The Trump administration’s steady assault on healthcare reverses years of progress and jeopardizes the health of the communities and individuals Public Health Solutions (PHS) serves.
In its latest salvo against the Affordable Care Act (ACA), the White House announced on October 13th that it will eliminate subsidies to health insurance companies that help pay out-of-pocket costs of low-income people. Scrapping these subsidies will have a devastating impact on New York State’s ability to offer affordable healthcare to its residents and harms gains achieved under the ACA. On October 12th, Trump issued an Executive Order directing federal agencies to rewrite regulations, encouraging the sale of insurance plans that don’t have to comply with certain consumer protections and benefits to entice healthy people away from ACA coverage. This will inevitably leave older and sicker people enrolled in the ACA markets facing higher costs. Trump already slashed the ACA advertising budget by 90 percent, cut enrollment periods in half, and cut useful consumer information on the HHS website. HHS also produced, at taxpayer expense, nearly 20 testimonial videos critical of the ACA. The IRS also suspended enforcement of a rule designed to encourage individuals to enroll in health insurance.
And that’s not all. Last week, HHS, under the banner of “religious liberty”, issued rules last week rolling back the ACA’s mandate requiring most employers to provide their employees with insurance coverage for birth control without co-payments. As a result of the ACA, more than 55 million women in the United States have access to birth control with no out-of-pocket costs. By removing out of pocket costs, the ACA has allowed millions of women to choose the birth control method that works best for their needs, which in turn helps avoid unintended pregnancies.
This is just the beginning. Directives issued by Attorney General Jeff Sessions and a “draft strategic plan” for fiscal year 2018-2022 issued by HHS lay the groundwork for the administration putting ideology before health at every opportunity. Sessions issued a sweeping 25-page, 20-point directive titled “Federal Law Protections for Religious Liberty” directing agencies, including HHS, to prioritize claims of religious liberty over all other protections and concerns in all government activity, including litigation, enforcement, programming, employment, and contracting. The directive shelters companies that want to deny health coverage like birth control to employees. It instructs government attorneys not to “second-guess the reasonableness of a religious belief,” allowing employers and businesses to ignore any law if they claim a religious belief – even if it’s not really a part of their faith. HHS’s draft plan issued in early October references “faith” or “faith-based” organizations more than 40 times in its five-year statement of priorities and refers to protecting individuals from “conception to natural death”, while erasing references to minority communities, including LGBT people.
These latest assaults on the ACA and the birth control mandate will have wide-ranging negative impact on many underserved New Yorkers who are helped through PHS’ services. Rolling back ACA subsidies threatens New York’s “Essential Plan”, which offers free or low-cost coverage to people and families with low incomes. York State receives roughly $900 million to finance the Essential Plan. The state may be forced to boost its own subsidies, raise rates or do away with the Essential Plan altogether. Young, high-risk women helped through our reproductive health services may find themselves with fewer low-cost birth control options – which alone damages decades-long progress in reducing unintended pregnancies.
In the face of these threats, we remain steadfast in our commitment to champion public health and to deliver quality services to New York City’s most vulnerable individuals and communities. We will continue to keep you informed about these and other issues effecting New York City’s public health.
President & CEO
Public Health Solutions