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FACT CHECK: SCOTT WALKER PUTS PRE-EXISTING CONDITIONS PROTECTIONS AT RISK

In response to a disingenuous new ad from the Scott Walker campaign, Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

“We know Scott Walker supports gutting protections for pre-existing conditions because he authorized a lawsuit that would eliminate these protections entirely. Scott Walker’s plan for health care would literally turn the clock backward by bringing back discrimination against pre-existing conditions through his lawsuit and by reviving Wisconsin’s high-risk pool, which has been panned by experts because it drives up costs and restricts coverage. In fact, in testimony before the U.S. House of Representatives, the chief medical officer of the American Cancer Society specifically criticized Wisconsin’s high risk pool for the deadly waiting periods it imposed on people who needed care when they got sick. I’ll say it again: if Scott Walker wants to show he stands up for people with pre-existing conditions, he’ll withdraw his lawsuit to take away the protections we have in current law away.”

SCOTT WALKER’S LAWSUIT WOULD REVERSE PRE-EXISTING CONDITIONS PROTECTIONS, THREATENING 2.4 MILLION WISCONSINITES’ CARE

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

IT IS THE AFFORDABLE CARE ACT THAT OUTLAWS DISCRIMINATION BASED ON PRE-EXISTING CONDITIONS

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.

HIGH RISK POOLS IMPOSE HIGH PREMIUMS & DEDUCTIBLES …

Premiums For Coverage In High Risk Pools Were As Much As 200 Percent Higher Than The Average Rate But Covered Less Care. “High-risk pool enrollees faced substantially higher premiums than people in the normal individual market, often by as much as 150 percent to 200 percent, although some pools did offer subsidies to low-income enrollees…And stunningly, the overwhelming majority of state high-risk pools actually refused to pay for services associated with a patient’s pre-existing conditions in the first months of their enrollment.” [Center for American Progress, 2/16/17]

Deductibles For High Risk Pool Enrollees Were Well Above Maximum Allowed By ACA. ”Fourteen states had plans with deductibles of $10,000 per year or higher, substantially greater than the current maximum $7,150 deductible for catastrophic plans in the marketplaces. Thirty states imposed maximum lifetime limits; others had annual coverage limits as low as $75,000 per year.” [Commonwealth Fund, 3/29/17]

… COST TAXPAYERS MORE …

Despite High Premiums, High Risk Pools Could Still Cost The American People Over $90 Billion Annually. “The U.S. Department of Health and Human Services (HHS) recently estimated that up to 17,875,000 people with preexisting conditions were uninsured in 2010. Had all of them been covered by high-risk pools, the cost would have been $194.8 billion in 2010 dollars, with premiums covering only $103.3 billion. Thus, states and the federal government would have needed to find $91.5 billion in additional funding to cover them all—much more than the up to $10 billion per year in federal assistance to states recently proposed by congressional Republicans.” [Commonwealth Fund, 3/29/17]

An Analysis Of High Risk Pools Under The ACHA Finds Such Pools Would Cost The Government Between $37 and $56 Billion Annually. “Government costs for supporting the high-risk pool using ACA-like coverage and subsidies would range from $37 to $56 billion in 2020 and $437 to $656 billion over 10 years (2020–2029), depending upon the eligibility rules used.” [The Urban Institute, May 2017]

Even Conservatives Estimated High Risk Pools Would Cost $15-$20 Billion Annually. “For comparison, conservative experts James Capretta and Tom Miller have estimated that $15 billion to $20 billion per year, or $150 billion to $200 billion over 10 years, would be needed to fully finance high-risk pools even if they covered only 2 million to 4 million people.” [Center For American Progress, 2/16/17]

Premiums For High Risk Pool Coverage Paid Just 53 Percent Of Program Costs. “Premiums ranged from 125 percent to 200 percent of average premiums in the individual market, yet covered only about 53 percent of claims and administrative costs nationally (Wisconsin allowed premiums up to 200 percent of average).” [Commonwealth Fund, 3/29/17]

… AND RESTRICT COVERAGE

High Risk Pools Typically Had Pre-Existing Condition Exclusions And Limited Benefits. “Many such pools had pre-existing condition exclusion periods, limited benefits, and enrollment limits; all of these characteristics served to reduce the value of the coverage, creating high financial burdens for enrollees and limiting the number of people who could access the coverage.” [Health Affairs, 3/15/16]

Most State High Risk Pools Had Lifetime And Annual Limits On Coverage.  “Thirty-three pools [out of 35 states] imposed lifetime dollar limits on covered services, most ranging from $1 million to $2 million. In addition, six pools imposed annual dollar limits on all covered services while 13 others imposed annual dollar limits on specific benefits such as prescription drugs, mental health treatment, or rehabilitation.” [Kaiser Family Foundation, 2/22/17]

High Risk Pools Typically Had Waiting Periods. “There were 35 state high-risk pools before the Affordable Care Act passed. To control costs, they would often do things like charge higher premiums than the individual market. Most had waiting periods before they would pay claims on members’ pre-existing conditions, meaning a cancer patient would need to pay premiums for six months or a year before the high-risk pool would cover her chemotherapy treatments.” [Vox, 5/3/17]

High Risk Pools Mean Delayed Or Forgone Care. “Even once they were in a high-risk pool, the high costs and limited benefits prompted some people to delay or forgo care, leading to poorer health outcomes and even more spending. And many families accrued substantial medical debt, even with the coverage.” [Stateline, 2/16/17]

HIGH RISK POOL = MORE PEOPLE UNINSURED

Limited Coverage And High Costs Cause People To Remain Uninsured. “Some patients also delayed care to save money, exacerbating their health conditions, and only entered the pools when their conditions became emergencies.” [Stateline, 2/16/17]

CMS: One-Third Of Uninsurable Were Unable To Afford High Risk Pool Coverage. A 2004-05 study by the Center for Medicare and Medicaid Services found that “nationally, high-risk pool premiums are above 25 percent of family income (i.e., are unaffordable) for 10 percent of all individuals, 18 percent of the uninsured, and 29 percent of the uninsurable. By these standards, almost one-third of the uninsurable are unable to afford high-risk pool coverage…” [CMS, Health Care Financing Review, Winter 2004-2005]

HIGH RISK POOLS HAVE BEEN TRIED & FAILED

In Wisconsin, “Cancer Doesn’t Wait” For High Risk Pool Waiting Periods. “The benefit waiting periods used by Wisconsin’s and other states’ high-risk pools are a big concern for patient advocates and provider groups. ‘A six-month exclusionary period is a serious issue,’ said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, who also testified at the House hearing. ‘Cancer doesn’t wait.’” [Modern Healthcare, 2/13/17]

California High Risk Pool Led To Waiting Lists, High Premiums, And Lifetime Limits. “For example, California’s high-risk pool imposed a shorter-than-average, three-month waiting period before enrollees could receive treatment for pre-existing conditions—but also imposed a $75,000 annual limit on benefits along with a $750,000 lifetime limit. In addition, the state capped enrollment, resulting in long waiting lists of people unable to enroll; at the same time, the pool’s high premiums proved difficult for enrollees to afford, leading some to drop out.” [Center for American Progress, 2/16/17]

Premiums in Florida’s High Risk Pool Were Twice The Normal Rate. “Many states starved high-risk pools of cash. Florida’s contained only about 200 people in 2011. Premiums were commonly twice the normal rate. Many states had enrollment caps, meaning that even people willing to fork over were not guaranteed coverage.” [The Economist, 1/16/17]

In Utah, High Risk Pools Were Limited In Size, And Offered Sub-Par, Delayed Coverage. “Stevenson said only 3,000 people signed up for Utah’s risk pool plan while 200,000 Utahns are signed up for insurance through Obamacare. ‘Utah’s past high risk pool plan had many limitations too,’ he said. People with pre-existing conditions had to wait six months before using their coverage. Pregnant women had a 10 month waiting period before they had any coverage for them or their baby. ‘The measure of success for a program is how many people it helps and if you are only covering 3,000 people and leaving tens of thousands uninsured, I don’t think that’s a good thing to go back to,’ he said.” [CBS KUTV, 3/9/17]

High Risk Pools Mean Higher Costs, Higher Uninsured, And Less Coverage. “The reality is that high-risk pool coverage was prohibitively expensive and there is little evidence to suggest that the existence of such pools made coverage less costly for others in the individual insurance market. Without substantially more federal funding than currently proposed, these facts are not likely to change. People with preexisting conditions may have “access” to coverage, but most will not be able to afford it and those who can will face limited benefits and extremely high deductibles and out-of-pocket payments.” [Commonwealth Fund, 3/29/17]

 

protectourcare
In News

FACT CHECK: HERE ARE ALL THE WAYS KEVIN CRAMER DOESN’T STAND UP FOR PEOPLE WITH PRE-EXISTING CONDITIONS

Brad Woodhouse, executive director of Protect Our Care, issued the following statement in response to a bogus new ad from the Kevin Cramer campaign:

“Kevin Cramer’s new ad is another unbelievably desperate attempt to sweep his own record under the rug. Make no mistake, Cramer has voted numerous times to eliminate pre-existing conditions protections hundreds of thousands of North Dakotans rely upon, he’s refused to take action to oppose the Trump-GOP lawsuit that would eliminate pre-existing conditions protections and he’s done nothing to fight the junk insurance plans promoted by the Trump Administration that don’t have to cover pre-existing conditions and can drop coverage for people when they get sick. If Kevin Cramer thinks he can fool the people of North Dakota about his record against pre-existing conditions protections, he’s got another thing coming.”

REP. KEVIN CRAMER VOTED TO REPEAL THE ENTIRE AFFORDABLE CARE ACT WHICH WOULD HAVE ELIMINATED PROTECTIONS FOR PEOPLE WITH PRE-EXISTING CONDITIONS

2013:  Cramer Voted For A Total Repeal Of The ACA.  Cramer voted for HR 45, an act “to repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010.” [HR 45, Roll Call Vote #154, 5/16/13]

2015:  Cramer Voted For A Total Repeal Of The ACA.  Cramer voted for HR 596, an act “to repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010.”  The bill also ordered House committees to develop a replacement that would “provide people with pre-existing conditions access to affordable health coverage,” but provided no specifics. [HR 596, Roll Call Vote #58, 2/3/15]

 

  • Cramer Said The Bill Would “Repeal The Affordable Care Act In Its Entirety.” “Today Congressman Kevin Cramer voted with the U.S. House of Representatives to repeal the Affordable Care Act in its entirety.” [Cramer Website, 2/3/15]

 

What would full repeal of the Affordable Care Act eliminate?

    • Protections for 316,000 North Dakotans with pre-existing conditions, if they buy coverage on their own
    • Improvements to Medicare, including reduced costs for prescription drugs
    • Allowing kids to stay on their parents’ insurance until age 26
    • Ban on annual and lifetime limits
    • Ban on insurance discrimination against women
    • Limit on out-of-pocket costs
    • Medicaid expansion currently covering 15 million people
    • Rules to hold insurance companies accountable
    • Small business tax credits
    • Marketplace tax credits and coverage for up to 20,000 North Dakotans.

REP. KEVIN CRAMER VOTED FOR THE HOUSE HEALTH REPEAL BILL WHICH WOULD GUT PROTECTIONS FOR PEOPLE WITH PRE-EXISTING CONDITIONS

2017: Cramer Voted For AHCA.  Cramer voted for passage of the American Health Care Act.  [HR 1628, Roll Call Vote #256, 5/4/17]

American Medical Association: “The Bill Passed By The House Today Will Result In Millions Of Americans Losing Access To Quality, Affordable Health Insurance And Those With Pre-Existing Conditions Face The Possibility Of Going Back To The Time When Insurers Could Charge Them Premiums That Made Access To Coverage Out Of The Question.” “The bill passed by the House today will result in millions of Americans losing access to quality, affordable health insurance and those with pre-existing health conditions face the possibility of going back to the time when insurers could charge them premiums that made access to coverage out of the question. Action is needed, however, to improve the current health care insurance system. The AMA urges the Senate and the Administration to work with physician, patient, hospital and other provider groups to craft bipartisan solutions so all American families can access affordable and meaningful coverage, while preserving the safety net for vulnerable populations.” [AMA, 5/4/17]

American College Of Physicians: “This Vote Makes Coverage Unaffordable For People With Pre-Existing Conditions.” “The American College of Physicians (ACP) is extremely disappointed that the U.S. House of Representatives passed the American Health Care Act (AHCA) today. This vote makes coverage unaffordable for people with pre-existing conditions,  allows insurers to opt-out of covering essential benefits like cancer screening, mental health, and maternity care, and cuts and caps the federal contribution to Medicaid while sunsetting Medicaid expansion…The House action is by no means the end of the story, however.  ACP will continue to do all that it can to ensure continued coverage and access for the millions of patients who have benefited from the Affordable Care Act. In a strongly worded letter to the United States Senate also sent today, ACP urged Senators to reject this harmful legislation and begin anew to craft bipartisan solutions to improve coverage and access for all Americans.” [ACP, 5/4/17]

American Association Of Family Physicians: AHCA “Allow[s] For Discrimination Against Patients Based On Their Gender, Age, And Health Status.” “The American Academy of Family Physicians is deeply disappointed with the U.S. House of Representatives passage of the American Health Care Act. This legislation will harm millions of their constituents. It will destabilize our health care system, cause 24 million Americans to lose their coverage, and allow for discrimination against patients based on their gender, age, and health status. Its inadequate and temporary high-risk pool funds are simply a band aid that does nothing to provide health security to the nearly one in three Americans who have a pre-existing condition. Its provision allowing annual and lifetime caps on benefits diminishes the value of every policy sold in the future.” [AAFP, 5/4/17]

American Cancer Society Cancer Action Network: AHCA “Would Create A Coverage Patchwork Whereby Patients With Pre-Existing Conditions Could Be Charged More For Their Coverage While Simultaneously Weakening The Rules For What Health Services Will Be Covered. “Today the House of Representatives passed a health care bill that could leave cancer patients, survivors and those at risk for the disease unable to access or keep quality health insurance. The bill would create a coverage patchwork whereby patients with pre-existing conditions could be charged more for their coverage while simultaneously weakening the rules for what health services will be covered.” [ACS CAN, 5/4/17]

AARP: AHCA “Now Puts At Risk The 25 Million Older Adults With Pre-Existing Conditions…Who Would Likely Find Health Coverage Unaffordable Or Unavailable To Them.” “AARP is deeply disappointed in today’s vote by the House to pass this deeply flawed health bill. The bill will put an Age Tax on us as we age, harming millions of American families with health insurance, forcing many to lose coverage or pay thousands of dollars more for health care.  In addition, the bill now puts at risk the 25 million older adults with pre-existing conditions, such as cancer and diabetes, who would likely find health care unaffordable or unavailable to them.” [AARP, 5/4/17]

Consumers Union: “In A Field Where ‘Do No Harm’ Is The Standard, This Bill Does Nothing But Harm American Families.” “Elizabeth Imholz, Special Projects Director for Consumers Union, the policy and mobilization arm of Consumer Reports, said, ‘The House of Representatives today failed their constituents and the American health system by passing the American Health Care Act. In a field where ‘do no harm’ is the standard, this bill does nothing but harm American families. Taking insurance away from 24 million people, devastating Medicaid, rolling back protections for preexisting conditions and older consumers, increasing out-of-pocket costs, encouraging junk insurance plans without any meaningful coverage, ​and even allowing the elimination of out-of-pocket cost caps and reinstating lifetime limits for the nearly half of all Americans who get their coverage through their employers — these are the real consequences of the AHCA. Each iteration has only made this bad bill worse.’” [Consumers Union, 5/4/17]

America’s Health Insurance Plans: “AHIP Believes That Every American Deserves Coverage And Care That Is Affordable And Accessible, Including Those With Pre-Existing Conditions.” “AHIP believes that every American deserves coverage and care that is affordable and accessible, including those with pre-existing conditions. The American Health Care Act needs important improvements to better protect low- and moderate-income families who rely on Medicaid or buy their own coverage. We stand ready to work with members of the Senate and all policymakers, offering our recommendations for how this bill can be improved to ensure the private market delivers affordable coverage for all Americans.” [AHIP, 5/4/17]

REP. KEVIN CRAMER SUPPORTS A CONSERVATIVE LAWSUIT TO REPEAL THE ACA ALONG WITH ITS PROTECTIONS FOR PEOPLE WITH PRE-EXISTING CONDITIONS

Cramer refuses to oppose a lawsuit designed to end protections for people with pre-existing conditions. This summer, the Trump Administration refused to defend against a lawsuit brought by twenty conservative states aimed at overturning the Affordable Care Act and its protections for people with pre-existing conditions. Cramer has come out in support of the lawsuit. [Politico, 8/17/18]

REP. KEVIN CRAMER WON’T WORK TO OVERTURN JUNK PLANS THAT ALLOW INSURERS TO DENY COVERAGE BECAUSE OF A PRE-EXISTING CONDITION

Cramer refuses to join the House effort to overturn Trump administration’s junk plan rule that lets insurance companies discriminate against people with pre-existing conditions. This summer, the Trump Administration finalized a rule that allows insurance companies to deny coverage to people with pre-existing conditions. Experts warn that this move will only increase the cost of comprehensive care, ultimately making it even harder for people with pre-existing conditions to get the care they need. House Democrats introduced legislation that would block Trump’s rule, but Cramer has not signed on.

ashoup
In News

Scott Walker: Drop Your Pre-ex Lawsuit

After Wisconsin Governor Scott Walker specifically “signed-off” on Attorney General Brad Schimel joining a partisan lawsuit to dismantle protections for pre-existing conditions protections and the other consumer consumer protections in the Affordable Care Act, today Scott Walker’s spokesperson reportedly said that Walker would call a special session if his own lawsuit is successful.

Said Amanda Harrington, communications director of Protect Our Care, in response:

“Scott Walker, no special session is needed. You authorized this lawsuit in the first place, and if you really want to protect Wisconsinites with pre-existing conditions, now you need to call it off.”

protectourcare
In News

Advocates, Elected Officials Fight Trump’s Junk Plans on All Fronts

New Lawsuit Filed by Health Care Organizations Seeks to Invalidate Trump’s Harmful Junk Plan Rule

New House Resolution, Mirroring One in the Senate, Would Override The Trump Administration’s Rule To Stop Junk Plans

Washington, D.C. – On the heels of the Trump Administration expanding junk plans that can deny coverage to people with pre-existing conditions, that are not required to cover key benefits, such as cancer treatments and prescription drug coverage, and that can refuse to pay for costs after a person gets sick, health care advocates and Democrats in Congress are fighting back.

Today, the Association for Community Affiliated Plans (ACAP), National Alliance on Mental Illness (NAMI), Mental Health America, American Psychiatric Association (APA), AIDS United, National Partnership for Women & Families, and Little Lobbyists filed suit in the U.S. District Court for the District of Columbia to invalidate the Trump Administration’s short-term junk plan rule issued last month. This lawsuit comes just after Congresswoman Kathy Castor (D-FL-14) introduced a resolution that would override the Trump Administration’s rule to allow insurance companies to sell junk plans that charge people more money for less care. The Senate has a companion resolution that is awaiting any Republican support.

Brad Woodhouse, executive director of Protect Our Care issued the following statement in response to the multi-front fight against junk plans:

“The Trump Administration’s never-ending war on health care is not going unanswered. It is facing resistance on the Hill, resistance in the courts and — as poll after poll shows — resistance from the public. House and Senate Democrats have entered the arena to fight for hard-working Americans. Now, it’s time for Republicans to join them.”

House Republicans Who Claim to Support Pre-existing Conditions Protections Should Prove It and Join Castor’s Resolution:

Rep. Martha McSally (R-AZ): “Rep. McSally Is Committed To Ensuring That Individuals With Pre-Existing Conditions Have Access To Affordable Coverage Options And Cannot Be Denied Health Insurance.” “Rep. McSally is committed to ensuring that individuals with pre-existing conditions have access to affordable coverage options and cannot be denied health insurance. She will work to ensure the House reform package includes these protections.” [Tucson Weekly Dispatch, 3/1/17]

Rep. Carlos Curbelo (R-FL): “We’re Keeping The Things That Work, Like Guaranteed Coverage For Pre-Existing Conditions.” “We’re keeping the things that work, like guaranteed coverage for pre-existing conditions, allowing young people to remain on their parents’ plans until the age of 26, and prohibiting discrimination against women.” [Sunshine State News, 3/11/17]

Rep. Brian Mast (R-FL): “We Also Need To Ensure That Patients With Pre-Existing Conditions Won’t Be Denied Coverage.” “We also need to ensure that patients with pre-existing conditions won’t be denied coverage and that those who rely on Medicaid have access to quality care.” [Palm Beach Post, 3/9/17]

Rep. Bruce Poliquin (R-ME): Rep. Poliquin Would Only Support A Repeal Of The ACA If The Replacement Includes Coverage For Pre-Existing Conditions.” “Poliquin would support a repeal of the Affordable Care Act, but only if the alternative plan includes coverage for pre-existing conditions, allows young adults to remain on their parents’ plans until the age of 26, and doesn’t immediately end Obamacare exchange policies.” [WABI TV5, 1/24/17]

Rep. Erik Paulsen (R-MN): “Rep. [Erik] Paulsen has long supported protections for individuals with pre-existing conditions, and he continues to do so,” a spokesman for Paulsen, the Republican representing Minnesota’s Third Congressional District, said in a statement. [Star Tribune, 6/23/18]

Rep. John Culberson (R-TX): “Health Care Should Be Accessible For All, Regardless Of Pre-Existing Conditions Or Past Illnesses.” [Rep. Culberson Website Content Current as of 4/20/17]

Rep. Dave Brat (R-VA): Rep. Brat Stresses Care Would Continue For Those With Pre-Existing Conditions.” “He calmed nerves, for some, by stressing care would continue for those with preexisting conditions.” [CBS WTVR 6 News, 2/21/17]

Rep. Scott Taylor (R-VA): “We Will Protect Those With Pre-Existing Conditions.” “We will protect those with preexisting conditions, we will work help those who can’t help themselves, work to get more access and more people covered.” [Republican Party of Virginia, 3/10/17]

 

ashoup
In News, Shot/Chaser

Shot/Chaser: Hawley, Stenehjem Hiding from Their Own Lawsuit to Overturn Pre-existing Conditions Protections

SHOT: For months, national patient groups, physicians, hospitals and insurers have emphasized how much the lawsuit could threaten care for people across the country. Health industry experts in the states involved in the lawsuit are making their concerns known, too.

USA Today: “Health Industry Experts Fear ‘Chaos’ if Texas Judge Suspends Affordable Care Act”

“The market would just be in chaos,” said Karen Bender, an actuary and president of Snowway Actuarial and Healthcare Consulting in Little Suamico, near Green Bay, Wisconsin, one of the states that has asked the judge to suspend the ACA.

Marty Anderson, chief marketing officer for Security Health Plan in Wisconsin, said the same.

“There would be chaos in the entire insurance market across the nation,” Anderson said. “That is the only way to describe it….I don’t understand what the end game is.”

CHASER: Feeling the heat not only from the medical community, but also from voters who strongly oppose ending protections for pre-existing conditions, the attorneys general who brought this case in the first place are trying — and failing — to duck and cover from it.

McClatchy: “Hawley Under Fire on Pre-existing Conditions as Pressure from Dems Mounts”

Missouri Attorney General Josh Hawley won’t offer details about his role in the Republican lawsuit that could strike down insurance protections for people with pre-existing conditions. […]

With pressure mounting, Hawley’s office has refused to clarify his role in the case after oral arguments took place in Texas last week. McClatchy first asked the office for an explanation of Hawley’s work on the case Monday.

[…] Hawley’s office already faces a Missouri Sunshine Law complaint from Protect Our Care, a liberal-leaning coalition of Missouri health care groups, for not turning over records related to his communications with President Donald Trump’s administration on the case.

HPR1 (North Dakota): “All Questions Go to Texas”

All questions related to the federal Texas lawsuit set to terminate current healthcare laws are still being referred to Texas, the North Dakota Attorney General’s office reported.

“We have no comments at this time,” Liz Brocker, public information officer for the Attorney General for North Dakota’s office stated when asked. The state, under Attorney General Wayne Stenehjem, joined the lawsuit along with 19 other Attorney’s General and two governors after the Tax Cuts and Jobs Act eliminated penalties for not obtaining insurance for health coverage.

ashoup
In News

Paul Ryan Spreads Lies To Save Face After Working To Dismantle Medicare For Years

Yesterday, Speaker Paul Ryan claimed that Republicans support Medicare. On the topic of health care and entitlement reform, Ryan said: “I think they want to see that we have Medicare on a path to solvency.”

The truth is that Paul Ryan and the Republican Party have attempted to gut Medicare every chance they could:

  1. Paul Ryan, December 2017: “It’s the biggest entitlement we’ve got to reform.” Ryan said: “We’re going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit…Frankly, it’s the health care entitlements that are the big drivers of our debt, so we spend more time on the health care entitlements…In- think the president is understanding that choice and competition works everywhere in health care, especially in Medicare…This has been my big thing for many, many years. I think it’s the biggest entitlement we’ve got to reform.”
  2. Paul Ryan is 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. How do Republicans plan on paying for it? Speaker Ryan’s answer is clear: “Frankly, it’s the health care entitlements that are the big drivers of our debt.” In an attempt to pay for these tax cuts, in April, House Republicans passed a budget amendment that would slash Medicare funding by $537 billion over the next decade.
  3. Ryan 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.
  4. Ryan has called to transform Medicare into a voucher program, which experts warn would lead to the “demise” of the program. Speaker Ryan has spoken about turning Medicare into a voucher system, and in Fall 2017, the Centers for Medicare and Medicaid services filed a Request for Information concerning a shift in a “new direction” for Medicare, which Senate Democrats worried might entail a voucher system. Experts warn, and Republicans including Newt Gingrich acknowledge, that such a shift would lead to the demise of traditional Medicare as premiums increase.
  5. Led by Ryan, 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.
  6. A report published by the Medicare Trustees finds that the program is worse-off financially because of Paul Ryan and Congressional Republicans’ actions. In the 2018 Medicare Trustees Report, trustees found that actions taken by President Trump and Congressional Republicans actually push make Medicare less financially stable. The Trustees point to the elimination of the Independent Payment Advisory Board (IPAB), which had been developed to extend the solvency of Medicare and slow cost growth. Without the IPAB, there is no mechanism to achieve those ends. Similarly, Republican tax cuts will reduce income for Medicare. In conjunction, both actions damage the financial stability of Medicare.
ashoup
In News, Stories

Senators, Cabinet Secretaries, Activists to Headline Protect Our Care’s Bus Tour

Kicking off With Sens. Chris Murphy and Angus King, Care Force One Will Travel to 23 States, Engaging Americans in the Fight Against the GOP War on Health Care

Washington, D.C. – Today, Protect Our Care is excited to announce that Senators Chris Murphy (D-CT) and Angus King (I-ME), former Secretary of Health and Human Services Kathleen Sebelius, former Acting Administrator of the Centers for Medicare and Medicaid Services Andy Slavitt and Center for American Progress President Neera Tanden will speak during Protect Our Care’s bus tour, joining health care advocate Laura Packard on the 1,303 mile journey across the United States. Sen. Chris Murphy will kick off the tour on Sunday, September 23 in Bridgeport, Connecticut, before Care Force One heads north to Portland, Maine with Sen. Angus King. Protect Our Care’s Founder and Chair Leslie Dach and its Executive Director Brad Woodhouse will join this all-star lineup at select stops.

“We’re thrilled to have such incredible health care champions joining us,” said Woodhouse. “Each of these leaders have spent years in the trenches working to expand access to quality, affordable health coverage, and resisting Republican repeal-and-sabotage at every turn.”

The tour will highlight for the public that the Republican war on health care is very much alive, with Republican officials using legislation, regulations, and the courts to continue their attacks on protections for the 130 million Americans with pre-existing conditions, for women and older Americans, and on  Medicaid and Medicare. Thanks to the Republicans’ tax bill and junk plan regulations, a typical family of four will see their health insurance premiums increase by $3,110 next year.

Check out when “Care Force One” is slated to come to you, and visit protectourcare.org/bus-tour/ for the latest information:

Bridgeport, CT on Sunday, September 23, 2018

Portland, ME on Monday, September 24, 2018

Bangor, ME on Monday, September 24, 2018

Albany, NY on Tuesday, September 25, 2018

Binghamton, NY on Tuesday, September 25, 2018

Harrisburg, PA on Wednesday, September 26, 2018

Pittsburgh, PA on Thursday, September 27, 2018

Erie, PA on Thursday, September 27, 2018

Cleveland, OH on Friday, September 28, 2018

Columbus, OH on Friday, September 28, 2018

Parkersburg, WV on Monday, October 1, 2018

Morgantown, WV on Monday, October 1, 2018

Charleston,WV on Monday, October 1, 2018

Cincinnati, OH on Tuesday, October 2, 2018

Indianapolis, IN on Tuesday, October 2, 2018

Lansing, MI on Wednesday, October 3, 2018

Grand Rapids, MI on Wednesday, October 3, 2018

South Bend, IN on Wednesday, October 3, 2018

Milwaukee, WI on Thursday, October 4, 2018

Green Bay, WI on Thursday, October 4, 2018

Madison, WI on Friday, October 5, 2018

Cedar Rapids, IA on Friday, October 5, 2018

Des Moines, IA on Monday, October 8, 2018

Minneapolis, MN on Monday, October 8, 2018

Fargo, ND on Tuesday, October 9, 2018

Minot, ND on Tuesday, October 9, 2018

Billings, MT on Wednesday, October 10, 2018

Butte, MT Thursday, October 11, 2018

Missoula, MT on Friday, October 12, 2018

Reno, NV on Monday, October 15, 2018

Las Vegas, NV on Tuesday, October 16, 2018

Phoenix, AZ on Wednesday, October 17, 2018

Tucson, AZ on Wednesday, October 17, 2018

Denver, CO on Friday, October 19, 201

Kansas City, MO on Monday, October 22, 2018

Springfield, MO on Monday, October 22, 2018

St. Louis, MO on Tuesday, October 23, 2018

Memphis, TN on Tuesday, October 23, 2018

Nashville, TN on Wednesday, October 24, 2018

Richmond, VA on Thursday, October 25, 2018

Raleigh, NC on Thursday, October 25, 2018

Atlanta, GA on Friday, October 26, 201

Miami, FL on Wednesday, October 31, 2018

West Palm, FL on Thursday, November 1, 2018

West Palm, FL on Friday, November 2, 2018

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protectourcare
In News

Protect Our Care Calls on Senate Republicans to Support Sen. Baldwin’s Resolution and Protect People with Pre-Existing Conditions

Resolution’s Passage Would Stop Junk Plans and Protect Americans With Pre-Existing Conditions

Washington, D.C. – Senator Tammy Baldwin (D-WI) has garnered enough support to force a vote on her resolution to block insurers from selling the Trump Administration’s short-term, junk insurance plans, with 45 Senators signing onto the bill. Now, Brad Woodhouse, executive director of Protect Our Care, calls on the full Senate to support and pass this bill, which is supported by over a dozen health care and patient advocacy groups.:

“By gathering enormous support for this resolution, Senator Baldwin and her colleagues are once again showing the American people who is fighting for them. Now it’s time for Senate Republicans who all of the sudden claim to be protectors of people with pre-existing conditions to put up or shut up. If the GOP truly cared about protecting Americans with pre-existing conditions, they would join their colleagues on this resolution in taking concrete action to preserve the protections and essential health benefits that tens of millions of Americans depend on — and they would do so immediately. Republicans’ silence on this resolution is complicity in Trump’s assault on people with pre-existing conditions through the promotion of junk insurance plans.”

 

ADDITIONAL BACKGROUND

Right Now, The GOP is Actively Pushing A Bill to Weaken Pre-existing Conditions Protections

  • Twenty-eight Patient Groups – Including the American Cancer Society Cancer Action Network, American Heart Association, March of Dimes – Oppose the GOP Senate Bill. Writing in opposition to the bill, the groups explain, “it would not ban pre-existing condition exclusions and would remove rating restrictions based on age, gender, tobacco use, or occupation. This means that many individuals could still face higher premiums and out-of-pocket costs and, even if enrollees paid the increased premiums for many months, they could still be denied benefits because of a pre-existing condition. In short, this bill would not replace critical protections in current law.”
  • Americans Could Be On The Hook For Tens Of Thousands Of Dollars Should Existing Pre-Existing Conditions Laws Be Replaced With Those Proposed By Republicans. According to a report in Vox, “An easy illustration: CMS says that lung cancer costs roughly 12 times as much as the average premiums. So if the average premium is $1,000 per month, then lung cancer treatment costs about $12,000 every month. Sickle-cell anemia is eight times the average premium. So is multiple sclerosis. Cystic fibrosis treatment is expected to cost $14,000 if the average premium is $1,000. Those numbers are hypothetical, to be clear, but you get the idea. Americans could be on the hook for tens of thousands of dollars if their health insurance no longer has to cover their preexisting conditions.”

GOP Senators Have Also Refused to Defend Pre-existing Conditions from the Trump-GOP Lawsuit

  • Not One GOP Senator Has Signed On To Sen. Manchin’s Resolution That Would Allow The Senate To Defend Pre-existing Condition Protections In Court. This summer, the Trump Administration refused to defend against  a lawsuit brought by twenty conservative states aimed at overturning the Affordable Care Act and its protections for people with pre-existing conditions. Last month, Senate Democrats introduced a resolution that would authorize the Senate Legal Counsel to intervene in the lawsuit and defend protections for people with pre-existing conditions. Senator Collins refuses to support the resolution.

Short-term Plans Hurt People with 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]

  • As Many As 130 Million Nonelderly Americans Have A Pre-Existing Condition. [Center for American Progress, 4/5/17]
  • One in 4 Children Would Be Impacted If Insurance Companies Could Deny Coverage Or Charge More Because Of A Pre-existing Condition. [Center for American Progress, 4/5/17]

Junk Plans Mean Higher Premiums For People With Pre-Existing Conditions. “By promoting short-term policies, the administration is making a trade-off: lower premiums and less coverage for healthy people, and higher premiums for people with preexisting conditions who need more comprehensive coverage.” [Washington Post, 5/1/18]

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

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

For more information, see Protect Our Care’s fact sheet on short-term junk plans.

ashoup
In News

Paul Ryan Latest Republican to Call for Return to Health Care Repeal

Last night, Paul Ryan became the latest Republican to call for a return to full health repeal:

Paul Ryan: Good reforms mean that we can better fulfill the mission of these important programs, health and retirement security, without bankrupting the country. And that’s why the kind of reforms we’ve been talking about I think are so necessary.

Jeff Mayers: Ok, but that would depend upon – I mean, the Senate didn’t even agree with you. That would depend on having broader control of Congress than you’ve had.

Ryan: We failed to pass our budget, our entitlement reform bill on health care by one vote in the Senate, that’s correct.

Mayers: So I guess what are the prospects of reigning that in, because –

Ryan: I think the election will have to determine that because, based upon our vote count in the Senate. We keep the House majority in the house, which I think we will, and then you have to have enough of a majority in the Senate to be able to pass heath care reform.

Mayers: But do people in Janesville, do people in Wisconsin – is that what they want? Do they really want their benefits taken away or curtailed?

Ryan: Did I say that?

Mayers: No, I know, but do they –

Ryan: I think they want to see an end to double-digit premium increases. I think they want to see that we have Medicare on a path to solvency. I don’t think they want to see 200 million people get added to Medicare to accelerate its bankruptcy, which is what a lot of people are running for, like Tammy and others. I think if you take a look at our proposals, they would have lowered health care premiums, it would have still protected pre-existing conditions, it would’ve done more to give people more choices.

As a reminder, the so-called American Health Care Act would have:

  • Raised Premiums By Double Digits. ​The nonpartisan Congressional Budget Office found that a key part of the American Health Care Act, repealing the requirement that most people have health insurance and was enacted as part of the GOP tax bill, will premiums 10 percent next year.
  • Imposed An Age Tax – Older Americans Would Have Paid Nearly $12,000 More. ​The American Health Care Act would have imposed what the AARP calls an “age tax” on older Americans by cutting the amount of assistance older people receive and by allowing insurers to charge people over 50 fives times more. Nationally, out-of-pocket costs for older people could have increased by as much as $11,917 by 2026.
  • Increased Premiums for People With Pre-Existing Conditions by Up to $150,000. ​The American Health Care Act would have allowed states to eliminate community rating, meaning insurers would be able to charge people with pre-existing conditions more. This surcharge could have been in the tens of thousands of dollars and even six figures: up to $4,270 for asthma, $17,060 for pregnancy, $26,180 for rheumatoid arthritis and $140,510 for metastatic cancer.
  • 23 Million Americans Would Have Lost Coverage. ​By 2026, 23 million U.S. residents would have lost coverage under this bill.
ashoup
In News

Final Rates Confirm Washingtonians’ Insurance Is Getting Even More Expensive

Rate Increase Due to Trump Administration and Washington Republicans’ Health Care Sabotage

Washington, D.C. – Today, Washington State announced final rates for 2019 individual-market health insurance plans, which indicate a 13.8 percent premium increase, in contrast to the average nationwide 4.3 percent decrease that Brookings Institution analysts predicted would occur absent GOP sabotage, on top of last year’s 19 percent rate hike due to Washington Republicans’ repeal-and-sabotage agenda. Brad Woodhouse, executive director of Protect Our Care, released the following statement in response:

“For the past year and a half, President Trump and his Republican allies in Congress have engaged in a deliberate, aggressive campaign to undermine health care and families in Washington are once again forced to pay the price. Until we stop Republicans’ war on health care, insurance companies will continue to make huge profits and enjoy record tax breaks from Republicans while they charge working families more and more. Washington Republicans should start working on bipartisan solutions to make coverage more affordable, instead of helping their friends in the insurance industry make another buck on the backs of hardworking Washingtonians.”

From the Insurance Commissioner:

Washington Insurance Commissioner Mike Kreidler: We Continue To Face “Targeted Hits On The Affordable Care Act That Increase The Uncertainty.” “We’re doing what we can to hold down costs, but it’s a struggle. Insurers need stability and we’re still facing inaction at the federal level as well as targeted hits on the Affordable Care Act that increase the uncertainty.” [NCW Life, 9/12/18]

From the Insurance Companies:

Molina Healthcare: “An Adjustment Was Applied To The Experience Period To Reflect The Anticipated Change In Morbidity Of The Market-wide Risk Pool Due To The Repeal Of The Individual Mandate.” “An adjustment was applied to the experience period to reflect the anticipated change in morbidity of the market-wide risk pool due to the repeal of the individual mandate. The Washington Marketplace is expected to decrease in size and have a higher average morbidity compared to the experience period. Molina performed an analysis using its own experience data to assess the impact of a subset of the population dropping coverage. The impacted membership included a portion of members with low claims in the previous year, members with higher member premiums, and members who are younger. The market-wide risk pool changes together with higher average morbidity are expected to increase the fee-for-service portion of the experience period allowed claims by 9.7%.” [Office of the Washington State Insurance Commissioner, 6/4/18]

Kaiser: “The Rate Changes Shown Are Primarily Driven By The Claims Experience Of The Single Risk Pool, Medical Inflation, And Projected Changes In The Risk Profile Of The Membership Due To The Elimination Of The Individual Mandate.”  [Office of the Washington State Insurance Commissioner, 6/4/18]

From the Experts:

Brookings Analysis Estimates That Individual Market Premiums Would Decrease If Not For GOP Sabotage. Among its key findings:

  • Estimates That Average Premium Would Fall By 4.3 Percent In 2019 In Stable Policy Environment. “I estimate that the nationwide average per member per month premium in the individual market would fall by 4.3 percent in 2019 in a stable policy environment.” [Brookings Institution, 8/1/18]
  • Insurance Companies’ Revenues Will Far Exceed Their Costs In 2018. “I project that insurers’ revenues in the ACA-compliant individual market will far exceed their costs in 2018, generating a positive underwriting margin of 10.5 percent of premium revenue. This is up from a modest positive margin of 1.2 percent of premium revenue in 2017 and contrasts sharply with the substantial losses insurers incurred in the ACA-compliant market in 2014, 2015, and 2016. The estimated 2018 margin also far exceeds insurers’ margins in the pre-ACA individual market. ” [Brookings Institution, 8/1/18]
  • Absent Republican Sabotage, Average Premiums For ACA-Compliant Plans Would Likely Fall In 2019. “In this analysis, I define a stable policy environment as one in which the federal policies toward the individual market in effect for 2018 remain in effect for 3 2019. Notably, this scenario assumes that the individual mandate remains in effect for 2019, but also assumes that policies implemented prior to 2018, like the end of CSR payments, remain in effect as well. Under those circumstances, insurers’ costs would rise only moderately in 2019, primarily reflecting normal growth in medical costs.” [Brookings Institution, 8/1/18]
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