Rob Portman and Mary Taylor
Sen. Rob Portman and Ohio Lt. Gov. Mary Taylor, talking with reporters after a Senate hearing in which they cited Obamcare flaws.
(Stephen Koff, cleveland.com)
WASHINGTON D.C. - Obamacare is a mess, crammed down the throats of Americans by Democrats in Congress. Premiums are soaring and insurers are backing out, cutting consumer choice. The next Congress must repeal and replace it.
These were the primary messages in a U.S. Senate committee hearing today that was scheduled by, and dominated by, Republicans. (The Obama administration disagrees with that message, as you'll see.)
Of four state insurance officials who testified before the Senate Committee on Homeland Security and Government Affairs, including Ohio Lt. Gov. Mary Taylor, three were Republicans or represented Republican state governments. Their states reluctantly joined the federal program that mandated an expansion of health coverage.
A partisan imbalance in a congressional hearing doesn't mean the critics are wrong or right about the Affordable Care Act, also known as Obamacare. But the hearing offered a preview of what's to come in 2017 - both for insurance and for politics, depending on which political party controls the White House and Congress. Key points:
Fewer choices, higher costs: The GOP senators and insurance regulators from Republican state administrations cited rising premiums over the last few years. They also mentioned the number of insurers who are exiting the Obamacare market after citing financial losses, some from customers who used more medical services than insurers were expecting.
Oklahoma next year will have only a single insurer offering Obamacare coverage, said Sen. James Lankford, an Oklahoma Republican. "We're in a bad place," he said, predicting that the lack of choice will eventually extend to other states. "In some ways, Oklahoma is the canary in the coal mine," he said.
Ohio's experience: At least four insurers sold Obamacare policies in each of Ohio's 88 counties for 2016, Taylor said. But in 2017, "19 counties will have just one insurer selling exchange products and 28 counties will have just two."
"This is not the competition and choice that the country was promised in 2010, to say nothing of the rate increase that Ohio has seen since the implementation of the ACA," she said.
Since the start of Obamacare, average premiums for individuals buying on Ohio's federally run exchange have gone up 91 percent, Taylor said.
Obamacare proponents often point out that the majority of those paying premiums get federal subsidies to offset the costs. But those "hundreds of billions of dollars in subsidies being spent across the country are taxpayer dollars," Taylor said.
The minority view stated today: Only two Democratic senators were present, and only one pro-Obamacare state regulator was invited to testify. Mike Kreidler, the elected insurance commissioner from Washington state, acknowledged imperfections in the system but said improvements could be made without destroying Obamacare's foundation.
He and the two Democratic senators cited declines in the number of Americans who lacked health coverage since Obamacare became law. They cited access to care that was once was denied to people with preexisting medical conditions or income issues. Debt from medical bills had been "the number one cause of personal bankruptcy," said Sen. Gary Peters, a Michigan Democrat.
Obamacare has had a "profoundly positive" effect in Washington, said Kreidler. "Not without problems, but profoundly positive."
The minority view as written: Senate Democrats, in the minority party and unable to present as many witnesses as Republicans, offered written statements from officials from four states not represented at the hearing. The states were California, Delaware, Virginia and Rhode Island, and their officials wrote in support of the health care law.
"The Affordable Care Act is working in California and for Californians, and we have built a sustainable and competitive marketplace," wrote Peter V. Lee, executive director of Covered California, his state's Obamacare marketplace. "We are seeing lives changed by the security they now have and the quality care they have received."
The Obama administration's view: The Department of Health and Human Services late today responded with its own figures and facts, chief among them that had it not been for the Affordable Care Act, individual premiums today would be a lot higher. This was spelled out in July by the Health Affairs Blog.
Averages tend to mask individual variations, and HHS said that in a recent analysis, it found 70 percent of Obamacare consumers in Ohio would be able to purchase coverage for less than $100 per month, even if all rates went up 50 percent for 2017.
"Headline rate changes do not reflect what consumers actually pay because tax credits reduce the cost of coverage below the sticker price and shopping helps consumers find the best deal," said HHS press secretary Jonathan Gold. "Since the Affordable Care Act became law, health care prices have risen at the lowest rate in 50 years, and premiums for the 150 million Americans with employer-sponsored insurance have grown at some of the slowest rates on record."
Fix or repeal: Obamacare was passed in 2010 without a single Republican amendment considered, said Sen. John McCain of Arizona. Democrats performed "a victory dance" at the time, he said.
"And now you want us to help you fix it?" McCain said to Sen. Tom Carper, a Delaware Democrat who spoke of working in 2017 to improve the law. "Give me a break," McCain said.
Sen. Ron Johnson, a Wisconsin Republican who chairs the committee, said the law's individual mandate - the requirement that everyone buy insurance or else face a small fine - must be eliminated. More power should be given to the states on insurance decisions, he said, and the so-called Cadillac tax on expensive employer health plans should be repealed.
Portman's view: Sen. Rob Portman, an Ohio Republican on the committee, said fixes are definitely needed.
"Our health care system wasn't perfect before," Portman said, but for a lot of Ohioans, "it is not an improvement."
Portman, who was not in the Senate when Obamacare passed, said McCain made valid points about its partisan nature. Still, Portman said, Congress should approach this on a bipartisan basis "and see if we can get a better result."