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CMS Administrator Seema Verma on Wednesday defended the Trump administration's actions on healthcare, telling the U.S. House of Representatives' Energy and Commerce Committee that her agency is trying to provide greater access to care in the face of rising healthcare costs. Verma touted the CMS' efforts on a range of healthcare issues from health IT interoperability to opioid abuse throughout her testimony, but the committee's Democratic members met her with fierce criticism. They said that under the Trump administration, the healthcare system is heading in the wrong direction and that the Affordable Care Act is succeeding "despite" the administration's best efforts to undermine it. (Brady, 10/23)

Democrats argued that premiums would have gone down more if the Trump administration had not taken certain actions, such as expanding the sale of short-term insurance plans that do not have to comply with all of the law's requirements. "In reality, it is you and the Trump administration who have done everything you can to sabotage the ACA and reverse the lost historic gains in health coverage," said Rep. Jan Schakowsky, D-Ill. "Imagine how much more money Americans could have saved if you were uplifting the ACA and helping them to get coverage." (McIntire, 10/23)

At Wednesday's hearing, Verma refused to answer how many people would lose insurance if the ACA is struck down. Representative Diana DeGette, the subcommittee's Democratic chairwoman, placed the number at 21 million. DeGette also asked Verma if the Trump administration has a contingency plan to protect people with preexisting conditions, considering Obamacare required insurers to cover them. Verma refused to answer, telling DeGette she was "not going to get into any specifics of the plan." Degette was just one of many members to press or criticize Verma about the existence of a contingency plan. (Cournoyer, 10/23)

Rep. Frank Pallone Jr. (D-N.J.), the chairman of the full committee, also pressed Verma for details about what the administration would do in a post-ObamaCare environment. “Does the president have a plan and what is the plan? It sounds like he has a secret plan he doesn’t want to reveal,” Pallone said. “Could you just tell us some information … in the event that he is successful in this awful lawsuit?” “I’m not going to get into specifics about the plan,” Verma said. “We have planned for a number of different scenarios, but we need to hear from the courts." (Weixel, 10/23)

Rep. Joe Kennedy III (D-Mass.) in a tense exchange Wednesday pressed the head of the Medicare and Medicaid programs to explain why she has allowed states to impose work requirements on Medicaid beneficiaries. Kennedy asked Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, to point to any study that backs up the administration’s argument that work requirements make people healthier. (Weixel, 10/23)

Verma contends that the drop stems from more people gaining jobs that carry employer health coverage — not new rules in Republican-led states that require recipients to work to receive the aid. “When we look at the Medicaid program it’s natural to see fluctuations in enrollment,” Verma explained during a House Energy and Commerce Committee hearing, adding “because we’re in a booming economy, less people in poverty, we’re going to see that in the Medicaid program.” (Coombs, 10/23)

The hearing was a rare opportunity for congressional Democrats who have been eager to publicly question Trump administration health officials on White House efforts to roll back the ACA, part of a messaging battle ahead of the 2020 election. Democrats, many of whom will seek re-election by promising to preserve the ACA, say the administration has adopted policies it knew would raise health-care costs and leave more people without coverage. They point to work requirements in Medicaid, the end of billions in payments to insurers that drove up premiums, and the Trump administration’s backing of a GOP-led lawsuit to strike down the ACA. (Armour, 10/23)

A federal appeals court decision that could strike down the Affordable Care Act as soon as this month has rattled officials in several states who are pursuing legislation to preserve some coverage in the absence of any Trump administration contingency plan. Lawmakers in states including Louisiana, Nevada, New Mexico and California have passed bills or are reviewing action aimed at dealing with the fallout if the ACA is overturned. Many of these lawmakers are also facing re-election campaigns this fall in some of the very states that brought the lawsuit. (Armour, 10/21)

Attorney General Eric Schmitt on Wednesday defended his decision to keep Missouri on the list of states challenging the Affordable Care Act — a day after his possible Democratic opponent in next year’s general election blasted the move as “pure politics.” ... Schmitt said Wednesday he had always “fought to make health care more available, more affordable and more portable, including fighting for our most vulnerable as it relates to insurance.” (Suntrup, 10/23)