RESCUING AMERICANS FROM THE FAILED HEALTHCARE LAW AND ADVANCING PATIENT-CENTERED SOLUTIONS HEARING BEFORE THE COMMITTEE ON EDUCATION AND THE WORKFORCE U.S. HOUSE OF REPRESENTATIVES ONE HUNDRED FIFTEENTH CONGRESS FIRST SESSION HEARING HELD IN WASHINGTON, DC, FEBRUARY 1, 2017 Serial No. 115–1 Printed for the use of the Committee on Education and the Workforce ( Available via the World Wide Web: www.gpo.gov/fdsys/browse/ committee.action?chamber=house&committee=education or Committee address: http://edworkforce.house.gov U.S. GOVERNMENT PUBLISHING OFFICE 23–826 PDF WASHINGTON : 2018 For sale by the Superintendent of Documents, U.S. Government Publishing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2104 Mail: Stop IDCC, Washington, DC 20402–0001 VerDate Mar 15 2010 10:24 May 03, 2018 Jkt 000000 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 C:\E&W JACKETS\23826.TXT CANDRA CEWDOCROOM with DISTILLER COMMITTEE ON EDUCATION AND THE WORKFORCE VIRGINIA FOXX, North Carolina, Chairwoman Joe Wilson, South Carolina Robert C. ‘‘Bobby’’ Scott, Virginia Duncan Hunter, California Ranking Member David P. Roe, Tennessee Susan A. Davis, California Glenn ‘‘GT’’ Thompson, Pennsylvania Rau´ l M. Grijalva, Arizona Tim Walberg, Michigan Joe Courtney, Connecticut Brett Guthrie, Kentucky Marcia L. Fudge, Ohio Todd Rokita, Indiana Jared Polis, Colorado Lou Barletta, Pennsylvania Gregorio Kilili Camacho Sablan, Luke Messer, Indiana Northern Mariana Islands Bradley Byrne, Alabama Frederica S. Wilson, Florida David Brat, Virginia Suzanne Bonamici, Oregon Glenn Grothman, Wisconsin Mark Takano, California Steve Russell, Oklahoma Alma S. Adams, North Carolina Elise Stefanik, New York Mark DeSaulnier, California Rick W. Allen, Georgia Donald Norcross, New Jersey Jason Lewis, Minnesota Lisa Blunt Rochester, Delaware Francis Rooney, Florida Raja Krishnamoorthi, Illinois Paul Mitchell, Michigan Carol Shea-Porter, New Hampshire Tom Garrett, Jr., Virginia Adriano Espaillat, New York Lloyd K. Smucker, Pennsylvania A. Drew Ferguson, IV, Georgia Brandon Renz, Staff Director Denise Forte, Minority Staff Director (II) VerDate Mar 15 2010 10:24 May 03, 2018 Jkt 000000 PO 00000 Frm 00002 Fmt 5904 Sfmt 5904 C:\E&W JACKETS\23826.TXT CANDRA CEWDOCROOM with DISTILLER CONTENTS Page Hearing held on February 1, 2017 ......................................................................... 1 Statement of Members: Foxx, Hon. Virginia, Chairwoman, Committee on Education and the Workforce ....................................................................................................... 1 Prepared statement of ............................................................................... 6 Scott, Hon. Robert C. ‘‘Bobby’’, Ranking Member, Committee on Edu- cation and the Workforce ............................................................................. 7 Prepared statement of ............................................................................... 14 Statement of Witnesses: Bollenbacher, Mr. Scott, CPA, Managing Partner, Bollenbacher and Asso- ciates, LLC, Portland, Indiana ..................................................................... 38 Prepared statement of ............................................................................... 40 Eddy, Mr. Joe, President and Chief Executive Officer, Eagle Manufac- turing Company, Wellsburg, West Virginia ................................................ 24 Prepared statement of ............................................................................... 26 Schlaack, Ms. Angela, St. Joseph, Michigan .................................................. 32 Prepared statement of ............................................................................... 34 Troy, Mr. Tevi, PH.D., Executive Officer, American Health Policy Insti- tute, Washington, DC ................................................................................... 17 Prepared statement of ............................................................................... 20 Additional Submissions: Adams, Hon. Alma S., a Representative in Congress from the State of North Carolina: Letter dated January 3, 2017, from Seven Children’s Groups .............. 130 Bonamici, Hon. Suzanne, a Representative in Congress from the State of Oregon: Letter December 28, 2016, from AARP ................................................... 71 Brat, Hon. David, a Representative in Congress from the State of Vir- ginia: Chart: Hitting the Wall: When Health Care Costs are No Longer Manageable ............................................................................................ 96 Courtney, Hon. Joe, a Representative in Congress from the State of Connecticut: Article: Is healthcare law really going into a death spiral? ................... 149 DeSaulnier, Hon. Mark, a Representative in Congress from the State of California: Article: One in Five 2014 Marketplace Consumers was a Small Busi- ness Owner or Self-Employed ............................................................... 142 Espaillat, Hon. Adriano, a Representative in Congress from the State of New York: Prepared statement of from Cuomo, Hon. Andrew M., Governor of New York ................................................................................................ 85 Article: AAMC Statement on President Trump’s Executive Order on Immigration ........................................................................................... 92 Chairwoman Foxx: Republican Subcommittee Assignments .................................................. 3 Key Facts on Obamacare .......................................................................... 169 Breaking Down the Uninsured ................................................................ 172 Polis, Hon. Jared, a Representative in Congress from the State of Colo- rado: Letter dated January 4, 2017, from Hickenlooper, Hon. John, Gov- ernor of Colorado ................................................................................... 64 (III) VerDate Mar 15 2010 10:24 May 03, 2018 Jkt 000000 PO 00000 Frm 00003 Fmt 5904 Sfmt 5904 C:\E&W JACKETS\23826.TXT CANDRA CEWDOCROOM with DISTILLER IV Page Additional Submissions—Continued Mr. Scott: Letter dated January 30, 2017, from the U.S. Department of Health and Human Services .............................................................................. 10 Report: Highlighting the Progress of the Affordable Care Act .............. 46 Prepared statement of from Pollack, Mr. Rick, President and CEO, American Hospital Association ............................................................. 172 Takano, Hon. Mark, a Representative in Congress from the State of California: Letter dated December 6, 2016, from the American Hospital Associa- tion and Federation of American Hospitals ......................................... 79 Thompson, Hon. Glenn ‘‘GT’’, a Representative in Congress from the State of Pennsylvania: Submission for the record ......................................................................... 156 Mr. Troy: Briefing Paper: How the Implementation of the Affordable Care Act Will Affect Doctors ................................................................................. 112 Questions submitted for the record by: Barletta, Hon. Lou, a Representative in Congress from the State of Pennsylvania ...................................................................................... 174 Stefanik, Hon. Elise, a Representative in Congress from the State of New York ........................................................................................ 174, 176 Responses to questions submitted for the record: Mr. Barletta ............................................................................................... 177 Mr. Eddy .................................................................................................... 178 VerDate Mar 15 2010 10:24 May 03, 2018 Jkt 000000 PO 00000 Frm 00004 Fmt 5904 Sfmt 5904 C:\E&W JACKETS\23826.TXT CANDRA CEWDOCROOM with DISTILLER RESCUING AMERICANS FROM THE FAILED HEALTHCARE LAW AND ADVANCING PATIENT-CENTERED SOLUTIONS Wednesday, February 1, 2017 House of Representatives, Committee on Education and the Workforce, Washington, D.C. The committee met, pursuant to call, at 10:04 a.m., in Room 2176, Rayburn House Office Building, Hon. Virginia Foxx [chair- woman of the committee] presiding. Present: Representatives Foxx, Wilson of South Carolina, Roe, Thompson, Walberg, Guthrie, Rokita, Messer, Byrne, Brat, Bishop, Grothman, Stefanik, Allen, Lewis, Rooney, Mitchell, Smucker, Scott, Grijalva, Courtney, Fudge, Polis, Wilson of Florida, Bonamici, Takano, Adams, DeSaulnier, Norcross, Blunt Rochester, Krishnamoorthi, Shea-Porter, and Espaillat. Staff Present: Bethany Aronhalt, Press Secretary; Andrew Banducci, Workforce Policy Counsel; Courtney Butcher, Director of Member Services and Coalitions; Ed Gilroy, Director of Workforce Policy; Jessica Goodman, Legislative Assistant; Callie Harman, Legislative Assistant; Nancy Locke, Chief Clerk; Dominique McKay, Deputy Press Secretary; James Mullen, Director of Infor- mation Technology; Michelle Neblett, Professional Staff Member; Krisann Pearce, General Counsel; Brandon Renz, Staff Director; Molly McLaughlin Salmi, Deputy Director of Workforce Policy; Alissa Strawcutter, Deputy Clerk; Olivia Voslow, Staff Assistant; Joseph Wheeler, Professional Staff Member; Tylease Alli, Minority Clerk/Intern andFellow Coordinator; Austin Barbera, Minority Press Assistant; Michael DeMale, Minority