In addition to trying
to repeal the Affordable Care Act (ACA), Congress heard testimony on how to shore
up the nation’s health care system. One House hearing in September focused on
trying to rebuild health workforce programs under Title VII, while a string of
four hearings in the Senate Committee on Health, Education, Labor and Pensions
(HELP) concentrated on how to stabilize premiums[TCM1]
and help people enroll in the 2018 individual insurance market.
hearing in the House Committee on Energy and Commerce’s health subcommittee
looked at funding for two primary care workforce programs: the National Health
Service Corps and the Teaching Health Center Graduate Medical
Education program. Funding for both programs is currently slated to expire on
Sept. 30 if Congress fails to pass legislation authorizing their continuation,
according to a hearing
memo put out by the subcommittee.
In a statement, subcommittee Chair Rep.
Michael Burgess, M.D.
[TCM2] (R-TX), who is also an obstetrician,
noted that the Association of American Medical Colleges has estimated that by
2030, the projected physician shortage will be anywhere from 40,800 to as many
as 104,900 providers. Rep. Burgess called programs like the National Health
Service Corps “essential,” saying they “tackle these shortages head on by
connecting young providers with underserved communities.”
In a rare show of bipartisanship, Senate
HELP committee Chairman Sen. Lamar Alexander (R-TN) and ranking member Sen.
Patty Murray held four days of hearings on stabilizing premiums in the
individual insurance market. The first hearing featured five state insurance
commissioners talking about the impact of the ACA on their respective states.
A second hearing on Sept. 7 featured a
bipartisan group of five governors. The third hearing, held on Sept. 12, focused
on state flexibility and included five witnesses, including Kaiser Foundation
Health Plan, Inc., and Hospitals CEO Bernard Tyson, who laid
out six “critical points” to help
stabilize the individual insurance market. His priorities include long-term or
permanent funding of cost-sharing reductions, federal support for reinsurance
programs and enforcement of the individual mandate.
The final hearing on Sept. 14 featured
five health care stakeholders as witnesses, including an orthopedic trauma
surgeon from Nashville, TN, Manny Sethi, who noted
that 78 of 95 Tennessee counties had only one insurer. Rising premiums, he
said, led to 30,000 Tennesseans leaving the individual market. Mr. Sethi also
called for a continuation of the cost-sharing reduction program, which helps
individuals with lower income levels pay for their premium coverage.
Sens. Alexander and Murray had hoped to
bring to the Senate floor a bill that would end the uncertainty that has roiled
the health insurance markets and help control health care spending. That effort
came to an end on Sept. 19, when influential Republicans made clear they would
not support the bipartisan effort and would instead focus on a proposal by
Senators Lindsay Graham (R-SC) and Bill Cassidy, M.D. (R-LA). With the failure
of Graham-Cassidy, Senator Alexander is said to be open to another attempt at
stabilization through the HELP committee.