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Protect Our Care Releases New Report Detailing the Threats Republican Policies Pose to Rural Health Care in Alabama

Senator Doug Jones’ SAME Act Would Help Expand Coverage and Benefit Rural Communities, Addressing the Unique Problems Outlined in New Report

Washington, DC — A day after Senator Doug Jones introduced the SAME Act, a bill that would benefit rural communities by providing each state expanding its Medicaid program with the same levels of Federal matching funds regardless of when it chooses to expand the program, Protect Our Care released a new report, “A Tough Row to Hoe: How Republican Policies are Leaving Alabama’s Rural Health Care in the Dust.” The report looks at how Republican sabotage of the Affordable Care Act and relentless attacks on Medicaid expansion have done damage to rural residents of the state, who face both a lack of coverage and a lack of care in their communities.  

Read the report here.

“Our report shows how President Trump and his Republican allies in Congress have stopped at nothing to wreak havoc on our health care, resulting in especially devastating impacts in rural America,” said Brad Woodhouse, executive director at Protect Our Care. “Premiums have risen, coverage has been lost, and rural hospitals face constant uncertainty as rural health care is threatened. Medicaid expansion has been particularly crucial to expanding access to health care in rural communities and Senator Jones’ leadership on the SAME Act is a major step towards encouraging more states to expand Medicaid and ensuring rural Americans will have access to the health care coverage they so desperately need.”

By The Numbers: Rural Health In Alabama


19 percent of Alabamians living in rural areas are uninsured, compared to 16 percent of Alabamians living in nonrural areas.

Since the Affordable Care Act, the uninsured rate has fallen by 9 percent in rural parts of Alabama.

24 percent of Alabamians living in rural areas have health coverage through Medicaid.

The Affordable Care Act led to a $112 million reduction in Alabama uncompensated care costs. Between 2013 and 2015, Alabama hospitals’ uncompensated care costs decreased by $112 million, or roughly 18 percent.

314,000 Alabamians could gain coverage if the state were to expand Medicaid. By failing to do so, the Robert Wood Johnson Foundation (RWJF) and Urban Institute estimate that 314,000 Alabamians are being denied coverage through the program. If Alabama were to expand Medicaid, it is estimated that the uninsured rate would drop from 17.5 percent to 12.5 percent.

21 rural hospitals in Alabama are at a high financial risk of closing. This represents roughly 50 percent of the state’s rural hospitals.

In Alabama, where lawmakers refused to expand Medicaid, five rural hospitals have closed since 2010, with a sixth expected to close in March.

These hospitals include:
Georgiana Medical Center (AL-02, will close in March 2019)
Florala Memorial Hospital (AL-02, closed in 2013)
Elba General Hospital (AL-02, closed in 2013)
Chilton Medical Center (AL-06, closed in 2012)
SouthWest Alabama Medical Center (AL-07, closed in 2011)
Randolph Medical Center (AL-03, closed in 2011)
protectourcare
In News

Protect Our Care Praises Effort Led by Senators Mark Warner (D-VA) and Doug Jones (D-AL) to Support Medicaid Expansion

The SAME Act Will Lead to Expansion of Coverage and Benefit Rural Communities

Washington, DC–Today, Senators Mark Warner (D-VA) and Doug Jones (D-AL), among others, introduced the States Achieve Medicaid Expansion (SAME) Act, which would provide each state expanding its Medicaid program with the same levels of Federal matching funds, regardless of when it chooses to expand the program. Brad Woodhouse, executive director of Protect Our Care, praised the legislation in a statement:

“Medicaid expansion has been one of the most successful facets of the Affordable Care Act, providing millions of Americans with the health care coverage they so desperately need. Medicaid expansion has been particularly crucial to expanding access to health care in rural communities and has helped rural hospitals keep their doors open. The SAME Act will not only give all states that enacted Medicaid expansion the same funding benefits, it will incentivize more states to follow suit. Under the leadership of Senators Mark Warner and Doug Jones, the SAME Act is a major step toward ensuring better access to care, lowering costs, and keeping rural hospitals open.”

BACKGROUND:

Medicaid Expansion Is A Lifeline To Rural Communities. The Affordable Care Act opened the doors to Medicaid expansion, which has significantly expanded access to health care in rural communities, reduced rural hospitals’ uncompensated care costs, and helped rural health providers keep their doors open by allowing states to expand Medicaid coverage for adults up to 138 percent of the federal poverty line. Medicaid expansion allowed 1.7 million rural Americans to gain coverage who had not previously been eligible.

Following Medicaid Expansion, The Uninsured Rate In Rural Parts Of Expansion States Decreased By A Median Of 44 Percent. In rural states that expanded Medicaid, the uninsured rates dropped significantly after the ACA became law:

  • In Montana, the uninsured rate dropped from 19 to 8.5 percent between 2013 and 2016.
  • In Kentucky, the uninsured rate dropped from 16.3 to 7.2 percent between 2013 and 2016.
  • In Arkansas, the uninsured rate dropped from 17.8 to 9.1 percent between 2013 and 2016.
  • In West Virginia, the uninsured rate dropped from 14.2 to 8.8 percent between 2013 and 2016.

By Reducing Uncompensated Care Costs, Medicaid Expansion Means Hospitals Have Greater Financial Security. Medicaid expansion also drastically reduced the amount of costs that a hospital absorbs for any treatment or service not paid for by an insurer or patient, known as uncompensated care.. The Center on Budget and Policy Priorities finds that “states that expanded Medicaid to low-income adults under the ACA saw both larger coverage gains and larger drops in uncompensated care: a 47 percent decrease in uncompensated care costs on average compared to an 11 percent decrease in states that did not expand Medicaid.” CBPP concludes that these declines in uncompensated care were “almost certainly” the result of the ACA’s coverage gains.

A June 2018 Protect Our Care Analysis Found That The Vast Majority Of Rural Hospital Closures Since 2010 Were In States That Had Refused To Expand Medicaid. Between 2010 and June 2018, 84 rural hospitals closed. The vast majority of those rural hospital closures, 77 percent, occurred in states that refused to expand Medicaid. Nearly 90 percent of the rural hospitals that have closed since 2010 were located in states that refused to expand Medicaid by the time of their closure. Only 10 out of 84 rural hospitals closed in states after they had expanded Medicaid; of hospital closures in states that expanded Medicaid, nine closed before the state expanded the program. Since Protect Our Care’s June report, even more hospitals have closed. The Scheps Center Rural Health Research Program tracks that 97 rural hospitals have closed since 2010.

protectourcare
In News

Protect Our Care and Sen. Sherrod Brown Oppose Trump Judicial Nominees Working to Strip Health Care from Americans

Washington, DC–Today, Protect Our Care partnered with Senator Sherrod Brown of Ohio on a press call to highlight why Chad Readler and Eric Murphy ’s nominations to the Sixth Circuit Court of Appeals would be disastrous for not only Ohioans, but all Americans’ health care. Readler attacked the Affordable Care Act by signing a legal brief refusing to defend the law at the Department of Justice in support of the Texas lawsuit, which would strip millions of their coverage and deny pre-existing condition protections enshrined in the ACA.

“No American should be denied health care because of a pre-existing condition, or because they’re a woman, or because they cannot afford it,” Senator Brown said. “I cannot support nominees who have actively worked to strip Ohioans of their health care rights. Special interests already have armies of lobbyists and lawyers on their side, they don’t need judges in their pockets.”

“Chad Readler wants to go back to the days where insurance companies could deny, drop or charge more for coverage and end protections for millions of people with pre-existing conditions,” said Brad Woodhouse, executive director of Protect Our Care. “Simply put, a vote for Chad Readler is a vote for full repeal of the Affordable Care Act. Readler tried to sabotage the ACA from within the administration, and if we put him on the court, he will be able to sabotage your care from the bench.The Senate must protect the American people’s health care by denying Chad Readler a lifetime appointment.”

Full press call audio here

Background on Chad Readler:

Readler filed the Trump administration’s brief in Texas V. United States, and his nomination for a judicial seat was announced the same day he filed the brief calling for the ACA’s protections for people with pre-existing conditions to be overturned.

If the Texas ruling is not overturned:

  • 4.8 million Ohioans with pre-existing conditions could lose their coverage
  • Ohioans over age 50 could face a $3,329 age tax
  • 151,026 Ohioans would lose tax credits and have to pay more for coverage in the marketplace
  • 214,338 Ohio seniors would have to pay more for their prescription drugs
  • 717,100 Ohioans could lose their health care due to possible repeal of Medicaid expansion
protectourcare
In News

Defiant Drug Company CEOs Offer Up the Same Old Excuses and No Answers for Their Massive Price Hikes

Washington, DC — Today, the CEOs and top executives from seven of the largest drug companies testified before the Senate Finance Committee. The big drug companies have seen billions in profits while Americans have seen the costs of their medications soar. They reaped billions of dollars from the Trump tax scam bill and used it for stock buybacks, enriching their already wealthy investors and CEOs. Headline after headline demonstrates that drug companies are jacking up the prices of vital medications, proving that their commitment to freeze drug prices last year was all political posturing.

Merck’s Ken Frazier admitted as much in the hearing stating, “We have lowered list prices in the past and found it creates a financial disadvantage for the company and it doesn’t get us more volume because of the incentives in the system.”

“The American people deserve answers from these CEOs but instead today they got the same old excuses,” said Brad Woodhouse, executive director of Protect Our Care. “It’s crystal clear that these drug companies won’t follow through on their rhetoric about making prescription drugs more affordable for the American people because it would cut into their record profits.  Senator Menendez said today that if drug companies don’t take meaningful action on their own to reduce prices then policy makers will do it for them. After today’s pathetic display by drug company executives the time for policy makers to act has clearly arrived.”

Background:

Watch Senator Menendez question CEOs on the Trump tax scam here.

Big Drug Companies Raked in Billions of Profits Last Year and Paid Their CEOs Millions…

Pharmaceutical Company2018 Profit ($ Billion)Stock Buybacks Since the 2017 GOP Tax Cut[1]CEOCEO Pay[2]Ratio of CEO Compensation to Median Employee Salary[3]
Pfizer$11.1[4]$10 billionAlbert Bourla$27.9 million313:1
Merck$6.22[5]$10 billionKen Frazier$17.6 million215:1
Johnson & Johnson$15.3[6]$5 billionAlex Gorsky$29.8 million452:1
Sanofi$4.9[7]—Oliver Brandicourt$11.1 million[8]—
Bristol-Meyers$4.9[9]$5 billion[10]Giovanni Caforio$18.7 million169:1
AbbVie$5.7[11]$15 billionRick Gonzalez$22.6 million144:1
AstraZeneca$2.2[12]—Pascal Soriot$12.3 million[13]—

AstraZeneca CEO Pascal Soriot Complained That Despite His $12 Million Salary He Was “The Lowest Paid CEO In The Whole Industry” Which Was “Annoying To Some Extent.” “Soriot, who heads AstraZeneca, has a penchant for going off message — and making headlines when he does…he groused to a reporter at London’s The Times earlier this year that despite his $12 million salary he was ‘the lowest-paid CEO in the whole industry,’ which he added was ‘annoying to some extent.’” [Stat, 2/21/19]

…All While Raising Prices on 1,000 Drugs for YOU

Nearly 30 Pharmaceutical Companies Are Raising Prices on Consumers This Year Alone.Pharmaceutical companies continue to increase prices. In January 2019 alone, drugmakers raised prices on nearly 490 prescription drugs. Johnson & Johnson raised prices on around two dozen drugs, and Pfizer and Novartis announced price increases on dozens of drugs, including increasing the cost of a breast cancer medication to $12,000 for 21 pills. All in all, nearly 30 drugmakers are expected to raise prices in 2019. 

CBS News: “Big Pharma ushers in new year by raising prices of more than 1,000 drugs” [CBS News, 1/2/19]

Reuters: “Big Pharma returning to U.S. price hikes in January after pause” [Reuters, 12/20/18]

Nostrum CEO Mulye: “I Think It Is A Moral Requirement to Make Money When You Can .. To Sell The Product For The Highest Price.” “Last month, Nostrum Laboratories, a small Missouri-based drugmaker, more than quadrupled the price of a bottle of nitrofurantoin from $474.75 to $2,392, according to Elsevier’s Gold Standard drug database. Nitrofurantoin is an antibiotic used to treat bladder infections…In an interview, Nirmal Mulye, Nostrum chief executive, said he had priced the product according to market dynamics, adding: “I think it is a moral requirement to make money when you can . . . to sell the product for the highest price.” [Financial Times, 9/11/18]

Mylan Chairman Coury Responds to Critics After Mylan Charged More Than $600 per Box of the EpiPen When It Only Contained $1 Worth of Ephinephrine: They Ought to Go Copulate with Themselves. “In meetings, the executives began warning Mylan’s top leaders that the price increases seemed like unethical profiteering at the expense of sick children and adults, according to people who participated in the conversations…At one gathering, executives shared their concerns with Mylan’s chairman, Robert Coury. Mr. Coury replied that he was untroubled. He raised both his middle fingers and explained, using colorful language, that anyone criticizing Mylan, including its employees, ought to go copulate with themselves.” [New York Times, 6/4/17]

In 2017, the FDA approved Marathon Pharmaceuticals’ request to charge $89,000 for a drug, a 6,000% price increase. “A drug company has brought a drug that has been available as a generic elsewhere in the world for decades at a shockingly inflated price…Yet a pharmaceutical company in Deerfield, Ill., has gotten approval from the U.S. Food and Drug Administration to sell deflazacort (snazzy brand name: Emflaza). The company, Marathon Pharmaceuticals, is charging a list price of $89,000 – a 6,000% price increase.” [Forbes, 2/10/17]

In 2015, Martin Shkreli hiked the price of a life saving drug by 5,000% overnight, from $13.50 a pill to $750, when it reportedly only cost $1 to make. “Shkreli, a former hedge fund manager and entrepreneur, earned his unflattering nickname by raising the cost of the drug from $13.50 per pill to $750 per pill. After a Bloomberg reporter suggested it cost around $1 to make, Shkreli acknowledged the drug cost ‘very little money’ to make.” [HuffPost, 3/9/18]

Meanwhile, Drug Companies Reaped Billions from The GOP Tax Cut

Pharmaceutical Companies Have Reaped Billions Of Dollars From The Trump Tax Bill. The Trump tax scam means billions of dollars in tax breaks for pharmaceutical companies. An Axios study found that 21 health care companies collectively expect to gain $10 billion in tax savings during 2018 alone. [Axios, 3/5/18]

Since 2017, Pharmaceutical Companies Have Announced $73 Billion in Share Buybacks.“Collectively, drug companies have announced nearly $73 billion in share buybacks since the tax law passed in December 2017, according to Americans for Tax Fairness. Stock buybacks mostly enrich the already wealthy, including CEOs: the wealthiest 10% of American households own 84% of all corporate shares, the top 1% own 40%. About one-half of households own no stock.” [Americans for Tax Fairness, 1/8/19]

Don’t Be Fooled: Big Drug Companies Promises to Lower Costs are “Nothing-Burger Steps”

Pharmaceutical Company Lobbyist On So-Called Concessions to the Trump Administration: They Are a “Calculated Risk” And “Nothing-Burger Steps.” “The gestures turned out to be largely symbolic — efforts to beat Trump at his own game by giving him headlines he wants without making substantive changes in how they do business. The token concessions are ‘a calculated risk,” said one drug lobbyist. ‘Take these nothing-burger steps and give the administration things they can take credit for.’” [Politico, 8/3/18]

Trump’s Proposals Always Fall Far Short Of His Promises. President Trump promised that he would allow Medicare to use its buying power to negotiate drug prices directly with suppliers, but after meeting with pharmaceutical executives early in 2017, Trump abandoned that pledge, calling it “price fixing” that would hurt “smaller, younger companies.” The planned announcement to move some drugs from Medicare Part B, in which pharmaceuticals are purchased and administered by medical providers, to Part D, will do little to restrain the cost of prescription drugs for America’s seniors and falls far short of Trump’s promises.

[1] Americans For Tax Fairness, 1/8/19

[2] Data for FY2017, Bloomberg, 2/22/19

[3] Data for FY2017, Bloomberg, 2/22/19

[4] Pfizer Fourth Quarter And Full Year 2018  Results,” Pfizer, 1/29/19

[5] SFGate, 2/5/19

[6] 2018 Fourth Quarter Results, Johnson & Johnson, 1/22/19

[7] Converted from 4.3 billion euro; The Pharma Letter, 2/7/19

[8] Converted from 9.8 million euro for FY2017; Bloomberg, Accessed 2/22/19

[9]  Fourth Quarter And Full Year Financial Results, Bristol-Myers Squibb, 1/24/19

[10] “Bristol-Myers Squibb expects to execute an accelerated share repurchase program of up to approximately $5 billion, subject to the closing of the transaction, market conditions and Board approval,” Bristol-Myers Squibb, 1/3/19

[11]Fourth Quarter And Full Year 2018 Results, Abbvie, 1/25/19

[12] Market Screener, Accessed 2/22/19

[13] Converted from 9.4 million GBP for FY2017; Bloomberg, Accessed 2/22/19


protectourcare
In News

Sen. Brown & Protect Our Care To Call For Opposition To Trump Nominees Who Worked To Strip Ohioans Of Health Care Rights

Trump Nominees Chad Readler and Eric Murphy will get Floor Vote in Coming Weeks

Readler Supported Efforts to Allow Insurance Companies to Deny Coverage for People with Pre-Existing Conditions; Murphy has Worked to Restrict Women’s Access to Health Care

WASHINGTON, D.C. – Tomorrow, U.S. Sen. Sherrod Brown (D-OH) and health advocates from Protect Our Care will host a news conference call where they will call on members of the Senate to oppose the nominations of Chad Readler and Eric Murphy to serve on the Sixth Circuit Court of Appeals. Both Readler and Murphy have proven too extreme for Ohio, with combined records of working to roll back health care protections and strip Ohioans’ of their rights. Readler has taken a leading role in the Trump Administration’s efforts to undermine the ACA, filing an anti-ACA Justice Department brief in the multi-state lawsuit that recently resulted in one federal court’s ruling that the entire ACA should be struck down. Brown opposed both nominees when they were first announced by President Trump last year and continues to oppose their nominations today.

WHO:  

U.S. Sen. Sherrod Brown (D-OH)
Brad Woodhouse, Executive Director for Protect Our Care
Health care advocates, Susan Hyde and Maya Zimmerman Brown

WHAT:    

News Conference Call Urging Senate Opposition to two Trump nominees, Chad Readler and Eric Murphy

WHEN:

Tomorrow, Tuesday, Feb. 26, 2019 at 2:30 p.m.

RSVP:

Email [email protected] to RSVP and receive call-in information


Sean England
In News

Big Drug Companies: Billions in Profits for THEM, Price Hikes for YOU

Meanwhile, the Administration Talks Big and Does Nothing to Reduce Prices

As CEOs and top executives from seven of the largest drug companies are set to testify before the Senate Finance Committee, the American people deserve answers. The big drug companies have seen billions in profits while Americans have seen the costs of their medications soar. They reaped billions of dollars from the Trump tax scam bill and used it for stock buybacks, enriching their already wealthy investors and CEOs. Headline after headline demonstrates that drug companies are jacking up the prices of vital medications, proving that their commitment to freeze drug prices last year was all political posturing. It’s time for Congress to hold these CEOs accountable.

Big Drug Companies Raked in Billions of Profits Last Year and Paid Their CEOs Millions…

Pharmaceutical Company 2018 Profit ($ Billion) Stock Buybacks Since the 2017 GOP Tax Cut[1] CEO CEO Pay[2] Ratio of CEO Compensation to Median Employee Salary[3]
Pfizer $11.1[4] $10 billion Albert Bourla $27.9 million 313:1
Merck $6.22[5] $10 billion Ken Frazier $17.6 million 215:1
Johnson & Johnson $15.3[6] $5 billion Alex Gorsky $29.8 million 452:1
Sanofi $4.9[7] — Oliver Brandicourt $11.1 million[8] —
Bristol-Meyers $4.9[9] $5 billion[10] Giovanni Caforio $18.7 million 169:1
AbbVie $5.7[11] $15 billion Rick Gonzalez $22.6 million 144:1
AstraZeneca $2.2[12] — Pascal Soriot $12.3 million[13] —

AstraZeneca CEO Pascal Soriot Complained That Despite His $12 Million Salary He Was “The Lowest Paid CEO In The Whole Industry” Which Was “Annoying To Some Extent.” “Soriot, who heads AstraZeneca, has a penchant for going off message — and making headlines when he does…he groused to a reporter at London’s The Times earlier this year that despite his $12 million salary he was ‘the lowest-paid CEO in the whole industry,’ which he added was ‘annoying to some extent.’” [Stat, 2/21/19]

…All While Raising Prices on 1,000 Drugs for YOU

Nearly 30 Pharmaceutical Companies Are Raising Prices on Consumers This Year Alone. Pharmaceutical companies continue to increase prices. In January 2019 alone, drugmakers raised prices on nearly 490 prescription drugs. Johnson & Johnson raised prices on around two dozen drugs, and Pfizer and Novartis announced price increases on dozens of drugs, including increasing the cost of a breast cancer medication to $12,000 for 21 pills. All in all, nearly 30 drugmakers are expected to raise prices in 2019. 

CBS News: “Big Pharma ushers in new year by raising prices of more than 1,000 drugs” [CBS News, 1/2/19]

Reuters: “Big Pharma returning to U.S. price hikes in January after pause” [Reuters, 12/20/18]

Nostrum CEO Mulye: “I Think It Is A Moral Requirement to Make Money When You Can .. To Sell The Product For The Highest Price.” “Last month, Nostrum Laboratories, a small Missouri-based drugmaker, more than quadrupled the price of a bottle of nitrofurantoin from $474.75 to $2,392, according to Elsevier’s Gold Standard drug database. Nitrofurantoin is an antibiotic used to treat bladder infections…In an interview, Nirmal Mulye, Nostrum chief executive, said he had priced the product according to market dynamics, adding: “I think it is a moral requirement to make money when you can . . . to sell the product for the highest price.” [Financial Times, 9/11/18]

Mylan Chairman Coury Responds to Critics After Mylan Charged More Than $600 per Box of the EpiPen When It Only Contained $1 Worth of Ephinephrine: They Ought to Go Copulate with Themselves. “In meetings, the executives began warning Mylan’s top leaders that the price increases seemed like unethical profiteering at the expense of sick children and adults, according to people who participated in the conversations…At one gathering, executives shared their concerns with Mylan’s chairman, Robert Coury. Mr. Coury replied that he was untroubled. He raised both his middle fingers and explained, using colorful language, that anyone criticizing Mylan, including its employees, ought to go copulate with themselves.” [New York Times, 6/4/17]

In 2017, the FDA approved Marathon Pharmaceuticals’ request to charge $89,000 for a drug, a 6,000% price increase. “A drug company has brought a drug that has been available as a generic elsewhere in the world for decades at a shockingly inflated price…Yet a pharmaceutical company in Deerfield, Ill., has gotten approval from the U.S. Food and Drug Administration to sell deflazacort (snazzy brand name: Emflaza). The company, Marathon Pharmaceuticals, is charging a list price of $89,000 – a 6,000% price increase.” [Forbes, 2/10/17]

In 2015, Martin Shkreli hiked the price of a life saving drug by 5,000% overnight, from $13.50 a pill to $750, when it reportedly only cost $1 to make. “Shkreli, a former hedge fund manager and entrepreneur, earned his unflattering nickname by raising the cost of the drug from $13.50 per pill to $750 per pill. After a Bloomberg reporter suggested it cost around $1 to make, Shkreli acknowledged the drug cost ‘very little money’ to make.” [HuffPost, 3/9/18]

Meanwhile, Drug Companies Reaped Billions from The GOP Tax Cut

Pharmaceutical Companies Have Reaped Billions Of Dollars From The Trump Tax Bill. The Trump tax scam means billions of dollars in tax breaks for pharmaceutical companies. An Axios study found that 21 health care companies collectively expect to gain $10 billion in tax savings during 2018 alone. [Axios, 3/5/18]

Since 2017, Pharmaceutical Companies Have Announced $73 Billion in Share Buybacks. “Collectively, drug companies have announced nearly $73 billion in share buybacks since the tax law passed in December 2017, according to Americans for Tax Fairness. Stock buybacks mostly enrich the already wealthy, including CEOs: the wealthiest 10% of American households own 84% of all corporate shares, the top 1% own 40%. About one-half of households own no stock.” [Americans for Tax Fairness, 1/8/19]

Don’t Be Fooled: Big Drug Companies Promises to Lower Costs are “Nothing-Burger Steps”

Pharmaceutical Company Lobbyist On So-Called Concessions to the Trump Administration: They Are a “Calculated Risk” And “Nothing-Burger Steps.” “The gestures turned out to be largely symbolic — efforts to beat Trump at his own game by giving him headlines he wants without making substantive changes in how they do business. The token concessions are ‘a calculated risk,” said one drug lobbyist. ‘Take these nothing-burger steps and give the administration things they can take credit for.’” [Politico, 8/3/18]

Trump’s Proposals Always Fall Far Short Of His Promises. President Trump promised that he would allow Medicare to use its buying power to negotiate drug prices directly with suppliers, but after meeting with pharmaceutical executives early in 2017, Trump abandoned that pledge, calling it “price fixing” that would hurt “smaller, younger companies.” The planned announcement to move some drugs from Medicare Part B, in which pharmaceuticals are purchased and administered by medical providers, to Part D, will do little to restrain the cost of prescription drugs for America’s seniors and falls far short of Trump’s promises.


Download the full report 

[1] Americans For Tax Fairness, 1/8/19

[2] Data for FY2017, Bloomberg, 2/22/19

[3] Data for FY2017, Bloomberg, 2/22/19

[4] Pfizer Fourth Quarter And Full Year 2018  Results,” Pfizer, 1/29/19

[5] SFGate, 2/5/19

[6] 2018 Fourth Quarter Results, Johnson & Johnson, 1/22/19

[7] Converted from 4.3 billion euro; The Pharma Letter, 2/7/19

[8] Converted from 9.8 million euro for FY2017; Bloomberg, Accessed 2/22/19

[9]  Fourth Quarter And Full Year Financial Results, Bristol-Myers Squibb, 1/24/19

[10] “Bristol-Myers Squibb expects to execute an accelerated share repurchase program of up to approximately $5 billion, subject to the closing of the transaction, market conditions and Board approval,” Bristol-Myers Squibb, 1/3/19

[11]Fourth Quarter And Full Year 2018 Results, Abbvie, 1/25/19

[12] Market Screener, Accessed 2/22/19

[13] Converted from 9.4 million GBP for FY2017; Bloomberg, Accessed 2/22/19

protectourcare
In News

Protect Our Care Launches Senate Accountability Effort in Key States

POC State Teams Will Target GOP Senators in ME, CO, NC, IA, AZ, GA, OH and AK in effort to Protect People with Pre-existing Conditions, Lower Health Care Costs, and Hold the Line Against Health Care Repeal and Sabotage

Washington, DC — Protect Our Care (POC), the group which successfully fended off the efforts of President Trump and Republicans to repeal the Affordable Care Act and then led the campaign to make it the defining issue of the 2018 elections, is launching its Senate accountability efforts. The program will focus on key states that are critical to holding the line against repeal and holding Republicans accountable for repeated attempts to sabotage health care.

Over the past two years, Protect Our Care maintained a significant presence in eighteen states and scores of congressional districts, where it used numerous tactics to lift up the success of the health care law and to defeat repeal including hundreds of events, protests and rallies; paid ads on television and social media; promoting the real health care stories of citizens; and a nationwide bus tour.

As the new congressional term gets underway with a Democratic majority in the House elected on the issue of health care, POC is kicking off its Senate accountability work in eight states — Alaska, Arizona, Colorado, Georgia, Iowa, Maine, North Carolina, and Ohio. POC’s state teams will work with in-state coalition partners and allies to put pressure on Republicans through earned media events, digital organizing, grassroots mobilization, rallies, protests, paid ads and other proven tactics. We will also mobilize the voices of people with pre-existing conditions, healthcare storytellers, and policy experts, so that these Republican Senators continue to hear from constituents from their home states.

“Health care is still the number one issue on the minds of voters and we’re going to continue to hold Republicans accountable for a repeal and sabotage agenda they simply can’t or won’t give up,” said Brad Woodhouse, executive director of Protect Our Care. “Whether these members have voted repeatedly for repeal, refuse to oppose President Trump’s sabotage of the law or voted for the tax scam bill which undermined the health care law while lining the pockets insurance and drug companies, we are going to make sure their constituents hear about it – loud and clear. Scores of Republicans paid the price in November for their anti-health care agenda yet those who remain are committed to repealing American health care or are turning a blind eye to the Trump administration’s sabotage of the law – and they simply must be held to account and that’s exactly what we intend to do.”

Over the last few weeks our state teams have:

protectourcare
In News

Domestic Gag Rule Puts Donald Trump Between Women And Their Doctors

Washington, DC — Today, ignoring the massive protests from the medical community and the American people, the Trump administration announced its final rule to erode the family planning guarantees of Title X, the nation’s program for affordable birth control and reproductive health care. Anne Shoup, communications director of Protect Our Care, issued a statement in response:

“The Republican war on women just entered a new phase with the administration’s rule that puts Donald Trump between women and their doctors. This rule, by banning providers from giving women all the facts even when they ask questions or when their lives are in danger, is cruelly designed to destroy women’s access to reproductive care. This radical rule is sadly in line with President Trump and his Republican allies’ previous attempts to dismantle women’s reproductive care and their continued sabotage of our health care in general.

THIS IS THE TRUMP ADMINISTRATION’S LATEST EFFORT TO STRIP WOMEN OF THEIR HEALTH CARE:

In Effort To Restrict Access To Information About Reproductive Health, The Trump Administration Removed Information About Contraceptive Coverage From Some Websites. “The Office of Population Affairs, under the Department of Health and Human Services (HHS), removed a collection of ten webpages related to the Affordable Care Act (ACA) (referred to as ‘the ACA Collection’ throughout this report) from its ‘Title X Family Planning’ website. The removed pages included a main ACA page, titled ‘Affordable Care Act,’ which linked to three pages titled ‘Initiatives,’ ‘Resources,’ and ‘Contraceptive Coverage.’ These three pages linked to six additional ACA-related subpages, including pages with the titles ‘Affordable Care Act Collaborative,’ ‘Health Insurance Marketplace,’ and ‘Contraceptive Coverage.’ The URLs for all ten pages were within the ‘hhs.gov/opa/title-x-family-planning/affordable-care-act/‘ filepath and now lead to error notices. An ‘Affordable Care Act’ menu in the sidebar of the ‘Title X Family Planning’ website, which previously linked to all webpages in the ACA Collection, was also removed.” [Sunlight Foundation, 2/5/19]

In January, A Trump Administration Rule That Would Have Allowed Employers To Restrict Women’s Access To Birth Control Was Meant To Take Effect — A Federal Judge Blocked It. “A federal judge in Pennsylvania stepped in at the last moment to pause Trump administration rules that would restrict the ability of some women to get birth control at no charge because their employers object on religious or moral grounds. U.S. District Judge Wendy Beetlestone issued a nationwide preliminary injunction Monday afternoon, the same day the new policy was to take effect. Her ruling came less than 24 hours after a federal district court judge in California issued a more limited stay covering 13 states and the District of Columbia. The rulings in rapid succession, both by judges appointed by President Barack Obama, are the latest legal twists in a dispute over the expansion of health-care benefits for women under the Affordable Care Act that has wound through the courts for years. The rulings do not permanently block the Trump policy but stop it from going into effect while legal challenges are pursued.” [Washington Post, 1/14/19]

For a more comprehensive look at the multiple ways the Trump administration has targeted women’s health, take a look at our fact sheet from last spring: Trump’s 11 Worst Attacks On Women’s Health.

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In News

Costs Up, Coverage Down: The Real HHS 2018 Annual Report

Washington, DC — Today, as HHS released its 2018 annual report and Secretary Azar gave a speech on drug pricing, one thing has become clear: the Trump administration does not want the American people to know the real impact of its war on health care — higher costs and less coverage. Leslie Dach, chair of Protect Our Care, issued a statement in response to Azar’s claims in his speech:

“While Secretary Azar is attempting to tout his record at HSS, Americans are suffering from the truth. The administration is  is hiding the real impact of its agenda: drug prices are going up, drug companies are enjoying massive tax giveaways, millions no longer have health insurance because of the administration’s sabotage campaign, and protections for pre-existing conditions are under attack. The claim that President Trump and Secretary Azar’s HHS improved America’s health care is ludicrous. The real story is that costs went up, coverage went down, and the American people lost out.”

Despite what’s in their annual report, we know what their record is:

  1. Drug companies continue to increase prices while reaping billions of dollars from the Trump tax bill and seeing massive profits. The Trump tax scam means billions of dollars in tax breaks for pharmaceutical companies. An Axios study found that 21 health care companies collectively expect to gain $10 billion in tax savings during 2018 alone. Most of the tax break windfall for health care companies is going toward share buybacks, dividends, acquisitions and paying down debt. Pharmaceutical companies raked in more than $30 billion in profits in the third quarter of 2018, with Pfizer alone bringing in $4.1 billion — the highest of any publicly traded health care company.  Meanwhile, pharmaceutical companies continue to increase prices. In January 2019 alone, Pfizer and Novartis announced price increases on dozens of drugs, including increasing the cost of a breast cancer medication to $12,000 for 21 pills. All in all, nearly 30 drugmakers are expected to raise prices in 2019. One drug industry lobbyist has said that drug companies’ limited concessions are “a calculated risk” summarizing big pharma’s strategy to play the Trump administration: “take these nothing-burger steps and give the administration things they can take credit for.”

  1. Under Trump, the uninsured rate has risen to its highest levels since the Affordable Care Act took effect. Gallup’s quarterly health survey reveals that the uninsured rate has risen to the highest rate since the Affordable Care Act’s coverage expansion was completed, leaping from 10.8 percent in 2016 to 13.7 percent in 2018 and representing about 7 million more Americans who are now uninsured. A major reason for this increase? Trump’s relentless health care sabotage. Among the factors contributing to this uninsured rate, Gallup cited increased premiums, major cuts to outreach funding and open enrollment, slashed funding to health care navigator groups, and Trump’s hostility to the ACA.
  2. Sec. Azar and the Trump administration have expanded access to junk plans that are allowed to discriminate against people with pre-existing conditions. In August, the Trump administration finalized a rule that allows consumers to purchase junk plans with an expanded duration of 364 days, as opposed to the the previously allowed maximum of three months, and renew such plans for up to three years. Since finalizing the rule, the Trump administration has urged navigator groups that help people sign up for coverage to push consumers toward junk plans and has issued guidance urging states to let ACA subsidies be used to purchase these skimpy plans. Junk plans are notoriously ripe for fraud, drive up health care premiums, leave consumers with worse coverage and at risk for bankruptcy.
  3. The Trump administration’s health care sabotage means Americans are paying more for premiums than they should. While Azar tries to claim that premiums have stabilized under him, health care analyst Charles Gaba has found that marketplace premiums are roughly 8 percent higher than they would be absent GOP sabotage. With GOP sabotage, premiums increased 2.8 percent in 2019. Absent such sabotage, premiums would have decreased 5.37 percent.
  4. The Trump administration has encouraged states to impose onerous Medicaid work requirements designed to kick people off of their health coverage — so far, more than 18,000 have lost coverage in Arkansas alone. In 2017, the Trump administration encouraged states to adopt policies that make it harder for people to access health care through Medicaid. One such way is by requiring Medicaid enrollees to work in order to maintain health coverage through Medicaid. So far, the Trump administration has approved waivers in seven states — AZ, AR, IN, KY, MI, MS, and WI — that will prevent people from being covered through Medicaid unless they meet restrictive requirements. Similar waivers are pending in eight states: AL, OH, OK, SD, TN, UT, and VA. Already, more than 18,000 Arkansans have lost coverage because of these burdensome requirements.
  5. Secretary Azar and the Trump administration have engaged in a years-long effort designed to sabotage the Affordable Care Act, going so far as to argue in court that protections for people with pre-existing conditions should be overturned. Trump along with Republican attorneys general and governors have already sued to try to overturn our health care laws in the Texas lawsuit. Just several weeks ago, President Trump boasted that the Affordable Care Act and its protections for people with pre-existing conditions would be “terminated” through the case. A complete list of the administration’s sabotage efforts is below and can be found in our health care sabotage tracker:

February 2019

  • Trump predicts the Affordable Care Act will be “terminated” through the Texas lawsuit seeking to overturn the law.
  • In an effort to restrict access to information about women’s reproductive health, the Trump administration removes web pages associated with the ACA and its contraceptive coverage from HHS’s Office of Population Affairs website.

January 2019

  • Thanks to GOP sabotage, the uninsured rate surges to the its highest level since 2014. Roughly seven million fewer people are estimated to have health care now than did two years ago.
  • The Centers for Medicare and Medicaid Services (CMS) proposes changes to the ACA’s benefit and payment parameters, reducing subsidies available to those who purchase health care through the exchange, increasing premiums, and raising  the out-of-pocket maximum for people with employer-sponsored health care.
  • In a win for big Pharma, the Trump administration proposes changes to the rebate system that would raise premiums, benefit pharmaceutical companies, and contain no mandate to lower list prices of drugs.

December 2018

  • Hand-picked Federal Judge Reed O’Connor rules in favor of twenty conservative states to overturn the Affordable Care Act, jeopardizing coverage for 17 million people and ripping away the ACA’s vital consumer protections such as protections for people with pre-existing conditions.
  • Under the Trump administration’s relentless sabotage, the uninsured rate increases for the first time since 2010. As the Kaiser Family Foundation finds, “In 2017, the uninsured rate reversed course and, for the first time since the passage of the ACA, rose significantly to 10.2% [from 10%].”

November 2018

  • Trump administration issues new guidance urging states to “tear down basic pillars of the Affordable Care Act, demolishing a basic rule” that federal subsidies can only be used to purchase ACA-compliant plans. Experts warn against this move, saying it will push affordable, comprehensive care further out of reach for individuals with pre-existing conditions.
  • Under the Trump administration, the number of uninsured children grows for the first time in nearly a decade. After a decade of steady decreases in the number of uninsured children, in 2017 the number of uninsured children increased from 3.6 million to 3.9 million.

October 2018

  • Republicans appoint Brett Kavanaugh to the Supreme Court. Kavanaugh is known to be hostile to the Affordable Care Act.
  • 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.

September 2018

  • The Trump administration’s Department of Justice joins twenty conservative states in court in opening arguments to argue that the Affordable Care Act’s protections for people with pre-existing conditions should be overturned.
  • Nearly 4,600 Arkansans are unable to meet Arkansas’ reporting requirements for the state’s Medicaid work requirements and lose Medicaid coverage.

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

  • CMS halts risk adjustment payments, that enable insurance companies to cover everyone, regardless of whether they are healthy or sick.
  • 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.
  • President Trump nominates Brett Kavanaugh to the Supreme Court. Kavanaugh has previously forced a young woman to continue a pregnancy against her will and has criticized Justice Roberts for upholding the Affordable Care Act’s constitutionality.

June 2018

  • Department of Justice takes to the courts to argue that insurance companies should be able to discriminate against as many as 130 million Americans with a pre-existing condition.
  • Republican coalition, the Health Policy Consensus Group, released their latest proposal to repeal the Affordable Care Act, which would gut protections for people with pre-existing conditions, let insurance companies charge older people an age tax, and deny key coverage for basic services like maternity care.
  • Trump Administration finalizes proposal to expand access to association health plans that skirt key consumer protections.

May 2018

  • President Trump boasts about health care sabotage: “We will have gotten rid of a majority of Obamacare.”
  • Trump Administration enlists help of former drug lobbyist in writing its drug plan.
  • Congressional Republicans try to use annual farm bill to authorize $65 million in taxpayer funding to set up association health plans, which can  exclude prescription drug coverage, mental health care, and maternity care.

April 2018

  • House Republicans vote on a balanced budget amendment that would cut Medicaid by $700 billion over ten years, $114 billion in a single year alone.
  • 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.

March 2018

  • Republicans sabotage efforts to pass a bipartisan bill that would have stabilized Affordable Care Act marketplaces by insisting the bill restrict access to abortion.

February 2018

  • The Trump Administration announces that it will expand access to short-term health plans that do not have to comply with key consumer protection provisions required by the Affordable Care Act.
  • Urban Institute calculates that repeal of the individual mandate and expansion of short term plans will increase individual market premiums by an average 18.2 percent in 2019.
  • Trump Administration releases budget that calls for the Affordable Care Act to be replaced by Graham-Cassidy, in a move that experts predict would reduce health coverage for 32 million Americans.

January 2018

  • The Trump Administration announces that it will support states that impose onerous work requirements on Americans covered by Medicaid, and approves Kentucky’s worst-in-the-nation waiver the next day.
  • The Trump Administration announces a move to allow providers to discriminate by allowing them to deny patient care for almost any reason.
  • The Trump Administration makes plans to announce even more exemptions from the requirement people have health coverage before this provision is repealed altogether.

December 2017

  • The Trump Administration proposes a rule to expand association health plans, which would gut consumer protections, raise costs for people with pre-existing conditions and further destabilize the insurance markets.
  • 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.

November 2017

  • Republicans refuse to move forward on the bipartisan Alexander-Murray bill to address the CSR crisis even though it had a filibuster-proof majority in the Senate.

October 2017

  • The Trump Administration takes direct aim at birth control by rolling back a rule that guaranteed women access to contraception. (A court has since questioned the legality of the action.)
  • President Trump signs an Executive Order to roll back key consumer protections that will result in garbage insurance, raise premiums, reduce coverage and again expose millions of Americans to discrimination based on pre-existing conditions.
  • The Trump Administration dramatically cuts in-person assistance to help people sign up for 2018 health coverage.
  • After threatening for months to stop funding cost-sharing reduction payments (CSRs) that help lower deductibles and out-of-pocket costs, the Trump Administration stops the payments altogether. The CBO finds that failing to make these payments will increase premiums by 20% and add nearly $200 billion to the debt.

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.

July 2017

  • The Trump Administration uses funding intended to support health insurance enrollment to launch a multimedia propaganda campaign against the Affordable Care Act.
  • President Trump, again, threatens to end cost-sharing reduction payments.

June 2017

  • Senate Republicans embark on a monthslong failed attempt to pass BCRA, Skinny Repeal and Graham-Cassidy, all repeal bills that would have caused millions of Americans to lose their health coverage and raised premiums by double digits for millions more. They would have ended Medicaid as we know it, putting the care of children, seniors and people with disabilities at risk.

May 2017

  • House Republicans vote for and pass a health care repeal bill that would cause 23 million people to lose coverage and gut protections for people with pre-existing conditions. It would have imposed an age tax and allowed insurers to charge people over 50 five times more for coverage and ended Medicaid as we know it, putting the care of seniors, children and people with disabilities in jeopardy.

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.
  • In an effort to convince Democrats to negotiate a repeal of the Affordable Care Act, President Trump threatens to cut off cost-sharing reduction payments (CSRs) that help low-income marketplace customers pay for out-of-pocket costs.

March 2017

  • The Trump Administration sends a letter to governors encouraging them to submit proposals which include provisions such as work requirements that make it harder for Medicaid beneficiaries to get affordable care and increase the number of people who are uninsured.

February 2017

  • The Trump Administration proposes a rule to weaken Marketplace coverage and raise premiums for millions of middle-class families.

January 2017

  • On his first day in office, President Trump signs an Executive Order directing the administration to identify every way it can unravel the Affordable Care Act.
  • 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.
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In News

Court Affirms Speaker Pelosi and Democratic Health Care Champions in Congress’s Fight to Protect Health Care From the Trump Texas Lawsuit

Washington, DC–Yesterday evening, the US Court of Appeals for the Fifth Circuit issued a ruling that allows the United States House of Representatives to intervene in the Texas, et. al. vs. United States, et. al. case which would overturn the Affordable Care Act and its protections for people with pre-existing conditions. Leslie Dach, chair of Protect Our Care, issued a statement in response:

“The Fifth Circuit correctly ruled that House Democrats can defend the American people against the Trump administration’s all out attack on America’s health care. Despite the GOP lies about protecting people with pre-existing conditions, President Trump himself bragged that the Trump Texas lawsuit would ‘terminate’ the ACA. This ruling is just another reminder that Speaker Pelosi and Democratic health care champions in Congress are not going to rest until every attack on our health care is stopped dead in its tracks. The Republican assault on health care needs to end.”

BACKGROUND:

Due to Judge O’Connor’s ruling on December 14th, 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. If this ruling is allowed to stand:

  • 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.
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