Hearings to examine assessing Obamacare.

Permanent Subcommittee on Investigations

2025-11-06

Summary

This meeting focused on the impact and future of the Affordable Care Act (ACA), particularly concerning healthcare affordability, rising premiums, and the role of government subsidies. Speakers from both sides of the aisle presented contrasting views on the ACA's effectiveness, its contribution to federal deficits, and the urgency of addressing healthcare costs for American families.

Themes

Healthcare Affordability and ACA Subsidies

The affordability of healthcare was a central theme, with significant debate surrounding the enhanced tax credits provided under the ACA. Senator Hassan highlighted that constituents in New Hampshire face doubled or tripled premiums due to the expiration of these tax credits, impacting families with chronic conditions and small business owners. Shana Verstegen shared her family's concern over a potential $2,400 increase in annual premiums, stating that extending the premium tax credits is crucial for their ability to afford coverage. [ 00:11:23 ]

Conversely, Senator Johnson and Brian Blase argued that the core Obamacare subsidies remain, limiting enrollee payments for most, and that the expiring enhanced subsidies were temporary COVID-era measures. They attributed high gross premiums to the "faulty design" of Obamacare, which they believe offers no incentive for lowering costs. Senator Blumenthal underscored that the affordability crisis is immediate, affecting families who must make decisions about their insurance "right now" amidst rising costs for groceries, housing, and electricity.

Effectiveness and Impact of the ACA

There was a stark division on the overall impact of the Affordable Care Act. Senator Ernst called for a robust discussion on the "failures" of Obamacare to find accessible and affordable healthcare choices. [ 00:01:50-00:02:06 ] In contrast, Senator Hassan recounted positive experiences, such as the ACA enabling people with pre-existing conditions to obtain insurance and Medicaid expansion helping chronically ill individuals return to work and private insurance. Ms. Verstegen's testimony supported this, explaining that the ACA provided her the confidence to test for Huntington's disease, overcoming fears about insurability that existed before the law. Senator Johnson, however, asserted that Obamacare dismantled individual markets, caused premiums to skyrocket, and has created many "victims." [ 00:53:18 ]

Senator Blumenthal countered that no individual has been harmed by the ACA itself, only by the prospect of higher premiums if subsidies are not extended.

Fraud and Improper Enrollment

The issue of fraud and improper enrollment within ACA exchanges and Medicaid was raised by some speakers. Brian Blase cited reports on "improper and phantom enrollment" and "zero claim enrollment," noting a significant increase in enrollees who claim no medical services, suggesting potential ineligibility. [ 00:00:27-00:00:33 ] [ 00:45:52-00:45:59 ]

Tarren Bragdon detailed how relaxed verification standards in Medicaid, under the Obama administration, intentionally allowed for more fraud, where ineligible individuals are enrolled and states leverage provider taxes to draw down federal money. Senator Johnson emphasized the existence of such fraud, mentioning "phantom policies" and people making no claims against their policies. [ 00:50:45-00:51:35 ] Senator Blumenthal challenged the validity of these reports, citing analyses that question their methodology, and proposed the "Insurance Fraud Accountability Act" to impose criminal penalties on brokers engaging in deceptive practices. [ 00:53:24-00:53:34 ]

Political Gridlock and Proposed Solutions

The meeting reflected a deep political divide, particularly concerning solutions and the current government shutdown. Senator Ernst and Senator Hassan both urged for reopening the federal government to allow for further discussions on healthcare. [ 00:01:47-00:01:48 ] Democrats insisted on extending the enhanced tax credits as part of reopening the government to address the immediate affordability crisis for millions. Senator Johnson stated his willingness to work with Democrats to "repair the damage of Obamacare" through free-market competition and consumerism, but refused to "throw hundreds of billions of dollars to mask the failure of Obamacare." [ 00:10:51-00:10:57 ]

He demanded an admission that Obamacare is flawed before good-faith negotiations could occur. Senator Blumenthal called for bipartisan reforms, including eliminating abuses in Medicare Advantage and empowering patients to join Medicare, while rejecting the idea of "dismantling Obamacare." [ 00:47:48-00:48:03 ]

Tone of the Meeting

The tone of the meeting was highly partisan and confrontational, reflecting a deep ideological divide on healthcare policy. While some speakers, like Senator Ernst, expressed a desire for bipartisan discussion [ 00:01:50-00:02:06 ] , the exchanges between Republican and Democratic senators were often critical and pointed. Senators Johnson and Blumenthal, in particular, engaged in direct accusations, with Johnson accusing Democrats of being in "denial" about Obamacare's failures [ 00:50:32-00:50:45 ]

and Blumenthal questioning the validity of Republican-cited reports. Personal stories from witnesses like Ms. Verstegen were used by both sides to reinforce their arguments, but ultimately did little to bridge the fundamental disagreements regarding the ACA's efficacy and the path forward. The discussion concluded with little indication of imminent bipartisan cooperation, particularly concerning the expiring subsidies and the government shutdown.

Participants

Transcript

BRIAN BLASE

to advertise things like free gift cards, cash, to get people's information, to sign them up for plans. Bloomberg did a report on this. They quoted a customer service agent who's had half of the people that they were signing up had no idea that they were enrolling in coverage. And the big winners are the health insurance companies. So they're getting monthly checks on behalf of all these enrollees that have no idea that they're signed up for coverage.

Joni Ernst

Right. Thank you. And I do think this is a real issue, and I do hope we can reopen the federal government. I hope Democrats come along with us and vote yes to open the federal government so that we can have further discussions. But I must say to all of my Democratic colleagues, we need to have a robust discussion about what is wrong with Obamacare. If we truly want to find accessible ways to provide healthcare to individuals, affordable choices, then we need to identify all of the failures within this system. So then maybe more people can pursue their dreams. But when it comes down to personal responsibility, You know, my family members have had to make that hard choice to seek employer coverage. It is a personal choice to take care of their own families. And I think personal choices then shouldn't be the obligation of the federal government to find ways to fund access to health care. We all need to figure this out. But, again, I really appreciate the opportunity to have this hearing today, and I hope that, again, we can open the federal government and have real discussions about these very real problems for Americans as they're trying to access healthcare.

Margaret (Maggie) Wood Hassan

Senator Hasen. Thank you, Mr. Chair and Ranking Member Blumenthal. Good afternoon to our witnesses. Thank you so much for being here. I just want to follow up a little bit on what Senator Ernst was just saying because, of course, Democrats and Republicans want to lower the cost of health care. There is bill after bill filed on a bipartisan basis in this chamber that would do that, including approaches to some changes in the Affordable Care Act. I remember, of course, when the Affordable Care Act was passed, when so many of my constituents in New Hampshire with pre-existing conditions could not get health insurance, full stop, impossible to get, where people were making the same kind of choices that Senator Ernst just talked about because they couldn't get individual insurance under any circumstances, so they went and took a full-time job or didn't move to a new opportunity because they would have had to wait for a year to get health insurance in that new job. I remember as governor the difference the Affordable Care Act made and has made with Medicaid expansion when people who were chronically ill and couldn't work and therefore couldn't have insurance got insurance through Medicaid expansion, got their diabetes under control, went back to work and went on to private insurance. That is exactly what the Affordable Care Act has done for tens of thousands of people in my state. And as I hear my colleagues talk, we do need to reopen the government and we need to take care of a mounting crisis for which we have a very small window to solve because There are insurance premium bills hitting my constituents' web pages or mailboxes that show them directly that premiums are skyrocketing in New Hampshire right now, both on the Affordable Care Act and on the private market. Open enrollment on healthcare.gov began on November 1st and I've heard directly from Granite Staters who when they logged on saw that their premiums have doubled or tripled for next year.

Margaret (Maggie) Wood Hassan

These premium increases are being driven by the Republicans' refusal to extend the enhanced tax credits that help Granite Staters afford their health care. This week, I met Nicole, a mom of four in Exeter who is a full-time caregiver for her children, all four of whom have disabilities. Her husband runs his own business. He also has a chronic health condition. So Nicole and her husband get their health insurance on healthcare.gov and their premium is set to triple in January due to the expiration of the enhanced tax credits. Nicole told me that she does not know how her family can pay thousands of dollars more for insurance next year. And I'll also add that Nicole's children with disabilities have been covered by Medicaid. But because of the changes in the great big bill that was passed in July, 50% of America's children are covered either by Medicaid or CHIP insurance. They are now not sure how her children are going to qualify for health care if some of the changes to Medicaid present barriers for that coverage. My office has also heard from Juliana in Sharon, who runs a small business with her husband and counts on healthcare.gov to get health coverage for herself, her husband, and her two children. Juliana is facing a premium increase of $600 per month next year, an increase so large that her family may not be able to afford any insurance at all. These are just two stories from the constituents who have reached out and urged me to protect their health care.

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