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New Navigator Poll Shows All-Time High Support for Affordable Care Act As Trump Reignites Repeal Threats

Navigator Research released new polling today showing that the Affordable Care Act’s favorability is at an all-time high of 61 percent (+37 points). The poll shows a 14-point increase in favorability since February 2020 as more Americans count on it to protect their coverage and lower their costs. 

This comes as Donald Trump and his GOP allies have renewed calls to “terminate” the health care law and destroy its protections for millions of Americans.

The poll also found that Democrats’ trust on health care remains strong, holding a 14-point advantage over Republicans. Democrats also win the ACA repeal argument by a large margin when the messaging emphasizes there is “too much of a risk” and that “Congress shouldn’t cut health care for 30 million Americans.” 

Read more here.

Biden Administration Announces Plans to Utilize March-In Rights to Lower Drug Prices for Patients

Washington, D.C. — Today, the Biden administration announced plans to lower prices for certain high-priced medicines that were developed with taxpayer dollars by creating a policy for using federal “march-in rights” to license other manufacturers sell those drugs for less. The plan includes a new framework for federal agencies to determine when it is appropriate to apply march-in rights authority to a specific high-cost drug that was developed using federal funding. The move is a powerful tool to stop price gouging and boost competition between drug manufacturers to lower prices for patients. 

This announcement follows a long line of actions the Biden-Harris administration has taken to reduce prescription drug and health care costs for the American people. The Inflation Reduction Act lowered drug prices for millions of seniors by capping insulin costs at $35 per month, limiting outrageous price hikes, and making essential vaccines free for people on Medicare. Soon, total out-of-pocket drug costs will be capped at $2,000 per year for seniors and lower drug prices from Medicare negotiation will take effect. Together, these measures could save seniors thousands of dollars on their health care. In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“This move is an important step as President Biden continues building on his historic victories to lower prescription drug prices for patients. For too long, big drug companies have abused the patent system to block competition and keep prices high for patients, including for drugs developed with taxpayer money. As a result, too many families are kept up at night worrying about how they’ll manage to pay for lifesaving medications while keeping a roof over their heads or paying for groceries. Now, drug companies can no longer rely on tax dollars to do the research to develop a drug and knowing they’ll be able to charge unlimited amounts for that drug. Even as big drug companies throw all of their resources at lawsuits and lobbying to keep their profits high, President Biden has not wavered in his commitment to fight for working families and make prescription drugs more affordable.” 

Background:

President Biden’s Health Care Accomplishments Tracker 

PRESS CALL: Attorney General Rob Bonta to Join Protect Our Care California to Highlight Why Medicare is Better Than Ever and Expanded Savings for Seniors

***MEDIA ADVISORY FOR WEDNESDAY, DECEMBER 06 AT 11 AM PT // 2 PM ET***

Open Enrollment for 2024 Medicare Plans Ends December 7th and Brings New Savings for Seniors

Los Angeles, CA – Today, December 06, 2023, at 11 AM PT // 2 PM ET, Attorney General Rob Bonta and Long Beach Commission on Aging Chair Naida Tushnet will join Protect Our Care California to discuss Medicare open enrollment and to educate seniors about new benefits thanks to the Inflation Reduction Act, legislation signed into law last year by President Biden. As seniors enroll in their 2024 Medicare plans, during the open enrollment period that ends December 7th, they could save thousands of dollars on their prescription drug costs, with even more savings down the road. New benefits for Medicare beneficiaries include Medicare negotiation for lower drug prices, a $35 monthly copay cap on insulin, free shingles and other essential vaccinations, and $2,000 out-of-pocket caps on prescription drugs beginning in 2025.

Right now, the Biden administration is in the process of lowering prices for the first round of high-cost prescription drugs under the Medicare Drug Price Negotiation Program, and those prices will take effect in 2026. The first ten drugs selected for negotiation are taken by nearly 9 million people on Medicare, who spent $3.4 billion in out-of-pocket costs last year alone. This new program will lower prices for some of the highest-priced prescription drugs on the market used to treat conditions like diabetes, heart failure, blood clots, and autoimmune disorders.

PRESS CALL:

WHO:
Attorney General Rob Bonta
Naida Tushnet, Chair, Long Beach Commission on Aging

WHAT: Virtual Press Conference

WHEN: Wednesday, December 06, 2023, at 11 AM PT // 2 PM ET

WHERE: Register for the Zoom here

Reminder: Repealing the ACA Means Ripping Away Critical Benefits and Protections From Tens of Millions of Americans

Not Only Would 20+ Million Lose Coverage, but the Entire Health Care System Would Be Thrown Into Chaos

Over the weekend, Governor Ron DeSantis (R-FL), Senator Lindsey Graham (R-SC), former Governor Nikki Haley (R-SC), and leading GOP Senate candidate Tim Sheehy (MT) echoed Donald Trump’s latest calls to “terminate” the Affordable Care Act (ACA). The MAGA GOP refuse to give up their war on health care, despite the ACA being more popular than ever with a record number of signups.

The consequences of ACA repeal would touch nearly every household in the country: in addition to 20 million losing coverage, over 135 million Americans with pre-existing conditions would lose critical protections, 49 million seniors would have to pay more for prescription drugs, and insurance companies would not be required to cover preventative care, such as vaccinations, contraception, and cancer screenings, and once again impose annual and lifetime limits on benefits and charge women more.  

Thirteen years after it was signed into law, the ACA is now woven into the fabric of our lives. Millions of Americans depend on the ACA in order to stay healthy. At a time when more people are covered by the ACA than ever before, the consequences would be devastating, particularly for women, people of color, older adults, people who live in rural areas, people with disabilities, and the LGBTQI+ community.

If the Affordable Care Act is repealed:

  • GONE: 2.3 million adult children will no longer be able to stay on their parents’ insurance. 
  • GONE: Insurance companies will be able to charge women more than men.
  • GONE: Ban on insurance companies having annual and lifetime caps on coverage.
  • GONE: Requirements that insurance companies cover prescription drugs and maternity care.
  • GONE: Protections for 135 million Americans with pre-existing conditions, including 54 million people with a pre-existing condition that would make them completely uninsurable.
  • GONE: Medicaid expansion, which covers more than 22 million people. 
  • GONE: Quality, affordable coverage that over 15.5 million people who buy insurance on their own.
  • GONE: Premium tax credits that make premiums affordable for 80 percent of people who purchase health care on the marketplace.
  • GONE: 49 million seniors will have to pay more for prescription drugs because the Medicare ‘donut hole’ will be reopened.
  • GONE: Critical funding for rural hospitals. 
  • GONE: 61.5 million Medicare beneficiaries will face higher costs and disruptions to their medical care. 

Republican Threats Could Lead To Nearly 40 Million People Losing Their Coverage

  • 40 Million People Would Lose Coverage. If Republicans succeed in repealing the ACA, nearly 40 million people will lose coverage. In 2023, over 16 million people have signed up for ACA marketplace coverage, over 22 million people are enrolled in Medicaid expansion coverage available due to the ACA, and another 1 million people have coverage through the ACA’s Basic Health Program.
  • The Uninsured Rate Would Increase By 69 Percent. Repealing the ACA would increase the number of uninsured Americans from 26.6 million to 61.6 million, according to 2020 data. Americans of all ages would be impacted by coverage losses:
  • 1.7 million children would become uninsured, an increase of 48 percent.
  • 4.9 million young adults aged 19 to 26 would become uninsured, an increase of 76 percent. 
  • 8.8 million adults aged 27 to 49 would become uninsured, an increase of 60 percent.  
  • 5.6 million million older adults aged 50 to 64 would become uninsured, an increase of 95 percent. 

Overturning The ACA Would Worsen Racial Disparities In Health

The uninsured rate for Black Americans would spike to 20 percent, 32 percent for American Indian/Alaska Natives, 17 percent for Asian/Pacific Islanders, and 33 percent for Hispanics — compared to 13 percent for white Americans. 

  • 3.1 Million Black Americans Would Lose Coverage. The Urban Institute estimates that 3.1 million Black Americans would become uninsured if the ACA were overturned. According to the Center on Budget and Policy Priorities, the ACA helped lower the uninsured rate for nonelderly African Americans by more than one-third between 2013 and 2016 from 18.9 percent to 11.7 percent. 
  • 5.4 Million Latinos Would Lose Coverage. The percentage of people gaining health insurance under the ACA was higher for Latinos than for any other racial or ethnic group in the country. According to a study from Families USA, 5.4 million Latinos would lose coverage if Republicans repeal the ACA.
  • 1.3 Million Asian/Pacific Islanders Would Lose Coverage. 1.3 million Asian/Pacific islanders would become uninsured if the ACA were overturned, according to estimates from the Urban Institute. Research shows the ACA cut uninsurance rates among Asian Americans by more than half–from nearly 20 percent to just under 8 percent — eliminating coverage disparities with white Americans.
  • 488,000 American Indians And Alaska Natives Would Lose Coverage. According to the Urban Institute, the uninsurance rate for American Indians and Alaska Natives would more than double in 10 states if the ACA is overturned. Nationwide, 488,000 would lose coverage. 

Republicans Want To Put Insurance Companies Back In Charge, Ending Protections For The 135 Million People With A Pre-Existing Condition

  • According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 135 million people, have a pre-existing condition. This includes:
    • 44 million people who have high blood pressure
    • 45 million people who have behavioral health disorders
    • 44 million people who have high cholesterol
    • 34 million people who have asthma and chronic lung disease
    • 34 million people who have osteoarthritis and other joint disorders
  • More than 17 million children, 68 million women, and 32 million people aged 55-64 have a pre-existing condition.

Republicans Want To Give Insurance Companies The Power To Deny Or Drop Coverage Because Of A Pre-Existing Condition

Before the Affordable Care Act, insurance companies routinely denied people coverage because of a pre-existing condition or canceled coverage when a person got sick. Now insurance companies could have the license to do this again. 

  • A 2010 congressional report found that the top four health insurance companies denied coverage to one in seven consumers on the individual market over a three-year period. 
  • A 2009 congressional report found that some of the largest insurance companies had retroactively canceled coverage for 20,000 people over the previous five-year period.
  • The Kaiser Family Foundation estimates that 54 million people, or 27% of adults aged 18 to 64, have a condition that would have been grounds for coverage denial in the pre-ACA marketplace. 

Coronavirus Could Be Considered A Pre-Existing Condition. Without the ACA, millions of Americans who have contracted the coronavirus would likely be deemed as having a pre-existing condition and be at the mercy of their insurance companies who could refuse to pay for needed care. 

Source: Kaiser Family Foundation, 2016; 2019

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

  • Premium Surcharges Could Once Again Be In The Six Figures. Republican threats to repeal the ACA could mean insurance companies once again could charge people more because of a pre-existing condition. The 2017 House-passed repeal bill had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma, $17,060 more for pregnancy, $26,180 more for rheumatoid arthritis and $140,510 more for metastatic cancer.
  • Women Could Be Charged More Than Men For The Same Coverage. Prior to the ACA, women were often charged higher premiums on the nongroup market than men were charged for the same coverage. 
  • People Over The Age of 50 Would Face A $4,000 “Age Tax.” Without the ACA, insurance companies could charge people over 50 more than younger people. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the 2017 Republican repeal bill, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market, according to AARP.
  • 80 Percent of People With Marketplace Coverage Would Pay More. If the ACA is repealed, consumers would no longer have access to tax credits that help them pay their marketplace premiums, meaning 80 percent of people who have marketplace coverage would see price increases.
  • Seniors Would Have To Pay More For Prescription Drugs. Republicans’ plan to repeal the ACA, would make 49 million seniors pay more for prescription drugs because the Medicare “donut” hole would be reopened. 
  • 60 Million Medicare Beneficiaries Could Face Higher Costs. In addition to paying more for preventive care and prescription drugs, Medicare beneficiaries could face higher premiums without the cost-saving measures implemented under the ACA. If Republicans are successful, seniors will also face less coordinated care. 
  • Insurance Companies Would Not Have To Provide The Coverage You Need. The Affordable Care Act made comprehensive coverage more available by requiring insurance companies to include “essential health benefits” in their plans, such as maternity care, hospitalization, substance abuse care, and prescription drug coverage. Before the ACA, people had to pay extra for separate coverage for these benefits. For example, in 2013, 75 percent of non-group plans did not cover maternity care, 45 percent did not cover substance abuse disorder services, and 38 percent did not cover mental health services. Six percent did not even cover generic drugs.

Republicans Want To Give Insurance Companies The Power To Limit The Care You Get, Even If You Have Insurance Through Your Employer

  • Insurers Could Reinstate Lifetime And Annual Limits On 179 Million Privately Insured Americans. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage for those insured through their employer or on the individual market. In 2009, nearly 6 in 10 (59%) covered workers’ employer-sponsored health plans had a lifetime limit, according to the Kaiser Family Foundation. 
  • Americans Could Once Again Have To Pay For Preventive Care. Because of the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no cost to consumers.
  • Employers Could Eliminate Out-Of-Pocket Caps, Forcing Employees To Pay More For Care. Under the ACA, health insurers and employer group plans must cap the amount enrollees pay for health care each year. If the law is overturned, these cost-sharing protections would be eliminated. The ACA also barred employer plans from imposing waiting periods for benefits that last longer than three months.

Republicans Want To End Medicaid Expansion

  • More Than 21 Million People Enrolled Through Medicaid Expansion Would Lose Coverage. As of 2022, more than 21 million people were enrolled in Medicaid in over 40 states and territories.
  • Access To Treatment Would Be In Jeopardy For 800,000 People With Opioid Use Disorder. Roughly four in 10, or 800,000 people with an opioid use disorder are enrolled in Medicaid. Many became eligible through Medicaid expansion.
  • Key Support For Rural Hospitals Would Disappear. States that haven’t expanded Medicaid have poorer financial performance than states that have expanded Medicaid. If Medicaid provisions in the ACA were to be stripped, all rural hospitals would face this financial cliff.

Republicans Are Willing To Sacrifice Your Care For More Tax Cuts For The Wealthy

  • The Richest Americans Would See Tax Cuts Averaging $200,000. Overturning the ACA would cut taxes for the top 0.1 percent of earners by an average of $198,000.
  • Drug Companies Would Save Billions. If the ACA is struck down, pharmaceutical companies would pay $2.8 billion less in taxes each year.
  • Repeal Would Weaken The Medicare Trust Fund. A significant portion of the tax cuts resulting from ACA repeal would come “at the direct expense of the Medicare Trust Fund,” according to the Center on Budget and Policy Priorities.

Republicans Echo Trump’s Call to Repeal the Affordable Care Act, Jeopardizing Health Care for Millions of People Across the Nation

Washington, D.C. — Over the weekend, Governor Ron DeSantis (R-FL), Senator Lindsey Graham (R-SC), former Governor Nikki Haley (R-SC), and leading GOP Senate candidate Tim Sheehy (MT) echoed Donald Trump’s latest calls to “terminate” the Affordable Care Act (ACA). Repealing the ACA means ripping away protections for the over 135 million Americans with pre-existing conditions, hiking premium costs for millions of working families, and allowing insurance companies to deny basic care like hospital visits and prescription drugs.

In total, 20 million Americans would lose coverage and 15 million would see higher health care costs. At a time when more people depend on ACA protections than ever before, the consequences would be devastating, particularly for people of color, older adults, rural populations, people with disabilities, and the LGBTQI+ community. In response, Protect Our Care Executive Director Brad Woodhouse issued the following statement: 

“Anyone who thought the Republican war on health care was over has their head in the sand. Donald Trump once again opened the door for Republicans to tell the truth on health care: they want to repeal the ACA and rip away protections that touch nearly every household in this country. Trump and MAGA Republicans won’t stop until millions are left without coverage, 135 million people with pre-existing conditions are no longer protected, and drug and insurance companies are back in charge. This position could not be more out of step with the American people — the law is more popular than ever before and, as we speak, record numbers are enrolling in coverage. Repealing the ACA remains central to the GOP platform and, as a result, health care for tens of millions hangs in the balance.” 

Background

If the Affordable Care Act is repealed:

  • GONE: Protections for 135 million Americans with pre-existing conditions, including 54 million people with a pre-existing condition that would make them completely uninsurable.
  • GONE: Medicaid expansion, which covers more than 21 million people. 
  • GONE: 49 million seniors will have to pay more for prescription drugs because the Medicare ‘donut hole’ will be reopened.
  • GONE: 2.3 million adult children will no longer be able to stay on their parents’ insurance. 
  • GONE: Insurance companies will be able to charge women more than men.
  • GONE: Premium tax credits that help 80 percent of people who purchase health care on the marketplace.
  • GONE: Key support for rural hospitals. 
  • GONE: Ban on insurance companies having lifetime caps on coverage.
  • GONE: Requirements that insurance companies cover prescription drugs and maternity care.
  • GONE: 61.5 million Medicare beneficiaries will face higher costs and disruptions to their medical care. 

Read more:
Report: The MAGA Republican War on American Health Care
Fact Sheet: The GOP’s Threat To The ACA Is As Real As Ever
Fact Sheet: Trump Vows to “Never Give Up” MAGA-Republican Efforts to Repeal the Affordable Care Act, Ripping Health Care Away From Millions

HEADLINES: North Carolina Expands Medicaid, A “Game-Changing Opportunity” for Nearly 600K Residents

North Carolina’s long-awaited Medicaid expansion program takes effect today, extending affordable health care to an estimated 600,000 people. The news comes as Donald Trump renewed calls to repeal the Affordable Care Act (ACA) — including Medicaid expansion — and rip coverage and core protections away from millions of Americans. 

Prior to this year, North Carolina was just one of 11 states that still refused Medicaid expansion after years of Republican obstruction. Democratic Governor Roy Cooper has fought tirelessly for expansion, making it one of his central priorities since taking office in 2017. In addition to securing coverage for those who need it, this measure will strengthen the economy, boost support for rural hospitals and other safety net providers, and relieve hardships for families living in poverty. Medicaid expansion will especially help low-income workers, moms and children, people with disabilities, and Black, Brown, Indigenous, and rural residents.

FEATURED:

President Joe Biden: “Every American deserves high-quality affordable health care. Today, we are one step closer towards meeting that promise, as 600,000 North Carolinians can now access the affordable, quality coverage they need under Medicaid. Thanks to Governor Roy Cooper’s years of leadership, in partnership with bipartisan elected officials, North Carolina is the 40th state to expand Medicaid under the Affordable Care Act.” [White House, 12/01/23]

Governor Roy Cooper: “Friday will be a historic day for North Carolina, with thousands of people across our state gaining access to critical health care. Medicaid Expansion will boost our economy, help keep rural hospital doors open and make our state a healthier place for all.” [X, @NC_Governor, 11/30/23]

Protect Our Care: “Today, North Carolina is celebrating this hard-fought victory after years of Republican obstruction. @NC_Governor, Democratic lawmakers, and advocates worked tirelessly for North Carolina’s #MedicaidExpansion for years — and now North Carolinians will see stronger hospitals, a better economy, and healthier communities.” 

[X, @ProtectOurCare, 12/01/23]

HEADLINES:

AP: Hundreds of Thousands in North Carolina Will Be Added to Medicaid Rolls This Week. “Expansion should help reduce the percentage of North Carolina’s adults under age 65 who are considered uninsured. A 2022 report from the National Center for Health Statistics estimated North Carolina’s uninsured population at 17.6%, significantly above the national average of 12.6%. The state currently has 2.9 million enrollees covered by some form of traditional Medicaid.” [AP, 11/30/23]

WBTV: Medicaid to Expand Dec. 1 to Include Nearly 600K Additional NC Residents. “Medicaid in North Carolina is set to expand on Dec. 1 to include nearly 600,000 more residents who have been stuck in ‘the gap.’ The policy change expands the range of income and household size residents need to qualify for benefits. ‘It means life. It means that people who didn’t have coverage, who wanted to be able to go to the doctor, who wasn’t feeling well but, ‘I can’t afford it now…’ People, even if you had been denied before, sign up, because it’s opened up to so many more people,’ pleaded 68-year-old cancer survivor DonnaMarie Woodson.” [WBTV, 11/29/23]

ABC11: NC Medicaid Expansion Starts December 1st. How Does It Work? “Eight months ago, Gov. Roy Cooper hailed Medicaid expansion as historic for the state. ‘This law, when implemented, will be the working families bill of the decade,’ Cooper said at the bill signing in March. And starting this Friday, the governor’s ‘bill of the decade’ takes effect.” [ABC11, 11/30/23]

North Carolina Public Radio: Expansion Adds Hundreds of Thousands of North Carolinians to Medicaid. “The state’s Republican-controlled legislature had for years rejected expansion, part of the Affordable Care Act that passed during President Obama’s administration and derided by opponents as ‘Obamacare.’ This year, however, the Tar Heel state changed course.” [WUNC, 12/01/23]

WECT: Local Leaders Preparing as Medicaid Expansion Starts Dec. 1 in North Carolina. “NCDHSS Director Kody Kinsley recently stopped by WECT and laid out the impact this coverage will have. ‘They’re gonna be able to go to the pharmacy and have their prescriptions covered. They’re gonna have the peace of mind that if they end up in the emergency room that’s going to be covered. It’s a game-changing opportunity for North Carolina’s health,’ Kinsley said.” [WECT, 11/30/23]

WFDD: Medicaid Expansion in North Carolina Could Help Narrow Racial Disparities in Health Care. “An estimated 600,000 people are set to benefit from the launch of Medicaid expansion on Friday. Experts say it could also narrow disparities in health coverage and access to care in North Carolina. According to data from the Center on Budget Policy Priorities, Medicaid expansion reduces uninsured rates between white people and people of color. The nonpartisan research institute studies federal and state policies.” [WFDD, 11/30/23]

WITN: State Medicaid Expansion Launching Today. “Under the new law passed by the North Carolina Legislature earlier this year, more than 600,000 North Carolinians may be able to get health care insurance through Medicaid even if they didn’t qualify before. The Medicaid Expansion covers people 19 to 64 years old with incomes that were too high under previous Medicaid guidelines but too low for private insurance, according to The North Carolina Department of Human and Health Services.” [WITN, 12/01/23]

WRAL: After 14 Years, Billions to Flow as 600,000 Qualify for Medicaid Insurance in NC. “The plan, a legacy of 2010’s federal Affordable Care Act, will mean billions of dollars — annually — for state hospitals and doctors as more people are enrolled in the government insurance program. That means more people getting routine checkups and seeking earlier intervention for health issues. That, policy makers hope, will keep people out of the emergency room and cut costs for hospitals, particularly in rural areas — and make for a healthier, more productive population.” [WRAL, 11/30/23]

WWAY: Medicaid Expansion Takes Effect Tomorrow, December 1st. “Medicaid Expansion will officially take effect Dec 1. This will allow more North Carolina residents, ages 19 through 64, access to healthcare. … Medicaid Expansion is designed to allow more people more access to coverage for doctor visits, yearly check-ups, emergency care, and more.” [WWAY, 11/30/23]

As North Carolina Implements Medicaid Expansion, Republicans Block Coverage for 3.5 Million People Across 10 Holdout States

North Carolina Is the 40th State to Expand Medicaid, Extending Affordable Health Care to 600,000 North Carolinians 

Washington, DC — Today, North Carolina is beginning to implement its Medicaid expansion program, extending affordable health care to an estimated 600,000 people. As North Carolinians are finally given this long overdue relief, Republican lawmakers in 10 states are blocking the lifesaving program. As a result, nearly 3.5 million people are uninsured and have no options for affordable coverage. 

Back in Washington, Donald Trump and his MAGA allies renewed calls to repeal the Affordable Care Act (ACA) — including Medicaid expansion — and rip coverage and core protections away from millions of Americans. In addition to securing coverage for those who need it, Medicaid expansion strengthens the economy, boosts support for rural hospitals and other safety net providers, and relieves hardships for families living in poverty. Medicaid expansion especially helps low-income workers, moms and children, people with disabilities, and Black, Brown, Indigenous, and rural residents. Medicaid expansion is widely supported, with voters in seven states, including six red states, opting to expand Medicaid. In response, Protect Our Care Executive Director Brad Woodhouse issued the following statement:

“North Carolina is celebrating this hard-fought victory after years of Republican obstruction. Governor Cooper, Democratic lawmakers, and advocates worked tirelessly for North Carolina’s Medicaid expansion for years, and now North Carolinians will see stronger hospitals, a better economy, and healthier communities. Yet there is more work to be done to ensure every state is providing this lifesaving access to health care. Republican lawmakers in the 10 holdout states could not be more out of step with the American people on this issue — Medicaid expansion is widely supported across the nation, even in some of the deepest red states. It’s time to stop playing politics and deliver relief to the 3.5 million Americans who desperately need care.” 

Background On The States That Refuse To Expand Medicaid

  • Alabama: Over 204,000 people would gain coverage if Alabama expanded Medicaid. Even though over 66 percent of Alabamians support Medicaid expansion adoption, Republicans continue to vote against the American people and lower-cost health care.
  • Florida: If the state were able to expand Medicaid around 1.4 million Floridians could have access to coverage. Since 2012, when then-Governor Rick Scott pledged to never pass Medicaid expansion, the state Republican party has refused to take up the question.
  • Georgia: Full Medicaid expansion in Georgia would provide coverage for up to 678,000 people in 2023, but Governor Brian Kemp and Republicans in the state legislature continue to block it. 
  • Kansas: Governor Laura Kelly ran her campaign on bringing Medicaid expansion to Kansas; however, at every turn and in every legislative session she has been blocked by Republican state legislators. In all, over 82,700 people have been actively denied the quality and affordable health care they would be eligible for under Medicaid expansion by Kansas Republicans.
  • Mississippi: Over 75 percent of all rural hospital closures from 2010 to 2021 occurred in states that had not adopted Medicaid expansion. Along with around 217,000 people who would be eligible for coverage under Medicaid expansion in Mississippi, expansion adoption would also open up billions in federal funding which could help end the hospital crisis plaguing Mississippi and leading to hundreds of excess deaths in the state.
  • South Carolina: From the Governor’s office to the state legislature, Republicans in South Carolina have staunchly refused to expand Medicaid to over 345,000 people. 
  • Tennessee: The Republican opposition to Medicaid expansion has meant that over $20 billion in potential funding to the state has been forfeited since 2014. Around 226,200 people would be eligible for low-cost health coverage if expansion was adopted and over 15,000 new jobs would be added to the state. 
  • Texas: Expanding Medicaid would bring access to coverage to over 1.4 million Texans, but Governor Greg Abbott and Republicans in the legislature continue to block it. 
  • Wisconsin: Republican legislators have shot down any proposals to adopt Medicaid expansion in the state, making it one of only two Midwest states to have not yet adopted the program. About 90,000 people in Wisconsin would be eligible for coverage under Medicaid expansion.
  • Wyoming: Despite a proposal adopting Medicaid expansion passing through committees this year, state Republican leaders refused to allow a reading of the proposal on the state House floor, effectively killing the bill. Year after year legislation is introduced which would expand coverage to more than 34,000 people, and every time Republicans block these measures.

As Trump Cries For Repeal, North Carolina Launches Medicaid Expansion Program

North Carolina Becomes the 40th State to Expand Medicaid, Extending Affordable Health Care to 600,000 North Carolinians 

Washington DC — Tomorrow, North Carolina’s long-awaited Medicaid expansion program will take effect, extending affordable health care to an estimated 600,000 people. The news comes as Donald Trump renewed calls to repeal the Affordable Care Act (ACA) — including Medicaid expansion — and rip coverage and core protections away from millions of Americans. 

Prior to this year, North Carolina was just one of 11 states that refused Medicaid expansion as a result of years of Republican obstruction. Democratic Governor Roy Cooper has fought tirelessly for expansion, making it one of his central priorities since taking office in 2017. In addition to securing coverage for those who need it, this measure will strengthen the economy, boost support for rural hospitals and other safety net providers, and relieve hardships for families living in poverty. Medicaid expansion will especially help low-income workers, moms and children, people with disabilities, and Black, Brown, Indigenous, and rural residents.

In response, Protect Our Care Executive Director Brad Woodhouse issued the following statement: 

“Governor Cooper, Democratic lawmakers, and advocates fought tirelessly for North Carolina’s Medicaid expansion for years — and now, people can begin enrolling in quality health care. This is a victory for the 600,000 individuals and their families who will now have access to lifesaving care and a victory for all North Carolinians, who will see stronger hospitals, a better economy, and healthier communities. While it is a time to celebrate, we cannot lose sight of Donald Trump and MAGA-Republicans in Washington who want to rip all of this away by repealing the ACA and slashing Medicaid. As more and more people benefit from affordable health care under the ACA, it’s unbelievable that anyone would want to go backward.” 

Background

More North Carolinians’ Lives Will Be Saved. According to the Center on Budget and Policy Priorities, Medicaid expansion saved the lives of 19,200 older adults aged 55 to 64 between 2014 and 2017. A study published in the Journal of Health Economics found that Medicaid expansion reduced mortality in non-elderly adults by nearly four percent. Medicaid expansion will insure over 365,000 North Carolinians, saving them millions of dollars and increasing access to quality and affordable health care.

North Carolinians Will Receive Expanded Services. Medicaid expansion in other states has helped patients access preventive care, including colon cancer screenings. Expansion has also increased patient access to kidney transplants and made diabetes medication more affordable for low-income patients. The program has also been tied to earlier diagnoses of colorectal cancer and reducing diabetes-related amputations.

North Carolina Will See Reduced Racial Disparities in Health Care. The ACA has led to historic reductions in racial disparities in access to health care, but racial gaps in insurance coverage have narrowed the most in states that adopted Medicaid expansion. States that expanded their Medicaid programs have seen a 51 percent reduction in the gap between uninsured white and Black adults after expansion, and a 45 percent reduction in the gap between white and Hispanic adults. There is evidence already that North Carolina’s adoption of Medicaid Expansion will not just follow these trends, but secondarily increase economic activity throughout the state and reduce economic inequities as well.

North Carolina’s 4.6 Million Rural Residents Will Secure Better Care. The uninsured rate for low-income adults dropped from 35 percent to 16 percent in rural areas and small towns in states that expanded Medicaid. Investigations into North Carolina have found areas in the western part of the state will see uninsurance rates drop by over 8 percent, with that number being even higher for those without a high school education. Research also confirms that rural hospitals in Medicaid expansion states are 62 percent less likely to close, and 75 percent of vulnerable rural hospitals are in non-expansion states. 

North Carolina Hospitals Will Receive Nearly $2.6 Billion To Support Access To Care For Low-Income Residents. By expanding Medicaid, 102 hospitals across North Carolina will receive nearly $2.6 billion in funds made available through the Healthcare Access and Stabilization Program. This funding will serve as a critical safety net supporting access to care for low-income North Carolinians seeking emergency care.

IN THE NEWS: Trump Is Feeling the Pressure As He Doubles Down on Threats to Repeal the ACA Despite Backlash

Last night, Donald Trump doubled down on his call to repeal the Affordable Care Act (ACA), saying it would be “a priority of the Trump administration.” This comes after a barrage of negative press for his call to “terminate” the ACA. In total, if the ACA were “terminated,” 20 million Americans would lose coverage and 15 million would see higher health care costs.

More people are relying on the ACA than ever before, with President Biden and Democrats in Congress lowering costs and making enrollment easier. The Trump-MAGA agenda of repealing the ACA is rejected by the American people, costing Republicans at the ballot box repeatedly, and unpopular among voters of all parties

FEATURED

Biden-Harris HQ: “This is what will happen if Trump gets his wish to repeal the Affordable Care Act.”

 [X, @BidenHQ, 11/28/23]

President Barack Obama: “The stakes could not be clearer.”

[Threads, @BarackObama, 11/28/23]

House Minority Leader Hakeem Jeffries (D-NY): “House Democrats will never let right-wing extremists destroy the Affordable Care Act.” [X, @RepJeffries, 11/28/23]

Speaker Emerita Representative Nancy Pelosi (D-CA-11): “Trump wants to “terminate” the Affordable Care Act — but we are NOT going back to the bad old days of greedy insurance companies denying health care for patients with pre-existing medical conditions. Democratic women, we need you to know your power and show your power in 2024!” [X, @TeamPelosi, 11/28/23]

HEADLINES:

Axios: GOP Cautiously Open to Trump’s Push for ACA Repeal. “Two top Senate Republicans signaled they could be open to a revived effort. ‘I think Obamacare has been one of the biggest deceptions on the American people,’ said Sen. John Cornyn. ‘I mean just look at your health care premiums.’ But he added he would ‘be interested to hear exactly how he [Trump] would try to accomplish it.’ Sen. Mike Crapo, in line to be Finance Committee chairman in a GOP Senate, said he’s still open to proposals similar to the 2017 repeal and replace bills.” [Axios Pro, 11/29/23]

The Hill: GOP Members Have Largely Conceded That an Obamacare Fight Is a Losing Issue. “Republicans don’t have a plan to replace ObamaCare. When Trump was president and Republicans controlled both chambers of Congress, they tried and failed to repeal the law. Three GOP-led attempts to repeal the law through the courts have also failed, including one backed by Trump in 2020. Since then, GOP members have largely conceded that an ObamaCare fight is a losing issue.” [The Hill, 11/27/23]

MSNBC: On ACA’s Future, Trump Isn’t Done Doing Democrats a Big Favor. “Trump’s talk about creating one of the world’s best health care systems certainly sounds nice, though the rhetoric is belied by the fact that he’s literally spent years assuring Americans that he was poised to unveil an amazing plan that would vastly improve upon the Affordable Care Act. The Republican has never followed through on the rhetoric, however, because he has no such plan — and he never will.” [MSNBC, 11/29/23]

Politico Florida Playbook: Trump’s Gift to Florida Democrats. “Congressional Republicans failed to undo Obamacare under Trump, largely because they couldn’t agree on a replacement. Since then, Democrats have used Obamacare as an effective rallying cry to win elections by focusing on the popular parts of the law that would go away under GOP repeal, such as how it forbids insurers from turning away or out-pricing sicker customers.” [Politico, 11/29/23]

USA Today: ‘Furious and Frightened’: Gen Z Voters Say Trump Is ‘Failing’ Them on Health Care. “The comments have raised concerns among young voters who are worried about the popular Obamacare provision that guarantees young adults receive health insurance coverage under their parents’ plans until age 26. … Health care ranks as a top concern for voters in their teens and twenties, according to recent polling. Jack Lobel, national press secretary for Voters of Tomorrow, said the issue spans the political spectrum. ” [USA Today, 11/29/23]

Miami Herald: Opinion: Trump Attacks Obamacare Again, but Floridians Have Embraced It. He Should Back Off. “Is Trump asking for a do-over? He might first want to take a good look around him. In his home state of Florida, Obamacare is more popular than ever. A record 3.2 million people in Florida obtained health insurance under the Affordable Care Act — aka Obamacare — early this year, a 19% increase over the previous year. Nationwide, that number reached 15.7 million.” [Miami Herald, 11/29/23]

OTHER MEDIA:

The Message Box Newsletter: ​​A Second Trump Term Would Be Very Bad! “Over the holiday, Trump took to Truth Social to announce that repealing the Affordable Care Act would be a priority in his return to the White House. While Trump failed to repeal the Affordable Care Act in his first term, there is ample reason to believe he could easily succeed in his second. John McCain, who famously saved the ACA with his thumbs down, is gone. The party as a whole has moved to the Right.” [The Message Box, 11/29/23]

What A Day Podcast: “Yet another wild stance to have to be like let’s take away this thing that gives 40 million people health care – something that is objectively good. But it all fits in the puzzle of the Republican platform … Republicans have been coy when asked about Trump’s comments saying that they don’t know what he is talking about and of course, this is all tied to Republicans’ failed attempt to repeal the ACA back in 2017 … If it wasn’t already clear, people, if he wins in 2024, Trump is going to not only continue to push to take away critical policies like the Affordable Care Act and punish his political opponents, but he’s gonna reignite that dumpster fire of harm that, you know, he started back in 2016.” [Crooked Media, 11/29/23]

SOCIAL MEDIA:

President Pro Tempore Senator Patty Murray (D-WA): “The leader of the Republican party wants to rip coverage away from 40 million Americans, ending pre-existing protections for over 100 million, and sending costs skyrocketing. While the GOP fights to repeal the ACA, Democrats will work to protect health care and lower costs.” [X, @PattyMurray, 11/27/23]

Vice Chair of the Senate Democratic Conference Elizabeth Warren (D-MA): “Donald Trump failed to repeal Obamacare, but he’s once again threatening to rip away health care from millions of Americans. It’s dangerous & must be rejected. How do we lower health costs? By taking on giant corporations who rig the system —exactly what the Biden admin’s doing.” [X, @SenWarren, 11/27/23]

Vice Chair of the Senate Democratic Conference Mark Warner (D-VA): “Quick reminder… terminating the ACA would mean 135 million Americans with pre-existing conditions would lose protections. 21 million folks served by Medicaid expansion (including in Virginia) could lose coverage. This is a deeply serious threat to make.” [X, @MarkWarner, 11/27/23]

Secretary of the Senate Democratic Conference Tammy Baldwin (D-WI): “I’ve taken on this fight before and I’ll do it again. Ripping away coverage from tens of millions of Americans and gutting protections for Americans with pre-existing conditions is just wrong.” [X, @SenatorBaldwin, 11/28/23]

House Minority Whip Katherine Clark (D-MA): “40 million Americans rely on the Affordable Care Act to receive affordable health care. What’s the Republican plan? Take it away.” [X, @WhipKClark, 11/28/23]

House Energy & Commerce Committee Ranking Member Frank Pallone Jr. (D-NJ): “Trump is saying the quiet part out loud – Republicans are still determined to repeal the ACA and take health care away from millions of people. Democrats are fighting hard to protect American’s health care, and we will continue to do so.” [X, @FrankPallone, 11/28/23]

Trump Doubles Down on Call to Repeal the Affordable Care Act, Jeopardizing Health Care for Millions of People Across the Nation

Washington, D.C. — Last night, Donald Trump doubled down on his call to repeal the Affordable Care Act (ACA), saying it would be “a priority of the Trump administration.” This comes after a barrage of negative press for his call to “terminate” the ACA. Repealing the ACA means ripping away protections for the over 135 million Americans with pre-existing conditions, hiking premium costs for millions of working families, and allowing insurance companies to deny basic care like hospital visits and prescription drugs.

In total, if the ACA were “terminated,” 20 million Americans would lose coverage and 15 million would see higher health care costs. At a time when more people are covered by the ACA than ever before, the consequences would be devastating, particularly for people of color, older adults, rural populations, people with disabilities, and the LGBTQI+ community. In response, Protect Our Care Executive Director Brad Woodhouse issued the following statement: 

“Donald Trump only has one plan for American health care – repeal and destroy. Trump and MAGA Republicans won’t stop until millions are left without coverage, 135 million people with pre-existing conditions are no longer protected, and drug and insurance companies are back in charge. More people are relying on the ACA than ever before, and millions are finding coverage for $10 or less thanks to President Biden and Democrats in Congress. Yet Trump wants to turn back the clock to the days when insurance prices were sky-high and people could be thrown off their coverage at the whim of insurance companies. Trump cannot run from the truth: his only plan is to repeal American health care. The American people refuse to go back.” 

Background

If the Affordable Care Act is repealed:

  • GONE: Protections for 135 million Americans with pre-existing conditions, including 54 million people with a pre-existing condition that would make them completely uninsurable.
  • GONE: Medicaid expansion, which covers more than 21 million people. 
  • GONE: 49 million seniors will have to pay more for prescription drugs because the Medicare ‘donut hole’ will be reopened.
  • GONE: 2.3 million adult children will no longer be able to stay on their parents’ insurance. 
  • GONE: Insurance companies will be able to charge women more than men.
  • GONE: Premium tax credits that help 80 percent of people who purchase health care on the marketplace.
  • GONE: Key support for rural hospitals. 
  • GONE: Ban on insurance companies having lifetime caps on coverage.
  • GONE: Requirements that insurance companies cover prescription drugs and maternity care.
  • GONE: 61.5 million Medicare beneficiaries will face higher costs and disruptions to their medical care. 

Read more:
Report: The MAGA Republican War on American Health Care
Fact Sheet: The GOP’s Threat To The ACA Is As Real As Ever
Fact Sheet: Trump Vows to “Never Give Up” MAGA-Republican Efforts to Repeal the Affordable Care Act, Ripping Health Care Away From Millions