By Emily Ethridge, CQ Roll Call
April 10, 2014 -- Health and Human Services (HHS) Secretary Kathleen Sebelius recently said that about 7.5 million people have chosen health plans in the exchanges, and said she did not expect any more delays in the health care law.
Sebelius told the Senate Finance Committee that 400,000 people had signed up in the federal and state exchanges since March 31, and she expects that number to continue to grow. Last week, the administration announced that 7.04 million consumers had applied for health insurance coverage through the exchanges as of March 31, the deadline for open enrollment.
A late surge in sign-ups in the days before the deadline helped pushed the administration above its goal of 7 million. The number has continued to tick up as the administration allows consumers who say they were unable to complete their applications by March 31 to finish the enrollment process. A number of state-run exchanges are also extending their open enrollment periods into April.
Lawmakers, led by new Chairman Ron Wyden, D-Ore,. set a mostly amiable tone at the hearing, focusing questions on the health care law (PL 111-148, PL 111-152) as well as the department's budget request for fiscal 2015. They covered topics ranging from President Barack Obama's commitment to the children's health insurance program to Alzheimer's disease to what HHS is doing to address obesity.
Ranking Republican Orrin G. Hatch of Utah asked Sebelius how many exchange enrollees had their previous insurance plans canceled because they did not meet requirements under the health care law, and how many were previously uninsured.
Sebelius said the administration continues to collect that information from insurers, and will share it with lawmakers once they get it all. She noted that more than 2 million people have signed up for plans since March 15, so the data will take awhile to gather.
"We will be feeding you information as soon as we get it from the companies," she said.
Sebelius also told Hatch that there would be no more delays in the rollout of the health care law. "We do not anticipate at this point, senator, additional delays. Most of the policy issues are out," Sebelius said.
Wyoming Republican Michael B. Enzi asked Sebelius why the next open enrollment period will not begin until Nov. 15, after the midterm elections He asked for assurance that the decision was not made to provide "political cover for vulnerable members."
Sebelius said the date was chosen in collaboration with insurers, who cannot make bids for new plans until they learn the makeup of their current pools of enrollees.
Panel Democrats mostly cheered the law, although Mark Warner, D-Va., said that he and several other Democrats have introduced a series of bills to fix or improve parts of it. He noted his bill (S 2176) that would streamline the reporting requirements for businesses under the law.
New Jersey Democrat Robert Menendez told Sebelius about the extensive backlog of applications in New Jersey's Medicaid department, in part because workers are having to manually input information for new applicants.
Sebelius said that the law's Medicaid expansion served as a "wake-up call" for many state agencies that were not ready to receive automated data. She said HHS is now "ramping up" pressure on states to get their programs ready to send and receive automated data with the federal system.
"We'll look at potentially some administrative reductions in payment if people don't pick up the pace," Sebelius warned. "Because having a backlog that is not being processed in a timely fashion is just keeping too many people from the health care that they are entitled to."
Wyden cheered the recent slowdown in Medicare growth, and asked Sebelius to analyze the reasons behind it. Sebelius said that between 2001 and 2009, Medicare per-capita spending grew at a rate of about 6 percent a year, falling to a rate of 1.6 percent between 2010 and 2012. Medicare actuaries recently adjusted the anticipated growth trend to be -3.4 percent, which Sebelius said was "the lowest growth ever seen in the history of the program." She attributed part of the slowdown to changes made in the health care law.