News

Ahead of the Republican Senator’s RNC Speech, Protect Our Care Sets the Record Straight on Her Health Care Sabotage

Tonight, Sen. Joni Ernst (R-IA) will take the stage at the Republican National Convention to spread lies about what Trump and Senate Republicans have accomplished in the last four years, but what she won’t talk about is her continuous attacks on Americans’ health care coverage. 

Sen. Ernst refuses to condemn Trump’s lawsuit to completely dismantle the Affordable Care Act, even if it means more than 185,000 Iowans will lose health care coverage as the country is still reeling from the coronavirus pandemic. Sen. Ernst has continually downplayed the threat of coronavirus and praised Trump for his failed response to the pandemic. Time and again, she has voted to repeal the ACA with no viable plan to replace it, a disastrous move for her constituents. Repealing the ACA would mean removing protections for 1.3 million Iowans with pre-existing conditions, kicking 150,000 Iowans off Medicaid and eliminating marketplace tax credits that help nearly 40,000 Iowans afford coverage. Joni Ernst is wrong on health care and wrong for Iowa. 

BACKGROUND:

Read More About Sen. Joni Ernst’s Health Care Record Here

Ernst Supports Repealing The ACA And Its Protections For 1.2 Million Iowans with Pre-Existing Conditions

2014: Ernst Campaigned For The Senate With An Ad Where She “Unloads” On Obamacare By Shooting It With A Handgun. “Republican U.S. Senate candidate Joni Ernst of Iowa has released a new TV ad vowing to ‘unload’ on Obamacare, in which she takes target practice at a shooting range with a handgun. [Washington Post, 5/4/14] 

2015: Ernst Voted To Repeal Most Of The ACA. Ernst voted for legislation that gutted the Affordable Care Act by eliminating the insurance exchanges and subsidies, and repealing the Medicaid expansion accepted by 30 states, including Nevada. [HR 3762, Roll Call Vote #114, 12/3/15] 

2017: Ernst Voted For The Senate “Repeal And Delay” Plan. Ernst voted for Obamacare Repeal and Replacement Act was a Republican effort to repeal the ACA without a replacement. Known as “repeal and delay,” the bill repealed major sections of the ACA, including the Medicaid expansion and premium tax credits, in 2020. [HR 1628, Roll Call Vote #169, 7/26/17] 

2017: Ernst Voted For “Skinny Repeal” Of The ACA. Ernst voted for “Skinny Repeal” of the ACA, which repealed the individual mandate and delayed the employer mandate while leaving most of the rest of the law in place. [HR 1628, Roll Call Vote #179, 7/28/17] 

2017: Ernst Refused To Give Up On Repealing The Affordable Care Act After The Failure Of The Senate Bills. “Ernst said Friday she’s also not ready to give up on repealing the Affordable Care Act. ‘We don’t have the option to sit back and do nothing; Iowans are demanding relief from Obamacare,’ she wrote in a statement released by her staff.” [Des Moines Register, 7/28/17] 

Ernst Claims To Support Coverage For People With Pre-Existing Conditions But Sponsors Legislation That Would Gut Those Protections 

In Response To The Court Ruling Striking Down All Of The ACA, Ernst Said It Was “Important That We Protect People With Preexisting Conditions, As We Repeal And Replace Obamacare.” “Republicans are facing a moment of reckoning on health care after a federal judge struck down the Affordable Care Act, imperiling the landmark law the GOP has struggled against for eight years. […] One of the Republican senators facing a potentially competitive reelection campaign is Joni Ernst of Iowa. Ernst issued a statement Saturday saying that it was ‘important that we protect people with preexisting conditions, as we repeal and replace Obamacare.’” [Washington Post, 12/15/18] 

2018: Ernst Co-Sponsored Legislation That She Claimed Would “Guarantee Americans Have Equal Health Care Coverage, Regardless Of Their Health Status Or Pre-Existing Condition.” “Yesterday, Senators Thom Tillis (R-NC), Lamar Alexander (R-TN), Chuck Grassley (R-IA), Dean Heller (R-NV), Bill Cassidy, M.D. (R-LA), Lisa Murkowski (R-AK), Joni Ernst (R-IA), Lindsey Graham (R-SC), John Barrasso (R-WY), and Roger Wicker (R-MS) introduced the Ensuring Coverage for Patients with Pre-Existing Conditions Act, legislation that would guarantee Americans have equal health care coverage, regardless of their health status or pre-existing conditions. Oral arguments in Texas v. United States will begin on September 5th, and if the judge rules in favor of the plaintiffs, protections for patients with pre-existing conditions could be eliminated. This legislation amends the Health Insurance Portability and Accountability Act (HIPAA) to guarantees the availability of coverage in the individual or group market, for all Americans, including those with pre-existing conditions, regardless of the outcome in Texas v. United States. The legislation prohibits discrimination against beneficiaries based on health status, including the prohibition against increased premiums for beneficiaries due to pre-existing conditions.” [Sen. Thom Tillis Press Release, 8/24/18] 

2019: Ernst Co-Sponsored The Protect Act That She Claimed Would Protect Americans With Pre-Existing Conditions. “Senate Republicans believe in patient-centered health care that delivers the choices they want, the affordability and protections they need, and the quality they deserve. That is why Senator Thom Tillis (R-NC) and his colleagues today introduced the Protect Act, legislation that protects Americans with pre-existing conditions, ensuring that Americans have the peace of mind knowing that they and their loved ones will never be denied health care coverage or be charged more because of a pre-existing condition. Joining Senator Tillis as co-sponsors of the Protect Act are Senators Lamar Alexander (R-TN), Chuck Grassley (R-IA), Bill Cassidy, M.D. (R-LA), Rob Portman (R-OH), David Perdue (R-GA), Joni Ernst (R-IA), John Cornyn (R-TX), Kevin Cramer (R-ND), Johnny Isakson (R-GA), Roger Wicker (R-MS), Shelley Moore Capito (R-WV), John Barrasso (R-WY), Rick Scott (R-FL), John Kennedy (R-LA), Todd Young (R-IN), Tom Cotton (R-AR), and Richard Burr (R-NC).’” [Sen. Thom Tillis Press Release, 4/10/19]

Ernst Refuses To Condemn The Texas Lawsuit That Would Rip Coverage Away From More Than 185,000 Iowans

2019: Ernst On The Texas Lawsuit: “I Am Not Going To Make A Determination On That.” Joni Ernst: In today’s day and age, we do see a lawsuit moving forward that could potentially dismantle the ACA. If that happens, we need to make sure that we are reiterating that preexisting conditions will be covered in any future insurance actions. […] Anchor: Do you support that lawsuit that is going forward that would dismantle the Affordable Care Act all together? Ernst: I am not going to make a determination on that. I am not an attorney. But I would say that, yes, I would like to see different forms of health care coverage that exist out there that will bring costs down. I do want to see that addressed” [WHBF, 4/28/19] 

2018: Ernst Refused To Discuss The Texas Lawsuit Threatening The ACA. “Sen. Joni Ernst (R-Iowa), who faces a potentially tough reelection bid in 2020, declined to discuss the ruling with a reporter in a Senate hallway on Monday, instead referring to her written statement.” [The Hill, 12/17/18]

Ernst Voted For The Tax Bill Which Forms The Basis For The Trump-Republican Lawsuit. Ernst was a key vote for the Republican tax bill, which repealed a key provision of the Affordable Care Act that required most people to have health coverage and which is the basis of the Trump-Republican lawsuit seeking to overturn the Affordable Care Act. 

Trump’s Lawsuit to Overturn the Entire ACA Will Be Argued Before the Supreme Court One Week After Election Day

As Trump and his Republican allies spin lies about health care during the Republican National Convention, he and his administration are actively plotting more health care sabotage. One week after the election, on November 10, the U.S. Supreme Court will hear oral arguments in California v. Texas, a lawsuit brought by the Trump administration to completely dismantle the Affordable Care Act. If successful, Trump’s lawsuit would rip away health care from more than 23 million Americans, end protections for more than 135 million people with pre-existing conditions and throw the entire American health care system into chaos — in the midst of a pandemic. This is Trump’s real health care agenda. 

Fact Sheet On Trump Lawsuit To Overturn ACA

President Trump is trying to rip apart our health care by going to court to eliminate the Affordable Care Act in its entirety. If the Trump lawsuit is successful, it will strip coverage from millions of Americans, raise premiums, end protections for people with pre-existing conditions, put insurance companies back in charge, and force seniors to pay more for prescription drugs. The result will be to — as the Trump Administration itself admitted in Court — unleash “chaos” in our entire health care system. 

If the Affordable Care Act is struck down:

• GONE: Protections for 135 million Americans with pre-existing conditions. The uninsured rate will increase by 65 percent. 
• GONE: Medicaid expansion, which covers 16 million people. 
• GONE: Nearly 12 million seniors will have to pay more for prescription drugs because the Medicare ‘donut hole’ will be reopened.
• GONE: 2.3 million adult children will no longer be able to stay on their parents’ insurance. 
• GONE: Insurance companies will be able to charge women 50 percent more than men.
• GONE: Financial assistance that helps 9 million people purchase health care in the marketplace.
• GONE: Key support for rural hospitals. As Americans lose coverage, already struggling hospitals will be hit even harder as their costs increase.
• GONE: Ban on insurance companies having lifetime caps on coverage.
• GONE: Requirements that insurance companies cover prescription drugs and maternity care.

Thanks To The Republican Lawsuit, 20 Million People Could Lose Their Coverage

• According to the Urban Institute, 19.9 million people could lose coverage by repealing the Affordable Care Act, meaning the number of uninsured Americans would increase from 30.4 million to 50.3 million, representing a leading to a 65 percent increase in the uninsured rate. As the uninsured rate swells, so will the amount of uncompensated care, which Urban predicts will grow by at least 82 percent.
• States would lose important federal health care funding — an estimated reduction of $135 billion in the first year. The Urban Institute estimates that a full repeal of the ACA would reduce federal spending on Medicaid/CHIP care and Marketplace subsidies by $135 billion, or 34.6 percent in the first year.
• Millions of children could lose their coverage. Almost three million children nationwide gained coverage thanks to the ACA. If the law is overturned, many of these children will lose their insurance.
• The percentage of people gaining health insurance under the ACA was higher for Latinos than for any other racial or ethnic group in the country. According to a study from Families USA, 5.4 million Latinos would lose coverage if the lawsuit succeeds in overturning the ACA. 

Republicans Want To Put Insurance Companies Back In Charge, Ending Protections For The 135 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 135 million people, have a pre-existing condition. This includes:
  • 44 million people who have high blood pressure
  • 45 million people who have behavioral health disorders
  • 44 million people who have high cholesterol
  • 34 million people who have asthma and chronic lung disease
  • 34 million people who have osteoarthritis and other joint disorders
• More than 17 million children, 68 million women, and 32 million people aged 55-64 have a pre-existing condition.

Republicans Want 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
• 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” if the Trump-GOP lawsuit is successful.

Republicans Want To Give Insurance Companies The Power To Charge You More, While Their Profits Soar

• 138 Million Americans Could Once Again Have To Pay For Preventive Care. Because of the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no cost to consumers. This includes nearly 138 million Americans, most of whom have employer coverage.
• 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 Want 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 On 109 Million Privately Insured Americans. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage for those insured through their employer or on the individual market.
• 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.
• 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.

Republicans Want To End Medicaid Expansion

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

Debuting During the Republican National Convention, the Ad Is Part of A Previously Announced $2 Million Digital and TV Ad Campaign on Trump’s Failed Coronavirus Response 

Washington, DC — Today, Protect Our Care released a new digital ad highlighting President Trump’s relentless war on health care, including his lawsuit to completely dismantle the Affordable Care Act. During the Republican National Convention, Trump and his allies have been lying about his response to the coronavirus pandemic and obscuring his years-long battle against health care and the chaos it has created for Americans.

The Trump administration is arguing before the Supreme Court in the middle of a pandemic that the entire Affordable Care Act should be struck down. If successful, President Trump would rip away health care from 23 million Americans and end protections for more than 135 million people with pre-existing conditions, including for millions of Americans who have contracted the virus.

Watch: Trump’s War on Health Care

“Don’t be fooled by President Trump’s lies at the Republican National Convention. He has been waging a war on health care since he took office,” said Protect Our Care Executive Director Brad Woodhouse. “Now, in the midst of an ever worsening pandemic, Trump is going to the Supreme Court to try to dismantle the Affordable Care Act and throw our entire health care system into chaos. Voters know health care is on the ballot in November, and we need to hold Trump accountable for his health care sabotage.”

Read: Fact Sheet On Trump Lawsuit To Overturn ACA

Script for Trump’s War on Health Care

AVO: For four years, President Trump has waged a relentless war on our health care. After failing in Congress, Trump is now before the Supreme Court trying again. 

TRUMP ON GOP LAWSUIT: We’re winning the lawsuit to terminate Obamacare.

TV REPORTER (BRUCE): Well, there is a new battle brewing here over health care.

TV ANCHOR(O’DONNELL): One of the jobs of the attorney general in the Justice Department is to defend the federal government’s position in litigation, but not anymore.

TV ANCHOR (BURNETT): His Justice Department, tonight, backing a judge’s decision to scrap the entire affordable care act, pre-existing conditions and all.

TV ANCHOR (CUOMO): 23 million people could lose their care. 

TV ANCHOR (MADDOW): 133 million Americans can be thrown off their coverage or denied coverage because they have a pre-existing condition of some kind.

TV ANCHOR (SCARBOROUGH): Donald Trump’s record on this is so abhorrent. Make no mistake, in 2020, health care will be the issue that determines who wins the White House.

AVO: Tell President Trump to drop his lawsuit and put the health of the American people first.

As the Republican National Convention kicks off, Trump and his allies will be hard at work trying to deceive Americans about their persistent war on American health care. Health care is a top priority for voters in the upcoming election and Trump knows voters don’t support his attacks on the Affordable Care Act, including his lawsuit to completely overturn the law that will be heard before the U.S. Supreme Court one week after the election. If successful, this lawsuit will end protections for over 135 million Americans with pre-existing conditions and will cause another 23 million to lose health care coverage during an ever worsening pandemic. During the RNC, Trump and the Republicans will try to spin his disastrous actions to rip health care away from millions of Americans, but voters know his true record:

Lies You’ll Hear

President Trump touts his record on prescription drugs, but the truth is that the cost of prescription drugs continues to skyrocket. Donald Trump promised that he would lower drug costs, but instead he gave drug companies billions in tax breaks. The year after the tax bill passed, the largest drug companies made $50 billion in profits and subsequently used their savings to invest billions more in stock buybacks for their shareholders. Meanwhile, more than 4,000 drugs saw price increases averaging 21 percent in 2019, and drug prices are steadily rising even as the nation fights the coronavirus crisis. Trump has rejected common sense reforms, like giving Medicare the power to negotiate for lower prices.

Time and again, Trump claims he supports protections for people with pre-existing conditions, but he has a case before the U.S. Supreme Court to dismantle these protections. Trump has peddled the bizarre lie that he has put protections for people with pre-existing conditions into place. He hasn’t. The Affordable Care Act — the law he is actively trying to sabotage — established the right to insurance for Americans with pre-existing conditions. The Washington Post fact-checker gave this claim its worst rating: “bottomless Pinocchio,” noting that Trump has falsely said he will protect pre-existing conditions nearly 100 times. After Trump repeated this claim at the State of the Union, Vox described it as “the biggest lie” in his speech. 

Trump often highlights his expansion of “cheaper” health insurance plans, but really his administration just funneled people into junk plans that do not include protections for pre-existing conditions. After dramatically cutting outreach and advertising funding for ACA enrollment, the Trump administration encouraged groups using the remaining funds to push people to sign up for junk plans that do not need to cover pre-existing conditions. Junk plans are particularly harmful during the coronavirus crisis: One analysis found widespread misleading marketing of short-term plans during the pandemic. Reports have already shown that patients covered by these plans have been left with thousands of dollars in medical bills for seeking treatment for coronavirus symptoms. 

What They Won’t Tell You

The Trump administration is before the Supreme Court trying to overturn the entire ACA. Trump notoriously tried and failed multiple times to repeal the Affordable Care Act. All of the repeal bills that went through Congress would have caused millions of Americans to lose their health coverage and raised premiums for millions more. Now the Trump administration has thrown its full support behind a lawsuit that would do the same. If the Republican lawsuit is successful, 23 million Americans will lose their coverage and more than 135 million people will lose protections for pre-existing conditions, including the millions of Americans who contracted the coronavirus. The lawsuit will be heard one week after the election.

Millions of people have lost coverage under Trump. Census data revealed the uninsured rate rose for the first time since the implementation of the Affordable Care Act under Trump. The rate increased from 7.9% in 2017 to 8.5% in 2018, or by approximately 2 million people. More than one million children lost Medicaid coverage between 2017 and 2019. Health care experts have pointed to a “chilling effect” from Trump-backed policies, including Medicaid work requirements. And as a result of Trump’s failed coronavirus response, an estimated 27 million people could lose their employer-sponsored health coverage during the pandemic. 

Trump’s budgets would have slashed Medicare and Medicaid. Donald Trump’s proposed federal budget in 2019 would cut funding for Medicare by more than $800 billion and repeal the ACA. Additionally, the budget would cut $1.5 trillion from Medicaid, which would result in millions of people losing health coverage, cuts to nursing home care, and cuts to care for children with disabilities. Most recently, Trump’s 2021 budget would reduce Medicare spending by $500 billion, in addition to more than $1 trillion in cuts to the ACA and Medicaid. 

Trump has declared war on Medicaid. The Trump administration has worked tirelessly to dismantle Medicaid, particularly through his efforts to impose enrollment barriers and red tape. After Arkansas imposed the nation’s first so-called work requirements program, more than 18,000 residents lost Medicaid coverage. While these state efforts have been blocked by a federal judge several times, the Trump administration keeps fighting to impose work reporting requirements in Medicaid, appealing federal court rulings that blocked such requirements because they are illegal. Meanwhile, a recent GAO report found that the administrative costs to implement the failed work requirement programs in five states topped $400 million. 

Trump’s policies promote discrimination against women, people of color and LGBTQ Americans. Since taking office, the Trump administration has taken multiple steps to make it harder for women, people of color, and LGBTQ Americans to access health care. 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. Moreover, experts point to Trump’s immigration policies for having deterred many Latino families from getting coverage, resulting in steep coverage losses, especially for children. Trump has also tried to make it easier for transgender Americans to be discriminated against in health care settings and allow providers’ to refuse patient care on the basis of the provider’s personal beliefs, a move likely to undermine access to care for patients who already face health care disparities.

Supreme Court Affirms Health Care Is on the Ballot

Washington, DC — Today, the U.S. Supreme Court announced it will hear oral arguments in California v. Texas on November 10, 2020, one week after the 2020 election. If successful, this case brought by Republican attorneys general and the Trump administration would dismantle the Affordable Care Act, rip away health care from more than 23 million Americans and end protections for more than 135 million people with pre-existing conditions. In response, Protect Our Care Chair Leslie Dach issued the following statement:

“The U.S. Supreme Court made clear today that health care is on the ballot this November. One week after election day, Donald Trump will be before the Supreme Court arguing that the entire ACA be dismantled in the middle of a pandemic. Let’s be clear: no matter what the president or his Republican allies say, this is Donald Trump’s health care plan — 23 million people losing their insurance and 135 million Americans with pre-existing conditions losing their protections. Four more years of President Trump would be a disaster for America’s health care. The contrast between Trump and Vice President Joe Biden could not be more clear or more consequential.” 

BACKGROUND: 

Fact Sheet On Trump Lawsuit To Overturn ACA

President Trump is trying to rip apart our health care by going to court to eliminate the Affordable Care Act in its entirety. If the Trump lawsuit is successful, it will strip coverage from millions of Americans, raise premiums, end protections for people with pre-existing conditions, put insurance companies back in charge, and force seniors to pay more for prescription drugs. The result will be to — as the Trump Administration itself admitted in Court — unleash “chaos” in our entire health care system. 

If the Affordable Care Act is struck down:

• GONE: Protections for 135 million Americans with pre-existing conditions. The uninsured rate will increase by 65 percent. 
• GONE: Medicaid expansion, which covers 16 million people. 
• GONE: Nearly 12 million seniors will have to pay more for prescription drugs because the Medicare ‘donut hole’ will be reopened.
• GONE: 2.3 million adult children will no longer be able to stay on their parents’ insurance. 
• GONE: Insurance companies will be able to charge women 50 percent more than men.
• GONE: Financial assistance that helps 9 million people purchase health care in the marketplace.
• GONE: Key support for rural hospitals. As Americans lose coverage, already struggling hospitals will be hit even harder as their costs increase.
• GONE: Ban on insurance companies having lifetime caps on coverage.
• GONE: Requirements that insurance companies cover prescription drugs and maternity care.

Thanks To The Republican Lawsuit, 20 Million People Could Lose Their Coverage

• According to the Urban Institute, 19.9 million people could lose coverage by repealing the Affordable Care Act, meaning the number of uninsured Americans would increase from 30.4 million to 50.3 million, representing a leading to a 65 percent increase in the uninsured rate. As the uninsured rate swells, so will the amount of uncompensated care, which Urban predicts will grow by at least 82 percent.
• States would lose important federal health care funding — an estimated reduction of $135 billion in the first year. The Urban Institute estimates that a full repeal of the ACA would reduce federal spending on Medicaid/CHIP care and Marketplace subsidies by $135 billion, or 34.6 percent in the first year.
• Millions of children could lose their coverage. Almost three million children nationwide gained coverage thanks to the ACA. If the law is overturned, many of these children will lose their insurance.
• The percentage of people gaining health insurance under the ACA was higher for Latinos than for any other racial or ethnic group in the country. According to a study from Families USA, 5.4 million Latinos would lose coverage if the lawsuit succeeds in overturning the ACA. 

Republicans Want To Put Insurance Companies Back In Charge, Ending Protections For The 135 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 135 million people, have a pre-existing condition. This includes:
  • 44 million people who have high blood pressure
  • 45 million people who have behavioral health disorders
  • 44 million people who have high cholesterol
  • 34 million people who have asthma and chronic lung disease
  • 34 million people who have osteoarthritis and other joint disorders
• More than 17 million children, 68 million women, and 32 million people aged 55-64 have a pre-existing condition.

Republicans Want 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
• 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” if the Trump-GOP lawsuit is successful.

Republicans Want To Give Insurance Companies The Power To Charge You More, While Their Profits Soar

• 138 Million Americans Could Once Again Have To Pay For Preventive Care. Because of the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no cost to consumers. This includes nearly 138 million Americans, most of whom have employer coverage.
• 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 Want 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 On 109 Million Privately Insured Americans. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage for those insured through their employer or on the individual market.
• 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.
• 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.

Republicans Want To End Medicaid Expansion

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

An Individual with A Pre-Existing Condition Could Still Be Denied Coverage Under Sen. Gardner’s Pre-Existing Conditions Protections Act of 2020 

Washington, DC — Today, in a blatant attempt to cover his abysmal health care record, Senator Cory Gardner (R-CO) released bill text for the “Pre-Existing Conditions Protections Act of 2020.” The Affordable Care Act (ACA), a law that Senator Gardner has repeatedly voted to repeal, already provides protections for people with pre-existing conditions. However, the ACA is currently in danger of being overturned in the courts in a lawsuit brought by the Trump administration and its Republican allies in the states. In addition to ensuring people with pre-existing conditions are not charged more for coverage, for any bill to fully protect people with pre-existing conditions, it must include the following provisions: preclude insurance companies from denying coverage based on health status, require coverage of essential benefits such as maternity care, cancer treatments, prescription drugs and mental health and substance use disorder treatments, and ban insurers from capping how much they will pay for medical care over a year or during a lifetime for these essential benefits. Senator Gardner’s bill includes none of these provisions. Protect Our Care Chair Leslie Dach issued the following statement in response: 

“More than 135 million Americans with pre-existing conditions are already protected by the Affordable Care Act. The only reason these protections are at risk is because Cory Gardner and Donald Trump have tried repeatedly to take them away. Right now Donald Trump, enabled by his Republican allies including Senator Gardner, is before the Supreme Court arguing to overturn the ACA in its entirety in the midst of a pandemic, ripping coverage away from 23 million Americans, eliminating Medicaid expansion, increasing drug costs for seniors, and ending requirements that all health insurance policies cover essential needs. Senator Gardner’s bill does not ensure coverage of essential health benefits like prescription drugs, maternity care and cancer treatments. Despite its name, this bill doesn’t actually protect people with pre-existing conditions because it allows insurance companies to place yearly and lifetime limits on essential benefits and to deny coverage outright based on a condition. Voters in Colorado won’t be fooled by Senator Gardner’s sham of a bill. This bill isn’t worth the paper it’s printed on.”

Watch the DNC Panel Here

Last night at the Democratic National Convention, Vice President Joe Biden and health care storytellers came together to hold President Trump accountable for his war on America’s health care and highlight Biden’s plan to make health care accessible and affordable. The five storytellers from Arizona, Colorado, Nevada and Wisconsin held a panel discussion with Vice President Biden and explained how the Affordable Care Act has benefited their lives, the lives of their families and their communities. Vice President Biden reassured them that he would protect their health care in the same way he protects his “own family.” 

Vice President Biden’s plan would strengthen the Affordable Care Act, make sure people with pre-existing conditions are protected and expand health care access to every American. Meanwhile, President Trump is arguing before the Supreme Court to dismantle the entire ACA, rip away health care from more than 23 million Americans and end protections for more than 135 million people with pre-existing conditions — all while Americans face the worst public health crisis in a century.

Washington, DC — Tonight at the Democratic National Convention, Vice President Joe Biden and health care advocates and storytellers came together to hold President Trump accountable for his war on America’s health care and highlight Biden’s plan to make health care accessible and affordable. Vice President Biden’s health care plan would strengthen the protections of the Affordable Care Act, make sure people with pre-existing conditions are protected and expand health care access to every American. In response, Protect Our Care Executive Director Brad Woodhouse issued the following statement:

“Trump has seized every opportunity to take away health care from Americans. He’s proposed slashing Medicare and Medicaid funding, supports gutting Medicaid coverage, and wants to take away protections for pre-existing conditions. He is arguing before the Supreme Court to dismantle the entire ACA — in the middle of an ever worsening pandemic. If the lawsuit is successful, President Trump would rip away health care from more than 23 million Americans and end protections for more than 135 million people with pre-existing conditions, including for millions of Americans who have contracted the virus.

“Four more years of Donald Trump would be a disaster for health care in our country. Vice President Biden is a tireless champion for health care and has a plan to make sure every American gets the care they need.”

Last week, President Trump admitted he’s intentionally slowing down United States Post Office (USPS) operations to prevent his opponents from voting by mail. Reports are now surfacing that people who rely on USPS for prescription delivery have waited weeks for life saving medications. Unlike its competitors, USPS is legally required to deliver all mail at a flat rate to every postal address nationwide, which is essential for seniors, people with disabilities, veterans and rural communities. Coverage makes clear undermining USPS not only threatens the upcoming presidential election, but also harms every person depending on the USPS for medications and other essential goods — particularly during the pandemic. Trump is putting their lives in danger all because he thinks the pandemic can give him an edge in the upcoming election.

By the Numbers

• USPS handles 1.2 billion prescription drug shipments per year. 
• The Department of Veteran’s Affairs fills roughly 80 percent of veteran prescriptions by mail, amounting to 120 million prescriptions a year. The VA delivers prescriptions to 330,000 veterans across the country daily. 
• A survey by the National Community Pharmacists Association found that 20 percent of adults over the age of 40 who take medication for a chronic condition receive their prescription through the mail. 
• More than half of people who get their medication delivered are over the age of 65. 
• Rural Americans face higher risks as a result of USPS delays. 14.5 million people lack access to broadband internet, and rural Americans are more likely to live in poverty. 

HEADLINES:

Forbes: Why Getting Prescriptions By Mail Is Stressing Out Employees And Stretching The USPS To Its Limits

Associated Press: Lawmakers: Postal Changes Delay Mail-Order Medicine for Vets

Columbus Dispatch: Mail Carriers Are a Lifeline for Rural Ohioans: ‘It’s Life or Death. That’s It’

Connecting Vets: As Veterans and VA Staff Report USPS Prescription Delays, Officials Say Order Early

Wall Street Journal: Postal Package Deliveries ‘Bogged Down’ With Delays, Backlogs

CBS Austin: 82-Year-Old Houston-Area Man Left Without Heart Medicine for a Week Due to USPS Delays

NBC Omaha: Omaha Woman Warns of Health Risks Related to Possible USPS Slowdown

Extended Coverage of What USPS Delays Mean for Seniors, Veterans and Rural Americans:

Forbes: “Reports Show Vets And Others With Chronic Conditions Who Do Not Wish To Risk Going To The Pharmacy Due To Covid-19 May Be Waiting Weeks For Medications They Needed Yesterday.” . “Cuts to the United States Postal Service are compromising millions of workers’ ability to get their medications delivered on time. Meanwhile, the mail order drug delivery is growing. Mail order prescription services saw an uptick of 21% over the previous year. CVS Health, AllianceRX Walgreens Prime and Express Scripts, as well as local pharmacies increased their mail-order services mostly due to Covid-19 concerns…reports show vets and others with chronic conditions who do not wish to risk going to a pharmacy due to Covid-19 may be waiting weeks for medications they needed yesterday.” [Forbes, 8/16/20]

Veterans Are Reporting Severe Delays In Receiving Essential Medications: “We Depend on These Medications.” “The vast majority of Department of Veterans Affairs prescriptions are fulfilled by mail. But as U.S. Postal Service delays mount, more and more veterans are reporting long wait times to receive critical medication and VA staff says the problem is only growing…in recent weeks, dozens of veterans said they faced wait times that have doubled, tripled or worse. Some reported wait times as long as three weeks or more for prescriptions that previously took a few days. None of them have been contacted by VA with an explanation, they said. ‘What used to take days now takes weeks,’ one said. ‘We depend on these medications,’ another veteran said. ‘This could be devastating. I can’t go without.’ ‘I received my life-saving medication 20 days late,’ another said.” [Connecting Vets, 8/5/20]

Senator Jon Tester Told NPR “The Postal Service Is Important In All Parts of This Country, But In Rural America It’s Critically Important.” “Sen. Jon Tester, a Democrat from Montana, told All Things Considered that the iconic blue USPS mailboxes were being removed throughout his state. ‘I don’t get it,’ Tester told NPR’s Ari Shapiro on Friday. ‘The Postal Service is important in all parts of this country, but in rural America it’s critically important whether you’re talking Social Security checks or whether you’re talking prescription drugs or parts for the farm or being able to vote.’” [NPR, 8/15/20] 

Baltimore Sun: “Mail Service Delays Have Been Especially Painful During the Coronavirus Pandemic.” “Mail service delays have been especially painful during the coronavirus pandemic because so many customers rely on deliveries of unemployment debit cards, retirement checks, medications and, for the November presidential election, absentee ballots.” [Baltimore Sun, 8/10/20] 

• Senator Chris Van Hollen Warned That “We Cannot Let These Problems Persist” as Americans Rely on the Postal Service for Medications. “’As Americans continue to rely on USPS for everything from paying bills, to prescription medicine deliveries, to exercising their right to vote, we cannot let these problems persist,’ said U.S. Sen. Chris Van Hollen, also a Maryland Democrat.” [Baltimore Sun, 8/10/20] 

Ohio Postal Worker Said That His Biggest Concern About the Future of USPS Was Delivering Medication. “Mail carriers in many ways are a lifeline for rural residents…Because most major delivery companies won’t deliver to rural areas, postal workers carry their packages for what they call ‘the last mile.’ Miller’s biggest concern about the Postal Service’s future? Delivering medication. Some days, Miller delivers as many as 30 packages of life-saving medication, everything from blood-pressure pills to cholesterol medicine. If mail delivery is reduced, Miller fears what might happen to one of his customers should a prescription runs out. ‘Just last week, I was delivering a package and the guy said to me, ‘Oh, thank God, I just took my last pill this morning.’” [Columbus Dispatch, 8/17/20]

• Rural Ohio Woman Depends On USPS for Medical Supplies, Saying Without the Postal Service, She’d Have to Drive to Columbus with a Weakened Immune System: “It’s Life or Death. That’s It.” “Carolyn Casey and her husband, Bill, know that feeling well. They’ve lived in their Gallipolis home for 49 years and have been customers on Miller’s route for most of that time.Carolyn, 69, gets medical supplies and testing equipment sent straight to her door multiple times a month. Without the Postal Service, she would have to drive to Columbus to pick up her supplies and pay more for FedEx or UPS to deliver her test results to New York. ‘When my immune system is down, I don’t want to be in big crowds,’ Carolyn said. ‘It’s life or death. That’s it.’” [Columbus Dispatch, 8/17/20]

Pennsylvania Woman Said She Is Facing Delays In Receiving Her Autistic Grandson’s Medication Through the Mail. “Valerie Rice said her mail has arrived only once every two weeks in July. She receives medication for her 25-year-old grandson, who has autism, through the mail. But now it doesn’t come on time, forcing her to go to different drugstores across the city, in hopes they have what he needs. ‘I try to stay by him and pray for life that I have what I need to take care of him,’ said Rice, 65.” [Philadelphia Inquirer, 8/2/20] 

82-Year-Old Houston Man Ran Out Of Heart Medication For The First Time As A Result Of USPS Delays. “Don White, 82, said he has been tracking the package and said it remained at a north Houston mail processing facility for 10 days. He’s hoping to get in on Monday. He said he’s irritated by the situation because his mail-order medication has never been this late before. ‘There have been a few times in which it’s taken a week, week and a half, two weeks, but this is the first time I actually ran out and checking with the post office didn’t do much good, even though I had a tracking number on it,’ White said.” [KHOU, 8/16/20] 

Former Omaha Nurse Relies on USPS for Cancer Medications: “…If I Don’t Take That Metrosal Then the Cancer Can Pop Back Up.” “One Omaha woman says slowdowns in the mail service could be fatal for many vulnerable Americans. Lorraine Touray discovered she had breast cancer two years ago. ‘I had the surgery…I had a lumpectomy before the radiation,’ said Touray. Now she takes medication daily. ‘I get my meds through the mail…now if I don’t take that Metrosal and if I don’t take that Metrosal then the cancer can pop back up,’ said Touray.” [NBC Omaha, 8/17/20]

• Omaha Woman Warned That If the Mail Doesn’t Come, Veterans Won’t Receive Their Medications. “Lorraine spent 20 years working as a nurse at the veterans’ hospital. She knows that sometimes vets need to be monitored to make sure they even take their medications. ‘Now if the mail doesn’t come and the veterans don’t get their medications, they’re not going to get it. They’re not even going to go ask somebody to get their medicines they’ll just say, oh forget it,” said Touray.” [NBC Omaha, 8/17/20] 

Watch the Virtual Event Here

At a virtual event for the Democratic National Convention this afternoon, U.S. House Speaker Nancy Pelosi (D-CA), California Attorney General Xavier Becerra, former Health and Human Services Secretary Kathleen Sebelius and health care advocates and storytellers discussed what’s at stake when it comes to health care in the upcoming November election. Four more years of Donald Trump would be a disaster for our health care. The Trump administration is arguing before the Supreme Court that the entire Affordable Care Act should be struck down — in the middle of a pandemic. If successful, Trump would rip away health care from more than 23 million Americans and end protections for more than 135 million people with pre-existing conditions, including millions of Americans who have had or will have COVID-19. 

Watch the Virtual Event Here

Protect Our Care also debuted a new ad during today’s virtual event. The new digital ad is part of Protect Our Care’s $2 million campaign holding President Trump accountable for his failed response to the coronavirus and how his years-long efforts to sabotage the ACA have only made it harder to tackle the virus.

This afternoon’s event consisted of opening remarks by Speaker Pelosi, and two panel discussions. Speaker Pelosi reflected on what’s at stake if President Trump wins a second term in office. During the first panel discussion, Attorney General Becerra and Secretary Sebelius commented on the Trump lawsuit to repeal the Affordable Care Act and why the ACA and Medicaid are more important than ever as the nation faces the coronavirus pandemic. The second panel included health care storytellers and advocates from Arizona, Colorado, Michigan, North Carolina, Pennsylvania and Wisconsin. These health care advocates explained exactly what’s at stake for them personally in November and the next steps for health care advocacy ahead of the election.