U.S. Senators Mark R. Warner (D-VA), Ben Cardin (D-MD), Jeanne Shaheen (D-NH), and Tammy Baldwin (D-WI) led a group of 38 Senators in calling on the Trump Administration to withdraw recent changes that makes it easier for states to promote “junk” plans. These health care plans typically lack protections for people with pre-existing conditions and would increase costs for millions of Americans. Under the Administration’s new guidance, states can use federal subsidies to pay for these subpar plans by utilizing a section of the Affordable Care Act (ACA) intended to give states additional flexibility to implement targeted improvements that expand coverage, reduce costs and provide more comprehensive benefits. The Senators argue that the Administration is improperly using Section 1332 to allow states to do the exact opposite.

“We have serious concerns they will increase health care costs for millions of consumers while weakening protections for individuals with pre-existing conditions. In light of substantive concerns that we have with the impact on patients, and procedural concerns that we have with the manner in which these significant policy changes have been promulgated, we ask that you immediately withdraw this guidance and re-engage with stakeholders, states, and Congress,” said the Senators in a letter to Health and Human Services Secretary Alex Azar, Centers for Medicare & Medicaid Services Administrator Seema Verma, and Treasury Secretary Steve Mnuchin.

The Senators made it clear these actions did not reflect Congress’ intent in creating the 1332 waiver program, stating “the Administration’s recent guidance significantly changes enforcement of these four important guardrails, undermining Congressional intent and posing a significant risk to consumers that now have affordable and comprehensive health coverage.”

Additionally the proposed changes, which were outlined in guidance provided by the Administration and a discussion paper released a few months back, will allow states to increase out-of-pocket maximums and reduce the value of coverage, weaken essential health benefits, and implement changes that increase health care costs for the majority of beneficiaries if a state can demonstrate costs will be lower for some.

“We ask that you immediately withdraw this guidance and work with us and other stakeholders on policies that maintain protections for individuals with pre-existing conditions and improve affordability,” concluded the Senators.

 In October, Senators forced a vote in the Senate on a discharge petition that would have blocked the Trump Administration’s rule to expand “junk insurance” plans. The measure was supported by 50 Senators, including one Republican. Ultimately, the petition did not receive the simple majority needed to pass the Senate and send it to the U.S. House of Representatives.

In addition to Sens. Warner, Cardin, Shaheen, and Baldwin, the letter was signed by Sens. Tom Carper (D-DE), Tim Kaine (D-VA), Amy Klobuchar (D-MN), Maggie Hassan (D-NH), Richard Blumenthal (D-CT), Jeff Merkley (D-OR), Chris Coons (D-DE), Bob Casey (D-PA), Chris Murphy (D-CT), Michael Bennet (D-CO), Elizabeth Warren (D-MA), Kamala Harris (D-CA), Debbie Stabenow (D-MI), Bob Menendez (D-NJ), Ron Wyden (D-OR), Gary Peters (D-MI), Chris Van Hollen (D-MD), Ed Markey (D-MA), Mazie Hirono (D-HI), Tina Smith (D-MN), Patty Murray (D-WA), Angus King (I-ME), Cory Booker (D-NJ), Bernie Sanders (I-VT), Dick Durbin (D-IL), Jack Reed (D-RI), Maria Cantwell (D-WA), Sherrod Brown (D-OH), Doug Jones (D-AL), Tammy Duckworth (D-IL), Martin Heinrich (D-NM), Patrick Leahy (D-VT), Tom Udall (D-NM), Kirsten Gillibrand (D-NY), Sheldon Whitehouse (D-RI), Dianne Feinstein (D-CA), Catherine Cortez-Masto (D-NV), and Brian Schatz (D-HI).

Click here for the  full text of the letter.