Conference Coverage

Hearing drills into patient impact of ACA legal challenge



“Such a result will have virtually no impact on the operation of the ACA, nor on the millions of Americans – in reality, substantially all Americans – who depend on the ACA and its guarantees for people with preexisting conditions and myriad other protections that now are ‘baked into’ the national health care system,” Mr. Lazarus testified at the hearing. “To declare invalid the law’s shared responsibility payment provision, when that provision has no financial penalty behind it, will, by itself, have little if any depressive effect on the number of enrollees in health insurance plans.”

However, Mr. Lazarus noted that the guaranteed issue and community rating provisions of the law are “critical protections” for people with preexisting conditions.

Avik Roy, president for the Foundation for Research on Equal Opportunity, a nonpartisan organization that supports universal health care, testified that the Trump administration’s position about the mandate being tied to the guaranteed issue and community rating provisions is being mischaracterized as implying the administration opposes protecting people with preexisting conditions. President Trump has repeatedly expressed that any reforms or replacements of the ACA cover those with preexisting conditions, he said.

Mr. Roy recommended that Congress pass a bill reiterating the guaranteed issue and community rating requirements in the individual market to ensure protection for patients with preexisting conditions in light of Texas v. United States.

“I understand that a motion to produce such legislation was proposed by House Republicans during floor debate at the beginning of this Congress, [a bill] that would guarantee that no American could be denied coverage, or be charged higher premiums or cost sharing, as a result of a previous or current illness – and that the motion was defeated by the majority,” Mr. Roy testified. To me, this is a shame, as such legislation would ensure that Americans with preexisting conditions would be protected whatever the courts decide. I hope that Congress will reconsider its position.”

A number of subcommittee members pledged their support for protecting people with preexisting conditions and encouraged discussion of further legislation proposals.

“Let me speak on behalf of Republicans; we fully support protecting Americans with preexisting conditions,” said Rep. Greg Walden (R-Ore.), ranking member of the full committee. “We’ve said this repeatedly, we’ve acted accordingly, and we mean it completely. We could and should inject certainly into the system by passing legislation to protect those with preexisting conditions.”

Rep. Michael C. Burgess (R-Texas)

Rep. Michael C. Burgess

Rep. Michael Burgess, MD, (R-Texas) questioned why the subcommittee was having a hearing on Texas v. United States, rather than focusing on making specific health policy improvements.

“It’s unfortunate we’re having a hearing that doesn’t move toward the development of any policies that will actually improve health care for Americans,” Rep. Burgess said during the hearing. “To that effect, there are numerous options that you could bring before us that could moot [Texas v. United States], but the subcommittee apparently has chosen not to do so.”

Committee Chairman Frank Pallone Jr. (D-N.J.), who called for the hearing, took offense at Rep. Burgess’ statements, expressing the importance of the hearing and the case at large.

Rep. Frank Pallone Jr.

Rep. Frank Pallone Jr.

“I saw no effort at all in the time that you were the chairman [of the health subcommittee] to try to work toward solutions in improving the ACA,” Rep. Pallone said. “What I saw were constant efforts to join with President Trump to sabotage it. ... and the reason that this hearing is so important is because the ultimate sabotage would be to have the courts rule that the ACA was unconstitutional, which is totally bogus.”

The Subcommittee on Health will hold another hearing on Feb. 13 to discuss ACA legislation and protections for patients with preexisting conditions.


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