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Iowa Conservatives Call for Preservation of Six Protected Classes

May 14, 2019

President Donald Trump

The White House
1600 Pennsylvania Avenue NW
Washington, D.C. 20500

U.S. Senator Chuck Grassley

135 Hart Senate Office Building
Washington, D.C. 20510

U.S. Senator Joni Ernst

730 Hart Senate Office Building
Washington, D.C. 20510

Dear President Trump, Senator Grassley, and Senator Ernst:

We are writing to urge you to oppose the recent proposal from the Centers for Medicare and Medicaid
Services (CMS) to reduce the protection of the six protected classes of drugs administered under
Medicare Part D.

We applaud the Administration for its attempts to lower drug costs and government spending, however
we have strong concerns with this proposal and its impact on those with life-threatening conditions. You
have been strong voices in standing up for policies that are in the best interest of Americans. We hope
you will continue to do the same with this policy.

Every patient is unique which requires individualized approaches to treatment. It is vital that we protect
the access to these treatments for Medicare patients with the most complex conditions to provide them
with the greatest opportunities to improve their health and heal. Part D currently provides patient
safeguards that allow them to utilize all options on the marketplace to receive the right individualized

Any proposal to reduce the availability of medications would impose pre-authorization and step therapy to
the already complicated and challenging health care regimen. These patients should be focusing their
time and energy on fighting their already difficult disease on their road to recovery, not figuring out how
they can survive through a new system with restrictive access to critical treatments.

Limiting the approved treatments can threaten the very livelihoods of patients. Furthermore, this type of
proposal is a government overreach in personal health care decisions. This type of rationing policy that
threaten to limit access to drugs on the marketplace leads down the road of a government-run health care

This is not the first time CMS has proposed to reduce the protection of the protected classes. This policy
was first attempted in 2014, and thanks to the overwhelming support from conservatives, the proposal
was defeated.

As conservatives, we not only advocate to protect the life of the unborn, but also for the care of our
seniors and those facing the most difficult health conditions. Fighting for the life of our seniors means
ensuring they have access to the best quality health care possible.

We urge you to stand firm and once again join us in rejecting the proposal by CMS that would interfere
with the care of those under the six protected classes.

Denise Bubeck
Christian Activist

Ginny Caligiuri

Naomi Corrie
Pottawattamie County Republican Executive Member

Caitlyn Dixson
Executive Director, Iowa Right to Life

Tom and Barbara Hovland

Gloria Mazza
President, Iowa Federation of Republican Women

Sue Martinek

Kathy Pearson
Small Business Owner

Marlys Pompa
GOP Consultant and Pro-Life Advocate

Stephen Scheffler
President, Iowa Faith & Freedom Coalition
Republican National Committeeman for Iowa

Luana and Stephen Stoltenberg