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affordable care act
With Trifecta Secured, GOP Already Eyeing Destructive Healthcare Cuts
"If there are a lot of details still to be filled in," wrote one analyst, "the theme of the GOP's healthcare agenda is clear: cuts."
Nov 14, 2024
Having secured control of both chambers of the U.S. Congress and the White House starting in January, Republicans are making no secret of their intention to pursue sweeping healthcare cuts that would raise costs and imperil insurance coverage for millions of people across the country.
Rep. Jodey Arrington (R-Texas), chairman of the House Budget Committee, told reporters earlier this week that the GOP is looking to use the filibuster-evading reconciliation process to pursue cuts to "mandatory programs"—a category that includes Medicare, Medicaid, and Social Security.
Bobby Kogan, senior director of federal budget policy at the Center for American Progress, noted in response to Arrington's comments that Republicans attempted to cut both Medicaid and Affordable Care Act (ACA) tax credits that help enrollees afford health insurance.
The Republican Study Committee, of which Arrington is a member, proposed eliminating the ACA tax credits in its 2025 budget proposal—a move that could result in around 4 million people losing insurance.
The tax credits are set to expire next year, meaning Republicans could just do nothing and allow them to lapse.
Last time Republicans had a federal trifecta, they tried and failed to fully repeal the ACA—an effort that sparked a
wave of civil disobedience on Capitol Hill.
Both President-elect Donald Trump and House Speaker Mike Johnson (R-La.) said on the campaign trail that they're looking to try again.
"We're going to replace it," Trump said during his lone debate with Vice President Kamala Harris in September—while admitting that he did not have a fully formed alternative plan.
Johnson, for his part, said during a campaign stop in Pennsylvania last month that "healthcare reform's going to be a big part of the agenda." When a voter posed the question, "No Obamacare?" Johnson replied in the affirmative, "No Obamacare."
"The ACA is so deeply ingrained, we need massive reform to make this work," he added, "and we've got a lot of ideas on how to do that."
Sarah Lueck and Allison Orris of the Center on Budget and Policy Priorities
wrote Wednesday that Trump's return to the White House and the GOP's capture of both chambers of Congress poses "big risks to people's ability to access and afford health coverage in Medicaid and the marketplaces."
"While Republicans have moved away from talking about their plans for changing health coverage in the U.S. as 'repeal,'" Lueck and Orris added, "Trump's first term and Republicans' recently released policy agendas suggest they may pursue policies that would have much the same result: higher costs for people, reduced access to care for vulnerable groups, and more people who are uninsured."
"Just as a grassroots movement of Americans around the country succeeded in saving the Affordable Care Act during Trump's first term, we can save Social Security and Medicare."
Even if Republicans don't succeed at enacting major legislative changes to the nation's healthcare system, Trump will still have the power to do significant damage unilaterally. Lueck and Orris noted that the first Trump administration "took numerous administrative steps that made it harder for eligible people to get coverage" and weakened consumer protections, from adding new paperwork requirements to the Medicaid enrollment process to expanding so-called "junk" insurance plans.
Vice President-elect JD Vance also suggested during the 2024 campaign that a second Trump administration could seek to roll back protections for people with preexisting conditions.
"If there are a lot of details still to be filled in, the theme of the GOP's healthcare agenda is clear: cuts," Vox's Dylan Scott wrote days before the November 5 election. "Cutting regulations. Cutting spending."
Stephanie Armour of KFF Health Newswrote following Trump's victory that his second term "will likely bring changes that scale back the nation's public health insurance programs—increasing the uninsured rate, while imposing new barriers to abortion and other reproductive care."
Medicaid is particularly vulnerable, Armour noted, with Trump and the Republican Party potentially set to pursue "the imposition of work requirements on beneficiaries in some states" and changes to how the program is funded.
"Now, the federal government pays states a variable percentage of program costs," Armour explained. "Conservatives have long sought to cap the federal allotments to states, which critics say would lead to draconian cuts."
As for Medicare, the Project 2025 agenda authored by many former members of Trump's first administration calls for making privatized Medicare Advantage plans the default enrollment option for the nation's seniors—a change that advocates say would pose an existential threat to traditional Medicare.
"Trump and Republicans will try to cut our earned benefits," Alex Lawson, executive director of the progressive advocacy group Social Security Works, warned in an op-ed for Common Dreams on Wednesday. "But just as a grassroots movement of Americans around the country succeeded in saving the Affordable Care Act during Trump's first term, we can save Social Security and Medicare."
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Trump's Healthcare Policies Nearly Killed Me. We Are Not Going Back
We will not go back to the terror that 135 million Americans with preexisting conditions felt in 2017 under the first year of Trump's rule, knowing that we could lose access to care at any moment.
Nov 01, 2024
Today is Michigan. Yesterday was Wisconsin. Tomorrow is Ohio. I’ve been traveling on the road with Protect Our Care on a big blue bus for six weeks with an important message. The Affordable Care Act saved my life, and we're not going back.
Back in 2017, I walked into a doctor's office with a cough, and walked out with a cancer diagnosis. I thought I was a healthy 40-year-old small-business owner, but was stunned to learn I had stage 4 Hodgkin lymphoma. Thankfully my insurance covered the treatments that have me in remission today.
White-knuckle days of chemotherapy and nights of after effects for a grueling six months, then many weeks of radiation followed. Surviving and recovering should have been my sole focus. But instead I had to drag myself through treatments, then to rallies and press conferences: begging former U.S. President Donald Trump and the Republican-controlled Congress not to strip away the insurance I needed to save my life.
Nearly a decade after Donald Trump promised us a healthcare plan, he only has "concepts of a plan". Neither doctors nor hospitals accept concepts in lieu of payment.
The day after my first chemotherapy session, while I was on the couch trying not to die, MAGA Republicans in the U.S. House egged on by Trump voted to repeal Obamacare. And then threw a party to celebrate.
We cannot go back.
So we're rolling forward on the Care Force One bus: traveling the country and sharing our healthcare stories, and coming to a city near you in these final days.
We will not go back to the terror that 135 million Americans with preexisting conditions felt in 2017 under the first year of Trump's rule, knowing that we could lose access to care at any moment without the protections of the ACA. Will we not go back to annual or lifetime limits on care. Being denied an insurance policy because of our past medical history. Kids under 26 relying on insurance through their parents' plans could lose it. Over 10 million of us (including me) had insurance directly through the health insurance marketplace. And over 15 million of us had insurance through Medicaid expansion in our states—also a part of the ACA.
Since the Affordable Care Act was passed in 2010, America has made further healthcare advances—including the Inflation Reduction Act of 2022 solely thanks to President Joe Biden, Vice President Kamala Harris, and Democrats in Congress. This law caps insulin copays for people on Medicare at $35 a month, provides subsidies for health insurance for middle class families, and finally allows Medicare to negotiate lower drug prices.
Checking the news every morning back during Trump's first term led to a sense of dread at whatever cruel back-of-the-envelope plan that Trump or Republicans would produce that day. These "plans" never expanded our healthcare or made it better, just threw vulnerable Americans to the wolves to pay for tax breaks to rich people. We cannot go back to that chaos and terror.
Nearly a decade after Donald Trump promised us a healthcare plan, he only has "concepts of a plan". Neither doctors nor hospitals accept concepts in lieu of payment.
His running mate JD Vance spilled the beans: The "concepts" include letting insurers cover only young and healthy people, and sending everyone else back to high-risk pools, which were notoriously underfunded and unable to protect people who need it most. And now Speaker Mike Johnson (R-La.) promises "No Obamacare."
It's like they don't understand the basic idea of insurance: everybody in one risk pool together, so that costs don't spiral out of control for the people who need it. If you stop covering people as soon as they get sick, of course insurance gets cheaper. This is like only offering blizzard damage insurance to Floridians, or hurricane damage insurance to Midwesterners–it's missing the entire point.
Republicans want to repeal and replace the Inflation Reduction Act now too.
We've seen the Heritage Foundation Project 2025 healthcare agenda, and it's not pretty. In the absence of plans of his own, will Trump and the entire Republican party just follow their playbook? That's what it was designed for, a detailed blueprint for the next Republican president starting on Day 1.
Whereas the Kamala Harris healthcare agenda would build on the gains of the Affordable Care Act and Inflation Reduction Act. Her administration would expand health coverage to more Americans, and lower drug prices for everyone.
We know what the candidates want to do and who their priorities are for. The choice is yours to make this fall: do we go forward, or do we go back?
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What the Inflation Reduction Act Has Meant for Healthcare 2 Years Later
From the $35 insulin co-pay to capping insurance premium costs, the legislation has been health-changing and life-changing.
Aug 30, 2024
I was honored to be at the White House this month for the Inflation Reduction Act anniversary event, featuring Americans sharing their stories of saving money and saving lives.
Thank you to the millions of people fighting every day for lower drug prices, to Congress for passing the Inflation Reduction Act, U.S. Vice President Kamala Harris for casting the deciding vote in the Senate, and President Joe Biden for signing it into law.
Meet Bob Parant, from New York. He’s a 71-year-old man who has been living with type 1 diabetes for over fifty years. He lost his leg in 2010, and became eligible for Medicare. Before the Inflation Reduction Act, the last price Bob paid for a vial of insulin was $580, which was “horrendous.”
We have made so much progress on healthcare. But as everyone reading this knows, there is so much more to do.
Listen to Pam Parker, from Maryland: She’s a retired electrician, 62 years old, and has been diabetic since she was 30. “I had to decide, a lot of months, between mortgage, groceries, utilities, and other things… I would juggle my expenses, and really juggle my healthcare.. I would eat less, or ration my insulin to make it last.. I had high blood pressure, I fell into a coma, my kidneys failed… they told me I coded.”
Learn from Robin Craycroft, from Missouri: When she turned 65 and had access to Medicare, the pharmacist told her that one insulin for three months was $3,000. “Everything that we had planned, cancelled, and our life just changed. And I felt such guilt over that… We’re gonna spend $2,000 a month (two insulin vials) to keep me alive. You start going through, am I worth it? Should I do that to [my husband]?”
Hear Steven Hadfield, from North Carolina: “Before the $35 cap, sometimes you had to skip a dose, sometimes you had to not test yourself, watch what you eat because you couldn’t afford it…”
The $35 insulin co-pay cap for people on Medicare is just one of the health-changing and life-changing parts of the Inflation Reduction Act.
This year, people on Medicare have their out of pocket Part D drug costs capped at around $3,500. And next year, the maximum drops down to $2,000. This means seniors on a fixed income won’t have to choose medicine over food or housing or anything else. Also recommended adult vaccines such as the new shingles vaccine are now free for Medicare recipients.
Pharmaceutical companies that raise their prices higher than inflation are required to pay Medicare a rebate, to encourage them to stop price gouging patients. And in 2026, price negotiations for the first 10 drugs under Medicare go into effect: lowering the costs of those drugs for millions of Americans. The savings will continue for patients and taxpayers as more drug prices are negotiated each year.
But the Inflation Reduction Act doesn’t just help people on Medicare. Over 21 million Americans like me get their health insurance through the Affordable Care Act marketplaces. When I was diagnosed with stage 4 cancer in 2017, I did not qualify for financial help for insurance. Thankfully I was able to afford a plan anyway, and to pay the maximum deductible for that year. A bargain compared to the over half a million dollars it cost to save my life.
I am so grateful to still be here, and for the Affordable Care Act made truly more affordable to millions of working Americans like me.
The American Rescue Plan, and then the Inflation Reduction Act, provided financial help for health insurance to many more who needed it. This law caps the cost of premiums at no more than 8.5% of your income, meaning people—especially older folks who face higher premiums, or people in more expensive healthcare markets—don’t get penalized, and can still afford the care they need.
We have made so much progress on healthcare. But as everyone reading this knows, there is so much more to do.
First, we have to defend the advances in the Inflation Reduction Act. A new administration and a new Congress next year means everything we’ve gained could be on the chopping block.
Second, the health insurance tax credits piece expires in 2025. Without that renewal, millions of Americans would go back to being priced out of health insurance.
Third, the Medicare provisions such as the $35 insulin cap, the drug price negotiation, and more, need to be expanded to everyone.
We are grateful to still be here, and to keep fighting until every American can get the healthcare they need. We cannot go back.
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