- HHS Secretary Tom Price, in testimony before Congress on Thursday, did not say whether the administration plans to pay insurers the cost-sharing subsidies (CSR) that many have said they would need to continue to participate in the Affordable Care Act (ACA) exchanges.
- Price insisted he remains focused on repealing the ACA through the American Health Care Act (AHCA), which passed the House last month. He did not give any details of the Senate’s negotiations on the bill, which have been kept from Democrats and the public.
- Democrats questioning Price focused their criticism on parts of the AHCA that would remove coverage protections for people with pre-existing conditions and could take coverage away entirely for about 23 million people.
If insurers were watching the regular budget hearing for an answer on CSRs, they were likely disappointed. With less than two weeks until their deadline for participating in the ACA exchanges and submitting rate requests, it’s getting too late for promises of action to matter.
Payers have been pulling out of exchanges left and right, saying without the CSRs they can’t justify participation financially. The GOP has spun this as proof the exchange market is collapsing, but multiple insurance executives have said the lack of certainty on CSRs is the problem, not the markets themselves.
Some key Republicans also support funding the CSRs. In his prepared remarks, House Ways and Means Chairman Kevin Brady (R-Texas) said the government should “act within our constitutional authority now to temporarily and legally” issue the payments. Still, no explicit action seems on the horizon.
Price and Senate Republicans are also coming under fire for being secretive about their version of the AHCA. No bill text has been released, no public hearings or markups have been scheduled and even public acknowledgement of the policies being debated has been absent.
The American College of Physicians wrote in a letter to leadership Thursday it is troubled the AHCA is moving forward “without a process that allows for direct engagement and outreach to organizations representing physicians, patients and others affected by the proposed policies.”