This blog post is a continuation of everything significant that happened with Obamacare, Medicare, Medicaid, and access to reproductive health care in the United States in 2019. Part Three left off at the end of June of 2019. This blog picks up in July of 2019.

You may want to go back and take a look at the efforts that the Trump administration and the GOP made to destroy people’s access to health care in 2017 and in 2018.

The purpose of this series of blog posts is to make it incredibly easy find information about what happened to health care access during the Trump administration.

July 1, 2019: The Hill posted an article titled: “Overnight Health Care: Panel of judges set for ObamaCare case | Trump officials delay ‘ conscience protection’ rule | Theranos founder to go on trial for fraud next summer”. It was written by Peter Sullivan. From the article:

Panel of judges set for big ObamaCare court case next week

The three-judge panel on the Fifth Circuit Court of Appeals that will hear the lawsuit seeking to overturn the Affordable Care Act was revealed on Monday.

The judges for the July 9 arguments are Carolyn King, Jennifer Elrod and Kurt Englehardt. King was appointed by President Jimmy Carter, while Elrod and Englehardt were appointed by President George W. Bush. That means there are two Republican-appointed judges to one Democratic-appointed judge.

Most legal experts in both parties view the lawsuit’s legal argument challenging the health care law as extremely weak and think that eventually ObamaCare will be upheld.

But there are still a lot of question marks around the case, especially after the court last week asked whether the blue states arguing to uphold the health law even have the legal standing to be involved…

Trump administration delays implementation of ‘conscience protection’ rule

The Department of Health and Human Services (HHS) is delaying the implementation of its “conscience protection” rule until November to give the administration more time to deal with a lawsuit over the policy.

HHS announced in a court filing Saturday that the rule, which was originally scheduled to take effect July 22, would not be implemented until Nov. 22 at the earliest.

A coalition of Democratic-led states filed a lawsuit against the administration in May saying the policy, which would allow health care providers to refuse to provide services on the basis of their religious beliefs, is unconstitutional…

…Background: President Trump announced the policy in May, which proponents say would protect health care workers and institutions from having to violate their religious or moral beliefs by participating in abortions, providing contraception sterilization, or performing other procedures…

July 1, 2019: NPR posted an article titled: “Court Order Delay Of Trump Administration’s Health Care ‘Conscience Rights’ Rule”. It was written by Selena Simmons-Duffin. From the article:

The federal government’s rule designed to support health workers who opt out of providing care that violates their moral or religious beliefs will not go into effect in July as scheduled. The effective date has been delayed by four months, according to court orders.

The “Protecting Statutory Conscience Rights in Health Care” rule was originally issued in May by the Department of Health and Human Services’ Office for Civil Rights. It aligns with that office’s religious freedom priorities and would put new emphasis on existing laws that give health care workers the ability to file a complaint with that office if they are forced to participate in medical care that violates their conscience – such as abortion, gender confirmation surgery, and assisted suicide.

As NPR reported, the rule also expands the type of workers who are able to file this kind of complaint to billing staff and receptionists and anyone else who in any way “assist[s] in the performance” of a procedure…

…Several groups sued the federal government over the rule immediately after it was issued. New York state led a coalition of 23 cities and states in one suit, and three jurisdictions in California also sued, including California state and San Francisco. Yet another plaintiff, Santa Clara County in California’s Bay Area, made the case that the rule put patient safety at risk, since it gave health workers the right to opt out of providing care without prior notice – potentially even in an emergency…

…Santa Clara and several other plaintiffs had filed for a preliminary injunction to prevent the rule from going into effect while the legal process played out…

…The new effective date is Nov. 22 – the federal judge in the California cases make that official over the weekend, and in the New York case, the federal judge certified the change on Monday…

July 1, 2019: CNBC posted an article titled: “Nancy Pelosi’s latest Medicare proposal would pass drug discounts to all consumers”. It was written by Berkeley Lovelace, Jr. From the article:

House Speaker Nancy Pelosi’s latest draft of legislation allowing Medicare to negotiate lower drug prices would also apply those discounts to private health plans across the U.S., according to a senior Democratic aide.

The Department of Health and Human Services is currently prohibited from negotiating drug prices on behalf of Medicare – the federal government’s health insurance plan for the elderly. Pelosi has been working for months on a plan that would give HHS that power, which private health insurers already have. The most recent draft of the legislation proposes to extend those cost savings to private insurance plans, the aide said, asking not to be identified because the legislation is still being drafted and could change.

Kaiser Health News first reported the news…

…It’s unknown if Pelosi’s plan would apply to all drugs. But according to Kaiser, it would authorize HHS to negotiate the prices of the 250 most expensive drugs.

July 1, 2019: The American Medical Association (AMA) posted news titled: “Supreme Court to Medicare: Seek feedback before changing rules”. It was written by Contributing News Writer American Medical Association Tanya Albert Henry. From the news:

A recent U.S. Supreme Court ruling ensures that Centers for Medicare & Medicaid (CMS) officials must tell the public about proposed changes to Medicare benefits – even if they seem minor – and give physicians and other stakeholders a chance to comment on modifications’ potential impact.

Physicians are cheering the ruling, as the outcome is one the Litigation Center of the American Medical Association and State Medical Societies advocated for in a friend of the court brief filed in the case before the high court on behalf of the AMA and the Medical Society of the District of Columbia. Physicians told justices that “even ‘seemingly minor’ modifications in reimbursement determinations give rise to extreme financial consequences for providers and ultimately their patients.”

The majority opinion, written by Justice Neil Gorsuch, opens by saying that in “one way or another, Medicare touches the lives of nearly all Americans,” noting that it provides health insurance for nearly one-fifth of the nation’s population. In explaining its reasoning for requiring the Department of Health and Human Services (HHS) to seek input, the court echoes arguments that the Litigation Center brief made about the importance of a notice-and-comment period for physicians, patients, and other stakeholders…

July 1, 2019: University of Wisconsin-Madison News posted an article titled: “Wisconsin Medicaid expansion lowered antidiabetic drug costs 70%”. It was written by Katie Gerhards. From the article:

…A new study by a team of University of Wisconsin-Madison researchers shows that Wisconsin Medicaid’s 2004 coverage expansion had a tremendous impact on making antidiabetic drugs more affordable for one of the state’s populations that needs them the most: childless adults with low income.

Although Wisconsin did not participate in the Affordable Care Act Medicaid expansion, legislators approved a limited expansion through a Section 1115 Medicaid Demonstration Waiver. Effective 2014, this waiver expands coverage for childless adults earning up to 100% of the federal poverty level.

Previously, this group had been covered by the BadgerCare Plus Core Plan, with covered fewer medications and had higher copays for generic and brand-name drugs. Transitioning from the Core Plan to the more comprehensive Standard Plan dropped out-of-pocket costs for antidiabetic medication by an average of 70 percent per childless adult, or $36.59 per year.

The expanded coverage also correlated with a 4 percent increase in childless adults using antidiabetic medications, such as insulin and oral medications like metformin. That increase is largely driven by a growing number of people using medication, suggesting affordability might have been an obstacle before the coverage expansion…

July 1, 2019: IndyStar posted an article titled: “State calls new rules ‘Gateway to Work.’ Activists call them a ‘poverty trap.'” It was written by Shari Rudavsky. From the article:

…The requirements began Monday. People covered under the Healthy Indiana Plan are expected to work at least 20 hours per month. That number will slowly climb until July 2020, when Medicaid recipients will need to show that they have worked, volunteered, studied, or acted as a caregiver for 80 hours each month.

State officials have said the Gateway to Work program will encourage low-income Hoosiers to find employment and improve lives. They said the program will support Hoosiers as they transition to employment at the same time it requires them to have “some skin in the game.”

Those who oppose the work requirements point to Arkansas, where an estimated 17,000 people have lost health insurance since work requirements went int effect in June 2018.

But officials for the Family and Social Services Administration have said the road map for Indiana looks nothing like the one overseen in Little Rock. They have estimated that about 20 percent of those currently on the Healthy Indiana Plan, or about 85,000 people, will be affected by the work requirement.

At the start, FSSA officials have said they will operate under “an economy of trust” and allow HIP recipients to log their work hours without requiring outside documentation.

Still, activists say they fear the new requirements will lead those in need to lose precious coverage, coverage that many value…

…Even if the system works as well as it can be expected, some recipients could still find it challenging to meet the requirement that they log on monthly to prove their eligibility, said Donna Neidnagel, a Brown County resident who spoke Monday.

Only about a third of people who are full-time residents in Brown County have access to the internet. Many people live in areas where cellphones have no reception…

July 1, 2019: Crain’s Chicago Business posted an article titled: “Illinois hiring hundreds to reduce Medicaid backlogs”. It was written by Stephanie Goldberg. From the article:

Illinois is hiring hundreds of frontline workers to resolve major delays of its Medicaid application and renewal process.

The Illinois Department of Healthcare and Family Services, which oversee Medicaid, and the Illinois Department of Human Services are working together to fill the vacancies, the departments said in a statement today. The first positions are expected to be filled this week.

The Medicaid redetermination process, which reviews eligibility for the state’s nearly 3 million Medicaid beneficiaries, can lead to lapses in coverage. Such gaps are hard on patients, especially those managing chronic conditions, and health systems that don’t get reimbursed for medical services when claims are denied by health plans.

Backlogs, which have increased in recent years, are considered delays of 45 days or more for initial applications and 60 days or more for renewals, the statement says…

…A recently passed a bipartisan Medicaid reform package also aims to reduce the backlogs.

July 1, 2019: The Independent posted an article titled: “Iowa sued for blocking Medicaid from funding reassignment surgery”. It was written by Lily Puckett. From the article:

The ACLU of Iowa has filed a lawsuit challenging a new state law that prohibits the use of Medicaid funding for gender reassignment surgery.

Governor Kim Reynolds signed a bill on 3 May that included language amending the Iowa’s Civil Rights Act so that the state is not required to pay for gender reassignment surgery.

On Friday, The ACLU sued Mr Reynolds, the state and the Iowa Department of Human Services on behalf of One Iowa, a group that advocates for transgender rights, and two transgender Iowans who qualify for Medicaid and whose doctors say they need the surgery to treat gender dysphoria.

The lawsuit filed in the state court asks a judge to declare the measure invalid because it’s unconstitutional and order the state to halt enforcement. It claims the law violates inalienable rights to liberty, safety and happiness and equal protection sections of article 1 of the Iowa Constitution…

…In March, the Supreme Court ruled that the Iowa Department of Human Services cannot block Medicaid from paying for gender reassignment surgery for two transgender women whose doctors recommended the procedure.

Republicans in the Iowa Legislature passed the law being challenged as part of a last minute addition to a human services budget bill responding to that ruling…

July 2, 2019: Politico posted an article titled: “GOP states seek delay in Obamacare case”. It was written by Dan Diamond. From the article:


The GOP-led states seeking to overturn Obamacare requested on Monday that they get an additional 20 days to file a supplemental brief and that the opening argument set for next week to be delayed to “a date of the Court’s choosing” after the filing.

In a letter to the clerk of the 5th U.S. Circuit of Appeals, attorney Kyle Hawkins said these “important” questions “merit a thorough response” that represents the views of all the states. “As of today, it appears unlikely that any such response will be completed by the Court’s July 3 deadline.”…


Plaintiffs suing to stop HHS’s rule to strengthen conscience rights will have their day in court on Oct. 30, a federal judge in California ordered on Monday.

The Trump administration’s rule, which would expand protections for religious-workers to deny health services, was to take effect on July 22, but U.S. District Court Judge William Alsup this weekend postponed the rule’s effect until Nov. 22. HHS was sued by San Francisco city attorney Dennis Herrera, California Attorney General Xavier Becerra and the Democratic-led states…


A coalition of 75 reproductive rights organizations and physicians sent an open letter to FDA calling for the agency and other government officials to remove barriers for patients to access abortion pills. The pills are supplied by a Dutch pharmacist through the website AidAccess.Org, but in March the FDA ordered the site in a warning letter to stop selling unapproved versions of two drugs – mifepristone and misoprostol – to U.S. consumers.

The groups, including Planned Parenthood and National Organization for Women, argued that the medicines have been proven safe and effective and if laws and regulations “were based on science – not politics” they would be readily available…

July 2, 2019: Aid posted “Open Letter – Medication Abortion Access Should Be Based on Science Not Politics”. From the open letter:

In October of 2018, the international group, led by Dr. Rebecca Gomperts, began offering mifepristone and misoprostol, commonly known as medication abortion pills, by mail, to patients in the United States. After an online medical consultation with a patient, Dr. Gomperts writes a prescription and a pharmacy fills the prescription and ships pills to the patient. According to analysis conducted by a research team at the University of Texas at Austin, in its first year of operation, received over 21,000 requests for abortion pills, without any advertising or outreach.

The two-medication combination that is providing has been demonstrated to be safe and effective in extensive research and is the same combination approved for use in the United States by the Food and Drug Administration (FDA). Yet, despite the strong safety record of medication abortion, in March 2019 the FDA sent warning letters to and Dr. Rebecca Gomperts, stating that they are violating the Federal Food, Drug, and Cosmetic Act by offering mifepristone and misoprostol directly to U.S. consumers seeking to end a pregnancy. The agency demanded that immediately cease offering these medications to people in the United States.

If the laws and regulations that determine the terms of abortion access in the United States were based on science – not politics – medication abortion would be widely available in the United States without medically unnecessary restrictions on distribution. Abortion with quality pills delivered by mail directly to one’s home with instructions for use in multiple languages and access to medical counseling and back-up, if needed, should be one of an array of abortion options available, ensuring everyone who needs to end a pregnancy has the freedom and control to do so in a way that best fits their lives. However, due to the politics of abortion, medication abortion has been over-regulated by the FDA, and pushed further out of reach for many by state restrictions.

The high demand for medication abortion by mail should come as no surprise. Access to abortion is under direct threat today, with near-total bans on abortion care recently signed into law in Alabama, Georgia, Kentucky, Mississippi, and Ohio. This is happening in a context in which abortion is already inaccessible for many: 90% of U.S. counties have no abortion clinic. In addition to having to travel a long distance to the nearest abortion clinic, many people have to endure legally-mandated waiting periods. These medically unnecessary waiting periods create further challenges for people who have to take time away from work or school or arrange for childcare. These hurdles may increase the cost of an abortion, which averages $500 in the first trimester and only becomes more expensive as pregnancy progresses. In 35 states and the District of Columbia, Medicaid does not cover abortion care except in rare cases, making abortion financially inaccessible for low-income people. These restrictions are about control and limiting options, not safety or health…

…The risk for a person self-managing an abortion with pills in the United States today is not medical but legal. Since the year 2000, there have been at least 21 known arrests in the United States of people for ending their own pregnancy or helping someone who has made the decision to do so. Some have gone to jail, but even those who have not have had their lives turned upside down by investigations and in some cases have suffered economic and social harm caused by negative media exposure. The threat of investigation, arrest, or punishment is particularly of concern for those who live under heightened government surveillance, including many in immigrant communities. Five states currently have laws on the books that criminalizes self-managed abortion. The fact that these laws are generally outdated and likely unconstitutional does not mean they are inert: they have been used in the last decade to arrest, investigate, and prosecute people who ended or who were suspected of ending their own pregnancies. And in states without such laws, prosecutors who wish to punish people for abortion have used laws that were never intended to apply to self-managed abortion to target people who have ended, or are suspected of ending, their own pregnancies.

The anti-abortion politicians and activists who propose restrictions are attempting to legislate legal abortion out of existence. They are well aware that the FDA’s restrictions and actions are a key element in the success of their own efforts to make abortion inaccessible…

The letter included a list of organizations who signed on to the letter, as well as a list of individual medical professionals. Here are the organizations:

  • Abortion Access Front
  • Abortion Care Network
  • ACCESS Women’s Health Justice
  • Advocates for Youth
  • All-Options
  • Carolina Abortion Fund
  • Catholics for Choice
  • Chicago Abortion Fund
  • Civil Liberties and Public Policy Program
  • Clarinda Regional Health Center
  • Feminist Women’s Health Center
  • Forward Together
  • Gateway Women’s Access Fund
  • If/When/How: Lawyering for Reproductive Justice
  • In Our Own Voice: National Black Women’s Reproductive Justice Agenda
  • Ipas
  • Legal Voice
  • Maine Family Planning
  • Mariposa Fund
  • Medical Students for Choice
  • Midwest Access Coalition
  • NARAL Pro-Choice Arizona
  • NARAL Pro-Choice Colorado
  • National Abortion Federation
  • National Asian Pacific American Women’s Forum (NAPAWF)
  • National Latina Institute for Reproductive Health
  • National Institute for Reproductive Health
  • New Voices for Reproductive Justice
  • Nurses for Sexual and Reproductive Health
  • Pendergrast Consulting
  • Physicians for Reproductive Health
  • Plan C
  • Planned Parenthood Federation of America
  • Progress Florida
  • Public Leadership Institute
  • Religious Coalition for Reproductive Choice
  • SisterLove, Inc.
  • SisterReach
  • Surge Reproductive Justice
  • URGE: Unite for Reproductive & Gender Equality
  • West Virginia Free
  • Whole Woman’s Health / Whole Woman’s Health Alliance
  • Women on Web

July 2, 2019: Statesman posted an article titled: “Court denies Texas bid to delay Affordable Care Act arguments”. It was written by Chuck Lindell. From the article:

Keeping a legal challenge to the Affordable Care Act on a fast track, a federal appeals court Tuesday rejected a request to delay next week’s oral arguments made by Texas and 19 the states seeking to overturn the law.

The Republican attorneys general, including Ken Paxton of Texas, said they needed more time to research and respond to questions – recently posed by the 5th U.S. Circuit Court of Appeals’ three-judge panel – that could end the appeal and provide a victory for opponents of the law.

With that response due Wednesday, Texas Solicitor General Kyle Hawkins, the top appellate lawyer in Paxton’s agency, asked for 20 additional days to submit the brief, with oral arguments to be reset for sometime afterward.

The appeals court rejected the request but pushed the deadline back two days, giving all sides until 5 p.m. Friday to submit the requested briefs.

The delay was opposed by Democratic-led states and the U.S. House, which are fighting to preserve the Affordable Care Act after a federal judge in Texas – based on a lawsuit filed by Paxton – ruled in 2018 that the law was unconstitutional…

…The law, sometimes known as Obamacare, remains in effect during the appeal…

July 2, 2019: WITF posted an article titled: “Pennsylvania’s own insurance exchange coming next year”. It was written by Marc Levy. From the article:

Pennsylvania is moving to replace the federally operated with its own website to sell Affordable Care Act-compliant policies in a bid to get more people into it and lower their costs.

Gov. Tom Wolf signed legislation Tuesday after it passed the Legislature unanimously last week. The administration unveiled the legislation in June after lining up support from a wide range of business and consumer advocacy groups, as well as leadership in the Republican-controlled Legislature.

Pennsylvania let the federal government know of its intent and is preparing to submit its plans, called a “blueprint,” in the coming weeks.

Wolf’s administration expects to take over some of the marketing and outreach efforts for next year before it unveils its new website next year for enrollment in the 2021 insurance year.

It says it expects it can lower premiums by 5% to 10% for the 400,000 people who buy policies in the marketplace. Wolf’s insurance commissioner, Jessica Altman, said the savings can especially help the roughly 80,000 people who buy policies through, but whose incomes are too high to qualify for a federal tax subsidy…

July 2, 2019: KTVA The Voice of Alaska posted an article titled: “Alaskans lose Medicaid dental benefits after Dunleavy budget cuts”. It was written by Lauren Maxwell. From the article:

After Gov. Mike Dunleavy vetoed $50 million from the state’s Medicaid budget last week, some Alaskans are already starting to feel the effects.

A large chunk of those cuts – $27 million – eliminates dental benefits for adults on Medicaid that in 2018 included approximately 30,000 Alaskans.

On Monday, Anchorage Dental Group began calling its Medicaid patients to tell them their dental benefits were gone. Office Manager Candace Fleming said that included some patients whose treatment wasn’t finished yet…

…The cuts eliminate all services including preventive care like cleanings and fillings – the kind of things that Dr. James Hyer said can keep small problems from getting worse…

…The State said services to children on Medicaid are not impacted by the budget cuts and that adults who need emergency care for immediate relief of pain or acute infection will still be covered.

July 2, 2019: Planned Parenthood posted a press release titled: “Ninth Circus Provides Emergency Relief for Millions of Title X Patients”. From the press release:

The U.S. Court of Appeals for the Ninth Circuit has blocked the Trump-Pence administration’s dangerous Title X gag rule. The court’s order provides much-needed emergency relief to millions of people who access birth control and other reproductive health services through the program.

Title X is the nation’s program for affordable birth control and reproductive health care, which serves four million people each year. Trump’s gag rule makes it illegal for health care providers in the Title X program to refer patients for abortion, and also blocks access to care at Planned Parenthood by imposing cost-prohibitive and unnecessary “physical separation” requirements. Title X helps millions of people struggling to make ends meet – the majority of whom are people of color, Hispanic, or Latino – access birth control, cancer screenings, STI testing, and other essential reproductive health care. Providers who serve nearly half of the patients who get care through Title X have made it clear that the rule would force them out of the program – the administration is putting health care at risk for patients across the country by pushing this rule to go into effect…

July 2, 2019: Center for Reproductive Rights posted a press release titled: “Trump Administration Postpones Denial of Care Rule”. From the press release:

In response to the Trump administration’s announcement that the Denial of Care Rule will no longer go into effect on July 22, the Center for Reproductive Rights, Lambda Legal, Americans United for Separation of Church and State, and the County of Santa Clara issued the following statement:

“As we know from the firsthand accounts of our plaintiffs – health care providers who are on the front lines every day caring for patients – discrimination in health care is dangerous and lives are truly at stake. Confronted with these facts and the flurry of lawsuits showing how the Denial of Care Rule would irreparably harm health care providers and patients across the country, the Trump administration agreed to delay implementation. The Rule invites health care workers to discriminate based on religious or moral objections, targeting LGBTQ people and women seeking reproductive health care. The Rule is unconstitutional and we are ready to take on the Trump administration in this fight.”

On Saturday, June 29, the U.S. Department of Health and Human Services (HHS) stipulated that it will delay the implementation of Denial of Care Rule. A court order put the delay of the rule into effect yesterday. The rule will no longer take effect on July 22 as originally planned; instead the rule will be delayed at least until November 22…

…The new regulation, issued in May by HHS, invites anyone employed by a health care provider – including doctors, nurses, EMTs, administrators, janitors, and clerical staff – to deny medical treatment and services to patients because of personal religious or moral beliefs. Health care facilities that do not comply risk losing federal funding. If allowed to go into effect, the Rule will cause mass confusion among health care providers and is completely infeasible to implement. As a result, some health care facilities – most of which receive federal funding through HHS – may do away with reproductive and LGBTQ services altogether, leaving millions without access to health care.

In the lawsuit, the civil rights organizations argue that the rule is unconstitutional because it advances specific beliefs in violation of the First Amendment; violates patients’ rights to privacy, liberty, and equal dignity as guaranteed by the Fifth Amendment; and chills patients’ speech and expression in violation of the First Amendment, all to the detriment of patients’ health and well-being. The lawsuit also asserts that HHS violated the federal Administrative Procedure Act in creating the rule by arbitrarily and capriciously failing to consider the impact on patients and the health care system.

July 3, 2019: The Hill posted an article titled: “Judge blocks Ohio’s ‘heartbeat’ abortion law”. It was written by Jessie Hellmann. From the article:

A federal judge on Wednesday temporarily blocked an Ohio law that would have banned abortions after six weeks of pregnancy.

The law, which bans abortions after a fetal heartbeat is detected, was signed earlier this year by Gov. Mike DeWine (R) and challenged by the American Civil Liberties Union (ACLU) and Planned Parenthood.

It was slated to take effect this month, but U.S. District Judge Michael Barrett issued a preliminary injunction, blocking the law from taking effect while it is challenged in court…

…Barrett wrote in his ruling that the law places an “undue burden” on a woman’s right to obtain an abortion before the fetus is viable, violating Supreme Court precedent.

The law would have been one of the strictest in the nation with no exemptions for cases of rape or incest…

The case is called Preterm-Cleveland, et. al. vs. David Yost, et. al. It is available online. Here are some parts of U.S. District Judge Michael Barrett’s ruling:

…In a nutshell, S.B. 23 bans abortion care at and after approximately six weeks in pregnancy. And, in so doing, according to Plaintiffs – a collection of reproductive clinics and physicians providing abortion care – violates women’s right to privacy as guaranteed by the Fourteenth Amendment…

…At six weeks LMP, many women are unaware that they are pregnant… Typically the menstrual cycle is approximately four weeks long, but varies based on the individual. Assuming a woman has consistently regular periods, she would be considered four weeks pregnant as measured from her LMP when her missed period occurs. Those who have irregular periods – caused by common medical conditions, contraceptive use, age or breastfeeding – or those who experience bleeding during early pregnancy that could be mistaken for a period may not realize that they missed a period…. But assuming a patient does know she is pregnant, there are certain logistical obstacles to obtaining abortion care before six weeks in pregnancy… She will need to schedule an appointment, make sure of payment, arrange for transportation, time off of work and possibly childcare during appointments… A minor patient, unless emancipated, also must obtain written parental consent or a court order… And all patients, regardless of age, must make two in-person trips – at least 24 hours apart – to the clinic before they can obtain an abortion… These reasons explain why the majority of abortions in Ohio – approximately 90% – take place at or after six weeks LMP. … S.B. 23, therefore, will prohibit almost all abortion care in Ohio…

…The Court concludes, based on current United States Supreme Court precedent, that Plaintiffs are certain to succeed on the merits of their claim that S.B. 23 is unconstitutional on its face…

…Plaintiffs argue that their patients will suffer serious and irreparable harm in the absence of a preliminary injunction, because allowing the Act to take effect will prevent Ohio women from exercising their constitutional right to reproductive freedom as protected by the Fourteenth Amendment… Inasmuch as this Court has determined that S.B. 23 places an “undue burden” on a woman’s right to choose a pre-viability abortion, and thus violates her right to privacy guaranteed by the Fourteenth Amendment, we further determine that its enforcement would, per se, inflect irreparable harm…

…[Planned Parenthood of Southeastern Pa. v] Casey acknowledged the State’s “legitimate interest from the outset of the pregnancy in protecting the … life of the fetus that may become a child.”… But that acknowledgement was preceded with the recognition that “[b]efore viability, the State’s interests are not strong enough to support a prohibition of abortion or the imposition of a substantial obstacle to the woman’s effective right to elect the procedure”…. An injunction will preserve the status quo that has been in place for more than 40 years since Roe was decided, and some 25 years since Casey followed…


For the foregoing reasons, Plaintiffs’ Motion for Preliminary Injunction … is GRANTED. Specifically, all Defendants, their officers, agents, servants, employees, and attorneys, and those persons in active concert or participation with them who receive actual notice of this Order, are preliminarily enjoined from enforcing or complying with S.B. 23 pending further Order of this Court…

July 3, 2019: The American Civil Liberties Union (ACLU) posted a press release titled: “Judge Blocks Ohio’s Near Total Abortion Ban in ACLU Case”. From the press release:

A federal judge temporarily blocked an Ohio law that would have banned abortion as early as six weeks into pregnancy, before most women know they are pregnant. The American Civil Liberties Union (ACLU), the ACLU of Ohio, and Planned Parenthood brought the lawsuit on behalf of Preterm-Cleveland and other abortion clinics in the state. Senate Bill 23 was signed by Governor DeWine and was scheduled take effect this month.

Ohio is one of more than seven states that have considered similar legislation so far this year. In addition to Ohio, the ACLU has challenged similar abortion bans in Kentucky and Georgia, a near total ban in Alabama, and an 18-week ban in Arkansas, among other litigation. Courts have already blocked identical measures in Kentucky and Mississippi. None of the bans are in effect, and abortion remains legal in all 50 states…

July 3, 2019: Politico posted an article titled: “Appeals court takes up fresh challenge to Trump abortion ‘gag rule'”. It was written by Rachel Roubein and Renuka Rayasam. From the article:

The full 9th U.S. Circuit Court of Appeals on Wednesday said it would take up a fresh challenge to the Trump administration’s overhaul of the federal family planning program just weeks after three of its Republican-appointed judges said the policy change can take effect nationwide while several legal challenges play out.

The appeals court froze the administration’s rule revamping the Title X program while it hears the case, according to Brigitte Amiri, deputy director at the ACLU’s Reproductive Freedom Project.

The court’s order marks the latest turn in a battle over the administration’s changes to the program, which seek to steer federal dollars away from providers such as Planned Parenthood that offer abortions and abortion referrals. Critics have dubbed the Trump policy a “gag rule”.

The order covers several challenges to the rules, but it’s unclear whether they will be heard together or separately…

July 3, 2019: The American Civil Liberties Union posted a press release titled: “Court Blocks Trump Administration’s Attempt to Gut Family Planning Program in Response to ACLU Lawsuit”. From the press release:

The Ninth Circuit Court of Appeals restored a preliminary injunction today in the ACLU’s case against the Trump Administration’s efforts to roll back Title X, the nation’s family planning program.

The decision blocks the implementation of the rule, which would have undermined the health care needs of four million low-income people each year, while the cases argued…

July 3, 2019: Center for Reproductive Rights posted a press release titled: “Judge refuses to block Title X Rule in Maine, jeopardizing healthcare access for thousands of Mainers”. From the press release:

U.S. District Court Judge Lance Walker today denied the Center for Reproductive Rights’ request to block the Trump Administration’s Domestic Gag Rule from going into effect in the state of Maine, jeopardizing the future of Maine Family Planning’s clinics across the state.

In June 2019, on behalf of Maine Family Planning (MFP), the Center for Reproductive Rights made an emergency request to re-block the rule after a federal appeals court overrode lower court decisions that had previously blocked the rule from going into effect nationwide.

Maine Family Planning is the state’s sole Title X grantee and the largest reproductive health care organization in Maine. With this ruling, 85% of abortion clinics in the state of Maine are in jeopardy…

The Domestic Gag Rule Will:

Force healthcare providers that receive federal funding like MFP to stop performing abortions, even though no federal funds are used to finance abortion.

Prohibit doctors at these facilities from making referrals to abortion providers, even when the patient has already decided to have an abortion and directly asks for a referral.

Force doctors to give all pregnant patients prenatal referrals, even when the patient doesn’t want one.

Give Title X funding to non-medical organizations known as “crisis pregnancy centers,” which are designed to look like medical clinics but aim to deter women from getting abortions…

July 3, 2019: The U.S. Court of Appeals for the Ninth Circuit posted its order on the case called State of California v. Alex M. Azar. It was written by Chief Justice Sidney R. Thomas.

Upon the vote of a majority of nonrecused active judges, it is ordered that these cases be reheard en banc pursuant to Federal Rule of Appellate Procedure 35 (a) and Circuit Rule 35-3. The three-judge panel Order on Motions for Stay Pending Appeal in these cases shall not be cited as precedent by or to any court of the Ninth Circuit.

Judges Graber, Christen, and Owens did not participate in the deliberations or vote in these cases.

July 3, 2019: Delaware Online posted an article titled: “For the first time, Highmark looks to lower its Obamacare marketplace rates”. It was written by Meredith Newman. From the article:

For the first time, Highmark BlueCross Blue Shield of Delaware is asking the state to decrease its Obamacare marketplace rates.

Highmark, the only insurer on the Delaware Affordable Care Act marketplace, has proposed decreasing rates by 5.8 percent in 2020, officials said. This is expected affect about 20,000 residents.

Previously, the insurer has increased rates in the double digits. Last year, rates increased by 3 percent, This decrease would only apply to Delawareans who are enrolled on the ACA marketplace, not those who have Medicaid, Medicare and private insurance…

July 3, 2019: Oklahoma’s News 4 posted an article titled: “Oklahoma Medicaid Office: Update address or lose benefits”. From the article:

Oklahoma’s Medicaid agency is warning its SoonerCare members to keep their current address on file with the agency or risk losing their health care benefits.

The Oklahoma Health Care Authority sent out a public reminder Wednesday of the new rule that was signed by Gov. Kevin Stitt last week. The agency says it intends to launch outreach efforts through social media and through outbound phone calls to SoonerCare recipients after hours and on weekends.

Agency officials say the rule is needed to comply with federal guidelines. But advocates for the poor have criticized the policy, saying low-income people move more frequently and that many members will be wrongfully cut from the programs…

July 3, 2019: RappNews posted an article titled: “Free Clinic changes business model to accommodate expanded Medicaid program”. From the article:

As of January 1, an additional 400,000 Virginians gained access to quality, low-cost health insurance through the state’s expanded Medicaid program.

The enduring mission of the Fauquier Free Clinic (FFC) is to provide eligible residents of Fauqier and Rappahannock counties with access to comprehensive medical, dental and mental health care. This year, the clinic’s business model underwent extensive changes to accommodate new and existing patients when Medicaid expanded its services for low-income adults throughout Virginia…

…In Fauquier County alone, 1,700 to 1,800 people have become eligible for Medicaid insurance benefits. In Rappahannock County, 300 to 400 people are now eligible. Throughout the state of Virginia, eligibility has been granted to around 400,000 people.

“Medicaid expansion was a great opportunity for the Commonwealth and Fauquier County to provide health insurance coverage for those most in need,” said FFC board member Gregory Bengston. “Changing our business model to ensure that clinic patients who were now Medicaid-eligible had continued access to health care services was a huge accomplishment”…

July 3, 2019: The Middletown Press posted an article titled: “Appeals court puts Trump abortion restrictions on hold again”. It was written by Gene Johnson. From the article:

Trump administration rules that impose additional hurdles for low-income women seeking abortions are on hold once again.

The 9th Circuit Court of Appeals in San Francisco on Wednesday vacated a unanimous ruling from a three-judge panel and said a slate of 11 judges will reconsider lawsuits brought by more than 20 states and several civil rights and health organizations challenging the rules.

Critics say the rules would force many clinics to find new locations, undergo expensive remodels or shut down…

…With [the three-judge panel’s decision] vacated, the injunction issued by the lower court judges are once again in effect. It’s not clear when new court arguments will be held.

“We are profoundly grateful the preliminary injunction is back in place,” said Clare Coleman, president of the National Family Planning and Reproductive Health Association, which is involved in the cases…

July 3, 2019: Senator Dick Durbin (Democrat – Illinois) posted a press release on his official website titled: “Durbin Calls On Congress To Protect And Strengthen The ACA, Not Undermine It”. From the press release:

With health care advocates once again under attack, U.S. Senator Dick Durbin (D-IL) today stood with advocates and individuals who have been helped by the Affordable Care Act (ACA) to address the Trump Administration’s latest lawsuit seeking to dismantle the health law and call on Congress to strengthen the ACA, not undermine it. Next week, oral arguments will be head on Texas v United States – a lawsuit over the constitutionality of the entire ACA. If the Trump Administration and 20 Republican state Attorneys General (AGs) succeed, the ACA could be struck down, leaving tens of millions of Americans without health care or protections for pre-existing conditions.

“Thanks to the Affordable Care Act, 20 million Americans gained health insurance, including more than one million people in Illinois,” said Durbin. “All of its important and life-saving protections will be gone if President Trump gets his way starting next week in court. I stand ready to work with my colleagues in Congress to protect and strengthen the Affordable Care Act.”

After President Trump’s failed attempt to repeal the ACA two years ago, he turned to the courts to sabotage the health law. Last February, 20 Republican AGs filed a lawsuit over the constitutionality of the ACA – arguing that because the individual mandate penalty was zeroed out in the 2017 Republican tax law, the rest of the ACA should also be struck down.

In December, a District Court judge in Texas sided with the Republican plaintiffs, and the case will go to the 5th U.S. Circuit Court of Appeals in New Orleans next week. If the Trump Administration and Republican AGs succeed, the entirety of the ACA could be struck down, meaning:

  • Protections for people with pre-existing conditions would be eliminated
  • Millions would be kicked off Medicaid
  • Individual insurance markets and premium assistance would be eliminated
  • Seniors on Medicare would face increased prescription drug costs
  • Women could be charged more than men for health care
  • Young people would no longer have access to their parents’ insurance plan up to age 26
  • Annual and lifetime caps on benefits could return
  • There would no longer be guaranteed coverage for preventative screening and contraception services without deductibles or copayments
  • There would no longer be guaranteed coverage for mental health or addiction treatment services

Since the ACA was signed into law in 2010, the uninsured rate in Illinois has fallen by 49 percent. More than one million uninsured Illinoisans now have health insurance thanks to Medicaid expansion and tax credits to purchase Exchange plans, and 90,000 young adults have health insurance by staying on their parents’ plans until age 26. Further, the approximately 5 million Illinois residents with pre-existing conditions now have protections against discrimination from insurance companies, and Illinois seniors have saved an average of more than $1,000 on their prescription drugs due to the ACA’s closing of the Medicare “donut hole” coverage gap.

Last month the House of Representatives passed bi-partisan legislation, Protecting Americans with Pre-Existing Conditions Act, to prevent President Trump from allowing health insurance companies to discriminate against people with pre-existing conditions, yet Senate Majority Leader Mitch McConnell (R-KY) has refused to call up this legislation for a vote. The House has also advanced legislation to crack down on junk health plans and restore funding for insurance sign-ups and outreach.

July 3, 2019: Kaiser Family Foundation posted information titled: “Explaining Texas v. U.S: A Guide to the 5th Circuit Appeal in the Case Challenging the ACA”. It was written by MaryBeth Musumeci. I highly recommend you read it want to understand more about that case.

In this blog post, I will include only the “Looking Ahead” portion of the information.

Oral argument is scheduled for 1:00 p.m. on July 9th, with 45 minutes to be shard among the state intervener-defendants and the House, and 45 minutes to be shared among the state plaintiffs, individual plaintiffs, and federal government. The case will be heard by a panel of three judges, including Judge Carolyn Dineen King (appointed by President Carter), Judge Jennifer Walker Elrod (appointed by President George W. Bush), and Judge Kurt D. Engelhardt (appointed by President Trump). There is no deadline by which the court must issue a decision, but it could come as early as fall 2019.

If the court finds that the individual mandate is unconstitutional and invalidates only that provision, the practical result will be essential the same as the ACA exists today, as amended by the TCJA, without an enforceable mandate. If the court adopts the position that the federal government took during the trial court proceedings and invalidates the individual mandate as well as the protections for people with pre-existing conditions, then the federal funding for premium subsidies and the Medicaid expansion would stand, and it would be up to the states whether to reinstate the insurance programs.

The most far-reaching consequences, affecting nearly every American in some way, will occur if the court decides that the entire ACA must be overturned. The number of non-elderly individuals who are uninsured decreased by 19.1 million from 2010 to 2017, as the ACA went into effect. The ACA made significant changes to the individual market, including requiring protections for people with pre-existing conditions, creating insurance marketplaces, and authorizing premium subsidies for people with low and modest incomes. The ACA also made other sweeping changes throughout the health care system including expanding Medicaid eligibility for low-income adults; requiring private insurance, Medicare, and Medicaid expansion coverage of preventative services with no cost sharing; phasing out the Medicare prescription drug “doughnut hole” coverage gap’ reducing the growth of Medicare payments to health care providers and insurers; establishing new national initiatives to promote public health, care quality, and delivery system reforms; and authorizing a variety of tax increases to finance these changes. All of these provisions could be overturned if the trial court’s decision is upheld, and it would be enormously complex to disentangle them from the overall health care system…

July 5, 2019: The Jamestown Sun posted an article titled: “Number of abortions continues to slide in North Dakota”. It was written by John Hageman. From the article:

The number of induced abortions performed in North Dakota slid for the fourth straight year in 2018, marking the lowest figure since recordkeeping began almost four decades ago, according to new state data.

There were 1,141 induced abortions recorded in North Dakota last year, down slightly from 1,155 in 2017, according to state Department of Health reports. The agency began tracking abortion statistics in 1981.

The state hit a record number of abortions in 1982 with 3,076.

Tammi Kromenaker, the director of the state’s sole abortion clinic, the Red River Women’s Clinic in Fargo, cited Medicaid expansion and the Affordable Care Act’s contraceptive mandate, which the Trump administration has tried to roll back.

“The (ACA) continuing to cover birth control, with no deductible and no co-pay, that is huge for so many families,” Kromenaker said Friday, July 5, noting that North Dakota is following a national trend in seeing abortion decline…

…The Red River Women’s Clinic recently joined the American Medical Association in filing a federal lawsuit against two North Dakota abortion laws they say will force doctors to misinform their patients and violate their medical ethics. That includes requiring physicians to inform patients it may be possible to revers a drug-induced abortion…

July 5, 2019: San Francisco Chronicle posted an article titled: “California offers doctors student-loan help to treat underserved patients”. It was written by Elizabeth Aguilera. From the article:

It’s a trade aimed at getting more doctors to treat poorer patients: California says it will help repay the student loans of 247 selected doctors in exchange for their promise that at least 30% of their caseload will be people enrolled in Medi-Cal.

The $60 million student loan repayment, CalHealthCares, is funded by the state tobacco tax that voters increased three years ago.

It’s all a part of California’s effort to increase the number of doctors who accept Medi-Cal, the state’s Medicaid health insurer of low-income residents, which has been plagued by shortages – due both to the state’s paltry rates for doctors in its provider network and to the substantial increase in the number of residents on Medi-Cal. California has one of the lowest Medicaid reimbursement rates in the country, and patients wait months, or longer, to see specialists.

More than 1,300 doctors and medical residents applied for the benefit which provides up to $300,000 over five years, and those selected were chosen based on their commitment to treat the underserved, their geographic location and their specialities…

…Research indicates that debt is a major concern for physicians nationwide: a 2017 server by an affiliate of the American Medical Association found that half owed $200,000 or more in medical school loans…

…This is the first doctor group to receive funding from the $340 million fund created by Prop. 56 tobacco tax revenue. The state expects there will be at least five more rounds of awards.

Later this summer, the state will announce awards for dentists who applied to participate in the loan repayment program for serving Denti-Cal patients.

Information about that lawsuit can be found on the American Medical Association website.

July 5, 2019: Idaho Press posted an article titled: Idaho seeks public comment on 2nd Medicaid waiver, for same purpose as 1st. It was written by Betsy Z. Russell. From the article:

The Idaho Department of Health and Welfare is taking public comment on a new Medicaid expansion waiver, less than a week after the comment period on a related waiver closed.

Both applications deal with people who earn between 100 percent and 138 percent of the federal poverty level. The intent is to give them the option to buy subsidized private health insurance through the state exchange, rather than shift to Medicaid. The agency announced the new waiver Wednesday, saying the move stems from conversations with the federal Centers for Medicare and Medicaid Services…

…The move stems from actions taken by the Idaho Legislature during the 2019 session. Rather than implement straight Medicaid expansion, as approved by voters, Republican lawmakers adopted a series of conditions and restrictions on the program. One of the conditions was that people in the 100 percent to 138 percent income category be given the choice to remain in the state exchange.

Under current federal rules, people who qualify for Medicaid aren’t eligible for the tax credits that will help lower the cost of private insurance through the state exchange. Consequently, Idaho will need federal approval to enact the Legislature’s will…

July 5, 2019: The Philadelphia Inquirer posted an article titled: “Medicaid enrollment growth driven by families working for large employers, CHOP study finds.” It was written by Sarah Gantz. From the article:

Enrollment in Medicaid and CHIP, the Children’s Health Insurance Program, among children whose parents work full time and earn more than 100 percent of the federal poverty level grew significantly between 2008 and 2016, according to a new study by researchers at the Children’s Hospital of Philadelphia published this month in Health Affairs.

Researchers found the growth was largely driven by families working for large private employers, where health insurance is a standard benefit – but an increasingly unaffordable one.

Employer-sponsored health insurance is still the most common type of health plan for adults under 65 and their children. But employees are spending more and more out of pocket as their wages remain stagnant.

As companies are strained by rising health-care costs, they are shifting more of the burden to their employees. Across the country, employees’ average share of a premium for family coverage increased 57 percent between 2008 and 2016, to $5,277, according to the Kaiser Family Foundation. Deductibles rose from $1,344 to $2,147 for a family during that period.

A study by the Commonwealth Fund found that nearly 24 million people with employer health plans spend at least 10 percent of their income on premiums, out-of-pocket costs, or both.

Meanwhile, Medicaid offers low-cost coverage and possibly more comprehensive benefits for eligible families who are finding that they can’t afford their employer health coverage, said David Rubin, director of PolicyLab at Children’s Hospital of Philadelphia and a co-author of the Health Affairs study…

July 8, 2019: The Texas Tribune posted an article titled: “Texas is going to court to end Obamacare. It hasn’t produced a plan to replace it.” It was written by Emma Platoff and Edgar Walters. From the article:

Last year, after a federal judge in Texas declared the entirety of the Affordable Care Act unconstitutional, throwing into question millions of Americans’ health coverage, the state’s Republican leaders promised they would come up with a plan to replace it.

But on Tuesday, a legislative session that seemed to have no room for issues other than property tax reform and school finance, Texas will ask a federal appeals court in New Orleans to end the law in its entirety – without offering a replacement plan.

The conservative crusade against portions of the act, known as Obamacare, has spanned a decade. But Texas’ latest lawsuit, filed in February 2018, became an existential threat to the law after U.S. District Judge Reed O’Connor ruled in December that it is unconstitutional in its entirety. At stake: subsidized health coverage of roughly 1 million Texans, sweeping protections for patients with preexisting conditions, young adults staying on their parents’ insurance plans until age 26, and a host of low-cost benefits available to all people with health insurance, including those covered through their employers.

Texas already has the highest uninsured rate in the nation…

…Attorneys for the state of Texas argue the health law cannot stand since the Republican-led Congress in 2017 zeroed out Obamacare’s individual mandate – a penalty imposed on people who choose to remain uninsured. Democrats had favored the penalty as a way to induce more people to purchase health insurance, with the goal of reaching near-universal coverage. Without it, Texas argues, the whole law must fall.

But the state’s Republican leaders have offered few ideas about what should replace Obamacare, a law that touches practically every aspect of health care regulations and includes several popular protections for patients. Gov. Greg Abbott – a vocal critic of the law – pledged in December that if the law remained struck down on appeal, “Texas will be ready with replacement health care insurance that includes coverage for pre-existing conditions.”

Since then, he’s been quiet on the issue, including during this year’s 140-day Texas legislative session…

July 8, 2019: Planned Parenthood posted a press release titled: “Congress Blocks D.C. Abortion Ban in Spending Bill”. From the press release:

The House of Representatives voted 224-196 to pass a spending bill that survived Republican efforts to include a provision to block District of Columbia residents with low incomes from accessing safe, legal abortion. The provision has been included in previous spending bills and in current law, and the fact that the House FY 2020 Financial Services and General Government Appropriations bill expands access to safe, legal abortion is in part due to the historic number of reproductive health champions in Congress. Unfortunately, the bill retains language in current law that prohibits federal employees and their dependents from purchasing insurance plans that cover abortion…

July 8, 2019: Center for Reproductive Rights posted a press release titled: “Statement on Commission of Unalienable Rights”. From the press release:

On Monday, July 8, Secretary Pompeo announced the creation of a Commission on Unalienable Rights, chaired by Professor Mary Ann Glendon, to advice on “human rights grounded in our nation’s founding principles” based on documents like the Declaration of Independence and the 1948 Universal Declaration of Human Rights (UDHR), for a term of two years.

The following is a statement by Stephanie Schmid, U.S. Foreign Policy Council at the Center for Reproductive Rights, about the Commission:

“The Commission is nothing less than a subterfuge for undermining reproductive rights and the rights of marginalized communities including LGBTQ persons.

“Contrary to its asserted purpose, there is no need to redefine or develop foundational principles on human rights. There is a clear and unequivocal consensus by U.N. human rights treaty bodies and independent experts that reproductive rights are human rights, grounded in the right to life, health, equality, non-discrimination and freedom from cruel, inhuman, and degrading treatment, among other rights.

“This new Commission is part of a comprehensive effort by this Administration to erase sexual and reproductive health and rights from global discourse. The State Department has deleted reporting on reproductive rights from its annual Country Reports on Human Rights Practices and the Center for Reproductive Rights currently has two lawsuits pending in the United States District Court for the District of Columbia challenging these cuts. In addition, this Administration has insisted on the elimination of sexual and reproductive health and rights protections from U.N. resolutions, sending a clear message that the United States does not care about the plight of women and girls, nor established international law.

“We are also alarmed by reports that the State Department has not engaged in Congressional consultation in advance of creating this Commission and similar reports that there was no consultation or input from career human rights experts working in the State Department’s Bureau of Democracy, Human Rights, and Labor (DRL). Indeed, this Commission appears to be an attempt to circumvent the State Department’s foreign policy and human rights experts in an effort to pick and choose which rights the United States will respect and promote. This redundant and duplicative Commission is a waste of tax-payer resources, which the House of Representatives recognized when it passed H.R. 2740 which included a provision explicitly prohibiting funds being allocated to this Commission.

“This unnecessary Commission will further compound the Administration’s disengagement, deprioritization, and rollback of human rights and further cede the United States’ leadership in advancing the full spectrum of human rights protections within the United States and globally.”

July 8, 2019: Planned Parenthood posted a press release titled: “State Department Attempts to Redefine Human Rights In Order to Violate Them”. From the press release:

Today, the U.S. Department of State rolled out the Commission on Unalienable Rights, with the stated objective of “promotion of individual liberty, human equality, and democracy through foreign policy.” As outlined by Secretary Pompeo, the intent of the commission is to redefine human rights according to what he calls “America’s founding principles.” The commission is stacked with advisors who have long records arguing against reproductive rights – including access to safe, legal abortion – and against rights for LGBTQ communities, including Chair Mary Ann Glendon, a prominent anti-abortion activist.

Statement from Dr. Leana Wen, President, Planned Parenthood Global:

“The Trump-Pence administration’s new sham commission should be seen for what it really is: an attempt to narrowly redefine human rights in order to violate them. At at time when this administration is attacking reproductive rights, rolling back LGBTQ rights, and detaining children and families under horrific conditions, this commission is nothing more than a thinly veiled attempt to unconscionably exclude specific groups from legal protections. The U.S. should be leading the charge to protect and defend human rights, not undermining them for political gain.”

July 8, 2019: Xavier Becerra tweeted: “The entire #ACA is at risk. In less than 24 hours, my team will be in court defending healthcare for millions of Americans just like Anna and her family. #ProtectOurCare”. The tweet includes a thread of tweets by Anna.

July 9, 2019: New York Attorney General Letitia James tweeted: “!! Today we’re in court to defend the #ACA & #ProtectOurCare because the health & safety of millions of Americans is at risk. Access to quality & affordable healthcare is a basic right. Rolling back the clock is dangerous & irresponsible. We’re ready to fight.”

July 9, 2019: CNBC posted an article titled: “Health-care stocks fall ahead of court arguments over constitutionality of Obamacare”. It was written by Berkeley Lovelace Jr. From the article:

Health-care stocks fell Tuesday ahead of a legal showdown between the Trump administration, a group of Republican-led states and more than a dozen Democratic state attorneys generals over the constitutionality of the Affordable Care Act before the U.S. 5th Circuit Court of Appeals in New Orleans…

…Shares of insurers UnitedHealth, Cigna and Humana were down more than 1% in early afternoon trading. Shares of HCA Healthcare, the largest for-profit U.S. hospital operator, and Tenet Healthcare were down 2% and 3%, respectively. Community Health Systems was falling by more than 7%…

July 9, 2019: Planned Parenthood posted a press release titled: Court Hears Challenge to Affordable Care Act, Risking Health Care for Millions”. From the press release:

The U.S. Court of Appeals for the 5th Circuit will hear oral arguments in Texas v. U.S., a case that seeks to strike the Affordable Care Act (ACA) in its entirety, putting access to health care for millions at risk. Under the ACA, 20 million people gained health care coverage and more than 62 million women have gained coverage for preventable services with no out-of-pocket costs, including birth control, STI screenings, breast cancer screenings, and Pap tests…

…Gutting the ACA would threaten the health and financial security of millions of people:

More than 62 million women now have access to no-copay preventative services, including birth control, STI screenings, and life-saving preventative services such as breast cancer screenings and Pap tests.

Under the ACA, women of color are able to access better preventative care, a step forward in leveling the playing field for communities the have faced years of discriminatory policies that result in poor health outcomes.

Financial assistance to purchase health insurance could be eliminated, threatening millions’ access to private insurance coverage, and coverage for the 12 million people who receive coverage under the ACA’s expansion of Medicaid is also threatened.

Prior to the ACA, routine women’s health conditions were considered pre-existing conditions, including pregnancy.

The Affordable Care Act eliminate “gender rating,” ensuring women do not pay an estimated $1 billion more annually than men for the same health care.

July 9, 2019: Representative Joe Kennedy III tweeted: “This is what the Trump Admin is arguing in court today: – Health care is a privilege – Preexisting conditions can be disqualifying – Low-income patients can’t be treated – Addiction treatment can’t be covered – This nation is too weak to care for all its citizens #ProtectOurCare.”

July 9, 2019: CBS News posted an article titled: “Judges have tough questions for Obamacare backers”. From the article:

The fate of former President Obama’s signature health care law, and its coverage and insurance protections for millions of Americans, was again being argued before a panel of judges – this time a federal appeals court in New Orleans.

Attorneys for states hoping to save President Obama’s health care law were hit with some intense and occasionally skeptical questioning from appellate judges in a New Orleans federal court.

The main issue in Tuesday’s hearing was whether Congress rendered the entire Affordable Care Act unconstitutional when it zeroed out the tax imposed people who don’t buy health insurance.

The law’s supporters say Congress clearly didn’t want “Obamacare” dismantled when it eliminated the tax in 2017. And they said the tax elimination doesn’t destroy the whole law.

But appellate judges Kurt Engelhardt and Jennifer Walker Elrod both noted the law still says people must buy insurance. They questioned whether that command now violates the Constitution. Engelhardt also suggested Congress, not the courts, should choose which parts of the law should be salvaged…

July 9, 2019: Senator Patty Murray tweeted: “ICYMI: Here’s what is at risk today because of the lawsuit being brought by Representatives to undermine families’ health care:” The tweet includes a link to a Seattle Times opinion piece from June of 2019.

July 9, 2019: Politico posted an article titled: “Appeals court skeptical Obamacare can survive”. It was written by Paul Demko. From the article:

A panel of federal appeals judges aggressively questioned whether Obamacare can survive during Tuesday afternoon oral arguments in a case that could upend the 2010 health care law.

Two Republican appointees on the three-judge panel frequently interrupted attorneys to question whether the Affordable Care Act’s individual mandate is unconstitutional and if not whether the entire law could stand without it. The ACA’s future appeared murky after two hours of oral arguments at the 5th Circuit Court of Appeals, but it’s not clear if the judges were ready to uphold a federal judge’s earlier decision invalidating the law…

…Appellate Judge Jennifer Elrod, a George W. Bush appointee, on Tuesday posited that lawmakers – who failed to agree on an Obamacare replacement plan two years ago – deliberately eliminated the mandate penalty because they knew the rest of the law would have to fall. She said perhaps lawmakers thought, “Aha, this is the silver bullet that’s going to undo Obamacare.”

Attorneys for the 20 Democratic-led states that are defending the law, as well as the Democratic-controlled House, countered that Congress clearly intended for the rest of the law to survive when it eliminated the mandate penalty.

“All the court has to do is lookout the text,” said Samuel Siegel, the attorney representing the Democratic-led states.

The three-judge appellate panel is expected to rule in the coming months. They could back the lower court ruling invalidating all of Obamacare or overturn it entirely. The judges may also determine that the elimination of the individual mandate penalty only renders certain parts of the ACA unconstitutional, such as its protections for individuals with preexisting medical conditions. That was the Trump administration’s original stance on the lawsuit before recently embracing the lower court ruling against the entire ACA…

June 9, 2019: California Governor Gavin Newsom tweeted: “The Trump administration is going to court today to try and overturn the ENTIRE Affordable Care Act. – 133 MILLION with pre-existing conditions could lose coverage. – 23 MILLION could lose their health insurance – 12 MILLION could lose Medicaid coverage” The tweet included a link to The New York Times from March of 2019.

June 9, 2019: Former Vice-President Joe Biden tweeted: “Today, the Affordable Care Act is back in the courts – putting the health care of millions of Americans at risk. It’s clear some will stop at nothing to sabotage Obamacare and roll back the progress we’ve made.” The tweet included a link to The New York Times.

July 9, 2019: The New York Times posted an article titled: “Appeals Court Seems Skeptical About Constitutionality of Obamacare Mandate”. It was written by Abby Goodnough. From the article:

…In 90 minutes of oral arguments on whether a federal district judge in Texas was correct in striking down the Affordable Care Act in December, two appellate judges appointed by Republican presidents peppered lawyers with blunt questions while the third judge, appointed by President Jimmy Carter, remained silent.

The two Republican appointees, Jennifer Walker Elrod, appointed by President George W. Bush in 2007, and Kurt Engelhardt, appointed by President Trump in 2018, seemed particularly skeptical of the Democratic defendants’ argument that Congress had fully intended to keep the rest of the law when it eliminated the penalty for going without insurance as part of its 2017 tax overhaul…

…The case, which could make its way to the Supreme Court ahead of those elections, threatens insurance protections for people with pre-existing medical conditions and many other sweeping changes the 2010 law has made throughout the health care system…

…The arguments did reveal some tensions between the Republican states that brought the case, led by Texas, and Mr. Trump’s Justice Department. For example, a lawyer for Texas took issue with a puzzling new Justice Department position – revealed in a May brief – that the ruling should apply to only the 18 plaintiff states, not nationwide. The Republican states would need to evaluate if they had “been the victims of a bait and switch,” said the Texas lawyer, Kyle D. Hawkins.

In another wrinkle, August E. Flentje, a lawyer for the Justice Department, appeared reluctant to answer questions from Judge Elrod about how applying the ruling only to the plaintiff states would work. He was also vague about another new and surprising position the administration mentioned almost in passing in its May brief: that some pieces of the health law, though not its insurance provisions, should be preserved….

…Over all, though, the panel spent the most time on the question of whether the rest of the law should fail if Judge O’Connor was correct in scrapping the insurance mandate – and Judge Elrod and Judge Engelhardt, based on their questioning, seemed to firmly believe he was. Judge Engelhardt asked Mr. Letter, the House lawyer, why Congress could not remedy the situation by writing a new health law or set of laws.

“The could do this tomorrow, ” Judge Engelhardt said, leading Mr. Letter to dryly point out that Mr. Trump would need to sign off on new laws, too.

“And obviously the president would sign this, right?” he asked sardonically. “No, obviously not.”..

…Judge Engelhardt twice asked Mr. Letter why, if Congress fully intended to keep the rest of the health law when it eliminated the penalty for going without insurance in 2017, the Senate, which is controlled by Republicans, had not also sent a lawyer to make that case.

“Why would the Senate not be here to say, ‘Oh, this is what we meant when we wrote this?” he asked. “They’re sort of the 800-pound gorilla that’s not in the room.”..

…The appeals panel also spent a good chunk of the allotted 90 minutes asking questions on a third topic: whether the Democratic states and House of Representatives even have standing to appeal Judge O’Connor’s ruling…

…If the appeals court ultimately decides that neither the House nor the intervening Democratic states have standing, it could either let Judge O’Connor’s ruling stand or vacate it. In any event, the losing party will almost certainly appeal to the Supreme Court…

July 9, 2019: Julián Castro tweeted: “The Trump administration is actively working to undermine our health care system and jeopardize the coverage of 130 million Americans with pre-existing conditions. We must #ProtectOurCare and work to expand, not restrict, access to quality health care.” The tweet included a link to The New York Times article above.

July 9, 2019: Beto O’Rourke tweeted: “We will defend the ACA. We will protect the care of those whose lives depend on it. And we will fight for universal, guaranteed, high-quality health care so every person can see a doctor, afford their prescriptions, and to live to their full potential.” The tweet included a link to The New York Times article above.

July 9, 2019: Governor Jay Inslee tweeted: “800,000 people who have healthcare coverage in WA state are at risk if the Affordable Care Act is struck down. The #ACA has saved lives, strengthened consumer and patient protections for everyone, and is keeping costs from growing unabated. #ProtectOurCare”. The tweet included a link to The New York Times article above.

July 9, 2019: Pete Buttigieg tweeted: “Republicans are putting health care for over 20 million Americans in jeopardy with their latest attack on the Affordable Care Act. Instead of restricting access, we should be expanding health care with Medicare for All Who Want It.” The tweet includes a link to an NPR article.

July 9, 2019: Elizabeth Warren tweeted: “The Trump administration is in court today in their never-ending crusade to destroy health care for millions of Americans. If they succeed, families like Chantel’s would go bankrupt. People would die. #ProtectOurCare.” The tweet includes a video featuring Chantel and her family.

July 9, 2019: Nancy Pelosi tweeted: “Under the ACA, the 130 million Americans w/ pre-existing conditions cannot be discriminated against y their insurer. Their health care costs could skyrocket if the GOP’s Texas v. US lawsuit succeeds in throwing out years of progress on health care. #ProtectOurCare”.

July 9, 2019: Speaker of the House Nancy Pelosi posted remarks on the official Speaker of the House website titled: “Pelosi Remarks at Press Conference on Day of Oral Arguments in GOP’s Texas v. U.S. Lawsuit to Destroy Health Care”. From the remarks:

…Today, the Trump Administration is demanding that the court strike down every last provision of the ACA. Protecting protections for the over 130 million Americans with pre-existing conditions and their families, bans on lifetime and annual limits, as the Leader mentioned, that can have a very devastating impact financially, as well as health-wise, for a family. The Medicaid expansion in the ACA, very important to people born with a pre-existing condition, babies born with a pre-existing condition and families otherwise, savings for seniors on prescription drug cost, the premium assistance that makes health coverage affordable for millions of American families.

As you all know, the Affordable Care Act extended benefits to 20 million people who did not have health care before and that was very important – a major achievement in itself, but that was not the full extent of the bill.

130 million Americans have pre-existing conditions and they are affected by this law case. And, what’s interesting about it is during the campaign, across the country, Republicans were saying, “We’re for preserving the pre-existing medical conditions [protections]” and yet they vote over and over again to prevent it and now they’re taking it to court.

And, the reason they think they have a chance in court is because of what they did on the horrible GOP Tax Scam bill, where they undermined the Affordable Care Act there. Every chance they get, they try to undermine the health and financial security of America’s working families.

The ACA is a pillar of health and economic security, standing alongside Medicare, Medicaid, and Social Security. But the GOP is showing that they want to destroy the Affordable Care Act for America’s families…

…But more than 190 Republicans that day voted to be fully complicit in the Administration’s attempt to tear away health care protections. Families across the nation have called on Congress to ‘Protect Our Care’ and House Democrats are fighting for them…

…Democrats will continue to fight For The People to lower health care costs and the cost of prescription drugs and to protect people with pre-existing conditions…

July 9, 2019: Representative Jerry Nadler tweeted: “Today the Trump Admin is arguing to strike down the entire ACA, turning their back on millions with preexisting conditions. @HouseJudiciary is committed to fighting this GOP assault, and will hold a hearing on the DOJ’s refusal to defend the ACA this month #ProtectOurCare”. The tweet included a link to an NPR tweet.

July 9, 2019: Covered California posted a news release titled: “California’s Initiatives Will Lead to Hundreds of Thousands Gaining Health Care Coverage With Lower Premiums and New Financial Help”. From the news release:

  • California’s individual market will see a preliminary rate change of 0.8 percent in 2020, which is the lowest change since Covered California’s launch, due to new state affordability initiatives designed to lower costs and encourage enrollment.
  • An estimate 922,000 people – including many middle-income Californians – will be eligible from a first-in-the-nation expansion of financial help that builds on the Affordable Care Act and lowers the costs of their health care coverage.
  • Covered California projects that lowering health care costs and reinstating the penalty on individuals who can afford coverage, yet choose to go without insurance, will result in 229,000 people becoming newly covered.
  • All 11 health insurance companies return to the market in 2020, and a major national plan, Anthem Blue Cross, with expand – giving nearly all Californians a choice of two carriers, and 87 percent able to choose from three carriers or more.
  • A Covered California analysis projects that an estimated 922,000 will be eligible for the new state subsidy program that will help lower the cost of their coverage in 2020. The consumers who are projected to benefit from the new state subsidies are:
  • An estimated 235,000 middle-income Californians who previously did not qualify for financial help because they exceeded federal income requirements. They will be eligible to receive an average of $172 per household per month, which will help them save an average of 23 percent off their current premiums. Many of these consumers, particularly those who live in high-cost regions, will see significant savings and annual reductions in their health care premiums in the hundreds or even thousands of dollars.
  • An estimated 663,000 Covered California enrollees who currently receive federal financial help. They will be eligible to receive an average of an additional $15 per household per month which will help them save an average of 5 percent on their current premiums.
  • An estimated 23,000 Covered California enrollees whose annual household income falls below 138 percent of the federal poverty level (FPL), which is less than $17,237 for an individual and $35,535 for a family of four. They will see their premiums for the benchmark plan lowered to $1 per member, per month.

July 9, 2019: Los Angeles Times posted an article titled: “With Obamacare in peril, California reins in rising health insurance premiums”. It was written by Barbara Feder Ostrov and Ana B. Ibarra. From the article:

Premiums on California’s health insurance exchange will rise by an average of 0.8% next year, the lowest increase in the agency’s history, state officials announced Tuesday.

Covered California Executive Director Peter Lee credited two new statewide initiatives for keeping the proposed rate hikes low: Next year, California will be the first state in the country to offer state-funded tax credits to middle-class enrollees, which will be paid for in part by a new tax penalty on Californians who don’t have health insurance…

…Covered California estimates that the state-based tax credits, in conjunction with the new state tax penalty, will result in 229,000 newly insured Californians.

The average rate hike for 2020 is far lower than this year’s average increase of nearly 9% and the five-year average increase of 8.4%. Covered California began offering health plans in 2014 to individuals and families who purchase their own insurance as part of the state’s implementation of the Affordable Care Act, a.k.a. Obamacare…

…The new individual mandate for Californians starts in 2020. The penalty for not having insurance will mirror the one under the Affordable Care Act, which as $695 per adult (and $347.50 per child under 18) or 2.5% of annual household income, whichever is greater. That can amount to thousands of dollars a year.

The revenue from the penalty, plus other state funds, will help pay for state-based tax credits for roughly 922,000 people who purchase insurance through Covered California. As part of the 2019-20 state budget signed by Gov. Gavin Newsom last month, the state will pledge $1.45 billion over the next three years for this effort.

Under the deal, California will become the first state to offer financial aid to middle-income enrollees who make between 400% and 600% of the federal poverty level – many of whom have been struggling to pay their premiums. That’s between about $50,000 and $75,000 a year for an individual and between about $103,000 and $154,500 for a family of four.

Under the Affordable Care Act, people who purchase plans through Covered California and other health insurance exchanges are eligible for federal tax credits only if they make between 138% and 400% of the federal poverty level. People who earn more than 400% of the federal poverty level get no federal aid…

July 9, 2019: Concord Monitor posted an article titled: “Sununu to sign Democrat-backed safeguards to Obamacare provisions”. It was written by Ethan DeWitt. From the article:

Gov. Chris Sununu is poised to sign a Democratic bill that would protect certain portions of the Affordable Care Act by codifying them into state law, his office said.

On Tuesday, Democratic legislative leaders in Concord sent a bill to Sununu that would add a range of provisions into state statute, including a requirement that health insurance plans cover those with pre-existing conditions.

The move comes as a New Orleans federal court takes up oral arguments over the constitutionality of the Affordable Care Act – a high stakes case that threatens funding as well as regulations within the law…

…Senate Bill 4 would add to state law a mandate that insurance plans also cover a range of “essential health benefits” such as coverage for emergency services, maternity care, and rehabilitative services. And it would prevent the re-emergence of lifetime caps on age or expenses for those on certain insurance plans.

Those protections were introduced into federal law by the ACA in 2010 – also known as “Obamacare” – which has faced opposition and legal challenges by several Republican attorneys general and supported by the U.S. Department of Justice…

…For Sununu, support for the bill puts him odds with some in his party. While SB 4 passed the Senate nearly unanimously, it left the House on party lines, after House Republicans argued it would tie the state’s hands in the event the ACA did fall and big decisions needed to be made…

July 9, 2019: The Catholic Health Association of the United States (CHA) posted a news release titled: “CHA Strongly Urges Upholding The ACA In Texas v. United States”. From the news release:

CHA Strongly Urges Upholding the ACA in Texas v. United States

Statement by Sr. Mary Haddad, RSM, President and Chief Executive Officer, Catholic Health Association of the United States

As the U.S. Court of Appeals for the Fifth Circuit considers the constitutionality of the Affordable Care Act (ACA), the Catholic Health Association of the United States (CHA) stands firmly with those defending the law. CHA joined with four hospital organizations earlier this year in filing a brief as amici curiae in support of the Intervenor-Defendants-Appellants in Texas v. United States.

“We believe health care is a basic human right and the effort to eliminate access to affordable health care coverage for millions of Americans is unconscionable,” stated Sr. Mary Haddad. The consequence of being uninsured are significant. Since uninsured patients are often forced to delay receiving necessary care, they are up to four times more likely than insured patients to require affordable hospitalization and emergency care. In addition to being harmful to patients’ health, the lack of coverage adds unnecessary expense to our nation’s health care system and deprives patients with an equitable opportunity for a healthy, productive life.

Under the ACA, we as a nation have taken significant steps toward expanding health care access and coverage, as well as improving our nation’s health care delivery system. Nearly 20 million Americans have gained affordable insurance coverage, including 12 million low-income individuals who have gained coverage through state Medicaid program expansions under the ACA. The law also provides protections for 130 million people with pre-existing health conditions – including 17 million children – all of whom no longer need to worry that they will be denied insurance coverage.

CHA believes that a decision by the Fifth Circuit to strike down the ACA as unconstitutional, if upheld, would reverse the progress we have made, adversely impacting the health of millions of Americans. We believe, as a matter of human dignity, everyone is entitled to health care. Like any basic element of life, health care sustains us and should always be accessible and affordable for everyone – where they need it, when they need it, no exceptions and no interruptions. CHA will continue to work with policy makers to advance the goal of ensuring everyone has access to affordable health coverage and high-quality health care.

July 9, 2019: Daily Memphian posted an article titled: “Pastors urge Lee to request Tennessee drop from Affordable Care Act lawsuit”. It was written by Sam Stockard. From the article:

With arguments set Tuesday in a lawsuit to dismantle the Affordable Care Act, a network of pastors is urging Gov. Bill Lee to request Tennessee drop out of the federal case.

The Southern Christian Coalition made a public appeal for the governor to call on Attorney General Herbert Slatery to remove the state from Texas v. United States. The case is to be argued in the U.S. Fifth Circuit Court of Appeals in New Orleans, and its next stop would be the U.S. Supreme Court.

“I appeal to Gov Lee, as a man of faith and a man of Christian values, to then live up to his values, to care for the least of these, to be compassionate… and to ask Slatery to remove the state of Tennessee from this lawsuit,” said Kelli X, minister of Village Church in Madison.

She argued dismantling the Affordable Care Act would take health care coverage from more than a million Tennesseans, decreasing the number of people able to seek mental health care, possibly causing them to wind up in prison and limiting access to health care for babies born with health problems such as asthma…

…The group points out no plan is in place to provide health care for Tennesseans with preexisting conditions if the law is overturned…

July 9, 2019: Roll Call posted an article titled: “States grapple with Medicaid work requirements”. It was written by Sandhya Raman. From the article:

State action to implement work requirements into their Medicaid programs is heating up, as some states roll out their programs while others are fighting in court to keep them alive.

New Hampshire announced Monday it would delay suspending any Medicaid coverage until September because of consumers’ noncompliance with the work requirements. Meanwhile, Indiana on July 1 began the first steps of implementing its work requirements. Court action in three other states is expected in the coming months,

The path to implementing requirements for work or other forms of community service through Medicaid, the health program that covers some of the nation’s poorest individuals, has been tricky and controversial.

MaryBeth Musumeci, associate director at the program on Medicaid and the uninsured at the nonpartisan Kaiser Family Foundation, said the overarching issue is whether requiring work is a permissible objective of Medicaid coverage…

…A June study published in the New England Journal of Medicine found that work requirements are not increasing employment and private insurance coverage…

…Arkansas was the first state to incorporate 80 hour per month work requirements in 2018 for some enrollees, but these are no longer in effect due to a circuit court ruling this year.

New Hampshire became the second state to start phasing in slightly stricter requirements but recently changes them. Starting in June, individuals were supposed to work 100 hours per month, and enrollees would have had until July 7 to report their June hours or risk suspension later this year. Pregnant women and people who are medically frail or have a disability were exempted.

But in late June, New Hampshire’s Democratic-controlled legislature passed a compromise scaling back the work requirements and expanding the exemptions. The legislation allowed the New Hampshire Department of Health and Human Services to delay implementation…

…Indiana rolled out its 20 hours per month requirements on July 1, with stricter requirements being phased in over time. Unlike in Arkansas, compliance is evaluated yearly rather than monthly.

Last year, Arkansas terminated consumers’ coverage after three months of noncompliance, resulting in almost 17,000 individuals being dropped from the program…

…Wisconsin and Michigan are the next states slated to roll out work requirements in late October and January, respectively. Both states also have New Democratic governors.

Maine, which also has a New Democratic governor this year, will not implement its work requirements, but it may not be as simple for Wisconsin and Michigan to reverse course…

…The next legal action expected is for New Hampshire’s program, which will be heard in the U.S. District Court for the District of Columbia.

U.S. District Judge James Boasberg, an Obama appointee who previously ruled that both Arkansas and Kentucky’s programs were invalid, is scheduled for the case…

…Both the Kentucky and Arkansas cases are set to be heard by the U.S. Court of Appeals for the District of Columbia Circuit. The states’ briefings end Aug. 1, and oral arguments are expected by October…

July 9, 2019: Deseret News posted an article titled: “Utah leaders react to the uncertain fate of the Affordable Care Act”. It was written by Kim Bojouquez. From the article:

Utahs are watching closely as the future of the Affordable Care Act is considered by three judges on the other side of the country.

A three-judge panel, two Republican-appointed and one Democrat-appointed, from the U.S. Court of Appeals for the 5th Circuit in New Orleans, heard oral arguments on the constitutionality of the Affordable Care Act, also known as Obamacare, on Tuesday.

In February 2018, Utah Attorney General Sean Reyes joined a 20-state coalition lawsuit against the federal government challenging the lawfulness of the health care law and calling it unconstitutional, after Congress repealed a provision that people without health insurance had to pay a fine…

…Lauren Simpson, policy director for Alliance for a Better Utah, a government advocacy and watchdog organization, said it’s too soon to tell where the judges will lean.

“This is something that’s going to have really serious consequences for Utah. It directly contradicts what we know Utahs want,” Simpson said.

Last November, Utahns voted in support of Proposition 3 to expand Medicaid coverage in the state. But in February, Gov. Gary Herbert signed a replacement to limit Medicaid expansion…

July 10, 2019: Des Moines Iowa Register posted an article titled: “Iowa agrees to give Medicaid management companies 8.6% raises”. It was written by Tony Leys and Stephen Gruber-Miller. From the article:

Iowa’s controversial use of private insurers to run its Medicaid program just got $386 million more expensive.

That’s how much more state and federal money Iowa officials have agreed to pay through this fiscal year for two national companies to manage the giant health care program.

The 8.6% raises will go to Amerigroup and Iowa Total Care, which Iowa hired to insure about 575,000 poor or disabled Iowans whose health care is covered by Medicaid…

…The Medicaid program is jointly financed by federal and state tax dollars, with rates set in closed-door negotiations between the companies and the Iowa Department of Human Services. The increased costs announced Wednesday include a 6.5% boost in state financing, which translates to $115 million, according to a summary posted by Iowa DHS.

The new terms come a year after DHS officials agreed to give Amerigroup and UnitedHealthcare, then the state’s Medicaid managers, a raise of 8.4% in state and federal money for fiscal year 2019. That year’s raise amounted to $344 million, including $103 million more in state money. As a result, legislators had to come up with more money last spring, in the middle of the budget year…

July 10, 2019: The Salt Lake Tribune posted an article titled: “Utah health care panel objects to state’s partial Medicaid expansion plan”. It was written by Benjamin Wood. From the article:

Most members of Utah’s Medical Care Advisory Committee oppose the state’s plan to partially expand Medicaid through the imposition of service reductions, spending and enrollment caps, and patient work requirements.

Ten of the advisory committee’s 19 members – who are appointed by Utah health care entities – signed on to a June 30 letter addressed to the state Department of Health asking local and national administrators to reject proposed changes to Utah’s Medicaid program, which “could risk the health and security of many Utah beneficiaries.”…

…The advisory committee’s objections were made as part of the public comment for a waiver that Utah is seeking from the federal government to implement a scaled-back version of Medicaid expansion approved by lawmakers earlier this year. The Legislature’s plan, SB96, replaced Proposition 3, a full Medicaid expansion initiative approved by voters last year that would have extended Medicaid services to tens of thousands of additional low-income Utahns.

In its letter, the advisory committee highlights four areas of concern with Utah’s waiver request: a per-capita funding scheme that could leave the state liable for increased health care costs without matching federal funds; enrollment caps that could exclude otherwise eligible patients from Medicaid if funding runs dry; a requirement that patients prove they are working, looking for work or engaged in other qualifying activities to participate in Medicaid; and the elimination of some Medicaid benefits for 19- and 20-year-old patients…

…Last month, the Utah Health Policy Project released a report suggesting that per-capita funding could cause Utah’s Medicaid program to face a $39 million budget shortfall by 2024. Budget constraints were among the primary motivations cited by lawmakers in repealing and replacing Proposition 3 with the scaled-back expansion of SB96 intended to control costs…

…Utah’s Medicaid program currently is operating under a temporary waiver, often referred to as the “bridge” plan, which includes a limited expansion population and approval for work requirements, but those work requirements have not yet been implemented…

July 11, 2019: Planned Parenthood posted a press release titled: “Ninth Circuit Denies Emergency Relief From Domestic Gag Rule”. From the press release:

An en banc panel of the U.S. Court of Appeals for the 9th Circuit refused to block the Trump-Pence administration from enforcing the dangerous Title X gage rule. Title X is the nation’s program for affordable birth control and reproductive health care, which serves 4 million people each year. Trump’s gag rule makes it illegal for health care providers in the Title X program to refer patients for abortion, and also blocks access to care through the program at Planned Parenthood by imposing cost-prohibitive and unnecessary “physical separation” requirements. Planned Parenthood will continue its effort to restore the nationwide preliminary injunction and fight to protect health care for millions across the country.

Providers that serve nearly half of the patients who get care through Title X have made it clear that the rule would force them out of the program – the administration is putting health care at risk for millions of patients across the country. Title X helps millions of patients struggling to make ends meet – the majority of whom are people of color, Hispanic, or Latino – access birth control, cancer screenings, STI testing, and other essential reproductive health care…

…Four district court judges had previously blocked the rule, with two judges blocking it nationwide. On June 20, 2019, the 9th Circuit granted the request from the Trump-Pence administration to stay the preliminary injunctions in California, Oregon, and Washington, which allowed the gag rule to be enforced. The 9th Circuit agreed to re-hear the administration’s request for a stay on July 3, 2019. Today’s order makes it clear that while the court is rehearing the request for the stay, the stay remains in place, jeopardizing the care of millions of people who access birth control and other reproductive health services through Title X.

In June, the House of Representatives passed a spending package including strong language blocking the Trump-Pence administration’s Title X gag rule from being implemented. Now, the Senate must push for a spending bill that includes protective language to make sure millions of people can continue to access health care through Title X…

July 11, 2019: Rewire News posted an article titled: “Republicans Get Another Win in Their Fight to Gut Title X”. It was written by Jessica Mason Pieklo. From the article:

The Ninth Circuit Court of Appeals on Thursday ruled the Trump administration’s domestic “gag rule” which bans family planning dollars from going to health-care providers who perform abortions or refer patients for abortion services, can take effect everywhere but the state of Maryland.

The ruling jeopardizes comprehensive reproductive health-care for nearly 4 million people…

…The Trump administration’s changes to the Title X program also mandate a new “physical and financial separation” between a Title X-funded program and a facility that engages in “abortion activities.” This separation must include separate waiting, consulting, examination, and treatment rooms, as well as office entrances and exists. Title X grantees would have to provide different phone numbers and email addresses for those staff members and facilities involved in abortion services. These separation requirements apply to all Title-X funded projects that give referrals to patients who wish to obtain an abortion, as well as any that engage in separately funded advocacy or public education activities that “promote” abortion as determined by the Trump administration.

To obtain Title X funding, providers would have to open and operate an entirely independent facility to merely provide a referral for abortion care…

…First proposed in May of 2018, the administration’s changes had been blocked by the courts from taking effect while lawsuits challenging them proceed. Thursday’s order, however, allows those changes to take effect immediately, except for the separation requirements: Title X grantees will have until March 4, 2020, to comply with those requirements…

July 11, 2019: Los Angeles Times posted an article titled: “Trump’s vaunted kidney initiative depends on Obamacare, which he’s trying to kill”. It was written by Michael Hiltzik. From the article:

President Trump was showered with praise Wednesday when he unveiled an initiative to fix the country’s wretched and ridiculously expensive system for dealing with kidney disease.

Only one problem. Trump’s plan depends on the Affordable Care Act, which he is trying to kill…

…He has eviscerated effective programs at the Department of Health and Human Services and replaced professional policy officials with ideology-driven hacks. His appointees at HHS have routinely approved state-level changes to Medicaid, the nation’s most important healthcare program for low-income Americans, that deprive enrollees of coverage by thousands at a time…

…There’s no question that the nation’s existing method of dealing with end-stage kidney disease is a mess. The most common treatment, dialysis, is so expensive – running an average of $90,000 per year per patient – that Congress in 1973 allowed advanced renal patients to enroll in Medicare at any age. The act effectively made end-stage renal disease the only condition subject to a single-payer program.

That helped turn dialysis into a hugely profitable business. About 10,000 patients were covered in 1973; today more than 750,000 are. Federal spending through Medicare has soared to more than $34 billion a year from $1.1 billion (in current dollars) in 1973…

…Two remedies for this situation have long been obvious. One is to increase the rate of kidney transplants, which sharply reduce the cost of treating kidney disease. But kidneys are hard to come by. More than 100,000 patients in the U.S. are on the waiting list, with only about 21,000 donor organs available per year. Kidney transplants cost an average of about $32,000 and annual post-surgical care only about $25,000.

The other remedy is to preform more dialysis at home, where it’s cheaper than at the dialysis centers operated by DaVita, Fresenius, and other companies, and certainly more convenient for patients. But only about 12% of U.S. patients receive dialysis at home, far less than in most other developed countries.

Trump’s proposal, embodied in an executive order signed Wednesday, aims to increase transplants by covering more of the costs for donors, including lost work time and child care expenses. The White House says that, along with other changes in the transplant system, would double the number of kidneys available for transplant by 2030.

The plan aims to increase the share of patients reviving dialysis at home to 80%. This would be done in part by changing the incentives for providers so they steer more patients to home dialysis (assuming that’s the right choice for them).

The rub is that such changes would require congressional authorization – if it wasn’t for the Affordable Care Act. The act established the Centers for Medicare and Medicaid Innovation, which allow the changes to be made administratively…

July 11, 2019: Planned Parenthood posted a press release titled: “New Multi-State Study Shows Telemedicine Abortion Is as Safe and Effective as In-Person Care”. From the press release:

A new study published in Obstetrics & Gynecology shows that medication abortion via telemedicine is just as safe and effective as when the health care provider is in the same health center as the patient. The study was conducted by Planned Parenthood Federation of America – with researchers from Ibis Reproductive Health and University of California San Francisco (UCSF) Advancing New Standers in Reproductive Health (ANSIRH) – and supports existing evidence that outcomes for medication abortion via telemedicine are comparable with medication abortion provided in person.

The study is the nation’s largest multi-state study of medication abortion via telemedicine to date, with researchers analyzing records from nearly 6,000 patients receiving medication abortion either through telemedicine or in person at 26 Planned Parenthood health centers in Alaska, Idaho, Nevada, and Washington…

Medication abortion has been safe and legal in the U.S. since the FDA approved of its use nearly 20 years ago. It helped ensure that patients are able to make their own private medical decisions, and it has expanded access to reproductive health care.

In a health-center-to-health center model of providing abortion via telemedicine, a patient has an ultrasound scan, laboratory testing, and counseling with health center staff. Telemedicine patients then meet with a provider in another health center through a secure videoconferencing platform, while standard medication abortion patients meet with a provider in person. During the study period, researchers compared rates of ongoing pregnancy, the need for a subsequent in-clinic abortion, and any significant adverse effects between the two groups. Researchers concluded that medication abortion provided remotely offers patients the same effective, high-quality care that they would receive if they were in the same room with the same trained providers. The study also found that complications are very rare for medication abortion via telemedicine, which is consistent with findings from previously published research.

Restrictions and political attacks on access to abortion have left entire swaths of the country without access to safe, legal abortion, disproportionately affecting people with low incomes, people of color, and people living in rural communities. Right now, anti-abortion politicians are pushing burdensome and medically unnecessary bans that effectively prohibit access to medication abortion via telemedicine. Leading medical associations, such as the American College of Obstetricians and Gynecologists (ACOG), agree that these bans are not based in evidence…

July 11, 2019: The Tennessean posted an article titled: “Blue Cross plans to return to Obamacare marketplace in Nashville, Memphis”. It was written by Brett Kelman. From the article:

…The state’s largest insurance company, BlueCross BlueShield of Tennessee, plans to reenter the Affordable Care Act marketplace in Nashville, Memphis and surrounding counties next year, providing another option for residents on Obamacare in these cities. Cigna and Oscar Health, are planning to significantly reduce the cost of their coverage plans.

Although the proposals are not final, it appears Tennesseans will have more options and competitive prices in the coming year, said Kevin Walters, a spokesman for the Department of Commerce and Insurance…

Five insurance companies that currently offer Obamacare coverage plan to continue to do so next year, according to the department. The companies have submitted the following proposals to state regulators for approval:..

Those companies are BlueCross BlueShield of Tennessee, Bright Health, Celtic/Ambetter Insurance, Cigna, and Oscar Health.

July 11, 2019: West Dakota FOX posted an article titled: “North Dakota argues Affordable Care Act’s validity”. From the article:

…North Dakota’s Democratic Party says if the Affordable Care Act is overturned, there would no longer be penalties.

“The penalty for those who don’t carry health insurance, they just reduced that penalty to zero, which essentially means there is no longer a tax,” said Kylie Oversen, Chairwoman of the Dem NPL.

House Dem-NPL legislators proposed an amendment to the insurance commissioner’s budget this past session, in case the ACA would be found unconstitutional. It would require health insurance companies in North Dakota to cover people with pre-existing conditions…

…Insurance Commissioner Jon Godfread says the language on the amendment was unworkable…

July 11, 2019: Military Times posted an article titled: “Yearlong birth control supply for female vets could cut costs and unplanned pregnancies”. It was written by Ariana Puzzo. From the article:

The Department of Veterans Affairs could save about $2 million a year in prenatal, birth and newborn care costs by offering female veterans a year’s supply of birth control pills, researchers say.

The VA does not currently offer an upfront 12-month supply option. Approximately 24,000 women receive oral contraceptives and a policy change could prevent an estimated 583 unintended pregnancies, found Colleen Judge-Golden, an MD, Ph.D. student the University of Pittsburg School of Medicine…

Judge-Golden, the lead author of the paper published Monday in the Journal of the American Medical Association, analyzed the expense of the proposed program with senior author Sonya Borrero, M.D., M.S., the associate director of the VA’s Center for Health Equity Research and Promotion. Research found that money saved on health care costs would exceed the cost of providing larger upfront quantities of birth control pills to women.

Forty-three percent of women receiving three-month increments of birth control will encounter at least one refill gap over a 12-month period that increases the risk of unintended pregnancies, VA data showed. Women outside of the VA who receive one year’s worth of birth control pills were alternatively found to experience fewer refill gaps and less pregnancies…

July 11, 2019: Reuters posted an article titled: “U.S. lawmakers advance bill to boost Puerto Rico Medicaid funding”. From the article:

A bill that would substantially boost federal Medicaid funding for Puerto Rico advanced out of a U.S. House subcommittee on Thursday after lawmakers agreed to work on stricter safeguards in the wake of a government corruption scandal in the territory.

The Health Subcommittee sent the legislation, which would give the bankrupt U.S. commonwealth an additional $12 billion over four years, to the full House Committee on Energy and Commerce.

On Wednesday, U.S. law enforcement officials announced a 32-count indictment and arrests of six people, including two former high-ranking Puerto Rico government officials, who were charged with conspiracy and other crimes in connection with millions of dollars in federal Medicaid and education funds…

…Federal funding to the five U.S. territories to support the healthcare program for low-income residents is capped, often leading to shortfalls during economic downturns or natural disasters like the devastating hurricanes that hit Puerto Rico in 2017 just months after it filed a form of bankruptcy in U.S. District Court…

July 11, 2019: NPR posted an article titled: “Young Undocumented Californians Cheer Promise of Health Benefits”. It was written by Sammy Caiola. From the article:

…California’s governor signed a law Tuesday that approved $98 million to expand Medi-Cal to income-eligible undocumented adults from age 19 until they turn 26, making it the first state in the United States to cover this group. California estimates 138,000 young adults will become insured under the new policy.

While the state has expanded options for children and young adults, most undocumented people in California still have limited access to health care. They can sign up for “restricted” MediCal, but it only covers emergencies and pregnancy-related care. Many people on this plan end ip putting off treatment or turning to county clinics for help.

Supporters who want to further expand Medi-Cal to all residents say that move would boost public health and bring down emergency room costs. California Gov. Gavin Newsom has vowed to make everyone eligible…

…But after months of debate at the California State Capitol, proposals to offer Medi-Cal to all undocumented adults, as well as a push to cover undocumented seniors, were deemed too costly…

…President Donald Trump has also criticized California for offering health insurance to undocumented people…

July 11. 2019: The Hill posted an article titled: “Nearly half of voters less likely to support lawmakers who back ObamaCare repeal.” From the article:

Almost half of Americans say they are less likely to support lawmakers who are in favor of repealing Obamacare, according to a new Hill-HarrisX poll.

The survey, released on Thursday, found that 47 percent of registered voters said they were less likely to cast a ballot for members of Congress who backed a lawsuit that aims to eliminate ObamaCare, compared to 28 percent of respondents who were more likely to support those lawmakers.

Twenty-six percent of voters said it doesn’t matter either way.

Older Americans and minorities were least likely to support lawmakers who favored the ObamaCare lawsuit. The poll found that 58 percent of respondents age 65 and older and 68 percent of African Americans were less inclined to back lawmakers who are opposed to ObamaCare…

…The survey of 1,001 voters was conducted online July 5-6. The margin of error is plus or minus 3.2 percentage points.

July 12, 2019: Planned Parenthood posted a press release titled: “Congress Expands Birth Control Access for Service Members”. From the press release:

The House of Representatives approved two amendments to the Fiscal year 2020 National Defense Authorization Act (NDAA) that would expand contraception and reproductive health care access for service members. Most service members receive health insurance coverage through TRICARE, which currently does not offer comprehensive contraception coverage and reproductive health care resources for service members and their families…

…The amendments were offered by Reps. Jackie Speier (CA-14), Veronica Escobar (TX-16), Katie Hill (CA-25), Deb Haaland (NM-01), Ayanna Pressley (MA-07), Judy Chu (CA-27), and Barbara Lee (CA-13). One amendment adopted into the underlying bill clarifies that all FDA-approved contraceptive methods are covered by TRICARE without a copay, and brings TRICARE in line with the ACA’s birth control benefits. The second amendment passed by a vote of 231-199 establishes a standard family planning education program across all branches of the military, increasing services members’ ability to make the best decisions for themselves and their families.

July 12, 2019: Fauquier Times posted an article titled: “Fauquier Free Clinic changes business model to include additional Medicaid patients”. From the article:

This year the Fauquier Free Clinic, which has a mission to provide eligible residents of Fauquier and Rappahannock counties with access to comprehensive medical, dental, and mental health care, underwent “extensive changes” to accommodate new and existing patients when Medicaid expanded its services for low-income adults throughout Virginia, the clinic said in a news release.

“In the past, our medical patients were not eligible for services if they had any type of medical insurance,” John McMahon, FFC board secretary said in the news release, “Now, approximately 60 percent are Medicaid eligible.”

In Fauquier County, between 1,700 and 1,800 more people are now eligible for Medicaid, according to the clinic news release. In Rappahannock County, 300 to 400 people are now eligible. Throughout the state of Virginia, eligibility has been granted to around additional 400,000 people…

July 12, 2019: Planned Parenthood posted a press release titled: “Planned Parenthood’s Clergy Advocacy Board Condemns the Trump-Pence Administration’s Gage Rule”. From the press release:

An en banc panel of the U.S. Court of Appeals for the 9th Circuit refused to block the Trump-Pence administration from enforcing the dangerous Title X gag rule. Title X is the nation’s program for affordable birth control and reproductive health care, which serves 4 million people each year. The Clergy Advocacy Board of Planned Parenthood Federation of America condemns the Trump-Pence Administration’s dangerous Title X gag rule that makes it illegal for doctors, nurses, hospitals, community health centers, and any other provider in the Title X program to tell patients how they can safely and legally access abortion.

The gag rule also makes it impossible for millions of patients to access birth control at Planned Parenthood health centers across the country.

“We, the Clergy Advocacy Board condemn this gag rule. It brings politicians into the exam room, impairing access to accurate and complete medical information, undermining the patient’s moral agency, harming the poor and those in need, and for blocking access to preventative health care, including contraception.

“We are called as clergy and faith leaders to provide pastoral care to people facing medical decisions. Day in and out, we witness the importance of how our congressional members get or don’t get the help they need, the medical information they need, the benefit of the doctor-patient relationship, and access to the care that arises from these personal, private deliberations.

“Our faiths and pastoral experience also bear witness to the urgency and moral good in available access to all forms of contraception, and in keeping abortion safe and legal.”

July 13, 2019: Reuters posted an article titled: “Democrats take aim as Trump abandons drug pricing plan”. It was written by Ginger Gibson. From the article:

…Trump talked regularly about drug prices during his 2016 campaign, but has failed so far to deliver the changes he promised.

On Thursday, his administration scrapped one of its most ambitious proposals for lowering prescription medicine prices, backing down from a policy aimed at health insurers and raising the possibility of new measures focused on drugmakers.

The abandoned proposal would have required health insurers to pass billions of dollars in rebates from drugmakers to Medicare patients…

…[Robert] Blendon [a political scientist at Harvard University] said Trump, having failed to broker any deals in Congress, made his drug price plan to complicated, and voters are unlikely to see him as having made any strides. That is an opportunity for Democrats to offer their own effort at messaging…

…On Thursday, U.S. Senators Kirsten Gillibrand unveiled a plan to lower drug prices. On Friday, Democrat Amy Klobuchar announced a plan to help lower the cost of pharmaceuticals purchased by seniors. Warren also has a Medicare pricing plan.

Sanders is heading to Canada later this month for an event to highlight the difference in the price of insulin…

…Klobuchar’s proposal, which includes investing in research for a cure for Alzheimer’s disease and improving the stability of Social Security, would allow the government to negotiate Medicare Part D costs, which cover prescriptions for seniors.

Klobuchar, a U.S. senator from Minnesota, would also let people order prescription drugs from countries like Canada, a proposal proponents say would Lowe drug costs…

July 12, 2019: The Rolla Daily News posted an article titled: “Governor Parson signs “Nathan’s Law,” fixes glitch in Affordable Care Act”. It was written by Ron Reports. From the article:

Governor Mike Parson signed House Bill 397 and Senate Bill 514 on Thursday. Both bills fixed an oversight in the Affordable Care Act related to youth formerly in foster care. One of the most popular provisions of the Affordable Care Act is the ability for children to stay on their parents’ health insurance until they turn 26…

The ACA allows children that aged out of the foster care system at 18 to remain on Medicaid until they are 26 years old. However, the language passed in the ACA only required a state to provide Medicaid to that individual if they aged out of that specific foster system. Currently, if a youth aged out of Illinois’s foster system, but moved to Missouri to work, they are not allowed to maintain their public insurance in Missouri…

…Research has shown that access to health care for youth previously in foster care is important because they are more likely to have health complications. Ensuring these youth remain insured helps the broader community by keeping them out of crisis that could lead to emergency room visits or hospitalizations…

…In the fall of 2018, Congress passed and President Trump signed into law a federal fix to this provision within the ACA, but it will not take effect until Jan. 1, 2023. These former foster youth in Missouri will be able to access Medicaid beginning August 28, 2019, when the bill takes effect, according to the nonprofit Kids Win Missouri, whose mission it is to further child well-being…

July 15, 2019: Former Vice President Joe Biden (who is running for President) revealed information about his Health Care Plan.

Here is some of the key parts of Joe Biden’s Health Care Plan:

Giving Americans a new choice, a public health insurance option like Medicare.

  • If your insurance company isn’t doing right by you, you should have another, better choice. Whether you’re covered through your employer, buying you insurance on your own, or going without coverage altogether, the Biden Plan will give you the choice to purchase a public health insurance option like Medicare. As in Medicare, the Biden public option will reduce costs for patients by negotiating lower prices from hospitals and other health care providers. It also will better coordinate among all of a patient’s doctors to improve the efficacy and quality of their care, and cover primary care without any co-payments. And it will bring relief to small businesses struggling to afford coverage for their employees.

Increasing the value of tax credits to lower premiums and extend coverage to more working Americans.

  • …The Biden Plan will help middle class families by eliminating the 400% income cap on tax credit eligibility and lowering the limit on the cost of coverage from 9.86% of income to 8.5%. This means that no family buying insurance on the individual marketplace, regardless of income, will have to spend more than 8.5% of their income on health insurance. Additionally, the Biden Plan will increase the size of tax credits by calculating them based on the cost of a more generous gold plan, rather than a silver plan. This will give more families the ability to afford more generous coverage, with lower deductibles and out-of-pocket costs….

Expanding coverage to low-income Americans.

  • …The Biden Plan will ensure these individuals get covered by offering premium-free access to the public option for those 4.9 million individuals who would be eligible for Medicaid but for their state’s inaction, and making sure their public option covers the full scope of Medicaid benefits. States that have already expanded Medicaid will have the choice of moving the expansion population to the premium-free public option as long as the states continue to pay their current share of the cost of covering those individuals. Additional, Biden will ensure people making below 138% of the federal poverty level get covered. He’ll do this by automatically enrolling these individuals when they interact with certain institutions (such as public schools) or other programs for low-income populations (such as SNAP)….

…The Biden Plan has several additional proposals aimed directly at cutting the cost of health care and making the health care system less complex to navigate. The Biden Plan will:

  • Stop “surprise billing”… The Biden Plan will bar health care providers from charging patients out-of-network rates when the patient doesn’t have control over which provider the patient sees (for example, during a hospitalization).
  • Tackle market concentration across our health care system… The Biden Administration will aggressively use its existing antitrust laws to address this problem…
  • Lower costs and improve health outcomes by partnering with the health care workforce. The Biden Administration will partner with health care workers and accelerate the testing and deployment of innovative solutions that improve quality of care and increase wages for low-wage health car workers, like home care workers…
  • Repealing the outrageous exception allowing drug corporations to avoid negotiating with Medicare over drug prices… The Biden Plan will repeal the existing law explicitly barring Medicare from negotiating lower prices with drug corporations.
  • Limiting launch prices for drugs that face no competition and are being abusively priced by manufacturers… For these cases where new speciality drugs without competition are being launched, under the Biden Plan the Secretary of Health and Human Services will establish an independent review board to assess their value. The board will recommend a reasonable price, based the average price in the countries (a process called external reference pricing) or, if the drug is entering the U.S. market first, based on an evaluation by independent board members. This reasonable price will be the rate Medicare and the public option will pay. In addition, the Biden Plan will allow private plans participating in the individual marketplace to access a similar rate.
  • Limiting price increases for all brand, biotech, and abusively priced generic drugs to inflation… The Biden Plan will also impose a tax penalty on drug manufacturers that increase the costs of their brand, biotech, or abusively priced generic over the general inflation rate.
  • Allowing consumer to buy prescription drugs from other countries… The Biden Plan will allow consumers to import prescription drugs from other countries, as long as the U.S. Department of Health and Human Services has certified that those drugs are safe.
  • Terminating pharmaceutical corporations’ tax break for advertisement spending. … As president, Joe Biden will end this tax deduction for all prescription drug ads, as proposed by Senator Jeanne Shaheen.
  • Improving the quality of generics… The Biden Plan supports numerous proposals to accelerate the development of safe generics, such as Senator Patrick Leahy’s proposal too make sure generic manufacturers have access to a sample.
  • Ensure Health Care Is A Right For All, Not A Privilege For Just A Few
  • Expanding access to contraception and protect the constitutional right to an abortion… The Biden Plan supports repealing the Hyde Amendment because health care is a right that should not be dependent on one’s zip code or income. And the public option will cover contraception and a woman’s constitutional right to choose.

In addition, the Biden Plan will:

  • Restore federal funding for Planned Parenthood… As president, Biden will reissue guidance specifying that states cannot refuse Medicaid funding for Planned Parenthood and other providers the refer for abortions or provide related information and reverse the Trump administration’s rule preventing Planned Parenthood and certain other family planning programs from obtaining Title X funds.
  • …President Biden will rescind the Mexico City Policy (also referred to as the global gag rule) that President Trump reinstated and expanded…
  • Reducing our unacceptably high maternal mortally rate, which especially impacts people of color…California came up with a strategy that halved the state’s maternal death rate. As president, Biden will take this strategy nationwide…
  • Defending health care protections for all, regardless of gender, gender identity, or sexual orientation… President Biden will defend the rights of all people – regardless of gender, sexual orientation, gender identity – to have access to quality, affordable health care free from discrimination.
  • Doubling America’s investment in community health centers… The Biden Plan will double the federal investment in these centers, expanding access to high quality health care for the populations that need it most…
  • Achieving mental health parity and expanding access to mental health care. As Vice President, Biden was a champion for efforts to implement the federal mental health parity law, improve access to mental health care, and eliminate the stigma around mental health. As President, he will redouble these efforts to ensure enforcement of mental health parity laws and expand funding for mental health services…


A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Three – Continued is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites.

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