Van Hollen, Casey, Senate Democrats to Administration: Stop Sabotaging our Health Care System

Congressional Documents & Publications

U.S. Senators Chris Van Hollen (D-MD) and Bob Casey (D-PA), joined by 11 Democratic Senators, demanded that the Trump Administration end its sabotage of the U.S. health care system. In a letter to Secretary of Health and Human Services Tom Price and Director of the Office of Management and Budget Mick Mulvaney, the Senators demanded that the Administration commit to making vital payments to ensure the viability of the health care system and to turn over documents, which the Administration likely possesses, that demonstrate the negative impacts that ending cost-sharing reduction payments would have on the health care system

The Senators wrote, "Instead of committing to making the ACA work, it appears the Administration is considering additional actions that would jeopardize the health and welfare of millions of Americans. One such action reportedly under consideration by the Administration is a decision to stop making cost-sharing reduction payments to insurers, which help them defray the cost of health care insurance for eligible enrollees. Despite health insurers, medical providers, and business leaders stating that continuing cost-sharing reduction payments is key to the success of the health insurance Marketplaces and is the 'most critical action' the Administration could take regarding the ACA, the Administration appears to be considering terminating these payments."

In addition to Senators Van Hollen and Casey, the letter was signed by Senators Tammy Baldwin, Patty Murray, Ron Wyden, Sheldon Whitehouse, Brian Schatz, Richard Blumenthal, Jack Reed, Debbie Stabenow, Elizabeth Warren, Edward J. Markey, Tim Kaine.

The full text of the letter is below:

Dear Secretary Price, Secretary Mnuchin, and Director Mulvaney:

Despite the fact that a majority of Americans support the Affordable Care Act (ACA), last week, you joined Republicans in the House of Representatives in celebration of legislation that will have devastating consequences for the health care that millions of Americans receive. We will continue to oppose this effort, but we remain equally concerned about actions and statements by the Administration to dismantle the law administratively. On April 4, many of us wrote to you about actions the Administration is taking that would undermine coverage for millions of Americans, including the unilateral repeal of ACA regulations by the Administration. In that letter, we called on you to set aside your plans for unraveling the ACA so we could move forward on improving our health care system.

Instead of committing to making the ACA work, it appears the Administration is considering additional actions that would jeopardize the health and welfare of millions of Americans. One such action reportedly under consideration by the Administration is a decision to stop making cost-sharing reduction payments to insurers, which help them defray the cost of health care insurance for eligible enrollees. Despite health insurers, medical providers, and business leaders stating that continuing cost-sharing reduction payments is key to the success of the health insurance Marketplaces and is the "most critical action" the Administration could take regarding the ACA, the Administration appears to be considering terminating these payments.

Over the past month, the Administration has sent conflicting signals about the future of cost-sharing reduction payments. On April 10, the Department of Health and Human Services (HHS) stated that it would continue to make cost-sharing reduction payments. One day later, on April 11, HHS reversed this statement by saying it was still deciding its position on the matter. Recently, it appeared a decision had been made by the Administration to continue making the payments. However, last week, the Administration once again reversed its position and indicated it could terminate the payments as soon as this month. The uncertainty being caused by the Administration's rhetoric is threatening the future of the ACA. Holding the health care of millions of people hostage as a bargaining chip is unacceptable.

These payments play an integral role in making health care affordable for hard-working Americans. Should they stop mid-year, some insurers may stop covering Marketplace enrollees in 2017 to prevent racking up huge financial losses. According to a recent Kaiser Family Foundation analysis, health insurance premiums could increase by nearly 20 percent on average without cost-sharing reduction payments. This would undoubtedly jeopardize the ability of millions of Americans to afford vital health care services.

We call on the Administration to halt efforts to undermine the law and permanently commit to continuing to make these payments. In order to provide transparency to the Administration's intentions regarding cost-sharing reduction payments, as well as the effect stopping these payments would have on the health care of millions of Americans, please provide the following records no later than May 22, 2017:

1. All documents reflecting any analysis conducted by the Office of Management and Budget, the Department of the Treasury, or the Department of Health and Human Services, including its Office of the Assistant Secretary for Financial Resources, Office of the Assistant Secretary for Planning and Evaluation, and Centers for Medicare & Medicaid Services, since January 20, 2017, regarding cost-sharing reduction payments, including the effect that discontinuing cost-sharing reduction payments would have on health insurance premiums, health insurance coverage rates, and/or health insurer participation in the health insurance Marketplaces.

2. All documents and communications between the Department of Health and Human Services and health insurance companies or health insurance policy or advocacy groups, since January 20, 2017, regarding cost-sharing reduction payments, including the effect discontinuing cost-sharing reduction payments would have on health insurance premiums, health insurance coverage rates, and/or health insurer participation in the health insurance Marketplaces.

3. All documents and communications among and/or between the Department of Health and Human Services, including the Office of the Secretary, the Office of the Assistant Secretary for Financial Resources, the Office of the Assistant Secretary for Planning and Evaluation, and the Centers for Medicare & Medicaid Services, the Department of the Treasury, the Department of Justice, and the Executive Office of the President, including the Office of Management and Budget, the Domestic Policy Council, and the National Economic Council, since January 20, 2017, regarding whether to make cost-sharing reductions payments under the Affordable Care Act.