ADEA Washington Update

Congress Focuses on the Health Workforce and Individual Insurance Market

(ACA, Legislation, House, Senate, GME, HRSA) Permanent link   All Posts


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.

The 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. 

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