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 change Senator Heller’s mind, by throwing $200 billion in additional funding at states that expanded Medicaid, like Nevada.

$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 your Senator 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]. I’m calling to thank Senator Heller for announcing his opposition to TrumpCare. This bill would be terrible for Nevada and terrible for our country. I’m very glad he’s decided to oppose it. 

Staffer: Well thanks so much for calling. 

Caller: Senator Heller needs to continue opposing 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 heard McConnell and Trump are trying to buy Senator Heller off, throwing in an additional $200 billion in funding for Medicaid expansion states. Is that true? 

Staffer: I don’t know, but the Senator is very concerned about the Medicaid expansion. 

Caller:  Well I want him to know McConnell’s latest gimmick, the $200 billion extra, isn’t good enough for me and that it is not a “fix.” Even with the extra funding, Medicaid is still cut by $572 billion and the extra funding does nothing to change the way the bill transforms traditional Medicaid into a cap system. That means Nevadans will go without the care they need. Senator Heller should vote no on this bill, whether it’s a full repeal bill or the Better Care Reconciliation Act. 

Staffer:  Yes, Senator Heller is opposed to the bill in its current form. 

Caller: I want Senator Heller to oppose this bill in any form. Please take down my information. I will be watching closely and would like to receive an update on how Senator Heller votes on the final bill.


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.

Under this framework, which repeals as much of the law as they can get away with through reconciliation without a replacement, 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 Heller 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 Heller should have never supported it then, and s/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 Heller 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 Heller 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 Heller 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 was glad to hear Senator Heller opposed the earlier version of this disastrous 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 Heller was a no on the previous version, 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 Heller 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 Heller votes. 


Monday, July 17

TRUMPCARE MEDICAID CUTS IN NEVADA 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.

87,000 Nevadans would lose Medicaid coverage under TrumpCare, whether the expansion is ended now or later -- so don’t let Senator Heller tell you that he “fixed” the bill by extending the phaseout. He has no real plan for a “transition” and no extra funding for Nevada would make up for the destruction of Medicaid.

Governor Sandoval got a full court press over the weekend from Vice President Mike Pence and Center for Medicare and Medicaid Services Administrator Seema Verma. At the conclusion of their meeting, he still did not support the bill. Today, make sure Senator Heller doesn’t either.

SAMPLE CALL DIALOGUE

Caller:  Hello! My name is [name] and I’m calling from [part of state]. I’m calling to thank Senator Heller for announcing his opposition to TrumpCare. This bill would be terrible for Nevada and terrible for our country. I’m very glad he’s decided to oppose it. 

Staffer: Well thanks so much for calling. 

Caller: Senator Heller needs to continue opposing the TrumpCare bill, no matter what. There’s nothing he can negotiate with Mitch McConnell that would make this bill something he should support. This bill would cause 87,000 Nevadans to lose their Medicaid coverage. That includes kids with disabilities and the elderly in nursing homes. 

Staffer: Yes. The Senator is very concerned about that and would like to see 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 Nevada 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. Senator Heller should vote no on this bill. 

Staffer:  Yes, Senator Heller is opposed to the bill in its current form. 

Caller: I want Senator Heller to oppose this bill in any form. Please take down my information. I will be watching closely and would like to receive an update on how Senator Heller votes on the final bill.


Friday, July 14

Governor Sandoval and TrumpCarE  

When Senator Heller announced his opposition to TrumpCare “in its current form” on June 23, he did so standing alongside Nevada Governor Brian Sandoval. Governor Sandoval has been one of the most outspoken critics of TrumpCare -- and for good reason. The first draft of TrumpCare destroys Medicaid as we know it, and it would cause 122,500 Nevadans to lose their coverage, including 87,300 through the Medicaid expansion.

Nevada also stands to lose $1.7 billion in federal funding because of TrumpCare under the first draft. That’s in part why Governor Sandoval joined six other Republican and Democratic governors on a letter to Mitch McConnell last month, expressing concern about the earlier House bill and its cuts to Medicaid.

Republicans revised their bill, but they left the devastating cuts to Medicaid in place. Governor Sandoval said it was his understanding that the revised bill “isn’t that much different than its previous iteration.” He is correct.

The Trump Administration will stop at nothing to persuade Governor Sandoval to give Senator Heller the green light to vote for this monstrosity. That’s why Vice President Pence and Center for Medicare and Medicaid Services Administrator Seema Vera plan to corner him this weekend at the National Governor’s Association meeting. Today, make sure he’s got the right talking points going into that meeting.

Call Governor Sandoval today and tell him to stand his ground against Mitch McConnell and Mike Pence. Ask him to demand that Senator Heller oppose TrumpCare for the good of Nevada. His office’s phone number is (775) 684-5670.

The Worst Parts of TrumpCare for Nevada

  • Coverage Losses: TrumpCare would cause 122,500 Nevadans to lose coverage. That includes 35,500 from the marketplace and 87,300 through Medicaid. It would cost Nevada $288 million to maintain coverage for the population receiving Medicaid through the expansion. The new money in the revised bill will not fully offset these losses.
  • Premium Increases: An analysis by the Senate Joint Economic Committee shows that under TrumpCare, when compared to ACA, Nevadans would see premiums increase by $1,020. TrumpCare would devastate support to low-income seniors in Nevada, who could see their premiums go up by as much as $11,000.
  • Opioid treatment: There are more than 50,000 Nevadans currently getting treatment for opioid abuse either through plans bought in the marketplace or through Medicaid, which is destroyed by TrumpCare. Even $45 billion in extra funding for opioid treatment would be woefully inadequate in making up for the serious harm done to Nevadans who need this help.

SAMPLE CALL DIALOGUE

Caller: Hello! My name is [name] and I’m calling from [part of state]. I’m calling to ask Governor Sandoval to stand up to Mike Pence this weekend, and continue opposing the Senate health care bill. 

Staffer: Thank you for calling. Governor Sandoval opposed the original health care bill, and has concerns about this one. 

Caller: Governor Sandoval was exactly right when he said the bill didn’t change that much. There was no change to the bill that should make him support it. Senator Heller has closely aligned himself with Governor Sandoval, and has said he won’t vote for a bill that Governor Sandoval doesn’t support. Will Governor Sandoval hold Senator Heller to that commitment? 

Staffer: I don’t know.

Caller: He should. TrumpCare is unfixable and would be a disaster for Nevada. It would cause 122,500 Nevadans to lose coverage. That includes 35,500 from the marketplace and 87,300 through Medicaid. It would cost Nevada $288 million to maintain coverage for the population receiving Medicaid through the expansion. It would drive up premiums, especially for rural Nevadans. As a resident of this state, will Governor Sandoval promise to oppose this unfixable bill?

Staffer: Governor Sandoval has serious concerns but hasn’t made a final decision. 

Caller: He should oppose it. I know he is meeting with Vice President Pence and CMS Administrator Verma this weekend. He should not cave into Pence’s political pressure or fall for Verma’s promises. She can’t promise him anything that would make this bill worth supporting. 

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

Caller: Thank you. And please make sure the Governor continues to pressure Senator Heller to hold firm on opposing TrumpCare. 


Thursday, July 13

NEVADA 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 Heller know you oppose TrumpCare and its rolls back of protections for Americans, including 439,000 Nevadans 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 Heller 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 Heller 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 439,000 Nevadans with pre-existing conditions. How could Senator Heller 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 Heller 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 NEVADA

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 439,000 Nevadans 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 Heller 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]. I’m calling to thank Senator Heller for announcing his opposition to TrumpCare. This bill would be terrible for Nevada and terrible for our country. I’m very glad he’s decided to oppose it. 

Staffer: Well thanks so much for calling. 

Caller: Senator Heller needs to continue opposing 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 Heller 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 439,000 people in Nevada. 

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 Heller 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 Heller 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 NEVADA 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.

87,000 Nevadans would lose Medicaid coverage under TrumpCare, whether the expansion is ended now or later -- so don’t let Senator Heller tell you that he “fixed” the bill by extending the phaseout. He has no real plan for a “transition” and no extra funding for Nevada would make up for the destruction of Medicaid.

SAMPLE CALL DIALOGUE

Caller:  Hello! My name is [name] and I’m calling from [part of state]. I’m calling to thank Senator Heller for announcing his opposition to TrumpCare. This bill would be terrible for Nevada and terrible for our country. I’m very glad he’s decided to oppose it. 

Staffer: Well thanks so much for calling. 

Caller: Senator Heller needs to continue opposing the TrumpCare bill, no matter what. There’s nothing he can negotiate with Mitch McConnell that would make this bill something he should support. This bill would cause 87,000 Nevadans to lose their Medicaid coverage. That includes kids with disabilities and the elderly in nursing homes. 

Staffer: Yes. The Senator is very concerned about that and would like to see 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 Nevada 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. Senator Heller should vote no on this bill. 

Staffer:  Yes, Senator Heller is opposed to the bill in its current form. 

Caller: I want Senator Heller to oppose this bill in any form. Please take down my information. I will be watching closely and would like to receive an update on how Senator Heller votes on the final bill.


Monday, July 10

TRUMPCARE WILL KILL JOBS IN NEVADA

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 5,100 in Nevada 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 [Heller] 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 [Heller] 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 [Heller] 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 5,100 in Nevada 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

Governor Sandoval and TrumpCare

When Senator Heller announced his opposition to TrumpCare “in its current form” on June 23, he did so standing alongside Nevada Governor Brian Sandoval. Governor Sandoval has been one of the most outspoken critics of TrumpCare -- and for good reason. TrumpCare destroys Medicaid as we know it, and it would cause 122,500 Nevadans to lose their coverage, including 87,300 through the Medicaid expansion.

Nevada also stands to lose $288 million in federal funding because of TrumpCare. That’s in part why Governor Sandoval joined six other Republican and Democratic governors on a letter to Mitch McConnell last month, expressing concern about the earlier House bill and its cuts to Medicaid.

We’re now hearing both the White House and Mitch McConnell are turning up the heat on Governor Sandoval, pressuring him to give Senator Heller the green light to vote for TrumpCare. McConnell is so desperate to pass this bill that he’s pressuring the most vulnerable member of his caucus to support it.

Call Governor Sandoval today and tell him to stand his ground against Mitch McConnell and Donald Trump. Ask him to demand that Senator Heller oppose TrumpCare for the good of Nevada. His office’s phone number is (775) 684-5670.

The Worst Parts of TrumpCare for Nevada

  • Coverage Losses: TrumpCare would cause 122,500 Nevadans to lose coverage. That includes 35,500 from the marketplace and 87,300 through Medicaid. It would cost Nevada $288 million to maintain coverage for the population receiving Medicaid through the expansion.
  • Premium Increases: An analysis by the Senate Joint Economic Committee shows that under TrumpCare, when compared to ACA, Nevadans would see premiums increase by $1,020. TrumpCare would devastate support to low-income seniors in Nevada, who could see their premiums go up by as much as $11,000.
  • Opioid treatment: There are more than 50,000 Nevadans currently getting treatment for opioid abuse either through plans bought in the marketplace or through Medicaid, which is destroyed by TrumpCare. Even the rumored $45 billion in extra funding for opioid treatment would be woefully inadequate in making up for the serious harm done to Nevadans who need this help.

SAMPLE CALL DIALOGUE

Caller: Hello! My name is [name] and I’m calling from [part of state]. I’m calling to ask Governor Sandoval to stand up to Donald Trump and Mitch McConnell, and continue opposing the Senate health care bill. 

Staffer: Thank you for calling. Governor Sandoval is opposed to the health care bill, but he ultimately doesn’t have a vote in the Senate. 

Caller: Of course. But Senator Heller has closely aligned himself with Governor Sandoval, and has said he won’t vote for a bill that Governor Sandoval doesn’t support. Will Governor Sandoval hold Senator Heller to that commitment? 

Staffer: I don’t know.

Caller: He should. TrumpCare is unfixable and would be a disaster for Nevada. It would cause 122,500 Nevadans to lose coverage. That includes 35,500 from the marketplace and 87,300 through Medicaid. It would cost Nevada $288 million to maintain coverage for the population receiving Medicaid through the expansion. It would drive up premiums, especially for rural Nevadans. As a resident of this state, will Governor Sandoval promise to oppose this unfixable bill?

Staffer: Governor Sandoval has stated that he opposes the bill. 

Caller: Great. I hope the Senator stands firm in his opposition. Thank you!

 

---Bonus Call Script on the Cruz Proposal---

 

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 439,000 Nevadans 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 Heller 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]. I’m calling to thank Senator Heller for announcing his opposition to TrumpCare. This bill would be terrible for Nevada and terrible for our country. I’m very glad he’s decided to oppose it. 

Staffer: Well thanks so much for calling. 

Caller: Senator Heller needs to continue opposing 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 Heller 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 439,000 people in Nevada. 

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 Heller 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 Heller 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 NEVADA’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 2,600 in Nevada. 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 Heller 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]. I’m calling to thank Senator Heller for announcing his opposition to TrumpCare. This bill would be terrible for Nevada and terrible for our country. I’m very glad he’s decided to oppose it. 

Staffer: Well thanks so much for calling. 

Caller: Senator Heller needs to continue opposing 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 2,600 in Nevada? Does Senator Heller support our veterans? 

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

Caller: If Senator Heller 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: As he’s said, the Senator has very serious concerns with the bill and can’t support it in its current form. 

Caller: I see. Well I want Senator Heller 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 he 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: NEVADA

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 29,244 in Nevada. Nevada families that paid premiums got an average rebate of $363 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 Heller know you expect him to continue opposing 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]. I’m calling to thank Senator Heller for announcing his opposition to TrumpCare. This bill would be terrible for Nevada and terrible for our country. I’m very glad he’s decided to oppose it. 
 
Staffer: Well thanks so much for calling. 
 
Caller: Senator Heller needs to continue opposing 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, 29,244 Nevadans got an average rebate check of $363 back. That’s a total of $6.2 million back in Nevadans’ pockets, taken out of excessive insurance company profits. I don’t want Senator Heller to let insurance company profits run wild again. How will he vote on the final bill once it’s been reworked? 
 
Staffer: I’m not sure. But I can tell you that the bill will definitely change.
 
Caller: Yes I heard. I suspect McConnell is putting the pressure on Senator Heller pretty strong this week. I want Senator Heller 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 Heller 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?  

Thursday, June 30

TRUMPCARE ATTACKS WOMEN AND PLANNED PARENTHOOD: NEVADA CALL SCRIPT

TrumpCare will be a disaster for the country and for Nevada. 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 Nevada alone, 3 centers provided care to 16,007 Nevadans including  11,758 STI tests, 1,321 pap tests, and 1,176 breast exams in 2015. Of those patients, 13,276 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 Heller rip funding from Planned Parenthood or healthcare away from those Nevadans, 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 has said he would not support this bill in its current form.
 
Caller:  That’s not good enough. Senator Heller needs to vocally 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 Nevada. How could Senator Heller waver on 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 is 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 Heller commit to me, a Nevadan, that he will vote against any bill that would result in women in Nevada having more expensive care, less coverage, or less access?
 
Staffer:  Again, the Senate bill will change. But I’ll be sure to let Senator Heller 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

NEVADA 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 keep doing whatever it takes to get Senator Heller’s vote. 

Senator Heller said he’s opposed to the bill in its current form, saying he would vote no on the first procedural vote. He said he shares the concerns of Governor Sandoval, regarding the increased cost to the state and the phase out of the Medicaid expansion. There is no fix for TrumpCare -- no policy tweak, amount of funding, or extra period of time that could make this bill something Senator Heller 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]. I’m calling to thank Senator Heller for announcing his opposition to TrumpCare. This bill would be terrible for Nevada and terrible for our country. I’m very glad he’s decided to oppose it. 

Staffer: Well thanks so much for calling. 

Caller:  You may know that over 122,000 Nevadans would lose coverage under this bill, including more than 87,000 on Medicaid. Nevada stands to lose over $1.7 billion from this bill. I’m glad Senator Heller is opposed to it.

Staffer: The Senator is very concerned about the changes to Medicaid and the cost to our state, which is partly why he opposes the bill.  

Caller: That’s great and I want to make sure that even if additional money is added for Medicaid, or if the Medicaid expansion phase out is stretched out over a longer period of time, Senator Heller won’t change his mind. Fundamentally transforming Medicaid from an open-ended commitment to a cap system would cause people to go without the life-saving care they need. It is a terrible idea for Nevada and for our country.

Staffer: Yes, the Senator agrees with you. 

Caller: The same goes for the cost to our state. Even if Senator Heller is able to get more funding or a higher growth rate for Nevada, he still needs to oppose this bill. 

Staffer: I’ll be sure to let him know your thoughts. 

Caller: Yes, please do. And thanks again for Senator Heller’s vote to oppose TrumpCare.


Wednesday, June 28

TRUMPCARE AND OPIOID ADDICTION TREATMENT: NEVADA CALL SCRIPT

In 2015, the opioid epidemic claimed the lives of more than 52,000 Americans, including 269 in Maine. 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, thank Senator Heller for announcing his opposition to the bill and make sure he’s committed to not ripping away treatment for opioid addiction.

SAMPLE CALL DIALOGUE

Caller:  Hello! My name is [name] and I’m calling from [part of state]. I’m calling to thank Senator Heller for announcing his opposition to TrumpCare. This bill would be terrible for Nevada and terrible for our country. I’m very glad he’s decided to oppose it. 

Staffer: Well thanks so much for calling. 

Caller:  You may know that 619 Nevadans died from opioid addiction in 2015. More than 50,000 Nevadans are currently receiving treatment for opioid addiction through the exchanges or through Medicaid, which this bill decimates. I’m glad Senator Heller is looking out for them. 

Staffer: The Senator is very concerned about the opioid epidemic and is committed to fighting it. He’s going to do all he can. 

Caller: That’s great and I want to make sure that even if additional funding is thrown in for opioid treatment, Senator Heller won’t change his mind. The bill still destroys Medicaid, which many people rely on to treat addiction. Without access to treatment through Medicaid, people could die. 

Staffer: Yes, the Senator agrees with you. I’ll be sure to let him know your thoughts. 

Caller: Yes, please do. And thanks again for Senator Heller’s vote to oppose TrumpCare.


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 Nevada. 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 $86,140 per year in Nevada. 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 Nevadans 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. 23,420 Nevadans received long term care through Medicaid, including nursing home and home-based care in FY2012.  The population of Nevadans 65 and over is expected to increase by 578,250 people between 2000 and 2030 – an increase of 264%, so I imagine the number of people receiving these services has grown. How could [Senator] support cutting care to these vulnerable Nevadans?

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, a Nevadan, that he/she will vote against any bill that would result in senior Nevadan 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: NEVADA CALL SCRIPT

TrumpCare will be a disaster for the country and for Nevada. 15 million disabled adults and children depend on Medicaid for health insurance coverage, including 125,056 in Nevada.

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 Senator Heller rip healthcare away from those Nevadans 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 Heller needs to oppose this awful bill. The bill could lead 15 million disabled Americans losing Medicaid coverage, including 125,056 in Nevada. How could Senator Heller 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 Heller commit to me, a Nevadan, that he will vote against any bill that would result in disabled Nevadans having less access to Medicaid and reduced coverage?
 
Staffer:  Again, the Senate bill will be different. But I’ll be sure to let Senator Heller 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 Heller will be voting.


Thursday, June 22

draft TRUMPCARE BILL: NEVADA 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 Heller that you won’t fall for tricks. Senator Heller said during consideration of the Affordable Care Act that “it is imperative we have the 72-hour process,” meaning the public deserved a chance to read the bill before it was voted on. But if he were serious about that, he’d be demanding hearings before this bill is voted on.

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 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 Heller 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 Heller commit to me, a Nevadan, 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. 

 

---Bonus Call Script for Governor Sandoval---

 

TrumpCare in Nevada: Key Points for Governor Sandoval

TrumpCare will harm millions of Americans, including Nevadans. Maybe that’s why 2 out of 3 Americans oppose it, and not a single state supports it — including Nevada.

Although the Senate is currently in the TrumpCare drivers seat, Governor Sandoval will be tasked with trying to salvage the wreckage and implement the bill in Nevada if it passes. He needs to hear from you today as to how bad TrumpCare will be for Nevada.

He’s already got some idea of the terrible impact TrumpCare would have for his state. Nevada stands to lose $288 million a year under TrumpCare, just because of its Medicaid cuts. That’s why he joined six other Republican and Democratic governors on a letter to Mitch McConnell last week, expressing concern about the House bill and its cuts to Medicaid.

We’re glad Governor Sandoval recognizes what a monstrosity TrumpCare is. But sending letters isn’t enough -- he needs to turn up the heat where it counts right now, and that’s by pressuring Senator Heller to oppose TrumpCare as well. Call Governor Sandoval today and tell him to demand that Senator Heller oppose TrumpCare for the good of Nevada.

The Worst Parts of TrumpCare for Nevada

  • Coverage Losses: The House version of TrumpCare would cause 138,100 Nevadans to lose their coverage. That includes 30,300 from the marketplace and 81,100 through Medicaid. It would cost Nevada $288 million to maintain coverage for the population receiving Medicaid through the expansion.
  • Rural Costs: TrumpCare would force Nevadans to pay more in increased premiums and out-of-pocket costs. TrumpCare would increase total out-of-pocket spending in Nevada by $2,005 a year. Tax credits would no longer take into account geographic differences in health care costs, which would hit rural Nevadans even harder.
  • Premium Increases: An analysis by the Senate Joint Economic Committee shows that under TrumpCare, when compared to ACA, Nevadans would see premiums increase by $1,020. TrumpCare would devastate support to low-income seniors in Nevada, who could see their premiums go up by as much as $11,000.

Governor Sandoval has not even seen the bill and Senator Heller has said nothing about the secretive, closed door process being used to jam TrumpCare through the Senate.

Call Governor Sandoval now: (775) 684-5670. Tell him TrumpCare is a bad deal for Nevada, and ask him to tell Senator Heller to oppose it.


    Wednesday, June 21

    TRUMPCARE PREMIUM INCREASES: NEVADA 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 $1,020 on average in Nevada. The increase is dramatically higher for [state]’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 your Senator accountable for allowing Nevadans’ 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 Heller needs to oppose this awful bill. The House version would cause an average premium increase of $1,020 for Nevadans. It’s even worse for [state]’s low-income seniors, who could see premium increases of $11,000! How could Senator Heller support that? 
     
    Staffer: Obamacare is collapsing and premiums are already skyrocketing. That’s why Senator Heller needs to act to protect Nevadans 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 Nevadans, especially if that bill is being written without public input. Will Senator Heller commit to me that he will vote against any bill that would cause premiums to go up for me or other Nevadans? 
     
    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 Heller will be voting.


    Tuesday, June 20

    TRUMPCARE PRE-EXISTING CONDITIONS CALL SCRIPT for Nevada

    TrumpCare will harm millions of Americans, including Nevadans, 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 Nevada.

    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 Nevada, 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 Heller needs to oppose this awful bill. The House version could cause as many as 439,000 Nevadans to lose their coverage because of pre-existing conditions. That is 25% of everyone here in Nevada. How could Senator Heller support that? 
     
    Staffer: Obamacare is collapsing. Senator Heller needs to act to protect Nevadans 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 Heller 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 Heller will be voting.

     


    Monday, June 19

    TRUMPCARE TRANSPARENCY: NEVADA 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 Heller 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 Heller 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 Heller decides I should be able to read the bill before he votes on it. 


    Friday, June 16

    TRUMPCARe MEDICAID CUTS in NEVADA

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

    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 81,000 in Nevada, which is one of the 31 expansion states affected.

    Don’t let Senator Heller rip healthcare away from thousands of Nevadans.

    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 Heller needs to oppose this awful bill. The bill would lead to 11 million Americans losing Medicaid coverage, including 81,000 in Nevada. How could Senator Heller 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 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 Heller going to do about that? 
     
    Staffer:  Again, the Senate bill will be different. But I’ll be sure to let Senator Heller 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 Heller will be voting.


    Thursday, June 15

    TRUMPCARE COVERAGE LOSS IN Nevada

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

    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 138,100 in Nevada.

    Hold Senator Heller accountable for ripping healthcare away from hundreds of thousands of Nevadans.

    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 Heller needs to oppose this awful bill. The House version would cause 138,100 Nevadans to lose their coverage. That includes 81,100 through the Medicaid expansion, 30,300 through the marketplace, and even 26,700 through employer-based coverage! How could Senator Heller support that?

    Staffer:  Obamacare if collapsing. The Senator needs to act to protect Nevadans 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 138,100 Nevadans.

    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 Nevadans to lose their coverage. Will Senator Heller commit to me, a Nevadan, that he will vote against any bill that would result in Nevada 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.