WASHINGTON – U.S. Representative Rosa DeLauro, D-Conn., on Wednesday criticized the Trump administration for intentionally undermining the 2010 Affordable Care Act, leading to skyrocketing premium costs and an increase in uninsured rates particularly for women, low-income people and those under 35.
DeLauro took the reins of the Appropriations subcommittee responsible for funding the Department of Health and Human Services at the start of the year, when House Democrats assumed the majority. Her first hearing as chairwoman focused on Trump administration policies impacting the ACA.
“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,” she said.
U.S. Rep. Tom Cole of Oklahoma, the ranking Republican on the panel, questioned the whether the panel had any role in overseeing the health insurance law saying “the direct jurisdiction falls outside this subcommittee.” He suggested that it would be better for such hearings to be conducted by the Energy and Commerce or Ways and Means committees.
DeLauro noted that the subcommittee provides the paychecks to the Trump administrators setting many of the ACA policies that she finds harmful.
Cole also downplayed criticism of the Trump administration noting that when Democrats wrote the law, it gave the Health and Human Services Secretary broad latitude to implement it. Republicans weren’t happy with the way the Obama administration implemented it, so it is no surprise Democrats would be unhappy with Trump, either, he said.
Joshua Peck, co-founder of Get America Covered, testified that the Trump administration’s decision in 2017 to cut the marketing budget for the health exchanges from $100 million to $10 million resulted in at least 2.3 million people not enrolling.
“That’s 2.3 million people — some of whom have unfortunately gotten sick or had an accident and without insurance, some of these people have gone bankrupt or forgone needed care,” he said.
Peck, who oversaw the health exchange marketing during the Obama administration, based his estimate on the results of a multi-year study undertaken during the Obama administration that correlated the impact specific marketing techniques had on enrollment. Peck said the same study was reviewed by the Trump administration weeks before it announced the 90 percent cut to the outreach and advertising budget.
Peck called the cut “just a single example” of the Trump administration’s efforts to “undermine the health insurance marketplace.”
“They’ve cut navigator funding by 80 percent, shortened the open enrollment period, championed the repeal of the individual mandate, encouraged the introduction of junk plans, didn’t engage with the news media to get out the word about the deadline and much more,” he said.
Peck’s testimony was challenged by Ed Haislmaier, a senior research fellow at the Heritage Foundation, who testified that outreach and advertising would have little impact on enrollment in the health marketplace.
“Enrollment plateaued starting about 2016. I don’t find that particularly surprising,” he said. Haislmaier noted that the Centers for Medicare and Medicaid predicted there would initially be robust enrollment — taking up 80 percent or more of those eligible within the first two years.
He said the data suggest a “mature market” in which the number of new enrollees has steadily declined while there is an increase in the numbers re-enrolling.
“From here, frankly, I don’t think we are going to see much change plus or minus, and that is regardless of what the subsequent administration does,” Haislmaier said.
DeLauro asserted that the Trump administration has harmed the Affordable Care Act in ways that have raised premiums for families and caused the number of people who are uninsured to increase.
The Center on Budget and Policy Priorities, she said, has compiled an 18-page list of actions the administration has taken to undermine the Affordable Care Act.
“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,” she said. “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.”
Connecticut’s experience doesn’t exactly mirror the experience at the national level, but enrollment is down by about 3,000 individuals so far in 2019.
An estimated 111,600 enrolled in one of the 17 exchange plans this year. Access Health CT spent about $4 million in its marketing efforts this year, which is similar to amounts they’ve spent in past years.
Access Health CT CEO James Michel, who oversees Connecticut’s exchange, said enrollment might be down this year because more people have coverage through their employers.
“Having a very strong economy and low unemployment” also contributed to the decrease in enrollment, Michel said last month. “If people have jobs, they’re probably getting insurance through their employer.”