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July 11, 2019

Trump-Backed Texas Lawsuit Would Devastate New Yorkers

President Trump is trying to rip away our health care by going to court to eliminate the Affordable Care Act in its entirety. If the Trump lawsuit is successful, it will strip coverage from millions of Americans, raise premiums, end protections for people with pre-existing conditions, put insurance companies back in charge, and force seniors to pay more for prescription drugs. The result will be to — as the Trump Administration itself admitted in court — unleash “chaos” in our entire health care system.

  • 607,000 New Yorkers could lose coverage. According to the Urban Institute, 607,000 New Yorkers would lose coverage by repealing the Affordable Care Act, leading to a 41 percent increase in the uninsured rate.
  • 147,000 New York young adults with their parents’ coverage could lose care. Because of the Affordable Care Act, millions of young adults are able to stay on their parents’ care until age 26.
  • New Yorkers would lose important federal health care funding — an estimated reduction of $10.1 billion in the first year. The Urban Institute estimates that a full repeal of the ACA would reduce federal spending on New Yorkers’ Medicaid/CHIP care and Marketplace subsidies by $10.1 billion, or 36.4 percent in the first year.

If Trump Gets His Way, Insurance Companies Would Be Put Back In Charge, Ending Protections For The 130 Million People Nationwide With A Pre-Existing Condition

According to a recent analysis by the Center for American Progress, roughly half of nonelderly Americans, or as many as 130 million people, have a pre-existing condition.

  • This includes44 million people who have high blood pressure
  • 45 million people who have behavioral health disorder
  • 44 million people who have high cholesterol
  • 34 million people who have asthma and chronic lung disease
  • 34 million people who have osteoarthritis and other joint disorders

8,398,900 New Yorkers have a pre-existing condition, including 1,006,000 New York children, 4,174,000 New York women, and 1,948,200 New Yorkers between ages 55 and 64.

If Trump Gets His Way, Insurance Companies Would Have The Power To Deny, Drop Coverage, And Charge More Because Of A Pre-Existing Condition

Before the Affordable Care Act, insurance companies routinely denied people coverage because of a pre-existing condition or canceled coverage when a person got sick. If the Trump-GOP lawsuit is successful, insurance companies will be able to do this again.

  • A 2010 congressional report found that the top four health insurance companies denied coverage to one inseven consumers on the individual market over a three year period.
  • A 2009 congressional report found that the largest insurance companies had retroactively canceled coverage for 20,000 people over the previous five year period.
  • An analysis by Avalere finds that “102 million individuals, not enrolled in major public programs like Medicaid or Medicare, have a pre-existing medical condition and could therefore face higher premiums or significant out-of-pocket costs” if the Trump-GOP lawsuit is successful.

If Trump Gets His Way, Insurance Companies Would Have The Power To Charge You More, While Their Profits Soar

  • 8,619,856 New Yorkers Could Once Again Have To Pay For Preventive Care. Because of the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no cost to consumers. This includes nearly 8,619,856 New Yorkers, most of whom have employer coverage.
  • Insurance Companies Could Charge Premium Surcharges in the Six Figures. If the Trump-GOP lawsuit is successful, insurance companies would be able to charge people more because of a pre-existing condition. The health repeal bill the House passed in 2017 had a similar provision, and an analysis by the Center for American Progress found that insurers could charge up to $4,270 more for asthma$17,060 more for pregnancy$26,180more for rheumatoid arthritis and $140,510 more for metastatic cancer.
  • Women Could Be Charged More Than Men for the Same Coverage. Prior to the ACA, women were often charged premiums on the nongroup market of up to 50 percent higher than they charged men for the same coverage.
  • People Over the Age of 50 Could Face a $4,000 “Age Tax.” Because Judge O’Connor sided with Republican lawmakers, insurance companies would be able to charge people over 50 more than younger people. The Affordable Care Act limited the amount older people could be charged to three times more than younger people. If insurers were to charge five times more, as was proposed in the Republican repeal bills, that would add an average “age tax” of $4,124 for a 60-year-old in the individual market according to the AARP.
  • 129,114 New Yorkers in the Marketplaces Would Pay More for Coverage. If the Trump-GOP lawsuit is successful, consumers would no longer have access to tax credits that help them pay their marketplace premiums,   meaning roughly nine million people who receive these tax credits to pay for coverage will have to pay more, including 129,114 in New Y
  • 348,566 New York Seniors Could Have to Pay More for Prescription Drugs. If the Trump-GOP lawsuit is successful, seniors could have to pay more for prescription drugs because the Medicare “donut” hole would be reopened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 CMS report. In New York, 348,566 seniors each saved an average of $1,320.

If Trump Gets His Way, Insurance Companies Would Have the Power to Limit the Care You Get, Even If You Have Insurance Through Your Employer

  • Insurance Companies Do Not Have to Provide the Coverage You Need. The Affordable Care Act made comprehensive coverage more available by requiring insurance companies to include “essential health benefits” in their plans, such as maternity care, hospitalization, substance abuse care and prescription drug coverage. Before the ACA, people had to pay extra for separate coverage for these benefits. For example, in 2013, 75 percent of non-group plans did not cover maternity care,45 percent did not cover substance abuse disorder services, and 38 percent did not cover mental health services. Six percent did not even cover generic drugs.
  • Reinstate Lifetime and Annual Limits On 6,432,000 Privately Insured New Yorkers. Repealing the Affordable Care Act means insurance companies would be able to impose annual and lifetime limits on coverage for those insured through their employer or on the individual market.
  • Large Employers Could Choose to Follow Any State’s Guidance, Enabling Them Put Annual and Lifetime Limits on Their Employees’ Health Care. Without the ACA’s definition of essential health benefits (EHB) in even some states, states could eliminate them altogether. Large employers could choose to apply any state’s standard, making state regulations essentially meaningless. Because the prohibition on annual and lifetime limits only applies to essential health benefits, this change would allow employers to reinstate annual and lifetime limits on their employees’ coverage.
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Topics: Affordable Care Act
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