House Democratic leaders have revealed that Seema Verma, the Trump administration official directly in charge of overseeing Affordable Care Act rules and programs, is trying to help people with ACA public exchange plan coverage keep their coverage.
Verma — President Donald Trump’s administrator of the Centers for Medicare and Medicaid Services (CMS) — predicted in August that some ACA public exchange program changes proposed by other administration officials could cut exchange plan enrollment by about 1 million in 2020 and later years.
She recommended that the administration stick with the 2019 exchange program rules, to help people stay covered.
Adopting the changes proposed for 2020 could hurt middle-income consumers, who have to pay the full retail price for exchange coverage; “undermine the limited progress made thus far in stabilizing the market; and set back the Administration’s priorities of devolving power to states, increasing affordability, and expanding consumer choice in health insurance coverage,” Verma wrote in the memo.
She wrote that some of the health system changes the administration has adopted or proposed, such as giving states more flexibility to change ACA rules and programs for their residents, depend on consumers having access to a stable individual health insurance market.
The Trump administration is still considering two of the proposed changes and has adopted one.
Three House leaders — House Energy and Commerce Chairman Frank Pallone Jr.; House Ways and Means Chairman Richard Neal; and House Education and Labor Chairman Bobby Scott — included a copy of Verma’s memo in a letter sent to Alex Azar II, the secretary of the U.S. Department of Health and Human Services (HHS).
The lawmakers say they found Verma’s memo when they asked HHS for materials related to the position of HHS on a federal suit that could give the U.S. Supreme Court a chance to strike down all of the Affordable Care Act.
CMS officials were not immediately available to comment on the lawmakers’ letter.
The Proposed Changes
The changes under consideration in August 2018 were:
1. Ending ‘silver loading’: The ACA public exchange system was originally supposed to pay insurers extra cash to help insurers reduce deductibles, co-payments and coinsurance amounts for low-income exchange plan users. ACA opponents in Congress cut off funding for the “cost-sharing reduction” program subsidy payments to insurers.