Medicaid funding among major themes in Price hearing

Senators questioned Tom Price, the nominee for Department of Health and Human Services secretary, on a wide range of subjects during Tuesday’s confirmation hearing—but one recurring issue was his position on Medicaid.

Sen. Claire McCaskill, D-Mo., pressed the point repeatedly, asking Price point-blank if he supports moving the system from its current open-ended financing structure to block grants, as some prominent Republicans have suggested.

Price replied: “I’m in favor of making sure that Medicaid is a system that responds to patients instead of the government,” but McCaskill indicated this didn’t exactly answer her question.

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She later pointed out that as chairman of the House budget committee, Price supported a 2017 budget that would have moved the program’s funding to block grants and “cut Medicaid by $1 trillion.”

Price, though, dodged her repeated attempts to nail down whether he would support such a policy as HHS secretary, maintaining that his past actions as a legislator are not necessarily indicative of what he would do as an administrator.

He also disputed Democratic Sen. Maria Cantwell’s accusation that Donald Trump’s administration is “creating a war on Medicaid,” noting that he has treated thousands of Medicaid patients and is committed to finding ways to provide better quality care for them.  

But Sen. Ron Wyden, D-Ore., warned that members of Price’s own political party are likely to see the Medicaid block grants as “a Trojan horse” to cut spending. “I think some of your biggest critics are going to be Republican governors on this,” he said.

Are Price and Trump drafting an ACA replacement?

Earlier this month, Trump said that his administration will submit an almost-simultaneous repeal and replacement plan as soon as Price’s nomination is approved by the Senate.  

At Tuesday’s hearing, Sen. Sherrod Brown, D-Ohio, asked Price if it’s true that he and Trump are working on replacement plan that they will reveal after he is confirmed.

“It’s true that he said that, yes,” Price replied, later adding that “I’ve had conversations with the president about healthcare.”

Brown, though, noted that “wasn’t quite the answer” he was looking for from Price.

Later, Brown added that while he's still not sure whether Trump lied to the public about whether he was working with Price on a replacement, "it sounds like he did.”

Senators drill down on GOP healthcare reform plans

Other lawmakers were skeptical of what will be in Republicans’ version of healthcare reform. Sen. Michael Bennet, D-Colo., asked Price if under Trump consumers would have to settle for catastrophic coverage if insurers aren’t forced to provide a minimum level of benefits.  

Price responded that while there absolutely has to be “credible coverage” available, consumers should be allowed to purchase the type of plan that they want.

Price and some Republican senators also pointed out that the ACA’s individual marketplaces aren’t exactly on solid footing. Sen. Pat Toomey, R-Pa., for example, said the individual markets “are in a classic death spiral.”

“It’s important to appreciate that things have gotten worse in the individual and small-group markets, and we believe—I believe—that it’s a direct result of policies coming from Washington, D.C.,” Price said.

But Sen. Debbie Stabenow, D-Mich., pressed Price on his support of using high-risk pools to reshape the individual marketplaces, which he said “can be incredibly helpful in making certain that individuals with preexisting conditions are able to be cared for in the highest-quality manner possible.”

“For about 35 years we have tried high-risk pools—35 states had them before the Affordable Care Act, and frankly they didn’t produce great results,” she said.

Price touches on health IT

Sen. John Thune, R-S.D., questioned Price about what he’d do about a not-yet-implemented government rule that requires all outpatient pharmaceutical services to be delivered under direct supervision. The long-delayed provision, he said, is a “regulatory burden” at critical access and small and rural hospitals.

Price responded by touting the power of health IT to solve such challenges.

“I think there are areas from a technological standpoint where we are missing the boat, especially for our rural areas and critical access hospitals,” he said. “In healthcare, we put roadblocks up to the expansion of technology, especially in rural areas. We ought to be incentivizing that so that patients are able to receive the highest-quality care.”