June 2024

New Navigator polling reveals overwhelming support for work Democrats in Congress did to lower health care costs in recent years. The poll surveyed 61 battleground congressional districts. Americans say lower health care costs will have a positive impact on their lives, especially giving Medicare the power to negotiate lower prescription drug prices, capping the cost of insulin, and providing free vaccines. A closer look:   

The majority of constituents in battleground states support congressional Democrats. 51 percent of battleground constituents give a 10 out of 10 rating of support for “Democrats in Congress… working to bring down the costs of health care and prescription drugs by capping the prices of prescription drugs like insulin, stopping price hikes for premiums, and expanding Medicare benefits to cover dental, vision, and hearing,” and the share giving this at least an 8 out of 10 support rating rises to two in three constituents (64 percent). 

Lowering drug prices for seniors ranks as the most impactful policy for constituents and their families. The poll found that among the policies enacted over the last couple of years, giving Medicare the power to negotiate lower prescription drug prices and capping the cost of insulin is the most popular with 62% of battleground constituents strongly supporting it. 

When assessing future priorities of Democratic lawmakers in Congress, lowering health care costs and combating corporate greed rise to the top. When constituents are asked about whether these policies would help people like them and their families on a 10-point scale, 41 percent of Americans rate giving Medicare the power to negotiate lower drug prices a 10 out of 10.

The Supreme Court Rejects The Case Challenging Access To The Abortion Drug Mifepristone, But Reproductive Care Is Still On The Chopping Block.

Washington, D.C. — In a major decision, the Supreme Court rejected a challenge to abortion medication drug mifepristone in FDA v. Alliance for Hippocratic Medicine and Danco v. Alliance for Hippocratic Medicine, holding that the plaintiffs lack standing. This ruling is a relief for millions of Americans trying to access abortion care after the same court took away the constitutional right to abortion just two years ago. 

The case was brought by a group of anti-abortion activists, represented by a far-right organization, hoping to achieve a national abortion ban. Mifepristone is a safe and effective medication that has been FDA-approved for 24 years and is the most common medication abortion regimen offered, accounting for more than 60 percent of all abortions in the United States. 

This case’s potential repercussions went far beyond abortion care — it would open the door for the politically motivated removal of other safe and effective drugs from the market, throwing the entire U.S. drug approval process into chaos. For now, the Supreme Court’s decision protects access to mifepristone and the FDA’s drug approval process. 

The Supreme Court still has a case in front of them awaiting a decision, Idaho and Moyle, et al. v. United States, that challenges the Emergency Medical Treatment and Labor Act and threatens to jail doctors for providing critical care to save pregnant patients. This case, brought by extreme right-wing politicians, seeks to deny pregnant patients who are experiencing a medical crisis the emergency abortion care they may need to prevent serious health consequences, including death.

In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“This is the right and obvious decision by the Supreme Court, but the threat to reproductive care remains. This case was a deliberate attack by MAGA extremists to deny people the freedom to make their own health care choices, attempting to undermine decades of research and the FDA’s scientific judgment. While the court made the correct decision, abortion rights, and other reproductive health care services remain on the chopping block. Red states are still in the courts right now trying again to ban mifepristone and take away a woman’s right to choose. The court will make a decision on whether doctors can go to jail for providing pregnant patients with necessary emergency medical care. 

“The MAGA agenda is clear. This decision comes as Republicans in Congress are working to ban IVF, further restrict abortion care, and hike health care costs. The MAGA Republican ‘Project 2025’ blueprint calls for pulling mifepristone off the market entirely. Patients and families deserve access to medication and treatment without political and judicial interference.”

While Drug Prices Rose Under Former President Trump, President Biden Is Lowering Drug Prices and Capping the Price of Insulin At $35 Per Month

Last week, former President Trump attempted to take credit for lower insulin prices during the Biden-Harris administration. We’ve heard it all before: President Trump has spent years claiming he will lower the cost of prescription drugs. In reality, Trump and his MAGA allies did everything possible to protect the rigged system for drug companies during his term in office. In 2017, America’s largest drug companies got a huge tax break from the Trump tax bill, and they have continued to line the pockets of shareholders and CEOs while raising prices for everyday Americans. Drug prices and profits soared under Trump while he fought to repeal the Affordable Care Act and its requirement that insurance companies cover prescription drugs in court and in Congress. Trump opposed negotiating lower drug prices, and after he left office, every Republican in Congress voted against the Inflation Reduction Act, the landmark legislation that finally gave Medicare the power to negotiate lower drug prices and capped the cost of insulin at $35 per month for people on Medicare. 

Trump had four years to take action on drug prices, but instead, he did nothing and now he’ll lie and say anything to cover up his failures. In reality, drug prices soared under Trump. During his first year in office, the list prices of 20 of the top 25 drugs covered by Medicare Part D increased between three and nine times the rate of inflation, according to KFF. AARP found that annual drug costs for the drugs most commonly used by seniors rose 5.8 percent in 2018, more than twice the rate of inflation. Likewise, drug prices increased an average of 21 percent in 2019 and rose faster than inflation in 2020. Further, Trump put profits over people and gave billions in tax breaks to drug and health insurance companies and executives, signing a $1.5 trillion tax bill disproportionately benefiting the wealthy and reducing the corporate tax rate from 35 percent to 21 percent. 

FACT CHECK: No, Insulin Was Not “As Cheap As Water” During The Trump Administration. The former president has told lie after lie to cover up his abysmal health care record. During Trump’s State of the Union Address in February 2020, he falsely claimed that the cost of prescription drugs fell for the first time in 51 years under his administration, and at the September 2020 presidential debate, Trump claimed he had lowered drug costs by “80 or 90 percent” and that insulin was “as cheap as water.” Independent fact-checkers have seen right through Trump’s absurd lies and called him out:

• STAT: “In reality, insulin still retails for roughly $300 a vial. Most patients with diabetes need two to three vials per month, and some can require much more.”
• The Washington Post: “Studies we found show drug prices have not declined, especially when it comes to branded drugs.” 
• Associated Press: “[I]n 2018, spending on prescription drugs was one of the main factors behind a 4.5% increase in U.S. health spending. Spending on prescription drugs grew much faster than in 2017, according to the study.”
• Associated Press: “There were 4,412 brand-name drug price increases and 46 price cuts, a ratio of 96 to 1” in the first seven months of 2018 alone.
• CBS News: “So far in 2019, more than 3,400 drugs have boosted their prices, a 17% increase compared with the roughly 2,900 drug price increases at the same time in 2018…The average price hike for those 3,400 drugs stands at 10.5%, or about 5 times the rate of inflation, the study found. About 41 drugs have boosted their prices by more than 100%.”
• The Washington Post, ‘Health 202’: “List prices for branded drugs grew 3.3 percent in this year’s first quarter, compared with 6.3 percent in the first quarter of 2018.”
• Politico: “Prescription drug prices jumped 10.5 percent over the past six months, more slowly than during the same period last year but still four times faster than inflation, despite increasing pressure on drugmakers from the Trump administration and Congress.”
• The New York Times: “This is misleading. It is true that, for a portion of last year, the Consumer Price Index for drugs declined. But that measure does not include all prescription drugs. (And it has since risen again.)”

Under Trump, Drug Companies Engaged In The Dangerous Practice Of Price-Gouging — Pursuing Massive Profits To The Detriment Of People Who Need Their Medication To Survive. During the Trump administration, drug companies showed no restraint, price gouging drug prices year after year. A 2019 report from the Institute for Clinical and Economic Review found that price hikes on seven prominent drugs cost Americans more than $5 billion over two years. The cost of the four most popular types of insulin has tripled over the past decade, with the average price per month rising to $450 in 2016. A report found that as many as one in four of the 7.5 million Americans dependent on insulin were skipping or skimping on doses due to rising costs.

Trump and MAGA Republicans Refused To Let Medicare Negotiate For Lower Drug Prices. Even though an overwhelming majority of Americans have long supported allowing the federal government to negotiate drug prices for Medicare beneficiaries, Donald Trump and MAGA Republicans refused to let Medicare negotiate drug prices, opposing the Elijah Cummings Lower Drug Costs Now Act of 2019, which would have lowered the cost of prescription drug prices by requiring the Department of Health and Human Services to negotiate maximum prices for insulin, new and existing single-source brand-name drugs without generics, the top drugs expensed through Medicare and Medicare Advantage and would have set price ceilings at 120 percent of the average price in similar countries or 85 percent of the price for domestic manufacturers.

Trump’s Actions In Office Did Little To Nothing To Lower Drug Prices, Fell Far Short Of His Grandiose Promises. During his first term, Trump repeatedly promised that he would allow Medicare to use its buying power to negotiate drug prices directly with suppliers, but after meeting with drug company executives early in 2017, Trump abandoned that pledge, calling it “price fixing” that would hurt “smaller, younger companies.” In 2018, Trump released a “blueprint” to lower drug prices, but the main proposals were put on hold or blocked by the courts. The D.C. Circuit Court of Appeals struck down Trump’s rule to require drugmakers to disclose prices in television ads. Trump also announced that drug makers agreed to participate in a voluntary program to limit insulin costs for certain Medicare beneficiaries, which officials acknowledged could actually result in higher premiums for beneficiaries and taxpayers. Trump signed four executive orders aimed at reducing drug costs, but experts pointed out that the measures were very limited and none were immediately enforceable. Big drug company CEOs themselves said they were “not expecting any impact” from the toothless executive orders. 

And now, Trump and MAGA Republicans Want To Roll Back The Achievements Of The Inflation Reduction Act. President Biden and Democrats in Congress passed the Inflation Reduction Act in 2022, finally giving Medicare the power to negotiate lower drug prices and capping the cost of insulin at $35 a month for seniors. Every single Republican in Congress voted against this landmark legislation. Among the first ten drugs selected for negotiation are four diabetes medications, Januvia, Jardiance, Farxiga, and Fiasp/NovoLog, which are collectively used by more than 3.6 million Medicare beneficiaries. U.S. patients pay as much as 20 times more than patients in other high-income countries like Canada, Switzerland, France, and Australia for some of these diabetes medications. In a second term, Trump could take steps to weaken the law and has expressed enthusiasm for repealing it altogether. If Trump and MAGA Republicans got their way:

• GONE: $35 monthly insulin cap for the 1.5 million Americans on Medicare who use insulin.
• GONE: Medicare’s power to negotiate lower prices for the most popular and expensive prescription drugs – including diabetes medications taken by more than 3.6 million Medicare beneficiaries, Januvia, Jardiance, Farxiga, and Fiasp/NovoLog.
• GONE: Protections from drug company price hikes through increased inflation rebates.
• GONE: Medicare beneficiaries’ prescription drug savings, including a $2,000 annual out-of-pocket cap and free recommended vaccinations.

More People Than Ever Have Access To Health Care Coverage Thanks To President Biden and Democrats

This morning, the Biden-Harris administration released new research showing how President Biden and Democrats in Congress have helped more people get health care and stay covered and announced $500 million in grants for the Navigators program over the next five years, which plays a key role in helping people across the country sign up for health care coverage through Affordable Care Act (ACA) marketplace plans.

A record 21.4 million Americans signed up for coverage through ACA marketplaces for 2024, and this historic investment into the Navigators program will only continue to expand access to affordable plans, particularly in underserved communities. Many communities of color have faced systemic barriers to accessing health care. The new data shows that more people have coverage than ever – including people who haven’t historically had a reliable source of coverage, with uninsured rates among Asian, Native Hawaiian, and Pacific Islander Americans falling by nearly two-thirds, nearly halving among Black and Latino Americans, and falling by more than a third for American Indians and Alaska Natives. 

President Biden has worked to rebuild the Navigators program after the Trump administration cut ACA outreach funding by 90 percent, which resulted in as many as 1.1 million fewer people getting covered, and slashed funding for Navigators down to just $10 million, instead encouraging people to sign up for junk plans skirting ACA coverage protections for pre-existing conditions, preventive services, and more. While the Biden administration works to expand affordable health care, MAGA Republicans continue to push a radical health agenda of ripping away coverage from millions of Americans by repealing the ACA. 

BY THE NUMBERS

• $500 million in new funding to help people enroll in ACA Marketplace plans over the next five years.
• The number of uninsured Black Americans dropped by 48 percent thanks to the ACA.
• The number of uninsured Latinos fell by 45 percent thanks to the ACA.
• The number of uninsured Asian, Native Hawaiian, and Pacific Islander Americans fell by 62 percent thanks to the ACA.
• The number of uninsured American Indians and Alaska Natives decreased by 38 percent thanks to the ACA.

HEADLINES

The New York Times: Minority Groups’ Uninsured Rate Has Plunged in Recent Years, Reports Find.

• “Uninsured rates among Black, Hispanic, Asian and Native Americans plummeted between 2010 and 2022, according to reports released Friday by the Health and Human Services Department, as more patients gained health coverage from the Affordable Care Act’s marketplaces, Medicaid and employer plans.”
• “The drops cut significantly into gaps between ethnic groups. The uninsured rate among Black Americans, for example, was almost eight percentage points higher than for white Americans in 2010, and was only four percentage points higher in 2022. The data points to the broad effects of the Affordable Care Act, the landmark law President Barack Obama signed in 2010 that created new state and federal insurance marketplaces and expanded Medicaid to millions of adults. National uninsured rates have continued to drop in recent years, hitting a record low in early 2023.” [The New York Times, 6/7/24]

The Hill: Minority Groups’ Uninsured Rates Plummeted Under Affordable Care Act: Research.

• “Uninsured rates among minority groups in the U.S. plunged between 2010 and 2022, according to reports released Friday by the U.S. Department of Health and Human Services (HHS). The increase in the number of insured people points to the impact of the Affordable Care Act, former President Obama’s signature health law.”
• “The administration also announced a $500 million investment in the agency’s Navigators program, which aims to promote the ACA and help Americans make sense of coverage options available under the legislation. The $500 million will be issued in grants over the next five years.” [The Hill, 6/7/24]

Politico Pulse: Navigators Get Boost.

• “HHS said today it’s investing an additional $500 million in its Navigators program, which helps people sign up for insurance on the marketplace or via state Medicaid. The program was created under the Affordable Care Act. The announcement comes as the Biden administration touts record-high enrollment numbers since the ACA was implemented — a cornerstone of the president’s reelection campaign — and points to gains in enrollment among minority communities.”
• “The $500 million in Navigator funding will be made available in grants over the next five years, HHS said, with the first investment at $100 million. The agency has praised the program for reaching underserved populations.” [Politico, Pulse, Accessed 6/7/24]

COMMENTARY

HHS Secretary Xavier Beccera: “The Biden-Harris Administration is laser focused on making sure everyone can get health care, regardless of the color of their skin. Today’s data show just how far we have come in reaching Black, Latino, Asian American, Native Hawaiian and Pacific Islander, and American Indian and Alaskan Native populations, who are disproportionately uninsured. HHS is doubling down on our efforts by announcing another historic investment in Navigators, helping us continue to reach record enrollment in underserved communities.” [Department of Health and Human Services, Press Release, 6/7/24]

Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure: “Behind the historic health equity gains championed by the Biden-Harris Administration are the countless communities we are connecting to health care coverage, often for the first time. The combination of asking the right questions and unprecedented investments in Marketplace outreach will help us better understand the communities we serve, making coverage more attainable than ever for people who are our neighbors, friends, and loved ones.” [Department of Health and Human Services, Press Release, 6/7/24]

White House Domestic Policy Advisor Neera Tanden: “President Biden firmly believes that health care is a right, not a privilege, and is committed to making sure that everyone one of us has the peace of mind that health insurance brings. These reports show that by making health insurance more affordable, more accessible, and easier to sign up for, millions of Americans in underserved communities are now able to access the health care they need and deserve.” [Department of Health and Human Services, Press Release, 6/7/24]

Senate Majority Leader Chuck Schumer (D-NY): “Big news thanks to Democrats passing the American Rescue Plan!” [Chuck Schumer, X, 6/7/24]

Ads Highlight the Inflation Reduction Act’s Drug Pricing Provisions, Recognize Health Care Champions in Congress, and Urge Them to Continue to Fight for Lower Drug Costs

Advertising Campaign Has Grown From an Initial $5 Million to Nearly $7 Million Today

Watch the New Ads Here. 

Washington, D.C. — Protect Our Care is expanding its $5 million dollar advertising program to promote the benefits of the Inflation Reduction Act’s provisions to lower drug costs, recognize health care champions, and urge them to continue the fight to lower health care costs. This expansion adds two new districts to the existing nine: Marcy Kaptur (OH-09) and Emilia Sykes (OH-13). The initial $5 million campaign has grown to nearly $7 million. Another round of ads were previously announced in April. 

Each of these members have championed the Inflation Reduction Act’s measures to cap the price of insulin at $35/month and give Medicare the power to negotiate lower drug prices. Congress is now considering a plan to lower costs even more by expanding those reforms to the broader health insurance market, not just seniors. The ads urge the members to continue to lead the fight for lower drug costs by passing H.R. 4895, the Lowering Drug Costs for American Families Act.

“It is crucial that Ohioans and all Americans know how their members of Congress have delivered lower health care and prescription drug costs,” said Protect Our Care Chair Leslie Dach. “We are dedicated to educating people across the nation so they can take advantage of these savings. The Inflation Reduction Act is bringing real economic relief to millions of families, saving them money so they can afford the drugs they need to stay alive.”

Links to each of the new ads can be found below:

Marcy Kaptur (OH-09)
Emilia Sykes (OH-13)

The seven-figure ad campaign began on Monday, March 11. The digital campaign will reach people through OTT/streaming, YouTube, Hulu, Meta, and more. The program also includes on-the-ground events and organizing to make sure people in these communities know about these reforms. The new ads build on the previous campaign that focused on the following districts: Yadira Caraveo (CO-08), Hillary Scholten (MI-03), Susan Wild (PA-07), Matt Cartwright (PA-08), Susie Lee (NV-03), Steven Horsford (NV-04), Pat Ryan (NY-18), Frank Pallone (NJ-06), and Gabe Vasquez (NM-02).

In addition to the positive advertising promoting these achievements, Protect Our Care is also running a $1 million ad campaign in 5 districts to hold lawmakers accountable for opposing lower drug prices. Read more about this campaign here.

Links to each of the existing ads can be found below:

Yadira Caraveo (CO-08)
Hillary Scholten (MI-03) 1
Hillary Scholten (MI-03) 2
Susan Wild (PA-07)
Matt Cartwright (PA-08)
Susie Lee (NV-03)
Steven Horsford (NV-04)
Pat Ryan (NY-18)
Frank Pallone (NJ-06)
Gabe Vasquez (NM-02)

Sample Ad Script for OH-09:

Doreen: I’ve had so many patients over the years tell me that they can’t afford their drugs. They’re skipping days, cutting pills in half – it’s just not safe. Thankfully, Congress passed a plan to bring down drug prices. 

Narrator: Congresswoman Marcy Kaptur voted to give Medicare the power to negotiate lower drug prices so seniors pay less.

Doreen: This will help so many of my patients afford the medicines they need.

Narrator: Tell Congresswoman Kaptur to keep fighting for lower health care costs.

The Senate is voting on the Right to Contraception Act just before the second anniversary of the Supreme Court overturning Roe v. Wade. Since then, Republican attacks on reproductive health care have skyrocketed. MAGA Republicans have placed reproductive health care in turmoil through draconian abortion bans, and they are once again threatening access to contraceptives by working to repeal the Affordable Care Act (ACA), which guarantees free access to hundreds of no-cost preventive services, including birth control. Trump and his closest allies are also planning on policies to further restrict contraception through executive action, extreme cuts to Medicaid, and more.

Trump And His Closest Allies Are Pushing To Restrict Access To Contraception. Trump and his MAGA allies are developing a blueprint for a second Trump administration to restrict birth control through a series of executive actions, and Trump recently said he was “looking at” imposing new policy restrictions on contraception. The Heritage Foundation’s Project 2025 plan includes numerous proposals that would require coverage of so-called “natural planning” contraceptive strategies and remove requirements that insurance cover certain forms of emergency contraception.

• The Trump Administration Already Made It Harder To Access Reproductive Health Care. The Trump administration took multiple steps to make it harder for women, people of color, and LGBTQI+ Americans to access reproductive health care. As President, Trump allowed more employers to opt out of birth control coverage in their workers’ health insurance. For example, in August 2019, the Trump administration began enforcing a rule that bars certain federally-funded clinics from referring women for abortions. As a result, the nation’s largest recipient of Title X funds, Planned Parenthood, was forced to exit the program, losing $60 million in funding previously used to provide birth control and reproductive health care services for low-income women.

Republicans Are Threatening To Repeal the Affordable Care Act, Which Covers Contraceptives. Republicans have spent years taking dozens of failed votes to repeal the Affordable Care Act. They have also taken their fight to overturn the ACA to the Supreme Court and failed all three times. During his first term, Donald Trump notoriously tried and failed multiple times to repeal the ACA he has repeatedly reignited his calls to “terminate” the Affordable Care Act, which he claims is a “disaster.” The ACA made enormous strides for women’s health. By taking these actions, Republicans are fighting to strip protections from women that provide access to lifesaving care. 

• The ACA Made Access To Birth Control Free For Over 60 Million Americans. The ACA guarantees that private health plans cover 18 methods of contraception and make them available to 58 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.

MAGA Judges Are Putting Free Preventive Services Guaranteed By The ACA On The Chopping Block. Extremists are challenging a provision of the ACA that requires insurers to cover lifesaving preventive services for free. Last year, a lower court overturned a narrow set of preventive services in a ruling that was stayed pending appeal, and insurance companies are already trying to charge copays for key preventive services like cancer screenings in defiance of the stay. Worse still, the plaintiffs now want the appeals court to go further and eliminate guaranteed free coverage of vaccines and women’s preventive services like additional types of cancer screenings, prenatal care, and contraception. The case, known as Braidwood v. Becerra, is set to be decided by a panel of judges at the MAGA-packed Fifth Circuit Court of Appeals. Two of the three judges deciding the case are extreme Trump appointees with long records of opposition to affordable health care, green-lighting abortion bans, medical misinformation campaigns, and anti-vaccine cases. Here are just some of the free, lifesaving benefits that could be invalidated: 

• GONE: Free, Guaranteed Coverage For Breast & Cervical Cancer Screenings. Braidwood threatens to overturn ACA requirements that insurers cover free screenings for breast cancer and cervical cancer.
• GONE – Free, Guaranteed Preventive Treatment for Pregnancy Complications. Braidwood threatens the ACA requirements that insurers cover medications used to prevent life-threatening complications in pregnancy like preeclampsia as well as mental health interventions for pregnancy-related depression. 
• GONE – Free, Guaranteed Pregnancy Screenings & Treatments. The ACA requires free access to a variety of preventive services related to pregnancy, including preeclampsia screenings, breastfeeding equipment like pumps and bottles, folic acid, and screenings for perinatal diabetes, in order, to support healthy pregnancies and fight the maternal mortality crisis.

Republicans Are Waging a War on Medicaid, Which Covers Reproductive Health Care For Millions of Americans. Medicaid, which covers tens of millions of Americans, is an essential source of reproductive health care. Republicans in Congress and Donald Trump are itching for a renewed war on Medicaid The latest proposals from the Republican Study Committee and the Trump team in waiting at the Heritage Foundation would throw millions of people off their coverage through block granting and burdensome work reporting requirements. Almost two-thirds, or 62 percent, of those who would lose their Medicaid coverage as a result of work requirements, are women and disproportionately women of color.

MAGA Republicans Across the Country Are Attacking Reproductive Health. Nearly two years ago, Donald Trump’s appointees to the Supreme Court overturned Roe v. Wade – and the consequences for reproductive health have been catastrophic, from cruel and archaic abortion bans to devastating uncertainty about access to IVF and other reproductive care. If MAGA Republicans get their way there will be even more extreme judicial appointments and an all-out push to use the Comstock Act to create a de facto national ban on abortions and sharply limit access to medications. 

Republicans and Anti-Choice Extremists Are Fighting In Court To Ban Access To Abortion Medications. Republicans, including at least 67 members of Congress and 22 Republican attorneys general, are battling in court right now to rescind the FDA’s approval of mifepristone, a safe and effective medication essential for abortion access. The case, (Alliance for Hippocratic Medicine v. U.S. Food and Drug Administration) is centered on revoking authorization for mifepristone, a safe and effective medication essential for abortion access that was approved by the FDA more than 20 years ago. Anti-abortion advocates, represented by a far-right legal organization, brought suit with the sweeping aim of achieving a nationwide ban. The case risks not only barring the use of mifepristone for safe and legal abortions for millions of women, but it opens the door for the politically motivated removal of other safe and effective drugs from the market — throwing the entire U.S. drug approval process into chaos. As is true for all abortion restrictions, people of color, low-income individuals, and those without regular access to a nearby health care provider will be disproportionately harmed by restrictions and uncertainty around medication access. 

Republicans and Red State Judges Are Threatening Fertility Treatments Like IVF Through Extreme, Anti-Choice Policies. Earlier this year, the Alabama Supreme Court ruled that frozen embryos should be considered children, putting the future of in vitro fertilization (IVF) in jeopardy. Republicans have made it clear that they have no intention to protect reproductive health care in the post-Roe landscape. A Senate Republican even moved to block a bill to establish federal protections for IVF and other fertility treatments.

Despite Progress Made By President Biden, the GOP is Putting LBGTQI+ Rights At Risk

Lowering drug costs, expanding affordable health insurance coverage, and banning health care discrimination are critical to improving access to comprehensive, high-quality health care and – together with other actions – advancing health equity for lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) people in America. The Biden-Harris administration has been leading the way in ensuring LGBTQI+ individuals have access to health care, while Republicans continue to sabotage LGBTQI+ rights in state legislatures by denying transgender youth access to gender-affirming care, and the ability to use chosen names and pronouns in schools, and banning drag as a form of gender expression. Policies to improve access to care and protect LGBTQI+ individuals from discrimination in health care and other settings are essential for improving the health and well-being of LGBTQI+ people nationwide.

However, Trump-appointed MAGA judges are setting a dangerous precedent to pull vital medications off the market and eliminate no-cost preventive services that LGBTQI+ people count on to stay healthy — including PrEP, a medicine that is 99 percent effective at preventing the spread of HIV and can cost thousands of dollars annually. This threatens to exacerbate health disparities in queer Black and Hispanic/Latino communities. Republicans in 10 states continue to block Medicaid expansion, while the program provides critical health care access for LGBTQI+ people. Meanwhile, state-level Republicans are igniting a war on trans health care, with Florida Republicans banning upwards of 80 percent of all gender-affirming care in the state. Whether it’s barring no-cost screenings or preventive medicine, banning gender-affirming care, or attacking other fundamental LGBTQI+ rights, Republicans’ war on LGBTQI+ health care is only getting worse.

The Biden-Harris Administration Is Helping Millions of LGBTQI+ Americans Gain Health Coverage

Expanding Health Coverage For Millions Of Americans. Premium subsidies for people who purchase coverage on their own made available by President Biden’s American Rescue Plan helped nearly 210,000 LGBTQI+ enrollees have access to zero-premium plans. Nationwide, 20 percent of Black LGBTQI+ individuals are uninsured, compared to 15 percent of Black heterosexual and cisgender individuals and 9 percent of non-LGBTQI+ individuals overall. Before the Affordable Care Act (ACA) went into effect in 2013, 34 percent of LGBTQI+ Americans were uninsured. As of June 2020, the uninsurance rate amongst LGBTQI+ individuals dropped to 16 percent. In the 2023 Open Enrollment period, a record-breaking 21.3 million Americans signed up for health insurance through the ACA, a 17 percent increase from 2022.

Reversing Trump Policy Allowing Sexual Orientation Discrimination. In May 2021, Department of Health and Human Services (HHS) Secretary Xavier Becerra announced that sexual orientation would be restored as a protected class under the ACA. In July 2022, HHS put forth a proposed rule implementing Section 1557 of the ACA, which prohibits discrimination on the basis of race, color, national origin, sex, age, and disability in certain health programs and activities. The rule affirms protections against discrimination on the basis of sex, including sexual orientation and gender identity consistent with recent U.S. Supreme Court decisions. In April 2024, this rule became finalized and ensures that LGBTQI+ individuals aren’t denied coverage or charged more for care. This Administration’s policy reversal has been especially important with transgender rights being attacked by Republicans. These new protections are already under attack with the state of Florida suing the administration to overturn the rule.

Closing The Coverage Gap Improves Outcomes For LGBTQI+ Individuals. As of June 2022, 1.2 million LGBTQI+ Americans were covered by Medicaid, and of those nearly 13 percent identified as transgender. According to a Center for American Progress survey, in 2019, the LGBTQI+ uninsured rate was 20 percent in the states refusing to expand Medicaid, compared to 8 percent in states that adopted Medicaid expansion. 29 percent of LGBTQI+ individuals faced difficulty seeking medical care when sick or injured due to cost. LGBTQI+ Americans are twice as likely to be without health insurance. Closing the Medicaid coverage gap is the single most important policy to expand coverage and reduce racial and ethnic inequities in the American health care system, and is an important policy solution for LGBTQI+ people because of the intersectional dimensions of their identities. A 2022 study found that more Black LGBTQI+ adults had Medicaid as their primary insurance compared to their heterosexual and cisgender counterparts. 

Biden-Harris Administration Helps LGBTQI+ Americans Age With Dignity

Millions Of LGBTQI+ Americans Able To Grow Old At Home. Federally provided home- and community-based services funds helped more than 100,000 individuals return to their homes and communities from nursing facilities between 2008 and 2019. Allowing LGBTQI+ seniors to grow old at home helps alleviate the concern older LGBTQ+ adults have about being neglected or abused, or facing discrimination in nursing homes or assisted living facilities. In President Biden’s fiscal year 2024 proposed budget, $150 million is dedicated to investing in Medicaid’s home- and community-based services to ensure more older Americans and people with disabilities have access to care in their own homes and communities. 

The Inflation Reduction Act Supports LGBTQI+ Seniors. The $2,000 cap on prescription drug prices for Medicare enrollees helps LGBTQI+ seniors on Medicare, who typically suffer more from poorer health and poverty. Medication costs are a frequent barrier to managing chronic health issues. 23 percent of the LGBTQI+ community lived in poverty in 2020, compared to 16 percent of their heterosexual counterparts. When looking at further dimensions of intersectionality, members of LGBTQI+ communities of color also disproportionately faced higher rates of poverty than heterosexual members of these communities. A 2021 study found that members of sexual minority communities are more likely than heterosexual individuals to engage in behaviors to reduce the cost of medicine such as skipping doses, trying alternate therapies, or delaying refills.

Biden-Harris Administration Is Defending Transgender Americans

Supporting Gender Affirming Care. On a state-by-state basis, the Center for Medicare and Medicaid Services is approving efforts to expand gender-affirming care under the ACA and other federal programs. HHS has also created a website and resources for LGBTQI+ youth, parents, and providers, on LGBTQI+ health and well-being and gender-affirming care.

Protecting Transgender Youth Mental Health. The Biden Administration is focusing on providing mental health support, creating a more welcoming environment in public schools, and acknowledging the positive impacts of gender-affirming care. President Biden signed the Executive Order on Advancing Equality LGBTQI+ Individuals in June 2022 to defend the rights and safety of LGBTQI+ individuals by directing relevant agencies to discredit conversion therapy, ensuring that federal benefit programs can be equitably accessed by LGBTQI+ households, and increasing federal support for family counseling to reduce the risk of family rejection of LGBTQI+ youth. The Substance Abuse and Mental Health Services Administration is also piloting additional dedicated services for LGBTQI+ youth in the national 988 Suicide and Crisis Lifeline. In February 2024, the Biden-Harris Administration dedicated $5.1 million to fund family counseling and support for LGBTQI+ youth and their families. The goal of this grant is to prevent health risks including suicide, depression, homelessness, and drug use, while also promoting wellness.

Stepping In When States Fail. In honor of Transgender Visibility Day in March 2022, the Justice Department issued a letter to all state attorneys general reinforcing federal transgender youth protections against discrimination and obtaining gender-affirming care. Due to the increase in anti-trans state legislation, the Department of Justice has also filed statements of interest and amicus briefs supporting legal action against state laws that restrict the rights of transgender youth.  

Republicans Are Pulling Medications They Don’t Like From The Market – Setting a Dangerous Precedent for LGBTQI+ Care

A Trump-Appointed Judge Is Working To Curb Access To Safe, Affordable Abortions. In April 2023, another Trump-appointed judge ruled against the FDA in a case seeking to remove a popular medication used to induce abortion from the market. Medication abortions are the most common, least expensive, and most accessible method for people to terminate pregnancy and the ruling impacts communities that already have difficulty accessing these key services. 

Republicans Want to Pull Medications They Don’t Like Off The Shelves. The case could set a dangerous precedent for any federal judge to pull controversial medications off the market, regardless of the science behind approval decisions or the bureaucratic steps taken to prove safety and efficacy. As Lambda Legal has pointed out, “The trial court’s approach just as easily (or perhaps more easily) could be aimed at HIV-related medications and puberty blockers and hormone treatments, as well as medications for many other health conditions that are specially relevant for our communities.”

Republicans Are Taking Away No-Cost Preventive Care From LGBTQI+ People and Communities of Color

Republicans Are Curbing Access To No-Cost Preventive Services, Disproportionately Impacting LGBTQI+ People and Communities of Color. In March 2023, a Trump-appointed judge decided against the federal government in Braidwood v. Becerra and struck down a major portion of the ACA requiring no-cost coverage of lifesaving preventive health care services recommended by the U.S. Preventive Services Task Force, including lung and breast cancer screenings, Hepatitis C screenings, HIV screenings, and PrEP medication. These changes have a disproportionate impact on historically marginalized populations like LGBTQI+ people and communities of color — curbing no-cost access to preventive services would create barriers to seeking needed care and exacerbate existing health disparities.

Republicans Are Targeting PrEP, A Key Prevention Strategy For HIV. The Trump-appointed judge’s ruling struck down a portion of the ACA guaranteeing access to pre-exposure prophylaxis (PrEP), a drug proven to substantially reduce the risk of contracting HIV. PrEP has been associated with a significant decrease in the number of new HIV diagnoses. PrEP is shown to lower the risk of infection from sex by more than 90 percent (more than 99 percent effective) and is widely viewed as a key prevention strategy for ending the HIV epidemic in the U.S. Thanks to ACA protections, the percentage of PrEP users has jumped from 3 percent of eligible patients in 2015 to 30 percent of eligible patients prescribed in 2021. The federal government’s 2022-2025 strategy to combat HIV recognized gay and bisexual men—particularly Black, Hispanic/Latino, and Native American men—Black women, and trans women as priority populations. Rural populations, especially gay and bisexual Native American men and Two-Spirit populations, have greater difficulty accessing preventive care for HIV.

• Ending ACA PrEP Protections Disproportionately Harms Black and Hispanic/Latino Gay and Bisexual Men. While 66 percent of eligible white people in America are prescribed PrEP, just 16 percent of eligible Hispanic/Latino Americans and 9 percent of eligible Black Americans are prescribed the lifesaving drug. Academic experts have concluded that Braidwood will disproportionately impact racial and ethnic sociodemographic groups at particularly high risk for HIV infection: “Even in our ‘best-case’ scenario, the predominant burden of new restrictions on access to PrEP will likely fall on Black and Latino gay and bisexual men, as well as transgender women, who already face significant barriers to HIV prevention and care.”

Ending ACA Cost-Sharing Protections Could Increase HIV Transmission By At Least 17 Percent In The First Year Alone. According to academic experts, ending the prohibition of cost sharing for PrEP will increase HIV transmission among men who have sex with men by at least 17 percent in the first year alone. Researchers at Yale have already determined that the Braidwood ruling could see coverage for PrEP drop from 28 percent to only 10 percent, mainly due to the fact that 80 percent of PrEP users are on commercial plans that would now have the ability to refuse to cover PrEP. A recent study found that PrEP medication costs nearly $350 for a 30-day supply on average. Outside of the cost of obtaining medication, PrEP users incur additional required charges as part of the care regimen like clinical visits and lab costs that can add up to thousands of dollars annually. 

Republicans Are Pushing An Anti-Trans Agenda

10 Republican-Led States Continue To Block Medicaid Expansion, Which Serves Millions Of LGBTQI+ Patients. Republicans in 10 states continue to block Medicaid expansion, while the program provides critical health care access for an estimated 1.2 million LGBTQI+ adults, disproportionately trans and non-binary Black, Hispanic/Latino, Pacific Islander, and Native American people. LGB individuals are more likely to qualify for Medicaid based on income, and Medicaid covers about 21 percent of trans and non-binary people in the U.S.

Republicans Are Waging War On Trans People and Their Health Care. Across the country, Republicans have escalated their war on trans people and health. As of May 2023, 16 Republican-led states have enacted new anti-trans health care laws and 22 states have passed anti-trans health care bills in at least one Republican-held legislative chamber. Republicans have re-centered their culture wars around trans people, with new legislation prohibiting drag shows from public property alongside bans on gender-affirming care. Anti-trans laws contribute to negative health impacts, including an increased risk of suicidality and substance use among trans and non-binary youths. Equitable access to health care services has always been a challenge for LGBTQI+ people. A 2018 survey found that 75 percent of people seeking gender-identity-based care have had negative experiences during physician visits. The fight to get insurers to cover basic care for trans patients—let alone gender-affirming care—has been a grueling, decades-long process even with ACA protections and federal and state-level enforcement. New bans threaten to undo decades of work to provide trans people with access to affordable, gender-affirming care.