Top Trump health official warned against controversial ObamaCare changes in private memo

Top Trump health official warned against controversial ObamaCare changes in private memo
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A top Trump administration health official warned against controversial changes that could undermine ObamaCare in a private memo last year that was released by House Democrats on Friday.

One of the three changes was later finalized by the administration, despite the warning from Centers for Medicare and Medicaid Services Administrator Seema Verma in the memo. And the other two have not yet been proposed but remain under consideration.

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House Democrats said Friday the fact that the administration approved an alteration that could undermine ObamaCare over the objections of one of its own top officials shows that the Trump administration is intent on “sabotage” of the Affordable Care Act.

The August 2018 private memo to Secretary of Health and Human Services (HHS) Alex Azar shows Verma was concerned with keeping ObamaCare markets stable and preventing disruption, but on at least one front was overruled by others in the administration.

The first change was a proposal to alter an index that is used to calculate how much money ObamaCare enrollees get in subsidies to help afford coverage, resulting in cuts.

Verma warned in the memo that the change would cause “coverage losses, further premium increases, and market disruption.”

But the administration went ahead with the change in early 2019 anyway. Administration estimates project that the move will save the government about $1 billion per year in lower subsidy payments, but will result in 70,000 people dropping coverage.

The second change Verma warned against was a proposal to ban “silver-loading,” a workaround that helped prevent premium increases after President TrumpDonald John TrumpMnuchin knocks Greta Thunberg's activism: Study economics and then 'come back' to us The Hill's Morning Report - House prosecutes Trump as 'lawless,' 'corrupt' What to watch for on Day 3 of Senate impeachment trial MORE canceled key ObamaCare payments to insurers in 2017. Verma warned in the memo that ending the practice would cause “significant disruption” and “substantial premium increases.”

The administration has not moved to end the practice since then, but officials have said the idea is under consideration, causing alarm among Democrats about the potential damage to ObamaCare.

The third change Verma warned against was ending automatic reenrollment, whereby ObamaCare enrollees’ coverage is automatically renewed for the next year unless they actively choose to end it or switch plans.

Verma cited estimates showing the move would cause 200,000 people to lose coverage.

That change has also not happened yet, but remains under consideration.

Three House Democratic chairmen, Energy and Commerce Committee Chairman Frank Pallone Jr.Frank Joseph PalloneOvernight Health Care — Presented by That's Medicaid — Deal on surprise medical bills faces obstacles | House GOP unveils rival drug pricing measure ahead of Pelosi vote | Justices to hear case over billions in ObamaCare payments Obstacles remain for deal on surprise medical bills This week: House impeachment inquiry hits crucial stretch MORE (N.J.), Ways and Means Committee Chairman Richard NealRichard Edmund NealKey House committee chairman to meet with Mnuchin on infrastructure next week Coalition of conservative groups to air ads against bipartisan proposal to end 'surprise' medical bills House revives agenda after impeachment storm MORE (Mass.) and Education and Labor Chairman Bobby ScottRobert (Bobby) Cortez ScottHoyer: Democratic chairmen trying to bridge divide on surprise medical bills To support today's students, Congress must strengthen oversight of colleges Democratic lawmaker tears into DeVos: You're 'out to destroy public education' MORE (Va.), wrote to Azar on Thursday demanding more documentation about HHS’s analysis of the possible changes, and calling on Azar not to go through with them.

“We call upon the Administration not to finalize these proposed policies, which the Administration itself admitted would cause chaos in the individual market," the chairmen wrote.

“I can confirm that we have received the letter,” an HHS spokesperson said Friday when asked for comment on the letter and Verma’s memo. “All congressional inquiries are taken seriously by the department and we will respond as appropriate in a timely fashion.”

A spokesperson for Verma referred questions on the memo to HHS.