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Price has not seen Senate version of health care bill
Days before an expected vote, HHS Secretary Tom Price, MD, said he has not seen the U.S. Senate bill to overhaul the nation’s health care system.
“I haven’t seen any legislative language,” Price said today during a hearing in front of the Senate appropriations subcommittee with jurisdiction over the HHS budget.
The Senate is said to be finalizing its version of the American Health Care Act (AHCA), a Republican-penned bill passed by the House last month that would repeal and replace the Affordable Care Act (ACA). But GOP Senators have received criticism that they are rewriting the House version of the bill in secret without a public debate and are rushing to call a vote before the July 4 holiday.
Responding to questions about the Senate’s work on the legislation, Price said his office has provided technical assistance to individual Senators but that no one on his staff has seen the bill.
“We haven’t seen it either and we’re told we’re going to vote on it in a matter of days,” Sen. Richard Durbin (D-Ill.) responded. “Do you think that’s a responsible thing to do in terms of the health care of all the people living in America?”
“I’ll leave the Article 1 branch of the Constitution to determine how the Article 1 branch works,” Price, a former Republican congressman, replied.
A ‘mean’ bill?
A day after Secretary of State Rex Tillerson testified about the impact that a 30% cut in the State Department’s budget for fiscal year 2018 would have on world health initiatives, Price sparred with Democrats — and some Republicans — over proposed deep cuts to the HHS budget.
But senators from the Subcommittee on Labor, Health and Human Services, Education, and Related Agencies also pressed Price on the AHCA and the effect it would have on coverage for patients. The House version passed by one vote last month without a score from the nonpartisan Congressional Budget Office (CBO). The CBO later estimated that 23 million more people would be uninsured by 2026 than under the current law.
The bill has been criticized as being bad for low-income families on Medicaid, for stripping coverage for 10 so-called essential health benefits mandated by the ACA and for making coverage too expensive for patients with pre-existing conditions. Supporters, including House Speaker Paul Ryan (R-Wis.), have said the AHCA will rescue patients from rising costs and dwindling choices under the ACA.
Price was among dozens of Republicans who celebrated the bill’s passage on May 4 during a White House news conference in the Rose Garden. At the time, President Donald J. Trump called the legislation “a great plan” and Price said it was “a victory for the American people.” However, Trump made headlines this week after reportedly telling senators that he thought the House bill was “mean.”
Sen. Patty Murray (D-Wash.), the subcommittee’s ranking Democrat, asked Price on Thursday if he still believed the bill was “a victory for the American people” amid what she characterized as a “clear” change in the administration’s support. Price said he disagreed that there was a “yes or no” answer to the question. Murray and Sen. Jeff Merkley (D-Ore.) each pressed Price to agree or disagree with Trump’s comment that the bill was “mean,” and he also declined to say yes or no to that.
“I think what we need to be talking about in terms of a health system is a constellation of reforms that need to be put in place because there are millions of Americans right now who are unable to gain the kind of coverage that they want, are paying higher premiums, higher deductibles. They’ve got insurance coverage, but they don’t have any care,” Price said.
Subcommittee ‘unlikely’ to support current budget
According to Sen. Roy Blunt (R-Mo.), the subcommittee chairman, Trump’s proposed budget would slash HHS funding by $15.1 billion during the next fiscal year, a reduction of about 20%. It includes a $7.5 billion cut in NIH funding and $1.2 billion decrease in funding for the CDC.
These potential funding cuts have alarmed public health advocates, but Price said the budget put forth by the administration “does not confuse government spending with government success.”
“The president understands that setting a budget is about more than establishing topline spending levels,” he said. “Done properly, the budgeting process is an exercise in reforming our federal programs to make sure they actually work — so they do their job and use tax dollars wisely.”
Federal budgets are referred to the House and Senate for changes before they are enacted, and both Democrats and Republicans had complaints during Price’s hearing. Blunt said he agrees there are places where cuts should be made but said the budget as it stands is unlikely to get support from his committee.
“You bring a new viewpoint to the HHS budget, and I hope we can work together to identify programs that are ineffective or no longer needed and put that funding to better use elsewhere. However, as the budget request stands today, I am concerned about its path forward,” Blunt said. “Looking at the history of this subcommittee and the benefits of many of these programs, I believe it’s unlikely this subcommittee will support these specific and significant funding reductions and eliminations.”
Senators expressed concern over proposed cuts to programs supporting patients with mental health or substance abuse issues and preventive services for women, including prohibiting funding for Planned Parenthood.
Murray said the budget proposal would deny women coverage for birth control, deny preventive care for women nationwide and leave families sicker and more vulnerable. She called it “an assault on women’s health.”
“I’m deeply disturbed by this budget in terms of its impact on women,” Murray said.
Durbin said the budget includes a 20% reduction in funds for medical research — a “dramatic” cutback he said will lead to 2,000 fewer competitive research grants. “How can that be in the best interest of America?” Durbin asked.
Price countered that the administration believes there is money to be saved that will not affect the number of grants being provided. “We support NIH. We support the research that’s being done,” he said.
Several senators also raised concerns about how budget cuts would impact the nation’s prescription opioid abuse epidemic. Sen. Patrick Leahy (D-Vt.) argued that cuts to Medicaid could negatively impact patients struggling with addiction. Price said there is $811 million available in the HHS budget to address the issue.
“Two years ago, it was $245 million,” he said. “Due to the incredible work that’s been done in a bipartisan fashion here in Congress, more and greater resources are available.”
But Leahy asked how the administration could hope to cut money and improve care at the same time.
“When I was a child I believed in the tooth fairy,” he said, “but I’m a little bit older now.” – by Gerard Gallagher
Reference:
U.S. Senate. Review of the FY2018 Department of Health & Human Services budget request. https://www.appropriations.senate.gov/hearings/review-of-the-fy2018-deptartment-of-health-and-human-services-budget-request. Accessed June 15, 2017.