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November 03, 2015 at 12:29 PM
Republicans and Democrats on the House Ways and Means health subcommittee today made the most of a chance to pin the recent wave of CO-OP carrier failures on each other.
Rep. Kevin Brady, R-Texas, chairman of the subcommittee, organized the hearing to take a look at the poor performance of the Consumer Operated and Oriented Plan (CO-OP) health insurers, a group of companies started with a loan pool created by the Patient Protection and Affordable Care Act of 2010 (PPACA).
See also: Is that CO-OP dead? Or alive but dying?
Dr. Mandy Cohen, the chief operating officer of the Centers for Medicare & Medicaid Services (CMS), was the only witness. She noted that Congress has taken away about two-thirds of the $6 billion in funding that PPACA had originally provided for the program.
CMS ended up approving CO-OP startup applications from just 24 of the 147 applicants, and it has monitored them by coordinating with state insurance regulators, and by conducting regular conference calls, on-site visits in 14 states, and audits, including forensic audits, Cohen said.
Cohen said CMS has tried to act quickly enough to ensure that CO-OPs will be able to meet obligations to pay health care providers for the care delivered to enrollees.
“We wanted to make sure there was not a mid-year failure next year,” Cohen said.
Although a funding shortfall at the PPACA risk corridors program — a program that was supposed to use cash from thriving PPACA exchange plan issuers to help ailing issuers — hurt the CO-OPs, the shortfall was just one of a number of important challenges they have faced, Cohen said. (You can watch the hearing video below.)
