HHS Secretary Tom Price in back-to-back congressional hearings Thursday on the Trump administration's fiscal year (FY) 2018 HHS budget proposal declined to say whether the administration would continue paying insurers for cost-sharing subsidies called for under the Affordable Care Act (ACA).
At the start of the House Ways and Means Committee hearing, Chair Kevin Brady (R-Texas) signaled support for continuing the ACA's cost-sharing payments. He said, "We should act within our constitutional authority now to temporarily and legally fund cost-sharing reduction payments as we move away from Obamacare and toward a patient-centered system that truly works for the American people."
However, Price during the hearing repeatedly declined to answer questions on the subsidies, citing his involvement in an ongoing lawsuit challenging the payments. Price said, "What I can tell you is that the budget reflects [continuing the] payments through 2018."
Price defends proposed Medicaid cuts
Price in testimony before the committees discussed how the administration's FY 2018 budget proposal—which would cut Medicaid spending by 47 percent over the next decade—would affect efforts to curb the ongoing opioid misuse epidemic and rural hospitals' finances.
Price said the problem with many federal programs "is not that they are too expensive or too underfunded. The real problem is that they do not work—they fail the very people they are meant to help."
For instance, Price said the administration's budget proposal—which would reduce Medicaid funding to states by $610 billion over a decade, on top of the $839 billion in Medicaid spending reductions called for under the House-approved American Health Care Act (AHCA)—would give states more flexibility over funding allocations. He said that control would lead to new innovations and efficiencies.
When questioned about how the Medicaid cuts would affect efforts to combat the opioid misuse epidemic, Price outlined his department's "five-part strategy," which he said includes $500 million for grants to the State Targeted Response to the Opioid Crisis program. However, Democrats on the panels said that funding would not be sufficient to curb the epidemic. Sen. Sherrod Brown (D-Ohio) said, "My state spent $939 million fighting the opioid epidemic last year alone."
Price also faced questions about how the proposed Medicaid funding cuts would affect hospital finances. Rep. Ron Kind (D-Wis.) said, "Nearly one in three rural hospitals would be at risk of closure" from the $839 billion in Medicaid spending reductions called for under the AHCA.
Sen. Ben Cardin (D-Md.) raised concerns about how the proposed Medicaid cuts would affect minorities and health disparities. He said, "Every minority community I go to, they mention Medicaid to me, and there's no capacity at the state level to pick up the slack if the federal government withdraws its commitment either in the number of people covered or the benefits that are reimbursed."
Rep. Lynn Jenkins (R-Kan.) during the House hearing also called on Price to permanently fix a federal regulation that requires a physician to supervise outpatient services. She said, "In my district, there are 26 critical access hospitals threatened by this regulation" because "many rural hospitals cannot afford to have doctors on staff several days a week."
Lawmakers also asked Price about a draft rule from HHS that would scale back the ACA's contraceptive coverage mandate. When asked whether he felt women should have access to birth control, Price said, "I think that for women who desire birth control, it should be available" (Bluth, Kaiser Health News, 6/8; Frieden, MedPage Today, 6/8; Howell, Washington Times, 6/8; AHA News, 6/8).
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