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ashoup
In Fact Sheet, News, Research

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.

ashoup
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, Report, Research

NEW REPORT: GREED WATCH: Big Drug Companies Continue to Put Profits Over People

Big Drug Companies Raked in $22.3 Billion in Profits in the Second Quarter of 2024, Spent Nearly $27 Million on Lobbying, and Spent $62 Billion On Stock Buybacks and Dividends In The First Half of 2024

Big drug companies have raked in eye-popping revenues this year. 14 of the biggest drug companies reported $184.2 billion in revenue between April and June, and over $22 billion in net profits, reflecting the record-high prices these companies charge for drugs.

Drug companies have been allowed to charge whatever they want for too long. They make billions while charging Americans prices up to eight times higher than in other high-income countries like Germany or Australia, forcing patients to cut pills and skip doses to make ends meet. Fortunately, the Biden-Harris administration and Democrats in Congress passed the Inflation Reduction Act, lowering drug costs for people on Medicare by finally giving Medicare the power to negotiate lower drug prices.

Drug companies are also rewarding their shareholders handsomely rather than making their products more affordable to patients. The fourteen companies have spent hundreds of millions or billions on dividends and stock buybacks this year so far. Additionally, Bristol Myers Squibb, Novartis, and Novo Nordisk spent more lining the pockets of shareholders than on their research and development budgets. Research shows that pharmaceutical manufacturers could lose $1 trillion in revenue over a decade and still be the most profitable industry.

Table 1: Q2 2024 Big Drug Company Revenue, Profits, and Spending

Drug ManufacturerQuarterly RevenueH1 Shareholder CompensationQuarterly Research & Development SpendingQuarterly Net Profits
Johnson & Johnson$22.4 billion$4.5 billion$3.4 billion$4.7 billion
Rochea$17.2 billion$11.3 billion$8.2 billion (H1)****$7.4 billion (H1)****
Merck$16.1 billion$2.4 billion$3.5 billion$5.5 billion
Pfizer$13.3 billion$4.8 billion*$2.7 billion$41 million
AstraZeneca$12.9 billion$3.0 billion*$3.0 billion$1.9 billion
AbbVie$14.5 billion$1.3 billion**$1.9 billion$1.4 billion
Bristol Myers Squibb$12.2 billion$5.0 billion**$2.9 billion$1.7 billion
Novartis$12.5 billion$11.3 billion$2.4 billion$3.2 billion
Sanofib$11.7 billion$5.4 billion$1.7 billion$1.1 billion
Novo Nordiskc$9.8 billion$7.0 billion$2.3 billion$2.9 billion
GSKd$10.0 billion$2.3 billion*$1.9 billion$1.7 billion
Eli Lilly$11.3 billion$1.1 billion*$2.7 billion$3.0 billion
Amgen$8.4 billion$2.4 billion*$1.4 billion$746 million
Bayer$11.9 billion$123.5 million*$1.6 billionN/A
Total$184.2 billion$62.0 billion$28.2 billione$22.3 billione
* dividends only
** share repurchases only
*** unreported or net loss
**** data not reported on a quarterly basis
a CHF converted to USD based on the average quarterly exchange rate of 0.90 CHF to $1.00
b EUR converted to USD based on the average quarterly exchange rate of €0.935 to $1.00
c DKK converted to USD based on the average quarterly exchange rate of 6.971 kr. to $1.00
d GBP converted to USD based on the average quarterly exchange rate of £0.791 to $1.00
e  Roche H1 numbers included in quarterly total, since Q1/Q2 numbers are unavailable

Big Drug Companies Remain Highly Profitable & Expanded Investment Activity This Quarter, Countering the False Claims that Medicare Negotiation Undermines Innovation.

In the year following the passage of the Inflation Reduction Act, drug companies increased investment in bringing new drugs to market through higher spending on research, development, and acquisitions. In fact, following the passage of the Inflation Reduction Act, investment in research and development spending reached $161 billion in 2023, a 16.6 percent increase over 2022 and a nearly 50 percent increase since 2018. And despite the big drug companies arguing that the new law disincentivizes investment in small molecule drugs, a recent investor report confirms that the opposite is true. 

Big drug companies continue to harp on the Inflation Reduction Act, pushing lawsuits to halt Medicare Negotiation and claiming it hurts innovation – all while touting innovative new drug portfolios to Wall Street:

  • Johnson & Johnson CEO Joaquin Duato touted his company’s “relentless focus on advancing the next wave of medical innovation” and admitted that he anticipated his business “growing 3% plus next year and then 5% to 7% out through 2030” – despite Medicare Negotiation impacting three separate drugs manufactured by Johnson & Johnson. The company also spent approximately $17 billion purchasing new products for its pipeline in the first six months of 2024.
  • AstraZeneca executive Dave Frederickson admitted, “I think that IRA represents a couple of headwinds that we’ve spoken through, I think that they’re manageable, and I think we’ve got a portfolio that allows us to grow through it” – despite suing to overturn the Negotiation Program so they can continue to charge whatever they want for their drugs. The company also spent $2.4 billion to acquire Fusion Pharmaceuticals, Inc. in June 2024 and over $1 billion to acquire Amolyt Pharma in July 2024.
  • Merck CEO Robert Davis bragged about “the growing breadth of our pipeline,” noting, “We have the potential to bring as many new drugs to market in the next five years, as we launched over the next ten years, across a greater number of therapeutic areas and modalities and with a significant proportion having blockbuster-plus potential” – all despite suing the federal government to halt Medicare Negotiation. The company also acquired two additional companies for a combined $2.6 billion in 2024.
  • Eli Lilly CEO David A. Ricks attributed massive quarterly revenue growth of 36 percent year-over-year in part to the continued success of Jardiance, a drug whose list price has doubled since it launched over a decade ago. Ricks serves on the board of directors for pharmaceutical trade group PhRMA, which is suing to block Medicare Negotiation so drug companies can continue charging whatever they want for drugs. The company also announced an agreement to acquire Morphic for approximately $3.2 billion this quarter.

The Companies Manufacturing Drugs Being Negotiated By Medicare Brought In Billions in Revenue and Profits from Taxpayers and Patients and Spent It Lavishly To Reward Shareholders.

This quarter, the ten drugs selected for Medicare’s first round of negotiations brought in $18.1 billion in revenue, while the companies that manufacture these drugs raked in $16.2 billion in combined profits and spent nearly $25 billion rewarding shareholders in the form of stock buybacks and dividends:

  • Amgen, the manufacturer of Enbrel, reported $8.4 billion in revenue and spent $1.2 billion on dividends for investors. Amgen has increased the price of Enbrel by 701 percent since it launched.
  • AstraZeneca, the manufacturer of Farxiga, reported $12.9 billion in revenue and $1.9 billion in net profits. AstraZeneca has increased the price of Farxiga by nearly 87 percent since it launched.
  • Bristol Myers Squibb, which jointly manufactures Eliquis with Pfizer, raked in $1.7 billion in profits this quarter. Bristol Myers Squibb and Pfizer have increased the price of Eliquis by 124 percent since it launched.
  • Johnson & Johnson, which manufactures three of the ten drugs with lower prices being negotiated – Xarelto, Stelara, and Imbruvica – made $22.4 billion in revenue and $4.7 billion in net profits, while spending $136 million on stock buybacks. Johnson & Johnson has increased the price of Stelara by nearly 185 percent since it launched.
  • Merck, which manufactures Januvia, raked in $16.1 billion in revenue and $5.5 billion in net profits and spent more than $251 million on shareholder compensation. Merck has increased the price of Januvia by 293 percent since it launched.
  • Novartis, which manufactures Entresto, reported $12.5 billion in revenue and $3.2 billion in net profits while spending $11.3 billion on investors. Novartis has increased the price of Entresto by 83 percent since it launched.
  • Novo Nordisk, the manufacturer of Fiasp/NovoLog, far exceeded even their earnings expectations, bringing in $9.8 billion in revenue and $2.9 billion in net profits while spending $2.5 billion on shareholder compensation. Novo Nordisk has increased the price of the drug by 82 percent since it launched.
  • AbbVie, which jointly markets Imbruvica with Johnson & Johnson, brought in $14.5 billion in revenue and $1.4  billion in net profits this quarter. AbbVie and Johnson & Johnson have increased the price of the drug by 114 percent since it launched.
  • Eli Lilly, which jointly markets Jardiance with privately-held Boehringer Ingelheim, brought in $11.3 billion in revenue and $3.0 billion in net profits while rewarding shareholders with over $1 billion in dividends. Eli Lilly and Boehringer Ingelheim have increased the price of the drug by 103 percent since it launched.
  • Pfizer, which jointly markets Eliquis with Bristol Myers Squibb, brought in $13.3 billion in revenue and $41 million in net profits and spent $2.4 billion rewarding shareholders with dividend payments.

Table 2: Q2 2024 Revenue For Drugs Selected For Medicare Negotiation

Selected DrugManufacturerCondition(s) TreatedQuarterly RevenueTotal Revenue Since Launch
EliquisBristol Myers Squibb, PfizerBlood clots$5.3 billion$117.3 billion
StelaraJohnson & JohnsonPsoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis$2.9 billion$69.7 billion
EntrestoNovartisHeart failure$1.9 billion$24 billion
FarxigaAstraZenecaDiabetes, Heart failure, and Chronic kidney disease$1.9 billion$24.7 billion
ImbruvicaAbbVie, Johnson & JohnsonBlood cancers$1.6 billion$61.7 billion
JardianceEli LillyType 2 diabetes$768.6 million*$11.2 billion*
Fiasp/NovoLogNovo NordiskDiabetes$554.9 million$45 billion
EnbrelAmgenRheumatoid arthritis, Psoriasis, and Psoriatic arthritis$909 million$85.8 billion
XareltoJohnson & Johnson, BayerBlood clots$1.5 billion$68.6 billion
JanuviaMerckType 2 diabetes$629 million$54.3 billion
Totals $18.1 billion$562.3 billion
*Revenue for Jardiance, which is co-manufactured by Boehringer Ingelheim, only includes Eli Lilly.

Big Drug Companies Are Suing to Block Medicare from Negotiating Lower Prices and Spending Millions On Lobbying. 

Big drug companies are suing to ban Medicare from negotiating lower prescription drug prices for millions of Americans. If they get their way, patients will pay more so the drug companies can make more money. Seven big drug companies have filed separate lawsuits against the federal government to overturn the Inflation Reduction Act, and multiple lobbying groups representing big drug companies have also filed lawsuits. These lawsuits have already faced serious setbacks; drug companies are zero for six in the courts. This quarter alone, a New Jersey district court rejected Novo Nordisk’s case, and a federal judge in Connecticut rejected Jardiance co-manufacturer Boehringer Ingelheim’s case.

Meanwhile, these same drug companies and their allies are spending millions of dollars lobbying Congress to protect their profits. 16 of the biggest drug companies spent $26.8 million this quarter on lobbying. Big drug companies have already been increasing their lobbying efforts dramatically, this year with industry group PhRMA’s advocacy spending growing 20 percent last quarter compared to 2024.

Table 3: Big Drug Companies Spent Nearly $27 Million On Lobbying In Q2 2024

ManufacturerSelected DrugQuarterly Lobbying Spending
MerckJanuvia$3.1 million
AmgenEnbrel$2.7 million
Eli LillyJardiance$2.6 million
PfizerEliquis$2.5 million
BayerXarelto$2.2 million
RocheN/A$2.0 million
GSKN/A$1.5 million
GileadN/A$1.5 million
Johnson & JohnsonImbruvica, Stelara, Xarelto$1.3 million
Novo NordiskFiasp/NovoLog$1.2 million
NovartisEntresto$1.1 million
AstraZenecaFarxiga$1.1 million
Boehringer IngelheimJardiance$1.0 million
Sanofi (US)N/A$860,000
Astellas (US)N/A$770,000
Bristol Myers SquibbEliquis$740,000
AbbVieImbruvica$580,000
Total$26.8 million

 

ashoup
In News, Report, Research

NEW REPORT: The MAGA Agenda Is An Existential Threat to Our Health Care

Protect Our Care Released New Report on the Threats to Health Care by Donald Trump, Project 2025, and MAGA Republicans

Read the Report Here. 

The MAGA Republican Party, led by Donald Trump, is escalating their attacks on American health care and doubled down on their plan to deny tens of millions of Americans affordable, lifesaving health care. Donald Trump has vowed to “terminate” the Affordable Care Act, hike costs, and rip away Medicare’s power to negotiate lower prescription drug prices. 

MAGA and Trump allies at the Heritage Foundation also released Project 2025, a dangerous promise that will raise drug prices, repeal protections for pre-existing conditions, and cut Medicaid funding. 

“If Donald Trump wins, health care is on the chopping block,” said Protect Our Care Chair Leslie Dach. “Donald Trump and MAGA Republicans continue to double down on their promises to raise drug prices and the cost of health insurance all while ripping away health care from millions of families. If they are successful, 45 million Americans could lose coverage, nearly 20 million would be paying higher premiums, and over 100 million Americans would lose protections for pre-existing conditions, while seniors on Medicare would pay more for their prescription drugs. While they raise costs on working people, they’re trying to give more tax breaks to billionaires, CEOs, and corporations. The bottom line is that Trump and MAGA Republicans remain an existential threat to our health care and a second Trump term would be disastrous for millions of hardworking people across the nation.”

Here are five of the the many ways Donald Trump and MAGA Republicans will destroy your health care: 

  1. Trump and his allies will repeal the $35 insulin cap for 4 million Americans. Project 2025 fully repeals the Inflation Reduction Act’s provisions that are saving Americans thousands of dollars on health care, such as the insulin cap for those on Medicare.
  2. Trump and his allies will repeal the Inflation Reduction Act and hike drug costs for seniors and families: Project 2025 fully repeals the Inflation Reduction Act’s prescription drug provisions that are saving Americans thousands of dollars on health care. Republicans are continuing to side with drug industry lobbyists by trying to stop Medicare from negotiating lower prices.
  3. Trump and his allies will dismantle protections for people with pre-existing conditions and repeal the ACA: Trump notoriously sabotaged affordable health care and pre-existing condition protections while he was in office, and has renewed his calls to “terminate” the ACA throughout his campaign.
  4. Trump and his allies will cut Medicaid and throw millions off of their coverage: Project 2025 repeatedly refers to Medicaid, and especially the ACA’s expansion of the program to low-income adults as “failing” and too expensive to maintain. Project 2025 proposes to kick people off Medicaid by tying Medicaid funding to state abortion bans, imposing onerous work requirements, and allowing states to redirect Medicaid funding toward private insurance.
  5. Trump and his allies will hike premium costs by hundreds of dollars a year, locking millions out of affordable coverage: The Project 2025 plan would end enhanced premium tax credits that lower insurance costs for Americans, which were originally enacted by Democrats’ American Rescue Plan and extended by the Inflation Reduction Act. Getting rid of premium tax credits would keep health care unaffordable and out of reach for millions of Americans.
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In Fact Sheet, News, 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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In News, Report, Research

Speaker Emerita Nancy Pelosi Joined Protect Our Care to Unveil New Report on Republicans’ Latest Attacks on American Health Care

Read the New Report Here. 

Watch the Full Event Here.

Washington, DC — Speaker Emerita Nancy Pelosi (D-CA-11) joined Protect Our Care and patient storytellers to discuss how Republicans are escalating their attacks on American health care. During the call, Protect Our Care released a new report on the GOP’s war on health care. The report finds that Donald Trump and MAGA Republicans are promising devastating health care policies in 2025, including repealing the ACA, dismantling reproductive care, hiking premiums, slashing Medicare and Medicaid, reversing recent coverage gains, and raising prescription drug costs for the American people.

This is in stark contrast to Democrats in Congress, who have expanded affordable coverage, lowered prescription drug costs, strengthened Medicaid for moms and kids, and worked to reduce inequities in care. This year, a record 21.3 million people signed up for coverage under the ACA marketplaces, seniors are saving on insulin and vaccine costs, and Medicare is negotiating lower prices for some of the costliest drugs on the market. 

“The cost of the American people’s health care is riding on the outcome of this election,” said Speaker Emerita Nancy Pelosi (D-CA-11). “We have to make sure people know that when you care about the cost of living, you need to care about the cost of medical care, cost of prescription drugs, and cost of having a pre-existing condition. We should care about it because the Republicans don’t. All they care about is corporate profits and putting insurance and drug companies back in charge. Health care is a priority for the Democrats. It is something we will fight for and protect because it makes a very big difference at the kitchen table of America’s working families, and more importantly, for their good health.”

“Over the last several months, Donald Trump and MAGA Republicans have laid bare their latest scheme to raise drug prices and the cost of health insurance and rip away health care from millions of families,” said Protect Our Care Chair Leslie Dach. “After enormous strides to expand affordable health care under President Biden, the GOP is trying to turn back the clock and put drug and insurance companies back in charge. Donald Trump is calling for total ACA repeal while Republicans in Congress are trying to overturn the entire Inflation Reduction Act, slash Medicare and Medicaid, and dismantle protections for pre-existing conditions.

“Health care is a key kitchen table issue that receives strong support from an overwhelming majority of voters, whether they live in red or blue states, or rural, suburban, or urban zip codes. Yet, the MAGA Republican Party, led by Donald Trump, has doubled down on their losing strategy of denying tens of millions of Americans affordable life-saving health care. The GOP agenda is reckless and unpopular among voters of all parties, and it would be devastating for hardworking people across our country.” 

Key Report Findings: MAGA Republicans Want to Hike Costs and Rip Away Health Care

  • Repeal 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. 
  • Cut Medicaid and throw millions off their coverage: MAGA Republicans propose 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.
  • Repeal the Inflation Reduction Act and hike drug costs for seniors and families: MAGA Republicans want to fully repeal the Inflation Reduction Act’s prescription drug provisions that are saving Americans thousands of dollars on health care.
  • Hike premium costs by hundreds of dollars a year: 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.
  • Dismantle 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 Affordable Care Act and would allow insurers to deny coverage or charge more. 
  • Expand access to junk plans: MAGA Republicans want to codify rules put forth by the Trump administration that expanded junk health insurance plans known as association health plans (AHPs). These plans are not required to cover the essential health benefits required by the Affordable Care Act and are allowed to charge people more based on their age, health status, and gender.

“One of the riskiest conditions to women in this country is pregnancy which is why protecting the Affordable Care Act is so important,” said Amy Raslevich, storyteller. “It guarantees essential health benefits, such as coverage of birth control. I genuinely fear for my daughter’s life given the rollback of Roe v. Wade and given the dangers of pregnancy in this country that we don’t talk about. She’s currently protected because we’re in Pennsylvania, and she has access to birth control. But if the ACA is repealed, and states have more control over how women manage their own health, we will see more women die in this country. I think that keeping people well is every bit as important, and it’s truly under threat for women right now.”

“The Affordable Care Act saved my life — I had no idea that I was ill,” said DonnaMarie Woodson, storyteller. “When the ACA was passed, I got health care, went to the doctor, and found out that I had stage three colon cancer and stage one breast cancer. So the ACA saved my life and it also saved my family from medical debt. In addition, my husband is a diabetic and his insulin could cost upwards of $200 a vial. But thanks to the Inflation Reduction Act, it is now capped at $35 a month. I’m so thankful and grateful for President Biden and Democrats for all that they have done to make life so much better for all Americans. The American people need to know this information and realize exactly who’s responsible for lowering their health care costs.”

“The last couple of decades, I’ve had to deal with increasingly severe psoriasis,” said Irv Varkonyi, storyteller. “Along with other prescription drugs that I take, my co-pays would now be approaching $12,000 per year. But this year, the situation has dramatically improved for me. The Inflation Reduction Act has capped out-of-pocket costs at $3,000 per year for Medicare, which I reached during the first part of 2024. I am so grateful to the leadership of President Biden and Speaker Emerita Pelosi in recognizing that solutions had to be found to reduce the cost of prescription drugs. Retired seniors, such as I, rely on limited income from Social Security, along with our retirement savings. Thanks to the Inflation Reduction Act’s annual out-of-pocket cap, I am now saving thousands of dollars a year, which I will pass on to my five grandchildren one day.”

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In News, Report, Research

“Congress Shouldn’t Let Big Pharma off the Hook”: Senator Welch and Rep. Dingell Join Protect Our Care to Release New Report on Massive Drug Company Profits

Report Finds Big Drug Companies Raked in Nearly $29 Billion in Profits & Spent Over $28 Billion Rewarding Shareholders In Just The First Three Months of 2024

Read the New Report Here. 

Watch the Full Event Here.

Washington, DC — U.S. Senator Peter Welch (D-VT) and U.S. Representative Debbie Dingell (D-MI-06) joined Protect Our Care to call out big pharmaceutical companies for continuing to put profits over patients. During the call, Protect Our Care released a new report summarizing big drug companies’ recent investor reports, demonstrating how they are raking in profit and rewarding shareholders while more than 1 in 3 Americans are cutting pills or skipping doses because they can’t afford their medication.

The report is the latest in Protect Our Care’s Greed Watch series, highlighting the hypocrisy of big drug companies. While drug companies are raking in billions, they are working to undermine the Inflation Reduction Act by filing lawsuits and increasing their lobbying to protect their profits. Drug companies have been working behind the scenes with Republican lawmakers to repeal all of the Inflation Reduction Act’s provisions aimed at making prescription drugs more affordable for seniors. Big drug companies claim that the new law to make drugs more affordable will harm patients, but in reality, they’re telling investors the opposite and spending billions on rewarding their investors through stock buybacks and dividends, paying their executives millions, and spending millions lobbying to keep their prices high.

“For too long, pharmaceutical companies have cashed in on the vulnerabilities of patients needing access to life-saving medication, charging patients sky-high prices with no repercussions. We’re working to change that,” said Senator Peter Welch (D-VT). “I’m fighting in the Senate to advance legislation that builds off our success in the Inflation Reduction Act, bringing more prescription drugs to negotiation, faster and sooner. Seniors and families shouldn’t be forced to put up with Big Pharma’s greed, and Congress shouldn’t let Big Pharma off the hook.”   

“Democrats are fighting every day to confront pharmaceutical companies who are putting profits over patients and are making billions of dollars at the expense of hardworking Americans,” said Representative Debbie Dingell (D-MI-06). “The Inflation Reduction Act is a landmark piece of legislation, and we’re already seeing the impacts and the cost savings for people across the country. Unfortunately, big drug companies continue to charge some of the highest prices in the world for the vital medicines that Americans need to stay healthy. If you’re sick in this country, and you need medicine, you should be able to get it, no matter who you are or where you live.” 

“Today we’re putting drug company greed on full display,” said Protect Our Care Chair Leslie Dach. “While drug companies are claiming they need to charge Americans more than anyone in the world for prescription drugs, they are celebrating massive profits on Wall Street. The Inflation Reduction Act is reining in drug prices for patients by stopping outrageous price hikes, capping costs for seniors, and giving Medicare the power to negotiate lower prices. President Biden and Democrats took on Big Pharma and won, but drug companies and their Republican allies are not backing down on their fight to rip away all of this progress and make it even harder for patients to get the drugs they need to survive.” 

Key Report Findings:

  • Big drug companies started off 2024 by raking in $29 billion in profits. In the first three months of 2024, 15 of the biggest drug companies reported nearly $173 billion in revenue and nearly $29 billion in net profits – eye-popping figures that reflect the record-high prices these companies charge for drugs.
  • The drug companies suing to block Medicare from negotiating lower prices brought in billions in revenue and profits, and spent lavishly to reward shareholders. In the first three months of 2024, the ten drugs selected for Medicare’s first round of negotiations brought in $16.5 billion in revenue, while the companies that manufacture these drugs raked in $25.4 billion in combined profits and spent nearly $26 billion rewarding shareholders in the form of stock buybacks and dividends. 
ashoup
In News, Fact Sheet, Research

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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In News, Fact Sheet, Research

FACT SHEET: Medicaid is Essential For Seniors & Older Adults’ Coverage

Medicaid Is the Largest Funder of Long-Term Care For Seniors and Without It, Millions Would Be Without Care

This April marks the 7th annual Medicaid Awareness Month. Medicaid remains a critical source of coverage as Americans age, with Medicaid serving as a primary funder for long-term care and filling many of the gaps in Medicare coverage, such as premium costs, transportation to medical appointments, and medical equipment. 18.2 million Americans aged 50 and up rely on Medicaid coverage. Without Medicaid, millions of seniors would be forced to go without lifesaving care. These benefits often go unnoticed but are essential to the health and well-being of seniors nationwide.  

Medicaid is a popular, lifesaving program, but Republicans want to cut it and rip coverage away from millions of hardworking families. Over 66 percent of Americans, including 55 percent of Republicans, have a favorable opinion of Medicaid. 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. Republicans also won’t quit their mission to repeal the Affordable Care Act (ACA) and Medicaid expansion, putting health care for millions of women and families in jeopardy. 

By The Numbers

  • Millions of Seniors & Older Americans Rely On Medicaid Coverage. 7.2 million Americans over 65 are enrolled in Medicaid and more than 11 million Americans ages 50 to 64 have health coverage through Medicaid – many thanks to the Affordable Care Act’s Medicaid expansion.
  • Nearly 6 Million Older Adults Live Below The Federal Poverty Level. For millions of seniors and older Americans on fixed incomes, Medicaid is a lifeline.
  • Medicaid Funds Nearly Half Of Long-Term Care Nationwide. As seniors age, long-term care services become more essential, serving about 70 percent of seniors who will need some form of long-term care in their lives.
  • 1.5 Million People Would Gain Coverage If Remaining States Expanded Medicaid. 1.5 million people would gain Medicaid coverage if the remaining states implemented expansion, roughly 270,000 of the uninsured in the coverage gap are aged 55-64.
  • Medicaid Pays For 62 Percent Of Long-Term Care Residents In Nursing Homes. Medicaid covers nursing home bills for over 60 percent of residents in nursing homes. In 2019, this totaled over $50 billion. The median private nursing home room cost over $100,000 yearly in 2024.
  • 12 Million Medicare Beneficiaries Also Have Medicaid Coverage. Nearly 8 million of the dual eligible Medicare-Medicaid beneficiaries are “full benefit” Medicaid enrollees who have access to a range of Medicaid benefits, not otherwise covered by Medicare.

Seniors And Older Adults Depend On Medicaid For Affordable, Comprehensive Care. As of 2021, 3.6 million older adults are going without coverage. Older Americans often have more complex health issues, requiring additional medical attention that is costly, pushing care out of reach. For seniors on Medicare, Medicaid helps fill many of the gaps in Medicare coverage, such as transportation to medical appointments and medical equipment. 

Medicaid Supplements Medicare Coverage For Millions Of Seniors. 12 million seniors are eligible Medicare-Medicaid dual beneficiaries. Nearly 8 million are “full benefit” Medicaid enrollees who have access to a range of Medicaid benefits, not otherwise covered by Medicare. Nearly half of dual enrollees are seniors of color and over half of dual enrollees suffer from long-term disabilities. 

Medicaid Helps Seniors And Older Americans Stay Retired And Out Of Poverty. Many seniors and older Americans survive off of low incomes or have chronic health conditions that prohibit them from working. Medicaid allows these individuals living on fixed incomes and often have chronic diseases to continue getting the care they need by filling in the gaps in their Medicare coverage without having to worry about choosing between food and housing or their health. Medicaid has long been considered one of the most effective anti-poverty programs in the nation, and its expansion has significantly improved health outcomes for seniors and older adults. In a nation where out-of-pocket health care spending forced more than 10 million Americans into poverty in 2016 alone, Medicaid serves as a lifeline not only for health care, but for economic stability as Americans age. A January 2021 study from Health Affairs found that the ACA helped reduce income inequality across the board, but much more dramatically in Medicaid expansion states.

Low-Income Seniors With Medicare Depend On Medicaid For Long-Term Care. It is estimated that 70 percent of seniors will need long-term care at some point and 62 percent of nursing facility residents utilize Medicaid to receive their care. Medicaid is a critical provider of home- and community-based care that are essential to keep loved ones at home with their families and neighbors. Without Medicaid, many seniors would not be able to afford these needed services with Medicare alone. 84 percent of individuals in nursing facilities covered by Medicaid in 2019 were dually eligible, with Medicaid covering costs once Medicare benefits have been depleted. 

Increased Medicaid Funding For Caregivers Benefits People With Disabilities. The Biden-Harris administration recently announced renewed efforts to increase Medicaid funding for caregivers, a critical contingent of care for millions of people with disabilities who rely on these types of providers to meet their basic needs.

Hundreds of Thousands of Seniors Are Stuck In The Medicaid Coverage Gap. 10 states have refused to expand Medicaid under the Affordable Care Act (ACA), stranding many seniors with low incomes in the Medicaid coverage gap. As a result, over 407,000 older Americans 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 seniors from at least 25 percent of those in the Medicaid coverage gap in Tennessee, Alabama, Georgia, South Carolina, and Florida.

  • Over 10,000 Older Americans Died Prematurely Due To States’ Decisions Not To Expand Medicaid. Due to states’ decisions not to expand Medicaid under the ACA, 10,444 older Americans died prematurely between 2014 and 2017 alone in the 10 states that have refused to expand the program.

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. Week one will focus 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. Week two will highlight 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. Week three will bring 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 will focus on how Medicaid helps seniors and people with disabilities access lifesaving care.
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In News, Fact Sheet, Research

FACT SHEET: Medicaid Works For Women & Children

April marks the 7th annual Medicaid Awareness Month. Medicaid is an essential source of coverage for women and children. More than 18 million, or nearly 1 in 5, adult women are enrolled in Medicaid. Approximately 40 million, or half of all children in the U.S., are enrolled in Medicaid or the Children’s Health Insurance Program. Medicaid coverage brings affordable care and financial security to women and families, and it helps narrow racial and rural disparities in health care. As the nation faces an unacceptably high and worsening rate of pregnancy-related death, Medicaid coverage is more important than ever to help pregnant women and new moms access the health care they need. 

Medicaid is a popular, lifesaving program, but Republicans want to cut it and rip coverage away from millions of hardworking families. Over 66 percent of Americans, including 55 percent of Republicans, have a favorable opinion of Medicaid. 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. And as Medicaid transitions back to its pre-pandemic eligibility and enrollment rules, too many people, especially children are losing coverage because of the carelessness and callousness of certain Republican governors who are terminating coverage for people who may still be eligible. Republicans also won’t quit their mission to repeal the Affordable Care Act (ACA) and Medicaid expansion, putting health care for millions of women and families in jeopardy.  

By The Numbers

  • Medicaid Covers Nearly 18.5 Million Women Nationwide. 18.44 million adult women ages 19-64 rely on Medicaid for coverage.
  • Most Women On Medicaid Are Working Or Have Caregiving Responsibilities. According to the Kaiser Family Foundation, the vast majority of women enrolled in Medicaid work, including mothers on Medicaid. In 2020, 93 percent of women enrolled in Medicaid were either working, going to school, at home caring for young children or relatives, or experiencing an illness or disability that does not permit them to work. 
  • Medicaid Is A Major Source Of Coverage For Women Of Color. Due to systemic inequality that results in fewer women of color having access to employer-provided coverage, women of color are disproportionately likely to enroll in Medicaid. 31 percent of Black women and 27 percent of Hispanic or Latina women rely on Medicaid, compared with just over 16 percent of white individuals. Women of color experience higher rates of poverty than white women and remain less likely to have access to quality care.
  • Medicaid Covers Nearly Half Of Women With Disabilities. Medicaid covers more than 44 percent of nonelderly women with mental and physical disabilities. As of 2019, Medicaid was the source of health coverage for one in four American women with mental illness.
  • Over 50 Percent Of Children Are Enrolled In Medicaid And CHIP. Approximately 40 million children in the United States are enrolled in Medicaid or CHIP. 
  • 1.6 Million People Would Gain Coverage If Remaining States Expanded Medicaid. Estimates from the Center on Budget and Policy Priorities found that roughly 1.6 million people, including children, would enroll in Medicaid and CHIP if the remaining 10 states implemented expansion. These states are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wyoming, and Wisconsin. 
  • The Children’s Uninsured Rate In Medicaid Holdout States Is Double The Rate In Expansion States. In 2021, the child uninsured rate was 7.1 percent in holdout states, compared to 4 percent in states that adopted expansion. If holdout states expanded Medicaid, the number of uninsured children would drop by 7.3 percent. 
  • Almost Half Of Births Are Covered By Medicaid. Medicaid covers over 40 percent of births in the United States. Thanks to the American Rescue Plan, states were given the option to extend coverage to new mothers for one year postpartum, which improves maternal health outcomes. Congress subsequently made this option permanent as part of end-of-year legislation signed into law at the end of 2022. 45 states, the District of Columbia, and the United States Virgin Islands have extended postpartum Medicaid coverage for a full year, and Nevada and Idaho are planning to do so. Arkansas, Iowa, and Wisconsin have not extended postpartum coverage. 

Medicaid Coverage Benefits Mothers And Women Of All Ages

Medicaid Is The Largest Payer Of Reproductive Health Care Coverage. Medicaid covers nearly 17 million women of reproductive age, giving them access to reproductive health care services such as birth control, cancer screenings, and maternity care without cost-sharing. Medicaid’s reproductive health coverage is especially important in states that have further restricted access to abortion in the wake of the Supreme Court overturning Roe v. Wade.

  • Expanding Access To Care At Every Stage. There is an urgent need for quality, affordable health coverage prior to, during, and after giving birth. The United States continues to experience the highest rates of maternal mortality among wealthy nations, deaths that Centers for Disease Control and Prevention (CDC) data show are largely preventable. While 48 percent of maternal deaths occur during pregnancy and delivery, more than half, 52 percent, occur in the year following the birth of a child. Recent CDC data show that 4 in 5 of maternal deaths are preventable. 12 percent of maternal deaths are deemed “late,” occurring between six weeks and one year following delivery, demonstrating the immense need for continuous health access and coverage for a minimum of one year following the birth of a child. The Biden-Harris Administration has established a pathway to coverage, providing states the opportunity to extend postpartum coverage under Medicaid from 60 days to 12 months following birth. Currently, 47 states have elected to extend Medicaid coverage for a full year postpartum.
  • More Than Four In 10 Births Are Covered By Medicaid. More than 4 in 10 births were financed by Medicaid in 2022. Rates varied across the nation, with 61 percent of births financed by Medicaid in Louisiana, and 22 percent in Utah. Medicaid covers 65 percent of all births to Black mothers and 59 percent of all births to Latina mothers.
  • Expanding Medicaid & Closing The Coverage Gap Is Critical To Improving Maternal Health. Women of color consistently experience higher rates of maternal mortality than white women, largely due to the intersection of health with race, gender, poverty, geography, and other social factors.
  • Medicaid Helps Keep Families Out Of Debt. 41 percent of Americans reported having debt due to medical costs or bills. Since Medicaid was expanded by the ACA, the program has covered the medical expenses of millions more poor and near-poor adults than it did previously, helping prevent households from becoming poor because of medical spending.

Medicaid Improves Access To Care For Women. Women with Medicaid are far more likely to receive care than uninsured women. According to the Kaiser Family Foundation, women with Medicaid coverage are less likely than women with private insurance to report delaying or forgoing care due to cost. Women with Medicaid coverage receive preventive care such as cancer screenings and well-women services at roughly the same rates as women with private coverage and at a higher rate than women without insurance. 

Medicaid Helps Pay For Long-Term Care, Relied On By Elderly Women. Medicaid pays for roughly half of the nation’s long-term services and supports. In 2019, women accounted for 59 percent of the 12.3 million dual-eligibles, or people who rely on both Medicare and Medicaid for coverage. Most dual-eligibles are elderly, and many need Medicaid coverage for their long-term care needs.

Medicaid Creates Jobs In The Health Industry, Which Is Overwhelmingly Female. Kaiser Family Foundation estimates that there are 15.5 million frontline health care workers — 77 percent of which are women — establishing Medicaid as a major job creator for women. 

Medicaid Coverage Has Long-Term Benefits For Children 

Research Shows Medicaid Prevents Child Deaths. A 2020 study found that children who received health insurance through Medicaid were less likely to die young, be employed in their adult life, and less likely to develop a disability as an adult. 

Medicaid Helps Children Stay Healthy, Leads To Long-Term Benefits For Children When They Grow Up. Medicaid eligibility during childhood lowers the high school dropout rate, raises college enrollment, and increases four-year college attainment. Medicaid for children also has a positive impact on employment opportunities later in life. For each additional year of Medicaid eligibility as a child, adults by age 28 had higher earnings and made $533 additional cumulative tax payments due to their higher incomes.

Thanks To Medicaid, Students Have Access To The Resources They Need To Focus In School. Medicaid’s Early Periodic Screening Diagnostic and Treatment benefit gives children under 21 years old access to comprehensive and preventive health services, such as yearly physicals, hearing, vision, and dental screenings, and physical, mental, and developmental disability treatments. The benefit also helps students gain access to medical supplies, such as hearing aids, glasses, and assistive technology, to help them succeed in school. 

The ACA’s Medicaid Expansion Helps Children Gain Access To Care

After the ACA expanded access to Medicaid, the children’s uninsured rate fell to an all-time low. Research confirms expanding access to Medicaid for parents has had ripple effects for their children. At the same time, the 10 states that continue to reject expansion are limiting children’s health care access: 

Medicaid Expansion Led To Gains In Coverage For Children As Well As Parents. Parents enrolled in Medicaid are more likely to access the support they need to be a healthy and effective parent. When parents gain coverage they are more likely to enroll the whole family, so the family will be protected from the economic strains of medical debt and lay the groundwork for optimal child development. Children of parents who are enrolled in Medicaid are more likely themselves to have coverage, due to parents having a more straightforward experience adding their children than if they have never signed up for coverage before. Medicaid for children will save families an estimated $1,222 per year per child when states implement 12-month continuous Medicaid and CHIP eligibility.

The Children’s Uninsured Rate In States That Have Rejected Expansion Is Twice The Rate In States That Expanded The Program — And That Gap Is Growing. The rate of uninsured children in states that have not expanded their Medicaid coverage grew at nearly three times the rate than that of states that have expanded Medicaid coverage. Texas and Florida, two non-expansion states, were responsible for 41 percent of coverage losses for children in a three-year period. 

When Parents Have Health Insurance, Children Are More Likely To Have Coverage. When parents are covered, their children are more likely to have access to health care and have long term benefits from that coverage. Adults who had health insurance as a child were more likely to have better health as adults, including fewer hospitalizations and emergency visits. Medicaid eligibility during childhood is also more linked to a higher likelihood of graduating from high school and college, as well as having higher wages in adulthood.

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. Week one will focus 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. Week two will highlight 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. Week three will bring 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 will focus on how Medicaid helps seniors and people with disabilities access lifesaving care. 
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