- 7 minutes ago
- #obamacare
- #senatehearing
- #apt
A heated Senate hearing on the fiscal impact of Obamacare saw sharp exchanges between lawmakers and witnesses over rising healthcare costs, fraudulent Medicaid enrollments, and subsidy expansions. Senator Rick Scott and others pressed experts on what they called “intentional loopholes” that have led to billions in federal overspending, while Democrats defended the program’s coverage protections. The debate highlighted deep divisions over the future of U.S. healthcare policy and the Affordable Care Act’s long-term sustainability.
#obamacare #senatehearing #apt
#obamacare #senatehearing #apt
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00:00Can you talk about what that would mean for you or your family?
00:05Yeah, absolutely. I actually, before the ACA, I remember having meetings with our state chapter
00:11social worker, the Huntington City Society of America social worker, and discussed the pros
00:16and cons of testing and how to go about it. And we looked into options if I did have a positive test
00:24and there was not a single affordable option. In fact, I'm not sure if there were
00:28any options for me for that. Like I said, luckily, I did not test positive for that. However,
00:35it's very important for me to know for the future of my children, that no matter what comes their way,
00:41they will be able to have health coverage. Now, the Trump administration is actually taking some
00:49action on health care. It has taken some unfortunate action, which is to increase the potential
01:06deductibles. It has issued new rules to increase deductibles. How would that kind of rule affect
01:15you, in other words, letting insurers charge higher deductibles as a solution to, quote,
01:23improper enrollments? What would it mean for your family if your deductible were to double next year?
01:29That would be a big no thank you. That is absolutely not help. We do have things come up. We are
01:36a healthy family. We have sports injuries and things like that. So having a high deductible does not help
01:43the situation at all. My time has expired. Okay, some more points of clarification.
01:50The ranking member has a tendency of quoting me out of context. I don't appreciate it. I believe
01:55when I use the term dismantled, I talked about the way Obamacare dismantled the individual markets
02:01and caused, through its faulty design, premiums to skyrocket. When I talked about high risk pools,
02:07I'm sure I always add, they weren't perfect. They would have some modifications to make sure that
02:13people with pre-existing conditions were covered. Every state high risk pool were different. Some
02:18worked better. I'm saying Wisconsin, the way it was set up and what it did, it worked beautifully.
02:24It worked beautifully. Take a look at the successful models. I think they had a great model in Maine,
02:28correct? But anyway, with that, Senator Scott. Thank you, Chairman. So, Ms. Ferdinand, what did
02:37you pay in 2019? What did you pay a month for your health care? I keep asking these numbers. Let's see,
02:452019, what do we pay? I believe, oh boy. 2019, I believe, is our, will you help me? You've got the
02:56numbers, I believe. That was our, before we dropped to a lower tier plan, $1,000 a month, yes. That was a-
03:01What did you pay in 25? This past year, $460 a month.
03:05So why, why should it, why should it go down? Did your income go down? What's that? We selected a
03:12lower tier plan. And then we also have the extended premium tax credit that's helping us too.
03:18Okay. And so if, if the, the Biden COVID era, what would it go to? If those, those were extended,
03:26what would it go to? So our, what would it, well, I'm not, I don't know exactly what that would add
03:31on, but currently this year we have about $800 in assistance from the extended premium tax credit.
03:37So I assume it would help us at least another $200, $300 next year. You're not, you don't make
03:44less than 400% of poverty, right? Your family doesn't? No. No. Okay. All right. Third place. So
03:51Senator Heston said that in New Hampshire, I guess, that a family of two, if they, you know,
03:59they're, if we don't extend this, a family of two, it just skyrocketed, you know, the, the premium.
04:05So what would, what actually would happen if it was a family of, of two in New Hampshire? Do you have
04:10any idea? I don't, aren't they within 400% of, of the, of poverty and wouldn't, so there's almost no
04:17change. So the, the underlying Obamacare subsidies, which the chairman said are permanent and aren't
04:23going away next year, they are very large. They limit the amount of premium that people have to pay
04:28for a plan. So as premiums have skyrocketed over time, the enrollee share has basically remained the
04:35same. Um, the vast majority of enrollees are lower income and they will receive, continue to receive
04:42large subsidies next year. So the vast majority of the premium for the vast majority of enrollees
04:48will be paid by the federal taxpayer. Um, the, uh, most enrollees will pay less than $80 a month
04:56for coverage that costs, you know, up to $1,000 a month, uh, for single coverage because
05:01of the design of the credits. Um, the subsidies in Obamacare only went up to four times the poverty
05:09line. The idea was that coverage, um, uh, when they were trying to limit the cost, um, uh, but those
05:16people didn't need subsidies, um, at that level. The problem with Obamacare is it has so increased
05:22the price of coverage over time, particularly for older, um, couples, that it has led to very high
05:31premiums for them. So they, that, that they do face higher premiums above 400% of poverty line
05:37if the subsidies expire. But it's a very small percentage of the overall Obamacare enrollees
05:43that have that income. But if you're in New Hampshire, I mean, you're making 85,000, you're probably
05:47within 400% of poverty, aren't you? Um, for a couple of two, you're probably just above four, four times
05:54the poverty line. Okay. So your number's not going to change. If you're under 400, um, you will still get
05:59a large subsidy. But it's the people just above 400, they're going to face the largest.
06:03Who, who, who, did the Democrats design it that way?
06:06That was one of the main features of the 2010 law, yes.
06:10Okay. All right. Why would they do that? I mean, I mean, this is their design. They were supposed to,
06:15and I assume they were generous and covered to the people they thought they had to cover.
06:18In 2010, uh, in 2009, President Obama said he would not sign legislation that increased the
06:25deficit by a dime. Now, once the law was signed.
06:28Supposed to save, like, $100 billion? Uh, there were several financing, uh, gimmicks. Um,
06:35there was a student loan takeover, which has clearly cost money. Um, but what Congress has done
06:41is repeal, um, the health insurance tax, um, the Cadillac tax, um, the medical device tax,
06:47the independent payment advisory board. Most of the cost savers in law have been repealed,
06:53which leaves just a giant spending. So what's the deal? They reduced the cost of Obamacare,
06:58didn't they? They wouldn't have, they wouldn't have reduced the revenue without reducing the
07:02cost, would they? So Obamacare is now significantly contributing to federal deficits and these COVID
07:08era credits, the Medicaid expansion because of the bad incentives with states when they're spending
07:13and getting $9 in federal money for every dollar of state funding. Like, Obamacare is significantly
07:19contributing to federal deficits and debt. So, um, Mr. Brangman, can you walk us through the
07:25fiscal impact of erroneous or fraudulent Medicaid enrollment that stems from Obamacare's relaxed
07:30verification standards? I'll just give you some numbers when I was governor. So when I walked in as
07:35governor, January, 2011, um, we, we had a horrible economy. The, um, we, um, so over eight years, I've,
07:44I worked on, we added 1.7 million jobs. Uh, we took the number of people on unemployment from over 900,000
07:51to 61,000 by getting people a job. We reduced the number of people on med, on welfare from over 250,000
07:58to 71,000 by helping people get a job. And I don't know if you know the numbers, but as part of this,
08:03there's no verification, this crappy verification, what, what, what's happened? I know in my, I think
08:09in Florida, doubled Medicaid population doubled, uh, in that timeframe, which you talk about the
08:15fraud fraud, fraud in Medicaid. Sure. There's two different ways that, uh, fraud happens in
08:21Medicaid on the enrollee side. You have somebody who's enrolled, who's not eligible. And there's a
08:27bunch of mechanisms where somebody who's not eligible can be enrolled in Medicaid for a period of
08:31time before they're then disenrolled. But you also had, during the Obama administration,
08:36you took away state's ability to verify income and eligibility more regularly.
08:42Why would, why would they do that? I mean, that doesn't seem to make much sense. That would,
08:45that actually would allow fraud. It would, because you have.
08:48That was intentional? It was. They changed the rules.
08:51It was intentional. They wanted more fraud.
08:52Well, there's a lot of incentive for it because a lot of individuals make more money when they
08:58remain on the program. If it wasn't to increase the fraud,
09:00why would they have done it?
09:04I wonder the same thing.
09:06So can you talk about provider tax, how that, how that is, you know, has cost the federal government
09:11massive amounts of money and basically allowed our states to just completely take advantage of the
09:16federal budget and federal taxpayer.
09:18So the provider tax is probably one of the craziest money laundering schemes sanctioned by the federal
09:23government, uh, for states where states can tax Medicaid managed care plans, or they can tax
09:29Medicaid providers. Those providers pay the tax to the state. And then the state increases the
09:36payments to Medicaid managed care or to providers and draw down federal money.
09:41Do they get the money back?
09:42They do. And sometimes they get back even more than they collect both on the provider side in the
09:47state side, particularly in Medicaid expansion states, because you have that $9 in federal money
09:53for every $1 in state money. So you have these incredibly perverse incentives to launder money
10:01from either Medicaid providers or now local governments to send that money to the state for the state to
10:07draw down additional federal money and then to use the difference for whatever programs they want
10:13and call it general fund money.
10:14Thank you, Mr. Chairman.
10:16Thank you. Okay. More clarification here. We've been hearing premiums double, premiums triple.
10:23First of all, do you, do any of you know of any gross premiums that are doubling or tripling?
10:28Again, I, I put up the national average going about 26%. So what we're talking about is we're talking about net
10:33premiums, correct? Uh, put, put this, uh, chart back up. I want to just show you this. Senator Scott,
10:40and again, trying to use, uh, Ms. Verstegen's example here, just to illustrate, I'm not saying
10:48this is exact, but in terms of the numbers you've given us are this year, you're paying 460 net,
10:54correct? And you got an $800 subsidy. That means your gross premium was $1,026 or $1,260. Okay. So you can
11:05see what the annual amounts in that would be. The other thing, you know, you've been telling us is
11:09you're going to pay about $700 this year if, if the enhanced premiums go away or enhanced subsidies go
11:16away. So again, again, we, we kind of, we looked at a bronze plan. We, you know, it's what's so difficult
11:22about this is the premium rates are all over the board for different ages. And so it's, it's just
11:27hard. So you can only take a look at one example, but I think this is, and I'm really asking, you
11:32know, our witnesses, does this look right to you then? So if, if that's what she paid last year and
11:38she's going to be 700 this year, that means her premium, uh, if it was going to go up 26%, it may
11:43not because Wisconsin is actually less, but somewhere in the $1,500 range, uh, she'd be getting a subsidy
11:49about 888. So more than she got last year. Correct. And on an annual is annualized basis. Last year,
11:56she got almost 10,000. This year she'd get more than 10,000. So what's going up is her net premium.
12:03And I'll keep arguing the reason your net premium is going up is because the gross premium is going up
12:10by a grotesque amount because of all the things we're talking about that there's no incentive for
12:15lowering costs. All the incentive is for insurance companies keep raising their premium and they get
12:21away with it because the federal government's their customer, the federal government and the federal
12:27government's got Democrats. They're just happy to throw hundreds of billions of dollars at the
12:32problem to mask the faulty design of Obamacare. That's what's going on here. So again, both Senator
12:40Scott and I, we are more than happy to work with Democrats to repair the damage of Obamacare,
12:47move to a system that will actually provide incentives. And that's generally through consumerism,
12:52through free market competition. All that's been driven out of healthcare. I mean, one of the things
12:57we talked about with Mr. White was the, the, the reliance on a third party payer system. Again,
13:03we went from, you know, many, many decades ago where patients pay for 80% to now we pay for about
13:1010%. So, so nobody knows about anybody, anything costs and nobody cares other than everybody cares
13:15about their insurance costs. But you know, when you don't care about the gross premium costs,
13:21the federal government is subsidizing you to tune about $10,000 a year. You don't care about that.
13:27You don't care that it's 19,000. You just care about what you're paying. And I understand that
13:31family and families are struggling, but let's, let's at least be honest in terms of what's
13:36happening here. I've got a, got an article just came out today. Again, this is, this is the media
13:41putting pressure, you know, to extend these things because there's a couple, apparently, I'm not sure
13:46this person actually exists, six year old couple making around $85,000 in Barron County could see
13:52premium skyrocket over 800% with an annual increase of $33,000 in costs. And I went, that's just not,
14:01possible. I mean, but it is, that that's, that's what the premium is for a 60 year old couple,
14:09$33,000. Now it's going up that much because they obviously make more than 4% of the poverty line.
14:16And this is a couple, I don't know, you know, we'll, we'll assume one of the reasons they thought
14:22they could retire, because that's, I mean, they're retired. They're having, they don't get through the
14:26employer. So these enhanced subsidies incentivize people to retire early, knowing they weren't going
14:35to have to pay much for healthcare. That they weren't, they weren't looking at the way the
14:39Democrats designed those enhanced premiums to expire. And then they weren't going to be able to
14:44afford the unaffordable Obamacare. But just speak to that, that incentive, because we've heard this
14:50time and time again, and I think it was, you know, Dr. Blaze or Taryn talk about, it's a kind of small
14:56group of people that aren't eligible yet for Medicare, who retired early, relying on those
15:04enhanced subsidies. And when they go away, because they make more than 400% of poverty level, again,
15:09Obamacare was designed not to provide any subsidy, anybody making more than 400% of the poverty level,
15:16which is, I don't have that number, but what is that for a, for, for families, like 20, 123 bucks
15:22a year, isn't it? For an individual is like 60 some? Yeah, 123,000. So if you're making more than
15:28$120,000 under original Obamacare, you didn't get any subsidy under the enhanced subsidies, sky was the
15:34limit, basically. Yeah. I mean, there was a news article a couple of weeks ago about an early retiree
15:38couple. They'd worked in government for 30 years. They had $140,000 pension and they, because of the,
15:46the COVID credits qualify for a $15,000 subsidy now towards their health insurance. There's no
15:51asset test on these, on these subsidies, right? You can have unlimited wealth and qualify these
15:57subsidies. It's based on income. Enormous incentive for, particularly if the enhanced subsidies are
16:03continued for couples to retire early. We're also seeing big incentive for cities and states to dump
16:12their retiree health plans into the exchanges.
16:17So
16:17So
16:22you
16:24you
16:26you
16:28you
16:29you
16:30you
16:32you
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