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Washington, DC — The Office of Management and Budget is currently reviewing a proposed rule from the Department of Health and Human Services (HHS) that is expected to weaken enforcement of the Health Care Rights Law (section 1557 of the ACA), which bans LGBTQ discrimination in health care and insurance coverage. Protect Our Care chair Leslie Dach issued the following statement in response:

“Donald Trump and Mike Pence have decided to target women and the LGBTQ community in their ongoing war against American health care. They want to make it harder for transgender people, same-sex parents, pregnant women, and other patients to get the medical care they deserve. LGTBQ Americans and women already face difficulty getting the care they need and this hateful rule is another blow to people who are now treated equally under the law. Every American, regardless of sex, sexual orientation, or gender identity, deserves access to quality and affordable health care. It’s high time for the Trump Administration to quit playing cruel political games that harm our communities.”

Washington, DC — President Trump is coming to Wisconsin for a rally on Saturday, but his visit to the Badger State is overshadowed by his relentless desire to destroy the health care of millions of Americans, including many Wisconsinites. Trump’s Texas lawsuit puts 150,000 Wisconsinites at risk of losing coverage and his ongoing war on Medicaid, combined with Badger State Republican’s refusal to allow expansion of the program puts the health care of tens of thousands more in jeopardy.

“If President Trump’s lawsuit to terminate the healthcare law is successful, it will strip coverage from millions of Americans and thousands of Wisconsinites, 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,” said Brad Woodhouse, Executive Director of Protect Our Care. “President Trump’s war on Medicaid and Medicaid expansion in particular is a war on children, seniors, people with disabilities, rural Americans, those fighting the opioid crisis, our schools, and everyone else who benefits from Medicaid. Voters in Wisconsin rejected the Republican war on healthcare last year when they showed Scott Walker the door and they want no part of President Trump’s ongoing repeal and sabotage agenda.”

How Trump’s Texas Lawsuit Would Devastate Wisconsinites

• 153,000 Wisconsinites Could Lose Coverage. According to the Urban Institute, 153,000 Wisconsinites would lose coverage by repealing the Affordable Care Act, leading to a 35 percent increase in the uninsured rate.
• 41,000 Wisconsin Young Adults With Their Parents’ Coverage Could Lose Care. Because of the Affordable Care Act, millions of young adults are able to stay on their parents’ care until age 26.
• Protections For The 130 Million People Nationwide With A Pre-Existing Condition Will End. 2,435,700 Wisconsinites have a pre-existing condition, including 308,100 Wisconsin children, 1,187,000 Wisconsin women, and 616,900 Wisconsinites between ages 55 and 64.
• Insurance Companies Could Charge Premium Surcharges In the Six Figures. If the Trump-GOP lawsuit is successful, 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.
• 86,264 Wisconsin Seniors Could Have To Pay More For Prescription Drugs. If the Trump-GOP lawsuit is successful, seniors could have to pay more for prescription drugs because the Medicare “donut” hole would be 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 Wisconsin, 86,264 seniors each saved an average of $1,129.

How the GOP War on Medicaid Would Devastate Wisconsinites

• 480,642 Wisconsin Children’s Care Is At Risk. 480,642 Wisconsin kids are currently enrolled in Medicaid and CHIP, and their care could be at risk because of funding cuts in the Trump budget. 31 percent of Wisconsin children rely on Medicaid for coverage. Medicaid pays almost $4 billion annually in school-based health services. Schools depend on these funds connect students with vital health resources — 68 percent of school superintendents said that they used these funds to keep nurses, counselors, and speech therapists on staff
• 1,020,034 Wisconsinites With Traditional Medicaid Coverage, Including Seniors, People With Disabilities, And Children, Are At Risk. The Graham-Cassidy bill that President Trump revived in his FY20 budget proposal would turn traditional Medicaid into a per capita cap, meaning the 1,020,034 Wisconsinites who are enrolled on Medicaid would have their care jeopardized. Medicaid disproportionately helps children, seniors in nursing home care and people with disabilities. A study by Avalere found that Graham-Cassidy would cut funding for people with disabilities by 15-percent and 31-percent for children by 2036, and the 55 percent of Wisconsin seniors living in nursing homes have coverage through Medicaid.
• 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.

The Kaiser Family Foundation’s newly released April Tracking Poll shows that the American people vehemently reject the Trump-GOP repeal and sabotage agenda and support the health care law as well as Democrats’ efforts to lower prices and improve care. Here are the poll’s key findings:

• Voters’ Top Priorities Are Lowering The Cost Of Prescription Drugs And Protecting People With Pre-existing Conditions. Nearly seven in ten Americans (68 percent), say lowering prescription drug costs for as many Americans as possible is a ‘top priority’ for Congress. This is followed closely by nearly two-thirds of the public (64 percent) who say making sure the ACA’s protections for people with pre-existing health conditions continue is a ‘top priority’ for Congress.

  

• Americans Overwhelmingly Disapprove Of Junk Plans. “Majorities, across party identification, think the federal government should require health insurance companies to cover a certain set of benefits and cover pre-existing conditions (67 percent) rather than allow them to sell short-term plans that cost significantly less but provide fewer benefits and do not cover some pre-existing conditions (26 percent). Majorities of Democrats (83 percent), independents (62 percent), and Republicans (53 percent) think the federal government should require health insurance plans to cover a certain set of benefits and cover pre-existing conditions.”

  

• People Oppose Trump’s Lawsuit To Overturn The Affordable Care Act By 15 Points And Oppose Overturning Pre-existing Condition Protections By 41 Points. “The majority of the public say they do not want to see the Supreme Court overturn either the pre-existing condition protections (68 percent) or the entire health care law (54 percent).

• Large Majorities Support Protections For People With Pre-existing Conditions. Seven in ten of those polled say it is ‘very important’ to prohibit insurance companies from denying someone coverage because of their health status, and 64 percent of voters say it is ‘very important’ that insurance companies be prohibited from charging people more because of their health status.

• Support For The Affordable Care Act Remains Steady At 50 Percent. Americans approve of the Affordable Care Act by 12 points(50-38).

Ahead of President Trump’s Appearance At A Summit on Opioid Abuse in Atlanta, It’s Clear His War On Health Care Is Hurting America’s Fight Against Opioid Addiction

Washington, DC – President Trump is set to address to the Rx Drug Abuse and Heroin Summit on Wednesday in Atlanta, but his visit is overshadowed by his administration’s relentless war on America’s health care and his relentless effort to strip protections for Americans with pre-existing conditions, including those with opioid use disorder. In his repeated attempts to gut Medicaid, Trump is cutting off a lifeline for people suffering from opioid addiction, and his Texas lawsuit to overturn the Affordable Care Act would gut protections for Americans with substance abuse disorder.

Ahead of his upcoming speech on the opioid epidemic, Protect Our Care chair Leslie Dach issued the following statement:

“Let’s be clear: Instead of waging a war on the opioid crisis, President Trump has waged a war on our health care that is hurting people with opioid use disorder. His drastic cuts to Medicaid, his lawsuit in Texas to dismantle the health care system and his support for junk insurance plans will take away care from millions. If there are two things that Americans agree on, it’s that the opioid crisis is serious and that pre-existing conditions protections need to be upheld; neither of which the Trump administration seems concerned about.”

BACKGROUND:

PRESIDENT TRUMP AND HIS REPUBLICAN ALLIES WANT TO ROLL BACK COVERAGE THROUGH MEDICAID, A LIFELINE FOR PEOPLE SUFFERING WITH OPIOID USE DISORDER

• Republicans Have Repeatedly Taken Aim At Medicaid. The GOP has attempted to restrict access to Medicaid by allowing states to impose onerous work requirements on Medicaid coverage, trying to impose per capita limits on Medicaid funding, and repeatedly proposinglegislation that would end Medicaid expansion. The Trump administration’s budget for 2020 calls for  $1.5 trillion in cuts to Medicaid, and would impose a nationwide Medicaid work requirement.

• Restricting Access To Medicaid Threatens Lives And Impedes States’ Ability To Respond To The Opioid Epidemic. Four in 10Americans with an opioid use disorder relies on Medicaid for access to treatment and life-saving overdose reversal medication. Restricting access to Medicaid puts people’s lives at risk and deprives states of funding and resources they depend on to fight the epidemic.

• Among Those With Opioid Addiction, People Covered Through Medicaid Are More Than Twice As Likely As Those With Private Insurance Or No Insurance To Receive Treatment. In 2016, 43 percent of people who had substance use disorders received treatment when they were covered through Medicaid, significantly higher than the 21 percent of those privately insured who received treatment and 23 percent of those who were uninsured and received treatment.

A TRUMP-GOP LAWSUIT COULD OVERTURN THE AFFORDABLE CARE ACT, WHICH PROTECTS PEOPLE WITH SUBSTANCE USE DISORDER

• Because Of The Affordable Care Act, Insurance Companies Can No Longer Deny Coverage Or Charge More Because Of Pre-Existing Conditions. The Affordable Care Act prevents insurance companies from denying someone coverage or charging them more because of a health problem they had before the date that new health coverage starts. It also prevents insurance companies from rescindingor canceling someone’s coverage arbitrarily if they get sick.

• The ACA Outlawed Medical Underwriting, The Practice That Let Insurance Companies Charge Sick People More. As the Brookings Institution summarizes, “The ACA outlawed medical underwriting, which had enabled insurance carriers to court the healthiest customers while denying coverage to people likely to need costly care. The ACA guaranteed that all applicants could buy insurance and that their premiums would not be adjusted for gender or personal characteristics other than age and smoking.”

• The ACA Requires That Insurance Companies Cover Mental Health And Substance Use Disorder Services, And Paved The Way For Medicaid Expansion, Which Helps People Access Services For Substance Use Disorders. The Affordable Care Act established ten essential health benefits, including mental health services, substance use disorder services, and prescription drug coverage, that insurance companies are required to cover. Without these protections, people in the individual market could be on their own — before the ACA, 45 percent of individual market plans did not cover substance use disorder services, and 38 percent of plans did not include mental health services.  The ACA also enabled states to expand Medicaid, which has helped people with substance use disorders and mental illness receive treatment. Recent research finds that Medicaid expanding reduced the unmet need for substance use treatment by 18.3 percent.

TRUMP-GOP JUNK INSURANCE PLANS OFTEN EXCLUDE COVERAGE FOR PRE-EXISTING CONDITIONS, MENTAL HEALTH CARE AND MORE

Short-Term Plans May Exclude Coverage For Pre-Existing Conditions. “Policyholders who get sick may be investigated by the insurer to determine whether the newly-diagnosed condition could be considered pre-existing and so excluded from coverage.” [Kaiser Family Foundation, 2/9/18]

• As Many As 130 Million Nonelderly Americans Have A Pre-Existing Condition. [Center for American Progress, 4/5/17]

• 1 in 4 Children Would Be Impacted If Insurance Companies Could Deny Or Charge More Because Of A Pre-Existing Condition.[Center for American Progress, 4/5/17]

Short-Term Junk Plans Can Refuse To Cover Essential Health Benefits.“Typical short-term policies do not cover maternity care, prescription drugs, mental health care, preventive care, and other essential benefits, and may limit coverage in other ways.” [Kaiser Family Foundation, 2/9/18]

Under Many Short-Term Junk Plans, Benefits Are Capped At $1 Million Or Less. Short-term plans can impose lifetime and annual limits –  “for example, many policies cap covered benefits at $1 million or less.” [Kaiser Family Foundation, 2/9/18]

Short-Term Junk Plans Can Retroactively Cancel Coverage After Patients File Claims. “Individuals in [short-term (STLDI)] plans would be at risk for rescission. Rescissions are retroactive cancellations of coverage, often occurring after individuals file claims due to medical necessity. While enrollees in ACA coverage cannot have their policy retroactively cancelled, enrollees in STLDI plans can.” [Wakely/ACAP, April 2018]

As part of Medicaid Awareness Month, Protect Our Care is detailing how President Trump and Republicans nationwide have waged a relentless war on Medicaid — with no signs of stopping. From seeking to end Medicaid expansion and aiming to force caps on the program’s funding to encouraging states to impose burdensome Medicaid work requirements, Republicans are hellbent on making it as hard as possible for millions of Americans to access Medicaid.

WHO REPUBLICANS HURT WHEN THEY TARGET MEDICAID

12.7 Million Americans Who Will Lose Coverage If The Trump Administration Successfully Ends Medicaid Expansion. The Trump administration is arguing in court that the Affordable Care Act and its Medicaid expansion should be overturned. If the administration ends Medicaid expansion, 12.7 million people will lose their health care.

Up To 4 Million Americans Who Could Lose Coverage If The Trump Administration Imposes A Nationwide Medicaid Work Requirement. The Trump administration is working to change the fundamental structure of Medicaid by preventing people from accessing coverage through Medicaid if they fail to document working a certain number of hours each month. Though experts warn that imposing such requirements could significantly reduce Medicaid enrollment by adding administrative hurdles that make it harder for people to access care, the administration has called for a nationwide Medicaid work requirement in its 2020 budget that is estimated will cause up to 4 millionpeople to lose coverage.

More Than 18,000 Arkansans Who Have Already Lost Coverage Under A Work Requirement In Arkansas. In Arkansas, more than 18,000 people lost coverage in 2018 due to the state’s onerous reporting requirements. Of those required to report their work activities, only 12 percent reported enough hours of qualifying activities. One difficulty in reporting? Though 20 percent of Arkansans with Medicaid do not have home internet access, the state is using an online portal as the primary way for people with Medicaid to report their work activities.

1.4 Million Adults With Disabilities Who Would Lose Medicaid Under Trump’s Plan For Medicaid. The Trump FY20 budget once again revived the call to pass Graham-Cassidy, a bill that would impose funding caps on Medicaid by block-granting the program. The Center for American Progress estimates that between 1.4 million and 1.8 million nonelderly adults with disabilities would lose coverage under the bill’s proposed cuts.

Children, Including 600,000 Who Disenrolled From Medicaid And CHIP Last Year. As the children lost access to Medicaid and CHIP, the children’s uninsured rate increased for the first time since the ACA was implemented. As Georgetown’s Center On Children and Families notes, the uninsured rate for children went up from 4.7 to 5 percent between 2016 and 2017. Three quarters of children who lost coverage lived in states that refused to expand Medicaid.

Four In Ten Americans With An Opioid Use Disorder Who Rely On Medicaid For Access To Treatment. Recent research finds that Medicaid expansion reduced the unmet need for substance use treatment by 18.3 percent. Should Republicans successfully overturn or restrict Medicaid expansion, these gains will be jeopardized.

430 Rural Hospitals That Are At A High Financial Risk Of Closing. Roughly 21 percent of the country’s rural hospitals are at a high financial risk of closing. Medicaid is a crucial support to rural hospitals, and cuts to the program threaten the stability of already struggling rural hospitals.

HOW PRESIDENT TRUMP & CONGRESSIONAL REPUBLICANS ARE TRYING TO DISMANTLE MEDICAID:

President Trump And His Republican Allies In Congress Have Repeatedly Tried To Slash Funding For Medicaid And Impose Per-capita Caps On Coverage. In 2017, the House of Representatives passed the American Health Care Act (AHCA) repeal bill, which included a per capita limit on federal Medicaid spending that would have resulted in huge cuts to Medicaid across states. After failing to pass the AHCA in the Senate, Republicans have continued to launch relentless attacks on Medicaid. The Trump administration’s budget for 2020 calls for  $1.5 trillion in cuts to Medicaid, and would impose a nationwide Medicaid work requirement. 

The Trump Administration Is Encouraging States To Impose Work Requirements And Other Bureaucratic Restrictions On Medicaid Enrollment In Order To Deny Coverage. Experts warn that work requirements are fundamentally bureaucratic hurdles designed to restrict access to health care rather than increase employment. Already, more than 18,000 have lost their Medicaid in Arkansas because of the work requirement the state imposed last year. Now, the Trump administration is proposing a nationwide work requirement for those with insurance through Medicaid.

Trump States Are Hurting Their Own Residents By Pushing Forward on Work Requirements. Despite a federal judge ruling that work requirements were unconstitutional in Arkansas and Kentucky, other states that President Trump won — Ohio, Utah, Idaho, Alabma, Oklahoma — have either rejected the will of voters by placing work requirements on Medicaid expansion, or have applied for waivers through Trump’s CMS.

President Trump And Congressional Republicans Are Targeting Medicaid To Pay For Tax Cuts For The Wealthiest. In 2017, President Trump signed a $1.5 trillion tax bill that disproportionately benefits the wealthy. How do Republicans plan on paying for it? Former Speaker Ryan’s answer was clear: “Frankly, it’s the health care entitlements that are the big drivers of our debt.” In an attempt to pay for these tax cuts, last April, House Republicans passed a balanced budget amendment that would slash Medicaid funding by $114 billionin a single year alone. Just a few weeks ago, President Trump announced his FY20 budget which would block grant Medicaid, cutting the program by $1.5 billion over ten years.

President Trump Fully Backs A Lawsuit That Would End Medicaid Expansion. By expanding access to Medicaid for parents, children were more likely to gain coverage. One study estimated that between 2013 and 2015, 710,000 low income children gained coverage because of Medicaid expansion.

Final Rule on Exchange Plans Will Increase Out-of-Pocket Costs and Rip Coverage Away from Countless Americans

Washington, DC – Yesterday, the Centers for Medicare & Medicaid Services (CMS) issued its final rule for the annual Notice of Benefit and Payment Parameters (NBPP) for the 2020 benefit year, which outlines regulatory and financial guidelines applicable to exchange plans. The administration predicts a cut to premium tax credits by nearly $1 billion and 70,000 people losing their marketplace coverage. In response to this latest act of sabotage, Brad Woodhouse, executive director of Protect Our Care, released the following statement:

“The Trump administration issued the final rule for exchange plans while the whole country is focused on the Mueller report hoping to hide the rule’s disastrous impacts on Americans who are already struggling with the cost of their health care. These Trump administration changes will cause premiums to increase, make patients pay more out-of-pocket, put protections for people with pre-existing conditions further at risk, and rip coverage away from countless Americans. It’s high time for President Trump and his allies to reverse course and stop sabotaging our health care system.”

Washington, DC – Today, Protect Our Care is releasing state-by-state reports as part of Medicaid Awareness Month that highlight the barriers many Americans living in rural communities face when it comes to receiving quality health care, and the significant role that Medicaid expansion has played in expanding coverage. The reports examine on a state-by-state basis the vital role Medicaid plays in rural communities, and the myriad ways President Trump and Republicans are working to undermine and sabotage the program.

Medicaid expansion has been instrumental in providing health care to America’s rural populations. These reports make clear that Medicaid, and especially expanded Medicaid, have overwhelmingly supported rural populations, giving communities increased access to care and health services. The reports also dig into the many risks rural communities face due to the Trump administration’s war on Medicaid and the Trump Texas lawsuit, which would dismantle the entire health care system and strip care from more than 20 million Americans.

Protect Our Care executive director Brad Woodhouse released the following statement on the new reports:

“America’s rural populations have benefited immensely from Medicaid, and the program has played an essential role in providing quality, and affordable health care to rural communities across the country. The Trump administration’s continued war against Medicaid jeopardizes access to rural health care, and the Trump Texas lawsuit would strip coverage from millions of Americans and take away programs that are instrumental in providing health care for rural America.”

State-By-State Rural Reports Can Be Found Here: 
Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South, Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming.

Washington, DC – Today, Senate Republicans led by Senators Chuck Grassley and Joni Ernst introduced a bill that would resurrect association health plans (AHPs) after they were struck down in the courts for not providing the vital health care protections mandated by the Affordable Care Act. AHPs are not required to cover the essential health benefits put in place by the Affordable Care Act and are allowed to charge people more based on their age, health status, and gender. While AHPs might legally be required to cover people with pre-existing conditions, they have broad discretion to refuse coverage for any treatment associated with a pre-existing condition. Anne Shoup, communications director of Protect Our Care, issued the following statement in response:

“Senate Republicans’ bill to resurrect association health plans after they were struck down in the courts is just their latest attempt to undermine the vital protections provided by the Affordable Care Act. In addition to a well-documented history of fraud and abuse, association health plans open the door to allowing insurance companies to once again refuse coverage at their discretion. We can’t go back to the days when people purchased a health care plan only to realize the coverage is not there when they need it.”

For more resources:

• Fact Sheet: Association Health Plans

• Reminder: Association Health Plans Have A Long History of Fraud and Unpaid Claims