Subcommittee hearings on investigations will come to order. We are hearing a hearing called sabotage. The purpose is to examine the efforts to ensure quality and Affordable Health care. The chair recognizes yourself for five minutes for an opening statement. Its no secret that the Trump Administration has worked to sabotage health care in this country. On his very first day in office, President Trump issued an executive order directing all federal agencies to dismantle the Affordable Care act, both, to the maximum extent bylaw. Ever since then, the Trump Administration has worked tirelessly to undermine the aca, and other Critical Health programs at every turn. In her role, this seema verma has been behind many of the efforts to undermine the Nations Health care. Despite her role in this, is the first time administrator has appeared to testify and an oversight hearing, and we have many questions regarding the administrations actions. Since for double care act was signed into law more, than 20 Million People gained affordable High Health Care coverage, but now under President Trump, this administration is determined to take us in the wrong direction. Last year, we saw the number of uninsured people in this country increase for the First Time Since the aca was passed, about 1. 9 were insured last year, compared to the year before, including half 1 million more children. Further, the Kaiser Family foundation estimates that Health Insurance premiums are 16 higher this year than they would happen if the Trump Administration has not worked to undermine the aca. We know the Trump Administration has taken numerous steps to sabotage the aca. Theyre chipping away at critical protections guaranteed by the law. They are allowing states to increase consumer costs, reduced their coverage, and undermine protections for those with preexisting conditions. They are promoting junk insurance plans that do not provide essential Health Benefits and leave patients on the hook, when they need coverage of the most. Theyre making it more difficult and expensive for individuals to find quality coverage on the Health Insurance marketplace. And, to top it off, their rooting for the aca is collapse, by declining to defend the law and the texas forces United States lawsuit. We will likely here today that obamacare sort of our problems, but while the Nations Health care law may not be perfect, its important to understand what would happen if the Trump Administration succeeded in dismantling the aca entirely. 21 Million People could lose their Health Insurance. Up to 133 million americans with preexisting conditions could be denied coverage or charge higher premiums. Those lucky enough to keep their coverage of the aca could once again face lifetime caps on coverage and could lose coverage for things like prescription drugs and maternity care. Women could be charged more than men for their Health Coverage. And 60 million seniors and disabled americans on metal care will have to pay more for Preventative Care prescription drugs. Yesterday, cmf announced that ac premiums will drop. Thats good news. However, lets think about how many more people would be covered now and how many more lower premiums could be if after the repeated acts of sabotage at the hands of this administration. The aca is succeeding despite the Trump Administrations efforts to tear it down. Time and time again, this administrations actions on health care have gone squarely against their duty to promote High Quality Health Care and the well being of children and families in need. Under this administration, thousands of children and families have lost coverage of basic Health Services, and this administrations actions have hurt those with disabilities, rural americana, veterans, women and young people of color. The Trump Administration have tried to make philosophical arguments for why they are doing these things. But the numbers dont lie and at a time when we are facing Critical Health challenges, like the Opioid Epidemic and high rates of infant mortality, its unconscionable that this administration is working to reverse the problems that weve made. They will have to answer, and administrator verma will have to explain why she and this administration are actively trying to take their health care away. With that, the chair will recognize the Ranking MemberMister Guthrie for an opening statement. Thank you for holding this, and i will like to welcome administrator verma for her first appearance before the committee. She oversees numerous federal programs cms will impact 145 million americans. And she represents more than 100 trillion dollars of the budget, emphasizing a Critical Role the agency plays in the Nations Health care system on how to illustrate how we cannot possibly cover all of the role of her work in a single hearing. And thank you for your commitment to promoting competition, after that work youve accomplished thus far. I was pleased to see the announcement of premiums decreasing in 2020. A far cry from the double digit premium increases weve seen in past years. Ive also heard from my constituents on how cms is patient over paperwork initiatives will provide focusing on the quality of care provided to patients rather than the burdensome administrative tasks. Im also glad that we are strengthening the oversight of Nursing Homes in recent months. This committee examine the care in Nursing Homes after instances abuse, neglect in standard care occurring in Nursing Homes across the country. Another critical issue is the Opioid Epidemic. This has been at the forefront of the fight for the Opioid Crisis. Our investigative in legislative work led to the support act for patients and communities act. This was signed into law one year ago tomorrow. While there is much to be done both logistically, to support act in responsibilities and helping to address the Opioid Epidemic. Many of the initiatives ive described share bipartisan support. This is why the title for this hearing, sabotage, the Trump Administrations attack on health care is over the top. No one can reasonably categorize the cms effort to protect populations in Nursing Homes are sabotage. Moreover, the democrats will spend a lot of time today criticizing cms recent actions relating to demonstrations, and innovation labors. I find it disingenuous to lay cmss commitment to strengthen its partnerships with states to promote innovation and sabotage. I do, however, want to discuss areas where i think well cms take additional action in the future. At the beginning of flu season, and that will potentially be one of the worst flu seasons weve ever seen. This subcommittee held a hearing. In 2018 examining the efforts to respond to seasonal influenza, and while scene was not a witness, we did learn that we were working to use medicare data to compare the effectiveness of flu vaccines. I have some questions about this, and i hope we can hear another hearing on flew preparedness as soon as possible. I have questions for cmss about the efforts to the inevitability of health care data. I appreciate the, work that same as has done to implement the cure act, but as i said in my letter to cms with congressman trader this summer, im concerned that a recent proposal is not adequately protecting health care data. Thank you again for being here today. I look forward to your testimony, and i will yield my time to the congresswoman from indiana. Welcome administrator verma. Seema verma and her family our constituents of mine back home in indiana, and we actually have been friends for a couple of decades. We worked together in merit Stephen Goldsmith office where she was focused on Health Policy in the late 90s. That innovation was recognized also by former indiana governor mitt sandals, who asked seema verma to work with him and ensure that health care was working for patients in indiana. This was a indiana popular bipartisan Medicare Program. Healthy indiana plan requires small number contributions what are called power accounts, that focus as incentivizes Preventive Care to drive down costs. We are very proud that seema verma stepped up at the invitation of the president to take the innovation and her incredible dedication to the health of americans here in washington d. C. We thank you for your work. I yield back. The chair recognizes the chairman of the full committee mr. Pallone for the purposes of an opening statement. I think the chairwoman. Todays hearing continues this ongoing work to bring oversight and accountability to the Trump Administrations relentless attack on Peoples Health care, whether be attacks on the Affordable Care act, medicare or medicare. Since day, one the Trump Administration has engaged in a concerted effort, i heard what my colleague said that he does not think that this administration is sabotaging anything but, the problem that i have here is, if someone is on the right, ideologically and says, look, the government should not be involved in health care, should not angle involved with Health Insurance, people are on their own. If you said that i would say, okay, i understand, you want to get rid of all the Health Insurance, you want to get rid of this, while this is not the governments role. The problem i hear my colleagues on the other side, including the president suggests otherwise. That they want to have cover, they want to have people have Health Insurance. I dont see that. I think, if you look at this practically and not ideologically, it is clear that fewer people have Health Insurance, that theyre essential benefits are being cut back, not being covered, so to suggest that somehow theyre not responsible for that i think its not true, they are responsible. Its a concerted effort to cut back on peoples Health Insurance. Their benefits, and will cover today. Half our witness today is the administrator for the centers for medicare services, cms, seema verma, who is the administrators a point person on this. She has a difficult record to defend, and thanks to the communications policies, the number of uninsured americans increased by 2 Million People from 2017 2018, rising to 27. 5 million uninsured. Between december 2017 and this june, more than 1 million children, lost Health Coverage through medicare or the childrens Health Insurance program. These are bipartisan programs. Why system annotation making it more difficult for people to get coverage and particular children. These are disturbing trend and, unfortunately they, could get worse if cmf and the Trump Administration are successful and pushing their harmful policies. The Trump Administration is actively supporting a lawsuit that would overturn Affordable Care act. The Health Insurance away from americans and would allow Insurance Companies to discriminate against people with preexisting conditions. The administration has expanded dock insurance plans that are not required to cover essential Health Benefits, like hospitalisation, prescription drugs, and Emergency Care services. The Trump Administration has also placed extremely burdensome and sometimes illegal hurdles in front of Medicare Beneficiaries. These roadblocks are closing pain for low income families. As 1 million children lost health care between december 2017 engine this year. These numbers show that the Trump Administration policies to drive people off medicaid, tied them up and red cape, or scare them into not even applying for insurance in the first place are working. I am deeply concerned by the Trump Administrations ongoing attempts to impose illegal work requirements, waivers on Medicare Beneficiaries. These requirements are not only costly, but a clear violation of both medicare statute and longstanding congressional intent. These legal actions have been rightfully defeated and the courts. The Trump Administration refuses to give up, and the Trump Administration is also not given up in the ongoing attempts to sabotage the health care millions of americans who threw the aca. These proposals have been so extreme, that even administrative amash has raised a red flag. And an internal nima nadal, and im quoting, cause coverage losses, and market disruption. The middle concluded that 1. 1 million americans will lose their coverage. I have requested it that miss seema verma provide the analysis discussed and that memo. If the Trump Administration is pursuing a policy that would have harmful impact on the american, people we need to know what the analysis shows. Up to date, ive not received a one page response that answers and in my questions. Under the leadership, cms has followed the Trump Administration and stonewalling legitimate congressional oversight requests, and im appalled by the family, nonresponsive letters that weve received from cms many times past the deadline. As a road unelectable to secretary azar and missed verma last week, obstruction of congressional oversight is acceptable and if it continues, it may necessitate the use of additional measures including compulsory processes. I appreciate you being here today. That says a lot, that you are here, and i dont want to take away from that. The stonewalling of our oversight requests have to end. With that, i yield back. The chair recognizes the Ranking Member of the full committee for five minutes. Good morning. Thank you for being here, we appreciate it, weve enjoyed working with you on minutes issues. Im glad you are here. Cnns is largest administrator of Health Benefit programs and the United States. 25 million americans will receive their benefits by cms, either big job and we appreciate you. That includes medicare, medicaid and chip. Republican leadership, has extended chip for five years and then six years, we have 14. We have for ten years, fully locked in childrens Health Insurance and a lot of democrats have not voted against this, almost every step of the way. I dont want to get into this part but its unfortunate because there are issues that we need to focus on. Together i think about the meetings ive had with the president , you and others, i have seen president s who have leaned and to get drug prices down. I wish you could be here during our markup, when every democrat was holding up posters about what President Trump said about drug prices. Well we may have some disagreements about the policies, they were the president advocates last week when we were dealing with drug costs. The chairman are working shoulder to shoulder with this administration to protect consumers from surprise billing. What i ran into in my part of the world is people are so concerned about the high costs of health care, and the Affordable Care act, weve had our debates about what the best policies are there, it did not deliver as promised to bring down premiums 2500 bucks. In fact, i cant find anybody in my district that has seen that level of reduction. But what they have seen is increase and deductibles and copay. s insurance by name, is not insurance by function if deductible oracle pace are so high you cant afford to access the care. So, there are issues there. In terms of the Affordable Care act. Things that we supported in the Affordable Care<