Shot/Chaser

SHOT: Scoop: Kevin McCarthy Tells Trump New Health Care Push Makes No Sense. “McCarthy told Trump over the phone that the decision made no sense — especially after Democrats killed Republicans in the midterms in part over the issue of pre-existing conditions.” [Axios, 3/27/19]

CHASER: 194 House Republicans voted FOR Trump’s lawsuit earlier this year

CHASER: 217 House Republicans voted FOR Trump’s health care repeal bill in 2017

Big Pharma Continues to be Big Winner in Trump’s America

Meanwhile, the GOP Slashes Health Care for the Rest of Us

SHOT: A new analysis by the Associated Press, released Monday of last week, showed that drug companies have announced “far more price hikes than cuts,” despite Trump’s promise to take action on prescription drug prices.

CHASER: A new analysis by CNBC, released Friday, showed that big drug companies are “having [their] best quarter in five years.” In fact, on Friday — the very same day that House Republicans passed massive tax cuts for the rich that they plan to pay for by cutting Medicare and Medicaid — big drug and insurance company profits “[surged] to an all-time high.”

“Mitt Romney, it’s actually not that complicated. Medicaid Expansion is a good thing. That’s why it’s popular and that’s why the people will vote for it — and not for you — in November,” said Brad Woodhouse, executive director of Protect Our Care

 

SHOT: Mitt Romney opposes Medicaid expansion, and believes that the issue is too complicated for the people to decide in an initiative to appear on November’s ballot. “Medicaid expansion is a very complex issue. It requires extensive research and analysis and I think is generally done best by elected representatives of the people.”

 

CHASER: Medicaid expansion has been studied, and it’s been found to provide numerous benefits for Americans. That’s why Utah’s proposed initiative to enact the Medicaid Expansion is enjoying support from 60 percent of residents.

Here are a few of the studies Mitt Romney must have willfully ignored:

• Research From Georgetown University Center For Children And Families Confirms That Rural Populations Are Especially Hurt When States Do Not Expand Medicaid. “The uninsured rate for low-income adult citizens (below 138 percent FPL) has come down since 2008/09 in nearly all states, but small towns and rural areas of states that have expanded Medicaid have seen the sharpest declines. The uninsured rate for this population dropped sharply from 35 percent to 16 percent in rural areas and small towns of Medicaid expansion states compared to a decline from 38 percent to 32 percent in non-expansion states between 2008/09 and 2015/16.” [Georgetown University Center for Children and Families, 9/25/18]
• Rural, Low-Income Voters Less Likely To Have Health Insurance In Than Urban Poor States That Did Not Expand Medicaid. “Rural, low-income voters who helped propel President Trump to victory in 2016 are less likely to have health insurance than the urban poor in states that didn’t expand Medicaid under the Affordable Care Act. A new study compared uninsured rates from 2008-2009 and 2015-2016 by the the Georgetown University Center for Children and Families and the University of North Carolina Rural Health Research Program. It examined insurance coverage in 46 states with significant rural populations and found a disparity between low-income adults living in rural areas and small towns versus those living in metropolitan areas.” [Washington Post, 9/25/18]
• Georgetown Report Emphasizes That Medicaid Expansion Plays Significant Role In Coverage Gains Given Difficulty Getting Insurance Companies To Cover Rural Communities. “There are several reasons cited in the Georgetown/University of North Carolina report that Medicaid expansion could be part of the solution:  It’s difficult to get insurance company to offer plans in sparsely populated rural towns; areas with more insured residents draw clinics and providers to operate there; and rural hospitals are less likely to close in places where they can depend on Medicaid payments.” [Washington Post, 9/25/18]
• University of Michigan Study Finds Medicaid Expansion Improves Access To Family Planning. “Among 1,166 reproductive-age women who enrolled in the Healthy Michigan Plan, Michigan’s expansion of the Medicaid program for low-income adults, 1 in 3 said the expanded coverage improved access to birth control and family planning services…’Our findings suggest that the expansion provided an important service for populations with a high unmet need for family planning care,’ says lead author Michelle Moniz, M.D., M.Sc., an assistant professor of obstetrics and gynecology at Michigan Medicine. ‘Insurance coverage also means that women have access to more options if they do not want to become pregnant at the current time.’…Each dollar spent on contraception is estimated to save the health care system more than $7 in return, according to a recent study from the Guttmacher Institute. About 40 to 50 percent of the 4 million live births in the U.S. every year are paid for by Medicaid.” [University of Michigan, 8/31/18, JAMA Publication]
• Northwestern University Research Heart Attack Patients Had Higher Rates Of Health Coverage In Medicaid Expansion States.“In a boost for cardiovascular care in the U.S., new research shows those suffering heart attacks and strokes were less likely to be uninsured for their hospital stays after states expanded Medicaid under the Affordable Care Act…Research led by Dr. Ehimare Akhabue from Northwestern University’s Feinberg School of Medicine showed Medicaid expansion states had a ‘significant reduction in the proportion of uninsured hospitalizations for major cardiovascular events within 1 year of Affordable Care Act Medicaid expansion compared with nonexpansion states.’ Researchers looked at more than 3 million ‘non-Medicare’ hospitalizations from hospital databases from 30 states.” [Forbes, 8/26/18]
• Ohio Medicaid Expansion Study Found That People Continuously Enrolled Through Medicaid Were Less Likely To Have Medical Debt. “People continuously covered by Medicaid were substantially less likely to have medical debt than eligible people who were still uninsured or people who churned on and off of Medicaid.That aligns with prior studies published in Health Affairs and elsewhere. If the purpose of Medicaid is to provide people with health care and a certain level of basic economic security, it seems to be succeeding.” [Vox, 8/24/18]
• Following Medicaid Expansion, The Percentage Of Uninsured Ohioans With Income At Or Below 138 Percent Of FPL Dropped Drastically. See chart below. [Vox, 8/24/18]

• Researched Published In JAMA Confirms That Medicaid Expansion Increased Access To Opioid Treatment. “Medicaid expansion significantly increased buprenorphine with naloxone prescriptions per 100 000 county residents in expansion counties, suggesting that expansion improved access to opioid use disorder treatment. Expansion did not significantly increase the overall rate per 100 000 county residents of OPR prescriptions, but increased the population with OPRs paid for by Medicaid. This finding therefore suggests the growing importance of Medicaid in pain management and addiction prevention.” [JAMA, Saloner et. al, 8/17/18]
• Health Affairs Study Finds Low-Income People More Able To Afford Diabetes Medications And Manage Disease In Expansion States. “Low-income people with diabetes are better able to afford their medications and manage their disease in states that expanded Medicaid under the Affordable Care Act, a new study suggests. The Health Affairs study, released Monday afternoon, found a roughly 40 percent increase in the number of prescriptions filled for diabetes drugs in Medicaid programs of the 30 states (including Washington, D.C.) that expanded eligibility in 2014 and 2015, compared with prior years.By contrast, states that didn’t embrace the Medicaid expansion saw no notable increase.” [Kaiser Health News, 8/6/18]
• University Of Kansas Research Finds Medicaid Boosts Employment For People With Disabilities. “People with disabilities are much more likely to be employed in states that have expanded Medicaid coverage as part of the Affordable Care Act, new research from the University of Kansas has found. Similarly, the number of those who report not working because of a disability has greatly declined in expansion states. Neither trend happened in states that chose not to expand Medicaid.” [Healthcare Finance News, 7/23/18]

 

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

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

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

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

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

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

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

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

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

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

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

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

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