Washington, D.C. – New data from America First Policies, compiled by President Trump’s own pollsters, found lowering the cost of health care to be the top issue voters want addressed in 2018, with these voters favoring fixes to the Affordable Care Act over repeal by a 47 to 34 percent margin. Protect Our Care Campaign Director Brad Woodhouse released the following statement in response:
“When President Trump’s own pollsters find that keeping and fixing the Affordable Care Act has a commanding double-digit advantage over repeal and that rising health care costs are the number-one issue on voters’ minds, it couldn’t be more clear that the Republican war on health care is failing. People across the country want to keep a health care system that stops insurance companies from discriminating against people with pre-existing conditions, imposing lifetime caps, or dropping coverage – and despite the rhetoric that Republicans have been pushing for nearly a decade, the law’s popularity only continues to rise.
“The GOP would do well to listen to the President’s own pollsters. No matter who conducts the polling, the results are clear: Americans continue to say they want Congress to lower their premiums and protect the ACA, repeating loudly and clearly: enough is enough – end the war on our health care.”
Washington, D.C. – As the Centers for Medicare and Medicaid Services released the final open enrollment numbers for 2018, which showed that 11.8 million people nationwide bought Affordable Care Act marketplace coverage, Protect Our Care Campaign Director Brad Woodhouse released the following statement:
“Millions of Americans rely on the Affordable Care Act for quality, affordable coverage, and today’s confirmed enrollment numbers provide clear evidence of the law’s critical importance in American health care. But for over a year, the Trump Administration has been carrying out an unprecedented sabotage campaign designed to undermine the law and make it fail. Nowhere was this more apparent that the Administration’s attacks on open enrollment, which included cutting the advertising budget by 90 percent, halving the enrollment time, and denying help for people trying to get coverage. But the American people rejected this partisan scaremongering, and now we know that 11.8 million people signed up for marketplace coverage, almost matching last year’s total enrollment despite the many obstacles the Trump Administration placed in their way. While this is heartening news, these 11.8 million people and millions more are living in fear that the Republican war on health care will hike their rates and make care prohibitively expensive or unavailable to people with pre-existing conditions.
“The American people don’t want to go back to a time when insurers could deny them health care for having a pre-existing condition or be priced out of the market based on their age, gender, or medical history. The Affordable Care Act is a lifeline for millions of Americans, and Republicans’ continuing attempts to undermine the law are being met with resistance through enrollment, protests, and at the ballot box as the American continue to say: enough is enough – it’s time for Republicans to end their war on our care.”
Anxiety About Health Care Mounts Due to Destructive Republican Rhetoric
Washington, DC – After new polling from the Kaiser Family Foundation confirmed Americans’ mounting anxiety about Republican health care sabotage, Protect Our Care Campaign Director Brad Woodhouse released the following statement:
“Despite everything Republicans have thrown at it, the Affordable Care Act still protects every single American with health insurance and connects millions of previously uninsured people with coverage – but you wouldn’t know it listening to Trump and Republicans in Congress. Republicans need to realize that misleading the public, sabotaging the law and spreading fear has real and damaging consequences. Whether you’re a person with a pre-existing condition or the parent of a sick kid, you deserve elected officials who make life easier, not scarier. The constant anxiety Americans now face is yet another hidden cost of Republicans’ relentless repeal-and-sabotage campaign against our health care.”
Key takeaways from the survey:
About half the public overall believes the ACA marketplaces are “collapsing,” including six in ten of those with coverage purchased through these marketplaces. This belief reflects the ongoing uncertainty caused by Republican sabotage and Trump’s divisive rhetoric, but contradicts what the President’s own economic advisors have confirmed about the stability and strength of the individual market.
Because of Republican sabotage, the number of people who are “very worried” or “somewhat worried” that rate hikes will make coverage unaffordable has skyrocketed to 67%, compared with 38% in October 2017.
People are more worried about copays and deductibles – up from 42% to 69%.
People are more worried that insurance companies will stop selling plans – up from 34% to 49%.
People are more worried that there won’t be any plans in their area – up from 33% to 51%.
One-third (34 percent) of shoppers in the individual market say the individual mandate that Republicans repealed was a “major reason” why they chose to buy insurance, and one in ten say they will not buy coverage without it. Research indicates that those most likely to drop coverage are “young invincibles,” who balance the risk pool and act as a downward pressure on premiums. Because of Republicans’ individual mandate repeal, CBO forecasts that average premiums in the nongroup market will increase by 10% in most years of the coming decade.
From:Brad Woodhouse, Protect Our Care Campaign Director
Date: May 3, 2018
Re: Health Care Remains Top Issue Heading Into Midterms
Throughout the Trump presidency, one issue has consistently stood out as the top priority for voters, critical to how Americans will cast their ballots in the midterm elections: health care.
Health care is a top issue in nearly every major issue-ranked poll in 2018;
Voters overwhelmingly trust Democrats over Republicans on health care; and
Voters resoundingly reject President Trump and Congressional Republicans’ repeal-and-sabotage campaign against the Affordable Care Act and Medicaid.
These polls, conducted by nonpartisan news outlets and by research firms from a wide array of ideological backgrounds, have shown consistent results despite asking differently-framed questions amid a turbulent political landscape. Clearly, health care is a dominant issue that will remain potent through the midterm elections, and the consistent partisan trust divide indicates that it should be a major focus for Democratic candidates in virtually every race in the country.
HEALTH CARE REMAINS A TOP ISSUE FOR AMERICAN VOTERS
Throughout 2018, poll after poll has surveyed which issues are top-of-mind for voters and nearly every time health care has been at the top of the list.
For example, a February CNN poll found that health care was voters’ top priority. Among its findings:
83% of voters said health care was extremely important or very important, the highest among all issues.
53% of voters said health care was extremely important, the highest among all issues – a 20% increase from August of 2010, a year when health care played a major factor in midterm elections.
78% of independent voters said health care was important, tied with the economy as their top issue.
At least 70% of voters in every demographic category said health care was important – a trend that stretches across gender, age, income level, education level, ideology, and party affiliation.
These results were echoed by a March Pew Research Center survey, which found health care is the number-one pocketbook issue for Americans across all income brackets:
More than half of those surveyed said that health care affects their household’s financial situation “a lot,” the only issue which more than half of Americans rated a key economic issue.
Health care is “a top household financial issue” across all income levels, with 53% of those earning more than $100,000 and 52% of those earning $30,000 or less saying it has a large effect.
An April HuffPost/YouGov poll found that health care was a top issue for voters, with, 28% of those surveyed listing health care as their top the top issue, leaving the Huffington Post to conclude:
“Heading into the midterm elections, American voters are more likely to say they’re focused about health care than any other issue.”
A March Gallup survey asked Americans about the issues they are most worried about and, 78% of those surveyed named health care as a worry, more than any other issue, leading Newsweek to frame its coverage of the poll, “Health Care Is A Bigger Concern Than Terrorism”:
“Americans are more concerned about health care than they are about terrorism, according to a poll released on Monday. The Gallup survey rated health care as the top concern among Americans, with 55 percent of respondents noting they were “a great deal” concerned about the availability and affordability of health care. Twenty-three percent were “a fair amount” concerned about the topic. It is the fifth year running that health care has topped Gallup’s list of concerns for Americans. It’s the 13th time overall that the issue has been a top concern. Democrats were more concerned about health care than Republicans, although 39 percent of Republicans still expressed concerns about the issue.”
A survey leaked in March from America First Policies using President Trump’s own pollsters found that health care was the top issue for voters, with 41% saying lowering health care costs should be Congress’ top priority. On the other side of the spectrum, a February poll from Priorities USA also found that independent voters continue to hold major concerns about President Trump’s war on health care:
“Donald Trump’s policies are adding to the economic burdens of average families by raising the cost of health care and driving up insurance premiums. And Trump has broken his promise to crack down on excessive drug prices. Instead, he has given the big drug companies huge tax breaks while allowing them to charge as much as they want, without any controls or negotiation. 60% of voters have major concerns, including 71% among independents.”
HEALTH CARE IS DRIVING DEMOCRATIC SUPPORT
Health care is not just a top concern for voters – it’s also a deciding factor for voters, and drives widespread support of Democrats.
On March 13, voters in Pennsylvania’s eighteenth district went to the polls and selected Conor Lamb over pro-repeal candidate Rick Saccone in a district which had gone for Donald Trump by nearly twenty points. A telephone exit poll of those who cast ballots found that:
Health care was a top issue for voters, with 52% listing it as important and only 19% deeming it not important. Among voters who said health care was the most important issue, Lamb beat Saccone 64-36, and among voters who said it was either the most important or a very important issue, Lamb beat Saccone 62-38.
On health care, voters said Lamb better reflected their views by 7 points, 45-38. Among independents, that gap widened to 16 points, with 50% saying Lamb’s health care views were more in line with theirs to only 34% for Saccone.
Voters were less likely to support Saccone because of the Republican health care agenda. Saccone’s support of the Republican health care agenda made 41% of voters less likely to vote for him and only 28% more likely to support him.
On April 24, Hiral Tipirneni nearly upset Republican Debbie Lasko in Arizona’s eighth district, a “closer-than-expected” result in a district Donald Trump carried by 21 points. A telephone exit poll of those who cast ballots similarly found that:
Health care was a top issue to voters, and these voters favored Tipirneni. Health care was ranked as a top issue for 58% of voters, with only 17% saying it was not that important or not important at all. Among these voters, Tipirneni beat Lesko 65-33.
On health care, voters said Tipirneni better reflected their views. Overall, voters said Tipirneni better reflected their views by 2 points, 45-43, over Lesko. Among independents, the gap widened to 30 points, 57-27 in favor of saying Tipirneni.
Voters were less likely to support Lesko because of the Republican health care agenda. Lesko’s support of the Republican health care agenda made 40% of voters less likely to vote for her and only 33% more likely to support her.
These were not special occurrences, either. A March 21 PPP poll among voters in battleground states found voters supporting pro-health care candidates and rejecting those favoring repeal:
In Arizona, health care is a top issue for 68% of voters, with 21% saying it is the most important issue. In a hypothetical Senate election, Democrat Kyrsten Sinema leads pro-repeal candidate Martha McSally 46-41
In Nevada, health care is a top issue for 65% of voters, with 27% saying it is the most important issue. In a hypothetical Senate election, Democrat Jacky Rosen leads pro-repeal Dean Heller 44-39.
In Pennsylvania, health care is a top issue for 71% of voters, with 25% saying it is the most important issue. In a hypothetical Senate election, Democrat Bob Casey leads pro-repeal candidate Lou Barletta 54-36.
In Tennessee, health care is a top issue for 71% of voters, with 31% saying it is the most important issue. In a hypothetical Senate election, Democrat Phil Bredesen leads pro-repeal candidate Marsha Blackburn 46-41.
In Wisconsin, health care is a top issue for 72% of voters, with 25% saying it is the most important issue. In a hypothetical Senate election, Democrat Tammy Baldwin leads pro-repeal candidates Leah Vukmir and Kevin Nicholson 51-39 and 51-38, respectively.
And in November, in what analysts deemed the election most seen as a bellwether for the rest of the country, exit polling from Virginia, where Democrats had their best performance in decades, found health care to be far-and-away the most important issue:
Asked whether health care, immigration, gun policy, taxes, or abortion was the most decisive issue, 39% of voters said health care was the issue which mattered most.
Among those who selected health care, 77% backed Democrat Ralph Northam.
VOTERS REJECT THE REPUBLICAN HEALTH CARE AGENDA
Ultimately, Americans don’t support or trust the GOP when it comes to health care.
A February PPP poll found Americans placing blame for rising health care costs on President Trump’s sabotage of the law. Among its findings:
Over half of voters know Republicans are sabotaging health care, with 51% stating that the Trump administration is actively taking steps that will raise people’s health care costs.
60% of voters want to keep the ACA in place and make fixes as necessary, with just 34% favoring repeal.
This rang true in Pennsylvania’s eighteenth district, with polling showing not just support for Conor Lamb based on his health care stance, but also a rejection of Rick Saccone for his pro-repeal views:
Voters in this heavily-Republican district disapproved of the Republican efforts to repeal the Affordable Care Act by 14 points, 53% to 39%.
59% of those surveyed said the Affordable Care Act should be kept in place with fixes made to it as necessary, while just 38% of those surveyed said the best path forward on health care was to repeal the ACA.
Among independent voters, the disparity is even wider, with 63% of independent voters opposing the GOP’s health care efforts and just 33% supporting them.
This was also the case in Arizona’s eighth district. Although Tipirneni was not able to pull off the upset, polling showed health care was a boost for her, and once again showed the ACA’s growing popularity:
Voters in this heavily Republican district disapproved of the Republican efforts to repeal the Affordable Care Act by 5 points (49% to 44%).
Only 41% of voters think the best path forward on health care is to repeal the Affordable Care Act, to 54% who think it should be kept in place with fixes made to it as necessary.
In fact, even the Trump-backed poll finds that voters don’t trust the GOP’s health care agenda. The America First Policies poll also found:
By 17 points, voters disapprove of Trump’s “handling of health care and health insurance” with only 38% approving (16% strongly) and 55% disapproving (44% strongly).
Among the 41% of voters who say lowering health care costs should be the top priority, 68% want Congress to either leave the Affordable Care Act as it is or work to fix it, with just 31% backing repeal.
And let’s not forget – in direct opposition of the Republican health care agenda, the popularity of the ACA continues to rise:
In the PPP poll, approval for the Affordable Care Act 12 was points above water, 47% approval to 35% disapproval, a dramatic reversal from trends before Trump took office.
In the PA-18 exit polling, a deeply-red district, 44% of voters supported for the ACA while just 42% opposed it.
And in the latest Kaiser tracking poll, 50% of voters expressed their support for the ACA to just 43% who disapproved, reflecting the long-term upward trend of support for the ACA that reached an all-time high in February at 54-42 approve/disapprove.
Ultimately, the message could not be more explicit: voters from all backgrounds and in states across the country are telling the GOP that enough is enough – it’s time for Republicans to end their war on health care and cease their repeal and sabotage agenda. As polls and election results have made clear, if Republicans continue their war on health care and Democrats call them on it, the opposition party will continue to widen its advantage in the midterm elections.
In response to Iowa Governor Kim Reynolds signing legislation which allows for the sale of association health plans and ‘benefit plans’ which don’t meet Affordable Care Act requirements, Protect Our Care Chair Leslie Dach released the following statement:
“The legislation takes Iowa back to the days when insurance companies could discriminate against people with pre-existing conditions and refuse to cover essential health benefits like maternity care and prescription drugs, paving the way for even higher premiums and further market destabilization. This legislation will allow insurance companies to sell junk plans without proper oversight – precisely the kind of abuses the Affordable Care Act was designed to stop.”
Washington Post [4/2/18]: Iowa tries another end run around the Affordable Care Act
As a growing number of Republican-led states look for end runs around the Affordable Care Act, Iowa is embracing a strategy that contends not all health plans are actually health insurance. Gov. Kim Reynolds (R) is scheduled Monday to sign into law a bill allowing the century-old Iowa Farm Bureau to collaborate with the state’s dominant insurer to sell “health benefit plans,” which are expected to cost health customers less than ACA coverage because they will not have to comply with federal requirements.
Washington, D.C. – A coalition of health care advocacy groups will observe Medicaid Awareness Month this April, conducting educational campaigns focused on a different topic each week, culminating in a national Medicaid Day of Action on April 30. As federal and state-level threats mount, advocates will highlight the full scope of this critical program.
As Kaiser Health News’ Medicaid Nation series has recently emphasized, Medicaid plays an often-unheralded but central role delivering a wide range of public services to children, seniors, working families, people with disabilities, and people coping with mental health and substance use disorders. From Medicaid’s essential role facilitating special education in K-12 schools to its financial support for over 60% of nursing home beds nationwide, Medicaid Awareness Month will enhance awareness of the many ways this popular program strengthens American communities.
Organizations participating in this year’s Medicaid Awareness Month include:
Protect Our Care
Autistic Self Advocacy Network
Center for American Progress
Community Catalyst
First Focus
Health Care for America Now
Health Care Voter
National Committee to Preserve Social Security and Medicare
Organizing For Action
SEIU
As advocates and activists across the country highlight Medicaid’s critical importance in our communities, they will also educate the public about threatened cuts to the program. These include the President’s most recent budget, which would slash the program by $1.4 trillion; ongoing Congressional leadership discussion of ‘entitlement reform’; and a series of recent actions by the U.S. Department of Health & Human Services that encourage states to cut Medicaid enrollment by imposing new restrictions and eligibility hurdles.
This year’s Medicaid Awareness Month will center around four distinct focuses: kids, families, and Medicaid; Medicaid’s key role in fighting the opioid crisis; seniors, older adults, and Medicaid; and how Medicaid serves people with disabilities.
NATIONALLY, ASSOCIATION HEALTH PLANS HAVE A HISTORY OF FRAUD AND UNPAID CLAIMS
Between 2000 and 2002, AHPs Left 200,000 Policyholders with $252 Million In Unpaid Medical Bills. “There have been several documented cycles of large-scale scams. According to the GAO, between 1988 and 1991, multiple employer entities left 400,000 people with medical bills exceeding $123 million. The most recent cycle was between 2000 and 2002, as 144 entities left 200,000 policyholders with $252 million in unpaid medical bills.” [United Hospital Fund, 3/6/18]
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]
Dr. James Madara, CEO of the American Medical Association: Association Health Plans Have Potential To Threaten Health And Financial Stability. “Fraudsters prey upon areas of regulatory ambiguity and may challenge such authority in courts to further delay enforcement, which allows more time to increase unpaid medical claims…Without proper oversight to account for insolvency and fraud, AHPs have the potential to … (threaten) patients’ health and financial security and the financial stability of physician practices and other providers.” [Modern Healthcare, 3/7/18]
INSURANCE COMMISSIONERS AGREE THAT ASSOCIATION HEALTH PLANS ARE BAD FOR CONSUMERS
National Association of Insurance Commissioners: Association Health Plans Are Bad For Consumers. “AHPs would fragment and destabilize the small group market, resulting in higher premiums for many small businesses…AHPs would be exempt from state solvency requirements, patient protections, and oversight exposing consumers to significant harm.” [NAIC]
Pennsylvania Insurance Commissioner Concerned About Potential For Consumer Harm Under AHPs.“The proposed rule would also loosen existing commonality of interest requirements to allow associations to form simply based on membership in the same trade, industry or profession..If a self funded MEWA were permitted to form in a neighboring state and to sell to Pennsylvania association members under the metro area provision, Pennsylvania regulators would not have the ability to assist a Pennsylvania resident if problems arise with the other state’s association, including claim denials, or, worse yet, in the event of insolvency or fraud.” [PA Insurance Commissioner Jessica Altman, 3/6/18]
California Insurance Commissioner: “The Proposed Rule Is A Perfect Storm Of Bad Ideas.” “The AHPs proposed by this rule will harm consumers by degrading the individual and small group health insurance markets through adverse selection, and will impinge upon states’ rights while opening the door to fraud, insolvency and abuse…The proposed rule in no way limits the ability of states to regulate MEWAs, insurers offering coverage through MEWAs, and insurance producers marketing that coverage to employers. However, the checkered history of MEWAs instructs that unscrupulous actors will try and exploit any change which can be mischaracterized as constituting ERISA preemption.” [CA Insurance Commissioner Dave Jones, 3/6/18]
PATIENT GROUPS, HOSPITALS, AND KEY HEALTH STAKEHOLDERS CONDEMN AHPs
American Cancer Society Cancer Action Network: “We Are Also Concerned About The Proliferation Of AHPs Because Of Their History Of Fraud And Financial Instability.” “For a long time, these products were not traditionally subject to the same state insurance solvency and licensing requirements that allowed regulators to maintain necessary oversight.5 If an AHP lacked the financial resources to pay claims, then enrollees were left with no coverage and high out-of-pocket costs. Even in cases of well-meaning AHP sponsors, insolvencies led to millions of dollars in unpaid claims.” [ACS-CAN, 3/6/18]
American Hospital Association: AHPs “Ultimately Decreas[e] Access To Affordable Coverage.” “We are concerned that this rule fails to protect against discriminatory insurance practices and could contribute to instability in the individual and small group market, ultimately decreasing access to affordable coverage.” [American Hospital Association, 3/6/18]
Coalition Of 118 Patient And Community Organizations Urges Department Of Labor To Reconsider AHPs. “We believe that the proposed changes would negatively impact access to quality, affordable care for consumers, disrupt the individual and small business marketplace, and further strain the limited resources of state regulators…The intent of the President’s executive order was to increase consumer choice while curbing costs, however we believe that AHPs as proposed would invariably weaken the individual and small group markets leading to higher healthcare costs for all; higher premiums for those who stay in the marketplace, and high out of-pocket costs for those who are covered by AHPs for unexpected medical needs.” [Coalition Of 118 Patient And Community Organizations, 3/6/18]
AHPs ARE HOTSPOTS FOR FRAUD IN STATES:
Florida
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]
In Florida, A Man Pleaded Guilty To Embezzling $700,000 In Premiums From the AHP He Ran in 2004 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 2004, A Florida Woman Was Left With $500,000 In Unpaid Medical Bills While She Was Covered By Association Health Plan. “Joan Piantadosi, a small business owner bought health insurance from Employers Mutual LLC through an association for herself, her family, and her employees. She was left with more than $500,000 in unpaid medical bills for her husband’s treatment during the time she was covered by Employers Mutual LLC. On top of that, her husband needed a liver transplant to live. In her own words, “[W]e were informed that since we lacked insurance coverage, we would have to pay a deposit of $150,000 before my husband could enter the hospital’s Liver Transplant Inpatient program. We simply did not have $150,000 to cover the deposit. Consequently, my husband was removed from the recipient list…We feared, among other things, that my husband might die while we were attempting to deal with the predicament of being uninsured despite having paid premiums to what appeared to be a legitimate health insurer.” [United Hospital Fund, 3/6/18]
Louisiana
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]
Texas
In Texas, Patients Thought They Were Insured Until Told Otherwise In A Moment Of Crisis. “Robert Loiseau, who represented fraud victims in Texas, recalled their shock when they tried to receive care. ‘People bought insurance coverage because it was cheap and seemed to provide them with coverage they needed,’ he said. ‘It had a veneer of legitimacy. But when they went to the doctor, they found out all of a sudden that their insurance company, their perceived insurance company, was in receivership and that they had no coverage.’” [New York Times, 10/21/17]
Between 2001 And 2003, Texas Shut Down 129 Unauthorized Insurance Operations. “In the last two years, the Texas Insurance Department shut down 129 unauthorized insurance companies, affiliates, operators, and their agents whose illegal actions affected more than 20,000 Texans.” [The Commonwealth Fund, August 2003]
New Jersey
In 2002, An AHP Became Insolvent With $15 Million In Outstanding Claims. “For example, when a long-standing AHP in New Jersey that covered 20,000 people became insolvent in 2002, it had $15 million in outstanding medical bills. This left participating businesses and their employees’ claims unpaid even though employers paid premiums to the AHP.” [Commonwealth Fund, 10/10/17]
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]
South Carolina
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]
Across State Lines: North Carolina, Maryland, And Beyond
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. 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]
At the annual National Association of Insurance Commissioners (NAIC) meeting, Trump Administration officials told insurers that they will not make a decision on their proposed junk plan rule until this fall, right before Open Enrollment begins. Axios noted: “That would give insurers very little time to adjust their premiums to account for the finalized regulations — which would probably make them more likely to err on the side of caution and seek bigger initial increases.” In response, Protect Our Care Campaign Chair Leslie Dach released the following statement:
“Middle-class consumers are already bracing for higher rates next year as a direct result of the TrumpTax bill and ongoing Trump Administration sabotage. After sabotaging their own half-hearted attempt at a so-called stabilization bill, Republicans in Congress have nobody to blame but themselves for the rate hikes that insurance companies are now predicting. If they truly want to contain the damage and protect consumers, they should call on the Trump Administration to immediately rescind the junk plan rule that would once again allow discrimination against people with pre-existing conditions and also force rate increases for real insurance. It’s important to remember that it didn’t have to be this way: before President Trump took office, rates were leveling out and some insurance companies were planning to offer lower premiums. But instead, Trump led Congressional Republicans into an all-out war on our health care, and now that they have failed to repeal the Affordable Care Act, they seem to have decided to just keep digging.”
In honor of the Affordable Care Act being signed into law eight years ago, last week the Protect Our Care coalition celebrated ACA Anniversary Week, highlighting the health care achievements made across America under the ACA and making clear that we won’t go back and erode this progress.
SUPPORTERS STAND UP FOR THE ACA: WE WON’T GO BACK
All across the country, from Alaska to Tennessee to the nation’s Capitol, health care voters held rallies for the ACA Anniversary Week of Action to made their voices heard and tell elected officials we won’t go back on eight years of progress.
ALASKA
Protect Our Care and the Alaska Grassroots Alliance held a rally in Anchorage.
ARIZONA
Protect Our Care and Planned Parenthood Advocates of Arizona held a rally in Phoenix. They were joined by Dr. Wylie Carhartt of the Mountain Park Health Center Family Practice, Phil Pangrazio, CEO of Ability 360, Steve Gomez, whose child received a heart transplant under the ACA, and cancer survivors.
COLORADO
Protect Our Care held rallies in Denver and Grand Junction, visiting Sen. Cory Gardner’s Denver office and Rep. Scott Tipton’s Grand Junction office.
MAINE
Protect Our Care joined State Senator Dr. Geoff Gratwick and Nurse Practitioner State Rep. Anne Perry to hold a rally in Bangor. Rep Perry expressed her disappointment in Senator Susan Collins’ recent sponsorship of legislation which would weaken women’s care and her support for the ACA, saying, “Even though there may be complaints of more spent because of Medicaid, we will have a healthier population. And I don’t know of one business who doesn’t want a healthier workforce.”
Protect Our Care, OFA, Nevada Advocates for Planned Parenthood Affiliates, the Alliance for Healthcare Security, and Battle Born Progress held rallies in Las Vegas and Reno. They were joined by representatives from Positively Kids, the Children’s Advocacy Alliance, SmartBuy Insurance, and the Nevada Alliance for Retired Americans, as well as cancer survivors and health care advocates.
Protect Our Care and For Our Future joined with DeWayne Lee of Healing Heart, local pastors, and city councilmembers to hold rallies in Cincinnati, Mansfield, and Toledo, outside of Sen. Portman’s Toledo office.
Protect Our Care and the Southern Christian Coalition joined with physicians, registered nurses, local faith leaders, and Sara Scott, whose son has asthma and progressive heart disease and whose daughter has developmental disabilities, neither of whom would be insurable without the ACA, to hold rallies in Nashville and Chattanooga, outside Sen. Lamar Alexander’s office.
Protect Our Care, West Virginians for Affordable Health Care, the West Virginia Citizen Action Group, Our Children, Our Future, and West Virginians Together for Medicaid joined with staff from the office of Senator Joe Manchin to hold a rally in Charleston.
HOUSE DEMOCRATS JOIN HEALTH CARE GROUPS TO CELEBRATE ANNIVERSARY
Last Thursday, Leader Nancy Pelosi, Whip Steny Hoyer, Assistant Minority Leader Jim Clyburn, Rep. David Cicilline, and Rep. Brenda Lawrence joined Protect Our Care, Little Lobbyists, Health Care Voter, Doctors for America, and other health care advocates at a press conference celebrating the millions of lives which have benefited since the ACA was signed into law.
POLLING SHOWS: HEALTH CARE A TOP ISSUE, VOTERS BACKING PRO-ACA CANDIDATES Last week, Public Policy Polling released a series of polls which found that not only is health care a top issue for voters across the country, but in battleground states pro-repeal candidates are being rejected. The polls found the following results:
In Arizona, health care is a top issue for 68% of voters, with 21% saying it is the most important issue. In a hypothetical Senate election, Democrat Kyrsten Sinema leads pro-repeal candidate Martha McSally 46-41
In Nevada, health care is a top issue for 65% of voters, with 27% saying it is the most important issue. In a hypothetical Senate election, Democrat Jacky Rosen leads pro-repeal Dean Heller 44-39.
In Pennsylvania, health care is a top issue for 71% of voters, with 25% saying it is the most important issue. In a hypothetical Senate election, Democrat Bob Casey leads pro-repeal candidate Lou Barletta 54-36.
In Tennessee, health care is a top issue for 71% of voters, with 31% saying it is the most important issue. In a hypothetical Senate election, Democrat Phil Bredesen leads pro-repeal candidate Marsha Blackburn 46-41.
In Wisconsin, health care is a top issue for 72% of voters, with 25% saying it is the most important issue. In a hypothetical Senate election, Democrat Tammy Baldwin leads pro-repeal candidates Leah Vukmir and Kevin Nicholson 51-39 and 51-38, respectively.
While much of Washington focused on the omnibus bill, the Trump Administration and Congressional Republicans continued their unprecedented assault on the American health care system this week. Here’s what happened this week in the GOP’s war on health care – and how as we approach the eighth anniversary of the Affordable Care Act being signed into law, the health care protections it provides Americans are more popular than ever.
GOP PRIORITIZES PARTISANSHIP OVER AMERICANS’ HEALTH, AGAIN…
Congressional Republican leaders left the bipartisan negotiating table and unilaterally released a “stabilization” bill riddled with poison pills designed to prevent Democrats from supporting its passage. The bill includes expansive anti-abortion language which effectively bans all private insurance from covering abortion services, and prevents states from taking action against the Trump Administration’s proposed junk insurance plans that can deny coverage for pre-existing conditions and refuse to cover essential benefits.
Once again, Republicans chose to prioritize an extreme agenda over their constituents’ interests, continuing to go after pre-existing condition protections and women’s health while artificially inflating rates through their relentless sabotage of our care. As Rep. Tom Cole (R-OK) said, “Nobody in that room voted for Obamacare, so the idea you’re going to vote for billions of dollars to stabilize a system you never supported in the first place — pretty hard to choke down.”
…TO OFFER A SHAM STABILIZATION BILL
And what of the bill itself? Alexander-Collins is simply a terrible proposal for Americans’ health care. The proposed GOP stabilization legislation would result in net coverage losses, higher out-of-pocket costs, and fewer coverage options for many Americans – and an attack on a women’s right to choose.
So despite what Republicans may be publicly saying, Alexander-Collins is not a serious attempt to stabilize the marketplaces. It’s a partisan bill designed to fail, and it represents nothing more politics at its worst from Republican leaders in Congress who otherwise have voted to repeal Americans’ health care.
CONFIRMED: TRUMP’S JUNK PLAN RULE HARMS OLDER AMERICANS
According to a new study from AARP, the Trump Administration’s plot to let insurance companies sell junk plans would cause premiums for older Americans to jump by double digits next year, with the average 60-year-old paying an average of 16.6% more for individual-market coverage. If the proposal moves forward, older Americans would face an eye-popping annual premium increase of over $2,000 next year. Here are full state-by-state estimates:
WHITE HOUSE CONTINUES IGNORING REAL OPIOID SOLUTIONS
On Tuesday, President Trump spoke in New Hampshire about the opioid crisis. Once again, his speech was heavy with rhetoric and short on solutions – more of the same from a White House more committed to politicizing the opioid crisis than ending it.
As a reminder, the Trump Administration has relentlessly attacked and sabotaged Medicaid, proposing to cut funding by hundreds of billions for the program that pays for one-fifth of all substance abuse treatment nationwide, and for two successive years has proposed a 95% cut to the Office of National Drug Control Policy, charged with coordinating the federal response to the nation’s raging opioid crisis.
HELLER RECEIVES HIS PAYOFF
Last summer, Senator Dean Heller (R-NV) supported the GOP’s repeal legislation, a bill he himself said ““takes insurance from tens of millions of Americans and hundreds of thousands of Nevadans.” This came just weeks after President Trump threatened Heller, sayings, “He wants to remain a senator, doesn’t he?” As CNN noted:
The subtle threat may have had an effect. Over the next several months, Heller aligned himself closely with the President, endorsing his efforts to repeal Obamacare, appearing right behind Trump at a White House event celebrating passage of the tax law, and avoiding direct criticism of Trump despite the seemingly endless string of controversies coming out of the West Wing.
This week, Sen. Heller received his final payoff: a tweet from President Trump.
Congrats to Sen. Heller! But he might want to take that endorsement with a grain of salt, because…
POLLING SHOWS: HEALTH CARE A TOP ISSUE, VOTERS BACKING PRO-ACA CANDIDATES
This week, Public Policy Polling released a series of polls which found that not only is health care a top issue for voters across the country, but voters are rejecting pro-repeal candidates in five battleground states. The polls found the following results:
In Arizona, health care is a top issue for 68% of voters, with 21% saying it is the most important issue. In a hypothetical Senate election, Democrat Kyrsten Sinema leads Republica Martha McSally 46-41
In Nevada, health care is a top issue for 65% of voters, with 27% saying it is the most important issue. In a hypothetical Senate election, Democrat Jacky Rosen leads Republican Dean Heller 44-39.
In Pennsylvania, health care is a top issue for 71% of voters, with 25% saying it is the most important issue. In a hypothetical Senate election, Democrat Bob Casey leads Republican Lou Barletta 54-36.
In Tennessee, health care is a top issue for 71% of voters, with 31% saying it is the most important issue. In a hypothetical Senate election, Democrat Phil Bredesen leads Republican Marsha Blackburn 46-41.
In Wisconsin, health care is a top issue for 72% of voters, with 25% saying it is the most important issue. In a hypothetical Senate election, Democrat Tammy Baldwin leads Republicans Leah Vukmir and Kevin Nicholson 51-39 and 51-38, respectively.
POLLING ALSO SHOWS: HEALTH CARE THE #1 POCKETBOOK ISSUE FOR AMERICAN FAMILIES
Today, the Pew Research Center released a new survey that finds the number-one pocketbook issue for Americans of all income brackets is health care, confirming the vital importance of this issue to American families. Key findings include:
More than half of those surveyed said that health care affects their household’s financial situation “a lot,” the only issue which more than half of Americans rated a key economic issue.
Health care is “a top household financial issue” across all income levels, with 53% of those earning more than $100,000 and 52% of those earning $30,000 or less saying it has a large effect.
THE ACA TURNS EIGHT, AND IS MORE POPULAR THAN EVER
Finally, today March 23, is the eight-year anniversary of the Affordable Care Act being signed into law. Since then, more than 20 million Americans have gained coverage; the uninsured rate fell to below 9 percent, the lowest-ever recorded rate; and health care prices rose at the slowest rate in more than half a century.
Yesterday morning, Leader Nancy Pelosi, Whip Steny Hoyer, Assistant Minority Leader Jim Clyburn, Rep. David Cicilline, and Rep. Brenda Lawrence joined Protect Our Care, Little Lobbyists, Health Care Voter, Doctors for America, and other health care advocates at a press conference celebrating the millions of lives which have benefited since the ACA was signed into law.
While there is countless work ahead, hundreds of millions of Americans are able to sleep easier at night knowing that insurers can no longer pick and choose who to cover, protecting from discrimination against those with pre-existing conditions, removing lifetime caps, and mandating essential coverage like maternity care and cancer treatment.
Today, the Affordable Care Act is more popular than it has ever been.
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