Congress relitigates healthcare reform at oversight hearing

The House Energy and Commerce Committee's first oversight hearing Wednesday on the healthcare reform law's implementation quickly turned into a battle over the law itself.

Republicans grilled administration officials about the more than 900 annual waivers that have been granted to low-cost plans that would not be able to afford $750,000 worth of coverage in 2011 as required by the law. Democrats, meanwhile, said the administration was within its rights because the law grants the Health and Human Services Department (HHS) flexibility.

Testifying were Jay Angoff, who headed the Office of Consumer Information and Insurance Oversight when it was an independent agency of HHS, and Steve Larsen, who took over when the office was downgraded last month to a center within the Medicare agency. The center is in charge overseeing the administration's changes to the private insurance market.

Energy and Commerce ranking member Henry Waxman (D-Calif.) used the hearing to push back against accusations by some Republicans that the administration has used the waivers to reward allies, such as unions. He said information provided by HHS shows that plans serving union members were almost five times as likely to be denied waivers as non-union plans.

"Is political support for the Obama administration a factor in any way for the CCIIO considering an evaluation of applications for waivers?" Waxman asked rhetorically.

"No, not in any way," Larsen answered. "We handle the applications in an unbiased fashion."

Democrats defended the waivers as a bridge to 2014, when the law's subsidies kick in and people will have access to a choice of high-quality health plans. Among the recipients are four states — Florida, Tennessee, New Jersey and Ohio — that were granted waivers of the annual dollar-limit requirements on behalf of issuers of state-mandated low-value policies.

"That's the dilemma," Larsen said. "They're not good coverage. They don't provide comprehensive coverage, but nonetheless, today, until the full reforms of the Affordable Care Act are in, that is an option for people."

But Republicans worried that premiums would be higher and insurance choices fewer by then.

"What happens in 2013 and 2014, when those companies are not able to get waivers?" asked Rep. Marsha Blackburn (R-Tenn.). "What happens when the other mandates of Obamacare are phased in?"

"Waivers," added Rep. Cory Gardner (R-Col.), "postpone reality."

Republicans also scored points when administration officials were unprepared to quantify the negative effects of the law, such as the number of insurers that have stopped offering child-only policies since enactment.

"I would understand it's your job — your office's job — to follow these effects on the insurance industry and the ability for people to have access to healthcare," said Rep. Steve Scalise (R-La.). "I would encourage you to go find out how many there are and find out what needs to be done to unravel it unless you're more concerned about invoking a policy than actually improving access to healthcare."

Republicans also pointed out that the law doesn't explicitly create the center or allow waivers, and demanded to know how the center was being funded.

Larsen said the center has 252 employees and has spent about $33.4 million to date. The healthcare reform law provided $1 billion for implementation.

"The functions that those agencies carry out are authorized in the bill," he said.