The man closest to the implementation of Obamacare told Congress that the handful of states with their own Obamacare exchanges are self-sustaining and doing a slightly better job at cutting their ranks of uninsured than states that rely on the federal HealthCare.gov website.
Yet Andy Slavitt, acting administrator for the Centers for Medicare and Medicaid Services, said he does not know if any of them will follow the lead of Oregon, Nevada and Hawaii, and abandon their portals because of technological and financial woes.
“I can’t predict who’s going to come into the federal exchange,” Mr. Slavitt told the House Energy and Commerce Committee.
Committee Republicans said they aren’t convinced that web-based markets set up under the Affordable Care Act will be able to survive, and they’re angry that some states received millions in start-up grants and then ditched their exchanges.
New Mexico set up its own exchange but has relied on HealthCare.gov from the beginning.
As it stands, 12 states and D.C. are maintaining their own portals, but GOP lawmakers say user fees on insurers may not sustain them over the long haul. They also want to recoup federal grant funds from exchanges that dropped faulty contractors or failed altogether.
Rep. Tim Murphy, Pennsylvania Republican, said overall, the federal government doled out $5.5 billion in start-up grants to the states.
“Despite this whopping investment of taxpayer dollars, four states exchanges have been turned entirely over to the federal exchange while countless others are struggling to become self-sustaining,” said Mr. Murphy, who chaired the oversight hearing.
Mr. Slavitt said the administration received money back from Maryland, which fired its first web contractor at a rough first year of signups, and is pursuing more where it can. He contended that all of the states were able to stabilize their systems and enroll people into the new marketplace, leading to a historic drop in America’s uninsured rate.
“That was after a lot of failure, a lot of waste of money,” Mr. Murphy retorted.
Both parties then fell into their usual postures over the 2010 health care law, which Republicans recently moved to repeal through a fast-track budget bill that will meet President Obama’s veto.
Democrats said the GOP was holding the law back, only to turn around a complain about its lackluster performance.
“Some of our colleagues, both here in Congress and around the country, have intentional placed roadblocks to implementation that actually make it harder for their own constituents to access care,” Rep. Diana DeGette, Colorado Democrat, said, citing efforts to hamstring a risk-corridor program that protects insurers against heavy losses in the new marketplace.
Obamacare’s third year of enrollment began Nov. 1 and will last until Jan. 31.
Mr. Slavitt acknowledged that it will be more difficult to this year to enroll Americans who haven’t already taken advantage of the exchanges and income-based tax credits that make premiums more affordable.
CMS is encouraging people to log onto the exchanges by Dec. 15, the deadline to hold coverage in time for the new year, and it’s increasingly pointing to Obamacare’s tax penalty for lacking coverage.
People who go remain uncovered in 2016 must pay the higher of $695 or 2.5 percent of their income above the filing threshold, up from $325 or 2 percent of income in 2015.
Administration officials say uninsured people will not receive extra time to sign up and avoid the penalty after the open enrollment period ends.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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