Lawmakers cited contrasting headlines to assess the performance of the Affordable Care Act during a hearing Wednesday where acting CMS Administrator Andy Slavitt once again defended the law under harsh questioning.
Republicans on the two House Energy and Commerce subcommittees hosting the hearing brought up recent news of major insurers dropping out of the ACA exchanges, several reports of large premium increases and more co-ops failing.
Slavitt and the Democrats, however, pointed to data released this week showing that the rate of uninsured in the country is at its lowest point ever as well as a report that most enrollees in exchange plans are satisfied with their coverage.
Slavitt said the high premium increases are likely a one-time effect resulting from the end of risk adjustment payments and insurers having access to more and more accurate claims cost data. Future years should see a “normalized, low-rate of growth” in premiums.
It's important to note that ensuring coverage for people regardless of health status or pre-existing conditions is new for the country, he said.
“No one knew when we entered into this exactly what that would cost,” he said.
Other witnesses at the hearing were officials from the HHS Office of the Inspector General and the Government Accountability Office, which have each released multiple reports on various aspects of the ACA.
The HHS OIG recently reported that the CMS did not adequately consider the impact of failing co-ops, while the GAO found that some fake applicants were approved for coverage and subsidies.
Slavitt said the CMS appreciated the work of the watchdog agencies and will implement suggested improvements, such as limiting special enrollment periods, as soon as possible. In his written testimony, Slavitt said the marketplace continues to grow and mature.
“This type of fundamental change rarely is easy, and from the outset, we knew that implementation of the Affordable Care Act would be a multi-year process,” he said. “Every day we learn more to help us improve our operations and enhance the consumer experience by making the purchasing of health insurance easier and simpler for our customers.”
The CMS is focusing on enrolling more young people in the upcoming open enrollment period with person-to-person outreach and on encouraging more states to expand Medicaid, Slavitt said.