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ashoup
In Fact Sheet, Research

Republican Premium Hikes Will Raise Health Care Costs for Everyone

Small Business Owners, Middle Class Families, And Rural Communities Will Be Among The Hardest Hit By Republican Premium Hikes

Republicans are raising health care costs for millions of Americans by taking away critical tax credits from working families. Countless families are one health care bill away from bankruptcy, but Republicans are planning to increase their health care costs even more. Republicans are doubling health care premiums for millions of families, which will result in an estimated 5 million Americans losing their coverage altogether. Under Republicans’ plan, families will pay up to 90 percent more for their health care, while billionaires and CEOs will get another huge tax break. Democrats are fighting to stop Republican premium hikes. As of January 2025, a record 24.2 million Americans are enrolled in quality, affordable coverage because of the tax credits passed by Democrats in Congress without a single Republican vote – more than twice as many people with insurance as when Trump held office. 

The bottom line: Americans cannot afford Republican premium hikes. Every family should be able to afford health coverage, regardless of their zip code or income. Because of Republicans, health insurance premium hikes will be announced this summer, and starting in January 2026, tens of millions of people who buy coverage on their own will see their premiums skyrockets and millions will become uninsured, including self-employed Americans, small business owners, people living in high-cost rural areas, farmers, people with pre-existing conditions, older adults, and more. Here are some of the groups who will be hit the hardest:

  1. Middle Class Families Will Pay Thousands More For Health Care. Thanks to Republicans, families of four making about $125,000 each year will lose the premium tax credits that made their health care affordable and be forced to pay an average of $18,300 each year in premiums, an increase of over $7,500 per year.
  2. Small Business Owners Will Lose Access To Affordable Health Care. Small business owners and sole proprietors often rely on ACA Marketplace plans for affordable, quality coverage. 82 percent of small business owners and self-employed workers enrolled in Marketplace coverage rely on premium tax credits to afford health care. Self-employed Americans make up nearly 4 in 10 of those who will lose affordable health care under GOP plans.
  3. Rural Americans Will Go Without Affordable Options. Premiums are known to be higher in rural counties than suburban and urban counties, making tax credits especially essential to rural Americans having affordable health care. The tax credits made it possible for 65 percent of uninsured rural Americans to have access to zero-dollar premium health plans, and more than 76 percent are able to find a plan for less than $50 a month. If Republicans have their way, the divide between rural and urban America will grow wider. Farm states will be especially hard hit: nearly all Marketplace enrollees in farm states receive a tax credit, which reduces their monthly premiums by an average of over $500, and many farmers stand to lose some or all of their tax credits if enhanced premiums are not extended. 
  4. Early Retirees Will Struggle To Afford Health Care. More than half of the adults who will lose premium tax credits under Republican plans are between the ages of 50 and 64, an age group that disproportionately experiences hiring discrimination and may have been forced into early retirement by economic conditions. Over 5 million Americans ages 55 to 64 enrolled in Marketplace coverage in 2024. Thanks to Republicans, premiums will increase by an average of $17,511 for a 60-year-old couple making $80,000 a year.
  5. Young People Will Go Without Health Insurance. Republicans are removing the tax credits that made it possible for 63 percent of uninsured young adults to have access to zero-dollar premium health coverage and more than 75 percent able to find a plan for less than $50 a month. By raising costs on young Americans, Republicans will force an estimated 2.8 million younger Americans out of their Marketplace coverage. 
  6. Uninsurance Rates Among People Of Color Will Skyrocket. Thanks to the enhanced premium tax credits, more than 65 percent of uninsured Black adults are eligible for zero-dollar premium plans and 75 percent are eligible for plans less than $50 a month. More than 68 percent of uninsured Latino adults are eligible for zero dollar premium plans and nearly 80 percent can access plans for less than $50 a month. Because of the Republican premium hike, the percentage of uninsured could return to the double digits for both groups.
ashoup
In Fact Sheet

FACT SHEET: Trump’s Crusade Against The ACA Continues With Renewed Attacks On The Law In His Second Term

Since its passage 15 years ago, the Affordable Care Act (ACA) has become the bedrock of American health care, with millions relying on its coverage and protections. But undoing the ACA and its protections for over 100 million people with pre-existing conditions has been one of Donald Trump’s core fixations since announcing his presidential campaign ten years ago. He spearheaded a failed attempt to repeal and replace the law in 2017, supported efforts to overturn it in court, and spent his first term working to undermine the ACA at every turn by ending outreach, limiting enrollment, and promoting plans circumventing the law. Now in his second term, Trump has picked up right where he left off in 2020, working overtime to revoke Biden-era executive protections, slash outreach, and limit enrollment once again. But he isn’t stopping there. This time, he is determined to target the law’s core features – including Medicaid expansion and free coverage for preventive services like vaccines – and is even working to gut the very agency that ensures the ACA is properly administered, implemented, and enforced. The Trump-led plan to gut health care will only take us backward and throw the entire health care system into chaos.

The Second Trump Administration’s First Executive Actions Have Targeted the ACA. The second Trump administration has relentlessly targeted the ACA’s consumer protections and health care coverage provisions that provide affordable care to millions of Americans. In January 2025, within days of retaking office, Trump revoked a Biden administration order that prioritized protecting and strengthening the Affordable Care Act by pushing federal agencies to extend enrollment periods and dedicate extra funding for the third-party Navigators that help people enroll in ACA insurance. Trump also revoked a Biden administration executive order that aimed to lower prescription drug costs for people on Medicaid – including those enrolled thanks to Medicaid expansion – by analyzing new payment models.

The Trump Administration Is Gutting ACA Enrollment Outreach. In February, the Trump administration officially cut nearly 90 percent of ACA Navigator funding, mirroring a similar move in 2017 that coincided with a dramatic reduction in ACA Marketplace enrollment throughout the first Trump administration. On March 1, the White House unilaterally designated English as the official language of the U.S., rescinding requirements that government entities provide language assistance to individuals who do not speak English. Although the order does not direct agencies to change existing policies or programs, the action could limit outreach to consumers seeking health care with limited English proficiency.

The Trump Administration Is Working To Curb ACA Enrollment By Shorting The Enrollment Period, Imposing New Requirements, and Barring ‘Dreamers’ From Marketplaces. In March, the administration announced new rules designed to significantly curb enrollment by shortening the enrollment period, taking away low-income families’ ability to sign up for coverage outside of the six-week enrollment period, imposing more paperwork burdens for enrolling and proving eligibility for tax credits, and barring immigrants with ‘Dreamer’ status from enrolling in ACA Marketplace plans. In 2017, the Trump administration similarly halved the duration of Open Enrollment, reducing the period from three months to just 45 days.

The Trump Administration Is Slashing The Federal Workforce Overseeing Open Enrollment. Trump and Elon Musk are working to cut the bureaucratic apparatus that ensures that the ACA continues to be enforced and implemented without interruption. They fired around 1,900 probationary workers from the Department of Health and Human Services, and the Trump administration hinted they could fire as many as 5,200.

The Trump Administration Endorsed Plans To Cut ACA Medicaid Expansion Funding. In February, President Trump endorsed a budget resolution later passed by House Republicans that included budget cuts of nearly $1 trillion – a threshold that would require cuts to Medicaid. One of the proposed cuts includes reducing the federal match rate for Medicaid expansion under the ACA, which would force states to spend more than 25 percent more to foot the bill to the tune of nearly $50 billion. Reducing the federal match rate would threaten state budgets and would even end Medicaid expansion automatically in states with “trigger laws” designed to rescind Medicaid expansion if the federal match rate drops below a certain level.

The Trump Administration Is Targeting Services Covered Under the ACA. The Trump administration is undermining preventive services covered through the ACA by postponing the Advisory Committee on Immunization Practices (ACIP) meeting – which offers guidance on vaccine approvals and influences which shots insurers are required to cover under the ACA. Additionally, new rules introduced by the Trump administration in March include a ban on ACA Marketplace insurers covering gender-affirming care as an essential health benefit.

ashoup
In News, Fact Sheet, Research

Fact Sheet: RFK Jr. Spread Conspiracy That Lyme Disease Came From a Military Bioweapon

In recent weeks, Robert F. Kennedy Jr. has been on a whirlwind tour attempting to convince the public and the Senate that he is right for the job of Secretary of Health & Human Services. However, Kennedy’s embrace of nutty medical misinformation and conspiracy theories, combined with his empty resumé, makes it clear that he is utterly unqualified to run HHS and would be an unmitigated disaster for American health care. 

One of his lesser-known conspiracy theories involves a wildly outlandish set of beliefs surrounding Lyme disease. He has claimed that the tick-borne illness is a military bioweapon and blamed vaccine research for creating the disease. There is still no vaccine for Lyme disease, in part due to the same misinformation pushed by Kennedy about vaccines supposedly causing the illness. Lyme disease is a serious illness with cases primarily concentrated in New England that impacts nearly 500,000 people every year. The disease can lead to distressing and even disabling symptoms in 10 to 20 percent of cases, and reportedly has an annual cost of diagnosis and treatment totalling almost $1 billion. Kennedy’s bizarre stances about a serious disease that impacts thousands of Americans annually demonstrate the real threat he poses to public health.

Kennedy Spread A Conspiracy Theory Claiming That It Was “Highly Likely” That Lyme Disease Was A Military Bioweapon. During an episode of his podcast discussing Lyme disease, Kennedy launched into a tirade about the disease supposedly being a bioweapon: “Another thing that keeps us from enjoying the outdoors and keeps us locked inside and the idea that this may have been, is highly likely to have been a military weapon, and we cannot say 100 percent for sure, but we do know that they were experimenting with tics there. The tics, as you show, are an epidemic because of what happened at Plum Island and the other labs. […] We also know that they were experimenting with diseases of the kind, like Lyme disease, at that lab, and they were putting them in tics and then infecting people. 

  • Kennedy’s Bioweapon Conspiracy Theory Has Been Discredited. The conspiracy theory that Lyme disease was supposedly created by the U.S. military as a bioweapon has been thoroughly debunked.  The American Lyme Disease Foundation wrote, “Some claim that Lyme disease was introduced into the northeastern region of the U.S. by a man-made strain of Borrelia burgdorferi that escaped from a high containment biological warfare laboratory on Plum Island. However, there is ample evidence to indicate that both Ixodes ticks and B. burgdorferi were present in the U.S. well before the Plum Island facility was ever established.” According to a Washington Post op-ed written by infectious disease professor Sam Telford, “It’s an old conspiracy theory enjoying a resurgence with lots of sensational headlines and tweets. Even Congress has ordered that the Pentagon must reveal whether it weaponized ticks. And it’s not true.”

RFK Jr. Blamed Vaccine Gain-Of-Function Research For The Creation Of Lyme Disease. As Rolling Stone reported, Kennedy convened a panel of health misinformation advocates in 2023, during which they discussed the origins of infectious disease and their relationship to vaccines: “At one point, he baselessly asserted that vaccine research had been responsible for the creation of some of the deadliest diseases in human history, including HIV, the Spanish flu, and Lyme disease.” Kennedy reportedly also promised he would “end all gain-of-function research…It’s just a disaster, it’s given us no benefits. It’s given us everything from Lyme disease to Covid, and many many other diseases. RSV, which is now one of the biggest killers of children, came out of a vaccine lab.” 

  • The Previous Lyme Disease Vaccine Was Pulled In Part Because Of The Same Type of Misinformation Spread By Kennedy. Dr. Robert Smith of MaineHealth said that the previous Lyme disease vaccination, which was on the market in the mid-90s, was removed from the market in part because of misinformation that the vaccine caused the very disease it was intended to cure. According to the Portland Press Herald, “There were a number of reasons the previous human vaccine was removed from the market, Smith said, including misinformation that the vaccine caused Lyme disease, and that the disease had not reached the high number of cases now being reported, especially in the Northeast. Knight said the new vaccine will likely be more effective than the previous one, which was only on the market for a few years starting in the late 1990s.”

KEY STATES

Maine Has Among Highest Rates of Lyme Disease and Is The Site Of Ongoing Vaccine Trials And A Lyme Disease Study. According to the CDC, Maine has some of the highest rates of Lyme disease in the nation. There were 2,544 cases reported in the state by October 2024, nearing the state annual record of 2,943 cases in 2023. Maine was also a key state in vaccine trials and a large study of the disease. MaineHealth has been helping test a new version of the Lyme disease vaccine after the previous one was pulled from the market in the mid-90s. The manufacturer of this new vaccine, Pfizer, reportedly chose Maine as its site for clinical trials due to the state’s high rate of Lyme disease: “Pfizer has partnered with a Maine health care system to conduct the third phase of a Lyme disease clinical trial to test the efficacy of the company’s vaccine. The trial, held at Northern Light Health system in Brewer, will span over 13 months and require patients to take two shots two months apart. In March, the patients will need to take a booster shot before the next summer’s tick season, The Bangor Daily News reported last week. […] Li said Pfizer approached the hospital system about the clinical trial because Maine has one of the highest rates of Lyme disease infections in the U.S., according to the Centers for Disease Control and Prevention.”

Rhode Island Has The Highest Incidence Rate of Lyme Disease and Continues to Trend Upwards. Rhode Island has the highest incidence rate of Lyme disease in the country, with 212 cases per 100,000 in the state in 2022. The years of 2021 and 2022 marked a massive increase in reported Lyme disease diagnoses with 2,617 cases reported in 2021 and 2,904 cases in 2022. In 2023 that number fell slightly to 2,852 cases reported but now evidence has shown that 2024 may have been the largest jump in annual cases reported in the last decade. This past year a whopping 3,218 cases were reported, a nearly 13 percent increase in the span of only one year. Studies have shown that climate change and the warmer winters in Rhode Island has had a direct impact on the number of tick-borne illness reports. A supermajority of Americans support not only a vaccine for Lyme disease but also vaccinating their children against it; however, Republicans like RFK Jr. continue to promote conspiracy theories even as rarer tick-borne illnesses like Powassan virus are becoming more and more prevalent alongside Lyme disease diagnoses.

Connecticut is Where Lyme Disease was First Discovered and Remains the Leader in the Uphill Fight Against Both Anti-Vaxxers like RFK Jr. and the Disease Itself. Connecticut is in the top ten states when it comes to Lyme disease transmission. Between the years of 1985 and 2017, the Connecticut Department of Public Health (DPH) reported an average of 2,718 cases of Lyme disease annually with a high count of 4,631. This pales in comparison to new research coming from the CDC on underreporting problems, which suggests that potentially 10 times as many people in Connecticut, around 30,000, could be infected with Lyme disease annually. Recent studies have shown the tick population as well as the prevalence of tick-borne illnesses are on the rise in Connecticut, with climate change’s effects of shortening winters and longer summers playing a major role in this development. DPH has reported that 26.5 percent, more than one in four, of the ticks they’ve tested have come back positive for Lyme disease; on top of this there are now reports of “trifecta infections” from tick bites, with doctors seeing a massive increase in symptoms and diagnoses, including the first report of a human Rickettsia parkeri case. As anti-vaccine rhetoric and policy from Republicans like RFK Jr. continues to grow it is imperative to reject in order to continue and expand the fight against tick-borne illnesses.

Lyme Disease Is Skyrocketing In Massachusetts, With Over 5,000 Cases In 2022. Massachusetts is by far the most populous state in New England, with a high population density translating to a high risk for tick exposure in the state. Lyme disease cases in Massachusetts have been skyrocketing recently, with state health officials reporting over 5,000 cases in 2022. Though this rise was in part attributable to recent methodological changes and improved data collection, the new numbers reflect better disease surveillance in the state and paint a clear picture of the serious threat Lyme disease poses in Massachusetts.

New Hampshire Has A High Rate of Lyme Disease. New Hampshire has one of the highest rates of Lyme disease in the U.S., reporting 1,563 cases in 2021, an incidence rate of 112.5. The disease was rare until the past two decades, with less than 300 cases reported every year before 2006. Since then, the number of annual cases reported in New Hampshire has never dropped below 600.

Lyme Disease Rates Are Rising In Vermont As Ticks Spread North With Urban Development. Vermont has a high rate of Lyme disease, with an increasing rate of annual reported cases over the past 20 years. Tickborne illnesses were rare in the 1990s in Vermont, but as of 2019, Vermont’s 3-year average incidence rate for Lyme disease was the second-highest in the country. In 2022, 1,312 cases were reported. Around half of all ticks studied are pathogen-carrying in the state, and urban development in northern Vermont has reportedly expanded the tick population to new parts of the state.

ashoup
In News, Fact Sheet, Research

FACT SHEET: RFK Jr.’s Plans To Defund, Slash Jobs and Undermine the National Institutes of Health Would Be Disastrous For Americans

RFK Jr. Has Vowed to Fire and Prosecute Hundreds of NIH And FDA Employees and Pause All Research On Drug Development And Infectious Disease

It’s no secret Donald Trump’s nomination of Robert F. Kennedy Jr. as Secretary of Health and Human Services (HHS) poses a huge threat to the top health institutions that keep Americans safe and healthy. As HHS Secretary, RFK Jr. would prioritize his own interests over the needs of the American people. Not only does he oppose lifesaving vaccinations, but he has also downplayed the severity of infectious diseases and plans to gut funding for the Food and Drug Administration (FDA) and the National Institutes of Health (NIH), which will halt the progress of essential research on lifesaving drug and vaccine development. 

The NIH is among the top medical research centers in the world. On top of the lifesaving research conducted by NIH, the research center also serves as the impetus behind a significant portion of the economy, both in the private and public sectors. Funding from the NIH contributed to 99.4 percent of all drugs approved in the U.S. from 2010 to 2019. The 50 states receive tens of billions in funding from NIH awards annually, and the research center supports nearly half a million jobs and hundreds of billions of dollars in economic activity in the states. 

RFK Jr. has absolutely no place leading our health care system. Working families deserve access to affordable, high-quality health care and an HHS leader who trusts science and is committed to strengthening public health, not tearing it down.

BY THE NUMBERS

  • Researchers across the country received $37.81 billion in NIH awards in FY2023.
  • $92.89 billion in state economic activity is supported by NIH funding, reflecting a 2.46x return on investment.
  • NIH grants directly support 412,041 American jobs. Nearly 2.3 million Americans are employed by around 150,000 businesses in the American bioscience industry.
  • Thousands of top universities, hospitals, research institutes, and biopharmaceutical companies are supported by NIH funding.

The NIH Funds Critical, Lifesaving Drug Research. The National Institutes of Health (NIH) contributes billions to critical drug research and development throughout the U.S. A study of 356 drugs approved by the FDA between 2010 and 2019 found that the NIH contributed funding to all but two of the drugs – 99.4 percent of the drugs included in the study, and every single new drug approved between 2010 and 2016, with funding totaling $187 billion. The study also found that spending from the NIH on drug research and development was not less than industry spending, demonstrating the vast scale and influence of the NIH in the pharmaceutical industry.

The NIH Is A Key Source of Economic Activity. Beyond prescription drug research, NIH funding is a massive generator of economic activity in the U.S. In FY2023 alone, researchers across the country were awarded $37.81 billion in NIH grants. In turn, $92.89 billion in state economic activity is supported by NIH funding – reflecting a 2.46x return on investment, or $2.46 in economic activity generated for every dollar awarded by the NIH. The NIH directly funds 412,041 American jobs, and nearly 2.3 million Americans are employed by around 150,000 businesses in the American bioscience industry overall. In addition, thousands of top universities, hospitals, research institutes, and biopharmaceutical companies are supported by NIH funding.

Kennedy Says He Will Pause All Research On Drug Development And Infectious Disease. At a June 2024 town hall meeting Kennedy said, “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. A little break, a little bit of a break for about eight years.” These remarks echo what he told an anti-vaccine conference in November 2023, when he said, “I’m gonna say to NIH scientists, God bless you all. Thank you for [your] public service. We’re going to give infectious disease a break for about eight years.” Kennedy has also claimed that he will go after medical journals and redirect funding away from epidemiology, a practice that seeks to prevent and control the spread of disease. 

Kennedy Has Vowed to Fire and Prosecute Hundreds of NIH And FDA Employees. Kennedy claims to have a list of 600 employees of the NIH that he plans to fire on day one. Before the 2024 election, Kennedy posted on social media, “FDA’s war on public health is about to end. This includes its aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything else that advances human health and can’t be patented by Pharma. If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Preserve your records, and 2. Pack your bags.” During a “Make America Healthy Again” event in October 2024, Kennedy also said he would fire every nutritional scientist at the FDA “on day 1,” claiming he would otherwise “ship them to a new HHS headquarters in Guam” if unable to fire them. Kennedy has threatened to prosecute Dr. Anthony Fauci and he claimed that he would eliminate “entire departments” and hundreds of employees at the FDA.

Kennedy: “I Do Not Believe That Infectious Disease Is An Enormous Threat To Human Health.” At a 2023 roundtable, Kennedy said he does “not believe that infectious disease is an enormous threat to human health.” Kennedy also claimed that “medical research on these diseases and vaccine research has created some of the worst plagues in our history” and baselessly asserted that vaccine research was responsible for the creation of HIV, the Spanish flu, Lyme, and RSV.

ashoup
In News, Fact Sheet, Research

FACT SHEET: Five Ways Republicans Are Planning To Gut Medicaid

The GOP war on Medicaid is alive and well. Republicans are targeting Medicaid for deep budget cuts as part of a reconciliation bill coming early next year in order to fund tax breaks for the wealthiest Americans. Medicaid is an essential pillar of our health care system. It is the largest health insurance program in the country, providing health care to more than 70 million Americans — nearly a quarter of the country. Medicaid is jointly funded by the federal government and the states, and it is supported by 76 percent of Americans. It covers one in five Americans, including kids, moms, seniors, people of color, rural Americans, and people with disabilities. 

Five key ways Republicans could cut federal Medicaid funding and leave millions of Americans uninsured and unable to afford health care include: imposing lifetime caps on coverage, slashing the federal matching rate for traditional Medicaid and Medicaid expansion, implementing bureaucratic reporting requirements, block granting Medicaid, and introducing per capita caps. All of these policies mean that millions would lose their coverage, state budgets would be strained, and rural hospitals would be more likely to close. Every family knows someone who counts on Medicaid. If MAGA Republicans get their way, Medicaid will be decimated — taking health care away from hardworking families across the country all to pay for more tax breaks for the wealthy. 

By The Numbers

  • Republican threats to Medicaid put health care at risk for 72 million (21 percent) of Americans including:
  • Republicans will create at least a $50 billion hole in state Medicaid budgets to pay for tax breaks for the wealthy and corporations. 
  • If Republicans decrease federal funding for people in the Medicaid expansion population, it would immediately rip health care away from over 4.2 million Americans across 12 states and jeopardize health care for about 21 million people.
  • Republicans threaten care for 18.5 million people on Medicaid by imposing lifetime caps.
  • Republicans could deny coverage to 36 million Americans through burdensome bureaucratic reporting requirements.

Five Ways The GOP Plans To Gut Medicaid

  1. The GOP Will Impose Lifetime Caps For People On Medicaid. Republicans want to enact the Project 2025 playbook by imposing lifetime caps for people on Medicaid. Proposals have suggested people remain eligible for just 36 months, potentially over their entire lifetime. If enacted, the Center For American Progress found that these caps would strip benefits from hardworking families and people with complex medical conditions, particularly in states that have not expanded Medicaid, endangering coverage for the 18.5 million people with Medicaid who qualify based on income alone.
  2. Republicans Want To Slash Federal Funding for Medicaid By Reducing the Amount of Federal Funding That Matches State Medicaid Funding. As part of their plans to slash spending, Republicans could achieve their longtime goal of eliminating federal funding for Medicaid expansion and decreasing funding for traditional Medicaid. The Affordable Care Act provided for states to expand Medicaid eligibility by offering matching federal funds as an incentive. Some recent proposals have suggested lowering the federal match rate to 90 percent or lower, which would create a $50 billion hole in state Medicaid budgets. Research shows Medicaid expansion improves people’s health, keeps hospitals open, increases families’ financial security, and saves lives – and, in turn, helps reduce racial and ethnic, rural, and other health disparities. As of 2024, 41 states (including DC) have expanded Medicaid under the ACA. However, 12 of these states – Arizona, Arkansas, Idaho, Illinois, Indiana, Iowa, Montana, North Carolina, New Hampshire, New Mexico, Virginia, and Utah – have a trigger law, which means that health care will be at risk or immediately be ripped away from 4,291,000 people across the country if the GOP succeeds in gutting funding for Medicaid expansion.
  3. Republicans Want To Impose Burdensome Bureaucratic Reporting Requirements. Several recent Republican budget proposals have included plans to introduce bureaucratic work reporting requirements as a mandatory part of Medicaid enrollment and verification. By imposing work reporting requirements, Republicans are only seeking to cut Medicaid and kick millions of people off the rolls. Research shows that work reporting requirements cost states money and do not improve people’s ability to find work. In Georgia, a GOP alternative to Medicaid expansion emphasizing work requirements cost taxpayers $26 million, only provided coverage to 3,500 people, and resulted in consulting firms pocketing 90 percent of the funding. If Republicans succeed in implementing work reporting requirements, up to 21 million Americans could be denied Medicaid coverage.
  4. Republicans Want To Radically Restructure Medicaid Through Block Grants, Resulting In Deep Cuts. Another way MAGA Republicans want to radically restructure Medicaid is by changing it into five block grants. In March, the Republican Study Committee released a proposal to do just that. Block grants would shift costs to states and inevitably result in deep cuts to Medicaid programs by capping the amount of federal Medicaid funding states receive. As CBPP found in 2017, a block grant would force states to make deep cuts to their Medicaid programs to compensate for the federal funding cuts. Currently, the federal government pays between 50 percent and 77 percent of enrollees’ Medicaid costs, and more for certain high-value services. Republicans’ proposals to slash billions in federal funding from Medicaid would strain state budgets and leave tens of millions of people uninsured.
  5. Republicans Want To Introduce Per Capita Caps For Medicaid, Shifting Costs To States. Past Republican budget proposals have established a per capita cap for states on Medicaid enrollment. This type of spending cap imposes a restriction on the amount the federal government will contribute per capita to states’ Medicaid budgets. The proposals also increase the amount states must contribute to their Medicaid programs. In practice, per capita caps only increase costs for Medicaid beneficiaries – often in the form of higher premiums and out-of-pocket costs, all but ensuring that even if one qualifies for Medicaid, the services may not be affordable. It also means Medicaid would not have the flexibility to take on an influx of new patients during public health emergencies.
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.

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