Hearing of the Health Subcommittee of the House Ways and Means Committee - Status of the Affordable Care Act Implementation

Hearing

Mr. Chairman:

Commissioner Koskinen and Deputy Administrator Slavitt, thank you for coming this morning.

Before we enacted the ACA four years ago, America's health insurance system was dysfunctional and deadly.

46 million people across the United States were uninsured. Every year, 45,000 Americans were dying because they lacked coverage.

Many Americans who did have insurance weren't getting a good deal. Their health security was tenuous at best and the prospect of bankruptcy due to medical costs was a real threat for too many families.

Insurance companies could hike up plan rates with impunity and without accountability.

Insurance companies could refuse to cover people with pre-existing conditions and benefits dropped away when people got sick and needed health security the most.

Meanwhile, Medicare costs were increasing at unjustifiably high rates, in part because the federal government was overpaying private insurance companies tens of billions of dollars through the Medicare Advantage program.

Waste, fraud and abuse continued to chip away at the Trust Fund as fraudsters and other questionable actors bilked beneficiaries and the American taxpayer, while law enforcement lacked the tools to crack down on fraud until after the fact.

Millions of seniors were falling into the Medicare prescription drug donut hole, where coverage evaporated as needs increased.

Today, things are very different.

There is real health security for millions of Americans due to the ACA.

Marketplaces across the country are up, running, and ready for business.

8 million Americans signed up for coverage during the first open enrollment period and the number of uninsured Americans has dropped by more than 10 million.

6 million Americans have gotten tax credits and subsidies to help offset their healthcare costs.

In addition, smart states have expanded Medicaid, which has increased coverage to millions more of the most vulnerable Americans.

Thanks to the ACA, hardworking Americans can no longer be denied coverage because they have a preexisting condition, and their rates cannot be arbitrarily raised when they get sick.

We're cracking down on fraud, waste, and abuse in Medicare.

Instead of targeting fraud after the fact, federal regulators are increasingly preventing violations on the front end.

Thanks to vigorous enforcement and the tools provided by the ACA, the Administration has recovered more than 19 billion dollars over the past five years.

Payments to private insurance companies have been reduced to more appropriately reflect the cost of delivering Medicare, while Medicare benefits have improved.

With free preventive care and coverage in the donut hole, millions of seniors have saved billions of dollars since the ACA was enacted.

Yes, there have been a few hiccups along the way.

Implementation of the ACA has suffered due to Republican propaganda designed to confuse and scare the public, senseless repeal votes and harmful budget cuts.

As Commissioner Koskinen has testified to in the past, the IRS is seriously understaffed, making it harder for the agency to implement key parts of the ACA.

Similarly, CMS has been denied needed resources.

Yet, despite Republicans' best efforts at sabotage, the ACA is working.

The law is saving money and lives.

We are on pace to guarantee health security for 32 million more Americans in the coming years and Medicare spending is at its lowest per person growth in history.

In light of the ACA's success, I look forward to the day when Republicans do an about face to accept their share of responsibility in guaranteeing health security for all Americans.

That means ending their senseless mission of sabotage and repeal.

That means working with Democrats to ensure all of our constituents benefit from all the ACA has to offer.

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