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Taxes and birth control and CHIP… Oh, my!

The year-end crush in Washington

Who has time to enjoy the holidays when the future of our health care is on the line in Washington? The federal government is due to run out of money on Saturday, and states are desperately seeking renewed funding for the Children’s Health Insurance Program (CHIP). But Republicans in Congress have been busy with other things, including trying to enact a giant corporate tax cut that will create a $1.4 trillion deficit, and thus pave the way for big deficit-reduction cuts to Medicare and Medicaid next year. Oh, and did we mention that the tax bill would undermine the Affordable Care Act, repealing its individual mandate and causing 13 million Americans to lose their health insurance?  More on all of those developments in a minute!
But first, this week we submitted comments expressing our strong opposition to the birth control rules issued by the Trump administration in early October. As we wrote about previously, the new rules (which went into effect immediately, even before public comments were sought) allow almost any employer to strip birth control coverage from their employees if the employer has either moral or religious objections to contraception. Under the new rules, universities can also deny birth control coverage in student health plans for religious or moral reasons, and insurance companies can do the same as long as the employer they're insuring agrees. 
In our comments we noted that the new rules harm women and their health and well-being, violate multiple federal laws and the Constitution, ignore Congress's explicit intent, and are based on false and distorted medical claims. We stated that there is nothing the administration could do to make the rules better and concluded that they should be struck in their entirety.

Reading the not-so-fine print of the tax bill

Senate Republicans successfully passed their bill to cut taxes on the wealthy and corporations at 2 am Saturday, voting 51-49 to pass a literally hand-written bill that none of them had read. They even voted down on strict party lines (52-48) a Democratic motion to delay voting for three days to give senators a chance to read through the new bill first. Every false complaint Republicans made about passage of the Affordable Care Act (ACA) seems to have been part of a playbook for how they would operate once in power.
Careful, deliberative lawmaking with hearings, public input and outside analysis isn’t window dressing. It’s critical for crafting laws that work as intended. In the days since the vote, experts poring over the bill have uncovered countless bugs, loopholes, and unworkable provisions in the Senate bill.
In the words of Greg Jenner, a former top tax official in George W. Bush’s Treasury Departmentquoted by Politico this week, “The more you read, the more you go, ‘Holy crap, what’s this? We will be dealing with unintended consequences for months to come because the bill is moving too fast.” Most concerning of all for Republicans, the Senate bill as passed currently eliminates all corporate tax deductions–the opposite of their intent.
While Republicans’ rush to pass a shoddy bill creates problems for them, it opens up both opportunities and challenges for health care advocates. Key Republican senators traded their votes in favor of the bill for assurances from GOP leadership that their other priorities would become law. Senator Susan Collins (R-ME), for example, said she was voting for the tax bill, despite its repeal of the ACA’s individual mandate, because she was promised that two of her health care priorities would get a vote before the tax bill became law. Those are the Alexander-Murray package to fund cost-sharing reduction (CSR) payments and open enrollment outreach and assistance, and $10 billion in re-insurance funding modeled on her bill with Senator Bill Nelson (D-FL). While these bills would not make up for the loss of the individual mandate, we support their enactment to address other components of GOP sabotage.

If the Senate had passed a carefully drafted and vetted bill, individuals senators would have lost all of their leverage to demand fulfillment of these promises: the House could have simply passed the Senate bill as-is, clearing it for the president to sign without any additional input from senators. But passing a bill that accidentally angers the business community makes it significantly less likely that the House can simply push through the Senate bill if the conference process sputters out. That, ironically, gives senators another bite at the apple.
That is where we find both challenges and opportunities. To fix their bill, Republicans may need to come up with $300 billion or more in additional revenue to stay within the Senate’s rules for passing the bill with only 51 votes. The House bill included a host of noxious tax hikes on low- and middle-income households that weren’t included in the Senate bill, among them repealing the deduction for high-cost medical expenses. Eliminating this deduction would particularly hurt senior women.
According to the AARP, the majority of tax-filers who claim the medical expense deduction are 50 or older and make $75,000 or less. The deduction is often used to help pay the costs of long-term care, which isn’t covered by most health insurance plans and which can cost tens of thousands of dollars. Meanwhile, research has found that the kinds of “extraordinary medical payments” likely to trigger the deduction account for more of women’s monthly take-home income than men’s, and leave “women with significantly more revolving credit card debt than men.” If the Senate were to fix its bill by taking up the House’s tax hikes, low- and middle-income women would pay the price.
But on the positive side, Senator Collins’ second bite at the apple means she could withhold her support for the tax bill until versions of Alexander-Murry and Collins-Nelson are enacted without additional conservative hostage-taking. Immediately after Senate passage, Speaker Paul Ryan (R-WI) and House conservatives made clear that they wouldn’t honor any of the commitments that Collins had receive around health care funding. But with her vote once again critical to passing the tax bill, grassroots activists should pressure Senator Collins to use her newly-restored leverage to insist on the best possible package.
Finally, it’s worth noting that while the tax bill is still a cornucopia of conservative social engineering—for example, taxing the state and local taxes that Americans pay to support their public schools, while giving wealthy parents who send their children to private schools a big tax break—key provisions related to abortion and church political activity were rejected by the Senate parliamentarian as not qualifying under the rules of reconciliation. Short of Republicans tossing out the filibuster altogether, those provisions can’t make a reappearance in any final package.
The tax debate is playing out against the backdrop of major year-end fights around federal spending. Stopgap funding to keep the government open expires on Saturday. House Republicans are pushing a two-week bill to fund the government through December 22 to give the two parties and chambers time to finish negotiating a larger package. After two-year deals in 2013 and 2015, sequestration is once again set to take a big bite out of health care and social welfare programs. Thus, a year-end package could include:
  • Several additional weeks of government funding,
  • Another two-year deal to partially repeal sequestration for both defense and non-defense spending,
  • Alexander-Murray and Collins-Nelson funding for ACA individual health insurance markets,
  • A 5-year reauthorization of CHIP,
  • Funding for community health centers,
  • A waiver of the statutory PAYGO provisions that will automatically cut $25 billion from Medicare next year alone due to the deficits caused by the tax bill, and
  • Possibly (though less likely) Dream Act provisions granting legal status to DACA immigrants whose lives were thrown into limbo when Donald Trump announced that he was ending the program in March.
In each of these fights, advocates must push to protect health care and the social safety net from long-term cuts for the sake of short-term gains.

It’s Women’s Week of Action!

The timing couldn’t be better for Women’s Week of Action!
Time is running out before this year’s Open Enrollment Period ends on December 15 in most of the country.  That’s why we are urging women to take time this week to shop around and enroll in health insurance.

Already have coverage for 2018? Then talk to your loved ones and the important women in your life and make sure they are covered too!

And, since it’s Giving Tuesday, consider making a tax-deductible donation to support our work helping women learn how to enroll in coverage and use it effectively. You can make a donation online through the Network for Good page of Community Catalyst, which is the fiscal sponsor of one of our RWV coordinating organizations, MergerWatch. Designate your gift for Raising Women’s Voices.
But those aren’t the only reasons we’re issuing a call to action for Raising Women’s Voices supporters and allies this week. We’re also facing a congressional attack on the Affordable Care Act (ACA) through a provision of proposed tax legislation that could come up for a vote in the Senate within days.

The threat in the Senate
Senate Republicans are set to vote as early as Thursday on a tax package that would enact deep tax cuts for corporations and the ultra-wealthy at the expense of health care for millions of low- and middle-income families. The Senate bill would permanently repeal the individual mandate, driving up premiums and causing 13 million people to lose their health insurance. The nonpartisan Congressional Budget Office (CBO) concludes that the overall impact of the bill would be to hurt poor households in order to help wealthy ones. The bill would also add $1.4 trillion to the deficit, which Republicans have said will give them the excuse they need to cut Medicare and Medicaid next year.
Once again, Republicans want to use reconciliation to ram a massive, unvetted bill through with just 20 hours of debate, and the support of 50 senators and Vice President Mike Pence. According to press reports, GOP leadership is working hard to strong arm senators into voting this week, because wealthy GOP donors have threatened to close the “piggy bank” unless they get tax cuts. Republicans are also anxious to rush the bill into law before the special election in Alabama on December 12 to fill Jeff Sessions’ former Senate seat.
The House passed its version of the tax cut bill on November 16. If the Senate passes its bill this week, the two chambers could hash out a compromise package. Even more likely, however, the House could simply pass the Senate’s bill as-is, clearing it for the president to sign into law as early as next week. This week represents our last, best chance to stop the GOP from ramming through this reverse Robin Hood transfer of resources from the poorest to the richest Americans. 
Once again, it’s critical to call your senators! You can reach them through the congressional switchboard at 202-224-3121. Or you can use a toll-free call line set up by SEIU at 866-426-2631.
Join our Women’s Week Twitter Chat this Thursday!
Help us spread the word that it is Women’s Week of Action! Join us @RWV4HealthCare for a #GetWomenCovered Twitter chat this Thursday from 3:00-4:00 pm ET. RSVP to to get the Twitter questions we’ll be asking ahead of time, so you can prepare some great answers.

There are many reasons to sign up for health insurance. Health insurance can help you stay healthy and give you peace of mind. It can protect you and your family from unexpected medical costs in the case of an emergency. Tell your family and friends that you care about their health and want them to check out their options at You can find a professional enrollment assister in your area to review health insurance options for free using this Enrollment Connector.  

While you are looking for the best online shopping deals this week, check Did you know that 80% of people can find plans for less than $75 per month? Also, 4.5 million people can get a plan with $0 premiums. Now that’s a steal! The last day to enroll in health insurance for 2018 isDecember 15, so don’t wait!  



Do something your family will thank you for!

It’s Thankful Week of Action for Health Coverage

Happy Thanksgiving! If you’re like most Americans, you’re probably thankful for your family and want to keep them healthy. What better reason could there be to get health coverage at

We’re helping people make the connection by promoting this week as Thankful Week of Action.  We created timely graphics to post on social media as part of our outreach and enrollment campaign.  This is just one way we and our amazing regional coordinators are making sure women of color, LGBTQ people, immigrants and low-income families know that Open Enrollment is happening NOW.

As with all of our Open Enrollment social media graphics, we have created tailored versions which highlight people who often feel excluded from mass media depictions of families. We want everyone to see themselves in our photos and know that the message is truly meant for them.

For example, here are images highlighting LGBTQ and immigrant families.

You can download and post any of these Thankful Week graphics. Spanish-language versions are also available.

Besides thinking about family and health during Thanksgiving week, a lot of us are thinking about holiday gift-giving. So, we created a graphic that taps into the shopping frenzy that commences with the day after Thanksgiving. After all, is an online shopping site!

Use our social media graphics, such as these two featuring a photo of an African-American family (left) and an LGBTQ couple (right):


You can download and post any of our Online Sale graphics.

Join Raising Women’s Voices in promoting Thankful Week of Action, along with other national non-profit groups that have partnered with Community Catalyst, to spread the word. Altogether, we have made hundreds of thousands of social media impressions. With 3-1/2 weeks to go, we intend to reach many thousands more.

You can help us bring the message about quality health coverage to more women of color, immigrants, low-income families and LGBTQ people! Won’t you include Raising Women’s Voices in your year-end gift-giving? You can make a tax-deductible donation designated to Raising Women’s Voices through our fiscal sponsor Community Catalyst. 

Looking ahead: Next week is Women’s Week of Action for Outreach and Enrollment. We’ll be hosting a #GetWomenCovered Twitter Chat on Thursday 11/30 at 3 p.m. Eastern. Plan to join us!

Giving thanks for MA action to protect birth control benefit

Women in Massachusetts can give thanks that their state lawmakers and governor have just acted to protect their access to contraceptive coverage with no co-pays!

On Monday, Massachusetts Governor Charlie Baker (R) signed into law the Advancing Contraceptive Coverage and Economic Security in our State (ACCESS) Act, which preserves and expands upon the ACA’s contraceptive coverage requirement.  H4009requires insurance carriers in Massachusetts (with the exception of self-funded plans, which are regulated by the federal government) to cover all FDA-approved contraceptive methods with no cost sharing. In addition, women will be able to pick up a 12-month supply of oral birth control at one time, as well as more easily obtain over the counter emergency contraception with no co-pays.

NARAL Pro-Choice Massachusetts, our Boston-based regional coordinator, has been working tirelessly alongside their women’s health allies to advocate for the adoption of the ACCESS Act. The bill’s passage took on an increased sense of urgency when the Trump Administration issued new regulations in October that roll back birth control coverage at the federal level, making state contraceptive coverage protections like Massachusetts’ even more important. The ACCESS Act will help ensure continued coverage for the 1.4 million Massachusetts women who gained access to no-cost contraceptive coverage, thanks to the ACA.



Watch out for sneaky ACA repeal in GOP tax bill!

13 million would lose coverage and premiums would rise!
The subtext for Republican efforts to rewrite the tax code has always been tax cuts for the wealthy paid for by health care cuts for the middle and working class. This week the subtext became text, literally, when the Senate Finance Committee released its tax bill. The proposal pairs deep cuts in the taxes paid by corporations and the wealthy with a repeal of the Affordable Care Act’s individual mandate.
Why is repeal of the insurance coverage mandate bad for women, LGBTQ people and our families? The Congressional Budget Office (CBO) estimates that eliminating the individual mandate will cause 13 million people to lose their health insurance. How would that happen? Some people—typically younger, healthier people—will decide to take the risk of skipping coverage if they no longer are penalized for going uninsured. But, millions of other people who want to keep their coverage will be driven out by rising premiums as the healthiest people leave the marketplace and the “risk pool” of insured people becomes too heavily weighted with sicker consumers.
The American Medical Association, the American Academy of Family Physicians and the American Hospital Association were unanimous in their opposition to this sneaky ACA repeal this weekwriting that "eliminating the individual mandate by itself likely will result in a significant increase in premiums, which would in turn substantially increase the number of uninsured Americans." Instead of helping low- and middle-income families afford coverage, the bill takes federal funds that would have been spent on subsidizing health coverage and spends them instead on big new tax cuts for the ultra-rich, like the elimination of the estate tax and the alternative minimum tax.
But that’s not the only way the tax bill goes after health care for middle and working class families. The House GOP tax plan also eliminates the medical expense deduction. Nearly 9 million people with high medical expenses—for example, seniors needing long-term care, people with chronic health conditions, and parents of children with disabilities—benefit from this deduction. Nearly 70% of people taking the medical expense deduction earn $75,000 or less.
This week, the CBO also released an analysis warning that by adding $1.5 trillion to the deficit, the GOP tax bill would trigger automatic cuts to mandatory spending under the 2010 pay-as-you-go law (PAYGO). That would mean $25 billion in cuts to Medicare in 2018 alone and additional cuts to the Affordable Care Act.
Once again, it’s critical to call your members of Congress. You can reach them through the congressional switchboard at 202-224-3121. Or you can use a toll-free call line that SEIU has set up at 866-426-2631.
Republicans want to once again use reconciliation to ram their bill through with just 20 hours of debate and the support of 50 senators and Vice President Mike Pence. But they can't waive PAYGO in a reconciliation bill without 60 votes. If they successfully pass their tax bill using reconciliation, it’s likely that enough Democrats would subsequently join them in a separate vote waiving PAYGO, possibly attached to must-pass legislation like a year-end spending deal, to protect seniors from these deep cuts.
But Republicans’ overarching goal of creating a big budget hole that must be filled through cuts to our safety net would remain. In fact, Speaker Paul Ryan (R-WI) has promised that he will push for “entitlement reform” (code for cuts to Medicaid, Medicare, and Social Security) to pay for the tax bill.
Right now, Republican leaders are trying to soften opposition from Senate moderates—particularly Senators Susan Collins, Lisa Murkowski, and John McCain who voted against “skinny repeal” of the ACA in July. GOP leaders are promising to simultaneously hold a vote on the bipartisan Alexander-Murray bill to fund cost-sharing reduction payments and open enrollment assistance for two years. But that bill’s namesake cosponsor, Senator Patty Murray (D-WA), notes that repealing the individual mandate will “really destabilize the marketplaces,” which is the exact opposite of what her bill is supposed to do. On Wednesday, Sen. Ron Johnson, R-WI, said he could not vote for the Senate tax cut bill in its current form for an entirely different reason, complaining that the tax cuts disproportionately benefit corporations at the expenses of other businesses. (However, we aren’t counting on his opposition to kill the bill.)

The House is set to vote on its bill today (Thursday). The Senate is expected to take up its bill immediately after Thanksgiving. Though congressional leaders had initially planned to go to conference to reconcile different versions passed by the House and Senate, new intelligence suggests that the Senate could adopt a last-minute amendment during vote-a-rama to satisfy House conservatives. Under that scenario, the House would then promptly pass the Senate bill without amendment, sending it to the president’s desk.
RWV Regional Coordinator New Jersey Citizen Action (NJCA) has been working to raise awareness about the harmful impact the Republican House tax bill would have on New Jerseyans. The GOP tax plan would cost New Jersey residents billions in deductions. Under the House plan, the wealthiest 5% of New Jerseyans—those with annual incomes over $440,000—would get two thirds (67%) of the tax cut coming to the state by 2027. And, programs like Medicaid, Medicare and the ACA would be on the chopping block in 2018 as Congress tries to make up for trillions in lost revenue as a result of these tax cuts.  
On Monday, NJCA and New Jersey Organizing Project rallied outside Representative Tom MacArthur's (R-NJ 3) invitation only forum, where he defended tax cuts for the rich. Every one of New Jersey's congressional delegation, both Democrats and Republicans, oppose this plan, except Representatives MacArthur and Frelinghuysen (R-NJ 11). They are also the same two New Jersey Representatives who voted to take health care away from 32 million Americans. Maura Collinsgru, NJCA Health Care Program Director, pictured above, held a sign that reads “Health Care Not Tax Cuts”
NJCA is also hosting a “Stop Tax Cuts Day of Action,” during which New Jerseyans can drop in at one of the GOP district office locations to deliver a phony check made out to the 1% from New Jersey's low and middle-income families. In addition, NJCA and NJ Organizing Project are holding vigils in Freehold, Toms River, Marlton, and May’s Landing to oppose this harmful tax plan.



We’re on a roll! Let’s keep it up!

What a week for health care!

We’ve had double helpings of good health care news this week. First, we learned that enrollment in Affordable Care Act health insurance plans is surging! More than 200,000 people chose a health plan on November 1, the first day of open enrollment. That’s more than double the number who signed up on the first day of open enrollment last year. Then, on Tuesday, voters in Maine made that the first state to approve Medicaid expansion by popular referendum.

Help us keep the enrollment momentum going! Raising Women’s Voices is producing a series of colorful social media badges and flyers to get the word out about the short six-week open enrollment period for most of the country this year. They feature images of our targeted audiences: African-American, Latinx, LGBTQ, immigrant and low-income individuals and families. We’re working with our regional coordinators and with national partner organizations to distribute these materials on line and at in-person outreach and enrollment events.

This week has been declared Latino Week of Action!  Latinx people (we use this more inclusive term) have made record gains in coverage since the passage of the Affordable Care Act. However, the Latinx community is still one of the largest uninsured populations in the country, with uninsured rates far above the national average. We joined our partners, Salud America! and Young Invincibles, in a #SaludTues Twitter chat this week and encourage all of you to help us spread the word.  Check out all of our materials in English and Spanish, including the social media badges shown here, on Community Catalyst’s Google Drive. Make sure your Latinx friends and family know Open Enrollment is happening now through December 15 in most of the country.

How about that vote in Maine?  By an overwhelming 18-point margin, Mainers voted on Tuesday to extend coverage to 80,000 people who are currently in Maine’s coverage gap because they are ineligible for traditional Medicaid, but don’t earn enough to afford the private marketplace health plans offered through Maine Governor Paul LePage, a conservative Republican, has vetoed bipartisan Medicaid expansion bills passed by the state legislature five times, and he campaigned hard against the referendum.

LePage, who is term-limited in 2018, has made clear that he will try to block the expansion, even if it means violating Maine’s constitution and the will of the people. But Maine's House Speaker Sara Gideon (D) responded that “any attempts to illegally delay or subvert this law will not be tolerated and will be fought with every recourse at our disposal. Mainers demanded affordable access to healthcare yesterday, and that is exactly what we intend to deliver.”

Our regional coordinator in Maine, Consumers for Affordable Health Care (CAHC), played an important role in building the massive public support for expansion. CAHC promised to keep up the fight: “This is a robust and clear message from voters across our state: it is long past time to provide a path to affordable coverage for all of Maine's people. We look forward to working hand-in-hand with consumers, our partners, the Legislature, and Governor LePage's administration to swiftly and faithfully uphold the will of the people and implement Medicaid expansion in Maine.”
This huge victory helps secure the ACA by sending an undeniable message to Congress. It also sets the stage for other states to move forward with expansion. Referenda on expansion have been proposed for 2018 in Utah and Idaho, and GOP-led state legislatures in Georgia, Kansas, and elsewhere have been flirting with expansion for several years, waiting for the threat of repeal to have passed. We’re feeling exuberant about this week’s victory and (cautiously) optimistic about the future.
RWV national coordinating team members were at the American Public Health Association conference in Atlanta this week. Our well-attended session, sponsored by the APHA Women’s Caucus, was entitled “If they come for one of us, they come for all of us!” It highlighted the need for cross-movement, intersectional work to defend our health care, our rights and our families at this perilous moment for our country.

RWV Co-founder Cindy Pearson kicked off the discussion by celebrating our victories so far in holding off repeal of the ACA and then warning of new challenges ahead. These include Trump administration encouragement of states to propose punitive requirements for Medicaid enrollees, as well as proposed GOP Congressional “tax reform” bills that would increase the federal deficit and pave the way for renewed attempts to slash Medicaid and undermine the ACA.
RWV Co-founder Lois Uttley and Regional Field Manager Kalena Murphy discussed some of the successful strategies, tactics and messaging we‘ve been using this year to defend the ACA and the gains for women’s health and LGBTQ health that have come from the ACA. These have included social media campaigns like our #IfILoseCoverage initiative that we kicked off just weeks after last year’s election, as well as rallies, vigils and participation in Congressional town hall meetings. Some of our Southern regional coordinators have had great success with Black Folks Day on the Hill-type events in their state capitols. RWV Co-founder Byllye Avery stressed the importance of working together in coalitions to fight the broad sweep of regressive policies coming out of Washington. She offered examples such as RWV-NY’s participation in New York City marches supporting immigrant rights.