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Wednesday
Apr052017

New GOP health care plan would hurt people who need health care most!


Republicans in the U.S. House of Representatives gave up on their first attempt to replace the Affordable Care Act (ACA). That was after the Congressional Budget Office (CBO) predicted it would cause 24 million people to lose their health insurance, in order to fund a massive tax cut for the very wealthy. Now they are back with the same basic repeal bill, but with the possible addition of two terrible ideas that would further undermine the ACA’s consumer protections, potentially stripping health insurance from millions more.
 
Under the new GOP plan, states would be allowed to drop two important provisions of the ACA: the requirement that insurance plans cover 10 Essential Health Benefits and provisions (known as “community rating”) to prevent insurance companies from discriminating against sick people.  There was also a report that Vice President Mike Pence had floated the idea of abandoning what is called “guaranteed issue” – essentially a requirement that insurance companies must offer you a health plan.

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.

 What are Essential Health Benefits and why do we need coverage for them?
 
One of the most important things the ACA did was require insurance companies to cover 10 important types  of health care called Essential Health Benefits. Examples include hospital stays, doctor visits, prescription drugs, maternity care and mental health services. Before the ACA, many insurance companies did not cover maternity care and mental health care and had skimpy coverage for other types of care.

If states are allowed to drop the Essential Health Benefits requirement, then insurance companies could sell plans that are 
cheaper but don’t cover very much. 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.

What is “community rating” and why do we need to keep it?

Under the ACA, insurance companies can't charge sick people more for the same coverage that they provide to healthy people in the same insurance market. This principle is known as “community rating” (versus “individual rating”) because insurance companies charge one premium based on the shared risk of the insurance pool instead of charging each person based on his or her individual health status. This keeps coverage affordable for the people who need it most and eliminates the extensive paperwork and reporting requirements of the pre-ACA days when insurance companies could discriminate based on health status.

If Republicans allow states to 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.
 
What would happen to people with pre-existing conditions?

People with pre-existing conditions, such as women with breast cancer, would be left without any affordable health plans that actually cover the care they need. This is exactly what happened in many states before the ACA.
 
Republicans in Congress say they would take care of people with pre-existing conditions by helping states to create what are called “high-risk pools.” A 
high-risk pool is made up of people who have pre-existing conditions and can’t afford health insurance that covers the care they need.

When 
high-risk pools were tried in the past, people with pre-existing conditions often had long waits (six to 12 months) before they could qualify. They needed to show documentation that they had a health condition, which could be difficult to do without insurance coverage to pay for the necessary tests. Not only that, even when people do get insurance through a high-risk pool, it still might not cover all the care they need.

Republicans say they will subsidize the cost of health insurance for people in those pools with a “stabilization fund” of $115 billion over 10 years. But people who have studied this plan say that wouldn’t be nearly enough money. They estimate it will cost between $200 billion to $1 trillion, and that would only cover a small proportion of the uninsured people with pre-existing conditions.

 

Thursday
Mar302017

Celebrate our victory, but don’t take your eyes off Washington!

 

We have a lot to celebrate in our come-from-behind victory over the proposed American Health Care Act (AHCA) last week, so here’s a toast to all our hard work! Together, we made the case that women, LGBTQ people, and our families would be hard hit by a bill that would have caused 24 million people to lose their health insurance, gutted Medicaid, blocked Planned Parenthood from accepting Medicaid and given almost a trillion dollars in tax cuts to major corporations and the very wealthy. Many thanks to all of our Raising Women’s Voices regional coordinators and all of you who raised your voices in defense of women’s health care.
 
But don’t take your eyes off Washington yet! Today, the Senate is taking a vote on a resolution that would allow states to deny Title X family planning funds to Planned Parenthood and other abortion providers. That’s even though Title X funds don’t pay for abortion services. Title X is an extremely important source of funding for the family planning services that low-income women, including many uninsured immigrant women, desperately need. Today’s vote would override a rule the Obama administration had issued blocking discrimination against Planned Parenthood in the Title X program.
 
Meanwhile, Republicans in the House of Representatives – smarting from a weekend of humiliating news coverage -- are talking about bringing the AHCA back to the House floor, possibly as soon as next week. We don’t know how seriously to take this talk, but we know hard-right Republicans are desperate to give Donald Trump a win and we know the entire conference is eager to pass
a round of massive tax cuts for the wealthy through ACA repeal (paid for by deep cuts to Medicaid!) before they officially start working on a tax package.
 
How did the AHCA fail last week?
 
Last Friday, House Republicans had to pull their bill from consideration when it became clear that they didn’t have votes to pass it on the House floor. In a desperate bid to shore up their right flank, leaders negotiated massive changes to the insurance markets in the dark of night, including stripping essential health benefit protections such as maternity and newborn care, prescription drugs, mental health care, and more from millions of women.
 
No one knows exactly how such a massive disruption to insurance regulations would have affected markets, because Republicans didn’t bother to consult Congress’s official scorekeeper, the Congressional Budget Office (CBO), before throwing the provision into the bill. But experts predict that it would have led to even worse coverage than before enactment of the ACA. With insurers still required to accept sick people, but no longer required to cover the medications, hospital visits, or other care those sick people require, insurers would race to design the skimpiest possible plans to lure in the healthiest possible enrollees. They’d also design plans just cheap enough that people could use their $2,000 tax credit, leading to the rise of, say, aromatherapy-only plans that bilk the government while providing no real benefit to taxpayers.
 
While much of the press coverage has focused on the extreme right wing group known as the House Freedom Caucus, it is clear that a number of those members were ready to cave right before the bill was pulled. So we must continue to take our fight to the “moderate” wing of the party, to any member sitting in a swing district, to any member whose state expanded Medicaid, and so on. Whether there’s a vote on this bill next week, a vote in May, or an attempt to pass parts of this legislation through must-pass bills later this year, our message must be clear: If you come for our care, we will come for you!
 
What are they likely to do next?
 
Even if this particular bad bill never again sees the light of day, we know they are far from done attacking women’s health. In Congress, members will have multiple opportunities for mischief. They hope to take on tax reform and may once again look to Medicaid as a piggybank. They need to fund the government for the remainder of the current fiscal year on April 28. They need to negotiate a budget that sets total appropriations for the next fiscal year. They need to prevent a debt default. They need to reauthorize the Children’s Health Insurance Program (CHIP), which forms a key backstop to the ACA.
 
Over in the executive branch, there’s considerable harm they could do even without congressional action. They could move to strip contraceptive coverage requirements or issue an executive order on “religious freedom” so broad that it nullifies most women’s health protections. In the aftermath of the House GOP’s failure last week, Trump repeatedly tweeted his seeming intent to sabotage the ACA and force it to “explode” in the hopes that voters blame his political opponents.
 
While numerous experts—including the CBO—believe that most ACA marketplaces are stable, the Trump administration could take actions to actively destabilize them. For example, the IRS could announce it was no longer enforcing the individual mandate, prompting the healthiest people to drop coverage and making premiums more expensive for everyone else.
 
What the IRS has actually done thus far represents the bare minimum of it complying with Trump’s inauguration day executive order. That order urged federal agencies to waive wherever possible “any provision or requirement” of the ACA that would impose any kind of “cost, fee, tax, penalty, or regulatory burden.” This year was the first year that the IRS was supposed to start turning away tax returns that didn't include self-reported health insurance information.
Instead, they very quietly let tax preparers know that they would continue to accept those returns as they always have. In short, the Trump administration could gut the individual mandate, but they haven't yet.
 
Equally disruptive, the Trump administration could stop fighting a lawsuit filed against the Obama administration by House Republicans in 2014 over subsidies paid to insurance companies to keep copays and deductibles low for low-income marketplace enrollees. Under the law, the insurance companies are required to provide the benefit, but without subsidies from the federal government, they would be forced to raise premiums or withdraw from markets. In an effort to keep markets stable, House Republicans and the Trump Department of Justice jointly agreed to delay the suit until May. Some Republican members of Congress have begun talking about formally appropriating these funds. But if they want to destroy the ACA from within, they’ll almost certainly start here.
 
Our job in all of these cases will be to remind Republicans that the politics of ACA sabotage have changed. Slowly degrading how Americans interact with the health system was great politics for Republicans under President Obama, when they could rightly or wrongly pin every problem on the law they nicknamed for him. But now that they control both Congress and the White House, voters will hold them accountable for how well the system functions.
 
Every single member of the US House of Representatives and one-third of the US Senate will be up for election in November 2018. It’s our job to let them know that we will hold them accountable for what happens in Congress and in the Trump administration. If the executive branch takes away our contraceptive coverage, if they harm ACA insurance markets, if they block women from accessing care at Planned Parenthood, we will hold them responsible at the ballot box.
 
Last week’s victory showed just how powerful we are when we make ourselves heard. The fight is far from over, but we know we can win it!

 

Friday
Mar242017

House leaders pull bill that would have devastated our health care


Rep. Jan Schakowsky, D- Illinois, stood on the House floor today and addressed Republicans who were announcing their support for the American Health Care Act (AHCA): “Did you really come to Congress to take health care away from 24 million people?”

No, as it turned out, not all of the Republicans thought that was a good idea. Thousands of calls from constituents and warnings from the Congressional Budget office about the likely impact of the bill apparently convinced enough Republicans that the AHCA was not ready for prime time. Last-minute changes to the bill to assuage the far-right House Freedom Caucus had made the bill even worse by opening the door for insurers to drop coverage for maternity care, hospital stays, prescription drugs, mental health care, cancer treatment and more. People with pre-existing conditions faced the possibility of exorbitant prices for health coverage.

Raising Women’s Voices joins our colleagues in the #ProtectOurCare coalition in a big sigh of relief that the American public has been spared this devastating bill – at least for now. We helped make the case to moderate Republicans that this bill went too far.

We extend our deepest thanks to all of Raising Women’s Voices regional coordinators, supporters and allies who helped make possible today’s action halting the AHCA in its tracks. Our families can rest easier tonight, with peace of mind that the health coverage we count on will still be there for us.

But, we must stay vigilant. This is only the first attempt to roll back the advances we have made with the Affordable Care Act! We must be mindful that a number of the Republican members of the House who refused to support the bill thought it didn’t go far enough!

As you celebrate tonight and this weekend, plan to stay with us going forward. We need to pull together to protect our health care in this turbulent political time.
Friday
Mar242017

Action Alert! #Killthebill that devastates women and families!


 

Overnight, House Republican leaders have once again amended the already awful proposed American Health Care Act (AHCA) and they are rushing to vote on it this afternoon. We must do everything we can to #Killthebill today and stop the momentum in Congress to repeal the Affordable Care Act (ACA) and cut Medicaid.


We already knew that the proposed AHCA would raise premiums 20 percent, charge older people five times more than young people, provide only skimpy subsidies, cut Medicaid, block women from using their Medicaid coverage at Planned Parenthood and cause 24 million people to lose their health insurance. The new amendments have made a bad bill even worse:
  • Maternity coverage would no longer be guaranteed. Nor would coverage for any of the Essential Health Benefits that women and our families need, such as ER visits, doctor visits and prescription drugs.
  • As a result, women would once again end up paying more than men. Anyone who needed maternity coverage (women of reproductive health age) would have to pay more for it. Trei Clark of Atlanta recalls paying $350 a month extra for maternity coverage before the ACA.
  • People with pre-existing conditions would end up having to pay exorbitant prices for health coverage. That’s because insurers would eliminate from their basic plans coverage for things like breast cancer treatment. Coverage for such treatment would become an expensive extra, effectively pricing health coverage beyond the reach of people with pre-existing conditions.
  • Because the ACA’s ban on annual or lifetime caps on coverage applied only to the Essential Health Benefits, when the EHBs are eliminated, insurers are free to once again impose annual and lifetime limits on coverage. This means that once again, we and our families could find ourselves running out of coverage part way through treatment for an illness, such as breast cancer, or accident. Once again, families could face bankruptcy because of skyrocketing medical bills.
What can you do?
  1. Call your members of the House of Representatives immediately! Here are the toll-free call-in numbers: English: 866-426-2631 Spanish: 877-736-7831
  2. Find a protest event near you and join it today! Check out ResistanceNearMe.org for events.
  3. Use social media to alert your family, friends and colleagues about this emergency call to action to save our health care. Check out the Raising Women’s Voices Facebook page at RWV4Healthcare.
Wednesday
Mar222017

The vote is here! Act now to save our health care!

We’re celebrating the seventh anniversary of the Patient Protection and Affordable Care Act (ACA), the biggest leap forward for women's health in a generation. Those first two words of the law’s name are often dropped for convenience but as we reflect on everything the law has done, it’s important to remember that “patient protection” is at the core of the ACA. It’s particularly important today, as we face a vote in the U.S. House of Representatives tomorrow on a bill that would partially repeal the ACA and change Medicaid as we know it in ways that will be devastating to women, LGBTQ people and our families.
 
What have we gained through the ACA?
 
The ACA has changed what Americans expect of their health system in ways that will make it difficult or impossible for Republicans to ever fully repeal, even as they attempt to strip insurance coverage from millions of people. Women are protected from being charged more than men for the same policy. We are guaranteed maternity coverage and other essential benefits that were often omitted from policies before the ACA. We cannot be denied coverage for a pre-existing condition. And our preventive services—ranging from mammograms and Pap tests to osteoporosis screenings and contraception—are covered without co-pay.
 
But the ACA has also empowered women in more subtle ways. Women live in poverty at higher rates than men do and we are much less likely than men to have employer-provided insurance in our own names. We’re also much more likely to serve as family caretakers. The “affordable care” part of the ACA means subsidies to help low- and moderate-income households purchase private insurance and an expansion of Medicaid for households living near the poverty line. The ACA’s subsidies are pegged to age, income, and cost of insurance, so they rise even if premiums do. As a result, the law has provided not only health benefits but also much greater financial independence and stability. These benefits have ranged from fewer missed housing payments to the freedom to leave an abusive partner.
 
But that’s not the only way that the ACA has worked toward affordable care. Under the law, insurance companies must spend at least 85 percent of the premiums they collect on health care, not executive salaries and bonuses, helping keep premiums lower. And out-of-pocket costs are capped to limit how much insurance companies can charge in deductibles and copays. And for seniors on Medicare, the ACA closes the prescription drug "donut hole," saving women millions of dollars in prescription drug costs.
 
What can we lose through ACA repeal?
 
On Thursday, House Republicans will vote on their bill to repeal key parts of ACA. The bill replaces the ACA’s subsidies with much skimpier financial assistance, slashing help for low-income families. It will also significantly raise premiums on people aged 50-64 and block women from using Medicaid at Planned Parenthood. Significantly, it will not only end the expansion of Medicaid but will also force deep cuts in traditional Medicaid. Half of all births in the U.S. are paid for by Medicaid.
 
The Congressional Budget Office (CBO), Congress’s official budget scorekeeper, concluded last week that the bill will lead to higher premiums, higher deductibles and co-pays, 7 million fewer people receiving insurance through their employer, and 24 million people losing insurance altogether.
 
One might wonder why Republicans are willing to spend so much time and political capital on a bill that will take coverage away from millions of their own supporters. But this bill goes far beyond the ACA. Perhaps its biggest goals are a massive tax cut for the wealthy paid for by a radical restructuring of original Medicaid. Under the guise of “Obamacare repeal,” this bill rewrites the rules for Medicaid, eliminating the federal government’s guarantee to cover a percentage of the costs of every eligible enrollee. The bill cuts $880 billion from Medicaid in the next decade
alone and uses those funds to provide tax cuts for corporations and the ultra-wealthy. Under the bill, the 400 richest households in America will receive an average tax cut of $7 million.
 
On late Monday, Republicans introduced an amendment re-writing over a third of their bill, promising to bring it up for a vote even before the CBO has a chance to update its score. The re-write includes a New York-only kickback of dubious constitutionality in order to win over moderate Republicans in the state. It allows states to impose work requirements for Medicaid that are guaranteed to punish women who serve as caretakers. It speeds up the tax cuts for major corporations and the wealthy. And it retains the ability of insurance companies to charge older Americans five times more than younger ones. Perhaps most shockingly, the amendment pretends to make the tax credits for purchasing insurance more generous for seniors without actually changing the subsidies at all.
Instead the bill simply kicks the can to the Senate to figure out.
 

With five open seats in the House, Republicans need 216 votes to pass the bill. Every Democrat is expected to oppose, meaning just 23 Republican no votes could sink the bill. Because the bill accepts (however grudgingly) the principle that government has a role to play in helping people afford health care, it has angered hard-right conservatives who have labeled it “Obamacare Lite” and have called for a full repeal without a replacement. Furthermore, some of the provisions included to win conservatives’ support—such as attacks on abortion coverage in private insurance—could be stripped out under Senate parliamentary rules. This group in the House—the Freedom Caucus—has threatened to vote no, but their opposition could crumble in the face of lobbying by the White House. In contrast, a number of vulnerable Republican moderates have signaled their openness to support the bill, even though Donald Trump remains unpopular in their districts and they could be facing steep re-election prospects for 2018.

If the bill passes the House, Senate Republicans are expected to bring it straight to the floor next week with no committee action at all. It would be the first health care bill of its size to ever be rammed through without a single hearing or amendment in the Senate Finance Committee. As in the House, every single Democrat in the Senate has publicly committed to oppose and just three Republican senators could sink the bill.
 
But we need to stop the bill before it gets any momentum.
 
What can we do to stop this attack on our health?

First, and most important, we must CALL our members of the House of Representatives! You can use Community Catalyst’s Take Action Page to find the name and phone number of your member, or if you already know who your representative is, call the U.S. House of Representatives switchboard at 202-225-3121. Your calls matter. Urge your representative to vote NO—and ask family and friends to call their representatives too.

Second, you can participate in a local phone bank or join a protest in your community. Look for events and phone banks near you through lists managed by the Center for America Progress, Organizing for America, and other alliesIt's critical to make your voice heard both BEFORE and AFTER Thursday's vote.

Our regional coordinators have been hard at work showing their support for the ACA. On Wednesday, RWV-NY’s Cindi Azuogu participated in New York City as health care advocates and consumers of health care gathered in Manhattan’s Foley Square to speak out about the importance of Medicaid to so many New Yorkers—whether they are seniors, people with HIV, people with mental illness, moms or kids. People who are worried about losing their Medicaid coverage chanted, “We are not disposable!”

At a press conference in Annapolis on Monday, Consumer Health First, our Maryland regional coordinator, joined Congressmen Elijah Cummings (D-MD 7), Steny Hoyer (D-MD 5), John Sarbanes (D-MD 3), and Jamie Raskin (D-MD 8) in calling on Governor Larry Hogan (R) to speak out publicly in opposition to the Republican repeal bill. If it is enacted, 390,000 Marylanders will be at risk of losing their health care coverage, and Maryland will lose $1.4 billion in Medicaid funding. “It is our watch to pave the way for generations yet unborn. Fighting for what we believe—
healthcare as a human right—is NOT grandstanding,” Representative Elijah Cummings (pictured) told the crowd.

Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR), our regional coordinator based in Denver,  attended a local town hall on “Transparent and Affordable Health Care” at West High School in Denver. Town hall attendees packed the school gym, where they heard from first Latina Speaker of the Colorado House of Representatives Crisanta Duran (D-Denver), Lt. Governor Donna Lynne (D), and Colorado State Representatives Daneya Esgar (D-Pueblo), Susan Lontine (D-Denver), and Janet Buckner (D-Aurora). They discussed the work they are doing to expand access to affordable health care in Colorado, and what their next steps at the state level will be if the ACA is repealed. Members of the audience expressed concerns about the GOP’s proposed changes to the ACA, including its impact on Medicaid and Medicare. COLOR tabled at the event (pictured above: Alicia Ybarra, Operations Manager; Gina Millán, Community Organizer; Gianella Millán, COLORistx), where they distributed bilingual RWV “What’s at Stake” materials. 

RWV’s regional coordinator in Maine, Consumers for Affordable Health Care, partnered with AARP Maine, Planned Parenthood Maine Action Fund, and Maine Medical Association at King Middle School in Portland for "My Health Care Town Hall." See live video from the town hall here.

London Lamar, policy associate for RWV’s coordinator in Tennessee, SisterReach, and staff got the crowd fired up at the #ResistTN Rally in Nashville, Thursday, March 16 advocating to protect the healthcare of women of color, rural women, and poor women! The rally was done in partnership with Planned Parenthood. Check it out here.
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