Doggett Opening Statement at Health Subcommittee Hearing
(As prepared for delivery)
Through health care crises like the COVID-19 pandemic to economic crises precipitated by Putin's brutal aggression in Ukraine, the Affordable Care Act has been the safety net keeping so many Americans covered and healthy. Increased enrollment in both Medicaid and Marketplace plans actually reduced uninsured rates modestly during the pandemic, despite many who lost coverage with initial job losses and economic turmoil—a situation worsened significantly by Trump's denial, delay, and dithering regarding the pandemic.
Affordable Care Act coverage has also ensured providers receive stable payments—essential for rural hospitals and other health care providers so that they can stay open and assure patient access. Whether it's an unexpected medical emergency and diagnosis of some dreaded disease or day-to-day wellness checks and preventative care, the ACA is there for patients and providers.
In my home state of Texas, we had an historic 42% increase in Marketplace enrollment, during the most recent enrollment period. Now, over 2.4 million Texans are insured through the Marketplace—their families don't just have insurance, they have quality health care that covers their essential needs, care that will be available regardless of any pre-existing condition.
Though the ACA does not permit discrimination, too many, primarily from communities of color and low-income families, are still denied any benefit from it because we gravely erred in assuming that all states would act responsibility to use federal funds to expand Medicaid.
I am pleased that this very day North Carolina finally joined the majority of states doing right by expanding Medicaid coverage. With their obstruction, Texas Republicans continue to deny access to a family physician for almost as many Texans as the number benefiting from Marketplace coverage. As if 50 or 60 previous votes to repeal the Affordable Health Care Act and three failed lawsuits were not enough, today we have yet another hearing to complain about it.
While there is a health care inflation problem, it hardly began with the ACA. Health care costs have long grown more rapidly than the overall cost of living. Returning to the days of fine print limitations, junk insurance, and exclusions and denials of coverage will not lower health care costs, it will only deny health care when it is needed most. Instead, we must work to tackle longstanding distortions in health care.
The poster child of our broken health market is the pharmaceutical industry. Big Pharma continues to spike prices year after year, with most recent data showing an average 31.6 percent drug price increase—almost 4 times the rate of inflation rate of 8.5 percent. Pharmaceutical companies use their government-granted monopolies to extract the very highest prices in the world, despite American taxpayers underwriting much of the research and development for these miracle drugs. Instead of rewarding taxpayers for their investment, manufacturers price gouge and manipulate the patent system to wrongly extend their monopolies and fend off competition.
While innovators deserve a profit and reasonable patent protection for their inventions, layering patents to extend monopoly power and monopoly prices for decades is an outrageous failing about which this Congress has done little. Charging Americans up to six times as much as patients in other countries for a drug whose development relied upon taxpayer dollars is not reasonable.
Some of us have been working for years to repeal the ban on drug price negotiation and place some restraint on this aggressive monopoly abuse and price gouging. Yet it still remains illegal to negotiate on the vast majority of drugs, and for the handful that will be subject to negotiation, no price reduction will occur for more than 2 years, and then, unless you rely on Medicare, you get no benefit whatsoever.
While the exceedingly modest drug negotiation program should be significantly strengthened, Republicans seek to undermine and repeal the nominal negotiation we will eventually have, much as they have worked so long, in so many different ways, to sabotage the ACA.
Similarly, Republicans have blocked action to address the growing role of private equity in health care consolidation and price inflation. They even rejected modest reforms to provide some transparency into the ownership of health care entities. The Administration is working to expose some of these business relationships and associated changes in health care quality, staffing, and worker conditions.
Under the Biden Administration, the Federal Trade Commission is also finally using its authority to closely scrutinize health care mergers and acquisitions—recognizing that a consolidated market will result in higher prices and unfair and abusive monopoly practices.
While economic crises may ebb and flow, what has not changed is sustained and substantial increases in health care prices. There is much we could be doing on a bipartisan basis. From banning anti-competitive contract clauses to supporting independent physician practices to ensuring robust insurance provider networks to reducing prescription drug prices.
I hope moving forward this subcommittee will engage in productive, bipartisan discussions to address health care price inflation instead of relitigating worn out and unsubstantiated accusations concerning the ACA.
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