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Burwell Defends Obamacare Exchanges

By Erin Mershon and Andrew Siddons, CQ Roll Call 

September 1, 2016 -- Health and Human Services Secretary Sylvia Mathews Burwell said in a Thursday roundtable with reporters that the health exchanges will stabilize in the long term even without congressional action.

She said that legislative fixes "could help speed and change the dynamic" of that stabilization. But she also said "stability exists, even using the administrative tools we have." Federal officials are exerting their regulatory authority during the final year of the Obama administration to shore up the marketplaces as much as possible. Burwell pointed to recent actions like a proposal, released Monday, that would overhaul one of the central mechanisms designed to stabilize risks on the exchanges set up under the 2010 health law.

Insurance giants like Aetna Inc. and UnitedHealth Group have announced dramatic withdrawals from many of the exchanges in which they currently sell plans. Proposals for double-digit premium hikes are also fueling Republican criticism of the law and raising questions about both affordability and sustainability.

Burwell argued that some of the instability could be attributed to insurance companies' figuring out how to set their prices in the new marketplaces. If insurers had set their initial prices higher, as many of the law's architects had expected, the upheaval would be more limited, she said.

"You would most likely be at a higher premium, but we wouldn't be having the conversation we're having," Burwell said.

She also emphasized that while the individual market faces challenges, the vast majority of Americans receiving employer-sponsored insurance, Medicare, or Medicaid are seeing lower-than-expected cost increases.

"The rate increases are something we're obviously concerned about," she said. "But when we have the conversation, it's important to make sure we're talking about health care in the U.S."

Burwell declined to say how many people the administration is hoping to sign up during the 2017 open enrollment period, which begins Nov. 1. She said the administration would be increasing its focus on retention.

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