Chairwoman DeLauro Statement at Oversight Hearing: Impact of the Administration’s Policies Affecting the Affordable Care Act
Congresswoman Rosa DeLauro (D-CT), the Chair of the Labor, Health and Human Services, and Education Appropriations Subcomittee, delivered the following remarks at the Subcomittee's oversight hearing on "Oversight Hearing: Impact of the Administration’s Policies Affecting the Affordable Care Act ":
The Subcommittee will come to order. It is my pleasure to open the first hearing of the Labor, HHS, and Education Appropriations Subcommittee of the 116th Congress.
This debate comes at a critical juncture. The changing energy of the country and the changing dynamics of the Congress are intersecting. The country has mandated that elected officials tip the scale for the people who deserve so much more.
First, let me thank our distinguished panelists for being here. I will introduce each of them in a few minutes.
Let me also acknowledge the new members of the subcommittee. Democratic Representatives Lois Frankel of Florida, Rep. Cheri Bustos of Illinois, and Rep. Bonnie Watson Coleman of New Jersey, and Republican Representative Tom Graves of Georgia.
Finally, I want to acknowledge the Ranking Member of the subcommittee, my good friend, Tom Cole. Thank you, Tom, for the last four years of cooperation and respect that we have shared on this subcommittee. I intend to maintain that tradition. I know we will continue to disagree in some areas — we have done so firmly and repeatedly — but we also manage to find common ground. I believe that is because we agree on this: how central the work we do in this committee can be for people and their lives.
And, that includes health care: the subject of today’s hearing.
This is an oversight hearing. This subcommittee is going to review the impact of the administration’s policies on the Affordable Care Act, specifically with regards to affordability, the increasing number of uninsured, and the quality of the benefits available to people.
Before the Affordable Care Act became the law of the land in 2010, the cost of health care was rising at an unsustainable rate. Spending was projected to rise to $4.1 trillion by 2017. More importantly, health care costs were taking up a larger and larger share of the family budget.
But since the Affordable Care Act went into effect, its impact exceeded expectations. As you can see from the slide, national spending on health care is well below pre-ACA expectations—more than $600 billion lower than projections for 2017.
Because of the ACA, more than 20 million people gained health coverage—many for the first time in their lives. For families, it meant that insurance companies could no longer discriminate against people because of their medical history and being woman was no longer a pre-existing condition.
Then this administration went to work.
The Department of Health and Human Services has written new rules to intentionally increase premiums and out-of-pocket costs for families covered by ACA health plans.
For example, the cost-sharing reduction payments to insurers who provide plans on the exchange were crucial to keeping down costs for families in the exchange. But, President Trump spent months threatening to eliminate them. And, when Democrats refused to bargain away this important mechanism for affordability, (on October 2017) he eliminated the payments outright, dramatically driving up health care costs. The Congressional Budget Office estimated doing so would cause premiums to rise 25 percent by 2020.
Thankfully, as Dr. Aron-Dine points out in her testimony, state regulators rushed to protect their state’s insurance markets. And, they mitigated the damage.
In 2018, repeal of the individual mandate was also responsible for driving up health care costs.
Now, let us look at pre-existing conditions. HHS has made a concerted effort to shift consumers toward ‘junk’ health plans, which allow insurance companies to gouge or deny insurance coverage to Americans with pre-existing conditions. And, the administration has also urged federal courts to strike down protections for preexisting conditions.
Our witness Mr. Peter Morley will share his story and emphasize how important these protections can be. Really, they are a matter of life and death.
Look at enrollment. We see the administration’s efforts, with regards to enrollment and outreach. HHS shortened open enrollment, reduced the annual budget for outreach and advertising by 90 percent, and reduced funding by 80 percent for ACA Navigators, those people who provide in-person assistance to consumers who need help finding a health plan.
In the administration’s first week (January 2017), the Department of Health and Human services announced it would stop planned advertising for the final week of open enrollment—typically the busiest period. But, they were only following the president’s lead. On his first day in office, the president issues an executive order directing federal agencies to begin dismantling the Affordable Care Act, quote, “to the maximum extent permitted by law.”
And, it goes on. The Center on Budget and Policy Priorities has compiled a list from January 2017 to today of actions this administration has taken to undermine the Affordable Care Act. The list runs for 18 pages.
One of today’s witnesses is Joshua Peck. He will explain that HHS made these decisions with full knowledge of the harm they would cause. Mr. Peck estimates that HHS’s decisions to undermine outreach, advertising, and enrollment efforts resulted in more than 1 million fewer enrollments in 2017 and a similar shortfall in 2018.
In all these ways, the administration has tried to undermine the ACA. I would ask — to what end?
Due to the Administration’s actions, costs for families and working people are skyrocketing. According to the Kaiser Family Foundation, premiums in 2018 rose 30 percent. And according to analysis by the Center For American Progress, a typical family of four will see 2019 premiums increase by more than $3,000 dollars. In addition, the uninsured rate is up to 13.7 percent from 10.9 percent. That is the equivalent of 7 million people losing their health coverage. And the uninsured rates have increased the most among women, low-income people, and those under 35. All because of the president’s efforts to undermine the Affordable Care Act.
This committee has the responsibility to stop the administration undermining health care for millions of Americans; to stop it from allowing insurance companies to discriminate again with junk plans; and to stop it going after the very mechanisms we have in place to hold down costs for Americans.
We need to bring the costs of premiums and deductibles.
The administration needs to defend the ACA in the Texas lawsuit; it needs to defend those Americans who rely on the laws protections for pre‑existing conditions. And, we need to work to close the Medicaid.
These measures would lower health care costs for families so they can afford quality coverage.
I anticipate today’s hearing to be a spirited debate. However, I intend it to be an informative conversation and a fact driven and a positive start to what I hope will be a bipartisan effort to strengthen and bolster instead of repeal and replace.
Now, let me turn it over to my good friend from Oklahoma, the Ranking Member, Mr. Cole, for any opening remarks he cares to make.