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ashoup
In Fact Sheet, Research

FACT SHEET: Dr. Mehmet Oz Is A Quack Grifter Unqualified To Administer Health Care For Over 160 Million Americans

By nominating Dr. Mehmet Oz to lead the Centers for Medicare and Medicaid Services (CMS), Donald Trump has taken another disastrous step to sabotage Americans’ health care. A staunch MAGA loyalist, Dr. Oz has a close relationship with Trump’s extreme Health & Human Services Secretary nominee Robert F. Kennedy Jr., having promoted his dangerous anti-vaccine conspiracy theories on his show a decade ago. Like Trump, Dr. Oz is a shameless grifter and TV personality; he rose to fame promoting dozens of health scams on his show – including one that led to a multimillion-dollar class action settlement for false advertising. The American Medical Association’s Journal of Ethics has called him “a dangerous rogue unfit for the office of America’s doctor.” 

More than 160 million Americans depend on programs administered by CMS. Trump has given Dr. Oz a mandate to slash Medicaid and Medicare. In the past, Oz has pushed to gut Medicare and force seniors onto expensive privatized plans that limit what doctors they can see, deny them care, cost taxpayers more, and give $200 billion away annually to big insurance companies,  pushing Medicare toward bankruptcy without improving care at all. He even opposes the Affordable Care Act, and he said he would have voted against it. With Dr. Oz and RFK Jr. overseeing the country’s health care sector, the second Trump administration will only lead us into chaos.

Dr. Oz Will Push To Gut Medicare and Push Seniors Onto Expensive Privatized Plans. As head of CMS, Oz would oversee Medicare, which covers over 67 million seniors and people with disabilities. In Trump’s announcement of his intention to appoint Oz as CMS administrator, he suggested cuts to Medicare would be on the table: “[Oz] will also cut waste and fraud within our Country’s most expensive Government Agency, which is a third of our Nation’s Healthcare spend, and a quarter of our entire National Budget.” Republicans often cloak health care cuts as cutting “waste and abuse” while actually risking care for people who need it. Oz previously praised a plan from Sen. Rick Scott (R-FL) which would have ended funding for all federal programs, including Medicare, in five years without Congressional action. In 2022, Oz also staked his Senate campaign on forcing millions of seniors off of traditional Medicare and onto privatized plans – a policy right out of Project 2025. He touted his plan as “Medicare Advantage For All,” even though these plans limit what doctors patients can see, deny patients care, cost taxpayers more, give $200 billion away annually to big insurance companies, and push Medicare towards bankruptcy. Experts estimate that if Medicare Advantage (MA) rose to 75 percent of Medicare enrollment, the program would waste nearly $2 trillion over 10 years on excess payments to these private plans “without any real improvement in health care quality for enrollees.” Even now, as lawmakers have worked to rein in overpayments, some MA plans are prioritizing shareholders over patients by decreasing benefits; of the 25 MA parent organizations by number of plan offerings, 76 percent are decreasing their offerings ahead of the upcoming open enrollment period. MA plans are also known to systematically underpay rural providers and deny coverage to rural Americans. Pushing seniors to MA plans would put rural hospitals at risk of closing and seniors at risk of losing access to care.

Dr. Oz Opposes The Affordable Care Act. After he launched his 2022 Senate campaign as a Republican, Oz called the Affordable Care Act (ACA) “wrong,” and said he “would not have voted for Obamacare.” As head of CMS, Oz would be responsible for implementing the ACA’s consumer protections and regulating state Health Insurance Marketplaces.

  • Dr. Oz Believes “Americans Don’t Have The Right To Health.” In a 2013 speech to Republican governors, Oz proclaimed, “[Americans] don’t have the right to health, but they have a right to access — a chance to get that health,” revealing his belief that only Americans who can afford top-tier health insurance deserve quality care.

Dr. Oz Is A Staunch Trump Loyalist and “Friend” To RFK Jr. Oz has always been a Trump loyalist, receiving Trump’s endorsement during his 2022 Senate run after going to “extensive lengths to win over the former president” and his relationship with RFK Jr. goes back at least 10 years to when Oz hosted him on his TV show to spread anti-vaccine misinformation. After Trump announced his selection of Oz for CMS, RFK Jr. proudly posted on X, “Very excited that my friend @DrOz has agreed to run CMS. Thank you ​@realDonaldTrump for this outstanding nomination. Welcome Dr​. Oz to ​The Avengers. ​Let’s Make America Healthy Again!” 

Just Like RFK Jr., Dr. Oz Has Spent His Career Pushing Pseudoscience. Oz has a long record of grifting dietary supplements unsupported by scientific evidence and recommending at-home ailments based on alarming pseudoscience. In 2012, Oz claimed that selenium supplements were “the holy grail of cancer prevention,” with no scientific evidence to back the claim. Instead, studies have found that high rates of selenium intake can cause severe heart problems. In February 2012, Oz baselessly claimed that raspberry ketones were “the No. 1 miracle in a bottle to burn your fat.” As the Public Affairs Council found, “There is a total lack of research on raspberry ketones’ effects on fat loss.” In 2014, Oz encouraged his followers to try using strawberries and baking soda to whiten teeth, even though studies have found that the mixture may harm tooth health. In 2015, Oz baselessly claimed that umckaloabo root extract was “incredibly effective at relieving cold symptoms,” even though the National Center for Biotechnology Information found that “there’s a lack of reliable studies on the benefits of these products.” In 2018, Oz tweeted a bizarre pseudoscientific claim that astrological signs “may reveal a great deal about our health.” During the COVID-19 pandemic, Oz even pushed unproven DIY treatments for the virus, publicly claiming that antimalarial drug hydroxychloroquine could be an effective treatment.

Dr. Oz Pushed Dietary Supplements Falsely Promising Weight Loss, Leading To A Multi-Million Dollar False Advertising Settlement. In July 2018, Oz reached a $5.25 million legal settlement in a class action lawsuit against him for pushing green coffee extract dietary supplements he promised had weight loss benefits. On his TV show, Oz promised that the supplements were a “magic weight-loss cure” and “revolutionary fat buster” despite having no scientific evidence to back his claims. Oz testified before Congress on false advertising in the diet and weight-loss industry four years prior. During the hearing, Oz attempted to defend his products to no avail; as one Senator pointed out, “the scientific community is almost monolithic against you.”

Dr. Oz Holds Extreme Anti-Abortion Views. Oz made it clear he opposed Roe v. Wade’s federal abortion protections. During a 2022 debate, when asked about reproductive health care access, Oz declared, “There should not be involvement from the federal government in how states decide their abortion decisions…I want women, doctors, local political leaders, letting the democracy that’s always allowed our nation to thrive to put the best ideas forward so states can decide for themselves.”

ashoup
In Fact Sheet, Research

FACT SHEET: Trump Threatens To Destroy America’s Top Health Institutions By Nominating RFK Jr. For HHS Secretary

Donald Trump has once again moved to undermine the health care of millions of Americans by nominating Robert F. Kennedy Jr. to be the next Secretary of the Department of Health and Human Services (HHS). Kennedy is a clear threat to the health care and public health institutions that keep Americans safe. From his fringe views on vaccines to outrageous racist and antisemitic conspiracy theories, Kennedy’s bizarre beliefs demonstrate his obvious lack of fitness for the position. Kennedy has no experience crafting health policy and he wants to dismantle drug development and infectious disease research. His abhorrent and deadly conspiratorial beliefs should not be anywhere near the top federal agency dictating health policy. If he gets confirmed, millions of American lives will be at stake.

RFK Jr. Is A Threat To Public Health

“No Vaccine Is Safe and Effective:” Kennedy Has Been A Leading Anti-Vaccine Voice For Decades With Deadly Consequences, Frequently Targeting Black Communities. Kennedy, who has said, “There’s no vaccine that is safe and effective,” has been a leading voice pushing anti-vaccine conspiracy theories for years. He even said he accosts strangers with babies and urges them not to vaccinate to “save” their children. Nearly two decades ago, Kennedy began spreading a conspiracy theory about the government supposedly working to cover up connections between autism and vaccines. Kennedy has specifically targeted his anti-vaccine dogma at Black Americans. He pushed false claims about Black Americans supposedly being “particularly vulnerable to vaccine injuries including autism” during a 2017 measles outbreak devastating Minnesota’s Somali-American community. In a 2020 interview, Kennedy also asserted without evidence that “People with African blood react differently to vaccines than people with Caucasian blood. They’re much more sensitive.” During the COVID-19 pandemic, he also called the COVID-19 vaccine “a crime against humanity” and falsely claimed that it is the “deadliest vaccine ever made,” releasing a film promoting disproven claims about the dangers of vaccines and explicitly warning Black communities of “sinister” vaccination campaigns. His rhetoric has had deadly consequences; in 2019, 83 people died in a measles epidemic in Samoa after Kennedy visited the island country and met with prominent local anti-vaccine activists.

Kennedy Promotes Dangerous Conspiracy Theories About Fluoridated Water, 5G Cell Service, Antidepressants, “Gay” Chemicals In The Environment, HIV/AIDS, and More. Kennedy believes fluoridated water is “drugging” our children, and has said the second Trump administration would advise states and communities to remove fluoride from the water supply completely. He has also circulated the bogus notion that 5G cellular networks are dangerous, alleging that 5G “causes cancer” and, ‘DNA dysfunction…making our children stupider and sicker.” Kennedy has promoted bizarre beliefs about antidepressants, blaming the SSRI class of medication for school shootings. He has also repeatedly shared unfounded conspiracies that man-made chemicals in the environment could be making children gay or transgender and causing the so-called feminization of boys and masculinization of girls. On multiple occasions, Kennedy has suggested that AIDS may not be caused by HIV, an established scientific fact for decades, claiming instead that, “There are much better candidates than HIV for what causes AIDS.”

Time and Again, Kennedy Has Embraced Blatantly Racist and Antisemitic Views On Public Health Issues. Kennedy has a long history of racism and antisemitism. He has frequently met with and promoted antisemites ranging from disgraced musicians like rapper Ice Cube to fringe online broadcasters and virulent antisemites. At a July 2023 dinner, Kennedy proposed that the COVID-19 virus may have been ethnically targeted to spare Jewish and Chinese people: “COVID-19 is targeted to attack Caucasians and Black people. The people who are most immune are Ashkenazi Jews and Chinese.” After the speech went viral, neo-Nazis, holocaust deniers, and antisemites celebrated Kennedy’s conspiracy theory as “100% correct.” In November 2024, new reporting revealed that Kennedy embraced the possibility that the government manufactured the COVID-19 “plandemic,” declaring that the public health response was part of an “agenda that will enslave the entire human race.”

RFK Jr. Is A Threat To The Health of Every American

“I Do Not Believe That Infectious Disease Is An Enormous Threat To Human Health:” Kennedy Threatens to Dismantle America’s Public Health Apparatus. Kennedy has said he will pause all research on drug development and infectious disease and fire hundreds of NIH and FDA employees: “I’m going to go to NIH my first week and I’m going to call all the division heads and I’m going to call all the bureau chiefs and I’m going to say, we’re going to give drug development and infectious disease a break…for about eight years.” Kennedy has also claimed that he will go after medical journals and redirect funding away from disease research. In 2023, Kennedy said, “I do not believe that infectious disease is an enormous threat to human health.”

Kennedy Will “Go Wild” On Women’s Health and Destroy Transgender Health Care. Trump has ominously threatened to let Kennedy “go wild” and “do whatever you want” on women’s health. In August 2023, he backed a 15-week federal abortion ban. Though his campaign quickly walked back the policy, Kennedy stated, “I think the states have a right to protect a child once the child becomes viable, and that right, it increases,” and suggested the point of viability was three months – suggesting that he never supported Roe v. Wade’s federal abortion protections in the first place. RFK Jr. also supports banning evidence-based gender-affirming care that many medical experts consider a medical necessity, calling it a “non-existential” issue.

RFK Jr. Is Unfit to Run America’s Health Care System

Kennedy Is Completely Unqualified To Lead The Nation’s Largest Civilian Agency. Kennedy has no relevant experience for this position, has never worked in government, and has never directed a large organization of any kind. His anti-vaccine group, Children’s Health Defense, lists fewer than ten staff members, compared to more than 80,000 employees of HHS across a diverse array of sub-agencies and departments. Despite being nominated to run HHS, RFK Jr. has failed to take any position on America’s largest health care institutions – Medicare, Medicaid, and the Affordable Care Act (ACA) which fall under the purview of HHS. In the past, Kennedy falsely claimed that the passage of the ACA resulted in Democrats “getting more money from pharma than Republicans.”

Brain Worms, Animal Carcasses, and Extramarital Affairs: Kennedy Is Unstable and Unfit to Hold Office. Kennedy has a long and well-documented history of erratic and bizarre behavior. In May 2024, Kennedy disclosed that in 2010 doctors found a dead parasitic worm in his brain, leading to brain fog and memory problems. In August 2024, Kennedy admitted to illegally napping roadkill, moving a bear cub’s carcass that was hit by a car in upstate New York to Central Park, and staging a bicycle accident. Federal law enforcement is also currently investigating RFK Jr. for cutting off the head of a dead whale and taking it home 20 years ago. Kennedy has a known history of extramarital affairs as well; this year alone, news broke of a sexting scandal with a reporter and four women came forward claiming to have been romantically involved with Kennedy.

ashoup
In Fact Sheet, Research

FACT SHEET: What’s At Stake For Health Care In The 2024 Election?

Vice President Harris Promises Lower Costs and Better Care While Trump Pushes For Higher Premiums and Worse Coverage

As tens of millions of voters head to the polls on Tuesday, the stakes couldn’t be higher – especially for the future of health care in this country. While Vice President Kamala Harris has promised to build on the Inflation Reduction Act and Affordable Care Act (ACA) by continuing to lower prescription drug costs and expand affordable coverage, MAGA Republicans are trying to turn back the clock and throw millions of people off their health care.

The last Trump administration was disastrous for the American health care system, and with Project 2025 as their blueprint, MAGA Republicans have big plans to raise costs or take away health care for nearly every American. Time and again, MAGA Republicans have declared they want to fight tooth and nail to raise costs, deny coverage to millions of people, and slash funding for Medicare and Medicaid. Trump and his MAGA allies are looking to repeal the Inflation Reduction Act’s measures that make prescription drugs more affordable for seniors, impose burdensome Medicaid paperwork requirements designed to throw people off of coverage, weaken protections for over 100 million people with pre-existing conditions, and even repeal the ACA entirely. Donald Trump and MAGA Republicans have made it clear that they intend to take America backwards. Key points of the GOP health care plan include:

MAGA Republicans Want to Repeal the Affordable Care Act (ACA). 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 with MAGA Republicans echoing his calls. If Trump doesn’t succeed at repealing the ACA altogether, he will stop at nothing to gut it and other critical protections that the American people rely on. 

MAGA Republicans Will Rip Away Protections For Pre-Existing Conditions. MAGA Republicans want to remove many protections for the over 100 million Americans with pre-existing conditions made possible through the ACA, allowing insurers to deny coverage or charge more. MAGA Republicans also want to codify rules put forth by the Trump administration that expanded junk health insurance plans. 

MAGA Republicans Will Raise Premium Costs on Middle Class Families. MAGA Republicans want to end enhanced premium tax credits that lower insurance costs for Americans, which were originally enacted in the American Rescue Plan and extended through 2025 by the Inflation Reduction Act. These enhanced tax credits have reduced ACA Marketplace enrollees’ premiums by an average of $800 per year and contributed to record enrollment. 

MAGA Republicans’ Health Care Plan Will Raise Drug Costs For Seniors. MAGA Republicans want to fully repeal the Inflation Reduction Act’s prescription drug provisions that are saving Americans thousands of dollars on health care. They want to raise costs on seniors while giving more tax breaks to drug companies and their CEOs. 

MAGA Republicans Will Slash Medicare and Medicaid Funding. MAGA Republicans continue to push for raising the retirement age, which would cut benefits for millions of American seniors, and they have proposed cutting Medicaid spending by over 54 percent in the next decade and ripping coverage away from tens of millions of children, seniors, and people with disabilities.

If Republicans are successful in enacting their health care plan, 46 million Americans across the country risk losing coverage, 20 million will see higher premiums, and 67 million people on Medicare will have to pay increased drug costs for lifesaving medications. 

If The Affordable Care Act Is Repealed:

  • GONE: Protections for more than 100 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 about 24 million people. 
  • GONE: Quality, affordable coverage for over 21.4 million people who buy insurance on their own.
  • GONE: Lower prescription drug prices for over 54 million seniors who would have to pay more for prescription drugs because the Medicare ‘donut hole’ will be reopened.
  • GONE: Critical funding for rural hospitals. 
  • GONE: Lower costs and better care for more than 67 million Medicare beneficiaries who will face disruptions to their medical care.
  • GONE: Coverage for 2.3 million adult children who are on their parents’ insurance.
  • GONE: Ban on insurance companies being 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.

If The Inflation Reduction Act Is Repealed:

  • GONE: A $35 monthly insulin cap for 4 million Americans on Medicare. 
  • GONE: Prescription drug savings for people on Medicare, including a $2,000 annual out-of-pocket cap and protections from drug company price hikes through inflation rebates. Nearly 19 million American seniors are expected to save an average of $400 per year.
  • GONE: Free vaccines for 52 million people on Medicare, including for shingles and pneumonia. 
  • GONE: Medicare’s power to negotiate lower prices for the most popular and expensive prescription drugs. Nearly 9 million people take the first ten drugs that were selected for Medicare negotiation, which accounts for 20 percent of annual Medicare Part D spending. 
  • GONE: Prescription drug savings for 400,000 low-income seniors through the Medicare Part D Extra Help program.
  • GONE: Free recommended vaccines for people with Medicaid and CHIP coverage. 
  • GONE: Premium tax credits that make premiums affordable for four out of five people who purchase health care on ACA Marketplaces.
ashoup
In Fact Sheet, Research

Speaker Johnson Confirms Health Care is Under Attack and All Americans are at Risk

As Democrats lay out their plans for building on their accomplishments, building on their vision for the future, Donald Trump and MAGA Republicans are working to drag America backwards. House Speaker Mike Johnson has openly confirmed that the MAGA agenda for health care if Donald Trump is elected includes “no Obamacare.” Donald Trump’s Republican Party wants to “take a blowtorch” to the Affordable Care Act, destroying protections for more than 100 million Americans with pre-existing conditions, ripping coverage away from more than 40 million Americans, and raising costs across the board for everyday Americans. 

READ MORE: ‘Mike Johnson Vows to Kill Obamacare’: MAGA Republicans Finally Admit They Want to Repeal The ACA. 

Time and again, MAGA Republicans have made clear plans for American health care: they are going to fight tooth and nail to raise costs, deny coverage to millions of people, and slash funding for Medicare and Medicaid. In 2023 alone, Republicans tried to repeal the Inflation Reduction Act’s measures that make prescription drugs more affordable for seniors, impose burdensome Medicaid paperwork requirements designed to throw people off of coverage, and weaken protections for 135 million people with pre-existing conditions. The threat that the ACA faces is the same, if not greater, than in 2016, and this election will make all the difference for the health and well-being of the American people.

Key points of the GOP health care plan include:

Repealing the ACA. 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 with MAGA Republicans echoing his calls. If Trump doesn’t succeed at repealing the ACA altogether, he will stop at nothing to gut it and other critical protections that the American people rely on. 

Ripping away protections for pre-existing conditions. MAGA Republicans want to remove many protections for the over 100 million Americans with pre-existing conditions made possible through the ACA, allowing insurers to deny coverage or charge more. MAGA Republicans also want to codify rules put forth by the Trump administration that expanded junk health insurance plans. 

Increasing premium costs on middle class families. MAGA Republicans want to end enhanced premium tax credits that lower insurance costs for Americans, which were originally enacted in the American Rescue Plan and extended through 2025 by the Inflation Reduction Act. These enhanced tax credits have reduced ACA Marketplace enrollees’ premiums by an average of $800 per year and contributed to record enrollment. 

Hiking drug costs for seniors. MAGA Republicans want to fully repeal the Inflation Reduction Act’s prescription drug provisions that are saving Americans thousands of dollars on health care. They want to raise costs on seniors while giving more tax breaks to drug companies and their CEOs. 

Slashing Medicare and Medicaid funding. MAGA Republicans continue to push for raising the retirement age, which would cut benefits for millions of American seniors, and they have proposed cutting Medicaid spending by over 54 percent in the next decade and ripping coverage away from tens of millions of children, seniors, and people with disabilities.

If Republicans are successful in enacting their health care plan, 46 million Americans across the country risk losing coverage, 20 million will see higher premiums, and 67 million people on Medicare will have to pay increased drug costs for lifesaving medications. 

ashoup
In News, Fact Sheet, Research

FACT SHEET: Open Enrollment Brings New Benefits and Savings for Millions of Seniors, But Republicans Want to Roll it All Back

Seniors Will Save in 2025 Thanks to the Inflation Reduction Act: $2,000 Annual Out-of-Pocket Cap, $35 Monthly Insulin Cost Cap, and Free Vaccines 

Medicare open enrollment begins on October 15 and runs through December 7. Starting October 1, seniors can begin reviewing coverage options for 2025. Seniors will see that   Medicare is better than ever thanks to the Inflation Reduction Act, and  they will save money on drugs and vaccines. The cost-saving measures in the Inflation Reduction Act were passed in Congress without a single Republican vote and are under attack by Donald Trump and Republican Members of Congress. 

For the first time ever, starting January 1, 2025, people on Medicare will benefit from a $2,000 annual out-of-pocket cap on prescription drug costs. This is in addition to benefits that went into effect on January 1, 2023: recommended vaccines are now free, monthly insulin costs are capped at $35 per prescription, and drug companies cannot take advantage of seniors by raising drug prices faster than the rate of inflation without penalty. Additionally, starting in 2026, Medicare beneficiaries will see lower drug prices across the board thanks to the Inflation Reduction Act’s provisions to give Medicare the power to negotiate lower drug prices, which will save seniors and taxpayers billions of dollars.

These savings and benefits are under attack: 

Republicans want to repeal the Inflation Reduction Act and hike drug costs for seniors. Trump’s Project 2025 makes the GOP’s plans clear: repeal the Inflation Reduction Act, ban Medicare from negotiating drug prices, and line drug companies’ pockets. Every Republican in Congress voted against the Inflation Reduction Act and Republicans in Congress continue to call for its repeal. The GOP’s latest attacks are just another attempt to carry out Trump’s Project 2025, do the bidding of the big drug companies, and repeal the law. 

Big drug companies are charging Americans two to four times more than people in other countries. While Democrats are doing what needs to be done to ensure seniors can afford the care they need without sacrificing groceries, gas, or rent – Republicans are siding with big drug companies and playing partisan games with seniors’ access to medication.

In 2025, Seniors Will Pay Less for Health Care:

The Inflation Reduction Act is drastically reducing the cost of prescription drugs for the more than 50 million Americans enrolled in Medicare’s Part D drug benefit, reducing racial, income, and geographic disparities in health care, and saving lives. Seniors will finally have the breathing room they need to pay for other essentials like food and housing, or transportation to visit their grandchildren.

By the Numbers:

  • Over 50 million Medicare Part D beneficiaries will have out-of-pocket costs for prescription drugs capped at $2,000 per year starting January 1, 2025. 
  • Medicare beneficiaries no longer face big drug companies’ outrageous price hikes that exceed inflation. 
  • All Medicare Part D beneficiaries have access to free vaccines, such as shingles and pneumonia, at no cost.
  • No Medicare beneficiary pays more than $35 a month for an insulin copay.
  • Lower prices were negotiated for the first 10 drugs selected for the Negotiation Program, with more drugs to be named each year. Nearly 9 million people on Medicare rely on these drugs and spent $3.4 billion on them in out-of-pocket costs last year alone.
  • Total monthly Part D premiums are expected to decrease by $7.45 (13%) on average from 2024 to 2025.

The Inflation Reduction Act Lowers Prescription Drug Prices

$2,000 Annual Out-of-Pocket Spending Cap. Starting January 1, 2025, no senior on Medicare Part D will spend more than $2,000 a year on prescription drugs. This cap could mean the difference between life and death for the countless seniors relying on high-cost drugs for complex conditions such as multiple myeloma. The 3.2 million on Medicare who are expected to reach the cap in 2025 will save an average of $1,500 per year on out-of-pocket costs. By 2029, 4.1 million enrollees, including one in ten seniors in 19 states and DC will benefit from the new annual out-of-pocket limit. 

Medicare Negotiation For Lower Drug Prices. In August, the Biden-Harris administration announced new, lower prices for ten of the most expensive and commonly used drugs among people with Medicare: Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, and Fiasp/ NovoLog. Nearly 9 million people on Medicare rely on these drugs and spent $3.4 billion on them in out-of-pocket costs last year alone. These prices go into effect in 2026 and will save seniors $1.5 billion out-of-pocket and save taxpayers an additional $6 billion in the first year alone.  Over 80 percent of Americans support Medicare negotiating lower drug prices — the most popular provision in the Inflation Reduction Act. 

$35 Insulin Cap For Seniors. In 2020, there were more than 3.2 million insulin users with Medicare, with nearly 1.7 million purchasing their insulin without low-income subsidies. On average, seniors with Medicare Part D or B who are not receiving subsidies pay an average of $572 every year for this life-saving medication — an unthinkable sum for many on fixed incomes. Patients who suffer chronic complications can expect to pay upwards of an additional $650 per year. Under the Inflation Reduction Act, monthly insulin copays for people on Medicare are capped at $35 per prescription. A recent study showed that 1.5 million people on Medicare would have saved an average of $500 in 2020 from the $35 insulin copay cap.

Ends Outrageous Price Increases For Seniors. Over the past 20 years, price increases for brand-name drugs in Medicare Part D have risen at more than twice the rate of inflation. The Inflation Reduction Act penalizes drug companies for raising drug prices faster than the rate of inflation starting at the beginning of 2023. Since this provision went into effect, manufacturers of 98 drugs have been penalized, saving at least 770,000 seniors directly on their drug costs, and saving people with Medicare and taxpayers nearly $3 billion. An analysis by KFF showed that half of all drugs covered by Medicare had list price increases exceeding the rate of inflation in 2020. For example, AbbVie has hiked the price of its blockbuster drug Humira 27 times, including in January 2021 when it raised its cost by 7.4 percent. 

Free Shingles, RSV, and Other Recommended Vaccinations. Thanks to the Inflation Reduction Act, 50.5 million seniors are eligible for no-cost shingles vaccinations. In 2020, nearly 4 million Medicare beneficiaries received the two-part shingles vaccination. With a single shot of Shingrix costing $212, seniors on Medicare Part D are saving over $400 on average on vaccinations in 2023. The high out-of-pocket cost of the shingles vaccine has been a key factor in low vaccination rates, especially among Black and Latino communities. This extends an important affordable preventive service to seniors on Medicare; Americans with private insurance could already typically receive shingles vaccinations at no cost.

ashoup
In News, Fact Sheet, Research

FACT SHEET: Medicare Open Enrollment Brings New Benefits and Savings for Millions of Seniors

Seniors Will Save in 2025 Thanks to the Inflation Reduction Act: $2,000 Annual Out-of-Pocket Cap, $35 Monthly Insulin Cost Cap, and Free Vaccines 

Medicare open enrollment begins on October 15 and runs through December 7. Starting October 1, seniors can begin reviewing coverage options for 2025. Seniors will see that   Medicare is better than ever thanks to the Inflation Reduction Act. Seniors will save money on drugs and vaccines, and can expect their premiums to remain stable or even decrease. The cost saving measures in the Inflation Reduction Act were passed in Congress without a single Republican vote and are under attack by Donald Trump and Republican Members of Congress. 

Starting January 1, 2025 people on Medicare will benefit from a $2,000 annual out-of-pocket cap on prescription drug costs. This is in addition to benefits that went into effect on January 1, 2023: recommended vaccines are now free, monthly insulin costs are capped at $35 per prescription, and drug companies cannot take advantage of seniors by raising drug prices faster than the rate of inflation without penalty. Additionally, starting in 2026, Medicare beneficiaries will see lower drug prices across the board thanks to the Inflation Reduction Act’s provisions to give Medicare the power to negotiate lower drug prices, which will save seniors and taxpayers billions of dollars and put downward pressure on premiums.

Seniors Will Pay Less for Health Care 

The Inflation Reduction Act is drastically reducing the cost of prescription drugs for the more than 50 million Americans enrolled in Medicare’s Part D drug benefit, reducing racial, income, and geographic disparities in health care, and saving lives. Seniors will finally have the breathing room they need to pay for other essentials like food and housing, or transportation to visit their grandchildren.

By the Numbers:

  • Over 50 million Medicare Part D beneficiaries will have out-of-pocket costs for prescription drugs capped at $2,000 per year starting January 1, 2025. 
  • Medicare beneficiaries no longer face big drug companies’ outrageous price hikes that exceed inflation. 
  • All Medicare Part D beneficiaries have access to free vaccines, such as shingles and pneumonia, at no cost.
  • No Medicare beneficiary pays more than $35 a month for an insulin copay.
  • Lower prices were negotiated for the first 10 drugs selected for the Negotiation Program, with more drugs to be named each year. Nearly 9 million people on Medicare rely on these drugs and spent $3.4 billion on them in out-of-pocket costs last year alone.
  • Total monthly Part D premiums are expected to decrease by $7.45 (13%) on average from 2024 to 2025.

The Inflation Reduction Act Lowers Prescription Drug Prices

$2,000 Annual Out-of-Pocket Spending Cap. Starting January 1, 2025, no senior on Medicare Part D will spend more than $2,000 a year on prescription drugs. This cap could mean the difference between life and death for the countless seniors relying on high cost drugs for complex conditions such as multiple myeloma. The 3.2 million on Medicare who are expected to reach the cap in 2025 will save an average of $1,500 per year on out-of-pocket costs. By 2029, 4.1 million enrollees, including one in ten seniors in 19 states and DC will benefit from the new annual out-of-pocket limit. 

Medicare Negotiation For Lower Drug Prices. In August, the Biden-Harris administration announced new, lower prices for ten of the most expensive and commonly used drugs among people with Medicare: Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, and Fiasp/ NovoLog. Nearly 9 million people on Medicare rely on these drugs and spent $3.4 billion on them in out-of-pocket costs last year alone. These prices go into effect in 2026,  and will save seniors $1.5 billion out-of-pocket and save taxpayers an additional $6 billion in the first year alone.  Over 80 percent of Americans support Medicare negotiating lower drug prices — the most popular provision in the Inflation Reduction Act. 

$35 Insulin Cap For Seniors. In 2020, there were more than 3.2 million insulin users with Medicare, with nearly 1.7 million purchasing their insulin without low-income subsidies. On average, seniors with Medicare Part D or B who are not receiving subsidies pay an average of $572 every year for this life-saving medication — an unthinkable sum for many on fixed incomes. Patients who suffer chronic complications can expect to pay upwards of an additional $650 per year. Under the Inflation Reduction Act, monthly insulin copays for people on Medicare are capped at $35 per prescription. A recent study showed that 1.5 million people on Medicare would have saved an average of $500 in 2020 from the $35 insulin copay cap.

Ends Outrageous Price Increases For Seniors. Over the past 20 years, price increases for brand-name drugs in Medicare Part D have risen at more than twice the rate of inflation. The Inflation Reduction Act penalizes drug companies for raising drug prices faster than the rate of inflation starting at the beginning of 2023. Since this provision went into effect, manufacturers of 98 drugs have been penalized, saving at least 770,000 seniors directly on their drug costs, and saving people with Medicare and taxpayers nearly $3 billion. An analysis by KFF showed that half of all drugs covered by Medicare had list price increases exceeding the rate of inflation in 2020. For example, AbbVie has hiked the price of its blockbuster drug Humira 27 times, including in January 2021 when it raised its cost by 7.4 percent. 

Free Shingles, RSV, and Other Recommended Vaccinations. Thanks to the Inflation Reduction Act, 50.5 million seniors are eligible for no-cost shingles vaccinations. In 2020, nearly 4 million Medicare beneficiaries received the two-part shingles vaccination. With a single shot of Shingrix costing $212, seniors on Medicare Part D are saving over $400 on average on vaccinations in 2023. The high out-of-pocket cost of the shingles vaccine has been a key factor in low vaccination rates, especially among Black and Latino communities. This extends an important affordable preventive service to seniors on Medicare; Americans with private insurance could already typically receive shingles vaccinations at no cost.

These savings and benefits are under attack: 

Republicans want to repeal the Inflation Reduction Act and hike drug costs for seniors. Trump’s Project 2025 makes the GOP’s plans clear: repeal the Inflation Reduction Act, ban Medicare from negotiating drug prices, and line drug companies’ pockets. Every Republican in Congress voted against the Inflation Reduction Act and Republicans in Congress continue to call for its repeal. The GOP’s latest attacks are just another attempt to carry out Trump’s Project 2025, do the bidding of the big drug companies, and repeal the law. 

Big drug companies are charging Americans two to four times more than people in other countries. While Democrats are doing what needs to be done to ensure seniors can afford the care they need without sacrificing groceries, gas, or rent – Republicans are siding with big drug companies and playing partisan games with seniors’ access to medication.

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In Research, Fact Sheet, News

FACT SHEET: President Biden’s Health Care Legacy is a BFD!

As the Democratic National Convention kicks off, Protect Our Care celebrates President Biden’s health care legacy. During his Presidency, Joe Biden has built on the Affordable Care Act (ACA), safeguarding its consumer protections and boosting access to affordable health care for millions of Americans by lowering costs and addressing health inequities. He signed the American Rescue Plan and Inflation Reduction Act, lowering prescription costs and premiums, and he has fought to protect and strengthen Medicare and Medicaid. Protect Our Care Chair Leslie Dach issued the following statement:

“Joe Biden’s health care legacy is a BFD. There would not be an Inflation Reduction Act without Joe Biden – he created it, he fought aggressively for it for months, he refused to give up, and his legislative skills made it happen. As President, he built on the success of the ACA, standing up to greedy drug companies, lowering the cost of drugs and health insurance and expanding affordable health care to millions of people across America. He kept America safe during the pandemic and launched the cancer moonshot program. He has paved the way for a future where every American has the health care they need and where health care is a right, not a privilege.” 

“Joe Biden has always been a health care champion; he sponsored a bill during his first year in the Senate establishing a Medicare drug price negotiation program and he partnered with President Obama to pass the ACA. Every American’s health care is better and more affordable today because of Joe Biden.”

The Inflation Reduction Act and the American Rescue Plan:

  • Protect seniors from prescription drug hikes. Under the Inflation Reduction Act, when drug companies hike prices faster than the rate of inflation, they will have to pay Medicare a rebate. This has not only saved the government billions of dollars, but it has drastically reduced out-of-pocket costs for people on Medicare. In June 2024 alone, the Biden-Harris administration announced that some seniors and people with disabilities will pay less for 64 drugs available through Medicare Part B thanks to the Inflation Reduction Act’s rebate program.
  • Give Medicare the power to negotiate lower drug prices, which will save taxpayers billions of dollars and lower costs for some of the most popular and expensive prescription drugs. By 2030, 80 of the most expensive prescription drugs will have lower prices because of these negotiations. This month, the Biden-Harris administration announced the new, lower prices for 10 of the highest-cost, most popular drugs taken by nearly 9 million people on Medicare who spent $3.9 billion in out-of-pocket costs in 2023. In the first year alone, these newly lowered prices will save seniors $1.5 billion in out-of-pocket costs and will save taxpayers $6 billion, slashing the list prices of the first ten drugs by 38–79 percent. Amidst negotiations, the Biden-Harris administration has also successfully fended off lawsuit after lawsuit from big drug companies and their allies seeking to ban Medicare from negotiating lower drug prices.
  • Cap drug costs for seniors. Under the Inflation Reduction Act, Part D plans are required to cap annual out-of-pocket spending to $2,000 by 2025, giving more than 50 million Americans with Medicare Part D more reassurance and financial stability. According to the Kaiser Family Foundation, this particularly helps seniors with serious conditions like cancer and Multiple Sclerosis. Seniors will also continue to save on insulin and vaccines.
  • Cut insulin costs. The Inflation Reduction Act capped insulin prices at no more than $35 starting January 2023 — saving seniors up to $1,500 annually. In response to calls from President Biden, the three largest insulin manufacturers announced $35 monthly out-of-pocket cost caps, lowering costs of about 90% of the insulin on the market.
  • Provide free vaccines for seniors. Millions of Americans enrolled in Medicare Part D have access to covered vaccines, such as shingles and Tdap, at no cost. HHS found that over 10 million people on Medicare received a free vaccine thanks to the Inflation Reduction Act.
  • Lower health insurance premiums for millions of Americans. The American Rescue plan lowered costs for millions by increasing financial assistance for people who buy coverage on their own and making financial assistance more widely available to middle-class families, ensuring people purchasing coverage through the ACA marketplaces will not pay more than 8.5 percent of their income for coverage. The Inflation Reduction Act carried on those provisions, and families continue to save an average of $2,400 a year on their health insurance premiums.
  • Cap the amount of money families pay for health insurance. The Inflation Reduction Act ensures families pay no more than 8.5 percent of their income towards coverage.
  • Eliminate premiums for low-wage workers. The Inflation Reduction Act and American Rescue Plan ensured no American with an income at or below 150 percent of the federal poverty level buying their coverage on the Marketplace will pay a premium.
  • Provide extra savings for low-income seniors. The Inflation Reduction Act expanded the Medicare Extra Help program, and the Biden-Harris administration announced investments in helping up to 3 million eligible seniors and people with disabilities enroll in the Extra Help program in 2023 to benefit from the program’s lower cost premiums, deductibles, and copayments.
  • Expand coverage and build on public health emergency continuous coverage protections. The American Rescue Plan provided robust financial incentives for the states that have not yet implemented Medicaid expansion. 
  • Create a pathway to coverage for new mothers. The American Rescue Plan called on states to extend postpartum coverage under Medicaid from two months to a full year following pregnancy, when most negative health outcomes occur.

Safeguarding and Building on The Affordable Care Act

“This Is A Big F*cking Deal:” Then-Vice President Biden Championed The Affordable Care Act. In 2010, the Obama-Biden administration and Democrats in Congress passed the landmark Patient Protection and Affordable Care Act, transforming the American health care system. The ACA cemented protections for more than 100 million Americans with pre-existing conditions, expanded Medicaid coverage to about 24 million people, and established affordable health care marketplaces now providing quality coverage for over 21.3 million people who buy insurance on their own. Then-Vice President Joe Biden championed the bill, telling then-President Obama, “This is a big f*cking deal.” Not only did President Biden champion the law, but he worked to strengthen it and protect it from Republican attacks: 

  • President Biden opened a Special Enrollment Period, allowing millions of Americans to enroll in affordable coverage. Just days into his presidency, President Biden issued an executive order reopening HealthCare.gov for a special enrollment period to help Americans gain coverage as they continue to suffer from the health and economic impacts of the pandemic. 2.8 million Americans enrolled during the Special Enrollment Period (SEP), with particularly large increases in enrollment for Hispanic, Black, and American Indian and Alaska Native people. 
  • President Biden defended the ACA from lawsuits seeking to dismantle all or part of the law. Less than a month into his Presidency, President Biden defended the Affordable Care Act in California v. Texas, the lawsuit before the Supreme Court to completely dismantle the law. The Biden-Harris administration has also defended a major provision of the ACA that requires no-cost coverage of lifesaving preventive health care services in Braidwood Management v. Becerra.
  • President Biden rolled back the Trump administration’s efforts to undermine the ACA and revoke consumer protections. In his first days in office, President Biden directed federal agencies to re-examine Trump-era policies that undermine the ACA. His administration has since taken steps to revoke Trump administration actions undermining the ACA’s consumer protections. In March, the Biden-Harris administration issued a final rule to protect consumers and limit short-term junk plans that do not need to cover pre-existing conditions, often use deceptive marketing practices, and leave American families with staggering medical bills. In April, the Biden-Harris administration issued a final rule under Section 1557 of the ACA to advance health care protections against discrimination on the basis of race, color, natural origin, sex, age, and disability. That same month, the Biden-Harris administration also reversed a Trump-era regulation allowing insurance companies to sell junk plans known as association health plans.
  • President Biden invested millions in ACA outreach. The Biden-Harris administration made historic investments in outreach, announcing $500 million in grants over the next five years for the Navigators program. The program plays a key role in helping people across the country sign up for health care coverage through ACA marketplace plans.
  • President Biden launched executive actions strengthening building on the ACA by protecting people with pre-existing conditions and making it easier for low-income enrollees. The Biden-Harris administration announced new executive actions to lower health care costs and protect people with pre-existing conditions. The new actions eliminate surprise medical bills and limit junk insurance plans that do not need to cover people with pre-existing conditions like asthma, cancer, and diabetes. In April, the administration also announced new policies to strengthen the ACA, making it easier for low-income Americans to enroll in coverage, increasing access to routine adult dental services, and setting standards for the time and distance people need to travel for appointments for in-network providers. 
  • President Biden expanded affordable health care to DACA recipients under the ACA. In May, the Biden-Harris administration finalized a policy to expand affordable health care to DACA recipients through the ACA. CMS estimates that this rule could lead to 100,000 previously uninsured DACA gaining coverage. 
  • Under President Biden, a record-breaking 21.3 million Americans signed up for affordable health care through ACA marketplaces. Earlier this year, the Biden-Harris administration announced that a record 21.3 million Americans have signed up for health insurance through the Affordable Care Act (ACA) marketplaces – over nine million more than when President Biden took office. 80 percent of enrollees were also able to find a health plan through the Marketplace for $10 or less per month thanks to the Inflation Reduction Act lowering health insurance premiums.
  • President Biden fixed the “family glitch,” expanding ACA marketplace eligibility to over one million Americans. In October 2022, the Biden-Harris administration issued a final rule to fix the “family glitch,” which blocked millions of families from accessing affordable coverage through the ACA marketplaces – expanding coverage and lowering health care costs for more than one million Americans.

Strengthening and Protecting Medicaid and Medicare

President Biden Has Worked To Strengthen and Protect Medicaid and Medicare. Throughout his Presidency, President Biden has made protecting and strengthening Medicaid and Medicare – which cover hundreds of millions of Americans – a cornerstone of his health agenda. During his tenure, President Biden has:

  • Protected Medicaid from budget cuts.
  • Cracked down on Trump’s disastrous paperwork requirements.
  • Pushed to make it easier for millions of eligible people to enroll in Medicaid, reducing red tape and simplifying applications, verifications, enrollment, and renewals for health care coverage through Medicaid and the Children’s Health Insurance Program (CHIP).
  • Signed legislation guaranteeing 12-month continuous coverage for kids on Medicaid and CHIP and announced a rule standardizing enrollment and renewal processes nationwide. The rule also applied consumer protections from the ACA to Medicaid and CHIP enrollees, like banning lifetime limits and waiting periods.
  • Fought to protect people on Medicaid from disenrollment. In September 2023, the Biden-Harris announced that nearly 500,000 children and adults who were improperly disenrolled from Medicaid and CHIP would regain their coverage thanks to their actions. 
  • Established national Medicaid and CHIP standards for patient wait times and travel distance, ensuring that people who rely on Medicaid have meaningful access to health care services including primary care, behavioral health and substance use disorder services, and OB/GYN care. The Biden-Harris administration also announced minimum staffing standards at nursing homes to promote safety and high-quality care for 1.2 million seniors and people with disabilities. 
  • Pushed for prescription drug transparency in Medicaid. 
  • Cracked down on Medicare Advantage plan providers publishing misleading ads.

Lowering Costs and Improving Health Care

President Biden Has Fought To Lower Drug Costs, Including Inhalers. In December 2023, the Biden-Harris administration announced plans to lower prices for certain high-priced medicines by developing a policy for using federal “march-in rights” to license drugs to other manufacturers who could sell them for less in order to stop price gouging and boost competition between drug manufacturers to lower prices for patients. That same month, the Biden-Harris administration announced a new policy to ensure the best value for taxpayers by establishing a fair pricing standard for medical products purchased by the Administration for Strategic Preparedness and Response. In March, President Biden hosted an event to celebrate lower inhaler costs following the FTC’s recent crackdown on drug companies that use improper patents to keep the price of inhalers too high. In response, two drugmakers have capped out-of-pocket costs for some top-selling inhalers at $35 per month. 

President Biden Has Fought To Improve Health Equity and Access to Health Care. President Biden has taken steps during his presidency to address health inequities, issuing several executive orders and new agency rules. On his first day in office, President Biden signed an executive order calling for the federal government to advance an ambitious, whole-of-government equity agenda. In April 2022, he signed another executive order focused on continued efforts to expand access to affordable, quality health coverage, and in February 2023, President Biden signed a new executive order aiming to strengthen and reaffirm the administration’s commitment to deliver equity. In September 2023, the Biden-Harris administration released a historic proposed rule that strengthens prohibitions against discrimination for people with disabilities in any program or activity receiving funding from HHS.

President Biden Has Worked Tirelessly To Address Maternal Health. President Biden has worked to address the maternal mortality crisis and invest in maternal health. In June 2022, the Biden-Harris administration released a whole-of-government blueprint for combating maternal mortality and morbidity. In March, President Biden signed an executive order directing federal agencies to prioritize women’s health research, including studying conditions like menopause, arthritis, and heart disease and in April, the Biden-Harris administration invested $105 million in funding to support more than 100 community-based organizations working to improve maternal and infant health.

President Biden Has Prioritized Reproductive Health Care As MAGA Republicans Rolled Out Abortion Bans and Pushed For Limited Contraception Access. In the wake of the MAGA Supreme Court overturning Roe v. Wade and rolling back nearly 50 years of abortion protections, President Biden has made protecting reproductive health care a top priority. Following the Dobbs v. Jackson decision, President Biden signed an Executive Order seeking to protect access to reproductive health care services and defend women’s fundamental rights. He has issued executive orders strengthening access to affordable contraception and family planning services and rolling back Trump’s gag rule barring family planning providers from mentioning abortion to patients to receive Title X funding. The Biden-Harris administration also recently released new guidance reminding state Medicaid agencies that they must ensure enrollees have access to comprehensive family planning services.

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In News, Fact Sheet, Research

FACT SHEET: Five Things You Should Know About Kamala Harris and Health Care

The Biden-Harris administration has been instrumental in expanding access to quality health care for millions of Americans while also driving down health care costs. Whether it’s lowering the cost of drugs, capping the monthly cost of insulin, or making sure millions of Americans have access to affordable health insurance, this administration has fought for everyday Americans and won. Vice President Harris has battled for better health care her entire time in public office – as California’s Attorney General, as Senator, and as Vice President. At every level of government, Vice President Harris has been a champion for better and more affordable health care for every American.

Here are some of the highlights from her extensive track record on health care:

  1. Vice President Harris cast the tie-breaking vote which allowed the Inflation Reduction Act to pass the Senate and become law. As Vice President, Kamala Harris has cast the most tie-breaking votes in history including for the seminal pieces of legislation of the Biden-Harris administration, the American Rescue Plan and the Inflation Reduction Act. Now two years after the passage of the Inflation Reduction Act, around 19.7 million Americans are saving on average $700 a month on health insurance, nearly 82 million Americans have access to no-cost vaccines and preventive care through Medicaid and CHIP, 10 million seniors received free vaccinations in 2023 alone, and Medicare is currently negotiating the price of 10 drugs taken by over 9 million seniors. On top of this, the Inflation Reduction Act capped monthly insulin costs at $35 for 3.3 million seniors on Medicare Part D. Surveys show around 1.5 million seniors would have seen cumulative savings of about $734 million in Part D and $27 million in Part B if this cap were in effect in 2020. Without her deciding vote, millions of Americans would be paying more for health care, with some not having any access at all. Now Vice President Harris is fighting to expand the savings from provisions like the $35 insulin cap to all Americans, including those with private coverage. 
  2. Kamala Harris filed 10 amicus briefs defending the Affordable Care Act as California Attorney General, and as Senator co-sponsored 14 pieces of legislation protecting and expanding on the ACA, including legislation expanding preventive care requirements for private and public health insurance. Kamala Harris has a long and consistent history of fighting to defend and expand the ACA. Whether she was defending the constitutionality of the ACA in court, to arguing for the protection of contraception mandates, to ensuring that Republican plans to flood the ACA marketplace with junk plans could not come to fruition, at every turn Harris has stood up for the American people against interest groups wanting to increase their health care costs. Her history on health care is clear, Kamala Harris wants Americans to have lower costs and better care. 
  3. Kamala Harris has always fought for reproductive freedom. During her time in the Senate, Kamala Harris co-sponsored 14 pieces of legislation that would expand and protect the reproductive rights of Americans. From supporting the Women’s Health Protection Act to protecting access to birth control to fighting for the expansion and protection of insurance coverage for abortions, Kamala Harris has a remarkably consistent record when it comes to ensuring Americans have access to quality and affordable reproductive health care. She has fought against the GOP war on reproductive rights since she was California’s AG filing amicus briefs arguing against the dystopian restrictions on abortion access in states like Texas and helping the California Congress create legislation ensuring equal access to reproductive health services to all people within the state. As Vice President, Harris has been a leader standing up for reproductive freedom working to protect access to abortion care and affordable high-quality contraception. 
  4. Kamala Harris has prioritized maternal health and increasing health care equity. Maternal mortality in the U.S. is highest in the industrialized world, with around one-third of maternal deaths occurring during the postpartum period. Studies show that at least a factor of the incredibly high rate of perinatal maternal mortality is due to coverage disruptions during the first year after pregnancy, something which disproportionately affects people of color. As Vice President, Harris has challenged states to extend postpartum Medicaid coverage from only two months to a full year. This policy would allow for over 720,000 people annually to see expanded coverage who wouldn’t have been able to access it otherwise. Now, thanks to these efforts, 46 states and Washington DC have adopted full extended postpartum coverage.Black women are three times more likely to die from pregnancy-related complications than white women in the United States and maternal mortality rates — already higher than any other developed country — are still dramatically increasing. Even so, an estimated 80 percent of these deaths are preventable, making the passage of legislation addressing this crisis even more critical. As a Senator, Kamala Harris was involved with creation and proposing of the first Black Maternal Health Momnibus Act to address this crisis in maternal health. The “Momnibus” would direct HHS to establish task forces to address social determinants of health and award grants to innovations in maternity care and maternal mortality tracking. It also would expand federal nutrition programs through increasing the postpartum and breastfeeding periods and reduce specific state funding to jurisdictions which have no laws restricting constraints on incarcerated pregnant people. Every year since 2020, the Momnibus Act has been reintroduced in the Senate. It is perhaps the most essential central piece of legislation existing to address maternal mortality rates and health equity.
  5. As the California Attorney General, Kamala Harris was a part of cases which fined pharmaceutical companies nearly $7.2 billion for deceptive marketing, inflating prices, and harming American consumers. Then-Attorney General Harris broke records throughout her term when it came to settlements holding pharmaceutical companies accountable for deceptive and illegal practices. She was involved in the second largest recovery from a pharmaceutical company and the largest consumer protection settlement reached with a pharmaceutical company. Of the billions she was able to recover due to inflated drug prices and illegal marketing practices, $2.2 billion came from Johnson and Johnson, whose drugs Xarelto, Stelara, Imbruvica are currently up for Medicare price negotiation, $71 million came from Amgen, whose drug Enbrel is currently up for Medicare price negotiation, $68.5 million came from AstraZeneca, whose drug Farxiga is currently up for Medicare price negotiation, and $19.5 million came from Bristol-Myers Squibb, whose drug Eliquis is currently up for Medicare price negotiation.
ashoup
In News, Fact Sheet, Research

FACT SHEET: The State of LGBTQI+ Health Care in America

Despite Progress Made By President Biden, the GOP is Putting LBGTQI+ Rights At Risk

Lowering drug costs, expanding affordable health insurance coverage, and banning health care discrimination are critical to improving access to comprehensive, high-quality health care and – together with other actions – advancing health equity for lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) people in America. The Biden-Harris administration has been leading the way in ensuring LGBTQI+ individuals have access to health care, while Republicans continue to sabotage LGBTQI+ rights in state legislatures by denying transgender youth access to gender-affirming care, and the ability to use chosen names and pronouns in schools, and banning drag as a form of gender expression. Policies to improve access to care and protect LGBTQI+ individuals from discrimination in health care and other settings are essential for improving the health and well-being of LGBTQI+ people nationwide.

However, Trump-appointed MAGA judges are setting a dangerous precedent to pull vital medications off the market and eliminate no-cost preventive services that LGBTQI+ people count on to stay healthy — including PrEP, a medicine that is 99 percent effective at preventing the spread of HIV and can cost thousands of dollars annually. This threatens to exacerbate health disparities in queer Black and Hispanic/Latino communities. Republicans in 10 states continue to block Medicaid expansion, while the program provides critical health care access for LGBTQI+ people. Meanwhile, state-level Republicans are igniting a war on trans health care, with Florida Republicans banning upwards of 80 percent of all gender-affirming care in the state. Whether it’s barring no-cost screenings or preventive medicine, banning gender-affirming care, or attacking other fundamental LGBTQI+ rights, Republicans’ war on LGBTQI+ health care is only getting worse.

The Biden-Harris Administration Is Helping Millions of LGBTQI+ Americans Gain Health Coverage

Expanding Health Coverage For Millions Of Americans. Premium subsidies for people who purchase coverage on their own made available by President Biden’s American Rescue Plan helped nearly 210,000 LGBTQI+ enrollees have access to zero-premium plans. Nationwide, 20 percent of Black LGBTQI+ individuals are uninsured, compared to 15 percent of Black heterosexual and cisgender individuals and 9 percent of non-LGBTQI+ individuals overall. Before the Affordable Care Act (ACA) went into effect in 2013, 34 percent of LGBTQI+ Americans were uninsured. As of June 2020, the uninsurance rate amongst LGBTQI+ individuals dropped to 16 percent. In the 2023 Open Enrollment period, a record-breaking 21.3 million Americans signed up for health insurance through the ACA, a 17 percent increase from 2022.

Reversing Trump Policy Allowing Sexual Orientation Discrimination. In May 2021, Department of Health and Human Services (HHS) Secretary Xavier Becerra announced that sexual orientation would be restored as a protected class under the ACA. In July 2022, HHS put forth a proposed rule implementing Section 1557 of the ACA, which prohibits discrimination on the basis of race, color, national origin, sex, age, and disability in certain health programs and activities. The rule affirms protections against discrimination on the basis of sex, including sexual orientation and gender identity consistent with recent U.S. Supreme Court decisions. In April 2024, this rule became finalized and ensures that LGBTQI+ individuals aren’t denied coverage or charged more for care. This Administration’s policy reversal has been especially important with transgender rights being attacked by Republicans. These new protections are already under attack with the state of Florida suing the administration to overturn the rule.

Closing The Coverage Gap Improves Outcomes For LGBTQI+ Individuals. As of June 2022, 1.2 million LGBTQI+ Americans were covered by Medicaid, and of those nearly 13 percent identified as transgender. According to a Center for American Progress survey, in 2019, the LGBTQI+ uninsured rate was 20 percent in the states refusing to expand Medicaid, compared to 8 percent in states that adopted Medicaid expansion. 29 percent of LGBTQI+ individuals faced difficulty seeking medical care when sick or injured due to cost. LGBTQI+ Americans are twice as likely to be without health insurance. Closing the Medicaid coverage gap is the single most important policy to expand coverage and reduce racial and ethnic inequities in the American health care system, and is an important policy solution for LGBTQI+ people because of the intersectional dimensions of their identities. A 2022 study found that more Black LGBTQI+ adults had Medicaid as their primary insurance compared to their heterosexual and cisgender counterparts. 

Biden-Harris Administration Helps LGBTQI+ Americans Age With Dignity

Millions Of LGBTQI+ Americans Able To Grow Old At Home. Federally provided home- and community-based services funds helped more than 100,000 individuals return to their homes and communities from nursing facilities between 2008 and 2019. Allowing LGBTQI+ seniors to grow old at home helps alleviate the concern older LGBTQ+ adults have about being neglected or abused, or facing discrimination in nursing homes or assisted living facilities. In President Biden’s fiscal year 2024 proposed budget, $150 million is dedicated to investing in Medicaid’s home- and community-based services to ensure more older Americans and people with disabilities have access to care in their own homes and communities. 

The Inflation Reduction Act Supports LGBTQI+ Seniors. The $2,000 cap on prescription drug prices for Medicare enrollees helps LGBTQI+ seniors on Medicare, who typically suffer more from poorer health and poverty. Medication costs are a frequent barrier to managing chronic health issues. 23 percent of the LGBTQI+ community lived in poverty in 2020, compared to 16 percent of their heterosexual counterparts. When looking at further dimensions of intersectionality, members of LGBTQI+ communities of color also disproportionately faced higher rates of poverty than heterosexual members of these communities. A 2021 study found that members of sexual minority communities are more likely than heterosexual individuals to engage in behaviors to reduce the cost of medicine such as skipping doses, trying alternate therapies, or delaying refills.

Biden-Harris Administration Is Defending Transgender Americans

Supporting Gender Affirming Care. On a state-by-state basis, the Center for Medicare and Medicaid Services is approving efforts to expand gender-affirming care under the ACA and other federal programs. HHS has also created a website and resources for LGBTQI+ youth, parents, and providers, on LGBTQI+ health and well-being and gender-affirming care.

Protecting Transgender Youth Mental Health. The Biden Administration is focusing on providing mental health support, creating a more welcoming environment in public schools, and acknowledging the positive impacts of gender-affirming care. President Biden signed the Executive Order on Advancing Equality LGBTQI+ Individuals in June 2022 to defend the rights and safety of LGBTQI+ individuals by directing relevant agencies to discredit conversion therapy, ensuring that federal benefit programs can be equitably accessed by LGBTQI+ households, and increasing federal support for family counseling to reduce the risk of family rejection of LGBTQI+ youth. The Substance Abuse and Mental Health Services Administration is also piloting additional dedicated services for LGBTQI+ youth in the national 988 Suicide and Crisis Lifeline. In February 2024, the Biden-Harris Administration dedicated $5.1 million to fund family counseling and support for LGBTQI+ youth and their families. The goal of this grant is to prevent health risks including suicide, depression, homelessness, and drug use, while also promoting wellness.

Stepping In When States Fail. In honor of Transgender Visibility Day in March 2022, the Justice Department issued a letter to all state attorneys general reinforcing federal transgender youth protections against discrimination and obtaining gender-affirming care. Due to the increase in anti-trans state legislation, the Department of Justice has also filed statements of interest and amicus briefs supporting legal action against state laws that restrict the rights of transgender youth.  

Republicans Are Pulling Medications They Don’t Like From The Market – Setting a Dangerous Precedent for LGBTQI+ Care

A Trump-Appointed Judge Is Working To Curb Access To Safe, Affordable Abortions. In April 2023, another Trump-appointed judge ruled against the FDA in a case seeking to remove a popular medication used to induce abortion from the market. Medication abortions are the most common, least expensive, and most accessible method for people to terminate pregnancy and the ruling impacts communities that already have difficulty accessing these key services. 

Republicans Want to Pull Medications They Don’t Like Off The Shelves. The case could set a dangerous precedent for any federal judge to pull controversial medications off the market, regardless of the science behind approval decisions or the bureaucratic steps taken to prove safety and efficacy. As Lambda Legal has pointed out, “The trial court’s approach just as easily (or perhaps more easily) could be aimed at HIV-related medications and puberty blockers and hormone treatments, as well as medications for many other health conditions that are specially relevant for our communities.”

Republicans Are Taking Away No-Cost Preventive Care From LGBTQI+ People and Communities of Color

Republicans Are Curbing Access To No-Cost Preventive Services, Disproportionately Impacting LGBTQI+ People and Communities of Color. In March 2023, a Trump-appointed judge decided against the federal government in Braidwood v. Becerra and struck down a major portion of the ACA requiring no-cost coverage of lifesaving preventive health care services recommended by the U.S. Preventive Services Task Force, including lung and breast cancer screenings, Hepatitis C screenings, HIV screenings, and PrEP medication. These changes have a disproportionate impact on historically marginalized populations like LGBTQI+ people and communities of color — curbing no-cost access to preventive services would create barriers to seeking needed care and exacerbate existing health disparities.

Republicans Are Targeting PrEP, A Key Prevention Strategy For HIV. The Trump-appointed judge’s ruling struck down a portion of the ACA guaranteeing 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. PrEP is shown to lower the risk of infection from sex by more than 90 percent (more than 99 percent effective) and is widely viewed as a key prevention strategy for ending the HIV epidemic in the U.S. Thanks to ACA protections, the percentage of PrEP users has jumped from 3 percent of eligible patients in 2015 to 30 percent of eligible patients prescribed in 2021. The federal government’s 2022-2025 strategy to combat HIV recognized gay and bisexual men—particularly Black, Hispanic/Latino, and Native American men—Black women, and trans women as priority populations. Rural populations, especially gay and bisexual Native American men and Two-Spirit populations, have greater difficulty accessing preventive care for HIV.

  • Ending ACA PrEP Protections Disproportionately Harms Black and Hispanic/Latino Gay and Bisexual Men. While 66 percent of eligible white people in America are prescribed PrEP, just 16 percent of eligible Hispanic/Latino Americans and 9 percent of eligible Black Americans are prescribed the lifesaving drug. Academic experts have concluded that Braidwood will disproportionately impact racial and ethnic sociodemographic groups at particularly high risk for HIV infection: “Even in our ‘best-case’ scenario, the predominant burden of new restrictions on access to PrEP will likely fall on Black and Latino gay and bisexual men, as well as transgender women, who already face significant barriers to HIV prevention and care.”

Ending ACA Cost-Sharing Protections Could Increase HIV Transmission By At Least 17 Percent In The First Year Alone. According to academic experts, ending the prohibition of cost sharing for PrEP will increase HIV transmission among men who have sex with men by at least 17 percent in the first year alone. Researchers at Yale have already determined that the Braidwood ruling could see coverage for PrEP drop from 28 percent to only 10 percent, mainly due to the fact that 80 percent of PrEP users are on commercial plans that would now have the ability to refuse to cover PrEP. A recent study found that PrEP medication costs nearly $350 for a 30-day supply on average. Outside of the cost of obtaining medication, PrEP users incur additional required charges as part of the care regimen like clinical visits and lab costs that can add up to thousands of dollars annually. 

Republicans Are Pushing An Anti-Trans Agenda

10 Republican-Led States Continue To Block Medicaid Expansion, Which Serves Millions Of LGBTQI+ Patients. Republicans in 10 states continue to block Medicaid expansion, while the program provides critical health care access for an estimated 1.2 million LGBTQI+ adults, disproportionately trans and non-binary Black, Hispanic/Latino, Pacific Islander, and Native American people. LGB individuals are more likely to qualify for Medicaid based on income, and Medicaid covers about 21 percent of trans and non-binary people in the U.S.

Republicans Are Waging War On Trans People and Their Health Care. Across the country, Republicans have escalated their war on trans people and health. As of May 2023, 16 Republican-led states have enacted new anti-trans health care laws and 22 states have passed anti-trans health care bills in at least one Republican-held legislative chamber. Republicans have re-centered their culture wars around trans people, with new legislation prohibiting drag shows from public property alongside bans on gender-affirming care. Anti-trans laws contribute to negative health impacts, including an increased risk of suicidality and substance use among trans and non-binary youths. Equitable access to health care services has always been a challenge for LGBTQI+ people. A 2018 survey found that 75 percent of people seeking gender-identity-based care have had negative experiences during physician visits. The fight to get insurers to cover basic care for trans patients—let alone gender-affirming care—has been a grueling, decades-long process even with ACA protections and federal and state-level enforcement. New bans threaten to undo decades of work to provide trans people with access to affordable, gender-affirming care.

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FACT SHEET: Medicaid Is A Lifeline For People With Disabilities

April marks the 7th annual Medicaid Awareness Month. Medicaid is a vital source of care for people with disabilities across the country and helps ensure they can access quality care. Up to 1 in 4 Americans have some type of disability. The program also provides half of all long-term care in the United States, which includes essential home- and community-based services for people with disabilities. Protecting access to Medicaid is essential for ensuring that people with disabilities get the care they need. 

Medicaid is a popular, lifesaving program, but Republicans want to cut it and rip coverage away from millions of hardworking families. Voters agree that it is important to prevent harmful cuts to Medicaid that would reduce health care access. Yet the latest GOP scheme slashes trillions from Medicaid and would throw millions of people off their coverage through block granting and burdensome work reporting requirements. These requirements are especially cruel for Americans with disabilities who may not be able to work long hours or secure a health-related exemption from the requirement. Republicans also won’t quit their mission to repeal the Affordable Care Act (ACA) and Medicaid expansion, putting health care for millions of people in jeopardy.  

By The Numbers 

  • 1 In 3 Medicaid Enrollees Have A Disability. One-third of Medicaid enrollees report having a disability, and 11 percent of enrollees qualified for Medicaid based on a disability determination.
  • Up To 1 In 4 U.S. Adults Have A Disability. Up to 27 percent of American adults have some type of disability. Medicaid covers 43 percent of nonelderly adults with disabilities, including adults with physical disabilities, developmental disabilities, brain injuries, and mental illnesses.
  • Over 10 Million Non-Elderly Adults Are Enrolled in Medicaid Due To At Least One Disability. More than 10 million people under age 65 enrolled in Medicaid qualified as a result of a disability determination. Other individuals with disabilities may qualify for Medicaid due to age, pregnancy, or income.
  • Medicaid Covers Half Of All Long-Term Care. The Medicaid program provides half of all long-term care in the United States, which includes essential home- and community-based services for people with disabilities.
  • Millions Lose Medicaid Coverage In Unwinding Post-Pandemic. As Medicaid transitions back to its pre-pandemic eligibility and enrollment rules, too many people are losing coverage because of the carelessness and callousness of certain Republican governors who are terminating coverage for people who may still be eligible. Americans with disabilities are at an increased risk of losing Medicaid coverage due to the renewal process barrier, regardless of whether individuals remain eligible.

Americans with disabilities have faced barriers to achieving and maintaining optimal health. They are 1.4x more likely to have obesity, 2x more likely to smoke, 2x more likely to have diabetes, and 2.8x more likely to have heart disease. Yet 1 in 4 report having an unmet health care need because of cost in the past year and the same proportion report not having a usual health care provider. Medicaid enrollees with disabilities have access to regular preventive care and treatment for chronic illnesses and conditions. States are also required to provide key services for adults, such as hospital stays, physician, lab, and x-ray services, and nursing home care.

In 2010, the ACA opened the door for states to expand Medicaid, and the results are piling in: Medicaid expansion works. In addition to providing coverage for about 24 million people, expansion has resulted in healthier people, communities, and economies. Study after study shows that Medicaid expansion increases access to care, improves financial security, and leads to better health outcomes for people with disabilities. 

People With Disabilities Rely On Medicaid Expansion For Coverage. More than six in 10 nonelderly Medicaid adults with disabilities do not receive SSI, meaning that they qualify for Medicaid on another basis (such as income, or as parents in non-expansion states). Medicaid is a significant source of health care coverage for these adults, providing critical access to care for serious health conditions and supporting those in the workforce.

Medicaid Expansion Helps Adults With Disabilities Gain Access To Affordable Care Without Having To Wait. Medicaid expansion helps adults with disabilities gain quicker access to coverage without waiting for a disability determination, which can take years. Thanks to the Affordable Care Act (ACA), Medicaid expansion has allowed people gain coverage who previously were not eligible for coverage and otherwise would have been uninsured. Many uninsured individuals with pre-existing conditions who would not have qualified for Social Security Disability Insurance yet are also eligible for coverage under Medicaid expansion.

Medicaid Expansion Has Improved Health Care Services For People With Disabilities. According to the same 2021 study, Medicaid expansion often improves the services provided to people with disabilities, as states have been able to provide better coverage of critical services including specialized treatments and coverage for behavioral health concerns and other chronic conditions.

Medicaid Expansion Reduces Out-Of-Pocket Health Care Spending, Which Is Especially Important For People With Disabilities Who Often Have Limited Incomes. A majority, or nearly 85 percent, of adults with disabilities who have Medicaid coverage earn annual incomes of less than 200 percent of the FPL, $12,060 for an individual, making access to affordable health care even more essential. In 2022, CMS adopted rules to lower maximum out-of-pocket costs by $400.

Medicaid Is One Of The Most Effective Anti-Poverty Programs, Particularly For People With Disabilities. Medicaid reduces poverty by limiting out-of-pocket spending and expanding state-level Medicaid programs.  The average out-of-pocket spending decreased in states that expanded Medicaid. The poverty-reducing effects were greatest for adults with disabilities, elderly, children, and racial/ethnic minorities.

Medicaid Expansion Has Increased Employment For People With Disabilities. According to a 2021 study, individuals with disabilities living in Medicaid expansion states are more likely to be employed than those living in non-expansion states. In expansion states, people with disabilities have seen increased health coverage and employment rates compared to non-expansion states. On the other hand, Republican-backed work reporting requirements reduce employment and can jeopardize health care for people with disabilities because definitions are outdated and don’t accommodate many types of disabilities that affect peoples’ ability to work. 

Hundreds of Thousands of Americans With Disabilities Are Stuck Without Coverage In States That Have Refused to Expand Medicaid. 10 states have refused to expand Medicaid under the Affordable Care Act (ACA), stranding many adults with low incomes in the Medicaid coverage gap. As a result, over 265,000 Americans with disabilities with incomes below the federal poverty level are ineligible for Medicaid or ACA marketplace assistance in these states. Over half of these individuals reside in Texas or Florida, and adults with disabilities form at least 20 percent of those in the Medicaid coverage gap in Alabama, South Carolina, Kansas, Tennessee, and Wyoming. 

 

Medicaid Helps People With Disabilities Access Comprehensive, Consistent Long-Term Care. Medicaid beneficiaries with disabilities comprised 95 percent of the fees for service of long-term care services while making up less than 25 percent of people who are enrolled in the program. 

  • Medicaid Provides Half Of Long-Term Care In The U.S. Medicaid provides half the nation’s long-term care – a broad category encompassing a critical array of services available for people with prolonged illnesses, disabilities, and other chronic conditions. Medicaid providers and consumers have worked to broaden access to care in at-home and community-based settings, where many seniors and people with disabilities would prefer to live.

Increased Medicaid Funding For Caregivers Benefits People With Disabilities. The Biden-Harris administration recently finalized new rules that require Medicaid to provide increased funding for home care services, a critical component of care for millions of people with disabilities who rely on care workers to meet their basic needs while living in their homes and communities.

Protect Our Care will continue to host events and activities throughout Medicaid Awareness Month, which includes the following themes each week:

  • Week 1: Republican threats to Medicaid. In the first week of Medicaid Awareness Month, Protect Our Care focused on how Republicans are actively seeking cuts to Medicaid while GOP leaders in 10 states continue to block Medicaid expansion. 
  • Week 2: Medicaid helps people of color and rural Americans. In week two, Protect Our Care highlighted how Medicaid is a critical tool to expand access to coverage, which together with policies that address other social and structural determinants of health, narrow stark disparities in health care, improve families’ financial security, and make people healthier. 
  • Week 3: Medicaid helps women and kids. For week three, Protect Our Care brought attention to the vital role of Medicaid for mothers and children across the country.
  • Week 4: Medicaid helps seniors and people with disabilities. The final week focuses on how Medicaid helps seniors and people with disabilities access lifesaving care. 
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