January 2023

On the 17th of January, Republican Congressman Brett Guthrie introduced the Pandemic is Over Act, a bill that would abruptly end the COVID-19 public health emergency on the day of enactment. If the Guthrie bill became law it would cause chaos in the health care system, sabotage the bipartisan Medicaid and health care provisions in the December Omnibus package, and likely result in millions being thrown off the Medicaid rolls.

The Biden administration and Democrats in Congress have, through passage of the American Rescue Plan and the Inflation Reduction Act, provided continuous Medicaid coverage  to working Americans since the pandemic began in 2020. This resulted in 91 million Americans receiving Medicaid as of September 2022. 

The Omnibus package passed in December ends the Public Health Emergency as of April 1st which will trigger a review of Medicaid coverage for current recipients. Experts estimate that millions of Americans will lose Medicaid coverage because of paperwork issues and others will become uninsured even though they qualify for affordable coverage under the ACA. The Omnibus sought to prevent these issues by creating federal guardrails and incentives for states as they conduct the Medicaid “unwinding” process. By statute, these protections begin April 1, 2023. If the Gurthrie bill is passed before April, these protections will be nonexistent.

What Comes Next

Republicans are looking to move Representative Guthrie’s bill through committee on Monday and bring it to the floor later in the week. The passage of this legislation would drastically hasten state plans to unwind Medicaid coverage and lead to even more Americans losing their Medicaid coverage who still meet all the criteria for coverage, and leave others without coverage who qualify for low-cost ACA coverage.

The legislation introduced by Guthrie aims to circumvent guardrails put in place by the Omnibus package, but no matter what, states can begin terminating beneficiary rolls in April of this year. If guardrails remain in place though, there are tools available to support the unwinding process.

• On January 27th, CMS released guidelines outlining a new special enrollment period for individuals leaving Medicaid or CHIP. This would allow those no longer receiving Medicaid coverage due to roll terminations to enroll in marketplace coverage outside of the open enrollment period. According to CMS, this SEP will last from March 31, 2023 to July 31, 2024.
• States can obtain temporary waivers through CMS to renew Medicaid coverage based on a wide variety of formulas that allow for individuals who may see their coverage terminated in April to continue having coverage for at least another 12 months. CMS has already approved over 158 waivers in 41 states. 
• CMS has outlined guidance for states to work with MCOs, community health centers, navigators, and other programs to help streamline updating enrollee information, potentially preventing Medicaid beneficiaries whose documentation has fallen through the cracks since 2020 to continue receiving coverage. Currently, around 39 states have reported plans to work with these stakeholders and agencies.
• Under the 2022 Omnibus package passed in December, the HHS now also has the authority to forbid states from terminating beneficiaries for purely administrative reasons, and impose monetary penalties on states who do so.

What’s at Stake

If this legislation were to become law and states proceed with Medicaid unwinding absent of guardrails, up to 15 million Americans could lose their Medicaid coverage. This would be the single greatest loss of Medicaid coverage in American history, vastly outpacing even the record fall in Medicaid coverage under President Trump in 2018 and 2019. The bill brought by Representative Guthrie would worsen health disparities due to preventable losses in health coverage.

• The uninsured rate during the COVID-19 pandemic fell to an all-time low, thanks in part to the Biden administration’s historic accomplishments in his first two years in office. If current Medicaid enrollees lose their coverage and cannot access a different form of health insurance, the uninsured rate could begin to increase once again as systemic barriers exist for those leaving Medicaid while still seeking coverage.
• Of those at risk of losing coverage, over 5 million are Latinos, 2 million are African American, and a million are Asian American or Pacific Islander. In all, 13 percent of all Black children, 12 percent of Native American and Latino children, and 10 percent of all Hawaiian Native and Pacific Islander children are at risk of losing Medicaid coverage completely. Studies show only 21 percent of children who lose Medicaid ever transfer over to S-Chip.
• Many states have not updated their enrollment systems to accommodate disabled Americans or those with limited English proficiency. Currently, 19 states only provide information in English and 11 states provide no reasonable modifications, such as braille, for their online Medicaid services. Traditionally marginalized groups along lines of income will see disproportionate effects due to the lack of these services, as individuals without caregivers or guardians may lose coverage for no fault of their own.

Senate Democrats are hitting the ground running to investigate the broken drug pricing system that has left one in four Americans struggling to afford their medications. After passing historic legislation to drive down prices for patients and curb drug company greed, Senate HELP Committee Chair Bernie Sanders (D-VT) is leading an aggressive strategy to hold Big Pharma accountable for their price hikes. 

Bloomberg: Pharma CEOs Are Among Likely Targets for Senate Democrats’ Subpoenas. “With long-time critic Bernie Sanders taking over the Senate Health, Education, Labor and Pensions Committee, pharmaceutical companies will be under a microscope like no other. The progressive firebrand says he’s ready to order executives to appear and has recently taken particular aim at a ‘dysfunctional’ and ‘broken’ health-care system.” [Bloomberg, 1/23/23] 

Axios: Drug Companies Brace for Chairman Bernie. “Sanders has signaled an early focus of the committee’s work will be drug prices, and manufacturers are bracing for some contentious hearings. ‘I have no doubt there will be tough hearings with people from industry being forced to testify, subpoenaed to testify, etc.,’ a pharmaceutical industry source said. ‘And I think that’s going to be a real challenge.’” [Axios, 1/30/23]

Protect Our Care Calls on Congress to Keep Up the Momentum to Lower Costs, Improve Care, and Advance Health Equity 

Read the Agenda Here

Washington, DC — Today, Protect Our Care released a health care agenda detailing steps Congress should take to build on the health care victories over the past two years. The agenda lays out legislative actions to expand coverage, lower costs, strengthen protections, and address inequities in care. The agenda comes after a historic year in expanding affordable health care, which has resulted in record enrollment on the ACA marketplaces and the national uninsured rate reaching an all-time low. These actions are particularly important as Republicans are in the majority in the House and are working to cut Medicare and Medicaid, repeal the ACA and the Inflation Reduction Act, rip away lifesaving protections, reverse recent coverage gains, and hike prescription drug costs for the American people.

“In every election since 2018, voters have gone to the polls prioritizing health care, and they want their elected officials to continue lowering costs and improving care,” said Protect Our Care Chair Leslie Dach. “By reducing premium and prescription drug costs, reaching historic coverage rates, and strengthening health care for moms, kids, and families, it is clear that Democrats’ hard work is paying off. As we enter a new Congress, we must protect these coverage gains and make health care even more affordable for the American people. At a time when Republicans have doubled down on their war on health care, including by seeking cuts to Medicare and Medicaid, trying to repeal the ACA and the Inflation Reduction Act, and ripping away critical protections, it has never been more critical to remain focused on protecting health care access and putting the health and well-being of families first.”

U.S. Senators Bob Casey (D-PA), Tammy Baldwin (D-WI), and Peter Welch (D-VT), HHS Secretary Xavier Becerra, HHS Regional Directors Headlined Events Across Six States 

Over the last several weeks, lawmakers, administration officials, health care experts, and advocates joined Protect Our Care to discuss the new health care savings for the American people thanks to the Inflation Reduction Act. On January 1, critical provisions took effect, including extending lower health insurance premiums for those who bought through the ACA, capping the monthly cost of insulin at $35 for seniors, and providing needed vaccines, like the shingles vaccine, at no cost for Medicare beneficiaries. 

During the events, speakers also discussed how the Inflation Reduction Act’s enhanced premium tax credits helped fuel a record-breaking open enrollment period, with 16.3 million people signing up for health care coverage on the ACA marketplaces. More than three million people are brand new to the marketplace. 

Lawmakers have long promised to rein in high drug prices, lower health costs, and expand access — President Biden and Democrats are getting the job done.

ARIZONA

Wednesday, January 25 – Regional HHS Director and Will Humble Highlight New ACA Open Enrollment Numbers in Arizona: Dr. Jeffrey Reynoso and Will Humble joined Protect Our Care Arizona to discuss the record number of people who purchased ACA marketplace coverage with lower premiums for 2023 thanks to the Advanced Premium Tax Credits extended under the Inflation Reduction Act. This morning, the Department of Health and Human Services announced that 16.3 million Americans, including 235,229 Arizonans signed up for health insurance through the Affordable Care Act (ACA) marketplaces, including 3.1 million new enrollees. This represents a more than 12 percent increase nationally from the same time last year. “In Arizona the average middle class family of four is set to save $4,763 on their yearly premiums because of the IRA,” said Dr. Reynoso. “Arizonans heard the news and enrolled in record numbers. This is a trend that we saw nationwide.” Learn more about how the Inflation Reduction Act lowers health care costs for Arizonans here. A recording of the event can be viewed here.

Coverage:

• Cronkite News: Record numbers sign up for Obamacare health coverage in Arizona, U.S.
• White Mountain Independent: Record numbers sign up for Obamacare health coverage in Arizona, U.S.
• Arizona Public Media/PBS/NPR: Record breaking Affordable Care Act health insurance sign ups

GEORGIA

Friday, January 13 – Open Enrollment Event with HHS Regional Director Antrell Tyson, Georgians for A Healthy Future, and Health Care Advocates: Experts from Georgians for a Healthy Future and the U.S. Department of Health & Human Services joined Protect Our Care Georgia to discuss the ACA Open Enrollment 2023 period – which started on November 1, 2022 and ends on January 15th. “Just like the Bulldogs’ victory on Monday night, this year’s open enrollment has already proven to be a huge victory for thousands of Georgians,” said Health and Human Services Regional Director Antrell Tyson. “Georgia residents without health insurance through their jobs have the opportunity from now, until Jan. 15, to enroll in comprehensive health coverage. The time is now,” he added. You can watch the event here.

Coverage:

• Capitol Beat: Georgia Affordable Care Act enrollment soars
• WALB (NBC/ABC): Affordable Care Act open enrollment deadline approaching
• Insurance News Net: Georgia Affordable Care Act enrollment soars
• The Douglas Sentinel: Georgia Affordable Care Act enrollment soars
• The Christian Index: Georgia Affordable Care Act enrollment soars
• The Augusta Press: Georgia Affordable Care Act enrollment soars
• The Morgan County Citizen: Georgia Affordable Care Act enrollment soars
• The Albany Herald: Georgia Affordable Care Act enrollment soars
• Business Insurance: Georgia reports record enrollment in ACA marketplace
• The Marietta Daily Journal: Georgia Affordable Care Act enrollment soars
• The Walker County Messenger: Georgia Affordable Care Act enrollment soars
• The Catoosa County News: Georgia Affordable Care Act enrollment soars
• The Rome News Tribune: Georgia Affordable Care Act enrollment soars
• The Calhoun Times: Georgia Affordable Care Act enrollment soars
• Polk Standard Journal: Georgia Affordable Care Act enrollment soars
• The Gwinnett Daily Post: Georgia Affordable Care Act enrollment soars
• WFXL: Georgia Affordable Care Act enrollment soars
• The Jackson Press Argus: Georgia Affordable Care Act enrollment soars
• The Henry Herald: Georgia Affordable Care Act enrollment soars
• The Rockdale Citizen: Georgia Affordable Care Act enrollment soars
• WALB (NBC/ABC): Affordable Care Act open enrollment deadline approaching

MICHIGAN

Thursday, January 26 — Health Care Leaders Celebrate Successful Michigan Open Enrollment Numbers and Costs Savings in 2023: Health care leaders joined Protect Our Care Michigan to celebrate a record-breaking enrollment of 322,273 Michiganders into the ACA marketplace for 2023. This year seniors in the state and across the country are saving on insulin costs and life-saving vaccines thanks to the Inflation Reduction Act. “The Inflation Reduction Act has been nothing short of a game changer in our community,” said Jim Ananich, President and CEO of the Greater Flint Health Coalition. “The monthly cap on insulin for Medicare recipients is a lifesaving benefit in communities of color like Flint disproportionately impacted by diabetes. Along with providing our seniors with shingles and other critical vaccinations at no cost, this landmark law is taking a major step toward reducing racial inequities in health care in our community and beyond.” You can watch the event here, and learn more about how the Inflation Reduction Act is keeping costs low for Michiganders here. 

Coverage:

• Detroit Free Press: Michigan sees highest Obamacare enrollment since 2016
• MLive: Record Michiganders seek health insurance through ACA marketplace in 2023
• WXMI-TV, Fox – Grand Rapids: Newsclip
• Gongwer: Health Care Leaders Boast Record-Breaking Open Enrollment

NEVADA

Tuesday, January 24 — U.S. DHHS Regional Director, Nevada Health Link Director Highlight ACA Open Enrollment Numbers in Nevada: Dr. Jeffrey Reynoso, U.S. Department of Health and Human Services Regional Director, and Ryan High, Executive Director of Nevada Health Link, joined Protect Our Care Nevada to discuss the record number of people who purchased ACA marketplace coverage with lower premiums for 2023 thanks to the Advanced Premium Tax Credits extended under the Inflation Reduction Act. “Americans know a good deal when they see one,” said Dr. Jeffrey Reynoso. “Thanks to the enhanced premium tax credits included in the Inflation Reduction Act, more people than ever signed up for health insurance during the 2022 open enrollment period. These tax credits will save an average middle-class family of four in Nevada $4,494 on their yearly premiums, giving them the breathing room to pay for other necessities like food, gas, and rent.” Learn more about how the Inflation Reduction Act lowers health care costs for Nevadans here. A recording of the event can be viewed here.

Coverage:

• KRXI (Reno Fox): Nearly 100,000 Nevadans signed up for health insurance this year
• KRXI (Reno FOX): Record-Breaking Open Enrollment Numbers
• KTVN (Reno CBS): Record Open Enrollment for Nevadans
• KTVN (Reno CBS): Open Enrollment in Nevada
• KRNV (Reno NBC): Record-Breaking Open Enrollment Numbers in Nevada
• KTNV (Las Vegas ABC): ACA Enrollment 
• Nevada Current: Opinion: Affordable health insurance empowers us all

PENNSYLVANIA

Wednesday, January 25 — Senator Bob Casey, HHS Region 3 Director Dr. Ala Stanford, and Health Care Advocates Highlight How the Inflation Reduction Act Caps Insulin Costs and Expands Access to Free Vaccines for Seniors: Senator Bob Casey, Dr. Ala Stanford, and health care advocates joined Protect Our Care Pennsylvania to highlight how seniors in Pennsylvania and across the country are saving on insulin costs and life-saving vaccines thanks to the Inflation Reduction Act. “Because of the Inflation Reduction Act, an estimated 261,000 Pennsylvania seniors can now access life-saving vaccines at no cost and 87,000 Pennsylvanians are starting to see reduced costs for their insulin. These are huge milestones, and I’m proud to have fought for these provisions alongside Protect Our Care, which has been an incredible partner in protecting health care across the Nation,” said Senator Bob Casey (D-PA). “Families shouldn’t have to choose between their health and their bank account. We still have more work to do, and I will continue to fight in Washington to help Pennsylvania families and seniors save on health care costs.” You can watch the event here, and learn more about how the Inflation Reduction Act is keeping costs low for Pennsylvanians here.

Coverage:

• WOLF (Hazleton FOX): Senator Casey Highlights Inflation Reduction Act Savings 
• WOLF (Hazleton FOX): Senator Casey highlights savings from the Reduction Inflation Act
• WCAU (Philadelphia NBC): Medicare Patients to See Savings on Insulin & Vaccines
• WPVI (Philadelphia ABC): Inflation Reduction Act Benefits 
• KYW Newsradio: Inflation Reduction Act Savings on Insulin & Vaccines 
• KYW Newsradio: Medicare beneficiaries across Pa. can expect to see big savings on insulin and vaccines

VERMONT

Monday, January 9 — HHS Secretary Becerra, Senator Welch, and Health Care Advocates Celebrate Inflation Reduction Act Provisions to Drive Down Drug Prices: U.S. Senator Peter Welch (D-VT) and Health and Human Services Secretary Xavier Becerra joined health care advocates in Rutland, Vermont, for a press conference celebrating prescription drug pricing provisions in the Inflation Reduction Act. “Already today, there are probably Vermonters who have bought insulin for $35 thanks to the Inflation Reduction Act,” said HHS Secretary Xavier Becerra. “The president said one thing on health care when he was campaigning and he said it again at his inauguration: we’re going to lower costs for more Americans with better benefits — and that’s exactly what he has done.”   

Coverage:

• WCAX: Top Biden official joins Welch in Rutland to talk prescription drug and opioids
• NBC5: Sen. Peter Welch’s 1st day on the job: The Inflation Reduction Act
• Rutland Herald: Welch: Medications are about to get cheaper for many on fixed incomes

WISCONSIN

Thursday, January 12 — Shingles Vaccine and Insulin Affordability Roundtable with Senator Tammy Baldwin and Wisconsin Seniors: Senator Tammy Baldwin joined Protect Our Care Wisconsin alongside Seniors from Green Bay and Appleton to highlight how Medicare enrollees are already benefiting from the Inflation Reduction Act, which took effect this month and is lowering costs improving health care for millions of Americans. “Too many Americans are seeing the costs of their prescription drugs increase and are struggling to afford the medications they need to survive,” says Senator Baldwin. “That’s why I was proud to support the Inflation Reduction Act last year, to finally provide some relief for Wisconsin families and hold drug companies accountable for prioritizing profits over people.” You can watch the event here. 

Coverage:

• Press Times: Local seniors discuss impact of new healthcare provisions

GOP Lawmakers Eye Cuts to Medicare, Social Security, and Medicaid With An Upcoming Debate Over the Debt Ceiling and Appropriations 

Republicans have not shied away from stating their goal for the 118th Congress: cutting Medicare, Social Security, and Medicaid. For months, GOP lawmakers have said they will rip away the basic benefits that are a lifeline for millions of seniors and working families. Cuts to Medicare and Social Security would disproportionately hurt people of color and rural Americans. Coverage dating back to before the election shows that Republicans have made crystal clear that they want to use their House majority to slash these vital programs to fund tax breaks for big corporations.  

Insider: Republicans’ Plans to Slash Social Security and Medicare Are Becoming Clearer: ‘We Have No Choice but to Make Hard Decisions.’ “‘We have no choice but to make hard decisions,’ Rep. Kevin Hern of Oklahoma, leader of the conservative Republican Study Committee, told The Post. ‘Everybody has to look at everything.’ The Post reported that in the past few days, a group of Republican lawmakers have pushed for House panels that would recommend changes to Social Security and Medicare.” [Insider, 1/25/23]

Washington Post: House GOP Eyes Social Security, Medicare Amid Spending Battle. “Only weeks after taking control of the chamber, GOP lawmakers under new Speaker Kevin McCarthy (R-Calif.) have rallied around firm pledges for austerity, insisting their efforts can improve the nation’s fiscal health. They have signaled they are willing to leverage the fight over the debt ceiling — and the threat of a fiscal doomsday — to seek major policy concessions from the Biden administration.” [Washington Post, 1/24/23]

HuffPost: Republicans Signal Cuts To Social Security, Medicare With New House Majority. “Their plans to target health care programs follow demands from a group of conservatives that helped elect House Speaker Kevin McCarthy (R-Calif.) over the weekend. Those far-right lawmakers have sought across-the-board spending cuts in order to tackle the growing national debt. But the narrow House GOP majority ― McCarthy can afford to lose just four votes on any bill ― is far more divided on cuts to defense spending than for entitlement programs. ‘I’m all for a balanced budget, but we’re not going to do it on the backs of our troops and our military,’ Rep. Michael Waltz (R-Fla.), a former Army Green Beret, said Monday during an interview on Fox Business. ‘If we really want to talk about the debt and spending, it’s the entitlements programs.’”[HuffPost, 1/9/23]

Axios: Debt Ceiling Fight Looms Over Medicare and Medicaid. “Why it matters: It’s not clear which cuts House Republicans will push for in exchange for raising the debt ceiling later this year — likely this summer — but at least some say Medicare and Medicaid should be on the table. Others, anticipating Democratic attacks, are saying they want to steer clear of the programs. What they’re saying: ‘We’re going to have to look at the whole board,’ conservative Rep. Barry Loudermilk told Axios, including mandatory spending like Medicare and Medicaid. ‘The easiest to start with is discretionary, but the main driver of the national debt is the mandatory.’ ‘Everything’s on the table,’ he added.” [Axios, 1/12/23]

Axios: GOP Floats Medicare Changes While Ducking Details. “What they’re saying: ‘If we’re going raise the debt ceiling, we can’t just raise it without focusing on some way to address the debt and the deficit,’ Rep. Bruce Westerman (R-Ark.), a member of the House GOP’s health care task force, told Axios, adding Medicare should be made ‘sustainable over time.’ ‘We’re going to have a lot of hearings on this,’ Rep. Jason Smith (R-Mo.), the current top Republican on the Budget Committee who wants to move up to chairman of Ways and Means, told Axios. ‘I’m not going to get into the inner details.’ ‘Everything is on the table, we haven’t really nailed down any specific policies one way or the other,’ Rep. Buddy Carter (R-Ga.), who is running to chair the House Budget panel. ‘I think it could be wrapped up with that [debt ceiling talks], that’s shaping up to be pretty dynamic.’ [Axios, 11/3/22]

New York Times: Republicans, Eyeing Majority, Float Changes to Social Security and Medicare. “The Republican leaders who would decide what legislation the House and the Senate would consider if their party won control of Congress have not said specifically what, if anything, they would do to the programs. Yet several influential Republicans have signaled a new willingness to push for Medicare and Social Security spending cuts as part of future budget negotiations with President Biden. Their ideas include raising the age for collecting Social Security benefits to 70 from 67 and requiring many older Americans to pay higher premiums for their health coverage. The ideas are being floated as a way to narrow government spending on programs that are set to consume a growing share of the federal budget in the decades ahead.” [New York Times, 11/2/22]

Fox News: Republicans Eye Using Debt Limit Hike to Overhaul Entitlement Programs if Entrusted With Majority. “Still, some Republicans say the key to shoring up both Social Security and Medicare might be by means-testing welfare programs and putting work requirements in place for beneficiaries. ‘There are over 70-plus federal welfare programs. The American people believe there should be work requirements for all those programs for able-bodied healthy adults,’ said Rep. Jason Smith of Missouri, who is vying to lead the House Ways and Means Committee.” [Fox News, 10/19/22]

Washington Post: GOP To Use Debt Limit To Force Spending Cuts, McCarthy Says. “Sen. Ron Johnson (R-Wis.) has suggested that Social Security and Medicare be eliminated as federal entitlement programs, and that they should instead become programs approved by Congress on an annual basis as discretionary spending. … In an interview in August, Johnson, who is seeking a third term in the Senate, lamented that the Social Security and Medicare programs automatically grant benefits to those who meet the qualifications — that is, to those who had been paying into the system over their working life. ‘If you qualify for the entitlement, you just get it no matter what the cost,’ Johnson said. ‘And our problem in this country is that more than 70 percent of our federal budget, of our federal spending, is all mandatory spending. It’s on automatic pilot.’” [Washington Post, 10/18/22]

Bloomberg: House GOP’s Scalise Defends Medicare, Social Security Plans. “Scalise is a member of largest House GOP caucus, the Republican Study Committee, which has proposed changes that would result in lower benefits for some future recipients. Scalise’s office said in an email he hasn’t specifically signed on to the RSC plan, however. … The RSC proposal would gradually raise the eligibility ages for both programs and slow the growth of benefits for higher earners in Social Security.  Medicare would transition to a new model where seniors would receive premium subsidies to buy a government run public option or privately run insurance.” [Bloomberg, 10/16/22]

Bloomberg: Entitlement, Spending Cap Plans Linked by GOP to Debt-Limit Deal. “The four Republicans interested in serving as House Budget Committee chairman in the next Congress said in interviews that next year’s deadline to raise or suspend the debt ceiling is a point of leverage if their party can win control of the House in the November midterm elections. The Republican position — which members are still formulating — could set the stage for an explosive standoff next year, reminiscent of the 2011 negotiations when the Tea Party wave of Republicans took on the Obama administration over spending.” [Bloomberg, 10/11/22]

Coverage is More Affordable Than Ever Before Thanks to The Inflation Reduction Act

Yesterday, the Department of Health and Human Services announced that 16.3 million people have signed up for health coverage during the 2023 open enrollment period. This represents a record number of Americans who signed up for coverage under the Affordable Care Act (ACA). This is more than a 12 percent increase from the same time last year. In California, New Jersey, New York, Rhode Island, and Washington DC, residents can continue to sign up for coverage through January 31. 

President Biden and Democrats in Congress have made incredible progress to ensure millions more Americans have the health care they deserve. This includes passing the American Rescue Plan and the Inflation Reduction Act, which provided enhanced premium tax credits to make coverage more affordable than ever before. The Biden administration also funded the  Navigator program with the single-largest investment ever to focus on outreach to racial and ethnic minorities, people in rural areas, LGBTQ+ people, and other underserved communities. In addition, the Biden administration fixed the family glitch, which previously blocked millions of families from receiving affordable coverage under the ACA, allowing an estimated 200,000 uninsured Americans to gain coverage and save hundreds of dollars each month on health premiums. President Biden and Congressional Democrats are to thank for this immensely successful open enrollment period.

HEADLINES

The New York Times: Record 16 Million Sign Up for Affordable Care Plans. “The growing enrollment follows the passage of legislation during the coronavirus pandemic to increase federal subsidies for people buying the plans — substantially lowering prices for nearly every American who buys their own insurance. Around 3.6 million people selected plans in the Obamacare marketplaces who did not receive coverage through them last year. Last year’s total had been the highest in the law’s history.” [The New York Times, 1/25/23]

The Hill: A Record of Over 16 Million People Signed Up for Insurance Through Obamacare. “More than 16.3 million people enrolled in a health plan through the Affordable Care Act (ACA) during the most recent open enrollment period, marking the highest number of enrollees since the program was signed into law 10 years ago.” [The Hill, 1/25/23]

Reuters: U.S. Signs Up Over 16 Million People for Obamacare Health Insurance. “About 12 million people enrolled from the 33 U.S. states that use the online marketplace funded by the federal government and about 4 million people from states that sell the insurance directly to their residents…About 3.6 million people who have signed up for the plans are new enrollees, White House Domestic Policy Advisor Susan Rice said on a press call.” [Reuters, 1/25/23]

CNN: Obamacare Sign-Ups Soar to Record 16.3 Million for 2023. “Sign-ups on the federal exchange, healthcare.gov, have skyrocketed nearly 50% since the Biden administration took office in 2021, thanks in large part to enhanced federal premium subsidies and increased outreach efforts. Plan selections are up 13% from this time last year.” [CNN, 1/25/23]

(AZ) Cronkite News: Record Numbers Sign Up for Obamacare Health Coverage in Arizona, U.S. “A record number of Arizonans signed up for health insurance this year under the Affordable Care Act, as enrollment in the program continues to rebound from the Trump administration’s efforts to suppress coverage…who trimmed funding and outreach and shortened the open enrollment period in an effort to handicap the ACA. President Joe Biden reversed those efforts shortly after taking office.” [Cronkite News, 1/25/23]

(FL) Miami Herald: Florida Sets Record in Obamacare Enrollment as People Clamor for Health Insurance. “In Florida, enrollment ballooned to 3.2 million, a 19% jump over last year’s open enrollment period under the health law, commonly known as Obamacare. The 3.2 million represents 20 percent of all enrollees nationwide, even though Florida, the third most populous state in the country with 22 million people, accounts for only about 7 percent of the U.S. population.” [Miami Herald, 1/26/23]

(MD) The Baltimore Sun: Obamacare Enrollment Increased for 2023 Coverage in Maryland With More Black, Hispanic Participants. “The number of Marylanders who enrolled in health coverage for 2023 through the state insurance exchange increased slightly from last year, to a record 182,166, the Maryland Health Benefit Exchange announced in a news release Tuesday.Although total enrollment in what is known as Obamacare only climbed by about 560 people from 2022, enrollment continued to grow for members of communities that are more likely to lack coverage, such as Black and Hispanic residents.” [The Baltimore Sun, 1/24/23]

(NV) KSNV: Nearly 100,000 Nevadans Signed Up for Health Insurance This Year. “Nevada Health Link has announced that nearly 100,000 Nevadans have enrolled in qualified, affordable health insurance plans during this year’s Open Enrollment Period (OEP), which ran from November 1, 2022, through January 15, 2023…This year’s Open Enrollment was Nevada Health Link’s second highest to record, just down less than 5% from last year’s record-breaking Open Enrollment.” [KSNV, 1/24/23]

(GA) The Taccoa Record: Affordable Care Act Achieves Record Number in Georgia. “A record number of Georgians – over 846,000 – signed up for health insurance for 2023 under the Affordable Care Act during the latest open enrollment period, which ended on Sunday. That’s about 8 percent of the state’s population, and at least 145,000 more than signed up for the program last year.” [The Taccoa Record, 1/23/23]

Seniors Are Already Saving Big After the Inflation Reduction Act’s Insulin Cap Took Effect January 1 

New estimates from the Department of Health and Human Services found that 1.5 Million seniors using insulin would have saved hundreds of dollars annually had the Inflation Reduction Act taken effect in 2020. In total, Medicare beneficiaries would have saved $761 million on insulin costs in 2020 — an average of $500 per patient. As insulin costs continue to skyrocket, the Inflation Reduction Act’s insulin cap is a godsend for seniors who have little to spare. 

HEADLINES 

(GA) Atlanta Journal-Constitution: HHS Says Americans Already Seeing Benefits Of New Insulin Price Cap. “The U.S. Department of Health and Human Services estimated that a $35 cap on monthly insulin costs for Medicare enrollees that took effect Jan. 1, will save Georgians over $21 million. The monthly cap in out-of-pocket costs for insulin was made under a provision of the larger Inflation Reduction Act, targeted to ease financial strains on people covered by Medicare.” [Atlanta Journal-Constitution, 1/25/23] 

(OH) Cleveland.com: Ohioans On Medicare Will Save More Than $36 Million Yearly On Insulin Under New Law, Feds Predict. “The U.S. Department of Health and Human Services announced Tuesday that a new law that caps monthly out-of-pocket insulin costs for Medicare beneficiaries at $35 will likely save more than $36 million in yearly costs for more than 72,000 Medicare beneficiaries in Ohio. Using statistics from 2020, a new report from HHS says the $35 monthly cap on out-of-pocket insulin costs, which went into effect on Jan. 1 as part of the Inflation Reduction Act, would have saved 1.5 million Americans who use Medicare an average of $500 in their insulin costs that year.” [Cleveland.com, 1/24/23] 

(PA) Philadelphia Inquirer: How Much Will People With Diabetes In Pa. And N.J. Save With The New Medicare Insulin Cap? “The Department of Health and Human Services estimates the change will save insulin users an average of $500 a year, based on 2020 medication costs. In Pennsylvania, nearly 80,200 people stand to save an average of $543 a year. And in New Jersey, about 39,600 insulin users with Medicare could save an average of $511 a year, according to HHS estimates. … The insulin price cap is one of several measures in the Inflation Reduction Act intended to stem high and rising prescription-drug costs. The legislation also allowed Medicare to begin negotiating prices for a small number of high-use medications and capped the total amount people with Medicare can pay for prescription drugs.” [Philadelphia Inquirer, 1/24/23] 

(VA) Richmond Times-Dispatch: Cap On Insulin Said To Save $18.6 Million A Year For More Than 36,000 Virginians. “More than 36,000 Virginians with diabetes will collectively save $18.6 million a year on the purchase of insulin under federal legislation that capped out-of-pocket costs at $35 a month, effective Jan. 1 for most Medicare members, a federal agency says. The cap, part of the Inflation Reduction Act that President Joe Biden signed into law last year, would save the average Virginian an estimated $510 a year on insulin, according to a national study the White House released Tuesday morning.” [Richmond Times-Dispatch, 1/24/23] 

(CT) CT Insider: New Monthly Savings on Insulin for Medicare Enrollees. “1.5 million Americans who are on Medicare Part B and D would have saved an average of about $500 in 2020 if the insulin cost-sharing limit were in place. In Connecticut specifically, seniors would have saved slightly above the average out-of-pocket savings for Medicare beneficiaries across the U.S. About 11,444 Medicare enrollees in Connecticut would have received out-of-pocket savings in 2020 under the Inflation Reduction Act. Those beneficiaries would have saved an estimated total of about $6.7 million with an average annual savings of $590 per enrollee.” [CT Insider, 1/25/23]

(NJ) NJ.com: Here is How Much New Jerseyans Will Save With New Insulin Price Cap. “Medicare recipients won’t have to pay more than $35 a month for insulin, and that should save nearly 40,000 New Jersey residents an average of $511 a year, the U.S. Department of Health and Human Services said Tuesday. Had the new benefit been in effect in 2020, that would have saved 39,641 New Jersey recipients $20.2 million, the agency said as officials touted the provision, which was part of last year’s climate change and health care law that passed Congress without Republican support and was signed by President Joe Biden.” [NJ.com, 1/24/23]

(MD) New Year, New Rules. Maryland Diabetics Won’t Have To Break The Bank For Insulin In 2023. “Hundreds of thousands of Maryland residents with diabetes will have one less thing to stress about in the New Year: the volatile cost of insulin, a lifesaving medication that enables chronically ill people with diabetes to keep their blood sugar in a safe range. That’s because new laws at the state and federal level cap the price of insulin for patients who are covered by Medicare and those with commercial insurance policies. In August, Congress passed the Inflation Reduction Act, a wide-ranging law that mandates all individuals covered by Medicare won’t pay more than $35 for a month’s supply of insulin, or $420 each year… Maryland’s new state law caps the patient cost for a 30-day supply of insulin to $30 or below, even for patients with private commercial insurance plans often through an employer.” [WYPR News, 12/30/23]

(CO) KRDO: New HHS Report Finds More Savings for Colorado Seniors. “Insulin-dependent seniors are getting some unexpected relief, thanks to president Biden’s Inflation Reduction Act. At the start of this year, a cap of $35 was placed on a monthly supply of insulin for seniors. A new report from the U.S. Department of Health and Human Services shows that if this cap had been implemented in 2020, Medicaid beneficiaries would have saved an average of $500. Researchers say this cap will affect about 1.5 million seniors across the country. White House advocates say, this provision – and other parts of the Inflation Reduction act – are evidence of president Biden’s promise to lower health care costs in America.” [KRDO, 1/25/23]

(TN) Chattanooga Times Free Press: How Much Will Tennesseans With Medicare Save Due to Insulin Cap? “The White House estimates that Tennesseans on Medicare who take insulin will save on average $494 per year with the new $35 monthly out-of-pocket spending cap on the drug, a provision of the Inflation Reduction Act that’s now in effect. Cost savings estimates are based on a report from the U.S. Department of Health and Human Services released Tuesday. The report is based on Medicare prescription data from 2020, at which time there were 39,562 Medicare enrollees in Tennessee who filled insulin prescriptions. During a media call Tuesday, Dr. Ben Sommers, deputy assistant secretary for health policy at Health and Human Services, said the data may not include thousands or more Medicare beneficiaries who didn’t pick up the insulin because they couldn’t afford it. According to the release, 37% of insulin prescription fills for people with Medicare in 2019 required beneficiaries to pay more than $35 out of pocket, including 24% that exceeded $70 per fill.” [Chattanooga Times Free Press, 1/24/23]

(TX) KVIA: Insulin Price Cap Helping El Paso Medicare Recipients Save Money. “El Pasoans on Medicare part D will not have to pay more than $35 a month for their insulin, thanks to the Inflation Reduction Act. Currently, only patients on Medicare part D are covered, but according to Health and Human Services Agency, starting in July, diabetes patients on Medicare part B will have access to the same savings. According to the El Paso Center for Diabetes, 13.9% of people in the El Paso region have diabetes. That compares to 10.5% of people in the United States. This includes people with both Type 1 and Type 2 diabetes. The local diabetes center added that the $35 cap is going to alleviate some of the burdens, especially for our seniors who are on a fixed income. They said many seniors wouldn’t have to choose between paying rent or groceries over their life-saving insulin.” [KVIA, 1/24/23]

Coverage is More Affordable Than Ever Before Thanks to President Biden and Democrats in Congress

Washington, DC — Today, the Department of Health and Human Services announced that 16.3 million people have signed up for health coverage during the 2023 open enrollment period. This represents a record number of Americans who signed up for coverage under the Affordable Care Act. This is more than a 12 percent increase from the same time last year. In California, New Jersey, New York, Rhode Island, and Washington DC, residents can continue to sign up for coverage through January 31. 

President Biden and Democrats in Congress have made incredible progress to ensure millions more Americans have the health care they deserve. This includes passing the American Rescue Plan, the Inflation Reduction Act, and funding the Navigator program with the single-largest investment ever to focus on outreach to racial and ethnic minorities, people in rural areas, LGBTQ+ people, and other underserved communities. In addition, the Biden administration solved the family glitch, which previously blocked millions of families from receiving affordable coverage under the ACA, was also eliminated, allowing an estimated 200,000 uninsured Americans to gain coverage and save hundreds of dollars each month on health premiums. The work put in by President Biden and Congressional Democrats is to thank for this immensely successful open enrollment period. In response, Protect Our Care Executive Director Leslie Dach issued the following statement: 

“President Biden and Democrats in Congress deserve all the credit for the success of this open enrollment period. Health insurance is more affordable than ever as a direct result of Democratic leadership. While Republicans opposed every move and spent years trying to dismantle the Affordable Care Act, President Biden and Democrats delivered on their promise to protect and expand it. By eliminating the family glitch rule and passing the American Rescue Plan and the Inflation Reduction Act, these strides made health care through the ACA marketplaces more affordable than ever before. The Biden administration also funded the Navigator program with the single-largest investment ever to help connect underserved communities to the care they so desperately need.

“President Biden and Congressional Democrats will not give up the fight until every American has access to the high-quality, affordable health care they need to thrive. The nation’s uninsured rate is at the lowest it has ever been in history. 16.3 Million Americans signing up for coverage is a big deal. These record numbers show that Americans want and need the affordable, quality health care made possible through the ACA.”

***MEDIA ADVISORY FOR WEDNESDAY, JANUARY 25 AT 11:30AM EST***

Thanks to the Inflation Reduction Act, Pennsylvania seniors are saving on health care costs

Philadelphia, PA – On Wednesday, January 25 at 11:30AM, Senator Bob Casey, Dr. Ala Stanford, PA Health Access Network (PHAN), and health care advocates will join Protect Our Care Pennsylvania to highlight how seniors in Pennsylvania and across the country are saving on insulin costs and life-saving vaccines thanks to the Inflation Reduction Act.

The Inflation Reduction Act is lowering costs and improving health care for millions of Americans – including the record number who purchased ACA marketplace coverage with lower premiums for 2023 thanks to the Advanced Premium Tax Credits extended under the Inflation Reduction Act. Additionally, effective January 1, 2023, insulin copays are capped at $35 per month for more than three million people with diabetes covered by Medicare. Additionally, all adults on Medicare Part D have access to covered vaccines, such as shingles and Tdap, at no cost. These policies alone will save seniors in Pennsylvania and across the country hundreds of dollars on their health care costs, keep millions of people healthy, and prevent dangerous complications associated with diabetes, shingles, and other serious diseases.

Speakers will discuss how these provisions are keeping costs low for Pennsylvanians, discuss additional savings to come, and highlight how seniors in the state can access these benefits.

WHO:
U.S. Senator Bob Casey
U.S. Department of Health and Human Services Region III Director Dr. Ala Stanford
Antoinette Kraus, Executive Director, Pennsylvania Health Access Network (PHAN)
Peggy Walsh of Bucks County, a senior who delayed shingles vaccine due to cost
Michael Berman, Protect Our Care Pennsylvania

WHAT: Virtual Press and Constituent Briefing

WHEN: Wednesday, January 25 at 11:30AM EST

WHERE: Register to join the Zoom event (Registration required)

Washington DC — Yesterday, U.S. Senator Jeanne Shaheen (D-NH) reintroduced legislation to lower health care costs and extend affordable coverage to millions of Americans. The Improving Health Insurance Affordability Act would make permanent enhanced tax credits passed under the Inflation Reduction Act and make health care even more affordable for millions of Americans. In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“Senator Shaheen is a true health care champion. Her leadership was key to the passage of the  Inflation Reduction Act, which is reducing the cost of health care premiums by $2,400 for the average family purchasing insurance on the ACA marketplace and helping the uninsured rate reach an all-time low. Increasing coverage means millions of families can finally afford quality care without sacrificing other basic needs like gas, child care, and rent. This added peace of mind is especially beneficial for communities of color and Americans in rural areas. The Inflation Reduction Act’s lifesaving tax credits should now be made permanent. Polling shows that health care remains a top issue for voters and that the American people want their elected officials to continue making progress to lower costs and improve care. The Improving Health Insurance Affordability Act is an essential next step to deliver on these promises and work toward a future where everyone can get the care they need to live longer, healthier lives.”