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In News

Trump Drug ‘Plan’ Could Punish Seniors With Cancer

Washington, D.C. – After new research from Avalere and a CBS News investigation exposed the dangers seniors with cancer could face under the Trump Administration’s drug pricing blueprint, Protect Our Care Campaign Director Brad Woodhouse said:

“The Administration has no answers on how its proposed changes to Medicare would protect seniors from prohibitively high out-of-pocket costs for specialized cancer treatment. This is more proof that the Trump Administration’s drug pricing ‘plan’ is a day late and a dollar short. Americans are already worried enough about rising health care costs; let’s not find new ways for the Trump Administration to make care more expensive.”

A tricky wrinkle in Trump’s Medicare Rx “Blueprint”

CBS News // Walecia Konrad // May 22, 2018

The Trump administration’s “Blueprint” to lower drug prices and reduce patient costs made one thing clear: The government will not directly negotiate with drug companies to secure lower prescription prices. But that doesn’t mean it isn’t proposing changes that would dramatically alter the way Medicare pays for some of the most expensive drugs, and in the process, potentially raise out-of-pocket costs for some of the country’s sickest patients.

A cornerstone of the Trump plan calls for all Medicare drug payments to be consolidated under Medicare Part D, the prescription drug plan for Medicare enrollees administered by private insurers. Under Part D, insurers and middlemen known as pharmacy benefit managers (PBMs) negotiate with drug companies for discounted prices in exchange for the drug companies’ products being included in the PBMs’ list of covered drugs.  

But drugs intravenously administered in physicians’ offices, such as chemotherapy and vaccines, are usually covered as a medical treatment under Medicare Part B. Physicians buy these drugs directly from manufacturers, and Medicare reimburses doctors for the drugs’ average sales price plus 6 percent.

Alex Azar, Health and Human Services secretary and former president of the U.S. division of pharmaceutical giant Eli Lilly (LLY), has been touting the move to consolidate Medicare drug payments during several public appearances since he and President Trump unveiled the Blueprint earlier this month. Azar and other proponents of the plan point out that the 6 percent markup included in Medicare Part B creates incentives for doctors to purchase more expensive drugs to get a higher dollar profit. Better, said Azar, for insurance companies and PBMs in Medicare Part D to negotiate discounts and lower prices.

Pharmaceutical companies are against the idea, partly because they generally are paid more under Part B than Part D. “Bringing negotiation to Part B drugs is such a potent way to bring down prices that PhRMA is already protesting the idea,” Azar said in a recent speech at the American Enterprise Institute in which he referred to the drug industry trade group called Pharmacuetical Research and Manufacturers.

But Azar and others have shed little light on exactly how this change would take place, leaving patients worried about the potential for astronomically higher out-of-pocket costs.  

Sky-high co-pays?

“If they shift Medicare Part B medicines to Medicare Part D without making any changes in the Part D structure, it will have a horrible effect on patients,” said David Mitchell, president and founder of Patients for Affordable Drugs. Mitchell, who’is currently undergoing cancer treatment, noted that he and most cancer patients with Medicare Part B have supplemental insurance that covers out-of-pocket costs, including drug co-pays, incurred under Medicare Part B insurance.

Mitchell points to his own regimen of cancer drugs, which adds up to about $23,000 each time he visits the infusion clinic. He pays $2,100 a year for a supplemental policy that covers his Part B co-payments. Medicare Part D recipients are not eligible to buy supplemental prescription drug insurance.

If his drugs were to fall under Medicare Part D, Mitchell explained that he would quickly pay enough in out-of-pocket co-pays to fall into a category called catastrophic coverage. Once in that category, Mitchell would pay 5 percent of his drug costs, which he estimates would equal about $15,000 in a year’s time. “That’s a completely unaffordable amount,” he said.

An analysis released Monday from health care consultants Avalere Health backs up Mitchell’s point. In 2016, average out-of-pocket costs were about 33 percent higher for Part D-covered new cancer therapies than for those covered in Part B. “Medicare beneficiaries typically have lower out-of-pocket costs in Part B — especially since so many seniors carry supplemental coverage,” said Richard Kane, senior director at Avalere, in a press release. “Any proposal for shifting drugs to Part D needs to account for these differences.”  

Logistical problems

“Having a doctor purchase, mix and handle the infusion of a drug is a completely different medical experience than going to the pharmacy and picking up a bottle of pills,” said Marc Samuels, founder of ADVI Health and former White House health policy adviser for President George H.W. Bush. Cancer treatments and other physician-administered drugs are complicated and personalized, often changing from week to week or even day to day depending on the patient’s reaction to the drugs.  

Patients and physicians are wondering how the actual delivery of drugs would work. “I heard someone say that I’d have to go to the pharmacy to pick up my drugs then bring them to the infusion center,” Mitchell of Patients for Affordable Drugs said. “That isn’t going to work.”

What’s more, Samuels argued that the 6 percent markup that doctors receive under Medicare Part B isn’t as profitable as it may sound.  Doctors purchase these expensive drugs then often have to discard them because the patient has serious side effects or needs a different drug for another reason. “The 6 percent is designed to help cover that cost,” Samuels said.

For now the Trump administration isn’t disclosing any details about how this part of its Blueprint would work. “I’m hoping,” said Mitchell, “we can work with the administration to find a way to allow negotiations to take place without harming patients.”

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In News

3 Lies Lamar Alexander Tells About Health Care

As Senator Lamar Alexander takes D.C. Republican politics to Tennessee in a blame-deflecting letter-to-the-editor, Protect Our Care is checking the facts:

“Republicans’ repeated efforts to sabotage the health care system are driving up health care costs across the country, and now Republican Senators who could have protected Americans but chose not to are running scared. For proof, look no further than the top Senate Republican on health care, Lamar Alexander, who just wrote a letter to his hometown paper in a last-ditch attempt to duck responsibility for the pain he’s causing American families. Senator Alexander has developed a history of misleading the public about health care, and once again, his claims just don’t pass the smell test,” said Brad Woodhouse, Campaign Director for Protect Our Care.

LIE 1: That efforts to stabilize health care markets failed because of Democrats. Republican poison pills on reproductive rights are what killed those efforts – full stop. Democrats continue to make overtures to Alexander on stabilization, but in a letter to lobbyists, he unilaterally declared he was walking away from the negotiating table.

LIE 2: That letting Lamar Alexander repeal the Affordable Care Act would have made matters better for anyone. In fact, millions of Americans would have lost their coverage, millions more with preexisting conditions would have faced discrimination from insurance companies, and premiums would have soared.

LIE 3: That Lamar Alexander is a moderate, reasonable or thoughtful voice on health care. His first priority is always repeal, making him no different from far-right Republicans like the Freedom Caucus or the Koch Brothers, who have been pouring millions of dollars into smearing the law for almost a decade. After this spring’s stabilization farce, Lamar Alexander has spent his last shreds of bipartisan credibility, and his letter indicates that people in Tennessee are noticing.

 

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In News, Stories, Roundup

Research Roundup: Studies Show Better Health Care Outcomes, Stronger Household Finances Thanks to Affordable Care Act & Medicaid Expansion

Six new studies highlight the positive impact of the Affordable Care Act is having on health care in America. Three outcomes-focused studies show clear improvements in care for gynecological cancer, head and neck cancer, and serious psychological distress, while two Medicaid Expansion studies find that expanded coverage leads to lower out-of-pocket costs and stabler household finances. Meanwhile, health care reform has entirely closed the demographic coverage gap between Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs) and white Americans.

This new research joins a growing body of work that leads to a simple conclusion: the Affordable Care Act provides measurable benefits for Americans’ health and financial well-being. Here’s a look at the six studies:

Effects of the Affordable Care Act on Young Women With Gynecologic Cancers [Obstetrics & Gynecology, 5/7/18]

This study finds that the ACA’s expansion of access of coverage allowed more young women to catch gynecologic cancer early, improving the likelihood of successful treatment.

  • The study examined nearly 4,000 cases of gynecologic cancer among 21-26-year-old-women and more than 20,000 cases among 27-35-year-old women, comparing those which came about before the ACA and those after its implementation, finding that those with access were more likely to be treated.
  • The study found that prior to the ACA just one in three women between the ages of 19 and 26 were insured, but after its implementation, more than nearly four in five women were covered, helping to account for the diagnoses.
  • The report concluded that, “Young women with gynecologic cancer were more likely to be insured and diagnosed at an early stage of disease.”
  • “This study adds to the evidence of the positive effects of improved coverage through the ACA on young women’s healthcare costs and choices,” noted Dr. Laura Havrilesky, a gynecologist at the Duke University Medical Center, in an editorial published in accordance with the findings.

Changes in Health Insurance Coverage and Barriers to Health Care Access Among Individuals with Serious Psychological Distress Following the Affordable Care Act [Administration and Policy in Mental Health and Mental Health Services Research, 5/12/18]

This study examined mental health outcomes in accordance with the Affordable Care Act, concluding that the ACA has led to better coverage outcomes and increased affordability for non-elderly adults with serious psychological distress (SPD).

  • Examining non-elderly adults with SPD from 2014-2016, the study’s authors found that these adults saw increased coverage and a reduction in the delaying or foregoing of necessary care due to the ACA, and that the law “reduced the odds of an individual with SPD not being able to afford mental health care.”
  • As the study’s authors note, “Mental health care access among racial and ethnic minority populations and people with low income has improved during 2014–2016,” something almost certainly attributable, at least in part, to the ACA

ACA Decreased Non-Insurance Rates Among Patients With Head and Neck Cancer [American Head & Neck Society, 4/19/18]

Another new study finds that in states that expanded Medicaid, patients with head and neck cancer had better health care access.

  • The study analyzed more than 89,000 patients, finding higher coverage rates among both Medicaid enrollees and private insurance, as well as an uninsured rate among diagnoses which decreased nearly 50% after January 2014, in states which expanded Medicaid.
  • The study found that those lacking coverage had an overall survival rate of just 49% compared to 63% among those insured, as well as a a 5-year disease-specific survival rate of just 57% compared to 72% among those insured.

The Effect of the Affordable Care Act Medicaid Expansions on Financial Wellbeing [Journal of Public Economics, 5/7/18]

Another study compiled by employees of the Federal Reserve Bank of Chicago and the University of Illinois, University of Michigan, and Northwestern University found that low-income residents saw better financial outcomes in states which expanded Medicaid.

  • Using credit reporting agency data, the researchers compared the financial outcomes among low-income adults in states which expanded Medicaid and those which did not, determining that Medicaid expansion “significantly reduced d the number of unpaid bills and the amount of debt sent to third-party collection agencies among those residing in zip codes with the highest share of low-income, uninsured individuals.”
  • The study found that Medicaid expansion lowered unpaid balances in collections “by between $65 and $88,” while Medicaid enrollees saw their amount of unpaid balances in collections decrease “by approximately $1,140.”
  • As the authors note: “Our findings suggest that the ACA Medicaid expansions had important financial impacts beyond increasing health care use.”

The Effect of ACA State Medicaid Expansions on Medical Out-of-Pocket Expenditures [Medical Care Research and Review, 5/10/18]

A new analysis from the University of Michigan’s Institute for Social Research finds that Medicaid expansion lowered out-of-pocket medical expenses.

  • The study, conducted by Joelle Abramowitz of the Institute of Social Research, analyzed data from the Current Population Survey Annual Social and Economic Supplement between 2011-2016, finding that those in states which expanded Medicaid saw their medical spending decreases, due to fewer premiums and reduced out-of-pocket medical expenses.
  • The study’s findings “suggest that the expansions were associated with a relatively larger likelihood of having zero premium expenditures and of having zero nonpremium medical out-of-pocket expenditures for low-income individuals,” as well as suggest “that the expansions were effective in reducing medical out-of-pocket expenditures.”

Health Insurance for Asian Americans, Native Hawaiians, and Pacific Islanders Under the Affordable Care Act [JAMA Internal Medicine, 4/30/18]

Researchers from the Harvard T.H. Chan School of Public Health analyzed the impact of the Affordable Care Act on coverage among Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs), finding that the ACA closed the uninsured rate gap between AANHPIs and white Americans.

  • Using data from the American Community Survey, the researchers examined the uninsured rate among AANHPIs prior to the ACA and after its implementation, the first study of its kind, finding that unlike other minority groups which saw a decrease in the coverage gap between themselves and white Americans, the coverage gap among AANHPIS was eliminated.
  • Overall, the uninsured rate among AANHPIs dropped 7.3% following the ACA. Among the subgroups of AANHPIs, all saw significant drops: 14.3% among Guamanian or Chamorro, 6.5% among Samoan, and 4.9% among Native Hawaiians, as well as 5.9% among other AANHPIs.
  • “The notable gains in health insurance coverage for AANHPI groups represent valued progress toward health equity,” said senior author Howard Koh, the Harvey V. Fineberg Professor of the Practice of Public Health Leadership at Harvard Chan School and Harvard Kennedy School.
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In News

The Cost of Sabotage: How Republicans’ Deliberate Actions to Undermine the Affordable Care Act Make Health Care More Expensive for American Families

From his first day in office, President Trump and his Republican allies in Congress have been waging a war on the American health care system, taking deliberate actions to repeal, undermine, and sabotage the Affordable Care Act (ACA).

This is not just some ideological debate of conservatives versus progressives, or Republicans versus Democrats. These efforts have real, negative consequences for millions of American families. And more and more Americans are paying the price, facing higher premiums and out-of-pocket costs – or losing coverage altogether.

This week, Protect Our Care will highlight the real, dollars-and-cents costs American families are facing because of Republican health care sabotage.

How Republicans Sabotaged Health Care

Some people may not be aware of all of the deliberate actions the Trump Administration and Republicans have taken over the past 18 months to sabotage our health care. Here are some examples:

  • On his first day in office, President Trump signed an Executive Order directing the administration to identify every way it can unravel the Affordable Care Act.
  • The Trump Administration cut the number of days people could sign up for coverage last year in during open enrollment in half.
  • It cut outreach so people know when to sign up by 90 percent and made dramatic cuts to in-person assistance that help people sign up for coverage.
  • And now, the Trump administration is pushing to allow insurance companies to sell junk plans that roll back key consumer protections in the Affordable Care Act and increase premiums for people seeking any meaningful coverage or who have a pre existing conditions.

Later that year, the Republican tax bill raised premiums by 10 percent, when they repealed the ACA’s individual mandate – the requirement that most people have health coverage.  That same bill gave hundreds of billions in tax breaks to the wealthy and big corporations, and resulted in huge profits and made CEOs and shareholders richer. Insurance companies got a 40% tax break.

Republicans in Congress repeatedly tried to pass a bill to repeal the Affordable Care Act and slash Medicaid. These bills would have ripped away coverage from tens of millions of people, raised costs for families by double digits, imposed an age tax on older Americans, cut Medicaid by more than $800 billion and weakened protections for people with pre-existing conditions. Those efforts failed, but they were successful in injecting uncertainty into the market that caused insurance companies to raise rates.

Sabotage Means American Families Face Higher Costs, Coverage Loss

Higher Costs
For proof that Republican sabotage is raising costs on American families, just ask the insurance companies. This spring, insurance companies are announcing their initial planned rate hikes for next year. And just like last year, they want to raise premiums by double digits, because of Republican sabotage. America’s Health Insurance Plans (AHIP) said that Trump Administration and Republican policies will “drive up the rate of premium increases, and exacerbate affordability issues for many other people.” The CEO of CareFirst Blue Cross Blue Shield said the marketplaces are “materially worse” under the Trump Administration because of its deliberate actions to undermine the system.

Here are examples from states where insurance companies’ initial rate hikes requests have been made public:

  • In Oregon, insurance companies want to raise rates by double digits – up to 14.3%. One insurance company cited “continued lack of funding for cost sharing reduction plans” as one of the factors for the increase.
  • In Vermont, insurance companies also want to significantly raise rates. One company cited “recent federal legislation [that] also eliminated the penalty associated with the individual mandate. As a result, it is expected that a number of healthy individuals will choose to forgo coverage and leave the single risk pool.”
  • In Maryland, insurance companies want to raise rates as high as 91 percent. As Kaiser Permanente said, “These proposed rates reflect the expected costs of providing coverage for these members, including the impact of eliminating the individual mandate penalty.”
  • In Virginia, insurance companies want to raise rates as high as 64 percent. Factors behind the rate request include “elimination of the Individual Mandate penalties” and “anticipated changes to regulations regarding Short Term Medical and Association Health Plans.”

In fact, a new analysis shows that because of two new Republican policies, encouraging junk plans and repealing the individual mandate, average individual-market premiums will increase by $1,013 next year. That compounds the damage done last year, insurance companies charged families $102 more per month in premiums, attributing the increases to the initial round of Trump Administration sabotage.

Fewer Americans Covered
A four-year trend of health coverage gains has been reversed under the Trump Administration. 3.2 million Americans lost coverage during the first year of the Republican war on health care, and millions more stand to lose their insurance over the coming years.

During President Trump’s first year in office, the national uninsured rate rose for the first time since Affordable Care Act implementation. Gallup reports that the national uninsured rate spiked by 1.3 percentage points to 12.2 percent in 2017, with 17 states experiencing statistically significant increases:

  • West Virginia (4.2 percent), New Mexico (3.8 percent), Iowa (3.3 percent), Hawaii (3.3 percent), Arizona (2.6 percent), Colorado (2.2 percent), Florida (1.4 percent), Illinois (1.6 percent), Indiana (1.5 percent), Missouri (2.1 percent), New York (1.2 percent), North Carolina (1.4 percent), South Carolina (2.1 percent), Texas (1.6 percent), Utah (2.1 percent), Washington (1.5 percent), and Wisconsin (2.1 percent).

Americans Agree: Republicans Are To Blame For Sabotaging Health Care

Recent polling confirms that the American people see Republicans’ actions for what they are: sabotage. A poll conducted last September found that 61 percent of voters believed President Trump was “trying to make the Affordable Care Act fail,” and 64 percent of voters said Trump is “playing politics with people’s health care.” The poll also found that the American people seriously disapprove of how Republicans in Congress are treating health care: 80 percent of voters disapprove while only 20 percent approve.

In a February poll, Public Policy Polling found that more than half of voters nationally (51 percent), said that they thought that the Trump Administration was actively taking steps that will hurt people’s health care and raise costs.

Today, six new Public Policy Polling Surveys in battleground states find that Americans will blame Republican sabotage for health insurance rate hikes:

  • In Arizona, 55 percent of voters say they will hold Republicans in Washington responsible if rates increase, compared to just 29 percent who said they would not. A plurality (49 percent) say they believe Washington Republicans and President Trump have been trying to undermine and sabotage the Affordable Care Act.
  • In Indiana, 49 percent of voters say they will hold Republicans in Washington responsible if rates increase, compared to just 20 percent who said they would not. A plurality (48 percent) say they believe Washington Republicans and President Trump have been trying to undermine and sabotage the Affordable Care Act.
  • In Missouri, 59 percent of voters say they will hold Republicans in Washington responsible if rates increase, compared to just 25 percent who said they would not. A plurality (47 percent) say they believe Washington Republicans and President Trump have been trying to undermine and sabotage the Affordable Care Act.
  • In Montana, 55 percent of voters say they will hold Republicans in Washington responsible if rates increase, compared to just 32 percent who said they would not. A plurality (47 percent) say they believe Washington Republicans and President Trump have been trying to undermine and sabotage the Affordable Care Act.
  • In Nevada, 56 percent of voters say they will hold Republicans in Washington responsible if rates increase, compared to just 32 percent who said they would not. A majority (55 percent) say they believe Washington Republicans and President Trump have been trying to undermine and sabotage the Affordable Care Act.
  • In Wisconsin, 59 percent of voters say they will hold Republicans in Washington responsible if rates increase, compared to just 31 percent who said they would not. A majority (53 percent) say they believe Washington Republicans and President Trump have been trying to undermine and sabotage the Affordable Care Act.

In short, while Republicans keep pushing their destructive repeal-and-sabotage agenda, more and more American families are paying the price.

 

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In News

New Rule Would Put Donald Trump Between Women And Their Doctors

Washington, D.C. – After the Trump Administration proposed to dramatically accelerate its attacks on women’s care, Protect Our Care Communications Director Marjorie Connolly released the following statement:

“Today’s rule would put Donald Trump between women and their doctors, and it signals a new phase in the Republican war on women’s health. By banning providers from giving women all the facts about their options and restricting them from getting any services at all from essential community health providers, including Planned Parenthood, this rule is designed to threaten women’s health care providers and restrict access to care. Courts blocked a similar proposal in the Reagan era, but now President Trump has gotten a record number of anti-choice judges confirmed, meaning this rule poses an even worse threat to women’s health than it did in the 80s. The Trump-Pence administration continues to pursue a radical anti-women’s health agenda, but today’s proposal will only strengthen the resolve of the millions of women who have been marching against these attacks since Day One.”

BACKGROUND: The Republican War on Women’s Care

Stacking Federal Courts With Anti-Choice Judges: The next generation of American women will face a growing threat posed by an increasingly anti-choice federal judiciary. Twelve of Trump’s judicial nominees were appointed to circuit courts during his first year – more than any other first-year president in American history.

Allowing States To Defund Clinics That Offer Abortion Care: Before today’s proposal, in early 2017, Trump signed a bill allowing states to withhold Title X family planning funds from health care providers that offer abortion-related care. Thirteen states used to withhold the Title X money from abortion providers before the Obama administration blocked them. (Because of the Hyde Amendment, federal funds can’t be used to pay for abortions, so the Title X money went to other health services at those clinics.) The legislation allows them to withhold the funds again and redirect them to providers that don’t offer abortion care.

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In News

House Farm Bill Becomes Latest Vehicle for Republicans’ War on Health Care

As the U.S. House prepares to vote on a farm bill that continues Republicans’ push to encourage subpar health plans, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“By including a provision encouraging association health plans, the House farm bill has become the latest vehicle for Republican attacks on health care and people with pre-existing conditions. The bill authorizes $65 million in taxpayer funding to set up association health plans, which can  exclude prescription drug coverage, mental health care, and maternity care. When these plans fail, they leave people who thought they had real coverage out in the cold. Hardworking Americans shouldn’t bet the farm on association health plan coverage.”

BACKGROUND

The National Association of Insurance Commissioners has warned that association health plans “provide inadequate benefits and insufficient protection to consumers” and “threaten the stability of the small group market.”

Subpar coverage and a lack of pre-existing condition protections pose a particularly large risk for agricultural workers because of the dangers of the profession. According to the U.S. Occupational Safety and Health Administration, the injury rate for agricultural workers is over 40 percent higher than the national workplace injury rate overall.

And as Roger Johnson, president of the National Farmers Union (NFU), wrote during last year’s repeal drive: “The Medicaid expansion has proven especially beneficial to rural communities, where the rate of enrollment is higher than in urban America, and the ACA’s system of tax credits and premium subsidies helps young farmers access insurance while enabling established farmers to maintain consistent coverage.”

 

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In News

GOP Health Care Sabotage In Dollars & Cents

This morning, Axios breaks down what Republicans’ continuing quest to undermine and sabotage health care is doing in dollars and cents.

SHOT: Health insurance and drug companies win big…

CHASER: People who work for a living pay more

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In News, Fact Sheet

Association Health Plans

By including a provision encouraging the proliferation of association health plans, the annual House farm bill has become the latest vehicle for Republican attacks on comprehensive coverage and pre-existing condition protections. The bill authorizes $65 million in taxpayer funding to set up association health plans, which would be allowed to exclude or limit basic services such as prescription drug coverage, mental health care, and maternity care. Before the Affordable Care Act, these kinds of plans had a long history of fraud and unpaid claims, because many states exempt them from key consumer protections. When these plans fail, they leave people who thought they had real coverage out in the cold.

ASSOCIATION HEALTH PLANS DON’T HAVE TO OFFER COMPREHENSIVE COVERAGE

Vox: Association Health Plans Could Allow Groups To Act As Large Employers Which Do Not Have To Cover Essential Benefits Under The ACA. “The result could in many cases be that these new association health plans would be considered large employers when it comes to health insurance. Large employers are not subject to the same rules as individual or small-group plans under Obamacare. Most notably, they do not have to cover all of the law’s essential health benefits or meet the requirement that insurance cover a minimal percentage of a person’s medical bills.” [Vox, 10/12/17]

Treating Association Health Plans Like Large Employers Would Exempt Them From Guaranteeing Essential Health Benefits And Allow Them To Charge People Based On Health Status And Gender. Treating Association Health Plans like large-employers would exempt them from key consumer protections under the Affordable Care Act. Large employers do not have to offer plans with the Essential Health Benefits like maternity care, prescription drug coverage or mental health and substance abuse services. Insurers for large employers can also charge more based on health status and gender. [Georgetown Center on Health Insurance Reforms, December 2017]

Katherine Hempstead, Robert Wood Johnson Foundation: “The Easier You Make It Not To Buy Comprehensive Coverage, The Harder You Make It Buy Comprehensive Coverage.” [New York Times, 10/11/17]

ASSOCIATION HEALTH PLANS HAVE A HISTORY OF FRAUD AND UNPAID CLAIMS

Former Insurance Fraud Investigator: “Fraudulent Association Health Plans Have Left Hundreds Of Thousands Of People With Unpaid Claims.” “Marc I. Machiz, who investigated insurance fraud as a Labor Department lawyer for more than 20 years, said the executive order was ‘summoning back demons from the deep.’ ‘Fraudulent association health plans have left hundreds of thousands of people with unpaid claims,’ he said. ‘They operate in a regulatory never-never land between the Department of Labor and state insurance regulators.’” [New York Times, 10/21/17]

2017: Labor Department Filed A Suit Against An AHP For 300 Employers In Washington State Alleging The AHP Had Charged Employers More Than $3 Million In Excessive Fees And Violating Its Fiduciary Duty By Using Assets For Personal Interests. “The problems are described in dozens of court cases and enforcement actions taken over more than a decade by federal and state officials who regulate the type of plans Mr. Trump is encouraging, known as association health plans. In many cases, the Labor Department said, it has targeted ‘unscrupulous promoters who sell the promise of inexpensive health benefit insurance, but default on their obligations.’ In several cases, it has found that people managing these health plans diverted premiums to their personal use. The department filed suit this year against an association health plan for 300 small employers in Washington State, asserting that its officers had mismanaged the plan’s assets and charged employers more than $3 million in excessive ‘administrative fees.’ Operators of the health plan violated their fiduciary duty by using its assets ‘in their own interest,’ rather than for the benefit of workers, the government said.” [New York Times, 10/21/17]

2016: A Labor Department Lawsuit Revealed An AHP Had Concealed Financial Problems And Left $3.6 Million In Unpaid Claims. “The Labor Department filed suit last year against a Florida woman and her company to recover $1.2 million that it said had been improperly diverted from a health plan serving dozens of employers. The defendants concealed the plan’s financial problems from plan participants and left more than $3.6 million in unpaid claims, the department said in court papers.” [New York Times, 10/21/17]

A Health Plan For New Jersey Small Businesses Collapsed With $7 Million In Unpaid Claims. “In another case, a federal appeals court found that a health plan for small businesses in New Jersey was ‘aggressively marketed but inadequately funded.’ The plan collapsed with more than $7 million in unpaid claims.” [New York Times, 10/21/17]

In Florida, A Man Pleaded Guilty To Embezzling $700,000 In Premiums From An AHP To Help Build A Home For Himself And Was Sentenced To 57 Months In Prison. “A Florida man was sentenced to 57 months in prison after he pleaded guilty to embezzling about $700,000 in premiums from a health plan that he had marketed to small businesses. The Labor Department and the Justice Department said he had used some of the plan premiums to build a home for himself.” [New York Times, 10/21/17]

In South Carolina, A Man Pleaded Guilty To Diverting Nearly $1 Million From An AHP For Churches And Small Businesses, Leaving $1.7 Million In Unpaid Claims. “A South Carolina man pleaded guilty after the government found that he had diverted more than $970,000 in insurance premiums from a health plan for churches and small businesses. ‘His embezzlement and the plan’s consequent failure left behind approximately $1.7 million in unpaid medical claims,’ the Labor Department said.” [New York Times, 10/21/17]

In Louisiana, Two People Pleaded Guilty To Using Money From The AHP For Spa Treatments, Diamond Cuff Links, Foreign Travel And Other Personal Expenses. “And in Louisiana, two people pleaded guilty to conspiracy charges after the government found that they had taken money from the medical benefit fund of a trade association and used it to pay for spa treatments, diamond cuff links, evening gowns, foreign travel and other personal expenses.” [New York Times, 10/21/17]

One AHP Scheme Shows How AHPs Can Move From State To State. Families USA chronicled an AHP scheme involving the American Trade Association, Smart Data Solutions, and Serve America Assurance. They found:

  • “Even after one state identifies a problem, the company may continue to operate for years in other states. North Carolina issued a cease and desist order to stop many of the players in this case from selling insurance in 2008.”
  • “But by June 2010, when Maryland issued a cease and desist order, the plans sold by these players had been identified in at least 23 states.2 „ Estimates of total premiums paid to these companies for unauthorized, unlicensed plans range from $14 million to $100 million.”
  • “This particular scheme operated through associations that went by many different names. (At least one of the players in this case was involved in a previous case concerned with fraudulent insurance sold through an association of employers in 2001-2002.”
  • “Consumers are often ill-protected when they buy coverage through an association, and the web of relationships among salespeople, associations, administrators, and actual insurers can be difficult for regulators to unravel and oversee. Consumers may be encouraged to join fake associations to buy health insurance so they have an illusion of coverage—and the insurers collect membership dues and premiums while illegally avoiding state oversight).” [Families USA, October 2010]

GAO Report In 1992 Showed Similar AHPs Left At Least 398,000 Participants With More Than $123 Million In Unpaid Claims And More Than 600 Plans In Almost Every State Failed To Comply With State Laws. “Back in 1992, the Government Accountability Office issued a scathing report on these multiple employer welfare arrangements (known as MEWAs; they’re pronounced “mee-wahs”) in which small businesses could pool funds to get the lower-cost insurance typically available only to large employers. These MEWAs, said the government, left at least 398,000 participants and their beneficiaries with more than $123 million in unpaid claims between January 1988 and June 1991. Furthermore, states reported massive and widespread problems with MEWAs. More than 600 plans in nearly every U.S. state failed to comply with insurance laws. Thirty-three states said enrollees were sometimes left without health coverage when MEWAs disbanded…’MEWAs have proven to be a source of regulatory confusion, enforcement problems and, in some instances, fraud,’ the GAO wrote at the time.” [Washington Post, 10/12/17]

Kentucky Experiment Showed AHPs Destabilize The Market And Caused Insurers To Leave Individual Market Or Not Sell New Policies Subject To Higher Standards. “In 1994, Kentucky passed a set of health insurance reforms (for the individual and small-group markets) that were very similar to the ACA’s market reforms.  These included a requirement for insurers to accept all applicants regardless of their health status, restrictions on exclusions of pre-existing health conditions, and a requirement that premiums be set without regard to health status, claims experience, or gender.  Premium variations for age, family size, and geographic factors were limited, and plan benefits were standardized. Insurers in the state resisted the reforms and lobbied to repeal parts of it. In 1996, Kentucky’s legislature passed legislation that repealed many of the market reforms.  Crucially, the law exempted associations of employers or individuals from the premium-rating and benefits requirements, a loophole that allowed associations to sell coverage under a much weaker regulatory scheme. In part because healthy individuals could buy association plans, the risk of adverse selection against the reformed individual market increased.  Nearly all insurers left Kentucky’s individual market or declined to sell new policies that were subject to the stronger rating and benefits standards. In 1998, the Kentucky legislature passed a bill that repealed many of the state’s remaining health insurance reforms.” [Center on Budget and Policy Priorities, 11/29/17]

KEY STAKEHOLDERS OPPOSE AHPs, SAYING THEY WOULD DESTABILIZE THE MARKETS, RAISE COSTS AND GUT PROTECTIONS FOR PEOPLE WITH PRE-EXISTING CONDITIONS

American Cancer Society Cancer Action Network, American Diabetes Association, American Heart Association, American Liver Foundation, American Lung Association, Arthritis Foundation, Crohn’s And Colitis Foundation, Cystic Fibrosis Foundation, Epilepsy Foundation, Lutheran Services In America, March Of Dimes, Muscular Dystrophy Association, National Health Council, National Multiple Sclerosis Society, National Organization For Rare Disorders, United Way Worldwide, Volunteers Of America, Womenheart: “This Order Has The Potential To Price Millions Of People With Pre-Existing Conditions And Serious Illnesses Out Of The Individual Insurance Market And Put Millions More At Risk.” “This order has the potential to price millions of people with pre-existing conditions and serious illnesses out of the individual insurance market and put millions more at risk through the sale of insurance plans that won’t cover all the services patients want to stay healthy or the critical care they need when they get sick…Together, these actions would likely split the market between those who need the comprehensive benefits provided under current law and those who are currently healthy and can gamble with substandard coverage. Siphoning off healthy people into risky, low-value plans, could leave millions of Americans with chronic or serious illnesses in an unsustainable insurance pool with rising premiums and fewer choices. It could also leave those who are healthy seriously underinsured when they face an unexpected health crisis.” [Letter, 10/12/17]

American Cancer Society Cancer Action Network: “Health Care Changes Could Leave Millions Of Cancer Patients And Survivors Unable To Access Meaningful Coverage.” “Today’s executive order jeopardizes the ability of millions of cancer patients, survivors and those at risk for the disease from being able to access or afford meaningful health insurance. Exempting an entire set of health plans from covering essential health benefits like prescription drugs or specialty care and allowing expansion and renewability of bare-bones short-term plans will split the insurance market. If younger and healthier people leave the market, people with serious illnesses like cancer will be left facing higher and higher premiums with few, if any, insurance choices.  Moreover, those who purchase cheap plans are likely to discover their coverage is inadequate when an unexpected health crisis happens leaving them financially devastated and costing the health care system more overall.” [ACS CAN, 10/12/17]

American Hospital Association: “These Provisions Could Destabilize The Individual And Small Group Markets, Leaving Millions Of Americans Who Need Comprehensive Coverage To Manage Chronic And Other Pre-Existing Conditions.” “Today’s Executive Order will allow health insurance plans that cover fewer benefits and offer fewer consumer protections…In addition, these provisions could destabilize the individual and small group markets, leaving millions of Americans who need comprehensive coverage to manage chronic and other pre-existing conditions, as well as protection against unforeseen illness and injury, without affordable options.” [AHA, 10/12/17]

American Medical Association: “The Executive Order’s Proposal To Expand Access To Association Health Plans And Allow Short-Term Plans To Cover Longer Time Periods May Weaken Important Patient Protections And Lead To Instability In The Individual Health Insurance Market.” “The AMA supports patient choice and promoting market competition, and supports the concept of association health plans. We have concerns, however, the Executive Order’s proposal to expand access to association health plans and allow short-term plans to cover longer time periods may weaken important patient protections and lead to instability in the individual health insurance market.” [AMA, 10/12/17]

American Academy Of Actuaries: “These Effects Could Include Tilting The Market In Favor Of Entities With Weaker Benefits Or Solvency Standards And Weakening The Protections For Consumers With Pre-Existing Health Conditions.” “‘Creating exemptions from the Affordable Care Act (ACA) insurance market rules can have far-reaching and unintended effects,’ said Academy Senior Health Fellow Cori Uccello. ‘These effects could include tilting the market in favor of entities with weaker benefits or solvency standards and weakening the protections for consumers with pre-existing health conditions.’” [AAA, 10/12/17]

Small Business Majority: “These Changes Would Be Bad For Small Businesses And Their Employees Because They Could Lead To Higher Premiums, Unbalanced Risk Pools And Lower-Quality Insurance.” “We are extremely disappointed this administration continues to undermine the Affordable Care Act (ACA), as evidenced today when President Trump signed an executive order allowing insurance companies to sell health insurance products across state lines and making it easier for groups to establish association health plans (AHPs). These changes would be bad for small businesses and their employees because they could lead to higher premiums, unbalanced risk pools and lower-quality insurance. While President Trump’s order would make it easier for a few select small businesses with younger and/or healthier employees to purchase association health plans that might be cheaper in other states, the tradeoff is that this would result in the emergence of parallel insurance markets for small businesses, leading to major spikes in premiums for small firms that remain in the small-group market.” [SBA, 10/12/17]

Consumers Union: “Executive Order On Health Plans Destabilizes Insurance Markets, Hurts Consumers, Drives Up Costs.” “While this executive order claims to help improve consumers’ access to affordable care, it would have the exact opposite effect. Allowing insurers to sell substandard association health plans that aren’t required to cover basic services and benefits will further fragment and destabilize the insurance markets as a whole. This action splits the market into two, pitting the healthy against those with preexisting conditions and life-threatening illnesses — but ultimately both groups lose in this new scheme.” [Consumers Union, 10/12/17]

American Federation Of Teachers: [Donald Trump] “Is Ignoring The Rule Of Law, Refusing To Compromise, And Doing An End-Run Around Congress In Order To Strip People Of Their Healthcare.” “Donald Trump owns the unwinding of the Affordable Care Act. He is ignoring the rule of law, refusing to compromise, and doing an end-run around Congress in order to strip people of their healthcare. Millions of Americans will be worse off because of his actions. This is an ongoing pattern of the Trump administration’s callous sabotage of Obamacare, and it will cause real harm to American families, leading to increased premiums and loss of coverage for those most in need of healthcare and flooding markets with cheap, limited ‘junk’ insurance.” [AFT, 10/12/17]

NETWORK Lobby: “The Trump Administration Continues To Do As Much As Possible To Destabilize The American Healthcare System, Increase Costs For Families, And Prevent People From Accessing The Care They Need.” “The Trump Administration continues to do as much as possible to destabilize the American healthcare system, increase costs for families, and prevent people from accessing the care they need. Today’s executive order is the latest attack on our healthcare, following a long line of attempts to repeal and cripple the ACA. This executive order will drive up premiums for many—especially middle-class families and people with pre-existing conditions—to further undermine the ACA. It is morally reprehensible to hurt people through unjust policies for political gain.” [Statement, 10/12/17]

ASSOCIATION HEALTH PLANS ALLOW PROVIDERS TO CHERRY PICK HEALTHIER PEOPLE, RAISING COSTS ON PEOPLE WITH PRE-EXISTING CONDITIONS AND DESTABILIZING THE MARKET

Tim Jost: “It Will Destroy The Small-Group Market…We’ll Be Back To Where We Were Before The Affordable Care Act.” “The result could in many cases be that these new association health plans would be considered large employers when it comes to health insurance. Large employers are not subject to the same rules as individual or small-group plans under Obamacare. Most notably, they do not have to cover all of the law’s essential health benefits or meet the requirement that insurance cover a minimal percentage of a person’s medical bills.If that change were made, association health plans would be freed to craft skimpier (and cheaper) health plans that appeal only to businesses with younger and healthier employees. Small businesses left in Obamacare’s marketplace would likely face higher costs and fewer options as the market became less attractive to insurers. ‘It will destroy the small-group market,’ Tim Jost, a law professor at Washington and Lee University who generally supports Obamacare, told me before the order was signed. ‘We’ll be back to where we were before the Affordable Care Act.’” [Vox, 12/29/17]

Georgetown Center on Health Insurance Reforms: Prior To ACA, AHPs Would Set Up Headquarters In A State With Fewer Regulations And Market To States With More Regulations. “Additionally, AHPs would often set up headquarters in one state with limited regulatory oversight and market policies to businesses and consumers in other states with more robust regulation, thereby bypassing those states’ more protective rating and benefit standards.” [Georgetown Center on Health Insurance Reforms, December 2017]

Deep Banerjee, S&P Global Ratings: “No One Healthy Is Now Going To Sign Up In The ACA Risk Pool, Because They Have This Cheaper Option.” “With associations, health care providers can effectively choose the most desirable participants, allowing the healthy to make the switch to save money — and potentially shutting out the less healthy. ‘No one healthy is now going to sign up in the ACA risk pool, because they have this cheaper option,’ Deep Banerjee, a health care analyst at S&P Global Ratings said.” [UPI, 10/12/17]

 

ashoup
In News

This Week in the War on Health Care

While a debate over Laurel and Yanny raged from coast to coast, Republicans continued their unprecedented assault on the American health care system. Here’s what happened this week in the war on health care, plus two more polls showcasing the massive unpopularity of the GOP sabotage campaign:

REPEAL AGAIN…REALLY?!

This week, Republican Senators once again started talking about reviving the worst of last year’s Republican repeal bills, Graham-Cassidy – apparently with the White House’s support. With the American people having rejected the GOP’s harmful repeal bills over and over again, Washington Republicans’ continued obsession with cutting Medicaid and ending protections for pre-existing conditions shows just how out of touch they are on the number one issue voters care about: health care.

THE COST OF SABOTAGE

On Monday, Protect Our Care launched Rate Watch, an educational campaign highlighting how Republican health care sabotage is forcing up health care costs across the country. As insurance companies’ preliminary rate filings point to Republican sabotage to justify hikes, Americans sat up and took notice:

The Hill: Premium Hikes Reignite The Obamacare Wars. “Democrats argue the price increases are the result of what they refer to as ‘Republican sabotage.’ They contend that, since the GOP controls Congress and the White House, the price hikes are their responsibility — and that’s the message they plan to take into the fall campaign… Protect Our Care, a pro-ObamaCare group, launched ‘Rate Watch’ on Tuesday, a media campaign and website aimed at getting out the Democrats’ message that Republicans are to blame for rate hikes..” [The Hill, 5/15]

Politico: Democrats Run On GOP Health Care ‘Sabotage.’ “Democrats are confidently running on Obamacare for the first time in a decade. They’ve got a unified message blaming Republicans for ‘sabotaging’ the health care law, leading to a cascade of sky-high insurance premiums that will come just before the November midterm elections. They’re rolling out ads featuring people helped by the law. And Tuesday, they’re starting a campaign to amplify each state’s premium increases — and tie those to GOP decisions… ‘Democrats need to prosecute the case against the Republican approach to health care,’ said Brad Woodhouse, campaign director at Protect Our Care and a longtime Democratic strategist.” [Politico, 5/15]

Washington Examiner: Obamacare Supporters Now Seizing On Rate Increases To Go After GOP. “The Obamacare advocacy group Protect Our Care announced its Rate Watch campaign Tuesday that will highlight proposed premium increases for Obamacare’s exchanges for 2019. The group said the goal of the campaign is to tie Republicans to the rate hikes because of moves such as the repeal of Obamacare’s individual mandate penalty that everyone have health insurance. ‘This is a purposeful, intentional campaign of sabotage that is making health insurance unaffordable,’ Sen. Chris Murphy, D-Conn., said on a call with reporters Tuesday.” [Washington Examiner, 5/16]

VERMONTERS AND OREGONIANS BECOME LATEST VICTIMS OF GOP SABOTAGE

Emphasizing the importance of Rate Watch, this week preliminary rate filings in Vermont and Oregon for 2019 plans were announced, and they included potential double-digit premium increases. Why? Here’s what insurance companies in the two states said:

“Recent federal legislation also eliminated the penalty associated with the individual mandate. As a result, it is expected that a number of healthy individuals will choose to forgo coverage and leave the single risk pool.” [BCBS Vermont, 5/14]

“These rate changes are necessary due to the increasing cost of medical care, the continued lack of funding for cost sharing reduction plans, and the expected reduction in the size of the Individual ACA market.” [BCBS Oregon, 5/14]

“The main drivers of the rate change are the increasing cost of medical care and the expected reduction in the size of the individual market. This filing reflects projected claim expenses increasing around 8.3% annually.” [BridgeSpan, 5/14]

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 now families in Vermont and Oregon are being asked to pay the price. President Trump and Congressional 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 Americans.

NEW STUDY FINDS PREMIUM INCREASES DUE TO GOP SABOTAGE CAMPAIGN

This morning, the Kaiser Family Foundation released a new study which attributed insurance companies’ premium increases to the GOP’s sabotage campaign, namely the repeal of the individual mandate and the embrace of short-term junk plans, and notes that:

However, absent any policy changes, it is likely that insurers would generally have required only modest premium increases in 2018 and in 2019 as well. Insurers are now beginning to file proposed rates for 2019.

As a reminder, the repeal of the individual mandate is expected to increase the uninsured rate by 13 million, and short-term plans have been estimated to raise premiums by 18.2%.

PRESIDENT’S PRESCRIPTION DRUG SPEECH NOT GETTING BETTER WITH AGE

Last Friday, President Trump gave a widely-panned speech on prescription drug pricing. The early reviews were not kind, and the coverage this week was no better. Here’s how the President’s remarks were covered this week:

Washington Post: Trump’s drug price retreat adds to list of abandoned populist promises

Washington Post: The health industry appears unfazed by Trump’s drug pricing speech

Bloomberg: Drug Industry Dodges Its Worst Fears in Trump’s Plan to Lower Prices

Pittsburgh Post-Gazette: Experts say Trump’s prescription to reduce drug prices is not what the doctor ordered

STAT News: Trump promised to bring pharma to justice. His speech sent drug stocks soaring

SEEMA VERMA ADMITS TRUMP ADMINISTRATION WILL LET UNINSURED RATE CONTINUE TO RISE

On Tuesday, Centers for Medicare & Medicaid Services Administrator Seema Verma admitted that the uninsured rate will continue to rise under her Administration’s watch.

Her remarks were only the latest example of the Trump Administration’s total disregard for Americans’ health care. During President Trump’s first year in office, the uninsured rate grew by 3 million – the largest increase since 2008. During President Trump’s second year in office, premiums are expected to increase double-digits across the country. The Trump Administration and Republicans in Congress have carried out a sabotage campaign designed to make the Affordable Care Act fail, and they have succeeded to the detriment of the American people. Administrator Verma’s admitting that the Administration has no plans to stop this suffering is disgraceful.

Enough is enough – it’s time for the GOP to end their war on health care. And if they don’t…

POLLS IN ARIZONA AND NEVADA CONFIRM: VOTERS SUPPORT THE ACA, OPPOSE GOP HEALTH CARE PLANS

This week, new polls were released in Arizona and Nevada. Most strikingly, the polls found that both Arizonans and Nevadans broadly support the Affordable Care Act over repeal.

From Arizona:

Republican candidates in Arizona running on the repeal of the Affordable Care Act do so at their own peril, according to a poll released Monday. The survey, conducted by the left-leaning Public Policy Polling, shows 33 percent of registered voters were more likely to vote for politicians who support scrapping ObamaCare compared to 46 percent who say they’re less likely. A majority of Arizonans also want to keep the current health law in place and would blame Republicans for health premiums increasing.

And Nevada:

In a poll released this week, most Nevada voters said they would hold Republicans “responsible” if ACA premiums increased this summer, and 53 percent favored fixing the law rather than repealing it and starting over.

Perhaps someone can bring these polls to the next Senate GOP caucus meeting.

ashoup
In News

Rate Watch Campaign Builds Momentum Against Republican Health Care Sabotage

Momentum is building against Republicans’ war on health care as families across the country start to count its consequences in dollars and cents. That’s why Protect Our Care’s ‘Rate Watch’ education and accountability campaign drew widespread attention yesterday:

The Hill: Premium Hikes Reignite The Obamacare Wars. “The cost of health insurance plans on the ObamaCare exchanges could jump in the coming weeks, some by double digits, inflaming the issue ahead of the midterm elections. Democrats argue the price increases are the result of what they refer to as ‘Republican sabotage.’ They contend that, since the GOP controls Congress and the White House, the price hikes are their responsibility — and that’s the message they plan to take into the fall campaign… Protect Our Care, a pro-ObamaCare group, launched ‘Rate Watch’ on Tuesday, a media campaign and website aimed at getting out the Democrat’s message that Republicans are to blame for rate hikes. Only a handful of states have released proposed premiums for next year, as insurers are largely still hammering out what their preliminary rates are going to be.” [The Hill, 5/15]

Circa News: Democrats Slam Trump, GOP Over Proposed Obamacare Rate Hikes. Protect Our Care, a coalition dedicated to preserving the ACA and opposing the GOP health care agenda, launched a campaign Tuesday to highlight proposed insurance rate increases and heap responsibility for them onto the Trump administration in advance of the November midterm elections. A ‘Rate Watch’ website, paid media, and coordinated educational efforts will aim to link high preliminary health insurance premiums to Trump’s policies as they are announced in the months ahead. ‘Families in every state in the nation are scared by the fallout of Washington Republicans’ repeal-and-sabotage war on health care, and with Rate Watch, we’re holding Republicans responsible for what they’ve done,’ said Protect Our Care Campaign Director Brad Woodhouse in a statement. ‘Every health care expert is confirming what ex-Secretary Tom Price just admitted: Republicans are responsible for hiking people’s premiums.’” [Circa, 5/15]

Politico: Democrats Run On GOP Health Care ‘Sabotage.’ “Democrats are confidently running on Obamacare for the first time in a decade. They’ve got a unified message blaming Republicans for ‘sabotaging’ the health care law, leading to a cascade of sky-high insurance premiums that will come just before the November midterm elections. They’re rolling out ads featuring people helped by the law. And Tuesday, they’re starting a campaign to amplify each state’s premium increases — and tie those to GOP decisions. That’s a big change from four election cycles of reluctance to talk about Obamacare on the stump… ‘Democrats need to prosecute the case against the Republican approach to health care,’ said Brad Woodhouse, campaign director at Protect Our Care and a longtime Democratic strategist. They will blame the next round of premium spikes on the GOP because Republicans repealed the individual mandate, eliminated a low-income subsidy, and let people enroll in health plans that don’t have the full range of ACA benefits and patient protections.” [Politico, 5/15]

Connecticut Mirror: Dems Predict ‘Eye-Popping’ Health Premium Hikes, Blame GOP. “Sen. Chris Murphy on Tuesday helped launch a Democratic initiative that blames Republicans for ‘sabotaging’ the Affordable Care Act, leading to sky-high health insurance premiums. Those sharp rate hikes — averaging more than 18 percent nationally for individual policies — will be announced just before November’s mid-term elections and will be an issue in many campaigns, the Democrats predict… Brad Woodhouse, campaign director at Protect Our Care and a longtime Democratic strategist, said Republicans had launched a ‘war on health’ that will result in ‘eye-popping rate increases.’” [CT Mirror, 5/15]

Washington Examiner: Obamacare Supporters Now Seizing On Rate Increases To Go After GOP. “A few years ago, Republicans would send out blaring alerts whenever an insurer proposed a double-digit rate increase for its Obamacare plans, putting Democrats on the defensive. Now Democrats and Obamacare supporters are hoping to do the same to the GOP, seizing on proposed rate hikes as evidence of GOP ‘sabotage’ of the law. The Obamacare advocacy group Protect Our Care announced its Rate Watch campaign Tuesday that will highlight proposed premium increases for Obamacare’s exchanges for 2019. The group said the goal of the campaign is to tie Republicans to the rate hikes because of moves such as the repeal of Obamacare’s individual mandate penalty that everyone have health insurance. ‘This is a purposeful, intentional campaign of sabotage that is making health insurance unaffordable,’ Sen. Chris Murphy, D-Conn., said on a call with reporters Tuesday… Protect Our Care is pointing to the proposals as evidence that the Trump administration is sabotaging the law. The Rate Watch campaign website lists a filing from Virginia insurer Cigna that stated a 15 percent increase is caused by the elimination of the individual mandate penalty and regulations to expand access to cheap, low-quality health plans. [Washington Examiner, 5/16]

Inside Health Policy: Protect Our Care Launches Campaign Blaming GOP For ACA Rate Hikes. “A pro-ACA group Wednesday launched a campaign that casts blame on the Trump administration and the GOP-led Congress for premium increases, holding up the GOP’s repeal of the individual mandate penalty, cutback of ACA advertising and outreach, and proposed non-ACA compliant plan options that could undermine the risk pools. Democrats say they want to work with the GOP on ways to reverse the rate hikes but see little hope for a way forward. Sen. Chris Murphy (D-CT) joined Protect Our Care, the left-leaning Center for American Progress and a Florida resident impacted by the rate hikes in announcing the co-called Rate Watch campaign. The Connecticut senator stressed that Democrats have spent the last 18 months fighting the GOP ‘sabotage’ of the Affordable Care Act.” [Inside Health Policy, 5/15]

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