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TODAY: U.S. Senator Wyden to Discuss Health Care Victories Ahead of the State of the Union Address

 ***MEDIA ADVISORY FOR MONDAY, FEBRUARY 6 AT 12:30 PM ET // 9:30 AM PT***

Senator Wyden and Protect Our Care to Celebrate Lower Health Care Costs and Discuss Need to Protect and Strengthen the Inflation Reduction Act

Washington, DC — On Monday, February 6, 2023 at 12:30 PM ET, Senate Finance Committee Chairman Ron Wyden (D-OR) will join patient advocates and Protect Our Care for a virtual press conference to discuss how Democrats have delivered the most important health care improvements since the passage of the Affordable Care Act (ACA), expanding affordable coverage, driving down prescription drug costs, strengthening Medicaid for moms and kids, and reducing inequities in care. As it stands, a record 16.3 million people signed up for coverage under the ACA marketplaces, seniors are saving on insulin and vaccine costs, and the uninsured rate has reached an all time low. 

The event comes ahead of President Biden’s State of the Union address, where he will celebrate the administration’s accomplishments and outline further action to lower costs and improve care for people across the nation. Republicans, on the other hand, are doubling down on their war on health care by raising premiums, ending Medicare and Medicaid as we know it, reversing recent coverage gains, and hiking prescription drug costs for the American people. 

PRESS CALL:

WHO:
U.S. Senator Ron Wyden (D-OR)
Linda Hamacher, patient advocate
Randie Snow, patient advocate
Leslie Dach, Chair of Protect Our Care

WHAT: Virtual Press Conference

WHERE: Register for the Event Here

WHEN: Monday, February 6, 2023 at 12:30 PM ET // 9:30 AM PT

PRESS CALL: U.S. Senator Wyden, Rep. Neal to Discuss Health Care Victories Ahead of the State of the Union Address

 ***MEDIA ADVISORY FOR MONDAY, FEBRUARY 6 AT 12:30 PM ET // 9:30 AM PT***

Senator Wyden, Rep. Neal, and Protect Our Care to Celebrate Lower Health Care Costs and Discuss Need to Protect and Strengthen the Inflation Reduction Act

Washington, DC — On Monday, February 6, 2023 at 12:30 PM ET, Senate Finance Committee Chairman Ron Wyden (D-OR) and House Ways and Means Committee Chairman Richard E. Neal (D-MA) will join patient advocates and Protect Our Care for a virtual press conference to discuss how Democrats have delivered the most important health care improvements since the passage of the Affordable Care Act (ACA), expanding affordable coverage, driving down prescription drug costs, strengthening Medicaid for moms and kids, and reducing inequities in care. As it stands, a record 16.3 million people signed up for coverage under the ACA marketplaces, seniors are saving on insulin and vaccine costs, and the uninsured rate has reached an all time low. 

The event comes ahead of President Biden’s State of the Union address, where he will celebrate the administration’s accomplishments and outline further action to lower costs and improve care for people across the nation. Republicans, on the other hand, are doubling down on their war on health care by raising premiums, ending Medicare and Medicaid as we know it, reversing recent coverage gains, and hiking prescription drug costs for the American people. 

PRESS CALL:

WHO:
U.S. Senator Ron Wyden (D-OR)
U.S. Representative Richard E. Neal (D-MA)
Linda Hamacher, patient advocate
Randie Snow, patient advocate
Leslie Dach, Chair of Protect Our Care

WHAT: Virtual Press Conference

WHERE: Register for the Event Here

WHEN: Monday, February 6, 2023 at 12:30 PM ET // 9:30 AM PT

Republicans, Following Through on Campaign Promise, Take Aim at Inflation Reduction Act, Threatening Health Care for Millions of Americans

Repealing the Inflation Reduction Act Means Raising Premiums, Hiking Prescription Drug Costs, and Worsening Care for Seniors

Washington DC — Yesterday, U.S. Representative Andy Ogles (R-TN-05) introduced legislation to fully repeal the Inflation Reduction Act. After running on repealing the historic legislation, Republicans are making good on this promise. Backed by major conservative groups including Heritage Action and Americans for Prosperity, the GOP plan would raise premiums, ban Medicare from negotiating drug prices, reverse recent coverage gains, exacerbate health inequities, and hike prescription drug costs for seniors. In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“Republicans want to go back to the status quo of hard-working families struggling to make ends meet due to outrageous health costs. The GOP have said time and time again they want to repeal the Inflation Reduction Act.  They actually campaigned on it. This attempt isn’t just a one-off – it is backed by key core right-wing groups that will determine Republican priorities for years to come. This bill to repeal the hard-fought health care wins would be a disaster for the American people who have already started to see the benefits and have finally gotten a breath of relief.”

What Repealing the Inflation Reduction Act Means for American Health Care

  • GONE: Premium savings for 13 million Americans covered under the ACA — averaging $2,400 per family. 
  • GONE: Medicare’s power to negotiate lower costs for the most popular and expensive prescription drugs.
  • GONE: Prescription drug savings for seniors, including a $2,000 annual out-of-pocket cap and protections from Big Pharma’s price hikes. 
  • GONE: Free vaccines for seniors, including shingles and pneumonia. 
  • GONE: $35 monthly insulin caps for Medicare beneficiaries. 

Republicans Campaigned For Office On A Promise To Repeal The Inflation Reduction Act

HEADLINE: “House GOP Eyes Repeal Of Dems’ Drug Pricing Law” [Axios, 9/23/22

HEADLINE: Senate Republican bill would repeal Democratic drug pricing law [The Hill, 10/7/22

HEADLINE: GOP previews repeal redux [Politico, 10/28/22

Ways And Means Chairman Jason Smith Said He Would Prioritize “Reversing” The Inflation Reduction Act.  “As of now, the top two contenders to lead the Ways and Means Committee are Rep. Jason Smith (R-Mo.), ranking Republican of the House Banking Committee, and Rep. Vern Buchanan (R-Fla.), who is seen as the Republican next in line. […]  Smith told Axios in a phone interview he thinks Republicans should leverage debt limit negotiations to ‘reverse’ the administration’s ‘radical’ policies — including by sending a bill gutting the Democratic agenda to President Biden’s desk and daring him to reject it. ‘If Republicans are trying to cut spending, surely he wouldn’t try to default. If we were trying to bring down inflation … trying to secure our border, surely he wouldn’t default,’ Smith said.”  [Axios, 9/29/22

Rep. Kevin Brady Said Repealing The Inflation Reduction Act Was A “Top Priority” For Republicans In Congress.  “Rep. Kevin Brady (R-Texas), the top Republican on the House Ways and Means Committee, indicated repealing the drug pricing law is a likely agenda item. ‘Because those drug provisions are so dangerous, by discouraging investment in life-saving cures, I would imagine that will be a top priority for Republicans in the new session,’ he said.” [Axios, 9/23/22

Rep. Buddy Carter Said “Undoing” Prescription Drug Cost Reductions In The Inflation Reduction Act Was A Top Priority.  “Buddy Carter: We’ve been asking that question not only about student debt loans, but also about a number of initiatives that have been instigated and put into place by the Biden administration, just like in the Inflation Acceleration Act that I mentioned before with the prescription drug pricing. That is something I’m very interested in as a pharmacist. I’ve been asking my colleagues, ‘How are we going to undo that when we get into the majority?’” [“Cavuto Coast to Coast,” Fox Business, 9/1/22

Republican War on Medicaid Threatens 90 Million Americans

GOP Attacks on Medicaid Continue As GOP Eyes Cuts

Republicans have declared war on Social Security, Medicare, and Medicaid. They are promising to defund all three programs and repeal the Inflation Reduction Act’s provisions to lower drug costs under Medicare and make Affordable Care Act coverage more affordable through premium tax credits. But in many ways, their biggest target appears to be Medicaid. Over 90 million Americans receive their care through Medicaid. Medicaid has been proven time and time again to save lives, increase coverage and – in turn – access to needed care, and help reduce racial, rural, and other health disparities. Republican attacks on Medicaid are especially harmful for communities of color, rural Americans, people with disabilities, and low-income families.

How The GOP Is Threatening Medicaid:

  • Promising draconian cuts to Medicaid in debt ceiling and appropriations negotiations
  • Attempting to abruptly end the Public Health Emergency, which could throw 5 to 14 million people off Medicaid coverage
  • Refusing to expand Medicaid in the 11 holdout states with Republican legislatures causing hospital closures in rural America due to lack of funding
  • Committing to repeal the Affordable Care Act and its provisions to expand Medicaid adopted by 39 states 

Medicaid Saves Lives

Thousands Of Lives Saved Each Year. As of September 2022, over 90 million Americans are enrolled in Medicaid. At least 19,000 lives were saved due to the ACA’s Medicaid expansion. An additional 7,000 lives per year could be saved if the 11 Republican hold out states expand Medicaid coverage. A study published in the Journal of Health Economics found that Medicaid expansion reduced mortality in non-elderly adults by nearly four percent

Expansion Of Lifesaving Care. Medicaid expansion has helped patients access preventive care, including colon cancer screenings. Expansion also increased patient access to kidney transplants and made diabetes medication more affordable for low-income patients. The program was also tied to earlier diagnosis of colorectal cancer and reducing diabetes-related amputations. Expansion is associated with improvements in access to care and outcomes related to substance use disorder and mental health care

Medicaid Reduces Racial Disparities In Health Care

Reduced Racial Disparities In Coverage And Access. Increasing Medicaid access is the single most important action available to expand coverage and, together with other actions that address access as a driver of health and other determinants of health, reduce racial disparities in health care. The ACA led to historic reductions in racial disparities in access to health care, but racial gaps in insurance coverage narrowed the most in states that adopted Medicaid expansion. States that expanded their Medicaid programs saw a 51 percent reduction in the gap between uninsured white and Black adults after expansion, and a 45 percent reduction between white and Hispanic adults. 60 percent of Americans who would gain coverage if the remaining 11 hold out states expanded Medicaid are people of color. 

Medicaid Coverage Is Critical To Improving Maternal Health. The United States is only one of two nations that has reported an increase in maternal mortality since 2000. Women of color consistently experience higher rates of maternal mortality than white women, with the Center on Budget Policy and Priorities finding this to be the result of a combination of factors, including life-long toxic stress resulting from racism and the impacts of structural racism in the health care system. If post-partum Medicaid coverage was expanded to a full year, more than 720,000 individuals would receive quality coverage.This is an important step combined with other efforts to address peripartum health outcomes, like the Momnibus legislation. In the 11 states that have refused Medicaid expansion, eight had more than 40 percent of births covered by Medicaid. Medicaid covers 65 percent of all births to Black mothers and 65 percent of women of reproductive age living in the coverage gap are women of color. 

Better Access To Care. Medicaid expansion reduced racial disparities in cancer care and resulted in earlier diagnosis and treatment for Black patients. In 2021, over 11 million Black Americans were covered by Medicaid, with an additional 2.4 million stuck in the coverage gap.

Medicaid Reduces Rural Disparities In Health Care

Medicaid Helps Rural Hospitals Stay Open. Rural hospitals in Medicaid expansion states are 62 percent less likely to close. The two most common types of supplemental Medicaid payments are disproportionate share hospital payments, that pay hospitals for uncompensated care for Medicaid and uninsured patients, and upper limit payments, which supplement the gap between fee-for-service Medicaid base payments and the amount that Medicare covers. Some states are also testing the use of global hospital budgets to increase care and improve health outcomes in rural hospitals.

Closure Of Specialized Care And Obstetrical Services. Some hospitals opt to close specific services or facilities that cause patients in rural areas to have to travel further for specialized care. On average, when a rural hospital closes patients have to travel over 20 miles further to access inpatient or emergency care. A 2021 study found that fewer than half of all rural counties in the United States had hospital-based obstetric care. When hospitals face financial hardship, obstetric services are among the first to be cut. African American and Native American women in rural areas are particularly at risk. African American and Native American women are two to three times more likely to die from pregnancy-related causes than white women.

Rural Hospitals Boost Local Economies. Besides hospitals providing higher paying jobs in the health care sector, rural hospitals also stimulate the local economies of other industries. Hospitals purchase goods or services from local private businesses which helps stabilize and reinforces the local economy. In turn, strong private sector employment allows for more tax dollars for public goods, such as education and safety services.

Medicaid Benefits Children

Almost Half Of Births Are Covered By Medicaid. According to the Kaiser Family Foundation, more than 4 in 10 births are covered by Medicaid. Under the American Rescue Plan, states were given the option to extend coverage to new mothers for one year postpartum, which will improve maternal health outcomes. Out of expansion states, 2 states, Texas and Wisconsin, have limited postpartum coverage. 

When Parents Have Medicaid, Their Children Are More Likely To Have Regular Care. The children of parents enrolled in Medicaid are 29 percent more likely to receive a well-child visit. This relationship is even stronger among families enrolled in Medicaid with household incomes at the federal poverty line as they are 45 percent more likely to receive a well-child visit. 

Medicaid Helps Those In Need Of Long Term Care

Low-Income Seniors With Medicare Depend On Medicaid For Long-Term Care. Nearly 70 percent of people aged 65 and older will need some form of long-term care for at least 3 years.  Medicaid is a critical provider of home and community based care that are essential to keep loved ones at home with their families and neighbors. Without Medicaid, many seniors would not be able to afford these needed services with Medicare alone. 84 percent of individuals in nursing facilities covered by Medicaid in 2019 were dually eligible, with Medicaid covering costs once Medicare benefits have been depleted.

Protect Our Care Celebrates Black History Month

In celebration of Black History Month, Protect Our Care is highlighting important steps under the American Rescue Plan and Inflation Reduction Act to reduce disparities in access to quality, comprehensive health care by expanding coverage, reducing costs, and improving care in the communities where it is most needed.

Protect Our Care’s dedication to protecting these coverage gains and making health care even more affordable and more equitable for the American people is driven by a broader commitment to tackling systemic inequities that persist due to racism and discrimination. The Biden-Harris administration and Democrats in Congress have been working to advance health equity through measures that address health care access and quality as a driver of health such as lowering prescription drug costs, expanding Medicaid coverage, and tackling the maternal health crisis. Democratic policymakers have also championed multi-sector policies that are also needed to address basic conditions that affect health and related outcomes, particularly for Black Americans and other marginalized communities. Protect Our Care Chair Leslie Dach issued the following statement:

“This Black History Month we are celebrating the continuous progress made by lawmakers to make health care more affordable, accessible, and equitable and a right for every American. Leaders like Vice President Kamala Harris, House Minority Leader Hakeem Jeffries, and U.S. Representative Lauren Underwood, are taking critical steps to secure health care for every American all while making history. Meanwhile, Republicans in Congress have promised to continue their ongoing threats to roll back this progress by voting to dismantle safeguards for Medicaid unwinding, threatening to repeal the Inflation Reduction Act, and blocking a universal $35 insulin cap — all of which disproportionately harm communities of color.”  

Lowering Prescription Costs

Millions of people in Medicare still struggle to pay for life-saving prescriptions or treatments, with Black Medicare beneficiaries being nearly twice as likely than White Medicare beneficiaries to stop taking a prescription due to cost. This is a two-fold problem of drug companies continuing to increase prices and Black seniors having to foot the bill for these price increases. From 2016 to 2021 alone, costs for specialty prescription drugs increased by 43 percent while some drug prices increased by rates of over 500 percent. The Inflation Reduction Act addresses these outrageous skyrocketing prices by requiring that manufacturers whose drug prices increase faster than that of the inflation rate will have to pay Medicare a rebate. This will not only save the government billions of dollars, but will drastically reduce out-of-pocket costs for Medicare beneficiaries. As well, the Inflation Reduction Act will implement by 2025 a $2,000 annual cap for out-of-pocket spending on prescription drugs, saving Black families on average $1,216 every year.

Capping Insulin Costs

According to the U.S. Department of Health and Human Services (HHS), Black adults are almost 60 percent more likely to be diagnosed with diabetes. As well, around 29 percent of adults aged 65 and older are diagnosed with diabetes, making it the most common chronic illness in the United States, with 1.6 times more Black seniors having been diagnosed than White seniors, despite 74 percent of seniors being white and only 9 percent identifying as African American. Insulin manufacturers have raised retail prices over 600 percent in the last 20 years, limiting the ability of low-income diabetics, who are disproportionately people of color, from accessing lifesaving treatment. Under the Inflation Reduction Act though, insulin prices have now been capped at $35 a month. This will save each individual Black senior who uses Medicaid up to $1,500 annually.

Expanding Vaccine Programs

White Americans are nearly twice as likely to have received the shingles vaccine than Black Americans and this is not the only area where vaccination programs highlight a consistent racial disparity. Much of these inequities can be traced back to cost and lack of access to this vital form of preventive health care. The Inflation Reduction Act aims to begin tackling this vast issue by making more vaccines available to Medicare Part D recipients with no cost-sharing. Free vaccines for more Black seniors means reducing hospitalizations, fewer complications in other health problems, and a more sustainable and equitable health system.

Bringing Down Uninsurance Rates

According to HHS reports, an estimated 2,954,000 more Americans, including nearly half a million Black Americans, will have access to health insurance next year compared to without the Inflation Reduction Act. Studies show that individuals having health insurance leads to more access to care, reduced financial strains, and better health outcomes  – all of which advance health equity. Since the passage of the Affordable Care Act, racial disparities in insurance rates have been falling and President Biden’s promise to build upon it has led to some of the lowest uninsured rates in history.

Extending Premium Savings

The premium savings continued through the American Rescue Act and extended by the Inflation Reduction Act have made more than 65 percent of uninsured Black adults eligible for zero dollar premium plans. Nearly 75 percent of uninsured Black adults can now also access plans for less than $50 a month. The Center on Budget Policy and Priorities estimates the continuation of these increased savings will cause a sharp decline in the uninsured rate across every racial group, with a projected one in three uninsured Black adults gaining coverage.

Lt. Gov. Austin Davis, Zach Sherman, Executive Director of Pennie, and Advocates to Discuss New Pennie Enrollment Numbers

***MEDIA ADVISORY FOR THURSDAY, FEBRUARY 2 AT 10:30AM***

The Inflation Reduction Act Is Keeping Health Care Costs Low for Pennsylvanians

Philadelphia, PA – Today at 10:30AM, Lt. Gov. Austin Davis, Zach Sherman, Executive Director of Pennie, The Pennsylvania Health Access Network, and health care advocates will join Protect Our Care Pennsylvania to release new Pennie enrollment numbers and the number of Pennsylvanians that will benefit from the lower insurance premiums in 2023 thanks to the Advanced Premium Tax Credits extended under the Inflation Reduction Act. On average, families saved thousands of dollars a year on health care, giving them much-needed breathing room to pay for other essentials like rent, groceries, and gas.  

These savings are a game-changer for Pennsylvanians — saving an average middle-class family of four in Pennsylvania $4,763 on their yearly premiums. Pennie will also announce that in Pennsylvania, 371,516 people have signed up for health insurance on the commonwealth’s exchange, including 64,872 new enrollees in the latest open enrollment period signaling the continued popularity of the state-operated health insurance marketplace.

WHO:
Lt. Gov. Austin Davis
Zach Sherman, Executive Director of Pennie
Antoinette Kraus, Executive Director, Pennsylvania Health Access Network
Michael Berman, Protect our Care Pennsylvania State Director
Health Care Advocates

WHAT: Virtual Press Conference

WHEN: Thursday, February 2nd at 10:30AM 

WHERE: Register to join the Zoom event (Registration required) 

Andrea Harris Joins Protect Our Care as Director of Policy Programs

Harris Previously Served as Chief of Staff to Rep. Lauren Underwood (IL-14), Chief of Staff to Two Assistant Secretaries at HHS, and Aide to Senate HELP Committee Chairmen Tom Harkin and Ted Kennedy 

Washington, DC — Andrea Harris is joining Protect Our Care on February 6 as Director of Policy Programs. She brings extensive experience from her service in the legislative and executive branches, including expertise in health coverage, drug pricing, and hospital pricing policy, which will further Protect Our Care’s work to make high-quality, affordable, equitable health care a right, and not a privilege, for everyone in America. Read Andrea’s full biography here

Harris will lead Protect Our Care’s work to support implementation of the Inflation Reduction Act and protect it from GOP efforts to repeal or sabotage the law. Harris’s work will be central to POC’s ongoing efforts to build on the Inflation Reduction Act and to further reduce drug costs and permanently extend the enhanced Affordable Care Act (ACA) tax credits that made coverage more affordable for millions of people. Harris will also help organize against efforts to overturn key components of the ACA through the courts, including the law’s provision guaranteeing free preventive care relied on by millions of Americans. Additionally, Harris will support POC’s advocacy for closing the Medicaid coverage gap, reducing harmful inequities in care, and strengthening coverage for mothers, children, and families across the country. 

“Andrea has dedicated her career to making quality, affordable health care a right for every American. She has been on the front lines of enacting, implementing, and strengthening the Affordable Care Act,” said Protect Our Care Chair Leslie Dach. “Andrea played a critical role in making health insurance more affordable as part of the Inflation Reduction Act. Andrea’s experience working for health care leaders in Congress and at the Department of Health and Human Services will be a tremendous asset to Protect Our Care’s work to make high-quality, affordable coverage and equitable care a reality across America. I had the privilege of working with Andrea at HHS and am delighted to have her bring her talents to Protect Our Care.” 

“Andrea understands how to develop, enact, and implement policies that save lives and make health care more accessible, and she’s done it,” said U.S. Representative Lauren Underwood (IL-14). “I am grateful she led my team to introduce and advance the Health Care Affordability Act and Black Maternal Health Momnibus, and I know she will continue to be an asset to the American people at Protect Our Care as they push to lower health care costs for families.”

“Everyone deserves high-quality, affordable health care as a fundamental right; it shouldn’t be for the privileged few,” said Andrea Harris. “This belief has guided my career, and over the past decade Democrats in Congress and the White House have made considerable gains in making coverage and prescription drugs more affordable and accessible for millions of Americans. As the GOP constantly seeks to overturn these benefits, the team at Protect Our Care fights tirelessly to protect and strengthen health care and prescription drug affordability. I am honored to join them and be part of this essential mission.”

Andrea Harris Bio

Andrea Harris has 15 years of experience in federal health policy and has held senior roles in the legislative and executive branches. She most recently served as Chief of Staff to Rep. Lauren Underwood, a nurse and health policy expert, helping enact legislation to lower health care and prescription drug costs, and improve maternal health outcomes and end disparities. During the Obama Administration, Andrea served as Chief of Staff to the Assistant Secretary for Health and Chief of Staff to the Assistant Secretary for Legislation at HHS, helping implement the Affordable Care Act and fund family planning programs. She began her career in public service working on the Affordable Care Act, women’s health, and children’s health as an aide to Senate Health, Education, Labor, and Pensions (HELP) Committee Chairmen Ted Kennedy and Tom Harkin. Andrea earned a Master’s degree in health policy and economics from the London School of Economics and a bachelor’s degree from UCLA. 

 

The Guthrie Bill Will Cause Chaos in the Health Care System and Kick Working Americans Off Medicaid

On the 17th of January, Republican Congressman Brett Guthrie introduced the Pandemic is Over Act, a bill that would abruptly end the COVID-19 public health emergency on the day of enactment. If the Guthrie bill became law it would cause chaos in the health care system, sabotage the bipartisan Medicaid and health care provisions in the December Omnibus package, and likely result in millions being thrown off the Medicaid rolls.

The Biden administration and Democrats in Congress have, through passage of the American Rescue Plan and the Inflation Reduction Act, provided continuous Medicaid coverage  to working Americans since the pandemic began in 2020. This resulted in 91 million Americans receiving Medicaid as of September 2022. 

The Omnibus package passed in December ends the Public Health Emergency as of April 1st which will trigger a review of Medicaid coverage for current recipients. Experts estimate that millions of Americans will lose Medicaid coverage because of paperwork issues and others will become uninsured even though they qualify for affordable coverage under the ACA. The Omnibus sought to prevent these issues by creating federal guardrails and incentives for states as they conduct the Medicaid “unwinding” process. By statute, these protections begin April 1, 2023. If the Gurthrie bill is passed before April, these protections will be nonexistent.

What Comes Next

Republicans are looking to move Representative Guthrie’s bill through committee on Monday and bring it to the floor later in the week. The passage of this legislation would drastically hasten state plans to unwind Medicaid coverage and lead to even more Americans losing their Medicaid coverage who still meet all the criteria for coverage, and leave others without coverage who qualify for low-cost ACA coverage.

The legislation introduced by Guthrie aims to circumvent guardrails put in place by the Omnibus package, but no matter what, states can begin terminating beneficiary rolls in April of this year. If guardrails remain in place though, there are tools available to support the unwinding process.

  • On January 27th, CMS released guidelines outlining a new special enrollment period for individuals leaving Medicaid or CHIP. This would allow those no longer receiving Medicaid coverage due to roll terminations to enroll in marketplace coverage outside of the open enrollment period. According to CMS, this SEP will last from March 31, 2023 to July 31, 2024.
  • States can obtain temporary waivers through CMS to renew Medicaid coverage based on a wide variety of formulas that allow for individuals who may see their coverage terminated in April to continue having coverage for at least another 12 months. CMS has already approved over 158 waivers in 41 states. 
  • CMS has outlined guidance for states to work with MCOs, community health centers, navigators, and other programs to help streamline updating enrollee information, potentially preventing Medicaid beneficiaries whose documentation has fallen through the cracks since 2020 to continue receiving coverage. Currently, around 39 states have reported plans to work with these stakeholders and agencies.
  • Under the 2022 Omnibus package passed in December, the HHS now also has the authority to forbid states from terminating beneficiaries for purely administrative reasons, and impose monetary penalties on states who do so.

What’s at Stake

If this legislation were to become law and states proceed with Medicaid unwinding absent of guardrails, up to 15 million Americans could lose their Medicaid coverage. This would be the single greatest loss of Medicaid coverage in American history, vastly outpacing even the record fall in Medicaid coverage under President Trump in 2018 and 2019. The bill brought by Representative Guthrie would worsen health disparities due to preventable losses in health coverage.

  • The uninsured rate during the COVID-19 pandemic fell to an all-time low, thanks in part to the Biden administration’s historic accomplishments in his first two years in office. If current Medicaid enrollees lose their coverage and cannot access a different form of health insurance, the uninsured rate could begin to increase once again as systemic barriers exist for those leaving Medicaid while still seeking coverage.
  • Of those at risk of losing coverage, over 5 million are Latinos, 2 million are African American, and a million are Asian American or Pacific Islander. In all, 13 percent of all Black children, 12 percent of Native American and Latino children, and 10 percent of all Hawaiian Native and Pacific Islander children are at risk of losing Medicaid coverage completely. Studies show only 21 percent of children who lose Medicaid ever transfer over to S-Chip.
  • Many states have not updated their enrollment systems to accommodate disabled Americans or those with limited English proficiency. Currently, 19 states only provide information in English and 11 states provide no reasonable modifications, such as braille, for their online Medicaid services. Traditionally marginalized groups along lines of income will see disproportionate effects due to the lack of these services, as individuals without caregivers or guardians may lose coverage for no fault of their own.

IN THE NEWS: Senate Democrats to Investigate Drug Companies’ Reckless Greed

Senate Democrats are hitting the ground running to investigate the broken drug pricing system that has left one in four Americans struggling to afford their medications. After passing historic legislation to drive down prices for patients and curb drug company greed, Senate HELP Committee Chair Bernie Sanders (D-VT) is leading an aggressive strategy to hold Big Pharma accountable for their price hikes. 

Bloomberg: Pharma CEOs Are Among Likely Targets for Senate Democrats’ Subpoenas. “With long-time critic Bernie Sanders taking over the Senate Health, Education, Labor and Pensions Committee, pharmaceutical companies will be under a microscope like no other. The progressive firebrand says he’s ready to order executives to appear and has recently taken particular aim at a ‘dysfunctional’ and ‘broken’ health-care system.” [Bloomberg, 1/23/23

Axios: Drug Companies Brace for Chairman Bernie. “Sanders has signaled an early focus of the committee’s work will be drug prices, and manufacturers are bracing for some contentious hearings. ‘I have no doubt there will be tough hearings with people from industry being forced to testify, subpoenaed to testify, etc.,’ a pharmaceutical industry source said. ‘And I think that’s going to be a real challenge.’” [Axios, 1/30/23]

Protect Our Care Releases 2023 Agenda to Build on Democrats’ Historic Health Care Victories

Protect Our Care Calls on Congress to Keep Up the Momentum to Lower Costs, Improve Care, and Advance Health Equity 

Read the Agenda Here

Washington, DC — Today, Protect Our Care released a health care agenda detailing steps Congress should take to build on the health care victories over the past two years. The agenda lays out legislative actions to expand coverage, lower costs, strengthen protections, and address inequities in care. The agenda comes after a historic year in expanding affordable health care, which has resulted in record enrollment on the ACA marketplaces and the national uninsured rate reaching an all-time low. These actions are particularly important as Republicans are in the majority in the House and are working to cut Medicare and Medicaid, repeal the ACA and the Inflation Reduction Act, rip away lifesaving protections, reverse recent coverage gains, and hike prescription drug costs for the American people.

“In every election since 2018, voters have gone to the polls prioritizing health care, and they want their elected officials to continue lowering costs and improving care,” said Protect Our Care Chair Leslie Dach. “By reducing premium and prescription drug costs, reaching historic coverage rates, and strengthening health care for moms, kids, and families, it is clear that Democrats’ hard work is paying off. As we enter a new Congress, we must protect these coverage gains and make health care even more affordable for the American people. At a time when Republicans have doubled down on their war on health care, including by seeking cuts to Medicare and Medicaid, trying to repeal the ACA and the Inflation Reduction Act, and ripping away critical protections, it has never been more critical to remain focused on protecting health care access and putting the health and well-being of families first.”