Azar plays coy about HHS stance on new Idaho plans, Medicaid lifetime caps

HHS Secretary Alex Azar answered a wide range of questions Thursday from lawmakers on two congressional committees. (House Energy and Commerce Committee)

Under questioning from Democratic lawmakers Thursday, Health and Human Services Secretary Alex Azar declined to say how his department will respond to two types of state-driven policy changes that have stirred up controversy.

First up was a Senate Finance Committee hearing to address the Trump administration’s fiscal year 2019 budget proposal. During the hearing, Sen. Ron Wyden, D-Ore., asked Azar about how the department will react to Blue Cross of Idaho’s announcement that it will sell plans that don’t comply with the Affordable Care Act.

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“This case is really being watched,” Wyden said, adding, “this is the one that is really going to determine whether states can just on their own say ‘we’re going back to yesteryear.’” 

Azar said he doesn’t want to be “prematurely involved” in reviewing the new plans, which haven’t received approval from Idaho officials yet.

“All we’ve seen is a press report that the Blues have submitted an application,” he said. 

However, he did agree that HHS has an oversight role to play, telling Wyden that “I don’t think we have any difference about the need of the department to be engaged here.”

Later in the day, Azar testified in front of the House Energy and Commerce Committee, where he was met with questions from Rep. Eliot Engel, D-N.Y., about how HHS will respond to waiver requests that seek to put a lifetime coverage cap on Medicaid recipients. 

There, too, Azar said it is too soon for him to know whether such requests would be approved by federal officials. 

“I really cannot, here, give you an answer on resolving a waiver I have not seen,” he said, adding that “I don’t even know the legal frameworks with regard to the issue of lifetime caps and how that would interact with our waiver or demonstration authorities.”

Azar also noted the Trump administration hasn’t taken a public stance on such requests. Such is not the case, though, with the concept of imposing work requirements on Medicaid beneficiaries, which the Centers for Medicare & Medicaid Services has expressly encouraged.