Category Archives: Healthcare

Exorbitant Drug Pricing: A Moral Issue

Exorbitant Drug Pricing: A Moral Issue

Siena Ruggeri
March 5, 2019

If the popular immunosuppressant Humira was a standalone company, it would be twice as big as the Hilton hotel chain and its sales would rival Southwest Airlines and Visa. How is this one drug so profitable? After rebates, the average price of the drug is $3,000 a month. The company that sells it, AbbVie, has made 115 billion in profit off the drug since 2010, and more than half of those profits come from the U.S.

Insulin, a drug whose patent was created almost a century ago, is skyrocketing in price. Diabetics around the country are forced to choose between rationing life-saving medication, falling behind on rent and car payments, or going without food. The original developers of these drugs wanted their scientific innovation to serve the public good—so what gives?

In the status quo, there’s no incentive to sell drugs at a reasonable rate. Pharmaceutical companies can claim that in order to recoup the costs of research and development, they must have exclusive access to the market for their specific drug. While they have market exclusivity, the drug company is then able to gouge the price of their drug. There is no competitor to incentivize lower costs. There’s also no government scrutiny as to why the price is what it is. We don’t know why certain pharmaceutical drugs are priced the way they are. Therefore, we have no control if those prices start rising exponentially, and patients have no way of affording the only drug available to cure their condition.

What is one supposed to do if they have breast cancer, Hepatitis C, or multiple sclerosis and can’t afford their drugs? We use public dollars to fund research to prevent this exact problem. Public research money contributed to the 210 new drugs approved from 2010-2016, to the tune of $100 billion dollars. Unfortunately, drug makers have taken advantage of the public’s investment in research to strengthen their bottom line.

 

These practices are an insidious betrayal of public trust and morally wrong. In the richest country in the world, people lose their lives because they can’t afford their medicine. It’s also peculiar that in a so-called free market, we allow monopolists to fully control markets without consequence. The pharmaceutical industry has gamed every rule set in place for them. It is past time for them to face the consequences for the system they have engineered.

Many members of Congress shy away from drug pricing reforms, citing its complicated nature. Others believe the current injustices are based off a few bad actors, not a whole industry that puts profit over human lives. We can’t just point to the most shocking examples of price gouging that make headlines—we have to examine the system that encouraged drug companies to price hike in the first place.

For far too long, the pharmaceutical industry has profited off a public too intimidated to scrutinize their business practices. By directing our attention to examples like “pharma bro” Martin Shkreli, the industry is absolved of any accountability for how they price drugs. This isn’t a case of a few bad actors. This is a system that thrives on taking advantage of the vulnerability and desperation of patients in need of life-saving drugs.

The details of drug pricing reform are complex, but don’t let the pharmaceutical industry bamboozle us into thinking reform is unattainable. To give just one example, every other country in the world allows price negotiations. In the United States, the Department of Veteran’s Affairs negotiates drug prices for their patients. When put together, the proposals coming out of Congress are reasonable reforms. They allow Medicare to use its bargaining power to negotiate prices for its patients, penalize drug corporations that spike the price of a drug without justification, and prohibit abusive tactics used to delay a drug going generic.

There is bipartisan support for doing something about the cost of prescription drugs. This is not an issue we can put off. Every day we refuse to engage and take action, another person risks their life to go without medicine they need to survive. A new poll reveals that 3 out of 10 adults report not taking their medicines as prescribed at some point in the past year because of the cost. Diabetics are risking their lives and rationing their insulin—in fact, 1 out of 4 diabetics admit to doing so.

During our 2018 Nuns on the Bus Tour, we encountered the deadly consequences of this issue. In Savannah, we heard the story of Niema Ross, a young working mother of three who had died that weekend because she couldn’t afford the inhaler she needed to breathe. Niema’s final post on Facebook was a photo of her empty inhaler captioned with a message asking if anyone had access to more. The community tried to raise money for her medication, but it came too late. Niema was never able to get her inhaler, and now her three children will grow up without a mother.

The drug industry’s success in putting profit over people over profit is perhaps one of the most blatant moral issues of our time, and Congress has the power to do something about it. Let’s remind our representatives that now is the time to be morally courageous and end the absurdity that is our prescription drug industry.

 

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Graphic courtesy of Voices for Affordable Health

NETWORK Advocates for Legislation to Lower Drug Prices

NETWORK Advocates for Legislation to Lower Drug Prices

Siena Ruggeri
February 13, 2019

Last week NETWORK sent the following letter to all members of the House of Representatives urging them to support a bill introduced by Rep. Lloyd Doggett that would require pharmaceutical companies to negotiate prices with Medicare Part D. The bill now has over 100 cosponsors and is being evaluated in the House Ways and Means Committee Subcommittee on Health.

In the State of the Union, President Trump voiced his support for Congressional legislation to lower prescription drug prices, saying: “It is unacceptable that Americans pay vastly more than people in other countries for the exact same drugs… This is wrong, this is unfair, and together we will stop it.”  Rep. Doggett’s Medicare Negotiation and Competitive Licensing Act is just the start of the House’s legislative action on drug pricing. NETWORK will evaluate additional legislation and continue advocating for policies that mend the gaps in access to healthcare.

Read the letter below or as a PDF here.


Dear Representative,

NETWORK Lobby for Catholic Social Justice urges members of Congress to become original cosponsors of the Medicare Negotiation and Competitive Licensing Act today.

It is morally reprehensible that 1 in 4 Americans have difficulty paying for their prescriptions. Congress must take specific steps to remedy this wrong.

Taking action to lower drug prices is the top domestic policy priority of Democrats and Republicans, and achieving lower prices for Medicare Part D through direct government negotiation with drug manufacturers is both popular and effective. This policy has support from more than 9-in-10 Americans across the political spectrum. The midterm election was clear—voters expect practical solutions that lower unreasonably high prescription drug prices.

The Medicare Negotiation and Competitive Licensing Act is a common-sense reform that would allow Medicare to negotiate reasonable and affordable drug prices for seniors. By including a fallback to negotiations of competitive licensing when pharmaceutical companies fail to offer an appropriate price, seniors are protected from unfair prices, and Medicare patients will have continued access to the medication they need.

Healthcare is a fundamental social good and essential human right. Inspired by Catholic Social Justice, we seek health care that is high-quality, accessible, affordable, and equitable. We know that unaffordable prescription drugs keep care out-of-reach for far too many people. Congress must take this concrete step to lower drug prices for patients to ensure no one has to go without their medication due to cost.

We urge you to cosponsor this important legislation.

Sincerely,

Sister Simone Campbell
Executive Director
NETWORK Lobby for Catholic Social Justice

Presidential Failures to Mend the Gaps

Presidential Failures to Mend the Gaps

Colleen Ross
February 8, 2019

Over the course of 2018, the Trump administration set numerous policies into motion that are sure to harm vulnerable communities and exacerbate the gaps in our society. Our spirit-filled network took action to denounce the harmful actions taken by the Trump administration and prevent them from going into effect. By writing and submitting comments on proposed rules in the federal register, organizing and attending protests, and raising awareness of these issues, you acted in solidarity with the individuals and families impacted by these unjust decisions.

Healthcare

In January 2018, the Trump administration announced that the Centers for Medicare and Medicaid (CMS) would begin approving states’ requests to impose burdensome Medicaid Work Requirements. Since then, work requirements have been approved in five states, and are pending in ten more states. These work requirements target already vulnerable low-income adults, many of whom are already working or doing their best to secure steady work that pays sufficient wages.

Nutrition

The Agriculture Department released a proposed rule to enforce stricter SNAP (Supplemental Nutrition Assistance Program) Work Requirements right at the end 2018. This happened just after Congress had finally reached agreement after months of bipartisan negotiations, resulting in a majority of Congress voting to not include these restrictive work requirements in the Farm Bill. This unilateral action from the administration is clear rejection of Congress’s hard-won, bipartisan agreement.

Census

President Trump’s Secretary of Commerce Wilbur Ross announced they would be adding a Citizenship Question to the 2020 Census just as it nears the final stages of preparation. The addition of a citizenship question is likely to further depress Census responses from communities of color (which are already undercounted), due to fear of immigration enforcement in the current climate. Additionally, concerning information about persuasion from the White House and undisclosed communication with the Department of Justice encouraging Secretary Ross to add the citizenship question, has become public.

Immigration

In September, the Trump administration released a proposed regulation that the advocacy community refers to as the Flores Rule. This new regulation would dismantle the current “Flores” standards, now allowing the indefinite detention of immigrant children and families, including asylum seekers. In addition to being morally reprehensible, this proposal rejects proven alternatives to mass detention, which are more humane and effective. This proposed rule would allow the federal government to set their own standards for holding families and children in detention and undermine independent oversight of conditions; it also reduces vulnerable families’ access to due process and humanitarian protections.

The Trump administration’s proposed “Public Charge” Rule, published in October, would make it more difficult for immigrants to apply for and receive legal immigration status in the United States. This proposed rule seeks to drastically redefine what it means to be a “public charge” in the immigration system. This would increase the probability that legal immigration applications would be denied based on factors such as age, health, family status, financial status, education, skills, and employment history and would hurt and potentially separate families. Even the threat of this rule is already causing parents to choose between needed public assistance to keep their families housed, fed, and healthy or making their family vulnerable to separation.

Throughout the year, the Trump administration has threatened immigrants with legal status through two programs. Temporary Protected Status (TPS) is a legal immigration status for nationals of a country experiencing ongoing armed conflict, environmental disaster, or another extraordinary and temporary condition. Deferred Enforced Departure (DED) allows foreign nationals to be protected from deportation and have the opportunity to work. Currently, the Trump administration is in the process of ending protections for TPS or DED holders from 11 countries. Many of these TPS/DED holders have been here for more than 20 years, have families in the United States, and would continue to face conflict or other difficult conditions in their home countries.

Judicial

The Senate approved 66 of President Trump’s Judicial Appointments in 2018, including Supreme Court Justice Brett Kavanaugh. This is a significant number of appointments and these confirmations will have a strong impact on the makeup of our judicial system.


This story originally appeared in the January 2019 issue of Connection Magazine. Read the full issue here.

Congress Takes First Step to Lower Maternal Mortality and Improve Health Equity

Congress Takes First Step to Lower Maternal Mortality and Improve Health Equity

Siena Ruggeri
December 17, 2018

There’s a silent but deadly epidemic occurring across the United States: women are dying during childbirth at an alarming rate. The United States is the only developed country where the maternal mortality rate is rising. Pregnancy-related deaths increased from 7.2 deaths per 100,000 live births in 1987 to a high of 17.8 deaths per 100,000 in 2009 and 2011. On top of that, 50,000 mothers a year experience dangerous complications that have the potential to kill them. U.S. women had a better chance of surviving their pregnancy thirty years ago than they do today. The fact women are worse off than thirty years ago is an embarrassment and a terrifying reality for women who are choosing to start families. If we truly care for one another, we must put a special focus on this critical issue impacting women across the country.

The rising maternal mortality rate is a public health crisis that is receiving a woefully low amount of coverage and legislative responses. California is the only U.S. state that has successfully lowered their maternal mortality rate. From 2006 to 2013, the state cut its maternal death rate in half. This was accomplished by a thorough investigation of the care process, and an implementation of better practices. California hospitals work in a collaborative that shares information and best practices specifically about maternal care. In order for other states to replicate California’s success, Congress must act.

Recently the House and the Senate passed the Preventing Maternal Deaths Act, which was introduced by Rep. Jaime Herrera-Beutler, with bipartisan support and a companion bill in the Senate introduced by Senator Heidi Heitkamp.  It creates maternal mortality review committees in every state that gather data and report their findings back to the Department of Health and Human Services.

(image courtesy of the Southern Coalition for Social Justice)

The U.S. healthcare system denies far too many women the care they need before, during, and after giving birth, a fact that needs to be remedied through legislation. Due to the medical racism that permeates the healthcare system, women of color are frequently ignored by providers when they advocate for their medical needs.

Black women are almost four times more likely to die of pregnancy-related causes, pointing to a shocking racial disparity. This is intensified in maternal health care deserts, where women lack access to critical healthcare. In rural and urban areas with limited OB-GYN services, women of color suffer greatly. In her congressional testimony, Stacey Stewart, the president of the women’s health nonprofit March of Dimes, emphasized that women of color often feel less trusted and feel less listened to in the medical system. She pointed to the fact that there are no obstetrical services east of the river in Washington, D.C.’s predominantly Black neighborhoods—women must cross the river to receive any sort of prenatal care. She also observed that in New York City, women of color are 12 times more likely to die as a result of pregnancy than white women. Women of color are disproportionately vulnerable to deadly pregnancy complications, making the maternal mortality crisis a horrifying manifestation of racial injustice.

In his testimony to the House Energy and Commerce health subcommittee in September, maternal healthcare advocate Charles Johnson told how he lost his wife Kira after she gave birth to their second child. Kira and Charles, a young Black couple, made sure that hospital staff were aware that Kira was bleeding heavily after her C-section. Yet the hospital waited ten hours to address her medical crisis. By the time hospital staff acted, it was too late. Kira died of massive internal bleeding, leaving behind an 11-hour-old child, her husband, and her other young child. Kira did everything right; she advocated for herself and her child throughout her time in the hospital. Despite Kira and her husband’s persistence, her symptoms were ignored until it was too late.

The CDC Foundation estimates that 60 percent of American pregnancy- and childbirth-related deaths could be prevented. The U.S. healthcare system is focused on infant health while ignoring the holistic needs of women.  As a result, healthcare providers are not equipped to protect pregnant women and prevent complications that can be easily addressed under the right care. We know many of these deaths can be avoided, but we must take action to examine how our healthcare system fails women and create policies that will prevent this.

Congress has taken the first step passing the Preventing Maternal Deaths Act, which was only possible because of the continued advocacy of the public. Using this as a first step, it’s important to keep the momentum going to fight for even bigger reforms to make health care safer and more equitable.  Health advocates need to make it clear to legislators that maternal health needs to be a key priority, both as we come to the end of the 115th Congress and in the new Congress. Far too many women, especially women of color, have needlessly died in this public health crisis. The only way to begin working toward a solution to this crisis is providing resources to gather more data on this epidemic so healthcare providers have the tools to prevent more tragic losses.

What to Look Out for in Lame Duck!

What to Look Out for in Lame Duck!

NETWORK Government Relations Team
November 5, 2018

The Midterm Elections are upon us — and NETWORK is busy looking ahead to the work that must be done for the rest of the year.

Members of Congress will arrive back to Washington, D.C. on Tuesday, November 13 to finish out the final legislative efforts for the 115th Congress. There are some time-sensitive issues Congress must address, as well as others that may be considered if there is time and political will. All the items on the agenda will be affected by two factors: the outcome of Tuesday’s election as well as subsequent leadership elections, especially in the House of Representatives.

With these uncertainties in mind, here is NETWORK’s analysis for upcoming issues in the final days of the 115th Congress.

Must Do: Fund the Government for 2019

Appropriations: Congress outperformed all expectations by passing 7 of the 12 appropriations bills for FY2019 before the start of the fiscal year, which began on October 1.  While kudos are in order, NETWORK is urging them to pick-up where they left off as soon as they return and it’s imperative that they finish the job before the end of the year.  Lawmakers have until December 7th to reach agreement on the 5 remaining spending bills which fund programs at more than 10 federal agencies, or risk a government shutdown.  Several of our Mend the Gap issues are among the log-jam.  These include: programs that fund the 2020 census, affordable housing and keep immigrant families together.

Border Wall

The most contentious issue will be funding for the Department of Homeland Security; which President Trump has already threatened a government shutdown if Congress fails to appropriate roughly $5 billion for his border wall.  A government shut-down would be detrimental just weeks before Christmas and would coincide with the anticipated arrival of thousands of migrants trekking toward the Southern border.  NETWORK has joined hundreds of advocacy organizations in calling for Congress freeze spending at FY 2018 levels for immigration enforcement officers, agents and detention beds.   And we urge Congress to pass a separate short-term extension for the Department of Homeland Security.  NETWORK is ready to kick our advocacy efforts into high-gear if we perceive threats around funding for our immigration and census priorities.

2020 Census

Funding for the Census Bureau, which requires a significant ramp-up for Census 2020 preparations and planning.   If Congress returns to the dysfunction we saw last year with repeated funding delays via Continuing Resolutions, it could seriously threaten the ramp-up and preparations for our government’s largest peacetime undertaking, the decennial.  Fiscal Year 2019 is the pivotal year leading up to the 2020 Census so postponing full funding would have dire consequences on the preparations and outcome of the count.  While the proposed funding levels from the Senate and the House seem acceptable, it is unclear what the budget impact would be on the impending court ruling on the controversial citizenship question.

Click here to read more about NETWORK’s FY 2019 appropriations priorities.

That being said, there are some outstanding “Maybe” issues that Congress could address: the Farm Bill, Criminal Justice, and the Low Income Housing Tax Credit.

Farm Bill: Protect SNAP

There has not been much apparent progress since the Farm Bill moved into conference in August.  One of the primary sticking points in negotiations is the nutrition title and reauthorization of the Supplemental Nutrition Assistance Program (SNAP).  The partisan House Bill—which passed by 2 votes on the second try—includes harmful provisions that would undermine the program’s effectiveness and cut nutrition assistance for millions of Americans.  The Senate bill, which saw the strongest bipartisan support of any prior Farm Bill (86-11), makes key improvements to strengthen SNAP without threatening food security of participants.  The 2014 Farm Bill expired this month but, fortunately major programs like SNAP have a funding cushion that minimizes the impact of Congress missing that deadline.  It’s highly likely, though, that the Farm Bill conference committee will kick into high gear when Congress returns on November 13th.  During Lame Duck NETWORK will need your help to ensure that the nutrition title from the Senate bill is what’s ultimately adopted and voted into law.

Criminal Justice

There is wide speculation that the Senate could join the House and take up a modest criminal justice reform package during the Lame Duck session, if 60 Senators agree to proceed.  In May, the House passed the First Step Act, a bipartisan bill purporting to be a significant step forward in prison reform.  Over the summer the President tentatively agreed to include several sentencing reform elements into a prison reform package. The Senate was split on the issue of separating prison reform from sentencing reform but has changed course given the President’s willingness to negotiate a compromise.  While NETWORK supports sentencing and prison reform as a joint legislative package we did not take an official position on the First Step Act.

Read NETWORK’s thoughts on the First Step Act, from when it passed the House, here.

Low Income Housing Tax Credit

As Congress concludes work for the year, there is a tradition that of a small group of tax bills that are bipartisan, non-controversial and relatively inexpensive get passed.  This group of tax bills is called “extenders.”  Members of the tax writing committees are now reviewing what their priorities are for any extender bill.  One of the tax initiatives under consideration is passage of “The Affordable Housing Credit Improvement Act of 2017” (S. 548) which expands the Low Income Housing Tax Credit (LIHTC) to meet the housing needs of extremely low income renter households. This credit is the primary tool to encourage private investment in affordable housing development and is responsible for 90 percent of all affordable housing developments built each year.  Since it was passed in the bipartisan Tax Reform Act of 1986, the credit has incentivized the creation of 3 million affordable rental homes around the country.  NETWORK will work with

Given the national shortage of affordable housing, NETWORK believes it is critical that new build more low income housing units. Passage of this bill will go a long way to meeting the needs of the homeless and other vulnerable low income individuals and families.

Thousands of Medicaid Recipients in Arkansas Lose Access to Care

Thousands of Medicaid Recipients in Arkansas Lose Access to Care

Siena Ruggeri
October 2, 2018

In September 2018, the state of Arkansas revoked coverage for more than 4,300 Medicaid users. The state recently implemented a stringent work requirement on Medicaid recipients under the Arkansas Works program, stipulating that they must perform 80 hours of work, service, job training, or education a month. The state unceremoniously dropped recipients who did not properly log their hours into an online portal for three months. These dropped Medicaid users have no possibility of reapplying for the entirety of 2018.

This news came as a shock to the many low-income Arkansans who previously qualified for Medicaid. Due to the low profile implementation of the program, many were not aware of the new requirements. Some will not even realize they have lost their healthcare coverage until they go to the doctor or try to fill a prescription.

This is not an isolated phenomenon. Across the country, the Trump administration and its allies are encouraging burdensome work requirements for programs like Medicaid and SNAP (the Supplemental Nutritional Assistance Program). Indiana, New Hampshire, and Kentucky already received federal approval to implement their own Medicaid work requirements, while at least nine other states are considering them.

Even if Medicaid recipients in Arkansas are aware of the recent changes, they might not be able to access the Arkansas Works website to log their hours. According to the Federal Elections Commission, about a fourth of Arkansas’s population lives in areas without Internet service. The online portal has also been fraught with problems, preventing many from logging their work hours. Curiously, the website is down for 10 hours every night for maintenance, leaving it out of commission for 70 hours a week. These barriers make compliance difficult for a population already stretched thin.

It’s not as if Medicaid recipients aren’t working. At best, only 15% of enrollees not exempt from existing work requirements are not employed (Urban Institute); the vast majority are already working. The reason they are utilizing Medicaid is not due a lack of work—it is due to the deep poverty they are experiencing. Recipients do not have access to quality jobs that pay a living wage and provide health benefits.

Let’s not be mistaken—programs like Medicaid already have strict work requirements. These additional work requirements are an attempt to burden vulnerable populations with administrative barriers to affordable, quality healthcare. By dropping more than four thousand people from Medicaid coverage, the state of Arkansas stands to save 30 million a year. States like Arkansas that choose to implement these cumbersome some work requirements are choosing savings over care for their people.

Burdensome work requirements don’t address the realities of the low-income populations Medicaid serves. Work requirements don’t create stable jobs that pay a living wage, nor do they do anything to alleviate the racial income gap. Black Arkansans are twice as likely to live below poverty level than their white counterparts. These work requirements are complex in nature—they are designed to quietly dismantle social safety nets while stigmatizing low-income people as the problem. If Arkansas is serious about getting its residents off Medicaid, it needs to address economic inequality and reinvest in the working class.

The data from Arkansas gives us a look at the true human cost of burdensome work requirements. As other states roll out similar programs, thousands of people will unknowingly lose their coverage. There is no human benefit to burdensome work requirements. They only serve to harm people who utilize programs like Medicaid and SNAP to survive. NETWORK opposes implementing work requirements on our most effective human needs programs, and urges lawmakers to craft these programs to uphold human dignity, not diminish it.

Progress from Congress on Appropriations

Progress from Congress on Appropriations

Tralonne Shorter
September 12, 2018

This summer, Congress made extraordinary progress toward completing the requisite 12 spending measures for upcoming fiscal year (FY) 2019. To date, the Senate has passed nine spending bills, while the House has passed six. Lawmakers have until September 30 to finalize spending bills or extend funding at current levels through a continuing resolution (CR).  Efforts are underway to bundle nine* out of 12 spending measures into three packages by September 30 and put the remaining three** bills into a CR, averting a government shutdown.

One reason for the Senate’s remarkable pace on appropriations is President Trump’s vow to not sign another omnibus spending bill.  To achieve this progress, the Senate uncharacteristically spent part of August in session.  Another reason is a bipartisan agreement between Appropriations committee Chairman Richard Shelby (R-AL) and Vice Chairman Patrick Leahy (D-VT) not to pack spending bills with controversial provisions that would weaken bipartisan support.

NETWORK continues to lead lobby efforts supporting our Mend the Gap priorities.  These include:  humane border enforcement that promotes family unity and funding increases for affordable housing, workforce development, job training, child welfare and health care.  In addition, NETWORK will continue to oppose efforts to defund the Affordable Care Act.

Immigration

Unsurprisingly, the Trump Administration’s “Zero Tolerance” immigration policy dominated the appropriations debate and faced strong opposition across party lines in both chambers.  NETWORK joined pro-immigration advocates in garnering support for more than 12 amendments to the Homeland Security bill that adds report language that clamps down on family separation with better oversight and accountability standards for ICE detention centers.  Additionally, we successfully lobbied for more funding to support alternatives to detention, family case management services, and mental health screening of unaccompanied minor children crossing the Southern border. However, a major disappointment by House Appropriators includes the reversal of the Flores Settlement, a 1997 agreement drafted by the ACLU which set a 20-day limit for family detention and governs the conditions of detention for children, including that facilities be safe, sanitary, and age appropriate.    If enacted this would allow immigrant families to be indefinitely detained in facilities with harsh conditions not supported by Flores.  Thankfully, the Senate approved LHHSED Appropriations bill leaves the Flores settlement agreement intact and the House language is not likely to be part of the final bill.

As for immigration enforcement spending contained in the Homeland Security Appropriations bill, the House Appropriations Committee approved $7 billion more than the Senate for Immigrations and Customs Enforcement (ICE), Customs and Border Patrol (CBP) and the Southwest Border Wall.  Other areas of concern include, a 10 percent increase in detention beds, as well as funding to hire almost 800 more border and customs agents/officers.

NETWORK will continue to push back on efforts to separate families or that would undermine humane border enforcement as negotiations gain momentum post the mid-term elections.

Supplemental Nutrition Assistance Program (SNAP)

The current Farm Bill is set to expire on September 30, unless Congress passes the next Farm Bill before then or extends the current reauthorization.  Regardless of when Congress finalizes the next Farm Bill, funding for SNAP will not lapse as the government is statutorily required to continue funding the program subject to participation demands.  Since 2015, SNAP enrollment has declined by more than 4.7 million people resulting in a $73 billion automatic appropriation for FY 2019.  This is $794 million less than FY 2018 and a 10 percent reduction since FY 2015.

Census

House appropriators gave a big boost to the Census Bureau in the FY 2019 Commerce, Justice, Science Appropriations (CJS) bill, approving nearly $1 billion more for the agency than the Senate. However, it is unclear how much of the $4.8 billion for the agency will be allocated for the 2020 Decennial.  Conversely, the Senate appropriators (under new leadership) appears to have taken a more conservative approach and adopted the President’s FY 2019 budget request to fund the 2020 Decennial at $3.015 billion.  This is drastically different from NETWORK’s request of $3.928 billion minimum baseline.

Besides census activities, the CJS bill also funds immigration related law enforcement and adjudication efforts within the Department of Justice.  Regrettably, the House Committee bill, fails to fully protect immigrant families and includes increased funding for immigrant-related law enforcement efforts.  Congress is not expected to finalize the CJS bill until sometime after the mid-term elections.  NETWORK will continue to call on our supporters to push for the higher number for the 2020 Census contained in the House bill.

Housing

Funding for housing programs fared better in the Senate.  The Senate approved a $12 billion increase above the President’s FY 2019 budget request−and is $1 billion above the House bill.  Housing programs help nearly 5 million vulnerable families and individuals.  This includes:  $22.8 billion for tenant-based Section 8 vouchers; $7.5 billion for public housing; $11.7 billion for project-based Section 8; $678 million for Housing for the Elderly; and $154 million for Housing for Persons with Disabilities.  Both committee bills reject the Administration’s rent reform proposal, and reinstate funding for the Community Development Block Grant (CDBG) and HOME Investment Partnerships programs, which were eliminated in the President’s FY 2019 budget request.  However, the House reduces spending for the HOME program by 12 percent.

NETWORK will continue to advocate for increased funding for affordable housing programs.

Children and Human Needs

The LHHSEd Appropriations bill funds popular safety net programs, like Medicare and Medicaid operations, home energy assistance, Head Start and the Child Care Development Block Grant.  It is the 2nd largest spending bill, after defense and comprises about 63 percent of total discretionary spending.  The House and Senate bills are slightly different—overall the Senate bill is better because it has a higher spending allocation and contains no poison pill riders unlike the House.

Unfortunately, the Affordable Care Act continues to be attacked by Republican lawmakers.  Both the House and Senate bills reduce access to affordable health care by cutting funding for the Centers for Medicare and Medicaid Services (CMS) operating budget by nearly half a billion dollars.  According to the House Committee report, Democrats view defunding CMS as “a misguided attempt to sabotage the Affordable Care Act’s health insurance marketplace.” If enacted this cut would significantly impact Medicare as it subject to mandatory 2 percent sequestration cut pursuant to the Balance Control Act of 2011 (P.L. 112-25).

NETWORK will continue to call on our supporters to push back against efforts to defund the Affordable Care Act.


* Agriculture; Defense; Energy and Water; Financial Services; Interior; Labor-Health and Human Services-Education; Legislative Branch; Military Construction and Veterans Affairs; Transportation and Housing and Urban Development.

**Commerce, Justice, Science; Foreign Operations; and Homeland Security.

Attempts to Sabotage the ACA Continue

Attempts to Sabotage the ACA Continue

Kaitlin Brown
July 27, 2018

This month has been particularly rough for the Affordable Care Act (ACA). In two acts of sabotage, the Centers for Medicare and Medicaid Services (CMS) announced policy decisions that will undermine access to health care for millions of people. (You can see our coverage of previous ACA sabotage from the Trump administration this year here).

First, the administration and the Centers for Medicare and Medicaid Services sent out a notice that funding for the navigator program would be cut to $10 million for the 2018-2019 enrollment period. Navigators work on the ground to help people navigate the online Insurance Marketplace and choose a plan that is right for them. Most navigators work for non-profit companies, and are present in congregations, public libraries, and other spaces to meet the needs of their community. Navigators also provide internet access to low-income and elderly people who might not have access to a computer find affordable health insurance. In 2016, the program was funded at $62 million, and only $36 million last year.

CMS also announced that it would be ending the risk adjustment program for insurance companies on the marketplace after a narrow ruling in New Mexico. The risk adjustment program is one of the main ways people with pre-existing and complex medical conditions can gain access to healthcare. The program uses premium money from healthy people in the individual market to pay for sicker people. It doesn’t cost anything, and is one of the main ways insurance works. Without this, however, costs could skyrocket for people with pre-existing conditions. This comes as rates and markets are being set for 2019, and without the ability to spread around risk between healthy and sick patients, premium rates could increase dramatically.

However, this decision was based on one case in New Mexico, where the judge ruled that the program in the state could not continue. Previous to this, a judge in Massachusetts had found the rule legal. However, CMS decided that the New Mexico ruling applied to all twenty-three states that have their own individual marketplace programs. Additionally, the Centers for Medicare and Medicaid Services could have done a few things, including starting the appeals process or asking if the court meant for the ruling to apply to markets outside of New Mexico, that they chose not to do.

The reduction in funding for the popular navigator program, combined with the ending of the risk adjustment program, are two more acts of sabotage against the Affordable Care Act. We are seeing time and again that what the administration cannot do through the legislative process, they are doing through the administrative one.

People of Faith Working for Access to Affordable Medicine

People of Faith Working for Access to Affordable Medicine

Fran Quigley
July 5, 2018

Last June, 26 year-old Alec Smith of Minnesota died because he could not afford to treat his Type 1 diabetes with insulin that has risen in price over 1,000% since the late 1990s.  One out of every five Americans does not fill a prescription each year because they can’t afford it—and risk strokes, heart attacks and unrelenting pain as a result.

Tobeka Daki of South Africa, the mother of two sons, died in 2016 because she could not afford a monopoly-protected cancer medicine priced at 193 times its manufacturing cost. The United Nations estimates that 10 million people each year die because they cannot afford the medicine to treat them.

The tragic stories of Alec Smith and Tobeka Daki could be repeated many times over in every community, and they could be told about vaccines, mental health medicines, asthma medication and nearly every other treatment. Many of us heard about the Epi-Pen 450% price increases or “Pharma Bro” Martin Shkreli’s 5,000% overnight spike in the price of the HIV medicine Daraprim. But these high-profile controversies are only the most visible symptoms of a deeply entrenched problem.

In stark contrast to Jesus bringing healing to the poorest of the poor, today’s lifesaving treatments have increasingly become a luxury that only the world’s wealthy can afford. Protected from market competition by monopoly patents, medicines are routinely priced at levels hundreds of times their manufacturing costs. The companies that sell the medicines make record-breaking profits yet still routinely raise prices by double-digit margins each year.

These companies tout their research investments, but they actually spend far more on advertising, executive salaries as high as $78 million per year, stock buybacks that enrich the top shareholders, and political campaign donations. In the meantime, our sisters and brothers are splitting their pills, maxing out credit cards just to go to the pharmacy, or simply going without their medication.

For people of faith, this status quo is unacceptable. All major religious and moral traditions embrace a clear responsibility to care for those who are poor and the sick. And that obligation goes beyond direct care to use our voices to ensure that our systems and laws do not lock out those in desperate need of medicines.

So it is not surprising that a significant majority of Americans are demanding drug pricing reform. And we have an opportunity to make it happen. Bipartisan proposals to change the system are pending in dozens of states and Congress.

Those proposals include allowing Medicare to negotiate drug prices the same way other countries do now, and speeding the process for drugs  to be available at far cheaper generic prices. The corporations setting record prices can do so only because our government has chosen to grant them private monopolies on selling taxpayer-funded developed medicines, even though nonprofit models for research and development have proven to be effective.

Advocates for affordable medicines have won before. In the HIV/AIDS treatment campaign of the turn of the century, much of  the faith community joined a global moral movement that successfully overcame monopolies and reduced antiretroviral medicine prices by more than 90%, saving millions of lives in the process.

The faith community can play this role again. We start with the foundation, set out in both our sacred texts and global human rights treaties, that people who are suffering should be able to access the medicines they need. The fact that Alec Smith, Tobeka Daki and millions of others cannot access the medicine they need to live is a moral failing.

But we can fix this, and people of faith can help lead the way.


Fran Quigley is a NETWORK advocate based in Indiana and the coordinator of People of Faith for Access to Medicines (PFAM).

To the NETWORK Community:

Do you have a personal story about drug prices that you’d like to share with NETWORK as we advocate for affordable medicine? Submit your story below. Thank you!