At most House hearings on Affordable Care Act implementation, Republicans attack the officials in charge of managing ACA programs and Democrats defend the officials.

Republicans did blast Centers for Medicare & Medicaid Services administration of the ACA Consumer Operated and Oriented Plan program and other ACA programs Wednesday, at a hearing in Washington.

Rep. Michelle Lujan Grisham, a Democrat from New Mexico, broke the mold, by telling a witness from the Obama administration, Kevin Counihan, that ACA program managers need to do more to provide for a minimum level of health insurer competition in the Albuquerque area and other areas hit hard by ACA-related issuer shutdowns and service area cuts.

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Counihan is the director of the Center for Consumer Information and Insurance Oversight, the arm of the Centers for Medicare & Medicaid Services that runs the ACA public health insurance exchange system and the CO-OP program. The CO-OP program provided tightly restricted loans for 23 groups that wanted to create nonprofit, member-owned health insurers.

As of Wednesday, only seven of the CO-OPs were still on track to be in business in January 2017, and Counihan said while testifying during the House Oversight health subcommittee hearing, which was streamed live on the Web, that six of the remaining CO-OPs are getting extra attention from program managers.

Lujan Grisham said that she supports the ACA, but that carrier failures and service cuts have left part of her district with just one carrier, and that carrier’s rates could increase more than 80 percent in 2017. She said she has tried repeatedly, without success, to get the Obama administration to help her address the problem.

“I find myself in a very interesting position, where I may disagree with you about the ACA and its impact,” Lujan Grisham told Counihan. “What are we going to do?”

At one point, Counihan said that he knew about the problems that New Mexico was facing and wanted to do more for rural areas.

Lujan Grisham said that Counihan seemed to be unaware that the major coverage supply problem her state is facing is in a city, Albuquerque.

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