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

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

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

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

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

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

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

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

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

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

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

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

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

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

And his decision was written on questionable legal grounds:

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

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

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

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

Experts were incredulous:

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

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

And here’s what elected officials said:

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

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

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

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

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

ashoup
In News

Donald Trump Celebrates Americans Losing Protections They Rely On

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

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

BACKGROUND:

Under this ruling:

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

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

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

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

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

BREAKING: COURT SIDES WITH TRUMP AND THE GOP AND RULES TO FULLY REPEAL THE ACA

BREAKING: COURT SIDES WITH TRUMP AND THE GOP AND RULES TO FULLY REPEAL THE ACA

Protections for Pre-Existing Conditions Gone

Medicaid Expansion Gone

Women Charged More Because They Are Women

Seniors Pay More for Prescription Drugs

Health Care Coverage for Children Up to 26 Gone

Millions Could Lose Health Care

“This decision is a disaster for American health care and it should be reversed immediately. Republicans at all levels own full responsibility for the harm this decision will cause, if it’s allowed to stand,” said Leslie Dach

Washington, D.C. – In response to conservative U.S. District Judge Reed O’Connor’s ruling in Texas, et. al. vs. United States, et. al., a case brought by Republican attorneys general and governors and the Trump Administration, Leslie Dach, chair of Protect Our Care, issued the following statement:

“Today, Republicans got their wish: they have ripped health care away from millions of people and raised costs for millions more. This decision is a disaster for American health care and it should be reversed immediately by a higher court. But make no mistake: what this judge ruled is what Republicans asked for. Republicans at all levels own full responsibility for the harm this decision will cause if it’s allowed to stand.

“If this ruling is not overturned, Republicans will bring us back to a time when insurance companies could deny the millions of Americans living with pre-existing conditions — like cancer, diabetes, or asthma — health coverage altogether or jack up their premiums, making life-saving health care unaffordable for millions. It forces seniors to pay more for drugs and allows insurance companies to charge women and seniors more based on their age and gender. It eliminates Medicaid expansion for 15 million Americans.  

“Donald Trump, every single Republican attorney general and governor on this case, and every Republican in Congress and in statehouses who refused to publicly oppose this lawsuit are responsible for what happens next. They own this, and deserve the wrath of the American people who just weeks ago voted to protect our care.”

ADDITIONAL BACKGROUND:

Under this ruling:

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

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

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

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

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

Wisconsin Republicans Cement Their Subversion of Democracy

Washington, D.C. – This afternoon, outgoing Wisconsin Governor Scott Walker signed legislation preventing the duly elected incoming Democratic Governor and Attorney General from withdrawing from the deeply unpopular Walker-Schimel-Trump assault on the Affordable Care Act and pre-existing conditions in federal court. In response, Brad Woodhouse, executive director of Protect Our Care, released the following statement:

“Scott Walker and Wisconsin Republicans don’t care about protecting their constituents’ health care, the rule of law, or the will of the people. After being trounced at the polls precisely because of their of their anti-health care agenda, despite their last ditch false promises to protect people with pre-existing conditions, they went ahead and rammed through legislation designed to take away Wisconsinites’ coverage while refusing to pass legislation to protect those individuals with pre-existing conditions. 2.4 million Wisconsinites could lose their health insurance and Scott Walker and his band of phony cronies could not care less. This is far from over.”

BACKGROUND:

MILLIONS OF WISCONSINITES AT RISK

2,435,700 Wisconsinites Live With A Pre-Existing Condition. About one in two Wisconsinites, 51 percent, lives with a pre-existing condition. [Center for American Progress, 4/5/17]

1,187,000 Wisconsin Women And Girls Have A Pre-Existing Condition. Approximately 1,187,000 women and girls in Wisconsin live with a pre-existing condition. [Center for American Progress and the National Partnership For Women and Families, June 2018]

308,100 Wisconsin Children Already Have A Pre-Existing Condition. Roughly 308,000 Wisconsinites below age 18 live with a pre-existing condition. [Center for American Progress, 4/5/17]

616,900 Older Wisconsinites Live With A Pre-Existing Condition. 616,900 Wisconsin adults between the ages of 55 and 64 live with at least one pre-existing condition, meaning attacks on these protections significantly threaten Wisconsinites approaching Medicare age. [Center for American Progress, 4/5/17]

THE AFFORDABLE CARE ACT OUTLAWED DISCRIMINATION BASED ON PRE-EXISTING CONDITIONS – GOP LAWSUIT TO OVERTURN THE LAW BRINGS DISCRIMINATION AGAINST PRE-EXISTING CONDITIONS BACK

Because Of The Affordable Care Act, Insurance Companies Can No Longer Deny Coverage Or Charge More Because Of Pre-Existing Conditions. “Under current law, health insurance companies can’t refuse to cover you or charge you more just because you have a ‘pre-existing condition’ — that is, a health problem you had before the date that new health coverage starts.” [HHS]

The ACA Outlawed Medical Underwriting, The Practice That Let Insurance Companies Charge Sick People And Women 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 Stopped Companies From Charging Women More Than Men For The Same Plan. The Affordable Care Act eliminated “gender rating,” meaning American women no longer have to pay an aggregated $1 billion more per year than men for the same coverage.

Thanks To The Affordable Care Act, Insurance Companies Can No Longer Rescind Coverage Because of Illness. Because of the ACA, insurance companies can no longer rescind or cancel someone’s coverage arbitrarily if they get sick.

HEALTH CARE WAS THE TOP ISSUE FOR WISCONSIN VOTERS

A Public Policy Polling election day survey of Wisconsin voters found that health care was the top issue for voters in the state — and that they overwhelmingly favored Democrats on it, propelling Tony Evers to victory.

  • 68% of voters said that health care was either a very important issue, or the most important issue to them. Those voters supported Evers over Scott Walker 65-33.
  • When asked to name the single issue most important to them in 2018, a plurality (27%) picked health care. Among those voters who said health care was their single most important issue in the election, Evers defeated Walker by a whopping 89-7 margin.
  • Evers especially had an advantage over Walker when it came to the issue of who voters trusted more to protect people with pre-existing conditions. 50% preferred Evers to protect pre-existing conditions to only 41% who preferred Walker.
  • Scott Walker’s support for the Republican health care repeal agenda hurt him badly. Only 32% of voters said his support for repeal made them more likely to vote for him, while 47% said it made them less likely to support him.

An overwhelming majority of Wisconsinites want to see the Affordable Care Act stay in place – 62% think it should be kept with fixes made to it as necessary, compared to only 32% of voters who support repealing it.

ashoup
In News

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

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

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

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

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

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

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

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

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

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

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

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

December 2018

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

October 2018

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

September 2018

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

August 2018

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

July 2018

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

July 2018

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

December 2017

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

October 2017

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

September 2017

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

August 2017

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

July 2017

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

April 2017

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

January 2017

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

The Rich Get Richer and the American People Continue to Bear the Costs – Just Another Day in Donald Trump’s America

“Yet again, another multinational pharmaceutical company got a giant tax break from the Trump Administration and has responded by buying back stocks and enriching its shareholders while continuing to increase its drug price. The rich continue to get richer and the American people continue to bear the costs – just another day in Donald Trump’s America.” -Brad Woodhouse, executive director of Protect Our Care

Axios reported the following this morning:

3. More Drug Company Stock Buybacks

Pharmaceutical company AbbVie, the maker of rheumatoid arthritis drug Humira, said yesterday it has authorized another $5 billion in stock buybacks.

AbbVie has now repurchased $15 billion of its own stock since the Republican tax overhaul was signed into law earlier this year, Axios’ Bob Herman reports.

The big picture: Drug companies are reporting massive profits, due in part to the tax law, and a lot of that money is being used on tools like stock buybacks that benefit Wall Street and executives. Patients, however, continue to voice frustration about their drug costs.

Where it stands: “The 10 biggest U.S. drug makers by sales together bought back about $52.4 billion of their own shares in the first nine months of the year, more than double the $21.7 billion they repurchased in the year-earlier period,” the Wall Street Journal reported earlier this month.

BACKGROUND:

The Price Of Humira Has More Than Doubled In The Previous Five Years. “The price of Humira, an anti-inflammatory drug dispensed in an injectable pen, has risen from about $19,000 a year in 2012, to more than $38,000 today, per patient, after rebates, according to SSR Health, a research firm. That’s an increase of 100 percent.” [New York Times, 1/6/18]

Humira’s Price Increase Makes It “The Costliest Price Hike” In America. “In the latter category is Humira. AbbVie’s 9.7% increase is likely to be the costliest price hike to the U.S. healthcare system. With the drug bringing in $12.6 billion in the U.S. each year, that price increase means ‘an added $1.2 billion to the healthcare system,’ Maris wrote. Over the past five years, Humira’s price has more than doubled, thanks to incremental hikes along the way, he noted.” [Fierce Pharma, 1/4/18]

Americans Pay Two Times What People In The U.K. Pay For Humira. Americans pay, on average, $2,669 for Humira while patients in the U.K. Pay $1,362. Patients in Switzerland pay even less — an average of just $822. [Vox, 11/30/18]

protectourcare
In News, Stories, Statement

Protect Our Care Statement on Introduction of the CURE High Drug Prices Act

Washington, D.C. – Today, Senators Richard Blumenthal (D-CT), Amy Klobuchar (D-MN), Kamala Harris (D-CA), and Jeff Merkley (D-OR) introduced the CURE High Drug Prices Act, which would give the Department of Health and Human Services (HHS) the power to stop drug company price gouging for common drugs like insulin. Leslie Dach, chair of Protect Our Care, issued the following statement in response:

 

“Senators Blumenthal, Klobuchar, Harris and Merkley’s bill takes direct aim at the ability of drug companies to charge excessive prices for common drugs like insulin – a critical issue impacting millions of Americans and they should be commended for their action today. The Trump administration and its Republican allies in Congress gave billions of dollars in tax breaks to big drug companies, and in response, their profits have soared while drug prices have gone through the roof. Voters sent a clear message in the midterm elections: they want Congress to reduce drug prices and take their side – not the side of the drug companies.”

ashoup
In News

GOP Congressman Says It’s Unfair That Searching Google Reveals How Awful His Health Care Repeal Bill Was

SHOT: In a recent Judiciary Committee hearing, Rep. Steve Chabot complained to Google CEO Sundar Pichai that Google revealed too many negative articles about the Republican health care repeal bill.

CHASER: All the people who know health care the best say repeal would have been the worst.

23 Million Americans Would Have Lost Coverage Under The AHCA. ​By 2026, 23 million people would have lost coverage. That’s a lot of people!

The AHCA Was The Least Popular Legislation In Three Decades. In Rep. Chabot’s defense, the AHCA never had a 12 percent approval like the Senate repeal plan did.

The Republican Repeal Bills Were Opposed By Nearly Every Major Patient Group, Health Care Provider, And Industry Organization – And Jimmy Kimmel. Among those who expressed opposition:

AARP

ALS Association

American Cancer Society Cancer Action Network

American College Of Physicians

American Diabetes Association

American Medical Association

American Academy of Family Physicians

American Academy of Pediatrics

American College of Physicians

American Congress of Obstetricians and Gynecologists

America’s Essential Hospitals

America’s Health Insurance Plans

American Heart Association

American Hospital Association

American Lung Association

American Nurses Association

American Osteopathic Association

American Psychiatric Association

The Arc

Arthritis Foundation

Association Of Community Affiliated Plans

Blue Cross Blue Shield Association

Catholic Health Association

Children’s Hospital Association

Coalition to Stop Opioid Overdose

Consortium for Citizens with Disabilities

Consumers Union

Cystic Fibrosis Foundation

Family Voices

Federation of American Hospitals

Greater New York Hospital Association

Jimmy Kimmel

JDRF

Lutheran Services in America

Kaiser Permanente

Kansas Hospital Association

March of Dimes

National Coalition for Cancer Survivorship

National Health Council

National Multiple Sclerosis Society

National Organization for Rare Diseases

The School Superintendents Association and 70+ Groups

Volunteers of America

WomenHeart

protectourcare
In News, Shot/Chaser

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

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

 

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

 

CHASER:

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

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

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

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

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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