Democrats Raise Concerns About Latest Executive Order Sabotaging Health Care Markets

WASHINGTON, Oct. 31 -- Rep. Frank Pallone Jr., D-N.J., ranking Democratic member of the House Energy and Commerce Committee, issued the following news release:

House Energy and Commerce Ranking Member Frank Pallone, Jr. (NJ-06), House Education and the Workforce Ranking Member Bobby Scott (VA-03), House Ways and Means Ranking Member Richard Neal (MA-01), Senate Health, Education, Labor, and Pensions Ranking Member Patty Murray (D-WA), and Senate Finance Ranking Member Ron Wyden sent a letter (http://democrats-edworkforce.house.gov/download/democrats-raise-concerns-about-latest-executive-order-sabotaging-health-care-markets) to Secretary Alexander Acosta, Secretary Steven Mnuchin, and Acting Secretary Eric Hargan regarding the implementation of the Executive Order entitled, "Promoting Healthcare Choice and Competition across the United States." The five Democratic Committee leaders expressed their concern that implementation could further sabotage access to affordable health coverage and erode consumer protections provided by the Affordable Care Act (ACA).

"The ACA has ensured that those who receive health coverage through the individual and small group markets have access to affordable and comprehensive coverage. This means that plans purchased through the individual and small group markets must have certain protections, including protections for those with pre-existing conditions and the essential health benefits package," the members wrote (http://democrats-edworkforce.house.gov/download/democrats-raise-concerns-about-latest-executive-order-sabotaging-health-care-markets). "Any actions by the Departments to create loopholes and allow the sale of bare bones plans could negatively impact millions of patients and small business owners, as well as their families."

The members warn this Executive Order has the potential to further sabotage the Marketplaces and leave millions of Americans without access to affordable, quality health insurance. Moreover, members reminded the Departments of their obligation to implement laws faithfully and urge the Departments to protect access to affordable health coverage for American families.

The full text of the letter (http://democrats-edworkforce.house.gov/download/democrats-raise-concerns-about-latest-executive-order-sabotaging-health-care-markets) is enclosed below:

Dear Secretary Acosta, Secretary Mnuchin, and Acting Secretary Hargan:

We are writing with regard to the Departments' implementation of the Executive Order entitled, "Promoting Healthcare Choice and Competition across the United States." We are deeply concerned that implementation could further sabotage access to affordable health coverage and erode consumer protections provided by the Affordable Care Act (ACA).

The ACA has ensured that those who receive health coverage through the individual and small group markets have access to affordable and comprehensive coverage. This means that plans purchased through the individual and small group markets must have certain protections, including protections for those with pre-existing conditions and the essential health benefits package. Any actions by the Departments to create loopholes and allow the sale of bare bones plans could negatively impact millions of patients and small business owners, as well as their families.

The proposal to expand association health plans (AHPs), as included in the Executive Order, is not a new idea. There is substantial evidence that coverage sold through an unregulated association health plan could erode the ACA's current protections for small employers and destabilize markets. Exempting association health plans from the consumer protections in the ACA, such as the essential health benefits standard and the prohibition on rating based on health status, would amount to sanctioned discrimination, allowing association health plans to "cherry pick" only the healthiest and lowest-cost consumers. Younger, healthier individuals who move to less regulated or unregulated AHPs would see skimpy coverage and be left without important consumer protections. Older, sicker individuals who would remain in non-AHP plans would face skyrocketing premiums and struggle to afford coverage. When the House considered legislation expanding association health plans earlier this year, the National Association of Insurance Commissioners asserted that AHP-type entities have "done more harm than good to small businesses" and that "...rehashing strategies that have failed would not be a step forward." Upon announcement of the Executive Order, a coalition of 18 patient groups expressed similar concerns, stating that "this order has the potential to price millions of people with pre-existing conditions and serious illnesses out of the individual insurance market and put millions more at risk through the sale of insurance plans that won't cover all the services patients want to stay healthy or the critical care they need when they get sick."

Similarly, expanding the allowable duration of short-term medical insurance would further disrupt the market and undermine the ACA's protections. These plans come with high out-of-pocket costs and limited benefits and are designed as a temporary safety net until individuals can access quality coverage. Encouraging their increased use in lieu of a comprehensive policy will leave young, healthy enrollees without coverage for preventive care, mental health services, or pre-existing conditions and force older, sicker individuals purchasing traditional coverage to pay higher premiums.

We are deeply concerned about the constant administrative actions to undermine the ACA, which remains the law of the land. The Trump Administration has already cut open enrollment by one-half, slashed funding to help individuals and families sign up for health care coverage through the Marketplaces, and now has indicated that it will no longer fund cost-sharing reduction subsidies that keep insurance affordable for millions of families. This Executive Order is another tactic in the broader strategy to undermine the progress of ACA, and with that, undermine the health of this country.

In short, this Executive Order has the potential to further sabotage the Marketplaces and leave millions of families without access to affordable, quality health insurance. We remind the Departments of their obligation to implement laws faithfully and urge your Departments to protect access to affordable health coverage for all.

Sincerely,

Bobby Scott (VA-03), Ranking Member, House Committee on Education and the Workforce

Frank Pallone (NJ-06), Ranking Member, House Committee on Energy and Commerce

Richard Neal (MA-01), Ranking Member, House Committee on Ways and Means

Patty Murray (D-WA), Ranking Member, Senate Committee on Health, Education, Labor, and Pensions

Ron Wyden (D-OR), Ranking Member Senate Committee on Finance