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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.”

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

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.

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.

In Case You Missed It: Under Trump, Uninsured Rate Increases For First Time Since Implementation Of Affordable Care Act

Last Friday, analysis by the Kaiser Family Foundation illuminated the impact of the Trump Administration’s non-stop sabotage on Americans’ health care: the number of uninsured nonelderly adults increased by nearly 700,000 in 2017.

After repeatedly attempting and failing to repeal the Affordable Care Act, President Trump and congressional Republicans pursued a relentless effort to sabotage the law. Kaiser’s analysis of the uninsured rate shows that Republicans’ sabotage agenda has jeopardized Americans’ access to care, particularly in states that refused to expand Medicaid. Take a look at Kaiser’s key findings below:

In 2017, The Uninsured Rate Increased For The First Time Since 2010. “As early provisions of the ACA went into effect in 2010, and as the economy improved, the number of uninsured people and uninsured rate began to drop. When the major ACA coverage provisions went into effect in 2014, the number of uninsured and uninsured rate dropped dramatically and continued to fall through 2016, when just below 27 million people (10% of the nonelderly population) lacked coverage…In 2017, the uninsured rate reversed course and, for the first time since the passage of the ACA, rose significantly to 10.2%.”

More People Became Uninsured In States That Refused To Expand Medicaid. “Changes in the uninsured rate in the set of states that expanded Medicaid were essentially flat overall…In contrast, the uninsured rate in states that did not expand Medicaid increased both overall (rising by 0.6 percentage points) and for most groups.”

Here We Go Again: House Republicans Target Health Care for More Tax Cuts For The Rich

Washington, D.C. –  As reported today in the Wall Street Journal, House Republicans are once again preparing to give hundreds of millions of dollars in tax breaks to drug and health insurance companies and ignoring the clear message from the midterms to end the GOP war on health care. Leslie Dach, chair of Protect Our Care, issued the following statement in response:

“Voters sent a clear message in the 2018 elections — end the GOP war on health care and stop attacking protections for pre-existing conditions. But instead of listening to their constituents, this latest GOP proposal is just another massive tax break for large drug and health insurance companies.  While their profits and CEO compensation soars, Americans pay more for their drugs and health care premiums. Make no mistake, Americans are fed up with the relentless Republican sabotage campaign and their ongoing support for President Trump’s effort in the courts to declare protections for pre-existing conditions unconstitutional.”

 

BACKGROUND:

Last December, Congressional Republicans Used The Tax Bill As A Vehicle To Sabotage The Affordable Care Act. By using the tax bill to repeal the requirement that most people have insurance, it Republicans are expected to increase the number of uninsured Americans by 12 million. In 2021, the repeal of the individual mandate is expected to save $30.6 billion from health care cuts, savings resulting from 12 million Americans losing health insurance. In that same year, the tax cuts for millionaires total $29.8 billion.

Drug Companies Are Reaping The Benefits Of Republicans’ Last Tax Bill While Americans Pay More. The health industry brought in $51.8 billion in profit during the third quarter — approximately 63 percent of which went to drug companies. Of 19 companies in the health industry that amassed at least $1 billion in third-quarter profit, 14 were drug companies. Axios reports that “Drug firm AbbVie paid $14 million of income taxes on $2.76 billion of pre-tax earnings in the third quarter — an effective tax rate of just 0.5%. Pfizer’s effective tax rate in Q3 was 1.6%.” These astronomical earnings come during a year during the first seven months of which there were 96 price hikes for every price cut.

More Proof: Trump Administration Targets Latinos In Its Open Enrollment Sabotage

Washington, DC – As part of its efforts to sabotage open enrollment, the Centers for Medicare and Medicaid Services removed a training guide for Latino outreach from a CMS website. This move is just one more part of the Administration’s sabotage efforts, including drastic cuts to outreach efforts and shortening the enrollment time period. Leslie Dach, Chair of Protect Our Care, issued the following statement in response:  

“From day one, Donald Trump has worked to sabotage health care for millions of Americans. Now, the Administration has targeted Latinos by deleting critical information from the HHS website that provides training for navigators as they assist Latino communities during the enrollment period. We all know open enrollment is a critical time for Americans to get the coverage they need. The Affordable Care Act is particularly important to Latinos, who are uninsured at a disproportionately high rate of 22 percent. There is no doubt in my mind that the Trump Administration is taking active steps to harm health care at the expense of the American people.”

 

BACKGROUND:

22 Percent Of Hispanic Americans Are Uninsured. The uninsured rate of Hispanic Americans is 22 percent, more than twice that of white Americans, 9 percent of whom are uninsured.

Between 2016 And 2018, The Trump Administration Has 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 2017, The Trump Administration Cut The Open Enrollment Advertising budget By 90 Percent. 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:

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.

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.

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

After Losing Midterms on Health Care, Here Are Eight Ways the Republican War on Health Care Rages On

Last month, Republicans got a thumping at the polls in large part due to their continued health care repeal-and-sabotage efforts. Health care was the top issue among voters of all backgrounds, who handed Democrats control of the House, flipped seven governors’ mansions, and elected to expand health care, even in deep red states. Unfortunately, Republicans across the country and the Trump Administration didn’t get the memo, and their reckless agenda has continued unabated.

Here’s what they’ve been up to, and how their actions are harming Americans:

  1. THE TRUMP ADMINISTRATION’S SABOTAGE OF OPEN ENROLLMENT IS PREVENTING INDIVIDUALS FROM OBTAINING COVERAGE

As open enrollment comes to its conclusion, individuals attempting to obtain coverage for 2019 have once again been harmed by Administration’s rampant sabotage efforts. The Administration slashed the sign-up period in half, cut navigator funding by 84 percent, pushed enrollment for junk plans which charge more money for less care and can deny coverage to people with pre-existing conditions, and again scheduled maintenance during the sign-up period. Taken together, these actions are expected to reduce Americans’ access to care, which national data is bearing out: A recent analysis of the first month of this year’s open enrollment period  found that enrollment was down nearly 13 percent compared to last year.

  1. THE TRUMP ADMINISTRATION HAS KICKED THOUSANDS OF AMERICANS OFF THEIR HEALTH INSURANCE

The Trump Administration has doubled down on imposing onerous Medicaid requirements designed to make it even harder for Americans to access health care. On Sunday, the Administration filed a motion to dismiss a lawsuit over its Arkansas-approved waiver, which has kicked more than 12,000 Arkansans off of their health insurance since its approval just three months ago.

Two weeks ago the Administration re-approved a Kentucky waiver containing work requirements, previously rejected by a federal judge who ruled the state failed to consider whether it would “in fact [help furnish] medical assistance to its citizens” and was estimated to kick 95,000 Kentuckians off of their insurance.”

The Administration has approved similar waivers in Indiana, New Hampshire, and Wisconsin, all of which will kick Americans off of their insurance while failing to promote work, as study after study has shown.

  1. THE TRUMP ADMINISTRATION IS PUSHING STATES TO ALLOW INSURANCE COMPANIES TO SELL JUNK PLANS THAT CIRCUMVENT CRUCIAL PROTECTIONS AMERICANS DEPEND ON

Last week, the Trump Administration issued new insurance guidance, encouraging states to “tear down pillars” of the Affordable Care Act. This move would allow federal subsidies to be used to purchase junk plans that are not required to cover pre-existing conditions, hospitalization, or prescription drugs. What will this mean?

  • Larry Levitt, Senior Vice President of Kaiser Family Foundation: 1332 waiver guidance gives states much the same flexibility as repeal would. [Business Insider, 10/22/18]
  • Timothy Jost, Washington and Lee University Law Professor: “Invariably, the coverage is going to be more expensive for people who really need comprehensive coverage.[Kaiser Health News, 11/29/18]
  • American Lung Association: New 1332 waiver guidance “Would further erode patient protections, undermine care for people with lung disease.” [American Lung Association, 11/29/18]
  • HuffPost: Rule change “almost certainly means that, overall, people with serious medical problems are likely to have a harder time finding coverage.” [HuffPost, 10/22/18]
  • Axios: Administration’s waiver “could add up to one of its most substantive blows yet against the affordable care act.”  [Axios, 10/23/18]
  1. THE TRUMP ADMINISTRATION ALSO APPEARS TO BE STEERING MEDICARE BENEFICIARIES TO PRIVATE PLANS

In another potential giveaway to Big Insurance from the Trump Administration, emails sent to Medicare beneficiaries by HHS appear to be steering them to private Medicare Advantage programs, over Medicare. Said Richard S. Foster, formerly the nonpartisan actuary of the Medicare program, told the New York Times the emails sounded “more like Medicare Advantage plan advertising than objective information from a public agency.”

  1. THE TRUMP ADMINISTRATION HAS CAUSED THE CHILDREN’S UNINSURED RATE TO DRASTICALLY INCREASE FOR THE FIRST TIME IN YEARS

Last week, the Georgetown University Center for Children and Families released a new report on the uninsured rate for children, and for the first time, the number and rate of uninsured children in the United States went up. Trump-GOP health care sabotage are chief among the reasons for the increase.

  1. THE TRUMP ADMINISTRATION CONTINUES TO TRY TO END PRE-EXISTING CONDITIONS PROTECTIONS IN COURT, AS PART OF A COORDINATED GOP EFFORT TO REPEAL THE AFFORDABLE CARE ACT AND RIP HEALTH CARE AWAY FROM MILLIONS

Any day now, a conservative federal judge in Texas is expected to rule on a lawsuit filed by a coalition of Republican attorneys general, and supported by the Trump Administration, that is designed to overturn the Affordable Care Act, including its protections for people with pre-existing conditions.

  1. WISCONSIN REPUBLICANS ARE TRYING TO DENY THE DULY ELECTED INCOMING DEMOCRATIC GOVERNOR AND ATTORNEY GENERAL THE AUTHORITY TO PULL WISCONSIN OUT THE LAWSUIT TO OVERTURN THE ACA AND END PRE-EXISTING CONDITIONS PROTECTIONS

Despite polls showing health care was the top issue for Wisconsin voters — and that they overwhelmingly favored Democrats on it, propelling them to victory in statewide race — Wisconsin Republicans passed legislation that seeks to deny the duly elected incoming Democratic Governor and Attorney General from withdrawing participation in Walker-Schimel-Trump’s assault on pre-existing conditions in federal court.

  1. TRUMP ADMINISTRATION APPROVES FLORIDA’S REQUEST TO RESTRICT RETROACTIVE MEDICAID ELIGIBILITY

Early this week, Florida received federal approval to shorten the amount of time people who sign up for Medicaid have for retroactive eligibility from 90 days to just 30. Critics charge that this change will hurt both patients and providers and that it will limit access to health care services for older patients and people with disabilities.

…MEANWHILE, THE TRUMP ADMINISTRATION GLOSSES OVER ITS RECORD WITH PHONY, FANCY “REPORTS”

A so-called “report” from the Department of Health and Human Services was actually “stuffed with conservative talking points” and “potshots at the Affordable Care Act,” according to Axios, rather than any substantive information about how the Trump administration plans to address the top health care concerns of the American people: lowering the cost of prescription drugs, ending junk insurance plans, funding Medicaid and Medicare and maintaining pre-existing conditions protections.

BREAKING: Wisconsin Republicans’ Pre-Existing Conditions Fraud

Senate Passes Bill Keeping Wisconsin in Pre-Existing Conditions Lawsuit, Despite Voters’ Wishes

Republicans Did Not Have Support to Even Pretend to Protect Pre-Existing Conditions as Walker Promised

Washington, D.C. – After hours of closed door debate, Republicans in the Wisconsin Senate failed to muster enough support to for legislation that they falsely claimed would ensure protections for people with pre-existing conditions, despite their efforts to invalidate them in federal court. This bill comes after Republican Senators passed legislation that seeks to deny the duly elected incoming Democratic Governor and Attorney General from withdrawing participating in Walker-Schimel-Trump’s assault on pre-existing conditions in federal court. That bill passed the legislature and now heads to the Governor.

Brad Woodhouse, executive director of Protect Our Care, released the following statement in response:

“I’d like to thank the Wisconsin Republicans who just proved that all of Scott Walker’s crocodile tears on the campaign trail about protecting people with pre-existing conditions were a total charade. For a decade, Wisconsin Republicans have tried to repeal the Affordable Care Act and its protections for the 2.4 million Wisconsinites living with pre-existing conditions, and that has never changed.

“By digging their heels in on their lawsuit to eliminate pre-existing conditions and repeal the Affordable Care Act, Scott Walker, Brad Schimel, and Wisconsin Republicans are proving they don’t really care about the health of their constituents and that they’ve learned nothing from the outcome of November’s election. Tony Evers and Josh Kaul were elected because of their pro-health care positions, including their pledges to withdraw from the Walker-Schimel-Trump lawsuit to overturn the Affordable Care Act and its protections for people with pre-existing conditions, and the will of the voters should be respected.”

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.

New Report is Another Health Care Bait-and-Switch from the Trump Administration

New Report is More Hot Air As the Trump-GOP War on Health Care Rolls On

Washington, DC – Today, the Trump Administration released a report that is nothing more than a bait-and-switch on health care from an Administration whose primary health care agenda is to take Americans’ coverage away. In response, Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

“No fancy report is going to change the fact that when it comes to health care, the Trump Administration’s real goals are crystal clear: to erode protections Americans depend on, like those for individuals with pre-existing conditions; to make people pay more money for less coverage; and to do whatever they can to get rid of or dismantle Medicare, Medicaid and the Affordable Care Act.”

Though they’re trying to distract from it, here’s the Trump Administration’s real health care record:

TRUMP AND REPUBLICANS ARE WORKING TO END PROTECTIONS FOR PRE-EXISTING CONDITIONS

If federal courts rule in favor of the Trump Administration and Republican attorneys general, protections for people with pre-existing conditions would vanish overnight, unleashing chaos in our entire health care system.

In addition to going to court to eliminate pre-existing conditions protections, the Trump Administration is urging states to skirt consumer protections in the Affordable Care Act through regulatory waivers.

TRUMP IS PUSHING JUNK PLANS THAT EXCLUDE COVERAGE OF PRE-EXISTING CONDITIONS

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

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

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

Junk Plans Are Notorious For The Scams They Attract. “Once the new rules were announced, vendors both fraudulent and legitimate adapted to market these short-term plans as the lines between the two became even more blurry. (The plans favored by our scam-happy president are also, unsurprisingly, historically scammy.)…As the administration promised, there are certainly more options, but there’s also not much by way of a filter. Since last summer, the federal budget for ‘insurance navigators’—the people you can call to parse your government-funded options, including Medicare and state healthcare—has been cut by 80%.” [Splinter, 11/21/18]

TRUMP’S HEALTH CARE SABOTAGE IS DRIVING COSTS UP FOR CONSUMERS

Larry Levitt, Senior Vice President Of Kaiser Family Foundation: Premiums Would Be Going Down If Not For Insurance Companies Compensating For Unstable Environment. “ACA premiums are stable for 2019 because they went up so much this year due to an uncertain environment and regulatory actions by the Trump administration. Premiums would be going down a lot if not for repeal of the individual mandate penalty and expansion of short-term plans.” [Levitt, 9/27/18]

Brookings Analysis Estimates That Individual Market Premiums Would Fall By 4.3 Percent In 2019 If Not For GOP Sabotage. [Brookings Institution, 8/1/18]

Health Care Analyst, Charles Gaba Has Calculated That Across The Country, Premiums Will Increase By An Average Of 2.8 Percent In 2019. The average premium increases indicate that premiums nationwide will be 8.1 percent higher than they would have been absent GOP sabotage. [Charles Gaba, Accessed 12/3/18]

TRUMP AND REPUBLICANS WANT TO UNDERMINE MEDICAID AND MEDICARE

President Trump’s FY 2019 budget proposed $1.4 trillion in cuts to Medicaid. In February, President Trump proposed a budget that would have gutted Medicaid by $1.4 trillion.

President Trump and Congressional Republicans are targeting Medicare and Medicaid to pay for tax cuts for the wealthiest. Last December, President Trump signed a $1.5 trillion tax bill that disproportionately benefits the wealthy. In an attempt to pay for these tax cuts, in April, House Republicans passed a budget amendment that would slash Medicare funding by $537 billion over the next decade.

Congressional Republicans proposed these cuts after passing a budget resolution last year that cut Medicare by $473 billion. The 2018 budget resolution passed by Republicans in December 2017 cut Medicare by $473 billion.

Larry Kudlow, Director of the National Economic Council, confirmed that he has his sights on cutting Medicare. Asked when programs like Social Security and Medicare will be looked at for reforms, Kudlow replied, “Everyone will look at that — probably next year.”

As the cost of drugs skyrocket, President Trump and his Republican allies in Congress will not allow Medicare to negotiate for better prescription drug prices. Under current law, the Secretary of the Department of Health and Human Services (HHS) is explicitly prohibited from negotiating directly with drug manufacturers on behalf of Medicare Part D enrollees. Although it would decrease both federal spending and beneficiaries’ out-of-pocket costs for prescription drugs, a policy allowing the federal government to negotiate drug prices for Medicare beneficiaries was noticeably absent from President Trump’s recent prescription drug announcement.  

Congressional Republicans repealed several components of the ACA designed to help keep Medicare’s costs down, effectively driving up costs for the program. By repealing the requirement that most people have insurance, Congressional Republicans knowingly voted for a measure expected to increase the number of uninsured. The 2018 Medicare Trustees Report predicts that this increase will increase the share of subsidies paid to hospitals via Medicare. Similarly, by repealing the Independent Payment Advisory Board, Congressional Republicans took away a mechanism that slowed Medicare cost growth.

TRUMP’S HRAs WILL FURTHER ERODE AMERICANS’ ACCESS TO AFFORDABLE HEALTH CARE

Standalone HRAs By Definition Contain An Annual Limit and Are Not Required to Cover Certain Preventive Services. “The ACA requires group health plans to meet certain standards that HRAs can’t meet, specifically the ban on annual and lifetime limits and the requirement to cover certain preventive services at no cost to plan enrollees. (HRAs by definition contain an annual limit on the amount of the employer’s contribution, and they are just accounts that do not cover any benefits.)” [Center on Budget and Policy Priorities, 11/29/17]

Increasing Access To Standalone HRAs Could Incentivize Businesses To Offer Limited Coverage HRAs Instead Of Full Health Coverage. “If the Administration attempts to broaden the availability of such “standalone” HRAs, that would likely prompt fewer businesses to offer health coverage to their employees.  Workers who now have good coverage and substantial contributions from an employer could see those benefits dropped and replaced with an HRA that leaves them paying higher premiums for less comprehensive coverage than what they have today.” [Center on Budget and Policy Priorities, 11/29/17]

HRAs Could Raise Premiums in the Individual Market By Drawing Healthy People Out Of Individual Market. “Depending on the specific proposals, and what employers do in response, HRAs could negatively affect the individual market by moving more high-cost people into that risk pool, raising overall premiums, and leaving other individual-market consumers and the federal government (through the premium tax credit) paying more.” [Center on Budget and Policy Priorities, 11/29/17]

American Cancer Society Cancer Action Network, American Heart Association, America’s Health Insurance plans, Blue Cross Blue Shield Association, Center on Budget and Policy Priorities, Crohn’s & Colitis Foundation, Epilepsy Foundation, Families USA, March of Dimes, The National Multiple Sclerosis Society Are Opposed to Expanding HRAs: “Expanding and extending short-term, limited-duration health plans, increasing enrollment in Association Health Plans (AHPs), and relaxing rules for employer Health Reimbursement Arrangements (HRAs) all increase adverse selection in insurance markets that serve millions of individuals and employers. We are concerned that this could create or expand alternative, parallel markets for health coverage, which would lead to higher premiums for consumers, particularly those with pre-existing conditions. Further, these actions destabilize the health insurance markets that guarantee access to comprehensive health coverage regardless of health status.” [Letter to State Departments of Insurance, 12/14/17]