CMS Acting Director Andy Slavitt is defending his agency's oversight of state-based exchanges, which he says are successful and sustainable.
Slavitt spoke at a congressional hearing Tuesday, the second one the Energy and Commerce Subcommittee on Oversight and Investigations has held on the subject of Affordable Care Act state marketplaces. At the first hearing, six state exchange administrators testified that despite some bumps, their experiences have been mostly positive and the exchanges are doing their job.
But lawmakers Tuesday pointed to a September report by the Government Accountability Office that noted some state marketplace administrators said that the CMS communicated poorly and that the agency had not clearly defined its oversight role.
Rep. Marsha Blackburn (R-Tenn.) referenced a statement from the report that not all of the exchange's information technology system functions were functioning. Slavitt said he “wouldn't agree with the characterization that they're not functional.”
This year 17 states are running their own exchanges. Three of them are using the federal Healthcare.gov technology platform.
Rep. Bill Flores (R-Texas) asked Slavitt how many other state exchanges would need to switch to using the federal IT platform. Slavitt answered that he couldn't predict that because it is affected by many factors.
The CMS reviews funding requests from the states and conducts audits on them to ensure the funds are spent correctly. It has recovered more than $200 million of the original federal grant rewards, Slavitt said.
Committee members also asked about the numerous failing co-op insurance plans and why more than half of the original co-ops have had to announce they will shut down operations.
Slavitt said the co-ops had difficulty determining the initial capital needed because they had little foresight into how many people would sign up and what type of claims they would submit. The CMS didn't see the cause for concern until about the middle of this year.
While several states had struggled to set up their exchanges, and in particular, had IT problems, Slavitt said, they were successfully enrolling the uninsured and accomplishing the goals of the ACA.