Andy Slavitt helped save Obamacare once already. He’s hoping he can do it again.
Until Inauguration Day, Slavitt had been acting administrator of the Centers for Medicare and Medicaid Services since March 2015. That agency oversees the two health programs in its name along with the Children’s Health Insurance Program and the Affordable Care Act’s health insurance exchanges. CMS, as it’s known, manages benefits for 140 million people and its $1 trillion budget is bigger than the Pentagon’s.
In the short time since Slavitt left federal service, he’s already seeing signs that President Donald Trump and the GOP Congress are dealing damage to the health care system before even repealing the Affordable Care Act. And health care executives are telling him the same thing, Slavitt said.
The Affordable Care Act first entered Slavitt’s life in the fall of 2013, when he helped lead the effort to salvage HealthCare.gov, the federal insurance exchange website, after its disastrous launch. From there, Slavitt left his position as group executive president of Optum, a unit of UnitedHealth Group, to join CMS as a senior official. President Barack Obama nominated Slavitt for the top job in July 2015 but the Senate never held a vote on him.
Now Slavitt is out of government, but he’s not abandoning the fight over the Affordable Care Act. In an interview with The Huffington Post, he argued that Trump is already undermining the law and threatening coverage for millions ― in spite of his repeated promises to ensure that all Americans would have health care under his policies.
“I take the new president at his word. He said he wants to expand coverage. He said he wants the coverage to be high-quality. He said he wants it to be affordable to Americans who have trouble affording health care,” Slavitt said. “Those are the right goals, and I think the president should start out with those goals. Now, the actions that we’ve seen so far don’t support those goals.”
Specifically, Slavitt cited the executive order Trump issued the day of his inauguration, which instructs federal agencies to “take all actions consistent with law to minimize the unwarranted economic and regulatory burdens of the Act, and prepare to afford the States more flexibility and control to create a more free and open healthcare market.”
The White House subsequently signaled this could include halting enforcement of the law’s individual mandate that most Americans obtain health coverage.
Executive actions such as these, and like the Trump administration halting television advertising for the sign-up period that ends Tuesday, threaten to destabilize the health insurance market, Slavitt. These moves signal to health insurers that enrollment will be lower this year than it could have been, and that fewer of the healthy consumers needed to offset the costs of the sick will buy coverage. Without the mandate’s tax penalty for being uninsured, some consumers will opt against buying insurance.
“It increases premiums, it will send people out of the market,” Slavitt said. “Those actions that we’ve seen haven’t gotten us on the track that we would hope and that we need to be on in a bipartisan fashion, and so I’d hope that they’re quickly corrected.”
HENRY KOTULA 