Our fight against TrumpCare

This is the most important week in our fight against TrumpCare.
Republicans are planning a vote THIS THURSDAY. But Republicans still don’t have the votes. This truly could go either way. This is the moment constituent power was made for. This is the time to stand up.

It’s imperative to keep up the pressure on our two senators. With a vote anticipated on Thursday, June 29, the only thing standing in Republicans’ way is YOU.

Contact our Senators today and every day this week to tell them to vote NO! on Trumpcare.

Ask to speak to the staffer who deals with healthcare!

Senator Ted Cruz, (202) 224-5922, Joel Heimbach, joel_heimbach@cruz.senate.gov

Senator John Cornyn, (202) 224-2934, Beth Nelson, beth_nelson@cornyn.senate.gov

The bill is scheduled to be voted on Thursday, July 29. Sample scripts:

Hello, my name is _______. I am a constituent and I am calling to ask the senator to vote against repealing and replacing the Affordable Care Act with the American Health Care Act. It’s critical that the provisions and benefits of the Affordable Care Act remain in place. Since its passage, 20 million Americans have gained health care coverage, and our country is enjoying a record low uninsured rate. http://www.cnbc.com/2017/02/14/the-rate-of-uninsured-americans-hits-a-record-low-as-obamacares-future-remains-a-question-mark.html

Hello, my name is _____ calling from zip code in your town. I am strongly opposed to Trumpcare because it guts Medicaid, defunds Planned Parenthood, punishes people with pre-existing conditions, and repeals health insurance for millions of Americans. Thank you for your time.

Check out three new Indivisible explainers to combat the most common talking points we’re seeing from Republican Senators (because facts matter):

  1. The Senate Bill Fails People with Pre-Existing Conditions https://www.indivisibleguide.com/resource/senate-trumpcare-bill-fails-people-with-pre-existing-conditions/

In order to give billions of dollars in tax breaks to the wealthy and corporations, it makes the deepest cuts to Medicaid in its 52-year history. Not only does it end the Medicaid expansion, it fundamentally (and permanently) alters Medicaid in a way that threatens the well-being of low-income families across the country.

Another terrible part of the bill is that it ends guaranteed protections critical for people with pre-existing conditions. You may have heard just the opposite—that people with pre-existing conditions are protected, and that this version of TrumpCare is “nicer” or “better” than the House version for that reason. Don’t fall for it. It’s still much worse than current law. And, if you’re one of the 130 million Americans with a pre-existing condition, you could be the one paying the price.

HOW THE AFFORDABLE CARE ACT PROTECTED PEOPLE WITH PRE-EXISTING CONDITIONS

The ACA has a provision requiring insurance companies to set premiums rates by “community rating,” which, when translated from wonk to English, means that people with pre-existing conditions can’t be charged more for insurance than those without. It worked.

This provision works hand-in-hand with another ACA protection for consumers, the requirement that all health plans cover “essential health benefits.” This is the menu of different coverage benefits insurers are required to cover, and it includes maternity care, mental health, and prescriptions. If plans aren’t required to cover needed benefits, especially care that people with pre-existing conditions need, it doesn’t matter whether you’re protected from being charged more for plans, because insurance companies can design plans to explicitly deter people with pre-existing conditions from enrolling. “Community rating” doesn’t work unless backed up with “essential health benefits.”

HOW THE SENATE VERSION OF TRUMPCARE CHANGES THIS

The Senate bill allows states to opt-out of covering essential health benefits, which means insurance companies can stop offering plans that cover the kind of services people with pre-existing conditions need. This has the effect of driving up the price for consumers for plans that offer the broader coverage they need, likely to the point where no one could afford it.

In other words, the Senate TrumpCare bill gives insurers a backdoor way of discriminating against people with pre-existing conditions.

DON’T BELIEVE THEM WHEN THEY SAY PEOPLE WITH PRE-EXISTING CONDITIONS ARE PROTECTED

Here’s the bottom line: under current law, people with pre-existing conditions have guaranteed access to health insurance that covers the care they need. They cannot be discriminated against for having a pre-existing conditions. Under the Senate TrumpCare bill, those protections go away. If affordable plans don’t cover the services someone with pre-existing conditions needs, it doesn’t matter whether they have access to it or not.

  1. The Senate Version of TrumpCare = Higher Costs for Consumers, https://www.indivisibleguide.com/resource/senate-version-trumpcare-higher-costs-consumers/

It would drive costs for consumers way up. Even if your Senator claims to be a “no” on this bill right now, don’t fall for the charade. It’s all a trick. It’s so that they can later claim that they’ve worked to “fix” the bill, when in reality this bill is beyond repair. Here’s what consumers can expect under the Senate version of TrumpCare, and why you should tell your Senator to vocally and unwaveringly oppose it.

PREMIUMS WILL GO UP

Like the House version of TrumpCare, you can definitely expect premiums to go up if the Senate version becomes law. That’s in part because it allows insurance companies to charge seniors more than they can under current law. TrumpCare also gets rid of what’s called the “individual mandate,” the requirement that people have health insurance or face a penalty. This key feature of the Affordable Care Act is what kept premiums from rising more steeply.

CONSUMER COSTS WILL INCREASE WHILE SUBSIDIES GO DOWN

The percentage of consumer costs covered by plans will decrease. Currently, plans have to cover at least 70% of the health care costs incurred by a consumer. TrumpCare drops that number to 58%, meaning consumers could see their out of pocket costs go up for things like co-pays and prescriptions. It will be much more expensive for you if you get sick or injured.

At the same time, TrumpCare reduces help to consumers buying insurance. Current law provides many Americans tax credits that offset the cost of their monthly premiums. The tax credits are available to anyone who makes less than 400% of the Federal Poverty Level. (In 2016, that is about $48,000 for a single person.) The Senate version of TrumpCare lowers that threshold to 350%—meaning higher premiums for middle-class families. But it gets worse: the tax credits under TrumpCare would be pegged to a lower-quality plan in your area. So not only will tax credit be less, they won’t go as far. And that affects anyone who receives them.

HIGHER COSTS FOR WORSE BENEFITS AND SERVICES

TrumpCare provides a loophole for insurance plans participating in the exchanges that allows states to get waivers of what are called “essential health benefits” (EHBs). EHBs define the menu of health care services that insurers must cover, including maternity care, mental health care, and prescriptions. If insurance plans aren’t required to cover certain services, then the health insurance is meaningless. By allowing waivers of EHBs, TrumpCare sends people back to the days of skimpy health plans and deciding whether to buy prescription drugs this month or eat. And, if consumers want better services, they’ll have to pay for them out of pocket, at a drastically higher price.

CONSUMER REBATES END ALONG WITH KEY INSURANCE RESTRICTIONS

Another feature of the the ACA is a requirement that insurance companies use money paid by consumers on actual health care services, and not wasted on other things. More specifically, plans must spend at least 80% of the premiums collected on providing actual health care, and not on administrative costs, marketing campaigns, CEO salaries, or—most importantly—profits. This ACA requirement returned a staggering $396 million to 4.8 million families in 2015. On average, families that paid premiums got a rebate of $138 back, taken out of shareholder profits. But TrumpCare would get rid of this starting next year. After that, it’s up to individual states to decide whether they’ll keep protecting consumers from insurance plans’ wasteful spending.

  1. The Senate Version of TrumpCare Destroys Medicaid As We Know It, https://www.indivisibleguide.com/resource/senate-trumpcare-bill-destroys-medicaid-know/

Perhaps the worst part is what it would do to Medicaid. In order to give billions of dollars in tax breaks to the wealthy and corporations, TrumpCare makes the deepest cuts to Medicaid in its 52-year history. Not only does it end the Medicaid expansion, it fundamentally (and permanently) restructures Medicaid in a way that threatens the well-being of low- and middle-income families across the country.

Even if your Senator claims to be a “no” on this bill right now, don’t fall for the charade. It’s all a trick. It’s so that they can later claim that they’ve worked to “fix” the bill, when in reality this bill is beyond repair. This is especially true for Senators who will tell you they worked to get a longer “glidepath” or “phaseout” for Medicaid. They have no plans for how to transition their state out of Medicaid—whether it’s in 3, 5, or 7 years. Here’s how this bill destroys Medicaid as we know it, and why you should demand that your Senator vocally and unwaveringly oppose it.

IT ENDS THE MEDICAID EXPANSION

One of the key ways the Affordable Care Act so successfully increased the number of people with health care coverage was by expanding the groups of Americans that are eligible for Medicaid. 11 million  Americans got coverage through the expansion of Medicaid. And, importantly, this expansion is paid almost entirely by the federal government—at 100 percent initially and then at 90 percent after 2020. This means that states can insure more of their residents without incurring many additional costs. It’s a win for states and a win for hardworking American families. If passed, TrumpCare would end that expansion, wiping out those important gains and putting American families at risk.

A MEDICAID “PHASE-OUT” STILL RIPS HEALTH CARE FROM MILLIONS OF AMERICANS

“Moderate” Republicans who have negotiated parts of the bill in recent weeks claim to have lessened the blow by “phasing out” the expansion starting in 2021. But whether the expansion ends now or ends later, what it means in real terms is that millions of Americans will lose their coverage. It means that individuals who are now eligible for Medicaid will be unable to enroll, and many will be left without any coverage options at all.

IT FUNDAMENTALLY TRANSFORMS TRADITIONAL MEDICAID

Not only does the Senate version of TrumpCare end Medicaid expansion—it also makes deep cuts into traditional Medicaid. We can’t overstate what a fundamental remaking of Medicaid this is. Currently, Medicaid is an open-ended commitment. If you’re covered by Medicaid and you receive medical care, the federal government helps the state pay your insurance company for the services you received. And just as importantly, if you happen to be eligible for Medicaid, you get it. Period.

That is not the vision contemplated by TrumpCare: for the first time, Medicaid funding would be capped under a system called “per capita caps.” This means that access to Medicaid, even if you’re eligible, won’t be guaranteed. In practice, the caps in the Senate TrumpCare bill mean Medicaid funding will be cut deeper and deeper each year, covering fewer people, fewer services, or both. That’s because the growth rate for Medicaid funding laid out by the bill doesn’t grow as fast as medical costs. What does all this mean In real terms? Millions of Americans would have to go without the care they need. Some might find themselves on waiting lists, and others on plans that are inferior to what they get now.

IT HURTS THE ELDERLY, CHILDREN, AND PEOPLE WITH DISABILITIES THE MOST

A common misconception is that Medicaid is program that only serves low-income Americans. The truth is that Medicaid helps more people than commonly thought. Sixty-four percent of all nursing home residents use Medicaid. Seventy-six percent of all low-income children receive some kind of help from Medicaid. Children with disabilities receive Medicaid-funded help in school, even for services like speech-pathology, which this bill would end. In all, 20 percent of all Americans get some kind of help from Medicaid. This bill threatens all of them.

Trumpcare isn’t about health. It’s a tax cut for the 1%, Robert Reich
https://www.theguardian.com/commentisfree/2017/jun/26/trumpcare-health-tax-cut-1-percent

A side-by-side comparison of Obamacare and the GOP’s replacement plans
http://www.latimes.com/projects/la-na-pol-obamacare-repeal/