Senate Finance Committee holds hearing on health insurance coverage

The Senate Finance Committee held a hearing on October 20 titled “Health Insurance Coverage in America: Current and Future Role of Federal Programs”. The hearing brought together a panel of witnesses including Senators Raphael Warnock (D-Ga.) And Rick Scott (R-Fla.) As well as several leaders of think tanks and advocacy organizations.

President Ron Wyden (D-Ore.) opened the hearing emphasizing the importance of insurance in promoting health care as a human right. He described Senate Democrats’ plans to increase access to coverage and close the coverage gap, noting that they are “on the verge of pushing through major legislation that will transform U.S. health care, helping consumers to be shot at the drugstore window, promoting innovation, and providing quality and cost-effective home and community services to the elderly and people with disabilities.

Wyden also said Democrats’ proposals to expand coverage would not impact the solvency of the Medicare trust fund. He, however, acknowledged his concerns about the trust fund’s impending solvency, saying that “strengthening the Medicare hospital insurance trust fund should be a bipartisan proposal to ensure that older people continue to receive the benefits they want. have won ”.

Ranking Member Mike Crapo (R-Idaho) focused his opening statement on Medicare Part D and Medicare Advantage – calling their success “unprecedented” and suggesting that future health system reforms should “build on what works within our current system”. Crapo also highlighted bipartisan support to accelerate Medicare coverage for advanced devices, avoid a telehealth access cliff, and cap direct spending under Part D.

Witnesses discussed extensively what could be done to improve access to health care. Warnock told the story of a Georgian woman who was not eligible for Medicaid and who delayed seeking treatment for an illness that ultimately claimed her life. “There are real consequences for real people when we don’t do what we were sent here to do,” he said. In his opening statement, Scott stressed that he believes greater federal control is “never the answer” and hailed price transparency as essential to improving the health care system.

Sara R. Collins, PhD, Vice President of Health Care Coverage and Access at the Commonwealth Fund noted that the Affordable Care Act (ACA, PL 111-148) “Extensions of coverage, market rules against underwriting and mandates for employers to provide coverage have enabled millions of people before [uninsured] people to be covered with comprehensive and affordable coverage, ”but said more needs to be done. She highlighted several proposals to expand coverage and increase access, including correcting the ‘family problem’, creating the temporary US bailout law of 2021 (PL 117-2) permanent grant credits, ruling over deductibles and reimbursable fees, and developing an automatic enrollment mechanism to ensure that people “enroll and remain enrolled in full coverage”.

Wyden asked Collins if a public option or additional Medicare Part B benefits would have a negative impact on the Medicare Part A trust fund. Collins replied that there would be no negative impact since these additional benefits would be financed from other sources of income. She said the ACA actually extended the trust fund’s solvency and increased payroll taxes. Wyden concluded the exchange by suggesting that he and Crapo team up to settle the credit issue, as they did with prescription drug pricing.

Douglas Holtz-Eakin, PhD, president of the vaunted American Action Forum the successes of Medicare Part D and Medicare Advantage, indicating that the programs are working well but could be even better with some reforms. For example, Holtz-Eakin suggested that “restructuring the design of Medicare Part D benefits in a way that realigns the incentives away from expensive, high-discount drugs may be the best option to reduce overall program costs as well as costs. drug prices in other parts of the market. In an exchange with Crapo, Holtz-Eakin expanded on this point, stressing that the Part D reforms would be a “great starting point” and “very bipartisan”.

Senator Elizabeth Warren (D-Mass.) Closed the hearing by highlighting the potential positive impacts of the Build Back Better Act (RH 5376) could have on increasing access to coverage. She said the Build Back Better Act presents a “historic opportunity to make a real difference in people’s lives and we should be doing it.”


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Justin D. O'Neill

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