Sparks fly between CMS, Congress during ACA hearing

WASHINGTON--At a congressional hearing Wednesday, House leaders grilled Centers for Medicare & Medicaid Services Acting Administrator Andy Slavitt over the problems with the Affordable Care Act, while others defended the law.

The ACA has been the target of increased scrutiny recently amid news that insurance giants including Aetna and UnitedHealth have backed out of many public insurance exchanges due to financial losses. The Obama administration has responded by strengthening eligibility requirements for special enrollment periods, allowing insurers more flexibility in what kind of health plans they can offer and increasing outreach efforts to young people, among other proposed fixes.

In response to many House members' questions, Slavitt pointed to the fact that the uninsured rate is at a historic low as partial evidence of the law’s success. The healthcare reform law is the “greatest shift in healthcare for millions of Americans” since Medicare was passed more than five decades ago, according to Slavitt.

"Undertaking fundamental change is rarely easy,” he added.  

But Rep. Tim Murphy (R-Pa.) questioned Slavitt's optimisim, specifically wondering whether his claims that insurance premiums are lower than projected match up with reality.

"If you're subsidizing premiums, any (claim) of premium reduction is false," Murphy said. 

Meanwhile, concerns linger over persistent vulnerabilities in the verification process on healthcare exchanges, as highlighted by a recent report from the government accountability office. One congressman noted that in the first year of a GAO investigation determining whether fictitiously created shoppers could get health plans, 17 of 18 successfully got health plans without proving their identity. 

But Rep. Frank Pallone (D-N.J.) said it is “impossible” to game the health insurance exchanges for financial benefit, and saying the “flawed” GAO report on the ACA exchanges' susceptibility to fraud is “utterly ridiculous.” While Democrats care about integrity and oversight, many allegations against the ACA are motivated by a desire for headlines, Pallone added.

Another congressmen pointed out that he believes the ACA has received unusual scrutiny. No laws are perfect, but “we need to do with the ACA what we’ve done for every other piece of legislation,” and suggest solutions rather than pointing out the law's failures, said Rep. Gene Green (D-Texas).