Republicans aim to capitalize this week on some high-profile problems with the Affordable Care Act by hosting hearings on issues such as high premiums and discussing legislation they say will protect consumers from the ACA's flaws.
Meanwhile, Congress is debating how to fund the government before the Sept. 30 deadline to pass a federal budget. Democrats are pushing for more than $1 billion to fight the Zika virus without restricting funding for Planned Parenthood.
Lawmakers have discussed continuing resolutions of various lengths and Republicans have hinted they want to pass several “mini-buses” to fund agencies instead of one overarching omnibus budget deal. Using a continuing resolution would save some agencies from planned cuts, but would mean the funding increase—ranging from $1.25 billion to $2 billion—for the National Institutes of Health would not occur for 2017.
Recent news has not been good for ACA supporters. Three large health insurers said they will drastically scale back their participation in the marketplaces in 2017, and some of those that are staying are warning of double-digit premium increases.
Also, the Government Accountability Office released a report Monday that found the marketplaces “remain vulnerable to fraud” in eligibility determination and enrollment processes.
The insurer pullouts are leaving some areas with few options for coverage. An analysis by the consulting firm Avalere Health showed that nearly 36% of the exchange markets will have only one participating health insurer in 2017, and seven states will have only one insurer in each of their ACA markets.
Republican senators highlighted these circumstances in introducing a bill that would exempt people in a county with one or fewer insurers offering plans from the ACA's individual coverage mandate. Pinal County in Arizona narrowly avoided being the only county in America without an insurer offering plans on the exchange when Blue Cross and Blue Shield of Arizona decided to remain in the exchange, although it said it would increase premiums by more than 50%.
Arizona Sen. John McCain said in a statement that the ACA was “fatally flawed from conception.”
“This failed law will only continue to place undue burdens on Arizona families unless we replace it with solutions that put patients back in charge of their healthcare,” said McCain, who also sent a letter to the CMS with questions about how it will respond to the lack of competition.
A bill approved last week by the House Ways and Means Committee would exempt anyone from the coverage mandate who lost coverage because an ACA co-op failed. More than half of the original 23 co-ops have shut down because of high-cost enrollees and restrictions that Republicans in Congress put on the risk-corridor funding intended to help with that issue.
Two hearings this week will examine concerns with the ACA. One will focus on high increases in premium rates expected in the exchanges next year, and another will give House Republicans an opportunity to push their ideas for replacing the ACA, which include individual tax credits for people to buy insurance along with more health spending accounts and the use of high-risk pools.