Oversight Committee Hears Problems and Looks for Healthcare Solutions

About 250 people, ranging from Republican stalwarts to supporters of the Affordable Care Act, made the trip to the Hall County Government Center on Monday to watch a congressional field hearing on the effects of Obamacare in rural areas. Congressmen (and coincidentally Senate candidates) Phil Gingrey and Jack Kingston joined three members of the House Oversight and Government Reform Committee, Georgia Reps. Doug Collins and Rob Woodall and North Carolina Rep. Mark Meadows.

They heard from four witnesses — Raymer Sale, the owner of an employee benefits company that sells insurance to small businesses, Dr. Jeff Reinhardt, a clinic owner, small business owner Michael Boyette, and self-employed Emma Collins.

As the hearing got underway, the congressmen and witnesses discussed the familiar litany of issues with the Affordable Care Act, including the false promise that “if you like your doctor, you can keep your doctor,” and “if you like your plan, you can keep your plan.” Mr. Sale noted that of the approximately 140 companies he works with, only four were able to keep grandfathered plans. Mrs. Collins stated that a policy covering her healthy husband and daughter they previously purchased for $265 per month is no longer available, and the replacement ACA-compliant plan would cost almost $900 per month, with a $6,000 deductible per person.

But there were also mentions of new benefits under Obamacare. One of Dr. Reinhart’s employees is battling cancer, and was getting close to the lifetime limit of her old policy. Under Obamacare, she will remain covered. Mrs. Collins, who was previously uninsurable due to a pre-existing condition, will now be able to purchase insurance, although she has not yet shopped for a policy due to concerns over security problems with the healthcare.gov website.

During the second half of the two hour long hearing, the congressmen questioned the witnesses, digging a little deeper into their issues. The congressmen were interested in hearing if there were any possible solutions to the problems caused by the healthcare act.

One of the biggest concerns was the limited number of insurance options available to choose from. Mr. Boyette and Mrs. Collins were happy with the plans they had previously, and didn’t consider them inferior. Congressman Woodall noted that people should have the right–and responsibility–to choose the amount of healthcare coverage they thought was necessary. Another concern was the huge number of regulations that came along with the healthcare act. These regulations, which could change at any time, make it more difficult for employers to comply with the law, and in the case of Mr. Sale’s company, could expose him to legal liability. Regulations and compliance costs, according to Dr. Reinhart, are causing doctors to limit or leave their practices, which will limit available care down the road.

Overall, yesterday’s hearing was not the “partisan tactic … intended only to trash the Affordable Care Act,” as Americans United for Change called it in a press release before the hearing. (And, by the way, their threatened protest did not happen.) The committee members were not only interested in hearing the problems the healthcare law were causing, but were also interested in learning about ways to improve it.

At the hearing, Congressman Woodall noted that if healthcare insurance reform had been divided into smaller bills instead of a 2,600 page omnibus, many of the things people like in the PPACA might have become law without bringing in the provisions that are not popular.

Yesterday’s hearing was one of several being conducted regarding the healthcare law and its effects on Americans. Now the committee and Congress must decide what to do with the information they have gotten. Some Democrats, facing re-election in 2014, are starting to express doubts about Obamacare. It’s too bad that they decided not to attend the hearing. They would have learned why the Affordable Care Act is so unpopular with the people it’s supposed to benefit. And that might have led to working together with Republicans to fashion a better law.

12 comments

  1. Dave Bearse says:

    “At the hearing, Congressman Woodall noted….many of the things people like in the PPACA might have become law without bringing in the provisions that are not popular.”

    Leave to a Congressman to inform us people want want benefits like no lifetime limits or pre-existing condition limitations without them being paid for.

    • DavidTC says:

      Now I wonder how long it’s going to take for people like Woodall to realize that the parts that _aren’t_ popular about the ACA, like the mandate, are required to keep insurance companies from melting down because of the parts that _are_ popular (Basically, everything else.)

      These regulations, which could change at any time, make it more difficult for employers to comply with the law, and in the case of Mr. Sale’s company, could expose him to legal liability.

      Look, it’s time for the parade of stupid people.

      Mr. Sales is an _insurance broker_. He does not create insurance plans. Assuming he’s not some sort of back-alley broker who sells _unlicensed_ insurance in this state, all he has to do to comply with the insurance regulations is to…keep doing exactly what he was before, because, like before, all plans presented to him by insurance companies to sell will be legal.

      Likewise, ‘more difficult for employers to comply with the law’ is just complete nonsense. Yes, there’s a new regulation that companies have to comply with. _One_ new regulation. Namely, that, if over a certain size, they must buy health insurance that is ACA compliant for their employees. Which is, of course, _all_ health insurance. You can’t buy non-compliant group insurance anymore…or, rather, if you can, it’s because it got a waiver and thus it’s perfectly legal for businesses to supply to employees. How the right forgets this at the exact same moment they’re whining about old insurance plans being canceled _for exactly this reason_(1) escapes me.

      This is like trying to complain about how companies have to comply with all the FCC regulations when their employees fly. Uh, while FCC regulations are indeed extremely complicated, no commercial air-traveler has to ‘comply’ with them. They just _buy a ticket on an airline_.

      Likewise, to comply with the ‘regulations’, companies call up BCBS and say ‘I would like to buy group insurance for my company’. Or go on healthcare.gov and say ‘I’m a small business’. The button is right there. And then buy something for their employees. That’s it. That’s the entire extent of the ‘regulations’ they have to comply with. (I guess BCBS could sell them _illegal_ insurance and _lie_ that it’s legal, but I rather suspect that, in those cases, it’s BCBS that would be in trouble, not the defrauded companies.)

      It’s not reasonable to argue ‘You must buy one thing for employees, and here’s a website to let you find people selling it’ is unduly _complicated_ and regulation-prone. You can argue it’s too much of a _burden_, cost-wise (It’s not, but it is at least a sane argument.), but you can’t argue there are too many regulations.

      1) Individual plans, of course, could be grandfathered in. Although insurance companies saw very little reason to, considering the plan-turnover that already existed and the fact modeling both the old and new plans was rather tricky. So they just went ahead and canceled them. Like they do every year. Which everyone thinks the law required, but it really didn’t. However, unconforming _group_ plans really did have to be cancelled (Or a specific waiver gotten)…although, as I said, insurance plans have such rapid turnover that anyone who has a group plan from 2009 should go unicorn hunting.

      • Jon Richards says:

        David, I think it’s more complicated that you say. While I agree that any plans sold my E2E Resources (Mr. Sale’s company) will by definition be compliant, the ACA’s regulations regarding the corporate mandate bring in a whole bunch of reporting and recordkeeping requirements that were not required pre-ACA. Companies now have to keep track of information that will let them prove they complied with regulations regarding providing insurance to all who are eligible, and apparently, according to Mr. Sale’s testimony, they need to provide certain notifications to employees about insurance. If they fail to do that, they are liable for fines and penalties from the IRS. Since E2E no only sells the policies but administers the insurance for its clients, Sale is worried about his liability, from what I understand.

        Disclosure: I know Mr. Sale due to my membership in the Gwinnett Chamber, although I have never used his company or his services.

        • DavidTC says:

          Companies now have to keep track of information that will let them prove they complied with regulations regarding providing insurance to all who are eligible, and apparently, according to Mr. Sale’s testimony, they need to provide certain notifications to employees about insurance. If they fail to do that, they are liable for fines and penalties from the IRS. Since E2E no only sells the policies but administers the insurance for its clients, Sale is worried about his liability, from what I understand.

          LOL. Let’s see if we can figure this out.

          So on addition to being brokers, Mr. Sale’s company is paid to administer insurance for companies. His company is in fact _paid_ to keep abreast of every single policy change of insurance, when people can purchase it, what plans are offering what. This is literally his company’s purpose in life, dealing with the rules and regulations of insurance.

          This is a company that, presumably, in being paid to administer insurance, _regularly_ notified the employees of their clients about all sorts of things, like changes in policies and whatnot.

          He now appears to be worried that his company will…have a slight change in the rules that they are required to keep up with, because he, uh, might have to notify them of the existence of insurance as an option…because, I guess, he didn’t bother to do that before. (?)

          Or he might not document that he did that, because that’s always a great plan for third-parties hired to administer things that are normally internal company stuff. Documenting you did the work you were hired to do is for losers!

          Yeah, I’m sure he’s got some sort of a legitimate worry about this completely trivial notification requirement and this isn’t some sort of political thing. It’s almost as bad as that time the IRS started including a single addition line on the tax forms and the tax-prep industry collapsed, or that time that states starting requiring license plates on the front of cars and the car rental industry almost failed.

  2. Jackster says:

    I was at this hearing, and in between attempting to join Jon richards’ iPhone, I had some thoughts:

    1) Testimony from Dr. Reinhardt and Mr. Sale were infinately valuable. Dr. Reihnardt brought home the point about capacity in a rural setting, how this bill does not actually address access outside of a city, and Mr. Sale brought insight into how businesses will react to being under the law.

    2) When two congressmen running for senate appear before a friendly crowd in a largely republican district, that IS NOT A COINCIDENCE. They were a distraction and took away from the credibility of the witnesses and the hosting congressmen.

    Two options that were not heard or brought forth by the congressmen:

    1) If there are only one or two options for ACA plans for certain areas, then perhaps there should be the option to purchase Medicare as an option, or a cash option, where there is a set cash price.

    2) To bring the costs down and provider numbers up, could there be a waiver to having a dual fee structure for insurance and self pay patients?

    And that’s because you can’t be looking to fix a problem if you aren’t willing to acknowledge all solutions, no matter how much they go against the party line.

    Again, if the two congressmen running for senate weren’t there, I would have hoped there would have been lines of questioning that have to do with solutions on a macro level, not just the ones that line up nicely with Gingrey or Kingston’s campaign messaging.

  3. In a better world, the Senate Republicans would have looked at the 60 vote filibuster, said this thing is going to pass anyway, and said instead of a 60 vote filibuster fight on every vote, let’s compromise, get some of our ideas in here/reduce the scope/cost of some of Obama’s ideas, and have a bill that passes with 80+ votes that everyone can live with.

    Of course, Mitch McConnell said their #1 priority was making Obama a one-termer and you know the rest.

    It’s ridiculous for either side to think they have all the answers and that the other side doesn’t have anything to add. I don’t believe the Democrats thought that – although they weren’t going to make changes for Republicans if the Republicans were just going to end up voting against it anyway (as happened with the stimulus). Whenever you’re passing a big bill, you WANT to have the side that says “we need to do this to help people” as well as the side that says “well what about the costs/is this the best way to do it.”

    I hope that this finally happens. Of course any major change is going to have market distortions and unintended consequences. That’s what happens when you make a big change. Had Republicans passed the Price or Ryan plan instead of the ACA, there would be big changes as well, some planned for (the whole point of reform is that the current system doesn’t work perfectly and needs to be changed, remember) and some unplanned for.

    The press coming out of this event is positive – the sooner the Republicans abandon a repeal only strategy, the better. Republican governors who have expanded Medicaid and Democratic insurance commissioners who have fought back against insurance companies have improved this law for the better in their states. Georgia initially introduced a bill to create its own exchange but then abandoned it because of tea party pressure. Georgia, which has done nothing to improve the implementation of Obamacare is, by definition, getting the worst possible version of it. Hopefully that will change.

    • View from Brookhaven says:

      Kingston apparently gave the slightest indication that he may be willing to work something other than “Repeal Only” yesterday…and naturally Broun and the usual conservative groups pounced and he’s desperately tracking back.

      Amusing.

    • DavidTC says:

      I hope that this finally happens. Of course any major change is going to have market distortions and unintended consequences. That’s what happens when you make a big change. Had Republicans passed the Price or Ryan plan instead of the ACA, there would be big changes as well, some planned for (the whole point of reform is that the current system doesn’t work perfectly and needs to be changed, remember) and some unplanned for.

      People seem to have missed that the Republican plan included removing the federal tax credit for employee-purchased plans. Instead, people would get subsidies to pay for insurance, either via their employer or alone. This would have resulted in young health people leaving employee-based group insurance and getting their own on the individual market, leaving all the older and sicker people (Unable to get insurance on the individual market without a ban on pre-existing conditions) paying more and more and more until the entire plan collapsed.

      In other words, to compare:

      The ACA tries to make the individual market, which _did not_ work for anyone except healthy people, into a bunch of group markets, which would work fine. This admittedly disrupted the individual market for everyone, including the few people that were happy there. This disruption has been pushed front and center by Republicans, ignoring the fact that even people whose insurance has been disrupted can usually find reasonable alternatives.

      But this is absurd hypocrisy, because the Republican’s plan did exactly the opposite…moving health people from the (working) group market into the broken individual market. (Or forced them to stay behind and pay crazy premiums.) Which would have disrupted, and completely broken, the group market that everyone loved!

      Even more people would have lost their plans, and it wouldn’t have been some reasonably healthy 22 year-old on the individual market who hypothetically has to pay slightly more for some other plan (Although this hypothetical becomes less and less likely the more we hear about the actual fact of prices on the exchange.)…it would have been a 55 year-old full-time worker who see their group plan’s premium’s rise as healthy people leave it and literally cannot purchase any other plan.

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