Committee holds hearing on 18 bills that look to build on the Affordable Care Act

The House Energy & Commerce Health Subcommittee on Tuesday discussed 18 bills which look to build on the Affordable Care Act (ACA) and undo health-related policies enacted during the Trump administration.

The hearing took place on the 11th anniversary of President Obama’s signing of the ACA into law.


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In his opening remarks, Energy and Commerce Committee Chair Frank Pallone Jr. highlighted the health reform provisions included in the recently passed American Rescue Plan, describing it as “the largest expansion of health care coverage since the passage of the ACA.”

He added that the rescue plan, however, is just the beginning of Congress’ work to lower health care costs and expand coverage.

The American Rescue Plan included new incentives for states to adopt Medicaid coverage expansion through the ACA, bumping up the federal share of expansion costs from 90 to 95 percent for the first two years. During the committee meeting, lawmakers discussed a bill that would take this incentive even further. H.R. 340 would provide states with a 100% federal medical assistance percentage (FMAP) for expansion beneficiaries during the first three years. The FMAP would gradually decline to 93% by year six, and would drop to 90% for year seven and beyond.

The bill is sponsored by Rep. Marc Veasey who represents Texas’s 33rd District, covering parts of Dallas and Tarrant Counties. Texas is one of 12 states that has not expanded Medicaid. Veasey told the committee that a third or more of his constituents currently don’t have health insurance.

“I think that this bill is really important now because of what we’ve seen related to COVID-19 and how it has really hurt our state…[Medicaid expansion] is something that has helped a lot of Americans and we need to try and expand it especially in states like mine that are growing so rapidly.”

Two other bills discussed during the hearing seek to make adjustments to federal matching funds. H.R. 1888 would increase the FMAP for Urban Indian Health Programs to 100%, and H.R. 1390 would provide a temporary 11.5 percentage point increase to the Children’s Health Insurance Program (CHIP) FMAP through fiscal year 2022.

The committee also discussed several bills that look to reverse changes made during the previous four years related to the ACA. These bills include the “MORE Health Education Act” and the “ENROLL Act of 2021” which would restore funding for consumer outreach and the navigator program to help people enroll in ACA insurance marketplaces.

In 2017, the Trump administration significantly cut ACA enrollment outreach efforts, slashing funding from $100 million to $10 million. The MORE Health Education Act would allocate $100 million yearly toward consumer outreach and enrollment education activities. The ENROLL Act would similarly fund the navigator program for the federal marketplace at $100 million per year.

According to Katie Keith, Associate Research Professor at Georgetown University, as of 2019 program funding reductions have lead to an estimated 2.3 million fewer new enrollees. Compared to 2016, enrollment of new consumers for 2021 is down by about 50%.

“Clear standards on funding levels, enrollment targets, and other guardrails will help ensure consistent, robust marketing campaigns for in the future. These investments can yield dividends: marketing and outreach has been shown to help maintain lower premiums through a healthier, more diverse risk pool.”

Another bill heard in committee, H.R. 1875, would require short-term limited duration insurance plans to comply with ACA consumer protections such as the ban on pre-existing condition exclusions. Rep. Kathy Castor, who sponsors the legislation, told the committee,

“So many companies are taking advantage of our neighbors who are searching for health plans and luring them into purchasing cheap, but insufficient coverage… Eliminating junk plans is an important step to increasing transparency in coverage and ensuring Americans aren’t on the hook for costly, out-of-pocket costs.”

Other notable bills include H.R. 1878 which would provide $10 billion annually for states to establish a state reinsurance program or to provide financial assistance to reduce out-of-pocket costs, H.R. 1896 which would provide states with $200 million in federal funds to establish state-based marketplaces, and H.R. 1025, a bill that would require Medicaid programs to pay primary care physicians no less than the Medicare pay rate.

The full video of the committee hearing is available here.