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Nominee for Health Secretary Is Vague on Replacing Affordable Care Act Nominee for Health Secretary Is Vague on Replacing Affordable Care Act
(about 2 hours later)
WASHINGTON — Representative Tom Price, the man President-elect Donald J. Trump has chosen to lead the Department of Health and Human Services, promised on Wednesday to “make sure that nobody falls through the cracks” if the Affordable Care Act is repealed and set a goal to increase the number of people with health insurance. WASHINGTON — Representative Tom Price, the man President-elect Donald J. Trump has chosen to lead the Department of Health and Human Services, promised on Wednesday to “make sure that nobody falls through the cracks” if the Affordable Care Act is repealed, and he set a goal to increase the number of people with health insurance.
But at a nomination hearing before the Senate Health, Education, Labor and Pensions Committee, Mr. Price provided only vague reassurance to members of both parties who pressed him for specific policies.But at a nomination hearing before the Senate Health, Education, Labor and Pensions Committee, Mr. Price provided only vague reassurance to members of both parties who pressed him for specific policies.
Republicans concluded he was well qualified; Democrats were not satisfied.Republicans concluded he was well qualified; Democrats were not satisfied.
“Just days ago, President-elect Trump promised ‘insurance for everybody.’ But Congressman Price, your own proposals would cause millions of people to lose coverage, force many to pay more for their care and leave people with pre-existing conditions vulnerable to insurance companies rejecting them or charging them more,” said Senator Patty Murray of Washington, the ranking Democrat on the committee. “Just days ago, President-elect Trump promised ‘insurance for everybody,’’’ said Senator Patty Murray of Washington, the senior Democrat on the committee. “But Congressman Price, your own proposals would cause millions of people to lose coverage, force many to pay more for their care and leave people with pre-existing conditions vulnerable to insurance companies rejecting them or charging them more.’’
In four hours of testimony, Mr. Price, a 62-year-old orthopedic surgeon from the affluent northern suburbs of Atlanta, set lofty goals for a health law that would replace President Obama’s signature domestic achievement, but he did not say how he would achieve those goals. In four hours of testimony, Mr. Price, a 62-year-old orthopedic surgeon from the affluent northern suburbs of Atlanta, set lofty goals for a plan to replace President Obama’s signature domestic achievement, but he did not say how he would achieve those goals.
He denied any impropriety in his trading of stocks in health care and pharmaceutical companies, saying he left many details to his broker. Mr. Price also denied any impropriety in his trading of stocks in health care and pharmaceutical companies, saying he left many details to his broker.
Senator Al Franken, Democrat of Minnesota, said some of the investments looked like “sweetheart deals.’’ But Mr. Price said, “I had no access to nonpublic information.’’
Like several other candidates for top jobs in the Trump administration, Mr. Price put a little distance between himself and the president-elect on several issues.Like several other candidates for top jobs in the Trump administration, Mr. Price put a little distance between himself and the president-elect on several issues.
Mr. Trump said last week that drug companies were “getting away with murder” and that Medicare should negotiate with drug makers to secure lower prices. Mr. Trump said last week that drug companies were “getting away with murder” and that Medicare should negotiate with drugmakers to secure lower prices, a position long championed by Democrats and fiercely opposed by Republicans.
Asked if he would press Congress to authorize such negotiations, Mr. Price did not give a definitive answer. “I think we need to find solutions to the problem of folks having access to needed medicines,” he said.Asked if he would press Congress to authorize such negotiations, Mr. Price did not give a definitive answer. “I think we need to find solutions to the problem of folks having access to needed medicines,” he said.
Mr. Price said that if he is confirmed, he will strive to give states more freedom and flexibility under Medicaid, the federal-state program that provides coverage for more than 70 million low-income people. Mr. Price said that, if confirmed, he would try to give states more freedom and flexibility under Medicaid, the federal-state program that provides coverage for more than 70 million low-income people.
He praised Indiana’s program to expand Medicaid eligibility under the Affordable Care Act with conservative policies that emphasized “personal responsibility.” He praised Indiana’s program to expand Medicaid eligibility under the Affordable Care Act, with conservative policies that emphasize “personal responsibility.”
“States know best” how to care for their Medicaid beneficiaries, Mr. Price said, adding, “What Indiana has done is really a best practice for other states to follow.”“States know best” how to care for their Medicaid beneficiaries, Mr. Price said, adding, “What Indiana has done is really a best practice for other states to follow.”
Mr. Trump has not said much about the future of Medicaid in the 31 states that have expanded eligibility, with large amounts of federal money.Mr. Trump has not said much about the future of Medicaid in the 31 states that have expanded eligibility, with large amounts of federal money.
Democratic senators were often frustrated in their efforts to get Mr. Price to say if he supported coverage requirements and insurance mandates in the Affordable Care Act. Democratic senators were often frustrated in their efforts to get Mr. Price to say if he supported the coverage requirements and insurance mandates in the Affordable Care Act.
In a typical response, he said that patients should have “access to the kind of coverage they want,” rather than having the government dictate to them. In a typical response, he said that patients should have “access to the kind of coverage they want,” rather than having it dictated to them by the government.
Mr. Price said he supported many objectives of the Affordable Care Act, but did not see why the federal government had to specify so many details of insurance coverage in an act of Congress and in myriad regulations. Senator Christopher S. Murphy, Democrat of Connecticut, said Mr. Price appeared to support the coverage and protections provided by the Affordable Care Act, but that “we don’t get any specifics as to how that’s going to occur’’ if the law is repealed.
For example, he said, the option for coverage of young adults under their parents’ policies has been “baked into the insurance programs that are out there right now” Without mandating coverage of specific benefits, Mr. Price said, the Trump administration could “make certain that individuals have the care and the kind of coverage that they needed for whatever diagnoses would befall them.’’
“I think that the insurance industry has included individuals up to age 26 on their parents’ polices virtually across the board,” Mr. Price said, “and I don’t see any reason that that would change.” He said the Trump administration could put in place “a different construct’’ that “would allow for every single person to gain access to the coverage that they want and have nobody fall through the cracks.’’
Senator Maggie Hassan, Democrat of New Hampshire, said that insurance companies did not routinely cover drug abuse treatment in the past and might not do so in the future without a federal requirement. He did not say how the Trump team would guarantee such protection.
The hearing Wednesday is being held by the Senate Committee on Health, Education, Labor and Pensions, led by Senator Lamar Alexander, Republican of Tennessee. But that panel does not vote on the nomination. Mr. Trump has expressed support for another provision of the 2010 health law under which insurers must allow children to stay on their parents’ policies until the age of 26. This option is “baked into the insurance programs that are out there right now,” Mr. Price said.
Another hearing has been scheduled for next Tuesday by the Senate Finance Committee, which will vote on whether to recommend confirmation. The two committees share authority over issues for which the Health and Human Services Department is responsible. “I think that the insurance industry has included individuals up to age 26 on their parents’ polices virtually across the board,” he said, “and I don’t see any reason that that would change.”
Democrats were skeptical. Senator Maggie Hassan of New Hampshire said there was no guarantee that such protections would continue in the absence of federal requirements. Insurance companies did not routinely cover drug abuse treatment in the past and might not do so in the future without a federal requirement, she said.
The Congressional Budget Office said on Tuesday that the number of uninsured Americans could increase by 18 million in one year if Congress repealed major provisions of the health care law while leaving others in place. Mr. Price tried on Wednesday to allay concerns about any disruption.
“I think there’s been a lot of talk about individuals losing health coverage,” Mr. Price said. “That is not our goal nor is it our desire nor is it our plan.”
“One of the important things that we need to convey to the American people is that nobody’s interested in pulling the rug out from under anybody,” Mr. Price added. “We believe that it’s absolutely imperative that individuals that have health coverage be able to keep health coverage and move, hopefully, to greater choices and opportunities for them to gain the kind of coverage that they want for themselves and for their families.”
Mr. Price said he would “absolutely’’ consider taking administrative action to stabilize the market for insurers, which are supposed to submit their proposals for 2018 coverage in April. Insurers say it will be nearly impossible to calculate premiums if they have no idea what will replace the Affordable Care Act.
Mr. Price championed “medical innovation’’ as an essential ingredient of high-quality care. But he criticized the Center for Medicare and Medicaid Innovation, created by the health law to test new ways of paying doctors, hospitals and other health care providers.
The agency has great promise, he said, but too often its experiments are compulsory for doctors and nearly nationwide in scope. He said he “adamantly opposed the mandatory nature’’ of some payment models, like one for joint replacement surgery and another for expensive prescription drugs administered in doctors’ offices.
Mr. Price said he would not object if Medicare began testing new methods of payment with “small pilot projects,’’ which could be expanded if they proved successful.
The health committee will not vote on the nomination of Mr. Price. Another hearing has been scheduled for Tuesday by the Senate Finance Committee, which will vote on whether to recommend confirmation. The two committees share authority over issues for which the Health and Human Services Department is responsible.