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BREAKING: Biden-Harris Administration Announces Grantees Of $500 Million Investment Into ACA Navigators

President Joe Biden and Vice President Kamala Harris Walking Through the White House

Historic Boost in Funding Will Help Secure Affordable Coverage for Millions of Americans 

Washington, D.C. — Today, the Biden-Harris administration announced the 44 organizations in the 28 states using HealthCare.gov that will receive the first five-year investment in Navigator funding in history. The $500 million investment will increase the number of people with affordable coverage by supporting outreach, education, and enrollment efforts to make sure people know how to enroll in a plan and stay covered. This is another investment made by the Biden-Harris administration to strengthen the Affordable Care Act (ACA) and ensure people have the health care they need. 

Navigators help connect people in underserved communities to health care, ensuring that language barriers or confusing paperwork doesn’t stand in the way of families getting covered. This year, a record 21.4 million Americans enrolled in ACA coverage, with the average family saving $2,400 a year thanks to the Inflation Reduction Act. In response, Protect Our Care Executive Director Brad Woodhouse issued the following statement: 

“Joe Biden and Kamala Harris are health care champions. The Biden-Harris administration is working around the clock to ensure everyone can get the health care they need for years to come. When Donald Trump was in the White House, he tried to repeal the Affordable Care Act, and when he failed, his administration deliberately sabotaged the ACA, drastically reducing enrollment. As a result, President Biden inherited a broken system that left Navigators underfunded and millions of people uninsured. Now, thanks to the Biden-Harris administration’s commitment to expanding access to affordable health care, more people are covered than ever before. Millions more have the peace of mind knowing they can go to the doctor when they get sick without worrying about affording other necessities like food or rent. This long-term investment not only gives Navigators the resources they need to help families enroll in coverage, but it also protects them from the MAGA agenda to cut funding and sabotage the ACA. The Biden-Harris administration has delivered another health care win for the American people.” 

Background

Trump’s Navigator Funding Cuts Contributed To People Losing Their Coverage. Trump cut the ACA Navigator program by over 80 percent while he was in office, from $63 million in the final year of the Obama administration to just $10 million per year from 2018 to 2020. During the Trump administration, enrollment in ACA coverage dropped by over 1.27 million people and a KFF consumer assistance survey found that there was a significant need for enrollment help while navigating the complex application and enrollment process.. 

Project 2025 Will Raise Health Care Costs Under The ACA. Repealing the Inflation Reduction Act, as proposed in Project 2025’s Mandate for Leadership, will eliminate premium tax credits that make health care more accessible and less expensive. Getting rid of tax credits threatens coverage for the over 20 million who buy their own coverage through the Marketplace and receive tax credits to lower their health care premiums. Ending the tax credits would mean a typical 60-year-old couple making $80,000 per year would see their premiums triple to over $24,000 per year and premiums for a family of four making $125,000 would increase by $7,676.

Biden-Harris Administration Has Made Historic Investments In The Navigator Program. In addition to today’s announcement, ahead of the 2022 open enrollment cycle, the Biden-Harris Administration invested $80 million to the Navigator program, quadrupling the Navigator budget at that time and helping increase enrollment that year from just over 12 million to 14.5 million people. For the 2023 open enrollment cycle, the administration invested a historic near $100 million into the Navigator program to help consumers navigate the application and enrollment process for the ACA Marketplace, Medicaid, and CHIP to make health care more affordable and accessible to everyone.

Kamala Harris to Unveil Economic Plan to Further Drive Down Health Care Costs

Washington DC — This afternoon, Kamala Harris is set to outline her economic plan to lower costs and give hardworking families more room to breathe. Her plan builds on the health care victories of the Biden-Harris administration to lower prescription drug costs, extend the Inflation Reduction Act’s drug savings to everyone, and relieve medical debt for millions. The plan also cracks down on big drug companies that use anti-competitive practices to raise prices on the American people. 

Harris’s plan is in stark contrast to the MAGA agenda, which calls for repealing the Affordable Care Act and the Inflation Reduction Act, ripping away protections for people with pre-existing conditions, banning Medicare from negotiating lower drug prices, and hiking health care costs across the board. In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“Vice President Kamala Harris has a plan to lower the cost of living and help the middle class thrive — and health care is central to that plan. While Vice President Harris will build on the success of the Inflation Reduction Act and lower drug prices for everyone, Republicans want to move us backwards. Polling shows that addressing health care costs is a top issue for voters of all parties, and Harris is sending a clear message that health care is one of her top priorities.”

STATEMENT: Biden Administration Cracks Down on MAGA Short-Term Junk Plans, Protecting People with Pre-Existing Conditions and Preserving Essential Benefits

Washington, D.C. — Today, the Biden administration issued a final rule to protect consumers and limit short-term junk plans. When Donald Trump was in office, he let insurance companies sell short-term junk plans, which can deny coverage for people with pre-existing conditions and can refuse to cover basic benefits guaranteed under the Affordable Care Act (ACA) like hospitalization and prescription drugs. This move by President Biden will protect consumers from junk insurance that often uses deceptive marketing practices and leaves American families with staggering medical bills. The President’s action is in stark contrast to the MAGA Republican efforts to enshrine junk plans into law.

In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“President Biden is reversing the deliberate efforts by Donald Trump and MAGA Republicans to gut protections for pre-existing protections and give insurance companies the right to deny coverage for basic benefits like prescription drugs and maternity care. The contrast between President Biden’s health care agenda and MAGA Republicans’ could not be clearer. Republicans continue to push these junk plans in their newest budget proposal, aiming to make these junk plans widely available. President Biden is on the side of the American people as he aims to make sure families aren’t scammed into substandard coverage that can deny lifesaving care.”

Background

President Biden And Democrats Delivered Lower Health Care Costs And Now A Record Number Of Americans Were Able To Purchase Quality and Affordable Health Care Through the ACA. A record-breaking 21.4 million Americans signed up for coverage with 80 percent of people able to find coverage through the Marketplace for $10 or less per month. The ACA has generated record savings and improved access to care and financial security for families. 

The Latest GOP Budget Expands Junk Plans. The latest budget proposal from the Republican Study Committee would codify rules put forth by the Trump administration that expanded health insurance plans known as association health plans (AHPs). These plans are not required to cover the essential health benefits put in place by the Affordable Care Act and are allowed to charge people more based on their age, health status, and gender. AHPs have a long history of fraud and unpaid claims and provide weaker cost and protection coverage. The proposal also applauds efforts by the Trump administration to expand short-term limited-duration plans, which engage in predatory marketing practices, fail to protect people with pre-existing conditions, and put patients at risk of bankruptcy when they get sick. The Trump administration’s decision to expand access to these plans exposed consumers to scams and reduced transparency about coverage limits and hidden fees.

The Trump Administration Cut Critical ACA Health Subsidies & Expanded Short-Term, Limited Duration Insurance (STLDI) Plans That Did Not Meet ACA Requirements. In late 2017, after Congressional Republicans’ efforts to repeal and replace the Affordable Care Act (ACA) failed to advance, then-President Trump ordered sweeping changes to health insurance policy with a pair of executive actions. He first announced that the sale of certain cheap policies with few benefits or protections – known as short-term, limited-duration insurance (STLDI) – would be allowed to be sold for up to 364 days with renewals for up to three years instead of three months, then announced cuts to critical health subsidies helping pay out-of-pocket costs for low-income people in America. In response, many patient and physicians groups raised concerns that junk plans would “cause significant economic harm to women and older, sicker Americans who stand to face higher-cost and fewer insurance options,” and “draw younger and healthier people away from the exchanges and drive additional plans out of the market.” The changes were solidified in August 2018 as a final rule allowing STLDI plans to be considered a form of individual health insurance coverage that would meet the ACA’s individual mandate.

Junk Plans Enabled By The Trump Administration Have Left Patients Without Protections For Pre-Existing Conditions Afforded By the ACA. “Because they tend to look less expensive up front, short-term plans continue to find buyers, and they have been championed by the Trump administration (which has loosened restrictions on them) as an alternative for consumers. […] Consumer advocates have long sounded alarm bells about short-term plans and others that don’t comply with the Affordable Care Act rules — rules that require plans to provide comprehensive benefits to all comers, regardless of their health. The ACA also prohibits annual or lifetime dollar limits on coverage for any plan sold on the federal or state health insurance exchanges.” [NPR, 12/3/20]

Patient Advocacy Groups, Health Policy Experts, and Insurance Insiders Alike Have Warned Against Junk Plans’ Lack of Transparency and Coverage. Patient advocacy groups and health policy experts have long warned about the fraud risks that come with STLDI and other non-ACA-compliant plans. In January 2019, the Georgetown University Health Policy Institute found that consumers searching online for ACA-compliant plans were often directed, instead, to “junk plans.” Another study sponsored by the Leukemia and Lymphoma Society found that junk plans often rely on misleading marketing, are often misunderstood by consumers who purchase them with no right to appeal plan decisions, drive up patients’ out-of-pocket costs, and “threaten prices across the insurance market.” In March 2021, 30 patient organizations published a report pushing for greater regulation of dozens of different types of “junk insurance,” including STLDI plans. Even health insurance industry insiders have warned that the “very profitable” plans are inadequate, and state insurance regulators have expressed concerns that STLDI plan administrators have been misleading and taking advantage of consumers while offering substandard coverage.

STATEMENT: Biden Administration Finalizes Rule to Make Enrolling in Medicaid and CHIP Easier for Millions of Children and Families

Washington, D.C. – Today, the Biden administration announced a final rule that improves how millions of Americans, including children, apply for and renew coverage through Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP). The rule standardizes enrollment and renewal processes nationwide and applies consumer protections from the Affordable Care Act (ACA) to Medicaid and CHIP enrollees, like banning lifetime limits and waiting periods.

This action to ensure more families have access to affordable coverage and cut paperwork requirements is in direct contrast to Republicans’ proposals, which gut funding for Medicaid and impose more red tape and bureaucratic barriers to make it harder for children to stay covered. For example, in Florida, Governor Ron DeSantis is fighting to rip CHIP coverage away from children if their parents can’t pay their premiums on time. The Republican party is dead set on raising the cost of health care for working families, denying coverage to millions of people, and slashing funding for critical programs. 

The Biden administration also announced that over 17 million children are now protected from losing coverage thanks to the new law that keeps eligible kids on Medicaid covered for at least a full year before needing to renew their coverage. 

In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“President Biden is cutting burdensome red tape, waiting periods, and annual and lifetime limits that make it harder for families to stay covered and access health care. Today’s action builds on key steps taken by the Biden administration to lower health care and prescription drug costs and ensure American families can get the care they need to stay healthy. While Republicans fight to cut Medicaid and kick people off of coverage, the Biden administration is fighting tooth and nail to lower costs and make affordable health care a reality for families across the nation.”

Background

The final rule includes: 

  • Eliminating annual and lifetime limits on children’s coverage in CHIP
  • Ending the practice of locking children out of CHIP coverage if a family is unable to pay premiums
  • Eliminating waiting periods for CHIP coverage so children can access health care immediately
  • Improving the transfer of children seamlessly from Medicaid to CHIP when a family’s income rises
  • Requiring states to provide all individuals with at least 15 days to provide any additional information when applying for the first time and 30 days to return documentation when renewing coverage
  • Prohibiting states from conducting renewals more frequently than every 12 months and requiring in-person interviews for older adults and those with disabilities

STATEMENT: After Fourteen Years, the Affordable Care Act Is Stronger and More Popular Than Ever

As MAGA Republicans Refuse to Give Up on Their War on Health Care, A Record Number of People Rely on the ACA

Washington, D.C. — Fourteen years ago tomorrow, President Barack Obama signed the Affordable Care Act (ACA) into law, and millions of Americans gained access to quality, affordable health care as a result. Thanks to the tireless work of President Biden and Democrats in Congress, the 2024 open enrollment period was the most successful in history — a record-breaking 21.4 million Americans signed up for coverage. Coupled with the health law’s expansion of Medicaid, protections for people with pre-existing conditions, and cost-saving measures, the ACA has touched the lives of nearly every person in the nation. Read Protect Our Care’s ACA anniversary fact sheet here

The ACA has survived countless repeal attempts, and now it’s stronger than ever. President Biden has shown what it means to make health care more affordable — he has lowered prescription drug costs for seniors, helped millions of families afford coverage, and taken on big drug companies and other corporate interests. Over 100 million Americans now rely on marketplace and Medicaid for coverage. Yet, Republicans still want to destroy the ACA and all of its protections for over 100 million people with pre-existing conditions. Just this week, they once again introduced a budget that would strip away protections for people with pre-existing conditions, increase insurance premiums and prescription drug costs, and put Medicaid coverage for millions in jeopardy. Presumptive GOP presidential nominee Donald Trump sabotaged affordable health care and pre-existing condition protections while he was in office, and has renewed his calls to “terminate” the ACA at least seven times over the last several months.

“Fourteen years in, the law is now woven into the fabric of America and is only getting stronger,” said Protect Our Care Chair Leslie Dach. “Thanks to the ACA, millions of people with pre-existing conditions like diabetes or asthma are protected from being refused coverage or charged more for it, over 45 million people who get insurance on their own have affordable coverage thanks to premium tax credits and Medicaid expansion, and over 150 million patients have access to free cancer screenings and other preventive care. We’ve seen people’s health and financial security improve. The ACA has been essential to reducing inequities in health care and has laid a strong foundation to do more to ensure everyone — no matter who they are or where they live — has access to the health care they need.” 

“On the ACA’s 14th anniversary, it’s important not to lose sight of Republicans’ war on health care,” said Protect Our Care Executive Director Brad Woodhouse. “They want to raise costs on families, they want to go back to a time where people with pre-existing conditions paid more, and they want to put big pharmaceutical and insurance companies back in charge. While President Biden and Democrats in Congress are working tirelessly to build on the ACA and expand affordable, quality health care to every American, the MAGA-Republicans are still fighting in Congress and in the courts to gut the ACA and undermine the law’s protections. Some things never change: Republicans want to gut health care, only taking us backwards and throwing the entire health care system into chaos.

Statement: Braidwood v. Becerra Appeal Aims To Rip Away Guaranteed Free Preventive and Reproductive Health Services From More Than 150 Million Americans

On March 4, Fifth Circuit Court of Appeals to Hear Oral Arguments in Braidwood Case 

Extremists aiming to strike down a key portion of the Affordable Care Act (ACA) are scheduled to give oral arguments before a panel of judges at the Fifth Circuit Court of Appeals on March 4. The plaintiffs are challenging a provision of the ACA that requires insurers to cover lifesaving preventive services for free, and they are dissatisfied with a lower court’s ruling last year that overturned a narrow set of services recommended by the U.S. Preventive Services Task Force (USPSTF) after the passage of the ACA, blocked required coverage of USPSTF’s future recommendations, and allowed employers to refuse to cover certain preventive services on religious grounds. The plaintiffs now want the appeals court to go further and eliminate guaranteed free coverage of vaccines and women’s preventive services like cancer screenings, prenatal care, and contraception.

“Lifesaving preventive care under the ACA is at risk,” said Protect Our Care Chair Leslie Dach. “More than 150 million Americans rely on these benefits to get no-cost access to routine screenings for cancer, diabetes, mental health, and heart disease, recommended vaccinations, contraception and pregnancy-related care, and more. If the MAGA-backed plaintiffs get their way, it will put Americans at the mercy of insurance companies and employers once again, empowering them to charge high out-of-pocket costs and refuse to cover certain preventive benefits entirely. As a result, more Americans will suffer because their cancers will be detected too late or they won’t receive the mental health or prenatal care they need.” 

Background

Last March, District Judge Reed O’Connor – the same Federal District Court judge whose decision invalidating the entire ACA was reversed by the Supreme Court in 2021 – struck down a portion of the ACA’s preventive health services mandate, invalidating key, no-cost services recommended by the USPSTF after the ACA’s enactment. The government immediately appealed the decision, and the Fifth Circuit paused the ruling and temporarily reinstated the requirement that insurers cover those preventive services, but the Fifth Circuit could choose to revoke the stay at any time.

The ACA’s elimination of out-of-pocket costs for these lifesaving screenings and services has transformed how preventive care is delivered, saved countless lives, improved health outcomes, reduced disparities in care, and cut consumer health care costs. Guaranteed no-cost coverage of preventive services, including screenings for chronic disease, is a key factor in expanding access to these services – which together with actions to address other social and structural determinants of health – are advancing health equity. 

The Braidwood case is driven by extremist, longtime foes of the ACA, abortion rights and reproductive freedom, marriage equality, vaccination mandates, and diversity policies – but the stakes are even higher than before. The case, which was originally decided by the same judge whose decision invalidating the entire ACA was reversed by the Supreme Court in 2021, will now be decided by two extreme Trump appointees. These radical judges could strike down coverage for these essential preventive services at any time, removing the current stay on the lower court’s ruling and putting free preventive services on the chopping block for more than 150 million Americans covered through private health insurance

Here are just some of the lifesaving, no-cost benefits that could be invalidated by MAGA judges on the Fifth Circuit if the panel lifts the stay and allows the district court ruling to stand:

  • GONE – Free, Guaranteed Cancer & Health Screenings. O’Connor’s ruling struck down ACA provisions requiring insurers to cover screenings for serious health issues including breast cancer, colorectal cancer, lung cancer, Hepatitis C, and HIV
  • GONE – Free, Guaranteed Preventive Medication For Cardiovascular Disease. O’Connor’s ruling struck down ACA provisions requiring insurers to cover drugs that can lower cholesterol for certain adults at risk of developing cardiovascular disease.
  • GONE – Free, Guaranteed Substance Use Screenings. O’Connor’s ruling struck down the ACA requirements that insurers cover screenings for unhealthy drug use
  • GONE – Free, Guaranteed Preventive Treatment for Pregnancy Complications. O’Connor’s ruling struck down the ACA requirements that insurers cover medications used to prevent life-threatening complications in pregnancy like preeclampsia as well as mental health interventions for pregnancy-related depression
  • GONE – Free, Guaranteed PrEP. O’Connor’s ruling struck down the ACA requirements that guarantee access to pre-exposure prophylaxis (PrEP), a drug proven to substantially reduce the risk of contracting HIV. PrEP has been associated with a significant decrease in the number of new HIV diagnoses.

If the Fifth Circuit agrees with the plaintiffs, they will eliminate the following additional services:

  • GONE – Free, Guaranteed Vaccinations. The ACA requires that over a dozen vaccinations, ranging from meningitis and pneumonia to flu shots, be covered free of charge for adults and children.
  • GONE – Free, Guaranteed Contraception & STI Counseling. The ACA guarantees women access to contraception without cost sharing, screenings for HIV, and counseling for sexually transmitted infections (STIs). Over 58 million women have benefited from free access to contraceptives, saving billions of dollars in out-of-pocket spending. 
  • GONE – Free, Guaranteed Pregnancy Screenings & Treatments. The ACA requires free access to a variety of preventive services related to pregnancy, including preeclampsia screenings, breastfeeding equipment like pumps and bottles, folic acid, and screenings for perinatal diabetes, in order, to support healthy pregnancies and fight the maternal mortality crisis.
  • GONE – Free, Guaranteed Routine Infant & Child Health Care. Under the ACA, all newborns have access to free, universal newborn screening and young children. As they grow, children are required to have free access to essential health screenings, behavioral assessments, growth measurements, behavioral assessments, routine childhood vaccinations, vision and dental screenings, and other essential preventive services.
  • GONE – More Free, Guaranteed Health Screenings. The ACA requires plans to cover screenings and counseling for a wide array of health issues, including risk factors for heart disease – the leading cause of death in the U.S. – like high blood pressure, high cholesterol, diabetes, and obesity.
  • GONE – Free, Guaranteed Mental Health & Substance Use Screenings. Under the ACA, insurers are required to cover a wide range of preventive assessments and treatments related to mental health and substance use, including depression, anxiety in adolescent and adult women, alcohol misuse, tobacco use, and adolescent drug use.

What Happens Next

The appeal is being made before the Fifth Circuit Court of Appeals, a circuit “where law goes to die” packed with MAGA appointees and ultra-conservative judges that have relentlessly chased an extreme agenda threatening health care access. If the Fifth Circuit approves a full reversal of the preventive services requirement, it would set off a massive disruption in the American health care system putting more than 150 million Americans at risk of losing access to no-cost preventive care when their insurance renews. 

Two of the three judges deciding the case, Don Willett and Cory Wilson, are extreme Trump appointees with long records of opposition to affordable health care, green-lighting abortion bans, medical misinformation campaigns, and anti-vaccine cases. Read more about these extreme MAGA judges here. Regardless of the outcome, the case will almost certainly end up at the Supreme Court.

Who Is Behind It?

The Braidwood v. Becerra Plaintiffs Have Repeatedly Sued To Overturn Parts Of The ACA. Plaintiff John Kelley filed an earlier and similar class action lawsuit against the ACA’s contraceptive mandate in DeOtte v. Azar. Kelley, his company Kelley Orthodontics, and Joel Starnes – all plaintiffs in Braidwood v. Becerra – brought a similar suit again in 2020 in Kelley v. Azar. Another plaintiff, Braidwood Management, owned by Dr. Steven Hotze, was also a plaintiff in DeOtte and has previously brought and lost challenges to other parts of the ACA. In addition to being a plaintiff in previous efforts to overturn the ACA, Hotze is a vocal advocate for multiple far-right conspiracy theories, claiming COVID-19 was an invention of the “deep state,” suggesting equal rights for LGBTQ+ individuals would lead to child molestation, and bankrolling election fraud vigilantism after making false claims regarding voter fraud in the 2020 election. 

The Lead Attorney For The Plaintiffs In Braidwood v. Becerra Is One of the Key Authors of SB8, Texas’ Vigilante Anti-Abortion Law. The lead attorney for the plaintiffs is Jonathan Mitchell, “who helped craft the Texas abortion law that was designed to evade judicial review by leaving enforcement to private citizens instead of government officials.”

  • Mitchell Filed Briefs Arguing the Supreme Court Should Overrule its Decisions Protecting Marriage Equality and Invalidating Anti-Sodomy Laws. Mitchell filed a brief in the Dobbs case urging the Supreme Court to overturn Roe v. Wade–and criticized Mississippi for suggesting that the Court could leave in place its 2015 ruling in Obergefell v. Hodges, holding that same-sex couples have the right to marry in all states. He said that Obergefell and Lawrence v. Texas, the 2003 ruling that invalidated all remaining state anti-sodomy laws, “are judicial concoctions, and there is no other source of law that can be invoked to salvage their existence.” Mitchell has also referred to PrEP, a life-saving medication that prevents HIV infection as a drug that would “facilitate and encourage homosexual behavior, prostitution, sexual promiscuity, and intravenous drug use.” 

The Plaintiffs In Braidwood v. Becerra Are Also Represented By The Trump-Aligned America First Legal Foundation. The plaintiffs are “represented by America First Legal Foundation, a nonprofit led by senior members of President Donald Trump’s administration, including Trump senior adviser Stephen Miller.” 

  • America First Legal Has Supported Suits To Overturn Vaccine Mandates And Block “Critical Race Theory.” America First Legal is involved in numerous hot-button conservative legal actions. AFL has supported suits seeking to overturn vaccine mandates and sued companies that have policies to increase diversity in their workforces. The group has also filed suits alleging that pandemic aid for minority farmers is “racist” and trying to force the Biden administration to stop allowing immigrant children into the country.
  • America First Legal Was Established By Former Trump Aide Stephen Miller “To Make Joe Biden’s Life Miserable.” America First Legal was founded by former Trump aide and white nationalist Stephen Miller who was “looking to use it to make Joe Biden’s life miserable.” He was also the architect of the Trump administration’s harshest immigration policies and a supporter of the forced sterilizations committed by ICE in Georgia.

Why The Plaintiffs’ Legal Arguments Are Wrong

The plaintiffs make three primary legal arguments – all are wrong. The plaintiffs will likely raise these arguments as the case is appealed.

The Plaintiffs’ First Argument: Plaintiffs argue that the law violates the Appointments and Vesting Clauses of the Constitution because members of the United States Preventive Services Task Force (USPSTF), Advisory Committee on Immunization Practices (ACIP), and Health Resources and Services Administration (HRSA) have not been nominated by the President or confirmed by the Senate and, according to the plaintiffs, can “unilaterally determine” the preventive care that must be covered by insurers and plans. 

Why The Plaintiffs Are Wrong: Congress made a conscious decision to require coverage of preventive services — specifying bodies that utilized well-established standards to guide their decisions — and ensured each entity in question (USPSTF, ACIP, and HRSA) is overseen by federal agencies whose heads have been appointed by the President and who all report to a senior official appointed by the President and confirmed by the Senate (the Secretary of Health and Human Services [HHS]). USPSTF members are appointed by the head of the Agency for Healthcare Research and Quality, who reports to the Secretary of HHS. The HRSA Administrator reports to the Secretary of HHS. The members of ACIP are appointed by the CDC Director who reports to the Secretary of HHS. HRSA is a component of HHS.

The Plaintiffs’ Second Argument: The preventive services provision violates the nondelegation doctrine because it delegates legislative power to the USPSTF, ACIP, and HRSA without providing an “intelligible principle” to guide their exercise of discretion. 

Why The Plaintiffs Are Wrong: Congress required the coverage of evidence-based and preventive services, and it specified bodies that applied well-established standards to guide their decisions. By specifying those bodies, Congress plainly endorsed and incorporated the standards that they utilized, and those standards provide a sufficient “intelligible principle” to limit discretion and govern the recommendations and guidelines that must be covered under the ACA.

The Plaintiffs’ Third Argument: The plaintiffs claim they have religious objections to paying for one of the preventive services mandated by the ACA — PrEP, a drug essential to HIV prevention – and that requiring coverage of this medication is a violation of the Religious Freedom Restoration Act (RFRA).

Why The Plaintiffs Are Wrong: As the Department of Justice explains in its court filings, the plaintiffs have not shown that their religious beliefs are burdened because they failed to prove that the availability of PrEP medications encourages behavior inconsistent with their beliefs or that the PrEP requirement causes an increase in their cost for health insurance. In addition, preventing the spread of HIV, a potentially fatal, infectious disease, is a compelling government interest–which is a separate basis for rejecting the RFRA claim.

Here’s What Health Experts Have Said About The Case

  • Over 100 Public Health Experts: If Successful, Plaintiffs’ Appeal “Would Result in Serious Illness and Deaths That Otherwise Would Have Been Prevented.” A coalition of 107 public health deans and professors—led by the American Public Health Association—urged the court not to end guaranteed preventive coverage because it “would result in serious illnesses and deaths that otherwise would have been prevented,” and, “would eliminate guaranteed cost-free access to preventive services in the other three statutory categories—immunizations; preventive treatments for infants, children, and adolescents; and preventive services for women.”
  • American Medical Association et al.: Invalidating the Preventive Health Services Mandate “Will Result In Worse Health Outcomes And Impose Higher Costs On The Health System.” A coalition of 20 leading medical organizations—led by the American Medical Association—warned that striking no-cost coverage of preventive services would threaten public health: “[A]pproximately 233 million people are currently enrolled in health plans that must cover preventive services without cost-sharing. That means that, in addition to the preventive services for adults covered by the USPSTF recommendations…millions of people now have access to no-copay vaccinations. And women and children have access to the specific preventive care recommended for their populations, allowing these individuals to avoid acute illness, identify and obtain treatment for chronic conditions, and improve their health. These recommendations have been critical to improving public health. […] Deterring patients from receiving these vital services will result in worse health outcomes and impose higher costs on the health system.”
  • The National Women’s Law Center: Millions of Women Who Rely on the ACA’s No-Cost-Sharing Coverage To Access Preventive Care Will Be Harmed. The National Women’s Law Center submitted an amicus brief in support of the government, writing, “[P]roviding these services without cost-sharing has helped to remedy discrimination in women’s health care and coverage and increased overall uptake of these services, improving women’s health and economic security and reducing racial disparities in both the use of these services and in health outcomes for populations facing multiple and intersecting forms of discrimination […] Further, the health and well-being of the millions of women who rely on the ACA’s no-cost- sharing coverage to access preventive care and who benefit from the resulting improvements to their health and economic security will be harmed.”
  • American Cancer Society et al.: Reducing Insurance Coverage For Preventable Services Will Lead To Worsening Patient Outcomes, Preventable Deaths, and Higher Medical Costs. A coalition of 16 patient advocacy organizations—led by the American Cancer Society—urged the court not to end guaranteed preventive coverage because, “Detecting severe diseases early allows for less invasive, more effective, and lower-cost treatment options, and substantially improves patient outcomes. Reducing insurance coverage for preventive services will lead to the opposite result—worsening patient outcomes, leading to preventable deaths, and creating higher long-term medical costs.”
  • American Lung Association et al.: Patients Could Discontinue Life-Saving Medications Despite Health Risks if Insurers Resume Cost-Sharing on Preventive Services. A coalition of 12 patient advocacy organizations–led by the American Lung Association–warned the court of “the demonstrated, severe public health effects of cost barriers” that invalidating guaranteed preventive coverage would “ameliorate,” writing: “If insurers impose cost-sharing requirements for patients to receive these life-saving medications, research suggests that patients could discontinue use despite the health risks.”

STATEMENT: Drug Company CEOs Must Face the American People About Their Outrageous Profits at the Expense of Patients

Senate HELP Committee Chair Bernie Sanders Calls On Merck and J&J to Explain Sky-High Prices for American Patients 

Washington, D.C. — Today, U.S. Senator Bernie Sanders (I-VT) is holding a press conference calling on Merck and J&J CEOs to testify in front of the Senate HELP Committee about high drug prices. The news comes as the HELP Committee is scheduled to vote on a subpoena for both CEOs next week. To date, these companies have refused to testify despite producing some of the most expensive prescription drugs on the market. Both companies are suing the federal government to stop Medicare from negotiating lower drug prices for seniors in a blatant effort to protect their massive profits. In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“We commend Senator Sanders for his tireless efforts to bring down drug prices for patients. While companies like Merck and J&J are raking in billions, Americans are routinely skipping doses and cutting pills in half because of the outrageous cost of lifesaving medications. Merck and J&J’s Janssen are in court right now to stop Medicare from negotiating lower prices in order to keep prices high for patients. We are all sick and tired of being ripped off by big drug companies, and these CEOs owe it to the American people to testify.” 

Background:

GREED WATCH: Johnson and Johnson Touts Strong Earnings As They Sue to Protect Their Profits By Blocking Medicare From Negotiating Lower Prices

GREED WATCH: Merck Announces Over One Billion More Revenue This Quarter Than Last Year

STATEMENT: Trump’s Victory in New Hampshire Puts Health Care At the Forefront of the Presidential Race

With Trump Marching Toward the GOP Nomination, Health Care is Once Again on the Chopping Block

Washington, D.C. — This evening, Donald Trump secured another victory in the 2024 primary, bringing him one step closer to the GOP nomination. Already, Trump has reignited his calls to repeal the Affordable Care Act (ACA), which would hike health care costs, throw millions of Americans off their coverage, and rip away vital protections from millions more. Once again, the issue is front and center leading up to this election. In response, Protect Our Care Executive Director Brad Woodhouse issued the following statement: 

“Trump’s victory in New Hampshire shows he is marching toward the GOP nomination, threatening the health and livelihoods of millions of households across the nation. We’re at a crossroads: While President Biden has delivered real relief to the American people by lowering costs and expanding affordable coverage, Trump has vowed to take all of this progress away and throw the health care system into chaos. Trump’s relentless calls for repealing the ACA demonstrate that the issue of health care will be front and center as voters head to the polls in November. Repealing the ACA would rip away protections for millions of Americans with pre-existing conditions, hike health care costs for working families, and throw millions of people off their health insurance. At a time when more Americans are enrolling in the ACA than ever before, it is outlandish that the likely GOP nominee is even considering another attempt at repeal. Sadly, the threat to American health care is as real as ever.” 

If the Affordable Care Act is repealed:

  • GONE: 2.3 million adult children will no longer be able to stay on their parents’ insurance. 
  • GONE: Insurance companies will be able to charge women more than men.
  • GONE: Ban on insurance companies having annual and lifetime caps on coverage.
  • GONE: Requirements that insurance companies cover prescription drugs and maternity care.
  • GONE: Protections for 135 million Americans with pre-existing conditions, including 54 million people with a pre-existing condition that would make them completely uninsurable.
  • GONE: Medicaid expansion, which covers more than 22 million people. 
  • GONE: Quality, affordable coverage that over 15.5 million people who buy insurance on their own.
  • GONE: Premium tax credits that make premiums affordable for 80 percent of people who purchase health care on the marketplace.
  • GONE: 50 million seniors will have to pay more for prescription drugs because the Medicare ‘donut hole’ will be reopened.
  • GONE: Critical funding for rural hospitals. 
  • GONE: 61.5 million Medicare beneficiaries will face higher costs and disruptions to their medical care. 

Protect Our Care Statement on Supreme Court Decision to Overturn Roe v. Wade

Washington, DC — Today, the Supreme Court issued a ruling overturning the landmark Roe v. Wade decision and revoking health care rights for millions of women across the nation. In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“Today, the highest court in the land solidified its attack on fundamental human rights. By voting to overturn Roe, the Trump-appointed justices lied to the American people, disregarded the Constitution, and created a health care crisis. This decision will kickstart a wave of laws banning abortion, stripping millions of control of their own bodies and their right to safe access to care. 

“Every Republican lawmaker who voted for these justices owns this decision, and Americans will hold them accountable. The elected officials who want to ban abortions are the same people who refuse to support the Momnibus legislation, which would combat infant and maternal mortality crisis, oppose Medicaid expansion, which has proven to improve health outcomes for mothers and their babies, and are fighting common sense reforms to lower the cost of health care for working families. We won’t give up the fight until access to safe, quality health care — including reproductive care — is a right for every American.

Protect Our Care Statement on Draft Supreme Court Decision to Overturn Roe v. Wade

Washington DC — Last night, after obtaining a leaked draft opinion, Politico reported that the Supreme Court appears to have enough votes to overturn the landmark Roe v. Wade decision. While abortion remains legal today, the decision threatens to open the floodgates for Republican states to ban abortion. In response, Protect Our Care Executive Director Brad Woodhouse issued the following statement: 

“This is a dark day in American history. After lying to the U.S. Senate and to the American people, far-right justices on the highest court in the land are poised to upend established law, disregard the Constitution, and attack fundamental human rights. If the leaked draft is accurate, we will face a health care crisis and millions of women will be stripped from their right to safe abortion access. The court is owned by the party of Trump, and we’re only beginning to see the true consequences. Every Republican who voted for these justices owns this decision and the American people will hold them accountable for their negligence. We won’t stop fighting until health care, including reproductive freedom, is a right for every American.