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ashoup
In News, Administration

Court Ruling Helps Mitch McConnell Rip Away Protections for People with Pre-Existing Conditions

Decision From Federal Judge Means:

Medicaid Expansion is Gone

Protections for Pre-Existing Conditions are Gone

Hundreds of Thousands of Kentuckians Will Lose Health Care

And Mitch McConnell OWNS IT

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

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

BACKGROUND:

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

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

What’s at stake for Kentucky:

  • The coverage that 404,000 Kentuckians gained through the ACA by 2015.
  • Protections for 1,795,500 Kentuckians who have a pre-existing health condition.
  • 462,000 Kentuckians who have coverage because of Medicaid expansion.
  • The health care of roughly 31,000 young adults in Kentucky who have coverage because they can stay on their parents coverage until age 26.
  • The nearly 1,884,719 Kentuckians, most of whom have employer coverage, who can access free preventive care at no cost.
  • The 2,326,000 Kentuckians with employer coverage who no longer have to worry about lifetime or annual limits.
  • Seniors’ drug savings — 83,989 Kentucky seniors are saving $100.3 million on drugs in 2017, an average of $1,194 per beneficiary because the ACA closed the Medicare prescription drug donut hole.

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

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

  • According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 130 million people, have a pre-existing condition. This includes:
    • 44 million people who have high blood pressure
    • 45 million people who have behavioral health disorders
    • 44 million people who have high cholesterol
    • 34 million people who have asthma and chronic lung disease
    • 34 million people who have osteoarthritis and other joint disorders
  • 17 million children. One in four children, or roughly 17 million, have a pre-existing condition.  This includes 240,400 Kentucky children.
  • 68 million women. More than half of women and girls nationally have a pre-existing condition.
  • 30 million people aged 55-64. 84 percent of older adults, 30.5 million Americans between age 55 and 64, have a pre-existing condition. This includes 412,100 Kentuckians.
  • 1,795,500 Kentuckians have a pre-existing condition.

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

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

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

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

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

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

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

  • More than 100 Million People With A Pre-Existing Condition Could Be Forced to Pay More. An analysis by Avalere finds that “102 million individuals, not enrolled in major public programs like Medicaid or Medicare, have a pre-existing medical condition and could therefore face higher premiums or significant out-of-pocket costs” thanks to the Republican lawsuit to repeal the Affordable Care Act.
  • Insurance Companies Could Charge Premium Surcharges in the Six Figures. If Judge O’Connor sides with Republican lawmakers, insurance companies would be able to charge people more because of a pre-existing condition. The health repeal bill the House passed in 2017 had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
  • Women Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women were often charged premiums on the nongroup market of up to 50 percent higher than they charged men for the same coverage.
  • People Over the Age of 50 Could Face a $4,000 “Age Tax,” Including $3,264 in Kentucky. If Judge O’Connor sides with Republican lawmakers, insurance companies would be able to charge people over 50 more than younger people. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, including $3,264 in Kentucky, according to the AARP.
  • Seniors Would Have to Pay More for Prescription Drugs. If Judge O’Connor sides with Republican lawmakers, seniors would have to pay more for prescription drugs because the Medicare “donut” hole got reopened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 CMS report. In Kentucky, 83,989 Kentucky seniors saved $100.3 million on drugs in 2017, an average of $1,194 per beneficiary .

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

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

Because Judge O’Connor Sided With Republicans, Medicaid Expansion Would Be Repealed

Fifteen million people have coverage through the expanded Medicaid program, including 162,000 in Kentucky.

ashoup
In News, Administration

Court Ruling Helps Thom Tillis Rip Away Protections for People with Pre-Existing Conditions

Decision From Federal Judge Means:

Medicaid Expansion is Gone

Protections for Pre-Existing Conditions are Gone

Hundreds of Thousands of North Carolinians Will Lose Health Care

And Thom Tillis OWNS IT

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

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

BACKGROUND:

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

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

What’s at stake for North Carolina:

  • The coverage that 552,000 North Carolinians gained through the ACA by 2015.
  • Protections for 3,929,400 North Carolinians who have a pre-existing health condition.
  • The health care of roughly 70,000 young adults in North Carolina who have coverage because they can stay on their parents coverage until age 26.
  • The nearly 3,966,308 North Carolinians, most of whom have employer coverage, who can access free preventive care at no cost.
  • The 3,091,000 North Carolinians with employer coverage who no longer have to worry about lifetime or annual limits.
  • Seniors’ drug savings — 165,931 North Carolina seniors are saving $185.3 million on drugs in 2017, an average of $1,117 per beneficiary because the ACA closed the Medicare prescription drug donut hole.

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

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

  • According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 130 million people, have a pre-existing condition. This includes:
    • 44 million people who have high blood pressure
    • 45 million people who have behavioral health disorders
    • 44 million people who have high cholesterol
    • 34 million people who have asthma and chronic lung disease
    • 34 million people who have osteoarthritis and other joint disorders
  • 17 million children. One in four children, or roughly 17 million, have a pre-existing condition, including 544,000 in North Carolina.
  • 68 million women. More than half of women and girls nationally have a pre-existing condition.
  • 30 million people aged 55-64. 84 percent of older adults, 30.5 million Americans between age 55 and 64, have a pre-existing condition. This includes 803,300 in North Carolina.
  • 3,929,400 North Carolinians have a pre-existing condition.

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

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

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

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

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

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

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

  • More than 100 Million People With A Pre-Existing Condition Could Be Forced to Pay More. An analysis by Avalere finds that “102 million individuals, not enrolled in major public programs like Medicaid or Medicare, have a pre-existing medical condition and could therefore face higher premiums or significant out-of-pocket costs” thanks to the Republican lawsuit to repeal the Affordable Care Act.
  • Insurance Companies Could Charge Premium Surcharges in the Six Figures. If Judge O’Connor sides with Republican lawmakers, insurance companies would be able to charge people more because of a pre-existing condition. The health repeal bill the House passed in 2017 had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
  • Women Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women were often charged premiums on the nongroup market of up to 50 percent higher than they charged men for the same coverage.
  • People Over the Age of 50 Could Face a $4,000 “Age Tax,” Including $5,720 in North Carolina. If Judge O’Connor sides with Republican lawmakers, insurance companies would be able to charge people over 50 more than younger people. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, including $5,720 in North Carolina, according to the AARP.
  • Seniors Would Have to Pay More for Prescription Drugs. If Judge O’Connor sides with Republican lawmakers, seniors would have to pay more for prescription drugs because the Medicare “donut” hole got reopened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 CMS report. In North Carolina, 165,931 North Carolina seniors are saving $185.3 million on drugs in 2017, an average of $1,117 per beneficiary

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

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

Court Ruling Helps Joni Ernst Rip Away Protections for People with Pre-Existing Conditions

Decision From Federal Judge Means:

Medicaid Expansion is Gone

Protections for Pre-Existing Conditions are Gone

Hundreds Of Thousands of Iowans Will Lose Health Care

And Joni Ernst OWNS IT

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

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

BACKGROUND:

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

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

What’s at stake for Iowa:

  • The coverage that 132,000 Iowans gained through the ACA by 2015.
  • Protections for 1,288,400 Iowans who have a pre-existing health condition.
  • The health care of roughly 24,000 young adults in Iowa who have coverage because they can stay on their parents coverage until age 26.
  • 150,000 Iowans who have coverage because of Medicaid expansion.
  • The nearly 1,530,502 Iowans, most of whom have employer coverage, who can access free preventive care at no cost.
  • The 1,862,000 Iowans with employer coverage who no longer have to worry about lifetime or annual limits.
  • Seniors’ drug savings — 51,596 Iowa seniors are saving $54.6 million on drugs in 2017, an average of $1,058 per beneficiary because the ACA closed the Medicare prescription drug donut hole.

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

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

  • According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 130 million people, have a pre-existing condition. This includes:
    • 44 million people who have high blood pressure
    • 45 million people who have behavioral health disorders
    • 44 million people who have high cholesterol
    • 34 million people who have asthma and chronic lung disease
    • 34 million people who have osteoarthritis and other joint disorders
  • 17 million children. One in four children, or roughly 17 million, have a pre-existing condition.
  • 68 million women. More than half of women and girls nationally have a pre-existing condition.
  • 30 million people aged 55-64. 84 percent of older adults, 30.5 million Americans between age 55 and 64, have a pre-existing condition.
  • 1,288,400 Iowans have a pre-existing condition.

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

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

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

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

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

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

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

  • More than 100 Million People With A Pre-Existing Condition Could Be Forced to Pay More. An analysis by Avalere finds that “102 million individuals, not enrolled in major public programs like Medicaid or Medicare, have a pre-existing medical condition and could therefore face higher premiums or significant out-of-pocket costs” thanks to the Republican lawsuit to repeal the Affordable Care Act.
  • Insurance Companies Could Charge Premium Surcharges in the Six Figures. If Judge O’Connor sides with Republican lawmakers, insurance companies would be able to charge people more because of a pre-existing condition. The health repeal bill the House passed in 2017 had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
  • Women Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women were often charged premiums on the nongroup market of up to 50 percent higher than they charged men for the same coverage.
  • People Over the Age of 50 Could Face a $4,000 “Age Tax,” Including $ 4,407 in Iowa. If Judge O’Connor sides with Republican lawmakers, insurance companies would be able to charge people over 50 more than younger people. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, including $ 4,407 in Iowa, according to the AARP.
  • Nine Million People in the Marketplaces Would Pay More for Coverage, Including 41,678 Iowans. If Judge O’Connor sides with Republican lawmakers, consumers would no longer have access to tax credits that help them pay their marketplace premiums, meaning roughly nine million people who receive these tax credits to pay for coverage will have to pay more, including 41,678 in Iowa.
  • Seniors Would Have to Pay More for Prescription Drugs. If Judge O’Connor sides with Republican lawmakers, seniors would have to pay more for prescription drugs because the Medicare “donut” hole got reopened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 CMS report. In Iowa, 51,596 seniors each saved an average of $1,058.

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

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

Because Judge O’Connor Sided With Republicans, Medicaid Expansion Would Be Repealed

Fifteen million people have coverage through the expanded Medicaid program, including 150,000 in Iowa.

ashoup
In Stories, News, Administration

“Misguided and Wrong”: Those Who Know Health Care the Best Say That the Judge’s Ruling Against the Affordable Care Act is the Worst

Last night, Judge Reed O’Connor ruled that the entire Affordable Care Act was unconstitutional and should be struck down. This ruling would end protections for those with pre-existing conditions, re-implement an age tax, no longer let children stay on their parents’ insurance until age 26, implement an age tax on seniors, and kick millions of Americans off of their insurance. Those who know health care the best – patients groups, medical associations, insurance companies – have been unanimous in their rejection of this ruling:

THE AMERICAN MEDICAL ASSOCIATION CRITICIZED THE RULING:

American Medical Association: “An Unfortunate Step Backward For Our Health System.” “The American Medical Association called the ruling ‘an unfortunate step backward for our health system’ and warned the decision could ‘destabilize health insurance coverage.’ ‘No one wants to go back to the days of 20 percent of the population uninsured and fewer patient protections, but this decision will move us in that direction,’ AMA president Barbara L. McAneny said in a statement.” [CNBC, 12/14]

THE NATION’S LEADING PATIENT GROUPS CALLED FOR THIS DECISION TO BE REVERSED:

American Cancer Society Cancer Action Network, American Diabetes Association, American Heart Association, American Lung Association,  And National Multiple Sclerosis Society: “We Are Hopeful The United States Court Of Appeals For The Fifth Circuit Will Support Individuals With Chronic Diseases And Preserve Health Care For Millions Of Americans.” “If the ruling stands, anyone with a pre-existing condition could be charged more for health coverage or denied access to coverage altogether. Health plans would no longer be required to offer essential benefits necessary to prevent and treat a serious condition and could once again impose arbitrary annual and lifetime limits on coverage… The court should have respected the will of Congress, instead of ruling to invalidate the law at the expense of the 27 million Americans who will lose their health care by 2020, according to Congressional Budget Office estimates. In the event of an appeal, we are hopeful the United States Court of Appeals for the Fifth Circuit will support individuals with chronic diseases and preserve health care for millions of Americans.” [American Lung Association, 12/15]

American Psychiatric Association: “This Decision Must Be Appealed And Reversed.” “‘This ruling has an unconscionable result,’ said APA President Altha Stewart, M.D. ‘Should this ruling stand, millions of our patients will lose their health care. We cannot afford to go back to the days when Americans were denied coverage due to pre-existing conditions or when insurance companies would not cover mental health and substance use disorders.’ ‘This harmful ruling must be appealed and overturned,’ said APA CEO and Medical Director Saul Levin, M.D., M.P.A. ‘The court’s decision to invalidate the ACA, including pre-existing conditions protections and the Medicaid expansion will hurt our patients with mental illness and all illnesses. This decision must be appealed and reversed.” [APA, 12/15]

INSURERS WERE QUICK TO BLAST THE DECISION:

America’s Health Insurance Plans: “The District Court’s Decision Is Misguided And Wrong.” “The district court’s decision is misguided and wrong. This decision denies coverage to more than 100 million Americans, including seniors, veterans, children, people with disabilities, hardworking Americans with low-incomes, young adults on their parents’ plans until age 26, and millions of Americans with pre-existing conditions. We argued in an amicus brief before the court that provisions of the Affordable Care Act (ACA) affecting patients with pre-existing conditions, and those covered by Medicaid and Medicare should remain law regardless of what the court ruled on the individual mandate. Unfortunately, this ruling harms all of these Americans.” [AHIP, 12/14]

Blue Cross Blue Shield: “We Are Extremely Disappointed In The Court’s Ruling.” “Yesterday’s federal district court ruling in a case challenging the Affordable Care Act is the first step in what we expect will be a lengthy legal process…While we are extremely disappointed in the court’s ruling, we will continue to work with lawmakers on a bipartisan basis to ensure that all Americans can access the consistent, quality health coverage they need and deserve.” [Blue Cross Blue Shield, 12/15]

HOSPITALS REJECTED THE RULING:

American Federation Of Hospitals: “The Judge Got It Wrong.” “‘The judge got it wrong,’ said Charles N. ‘Chip’ Kahn III, president of the Federation of American Hospitals. ‘This ruling would have a devastating impact on the patients we serve and the nation’s health-care system as a whole. . . . Having this decision come in the closing hours of open enrollment also sows seeds of unnecessary confusion.’” [Washington Post, 12/14]

American Hospital Association: “America’s Hospitals And Health Systems Are Extremely Disappointed.” “America’s hospitals and health systems are extremely disappointed with today’s federal district court ruling on the constitutionality of the Affordable Care Act. The ruling puts health coverage at risk for tens of millions of Americans, including those with chronic and pre-existing conditions, while also making it more difficult for hospitals and health systems to provide access to high-quality care…We join others in urging a stay in this decision until a higher court can review it and will continue advocating for protecting patient care and coverage.” [American Hospital Association, 12/14]

MEDICAL COLLEGES REJECTED IT, TOO:

American Association of Medical Colleges: “This Ruling Puts Millions Of Americans, Including The Most Vulnerable Patients, At Risk.” “Dismantling the ACA will be disastrous for the nation’s health care system. Patients—particularly those with preexisting and complex conditions—require stability and continuity in their care. Without access to affordable meaningful coverage, many would forego or delay necessary medical care. This ruling puts millions of Americans, including the most vulnerable patients, at risk.” [American Association of Medical Colleges, 12/15]

AND SO DID SMALL BUSINESSES:

Small Business Majority: Court “Made A Grave Error… Ending The ACA Would Be An Unmitigated Disaster.” “The U.S. District Court for the Northern District of Texas made a grave error in the case of Texas v. United States when it recklessly decided the Affordable Care Act (ACA) is unconstitutional… Prior to the enactment of the healthcare law, small businesses and their employees represented a disproportionate share of uninsured workers, and small business owners paid 18 percent more on average for coverage than their big business counterparts. Since 2010, however, the growth in small business healthcare costs slowed dramatically, following regular double-digit increases prior to the law’s enactment. And because the law makes it much easier for the self-employed to obtain their own coverage, many more aspiring entrepreneurs have escaped ‘job lock’ and been willing to go out on their own to start new ventures. In fact, more than 5.7 million small business employees or self-employed workers are enrolled in the ACA marketplaces, and more than half of all ACA marketplace enrollees nationwide are small business owners, self-employed individuals or small business employees… Ending the ACA would be an unmitigated disaster for America’s entrepreneurs: It would cause a rapid rise in healthcare costs and create substantial economic instability. For the good of America’s job creators, the constitutionality of the ACA must be upheld, and we hope this decision is immediately appealed.” [Small Business Majority, 12/15]

THE RULING WAS PRAISED BY ONE PERSON, HOWEVER. WHO WAS THAT?

President Donald Trump: “Great News For America!” “Wow, but not surprisingly, ObamaCare was just ruled UNCONSTITUTIONAL by a highly respected judge in Texas. Great news for America!” [Donald Trump Twitter, 12/14]

ashoup
In News, Administration, Stories

Court Sides with Trump and Republicans and Rules to Overturn the Affordable Care Act: Here are the Facts

For the past two years, Republicans have been waging a relentless war on health care trying to repeal the Affordable Care Act (ACA). Last night, Republicans got their wish when U.S. Northern Texas District Court Judge Reed O’Connor sided with Republican lawmakers in 20 states and invalidated the ACA in its entirety. With this decision, Republicans are close to doing through the Courts what they failed to do legislatively: repeal our health care, which will rip coverage from millions of Americans, raise costs, end protections for people with pre-existing conditions, put insurance companies back in charge, and force seniors to pay more for prescription drugs.

The ruling is legally wrong and must be overturned. If not, this ruling will, as the Trump Administration itself admitted in Court, unleash “chaos” in our entire health care system.

Thanks To The Republican Lawsuit, 17 Million People Could Lose Their Coverage

Republicans Convinced The Court To Put Insurance Companies Back In Charge, Ending Protections For The 130 Million People With A Pre-Existing Condition

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

Republicans Convinced The Court To Give Insurance Companies The Power To Deny Or Drop Coverage Because Of A Pre-Existing Condition

Before the Affordable Care Act, insurance companies routinely denied people coverage because of a pre-existing condition or canceled coverage when a person got sick. Now insurance companies have license to do this again.

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

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

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

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

Republicans Convinced The Court To Give Insurance Companies The Power To Charge You More

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

Republicans Convinced The Court To Give Insurance Companies The Power To Limit The Care You Get, Even If You Have Insurance Through Your Employer

  • Reinstate Lifetime and Annual Limits. Thanks to the Republican lawsuit, insurance companies can once again impose annual and lifetime limits on coverage.
  • Insurance Companies Do Not Have to Provide the Coverage You Need. The Affordable Care Act made comprehensive coverage more available by requiring insurance companies to include “essential health benefits” in their plans, such as maternity care, hospitalization, substance abuse care and prescription drug coverage. Before the ACA, people had to pay extra for separate coverage for these benefits. For example, in 2013, 75 percent of non-group plans did not cover maternity care, 45 percent did not cover substance abuse disorder services, and 38 percent did not cover mental health services. Six percent did not even cover generic drugs.

Republicans Convinced The Court To End Medicaid Expansion

  • Fifteen million people have coverage through the expanded Medicaid program.
ashoup
In News, Administration, Stories, Capitol Hill

“If The Trump Administration’s Argument Were to Prevail, Insurers Could Once Again Be Able to Flat-Out Deny Americans Insurance Based On Their Health Status”: Reactions to Judge Ruling to Fully Repeal Affordable Care Act

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

His decision would cause irreparable harm to the nation’s health care system:

New York Times: 17 Million Americans Would Lose Their Health Insurance. “If Judge O’Connor’s decision ultimately stands, about 17 million Americans will lose their health insurance, according to the Urban Institute, a left-leaning think tank. That includes millions who gained coverage through the law’s expansion of Medicaid, and millions more who receive subsidized private insurance through the law’s online marketplaces” [New York Times, 12/14/18]

Vox: Americans Could Once Again Be Denied Coverage For Pre-Existing Conditions. “Usually, a presidential administration defends current law, but the Trump administration took a different approach in this case. It agreed with the conservative states that the mandate and, with it, the law’s rules that prohibits insurers from denying people health insurance or charging them higher rates, should be found unconstitutional…. If the Trump administration’s argument were to prevail, insurers could once again be able to flat-out deny Americans insurance based on their health status. No amount of federal subsidies would protect them. Medicaid expansion would remain, but the private insurance market would no longer guarantee coverage to every American.” [Vox, 12/14/18]

Texas Tribune: Ruling “Could Throw The Nation’s Health Care System Into Chaos.” “In a ruling that could throw the nation’s health care system into chaos, Fort Worth-based U.S. District Judge Reed O’Connor on Friday ruled that a major provision of the Affordable Care Act is unconstitutional — and that the rest of the landmark law must fall as well…Legal scholars — even some conservatives who oppose the law — have nonetheless called Texas’ argument unconvincing.” [Texas Tribune, 12/14/18]

Larry Levitt, Kaiser Family Foundation: “If Upheld, This Would Throw Out Not Only The law’s Pre-Existing Condition Protections, But Also Everything Else.” “If upheld, this would throw out not only the law’s pre-existing condition protections, but also everything else — premium subsidies, expanded Medicaid, preventive services, and much more.” [Larry Levitt Twitter, 12/14/18]

His decision came following midterm elections in which health care carried Democrats to elected office across the country:

Politico: Decision Comes After Midterm Elections Which Partially Served “As A Rebuke To Republican Efforts To Tear Down Obamacare.” “The invalidation of the landmark 2010 law is certain to send shock waves through the U.S. health system and Washington after a midterm election seen in part as a rebuke to Republican efforts to tear down Obamacare.” [Politico, 12/14/18]

CNN: “Protecting Those With Pre-Existing Conditions Became A Central Focus Of [Midterm] Races.” “The lawsuit entered the spotlight during the midterm elections, helping propel many Democratic candidates to victory. Protecting those with pre-existing conditions became a central focus of the races. Some 58% of Americans said they trust Democrats more to continue the law’s provisions, compared to 26% who chose Republicans, according to a Kaiser Family Foundation election tracking poll released in mid-October.” [CNN, 12/14/18]

His decision came as open enrollment wraps up, underscoring the GOP’s obsession with sabotaging America’s health care system:

Bloomberg: Decision “Underscores A Divide Between Republicans Who Have Long Sought To Invalidate The Law And Democrats Who Fought To Keep It In Place.” “The decision Friday finding the Affordable Care Act unconstitutional comes just before the end of a six-week open enrollment period for the program in 2019 and underscores a divide between Republicans who have long sought to invalidate the law and Democrats who fought to keep it in place.” [Bloomberg, 12/14/18]

Washington Examiner: The Decision Came The Day Before The End Of Open Enrollment, Cementing the Trump Administration’s Sabotage Of The Marketplace. “The decision came just a day ahead of when the open enrollment for Obamacare’s marketplaces are set to close across most of the U.S. Enrollment in these marketplaces has been lagging, with some critics arguing that the zeroing out of the fine is partially to blame.” [12/14/18]

Axios: “Republicans Have Never Come Up With A Replacement Plan That Would Offer The Same Level Of Protection As The ACA.” “In an interview with “Axios on HBO,” President Trump said he’d reinstate protections for pre-existing conditions if the lawsuit gutted the ACA. But as Axios’ Sam Baker notes, Republicans have never come up with a replacement plan that would offer the same level of protection as the ACA.” [Axios, 12/14/18]

And his decision was written on questionable legal grounds:

The Hill: “Legal Experts In Both Parties Have Denounced [The Judge’s] Argument.” “In a controversial move, the judge added that because the mandate is ‘essential’ to the rest of the law, without the mandate, the entire law is invalid. Legal experts in both parties have denounced that argument, saying it is obvious that Congress wanted the rest of the Affordable Care Act to remain when it repealed only the mandate penalty last year.” [The Hill, 12/14/18]

Washington Post: “Many Health-Law Specialists Have Viewed Its Logic As Weak.” “A federal judge in Texas threw a dagger on Friday into the Affordable Care Act, ruling that the entire health-care law is unconstitutional because of a recent change in federal tax law….Since the suit was filed in January, many health-law specialists have viewed its logic as weak but nevertheless have regarded the case as the greatest looming legal threat to the 2010 law, which has been a GOP whipping post ever since and assailed repeatedly in the courts.” [Washington Post, 12/14/18]

Jonathan Cohn, HuffPost: “This Is A Breathtaking Ruling In Favor Of A Lawsuit That Even Conservative Legal Experts Have Trashed.” [Jonathan Cohn Twitter, 12/14/18]

Paul McLeod, Buzzfeed: When It Comes To Judicial Activism, “You Can’t Come Up With A Clearer Example Than This.” “Can’t stress enough that when we hear about ‘judicial activism’ you can’t come up with a clearer example than this. This judge overturned the will of Congress (technical details of why/how are in the story.) But legal experts I talked to described this interpretation as ludicrous.” [Paul McLeod Twitter, 12/14/18]

Experts were incredulous:

Nicholas Bagley, University Of Michigan Health Law Professor: “This Is Insanity In Print.” “The court’s decision is NOT limited to guaranteed issue and community rating. In the court’s view — and this is *absolutely* insane — the entire Affordable Care Act is unconstitutional…If you were ever tempted to think that right-wing judges weren’t activist — that they were only “enforcing the Constitution” or “reading the statute” — this will persuade you to knock it off. This is insanity in print, and it will not stand up on appeal.” [Nicholas Bagley Twitter, 12/14/18]

Timothy Jost, Washington And Lee University Law Professor: “It’s Timed To Cause Maximum Chaos.” “This is breathtaking in its sweep & I think O’Connor has no idea what he’s doing..This is going to get thrown out. But I also think it’s timed to cause maximum chaos.” [Emma Platoff, Texas Tribune Reporter, 12/14/18]

And here’s what elected officials said:

Speaker-Designate Nancy Pelosi (D-CA): “Tonight’s District Court Ruling Exposes The Monstrous Endgame Of Republicans’ All-out Assault On People With Pre-existing Conditions.” “Tonight’s district court ruling exposes the monstrous endgame of Republicans’ all-out assault on people with pre-existing conditions and Americans’ access to affordable health care. The GOP Congress tried and failed to destroy the Affordable Care Act and protections for pre-existing conditions.  Then, in the midterm election, the American people delivered a record-breaking margin of almost 10 million votes against House Republicans’ vile assault on health care. Now, the district court ruling in Republicans’ lawsuit seeks to subvert the will of the American people and sow chaos in the final day of HealthCare.gov open enrollment.” [Office Of The Speaker-Designate, 12/14/18]

House Ways & Means Ranking Member Richard Neal (D-MA), Energy and Commerce Ranking Member Frank Pallone, Jr. (D-NJ), and Education and the Workforce Committee Ranking Member Bobby Scott (D-VA): “It Is An Ideological Decision In A Case That Has No Legal Merit.” “This reckless court decision endangers the lives of millions of Americans who are going to lose their health care. It is an ideological decision in a case that has no legal merit.  Last month’s election results showed how important access to health coverage and protections for pre-existing conditions are for American families, and we are calling for an emergency stay of this heartless ruling. We will take immediate action in the new Congress to intervene in this case and appeal this decision. House Democrats will do whatever it takes to make sure the protections enshrined in the Affordable Care Act endure. The lives and wellbeing of millions of Americans – including those living with pre-existing conditions – are on the line.” [Ways and Means Democrats, 12/14/18]

Senate Minority Leader Chuck Schumer (D-NY): “If This Awful Ruling Is Upheld In The Higher Courts, It Will Be A Disaster For Tens Of Millions Of American Families.” “If this awful ruling is upheld in the higher courts, it will be a disaster for tens of millions of American families, especially for people with pre-existing conditions. The ruling seems to be based on faulty legal reasoning and hopefully it will be overturned. Americans who care about working families must do all they can to prevent this district court ruling from becoming law.” [Sen. Chuck Schumer Twitter, 12/14/18]

Sen. Chris Murphy (D-CT): “This Is A Five Fire Alarm — Republicans Just Blew Up Our Health Care System.” “This is a five alarm fire — Republicans just blew up our health care system. The anti-health care zealots in the Republican Party are intentionally ripping health care away from the working poor, increasing costs on seniors, and making insurance harder to afford for people with preexisting conditions…Don’t be fooled, this rests one hundred percent on the shoulders of President Trump and Republicans in Congress who empower him. Trump took the extraordinary step of sending his lawyers to argue to end health coverage for 20 million people and he got his wish. Not a single Senate Republican challenged him, and now they own this disaster as much as he does.” [Sen. Chris Murphy, 12/14/18]

Senate Finance Committee Ranking Member Ron Wyden (D-OR): “A Deliberate, Ideological Move To Sabotage The Affordable Care Act At The Expense Of Families’ Health Care.” “Today’s ruling is an assault on all Americans’ basic health care rights and judicial overreach at its worst. Trump and Republicans in Congress will achieve their long-sought goals if this ruling stands: the elimination of pre-existing condition protections and Medicaid coverage for millions of vulnerable Americans. Seniors will pay more for their prescriptions and middle-class families will lose tax breaks that keep their health care affordable. This judge chose to deliver his ruling the day before the end of open enrollment – a deliberate, ideological move to sabotage the Affordable Care Act at the expense of families’ health care.” [Sen. Ron Wyden, 12/14/18]

ashoup
In News, Administration

Donald Trump Celebrates Americans Losing Protections They Rely On

Washington, D.C. – Tonight, after District Judge Reed O’Connor ruled the entire Affordable Care Act unconstitutional, President Donald Trump tweeted that this was, “Great news for America!” Brad Woodhouse, executive director of Protect Our Care, released the following statement in response:

“The Grinch might be playing in theaters, but America’s foremost grinch lives in the White House. This decision by a conservative judge represents an absolute disaster – it would end protections for people with pre-existing conditions, re-institute lifetime limits on coverage, implement an age tax on older Americans, and take away coverage from 26 million Americans while raising costs for millions more. And yet Donald Trump sees these results as a cause for celebration. Americans from coast to coast will go to bed tonight in fear of losing their health care, and Donald Trump and Republicans owns this entirely. If this stands, 2020 will make the health care-fueled Democratic wave of 2018 look like child’s play.”

BACKGROUND:

Under this ruling:

  • Seventeen million more people could lose their coverage in a single year, leading to a 50 percent increase in the uninsured rate
  • Protections for 130 million people with pre-existing conditions would be removed
  • Annual and lifetime limits would once again be legal
  • Children would no longer be allowed to stay on their parents’ insurance until age 26
  • Medicaid expansion, currently covering 15 million people, would end
  • Improvements to Medicare, including reduced costs for prescription drugs, would be eliminated
  • Insurance discrimination against women and people over age 50 would once again be allowed
  • Limits on out-of-pocket costs would be eliminated
  • Small business tax credits would no longer exist
  • Marketplace tax credits for up to 9 million people would end

Republicans at all levels own the consequences of this decision on the American people.

  • The Republican attorneys general and governors who brought this case have been hellbent on restricting people’s access to health care. Many of those involved in this lawsuit have been involved in prior efforts to dismantle the Affordable Care Act, block the Medicaid expansion and restrict women’s health.  
  • The Trump Administration took the shocking step of abandoning its legal and constitutional responsibilities to defend the law of the land, instead prioritizing its no-holds-barred war on American health care by siding with the Republican states in this case.
  • Republicans in Congress voted for the tax scam that opened the door for this lawsuit in the first place.
  • Republicans in Congress refused to join Democratic efforts in the Senate and House to intervene in this lawsuit to protect health care.
  • Republican governors who want to distance themselves from this lawsuit could have directed their attorneys general to withdraw from this case, or urged them to drop it altogether, but they refused to do so.

The medical community has spoken loudly and clearly about the harms this ruling would cause people around the country.

  • American Cancer Society-Cancer Action Network, American Diabetes Association, American Heart Association, American Lung Association, and National Multiple Sclerosis Society: “Striking down these provisions would be catastrophic and have dire consequences for many patients with serious illnesses.”
  • American Medical Association, the American Academy of Family Physicians, the American College of Physicians, the American Academy of Pediatrics, and the American Academy of Child and Adolescent Psychiatry: “​Invalidating the guaranteed-issue and community rating provisions — or the ​entire ACA — would have a devastating impact on doctors, patients, and the American health care system as a whole.”
  • American Hospital Association, Federation of American Hospitals, the Catholic Health Association of the United States, and Association of American Medical Colleges: “A judicial repeal would have severe consequences for America’s hospitals, which would be forced to shoulder the greater uncompensated-care burden that the ACA’s repeal would create.”
  • AARP: Before ACA’s protections, discrimination against those with pre-existing conditions, age rating, and annual and lifetime caps made accessing health care out of reach for older adults.
ashoup
In News, Administration

When the Trump Administration Sabotages Open Enrollment, Americans Pay With Their Health Care

Washington, D.C. –  With one day left in open enrollment, the consequences of the Trump Administration’s decision to double down on sabotage for the 2018 open enrollment are clear and dramatic. Despite the availability of affordable, quality plans, the number of Americans purchasing coverage is significantly down. Leslie Dach, chair of Protect Our Care, issued the following statement in response:

“This year, Donald Trump pulled out all the stops and left no stone unturned when it came to sabotaging open enrollment. The Trump Administration shortened the sign-up period, slashed funding for outreach, and removed critical information on how to gain coverage from Healthcare.gov. We all know the Affordable Care Act helps millions of Americans find quality, affordable health care, protects people with pre-existing conditions, and ensures coverage when we get sick. But instead of listening to the voters who made health care the top issue during the midterm elections, Donald Trump is raging forward with his war on health care and costing millions of American families access to life-saving care. It’s shameful.”

BACKGROUND: TRUMP ADMINISTRATION DOUBLED DOWN ON OPEN ENROLLMENT SABOTAGE IN 2018

The Trump Administration Removed Information On Applying For Coverage From HealthCare.gov. The Trump Administration overhauled the “Apply for Health Insurance” section of HealthCare.gov, removing the options of signing up for coverage via mail and phone and directing people to sign up for coverage through enrollment sites run by private companies.

Between 2016 And 2018, The Trump Administration Cut Funding For Groups That Help People Sign Up For Coverage By 84 Percent. After cutting funding for navigator groups that help people sign up for coverage from $63 million in 2016 to $36 million in 2017, the Trump Administration made yet another round of cuts in 2018, leaving just $10 million in funding for health navigator groups. Since 2016, Trump has cut navigator funding by 84 percent.

Health Navigators, Like Jodi Ray At The University Of South Florida, Say Cuts To Navigator Programs Prevent Them From Adequately Letting People Know That Open Enrollment Is Happening. Ray said, “We don’t have the people to provide the enrollment assistance nor to do the outreach and marketing to let people know what’s happening.”

This Year, 800 Counties Served By The Federal Marketplace Are Operating Without Any Federally-Funded Navigators. This is more than six times as many counties served by the federal marketplace that operated without federally funded navigators in 2016, when 127 counties lacked such a navigator.  

The Trump Administration Wants Navigator Groups To Push Consumers To Sign Up For Junk Coverage That Is Exempt From Covering Prescription Drugs And Hospitalization Instead Of Comprehensive Plans. The Administration announced in July that it would encourage navigator groups to use their remaining funding to push consumers to sign up for junk health plans, which cover few benefits and notorious for the fraud they attract.

In December 2017, The Trump Administration Repealed The Requirement That Most People Have Insurance Despite The CBO Estimate That Doing So Would Increase The Number Of Uninsured By 13 Million. The Republican tax bill passed last December was estimated by the nonpartisan Congressional Budget Office to increase the number of uninsured by 13 million in 2027.

All Of This Comes After The Trump Administration Cut The Open Enrollment Advertising Budget By 90 Percent in 2017. As ABC News summarized, “In 2016, the Centers for Medicare & Medicaid Services spent $100 million on Obamacare advertising and outreach, but for [2017]’s open enrollment period, CMS plans on spending $10 million.” CMS chose not to increase the budget for 2019.

A full timeline of the Trump Administration’s crusade to sabotage open enrollment is below:

December 2018

  • Sunlight Foundation investigation finds that Trump Administration removed information about ways to apply for coverage on HealthCare.Gov and is directing people to sign up for coverage through enrollment sites run by for-profit companies.

October 2018

  • The Trump Administration issues guidance that allows federal subsidies to be used to purchase junk plans that can deny coverage to people with pre-existing conditions, a move expected to worsen ACA risk pools.
  • Trump Administration announces scheduled maintenance on the open enrollment website, preventing people from signing up for coverage on Sundays from 12:00 AM – 12:00 PM.

September 2018

  • Centers for Medicare and Medicaid Services removes a training guide for Latino outreach from a CMS website just over a month before the beginning of open enrollment. Latinos are at a disproportionately high risk of being uninsured compared to white non-hispanic Americans.

August 2018

  • Trump Administration finalizes rule for bare-bones short-term plans that are exempt from key consumer protections, such as the requirement that insurance covers prescription drugs, maternity care, and hospitalization.

July 2018

  • Trump Administration slashes funding for non-profit health navigator groups that help people shop for coverage, from $36 million to $10 million. CMS encourages groups to use the remaining funds to push people to sign up for junk plans that skirt important consumer protections.

July 2018

  • Trump Administration limits access to assistance for consumers who want to enroll in marketplace coverage. This change removes the requirement that every area has at least two “navigator” groups to provide consumer assistance and that one be local. Now, just one group could cover entire states or groups of states.

December 2017

  • Congressional Republicans pass their tax scam, which doubles as a sneaky repeal of the Affordable Care Act  by kicking 13 million people off of their insurance and raising premiums by double digits for millions more.

October 2017

  • The Trump Administration dramatically cuts in-person assistance to help people sign up for 2018 health coverage.

September 2017

  • The Administration orders the Department of Health and Human Services’ regional directors to stop participating in Open Enrollment events. Mississippi Health Advocacy Program Executive Director Roy Mitchell says, “I didn’t call it sabotage…But that’s what it is.”

August 2017

  • The Administration cuts the outreach advertising budget for Open Enrollment by 90 percent, from $100 million to just $10 million – which resulted in as many as 1.1 million fewer people getting covered. Emails obtained by Democracy Forward reveal that the administration chose to cut outreach despite having been warned that over 100,000 fewer people would enroll in coverage.

July 2017

  • The Trump Administration uses funding intended to support health insurance enrollment to launch a multimedia propaganda campaign against the Affordable Care Act.

April 2017

  • The Trump Administration cuts the number of days people could sign up for coverage during open enrollment by half, from 90 days to 45 days.

January 2017

  • Also on January 20th, the Department of Health and Human Services begins to remove information on how to sign up for the Affordable Care Act.
  • The Trump Administration pulls funding for outreach and advertising for the final days of 2017 enrollment. This move is estimated to have reduced enrollment by nearly 500,000.
protectourcare
In News, Administration

Shot/Chaser: The Trump Administration Feigns Ignorance on Health Care Sabotage

Today, at an event sponsored by Axios, Health and Human Services Secretary Alex Azar feigned ignorance about why enrollment in the health care marketplaces is lower this year compared to last year. We have an idea. Don’t forget: the last day to sign up is December 15.

 

SHOT: “We don’t know why they’re at where they are now.” [Axios]

 

CHASER:

  • This year, the Trump administration slashed funding for non-profit health navigator groups, that help people shop for coverage, by nearly 75 percent.
  • For the second consecutive year, the Trump administration spent $10 million on the advertising budget to get the word out about open enrollment, down 90 percent from $100 million under the Obama administration.
  • This year, the Trump administration issued new guidance urging states to “tear down basic pillars of the Affordable Care Act,” that would make comprehensive coverage more unaffordable.
  • This year, the Trump administration made it easier for insurance companies to sell junk health insurance that can deny people coverage based on a pre-existing condition.
protectourcare
In News, Administration

INVESTIGATION REVEALS: Trump Administration Tries to Rig Health Care Enrollment To Make Coverage Options Secret

Washington DC – This morning, a new Sunlight Foundation investigation revealed that the Trump Administration is sinking to new levels to sabotage the Affordable Care Act. Days before the open enrollment deadline, HHS removed information about ways to apply for coverage on HealthCare.Gov, which may cause confusion and could impede consumers ability to obtain health insurance coverage. According to Sunlight’s investigation, they are directing people to sign up for coverage through enrollment sites run by for-profit companies, and have removed the option of signing up for coverage by mail and phone. Brad Woodhouse, executive director of Protect Our Care, released the following statement in response:

“The Trump administration wants to make it as hard as possible for people to get the health care that they deserve and as easy as possible for the big health insurance companies to profit. Today, that means another round of health care sabotage. That sound you hear is the constant screech of a broken record, but it’s nothing in comparison to the real pain Americans are feeling from the Trump administration’s continued sabotage of our nation’s health care system. This administration’s relentless attacks on open enrollment, which include slashing the open enrollment period, dramatically cutting advertising, and instructing navigators to direct folks to junk plans, is now being punctuated by the removal of information explaining how to apply for coverage, serving no purpose other than to separate individuals from their health care coverage.”

 

In overhaul of HealthCare.gov webpage, information about ways to apply is gone

Sunlight Foundation// Rachel Bergman // December 11, 2018

A side-by-side of a previous version of the “Apply for Health Insurance” page from November 14, 2018, and a new version of the page from November 22, 2018. Snapshots captured by the Internet Archive’s Wayback Machine.

A few weeks after the start of the Open Enrollment period to sign up for Affordable Care Act (ACA) coverage, which runs from November 1 to December 15, 2018, HealthCare.gov’s “Apply for Health Insurance” webpage was altered. Information about two ways to apply is now missing and has been replaced by a new list of application options and links, including a link for “Help On Demand,” a third-party consumer assistance referral system, operated by a for-profit software company, BigWave Systems.

In today’s new report from the Web Integrity Project, we document the overhaul of the “Apply for Health Insurance” page, the portion of the ACA enrollment website that describes different ways consumers can apply for health coverage.

Previously, the page contained a table that listed five ways to apply, with links to pages that provided more information about each option: 1) online (using HealthCare.gov), 2) by phone, 3) with in-person help (from assisters), 4) through an agent or broker, and 5) by mail. Now, the page lists only four options: 1) Find and contact an agent, broker, or assister; 2) Have an agent or broker contact you; 3) Use a certified enrollment partner’s website; and 4) Use HealthCare.gov.

Two of the options — to enroll by phone and by mail — have been completely removed. These removals occurring well into the Open Enrollment period, after consumers may have already visited HealthCare.gov and decided to use one of these methods. The removals may cause confusion and could impede consumers’ ability to obtain health insurance coverage.

The third option, enabling users to get “in-person help” from assisters has been merged with the fourth option, to find an agent and broker. (Although these option were previously listed as distinct options, they both provided a link to the same page.) While the assister community is broad, and includes all individuals or organizations trained to provide free help to consumers and small businesses searching for and enrolling in health coverage, agents and brokers are part of narrower group of this community and usually receive commissions from health insurance companies for each plan they sell.

Some of the added links associated with new options may reflect policy changes at the Centers for Medicare and Medicaid Services (CMS) — the office that manages and funds HealthCare.gov. These policy changes are aimed at making it possible for consumers to bypass HealthCare.gov to find ACA coverage. The added links preceded CMS’s release of new guidance on enhanced direct enrollment, which allows websites of approved third-parties, including agents and brokers, to provide consumers with the same information and capacity to manage their coverage as is available through HealthCare.gov.

The new set of options includes third-party entities in three of the four options, listing agents and brokers twice and linking to information about using partner websites to enroll in coverage.

Specifically, a link listed as part of the new “Have an agent or broker contact you” option directs users to an “exit” webpage, warning “Once you leave HealthCare.gov, you’re subject to the privacy and security policies of the Help On Demand site, operated by BigWave Systems.” Clicking the “Go Now” button from this page directs users to the third-party website. According to CMS, the “Help on Demand” website, which is run by a for-profit, private software company, “connects consumers seeking assistance with Marketplace-registered, state-licensed agents and brokers in their area who can provide immediate assistance with Marketplace plans and enrollments.”

The page linked from the new “Use a certified enrollment partner’s website” option explains that certified partners may include online health insurance sellers, who will show you all the Marketplace coverage plans offered in your area, or insurance companies, whose websites may show you only the Marketplace plans they offer. Some certified partners let you shop for plans on their websites but require you to enroll on HealthCare.gov, and others allow you to shop, enroll, and manage your plan on their own websites, completely separate from HealthCare.gov.

Beyond including new options to use “Health On Demand” and partner websites, the order in which options appear on the page changed. The option to use HealthCare.gov — the website on which the “Apply for Health Insurance” page is hosted — is now last on the list of ways to apply. Before the change, it was listed as the first option. This change, in conjunction with options that direct consumers off of the HealthCare.gov website, demonstrates a de-emphasis by CMS of the very website it manages.

The shifts in information on the “Apply for Health Insurance” page are not a one off. This report on the overhaul comes on the heels of WIP’s recent report, describing the removal of an assister training guide for Latino outreach. Jodi Ray, who oversees an assister effort as director of Florida Covering Kids & Families at the University of South Florida, told the Washington Post about the importance of these training materials in enabling her work. “If you pull credible resources, make it less accessible, it does make our job more difficult,” said Ray. “You have to know your community, the population, the culture of who you’re trying to reach. If we’re not providing the resources to be able to do that effectively, we’re going to lose that population that needs this more than anyone.”

Indeed, the overhaul of the “Apply for Health Insurance” page and the removal of the Latino outreach training guide come amid an array of Trump administration efforts to undermine the Open Enrollment period. These efforts include cutting the advertising and promotional budget for the ACA last year and multiple budget cuts to federally-funded assister programs.

Through a de-emphasis of HealthCare.gov, the removal of information about some of the simple methods for applying for coverage under the ACA, and the addition of options directing users to insurance sellers outside of the Marketplace, the overhaul of the “Apply for Health Insurance” page reduces access to information and options for obtaining health insurance. This ultimately amplifies the many other efforts by this administration to undermine Open Enrollment and access to health coverage broadly.

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