PROTECT OUR CARE. ** WEEKLY WRAP UP ** [ June 11 - June 16, 2017 ]

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1 PROTECT OUR CARE ** WEEKLY WRAP UP ** [ June 11 - June 16, 2017 ] Senators Continue to Keep Their Repeal Bill So Secret that Even Their Members are in the Dark Senate Republicans admitted they were deliberately keeping their health repeal bill from public scrutiny. We aren t stupid, said one Senate aide. They are concerned the more the public knows, the more opposition will grow. Take a look at their moments of candor admitting the secret process, or promising to be more open and transparent over the next couple of weeks:: Senate Finance Committee Chair Orrin Hatch (R-UT): "Well I think we re not worried so much about that as we are getting it together so we can get a majority to vote for it." Senate GOP aide on not releasing a plan: "We're not stupid." Senate Conservative aide: We are assuming since they sent it to CBO today that it will then make its way to K Street, then to Politico, then we will see it. You know, the way government is supposed to work. Sen. John Barrasso (R-WY): "'The House bill is what, 100 and some pages? People are able to read that in an amount of time, it doesn t take too long,' he said, when asked how much time the public would get review their legislation. 'How long does it take you to read 100 pages?...there will be plenty of time for amendments to be written and offered on and voted on the floor. It will be an open process." [Talking Points Memo, 6/13/17] Sen. John Hoeven (R-ND): There s been some criticism that we re not going through hearings and that kind of thing...i think Mitch is trying to get input and pretty quick here we ll have an initial working draft, and there will be a chance for more transparency and more input.'" [Talking Points Memo, 6/13/17] Sen. Lindsey Graham (R-SC), asked if he wanted to see more details of the repeal bill: No.

2 Not everyone is happy about the secretive process. Numerous senators this week criticized the Senate process - the question is whether they will do anything to stop it from being so secretive: Senate Finance Committee Chair Orrin Hatch (R-UT) on the public not knowing details of the bill: I m in the same category. Sen. Lisa Murkowski (R-AK): I think that we do better as a body when we respect the process. And the process allows for committee involvement, debate and discussion...if I'm not going to see a bill before we have a vote on it, that's just not a good way to handle something that is as significant and important as health care...do I think that's the best route to go? No. I'm a process person...it is certainly my hope that when the time comes to have a measure on the floor, there is ample opportunity for debate and consideration and amendment.'" Sen. Bob Corker (R-TN): The process is better if you do it in public, and that people get buy-in along the way and understand what s going on. Obviously, that s not the route that is being taken. Sen. John McCain (R-AZ), on his comfort level with the process: None. Sen. Ron Johnson (R-WI): It s not a good process. Sen. Bill Cassidy (R-LA): "Not confident" in the process so far. Coverage Highlights Washington Post: Republicans are employing a new ruse to destroy Obamacare. Don t fall for it. June 16, 2017 // Greg Sargent Vox: The Senate GOP's plan to repeal Obamacare: don't let anyone see their bill June 13, 2017 // Dylan Scott New York Times: Secrecy Surrounding Senate Health Bill Raises Alarms in Both Parties June 15, 2017 // Thomas Kaplan and Robert Pear NBC News: The Senate s Health Care Bill Remains Shrouded in Secrecy June 15, 2017 // Benjy Sarlin and Leigh Ann Caldwell Local Headlines In addition to national publications, a variety of criticisms over the Republican health plan were featured in local publications across the country. Below are some highlights: Alaska Alaska Daily News: Murkowski says she s unhappy with secrecy surrounding Senate health care bill June 14, 2017 // Erica Martinson Colorado Westword: How Trumpcare Could Make Colorado s Opioid and Addiction Crisis Worse June 15, 2017 // Michael Roberts Maine Maine Public Radio: GOP s proposed cuts to Medicaid Threaten Treatment For Opioid Addiction June 11, 2017 Nevada Nevada Independent: Sandoval, Heller on opposite sides of phasing out state Medicaid expansion as part of ACA repeal

3 June 13, 2017 // Riley Snyder Ohio Cleveland Plain Dealer: Prominent health groups choose Cleveland as launch site for national campaign pushing back on GOP healthcare bill June 16, 2017 // Andrew J. Tobias Pennsylvania Tribune Review: Report: Pennsylvania could lose 85,000 jobs by 2026 under House GOP health-care plan June 14, 2017 Tennessee The Tennessean: AARP urges Corker, Alexander to vote against AHCA in new ads June 13, 2017 // Joel Ebert West Virginia Charleston Gazett CAMC CEO criticizes Republican health care plan June 15, 2017 // Erin Beck New Analyses Show How the Senate Repeal Bill Will Hurt People The Senate is keeping its repeal bill under lock and key and away from public view, and we think we know why. For one, the public is rejecting the Republican repeal. Even President Trump this week called the House bill mean. The Senate is considering a bill that is pretty similar (from what we know). Numerous reports and analyses released reveal the devastating impacts the repeal bill will have on consumers, patients, children, older Americans and the economy. Here is a summary of these new reports. Uninsured Rate for Kids Would Increase by 50%. A new analysis by the Center on Budget and Policy Priorities shows that about 3 million children would lose their health insurance by an astonishing 50 percent increase in the uninsured rate for kids. In large part, this is due to the radical cuts Republicans in Congress are pushing for Medicaid. Up to 27 Million Employer Plans Hit by Republicans Reinstating Lifetime or Annual Limits. A new analysis by the Center for American Progress shows that as many as 27 million Americans could face annual limits on their coverage, while 20 million could be hit with lifetime limits as a result of allowing states to waive essential health benefits as the Senate repeal bill apparently proposes. Maternity Care, Substance Abuse, Likely to Be Dropped. The Kaiser Family Foundation looked at what would happen if states opted out of covering essential health benefits and found that the benefits most likely to not be covered under the Republican repeal bill were maternity care, substance abuse and mental health because those services were more likely not to be covered prior to the ACA.

4 State-by-State Estimates of the AHCA s 2018 Rate Hikes and Age Tax. A new study by the Center for American Progress shows the effect that the health care repeal bill would have on premiums and tax credits. The AHCA as passed by the House of Representatives would slash subsidies and repeal other federal policies that help make health coverage affordable nationwide. Two particularly notable consequences of the House-passed bill would be widespread premium hikes in 2018 and severe premium increases for older Americans in On the age tax, a 64-year-old making $26,500 would only pay $1,700 for their health coverage under the ACA. Under the Republican repeal plan, premiums for a 64-year-old become completely unaffordable. State-by-State Analysis on Number of People Lose Coverage to Pay for Tax Cuts for the Wealthy. The Center for American Progress released a report providing a breakdown of how many people would lose coverage under the House repeal bill to pay for the tax cuts in the House repeal bill. The analysis also shows how many people by state would benefit from these tax cuts and the average savings. 1 Million Jobs Lost Because of Health Care Repeal. A new study from the Commonwealth Fund shows just how damaging repeal will be to the economy - it could result in nearly 1 million jobs being cut by Rural Hospitals At Risk. A new data-driven study from Healthcare Management Partners shows that rural hospitals rely on federal funding more than their urban counterparts, and the cuts proposed by Republicans to Medicaid will mean that many rural hospitals will close in the next few years. Also noted: 95 percent of rural hospitals are in Republican congressional districts. On top of all of this, new data show that not one state supports the House repeal bill. No wonder the Senate wants to keep its process secret and behind closed doors.

5 By the Numbers in Key States A number of studies released this week paint an especially grim picture for residents of Alaska, Arizona, Maine, Nevada and West Virginia, where folks would face annual limits on their coverage and rising premiums, while each of these states would experience significant job losses brought by repeal. As such, perhaps it s no surprise the Republican legislation is opposed by residents across all five states. Alaska: 54,000 residents would face annual limits on their coverage; 2018 premiums would increase by $2,499; 2018 premiums for a 64-year-old with an income of $26,500 would increase by $47,370; and 2,571 jobs would be lost in Residents of Alaska oppose the AHCA Arizona: 523,000 residents would face annual limits on their coverage; 2018 premiums would increase by $1,466; 2018 premiums for a 64-year-old with an income of $26,500 would increase by $23,430; and 7,591 jobs would be lost in Residents of Arizona oppose the AHCA Maine: 106,000 residents would face annual limits on their coverage; 2018 premiums would increase by $1,243; 2018 premiums for a 64-year-old with an income of $26,500 would increase by $15,870; and 9,992 jobs would be lost in Residents of Maine oppose the AHCA Nevada: 242,000 residents would face annual limits on their coverage; 2018 premiums would increase by $909; 2018 premiums for a 64-year-old with an income of $26,500 would increase by $11,040; and 474 jobs would be lost in Residents of Nevada oppose the AHCA West Virginia: 149,000 residents would face annual limits on their coverage; 2018 premiums would increase by $1,684; 2018 premiums for a 64-year-old with an income of $26,500 would increase by $20,700; and 10,240 jobs would be lost in Residents of West Virginia oppose the AHCA New Ads Keep Pressure on Key Senators to Reject Repeal As the Senate rushes in secret to find a bill that can get only Republican votes, Save My Care and AARP announced new television and radio ads to urge key senators to vote against repeal. Save My Care: New rural radio ads and television ads started this week in Alaska, Maine, Nevada and West Virginia urging Senators to oppose repeal because of the devastating impact it would have on their states. LISTEN TO THE RADIO ADS HERE. WATCH THE TV ADS HERE.

6 AARP: AARP announced new television ads urging Senators to vote against health care repeal, particularly the age tax that means people over 50 can be charged up to 5 times more than a younger person. The ads are running in Alaska, Arizona, Colorado, Iowa, Nevada, Ohio, Tennessee and West Virginia. WATCH THE TV ADS HERE. Coalition to Protect Women s Health: The Coalition to Protect Women s Health is running ads in Arizona, Iowa, Nevada, Ohio, Pennsylvania and West Virginia criticizing the Republican repeal effort to hurt women s access to critical care. WATCH THE AD HERE. Coalition to Protect America s Health Care: The Coalition to Protect America s Health Care released a new ad warning that the health care of 23 million Americans is on the line. WATCH THE AD HERE. Women s Groups to Senate Republicans: Say NO to Repeal Seven women s health care organizations sent a letter to Senate Majority Leader Mitch McConnell urging him to reject repeal. The letter - signed by American Academy of Pediatrics, American College of Nurse-Midwives, American College of Physicians, American Congress of Obstetricians and Gynecologists, National Association of Nurse Practitioners in Women's Health, National Partnership for Women & Families and Planned Parenthood Federation of America - stated: We believe that [a repeal] would turn back the clock and reverse hard-won progress on gains in women s access to healthcare and coverage. We stand ready to work with Congress to advance legislation that would instead promote women s health and access to care and coverage When women have access to quality, evidence-based, affordable care throughout their lives, they enrich our workforce, achieve higher levels of education, reach their goals, and actively contribute to the success of their families and their communities. READ THE LETTER HERE. ⅔ of Rate Increases Attributed to Sabotage: New Analysis A new report released this week show how the Trump administration and Republican Congress sabotage of the Affordable Care Act is raising people s premiums. The new analysis by Oliver Wyman estimates that as much as two-thirds of the rate hikes for 2018 can be attributed to uncertainty in the marketplaces, namely whether cost sharing reduction subsidies will be funded and if the individual mandate will be enforced. Bipartisan Group of Governors Urge the Senate New Opioid Fund Under Discussion Would Limit Care A bipartisan group of governors - Republican governors John Kasich of Ohio, Charlie Baker of Massachusetts and Brian Sandoval of Nevada, along with Democratic governors John Hickenlooper of Colorado, Tom Wolf of Pennsylvania, Steve Bullock of Montana and John Bel Edwards of Louisiana, signed a letter urging Senators to prioritize stabilizing the marketplaces and to not shift cost to states and hurt the most vulnerable. Instead, they argue Congress should address factors we can all agree need fixing. READ THE LETTER HERE. Upcoming Actions Tuesday, June 20 Save My Care Bus from WV to DC On June 20 ( West Virginia Day ), a bus full of West Virginians with health care stories will travel from West Virginia to DC to share their stories with Senator Capito and urge her to vote no on AHCA. SEIU Call-In Day

7 Wednesday, June 21: Speaking Out to Protect Our Care Event A Protect Our Care coalition of organizations will combine forces and gather at Capitol Hill to voice opposition to the AHCA bill being considered by the Senate and call out the shady, secret process being used to move it forward. Speaking program will include Democratic Senators and stories from real people from around the country. Event will take place at 11:00am on the Capitol Lawn in between SCOTUS and the Capitol Building. Thursday, June 22: Doctors For America Emergency White Coat Fly-In To voice opposition to the AHCA and highlight the harmful impact of the legislation on its patients, DFA will be organizing a press event with Congressman Raul Ruiz, MD and partners. Following the event, DFA will also hold meetings with key Senators in NV, WV, AK, ME, AZ, OH, CO, LA, PA.