[House Hearing, 114 Congress]
[From the U.S. Government Publishing Office]
FROM HEALTH CARE ENROLLMENT TO TAX
FILING: A PPACA UPDATE
=======================================================================
HEARING
BEFORE THE
SUBCOMMITTEE ON HEALTH CARE,
BENEFITS AND ADMINISTRATIVE RULES
OF THE
COMMITTEE ON OVERSIGHT
AND GOVERNMENT REFORM
HOUSE OF REPRESENTATIVES
ONE HUNDRED FOURTEENTH CONGRESS
FIRST SESSION
__________
FEBRUARY 26, 2015
__________
Serial No. 114-6
__________
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COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM
JASON CHAFFETZ, Utah, Chairman
JOHN L. MICA, Florida ELIJAH E. CUMMINGS, Maryland,
MICHAEL R. TURNER, Ohio Ranking Minority Member
JOHN J. DUNCAN, JR., Tennessee CAROLYN B. MALONEY, New York
JIM JORDAN, Ohio ELEANOR HOLMES NORTON, District of
TIM WALBERG, Michigan Columbia
JUSTIN AMASH, Michigan WM. LACY CLAY, Missouri
PAUL A. GOSAR, Arizona STEPHEN F. LYNCH, Massachusetts
SCOTT DesJARLAIS, Tennessee JIM COOPER, Tennessee
TREY GOWDY, South Carolina GERALD E. CONNOLLY, Virginia
BLAKE FARENTHOLD, Texas MATT CARTWRIGHT, Pennsylvania
CYNTHIA M. LUMMIS, Wyoming TAMMY DUCKWORTH, Illinois
THOMAS MASSIE, Kentucky ROBIN L. KELLY, Illinois
MARK MEADOWS, North Carolina BRENDA L. LAWRENCE, Michigan
RON DeSANTIS, Florida TED LIEU, California
MICK MULVANEY, South Carolina BONNIE WATSON COLEMAN, New Jersey
KEN BUCK, Colorado STACEY E. PLASKETT, Virgin Islands
MARK WALKER, North Carolina MARK DeSAULNIER, California
ROD BLUM, Iowa BRENDAN F. BOYLE, Pennsylvania
JODY B. HICE, Georgia PETER WELCH, Vermont
STEVE RUSSELL, Oklahoma MICHELLE LUJAN GRISHAM, New Mexico
EARL L. ``BUDDY'' CARTER, Georgia
GLENN GROTHMAN, Wisconsin
WILL HURD, Texas
GARY J. PALMER, Alabama
Sean McLaughlin, Staff Director
David Rapallo, Minority Staff Director
Subcommittee on Health Care, Benefits & Administrative Rules
JIM JORDAN, Ohio, Chairman
TIM WALBERG, Michigan MATT CARTWRIGHT, Pennsylvania,
SCOTT DesJARLAIS, Tennessee Ranking Member
TREY GOWDY, South Carolina ELEANOR HOLMES NORTON, Distict of
CYNTHIA M. LUMMIS, Wyoming Columbia
MARK MEADOWS, North Carolina BONNIE WATSON COLEMAN, New Jersey
RON DeSANTIS, Florida MARK DeSAULNIER, California
MICK MULVANEY, South Carolina, Vice BRENDAN F. BOYLE, Pennsylvania
Chair JIM COOPER, Tennessee
MARK WALKER, North Carolina MICHELLE LUJAN GRISHAM, New Mexico
JODY B, HICE, Georgia Vacancy
EARL L. ``BUDDY'' CARTER, Georgia
Sean Hayes, Staff Director
Sarah Vance, Clerk
C O N T E N T S
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Page
Hearing held on February 26, 2015................................ 1
WITNESS
Mr. Kevin Counihan, Director and Marketplace Chief Executive
Officer, Center for Consumer Information and Insurance
Oversight, Centers for Medicare and Medicaid Services, U.S.
Department of Health and Human Services
Written Statement............................................ 4
Oral Statement............................................... 6
FROM HEALTH CARE ENROLLMENT TO TAX FILING: A PPACA UPDATE
----------
Thursday, February 26, 2015,
House of Representatives
Subcommittee on Health Care, Benefits, and
Administrative Rules,
Committee on Oversight and Government Reform,
Washington, DC.
The subcommittee met, pursuant to notice, at 10 a.m., in
room 2154, Rayburn House Office Building, Hon. Jim Jordan
(chairman of the subcommittee) presiding.
Present: Representatives Jordan, DesJarlais, Meadows,
DeSantis, Mulvaney, Walker, Hice, Carter, Cartwright, and
DeSaulnier.
Also present: Representatives Cummings, Connolly, and Lujan
Grisham.
Mr. Jordan. The subcommittee will come to order.
We are pleased to have Mr. Counihan here today, who is the
Director and CEO of Marketplace and Exchanges. We are glad to
have you here, but we are disappointed that much of the
information that the committee has been requesting, primarily
through Congressman Meadows office, has yet to be provided to
the committee. So, Mr. Counihan, you are going to get some
questions about that.
Beginning on December 8th of last year, Chairman Meadows
staff started requesting detailed information on Obama Care
enrollment. The Administration's response to this basic data
request has been nothing short of ridiculous.
We met with Mr. Counihan on January 9th. He told us
repeatedly that he wanted to make sure we got the information
we requested. Of course, it is not a surprise that last night
the Administration came out with another enrollment update. So
we hope the witness today answers some basic questions, like
how many people were automatically enrolled in their health
care plan; how many Americans actively use the health care law
and how many are now passive participants in what the law
forces them to do; how many of them were automatically enrolled
in another plan; and a host of other questions we hope to get
answered.
Of those who automatically enrolled, did CMS place people
in new plans if their old plans were no longer available? Who
made that decision? How was the new plan chosen? Was any
analysis done of whether these new plans had different
benefits? Was any analysis done of whether an individual would
need to see a different doctor?
We are still seeing problems with Healthcare.gov. Last week
the Administration announced the Website had generated 800,000
incorrect information to Americans, and obviously that will
impact their tax status. That is nearly 10 percent of the
people who used Healthcare.gov received incorrect data and
incorrect information.
And for the 50,000 people who already filed their taxes,
the IRS just said last week, don t worry about it. This is
outrageous considering how often the IRS has bemoaned their
budget and inability to collect tax dollars.
Finally, since the President's immigration announcement, we
have learned that illegal immigrants can now potentially obtain
tax refunds they are not entitled to, and maybe even
potentially participate in our election process.
So those are the questions, too, we want to ask Mr.
Counihan today. So we view this as an important hearing. We are
pleased to have you here and we are hopeful you will answer
some of the questions that we have been trying to get answers
to for now over 3 months.
With that, I would yield to the ranking member, the
gentleman from Pennsylvania, for an opening Statement, and then
we will get right to Mr. Counihan s testimony.
Mr. Cartwright. Thank you, Mr. Chairman, for holding today
s hearing.
I would like to welcome our witness today, Mr. Counihan. I
thank you for appearing before our subcommittee.
There is good news and bad news about the ACA. I know my
colleagues are adept at sharing all the bad news about the ACA,
but I want to highlight some of the good news, if I may.
The 2015 open enrollment period was a success, with a
record 11.4 million Americans selecting marketplace plans or
automatically re-enrolling in quality affordable coverage as of
February 15. In my home State of Pennsylvania, 471,930 people
selected a plan or were automatically re-enrolled by the end of
the most recent open enrollment period.
These strong open enrollment numbers, both across the
Country and in my home State, show that the ACA seems to be
working and continues to benefit millions of Americans.
Insurance companies are joining the marketplace in significant
numbers, offering greater plan choice to consumers. There are
over 25 percent more insurers participating in the marketplace
in 2015 than there were in 2014. Ninety-one percent of
consumers can now choose to purchase plans from three or more
insurers, up from 74 percent in 2014. And consumers are able to
pick from an average of 40 health plans for 2015 coverage.
I also want to say the ACA appears to be helping to reduce
premium cost increases in the individual market. In 2015,
premiums for the benchmark, or, that is, the second lowest
cost, Silver plan, will increase by only 2 percent, of course,
far below the historic trend of double digit premium increases
that we all endured throughout the last 15 years or so.
Since ACA open enrollment started in 2013, Medicaid and the
Children's Health Insurance Program enrollment has increased by
10.1 million. The ACA has also reduced the number of uninsured
people across our Country. Because of this law, we have seen
the largest decline in the uninsured rate since the early
1970's, and people who care about keeping hospitals open in
your communities will want to note that. The lower the rate of
uninsured, the healthier our hospitals will be.
According to the CBO, the Congressional Budget Office, the
combined effect of the ACA coverage expansions has been to
extend coverage to 12 million previously uninsured in 2014. In
2015, CBO estimates that 19 million uninsured Americans will be
covered. Thanks to the ACA, millions of young adults, many of
whom might have otherwise been uninsured, have been able to
stay on their parents health plan, 129 million Americans with
pre-existing conditions can no longer be denied coverage or
charged higher premiums, and more than 100 million individuals
no longer have an annual or life-time limit on their coverage,
providing the kind of peace of mind that they will not go
bankrupt if diagnosed with cancer or some other kind of serious
illness.
On February 20, CMS announced an additional special
enrollment period, from March 15, 2015 through April 30, 2015,
for taxpayers affected by the individual shared responsibility
payment. I am pleased that CMS is taking additional steps to
help those individuals who were unaware of the penalty for not
having coverage.
Now, earlier this month, House Republicans voted for the
fifty-sixth time to repeal or weaken the ACA. But they have yet
to offer concrete legislation that would serve as an
alternative to the consumer protections and cost savings
reforms that the law has already brought to millions of
Americans.
The evidence is clear. The ACA is improving the lives of
Americans nationwide as a whole, including the constituents of
all of the members of this subcommittee who are already
receiving important benefits under the law. It is time for us
all to stop these constant attacks and focus instead on working
together more effectively and efficiently to implement this new
American law.
I thank the chairman again and look forward to this hearing
and our witness's testimony.
Mr. Jordan. I thank the gentleman from Pennsylvania. I
would just point out that they are not attacks, it is facts.
Eight hundred thousand people got notices that were inaccurate.
People are being automatically re-enrolled in plans that they
didn't opt into and may be different from the ones that
currently exist. And that is the information we are trying to
get at. It would be nice if we had some cooperation from Mr.
Counihan and his folks.
Without objection, the chair is authorized to declare a
recess at any time, and we will hold open for five legislative
days the record for any members who would like to submit a
written Statement.
I am pleased to welcome our witness today, Mr. Kevin
Counihan, who is the Director of Marketplace, Chief Executive
Officer of the Center for Consumer Information and Insurance
Oversight, the Centers for Medicaid and Medicare Services.
Pursuant to all rules, we swear in our witnesses, so if you
would please stand, Mr. Counihan, raise your right hand. Do you
solemnly swear or affirm that the testimony you are about to
give will be the truth, the whole truth, and nothing but the
truth, so help you, God?
[Witness responds in the affirmative.]
Mr. Jordan. Let the record show that the witness answered
in the affirmative.
With that, you are recognized for 5 minutes. We have your
written Statement, so every member has that, Mr. Counihan, but
you have 5 minutes now for an oral Statement, then we will get
right to questions. So the floor is yours.
WITNESS STATEMENT
STATEMENT OF KEVIN COUNIHAN
Mr. Counihan. Good morning, Chairman Jordan, Ranking Member
Cartwright, and members of the committee. It is an honor to
appear here today to answer your questions about CMSs
continuing efforts to provide affordable, high-quality health
care to the Americans we serve.
I joined CMS last September as CEO of the Health Insurance
Marketplace after 30 years of experience in the health care
industry. I worked in senior roles at three private health
insurance companies. I was president of a health insurance
exchange and most recently was CEO of AccessHealthCT, the State
of Connecticut s health insurance exchange.
I am pleased that the Affordable Care Act is making a real
difference in the lives of consumers. Since the open enrollment
period began last year, November 15th through February 15th,
about 11.4 million Americans selected a plan or were
automatically re-enrolled in States using Healthcare.gov or
through State Marketplaces.
Yesterday we provided updated data on plan selections in
States using the Federal facilitated Marketplace which shows
that approximately 8.84 million consumers who selected a plan
or who were automatically re-enrolled through the
Healthcare.gov platform. The number of uninsured in the United
States fell by an estimated 10 million since the start of open
enrollment in 2013. The Nation's uninsured rate is now at or
near the lowest level recorded in five decades of data.
CMS is constantly working to increase value to consumers by
providing more affordable choices and improving the customer
experience. We added 25 percent more issuers participating in
the Marketplace in 2015; provided consumers with an average of
40 health plans to choose from, up from 30 last year. About 8
in 10 consumers in the 37 States using Healthcare.gov received,
on average, a $268 monthly tax credit.
Over the last several years, CMS has been working with the
IRS to plan for tax season and to provide outreach and
education on the new tax filing requirements to individuals and
tax filing preparers. About three-quarters of tax filers simply
need to check a box to show that they had health coverage for
all of 2014. The remaining taxpayers will need to take
different steps, like claiming an exemption if they could not
afford insurance, or paying a fee if they could but chose not
to get covered.
Those with the Marketplace coverage are receiving new forms
in the mail from the Marketplace, Form 1095-A, used to
reconcile their up-front financial assistance. This is the
first time Americans will be working through this new process,
and we are prepared for the inevitable challenges. While the
vast majority of consumers received correct 1095-A forms, some
received a form that contained an incorrect calculation. This
affects less than 1 percent of all tax filers and is being
fixed so that, beginning next week, those consumers can access
a new tax form. We conducted a robust outreach effort to give
consumers information needed.
The Administration is committed to providing the
information and tools tax filers need to understand the new
requirements. Individuals who cannot afford coverage or who
meet other conditions may receive an exemption from the shared
responsibility payment.
We recently launched a tool on Healthcare.gov to help
consumers who did not have insurance last year determine if
they qualified for an exemption. This tool will help consumers
determine which exemptions they may be eligible for and how to
apply for exemptions, whether through the Marketplace or
through their tax return.
CMS is also providing a special enrollment period in States
which use the federally facilitated Marketplace for individuals
and families who did not have health coverage in 2014 and are
subject to the fee when they file their 2014 taxes. The special
enrollment period for March 15th to April 30th will allow
individuals and families to buy coverage through the
Marketplace.
As I mentioned, having been involved in both the State
exchange and private exchanges prior to coming to Washington, I
have seen how powerful the private sector companies can be in
competing for consumers business. I have learned from my
experiences that communication and collaboration is key. If
anyone has suggestions on how to improve our systems and our
programs, I would appreciate hearing from you personally, and I
look forward to working with you.
We are proud of what we have accomplished so far and the
difference the high-quality, affordable health care coverage is
making in the lives of people throughout the Country. Thank you
for your time, and I look forward to your questions.
[Prepared Statement of Mr. Counihan follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
Mr. Jordan. Thank you.
The gentleman from North Carolina, Mr. Meadows, is
recognized for 5 minutes.
Mr. Meadows. Thank you, Mr. Chairman.
Thank you for your opening Statement. You are gifted with
your words. I guess my concern, and you know that I have a
concern, and I am going to share this with the ranking member,
Mr. Cartwright, because even though we are on different sides
of the aisle, we believe that this should not be political.
Indeed, I met with you personally, told you I didn't want it to
be political; I wanted to get the information.
So I guess my question is why do we still not have the
information we requested after 23 emails, seven phone calls,
one personal meeting, countless other indirect contacts that we
have had, two text messages? I have been reaching out for over
70 days. And it is real simple: we haven't gotten the
information that you have had. So you have been working through
the information, so you have not had the re-enrollment numbers
in order to comply, is that correct?
Mr. Counihan. That is correct. I will wait until you are
done.
Mr. Meadows. No, that is the question. You are under oath.
So you have not had the re-enrollment numbers that I have
requested multiple times?
Mr. Counihan. What is critical, Congressman, is that the
information that we provide you, or anyone on this committee,
be accurate, be verified, be validated, and make sure that it
is correct before submitting to you.
Mr. Meadows. So is it your testimony here today that you
have not had those numbers until today? Or yesterday.
Mr. Counihan. Correct. You and I spoke yesterday and I gave
you numbers over the phone, and that is correct. We have
numbers, but they are not verified, fully validated, fully
vetted that I would give to you.
Mr. Meadows. Well, why would you not give me numbers, as I
have requested them 23 times? Why would you not give me
numbers? Because then I made a simple request. I said just send
me the batch information. I had to go through and dig through
this and just ask for the batch information that you were
giving to other insurance companies. Why did you not give me
that?
Mr. Counihan. Can I respond? I feel a personal
accountability in responding to you. I think you know that; you
and I have talked. I am committing to giving you information
that----
Mr. Meadows. Why do we have to have a hearing in order for
me to get a phone call the day before to get partial, it is not
even all the information; I only got a little bit of it. So why
would we have to wait that long?
Mr. Counihan. Congressman, as I said, I am very committed
to getting the information, but it has to be accurate. It has
to be tested.
Mr. Meadows. All right, so let me ask you this.
Mr. Counihan. It has to be one that stands up because, if
it is not, that creates a different problem.
Mr. Meadows. All right, so let me ask you a more difficult
question, then. If indeed you were afraid to give me those
numbers because you indeed say you didn't have them, and that
you were verifying the numbers and that you were concerned that
they were not accurate, did you give re-enrollment numbers to
anybody else outside of CMS? And be careful, because you are
under oath.
Mr. Counihan. I understand that. What I am committing to
you, Congressman, is that any information that I give you to a
request----
Mr. Meadows. That is not my question.
Mr. Counihan [continuing]. Is verified and validated.
Mr. Meadows. That may be a good answer to a question I
didn't ask. Did you provide it to anybody outside of CMS?
Mr. Counihan. I am giving you information, Congressman,
that is verified and validated. I have enormous respect for
you. I understand your goals and I appreciate what you are
trying to do.
Mr. Meadows. So yes or no?
Mr. Counihan. I am telling you, Congressman, that no
information I am giving to you is not going to be fully vetted
and fully verified.
Mr. Meadows. That is not my question. Are you going to
answer the question? Did you give it to anybody outside of CMS?
Mr. Counihan. I am repeating my answer, Congressman, with
deepest respect. I am giving you information when it is
verified and fully validated.
Mr. Meadows. All right, well, let me finish it. I have
information that would suggest that you gave it to other people
out of CMS. Yes or no, is that accurate?
Mr. Counihan. Congressman, I am not familiar with the
information that you may have, but----
Mr. Meadows. Did you not send re-enrollment numbers, did
you not send re-enrollment numbers to health care providers on
December 18th? Did you not send that to them?
Mr. Counihan. Congressman, I have to go back and check
correspondence from December 18th. I do not have recollection
about that.
Mr. Meadows. All right. Did you give re-enrollment numbers
to the White House?
Mr. Counihan. Congressman, I have to go back and check
this. I am not----
Mr. Meadows. You know what, Mr. Counihan?
Mr. Counihan. I am not familiar with this.
Mr. Meadows. Let me just tell you, and I will conclude with
this Statement, I guess. Either CMS intentionally gave
misleading information to insurers, insurance companies across
the Country on December 18th or you lied to me and said that
you didn't have it. Which is it? Either you intentionally
misled them, because they got it, or you lied to me. Which is
it?
Mr. Counihan. Congressman, I have to check the facts of
what you are alleging.
Mr. Meadows. Well, you have counsel behind you. She shows
up at every one of these meetings. Ask her to check on it while
you are here and we would love to hear your answer.
I yield back.
Mr. Counihan. Congressman--OK.
Mr. Mulvaney [presiding]. The gentleman s time is expired.
Now recognize the gentleman from Pennsylvania for 5
minutes, the ranking member.
Mr. Cartwright. Thank you, Mr. Chairman.
Well, Mr. Counihan, I want to say, at the outset, that Mr.
Meadows and I agree on a great many things here in the U.S.
House of Representatives, and one of them is that we want
transparency and accountability in the Government; that is why
we have put in to serve on this here committee, because this is
a committee that is charged with the responsibility of
ferreting out problems in the Government. And we want to see
that when somebody on the committee, particularly Mr. Meadows,
when he calls you, you call back. Has that been happening; when
he calls you, do you call back?
Mr. Counihan. I believe it has been happening. We had a
conversation yesterday as a followup to a conversation that we
have been having since December. I value Congressman Meadows
quite a bit.
Mr. Cartwright. And I want to also say for the record if
Mr. Meadows is having a hard time getting ahold of you, I want
him to call me and I will help him get ahold of you.
Mr. Meadows. Would the gentleman yield?
Mr. Cartwright. I certainly will.
Mr. Meadows. I would be glad to give you a timeline. We
will share it with you and I will let you make your own
decision on whether he has been responsive or not. I sent him a
text message the last time and said if he is not going to be
willing to provide us with the numbers, there is no sense going
through that. But, Mr. Cartwright, I trust you and I will give
you the timeline.
Mr. Cartwright. Thank you. Reclaiming my time.
I think that it would make sense for Mr. Meadows and me to
work together to make sure you are being fully transparent and
accountable, Mr. Counihan.
There was a comment, though, that was made about it took a
hearing to be scheduled before you would make a phone call. I
just want to make it clear. Were you subpoenaed to come to
today s hearing or did you come voluntarily, of your own will,
Mr. Counihan?
Mr. Counihan. I came voluntarily.
Mr. Cartwright. All right. And forgive me if I misState
this, but it seems to me that, when we are talking about
numbers and talking about testimony under oath, as you are, you
understand you are under oath today, right?
Mr. Counihan. Yes.
Mr. Cartwright. And you have understood that very plainly
that, when you come to our committee, you are going to be under
oath, so we are going to expect exactitude in the numbers that
we get from you.
Mr. Counihan. Yes.
Mr. Cartwright. Is that one of the concerns that has been
driving your reticence about sharing particular numbers, that
you want to make sure they are exact and precise when you
testify to them under oath?
Mr. Counihan. Yes.
Mr. Cartwright. All right. Now, I want to visit this
question about the erroneous tax information that was sent out,
because that is a concern of mine as well. The agency has sent
erroneous tax information to roughly 800,000 tax filers who
receive coverage through the federally facilitated Marketplace
in 2014. It is my understanding that these tax filers received
erroneous 1095-A forms. Is that correct?
Mr. Counihan. Correct.
Mr. Cartwright. And these are the people that you said
constituted less than 1 percent of the filers?
Mr. Counihan. Correct.
Mr. Cartwright. OK. How did it happen?
Mr. Counihan. You know, to the best of our understanding so
far, and we are still doing research into this, it appears that
there was an unfavorable interaction between two pieces of
software code, and upon identifying that we began our fix.
Mr. Cartwright. OK. So those of us that have employer-
sponsored coverage or government coverage such as Medicare or
Medicaid are not affected by this.
Mr. Counihan. Correct.
Mr. Cartwright. And would you take this moment, Mr.
Counihan to explain to us now what the agency is doing to alert
tax filers who received the erroneous 1095-A forms about what
they need to do to proceed with filing their tax returns?
Mr. Counihan. We are doing quite a bit. We take the issue
of the disruption caused by these incorrect forms very, very
seriously, and it wouldn't matter whether it were one tax filer
or 820,000. We jumped on this issue very fast to uncover it. We
have created new tools on our Website, Healthcare.gov, that
help people both understand whether they were impacted by it,
how to calculate the correct benchmark plan, that second lowest
cost, Silver. We have trained our call center representatives
to take calls from recipients so that they can get the answers
that they need. We have made robocalls out, we have sent
letters, we have sent emails. We have had a broad-based
communication effort.
Mr. Cartwright. OK. Well, Mr. Counihan, I want to express,
before I yield my time, I am disappointed that the agency made
this kind of mistake at such a critical time. This is an
unforced error that provides fodder for those who want to tear
down the ACA. But I want to remind my colleagues that it
doesn't detract from the fact that millions of Americans now do
have access to life-saving healthcare coverage that they did
not previously have.
With that, I yield back, Mr. Chairman.
Mr. Mulvaney. I thank the gentleman.
We now recognize the gentleman from Tennessee, Mr.
DesJarlais.
Mr. DesJarlais. Thank you, Mr. Chairman.
Good morning, Mr. Counihan.
Mr. Counihan. Morning.
Mr. DesJarlais. It is good to have somebody here that is
concerned about exact and precise numbers, because we have had
a lot of trouble getting accurate numbers when it comes to the
Affordable Healthcare Act. You gave a pretty resounding, rosy
testimony in terms of how the healthcare law is working, but it
doesn't seem to coincide with a lot of the people that I hear
from, so I was hoping you could help clear up some numbers.
You had indicated that the uninsured rate is at the lowest
point in the recorded history of the Country, is that correct?
Mr. Counihan. I said that the uninsured level has dropped
significantly.
Mr. DesJarlais. I think you followed with saying that it
was the lowest that had been recorded, and I was wondering how
you came to that number.
Mr. Counihan. Just to be precise, sir, what I said was the
uninsured rate is now at or near the lowest level recorded
across five decades of data.
Mr. DesJarlais. OK, so pretty good. How did you get that
data? Where did it come from? How many people are insured in
this Country, what do we have, 310, 330 million people?
Mr. Counihan. About 330 million people. To be frank with
you, sir, I need to get back to you with that.
Mr. DesJarlais. OK. How many people were uninsured when
this law first came into effect, when they were selling it to
the American people?
Mr. Counihan. Sir, I need to do the same.
Mr. DesJarlais. Well, I mean, roughly. You don t have to be
precise. The President was throwing out numbers, 30 million, 40
million were uninsured.
Mr. Counihan. You know, sir, I am not trying to be
difficult.
Mr. DesJarlais. Did you prepare at all for this hearing?
Mr. Counihan. Yes.
Mr. DesJarlais. I listened to your answers to Mr. Meadows,
and it just astounds me that you can't remember whether or not
you gave information to CMS or to the White House. That is your
testimony, that you just don't remember?
Mr. Counihan. No, it is not. What I simply want to say is
that you have asked me a question that has to do with data. I
respect that question. I would like to respond with a precise
answer.
Mr. DesJarlais. OK. If people don't sign up for the
healthcare law, they are going to pay a tax penalty here soon,
right?
Mr. Counihan. Only if they do not qualify for an exemption.
Mr. DesJarlais. So it is kind of hard to get the number of
uninsured until we see how many people have to pay a penalty,
because we have heard the President said 30 or 40 million
people were uninsured in this Country; now you are saying 10 or
11 million have insurance. And we have 330 million people, but,
yet, is it your testimony that about 90 percent of the people
who have signed up are getting subsidies?
Mr. Counihan. What I would say based on our enrollment is
roughly 87 percent of people that enroll in the Marketplace----
Mr. DesJarlais. OK, so roughly 9 out of 10 are getting
subsidies. And we have 330 million people. You can't tell me
how many had insurance and how many don't have insurance, but
you are saying we have the lowest insurance rate. So you are
not really helping me with your exact and precise numbers. But
what we are seeing is people paying about two to 4,000 more for
premiums, paying much higher deductibles. And yet the President
promised most people's premiums would drop 2500. So it is clear
at this point we were sold a bill of goods. Do you agree with
that?
Mr. Counihan. With deep respect, I do not agree with that,
and the reason I don't is because I have been doing this
between States and now here in this job for almost 9 years, and
I have seen the impact of people getting access to coverage
that is more affordable for them, that----
Mr. DesJarlais. Well, you and I are talking to different
people, but let's move on. Let's talk about some more exact and
precise numbers. This month, HHS announced that you will
terminate coverage for individuals who signed up in 2014 who
have been unable to verify their citizen status, so that is
about 200,000 individuals, right?
Mr. Counihan. It appears that number is going to be less
than that.
Mr. DesJarlais. OK. We have numbers that show up to 312,000
individuals should not be receiving coverage, so that is not
correct?
Mr. Counihan. Congressman, I would appreciate the
opportunity to come back to you with precise numbers on all
these questions.
Mr. DesJarlais. It sounds like you are going to have to
come back, because you are certainly not ready today. First of
all, how do these people sign up, what data do they need? Do
they need a driver's license, a Social Security card? How can
they sign up for healthcare if they are getting it illegally?
Mr. Counihan. So an individual attests on their application
to specific amounts of parts of information. We check that
information against electronic data sources to verify its
validity. There can be situations where that data is going to
match; there will be situations where that data does not match.
When the data does not match the verified sources, the trusted
sources, it is up to that individual to provide the evidence
that supports that they are legally eligible for coverage.
Mr. DesJarlais. So how do we get this money back? And let
me ask a second question. With the President s executive order,
with four to five million new people gaining access to Social
Security cards and driver's licenses, probably the very
information that it takes to get this healthcare coverage, how
are you going to prevent that and how are you going to get that
money back?
Mr. Counihan. Congressman, I think the point is that we
take self attestations, we verify them against proper data
sources to make sure that they are accurate. If they are not
verified, the applicant is required to provide proof, that in
fact, it is true. If the proof is provided, they may maintain
their coverage and the appropriate subsidies and such; if the
proof is not provided----
Mr. DesJarlais. Bottom line is this law wasn't ready and it
is never going to be ready.
I yield back.
Mr. Mulvaney. I thank the gentleman.
We now recognize the ranking member, the gentleman from
Maryland, Mr. Cummings, for 5 minutes.
Mr. Cummings. Thank you very much.
Mr. Counihan, we are very pleased to have you here. Despite
strong evidence to the contrary, Republicans continue to claim
that the Affordable Care Act is causing an increase in
healthcare costs. However, multiple reports show that the
growth of healthcare spending in the United States, in fact,
slowing to historically low levels. Thanks to the Affordable
Care Act, we have seen the slowest growth in healthcare prices
in nearly 50 years, and Congressional Budget Office estimates
show that the ACA will reduce the deficit by about $100 billion
over its first 10 years and a total of $1.7 trillion over the
first two decades.
When we look at the benefits of it, of course, there are a
lot of people who are staying well because they now have access
to insurance and, therefore, medical care. There are people who
have preexisting conditions that are now able to get treatment.
So there are a lot of benefits to this very important law.
In December 2014, Mr. Counihan, the Centers for Medicare
and Medicaid Services issued its national health expenditures
report. Are you familiar with that report, sir?
Mr. Counihan. I have heard of it. I am not familiar with
the details of it.
Mr. Cummings. Well, maybe some of this will be familiar to
you. The report found that national health spending grew by
just 3.6 percent in 2013, the lowest rate of growth since 1960.
This is down from 4.1 percent growth in 2012. In your opinion,
what factors are driving these low rates? The low rate of
growth, that is.
Mr. Counihan. Congressman, I would have to understand the
report better before I responded.
Mr. Cummings. OK. Are the Affordable Care Act's payment and
delivery reforms, do you think that has been part of the
explanation? I know you have to get back to me, but do you
think that would be a part of it?
Mr. Counihan. I do.
Mr. Cummings. I want to go back to some questions that were
asked of you earlier about certain data that you were
questioned about whether you had released that data to the
White House and then I think you were also asked about
insurance companies. It sounds like you wanted to make sure, as
far as the committee is concerned, that the data was properly
vetted. And I agree with the ranking member and chairman of the
subcommittee that we do have to get accurate information.
I guess, as I listened to you, I just have one question. If
the information was released to others, is it done with a
caveat? How does that work? And I know you said you need to get
back to us, but I am just trying to figure out. I can
understand definitely you making sure you deliver very accurate
and up-to-date information to this committee, because, man, if
you don't, next thing you know, you have big problems. But the
question becomes are there circumstances where information is
released to others? Is there a caveat if that happens? Or does
it happen?
Mr. Counihan. Sir, I have to look at the information that
was provided that Congressman Meadows referred to this December
18th. I am not familiar with that report.
Mr. Cummings. OK. So I am talking about just general
information. In your experience, do you ever release
information with a caveat, that this is not accurate, it still
has to be vetted? I think that is a pretty reasonable question.
Mr. Counihan. It is a reasonable question, and the answer
to that question is that, depending on the circumstance
involved, there may be internal information that is shared, but
at all times, when we would ever release information to you, to
Congressman Meadows, to this committee, we would not do
anything without having that information checked, triple
checked, fully, fully verified.
Mr. Cummings. So, again, do you ever release raw data
without vetting to anybody else? Does that happen?
Mr. Counihan. We have released on a weekly basis a snapshot
report of how we do in our open enrollment period.
Mr. Cummings. OK.
Mr. Counihan. I assume this committee has received that.
Mr. Cummings. OK. And so that data is not vetted, is that
right?
Mr. Counihan. No, that data is vetted.
Mr. Cummings. All right. I see my time has expired.
Mr. Mulvaney. Thank the gentleman.
We need to take care of a housekeeping matter here. We have
a new member to the full committee, Ms. Lujan Grisham from New
Mexico. I ask, even though she is not part of the subcommittee,
that she be permitted to participate today fully in this
subcommittee. Without objection.
At this point, recognize for 5 minutes the gentleman from
Georgia, Mr. Hice.
Mr. Hice. Thank you, Mr. Chairman.
Mr. Counihan, does your office obtain any supplemental
funding from other areas within HHS or CMS?
Mr. Counihan. Sir, I am not sure of the answer to that
question. I need to respond back to you on that.
Mr. Hice. So you are not aware if there are any
supplemental funds at all. Have you ever made a request for
supplemental funding?
Mr. Counihan. Sir, I have to get back to you with answers
around supplemental funds.
Mr. Hice. Do you know if you have ever made a request for
supplemental funding?
Mr. Counihan. Sir, it is not coming to mind that I have
made a request for supplemental funds, but I don't want to say
anything that may not be true, so I please need to get back to
you.
Mr. Hice. Sir, we are providing you with information that
HHS provided us regarding transfers that were made last year,
some $109 million that was transferred into program management
to ensure that the CMS had operations of the Marketplace to
support what they are doing. Are you aware that this money was
transferred to help Marketplace operations?
Mr. Counihan. Sir, I arrived in September of last year. I
don't know the date or timing of when those requests or
allocations may have been made. This was before my time.
Mr. Hice. Sir, I understand that, but you are the CEO.
Mr. Counihan. My suspicion is it was before my time.
Mr. Hice. OK. This is your area of responsibility. So you
are not aware at all of where $109 million supplemental funding
came from?
Mr. Counihan. I am not aware of that specific supplemental
funding you have just referred to.
Mr. Hice. Well, let me ask you this way. Do you believe
that it is appropriate for Healthcare.gov to receive money from
the CDC?
Mr. Counihan. Sir, I need to----
Mr. Hice. Well, it is there in front of you, provided by
your own staff to us that that took place. Do you believe it is
appropriate for money to come from NIH for Healthcare.gov?
Mr. Counihan. The issue of supplemental funds, Congressman,
is unfamiliar to me, and I would need to respond back to you
upon----
Mr. Hice. Well, sir, would you believe that it should not
be a strange subject to you, seeing that this is the area that
you are responsible for?
Mr. Counihan. I accept full responsibility for my offices
and for the exchange. I am just unfamiliar with this issue of
supplemental funding that you are referring to.
Mr. Hice. All right, sir. Are you familiar with Form 8962?
Mr. Counihan. With that tax form?
Mr. Hice. With the tax form, yes, sir.
Mr. Counihan. Yes, I am.
Mr. Hice. OK. CBS News referred to this as a mind-boggling
form. Were you in any way responsible or helpful, if we can put
it that way, to the IRS for this form and the information?
Mr. Counihan. The creation of IRS forms is not in my
bailiwick.
Mr. Hice. But, according to your testimony, you work
closely with the IRS to provide information they needed to
develop some of these forms, is that correct?
Mr. Counihan. Our offices are collaborative with a number
of Federal agencies. We were not, to my knowledge, involved in
the design of Form 8962.
Mr. Hice. Well, sir, you are familiar with the form,
though.
Mr. Counihan. Yes, I am.
Mr. Hice. The premium tax credit form.
Mr. Counihan. Yes, I am.
Mr. Hice. Do you have a copy of it there?
Mr. Counihan. Yes, I do.
Mr. Hice. OK. Just a simple observation of this thing. This
is two pages, over 90 questions just on one page alone, looking
at this, sir. Let me ask you. Just looking at that form, is
this something that you believe, as a CEO here, that you could
fill out yourself, without some assistance?
Mr. Counihan. This form, Congressman, is not a form that my
office created; it is an IRS form. I know that there are
directions for the form. We provide tools on Healthcare.gov to
also assist in the completion and the use of the benchmark plan
information that is used to complete that form. The 1095-A form
provides the information needed to complete that.
Mr. Hice. So you are saying you have nothing to do with
this form. It certainly is not a simple form for an American to
fill out, but it is necessary if they had any break during the
year.
Mr. Counihan. As I said, Congressman, not involved in
creating IRS or Treasury forms.
Mr. Hice. OK. The Associated Press said that consumer
information has been shared with other companies; the people
put in information with Healthcare.gov, that information has
been shared with other companies. Are you aware of that
information being shared?
Mr. Counihan. We have shared no names, addresses, Social
Security numbers, any personal information with any third
parties.
Mr. Hice. You have not.
Mr. Counihan. We have not.
Mr. Hice. OK. Well, the report is otherwise. Is it
appropriate for information to be shared?
Mr. Counihan. I will confirm. We have not shared any names,
addresses, Social Security numbers, or any personal
information. We will not do so, we have not done so, and we
will not do so.
Mr. Hice. I yield. Thank you.
Mr. Mulvaney. The gentleman s time has expired.
We now recognize the gentlewoman from New Mexico, Ms. Lujan
Grisham, for 5 minutes.
Ms. Lujan Grisham. Thank you, Mr. Chairman.
In New Mexico, where we have some of the most challenging
uninsured and access issues in the Country, the number of
individuals uninsured has dropped by about 25 percent, and it
is one of the largest drops of any State in the Country, and it
is making a powerful difference in making sure that the health
status of a poorer State is on its way to improving, and we
want to continue to build on that progress.
Notwithstanding, it concerns me greatly, and I know that
you are hearing that from all of my colleagues today, that CMS
sent approximately 800,000 inaccurate tax forms to individuals
who signed up for coverage. I also understand that this is a
very large, complicated program, and I understand also, and you
have reStated it today, that the majority of the tax forms that
were sent out inaccurate. But we want to make sure that we are
also highlighting that tons of information has also gotten out
that has been incredibly accurate and has provided the right
avenue for folks to sign up for coverage and get the subsidies
and related issues that caused them to not only be covered, but
stay covered.
We have had several hearings, and I am going to kind of
segue now into the focus of my question, on HHS's efforts and
CMSs efforts to make sure that we are addressing the security
of this information and the processes are sound, and that we
have done a million--I hope that that is not an exaggeration,
probably is--but that we are really sufficiently addressing the
cybersecurity issues significantly.
So it is clear to me that that is happening. What is not
clear to me, given this mistake, is CMS using, specifically,
the same continuous monitoring that HHS is using to test the
Website, and do you feel that CMS has those tests and those
data points to detect your vulnerabilities?
Mr. Counihan. Congresswoman, please, just to make sure that
I understand, this is an issue related to security and perhaps
cybersecurity risks?
Ms. Lujan Grisham. Be broad. I use that as an example.
Including the cybersecurity, including privacy, including
protection, and making sure that it is fully integrated, and
making sure that States integrate one-stop shopping and make
sure that their data points are all integrated.
We know that HHS has done incredible testing. Is CMS using
those same mechanisms to test the accuracy of your data on your
Websites?
Mr. Counihan. I can speak to the Website. I can speak to
the area that I oversee. What I would tell you is the
following. One is that the security of our Website is among our
absolute highest priorities. No. 2 is that we use the same type
of tools and protections used in the most secure industries in
the private sector. No. 3 is that we conduct continuous
monitoring using multi-layer professional security team to
mitigate any potential types of risks. And we are fully
committed to maintaining the security.
Ms. Lujan Grisham. Given this mistake, can you point to
specifically the safeguards in place, notwithstanding the
mistake, that should have caught this mistake? Because my next
question, as you answer, maybe you can dp both at the same
time, is what are you doing right now to correct this problem
so that we don't have future mistakes of this nature in this
regard or any other regard? And I recognize that no system is
full-proof, but what I do expect is that there is this
continuous monitoring, you identify the problem, and that you
can assure this committee that it is addressed.
Mr. Counihan. Yes. I appreciate the question. No. 1 is I
think I outlined the issue with respect to the interaction
between these two pieces of software code. We are still digging
deeper to understand the root cause, but we believe we have a
fairly good sense of how it is going.
I think what is critical, to your point, Congresswoman, is
that we have a structure and a process in place that once an
issue is identified, that we can understand it, remediate it,
fix it, develop a customer support focus to aid customers, and
then have a broad outreach program to show customers how to
react.
Ms. Lujan Grisham. And I appreciate your answer very much,
and I realize that I am interrupting you. I only have 20
seconds left. I am going to ask that you be much more specific,
and I am going to ask that you do that in writing and provide
those specifics that you have been asked by my colleagues to
get data back to this committee so it is clear to us what that
means in very concrete, substantive context so that we can
support you to assure that you have the tools and resources to
prevent these mistakes and to mitigate.
With that, Mr. Chairman, I yield back my time.
Mr. Mulvaney. I thank the gentlelady and I will now
recognize the gentleman from North Carolina, Mr. Walker, for
his 5 minutes.
Mr. Walker. Thank you, Mr. Chairman.
Mr. Counihan, thank you for coming out today. This hearing
is morphing into more or less about enrollment numbers than it
is about transparency. You talked about the pre-September,
maybe not responsible for all the things that happened there,
so let's talk about post-September, if we could, for just a few
minutes.
In fact, this week, H&R Block announced that 52 percent who
enrolled in insurance via the State or the Federal Marketplaces
are paying back a portion of their advanced premium tax credit.
We have the world's largest tax preparer that for more than
half of the enrollees, ObamaCare is costing more than they were
told at first.
My question is how do you account for this mishap?
Mr. Counihan. Congressman, our enrollment process relies on
eligibility and income information provided by an applicant.
That eligibility information and income information is then
validated with the appropriate sources to make sure that it is
true. As we all know, income can sometimes fluctuate.
Mr. Walker. So this was the enrollee's fault; had nothing
to do with your department?
Mr. Counihan. I am saying that income can fluctuate. If the
enrollment information and eligibility information is not
updated, sometimes an individual may be getting more tax
credits or less tax credits than they would warrant.
Mr. Walker. Do you know what the average tax credit is,
return?
Mr. Counihan. It is $268 a month.
Mr. Walker. And H&R Block reported the average payback is
$530. Would you say that is significant?
Mr. Counihan. Again, sir, I think that having to pay back
anything is significant. The $268 translates to roughly $3200 a
year. Again, I think that with 87 percent of our enrollment
receiving tax credits, it has made a profound difference in
providing and accessing affordable care.
Mr. Walker. Thank you. We have hit already eight to ten
different specific areas. Let me talk about a number that you
might be able to provide. On a scale of one to ten, how would
you rate the department's handling of these issues that we are
talking about today?
Mr. Counihan. I feel extremely proud and comfortable
representing the way that we have handled our issues.
Mr. Walker. Eight? Nine?
Mr. Counihan. And the reason why is because we have created
a process that identifies a problem, looks at root cause,
fixes, provides customer support and outreach. And I say that
because it is a repeatable process and it is the appropriate
way to respond.
Mr. Walker. Sure. You spoke earlier about you are unable to
give numbers out until they are fully vetted. I believe you
used the word verifying.
Mr. Counihan. Yes.
Mr. Walker. Can you speak for a few seconds what is your
vetting and verifying process?
Mr. Counihan. So we have a data analytics team that is
dedicated to reviewing our data. They are in charge and
accountable for ensuring that it is right, that it is tested,
that it is appropriately validated and vetted, and they are
accountable for that.
Mr. Walker. Once it is vetted, do they give those numbers
to you, Mr. Counihan?
Mr. Counihan. When the numbers are appropriately tested,
verified, and validated, yes.
Mr. Walker. Who provides those numbers to you?
Mr. Counihan. The data analytics department.
Mr. Walker. And those numbers, since September, have you
given those out to more than five or less than five?
Mr. Counihan. I am sorry, when you say five?
Mr. Walker. As far as the numbers, as far as these numbers
that have been released, people that you have shared these
numbers with even though they are not complete, is it more than
five groups, agencies, individuals, or less than five?
Mr. Counihan. Well, as I said, it is critical for us that
we don't share any numbers that haven't gone through this
process. And what I have tried to communicate this morning is
the urgency and the priority we place on making sure that the
numbers that we give are accurate.
Mr. Walker. So up until today there have been no numbers
shared pre-vetting or post-vetting until now.
Mr. Counihan. The example that I would use, Congressman, is
the weekly snapshots that we provide that are an update of our
open enrollment progress is a good example of how that
information gets verified and validated before it is released.
Mr. Walker. Thank you, Mr. Chairman. I yield back.
Mr. Mulvaney. Thank the gentleman.
Now recognize the gentleman from California, Mr.
DeSaulnier, for 5 minutes.
Mr. DeSaulnier. Thank you, Mr. Chairman. Great job on the
pronunciation.
Mr. Mulvaney. Did I get that right?
Mr. DeSaulnier. Yes.
Well, thank you for being here today.
And I must admit, Mr. Chairman, as a freshman from
California, it is taking some use to assimilating some of the
comments from other parts of the Country. While we have had
challenges in California, generally, it has been positive. In
my previous life, I chaired the budget subcommittee for Health
and Human Services and worked closely with members of our
exchange, both Republicans and Democrats.
So, having said that, as a supporter of the ACA and
believing that we have to recognize the size of the challenge
that you are trying to implement, but also being consistent
with all concerns by members on both sides, as a supporter, I
want as few criticisms as possible within the range of this is
huge domestic policy that is very complicated.
So sort of to the last comments, within that context,
without quantifying it, and in the spirit of I would really
like to not see these kinds of things happen, and not have to
defend them because I don't think they are acceptable, where do
you feel as if you have done enough corrective actions on the
macro level so that we don't see these kinds of things in the
media and give the critics the opportunity to take on the whole
program altogether?
Mr. Counihan. The process of implementing the law requires
significant amount of testing, and an example of that type of
testing, whether it is stress testing, load testing,
performance testing and such, was the relaunching of our
Website this year.
I think that it is probably well known that we had a few
bumps or glitches in the first year of its rollout. In its
second year we went out of our way to be very conscious about
improving the customer experience. We have reduced the number
of enrollment screens from 76 down to 16. We put new decision
support tools in place that allowed people to select plan
either by issuer, by deductible, by even being conscious of a
healthcare condition, by premium.
We have a whole section, the learning section of our
Website, that provides additional decision support tools to
help people pick a plan. We offer 25 percent more issuers than
we did the year before, which is providing more competition. We
believe in the Marketplace; we believe in competition. We have
seen, in fact, that it has driven the adding of more value to
consumers that came back and shopped and compare.
So all of which you have described is required as part of a
testing process. Is testing always perfect? No. Can there be
these instances which occurred here, where you have these two
pieces of code that interact unfavorably? Yes. I think the
point from our perspective is what do you do about it. And,
from our perspective, we have put in a repeatable process of
identification, remediation, tools, and communication.
Mr. DeSaulnier. I believe in cost-benefits when they are
done right, so you have the cost-benefit sort on the political
side and the fiduciary side. We have talked a lot about the
costs in this context. The benefits I want to talk about for a
minute.
So, according to the CBO, the ACA reduced the number of
uninsured Americans by 12 million in 2014 and would bring down
the uninsured rate by 19 million in 2015. CBO has also found
that between 2016 and 2025 the ACA would reduce the number of
uninsured by between 24 to 27 million Americans. Can you
explain the impact reductions the uninsured rate have on
uncompensated care costs and the price of premiums?
Mr. Counihan. To the States that I have worked in in
particular, it has had significant results in impacting and
lowering those costs.
Mr. DeSaulnier. Thanks. If you could give me, if you have
any for the future, both on the testing and more specific, I
know it is on a broad range of numbers that you could give me
after the hearing at some point, that would be helpful.
Since the ACA open enrollment started in 2013, an
additional 10.1 million Americans have been newly enrolled in
Medicaid and the Children's Health Insurance Program, CHIP. To
date, 22 States have decided not to expand Medicaid to their
residents. The question is if all 50 States expanded Medicaid,
do you have an estimate of approximately how many more low-
income Americans would gain access to affordable healthcare?
Mr. Counihan. Congressman, I don't have a significant
estimate that I would be confident enough sharing. I do know
that, again, based on my experience, it would have a dramatic
impact.
Mr. DeSaulnier. Appreciate it.
I yield back the remainder of my time, Mr. Chairman.
Mr. Mulvaney. Thank the gentleman.
Now recognize the gentleman from Georgia, Mr. Carter, for 5
minutes.
Mr. Carter. Thank you, Mr. Chairman.
Mr. Counihan, thank you for being here. You testified
earlier that you came here voluntarily. How long have you known
that you were going to be coming here?
Mr. Counihan. I think a couple of weeks, but I am not
exactly sure.
Mr. Carter. Couple of weeks? Well, for someone who knew for
a couple weeks they were going to be coming here, I hear a lot
of answers of I don't know, I will have to get back to you. So
I am not sure about the preparation for it, but I do appreciate
you being here.
I want to ask you, 800,000, 800,000 incorrect forms. Is
that acceptable?
Mr. Counihan. Congressman, having one incorrect form is not
acceptable.
Mr. Carter. Well, there is a big difference between having
one and having over 800,000.
Mr. Counihan. I understand that. But I think the point is
what do you do about it. And what I tried to communicate is the
process put in place to identify, remediate, communicate, and
move on.
Mr. Carter. OK. Well, what have you done? First of all,
let's back up. What happened? What was the typical error?
Mr. Counihan. As I mentioned earlier, the best of our
understanding right now is there were two pieces of software
code that interacted in what is called unfavorably, so it ended
up replacing the 2014 benchmark price and putting in the 2015
benchmark price on those forms for the 820,000. It didn't
happen, obviously, for all of them, and it was a minority of
the forms, but that is our best understanding.
Mr. Carter. OK. And when are you going to get it corrected?
My daddy used to tell me, he used to say, son, that is why they
put erasers on pencils. Well, you know, I hope you all have
invested in an eraser factory because you are going to need a
bunch, a whole bunch. When are you going to get them corrected?
I don't know about you, but April 15th I get knots in my
stomach. Man, I am trying to get all this stuff together for
the taxes and my wife, and it is not a good time.
Mr. Counihan. Sir, I can relate to that; I have the same
issue with my wife. The forms will be going out next week.
Mr. Carter. So you have it corrected?
Mr. Counihan. The corrected forms are going out beginning
next week.
Mr. Carter. Well, thank you.
I want to shift gears real quick. King vs. Burwell. You are
aware of that.
Mr. Counihan. I am.
Mr. Carter. You know that that is coming up, and I think we
all have our own opinions on what the Supreme Court will rule.
I know I think it is pretty clear what they should rule. I
think it is pretty obvious that those subsidies were intended
for State-run exchanges and not for federally run exchanges;
and it is important in my State, in the State of Georgia,
because we have a federally run exchange. If those subsidies go
away, what is your plan? Have you got a backup plan?
Mr. Counihan. Secretary Burwell has spoken to this issue
consistently. I don't have anything more to say. The secretary
has spoken for us.
Mr. Carter. So you haven t had any input into what you
might be able to offer as a backup plan?
Mr. Counihan. As I said, the secretary has been very clear
about our position on this issue and that is perfectly fine
with me. I don't have anything more to add to what the
secretary said.
Mr. Carter. Do you mind repeating to me what the secretary
has said?
Mr. Counihan. She believes that we are on the right side of
the issue and that we will prevail.
Mr. Carter. OK, so we take the attitude that we are going
to win, so we don't need a backup plan.
Mr. Counihan. As I said, the secretary has been very
specific on it and I don't have anything more that I could
contribute to her.
Mr. Carter. Have you spoken to the White House about it at
all?
Mr. Counihan. I have not spoken to the White House, but the
Secretary has spoken on the issue and I don't have any more to
add.
Mr. Carter. Goodness, gracious. I know that gives the
American people a lot of relief to know that. You know, we all
have backup plans. Nevertheless, if that is the case, I
certainly understand.
I want to get back to a question that was asked earlier
about the sharing of information. Now, it has been reported,
between reported by a very reputable source, the Associated
Press, that information from Healthcare.gov has been shared,
shared to private companies. You are telling me that is not
true?
Mr. Counihan. I am telling you definitively, sir, that that
is not true. We have not shared any personal information. We
have not shared anything that includes names, addresses, Social
Security numbers, any personal information.
Mr. Carter. OK, you haven t shared it, but do you know if
any has been obtained? Do you know if any has been leaked?
Mr. Counihan. We have not shared any information, sir, any
personal information.
Mr. Carter. OK. Mr. Counihan, again, I thank you for being
here. I wish you had been better prepared, but it is what it
is. Thank you.
Thank you, Mr. Chairman. I yield back my time.
Mr. Mulvaney. I thank the gentleman and I think I am up, so
I will recognize myself for 5 minutes.
Mr. Counihan, it is nice to meet you. I am a new member of
the committee, so I haven t had a chance to talk with you
before.
Mr. Counihan. Nice to meet you.
Mr. Mulvaney. Mick Mulvaney from South Carolina. And what I
want to spend most of my time on is just following up on some
of the things you have said to some of my colleagues on both
sides, starting with Mr. Meadows from North Carolina. He asked
you why you had not been able to provide the breakout data that
he had sought on the enrollment numbers, and your answer was
that you wanted to make sure the numbers were vetted and
verified. I think Mr. Cummings actually asked you similar
questions; you said you wanted to make sure the numbers were
checked and double-checked and triple-checked. So let me ask
you a couple questions about that.
Is that the same standard that you use, sir, before you
release information to the public?
Mr. Counihan. Yes.
Mr. Mulvaney. Is it the same standard that you use before
you release information to the media?
Mr. Counihan. Yes.
Mr. Mulvaney. All right. So the information that came out a
couple weeks ago that said that somebody had miscounted folks
who had enrolled in dental coverage, did that come out of your
office?
Mr. Counihan. As I recall that issue, that was an issue
related to enrollment of last year where stand-alone dental
membership was included with healthcare.
Mr. Mulvaney. Correct. And did that data come from your
office?
Mr. Counihan. Yes, it did.
Mr. Mulvaney. Had that been vetted, verified, checked,
double-checked, and triple-checked before it was released to
the press?
Mr. Counihan. Our commitment in communicating data----
Mr. Mulvaney. Hasn't changed. OK, I got you.
Mr. Counihan [continuing]. Is to make sure that it is
verified.
Mr. Mulvaney. Fair enough. And it wasn't in that particular
circumstance, was it? It was wrong.
Mr. Counihan. Mr. Chairman----
Mr. Mulvaney. There is no shame in admitting you were
wrong, Mr. Counihan. I have been wrong. I mean, it is only 11
and I have been wrong three or four times today. The data that
came out on the enrollment data was wrong, wasn t it?
Mr. Counihan. Sir, what I would like to communicate to you
and to the committee is not only our commitment to verification
of----
Mr. Mulvaney. I get it. That is fine. I promise not to beat
up on you if you promise not to filibuster the time.
Mr. Counihan. But we have put in new safeguards to avoid
that type of problem.
Mr. Mulvaney. I know a lot of people who would--listen, I
work with politicians. I have a lot of people who admit they
are wrong sometimes. Don't worry about it.
Let me do ask you this. The process. How long does it take
to answer Mr. Meadows question?
Mr. Counihan. Well, Mr. Meadows had several questions.
Mr. Mulvaney. OK, let me do it this way. If I ask you a
question, listen, Mr. Counihan, can you tell me how many people
were auto-enrolled in a different program last year, how long
should it take you to answer that question?
Mr. Counihan. It is a seemingly simple question; it is a
very complex question.
Mr. Mulvaney. Again, I recognize and I simply ask you how
long should it take you to be able to get--if the White House
called you and asked you for that, how long would it take you
to get that number to them on a vetted, verified, checked,
triple-checked basis?
Mr. Counihan. I am unsure.
Mr. Mulvaney. OK. Let's go a different way at this. How
many people were unenrolled or uncovered by health insurance
before the Affordable Care Act came under law?
Mr. Counihan. That is one of the issues one of your
colleagues asked that I need to followup on.
Mr. Mulvaney. Yes. The President said it was roughly 30
million people. Was he roughly correct? He said that, I think,
in 2009, in a joint session of Congress.
Mr. Counihan. I suspect he is.
Mr. Mulvaney. OK, so roughly 30 million people were
uinsured at the outset of the Affordable Care Act, before the
Affordable Care Act became law. Fair enough.
How many people in the Country are uninsured today?
Mr. Counihan. Sir, that also came up from one of your
colleagues. It is a good question that I am coming back to you
with an answer.
Mr. Mulvaney. OK. Can you give me an educated estimate
within, say, a million people?
Mr. Counihan. Sir, I need to get back to you with a more
precise response.
Mr. Mulvaney. Can you give me an estimate within 5 million
people?
Mr. Counihan. I want to get back to you with a precise
response.
Mr. Mulvaney. How about 10?
Mr. Counihan. I want to get back to you with a precise
response.
Mr. Mulvaney. You don't have any idea how many people are
uninsured in this Nation?
Mr. Counihan. Sir, I have learned, with information, it is
important to be precise.
Mr. Mulvaney. I get you. Let me ask this. You had a
question earlier from, I believe, Mr. Hice, regarding
supplemental funds that were available to your organization.
Mr. Counihan. Right.
Mr. Mulvaney. Who knows whether or not that is a true
Statement, whether or not you received supplemental funds? You
said you don't. You said you weren't familiar with it, is that
correct?
Mr. Counihan. That is correct.
Mr. Mulvaney. So who in your office would know that answer?
Mr. Counihan. I need to explore that.
Mr. Mulvaney. Are you aware, Mr. Counihan, that if you were
the CEO of a publicly traded corporation that was subject to
the Sarbanes-Oxley requirements that many of the answers that
you are giving today could get you throw in jail?
Mr. Counihan. Sir, I am unfamiliar with the Sarbanes-Oxley.
Mr. Mulvaney. Have you told anybody in your office not to
provide you with information?
Mr. Counihan. I have not.
Mr. Mulvaney. OK. Has anybody in the White House told you
not to seek information regarding any of the information this
committee has sought?
Mr. Counihan. No.
Mr. Mulvaney. OK. Do you feel like you have faithfully
undertaken to collect the information this committee is seeking
from you?
Mr. Counihan. I believe I have a commitment and it is my
responsibility to provide that information. I also believe----
Mr. Mulvaney. Actually, that may be the most stunning
answer you have given, Mr. Counihan, because that was an easy
yes. I asked you if you thought you had faithfully undertaken
to give us the information, and you should have said yes, and
you didn't.
My time, however, has expired, so I am going to recognize
now the chairman of the committee for 5 minutes, Mr. Jordan.
Mr. Jordan. I thank the gentleman.
Mr. Counihan, we are having a little debate here in
Congress this week over what I believe is an unconstitutional
action the President took last November with 5 million folks
who are in the Country illegally. Will any of the individuals
affected by the President's executive action, which I think was
unconstitutional--and you don't have to take my word for it,
lots of legal scholars on both sides of the aisle think was
unconstitutional, and a Federal judge ruled just last week that
it was unlawful--will any of those individuals affected by the
President's order on immigration be eligible for advanced
premium tax credits or subsidies to purchase health insurance?
Mr. Counihan. What I know, Mr. Chairman, is that in order
to be eligible, one has to be either a citizen of the United
States or lawfully present.
Mr. Jordan. So----
Mr. Counihan. As a result, sir, the answer to your question
is no.
Mr. Jordan. Can you guarantee that the folks who have
enrolled through the Marketplace, can you guarantee none of
them are illegal aliens, people impacted by the President's
executive action?
Mr. Counihan. As I mentioned before, we have a specific
process for verifying any self attestations for enrollment. If
someone says that they have a certain type of eligibility
information, that gets validated against data sources to see if
it is true, and if they can't provide that, we require that
they provide specific documentation to prove their eligibility.
And that is binary; they either can or they can't.
Mr. Jordan. To date, do you know if any non-citizens have
actually enrolled through Healthcare.gov and are receiving
benefits under the Affordable Care Act?
Mr. Counihan. We have had enrollees that have been unable
to provide the documentation necessary to prove their
eligibility, and they have been terminated.
Mr. Jordan. OK. Two weeks ago, in this committee room, a
colleague of ours, Mr. Mulvaney, in fact, the gentleman
chairing the committee, asked the head of the IRS if illegal
non-citizens could in fact go back and receive tax benefits
through the Earned Income Tax Credit, and the answer was, yes,
that can happen. We also asked Mr. Koskinen, the head of the
IRS, if in fact he had been consulted by the White House before
the President took his unconstitutional executive actions last
November. He indicated that the White House did not talk to
them.
Has the White House talked to you, the CEO of the
Marketplace for Healthcare.gov and for the Affordable Care Act?
Did the White House consult you before making their decision
last November?
Mr. Counihan. No.
Mr. Jordan. Not at all?
Mr. Counihan. No.
Mr. Jordan. Have you been in consultation with them since
the decision has taken place to understand it better, or any
type of consultation since the decision was made?
Mr. Counihan. No.
Mr. Jordan. OK.
With that, Mr. Chairman, I would like to yield the
remainder of my time to the gentleman from North Carolina.
Mr. Meadows. I thank the gentleman from Ohio.
I want to followup on Mr. Mulvaney's question, because you
say that you vet all the numbers that you give out. So when you
put out a press release that said 800,000 people had gotten the
wrong information----
Mr. Counihan. Eight hundred twenty.
Mr. Meadows. Well, you put out 800. But when you said that
it was 800,000 and that 50,000 of those had already filed, how
did you know that?
Mr. Counihan. Congressman, I am not sure of the----
Mr. Meadows. You didn't know that.
Mr. Counihan. I am not sure of the details of how we----
Mr. Meadows. Well, let me tell you how you didn't know
that. Because you are not with the IRS. So how was that vetted?
I mean, you just told Mr. Mulvaney you vet every number that
goes out, you only put it out, and yet you couldn't have vetted
that number because you didn't have access to the IRS
information, do you?
Mr. Counihan. What I meant to say, Congressman, is that we
have a data analytics department in my operation, our
operation, that is responsible for exactly vetting data that
comes out of our office.
Mr. Meadows. So did that information come out of your
office? It was your press release.
Mr. Counihan. I----
Mr. Meadows. So you only vet the information that you don't
want to give to Congress, is that correct?
Mr. Counihan. No, that is not correct.
Mr. Meadows. So you vet all information----
Mr. Counihan. We vet----
Mr. Meadows [continuing]. Except when it is a press release
that may look negative toward you. Because you didn't vet that
information. Let me tell you how you got that 50,000. It was a
guess based on percentages of people that may or may not file
returns; and yet you put it out as the fact.
Mr. Counihan. Sir, what I can respond to and what I can----
Mr. Meadows. Was it not a guess?
Mr. Counihan. What I can speak to you factually is the
protections we put in place to ensure that the data that we
give you, that I gave to you yesterday over the phone, for
example, is accurate.
Mr. Meadows. I yield back.
Mr. Mulvaney. The time belongs to the gentleman from Ohio,
and his time has expired.
We are going to now recognize for a brief second round of
questions, the ranking member, the gentleman from Pennsylvania,
Mr. Cartwright, for an additional 5 minutes.
Mr. Cartwright. Thank you, Mr. Chairman.
Mr. Counihan, you are appearing before the Oversight and
Government Reform Committee Subcommittee on Healthcare, and we
are a collection of Members of Congress. Some of us voted for
the ACA; some of us voted against it; some of us were not here
when it came up to be voted on. My own view is that the ACA is
the law and we need to try to smooth out the rough parts on it
and make it work for Americans, and to amend it where it needs
to be amended and make it better.
But as much as we disagree about these things, I and the
people across the aisle from me, we do not disagree about the
function of this committee and of the Government employees who
come before it. We demand Government transparency here in the
OGR Committee. We demand accurate answers and timely answers.
And I want you to commit to followup with Mr. Meadows and
anyone on this committee in an accurate and timely fashion.
I understand. It was brought up before. There was the
question of including dental coverage in the numbers of people
enrolled, and I think it was something like 400,000 people that
got dental insurance were included in the overall numbers. But
the bottom line was it was an honest mistake, but it inflated
the numbers, so it looked like somebody was trying to paint a
rosier picture than actually existed. And it came out of your
office.
It was wrong; it was pilloried here on this committee as
being wrong, and in the national press; and I must say, I have
to say it has to be fair to say that you emerged from that
experience much chastened about bandying about numbers that
later turned out to be wrong.
So I encourage you, Mr. Counihan, be really careful
because, as we continue to debate the merits of the ACA, as we
continue to decide what needs to be changed about it going
forward into the future, the more you make mistakes about
numbers, inaccurate numbers, the more you make mistakes about
tax forms, or whoever made that mistake, whether it was a
software error or a human error, the more you damage the debate
about the merits of the ACA. I appreciate your reticence about
giving inaccurate numbers today, but I do encourage you to
hurry up, get the accurate numbers, and get them to this
committee.
Do you undertake to do that, Mr. Counihan?
Mr. Counihan. Yes.
Mr. Cartwright. Well, I thank you, sir, and I yield back my
time.
Mr. Mulvaney. Thank the gentleman from Maryland.
I am going to recognize myself an additional 5 minutes.
Mr. Counihan, I am going to take a different line of
questioning now. I am just going to ask you about some data,
whether you do or do not track this kind of data; and I am
going to use myself as an example.
I am enrolled in the ObamaCare exchanges, as are many
Members of Congress and many of our staff. I had coverage
through my employment, as most folks do--most folks who have
coverage get it through their work--prior to enrolling in the
ObamaCare exchanges. So my question to you, sir, is am I
counted in the roughly 10 or 11 million people who have
enrolled?
Mr. Counihan. You are enrolled through the Washington, DC.
link exchange?
Mr. Mulvaney. Correct. Yes, sir, the D.C. shop, I think.
Mr. Counihan. You would be not part of the Federal exchange
Marketplace numbers; you would be included as part of the
State-based Marketplace numbers.
Mr. Mulvaney. But when you say that 11 million people
signed up for ObamaCare, me and my family, we are five of those
11 million people?
Mr. Counihan. Yes. As I understand it, you and your family
are enrolled through D.C. Link?
Mr. Mulvaney. Yes, sir.
Mr. Counihan. Which is a State-based exchange.
Mr. Mulvaney. But my kids are enrolled through South
Carolina. My wife and I enrolled separately because they live
back home.
Mr. Counihan. OK.
Mr. Mulvaney. But, generally speaking, we signed up through
the exchanges.
Mr. Counihan. OK. Well, I don't know if it is just you that
is in D.C. Link or the family, but----
Mr. Mulvaney. But we are all counted in the 10 to 11
million people who have signed up for ObamaCare.
Mr. Counihan. If you and your family are in D.C. Link, you
would be counted.
Mr. Mulvaney. And in South Carolina the folks are counted
as well, aren't they?
Mr. Counihan. In South Carolina, people that participate in
the Federal Marketplace, yes.
Mr. Mulvaney. Yes. OK, that is fine. And that is what we
are. So here is my question to you: When you tell Congress,
when you tell the public, when you tell the media that between
10 and 11 million people have signed up for ObamaCare, do you
track differently people who had insurance before and are now
on the exchange?
Mr. Counihan. When you say track, could you define that,
please?
Mr. Mulvaney. Do you know how many of the--let's use the
number 11 million people. I will give you the benefit of the
doubt here. let's say 11 million people have signed up for
ObamaCare. Do you know how many of those folks were insured
separately before they signed up for ObamaCare?
Mr. Counihan. Not consistently.
Mr. Mulvaney. So you don't know how many of those 11
million people are newly covered.
Mr. Counihan. Well, there are studies that are done by many
organizations that track----
Mr. Mulvaney. I am not asking about studies by outside
organizations. I am asking about you folks. Do you track that
number?
Mr. Counihan. But the numbers that you are referring to is
a combination of two sources; it is a combination of the
Federal Marketplace and it is a combination of State
Marketplaces.
Mr. Mulvaney. Correct.
Mr. Counihan. Some States track that information; some
States do not.
Mr. Mulvaney. Does the Federal exchange?
Mr. Counihan. D.C. Link, as a matter of fact, does track
that.
Mr. Mulvaney. So you know how many people within the
Federal exchanges have----
Mr. Counihan. I said D.C. Link, which is the Washington,
DC. State-based exchange.
Mr. Mulvaney. OK. Well, good. We will look forward to
getting that data, then.
All right, with that, I have two and a half minutes left. I
am going to yield the balance of my time, then, to the
gentleman from North Carolina, Mr. Meadows.
Mr. Meadows. So let's go back to the definition of fraud,
would you agree, is knowing that you are doing something that
is incorrect and not telling anybody? Would you agree with
that? Is that fraud? Is that fraudulent?
Mr. Counihan. Sir, I am not a lawyer.
Mr. Meadows. OK. I am not a lawyer either. How would you
define fraud? OK, maybe that is too hard of a question. So let
me get to an easier question.
Mr. Counihan. OK.
Mr. Meadows. Are there people in the Affordable Care Act,
through no fault of their own, not misrepresenting their
income, that are getting the wrong subsidy?
Mr. Counihan. The subsidies are very dependent on
information provided by the----
Mr. Meadows. That is not my question. My question is
without their income, assuming everything they told you is 100
percent accurate----
Mr. Counihan. Right.
Mr. Meadows [continuing]. Are there people in the
Affordable Care Act that have done everything right that are
getting the wrong subsidy?
Mr. Counihan. If there are people that provided all the
correct information, that updated their eligibility in a timely
way----
Mr. Meadows. That is not what I asked.
Mr. Counihan. Well, I am trying----
Mr. Meadows. I asked a very specific question. They did
everything right. You auto re-enrolled them.
Mr. Counihan. Yes.
Mr. Meadows. Are they getting the wrong subsidy?
Mr. Counihan. OK, I didn't----
Mr. Meadows. You know where I am going with this.
Mr. Counihan. I understand it clear now. You are talking
about the enrollment for 2015 and the----
Mr. Meadows. The auto re-enrolled people, are they getting
the wrong subsidy?
Mr. Counihan. If they did not come back into the
marketplace and update their income and eligibility like we
have strongly encouraged throughout the summer and throughout
the fall, it is possible that they are getting an incorrect
subsidy.
Mr. Meadows. Yes or no, are they getting--you know the
answer.
Mr. Counihan. Congressman, with----
Mr. Meadows. There are almost 2 million people, according
to the numbers you gave me yesterday, that were auto re-
enrolled.
Mr. Counihan. Correct.
Mr. Meadows. Are the vast majority of those getting the
wrong subsidy?
Mr. Counihan. I don't know the answer to that.
Mr. Meadows. OK. Well, let me answer it for you.
Mr. Counihan. OK.
Mr. Meadows. Because I have had to go do all the work, and
I can tell you the answer to that is yes; and you know it is
yes, and you are perpetrating a fraud on the American people.
Do you not know that they are getting the wrong subsidy?
Mr. Counihan. Sir, with all due respect, I am not sure that
you can say that they are getting the wrong subsidy.
Mr. Meadows. OK, I know that over 9,000 people in my
district that were auto re-enrolled are getting the wrong
subsidy because you used the subsidy from last year, and the
Silver benchmark plan that they were on last year changed. So
would you agree that 9,000 people in my district are getting
the wrong subsidy?
Mr. Counihan. I would not necessarily agree with that
because unless you have different information, Congressman, and
you very well might, but some of those 9,000 people could well
have come back to Healthcare.gov, updated their income and
eligibility, and be getting the 2015----
Mr. Meadows. I am talking about passive re-enrollment.
Listen, you are splitting hairs. I know this almost as well as
you do now. The passive re-enrolled people, are they getting
the wrong subsidy, yes or no?
Mr. Counihan. If people did not come back to the
Marketplace and did not update their eligibility, it is
possible that they could be getting the 2014 subsidy, yes.
Mr. Meadows. And you know that. So have you notified those
people that it is incorrect?
Mr. Counihan. We notified people, as I understand it--this
was before my time, but when this decision was made last
summer, so this would be the summer of 2014, there was a broad
communication campaign to alert people to this decision.
Mr. Meadows. In January, of the almost 2 million people,
and it was more than that in January, but assuming that there
is 2 million people that were auto re-enrolled, you know
because 820,000 of them just got the wrong 195-As, you know
approximately how many people are getting the wrong subsidy.
Mr. Counihan. But, sir, those are actually independent
actions.
Mr. Meadows. I understand that.
Mr. Walberg [presiding]. The gentleman s time from South
Carolina has expired. Give another 5 minutes to the gentleman
from North Carolina.
Mr. Meadows. I thank you.
So let's followup on this questioning. Do you have any
estimates on how many people are getting the wrong subsidy
today?
Mr. Counihan. Sir, I do not. What I----
Mr. Meadows. Have you looked for those?
Mr. Counihan. What I can tell you is the information that I
gave you yesterday, for example, showed that 1.96 million
people were auto re-enrolled.
Mr. Meadows. No, that is not correct.
Mr. Counihan. What do you mean it is not correct?
Mr. Meadows. Auto re-enrolled was 2.8 something, and then
people came back and actually came back, so then the net number
now is that number you just gave me.
Mr. Counihan. That is correct. It was 2.83 as of December
16th, 2014.
Mr. Meadows. Well, December 16th is curious because open
enrollment didn't stop and automatic re-enrollment didn't stop
until December 18th. So why the 2-day difference?
Mr. Counihan. But that was where we ended auto re-
enrollment.
Mr. Meadows. So on December 16th that was the accurate
number.
Mr. Counihan. That is correct. And as a matter of fact, as
you may recall, over the phone, you and I actually walked
through----
Mr. Meadows. Where the other numbers came from.
Mr. Counihan. That is right.
Mr. Meadows. Right.
Mr. Counihan. That is right. And I am sorry, sir, just to
insert one other point is that we continue to strongly
encourage people to back to Healthcare.gov----
Mr. Meadows. I will too because, according to my numbers,
there are hundreds of thousands of people getting the wrong
subsidy, and you know that that is correct, don't you?
Mr. Counihan. Sir, we are encouraging people to go back to
Healthcare.gov, update their eligibility----
Mr. Meadows. That is a Statement; that is not an answer to
my question. Do you know that hundreds of thousands of people
are getting the wrong subsidy.
Mr. Counihan. Sir, as I am telling you, we are encouraging
people to get the right subsidy by updating their eligibility.
Mr. Meadows. OK. Is it not fraud when you know that you are
doing wrong and not informing the very people that you have
been charged to support? Is that not fraudulent?
Mr. Counihan. Sir, I don't know the legal definition of
fraud, but what I can tell you is----
Mr. Meadows. Is it ethical?
Mr. Counihan [continuing]. Is when this decision was made,
back last summer, there was broad communication and outreach
about the decision. Going into the fall, when I arrived, that
has been going on in the same and continues now.
Mr. Meadows. So you support that decision. You support the
decision to keep the American people in the dark. Most of these
are very low-income folks or, at best, moderate income, and
what they are going to get is a surprise, and you know they are
going to get a surprise a year from now where you have given
them the wrong subsidy.
Mr. Counihan. The decision was made in the summer of last
year. Since that time----
Mr. Meadows. And you support that decision, obviously; you
haven t changed it.
Mr. Counihan. Since that decision was made, we continue to
try to get people to go back and update their income to make
sure exactly what you are saying does not occur.
Mr. Meadows. But it is occurring, wouldn't you agree?
Mr. Counihan. I would agree that it may occur.
Mr. Meadows. You are an intelligent individual. Is it
occurring or not?
Mr. Counihan. When people do not update their eligibility,
they are going to be having the 2014 APTC, the Advanced Premium
Tax Credit, applied. But as I said, sir----
Mr. Meadows. So if that is the case, so let's take your
assumption. Out of all the people that auto re-enrolled in
North Carolina, if that is the case, over half the counties
have a different benchmark plan, so they would be getting a
different subsidy, because their carrier is no longer the same
carrier.
Mr. Counihan. But, sir, I think you are forgetting one
critical component, which is you are assuming that nobody is
coming back to update their eligibility or income, and I don't
that that is true.
Mr. Meadows. No, I am not. I started out with that. These
are passive re-enrolled people, which means they never came
back.
Mr. Counihan. That is correct, sir. But it is still
possible for people to come and update their eligibility.
Mr. Meadows. I understand that. So if they didn't come
back, they are getting the wrong subsidy.
Mr. Counihan. They would be getting the 2014 subsidy.
Mr. Meadows. So is it wrong or right?
Mr. Counihan. It is the 2014 subsidy, it is not the 2015
subsidy.
Mr. Meadows. OK. Did the subsidy--and I hate the way you
are going through this, making me go through all of this--did
the subsidy, in most of the counties in North Carolina and, in
fact, across the Country, according to your press release,
change because the Silver benchmark plan changed?
Mr. Counihan. You are absolutely right, sir. It depends on
the county. It is a county-specific issue. I can t recall,
offhand, how many counties throughout the Country where that
occurred.
Mr. Meadows. Well, according to your press release, over 85
percent of the people could have gotten a lower plan. So is
that correct? I am sure you vetted that number.
Mr. Counihan. There are instances where the----
Mr. Meadows. Well, I am out of time, so I will yield back.
I thank the patience of the chair.
Mr. Walberg. Thank you, Mr. Meadows.
The chair recognizes the gentleman from Tennessee.
Mr. DesJarlais. Mr. Counihan, what would you say would be
the best way to define success of the Affordable Healthcare
Act?
Mr. Counihan. That is a very good question. I think it is
several things. I think one would be reduction of uninsured----
Mr. DesJarlais. OK, well, let's talk about that. I think
that s probably how you would define that.
Mr. Counihan. I think it is multi-dimensional.
Mr. DesJarlais. OK, but let's start with that because that
is an important topic. That is what the President said, we
needed this law because there are 30 million uninsured people
in this Country, and we need to help those people.
Did you write your opening Statement or did somebody write
it for you?
Mr. Counihan. It was written with my input.
Mr. DesJarlais. OK. And when you talked about the number of
uninsured, you told me it was the lowest in five decades. What
was the uninsured rate five decades ago?
Mr. Counihan. I am not sure.
Mr. DesJarlais. OK, how do you know that it is the lowest
if you don't know what that was, and how can you tell us today,
tell this committee that we have the lowest rate of uninsured
in five decades? I think Mr. Mulvaney asked if you could tell
us within 1 million or even within 5 million, and you didn't
give us an answer. Can you give me an answer now?
Mr. Counihan. What I can tell you, and I am happy to
provide this as part of my Statement, is that each of the data
that has been cited has a reference point to where that came
from.
Mr. DesJarlais. OK. Well, you are telling us that there are
11.6 million people signed up, so we don't know whether those
were previously uninsured or people who just changed
insurances.
Mr. Counihan. So that is information that is tracked by
some States. There are studies done periodically that do
measure the impact on the uninsured both through Medicaid
expansion and through the rollout of qualified health plans.
Mr. DesJarlais. Do you feel like your opening Statement was
accurate and truthful?
Mr. Counihan. Yes.
Mr. DesJarlais. OK, so your claim that we have the most
uninsured can't be substantiated by you today because you can't
give us any numbers. So are you just theorizing that that is
the truth or is that the truth?
Mr. Counihan. No. Every piece of information in my
testimony, my opening Statement was qualified and cited to a
specific data source.
Mr. DesJarlais. Well, we worry a little bit about
propaganda because this was a really unpopular law when the
President tried to pass it; he had to cut all kinds of deals to
get the votes to pass it. Then the IRS had to change the rule
that the Supreme Court is going to be looking at here in a few
weeks, King and Burwell, very important, and we will talk about
that for a minute, too. But when you said that you send out
weekly data, that is accurate; every week you put that out it
is accurate.
Mr. Counihan. Yes.
Mr. DesJarlais. But today you can't tell us what is
accurate or not.
Mr. Counihan. No, I think I didn't speak properly. What I
said was that in my opening Statement, whenever there was a
reference to information or to data, that it was cited.
Mr. DesJarlais. Well, if you were the President, you would
want to make your program look go. So by saying that you have
the lowest number of uninsured in five decades, that is
obviously an attempt to say, hey, this thing is working. But
when we ask you those numbers, you can't give them to us. So is
this just propaganda? Is this the President trying to make his
law look better than it is?
Mr. Counihan. What I tried to say, and perhaps I didn't say
it as clearly as I should, is that any data or information that
I share with this committee has to be spot-on.
Mr. DesJarlais. OK, are the weekly reports spot-on?
Mr. Counihan. They are.
Mr. DesJarlais. OK. Actually, there seems to be a
disconnect here because every week you can give spot-on data,
but today, in our committee, you can't tell any of us spot-on
data.
Mr. Counihan. I think I gave some spot-on data, sir.
Mr. DesJarlais. It would be squeezed in between a lot of
non-answers.
I asked you earlier how do you get the money back from the
illegals who have gotten or the people you can't verify should
be getting healthcare, and I don't think you had time to
answer. Mr. Jordan brought it up as well. How do we get the
money back, subsidies that were given to people illegally?
Mr. Counihan. What I tried to describe, sir, was the
process that we use that is very specific to verify people's
eligibility.
Mr. DesJarlais. How do we get the money back?
Mr. Counihan. Specific to your point about getting money
back would relate to how much money has been inappropriately
spent, and I don't know the answer to either one of those two.
I don't have the facts behind that.
Mr. DesJarlais. And you told Mr. Jordan that you didn't
talk to anybody about the impact that the President's executive
action may have?
Mr. Counihan. Correct.
Mr. DesJarlais. OK, it sounds like something we might want
to be concerned about because it sounds like we are talking
about a lot of money. And you said Secretary Burwell handled
the issue of what is going to happen or not in King.
Mr. Counihan. Yes.
Mr. DesJarlais. OK, so you don't have an opinion on that?
These 11 million people that you are here today saying that
this law has been a success because you are helping cover, you
don't have an answer for them if the Supreme Court strikes down
the subsidies from the employees?
Mr. Counihan. The secretary has spoken for us.
Mr. DesJarlais. And what she said is that they don't have a
plan, they don't need a plan. Do you all know something we
don't know about the Supreme Court decision?
Mr. Counihan. The secretary has spoken for us. I don't have
a comment on that issue, sir.
Mr. DesJarlais. Are you comfortable with her answer? I
mean, you have to be able to think for yourself. Does that make
you feel a little bit nervous about what might happen if it is
not ruled in your favor?
Mr. Counihan. I am very comfortable with the secretary s
answer.
Mr. DesJarlais. All right, thank you for your time.
Mr. Counihan. Thank you.
Mr. Walberg. The gentleman from Ohio is recognized for 1
minute.
Mr. Jordan. I thank the chairman. Just real quickly, I
wanted to followup where the gentleman from Tennessee was.
So you say you have this elaborate fail-safe process that
no illegals are going to sign up for the Affordable Care Act;
yet, you have 50,000 folks who have already filed their tax
returns with false information that you all gave to them. Can
you assure this committee and, more importantly, the American
people that no illegals have signed up for ObamaCare and
received any kind of subsidy or any kind of benefit?
Mr. Counihan. What I described----
Mr. Jordan. No, no, that is a real simple question. Can you
assure this committee and, more importantly, the American
people that no illegals have signed up and received benefits
from ObamaCare?
Mr. Counihan. What I have tried to do is to describe the
process we do to validate----
Mr. Jordan. That is not the question. You did that with my
line of questioning the last time. I am asking you can you
assure us that no one has received benefits who is an illegal?
Mr. Counihan. Sir, we have an elaborate validation
process----
Mr. Jordan. Can you----
Mr. Counihan [continuing]. And I am confident in the
process.
Mr. Jordan. We have been here now an hour and a half, and
we would like one time for you to give us just a yes or no when
we ask a question. Mr. Meadows tried for 15 minutes to get you
to answer a question. We would like you to answer this one
question because it is important to the debate that is taking
place in Congress this week, important debate that the American
people care pretty deeply about. Can you assure this committee
and the American people that no one, no illegal has received
benefits under the Affordable Care Act?
Mr. Counihan. Sir, I am going to repeat----
Mr. Jordan. OK, so here is the point, Mr. Counihan.
Mr. Counihan. We have a very----
Mr. Jordan. If your fail-safe, wonderful approach to make
sure this doesn't happen, if it is so good, that would be easy
for you to say, yes, I can assure you. But my guess is you
won't say yes because obviously your approach on sending out
tax information to these folks is not fail-safe. You have
50,000 people already filed, 800,000 people who got false
information. So it is a logical question for the American
people to ask, now, if that happened, might some illegals be
getting benefits under the Affordable Care Act today. And you
should be able to assure the American citizens that that is not
happening, and you won't do it.
Mr. Counihan. What I can assure the American people is the
same assurance I give you and the rest of the committee, which
is the discipline of the process for validating eligibility.
Mr. Jordan. This is amazing, Mr. Chairman. This is amazing.
Mr. Walberg. Thank you, Mr. Jordan.
The chair recognizes the gentleman from Florida.
Mr. DeSantis. Good afternoon, sir. The President's program,
executive program that is subject of much controversy, where he
is going to issue up to 5 million work permits to people who
are in the Country illegally, Social Security numbers, when
they get those documents, would they then be eligible to have
ObamaCare subsidies?
Mr. Counihan. Sir, I need to educate myself better in the
details of that.
Mr. DeSantis. And are you aware if a business, if faced
with who otherwise is subject to the ObamaCare system, has a
choice to hire either a U.S. citizen or somebody with one of
these work permits, isn't it the case that the U.S. citizen
would be subject to the employer mandate? In other words, the
employer would have to provide the ObamaCare-prescribed
insurance, but somebody who is here illegally, the employer
would actually not have to provide it; therefore, the person
who is here illegally can be hired at a lower price?
Mr. Counihan. Well, sir, and I am not a labor lawyer and I
am not an expert in this, but----
Mr. DeSantis. With the employer mandate, though, if
somebody has a work permit and they are not here legally, the
employer, it is as if that doesn't apply to them, right?
Mr. Counihan. I think there are some consequences for
hiring illegal aliens if I am an employer.
Mr. DeSantis. Well, the President is issuing work permits.
I am saying if he issues the work permits, then that is
basically a signal to the employer that you can hire these
people. Otherwise, why would you issue the work permits?
Mr. Counihan. You know, sir, with deep respect, this is a
Department of Labor issue. This is beyond my bailiwick.
Mr. DeSantis. It is an ObamaCare issue, because the reason
why you would have a hiring incentive, perhaps, is because of
the disparate treatment that folks will get the way the law is
written. So I just think it is important for the American
people to know if these work permits enable people to go and
get subsidies, then taxpayers would want to know that. If they
are actually exempt from the employer mandate, then that seems
to me to provide an incentive for employers to hire folks who
have those, who are not legally in the Country but have the
work permit. And, yes, they are hiring, but it is an issue that
is germane to the patient protection in Affordable Care Act and
its requirements.
Mr. Counihan. Sir, I understand the question. It calls for
speculation.
Mr. DeSantis. Why would it call for speculation? The law
has been on the books since 2010. wouldn't we know?
Mr. Counihan. My understanding of your question is you are
asking me to speculate if there is some type of incentive in
place for an employer to hire a certain type of work force.
That is my understanding of your question.
Mr. DeSantis. So you look at the law on the books, you know
that these work permits are coming down the pike, so it is a
simple question of if somebody is illegally here and they get a
work permit, what is the interaction with that and the
Affordable Care Act. So it is not a speculation; it is looking
at the law on the books and then explaining what the department
s position would be.
Mr. Counihan. Sir, I need to think through your question.
Mr. DeSantis. So can you reply to us in writing and we can
lay out the question? Because I just think it is important to
know. Some of this stuff, it seems, that has frustrated a lot
of the American people is kind of done on the fly and we don't
even know the rules. This one we need to know one way or
another.
With that, I am going to yield the remainder of my time to
my friend from North Carolina, Mr. Meadows.
Mr. Walberg. The gentleman from North Carolina is
recognized.
Mr. Meadows. I thank the gentleman from Florida.
So let me ask the last question, since you know we would
not have had this hearing if you had just had responded to any
of the 23 emails. Do you realize that, that if you just
responded to my simple request, that this wouldn't have had to
happen? So let me ask this question. How many people were put
in a plan other than the exact plan that they had in 2014?
Mr. Counihan. I don't know the answer to that yet. I know
that that is a critical question and that is information that
we will be getting.
Mr. Meadows. So it is your testimony here today that you do
not know the number, be careful because you are under oath, you
do not know the number of the number of people that were put in
a plan other than the one they were in 2014, after 70 days of
me asking?
Mr. Counihan. Sir, I do not have a number I would share
with you. I don't have a verified number that I am confident to
share with you.
Mr. Meadows. OK. Well, give me the non-verified; we will
put a big qualifier around it. How many?
Mr. Counihan. Sir, with the deepest respect, I am not going
to share a number with you that is not verified.
Mr. Meadows. So you have done analysis.
Mr. Counihan. We are doing analysis.
Mr. Meadows. Would you say there are over 800,000 of them?
Mr. Counihan. I think the number is significantly smaller
than that.
Mr. Meadows. So you have a ballpark.
Mr. Counihan. I have a ballpark. I am not sharing a
ballpark until it is verified, sir.
Mr. Meadows. All right, so you put between 500,000 and
800,000 people in a plan other than the one they had had, so
they may not have the same doctor.
Mr. Counihan. The issue about provider networks--and you
and I have had a discussion about this--is actually independent
of that transfer.
Mr. Meadows. It is. Yes. So who decides who is in that, you
or the insurance companies?
Mr. Counihan. And you and I discussed this as well.
Mr. Meadows. And I know the answer. So go ahead and answer
it for the American people.
Mr. Counihan. OK, because I come from that world. That is a
relationship, a contractual relationship, as you know, that is
created between the insurance company and the providers.
Mr. Meadows. All right. And that is exactly where I wanted
to go. So the insurance company and the patient are the ones
that have the contractual obligation.
Mr. Counihan. You mean the insurance company and the
provider.
Mr. Meadows. And the provider.
Mr. Counihan. Yes.
Mr. Meadows. Right. So as we have done that, you have
reached in and you have decided for over a half million people
what plan they should have. Did you not do that?
Mr. Counihan. Sir, in the first place, that number that you
threw out is not a number that I would necessarily support. You
said a half million people. That is one.
Mr. Meadows. So you say it is less than that.
Mr. Counihan. As I said, I believe it is less than that,
but----
Mr. Meadows. Well, you have people behind you. If they are
not going to help you with it, don't bring them. They know the
number. You know the number.
Mr. Counihan. Sir, you and I have discussed this. I am----
Mr. Meadows. All right, can we get that answer within the
next 7 days?
Mr. Counihan. Sir, I will get that answer to you as quickly
as I can.
Mr. Meadows. Mr. Chairman, I would yield back, but before
yielding back I would suggest the committee strongly look at
subpoenaing all the data, all the correspondence, because it is
obvious that this gentleman is stonewalling the committee and,
more important, it is not the committee, it is the American
people, and I take that very seriously. And I thank the
patience of the chair.
Mr. Walberg. Thank you, Mr. Meadows.
I would like to yield myself just a minute or two to
finalize a couple questions here, then we will close the
hearing for the day.
The Navigators program was funded through Federal grants to
outreach groups so that they could enroll individuals in their
exchanges. Our review has uncovered that this program, in 2014,
had a negligible effect. The question is this: Mr. Counihan,
was the Navigators program in operation for this last
enrollment period?
Mr. Counihan. Yes.
Mr. Walberg. How much funding was given to these support
groups?
Mr. Counihan. I need to confirm that with you; I am not
exactly sure. I have that information, but I can't remember it
right offhand.
Mr. Walberg. Where do you have the information?
Mr. Counihan. In my office.
Mr. Walberg. In your office. You didn't bring the
information with you?
Mr. Counihan. Not for that specific question.
Mr. Walberg. OK. Did you conduct any analysis on whether
the Navigator program was actually improving the quality of
applications submitted, that is, they had fewer mistakes?
Mr. Counihan. We have done a lot of analysis about the
Navigator and a sister program.
Mr. Walberg. And why did you feel like you had a need to do
that?
Mr. Counihan. I am sorry, why did we feel?
Mr. Walberg. Yes.
Mr. Counihan. Well, to be quite frank with you, sir, it is
because it involves taxpayer money. We want to be appropriate
stewards of taxpayer money; it is all of our money and we want
to make sure we are getting the proper return.
Mr. Walberg. You want to be properly stewards of taxpayers
money, but 52 percent of them have trouble as far as whether
they are paying back $530 I believe was the exact number?
Mr. Counihan. I am unfamiliar with that quote. I know you
referred to H&R Block or something like that. I don't know
about that.
Mr. Walberg. I wouldn't think you would.
You know, I will just be frank with you. I am fairly new at
the process here, have sat through a few hearings, but I would
venture to guess if we were to ask you all these questions or
all the answers to all the questions we asked that you did not
know, if we were to extend a week to you, is that something
that you would be willing to do to bring back the answers to
multiple questions that there was basically I can't recall?
Mr. Counihan. Sir, I am responsible for the program. It is
my responsibility to be accountable to the department, as well
as to you, for information that you need.
Mr. Walberg. That was my final question, and I still didn't
get a yes or no. If you were extended a week, would you be able
to come back with most of this information?
Mr. Counihan. Yes.
Mr. Walberg. Thank you.
Mr. Meadows. Would the gentleman yield for one point of
clarification?
Mr. Walberg. The gentleman is recognized from North
Carolina.
Mr. Meadows. You mentioned that automatic re-enrollment
ended on December 16th. That highlighted comes from your
Website. And I know that you can't read that from there, but
your Website actually says that auto re-enrollment started on
December 16th and closed on December 18th. So is----
Mr. Counihan. No.
Mr. Meadows. I mean, I just pulled that off, because all I
have to go by is what you put on the Web.
Mr. Counihan. I understand.
Mr. Meadows. So what you are saying is it is vetted
incorrectly on your Website.
Mr. Counihan. No, I am not saying that. What I am saying is
I can't see that document, to be frank with you----
Mr. Meadows. Well, you can have them pull it up, because it
is on Healthcare.gov right now, and it says that auto re-
enrollment stopped on December 18th.
Mr. Counihan. That is because of processing time. That is
the difference between the actual stop date of the 16th and the
processing time to the 18th.
Mr. Meadows. All right. Thank you for that clarification.
Mr. Walberg. Thank you, Mr. Meadows.
My closing remark would be one of the things that I believe
that could help what I feel like is a very poor performance is
a very prompt response to many of these questions, and I hope
that we look forward, we all look forward to some of these
vital answers that are important to the American people.
I would like to thank our witness for sitting in that seat
for the last hour and 40 minutes and doing your best job to
answer, I hope, the many questions.
If there is no further business, without objection, the
committee stands adjourned.
[Whereupon, at 11:50 a.m., the subcommittee was adjourned.]
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