Intro: Holding Trump Accountable During A Health Care Recess

With the impeachment process behind us, this recess is a perfect opportunity to pivot back to the number one issue for American families: health care. Given President Trump and his allies in Congress’ continued assault on health care including the president’s recently announced budget and his blatant lies about his record at his State of the Union Address, it’s more important than ever to remind constituents who is really on their side and who is on the side of big drug and insurance companies. The contrast could not be clearer: Republicans would rather lie about their records and continuing to sabotage health care, while Democrats actually work to lower costs and improve care. 

President Trump knows he is in deep political trouble on health care. You don’t have to look any further than his tirade against his own HHS Secretary last month or the polling that consistently shows that his policies are overwhelmingly rejected by large majorities of voters. Sensing vulnerability, Trump has ramped up his health care lies. Between claiming to have “saved” protections for people with pre-existing conditions to telling the American people at the State of the Union that his administration lowered drug costs, he is trying to distract from the fact that his own administration is trying everything to destroy our health care. The Trump administration joined a lawsuit that would rip coverage from 20 million Americans, pushed junk insurance plans that don’t have to cover people with pre-existing conditions, and gave his friends in the pharmaceutical industry big tax breaks while they continue to hike drug prices. His administration also recently announced a new plan to encourage states to apply for so-called “block grants” that would gut Medicaid coverage and kick people off the rolls.

Finally, just this week the Trump administration released a budget that shows his true colors, slashing funding for critical health care people depend on especially Medicaid, which serves as a lifeline for the most vulnerable Americans. The president’s budget cuts over $1 trillion from Medicaid and Medicare in order to pay for his tax breaks for drug and insurance companies and to carry out his health care agenda that raises costs and rips away coverage from millions. Instead of proposing policies that make America healthier or health care more affordable, he is just repeating the lies and making more of the false promises that have defined his record since the first day he took office. 

As you communicate with constituents over the recess, our view is to weave all these individual assaults on our health care into one overall accountability message that describes their agenda of ripping away coverage, raising costs, and taking the side of big drug and insurance companies — all part of a relentless war on America’s health care. 

This packet provides fact sheets and message guidance on all these issues. If you’d like to work with Protect Our Care in your district, contact Anne Shoup at [email protected]. 

ACA at 10

Remember that next month just after the March recess (March 23rd) is the 10th anniversary of the Affordable Care Act being signed into law. Protect Our Care is already drafting state-by-state reports and fact sheets touting the benefits of the ACA, working with partners to plan events around the country and planning a bus tour through key states. It’s not too early to start socializing this important milestone with the press and the public as an inflection point in the debate with President Trump and Republicans over their relentless war on Americans’ health care or to plan for events and other activity marking the anniversary which is just roughly six weeks away. 

Fact-Checking Trump’s Biggest Health Care Lies

Another year of President Trump’s administration is in the books and another year of lies and broken promises. The president knows his abysmal health care record is an anvil weighing down his chances for reelection and that’s why he attempts to paint a rosy picture, but voters know that Donald Trump’s war on health care is alive and well.

Here’s the truth: President Trump is a threat to Americans’ health care. No matter how much he repeats lies about his failed policies, his actions speak louder than his empty rhetoric. Here are a few of Trump’s most egregious lies on health care and meaningless policy initiatives we expect to hear on Tuesday contrasted with the truth about what he’s actually done. 

Pre-Existing Conditions

Lie: Trump claims that he “saved” protections for people with pre-existing conditions. 

Truth: Trump has tried repeatedly to strip protections from 135 million Americans with pre-existing conditions through failed attempts to repeal the Affordable Care Act in Congress and through his ongoing federal lawsuit to overturn the health care law. Despite that fact, Trump has repeatedly lied about protecting people with pre-existing conditions, even though the lie is easily debunked by his repeated attempts to strip them away.

• Trump supported multiple House and Senate repeal bills that would have ended such protections. 
• He is pushing junk insurance plans that allow for insurance companies to discriminate against people with pre-existing conditions. 
• He is arguing in court that pre-existing condition protections for 135 million Americans should be eliminated in a lawsuit Trump himself claimed would “terminate” the Affordable Care Act and its consumer protections.

Prescription Drugs

Lie: Trump claims to have lowered prescription drug costs. He stated “drug prices are coming down, first time in 51 years because of my administration.”

Truth: Drug prices have soared under President Trump. While drug companies have continued to raise prices, Trump rewarded them with massive tax breaks and now opposes giving Medicare the power to negotiate for lower drug costs – the single most effective measure to do so. 

• President Trump gave drug companies billions of dollars in tax breaks while they rake in massive profits and raise prices on Americans. 
• Drug prices have soared under President Trump.
• He has repeatedly talked about lowering prices based on costs in other countries, but independent experts have said his proposals would be ineffective.
• He opposes the single most important thing you can do to lower drug prices — giving Medicare the power to negotiate for lower prices.
• He has repeatedly talked about lowering prices based on costs in other countries, but independent experts have said his proposals would be ineffective.

Medicare, Medicaid and Social Security

Lie: Trump claims he and Republicans will “stand for protecting Social Security and Medicare and Medicaid.” 

Truth: President Trump has repeatedly asked for massive cuts to these programs in his budgets and signaled he will put slashing benefits for Medicare, Medicaid and Social Security on the table in 2020 if re-elected. 

• As recently as January, President Trump signaled that he is open to slashing benefits for vital programs like Medicare, Medicaid and Social Security. 
• President Trump’s most recent budget proposed slashing Medicaid by $1.5 trillion and Medicare by $845 million.
• Through his support for repeal and the Texas lawsuit, President Trump has supported eliminating Medicaid expansion which has provided coverage to 17 million Americans in 37 states.

“Insurance for Everybody”

Lie: Trump has promised his health care plan would cover everyone, and claimed he is “far better on HealthCare than the Democrats!”

Truth: President Trump’s systematic war on health care has made it less affordable, and his harmful policies have left more Americans uninsured. His own polling shows he is extremely unpopular on the issue. And despite his many promises to release a “phenomenal” health care plan, he has yet to produce one.

• Under the Trump presidency, the number of uninsured Americans has gone up by at least 7 million, in large part due to his policies to undermine the Affordable Care Act. 
• Trump’s war on health care is deeply unpopular, and polls have shown that Americans trust Democrats more to protect their health care and lower costs.
• Democrats have put forward popular provisions to strengthen protections for pre-existing conditions, and lower the costs of prescription drugs by giving Medicare the power to negotiate for lower prices. Trump opposes them all.
• President Trump has continuously undermined health care by pushing harmful policies like junk insurance plans that don’t cover pre-existing conditions, and harmful work requirements on Medicaid that have resulted in thousands losing coverage and puts millions more Americans at risk of being kicked off the rolls.

Trump Administration’s Block Grant Guidance Puts Medicaid on the Chopping Block

The Trump administration is taking another step to sabotage Americans’ health care by issuing new guidance that could severely limit state funding for those enrolled in Medicaid expansion under the Affordable Care Act. A perennially unsuccessful conservative priority dating back to Ronald Reagan, block grants are a blatant attempt to gut coverage and kick people off the rolls. Block grants would reduce funding for states and have repeatedly been rejected by Congress.

28 Million People Could Be Affected By Trump’s Latest Block Grant Proposal. “Overall, the HAO demonstrations could cover nearly 30 million adults if adopted in all states. This total includes approximately 13 million adults newly covered through the ACA Medicaid expansion, 10 million adults currently covered through other state options (using the estimate that 16.1% of Medicaid enrollees are adults covered at state option without accounting for the ACA expansion), and nearly five million uninsured low-income adults in non-expansion states who could be eligible for Medicaid if the state adopted the expansion.” [Kaiser Family Foundation, February 2020] 

American Lung Association, American Heart Association, And 25 Other Patient Groups Said Trump’s Block Grants “Will Reduce Access To Quality And Affordable Health Care For Patients With Serious And Chronic Health Conditions And Are Therefore Unacceptable To Our Organizations.” “Per capita caps and block grants are designed to reduce federal funding for Medicaid, forcing states to either make up the difference with their own funds or make cuts to their programs that would reduce access to care for the patients we represent. As the gap between the capped allotment and actual costs of patient care increases over time, states will likely limit enrollment, reduce benefits, lower provider payments or increase cost-sharing for patients. States are already moving forward with deeply troubling proposals in anticipation of today’s guidance promoting these limiting financing arrangements. Simply put, block grants and per capita caps will reduce access to quality and affordable health care for patients with serious and chronic health conditions and are therefore unacceptable to our organizations.” [American Lung Association, 1/30/20] 

The American Academy of Pediatrics, Children’s Defense Fund, Children’s Hospital Association, Family Voices, First Focus on Children, Georgetown University Center for Children and Families, March of Dimes and National Association of Pediatric Nurse Practitioners Said “At A Time When Child Uninsurance Is Already On The Rise, This Guidance Makes It Even Harder To Guarantee Children Can Get The Care They Need.” “Our organizations are united in opposition to any threat to Medicaid that would dismantle a pillar program millions of families rely on. At a time when child uninsurance is already on the rise, this guidance makes it even harder to guarantee children can get the care they need. We urge CMS to immediately rescind the guidance and keep Medicaid strong.” [American Academy Of Pediatrics, 1/30/20] 

AARP: Block Grants “Could Put At Risk The Health Coverage For Millions Of Vulnerable Americans.” “AARP is deeply concerned that new guidance released today by CMS letting states cap funding in the Medicaid program could put at risk the health coverage for millions of vulnerable Americans. Capping the program’s funding structure and limiting benefits and services could leave millions without the coverage and care they need.” [AARP, 1/30/20] 

Health Care is an Albatross for Trump in Battleground States

Polling from Public Policy Polling on behalf of Protect Our Care finds that health care is the most important issue or a very important issue for a large majority of voters (68%) in the battleground states of Florida, Michigan, North Carolina, Pennsylvania and Wisconsin when deciding who to vote for in 2020. 

This issue is important to voters across party lines, including 66% of independents and 53% of

Republicans, while just 7% of overall voters do not consider health care to be an important

Issue. President Trump’s decisions on health care issues are deeply unpopular among

battleground voters.

• The overwhelming majority (83%) support allowing Medicare to negotiate for lower prescription drug costs with drug companies, which Trump has promised to veto. Just 5% of voters oppose ending the ban on Medicare negotiating drug prices.
• 70% of voters oppose President Trump’s plan putting Medicare cuts on the table if he is re-elected—including by a plurality of Republicans, with 49% opposing his decision and only 38% in support. 

The results show a majority of voters do not trust President Trump’s positions on health care. Battleground voters in these states Trump won in 2016 trust Democrats more than President Trump on both the issue of pre-existing conditions (53-43) and prescription drugs (51-45), two of the most important issues on voters’ minds in 2020. 

When voters are given a choice between whether they think President Trump has improved health care for the American people or undermined health care for the American people, a majority (52%) feel that the president has undermined health care for the American people.

Other key findings from the survey include:

• Only 27% agree with President Trump’s lawsuit to strike down the Affordable Care Act in the courts.
• Trump’s effort to use the courts to eliminate protections for people with pre-existing conditions is a major concern for 72% of battleground state voters, including 73% of independents and 58% of Republicans.
• Similarly, the fact that 20 million Americans would completely lose their health insurance coverage if President Trump’s lawsuit is successful is a major concern for 69% of voters, including 71% of independents.

PPP surveyed 1,867 voters in Florida, Michigan, North Carolina, Pennsylvania, and Wisconsin from January 23-27, 2020. The margin of error is +/- 2.3%. The survey was conducted by telephone on behalf of Protect Our Care.

The Top Ten Ways Trump Has Sabotaged Americans’ Health Care

From trying to eliminate protections for pre-existing conditions, to gutting funding for Medicaid and his allegiance to drug companies over patients, Trump’s agenda has been all about taking health care away and enriching big pharma while they raise costs on Americans. 

Trump recently made one of his most bald-faced lies about how he “saved” protections for pre-existing conditions. That could not be further from the truth. To understand just how disastrous the Trump health care agenda is, and the extent of his lies, here are ten of the most egregious ways he has sabotaged Americans’ health care. 

1. Trump Won’t Stop Trying To Repeal Our Health Care Law. Trump notoriously tried and failed multiple times to repeal the Affordable Care Act. All of the repeal bills that went through Congress would have caused millions of Americans to lose their health coverage and raised premiums by double digits for millions more. They would have ended Medicaid as we know it, putting the care of children, seniors and people with disabilities at risk.
2. Trump Is All-In On The Texas Lawsuit, Threatening Health Care For Millions. After failing to repeal the health care law, Trump took his war on America’s health care to a new level and went to court seeking to strike down the entire Affordable Care Act–including protections for pre-existing conditions. If President Trump and Republicans have their way, 20 million Americans will lose their insurance coverage, 135 million Americans with pre-existing conditions will be stripped of their protections, and costs will go up for millions. 
3. Trump Continues To Stand With Big Pharma As Drug Prices Have Soared. Donald Trump promised that he would lower drug costs, but instead he gave drug companies billions in tax breaks. The year after the tax bill passed, the largest drug companies made $50 billion in profits and subsequently used their savings to invest billions more in stock buybacks for their shareholders. Meanwhile, more than 3,400 drugs saw price increases in the first half of 2019 alone. Trump has rejected common sense reforms, like giving Medicare the power to negotiate for lower prices.  
4. Trump Has Declared War On Medicaid. Between encouraging states to impose red tape and paperwork requirements and championing work requirements, the Trump administration has worked tirelessly to dismantle Medicaid. After Arkansas imposed the nation’s first so-called work requirements program, more than 18,000 residents lost Medicaid coverage. While these state efforts have been blocked by a federal judge several times, the Trump administration keeps fighting to impose work reporting requirements in Medicaid, appealing federal court rulings that blocked such requirements because they are illegal. Meanwhile, a recent GAO report found that the administrative costs to implement the failed work requirement programs in five states topped $400 million. 
5. At Least Two Million People Have Lost Coverage Under Trump. Census data revealed the uninsured rate rose for the first time since the implementation of the Affordable Care Act. The rate increased from 7.9% in 2017 to 8.5% in 2018, or by approximately 2 million people. More than one million children lost Medicaid coverage between 2017 and 2019. Health care experts have pointed to a “chilling effect” from Trump-backed policies, including Medicaid work requirements.
6. Trump’s Budget Would Have Slashed Medicare And Medicaid. Donald Trump’s proposed federal budget in 2019 would cut funding for Medicare by more than $800 billion and repeal the ACA. Additionally, the budget would cut $1.5 trillion from Medicaid, which would result in millions of people losing health coverage, cuts to nursing home care, and cuts to care for children with severe disabilities.
7. The Trump Tax Scam Gave Hundreds Of Billions To Drug And Insurance Companies With Soaring Profits While Further Eroding Access to Health Care. Trump signed into law a Tax Bill that, among other things, repealed a key provision of the Affordable Care Act that required most people to have health coverage and which is the basis of the Trump-Republican lawsuit seeking to overturn the Affordable Care Act. Additionally, the repeal of the individual mandate contributed to thousands of dollars in increased premiums on the individual market in 2019. 
8. Health Care Costs Have Skyrocketed Under Trump. Under Donald Trump, health insurance costs have risen faster than people’s wages–to more than $20,000 per year for the average family, making it harder and harder for many Americans to get ahead. 
9. Trump Cut Open Enrollment Funding, And Instead Funneled People Into Junk Plans That Do Not Include Protections For Pre-Existing Conditions. In 2017, the Trump administration cut the outreach advertising budget for Open Enrollment by 90 percent, from $100 million to just $10 million – which resulted in as many as 1.1 million fewer people getting covered. The administration also slashed funding for non-profit health navigator groups, that help people shop for coverage, from $36 million to $10 million. CMS has encouraged groups to use the remaining funds to push people to sign up for junk plans that skirt important consumer protections.
10. Trump’s Policies Promote Discrimination Against Women, People Of Color, And LGBTQ Americans. Since taking office, the Trump administration has taken multiple steps to make it harder for women, people of color, and LGBTQ Americans to access health care. For example, in August 2019, the Trump administration begins enforcing a rule that bars certain federally-funded clinics from referring women for abortions. As a result, the nation’s largest recipient of Title X funds, Planned Parenthood, was forced to exit the program, losing $60 million in funding previously used to provide birth control and reproductive health care services for low-income women. Moreover, experts point to Trump’s immigration policies for having deterred many Latino families from getting coverage, resulting in steep coverage losses, especially for children. Trump has also tried to make it easier for transgender Americans to be discriminated against in health care settings and allow providers’ to refuse patient care on the basis of the provider’s personal beliefs, a move likely to undermine access to care for patients who already face health care disparities. 

House Democrats’ Bold Plan: The Lower Drug Costs Now Act 

In December, House Democrats passed an aggressive plan to reduce the price of drugs for every American family — taking on the drug companies, leveling the playing field so Americans don’t pay more than other countries for their medicines, and ending the rigged system that keeps drug company profits and prices high. Too many American families are staying up at night worrying about rising prescription drug prices and choosing between getting their medication and paying their rent. The big drug companies have spent billions to rig the system so they keep prices high and profits going up, but that ends with this bill. 

• The plan gives Medicare the power to negotiate with drug companies for lower drug prices.
• Not only will those on Medicare benefit from lower drug prices, but the lower prices would apply to anyone purchasing drugs no matter how they are insured. Prices would go down for those who get insurance from employers and buy it directly from insurance companies. Whether you’re a child with asthma, a teen with diabetes or a young parent with a rare illness, this bill will bring drug prices down for everyone. 
• This plan will stop unjustified price gouging for thousands of medications, including insulin, and require drug companies to lower their prices or pay a penalty. 
• Drug companies would be penalized if they keep the system rigged and their prices high. 
• No longer will drug companies be allowed to charge Americans double and triple the price for the same prescription drugs as others pay around the world. 

Nonpartisan analysis from the CBO and CMS Office of the Actuary confirms the bill will reduce drug prices by up to 55% and save patients and taxpayers hundreds of billions of dollars over the next few years. 

• Newly-released analysis from the nonpartisan Congressional Budget Office and the CMS Office of the Actuary the bill confirm it will reduce negotiated drug prices by as much as 55 percent – saving patients an estimated $158 billion over the next few years and decreasing deficits by $345 billion. 

Republicans continue to stand with the drug companies, and oppose the key elements of this plan to reduce drug prices.

• President Trump has stood with the big drug companies whenever he can. He refuses to support giving Medicare the power to negotiate with drug companies for lower drug prices, gave drug companies billions in tax breaks and has put former drug executives in charge of his health care policy.
• Republicans gave nearly $100 billion in tax breaks to the biggest drug companies just last year.
• Big drug company supporters have already started funding secret groups to attack this plan. 
• Republicans have voted, repeatedly, to let health insurance plans stop covering any of the costs of prescription drugs.
• Senate Republicans voted against Medicare negotiations in the Senate Finance Committee last month.

Drug Prices Are Soaring Under Trump

Drug Prices In 2019 Surged Compared To The Year Before. With Hikes At 5 Times Inflation — “More Than 3,400 Drugs Have Boosted Their Prices In The First Six Months Of 2019.” “Price hikes on prescription drugs are surging in 2019, despite vows from the Trump administration to rein in pharmaceutical costs. So far in 2019, more than 3,400 drugs have boosted their prices, a 17% increase compared with the roughly 2,900 drug price increases at the same time in 2018, according to a new analysis by Rx Savings Solutions, a consultant to health plans and employers. The average price hike for those 3,400 drugs stands at 10.5%, or about 5 times the rate of inflation, the study found.” [CBS News, 7/1/19]

AARP Analysis Found Specialty Drug Prices Have Grown More Than Three Times Faster Than Inflation. “The prices of widely used specialty prescription drugs grew more than three times faster than general inflation in 2017…The new report found that the average annual price for a single specialty drug used on a chronic basis is now nearly $79,000, compared to $27,824 in 2006.” [AARP, 6/25/19] 

Insulin Costs Have Tripled Over The Past Decade. As costs continue to rise, as many as one in four of the 7.5 million Americans dependent on insulin are skipping or skimping on doses.

Despite Tough Rhetoric, Trump And His Republican Allies Continue To Block Meaningful Reform.

Trump And His Republican Allies Continue To Block Medicare Negotiation For Lower Drug Prices. Even though 86 percent of Americans support allowing the federal government to negotiate drug prices for Medicare beneficiaries, Republicans refuse to allow Medicare to negotiate. A 2018 Senate Homeland Security and Governmental Affairs Democratic Committee report found that Medicare Part D could save $2.8 billion in a single year if it were allowed to negotiate drug prices. Although it would decrease both federal spending and beneficiaries’ out-of-pocket costs for prescription drugs, a policy allowing the federal government to negotiate drug prices for Medicare beneficiaries was recently blocked by Senate Republicans.

And Don’t Forget, The Trump Tax Bill Gave Drug Companies Billions Of Dollars In Tax Breaks.

• Pharmaceutical Companies Reaped Huge Benefits From The Trump Tax Bill. The Trump tax scam means billions of dollars in tax breaks for pharmaceutical companies. An Axios study found that 21 health care companies collectively expected to gain $10 billion in tax savings during 2018 alone. Most of the tax break for health care companies is going toward share buybacks, dividends, acquisitions and paying down debt. According to Axios, nine pharmaceutical companies are spending a combined $50 billion on new share buyback programs. 
• Despite Massive Profits From Tax Bill, Pharma Continued To Raise Prices. Pharmaceutical companies raked in more than $30 billion in profits in the third quarter of 2018, with Pfizer alone bringing in $4.1 billion – the highest of any publicly traded health care company. Of the 19 companies that tallied at least $1 billion of third-quarter profit, 14 were drug companies. Meanwhile, pharmaceutical companies continue to increase prices. In January 2019 alone, Pfizer and Novartis announced price increases on dozens of drugs, including increasing the cost of a breast cancer medication to $12,000 for 21 pills. 

For more on Trump’s broken promises on drug pricing, click here.