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RWVoices

Thursday
May112017

Warning to Senate: Don’t poke the mama bear!


 

With Mother’s Day coming up on Sunday and National Women’s Health Week starting Monday, moms across the country are speaking out against the American Health Care Act (AHCA) approved by the House of Representatives last week. Among other things, it would empower states to allow insurance companies to drop coverage for maternity care and other Essential Health Benefits. Insurers could also charge women more if they have pre-existing conditions, such as pregnancy, or for having been a victim of domestic violence or having been sexually assaulted.
What else would moms stand to lose if the Affordable Care Act (ACA) is repealed and replaced by the AHCA? Check out our new fact sheet.


Allison Hooban, a pregnant 40-year-old mother of a 4-year-old girl, spoke out at a press conference held by U.S. Senator Kirsten Gillibrand of New York to blast the AHCA:

“They poked the mama bear. We won’t stand for it. Me and other moms refuse to let this pass.”

She explained that “The Affordable Care Act has been so helpful to my family. All of my wellness visits for pre-natal care are covered with nothing out of pocket... For my daughter and son -- when he’s born -- all their [routine] pediatrician visits are completely covered with nothing out of pocket for me and my husband, which
is huge.” She said she is worried that “If this [pregnancy] becomes a pre-existing condition and for some reason I have a gap in my health insurance, they could use that as an excuse to make my premiums prohibitively expensive so that I can’t afford it.”

Watch Allison speak out and share the video with your friends and family. Share our new #DontPokeMamaBear social media cartoon on Facebook and Twitter. You can find it on our Facebook page. Like our page and share our posts widely this Mother’s Day weekend!
 
Want to take grassroots action? A new initiative, the Payback Project, has been created to help health consumers hold accountable those members of the House who voted for the AHCA. It’s being sponsored by Indivisible, Moveon, the Town Hall Project and the Women’s March. Visit their website to find out about actions happening near you. 
 

What’s likely to happen as the Senate takes up ACA repeal/replace?


With the battle over Trumpcare now moving to the Senate, there are reasons to be both hopeful and concerned.

In the column for optimism:
The Senate won’t simply take up the House Trumpcare bill. Instead, they are writing their own bill. While there has been talk of a Senate vote in early June, Senate Republican leadership has made clear that they won’t schedule a vote until the Congressional Budget Office (CBO), Congress’s official scorekeeper, provides an estimate on cost and coverage. They have also promised to abide by rulings from the Senate parliamentarian if she finds that certain provisions don’t qualify under the narrow “Byrd rule” restrictions mandated by “budget reconciliation,” the parliamentary process that would let the GOP pass Trumpcare with just 51 votes.
 
There had been chatter among conservatives that the Senate GOP could simply change Senate rules and eliminate these restrictions. But forgoing a CBO score or overruling the Senate parliamentarian as she plays referee would be a de facto elimination of the legislative filibuster—something most Senate Republicans have been reluctant to do.
 
When CBO scored an earlier version of the House Trumpcare bill, it concluded that 24 million people would lose insurance—and that was before the bill turned more sharply to the right, making critical consumer protections optional for states.
 
Senate leadership can only afford to lose two GOP senators (with Vice President Mike Pence casting the tie-breaking vote), and there are likely more than three unwilling to vote for the kinds of coverage losses that the AHCA’s deep tax cuts require. If the Senate passes a less radical bill that retains most of the Affordable Care Act’s taxes and infrastructure, it’s possible that House conservatives would then balk when the Senate bill goes over to the House.
 
Similarly, the decision to abide by the rules of reconciliation could have complicated, unpredictable ripple effects on both women’s reproductive health and the politics of the vote. In 2015, the Senate parliamentarian ruled that blocking Planned Parenthood from accepting Medicaid patients (aka “defunding Planned Parenthood”) qualified under the Byrd rule, in part because CBO had concluded in 2015 that more providers than just Planned Parenthood could possibly be affected. In 2017, the CBO has come around to what we already knew: only Planned Parenthood will be affected. That, in turn, could impact the parliamentarian’s view.
 
Meanwhile, the House-passed version of Trumpcare eliminated the ACA’s subsidy to help low- and moderate-income households purchase private health insurance. The bill created a new, much skimpier subsidy, and tacked on a provision to prevent any of the funds from being used to pay for private insurance coverage of abortion. That provision is unlikely to qualify under the Byrd rule.
 
Should the Senate parliamentarian reject either the attack on Planned Parenthood or the attack on private insurance coverage of abortion—and certainly if she rejects both—anti-abortion groups have threatened to withdraw their endorsements.
 
In the column for pessimism: The House’s vote on Trumpcare is a good reminder that members of Congress under fire from their leadership and wealthy donors can be pushed into voting against their principles and their electoral self-interest. They might do so even to pass a bill with a sub-17% approval rating and in the face of overwhelming opposition from the American Medical Association, AARP, patient groups like the American Cancer Association, the American Hospital Association, and their own constituents. (In fact, the only true enthusiasm for the GOP proposal has come from groups dedicated to lobbying Congress on behalf of tax cuts for the rich.)
 
Right now, groups of GOP senators are meeting to hash out a substitute proposal to the House bill with
the goal of bringing it to a vote in early June immediately following the Memorial Day recess. A formal leadership-blessed working group of 13 white male Senators (pictured at right) representing the conservative wing of the party has already begun meeting regularly. Informal groups of GOP moderates and Medicaid expansion state members are also meeting. 
 
The Senate could eliminate some of the higher-profile problems with the House-passed Trumpcare bill—such as its attack on consumer protections for pre-existing conditions or its 67% increase in premiums for seniors—and delay the end of the Medicaid expansion, while leaving the core of the House bill in place, including its radical restructuring of original Medicaid. That would still leave us with a terrible bill.
 
Advocates must use the next three weeks to delay and divide the Senate GOP! While a number of Republican senators have been quick to voice their opposition to the House’s Trumpcare bill, few have yet drawn lines in the sand about what they won’t support in a Senate version. We are urging senators to state their opposition to any bill that does any one of the following things:

  1. Ends the Medicaid expansion, regardless of when;
  2. Ends Medicaid as we know it by switching to a per capita cap or block grant structure; or
  3. Increases the number of uninsured Americans, which encompasses everything from dismantling essential health benefits, driving up premiums, cutting subsidies, and more.
Thursday
May042017

Hold them accountable for assaults on women’s health care!


The Trump Administration and Republican majority in the House of Representatives have given us the worst week for women’s health in a long time. By a narrow margin of 217 to 213, members of the House of Representatives voted today to approve an amended version of the American Health Care Act (Trumpcare) that would:

  • Bar Medicaid enrollees from using their coverage at Planned Parenthood.
  • Give states the option to allow insurance companies to drop coverage of maternity care and other Essential Health Benefits, such as hospitalizations, prescription drugs, and mental health services.
  • Give states the option to allow insurance companies to charge higher premiums to people with pre-existing conditions, such as women who have had babies through c-section deliveries.
  • Cause at least 24 million people to lose their health insurance.
  • Allow states to do away with caps on annual and lifetime spending limits.
  • Cut money from Medicaid, Medicare and other health programs to finance a huge tax cut for wealthy individuals. 

The amended American Health Care Act was voted on without a new official Congressional Budget Office (CBO) score to determine the impact on people and the health care system.

Raising Women’s Voices and our regional coordinators and supporters across the country will hold accountable those members of the House who voted for this terrible bill. As this legislation moves forward to the U.S. Senate, we will join the fight to defeat it.  We call on our Senators to reject this blatant assault on women’s health and the health care that our families need!

Earlier today, Donald Trump issued an Executive Order that appears to open the door to creating even broader religious or conscience exemptions to the ACA’s contraceptive coverage mandate.

U.S. Health and Human Services Secretary Tom Price, a long-time critic of contraception coverage, welcomed the opportunity to reexamine the contraceptive mandate. New Trump appointees to HHS this week are likely to embrace this idea since they are  opponents of contraception, as well as abortion:

  • Charmaine Yoest, the former CEO of Americans United for Life, is a new assistant secretary for health and human services; and
  • Teresa Manning, a former lobbyist for the National Right to Life Committee, is expected to be appointed to oversee the nation’s family planning program.

Raising Women’s Voices deplores any effort to deny women the contraceptive coverage we need, just because our bosses do not approve of it.

Wednesday
May032017

Act now to protect people with pre-existing conditions!

 

Desperate to revive Trumpcare and get it across the finish line in the House before members return to their districts for another recess at the end of this week, House Republicans have announced an amendment to include an additional $8 billion in funds for high-risk pools. We aren’t sure whether to laugh or cry.
 
As Republican Congresswoman Ileana Ros-Lehtinen (FL) noted, even adding six times that amount to the high-risk pools would still only be "a little baby down payment." In fact, experts think high-risk pools could actually need more than a trillion dollars (i.e. seven times more than what the entire bill provides) to match the coverage that people with pre-existing conditions currently have under the Affordable Care Act (ACA).
 
Tell your member of Congress you aren’t fooled
 
Even if your member of Congress has said “no” to previous versions of this bill, it’s critical to once again call and tell him or her that
Trumpcare would be a disaster for millions of Americans (read more about the bill here). This amendment is nothing more than an empty talking point. Let your member of Congress know you aren’t fooled.
 
The toll-free number to call Congress is 1-844-898-1199.
 
So what’s this amendment really about?
 
Maybe it’s an attempt to look responsive to the emotional appeal made by late-night show host Jimmy Kimmel, who revealed this week that his newborn son has a serious heart condition that required immediate surgery and will constitute a pre-existing condition for the rest of his life:

“We were brought up to believe that we live in the greatest country in the world, but until a few years ago, millions and millions of us had no access to health insurance at all,” Kimmel told this television audience. “Before 2014, if you were born with congenital heart disease like my son was, there was a good chance you’d never be able to get health insurance because you had a pre-existing condition. You were born with a pre-existing condition. And if your parents didn’t have medical insurance, you might not live long enough to even get denied because of a pre-existing condition.”

This new amendment could be about giving members of Congress “cover” to vote yes, without actually doing much to protect people with pre-existing conditions. Maybe they don’t want to take the blame among the conservative base for “killing Obamacare repeal.”

Let’s talk about pre-existing conditions
 
But whatever their true reason, let’s be clear: this bill would take us back to the days before the ACA, when millions of Americans with serious illnesses couldn’t get coverage. Some went bankrupt paying for treatments their insurance would not cover. Others died waiting to get into underfunded high-risk pools.

Those days will be back if Republicans pass Trumpcare. That’s because it would allow each state to eliminate the ACA’s protections for people with pre-existing conditions like cancer, asthma, or depression in two ways: 1) Insurance companies would once again be able to charge sick people sky-high premiums and 2) they wouldn’t be required to offer the coverage sick people actually need. Sure, insurance companies would still be required to offer everyone coverage, but they would be allowed to offer a cancer patient $10,000/month coverage that didn’t actually cover any cancer treatments or hospital stays.
 
Before the ACA, 47 states allowed insurance companies to charge people with pre-existing conditions exorbitant rates and exclude treatment for their known illnesses. Experts think the same thing will happen again because the proposed law also phases out the ACA rules and federal funding that help keep the insurance market financially stable. Once those rules are gone, states will be under enormous pressure from insurance companies to let them weed out the sick people.

Because Trumpcare also makes it easy for the states to stop requiring insurance companies to cover 10 Essential Health Benefits including maternity care, mental health care, and emergency room visits, insurance companies will be free to go back to setting yearly and lifetime caps on coverage.
 
Forced out of regular insurance, those with pre-existing conditions would be shunted into those high-risk pools we mentioned above. When programs like this were tried in the past, they resulted in limited coverage, higher costs, and long waiting periods for coverage for people in need.
 
And don’t forget, Trumpcare
strips $880 billion out of Medicaid and funds high-risk pools at a tiny fraction of what they need to work in order to give the 400 wealthiest households in America an average tax cut of $7 million each.
 
Remember: The toll-free number to call Congress is 1-844-898-1199.

Thursday
Apr272017

TheTrumpcare #zombiebill is back!

 


Like the zombie in a bad horror movie that keeps rising again and again, the Trumpcare bill to repeal the Affordable Care Act (ACA) is once again threatening our health care. With Donald Trump’s 100th day in office just two days away, the media-obsessed White House has been in a panic to notch a win—even if it means stripping affordable health care away from millions of people. At the same time, members of the House Freedom Caucus and conservative think tanks have been under pressure to avoid the blame for killing ACA repeal.
 
A vote in the House could come as early as Friday or Saturday. We must keep the vote from ever being scheduled at all. With so many calls to action over the last few weeks and no vote scheduled, advocates and activists may wonder if there’s really cause for alarm this time. Are we “crying wolf” (or crying zombie!)?
 
Citizen engagement through phone calls, town halls, and protests has been the only thing keeping
Trumpcare from become law. Reluctant to re-live their March humiliation of scheduling and then scrapping a vote, Republican leaders have made clear that they won’t schedule a vote until they know for certain that the bill will pass. Every week without a vote is a sign that our collective outreach is working. We can’t stop now!
 
What can you do? Call your member of Congress at 1-844-898-1199. Use the
Trumpcare toolkit developed by the Protect Our Care Coalition: www.trumpcaretoolkit.org Share our Raising Women’s Voices social media alerts, including the new #Zombiebill graphic shown above. You can find us @RWV4Healthcare.

 
How the #Zombiebill has become even worse

 
When the Congressional Budget Office (CBO) scored
Trumpcare I, it concluded that 24 million people would lose health insurance. Republicans are anxious to vote on Trumpcare II before CBO can score these new changes because they know the number of people losing insurance is going to be much higher.
 
That’s because, as in many horror movies, this zombie has only grown more grotesque over time. Under the legislative text released by House Republicans on Tuesday, states would be allowed to drop two important provisions of the ACA:
 

  • The requirement that insurance plans cover 10 Essential Health Benefits, such as maternity care, hospitalizations, doctor visits and prescription drugs.
  • Provisions (known as “community rating”) to prevent insurance companies from discriminating against sick people by charging them much more.

If states drop the Essential Health Benefits requirement, then insurance companies could sell plans that are cheaper but don’t cover much at all. If we get sick or become pregnant, we would have to pay out of pocket for anything that isn’t covered—like cancer treatment or childbirth and newborn care. Comprehensive health plans would be significantly more expensive than they are now—or they might disappear altogether.
 
If states get rid of community rating, insurance companies will once again sort us based on how healthy or sick they think we are and charge millions of people substantially more for their insurance, pricing millions out of people out of coverage altogether. We will have to fill out lengthy questionnaires about whether health status and history and could once again have our policies canceled if we forget to list even mild pre-existing conditions like acne. These policy cancellations were common before the ACA.

 

 
The people who would be hurt are those who need good health insurance the most—like pregnant women and people with pre-existing medical conditions! Insurance companies couldn’t refuse them coverage, but they could sell bare-bones plans that don’t cover the medical care that sick people need, or they could charge such expensive premiums that sick people couldn’t afford coverage.
 
Trumpcare’s sponsors claim that no one with pre-existing conditions would be hurt under these changes because states would set up high-risk pools for the very sickest—even though when high-risk pools were tried in the past, they didn’t work. But we know what members of Congress really think because the bill text released Tuesday explicitly exempts them from the provision letting states drop Obamacare’s protections for pre-existing protections. While this exemption is likely to be dropped, it has revealed the gap between GOP talking points and what they really think.
 
Would we be able to stop states from dropping these important coverage protections? It could be difficult. Under the bill, state plans to drop these critical consumer protections would be filed with the U.S. Department of Health and Human Services (HHS) and automatically go into effect after 60 days unless HHS objected. How likely is it that HHS Secretary Tom Price, a Trump appointee, would object to states carrying out provisions of
Trumpcare?
 
One of the main architects of
Trumpcare II is New Jersey Congressman Tom MacArthur (R-NJ 3), co-chair of the “moderate” Republican House caucus, the Tuesday Group. News of the MacArthur amendment has only served to strengthen the resolve of RWV regional coordinator New Jersey Citizen Action (NJCA). During the first week of the congressional April recess, NJCA and local activists held a rally to protest Congressman MacArthur’s health care stance. More than 75—mostly women—gathered outside the gates of a senior living community where MacArthur was holding a
closed door forum with residents. 

Protesters like Barbara Blonsky, constituent/member NJ 3rd Congressional District Action Group (shown at left in the photo), and Dr. Eileen Hill, SJ NOW Indivisible leader (right in photo) carried signs and chanted. In addition, an airplane sponsored by NJCA flew overhead pulling a banner that said “Warning: Rep. MacArthur Wants to Take Away Your Healthcare.” 
 
A news conference and vigil will be held at MacArthur’s district office this week.  Constituents plan to press MacArthur to reverse his stance and have made it clear they will work to remove him if he continues to support a bill that would cause nearly 34,000 in his district to lose coverage and tears down many of the protections and benefits millions rely on.

 
 

Don’t forget: Trumpcare II keeps all the bad parts of Trumpcare I

 
These new provisions in
Trumpcare II have been added on top of all of the worst parts of Trumpcare I:

  • A massive tax cut for corporations and the ultra-wealthy paid for with $880 billion in cuts to Medicaid. Under the guise of “Obamacare repeal,” this bill rewrites the rules for original Medicaid, eliminating the federal government’s guarantee to cover a percentage of the costs of every eligible enrollee. The bill caps and ratchets down federal support so that it provides less and less help each year, forcing states to cut benefits or drop children, pregnant women, disabled people, and seniors from coverage. All to give the 400 richest households in America an average tax cut of $7 million.
  • Elimination of the ACA’s Medicaid expansion. The CBO predicts that more than two-thirds of those who gained coverage through Medicaid expansion will lose their eligibility within just two years of implementation of the repeal bill.
  • Deep cuts to the subsidies that help low- and moderate-income people buy insurance. For example, a 60-year-old woman making minimum wage receives (on average) almost $10,000 in subsidies (premium tax credits) from the ACA to help her buy good insurance—and more if she lives where premiums are high. Under the GOP repeal, she would get just $4,000—no matter where she lives or how expensive her insurance.
  • Permission for insurance companies to charge older Americans five times more than younger ones. CBO predicts that it will “substantially rais[e] premiums for older people.” Women in their 50s and 60s who lose coverage through divorce or widowhood will be hard pressed to find affordable coverage.
  • Higher copays and deductibles. CBO noted that “lower-income people’s share of medical services paid in the form of deductibles and other cost sharing would increase.”
  • An attack on Planned Parenthood. The bill would prevent women from being able to use their public health insurance, such as Medicaid, at Planned Parenthood, which would be barred from receiving federal funds. Planned Parenthood is often the only women’s health provider in rural and other underserved areas. CBO reported that “The people most likely to experience reduced access to care would probably reside in areas without other health care clinics or medical practitioners who serve low-income populations.”
Tuesday
Apr182017

The fight to save our health care isn’t over yet!

With members of Congress back home in their districts for the April recess this week and last, the biggest news out of Washington has been the Trump Administration’s reckless game of chicken with the health insurance marketplaces created through the Affordable Care Act (ACA). Even as the Republican ACA repeal bill has entered a “zombie” phase—neither alive nor dead, but getting uglier by the day—Donald Trump has opened a new line of attack, threatening to take the health care of millions of Americans as his hostage. At stake is $7 billion in funding for “cost-sharing reductions”  -- essentially subsidies -- to keep co-pays and deductibles low for low-income households enrolled in marketplace plans.
 
This week, advocates are working to protect our health care from these latest threats. Below we will tell you how you can join in. But first, we want to bring you up to speed. 
 
In 2014, House Republicans sued the Obama Administration to stop the cost-sharing reduction subsidies,  arguing that they were never appropriated by Congress. The suit was expected to be dismissed—few legal experts thought the House had standing to sue—but a conservative lower court judge sided with Republicans. The payments were allowed to continue while the Obama Administration appealed. With the change in power, insurers hesitant about committing to the marketplaces for 2018 coverage have been watching to see what the Trump Administration will do.
 
Now that Republicans are increasingly likely to be blamed by the public for chaos in health insurance markets, most congressional Republicans would like to see the subsidies continue—but without their fingerprints. What was cynically tarred as a“taxpayer bailout for insurance companies” under President Obama is now being called a necessity for “marketplace stability.”
 
So, the New York Times reported last week that the U.S. Department of Health and Human Services (HHS) would continue to pay the subsidies while the lawsuit is pending, with the support of Speaker Paul Ryan (R-WI). But Trump himself reportedly angrily intervened and forced HHS to denounce the story, believing it lessened his negotiating position with Democrats. Trump gave several interviews where he said he wouldn't pay the subsidies in order to force Democrats to support the failed Trumpcare bill.

Congressional Democrats responded by suggesting that they are willing to let the government shutdown when current appropriations expire at the end of April unless Congress funds the subsidies directly. Since appropriations bills require 60 votes in the Senate, Republicans will need at least eight Democrats to pass a funding bill and prevent a shutdown. Meanwhile, all the uncertainty is driving insurers to leave marketplaces. And University of Michigan Law School professor Nicholas Bagley argues that resolving the subsidies through the lawsuit could be far trickier than most people realize.
 
Where does that leave us? We must demand that Congress fund the subsidies directly. Even as we fight continuing efforts to repeal the ACA, gut Medicaid and block women from accessing care at Planned Parenthood, we must press Congress to prevent the administration from sabotaging health care access from the inside. Insurers will not participate in the 2018 marketplaces unless they are assured that Republicans won’t pull a $7 billion rug out from under them. Only Congress can stabilize markets both near- and long-term.

 

What can you do?

The national Protect Our Care coalition, in which Raising Women’s Voices participates, is encouraging people to communicate with members of Congress while they are home in their districts during this Congressional recess. While the focus of much of this advocacy has been on persuading opponents of the ACA to stop trying to repeal it, we also need to remind supporters of the ACA that we appreciate their work! You can find out if there is a Congressional town hall meeting or another event near you by going to the website of Resistance Recess.

 
Planned Parenthood of Southern New England (PPSNE), our Raising Women’s Voices regional coordinator working in Connecticut and Rhode Island, hosted a Congressional recess “roundtable” discussion in Stamford, CT, on Friday. The event attracted more than 60 supporters of Planned Parenthood to hear directly from U.S. Senators Richard Blumenthal and Chris Murphy about their active support of PPSNE’s work, and the fight to preserve the Affordable Care Act (ACA). 
 
They warned of tough times still ahead, although both Senators are outspoken champions of protecting family planning programs and access to reproductive health care. The Senators discussed recent attacks on Planned Parenthood’s funding as well as the risks of newly appointed conservative Supreme Court Justice Neil Gorsuch.
 
There was time for audience participation, and multiple stories were readily shared about how Planned  Parenthood’s services were, in several cases, literally life-saving. Even Stamford Mayor David Martin told the story of someone very close to him who had sought Planned Parenthood’s services nearly 50 years ago, and how that health care changed her life…and his.
 
Last Wednesday, New Jersey Citizen Action rallied outside of Congressman Leonard Lance’s (R-NJ 7) Town Hall meeting to voice their opposition to the ACA repeal bill – the American Health Care Act or AHCA -- and to urge policymakers to save the health care of New Jersey residents. Lance voted for a version of the AHCA in committee but ultimately opposed the final bill under pressure from his constituents.  
 
On the same evening, NJ Citizen Action held a vigil outside of Congressman Tom MacArthur’s (R-NJ 3) office. MacArthur is the only New Jersey Member of Congress who supported the AHCA in its final form and continues to support efforts to take health care away from millions of Americans. 

What to say at a Congressiona Town Hall Meeting

If you go to a Congressional Town Hall meeting, what should you say?Here are some tips from the Protect Our Care coalition: Keep it simple. Our message is: Do not take away our care. Stop trying to repeal the Affordable Care Act. 

Members need to keep hearing from their constituents so they understand that it’s time to give up on repealing the health care law. Remember: Keep it personal. The best and most impactful questions are ones where someone shares their story about what the Affordable Care Act has meant to them or their family.
  1. Will you give up on repealing and replacing the law with anything that results in people losing their health coverage and increasing costs?
  2. Do you agree with the latest repeal efforts that include weakening protections for people with pre-existing conditions by allowing insurance companies to charge them as much as they want?
  3. Do you think the Trump Administration should be working to strengthen the individual market versus trying to sabotage it?
  4. Choose your own issue: It’s clear that people are against the American Health Care Act. Will you pledge to never vote for legislation that:
    1. Creates an age tax that makes health care more expensive for people between the ages of 50-64?
    2. Guts Medicaid by shifting costs to states through a block grant or per-capita cap and rationing the care of seniors, kids and people with disabilities?
    3. Allows insurance companies to stop covering basic services such as prescription drugs, maternity care, and cancer screenings?
    4. Stops women from getting their health care from a Planned Parenthood?
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