HHS Secretary Alex Azar goes before House panel to defend health program cuts in Trump’s proposed FY19 budget

Newly confirmed Health and Human Services Secretary Alex Azar told the House Committee on Ways and Means Wednesday morning that the Trump administration’s proposed budget for fiscal year 2019 makes significant and strategic investment in health programs, boosting discretionary spending by 11% and increasing funding for the National Institutes of Health and Food and Drug Administration by millions.

It also supports major priorities of HHS, he said, including combating the opioid crisis, lowering the price of prescription drugs, reducing the costs of health insurance in the individual markets and moving Medicare to a more value-based direction.

Although Trump actually proposed a 21% cut to the HHS budget, the two-year spending bill approved last week provides an additional $27 billion to the department. In total, HHS is poised to receive $95.4 billion under the proposal. The funding, Azar told the committee, includes an additional $747 million for the National Institutes of Health, a $473 million increase for the Food and Drug Administration and a $157 million increase over 2018 funding for emergency preparedness.

But Ranking Member Rep. Richard Neal, D-Mass., said in his opening statement that the budget proposal “sabotages” healthcare programs, cutting nearly $1.4 million from Medicaid and another trillion from Medicare. The decrease in Medicaid funding, he said, will lead to cuts to healthcare for children, individual with disabilities and people who need long-term care. He also said that Trump’s budget cuts more than $200 billion in payments to hospitals, which could lead to closures.

Azar countered that the changes to Medicare payments to providers will actually extend the life of the program by reducing spending by $250 billion over 10 years. Under the current plan, he said, Medicare currently grows 9.1% each year. Under the proposal, it will grow 8.5% each year, proving an additional eight years of life to Medicare.

Rep. Mike Thompson, D-Calif., said the cuts to Medicaid don’t just hurt low-income families, they also will have a negative impact on state budgets and limit their ability to respond to nationwide epidemics such as the opioid crisis. The proposal, he said, essentially means the government will provide less services to Americans in return for greater debt.

And Bill Pascrell, D-N.J., said he is concerned that the budget proposal cuts $43 million from the Ryan White HIV/AIDS program. Pascrell said is another example of the Trump administration abandoning people with HIV, noting that the president shut down the HIV advisory council and by cutting funding is closing the door on progress made under Democratic and Republican Presidents to curb the disease.

Throughout the hearing, Azar indicated his willingness to work with committee members on several issues, including expansion of telehealth, rural health concerns and lifting restrictions on physician-owned hospitals.

The Affordable Care Act restricts existing physician-owned hospitals from expanding and constructing any new physician-owned facilities that treat Medicare and Medicaid patients as part of a condition of participating in the Medicare program. The severe restrictions forced many facilities to drop Medicare.  Sam Johnson, R-Texas, asked Azar to help repeal the ACA's ban on physician-owned hospitals. Although he didn't commit to supporting a full repeal, Azar said he would work with Johnson to help make changes that would allow physician-owned hospitals to compete and deliver high-quality, low-cost care.