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In Administration, News, Stories

“Consumers Really Want Coverage”: Nearly 12 Million Americans Sign Up For Marketplace Plans Despite Rampant Obstacles

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Despite more than a year of sabotage from President Donald Trump, his Administration, and Congressional Republicans, it was announced today that 11.8 million Americans purchased 2018 health insurance through Affordable Care Act marketplaces — 96% of last year’s total. These Americans did so in the face of rampant obstacles put in their way, from a shortened sign-up period to the President declaring the law ‘dead,’ and did so for one reason: they want and need quality, affordable coverage.

Overall, the open enrollment period this year was a resounding success that proved the skeptics wrong. Don’t believe us? Take a look for yourself…

NBC News: “Despite Trump, Obamacare Records Strong Enrollment.” [NBC News, 2/7/18]

Josh Peck, Former HealthCare.Gov CMO: “Without The Trump Administration’s Efforts To Undermine Enrollment, National Enrollment Would Have Exceeded 12.9 Million Enrollments Or Roughly 1.1 Million Additional People Would Have Enrolled.” [Get America Covered, 2/8/17]

Kaiser Family Foundation: 11.8 Million People Signed Up “Amid Steep Reductions In Federal Funding For Outreach In Navigators, An Enrollment Period Half As Long, And A Climate Of Political Uncertainty Surrounding The Law.” “11,760,418 people signed up for 2018 health insurance coverage on the ACA individual marketplaces, amid steep reductions in federal funding for outreach and navigators, an enrollment period half as long, and a climate of political uncertainty surrounding the law. The federal government also terminated cost-sharing subsidy payments to insurers in advance of the open enrollment period, leading to increases in premiums but also increased premium subsidies for many consumers that in some cases led to reductions in what they had to pay for coverage.” [KHN, 2/7/18]

Los Angeles Times: The Numbers “Suggest Surprising Strength In Many Markets Across The Country.” “Almost 12 million Americans signed up for 2018 health coverage through marketplaces created by the Affordable Care Act, according to a new tally that indicates nationwide enrollment remained virtually unchanged from last year despite President Trump’s persistent attacks on the 2010 health law. The new enrollment numbers — which include totals from California and other states that operate their own marketplaces, as well as states that rely on the federal HealthCare.gov marketplace — offer the most detailed picture to date of the insurance markets. And they suggest surprising strength in many markets across the country, with consumers steadily signing up for health plans even as Trump and his Republican congressional allies derided the markets as crumbling and unaffordable.” [Los Angeles Times, 2/7/18]

Bloomberg: “President Donald Trump Has Frequently Been Accused Of Trying To Undermine Obamacare, His Predecessor’s Signature Health Law. New Data Show That By At Least One Measure He Didn’t Do A Particularly Good Job Of It.” President Donald Trump has frequently been accused of trying to undermine Obamacare, his predecessor’s signature health law. New data show that by at least one measure he didn’t do a particularly good job of it. Enrollment in individual health-insurance plans under the Affordable Care Act fell 3.7 percent in 2018 to 11.8 million, from 12.2 million a year earlier, according to data compiled by the National Academy for State Health Policy, which calls itself a nonprofit, nonpartisan association of state health-policy makers. That’s a far smaller drop than some health-policy watchers had foreseen, after the Trump administration halved the enrollment season and cut marketing and enrollment-assistance efforts. Trump himself declared the law ‘dead.’” [Bloomberg, 2/718]

Trish RIley, National Academy For State Health Policy Executive Director: “This Shows Consumers Really Want And Need Coverage.” “‘This shows that consumers really want and need coverage,’ said Trish Riley, executive director of the National Academy for State Health Policy, which compiled the nationwide enrollment tally. ‘These are stable markets and a stable program,’ she said.”  [Los Angeles Times, 2/7/18]

Allison O’Toole, MNSure Chief Executive: “We Had The Best Open Enrollment Period We Have Ever Had.” “‘We had the best open enrollment period we have ever had,’ said Allison O’Toole, chief executive of Minnesota’s insurance marketplace, known as MNsure, which saw enrollment surge nearly 6% this year. Elected officials in Minnesota developed their own reinsurance system to help control premiums this year.” [Los Angeles Times, 2/7/18]

Washington Post: “Enrollment Was Surprisingly Resilient.” “With the Trump administration taking steps to undercut these marketplaces and congressional Republicans having spent much of last year trying unsuccessfully to dismantle large parts of the ACA, leaders of state insurance exchanges and other health-policy experts said that enrollment was surprisingly resilient.” [Washington Post, 2/7/18]

The Hill: The Numbers “Show The Obamacare Remains Stable In The Face Of ‘National Uncertainty.’” “Experts and advocates of ObamaCare had expected a bigger drop in enrollment, mainly due to attacks on the system from the Trump White House. The administration slashed the advertising budget for open enrollment by 90 percent and also cut funds for local groups that help people sign up for coverage.  Experts also worried that multiple attempts by congressional Republicans to repeal and replace the law could cause confusion and deter consumers from signing up… The final numbers released Wednesday, however, show the ObamaCare remains stable in the face of ‘national uncertainty,’ says the National Academy for State Health Policy (NASHP), the group that released the numbers. ‘For the first time we now have the full national picture of how the individual marketplaces did this year and it is a picture of remarkable stability,’ said Trish Riley, executive director of NASHP.” [The Hill, 2/7/18]

Associated Press: “Enrollment Remained Remarkably Stable Despite President Donald Trump’s Disdain For ‘Obamacare,’ And Repeated Efforts By The Republican-led Congress To Repeal The Program.” “Enrollment remained remarkably stable despite President Donald Trump’s disdain for ‘Obamacare,’ and repeated efforts by the Republican-led Congress to repeal the program. The Trump administration also cut the sign-up window in half, slashed the ad budget, and suddenly stopped a major subsidy to insurers, which triggered a jump in premiums.” [AP, 2/7/18]

Larry Levitt, Kaiser Family Foundation: “If You Had Asked Me A Year Ago Whether Enrollment For 2018 Would Be Almost Equal To 2017, I Would Have Laughed At You.” “‘If you had asked me a year ago whether enrollment for 2018 would be almost equal to 2017, I would have laughed at you,’ said Larry Levitt, who follows health law for the nonpartisan Kaiser Family Foundation. ‘So long as lots of people are still getting insurance it becomes much harder to take that away.’” [AP, 2/7/18]

Washington Times: “Interest In The Exchanges Outpaced Last Year On A Day-To-Day Basis.” “Based on its figures, the 11 states — plus D.C. — that ran their own exchanges matched last year’s signups. In fact, there was a tiny increase of 0.09 percent, compared to a 5.3-percent drop among the 34 states that solely relied on HealthCare.gov. Five states that run their own exchanges, yet use the federal website, saw a minuscule increase of 0.2 percent, according to the academy. Mr. Trump slashed the enrollment season in half this year, meaning consumers in HealthCare.gov states had to sign up by mid-December, though hurricane-battered areas got extra time. Interest in the exchanges outpaced last year on a day-to-day basis.” [Washington Times, 2/7/18]

San Diego Union Tribune: States “Generally Attributed The Reduction To The Trump Administration’s [Actions].” “States with larger enrollment declines have generally attributed the reduction to the Trump administration’s decision to cut back on marketing efforts and shorten the 2017 open-enrollment period which ended more than a month earlier than it did in California. Double-digit premium increases in many states are also blamed for decreasing enrollment in many locations. The president’s late 2017 executive order to eliminate special “cost sharing reduction” payments directly to health insurance companies are blamed for the price hikes.” [San Diego Union Tribune, 2/7/18]

Mark Hall, Wake Forest University Professor Of Law And Public Health: “Despite The Trump Administration’s Effort To Undermine The Affordable Care Act, Its Basic Structure Remains Solid.” “Mark Hall, a professor of law and public health at Wake Forest University, said the report ‘shows that, despite the Trump administration’s effort to undermine the Affordable Care Act, its basic structure remains solid. This is a testament to its fundamental soundness. In North Carolina, enrollment dipped, but not as much as some people feared.’” [Winston-Salem Journal, 2/7/18]

ashoup
In Administration, News

As Trump Administration Undermines Medicaid, Some States Attempt to Expand It

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It was revealed yesterday that the Trump Administration may allow lifetime coverage caps for people covered by Medicaid, an illegal move that would threaten the health and well-being of millions of Americans. But beyond the nation’s capital, states are instead looking at ways to expand Medicaid coverage.

Just today, a children’s advocacy organization in North Carolina released a new report arguing that Medicaid expansion could reduce the state’s fetal and infant mortality rates, bolstering the case for the bipartisan expansion proposal the state is currently considering.

Outside of North Carolina, grassroots movements are underway in Nebraska, Utah, Missouri and Idaho to put Medicaid expansion on state ballots in 2018. And just three weeks ago, Oregon voters supported a legislative tax package funding the state’s Medicaid program. Back in November, Maine voters overwhelmingly approved Medicaid expansion in the state.

“The Trump Administration and Congressional Republicans are doing the exact opposite of what the American people want, which is expanded access to coverage. It’s time for this Administration and its sabotage partners in Congress to get the message being sent to D.C. by countless states and take ACA repeal, Medicaid block grants, and administrative actions that diminish access off the table. Enough is enough: it’s time for the GOP to end its war on our health care,” said Protect Our Care Campaign Director Brad Woodhouse.

Groups: Medicaid expansion could lower baby-death rates

Winston-Salem Journal // Richard Craver // February 7, 2018

A state child advocacy group has added its voice to those urging the Republican-controlled legislature to expand Medicaid to more than 500,000 North Carolinians

States that have expanded Medicaid have a lower infant mortality rate than those who haven’t, NC Child said in a 2016 report.

An update of that report, which was scheduled to be released today, focuses on fetal mortality, which is defined as the death of a fetus that occurs at 20 or more weeks of gestation.

Both rates are affected by a wide range of factors, including tobacco use and substance use disorders, obesity, domestic violence, poverty, racism, education and access to pre-conception and prenatal healthcare.

In North Carolina, 58 percent of women between the ages of 18 and 44 are considered to be overweight or obese, while 16 percent have been diagnosed with hypertension and 20 percent are smokers.

In 2016, North Carolina had almost as many fetal deaths (818) as infant deaths (873).

From 2012 to 2016, there were 6.9 fetal deaths per 1,000 live births in North Carolina, compared with an infant mortality rate of 7.2 per 1,000 live births.

In Forsyth County, the rate of fetal deaths was 6.4 during that time span, while the infant mortality was 8.3. Forsyth’s highest infant mortality rate was 14.7 in 1997.

“By utilizing available federal funding to expand access to affordable health care for women of childbearing age, the state can influence both fetal and infant mortality simultaneously, effectively doubling the positive impact for North Carolina families,” said Whitney Tucker, research director at NC Child.

Statewide, premature birth and low birthweight are the leading causes of death for infants under 1 year old, causing 20.6 percent.

“These chronic conditions and risk factors can be addressed most effectively when women have access to health insurance,” NC Child said. “Unfortunately, 20 percent of North Carolina women of childbearing age (18 to 44) lacked health insurance in 2016.”

NC Child said 20.5 percent of Forsyth women of childbearing age do not have health insurance, while 31 percent do not receive prenatal care in their first trimester of their pregnancy.

“Newborns of mothers with no prenatal care are three times more likely to have a low birthweight and five times more likely to die than children born to mothers who do receive prenatal care,” according to the report.

NC Child spokesman Rob Thompson said “certain groups of non-citizens are eligible for Medicaid and Obamacare, but not undocumented immigrants.”

“I don’t know exactly what portion of the 20 percent is composed of undocumented immigrants. With children in N.C., 96 percent are insured and the general thinking is that somewhere between one-third and one-half of the remaining uninsured are undocumented.”

Most Republican legislative leaders argue that the federal government, first under the Obama administration and now under the Trump administration, may not be able to keep its pledge of covering 90 percent of the administrative costs of Medicaid expansion.

The advocacy group supports House Bill 662, titled “Carolina Cares,” that represents a bipartisan effort to expand Medicaid. The bill has Rep. Donny Lambeth, R-Forsyth, as its main sponsor.

The bill would require some people who get Medicaid to work, which has proven controversial. North Carolina is one of 10 states with federal regulatory permission to move forward with a work requirement, if legislatively approved.

However, HB 662 has not appeared on either chamber’s agenda for the current special session after not advancing out of committee during the regular 2017 session.

“While the proposal includes elements that will negatively impact enrollment — premiums and work requirements — it has the potential to provide currently unavailable health care options for women of childbearing age at high risk of experiencing fetal or infant mortality,” NC Child said.

“Whether it’s Carolina Cares or a different bill, the legislature should act quickly to close the health insurance coverage gap and support healthy pregnancies and healthy babies,” Tucker said.

Marlon Hunter, Forsyth’s health director, has said the county health department, along with its community and agency partners, encourage women of child-bearing age “to achieve optimal health before they become pregnant in order to improve birth outcomes.”

“Almost half of all pregnancies in our community are not planned.”

The county health department and county Infant Mortality Reduction Coalition are focusing on reducing pre-term birth, supporting and improving mental health services for women, and stressing the importance of women and men of reproductive ages to develop reproductive life plans.

The Kate B. Reynolds Charitable Trust and Novant Health Inc. launched Forsyth Connects in May 2016. Their initiative provides free in-home nurse visits to all mothers with newborn babies who are born and reside in Forsyth. The baby doesn’t have to be the mother’s first.

ashoup
In Administration, News

3 Questions Secretary Azar Must Answer After Today’s Meeting With President Trump

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This morning, as news breaks that almost 12 million people enrolled through the Marketplaces despite Republican sabotage, Health and Human Services Secretary Alex Azar will meet with President Trump to discuss the Administration’s path forward. Will they continue their unpopular, partisan war on our care, or listen to the American people, who want an end to sabotage and repeal?

Here are three questions Secretary Azar must answer following his meeting with the President:

1. Will the Trump Administration Stop its War on Medicaid?

Yesterday, the Trump Administration announced it might allow states to impose lifetime limits for people with Medicaid, a direct affront to Medicaid’s mission. This proposal puts care for roughly 1 in 5 Americans, or 77 million people, in danger most of whom are seniors living in nursing homes or receive other long-term care, children, and people with disabilities. The reality is the majority of Americans with Medicaid coverage live in working households, and now the Trump Administration is considering punishing people just because their employer doesn’t offer insurance or because they got sick or have a disability and lost their job. The Affordable Care Act stopped insurance companies from imposing dollar lifetime limits on coverage, and as a result, 105 million Americans are now free from arbitrary limits on care. But the Trump Administration wants to take us back to the days of lifetime coverage caps, and they’re targeting our most vulnerable citizens as guinea pigs. The Administration has also just started allowing states to impose onerous work requirements for people with Medicaid, which will not help people find or keep a job, but will just take away their health care.

These are the latest salvos in their war on Medicaid. Last year, the House of Representatives passed a health repeal bill that cut Medicaid by $839 billion, or 25 percent, and converted the program into a “per capita cap”, thus ending the guaranteed coverage for everyone who has it.

2. Will the Trump Administration Stop Pushing Junk Health Care Plans that Roll Back Key Protections for People with Pre-Existing Conditions?

The Trump Administration is taking steps to gut key protections and expose people to discrimination based on pre-existing conditions through their so-called “association health plans” and short-term plans. These efforts allow insurance companies to once again sell plans that do not meet the requirements of the Affordable Care Act. These skimpy plans could refuse to cover essential health benefits such as cancer treatments, maternity care, and addiction treatment, forcing people who actually want or need comprehensive coverage or have a pre-existing condition to pay more.

3. Will the Administration Start Walking the Walk on Fighting the Opioid Crisis?

Yesterday, Politico reported that White House Counselor Kellyanne Conway was “quietly freezing out drug policy professionals and relying instead on political staff to address a lethal crisis claiming about 175 lives a day.” Sen. Shelley Moore Capito of West Virginia said, “I haven’t talked to Kellyanne at all and I’m from the worst state for this…I’m uncertain of her role.”

To date, the Administration has completely failed to address  the nation’s raging opioid crisis. The window-dressing public health emergency declaration the President made freed up a fund worth only $57,000, falling pathetically short of the billions that experts say are desperately needed to combat the crisis. The House repeal bill that President Trump supported would make the opioid crisis worse by eliminating coverage requirements for mental health and addiction treatment, and through drastic Medicaid cuts that put states on the hook for the huge cost of dealing with the epidemic. The Trump Administration has relentlessly attacked and sabotaged Medicaid, which helps people with opioid addiction receive care, paying for one-fifth of all substance abuse treatment nationwide. And, the Trump Administration proposed a 95% cut to the Office of National Drug Control Policy, which is charged with coordinating the federal response to the nation’s raging opioid crisis – for the second year in a row.

ashoup
In Administration, News

Protect Our Care Statement on 11.8 Million Final Open Enrollment Total

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After final confirmation that 11.8 million people nationwide purchased 2018 health insurance through the individual insurance marketplaces created by the Affordable Care Act, meaning that despite a year of aggressive sabotage by the Trump Administration, overall enrollment equaled 96% of last year’s total, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“The American people are our own best health care advocates, and today’s enrollment total shows that we keep on beating the odds. This year’s open enrollment succeeded thanks to an untold number of enrollment assisters, community activists, health care professionals, and volunteers who did what their government refused to and helped their fellow Americans get covered.

“Despite everything the Trump Administration threw in their way, the high number of people who bought comprehensive insurance through the individual insurance marketplaces this year, 11.8 million, shows that the marketplaces are an essential component of the American health care system. Enrollment could have been even higher this year, but unfortunately, the cumulative effect of Trump’s year of sabotage was that too many Americans faced higher prices or fewer choices, as well as new hurdles to enrollment.

“The millions of people who bought coverage deserve a Congress that will protect and improve their access to care, but instead, their own Republican elected officials continue to sabotage the Affordable Care Act. They have already spiked next year’s premiums double digits by repealing the individual mandate and will do even more damage if they refuse to address and fix President Trump’s administrative sabotage.

“Along with Medicaid expansion, the marketplaces are how the Affordable Care Act succeeded in driving the American uninsured rate down to historic lows. Clearly Americans want and need to shop on their own for coverage in a marketplace where they can’t be denied for having a pre-existing condition or priced out based on their age, gender, or medical history.

“Despite the odds, this year’s enrollment total was 96% of last year’s. When you look at the numbers, it’s clear that with nurturing instead of sabotage, these marketplaces could keep expanding access to coverage and help reverse the increase in the uninsured rate that’s being caused by President Trump and his Republican allies’ war on our care.”

ashoup
In Administration, News

Protect Our Care Blasts Consideration of Medicaid Lifetime Limits

Washington, D.C. – In response to the news that the Trump Administration may allow states to impose arbitrary lifetime limits on Medicaid coverage, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“The appalling concept of lifetime Medicaid limits represents a new low for the Trump Administration, and it threatens the health and well-being of the millions of Americans who get their coverage through Medicaid. Allowing states to impose arbitrary time limits on access to health care would leave innocent Americans with nowhere to turn and fundamentally change and weaken the popular Medicaid program, which serves millions of American seniors, children, and people with disabilities.  

“The Affordable Care Act stopped insurance companies from imposing dollar lifetime limits on coverage, and as a result, 105 million Americans are now free from arbitrary limits on care. But the Trump Administration wants to take us back to the days of lifetime coverage caps, and they’re targeting our most vulnerable citizens as guinea pigs. The majority of Americans with Medicaid coverage live in working households, but the Trump Administration is now considering punishing people just because their longtime employer doesn’t offer insurance or because they got sick or have a disability and lost their job.

“Today’s news makes it clear that threats to the Affordable Care Act, Medicaid, and the health of millions of Americans will remain very much alive for as long as the Trump Administration and Congressional Republicans continue their war on Americans’ health care. The idea of arbitrary time limits on Medicaid eligibility is not only illegal, it is immoral, and the Trump Administration should be ashamed. Enough is enough – it’s time for the GOP to stop trying to kick Americans off their coverage and end its war on our health care once and for all.”

ashoup
In News, Administration

Trump’s Opioid Mess Keeps Getting Worse

New Report: Congressional Republicans Fed Up With Inaction

After new POLITICO reporting reveals mounting frustration among even Congressional Republicans about the Trump Administration’s failure to confront the national opioid crisis, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“When Republican Members of Congress are willing to go on record about your Administration’s continuing failure to confront a massive public health crisis, you have a problem. President Trump needs to wake up to reality and get serious about this out-of-control crisis instead of continuing his harmful efforts to gut the agency charged with fighting it and to sabotage Medicaid, which funds one-fifth of all substance abuse treatment nationwide.”

Kellyanne Conway’s ‘opioid cabinet’ sidelines drug czar’s experts

POLITICO // BRIANNA EHLEY and SARAH KARLIN-SMITH // 02/06/2018

President Donald Trump’s war on opioids is beginning to look more like a war on his drug policy office.

White House counselor Kellyanne Conway has taken control of the opioids agenda, quietly freezing out drug policy professionals and relying instead on political staff to address a lethal crisis claiming about 175 lives a day. The main response so far has been to call for a border wall and to promise a “just say no” campaign.

Trump is expected to propose massive cuts this month to the “drug czar” office, just as he attempted in last year’s budget before backing off. He hasn’t named a permanent director for the office, and the chief of staff was sacked in December. For months, the office’s top political appointee was a 24-year-old Trump campaign staffer with no relevant qualifications. Its senior leadership consists of a skeleton crew of three political appointees, down from nine a year ago.

“It’s fair to say the ONDCP has pretty much been systematically excluded from key decisions about opioids and the strategy moving forward,” said a former Trump administration staffer, using shorthand for the Office of National Drug Control Policy, which has steered federal drug policy since the Reagan years.

The office’s acting director, Rich Baum, who had served in the office for decades before Trump tapped him as the temporary leader, has not been invited to Conway’s opioid cabinet meetings, according to his close associates. His schedule, obtained under a Freedom of Information Act request, included no mention of the meetings. Two political appointees from Baum’s office, neither of whom are drug policy experts, attend on the office’s behalf, alongside officials from across the federal government, from HHS to Defense. A White House spokesperson declined to disclose who attends the meetings, and Baum did not respond to a request for comment, although the White House later forwarded an email in which Baum stressed the office’s central role in developing national drug strategy.

The upheaval in the drug policy office illustrates the Trump administration’s inconsistency in creating a real vision on the opioids crisis. Trump declared a public health emergency at a televised White House event and talked frequently about the devastating human toll of overdoses and addiction. But critics say he hasn’t followed through with a consistent, comprehensive response.

He has endorsed anti-drug messaging and tougher law enforcement. But he ignored many of the recommendations from former New Jersey Gov. Chris Christie’s presidential commission about public health approaches to addiction, access to treatment, and education for doctors who prescribe opioids. And he hasn’t maintained a public focus. In Ohio just this week, it was first lady Melania Trump who attended an opioid event at a children’s hospital. The president toured a manufacturing plant and gave a speech on tax cuts.

Much of the White House messaging bolsters the president’s call for a border wall, depicting the opioid epidemic as an imported crisis, not one that is largely home-grown and complex, fueled by both legal but addictive painkillers and lethal street drugs like heroin and fentanyl.

“I don’t know what the agency is doing. I really don’t,” said Regina LaBelle, who was the drug office’s chief of staff in the Obama administration. “They aren’t at the level of visibility you’d think they’d be at by now.”

Conway touts her opioids effort as policy-driven, telling POLITICO recently that her circle of advisers help “formalize and centralize strategy, coordinate policy, scheduling and public awareness” across government agencies.

That’s exactly what the drug czar has traditionally done.

Conway’s role has also caused confusion on the Hill. For instance, the Senate HELP Committee’s staff has been in touch with both Conway and the White House domestic policy officials, according to chairman Lamar Alexander’s office. But lawmakers who have been leaders on opioid policy and who are accustomed to working with the drug czar office, haven’t seen outreach from Conway or her cabinet.

“I haven’t talked to Kellyanne at all and I’m from the worst state for this,” said Sen. Shelley Moore Capito, a Republican from West Virginia, which has the country’s highest overdose death rate. “I’m uncertain of her role.” The office of Sen. Rob Portman (R-Ohio,) another leader on opioid policy, echoed that – although Portman’s wife, Jane, and Conway were both at the event with Melania Trump this week.

Some drug abuse experts and Hill allies find a silver lining, noting that Conway’s high-rank brings White House muscle and attention.

“If I want technical advice, I’m going to work with Baum,” said Rep. Tom MacArthur (R-NJ), a co-chair of the Bipartisan Heroin Task Force. “If I want to get a message to the president, Kellyanne is somebody that I know I can talk to.”

“It’s a really good sign that one of the president’s top advisers has been assigned to such an important topic,” said Jessica Hulsey Nickel, president and CEO of the Addiction Policy Forum.

Baum’s email called the drug office the “lead Federal entity in charge of crafting, publishing and overseeing the implementation of President Trump’s National Drug Control Strategy,” which multiple agencies review. He called Conway’s opioids cabinet an “interagency coordinating apparatus for public-facing opioids-related initiatives” and said that it was not overseeing national policy. But several administration officials did say her cabinet was indeed focused on a variety of policies.

Whatever Conway’s ties to the president, her career has been in polling and politics, not public health, substance abuse, or law enforcement.

Some of her “cabinet” participants do have a broad, general health policy background. But they don’t match the experience and expertise of the drug office’s professional staff. In her circle is Lance Leggitt, the deputy director of the White House’s Domestic Policy Council who was also chief of staff to former HHS Secretary Tom Price. Another top Price aide, Nina Schaefer, recently returned to the Heritage Foundation. The conservative think tank then touted her as having managed “the development of the HHS response to the opioid abuse crisis,” but when POLITICO recently tried to contact her, she said through a spokesperson she was not an expert on the topic.

Among the people working on the public education campaign that Trump promised is Andrew Giuliani, Rudy Giuliani’s 32-year-old son, who is a White House public liaison and has no background in drug policy, multiple administration sources told POLITICO. Nor has Conway spent her career in the anti-opioid trenches.

“Kellyanne Conway is not an expert in this field,” said Andrew Kessler, the founder of Slingshot Solutions, a consulting group that’s worked on substance abuse with many federal agencies.“She may be a political operative and a good political operative,” he added. “But look. When you appoint a secretary of Labor, you want someone with a labor background. When you appoint a secretary of Defense, you want someone with a defense background. The opioid epidemic needs leadership that ‘speaks’ the language of drug policy.”

The set-up befuddles other experts who’ve worked on substance abuse for prior administrations. Fresh ideas are fine, they say. But the drug office has a purpose.

“The whole reason we created ONDCP in 1988 was to be a coordinating force with power in the government and to bring together 20 agencies, many reluctant to be involved in drug control,” said Bob Weiner, who served in that office in both the George W. Bush and Clinton White Houses. “This is exactly when the agency should get maximum support from the White House,” he added.

An ONDCP spokesperson told POLITICO the office “works closely with other federal agencies and White House offices, including Kellyanne Conway’s office, to combat the opioid crisis” but declined to say whether the office’s career experts have attended any of her “opioids cabinet” sessions. The drug office is still crafting the annual drug control strategy, outside the Conway group, administration officials said.

A senior White House official confirmed that officials considered kicking off the media campaign with a big splash during the Super Bowl, but that fell through. Beyond that, many experts on drug policy and substance abuse say messaging alone won’t solve the problem anyway. People with addiction need treatment, and many people get addicted in the first place to painkillers their doctors have prescribed. An ad campaign won’t solve that.

One big test for the drug office will come when Trump releases his budget Monday, which is expected to slash the office’s budget, turning much of its work over to HHS and the Department of Justice. Both departments are developing their own opioid approaches; in past administrations, the drug czar would have coordinated. Lawmakers are already sounding the alarms over the budget plan.

A bipartisan group of senators last week wrote a letter to White House budget director Mick Mulvaney, urging him to reconsider and maintain the office’s programs that “prevent and fight against the scourge of drug abuse.”

Pushback to a similar proposal last year led the Trump administration to reverse the decision and maintain the office’s budget. Lawmakers hope that there will be a similar outcome this time — along with a smarter utilization of the drug policy office.

“What we haven’t seen is the kind of coordination of critical programs that ONDCP has traditionally done,” said Sen. Maggie Hassan, a Democrat from New Hampshire, another state with one of the highest overdose death rates in the country.

Trump officials say it was the Obama administration that began undermining the drug policy office, demoting the director from the Cabinet, shrinking the staff and stressing the health aspects more than a law enforcement-focused “war on drugs.” They say the emergency requires a new approach.

Bob Dupont, who served as the second White House drug czar under President Gerald Ford, before the formal drug policy office was created, and still informally advises the Justice Department on drug policy, believes the White House will eventually realize it needs the expertise that ONDCP has to offer.

The West Wing doesn’t “have the staff or capability” to carry out drug policy work like ONDCP does, Dupont told POLITICO. “I don’t think swashbuckling your approach is going to last very long.”

 

ashoup
In Stories, Administration, News

Protect Our Care Statement on World Cancer Day

Today the world unites to recognize World Cancer Day, raise awareness, and call for governmental actions to combat this terrible disease. Unfortunately, here at home the Trump Administration has taken numerous steps which could make life even more difficult for Americans with cancer. On World Cancer Day, Protect Our Care Campaign Director Brad Woodhouse released the following the statement:

“On World Cancer Day, we pause and reflect. For too long this devastating disease has caused untold pain and suffering without regard for circumstance. One of today’s main goals is to encourage further governmental action to fight cancer; sadly, we know our country could be doing more.

“Over the past year, President Trump unveiled a budget which cut $1 billion from the National Cancer Institute, as well as a twenty percent cut for the National Institutes of Health; he hosted a White House celebration for a GOP bill the American Cancer Society-Cancer Action Network said contained ‘numerous provisions [which] would adversely impact access to adequate and affordable health insurance coverage for cancer patients and survivors,’ including the re-implementation of lifetime caps, increased costs tied to pre-existing conditions, and penalties for those with coverage gaps; and he signed legislation repealing the individual mandate, which ACS-CAN explained ‘leaves cancer patients, survivors and all those with serious illnesses at risk of being priced out of the individual health insurance market.’

“On this World Cancer Day, let us unite as a nation to affirm our support for a health care system that provides the best care possible for those with cancer and bans discrimination against cancer survivors, and keep working toward a cure.”

ashoup
In Capitol Hill, Stories, Administration, News

PHOTOS: Health Care Protests at GOP Retreat in West Virginia

As Congressional Republicans retreated to West Virginia to discuss their plans for 2018, they were greeted by protesters who are furious about the GOP’s ongoing war on health care. Hundreds of protesters greeted Vice President Pence at the airport, lined up along the President’s motorcade route, and made sure every Member of Congress in attendance knew just how furious voters are about their party’s health care sabotage:

[Beckley Register-Herald]

The protesters made clear just how devastating the GOP’s health care attacks would be to West Virginia:

“An issue on the minds — and signs — of many of the protesters was health care. Hanno Kirk, 78, of Lewisburg, said his main concern as a health care provider is the 230,000 people in West Virginia who are in danger of losing health insurance if the GOP succeeds in dismantling the Affordable Care Act. ‘It’s totally misguided to attempt to do away with the ACA simply because it’s called ‘Obamacare,’ Kirk said, noting he used to be a ‘liberal Republican in Washington, D.C., back when there was such a thing as a liberal Republican.’ Stephen Josephine Fritsch of Harrisburg, Pa., the daughter of a combat veteran, said it appears the values her father fought for are slipping away. ‘This is America,’ she said. ‘It should be we the America, not me the America.’ Fritsch expressed concern about the state of U.S. health care under GOP leadership.”

“‘Well, we have a lot of issues in West Virginia,’ said psychotherapist and protester Hanno Kirk. ‘As a healthcare provider, I am acutely aware how many of my patients are reliant on Medicaid and Medicare and CHIPS. And if those two are eliminated, as there is a threat to that, we would have a huge number of uninsured people.’” [WVVA, 1/31]

[Beckley Register-Herald]

Protesters gathered at Senator Moore-Capito’s office ahead of Congressional Republicans’ arrival:

Protesters are hitting the streets in Charleston, a day ahead of the GOP retreat at The Greenbrier, to voice their concerns about cuts to health care and Medicaid. A rally Wednesday evening included people from all over the eastern U.S. gathering in Charleston, including one woman from as far away as Vermont. It is a test run for a bigger demonstration on Thursday in Greenbrier County. By the end of the night Wednesday, the group is expecting about 500 advocates in town — standing together against Medicaid and health care cuts. [WSAZ, 1/31]

They met Vice President Pence at the Charleston airport:

“‘We’re just ready for that change,’ Debbie Naeter says. She’s right outside the Greenbrier Valley Airport gates with protestors prepared to welcome Vice President Pence with their concerns. ‘It’s health care, and fracking, and equality, and being nice again,’ she says.” [WDBJ, 1/31]

Engaged activists traveled from all over the country to make their voices heard:

“Protesters came from all over the United States. WDBJ7’s Sara Machi spoke with protesters from West Virginia, New York City, Charlotte, and Arkansas. Many protesters present Thursday said they have decided to protest because of issues important to them. These issues include immigration, healthcare, the recent tax bill, clean water, and other issues.” [WDBJ, 2/1]

[Beckley Register-Herald]

As Paul Ryan raised the specter of “entitlement reform” inside, protesters at the gates of the five-star resort raised awareness about the GOP’s proposed cuts to Medicare and Medicaid:

“President Donald Trump’s address to Republican congressmen at The Greenbrier resort in southern West Virginia has drawn several hundred protesters with signs and chants criticizing him and calling for living wages, protecting Medicaid and Medicare, defending immigrants and decrying hate speech.” [AP, 2/1]

[Twitter]

The bottom line from protesters: Enough is enough. It’s time to stop the Republican war on our care.

“While President Donald Trump and Vice President Mike Pence plan to attend a GOP congressional retreat in West Virginia, some health care advocates plan to attend rallies to protest Medicaid and health care cuts… Organizers said in a news release that West Virginia health care advocates would join more than 500 people gathering to protest and send a message ‘that any cuts to health care — the issue expected to top the GOP’s agenda — will be met with a fierce nationwide fight.’” [WCHS, 1/31]

[Beckley Register-Herald]

Lest anyone be confused, they made clear what the protests were really about:

“Sammi Brown, the federal campaigns director for Our Children, Our Future, said this started after activists in Greenbrier County reached out to individual groups, and word of the action reached organizations in West Virginia and other states shortly afterward. ‘It is folks all along the East Coast that are standing in solidarity with West Virginia. We are expecting upwards of 600 people tomorrow to march with us,’ she said. Brown said the protest was not about Trump but rather the agenda of what she called ‘attacking health care.’” [West Virginia Metro News, 1/31]

And Vice President Pence found one special health care protester – West Virginia Senator Joe Manchin. After Pence chided him for not voting for the GOP tax scam, which kicked millions of Americans off of their coverage, Manchin hit back:

[Twitter]

As President Trump, Vice President Pence and GOP Members of Congress were shown upon their arrival in West Virginia, Americans, from local organizers to United States senators are furious about their repeal and sabotage memo. They’re furious over their weakening of the Affordable Care Act; they’re furious over their attempts to gut Medicare and Medicaid; and they’re furious over their unnecessary attacks on America’s health care system. And if they don’t stop, it’s only going to get worse.

Enough is enough – it’s time for the GOP to end their war on health care.

ashoup
In Administration, News

Indiana Waiver Approval Accelerates Trump Administration’s War on Medicaid

Washington, DC – As the Trump Administration accelerates its war on Medicaid today by approving Indiana’s waiver proposal, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“By announcing today’s approval, Secretary Azar is escalating the Republican war on health care and its effort to demolish Medicaid from the inside out. The Trump Administration is choosing to cause real pain in Indiana by letting the state make Mike Pence and Seema Verma’s cruel, failing Medicaid ‘experiment’ even worse. Hoosiers with Medicaid will face a 6-month lockout for a simple paperwork mistake, reversing Obama-era progress to streamline enrollment and reduce administrative hurdles. A person caring for a sick child or parent, someone working to control their opioid addiction, or someone who has chronic health conditions that make it impossible to work will now have the added worry of losing their health insurance. This is just cruel. The truth is that imposing work requirements will do nothing to help Hoosiers find or keep jobs. In fact, it most likely will have the opposite effect.

“With today’s announcement, Secretary Azar is also showing that he is a Trump foot soldier who’s happy to help distract from CMS Administrator Verma’s conflicts of interest in Indiana: the agency she leads has just signed off on an even worse version of a badly failing program she personally made millions of taxpayer money off of thanks to Vice President Pence while he was Governor.

“Today’s announcement is a direct affront to Medicaid’s stated mission of improving people’s health.  This is not about work. It’s about taking away people’s health care. All it does is kick people while they’re down.”

BACKGROUND:

In 2015, in order to expand Medicaid to over 350,000 Hoosiers, the Obama administration approved then-Indiana Governor Mike Pence’s experimental proposal to impose nominal “show” premiums (often $1) for people with Medicaid, and then take away their coverage with a “lockout” of at least 6 months if they missed a payment. Since then, 25,000 Hoosiers have been kicked off their coverage by lockouts.

CMS Administrator Verma’s Checkered Anti-Medicaid Past in Indiana & Beyond

Verma Created The “Healthy Indiana Plan 2.0” Under Pence, Which Put Restrictions On Medicaid Recipients That “Warranted A Six-Month Lockout From Coverage” If They Missed A Single Monthly Payment. According to the International Business Times, “Verma has an extensive history in the healthcare industry. Her consulting firm, SVC Inc., worked alongside Pence to reform Indiana’s Medicaid program following the induction of President Barack Obama’s Affordable Care Act (ACA). […]While Pence was governor of Indiana, Verma helped create Healthy Indiana Plan 2.0, which required users, including low-income recipients, to make monthly payments for their health insurance services with restrictions that warranted a six-month lockout from coverage if even a single payment was missed.” [International Business Times, 11/30/16]

A Mother Of Three In Indianapolis Was Kicked Out Of The Program For A Misplaced $1 Payment. According to NPR, “So how does it work in practice? For Amber Thayer, a mom of three who lives in a Volunteers of America family shelter in Indianapolis, it’s been a bit of a nightmare. Thayer is a recovering addict who has been clean for six months with the help of the medication Suboxone. And she’s training to be a nursing assistant. ‘It’s been quite, quite the struggle, but we’ve gotten there and we’re doing great, and we’re getting ready to get into our own home,’ she says. She pays $1 a month for her Medicaid insurance. In October, she got a bill for that $1 from a different company than the one she had been dealing with. She assumed the state had switched her. ‘It is only a dollar,’ she says. ‘I could pay a dollar a month, or I could pay $12 and that will cover me for the year. Unfortunately, at that time, I only had I believe it was like $2.38 on my card.’ So she called the company and used her bank card to pay the dollar. But the company, or perhaps the state, lost track of her dollar, and her insurance was cut off. She had her bank statement and a receipt from the insurer that proved she had paid. But she still spent six weeks, with multiple phone calls and visits to state health offices, trying to get her coverage restored.” [NPR via Houston Public Chronicle, 1/3/17]

Indiana Medicaid Recipients Could Be “Locked Out Of The Program” For Not Paying Their Premiums, “A Provision Even Commercial Insurance Does Not Impose.” According to The Guardian, “In Indiana, if people on Medicaid earning between $11,000 and $16,000 don’t pay their ‘premiums’, they can be locked out of the program for up to six months, a provision even commercial insurance does not impose. ‘If someone can’t scrape up the money for premiums for two months, they get dis-enrolled, and they get locked out for six months,’ said Kallow. ‘Then say they get cancer, they get hit by a truck, they have an accident. They have absolutely no place to turn for health coverage.’” [The Guardian, 12/4/16]

While Kicking People Off Of Medicaid, Verma’s Firm SVC, Inc. Was Contracted To Receive More Than $4.8 Million From The State Of Indiana Between 2014 And 2017. According to SVC’s contract with the Indiana Family and Social Services Administration, SVC Inc. was contracted to receive $4,851,400 between May 2014 and June 2017. [SVC Inc. Contract – Indiana Family and Social Services Administration, 6/17/16]

At The Same Time Verma Worked On The Redesign Of Indiana’s Medicaid Program Under A $3.5 Million State Contract She Was Working For “One Of The State’s Largest Medicaid Vendors,” Receiving More Than $1 Million.” According to the Indy Star, “Largely invisible to the public, Verma’s work has included the design of the Healthy Indiana Plan, a consumer-driven insurance program for low-income Hoosiers now being touted nationally as an alternative to Obamacare. In all, Verma and her small consulting firm, SVC Inc., have received more than $3.5 million in state contracts. At the same time, Verma has worked for one of the state’s largest Medicaid vendors — a division of Silicon Valley tech giant Hewlett-Packard. That company agreed to pay Verma more than $1 million and has landed more than $500 million in state contracts during her tenure as Indiana’s go-to health-care consultant, according to documents obtained by The Indianapolis Star. Verma’s dual roles raise an important question: Who is she working for when she advises the state on how to spend billions of dollars in Medicaid funds — Hoosier taxpayers or one of the state’s largest contractors?” [Indy Star, 8/26/14]

  • Indiana Lawmakers Were Unaware That Verma Was Working For The State And For HP Simultaneously. According to the Indy Star, “If Verma was a federal contractor, her dual roles ‘would certainly raise tremendous concern for regulators and purchasing officials,’ he said. ‘This is exactly the kind of thing that would land an agency in a hearing before a legislative oversight committee.’” [Indy Star, 8/26/14]

Verma’s Medicaid Reforms In Iowa Were “A Nightmare.” According to STAT News: “When President Donald Trump tapped policy consultant Seema Verma to run Medicaid and Medicare in his administration, he called her part of a health care ‘dream team.’ But the health policy changes she helped design in Iowa have felt more like a nightmare to providers serving poor and disabled residents across the state. Verma has helped several states revamp Medicaid, including Kentucky and Indiana. Here in Iowa, she worked on an aggressive effort to privatize the program, which provides health care to about 600,000 adults and children.” [STAT News, 1/24/17]

  • Ablekids Pediatric Therapy In Sioux Falls Reported Struggle to Keep Doors Open. According to a Des Moines Register editorial: “The Cedar Rapids Gazette has reported on billing problems experienced by outpatient rehabilitation clinics across the state. ‘We’re not even getting half of what we got with Iowa Medicaid,’ said Jessica McHugh, owner of AbleKids Pediatric Therapy in Sioux City, referring to the many years when the state administered Medicaid.” [Editorial – Des Moines Register, 7/16/16]
ashoup
In Capitol Hill, Administration, News

This Week In the War on Health Care — January 29 – February 2, 2018

While Washington focused on the State of the Union, the Trump Administration continued its unprecedented assault on the American health care system. Here’s what happened this week in Republicans’ war on health care – and why they’re losing battles to the American people:

LIES FROM THE LECTERN

During his State of the Union address, President Trump doubled down on the war on health care his administration and his Republican allies in Congress waged last year, saying he “repealed the core of disastrous Obamacare” — a widely debunked lie. He also failed to mention that:

The President then pivoted to the opioid crisis, attempting to take credit for addressing the epidemic. But in reality, Trump has done nothing to facilitate treatment for Americans struggling with addiction. In fact, his attacks on critical federal health care and opioid response programs stand to make the situation worse:

  • His public health emergency declaration speech freed up just $57,000, pathetically short of the billions experts say are desperately needed.
  • His Administration sabotaged Medicaid, which pays for one-fifth of all substance abuse treatment nationwide.
  • He proposed a 95% cut to the Office of National Drug Control Policy, which coordinates the federal opioid response – and he did so for the second year in a row.

Sadly, the Trump Administration is not only offering a pathetic response to the nation’s most urgent public health crisis, it’s actively sabotaging communities that are fighting to turn the tide on this deadly epidemic.

A NEW GENERAL TAKES HIS OATH

On Monday, former Big Pharma lobbyist Alex Azar was sworn in as the new secretary of Health and Human Services. Azar lied about the Trump Administration’s sabotage throughout his confirmation process, choosing to embrace the Republican agenda that takes coverage from millions of Americans, raises costs for millions more, and protections for people with pre-existing conditions.

Whether Azar upholds the oath he swore will soon be tested because of…

IDAHO’S ATTEMPT TO FLOUT FEDERAL LAW

Negative reactions continued as experts digested Idaho Governor Butch Otter’s illegal proposed assault on the Affordable Care Act. University of Michigan law professor and former Department of Justice attorney Nicholas Bagley called such an action “crazypants illegal,” noting that Idaho, “appears to be claiming they do not have to adhere to federal law.”

What Secretary Azar does with this will be an excellent indicator of whether he plans to truly support the health of the American people, like he claimed, of if he will merely be another foot soldier in the Administration’s war on health care.

COSTS FOR SENIORS CONTINUE TO RISE

A new report from the Kaiser Family Foundation highlights massive increases in out-of-pocket medical costs for Medicare beneficiaries – costs that are projected to keep skyrocketing.

While President Trump has claimed he wants to lower costs, the reality is the opposite: he has consistently supported proposals making health care more expensive, from repeal legislation allowing insurance companies to charge people over 50 an ‘age tax’ with rates five times higher to the GOP tax scam set to raise premiums double digits. Seniors should rightly be furious, as are…

HEALTH CARE PROTESTS IN WEST VIRGINIA

As GOP Members of Congress retreated to West Virginia, they were greeted by protesters furious about the ongoing war on health care:

OPEN ENROLLMENT NUMBERS BLOW EXPECTATIONS OUT OF THE WATER

And finally, yesterday was the scheduled final day of open enrollment. Despite the widespread attempts at sabotage by the Trump Administration, from cutting the sign-up period in half to dropping advertising by ninety percent, we have already reached 96% of last year’s enrollment total:

  • Nearly 8.8 million people signed up for coverage through HealthCare.gov.
  • Demand from new consumers outpaced new enrollments every single week of last year, with 2.5 million new people signing up for coverage.
  • Almost 6.3 million returning consumers actively renewed their coverage or were automatically re-enrolled compared to 6.2 million people last year.
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