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Senate health chief wants to abandon 'loser' coverage debate as ACA sign-ups lag


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Senate health chief wants to abandon 'loser' coverage debate as ACA sign-ups lag

The Republican head of the Senate health committee said he wants to pivot away from trying to get anything done on fixing the individual healthcare insurance market and focus instead on reining in costs.

"You'll never get low-cost health insurance until you have lower-cost healthcare," Sen. Lamar Alexander, R-Tenn., chairman of the Senate Health, Education, Labor and Pensions Committee, said during a Dec. 12 forum in Washington hosted by Axios.

Alexander, who is expected to continue in the role in the next Congress in January 2019, said he wants to focus over the next two years on getting one or two big things done on reducing healthcare costs "and maybe 10 or 12 little things and try to move the whole debate from health insurance, where we've been stuck for eight years arguing about 6% of the health insurance market — that's Obamacare — to healthcare costs."

Last year, Alexander teamed with Sen. Patty Murray, D-Wash., the committee's ranking member, to try to get a bill through Congress that sought to make some short-term fixes to the Affordable Care Act aimed at stabilizing the insurance market and restoring subsidies to millions of Americans.

The effort, however, failed.

Alexander made another go at it earlier this year, partnering with Sen. Susan Collins, R-Maine, on another bill, which built on the legislation he co-authored with Murray.

But that proposal also has floundered.

Now, Alexander said, it is time to turn the debate away from the individual market — which he acknowledged was "maybe" a loser issue for Republicans — and toward healthcare costs.

He said he had sent a broad call out to healthcare experts at the American Enterprise Institute and the Brookings Institution — two Washington think tanks — and a number of economists, doctors, nurses, patients, hospital administrators, state regulators and legislators, governors, employers, insurers and innovators asking them to identify specific ideas about how to reduce healthcare costs for Americans.

The senator noted that he had convened five hearings in the past year on the matter, in which one witness from the National Academy of Medicine testified that as much as 50% of all the money spent on healthcare was unnecessary.

"I was so startled by that," Alexander said at the Washington forum.

ACA enrollment significantly slides

The Tennessee lawmaker's remarks come as enrollment in plans offered under the Affordable Care Act's marketplace continues to lag, with only days left for Americans to sign up for 2019 coverage.

Enrollment for the ACA plans is due to end on Dec. 15.

The Centers for Medicare and Medicaid Services reported on Dec. 12 that just over 4.1 million Americans had enrolled by the sixth week, down 11.7% from the same period last year, when nearly 4.7 million people had signed up.

A day earlier, CMS said it had the highest traffic during the open enrollment period on the federal online marketplace,, which also happened to be the same day former President Barack Obama urged Americans to sign up, reminding them of the Dec. 15 deadline.

"Sign up," Obama said in a video he tweeted with his message. "Most folks can find coverage for $50 to $100 per month. That's probably less than your cell phone bill."

A new analysis from the nonpartisan nonprofit Kaiser Family Foundation found that 4.2 million currently uninsured ACA marketplace shoppers could get a so-called bronze-level plan — one of the four metal categories, which also includes silver, gold and platinum — for 2019 and pay nothing in premiums after factoring in tax credits.

Meanwhile the nonpartisan, nonprofit Sunlight Foundation reported on Dec. 11 that a few weeks after open enrollment started for ACA coverage, CMS altered the website, removing information about two ways to apply — to enroll by phone and by mail — a change the group said may confuse plan shoppers and "could impede consumers' ability to obtain health insurance coverage."

CMS also shifted the options for ways to apply for coverage — moving from the top to the bottom and putting options for using an agent or broker above it.

The Sunlight Foundation report sparked immediate criticism by Rep. Frank Pallone, D-N.J., who is expected to be the next chairman of the House Energy and Commerce Committee when Democrats take control in January 2019, that the Trump administration's changes to the ACA marketplace were more attempts to sabotage it.

"Even worse, it appears the administration is directing people away from, and steering them towards private websites that sell junk insurance plans," Pallone said in a Dec. 12 statement. "These junk plans will leave patients at risk of massive out-of-pocket costs and no coverage for critical healthcare services such as prescription drugs."

Come January, Pallone said, the Democrats plan to hold the Trump administration "accountable for their efforts to sabotage the American healthcare system and prevent people from accessing health coverage."