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Republicans Block Congresswoman Waters’ Attempt to Oversee States’ Difficulties Resulting from Defunding of Health Care Reform

May 3, 2011
Press Release

Congresswoman Maxine Waters (D-Calif.) offered an amendment today to H.R. 1213, a bill to repeal mandatory funding provided to the states to set up Health Benefit Exchanges as part of the historic health care reform law passed last year.  Health Benefit Exchanges are marketplace-like entities required by the health care reform law where people can shop around for different health care options.

Though opposed to the bill to repeal funding for the exchanges, Congresswoman Waters wanted to ensure that Congress would be aware of the difficulties that the states would have in setting up these exchanges. Therefore, her amendment required the Department of Health and Human Services to complete a report on the impact of the federal government's withholding of funds. The Rules Committee allowed the Congresswoman's amendment to go forward, but it was ultimately defeated by the full House.

Congresswoman Waters attempted to offer several other amendments to H.R. 1213, including one to require the Department of Health and Human Services to complete a report on the extent to which uninsured Americans will have difficulty obtaining affordable health insurance coverage without being able to purchase insurance on the exchanges.  However, none of her other amendments were allowed by the Republican-dominated Rules Committee.

Below is a statement Congresswoman Waters delivered on the House floor in support of her amendment:

"My amendment requires the Secretary of Health and Human Services to submit to Congress a report on the extent to which states are expected to have difficulties establishing Health Benefit Exchanges without the federal assistance repealed by this bill.

"The Affordable Care Act requires the establishment of Health Benefit Exchanges in every state.  These exchanges will be a marketplace where individuals, families, and small businesses can purchase health insurance.  The exchanges will feature a variety of health plans offered by different insurance companies, all of which must offer a comprehensive set of essential health benefits at affordable prices.  The purpose of these exchanges is to enable American consumers to compare premiums, out-of-pocket expenses, and benefits and make informed choices among competing health plans. 

"The Affordable Care Act places an emphasis on state-based health reform.  The Affordable Care Act allows states to set up their own Health Benefit Exchanges and offers grants to states to assist them in doing so.  A total of 49 states, the District of Columbia, and 4 territories have already applied for these exchange grants.  These states and territories are working hard to determine what type of health insurance marketplace will be best for their families and businesses.

"Without federal funding, some states could have difficulty establishing exchanges in a timely manner.  This could lead to poor management of the exchanges, fewer health plans included on the exchanges, and years of delay in getting the exchanges up and running. 

"Some states might simply refuse to establish exchanges at all in the absence of federal assistance.  This would result in greater costs for the federal government, because the Affordable Care Act requires the federal government to set up health exchanges in those states that do not set up their own exchanges. 

"According to the Congressional Budget Office (CBO), states that attempt to set up health exchanges without federal funding may face challenges in making their exchanges fully operational by 2014, as the law requires.  These challenges could limit the desirability of the exchanges for consumers and reduce the capacity of some exchanges to process enrollment.  As a result, CBO estimates that by 2015, there will be almost two million fewer people enrolled in state exchanges.

"Many states are already facing declining revenues and budget pressures as a result of the Great Recession.  Some states have been forced to make painful choices, increasing taxes or cutting spending, in order to make ends meet.  Budget pressures have forced states to consider closing public health facilities, postponing transportation and infrastructure projects, and laying off teachers, law enforcement officers, and other public employees.   If the federal government expects states to set up health exchanges without any assistance, it will only compound their budgetary problems.

"My amendment requires the Secretary of Health and Human Services to report to Congress within 6 months of enactment on the difficulties states will encounter while trying to set up these exchanges without federal help.  If Congress is going to deny states the funding that was mandated for them to set up their health exchanges, Congress needs to know the extent of the difficulties states will face without these funds.

"I urge my colleagues to support this amendment."