Obamacare loomed large Wednesday during a House Democratic hearing meant to focus on “Medicare for all” and other forms of universal health coverage.
Republicans warned that proposals to increase the government’s role in healthcare would have the same disruptions that Obamacare did, but at a larger scale, including forcing people from health insurance plans they might like.
Democrats, on their end, praised Obamacare’s rules obligating insurers to cover people with pre-existing illnesses. They blamed Republicans in Congress and the Trump administration for problems that the market has faced, and appeared to conclude that they would need to shore up or expand Obamacare before pursuing other, more comprehensive measures.
At the conclusion of 4.5 hours of questions in the Ways and Means Committee, the chairman of the committee, Rep. Richard Neal, D-Mass., told Republicans that they had an opportunity to vote for improvements to Obamacare, formally known as the Affordable Care Act. Several provisions have already passed the House floor thanks to Democratic support and others are being considered.
Neal’s office set up the hearing to discuss other ways that lawmakers might help cover the remaining 30 million uninsured living in the U.S. The event was in part to assuage concerns of progressives, who say that the Medicare for All Act should be given attention because it has more than 112 co-sponsors and is backed by Democratic presidential candidates in the Senate, including Sens. Bernie Sanders of Vermont, Elizabeth Warren of Massachusetts, Kirsten Gillibrand of New York, Cory Booker of New Jersey, and Kamala Harris of California.
The bill would enroll everyone living in the U.S. into a government plan and do away with private health insurance coverage.
Democrats remain deeply divided over their next steps on healthcare, though they’ve tried to present themselves publicly as having a unified front over the general goal of achieving universal coverage. Wednesday marked the third hearing this year that has talked about the Medicare for All Act, but, meanwhile, House leadership has moved quickly on passing bills to shore up Obamacare, which have support from the healthcare industry.
Witnesses who testified at the hearing Wednesday said that they saw shoring up Obamacare as a key step to achieving universal healthcare coverage. The Obamacare plans remain prohibitively expensive for millions of people, and proponents of the healthcare law want to see more states unlock its provision to expand the Medicaid program to low-income people.
“I don’t see competition between the Medicare for All idea and the preservation and continuation of the Affordable Care Act en route to doing that,” said Dr. Don Berwick, a supporter of government healthcare who helped to implement Obamacare as the former administrator for the Centers for Medicare and Medicaid Services and is now senior fellow at the Institute for Healthcare Improvement.
Pam MacEwan, CEO for the Washington Health Benefit Exchange, which is the Obamacare marketplace in Washington state, recommended allowing more federal subsidies to go to people who buy their own health insurance and adding a reinsurance fund, which would lower the cost of premiums for enrollees.
Chiquita Brooks-LaSure, managing director at Manatt Health, recommended improving outreach about the plans so that more people enroll. The Trump administration cut outreach from $100 million in former President Barack Obama’s last year to its current $10 million.
At times in the hearing, Democrats also touched on the public option, which would give people the option to buy coverage from the government rather than a private health insurer. Republicans focused much of their time on problems that government plans could cause by limiting access to doctors and hospitals and increasing government spending.
The co-sponsors of the Medicare for All Act were undeterred.
“I support it not because its perfect, not because it doesn’t need further refinement, but because it represents real progress in presenting a bold idea to address the shortcomings in our system,” said Rep. Lloyd Doggett, D-Texas.