Dive Brief:
- CMS Administrator Seema Verma's testimony in front of the House Energy and Commerce Committee on Wednesday raised further questions about the Trump administration's preparedness should the Affordable Care Act be struck down.
- Verma would not provide details on President Donald Trump's promised healthcare plan in several fiery exchanges with House Democrats over the fate of Americans with pre-existing conditions, adult children under the age of 26 on their parents' plans and the roughly 21 million people who would lose coverage if the landmark law is invalidated.
- "The president has made clear that we will have a plan in action to ensure Americans will have access to insurance," Verma said. "I'm not going to give any details of the plan."
Dive Insight:
Verma testified in front of House Democrats for the first time Wednesday in the nearly three-hour hearing.
Democrats expressed frustrated over Verma's dodging of their efforts to get more clarity around how the administration is prepared if the Fifth Circuit Court of Appeals, which is reviewing a district judge's finding that the ACA is unconstitutional, affirms that ruling.
In arguments earlier this year the judges' lines of questioning hinted they'd prefer to punt the case back to Congress. It's expected to eventually wend its way to the Supreme Court.
If the Obama-era health legislation is overturned, millions of Americans — many low-income or with pre-existing conditions — could lose their coverage. Though Trump's Department of Justice declined to defend the ACA in court against the Texas-led case, saying it supported repeal, the administration has yet to produce a proposal to deal with the fallout.
"You have no plan, you can't produce a document, you can't give us a detail, you're skirting the issues, and all we are getting are talking points," Rep. Raul Ruiz, D-Calif., told Verma at the hearing.
Verma repeated a popular Republican talking point that, for Americans who don't receive ACA subsidies, the premiums are mostly unaffordable and the law can't protect those who can't afford coverage as it is. She also touted the 4% dip in plan premiums for 2020 as evidence Trump-era policies were propping up the exchanges, though many experts say the market is chugging along despite those initiatives.
The CMS chief also faced questions on other controversial Trump administration programs, including work requirements, short-term limited duration health insurance plans and policies that critics say have destabilized the federal ACA exchanges.
CMS has approved work requirements or "community engagement programs," which yoke Medicaid insurance to employment or volunteering hours, in nine states, though the programs in Kentucky, Arkansas and New Hampshire have been struck down by a federal judge.
The programs cost taxpayers $408 million, according to the Government Accountability Office, and sharply cut the volume of low-income Americans eligible for Medicaid. The Kaiser Family Foundation estimates that 1.4 million to 4 million impoverished Americans could lose coverage if work requirements were scaled nationwide.
Despite those figures, "it's premature to draw conclusions" about the program, Verma said Wednesday, defending the administration's expansion of short-term, limited duration plans critics call "junk coverage" and CMS policies paring down resources in open enrollment in a similar fashion.