House Energy and Commerce Subcommittee on Health Hearing State of Uncertainty: Implementation of PPACA's (Patient Protection and Affordable Care Act) Exchanges and Medicaid Expansion.Testimony by Rep. Burgess, Michael - (R-TX)
It has been nearly 1,000 days since President Obama signed the Affordable Care Act into law. However, the Obama administration has still not provided critical information to Congress, the states, or the health plans that they need to begin implementing the health care law's exchanges, Medicaid expansion, or insurance market reforms.
The president's law intends that the exchanges will be ready to begin enrollment by September 30 of next year. In less than ten months the administration states they will have a fully-functioning, technologically-advanced system by which Americans will be able to enroll in an exchange. The administration has yet to explain how it will share information between three different federal agencies involved in determining eligibility for the exchange, how it will distribute the income subsidies to beneficiaries to purchase coverage in the exchange, or how a state will be able to afford the administrative costs to deal with eligibility changes.
While the administration has the ability to push back dates of implementation for federal provisions, states and the plans that are required to meet statutory standards do not have that luxury.
Medicaid accounts for a quarter of most state budgets. Governors cannot be expected to plan for major changes and have legislative authority to prepare unless the administration makes clear the basic ground rules.
There is a lot to be sorted out between now and the end of the year. The uncertain regulatory environment and the overall lack of response from HHS are not encouraging states or plans to move forward in cooperation with HHS. The time is running out. Meanwhile, the future of our health care system only becomes more uncertain.
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