Friday, July 28

Accountability: Arizona

Last night, Senator Flake voted to support the “skinny repeal” bill that would have repealed key provisions of the Affordable Care Act. He did this having only seen the final text an hour or two before, with no time to study the CBO score or understand the bill’s effects on Arizona.

Skinny repeal would have caused premiums in Arizona to increase by $1600 next year. It would have led to 16 million more Americans uninsured. In short, it would have been a disaster for Arizona and the country.

But Senator Flake put politics over his constituents and voted for the bill anyway. His insatiable preoccupation with repealing the Affordable Care Act made him side with Trump and McConnell, and not the people of Arizona that would have been hurt by this reckless bill.

Today, hold Senator Flake accountable.

SAMPLE CALL DIALOGUE

Caller: Hello! My name is [] and I’m calling from [part of state].

Staffer: Hello there!

Caller: I’m calling to let you know that I know how Senator Flake voted on the skinny repeal bill last night. I know that he chose politics over the people of Arizona, and that he sided with Trump and McConnell instead of me. I am extremely disappointed in Senator Flake’s vote. 

Staffer: Senator Flake continues to think Obamacare is a disaster and he stands by his vote.

Caller: That’s terrible. The Affordable Care Act is not a disaster and the American people agree. The skinny repeal bill Senator Flake voted for last night would have increased premiums in Arizona by $1600. Our state can’t afford that. I’m glad Senator McCain voted to oppose it and I’m extremely disappointed Senator Flake did not do the same. 

Staffer: I’ll let the Senator know you called. 

Caller: Thanks and have a nice day. I won’t soon forget this. 


Thursday, July 27

TrumpCare’s Last Stand: Skinny Repeal

Republicans have taken multiple votes since barely getting past their first hurdle, the motion to proceed, on a 51-50 vote. Every vote since has failed.

Their latest plan is to just get something across the finish line. That plan is being called “skinny repeal.” To the best anyone actually knows, it’s comprised of three main parts: repealing the individual mandate, repealing the employer mandate, and repealing the medical device tax.

The “skinny repeal” plan is bad on substance and process.

On substance:
The individual mandate is a critical ingredient to a well-functioning insurance market because it ensures a mix of healthy and sick people participate. Without it, costs would be much higher and there would be fewer plan choices. One analysis shows that it would increase the average marketplace premium by over $1200 next year and the CBO says it would lead to 16 million people uninsured. (Also, it’s the crucial provision  that makes it possible to protect people with pre-existing conditions from price discrimination.)

On process:
No one actually thinks the substance of this bill is a good idea (except for maybe Rand Paul). What makes this plan so dangerous is it kicks the can down to the next step in the process, which is Conference Committee. If the Senate passes anything, including a “skinny repeal,” it would let them get to this step. Conference committee is where members of the House and Senate meet to hash out differences between the bills.

Moderate members are trying to fool themselves (and you!) that this is a safe vote to take.

They feel safe voting for skinny repeal because it doesn’t technically make changes to the Medicaid program they care about. But that is extremely disingenuous. Senators know exactly how the process works and they know their skinny bill will be merged with the bill from the House, which decimates Medicaid. Even if the Senate passes a bill without the destructive cuts to Medicaid in it, the members of the Conference Committee from the House will put them right back in.

Voting for skinny repeal is indefensible on both substance and process—and you need to let your Senator know you oppose it.

SAMPLE CALL DIALOGUE

Caller: Hello! My name is [name] and I’m calling from [part of state]. Can you please tell me how Senator [   ] intends to vote on the skinny repeal bill?

Staffer: He hasn’t taken a position on that yet.

Caller: I want Senator [   ] to vote no on the skinny repeal plan. I am strongly opposed it. Skinny repeal would cause insurance markets to collapse and lead to 16 million people being uninsured. One analysis shows it would cause premiums to increase by more than $1200 next year. Our state can’t afford that.

Staffer: Obamacare is collapsing. The Senator thinks we have to act now to save the American people from Obamacare.

Caller: That is not true. Insurance companies agree, and have said so themselves, that the individual mandate is a crucial element of any bill.

Staffer: I’ll let the Senator know your thoughts.

Caller: Yes please do. And please take down my contact information so you can let me know how the Senator decides to vote.

---If they claim their Senator “voted against” TrumpCare---

Staffer: Senator [   ] agrees with you. That’s why he voted against the Better Care Reconciliation Act on July 25.

Caller: No, that’s not good enough. That vote didn’t matter and Senator [   ] knows it. Republicans knew they’d lose that vote. The vote that mattered was the motion to proceed and Senator [   ] voted YES. Don’t think I didn’t notice. I do not want the Senate to pass a bill that gets them to the conference committee. The conference committee will force the Senate to accept deep cuts to Medicaid. Will Senator [   ] oppose the skinny repeal?

Staffer: Senator [   ] will make a decision later in the week once they’ve had a chance to review the legislation.

Caller: I expect Senator [   ] to vote against skinny repeal. I know that it is nothing but a procedural trick to kick the can down the road that will only end with a terrible bill for our state. Please take down my information so you can let me know how Senator [   ] votes on this. I will be watching his vote very closely.


Wednesday, July 26

Arizona Skinny Repeal call script

It’s hard to believe, but Senators still don’t know what they’re voting on and when this week. One idea that seems to catching momentum is the concept of a “skinny repeal.” (If this seems new to you, it’s because it’s new to Republicans too -- they just cobbled it together on Tuesday.)

“Skinny repeal” -- to the best anyone actually knows -- is comprised of three main parts: repealing the individual mandate, repealing the medical device tax, and reducing the generosity of tax credits to help people afford insurance.

The individual mandate is a critical ingredient to a well-functioning insurance market because it ensures a mix of healthy and sick people. Without it, costs would be much higher and there would be fewer plan choices. That’s what makes repealing the individual mandate such a catastrophic idea: one analysis shows that it would increase the average marketplace premium by over $1200 next year.

If this is the version of TrumpCare the Senate ultimately votes on -- and we think it will be -- tell Senator McCain this is a terrible idea for Arizona and ask him to oppose final passage of the bill.

SAMPLE CALL DIALOGUE

Caller: Hello! My name is [name] and I’m calling from [part of state]. Can you please tell me how Senator McCain intends to vote on final passage of the health care bill this week? 

Staffer: He hasn’t taken a position on final passage yet. 

Caller: I want Senator McCain to vote no on final passage. I’ve heard the Senate plans to take a final vote on something that’s being called “skinny repeal.” I want Senator McCain to know I am strongly opposed to that. Skinny repeal would cause insurance markets to collapse and one analysis shows it would cause premiums to increase by more than $1200 next year. Arizonans can’t afford that. 

Staffer: Senator McCain has serious concerns about the process, as he said in his speech yesterday. He will vote against final passage if his concerns are not met.

Caller: That’s good to hear, but I want Senator McCain to oppose final passage no matter what. I agreed with a lot of what he said in his speech, about the need for bipartisanship and a meaningful committee process. But this bill didn’t get any of that -- it was drafted in complete secret and is being jammed through. McConnell isn’t even telling Senators what they’re voting on. I want Senator McCain to oppose final passage. Please take down my information so you can let me know how he votes on the bill.


Tuesday, July 25

No on the Motion to Proceed (Arizona)

It’s hard to believe, but Mitch McConnell is asking his Senators to vote yes on the first procedural vote, the “motion to proceed,” without telling them what they’re voting on.

Read that again, and let it sink in. Senators are expected to vote yes… even though Mitch McConnell won’t tell them what they’re voting on later in the week.  

No matter which version of TrumpCare Mitch McConnell puts to a vote -- Senator Flake should vote no. The bill destroys Medicaid as we know it, and the latest slush fund buy off, putting back $200 billion of the $756 billion they cut out, is barely a band aid. The bill would cause costs to skyrocket in Arizona, so high that CBO predicts some people may not buy insurance. It fails Arizonans who need treatment for opioid addiction.

Today, tell Senator Flake not to sell out Arizona.

SAMPLE CALL DIALOGUE

Caller: Hello! My name is [name] and I’m calling from [part of state]. Can you please tell me how Senator Flake intends to vote on the motion to proceed this week?

Staffer: He hasn’t taken a position. 

Caller: Does Senator Flake know which bill will be considered following the vote on the motion to proceed? 

Staffer: Not yet...

Caller: This is getting absurd. What more does Senator Flake need to say no? He doesn’t even know what he’s voting on. He needs to oppose the motion to proceed. The bill would be terrible for Arizona, in large part because it destroys Medicaid as we know it.

Staffer: Well, now the bill adds an extra $200 billion for Medicaid. 

Caller: That’s not true -- the $200 billion is not “extra.” The bill starts by cutting $756 billion from Medicaid, and this new buy off -- which may or may not be what Senator Flake is voting on -- just puts $200 billion back. That is not enough to cover the needs of Arizonans who will lose their Medicaid coverage. But nevertheless, no extra slush fund can make up for the rest of the bill. And it doesn’t do anything for people with pre-existing conditions that will be hurt by the Cruz Amendment, another provision which Senator Flake doesn’t know if he’s voting on or not.

Staffer: This bill protects people with pre-existing conditions. 

Caller: That’s not true. The bill allows states to let insurance companies sell plans that don’t cover essential health benefits, meaning people with pre-existing conditions won’t be able to get the care they need. And the Cruz Amendment makes that even worse.

Staffer: The Senator is still undecided. I’ll be sure to pass along your thoughts. 

Caller:  I expect Senator Flake to oppose the motion to proceed. Please take down my contact information so you can let me know whether he decides to stand with me or with Trump. 


Friday, July 21

New CBO Score and Deductibles (Arizona)

Yesterday, a new CBO score was released on the revised version of Senate TrumpCare. It confirmed that even though Republicans spent more money, the revised version of the bill would still cause 22 million people to lose their health insurance.

CBO also said that by 2026, the deductible for a standard plan under this bill would be $13,000. It’s worth repeating here verbatim what the CBO said next: “Because a deductible of $13,000 would be a large share of their income, many people with low income would not purchase any plan even if it had very low premiums—on net, after accounting for premium tax credits—CBO and JCT estimate.” CBO went on to say that for someone with an annual salary of $56,800, their deductible would constitute about a quarter of their income.

There is no clarity on which of the various versions of TrumpCare the Senate will vote on next week. Even Senators don’t know. Today, tell Senator Flake that no matter which bill gets voted on, he should oppose TrumpCare because it is terrible for the people of Arizona.

SAMPLE CALL DIALOGUE

Caller: Hello! My name is [name] and I’m calling from [part of state]. Can you please tell me which health care bill will be voted on next week? 

Staffer: There is no vote currently scheduled, and we don’t know which bill will be voted on.

Caller: Don’t you think that’s a little crazy? Considering healthcare makes up one-sixth of our economy, doesn’t Senator Flake deserve to know ahead of time what bill he has to vote on?

Staffer: The Senator is frustrated. 

Caller: I’m frustrated too. Senator Flake needs to oppose the motion to proceed to whichever bill comes to the floor next week. Every version floating around is terrible for Arizona. The CBO said yesterday that deductibles would be as high as $13,000 -- in some cases making up as much as a quarter or half of a person’s salary! That’s just not affordable, and it means people will go without the care they need. 

Staffer: Well, the bill may not be final yet. CBO didn’t score the most recent proposals. 

Caller: Yes I know, I’m very unhappy it sounds like the Senate will vote on something without having a complete CBO score on it. I heard one of the latest proposals is an extra pot of money for Medicaid. Even if the bill has an extra $200 billion in Medicaid funding, I want Senator Flake to oppose it. The bill starts by cutting $756 billion from Medicaid, it doesn’t help to put just $200 billion back. The extra funding does nothing to change the way traditional Medicaid is radically transformed into a cap system that will cause Arizonans to go without the care they need. How could Senator Flake support that? 

Staffer: Well, the Senator is pushing for a longer phaseout of the expansion and more money for a Medicaid wrap around.

Caller:  That’s not good enough for me. The extra $200 billion is not a “fix.” It doesn’t matter whether Medicaid is cut now or cut later, and even with an extra $200 billion, Medicaid is still cut by $556 billion. Will Senator Flake commit to me that he will vote against any bill that would result in Arizonans losing access to Medicaid coverage? 

Staffer:  The bill isn’t final yet. I’ll let the Senator know of your thoughts. 

Caller: Yes, please do. And please take down my information. I will be watching closely and would like to receive an update on how the Senator will be voting.


Thursday, July 20

McConnell’s Latest Gimmick, a Medicaid Buy Off

McConnell hasn’t given up on TrumpCare yet, even though too many Republican Senators currently oppose the bill for him to pass it. He thinks he has a serious chance to persuade Senator Flake, by throwing $200 billion in additional funding at states that expanded Medicaid, like Arizona.

$200 billion sure sounds like a lot -- but remember, TrumpCare cuts $772 billion from Medicaid. That means Medicaid still sees a staggering cut of $572 billion.

Just as bad, this extra $200 billion, as it’s being reported, does nothing to change the fundamental and permanent way Medicaid is transformed into a cap system. That would leave people without a way to get the care they need. Medicaid would be cut even deeper starting in 2025, when the growth rate stops mirroring medical costs and instead starts mirroring the slower-growing cost of milk and bread.

Combined with the funding cuts, these changes destroy Medicaid as we know it. The extra $200 billion McConnell is throwing in to entice moderates does absolutely nothing to change that. Today, make sure Senator Flake doesn’t get bought off by McConnell’s latest gimmick.

SAMPLE CALL DIALOGUE

Caller: Hello! My name is [name] and I’m calling from [part of state]. Can you please tell me how Senator Flake intends to vote on the Better Care Reconciliation Act? 

Staffer: There is no vote currently scheduled on that bill.

Caller: Yes, but I’m sure the Senate will vote as soon as they can. How will Senator Flake vote on the bill?

Staffer: He hasn’t taken a position on the bill yet. He has some concerns though.

Caller: I want Senator Flake to oppose the bill no matter what, whether Senator McConnell calls up a full repeal bill or the Better Care Reconciliation Act. Even if the bill has an extra $200 billion in Medicaid funding, I want Senator Flake to oppose it. The extra funding does nothing to change the way traditional Medicaid is radically transformed into a cap system that will cause Arizonans to go without the care they need. How could Senator Flake support that? 

Staffer: Well, the Senator is pushing for a longer phaseout of the expansion and more money for a Medicaid wrap around.

Caller:  That’s not good enough for me. The extra $200 billion is not a “fix.” It doesn’t matter whether Medicaid is cut now or cut later, and even with an extra $200 billion, Medicaid is still cut by $572 billion. Will Senator Flake commit to me that he will vote against any bill that would result in Arizonans losing access to Medicaid coverage? 

Staffer:  The bill isn’t final yet. I’ll let the Senator know of your thoughts. 

Caller: Yes, please do. And please take down my information. I will be watching closely and would like to receive an update on how Senator Flake will be voting.


Wednesday, July 19

McConnell’s Unbelievably Reckless Plan B: Repeal ACA With Nothing to Replace It

Republicans want a win so badly they are willing to gamble with the future of the American healthcare system. Having lost the support of at least four Senators on the latest version of TrumpCare, enough to block the bill, Mitch McConnell is switching gears. He plans to hold a vote on repealing much of the Affordable Care Act without anything to replace it.

That would mean, in two years, the Medicaid expansion would end. Tax credits to help people pay for insurance would disappear. And unlike earlier versions of TrumpCare, there is not even an attempt to replace the tax credits or keep pieces of the expansion.

And unlike earlier versions of TrumpCare, nothing replaces them. Under this framework, which repeals as much of the law they can get away with through reconciliation, the Congressional Budget Office estimates that 18 million Americans would lose their insurance in the first year, and a staggering 32 million by 2026. CBO also said premiums would increase by 25% in the first year and that they would double by 2026.

Republicans may try to argue that they are repealing now and will work on a replacement later that Democrats will be forced to negotiate on. This is nothing short of holding millions of lives hostage for their failed partisan agenda, and a repeat of a tactic that was considered a failure in January.

The scariest part of this plan? Senator Flake is already on the record voting to support this proposal. The Senate passed it in 2015, knowing they didn’t need a replacement because President Obama would veto the repeal bill. Senator Flake should have never supported it then, and he definitely shouldn’t support it now. Any Senator with the least bit of doubt about any previous version of Trumpcare has no business even considering supporting this disaster.

Before we move on to what’s next, we need to kill this zombie bill. Today, make sure Senator Flake opposes any vote on a straight repeal of the Affordable Care Act.

SAMPLE CALL DIALOGUE

Caller: Hello! My name is [name] and I’m calling from [part of state]. Can you tell me how Senator Flake plans to vote on the motion to proceed on the health care bill?

Staffer: The Senator hasn’t made a decision on that yet. 

Caller: That’s terrible. Senator Flake should absolutely oppose any attempt to repeal the Affordable Care Act. This is a reckless move that Mitch McConnell is making out of desperation with no plan whatsoever as to how the ACA would be replaced. The Congressional Budget Office says 32 million people will lose their insurance and that premiums will double. How could Senator support that? 

Staffer: Again, Senator hasn’t made a decision yet. 

Caller: I know Senator Flake had concerns about the previous version of the TrumpCare bill. Not only would millions lose their insurance and face higher costs, but it would also end the Medicaid expansion with no transition plan after 2 years. If Senator Flake had concerns about the previous version, s/he should definitely oppose the straight repeal version. 

Staffer: I really appreciate your call and will be sure to let the Senator know your thoughts. 

Caller: Thank you. I want Senator Flake to oppose any effort to repeal the Affordable Care Act, especially if there is no plan in place to replace it. Please take down my contact information so you can let me know how Senator Flake votes. 


Monday, July 17

TRUMPCARE MEDICAID CUTS IN ARIZONA CALL SCRIPT

TrumpCare would destroy Medicaid as we know it. In order to give billions of dollars in tax breaks to the wealthy and corporations, TrumpCare makes the deepest cuts to Medicaid in its 52-year history. Not only does it end the Medicaid expansion, it fundamentally (and permanently) restructures Medicaid in a way that threatens the well-being of low- and middle-income families across the country.

246,000 Arizonans would lose Medicaid coverage under TrumpCare, whether the expansion is ended now or later -- so don’t let Senator Flake tell you that they “fixed” the bill by extending the phaseout. Senator Flake also apparently likes the Ted Cruz amendment, but that is not a fix for people who rely on Medicaid or for people with pre-existing conditions.

SAMPLE CALL DIALOGUE

Caller: Hello! My name is [name] and I’m calling from [part of state]. Can you please tell me how Senator Flake intends to vote on the Better Care Reconciliation Act? 

Staffer: There is no vote currently scheduled on that bill.

Caller: Yes, but I’m sure the Senate will vote as soon as they can. How will Senator Flake vote on the bill?

Staffer: He hasn’t taken a position on the bill yet. He has some concerns though.

Caller: I want Senator Flake to oppose the bill no matter what. This bill would cause 246,000 Arizonans to lose their Medicaid coverage. That includes kids with disabilities and the elderly in nursing homes. How could Senator Flake support that? 

Staffer: Well, the Senator is pushing for a longer phaseout of the expansion. 

Caller:  That’s not good enough for me and that is not a “fix.” It doesn’t matter whether Medicaid is cut now or cut later. What matters is that people will lose coverage. Many seniors also rely on Medicaid and Alaska has a higher proportion of seniors over 85 than other states. This means, under TrumpCare, our Medicaid funding won’t keep up with the cost of providing care to seniors. What is Senator Flake going to do about that? 

Staffer:  The bill isn’t final yet. There may still be major changes to the bill which we’ll know about later in the week. 

Caller: Yes, I’m glad you mentioned that. I read Senator Flake is open to the Cruz Amendment. That is a terrible idea that hurts people with pre-existing conditions and drives up costs for people who need more care. And it does nothing to help the 246,000 Arizonans who lose the Medicaid coverage they rely on.

Staffer: I’ll let the Senator know of your thoughts. 

Caller: Yes, please do. And please take down my information. I will be watching closely and would like to receive an update on how Senator Flake will be voting.


Thursday, July 13

ARIZONA AND TRUMPCARE’S PROPOSAL TO REINSTATE LIFETIME CAPs

Live on late night television, comedian Jimmy Kimmel told a heart wrenching story with a happy ending about his newborn son’s battle with a life-threatening congenital heart defect. Kimmel credited excellent health care providers and his family’s access to them as saving his son’s life. Tearfully, Kimmel said he hoped that every family in a similar situation would be able to receive the same level of care. Not long after, Sen. Bill Cassidy (R-LA) declared that any health bill should have to pass a “Jimmy Kimmel test” and agreed that “No family should be denied medical care for an emergency or otherwise because they can’t afford it.”

TrumpCare does not pass the Kimmel test. TrumpCare would allow insurance companies to limit how much money they spend on medical treatment for an individual. These so-called “lifetime caps” disproportionately hurt anyone facing high-cost medical treatment such as disabled Americans, kids born with cerebral palsy, or people with hemophilia, rheumatoid arthritis, or cancer. In all likelihood, Jimmy Kimmel’s son would have exhausted a lifetime cap within a few short months because of his congenital heart condition.

Americans with high-cost medical conditions depend on the ACA’s consumer protections against lifetime insurance caps. Call today and let Senator Flake know you oppose TrumpCare and its rolls back to protections for Americans, know that you oppose TrumpCare and its rolls back to protections for Americans, including over 1 million Arizonans with pre-existing conditions.

SAMPLE CALL DIALOGUE

Caller: Hello! My name is [name] and I’m calling from [part of Arizona]. Can you please tell me how Senator Flake intends to vote on the Better Care Reconciliation Act? 

Staffer: He/she [hasn’t taken a position on the bill yet] [said last week he/she will not support the bill in its current form. He/she has serious concerns.]

Caller: Senator Flake needs to oppose TrumpCare. I strongly oppose TrumpCare’s roll back of the ACA’s consumer protection from lifetime caps for consumers. Lifetime caps  disproportionately harm people facing high-cost medical treatment, including including over 1 million Arizonans with pre-existing conditions. How could Senator Flake support a proposal that jeopardizes their access to care?

Staffer: This bill protects people with pre-existing conditions. 

Caller: That’s not true. TrumpCare allows insurance companies to reinstate lifetime caps. This means that insurance companies could stop paying for services when people need them the most and gamble with American lives. Lifetime caps would likely send thousands of Americans  with expensive medical debt back to bankruptcy court. That’s just not right.  

Staffer: Well, the Senate will likely change the bill further. 

Caller: There is no change — not extra time, not extra funding, not policy tweaks — that could make this bill something Senator Flake should support. 

Staffer: I’ll be sure to pass along your thoughts to the Senator.

Caller: Thank you. Please take down my contact information so you can let me know how the Senator decides to vote on this bill.


Wednesday, July 12

THE CRUZ PROPOSAL MAKES TRUMPCARE EVEN WORSE FOR PEOPLE WITH PRE-EXISTING CONDITIONS IN ARIZONA

Senator McConnell has a tight needle to thread: he’s trying desperately to recruit “moderate” Republicans that are holding out, but he also needs to get the extreme wing on board. That’s why he’s pushing a proposal from Ted Cruz that will allow insurance companies to sell plans that have fewer benefits and fewer patient protections than plans currently sold through the health insurance marketplace do. They’d be allowed to do this as long as they sell just one plan that complies with the ACA’s protections, such as the requirement to cover people with pre-existing conditions, which 1,043,000 Arizonans rely on.

What will this mean? It separates people who need better coverage from people who don’t -- meaning costs go way up for people who need higher quality plans. People with pre-existing conditions, especially middle-income families who don’t get tax credits, will have no choice but to pay higher costs in order to get the plans that cover them. This could also create serious confusion for customers buying through the exchange when trying to understand which plans cover the services and prescriptions they need-- and which do not. The ACA created standards for what qualified as health insurance and this proposal tears those standards away.

Senators are looking for any excuse to support this bill and claim it’s been fixed. But let’s be clear, this bill is unfixable. Today, let Senator Flake know you oppose TrumpCare and this new Cruz proposal.

SAMPLE CALL DIALOGUE

Caller: Hello! My name is [name] and I’m calling from [part of state]. Can you please tell me how Senator Flake intends to vote on the Better Care Reconciliation Act? 

Staffer: There is no vote currently scheduled on that bill.

Caller: Yes, but I’m sure the Senate will vote as soon as they can. How will Senator Flake vote on the bill?

Staffer: He hasn’t taken a position on the bill yet.

Caller: Senator Flake needs to oppose the TrumpCare bill no matter what. There’s nothing he can negotiate with Mitch McConnell that would make this bill something he should support. I’m also strongly opposed to the new proposal from Ted Cruz regarding what kind of plans can be sold in the marketplace. Do you know if Senator Flake supports that proposal?

Staffer: I’m not sure.

Caller: That proposal would make things even worse for people with pre-existing conditions. It says that insurance companies can sell whatever plans they want -- no matter how low-quality they are -- as long as they sell just one plan that meets the ACA’s standards. . That is a waste of taxpayer dollars because it means people will use tax credits to buy plans that don’t cover anything. And even worse, it means prices will go way up for people with pre-existing conditions, including 1,043,000 people in Arizona. 

Staffer: This bill protects people with pre-existing conditions. 

Caller: That’s not true. The bill allows states to let insurance companies sell plans that don’t cover essential health benefits, meaning people with pre-existing conditions won’t be able to get the care they need. And the new proposal from Ted Cruz makes it even worse. Someone who is in the middle class and doesn’t qualify for subsidies likely wouldn’t be able to afford the coverage they need because of the Cruz proposal. How could the Senator support that? 

Staffer: The Senator is waiting for a new CBO score to make a decision on the bill. CBO is scoring the bill with the Cruz proposal and without it. 

Caller: I see. Well I want Senator Flake to oppose this bill whether it has the Cruz proposal in it or not. There is no change -- not extra time, not extra funding, no policy tweak, and definitely not this Cruz proposal, that could make this bill something Senator Flake should support. 

Staffer: I’ll be sure to pass along your thoughts to the Senator.

Caller:  Thank you. Please take down my contact information so you can let me know how the Senator decides to vote on this bill.


Tuesday, July 11

TRUMPCARE MEDICAID CUTS IN ARIZONA CALL SCRIPT

TrumpCare would destroy Medicaid as we know it. In order to give billions of dollars in tax breaks to the wealthy and corporations, TrumpCare makes the deepest cuts to Medicaid in its 52-year history. Not only does it end the Medicaid expansion, it fundamentally (and permanently) restructures Medicaid in a way that threatens the well-being of low- and middle-income families across the country.

246,000 Arizonans would lose Medicaid coverage under TrumpCare, whether the expansion is ended now or later -- so don’t let Senator Flake tell you that they “fixed” the bill by extending the phaseout. Senator Flake also apparently likes the Ted Cruz amendment, but that is not a fix for people who rely on Medicaid or for people with pre-existing conditions.

SAMPLE CALL DIALOGUE

Caller: Hello! My name is [name] and I’m calling from [part of state]. Can you please tell me how Senator Flake intends to vote on the Better Care Reconciliation Act? 

Staffer: There is no vote currently scheduled on that bill.

Caller: Yes, but I’m sure the Senate will vote as soon as they can. How will Senator Flake vote on the bill?

Staffer: He hasn’t taken a position on the bill yet. He has some concerns though.

Caller: I want Senator Flake to oppose the bill no matter what. This bill would cause 246,000 Arizonans to lose their Medicaid coverage. That includes kids with disabilities and the elderly in nursing homes. How could Senator Flake support that? 

Staffer: Well, the Senator is pushing for a longer phaseout of the expansion. 

Caller:  That’s not good enough for me and that is not a “fix.” It doesn’t matter whether Medicaid is cut now or cut later. What matters is that people will lose coverage. Many seniors also rely on Medicaid and Alaska has a higher proportion of seniors over 85 than other states. This means, under TrumpCare, our Medicaid funding won’t keep up with the cost of providing care to seniors. What is Senator Flake going to do about that? 

Staffer:  The bill isn’t final yet. There may still be major changes to the bill which we’ll know about later in the week. 

Caller: Yes, I’m glad you mentioned that. I read Senator Flake is open to the Cruz Amendment. That is a terrible idea that hurts people with pre-existing conditions and drives up costs for people who need more care. And it does nothing to help the 246,000 Arizonans who lose the Medicaid coverage they rely on.

Staffer: I’ll let the Senator know of your thoughts. 

Caller: Yes, please do. And please take down my information. I will be watching closely and would like to receive an update on how Senator Flake will be voting.


Monday, July 10

TRUMPCARE WILL KILL JOBS IN ARIZONA

There’s been a lot of talk about the disastrous consequences of TrumpCare on our health and access to care but not about the economic consequences. Hospitals, doctors, pharmacies and other providers all are important job providers. If fewer people are accessing health care, these businesses are forced to cut jobs. According to one report, nearly 1.5 million jobs would be lost nationwide, including 12,800 in Arizona due to Senate TrumpCare.

Republicans don’t want to talk about their job-killing legislation and spent the July 4th recess avoiding their constituents. As they return to Washington under pressure to support this bill,  we need to hold them accountable for the families whose livelihoods they’re considering throwing away.

SAMPLE CALL DIALOGUE

Caller: Hello! My name is [name] and I’m calling from [part of state]. Can you please tell me how Senator [Flake] [McCain]  intends to vote on the Better Care Reconciliation Act? 

Staffer: There is no vote currently scheduled on that bill.

Caller: Yes, but I’m sure the Senate will vote as soon as they can. How will Senator [Flake] [McCain] vote on the bill?

Staffer: He[hasn’t taken a position on the bill yet] [said last week he will not support the bill in its current form. He has serious concerns.]

Caller: Senator [Flake] [McCain] needs to oppose this job-killing bill no matter what. By cutting federal health care funding, TrumpCare forces businesses to lay off their workers, including 12,800 in Arizona alone. 

Staffer: Federal cuts don’t lead to job cuts, in fact this bill ends regulations and taxes that have prevented job growth.

Caller: Those regulations are protecting consumers and those tax cuts go to the rich. Meanwhile, this bill takes away health care from families who need it and ends the jobs of the providers who serve them. 

Staffer: Thank you for your views, I will pass them on to the Senator.

Caller: Thank you. Please take down my contact information so you can let me know how the Senator decides to vote on this bill.


Friday, July 7

THE CRUZ PROPOSAL Will MAKE TRUMPCARE EVEN WORSE FOR PEOPLE WITH PRE-EXISTING CONDITIONS

Senator McConnell has a tight needle to thread: he’s trying desperately to recruit “moderate” Republicans that are holding out, but he also needs to get the extreme wing on board. That’s why he’s pushing a proposal from Ted Cruz that will allow insurance companies to sell plans that have fewer benefits and fewer patient protections than plans currently sold through the health insurance marketplace do. They’d be allowed to do this as long as they sell just one plan that complies with the ACA’s protections, such as the requirement to cover people with pre-existing conditions, which 1,043,000 Arizonans rely on.

What will this mean? It separates people who need better coverage from people who don’t -- meaning costs go way up for people who need higher quality plans. People with pre-existing conditions, especially middle-income families who don’t get tax credits, will have no choice but to pay higher costs in order to get the plans that cover them. This could also create serious confusion for customers buying through the exchange when trying to understand which plans cover the services and prescriptions they need-- and which do not. The ACA created standards for what qualified as health insurance and this proposal tears those standards away.

Senators are looking for any excuse to support this bill and claim it’s been fixed. But let’s be clear, this bill is unfixable. Today, let Senator Flake know you oppose TrumpCare and this new Cruz proposal.

SAMPLE CALL DIALOGUE

Caller: Hello! My name is [name] and I’m calling from [part of state]. Can you please tell me how Senator Flake intends to vote on the Better Care Reconciliation Act? 

Staffer: There is no vote currently scheduled on that bill.

Caller: Yes, but I’m sure the Senate will vote as soon as they can. How will Senator Flake vote on the bill?

Staffer: He hasn’t taken a position on the bill yet.

Caller: Senator Flake needs to oppose the TrumpCare bill no matter what. There’s nothing he can negotiate with Mitch McConnell that would make this bill something he should support. I’m also strongly opposed to the new proposal from Ted Cruz regarding what kind of plans can be sold in the marketplace. Do you know if Senator Flake supports that proposal?

Staffer: I’m not sure.

Caller: That proposal would make things even worse for people with pre-existing conditions. It says that insurance companies can sell whatever plans they want -- no matter how low-quality they are -- as long as they sell just one plan that meets the ACA’s standards. . That is a waste of taxpayer dollars because it means people will use tax credits to buy plans that don’t cover anything. And even worse, it means prices will go way up for people with pre-existing conditions, including 1,043,000 people in Arizona. 

Staffer: This bill protects people with pre-existing conditions. 

Caller: That’s not true. The bill allows states to let insurance companies sell plans that don’t cover essential health benefits, meaning people with pre-existing conditions won’t be able to get the care they need. And the new proposal from Ted Cruz makes it even worse. Someone who is in the middle class and doesn’t qualify for subsidies likely wouldn’t be able to afford the coverage they need because of the Cruz proposal. How could the Senator support that? 

Staffer: The Senator is waiting for a new CBO score to make a decision on the bill. CBO is scoring the bill with the Cruz proposal and without it. 

Caller: I see. Well I want Senator Flake to oppose this bill whether it has the Cruz proposal in it or not. There is no change -- not extra time, not extra funding, no policy tweak, and definitely not this Cruz proposal, that could make this bill something Senator Flake should support. 

Staffer: I’ll be sure to pass along your thoughts to the Senator.

Caller:  Thank you. Please take down my contact information so you can let me know how the Senator decides to vote on this bill.


Thursday, July 6

TRUMPCARE AND ARIZONA’S VETERANS

Most people assume our nation’s veterans get their healthcare through the Veterans Administration. And that’s correct, nine out of ten veterans do. But eligibility for VA healthcare depends on a variety of factors, like length and type of service, disability, and discharge status. That means that 1 out of 10 veterans get their healthcare through private insurance or through Medicaid, which means TrumpCare has a significant effect on veterans as well.

The Center for American Progress estimates that more than 441,000 veterans could lose insurance under TrumpCare, including 6,400 in Arizona. That’s for two reasons: the bill’s destruction of Medicaid as we know it, and the way the bill fails people with pre-existing conditions -- which, for veterans, can include spinal injuries, amputations, and PTSD.

Today, let Senator Flake know you oppose TrumpCare because it hurts our nation’s veterans.

SAMPLE CALL DIALOGUE

Caller: Hello! My name is [name] and I’m calling from [part of state]. Can you please tell me how Senator Flake intends to vote on the Better Care Reconciliation Act? 

Staffer: There is no vote currently scheduled on that bill.

Caller: Yes, but I’m sure the Senate will vote as soon as they’re back from July 4 recess. How will Senator Flake vote on the bill?

Staffer: He hasn’t taken a position on the bill yet.

Caller: Senator Flake needs to oppose the TrumpCare bill no matter what. There’s nothing he can negotiate with Mitch McConnell that would make this bill something he should support. Did you know that TrumpCare would cause 441,000 veterans to lose their healthcare, including 6,400 in Arizona? Does Senator Flake support our veterans? 

Staffer: Of course the Senator supports our nation’s vets. He is proud of his record standing up for veterans, including the law that was just passed to clean up the VA. 

Caller: If Senator Flake really wanted to stand up for veterans, he would oppose TrumpCare. The bill decimates Medicaid, which hundreds of thousands of veterans rely on because they don’t qualify for VA coverage. It also undermines protections for people with pre-existing conditions, which for veterans can include service-related injuries and PTSD. 

Staffer: This bill protects people with pre-existing conditions. 

Caller: That’s not true. The bill allows states to let insurance companies sell plans that don’t cover essential health benefits, meaning people with pre-existing conditions, including veterans, won’t be able to get the care they need. And the new proposal from Ted Cruz, which CBO is now scoring, makes this even worse. His proposal will make it even more expensive for people with pre-existing conditions to afford coverage. 

Staffer: The Senator is waiting for a new CBO score to make a decision on the bill. 

Caller: I see. Well I want Senator Flake to oppose this bill no matter what. There is no change -- not extra time, not extra funding, and no policy tweak that could make this bill something Senator Flake should vote for. 

Staffer: I’ll be sure to pass along your thoughts to the Senator.

Caller: Thank you. Please take down my contact information so you can let me know how the Senator decides to vote on this bill.


Wednesday, July 5

INSURANCE COMPANY PROFIT TRUMPCARE CALL SCRIPT: ARIZONA

A little known but hugely impactful provision of the Affordable Care Act is known as “Medical Loss Ratio.” It benefits everyone -- even people who have insurance through their employer, in addition to people that buy plans through the marketplace. MLR requires insurance companies to use the premiums they collect from patients for actual health care services, and not waste it on other things. More specifically, plans must spend at least 80% of the premiums collected on providing actual health care, and not on administrative costs, marketing campaigns, CEO salaries, or—most importantly—profits. If they break that rule, they have to send a rebate back to their customers.

This ACA requirement returned a staggering $396 million to 4.8 million families in 2015, including 58,430 in Arizona. Arizona families that paid premiums got an average rebate of $185 back. That’s a chunk of money taken right out of shareholder profits and returned to patients. TrumpCare, as you might have guessed, would get rid of this requirement after next year. After that, it’s up to individual states to decide whether they’ll keep protecting consumers from insurance plans’ wasteful spending.

Today, let Senator Flake know you expect him to oppose TrumpCare because you expect insurance companies to spend the premiums you pay on care, not profits.

SAMPLE CALL DIALOGUE
 
Caller: Hello! My name is [name] and I’m calling from [part of state]. Can you please tell me how Senator Flake intends to vote on the Better Care Reconciliation Act? 
 
Staffer: There is no vote currently scheduled on that bill.
 
Caller: Yes, but I’m sure the Senate will vote as soon as they’re back from July 4 recess. How will Senator Flake vote on the bill?
 
Staffer: He hasn’t taken a position on the bill yet.
 
Caller: That’s terrible Senator Flake needs to oppose the TrumpCare bill no matter what. There’s nothing he can negotiate with Mitch McConnell that would make this bill something he should support. Did you know that TrumpCare eliminates a requirement that insurance companies spend at least 80% of the premiums they collect on actual health care services, and not profits? In 2015, 58,430 Arizonans got an average rebate check of $185 back. That’s a total of $5.7 million back in Arizonans’ pockets, taken out of excessive insurance company profits. Is Senator Flake ok with letting insurance company profits run wild again? 
 
Staffer: I’m not sure. But I can tell you there is still time for the bill to change. 
 
Caller: Yes I heard. I suspect McConnell is putting the pressure on Senator Flake pretty strong this week. I want Senator Flake to oppose this bill no matter what. There is no change -- not extra time, not extra funding, and no policy tweak that could make this bill something Senator Flake should vote for. 
 
Staffer: I’ll be sure to pass along your thoughts to the Senator.
 
Caller:  Thank you. Please take down my contact information so you can let me know how the Senator decides to vote on this bill.


Monday, July 3

SAMPLE QUESTIONS FOR YOUR SENATOR THIS JULY 4 RECESS

The next two weeks are critical for stopping TrumpCare: the week of July 3 when Senators are back home in their states and the week of July 10 when Senators are back in DC and ready to vote. Almost every Senator is hiding from their constituents and not holding a town hall this recess, so you’ll have to find them elsewhere. And no Senator can resist the patriotic draw of a July 4 parade. Once you’ve found them at a parade or a public event, ask them these questions:

  • The Congressional Budget Office estimates that 15 million people will lose their Medicaid coverage under TrumpCare. That includes [x] people in our state [find your number here]. Kids with disabilities and the elderly rely on Medicaid—it’s not just low-income people like you probably think. It’s true that Medicaid funding increases in raw dollar terms, but by so little that millions will lose their coverage. All of this so you can give $700 billion in tax breaks to your rich friends. Will you side with me or side with Trump and the billionaires? Will you commit to me, your constituent, that you will vote against any bill that gives tax breaks to the rich at the expense of constituents?
  • I have family and friends getting treatment for opioid abuse. Ending the Medicaid expansion and letting states opt out of patient protections means that many people who need treatment for opioid abuse will lose the care they need. I know the Senate is talking about adding an extra $45 billion for opioids. It’s insulting how totally inadequate that number is, especially compared to the $[xx] that our state really needs (find your number in Table 1 here). Are you really committed to helping your constituents fight opioid addiction or, in the end, are you going to give tax breaks to your billionaire friends and the pharmaceutical companies instead?
  • TrumpCare would result in significantly higher costs for Americans. It’s true that CBO estimates premiums will go down after seeing them spike in the first few years. But deductibles and out of pocket costs go up more than premiums go down, resulting in net higher costs! Even worse, plans will be skimpier and will include fewer benefits, meaning care we need might have to be paid for totally out of pocket. In short, costs go up for us while taxes for your rich friends go down. Will you side with me or side with Trump and the billionaires? Will you commit to me, your constituent, that you will vote against any bill that increases out-of-pocket costs?
  • I’m concerned about people with pre-existing conditions. It’s technically true that the bill maintains the requirement that people with pre-existing conditions have access to coverage. But the bill also has a backdoor way to let insurance companies get around this if states opt out of patient protections. Sure, people with pre-existing conditions have access to coverage—but they may not be able to find any plans that cover their pre-existing condition! The bottom line is, people with pre-existing conditions will be much worse off under this bill than they are under current law. Are you going to put people with pre-existing conditions at risk so you can fulfill a political promise? Will you commit to voting against any bill that weakens protections for people with pre-existing conditions?
  • I know the vote got delayed because the votes weren’t there in the Senate and that Mitch McConnell has a $200 billion goodie jar he’s using to bribe Senators. But this bill is terrible no matter what: it destroys Medicaid as we know it, it takes away treatment for opioid addiction, it puts people with pre-existing conditions at risk, it raises costs for patients, and it shifts huge costs to already-strapped state budgets. Are you going to let McConnell bribe you with some token change to the bill or will you stand up for your constituents? Will you commit to me, your constituent, to vote against this unfixable bill?  

Friday, June 30

TRUMPCARE ATTACKS WOMEN AND PLANNED PARENTHOOD: ARIZONA CALL SCRIPT

TrumpCare will be a disaster for the country and for Arizona. It defunds Planned Parenthood. Nearly 3 million Americans, especially women and families, receive affordable health care services annually at Planned Parenthood facilities. TrumpCare prohibits any funding from going to these clinics which will decimate the health care safety net. 
 
In Arizona alone, 2 centers provided care to 32,818 Arizonans including  34,685 STI tests, 2,924 pap tests, and 3,392 breast exams in 2015. Of those patients, 23,431 received contraceptive services. For many women, Planned Parenthood is their only safe and affordable place to receive vital health care services. 
 
Additionally, TrumpCare would destroy the Medicaid program as we know it by putting in place a cap and massively cutting the program. This will hurt American families as Medicaid pays for half of all births in the U.S.
 
Don’t let Senator Flake rip funding from Planned Parenthood or healthcare away from those Arizonans, including many women, who need it most. Call today!

SAMPLE CALL DIALOGUE

Caller:  Hello! My name is [name] and I’m calling from [part of state]. Can you tell me how the Senator plans to vote on TrumpCare, the Better Care Reconciliation Act? 
 
Staffer:  The Senator hasn’t made a decision on that yet.
 
Caller:  That’s terrible. Senator Flake needs to oppose this awful bill. I stand with Planned Parenthood and this bill could lead to 3 million Americans losing access to their services, including 16,007 in Arizona. How could Senator Flake support that? 
 
Staffer:  Well, the Senate isn’t going to pass the bill in its current form. It will be different. And some Senators are discussing changing the Planned Parenthood provisions. 
 
Caller:  No, there’s no fixing this bill. It would increase costs for women, no longer require coverage for pregnancies, and dramatically cut funding for Medicaid. The Senator should oppose any bill that makes being female a pre-existing  condition or dramatically cuts Medicaid. Will Senator Flake commit to me, an Arizonan, that he will vote against any bill that would result in women in Arizona having more expensive care, less coverage, or less access?
 
Staffer:  Again, the Senate bill will change. But I’ll be sure to let Senator Flake know your thoughts.
 
Caller: Yes, please do. And please take down my contact information. I will be watching closely and would like to receive an update on how the Senator will be voting.


Thursday, June 29

ARIZONA UNFIXABLE TRUMPCARE BILL CALL SCRIPT

Senate Republicans want to finish the next draft of their TrumpCare bill, after the first one was met with enough opposition to sink it, by June 30. That way they can send changes to CBO, have a new score back in a week, and fast track TrumpCare through the Senate as soon as they get back from the July 4 recess. 

Mitch McConnell is desperate to keep his caucus together to cobble together at least 50 votes for TrumpCare. That means he’ll do whatever it takes to get Senator Flake’s vote. 

Senator Flake has been extremely quiet so far. He put out a statement on a federal water regulation on the same day TrumpCare’s CBO score was released, but nothing on TrumpCare. The Republican Governor of Arizona, Doug Ducey, said that he wanted to see a longer phase out of Medicaid and a higher Medicaid growth rate in order to get his support. But there is no fix for TrumpCare -- no policy tweak, amount of funding, or extra period of time could make this bill something Senator Flake should support. Today, let him know you want him to oppose TrumpCare no matter what.

SAMPLE CALL DIALOGUE

Caller: Hello! My name is [name] and I’m calling from [part of state]. Can you please tell me how Senator Flake intends to vote on the Better Care Reconciliation Act? 

Staffer: There is no vote scheduled for this week on that bill.

Caller: Yes, but I’m sure the Senate will vote as soon as they’re back from July 4 recess. How will Senator Flake vote on the bill?

Staffer: He hasn’t taken a position on the bill yet. He is taking his time to thoroughly review and study the bill. 

Caller: Senator Flake needs to oppose the TrumpCare bill no matter what. There’s nothing he can negotiate with Mitch McConnell that would make this bill something he should support. Even if he gets a longer Medicaid phase out or a higher Medicaid growth rate, as Governor Ducey suggests. The bill is still a disaster for our state that will cause 461,000 Arizonans to lose their coverage. That includes more than 246,000 receiving Medicaid.

Staffer: The Senator is pleased the Senate postponed the vote on the bill so Senators had more time to hear from their constituents and study the bill. I’ll let him know your thoughts. 

Caller:  Thank you. Please take down my contact information so you can let me know what the Senator says after you let him know my thoughts. Like I said, there is no fix for Trumpcare -- not extra funding, not extra time, no policy tweak -- that could make it worth supporting.  

Staffer:  Ok, I will pass along your thoughts to the Senator.

Caller:  Great, thank you. Can you repeat my contact information back to me? I just want to make sure you recorded it correctly. 


Wednesday, June 28

TRUMPCARE AND OPIOID ADDICTION TREATMENT: ARIZONA CALL SCRIPT

In 2015, the opioid epidemic claimed the lives of more than 52,000 Americans, including 1,274 in Arizona. And yet, the Senate version of TrumpCare decimates Medicaid, which is how a substantial population of people requiring addiction care get the treatment they need. The bill adds funding for fighting opioid abuse for just one year -- an insufficient, token acknowledgement of what a serious crisis this is.

We know that under TrumpCare, 22 million would lose coverage to give $700 billion in tax breaks to the wealthy and corporations, and consumers will have fewer guaranteed protections. Insurance companies will be back in charge. Today, hold Senator Flake accountable for ripping away treatment for opioid addiction.

SAMPLE CALL DIALOGUE

Caller:  Hello! My name is [name] and I’m calling from [part of state]. Can you tell me how the Senator plans to vote on TrumpCare, the Better Care Reconciliation Act? 

Staffer:  There will not be a vote on that bill this week. 

Caller:  Yes, I know that. But I’m sure there will be a vote shortly after the Senate gets back from recess next week. How will the Senator vote on the bill then? 

Staffer:  The Senator hasn’t made a decision on that yet.

Caller:  That’s terrible. Senator Flake needs to oppose this awful bill. In 2015, 1,274 Arizonans died from opioid addiction. Over 78,000 Arizonans are currently receiving treatment for opioid addiction through the exchanges or through Medicaid, which this bill decimates. How could Senator Flake support that? 

Staffer: The Senator is committed to fighting the opioid crisis. That’s why he is pleased extra funding in the bill for that purpose. 

Caller: That’s pathetic. There is only one year of extra funding. Then what? Without access to treatment through Medicaid, people could die. 

Staffer:  The Senator agrees with you, which is why he is also pleased there is a longer Medicaid phaseout.  

Caller:  It doesn’t matter whether Medicaid is cut now or cut later. What matters is that people will lose coverage. What does it matter whether this goes away now or later? Many seniors also rely on Medicaid and our state has a higher proportion of seniors over 85 than other states. This means, under TrumpCare, our Medicaid funding won’t keep up with the cost of providing care to seniors. What is Senator Flake going to do about that? 

Staffer: I’m not sure. I’ll be sure to let the Senator know your thoughts. 

Caller: Yes, please do. And please take down my information. I will be watching closely and would like to receive an update on how Senator Flake will be voting.


Tuesday, June 27

How to Talk to Your Senator about TrumpCare

We now have a bill text and CBO score for the Senate version of TrumpCare. Here’s what we know:

  • 22 million of Americans would lose their healthcare coverage, including 15 million from Medicaid alone, all to give $700 billions in tax breaks to corporations and the ultra-rich.
  • Out-of-pocket costs would increase for all Americans, and coverage would be skimpier than under the ACA. For someone at the poverty level, the deductible would be half of their annual income.
  • TrumpCare would allow states to opt-out of critical consumer protections that ensure insurance covers vital services, meaning insurance companies can once again discriminate against Americans, like charging more for those with pre-existing conditions who need those services.

In this crucial week for the fate of TrumpCare, calls and visits to your Senator’s district office matter more than ever. If your Senator is one of the key Republicans who has come out against the bill, call to thank them and make sure they stay strong. For all other Republican senators, use the script below. And remember, Democrats have a crucial role to play in resisting TrumpCare this week by grinding the process to a halt and denying Mitch McConnell any “sweetener” amendments that might help TrumpCare pass. There is a separate script for them below also.

SAMPLE CALL DIALOGUE

Caller: Hi! My name is [name] and I’m calling from [part of state]. Now that [Senator] has the CBO score on the TrumpCare bill, has he/she made up his mind on it?

Staffer: The Senator hasn’t made a decision on that yet.

Caller:  That’s terrible. [Senator] now has all the information he needs to know the damage this bill would do to me [or loved one] because of [my/their] pre-existing condition [describe situation]. Did you know that the CBO predicted that costs to consumers would be so high under TrumpCare that millions of people would simply not be able to buy insurance? 22 million people would end up without coverage-- that’s unacceptable!

Staffer: The bill is still being negotiated and the final version will be better for our [State]. Besides, Obamacare is collapsing and we need to do something about it.
 
Caller: I know that Obamacare needs improvement, but this isn’t it. This bill would only harm millions of families, reduce coverage options, and destroy Medicaid. This bill is unfixable. The final version of the bill will still leave millions of Americans without health insurance, or paying more for less. What more does [Senator] need? I expect her/him to vote NO on this bill.
 
Staffer: Thank you, I’ll pass along your thoughts to the Senator.
 
Caller: Thank you. Please take down my contact information so you can let me know what the Senator says after you let him/her know my thoughts. I expect the Senator to realize his political future depends on walking away from this bill.
 
Staffer: Ok, I will.
 
Caller: Can you repeat my contact information back to me? I just want to make sure you recorded it correctly.


Monday, June 26

TRUMPCARE DECIMATES MEDICAID COVERAGE FOR SENIORS

TrumpCare will be a disaster for the country and for Arizona. Medicaid provides coverage for 6 million seniors.  While seniors account for just 1 in 12 (8 percent) of those receiving Medicaid, the protections that they receive are significant-- 14 percent of all Medicaid spending goes to healthcare services for our nation’s seniors. The Department of Health and Human Services estimates that at least 70 percent of Americans ages 65 and older will one day need long-term care services and supports, which include nursing home care, home health aides, personal care, and family caregiving. In addition to the provision of long term care support and services, Medicaid also finances critical acute care for our nation’s low-income seniors who cannot afford Medicare’s out-of-pocket costs and who struggle to meet basic costs of living, let alone health care costs.

Medicare’s coverage of long-term care is extremely limited, and similar coverage under private insurance is typically unaffordable. As a result  seniors with chronic conditions and those with disabilities  who require assistance with daily living (such as help eating, dressing, or bathing) often exhaust their resources paying for long-term care services. Medicaid spends more money on long term care for seniors and people with disabilities than anything else; one-fifth of Medicaid’s overall budget is spent on long-term care.

Nursing home coverage is expensive for all seniors but, especially for seniors with limited means—according to a 2015 survey, the typical annual cost of a semi-private room in a nursing home is $80,300.10 and $70,080 per year in Arizona. Without Medicaid, seniors of all incomes levels, but particularly those living in or near poverty would be forced to forego much-needed nursing home care. States would likely cut home-based long-term care programs which are often preferable to seniors and their families as well as cheaper to the state.

TrumpCare will devastate older Americans care by cutting Medicaid by $880 billion. In the U.S, seniors will be particularly impacted by TrumpCare’s decimating cuts to Medicaid and the addition of caps that limit spending per individual, dubbed “per capita caps.”

Don’t let your Senator rip healthcare away from those Arizonans who need it most. Call today!

SAMPLE CALL DIALOGUE

Caller:  Hello! My name is [name] and I’m calling from [part of state]. Can you tell me how the Senator plans to vote on TrumpCare, the American Health Care Act?

Staffer:  The Senator hasn’t made a decision on that yet.

Caller:  That’s terrible. [Senator] needs to oppose this awful bill.  58,494 Arizonans received long term care through Medicaid, including nursing home and home-based care in FY2012. Over 16 percent of Arizonans are 65 or older, so I imagine the number of people receiving these services has grown. How could [Senator] support cutting care to these vulnerable Arizonans?

Staffer:  Well, the Senate is different than the House bill. It isn’t as severe as what we saw in the House version. It protects seniors.

Caller:  No, that’s not true. Even the draft bill we’ve seen would destroy Medicaid. The Senator should oppose any bill that dramatically cuts Medicaid and puts a cap in Medicaid for individual spending for health care. Does the Senator know exactly how seniors who rely on Medicaid would be affected under the Senate bill? 

Staffer:  The details are still being worked out, but the final Senate version will likely slow any cuts to Medicaid.

Caller:  It doesn’t matter whether Medicaid is cut now or cut later. What matters is that people will lose coverage and have their coverage limited by caps. Seniors who need help at home, help paying their Medicare premiums, or who need to go to a nursing home rely on this care.  What does it matter whether the cuts come now or later?

Will [Senator] commit to me, an Arizonan, that he/she will vote against any bill that would result in senior Arizonans having less access to Medicaid and reduced coverage?

Staffer:  Again, the Senate bill will be different. But I’ll be sure to let [Senator] know your thoughts.

Caller: Yes, please do. And take down my information. I will be watching closely and would like to receive an update on how [Senator] will be voting.


Friday, June 23

TRUMPCARE’S IMPACT ON PEOPLE WITH DISABILITIES: ARIZONA CALL SCRIPT

TrumpCare will be a disaster for the country and for Arizona. 15 million disabled adults and children depend on Medicaid for health insurance coverage, including 304,314 in Arizona.

TrumpCare will devastate disabled Americans care by cutting Medicaid by $834 billion. Because their health care costs are substantially higher than for those without disabilities, people with disabilities will be particularly impacted by TrumpCare’s decimating cuts to Medicaid and the addition of caps that limit spending per individual, dubbed “per capita caps.”

And if that weren’t enough, TrumpCare harms children with special needs by cutting Special Education funds for schools. Medicaid funds a large portion of education for students with a variety of disabilities. Buried in the bill is a provision that no longer recognizes schools as required Medicaid providers, on top of the massive cuts to the program.

Don’t let your Senator rip healthcare away from those Arizonans who need it most. Call today!

SAMPLE CALL DIALOGUE

Caller:  Hello! My name is [name] and I’m calling from [part of state]. Can you tell me how the Senator plans to vote on TrumpCare, the American Health Care Act? 
 
Staffer:  The Senator hasn’t made a decision on that yet.
 
Caller:  That’s terrible. Senator Flake needs to oppose this awful bill. The bill could lead 15 million disabled Americans losing Medicaid coverage, including 304,314 in Arizona. How could Senator Flake support that? 
 
Staffer:  Well, the Senate isn’t going to pass the House bill. It will be different. 
 
Caller:  No, that’s not good enough. We don’t know because it’s being negotiated in secrecy. The Senator should oppose any bill that dramatically cuts Medicaid and puts a cap in Medicaid for individual spending for health care. Does the Senator know exactly how adults and children with disabilities who rely on Medicaid would be affected under the Senate bill? 
 
Staffer:  No, we don’t yet have all the details, but the Senate version will likely slow any cuts to Medicaid.
 
Caller:  It doesn’t matter whether Medicaid is cut now or cut later. What matters is that people will lose coverage and have their coverage limited by caps. Kids with disabilities — even something like needing a speech pathologist — rely on Medicaid funding for extra help at school. What does it matter whether the cuts come now or later? 
 
Will Senator Flake commit to me, an Arizonan, that he will vote against any bill that would result in disabled Arizonans having less access to Medicaid and reduced coverage?
 
Staffer:  Again, the Senate bill will be different. But I’ll be sure to let the Senator know your thoughts.
 
Caller: Yes, please do. And take down my information. I will be watching closely and would like to receive an update on how Senator Flake will be voting.


Thursday, June 22

draft TRUMPCARE BILL: ARIZONA CALL SCRIPT

You’ve probably heard that text of the Senate’s awful TrumpCare bill is now available to read. Here’s what we know: 

  • Millions of Americans will lose their healthcare coverage, just like the House bill.
  • Americans will see a drastic erosion of the quality of their healthcare, because states will be allowed to waive a number of consumer protections -- including the scope of benefits plans have to cover, and what percentage of consumer costs plans are required to cover. 
  • Medicaid is cut even deeper than the House bill. Not only does the Senate version essentially end the Medicaid expansion, it even cuts benefits for people covered through traditional Medicaid. 
  • The bill yanks affordable healthcare from millions of American families in order to give a giant tax break to corporations and wealthy.

But the worst part of all? Republicans aren’t done. This bill is not final. They’ve released what even they will say is a flawed product as a charade, so they can then pretend to “fix it.” CBO has scored the version of the bill released -- not the eventual “fixed” version -- meaning Republicans will be able to dodge questions about the CBO score by saying they “fixed” anything people don’t like. Senator McConnell can even start debate in the Senate on this draft version of the bill, and only drop the REAL version of the bill at the very last minute as an “amendment in the nature of a substitute.” That will be the very last thing that happens before TrumpCare is voted on once and for all, unless we can find three Republicans to stand up and say NO.

Don’t let them get away with this charade. Tell Senator Flake that you won’t fall for tricks. The bottom line is that TrumpCare cannot be fixed. It will still rip healthcare away from 23 million people, will defund Planned Parenthood, will destroy the Medicaid program, and will cause hardship for millions of Americans--all to give a giant tax break to those who need it the least. Tell him/her to vote NO on this bill. 

SAMPLE CALL DIALOGUE
 
Caller: Hi! My name is [name] and I’m calling from [part of state]. Is Senator Flake committed to giving the public a meaningful chance to read and understand the final TrumpCare bill before voting on it?
 
Staffer:  Yes! The Senator is very pleased that Leader McConnell buckled to his demands to give the public a chance to read the bill. It was posted on Thursday! Here, let me give you the link so you can read it. 
 
Caller:  Is this the final version of the bill? Or will it be amended before there is a final vote? 
 
Staffer:
 There will be an open amendment process before the final vote. 
 
Caller:  I won’t fall for this. Senator McConnell can offer a completely different bill as “an amendment in the nature of a substitute” at the very end of vote-a-rama. That means the bill that’s been released is a complete charade. 
 
Staffer:  Well, I don’t know about that. What I can say is that the Senator is committed to transparency, but he does not control what bills come for a vote when.
 
Caller:  Yes, he does. He can and should refuse to vote for any bill released at the very last minute. Why haven’t there been hearings on this bill that affects ⅙ of our economy? In 2009 and 2010, there were hundreds of hours of hearings. There were town halls. There were committee mark ups. And there were even dozens of substantive Republican amendments included in the final bill. Will Senator Flake commit to me, an Arizonan, that he won’t let this bill come to a vote until there’s been a hearing on it? 
 
Staffer:  I don’t know. I’ll pass along your thoughts to the Senator.
 
Caller:  Thank you. Please take down my contact information so you can let me know what the Senator says after you let him know my thoughts. I expect the Senator to make sure there is at least one hearing on this bill before it is voted on. 
 
Staffer:  Ok, I will.
 
Caller:  Can you repeat my contact information back to me? I just want to make sure you recorded it correctly. 


Wednesday, June 21

TRUMPCARE PREMIUM INCREASES: ARIZONA CALL SCRIPT

Premiums are expected to skyrocket under TrumpCare for most Americans. We don’t know exactly by how much, because Republicans are negotiating in absolute secrecy and we don’t have a CBO score. But using CBO’s score of the House version passed in May, we know that premiums are expected to increase $1,217 on average in Arizona. The increase is dramatically higher for Arizona’s low-income seniors.
 
We know that under TrumpCare, 23 million would lose coverage to give $600 billion in tax breaks to the wealthy and corporations, and consumers will have fewer guaranteed protections. Insurance companies will be back in charge. Today, hold Senator Flake accountable for allowing Arizonans’ premiums to skyrocket.

SAMPLE CALL DIALOGUE
 
Caller:  Hello! My name is [name] and I’m calling from [part of state]. Can you tell me how the Senator plans to vote on TrumpCare, the American Health Care Act? 
 
Staffer:  The Senator hasn’t made a decision on that yet.
 
Caller:  That’s terrible. Senator Flake needs to oppose this awful bill. The House version would cause an average premium increase of $1,217 for Arizonans. It’s even worse for Arizona’s low-income seniors, who could see a premium increase of $23,000! How could Senator Flake support that? 
 
Staffer: Obamacare is collapsing and premiums are already skyrocketing. That’s why Senator Flake needs to act to protect Arizonans from its devastating effects.
 
Caller: That is not true. For seven years, Republicans have been doing everything they can to sabotage the Affordable Care Act. Independent analysis shows that premiums are increasing at a slower rate than before thanks to Obamacare — even as quality of coverage got better! TrumpCare won’t fix anything: it will increase premiums and allow states to let insurance companies sell plans that don’t cover necessities like maternity care, prescription drugs, and mental health services. 
 
Staffer:  Well, the Senate isn’t going to pass the House bill. It will be different. 
 
Caller:  Ok, but that’s not good enough. What can you tell me about how this bill will be different? 
 
Staffer: Well, it isn’t finalized yet.
 
Caller: The Senator should oppose any bill that causes premiums to increase for Arizonans, especially if that bill is being written without public input. Will Senator Flake commit to me that he will vote against any bill that would cause premiums to go up for me or other Arizonans? 
 
Staffer:  I’ll be sure to let him know your thoughts.
 
Caller: Yes, please do. And please take down my information. I will be watching closely and would like to receive an update on how Senator Flake will be voting.


Tuesday, June 20

TRUMPCARE PRE-EXISTING CONDITIONS CALL SCRIPT for Arizona

TrumpCare will harm millions of Americans, including Arizonans, by undermining critical protections for people with pre-existing conditions. If passed, TrumpCare could dramatically increase costs for those with pre-existing conditions like diabetes, asthma, cancer, and dozens of others. That’s probably why 2 out of 3 Americans oppose it, and not a single state supports it either — including Arizona.

People with pre-existing conditions are not guaranteed protection under TrumpCare. The ACA created protections against insurance companies denying or charging people more because they had been sick. TrumpCare eliminates this guarantee and allows states to easily opt-out of complying with the ACA’s protections.

Call your Senator and ask them why they would want to strip insurance protections from Americans with pre-existing conditions. If Republicans are serious about protecting people with pre-existing conditions in Arizona, they should vote against TrumpCare.

SAMPLE CALL DIALOGUE
 
Caller:  Hello! My name is [____] and I’m calling from [part of state]. Can you tell me how the Senator plans to vote on TrumpCare, the American Health Care Act? 
 
Staffer:  The Senator hasn’t made a decision on that yet.
 
Caller:
 That’s unacceptable. Senator Flake needs to oppose this awful bill. The House version could cause as many as 1,043,000 Arizonans to lose their coverage because of pre-existing conditions. That is 26% of everyone here in Arizona. How could Senator Flake support that? 
 
Staffer: Obamacare is collapsing. Senator Flake needs to act to protect Arizonans from its devastating effects.
 
Caller: That is not true. For seven years, Republicans have been doing everything they can to sabotage the Affordable Care Act. And experts believe the ACA is not collapsing. TrumpCare doesn’t fix anything -- it only takes away health care from tens of millions of Americans, and allows insurance companies to charge people with pre-existing conditions, such as diabetes, stroke, cancer and even pregnancy, more for their coverage. [If applicable, share personal story or story about a loved one whose pre-existing condition would not be protected under TrumpCare]
 
Staffer:  Well, the Senate isn’t going to pass the House bill. It will be different. 
 
Caller:  That’s not good enough. The Senator should oppose any bill that allows insurance companies to discriminate against people who suffer from pre-existing conditions. Will Senator Flake commit to me that he/she will vote against any bill that would have this effect?
 
Staffer:  I’ll be sure to let the Senator know your thoughts.
 
Caller: Yes, please do. And take down my information. I will be watching closely and would like to receive an update on how Senator Flake will be voting.

 


Monday, June 19

TRUMPCARE TRANSPARENCY: ARIZONA CALL SCRIPT

Republican Senators are devising their version of TrumpCare right now, in secret rooms with no transparency. Amazingly, they are being even less transparent than the House was, which many Senators criticized. Why? Because they know the public hates TrumpCare and as one Senate Republican staffer said, “we aren’t stupid.”

We know the bill will harm millions of Americans, but we still don’t know exactly how bad it will be.  That’s because they plan to hold no hearings, will release no drafts for input and appear ready to hold a vote within a day or even a few hours of releasing the bill’s text. While they are required to have a CBO score before a vote, they may game the system so that the score is similarly released only shortly before a vote, allowing no one time to truly understand what the bill does. Contrast this to the process to pass the Affordable Care Act, which had dozens of hearings with hundreds of witnesses and bipartisan amendments.

Health care makes up 1/6th of the economy. For so many, it is policy that leads to life or death outcomes. Senators were elected to represent the interests of their constituents, which they simply can’t do when a bill of this importance is being negotiated in secrecy. We will hold our Senators accountable to blocking any bill that does not receive a thorough public review process.

SAMPLE CALL DIALOGUE
 
Caller: Is Senator Flake committed to giving the public a meaningful chance to read and understand the TrumpCare bill before allowing a vote on it?
 
Staffer: While the Senator is committed to transparency, he does not control when bills come for a vote.
 
Caller: Yes, he does. He can and should refuse to vote for any bill released within a few hours or days before the vote, so the public can read and understand it. This legislation impacts 1/6th of our country’s economy and drafting it in secrecy is reckless.
 
Staffer: The Senator will take that into consideration, and while he may not like the process, Obamacare is a disaster and we must fix it.
 
Caller: We can’t know if the bill improves health care or not if it is drafted in secret and only released right before the final vote. The House bill had no CBO score before a vote and it turns out it’ll kick 23 million people off health care. I hope Senator Flake will take action to ensure this is a transparent process with public input.
 
Staffer:
This is exactly what the Democrats did with Obamacare. They had to pass it so they could know what was in it. 
 
Caller: That is not true. There were hundreds of hours of hearings. There were town halls. There were committee mark ups. And there were even dozens of substantive Republican amendments included in the final bill. That only happened because there was a real, transparent process in place. 
 
Staffer: I’ll pass along your thoughts to the Senator.
 
Caller: Thank you. Please take down my contact information so you can let me know when Senator Flake decides I should be able to read the bill before he votes on it. 


Friday, June 16

TRUMPCARE MEDICAID CUTS IN ARIZONA

TrumpCare will be a disaster for the country and for Arizona. That’s probably why 2 out of 3 Americans oppose it, and not a single state supports it either -- including Arizona.

In part that’s because if TrumpCare becomes law, it would effectively END the Medicaid expansion, which extends coverage to 11 million Americans. In fact, most people who have obtained healthcare through the ACA have gotten it through Medicaid expansion.

We don’t know exactly how many would lose coverage under the Senate version, because Republicans are negotiating in absolute secrecy. But their starting point, the House bill that passed in May, would lead to at least 11 million losing access to Medicaid coverage. That includes 223,300 in Arizona.

Don’t let your Senator rip healthcare away from millions Americans. Call Today!

SAMPLE CALL DIALOGUE

Caller:  Hello! My name is [name] and I’m calling from [part of state]. Can you tell me how Senator Flake plans to vote on TrumpCare, the American Health Care Act? 
 
Staffer:  The Senator hasn’t made a decision on that yet.
 
Caller:  
That’s terrible. Senator Flake needs to oppose this awful bill. The bill would lead to 11 million Americans losing Medicaid coverage, including 223,300 in Arizona. How could Senator Flake support that? 
 
Staffer:  Well, the Senate isn’t going to pass the House bill. It will be different. 
 
Caller:  No, that’s not good enough. We don’t know because it’s being negotiated in secrecy. The Senator should oppose any bill that cuts into Medicaid. Does the Senator know exactly how many seniors, people with disabilities, and families with children who rely on Medicaid would be affected under the Senate bill? 
 
Staffer:  No, we don’t yet have all the details, but the Senate version is likely to phase out the Medicaid expansion more slowly, to allow for a “transition period.”
 
Caller:  It doesn’t matter whether Medicaid is cut now or cut later. What matters is that people will lose coverage. Families caring for an older parent rely on Medicaid to help with nursing home care. Kids with disabilities -- even something like needing a speech pathologist -- rely on Medicaid funding for extra help at school. What does it matter whether this goes away now or later? 
 
Many seniors also rely on Medicaid and Arizona has a higher proportion of seniors over 85 than other states. This means, under TrumpCare, our Medicaid funding won’t keep up with the cost of providing care to seniors. What is Senator Flake going to do about that? 
 
Staffer:  Again, the Senate bill will be different. But I’ll be sure to let Senator Flake know your thoughts.
 
Caller: Yes, please do. And take down my information. I will be watching closely and would like to receive an update on how Senator Flake will be voting.


Thursday, June 15

TRUMPCARE COVERAGE LOSS IN ARIZONA

TrumpCare will be a disaster for the country, but more importantly, it’ll be a disaster for Arizona. Two out of three Americans oppose it, and not a single state supports it either -- including Arizona.

In part that’s because millions of Americans will lose coverage if TrumpCare becomes law. We don’t know exactly how many, because Republicans are negotiating in absolute secrecy and we don’t have a CBO score. But their starting point, the House bill that passed in May, would cause 23 million Americans to lose coverage. That includes 465,200 in Arizona.

Hold Senator Flake accountable for ripping healthcare away from hundreds of thousands of Arizonans.

SAMPLE CALL DIALOGUE

Caller:  Hello! My name is [name] and I’m calling from [part of state]. Can you tell me how the Senator plans to vote on TrumpCare, the American Health Care Act?

Staffer:  The Senator hasn’t made a decision on that yet.

Caller:  That’s terrible. Senator Flake needs to oppose this awful bill. The House version would cause 465,200 Arizonans to lose their coverage. That includes 57,500 through the Medicaid expansion, 223,300 through the marketplace, and 184,100 through employer-based coverage! How could Senator Flake support that?

Staffer:  Obamacare if collapsing. The Senator needs to act to protect Arizonans from its devastating effects.

Caller:  That is not true. For seven years, Republicans have been doing everything they can to sabotage the Affordable Care Act. And experts believe the ACA is not collapsing. TrumpCare doesn’t fix anything -- it only takes away healthcare from 465,200 Arizonans.

Staffer:  Well, the Senate isn’t going to pass the House bill. It will be different.

Caller:  Ok, but that’s not good enough. The Senator should oppose any bill that causes Arizonans to lose their coverage. Will Senator Flake commit to me, an Arizonan, that he will vote against any bill that would result in Arizonans losing coverage?

Staffer:  Again, the Senate bill will be different. But I’ll be sure to let the Senator know your thoughts.

Caller: Yes, please do. And take down my information. I will be watching closely and would like to receive an update on how the Senator will be voting.