thousands of premature deaths each year, a landmark study finds. It saved the lives of at least 19,200 adults aged 55 to 64 over the four-year period from 2014 to 2017. Conversely, 15,600 older adults died prematurely because of state decisions not to expand Medicaid.” [Center On Budget And Policy Priorities, 11/6/19] 

AARP: Before ACA’s Protections, Discrimination Against Those With Pre-Existing Conditions, Age Rating, And Annual And Lifetime Caps Made Accessing Health Care Out Of Reach For Older Adults. [AARP, 6/14/18]

Thanks To The ACA: 

• Seniors Are Guaranteed Free Preventive Services And Annual Check-Ups. 60 million people with Medicare have access to free preventive services because of the Affordable Care Act. 
• 8.9 million Medicare Beneficiaries Are Benefiting From Higher Quality, More Coordinated Care. Provisions in the ACA encouraged groups of doctors, hospitals, and other health care providers to come together to provide coordinated high-quality care to the Medicare patients they serve. 

Seniors Stand To Lose If The ACA Is Overturned. If The ACA Is Struck Down In Court: 

People Over The Age of 50 Will Face A $4,000 “Age Tax.” If the Republican lawsuit to overturn the ACA is successful, insurance companies would be able charge people over 50 much 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, according to the AARP.

Seniors Will Have To Pay More For Prescription Drugs. Thanks to the Republican lawsuit, 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 Centers on Medicare and Medicaid Services report.

Ahead of the 10th anniversary of the passage of the Affordable Care Act (ACA) on March 23, Protect Our Care is holding 10 days of action to raise awareness of the most critical components of the law which has improved the lives of millions of Americans. Working with partner organizations and health care advocates, Protect Our Care will highlight a different aspect of the law each day while making clear what’s at stake if the Trump administration is successful in overturning the law through the courts.  

“The Affordable Care Act has been an incredibly positive force for Americans over the last 10 years, particularly for women, whose health outcomes improved across the board,” said Protect Our Care Executive Director Brad Woodhouse. “Over the course of these 10 days of action, Protect Our Care will remind Americans how the ACA has improved the lives of millions while making clear that President Trump and Republicans’ lawsuit to overturn the law poses an existential threat to Americans’ health care.” 

Days of Action: Day 5 of 10 focuses on Women’s Coverage. To learn more about our days of action, visit our website.

Thanks To The ACA: 

68 Million Women With Pre-Existing Conditions Cannot Be Charged More Or Denied Coverage. Prior to the ACA, conditions like asthma, diabetes, and even pregnancy were grounds for insurance companies to charge more or deny coverage altogether. Additionally, insurance companies could impose annual and lifetime limits on coverage, which further eroded access to care for the sickest patients. 

Women Cannot 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 men for the same coverage. Without the ACA, women would also lose guaranteed coverage of birth control and other preventive care services. Before the ACA, 1 in 5 women reported postponing or going without preventive care due to cost.

More Than 60 million People Have Access To Birth Control With No Out-Of-Pocket Fees. The ACA guarantees that private health plans cover 18 methods of contraception and make them available to 62.4 million patients with no out-of-pocket costs. More than 99 percent of sexually-active women have used contraceptives at some point in their lifetimes, and approximately 60 percent of women of reproductive age currently use at least one birth control method. In addition to increasing access to this essential treatment, this ACA provision has saved money for women and their families: women saved $1.4 billion on birth control pills alone in 2013.

Women Can No Longer Face Discrimination In Health Care Settings. Section 1557 of the ACA prohibits discrimination the basis of race, color, national origin, sex, age, or disability by any health program or activity receiving federal assistance. It also prohibits these types of discrimination in health programs and activities administered by HHS as well as the ACA marketplaces. 

Nursing Parents Gained Breastfeeding Support And Critical Workplace Protections. The Affordable Care Act requires insurance companies to cover breastfeeding support and counseling as well as breast pumps without cost-sharing for pregnant and nursing women. 

Research Confirms The ACA Expanded Coverage, Improved Health For Women: 

The Number Of Uninsured Women In The U.S. Had Fallen By Nearly Half In 2016. “By 2016, the number of working-age women (ages 19–64) lacking health insurance had fallen by almost half since 2010, from 19 million to 11 million, or from 20 percent to 11 percent of this population. Women with low incomes have made particularly large gains: uninsured rates for those with incomes below 200 percent of the federal poverty level ($23,760 for an individual or $48,600 for a family of four), fell from 34 percent in 2010 to 18 percent in 2016. The findings are similar for low-income women of all races and ethnicities.” [Commonwealth Fund, 1/10/17] 

Medicaid Expansion Fills Gaps In Maternal Health Coverage Leading To Healthier Mothers And Babies. “New research shows states that expand Medicaid improve the health of women of childbearing age: increasing access to preventive care, reducing adverse health outcomes before, during and after pregnancies, and reducing maternal mortality rates. While more must be done, Medicaid expansion is an important means of addressing persistent racial disparities in maternal health and maternal mortality. The uninsured rate for women of childbearing age is nearly twice as high in states that have not expanded Medicaid compared to those that have expanded Medicaid (16 percent v. 9 percent).” [Georgetown University Center for Children and Families, May 2019]

Medicaid Expansion Improves Access To Family Planning. “Among 1,166 reproductive-age women who enrolled in the Healthy Michigan Plan, Michigan’s expansion of the Medicaid program for low-income adults, 1 in 3 said the expanded coverage improved access to birth control and family planning services…’Our findings suggest that the expansion provided an important service for populations with a high unmet need for family planning care,’ says lead author Michelle Moniz, M.D., M.Sc., an assistant professor of obstetrics and gynecology at Michigan Medicine. ‘Insurance coverage also means that women have access to more options if they do not want to become pregnant at the current time.’…Each dollar spent on contraception is estimated to save the health care system more than $7 in return, according to a recent study from the Guttmacher Institute. About 40 to 50 percent of the 4 million live births in the U.S. every year are paid for by Medicaid.” [University of Michigan, 8/31/18]

Black Women Were More Likely To Receive Care Because Of The ACA. “There has been an increase in the share of black women with a ‘usual source of care’—meaning a particular doctor’s office, clinic, or health center. In 2010, 83 percent of black women had a usual source of care. By 2014, the share had risen to 88.1 percent. Furthermore, black women have experienced a reduction among those who delayed or went without care due to cost. In 2010, 18.6 percent of black women ‘who had to delay or forgo care because of cost’; by 2014, only 15.1 percent of black women did so.” [Center for American Progress, 2/28/17] 

If The ACA Is Overturned, Key Protections For Women Would Be Ripped Away Overnight: 

• GONE: Insurance companies will be able to charge women 50 percent more than men.
• GONE: Contraception coverage for 60 million people who now have access to birth control with no out-of-pocket costs.
• GONE: A ban on discrimination for women, LGBTQ Americans, and individuals with disabilities in health care settings. 
• GONE: Essential protections for breastfeeding parents, including workplace standards and access to breast pumps with no out-of-pocket costs.  

Ahead of the 10th anniversary of the passage of the Affordable Care Act (ACA) on March 23, Protect Our Care is holding 10 days of action to raise awareness of the most critical components of the law which has improved the lives of millions of Americans. Working with partner organizations and health care advocates, Protect Our Care will highlight a different aspect of the law each day while making clear what’s at stake if the Trump administration is successful in overturning the law through the courts.  

“The Affordable Care Act has been an incredibly positive force for Americans over the last 10 years, especially for rural Americans who have traditionally experienced higher rates of uninsurance and barriers to coverage,” said Protect Our Care Executive Director Brad Woodhouse. “Over the course of these 10 days of action, Protect Our Care will remind Americans how the ACA has improved the lives of millions while making clear that President Trump and Republicans’ lawsuit to overturn the law poses an existential threat to Americans’ health care.” 

Days of Action: Day 4 of 10 focuses on Health Care For Rural Americans. To learn more about our days of action, visit our website.

The Affordable Care Act Led To Coverage Gains In Rural America 

• Nearly 1.7 million rural Americans gained coverage through Medicaid expansion under the ACA. 24 percent of Americans living in rural areas have health coverage through Medicaid.
• In 2017, nearly 1 in 5 marketplace enrollees (1.6 million people) lived in rural areas. 
• The uninsured rate for low-income adults dropped from 35 percent to 16 percent in rural areas and small towns in states that expanded Medicaid. 

Medicaid Is A Lifeline For Rural Hospitals

• The ACA led to a $12 billion reduction in uncompensated care costs. Between 2013 and 2015, hospitals’ uncompensated care costs decreased by $12 billion, or roughly 30 percent. The majority of this reduction was concentrated in states that chose to expand Medicaid. 
• 430 rural hospitals are at a high financial risk of closing. This represents roughly 21 percent of the country’s rural hospitals. 
•  120 rural hospitals have closed since 2010. The vast majority closed in states that had not expanded Medicaid at the time of the hospital closure.

The ACA’s Medicaid Expansion Plays A Central Role In Fighting The Opioid Crisis

• More than half of people with an opioid use disorder earn incomes below 200 percent of the federal poverty line.
• In 2014, Medicaid paid for 25 percent of all addiction treatment nationwide.
• It is estimated that Medicaid expansion covers four in ten people with an opioid use disorder.
• Among those with opioid addiction, people covered through Medicaid are nearly twice as likely as those with private insurance to receive treatment. In 2017, 44 percent of people who had substance use disorders received treatment when they were covered through Medicaid, significantly higher than the 24 percent of those privately insured who received treatment and 32 percent of those who were uninsured and received treatment.
• Medicaid expansion has reduced unmet need for substance use treatment by more than 18 percent. Recent research finds that Medicaid expansion reduced the unmet need for substance use treatment by 18.3 percent.
• Medicaid expansion may have saved more than 8,000 people from fatal opioid overdoses. A recent study found that Medicaid expansion prevented as many as 8,132 deaths in the 32 states that expanded Medicaid between 2014 and 2016.
• The uninsured rate for opioid-related hospitalizations in Medicaid expansion states dropped by 79 percent. In expansion states, the uninsured rate for opioid-related hospitalizations dropped from 13.4 percent in 2013 to 2.9 percent in 2015. Non-expansion states only saw a 5 percent decline over the same period. 

Republicans Want To End Medicaid Expansion Through Their Lawsuit To Overturn The ACA

• Seventeen Million People Enrolled Through Medicaid Expansion Could Lose Coverage.
• Access To Treatment Would Be In Jeopardy For 800,000 People With Opioid Use Disorder. Roughly four in ten, or 800,000 people with an opioid use disorder are enrolled in Medicaid. Many became eligible through Medicaid expansion.
• Key Support For Rural Hospitals Would Disappear, leaving hospitals with $9.6 billion more in uncompensated care.