Republicans See Failure, Democrats Success in Obamacare

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By James Swann

Sept. 14 — Republicans called the Affordable Care Act a failure at a House hearing Sept. 14, while Democrats praised it for cutting the number of uninsured Americans.

The ACA’s health insurance exchanges have limited consumer options and driven insurers out of the marketplace, Energy and Commerce Subcommittee on Health Chairman Joe Pitts (R-Pa.) said. Pitts also highlighted failures within the Consumer Operated and Oriented Plan (CO-OP) program, which created nonprofit health insurers under the law. Seventeen out of 23 CO-OPs have either closed or will have by the end of the year.

However, Energy and Commerce Subcommittee on Oversight and Investigations ranking member Diana DeGette (D-Colo.) said the ACA has led to 12 million additional enrollees in Medicaid and the Children’s Health Insurance Program, as well as a historic reduction in the number of uninsured individuals. Likewise, Subcommittee on Health ranking member Gene Green (D-Texas) said Texas has seen a flood of new insurance consumers, and he urged Congress to work on fixing problems within the ACA rather than getting ride of it altogether.

The ACA, also known as Obamacare, has been a source of contention as well as hearings since it was enacted into law in 2010, with Republicans repeatedly calling for its repeal.

The joint hearing by the two Energy and Commerce subcommittees featured testimony from Andy Slavitt, acting administrator of the Centers for Medicare & Medicaid Services, as well as representatives from the Government Accountability Office and the Health and Human Services Office of Inspector General.

Vulnerable to Fraud?

At the hearing, lawmakers discussed two recent reports from the GAO that determined the health insurance exchanges are still vulnerable to fraud (177 HCDR, 9/13/16). One report found that the federal health exchange or selected state exchanges approved each of 10 fictitious applications for subsidized health plans in 2015, while another report said the exchanges were still vulnerable to fraud as of 2016.

This is the third year the GAO has found vulnerabilities in exchange plan enrollment by using fictitious “secret shopper” applications for federal subsidies for insurance coverage.

Democrats were quick to challenge the GAO, with Energy and Commerce ranking member Frank Pallone (D-N.J.) referring to the reports as a “farce.”

“Let me start by saying that it is inconceivable to me that anyone would be skilled enough or motivated enough to try to fraudulently gain health insurance coverage this way, particularly since there is no possible scenario in which an individual could financially gain from gaming this system,” Pallone said.

Pallone said the hearing was the Energy and Commerce Committee's 10th on the ACA, and he said Republicans were still committed to repealing the law without proposing any alternative.

Republicans should focus on making improvements to the ACA rather simply repealing it, Pallone said.

DeGette also questioned the GAO reports, saying they had no real-world value, as no one would actually try to do what the GAO did.

Lack of Oversight

Republicans from the two subcommittees spent the hearing listing what they considered to be the ACA's major flaws, including higher premiums, lack of oversight and consumers being forced out of their preferred insurance coverage.

Energy and Commerce Chairman Fred Upton (R-Mich.) said premiums have skyrocketed, providing examples from constituents who have seen their premiums more than double, while Subcommittee on Oversight and Investigations Chairman Tim Murphy (R-Pa.) questioned a statement from Slavitt that premiums are lower than Congressional Budget Office projections

Murphy said insurance exchange plan are being subsidized, making any claims of premium reduction false.

Rep. John Shimkus (R-Ill.) said copayments under the ACA are unaffordable and said Illinois was in better shape before the ACA was enacted.

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