Thank you, Mr. Chairman for holding today’s hearing, and thank you Mr. Kouzoukas for joining us this afternoon.
Nearly three years ago, President Obama signed into law the Medicare Access and CHIP Reauthorization Act, or MACRA. This bipartisan legislation put an end to the recurring threat of draconian Medicare cuts under the flawed Sustainable Growth Rate formula.
By creating a new Quality Payment Program and Alternative Payment Models that reward physicians that coordinate care and achieve better outcomes, MACRA took us several steps forward in our effort to make Medicare an increasingly value-based program. I look forward to hearing about the progress being made under this law.
However, as useful as today’s meeting is in reviewing MACRA, we must recognize that we are not holding this hearing in a vacuum. The actions of Republican majority and the Trump Administration have caused upheaval in the health care system that has undermined many of the goals we hope to achieve through MACRA. Regrettably, throughout all of this chaos, this Subcommittee has been remarkably inactive during the 115th Congress, holding just three hearings prior to today.
President Trump has consistently worked to undermine and sabotage key aspects of the Affordable Care Act through administrative actions. These include ending cost-sharing reduction subsidies, slashing funding for Navigator groups and outreach, and - most recently - expanding the reach of short-term policies that can evade important patient protections.
These and other actions have left the insurance markets in chaos and resulted in major premium increases throughout the country. Yet, despite the urging of Ways and Means Democrats, we have held no hearings on any of these issues. Not one.
As we move forward, we must no longer ignore these harmful proposals. Furthermore, we must acknowledge that President Trump’s budget would devastate access to care for millions of Americans. His budget cuts more than $1.4 trillion from Medicaid by switching to per capita caps and block grants while ending the ACA’s Medicaid expansion. It also slashes $532 billion from Medicare through - among other cuts - a radical restructuring of the graduate medical education program and devastating cuts to home health agencies and nursing facilities that serve the most vulnerable beneficiaries.
When it comes to value-based payment, the approach of this Administration has not reflected the bipartisan commitment that Congress showed in passing MACRA. Instead, it is more about conservative ideology than common-sense innovation.
By massively scaling back value-based payment efforts begun during the Obama Administration and hinting at a shift toward premium support and privatization experiments, the Administration has left many seniors worried about what lies ahead for Medicare.
Mr. Chairman, MACRA was a truly bipartisan effort, and we have a shared goal of ensuring that it is ultimately a success. Today’s hearing reflects that bipartisan commitment. However, we must not ignore the broader developments that have undermined this spirit and threaten to greatly overshadow the improvements made by MACRA.
