HHS Nominee Dodges Questions on ACA repeal, Medicare, and Medicaid in Confirmation Hearing

  

As expected, Congressman Tom Price (R-GA), Health and Human Services Secretary nominee, faced intense scrutiny at today’s confirmation hearing before the Senate Finance Committee. Despite President Trump’s recent Executive Order instructing his Administration to facilitate the repeal and replacement of the Affordable Care Act (ACA) by “minimizing any unwarranted economic and regulatory burdens,” Price would not reveal whether penalties would be removed for people who don’t purchase insurance. He said that our current system works for the government, but not patients. As Secretary, he would ensure that everyone has “access to affordable coverage.”

Throughout the hearing, Price skirted questions about the replacement plan. He declined to reveal any potential changes to ACA. Instead, he stressed that it was Congress’ responsibility to devise an ACA replacement plan. He maintained that, as Secretary, he would merely implement the plan passed by Congress.

Ranking Member, Senator Ron Wyden (D-OR), referenced Price’s previous ACA replacement legislation during questioning. He expressed concerns that repeal would destroy the market and urged Price to keep patients at the “center of healthcare, not money or special interests.” Price said he wouldn’t abandon individuals with pre-existing conditions, but stopped short of guaranteeing coverage. He repeated his desire to make sure every American had an “option and opportunity for care.”

In his own plan, Price has supported privatizing Medicare in the past, but denied plans to privatize it in the replacement. Sen. Bill Nelson (D-FL) pointed out that seniors are “petrified about a privatized Medicare.” When questioned on Medicaid, Price would not reveal whether the replacement plan would eliminate the ACA’s Medicaid expansion. Despite his past efforts to change Medicaid into block grants, which would provide money directly to states and allow them to make coverage decisions, Price said he would defer to Congress.

Price weighed in on a successful nursing program. Sen. Tim Scott, (R-SC), highlighted the Nurse Family Partnership, a Medicaid-funded program which pays to send nurses into the homes of low-income, first-time mothers. While he was impressed with the program, Price pointed out that Medicaid “coverage doesn’t always equal care.” Price did share that he favors an eight year extension of the Children’s Health Insurance Program.

Price has been a vocal critic of the Center for Medicare & Medicaid Innovation (CMMI), which pays providers based on quality and outcomes. He said CMMI should incentivize innovation and benefit patients, but that CMMI is “off track a bit” in that it dictates how providers must practice without exception.

Senate Democrats questioned Price’s judgment for receiving discounts and actively trading health care stocks. Price said everything he did was ethical and legal. The discounts, he said, “were available to every single individual that was an investor at the time.” Despite the testy exchanges around ethics, there was bipartisan support for improving access to high-quality healthcare in rural America. Sen. Pat Roberts (R-KS) pointed out that the rural healthcare delivery system was “under stress.” He asked if Price would reduce documentation burdens on providers and hospitals. Price agreed, noting that government sometimes puts up roadblocks to expanding technology, especially in rural areas. He said we ought to be incentivizing innovation for patients to receive the highest quality care. Price said telemedicine is improving lives of patients in rural communities. If confirmed, he promised to strengthen rural healthcare and establish less burdensome regulations.

Senate Finance Committee Chairman Orrin Hatch, (R-UT), praised Price’s “performance.” He said Price has the experience and qualifications to effectively lead HHS. He plans to schedule a committee vote to send Price’s nomination to the full Senate for final vote as soon as possible.

President Trump – First 100 Days

  

On Friday, January 20th Donald J. Trump was sworn in as the 45th President of the United States. It is the 58th inauguration and the 72nd time the oath of office has been administered to an incoming president.

At 70 years old, Trump breaks Ronald Reagan’s record as the oldest president to ever take office and is now the third president born in 1946, following George W. Bush and Bill Clinton. Trump is also the first president since Dwight Eisenhower with no prior elected office experience, and the first ever to have no government or military service.

Trump will enter the White House with Republicans controlling 241 House seats and 52 Senate seats, the largest majorities for an incoming GOP president since Herbert Hoover in 1929. Clinton and Barack Obama enjoyed larger Democratic majorities in both chambers upon becoming president but lost those advantages in ensuing midterm elections

Now that he has officially taken residence in the White House here’s what we could expect in his first 100 days.

Health Care… As in repeal and replace the Affordable Care Act. Still working on the replace part. However, as one of Trump’s first acts as President he signed an executive order late Friday giving federal agencies broad powers to unwind regulations created under the Affordable Care Act, which might include enforcement of the penalty for people who fail to carry the health insurance that the law requires of most Americans.

The executive order, signed in the Oval Office as one of the new president’s first actions, directs agencies to grant relief to all constituencies affected by the sprawling 2010 health-care law: consumers, insurers, hospitals, doctors, pharmaceutical companies, states and others. It does not describe specific federal rules to be softened or lifted, but it appears to give room for agencies to eliminate an array of ACA taxes and requirements.

Supreme Court…as in there’s been a job opening on the bench for almost a year and Trump is ready to fill it. He’s said he’s considering a list of right-leaning names.

Trade…as in Trump wants to renegotiate NAFTA (the ’90s trade deal between the US, Canada, and Mexico). And then he wants to pull out of the TPP. That’s the trade deal between the US and 11 other Pacific Rim countries (countries that border the Pacific Ocean like Canada, Japan, Mexico) that President Obama put together. The aim was to open up trade between countries that produce almost half of the world’s goods and services. Critics on both sides of the aisle point out that this could hurt US workers by sending jobs overseas. One of those very loud critics is Trump.

Trump announced a series of executive actions focused on trade and the federal workforce, making good on a pair of his core campaign promises.

The actions, signed at the White House, implement a federal employee hiring freeze, formally withdraw the U.S. from the Trans-Pacific Partnership trade deal and reinstate a GOP-backed policy regarding foreign aid and abortion funding.

Energy…as in Trump plans to get rid of a bunch of federal rules on US energy production including oil, gas, and coal put in place to fight climate change. He’s said he’ll also make it easier for oil pipelines (such as the, Keystone XL) to move forward. Trump says this would boost job creation.

Lobbying ban…as in Trump wants the ‘revolving door’ between K Street and the US gov to swing a little slower. He’s calling for a five-year ban on White House and Congressional staffers taking lobbying jobs after they leave. He also wants a lifetime ban on White House officials lobbying for foreign governments.

Immigration…as in Trump will move to “cancel all federal funding to Sanctuary Cities” – aka cities that allow undocumented immigrants to stay without fear of being prosecuted or deported. He’s also said he’ll start deporting about two million undocumented immigrants with criminal records. And that he’ll hit ‘pause’ on immigration from regions with a history of terrorism that do not vet people coming into the US. He’ll also practice “extreme vetting” for all immigrants.

Hello, Congress? It’s nurses. We need to talk.

  

Nurses have the power to change the conversation on health care – starting with your senators, right now.

Can you speak out for your patients today? A two-minute phone call could make all the difference for patients who are on the brink of losing their health insurance.

Just dial 1-202-224-3121 to reach the Capitol Switchboard and an operator will connect you to your senator’s office.

When you’re connected, here are some pointers to guide your conversation:

  • Share your name and your town or city so they’ll know you’re a constituent.
  • Tell the staffer that you are a nurse, and you’re concerned that patients like yours could lose access to health care if the Affordable Care Act is repealed.
  • Remind them that insurance costs were skyrocketing before the ACA went into effect, and that without it, millions of people would have simply been priced out of healthcare already.1
  • Explain that, as a nurse, you want to share your personal story of how you experience the healthcare system. Share your vision for what is working and what is not, and what Washington can do to fix those problems.
  • Finally, thank them for their time. If you have another minute, call the switchboard again and ask to speak to your other senator’s office.

Once you’re done, let us know you’ve made your call so we can keep track of which senators are hearing from nurses and hold them accountable here in Washington.

Yes, I called my senator’s office and spoke with a staffer.

Yes, I called both my senators’ offices and spoke with their staff.

No, I wasn’t able to get through, but I’ll try again later!

Thank you for taking care of your patients every day, and thank you for speaking out today. Nurses like you truly are making a difference in Washington!