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Senate Bill Still Cuts Tax Credits, Increases Premiums and Deductibles for Marketplace Consumers
WASHINGTON, June 25 -- The Center on Budget & Policy Priorities issued the following news release:
The House-passed health care bill (the American Health Care Act) slashed subsidies that help people afford individual market coverage, increasing out-of-pocket costs by thousands of dollars for people who get their coverage through the Affordable Care Act (ACA) marketplaces.
While the Senate bill's cuts to tax credits are structured differently and are somewhat smaller on average, their broad consequences would essentially be the same: coverage and care would become much less affordable for
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WASHINGTON, June 25 -- The Center on Budget & Policy Priorities issued the following news release:
The House-passed health care bill (the American Health Care Act) slashed subsidies that help people afford individual market coverage, increasing out-of-pocket costs by thousands of dollars for people who get their coverage through the Affordable Care Act (ACA) marketplaces.
While the Senate bill's cuts to tax credits are structured differently and are somewhat smaller on average, their broad consequences would essentially be the same: coverage and care would become much less affordable formillions of people with modest incomes. Moreover, the Senate's subsidy changes, like those in the House bill, would particularly harm older people, lower-income people, and people in high-cost states.
What the Senate Health Bill Would Do
The Senate health bill, released June 22, makes five major changes affecting marketplace premiums and financial assistance.
First, it makes an across-the-board cut to premium tax credits by linking them to less generous health coverage. Today, premium tax credits are based on the value of "silver plan" coverage: coverage with a 70 percent actuarial value. In other words, tax credits are calibrated so consumers can afford plans that cover 70 percent of their medical costs (on average); consumers pay the remaining 30 percent through deductibles, copays, and coinsurance. Under the Senate bill, tax credits would instead be based on the cost of a plan with an actuarial value of 58 percent -- roughly equivalent to current "bronze plan" coverage. This means consumers would have to pay 42 percent of the cost of health services that their insurance plan covers, rather than 30 percent. This would mean much higher deductibles: in 2016, the median deductible for bronze plans was about twice as high as the median deductible for silver plans -- $6,300 versus $3,000.[2]
Second, the bill rearranges the current tax-credit schedule, generally reducing premium tax credits for older people while increasing them for younger people. For example, under current law in 2020, people with incomes between 300 and 350 percent of the poverty level (between $36,000 and $42,000 for a single person) would pay about 9.9 percent of their income in premiums to obtain "silver plan" coverage -- with the tax credits covering the remainder.[3] Under the Senate bill, older people in this income range would pay about 12 to 17 percent of income for the lower-value "bronze" coverage, meaning that they would pay significantly more in premiums to buy plans that have much higher deductibles. (Younger people would pay 4.5 to 6.7 percent of income for bronze-plan coverage.)[4]
In dollar terms, a 60-year-old with income of $36,000 would see her out-of-pocket premium rise from $3,425 for silver-plan coverage to $4,174 for (skimpier) bronze-plan coverage due to this change. In contrast, a 25-year-old would see her premium fall from $3,425 to $1,620.
Third, the Senate bill eliminates tax credits entirely for people with incomes between 350 percent and 400 percent of the poverty line -- about $42,000 to $48,000 for a single person.
Fourth, like the House bill, the Senate bill would allow insurers to charge older people up to five times as much as younger people in premiums (before the tax-credit premium subsidies are applied), compared to a three-to-one limit today.
Finally, also like the House bill, the Senate bill eliminates cost-sharing reductions (CSRs), or subsidies that reduce deductibles, copayments, and coinsurance for lower-income consumers -- those with incomes below 250 percent of the poverty line (about $30,000 for a single person).
How These Changes Would Affect Consumers
These changes would make coverage and care significantly less affordable than they are today. And while the Senate bill, unlike the House bill, maintains the ACA's approach of basing tax credits on income and geography, as well as age, it would still impose the largest cost increases on lower-income people, older people, and people in high-cost states.
Reductions in Tax Credits and Increases in Premiums
Appendix Table 1 shows the combined effects of the Senate bill's changes in premiums -- after accounting for tax-credit subsidies -- for consumers in different states at three different income levels (150 percent, 300, and 350 percent of the poverty line) and three different ages (30, 45, and 60). The tables estimate consumers' change in premiums under the Senate bill, assuming that they wanted to continue purchasing current benchmark coverage (i.e., silver plans) and that they faced the average benchmark premium for such coverage in their state. (For a detailed explanation of the methodology behind these calculations, see the Appendix.)
As the tables show, the Senate bill's changes would increase premiums, net of tax credits, for most marketplace consumers who receive subsidies (which is the great bulk of those consumers), although younger people at some income levels in some states would see premium decreases. The premium increases would be especially large for:
Older people with modest incomes, who would be affected both by the bill's across-the-board cut to the value of the premium tax credits as a result of tying the tax credits to less comprehensive health coverage, and by the changes to the tax credit schedule noted above that increase the percentage of income that many people would have to pay out of pocket in premiums. For a 60-year-old with income of 35 0 percent of the poverty level (about $42 ,000 today) facing the average premium on HealthCare.gov, out-of-pocket premiums would jump by an estimated $4,994. Premiums would rise by $ 2,022 for a 45-year-old at this income level, and fall by $75 for a 30-year-old. Premiums would rise by $2,694 for a 60-year old with income of 300 percent of the poverty line, and by $1,903 for a 60-year old with income of 150 percent of the poverty line.
People in high-cost states, who would face especially large premium increases primarily because the across-the-board cuts to the premium tax credits would be larger in these states than in other states. In states where health costs -- and hence premiums -- are high, the difference in premiums between more and less generous coverage also is high. Under the Senate bill, as explained above, the plans to which the tax-credit subsidies would be tied would cover only 58 percent of consumers' health care costs, rather than 70 percent as under current law. As a result, to maintain their current coverage (i.e., to maintain a plan that covers 70 percent of their health costs), consumers would have to pay more. And the amount by which their premiums would rise would be greater in states that have high health-care costs, because premiums would go up by an amount sufficient to cover 12 percent of average health care costs (the difference between the health plan covering 70 percent of medical costs and 58 percent of these costs). That 12 percent is a larger amount in states where health care costs are higher.
As Figure 1 shows, out-of-pocket premium increase for a 60-year old with income of 350 percent of the poverty level would range from about $4,000 in New Hampshire to over $8,000 in Alaska.
For moderate-income people who would lose tax credits altogether under the Senate bill -- those with incomes between 350 and 400 percent of the poverty level -- premium increases would generally be even larger. As with the bill's other changes, older people and people in high-cost states would see the largest cost increases, because they receive the largest tax credits under current law as a result of their states having the highest health care costs. A 60-year-old just above 350 percent of the poverty line in Alaska would lose tax credits worth more than $22,000. But as Figure 2 shows, older people in all states at these income levels would lose thousands of dollars in tax credits.
Notably, a number of Senate Republicans have criticized the ACA for cutting off financial assistance abruptly at 400 percent of the poverty line.[5] But the Senate bill, by lowering that cut-off to 350 percent of the poverty line, would likely increase the number of people affected by the so-called "cliff" in assistance, and could make the cliff steeper.
Increases in Deductibles
Consumers could try to keep premiums down by switching from their current plan to the new, lower-value benchmark plan (i.e., to a "bronze" plan that covers 58 percent of medical costs). If so, however, they would see very significant increases in their deductibles, and many older people with modest incomes would still see premium increases as well. In addition, marketplace consumers with incomes below 250 percent of the poverty line would see large increases in their deductibles even if they maintained silver-plan coverage -- because the bill eliminates cost-sharing-reduction subsidies. (See Figure 3.)
For consumers switching from silver to bronze plan coverage, deductibles would roughly double. As noted above, the median deductible for bronze plans is currently $6,300, compared to $3,000 for silver plans.
Moreover, although middle-aged people could generally keep their premiums roughly constant by switching to bronze plans, and younger people could reduce their premiums modestly by doing so, modest-income older people would see significant increases in premiums even if they switched to bronze plans with much higher deductibles, because of the provision in the Senate bill raising the percentage of income that older people must pay in premiums before tax-credit subsidies kick in.
And for people with incomes below 200 percent of the poverty level -- who today are eligible for significant cost sharing assistance -- deductibles would rise sharply even if they paid higher premiums to stay in a silver plan. Currently, the deductibles that these people face are well below $1,000 because of the cost-sharing subsidies. The Senate bill ends these subsidies after 2019, however, causing the deductibles these people would face to spike by thousands of dollars.
Senate Bill Does Not Offer Affordable Coverage to People in Poverty
Like the House bill, the Senate bill effectively ends the ACA's expansion of Medicaid, which has enabled 31 states and the District of Columbia to extend coverage to millions of adults with incomes below 138 percent of the poverty line. Some congressional Republicans have argued that the millions of poor and near-poor adults losing Medicaid would be able to buy health insurance in the private individual market instead.[6]
In practice, however, the overwhelming majority of those losing Medicaid coverage would end up either uninsured or underinsured.
Premiums alone would put coverage out of reach for many of those losing Medicaid coverage. Under the Senate bill, people losing Medicaid would have to pay premiums equaling 2 percent of their income to purchase individual market coverage. While this is much lower than the premiums they would pay under the House bill,[7] a large body of research finds that premiums at these or even lower levels put coverage out of reach for many people in poverty.[8]
More importantly, as discussed above, the benchmark plans that people could purchase for 2 percent of their income would have deductibles in the range of $6,300. For a person at the poverty line, a $6,300 deductible equals about half of her annual income. Even if they could afford their premiums, low-income people enrolled in benchmark coverage could not afford the out-of-pocket payments required to obtain health care. And, knowing that, they would be even less likely to sign up for coverage and cut back on other expenses like rent, transportation, or food in order to stay current on their premiums.
In addition, the Senate bill, like the House bill, would allow states to waive the ACA's requirements that plans cover essential health benefits. The Congressional Budget Office estimated that this could result in individual market plans in up to half the country dropping coverage for services including mental health and substance use treatment.[9] These services are particularly important to low-income people enrolled in Medicaid expansion coverage.[10]
The Medicaid expansion has allowed millions of low-income adults to gain not just coverage but access to health care. One recent study found that expansion led to increases in the share of people getting check-ups, getting regular care for chronic conditions, and reporting that they are in excellent health, as well as reductions in the share of people skipping medications due to cost, relying on the emergency room for care, and screening positive for depression.[11] The Senate bill would reverse most or all of these gains. It would also prevent states that have not yet expanded Medicaid from ever sharing in these gains, since it would prevent these states from receiving the enhanced federal match for expansion, even for the limited period in which it would remain available under the Senate bill.
Senator Shelly Moore Capito of West Virginia recently said that if the Medicaid expansion were to end, she would want to see the expansion population transition to "coverage that's as good as the Medicaid coverage that folks are on."[12] The coverage poor and near-poor people could access in the individual market under the Senate bill comes nowhere close to meeting that test.
Appendix: Methodology
Our projections for premiums and tax credits under the ACA and the Senate bill draw on data on actual premiums and tax credits from the Department of Health and Human Services (HHS) and on projections from the Congressional Budget Office (CBO) and the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary.
Premiums. We obtain data on 2017 benchmark marketplace premiums by state from HHS.[13] To project premiums for 2020, we inflate 2017 premiums to 2020 using National Health Expenditure (NHE) projections from the CMS Office of the Actuary. [14] To project premiums under the House bill for different age groups, we follow the approach described in a recent Brookings analysis to convert CBO's estimated changes in premiums for silver plan coverage under the House bill for people age 21, 40, and 64 into a complete forecast of premium changes by age.[15] While the Senate bill differs from the House bill in a number of respects, the major provisions affecting premiums -- changes in age rating, elimination of the individual mandate, and reinsurance funding -- are the same or very similar.
Tax credits. To calculate tax credits for hypothetical consumers, we follow the approach used in a recent Kaiser Family Foundation analysis.[16] Specifically, we inflate the ACA's required premium contributions using the ratio of growth in employer-sponsored insurance spending per enrollee and gross domestic product per capita from the NHE and inflate federal poverty guidelines using consumer price index projections from CBO. We then compute tax credits under both the ACA rules and the alternative rules specified in the Senate bill.
As discussed in the main text, the Senate bill alters the benchmark plan used to calculate tax credits. To estimate the effects of this change on tax credits, we assume that benchmark premiums fall by about 13 percent: the expected difference in premiums between a plan that covers 66 percent of costs (the minimum allowed actuarial value for a silver plan) and a plan that covers 58 percent of costs.[17]
See the details here (http://www.cbpp.org/research/health/senate-bill-still-cuts-tax-credits-increases-premiums-and-deductibles-for)
Footnotes:
[1] This paper has been revised to correct a modeling error, resulting in changes to the premium estimates in Figure 1 and the appendix tables. In addition, Figure 1 has been revised to show estimates for a consumer with income of 350 percent of the poverty level, and we have added an appendix table with the corresponding estimates.
[2] Centers for Medicare & Medicaid Services, "2016 Median Marketplace Deductible $850, With Seven Services Covered Before the Deductible on Average," July 12, 2016, https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-07-12.html.
[3] In 2017, the poverty level for a single adult is $12,060 in the 48 continuous states, $15,060 in Alaska, and $13,860 in Hawaii. Poverty levels shown in the main text are for the 48 continuous states. See https://aspe.hhs.gov/poverty-guidelines.
[4] Under both the ACA and the Senate bill, the share of income that people are expected to contribute toward benchmark health coverage rises slowly over time. These percentages are as of 2020.
[5] See, for example, comments from Senator Susan Collins in Jennifer Steinhuaer, "From Maine, a Call for a More Measured Take on Health Care," New York Times, June 4, 2017, https://www.nytimes.com/2017/06/04/us/politics/maine-health-care.html?_r=0.
[6] For example, Representative Mark Amodei of Nevada said in a statement that "tax credits paid in advance ... ensure those recently leaving Medicaid can have access to insurance on the private market." Representative Mark Amodei, "Amid Political Semantics, Amodei Analyzes the American Health Care Act," press statement, May 4, 2017, https://amodei.house.gov/news-releases/amid-political-semantics-amodei-analyzes-the-american-health-care-act/.
[7] Tara Straw, "People Losing Medicaid Under House Republican Bill Would Face High Barriers to Coverage," Center on Budget and Policy Priorities, June 6, 2017, http://www.cbpp.org/research/health/people-losing-medicaid-under-house-republican-bill-would-face-high-barriers-to.
[8] Jessica Schubel and Judith Solomon, "States Can Improve Health Outcomes and Lower Costs in Medicaid Using Existing Flexibility," April 9, 2015, http://www.cbpp.org/research/health/states-can-improve-health-outcomes-and-lower-costs-in-medicaid-using-existing.
[9] Congressional Budget Office, "American Health Care Act of 2017," May 24, 2017, https://www.cbo.gov/system/files/115th-congress-2017-2018/costestimate/hr1628aspassed.pdf.
[10] Judith Dey et al., "Benefits of Medicaid Expansion for Behavioral Health," Department of Health and Human Services, March 28, 2016, https://aspe.hhs.gov/system/files/pdf/190506/BHMedicaidExpansion.pdf.
[11] Benjamin D. Sommers et al., "Three-Year Impacts of the Affordable Care Act: Improved Medical Care and Health Among Low-Income Adults," May 2017, http://content.healthaffairs.org/content/early/2017/05/15/hlthaff.2017.0293.
[12] Joe Williams, "Republicans Weigh Higher Medicaid Growth Rate for Some States," Roll Call, June 14, 2017, http://www.rollcall.com/news/politics/republicans-weigh-higher-medicaid-growth-rate-for-some-states.
[13] Data on benchmark premiums are from "Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace," HHS Office of the Assistant Secretary for Planning and Evaluation, October 24, 2016, https://aspe.hhs.gov/system/files/pdf/212721/2017MarketplaceLandscapeBrief.pdf. Data on average premiums are from Centers for Medicare & Medicaid Services, "Health Insurance Marketplaces 2017 Open Enrollment Period."
[14] Premium growth-rate projections are from CMS Office of the Actuary, National Health Expenditure Projections, 2016-2025, https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsProjected.html.
[15] Matthew Fiedler and Loren Adler, "How Will the House GOP Health Care Bill Affect Individual Market Premiums?" Brookings Institution, March 16, 2017, https://www.brookings.edu/blog/up-front/2017/03/16/how-will-the-house-gop-health-care-bill-affect-individual-market-premiums/.
[16] Cynthia Cox, Gary Claxton, and Larry Levitt, "How Affordable Care Act Repeal and Replace Plans Might Shift Health Insurance Tax Credits," Kaiser Family Foundation, March 10, 2017, http://kff.org/health-reform/issue-brief/how-affordable-care-act-repeal-and-replace-plans-might-shift-health-insurance-tax-credits/.
[17] We use the minimum allowed actuarial value for silver plans to be conservative, and to compensate for the fact that the current benchmark is based on the second-lowest silver plan, while the Senate bill benchmark is based on the median cost 58 percent actuarial value plan, which could be higher in the plan cost distribution. The 13 percent figure is calculated using the methodology described in Fiedler and Adler, which takes into account the change in actuarial value and the effect of that change on health care utilization.
Rev. Susan Frederick-Gray Is Elected President of the Unitarian Universalist Association
BOSTON, June 25 -- The Unitarian Universalist Association of Congregations issued the following news release:
The Rev. Susan Frederick-Gray has been elected president of the Unitarian Universalist Association (UUA) at the Association's General Assembly in New Orleans. Frederick-Gray is the first woman elected to serve as the UUA's president.
Frederick-Gray, 41, has been serving as the minister of the Unitarian Universalist Congregation of Phoenix in Phoenix, Arizona. She begins her six-year term on Sunday, June 25.
"I am honored that Unitarian Universalists elected me as our next president.
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BOSTON, June 25 -- The Unitarian Universalist Association of Congregations issued the following news release:
The Rev. Susan Frederick-Gray has been elected president of the Unitarian Universalist Association (UUA) at the Association's General Assembly in New Orleans. Frederick-Gray is the first woman elected to serve as the UUA's president.
Frederick-Gray, 41, has been serving as the minister of the Unitarian Universalist Congregation of Phoenix in Phoenix, Arizona. She begins her six-year term on Sunday, June 25.
"I am honored that Unitarian Universalists elected me as our next president.I am excited about moving forward with a vision of a spiritually vital, mission-focused UUA that is grounded in partnership and organized for impact," said Frederick-Gray.
Frederick-Gray defeated the Rev. Alison Miller of Morristown, New Jersey, and the Rev. Jeanne Pupke of Richmond, Virginia. She succeeds the Rev. Peter Morales, the Association's first Latino president, who resigned from his position in April 2017. Since April, the UUA has been led by three interim co-presidents appointed by its Board of Trustees to fulfill Morales' term in office.
While serving the Phoenix congregation, Frederick-Gray led the Unitarian Universalist response to Arizona's anti-immigrant laws in 2010. She was a leader of the UU Arizona Immigration Ministry and a key organizer of the 2012 UUA Justice General Assembly in Phoenix. Frederick-Gray affirmed, "I believe that Unitarian Universalists bring to the world organizing leadership that has been shaped by the experience of resistance to SB1070 in Arizona."
Frederick-Gray previously served as minister of First Unitarian Universalist Church of Youngstown, Ohio, where she was a leader in congregation-based community organizing efforts, and served as intern minister at First Unitarian Universalist Church of Nashville, Tennessee. She is a graduate of the University of Wisconsin, Madison and Harvard Divinity School. She is married to the Rev. Brian Frederick-Gray and they have a nine-year-old son, Henry.
For more information about Rev. Frederick-Gray, please visit UUWorld.org.
National Voting Rights Leader Highlights Need to Keep Up Fight Against GOP Efforts to Rig Elections
MADISON, Wis., June 25 -- One Wisconsin Now, a liberal issue advocacy organization that focuses on advancing progressive leadership and values, issued the following news release:
With bills passed to impose a voter ID requirement, limit hours of early voting, make casting a ballot more complicated for seniors and students and rig legislative district lines, Wisconsin under Gov. Scott Walker and the Republican-controlled legislature is a prime example of how politicians trying to manipulate the rules on voting to give themselves an unfair advantage. At a press conference in Madison today, national
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MADISON, Wis., June 25 -- One Wisconsin Now, a liberal issue advocacy organization that focuses on advancing progressive leadership and values, issued the following news release:
With bills passed to impose a voter ID requirement, limit hours of early voting, make casting a ballot more complicated for seniors and students and rig legislative district lines, Wisconsin under Gov. Scott Walker and the Republican-controlled legislature is a prime example of how politicians trying to manipulate the rules on voting to give themselves an unfair advantage. At a press conference in Madison today, nationalvoting rights leader Jason Kander, president of Let America Vote, joined with Wisconsin voting rights activists to discuss how critical it is, now more than ever, to protect voting rights.
"Lawmakers should be doing everything they can to protect the right to vote and make voting as convenient as possible," said Kander. "There's a group of politicians using voter suppression as a political strategy to win elections, and we saw that right here in Wisconsin in 2016. It's wrong and we will hold those politicians accountable."
In recent years, Wisconsin has been at the forefront of a coordinated, partisan effort by Republicans to manipulate the rules on voting to give themselves an unfair advantage. Barriers were erected by the GOP majority with the intent of suppressing votes among targeted groups, especially people of color and students, who were less likely to support conservatives.
One Wisconsin Now's partner organization, One Wisconsin Institute, was the lead plaintiff in an ongoing federal lawsuit, One Wisconsin Institute, et. al. v. Thomsen, et. al, that exposed the Republican voter fraud of manipulating the rules on voting for their own benefit.
The lawsuit resulted in a number of onerous requirements being struck down at the federal district court level. Limits on the hours and locations of early voting, prohibitions on using university dormitory lists to verify student residency and extending the time a person must live in their home before being able to vote there were among the stricken anti-voter provisions. In addition, the judge overseeing the case ruled the state unconstitutionally administered its strict voter ID requirement.
In separate litigation, a panel of three federal judges ruled the state Assembly district lines adopted by the Republican controlled legislature in 2011 constituted an impermissible partisan gerrymander and violated the rights of the people of Wisconsin. The U.S. Supreme Court will be hearing an appeal of the decision brought by Republicans seeking to protect their rigged maps.
State Senator Mark Miller, a former military pilot and now ranking member on the state Senate Committee on Elections and Utilities commented, "Our democracy is strongest when everyone is allowed to participate and voice their opinions. Republicans continue to create barriers and limit the freedom to vote."
Continued vigilance is needed to protect gains made in pushing back against efforts to restrict access to the franchise. While Republicans in Wisconsin continue to fight tooth and nail to protect the rigged system they've put in place, at the federal level Donald Trump is attempting to use bogus claims of voting impropriety as a set up to justify new voting restrictions from the federal level.
One Wisconsin Now Research Associate and University of Wisconsin - Madison student Savion Castro concluded, "Voting is one of the more precious rights we have in American democracy, and for students and people of color like me, that right is always in a precarious position. For me and a generation of students looking down the barrel at the growing $1.4 trillion in student debt, it is critical we make our voices heard in the policy debate by voting."
Church of England Announces Contactless Payment Trial to Be Launched This Summer
LONDON, June 25 -- The Church of England issued the following news release:
The Church of England has announced plans to trial "tap and go" contactless payment systems for donations.
Starting this summer, around 40 churches will be equipped with handheld terminals to process card payments - up to the value of GBP30 - with a view to offering the system to every diocese next year. The trial aims to encompass a variety of churches - urban, rural, large and small - to make sure that the needs of different parishes are considered when the scheme is offered nationally.
John Preston, National
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LONDON, June 25 -- The Church of England issued the following news release:
The Church of England has announced plans to trial "tap and go" contactless payment systems for donations.
Starting this summer, around 40 churches will be equipped with handheld terminals to process card payments - up to the value of GBP30 - with a view to offering the system to every diocese next year. The trial aims to encompass a variety of churches - urban, rural, large and small - to make sure that the needs of different parishes are considered when the scheme is offered nationally.
John Preston, NationalStewardship Officer, told the Financial Times: "We're aware that younger generations - and there are many people now who don't carry cash - want to give in different ways. Enabling them to give in a way that suits them is something we'd like to try."
The scheme will be run by Parish Buying. John Preston's interview with the Financial Times can be seen here (https://www.ft.com/content/2e803942-5817-11e7-9fed-c19e2700005f?FTCamp=engage/CAPI/webapp/Channel_Moreover//B2B).
Study: Tobacco Companies are Marketing Flavored Cigarettes to Appeal to Children in Latin America; Countries Must Act to Protect Kids
WASHINGTON, June 24 -- The Campaign for Tobacco-Free Kids issued the following news release:
Multinational tobacco companies are marketing a new generation of highly flavored tobacco products, like menthol, mint and fruit, that appeal to kids throughout Latin America. In many cases they are selling them near schools, according to a new study released today by Johns Hopkins Bloomberg School of Public Health. While total cigarette sales are declining in Latin America, sales of flavored cigarettes are climbing. Most of the flavored cigarettes observed are sold by large, multinational tobacco companies
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WASHINGTON, June 24 -- The Campaign for Tobacco-Free Kids issued the following news release:
Multinational tobacco companies are marketing a new generation of highly flavored tobacco products, like menthol, mint and fruit, that appeal to kids throughout Latin America. In many cases they are selling them near schools, according to a new study released today by Johns Hopkins Bloomberg School of Public Health. While total cigarette sales are declining in Latin America, sales of flavored cigarettes are climbing. Most of the flavored cigarettes observed are sold by large, multinational tobacco companiessuch as Philip Morris International, British American Tobacco and Japan Tobacco International.
This study shows that as Latin American countries have stepped up their efforts to reduce tobacco use in recent years, tobacco companies are finding new ways to target children and undermine the region's progress. Despite their claims to the contrary, big tobacco companies like Philip Morris, British American Tobacco and Japan Tobacco continue to engage in harmful marketing practices that lure kids into this deadly addiction.
This study demonstrates the need for countries throughout Latin America to enact and effectively enforce strong policies to protect children, reduce tobacco use and save lives. Countries should ban all flavored tobacco products, including menthol cigarettes. They should also enact comprehensive bans on tobacco advertising, promotions and sponsorships, which are needed to stop tobacco companies from marketing to kids and misleading consumers. Brazil can provide an example for the entire region and protect the health of its own citizens by implementing its regulation prohibiting cigarette additives, including flavorings, despite the continuing efforts of tobacco companies to stall this important measure.
The new study examined cigarette retailers within a radius of 100-250 meters around schools in five cities in Latin America: Buenos Aires, Argentina; La Paz, Bolivia; Rio de Janeiro, Brazil; Santiago, Chile; and Lima, Peru. Key findings include:
* 69 percent of retailers within the sampling areas sold cigarettes. Of these cigarette retailers, 85 percent sold flavored cigarettes.
* The most common cigarette flavors found were mint or menthol. An additive commonly used by tobacco companies, menthol makes cigarettes less harsh and easier to smoke, especially for new users, and leads to increased smoking initiation among young people, greater addiction, and decreased success in quitting smoking, studies have shown. Other cigarette flavors found include fruit (such as cherry), alcohol (such as daiquiri and mojito), spices or nuts, and unconventional flavors described as "Double Click Crisp" or "Ice Blast."
* Flavored cigarettes were often displayed near other products commonly used by kids, such as sweets, snacks and sugary drinks, "thereby normalizing these harmful and addictive products in the context of products that attract the attention of children," according to the study.
* As noted previously, most of the flavored cigarettes are sold by large, multinational tobacco companies that claim not to market to kids.
As the study details, tobacco companies have long used flavored products to attract new customers, especially kids. Flavored cigarettes mask the harsh taste of tobacco smoke and make it easier for new users to start smoking.
This study demonstrates the urgent need for countries to act swiftly to stop tobacco companies from marketing their deadly and addictive products to kids.
The study was led by the Institute for Global Tobacco Control (IGTC) at the Johns Hopkins Bloomberg School of Public Health (JHSPH). IGTC partnered with the Campaign for Tobacco-Free Kids, Alianca de Promocao da Saude, Comision Nacional Permanente de Lucha Antitabaquica, Educacion Popular en Salud, Fundacion InterAmericana del Corazon Argentina, and the Fundacion InterAmericana del Corazon Bolivia.
New U.S. Survey Shows Broad Declines in Youth Tobacco Use, Including E-Cigarettes
WASHINGTON, June 24 -- The Campaign for Tobacco-Free Kids issued the following news release:
The government's 2016 National Youth Tobacco Survey released today provides good news across the board about the nation's fight to protect kids from tobacco use - the leading cause of preventable death. It shows that cigarette smoking among high school students fell to a record-low 8 percent in 2016, youth use of electronic cigarettes declined for the first time after skyrocketing in recent years, and the percentage of high school students using any tobacco product dropped from 25.3 percent in 2015 to
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WASHINGTON, June 24 -- The Campaign for Tobacco-Free Kids issued the following news release:
The government's 2016 National Youth Tobacco Survey released today provides good news across the board about the nation's fight to protect kids from tobacco use - the leading cause of preventable death. It shows that cigarette smoking among high school students fell to a record-low 8 percent in 2016, youth use of electronic cigarettes declined for the first time after skyrocketing in recent years, and the percentage of high school students using any tobacco product dropped from 25.3 percent in 2015 to20.2 percent in 2016 (a 20 percent decline).
The dramatic, long-term decline in youth cigarette smoking is a public health success story of extraordinary importance. Since this survey was first conducted in 1999, high school smoking has fallen by a remarkable 72 percent - from 28.5 percent to 8 percent. This means millions of Americans will be spared the terrible diseases and premature deaths caused by smoking.
Youth e-cigarette use declined significantly from 2015 to 2016, falling from 16 percent to 11.3 percent among high school students after increasing from just 1.5 percent in 2011. This drop is promising, but it is too soon to know whether it is a long-term trend or a one-year blip. E-cigarettes are still used by too many youth, and they continue to be marketed using sweet flavors and other tactics that clearly appeal to kids. As a Surgeon General's report concluded last year, youth use of nicotine in any form, including e-cigarettes, is unsafe, can cause addiction and can harm the developing adolescent brain.
Today's survey reminds us of two central facts: 1) We know how to reduce tobacco use and win this fight; and 2) the nation's battle against tobacco is far from over. The new survey shows why elected officials at all levels must fully implement the proven strategies that have achieved such enormous progress. It is unacceptable that 3.9 million middle and high school students - including one in five high school students - still use some form of tobacco. It is also troubling that 13.8 percent of high school students still smoke tobacco products such as cigarettes, cigars and hookah.
Our progress stems directly from implementing proven strategies, including higher tobacco taxes, comprehensive smoke-free laws, effective FDA oversight of tobacco products and marketing, well-funded tobacco prevention and cessation programs, and hard-hitting media campaigns, like the campaigns conducted by the CDC, the FDA and Truth Initiative in recent years. In addition, California, Hawaii and over 245 cities and counties (PDF) have now raised the tobacco sale age to 21.
However, continued progress is threatened by pending proposals that would undermine the FDA's authority over e-cigarettes and cigars and slash funding for the CDC's tobacco prevention and cessation programs. Legislation introduced in Congress would greatly weaken FDA oversight of e-cigarettes and cigars, and the Trump Administration is deciding whether to defend FDA oversight of these products against tobacco industry legal challenges. In addition, the Trump Administration's proposed FY 2018 budget would eliminate the CDC's Office of Smoking and Health and dedicates no funds specifically for tobacco control. If the U.S. is to keep making progress against tobacco, these harmful proposals must be rejected.
The fight against tobacco must remain a national priority as tobacco use still kills nearly half a million Americans and adds $170 billion in health care expenses each year. In addition, our progress has been uneven and adult smoking rates remain high among the most vulnerable Americans, including those who are poor, have less education, are uninsured or covered by Medicaid, have mental illness, are American Indian/Alaska Native, or are lesbian, gay, bisexual or transgender (LGBT).
We cannot declare victory until all children can grow up tobacco-free and all Americans are protected from the devastating consequences of tobacco use.
India Dramatically Reduces Tobacco Use, Showing Strong Public Health Laws Save Lives
WASHINGTON, June 24 -- The Campaign for Tobacco-Free Kids issued the following news release:
India has reduced tobacco use among adults by 17 percent since 2010. As a result there are over 8 million fewer tobacco users today than there were just seven years ago despite the growth in the Indian population, according to new data released last week by the Indian government. The percentage of adults using tobacco in India fell from 34.6 percent in 2009-10 to 28.6 percent in 2016-17. The dramatic decline in tobacco use is highlighted in India's second Global Adult Tobacco Survey (GATS) and confirms
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WASHINGTON, June 24 -- The Campaign for Tobacco-Free Kids issued the following news release:
India has reduced tobacco use among adults by 17 percent since 2010. As a result there are over 8 million fewer tobacco users today than there were just seven years ago despite the growth in the Indian population, according to new data released last week by the Indian government. The percentage of adults using tobacco in India fell from 34.6 percent in 2009-10 to 28.6 percent in 2016-17. The dramatic decline in tobacco use is highlighted in India's second Global Adult Tobacco Survey (GATS) and confirmsthat India's package of public health laws are working to reduce tobacco use and save lives.
The declines have even been greater among young people. The prevalence of tobacco use among Indians aged 15 to 24 fell by 33 percent, from 18.4 percent to 12.4 percent. Among youth aged 15 to 17, tobacco use fell by 54 percent.
Since 2010, India's leaders have taken a series of strong actions at both the national and state level to curb the country's enormous tobacco epidemic, which claims one million lives each year. These actions include large, graphic warning labels that cover 85 percent of tobacco products. India's warnings are among the largest in the world, showing that graphic warnings depicting the deadly consequences of tobacco use work to help current users quit and prevent people from starting to use tobacco.
India has also increased tobacco taxes at the state level and many states have banned gutka, a popular, but deadly form of smokeless tobacco. India's newest data show that smokeless tobacco use has declined by 24 percent - a historic decrease that will save many lives in a country known as the oral cancer capital of the world.
Although India's long battle to put graphic warnings on tobacco products has been fought by tobacco companies at every step, and is still being challenged by the tobacco industry in court in Karnataka, this policy has had a profound effect on smokers' attitudes. According to the latest survey, there has been a 63 percent increase in the number of cigarettes smokers and an 84 percent increase in the number of smokers of bidis (cheap, hand-rolled cigarettes) who thought about quitting due to warning labels.
Despite these historic strides, there are still 267 million tobacco users in India. There are 199 million smokeless tobacco users, 72 million bidi smokers and 32 million dual users. India's tobacco use is different than most countries. The three most commonly used tobacco products are khaini (a form of smokeless tobacco), bidis and gutka - making an emphasis on bidis and smokeless tobacco a high priority.
To further reduce tobacco-related death and disease in India, the government must strengthen its implementation of its existing tobacco control measures, as called for the World Health Organization's Framework Convention on Tobacco Control (WHO FCTC), with particular focus on policies meant to reduce the use of bidis and smokeless tobacco products. These measures include smoke-free public places, increased tobacco taxes, warning labels on tobacco products, effective mass media campaigns and restrictions on tobacco advertising.
Just this week, the Indian government took an important step and announced that it will tax cigarettes, smokeless tobacco and bidis at the highest rate of 28 percent under a new Goods and Services Tax (GST) structure. The government must make sure that none of these products are exempted and stand strong against the tobacco industry appeals and lobbying that will start immediately to water down the decision.
We congratulate the government of India for its significant progress against such a terrible epidemic. These results should spur state and national government officials to enforce and defend existing tobacco control laws across the country - and to continue passing laws designed to protect public health. India's progress also shows the world that even countries with soaring numbers of tobacco users can drastically reduce the burden of tobacco use and improve public health for all. Without urgent action by more governments, tobacco use will kill one billion people worldwide this century.
