As HHS secretary, Tom Price has significant powers to change health care

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Rep. Tom Price (R-GA) arrives to testify before the Senate Health, Education, Labor and Pensions Committee on  Jan. 18. Price was confirmed as health secretary Feb. 10. Photo by REUTERS/Joshua Roberts.

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JUDY WOODRUFF: But first: The president gets a key member of his Cabinet confirmed, a right-hand man who will take aim at the Affordable Care Act, and will serve as the country’s top health official.

Lisa Desjardins has the story.

LISA DESJARDINS: He is, after his swearing-in today, the nation’s 23rd secretary of health and human services.

The U.S. Senate confirmed Georgia Congressman Tom Price in the wee hours this morning on a party-line vote of 52-47. Secretary Price is a longtime opponent of the Affordable Care Act.

To Democrats like Maria Cantwell of Washington State, that is the problem.

SEN. MARIA CANTWELL, D-District of Columbia: My view is, this vote is the first vote in the repeal of the Affordable Care Act.

LISA DESJARDINS: But to Republicans like Tom Cotton of Arkansas, that’s Price’s appeal.

SEN. TOM COTTON, R-Ark.: You could say his chief qualification for the job of replacing Obamacare is, he had the good sense to oppose it in the first place.

LISA DESJARDINS: Price is also a retired doctor, the first physician to lead HHS in nearly 25 years. But in confirmation hearings, he faced tough questions over his relationship with health care companies, and his investment in some which were affected by his actions in Congress.

Now Price is responsible for a more than a trillion-dollar health agency budget, for a department that oversees food and drugs, biomedical research, public health threats, and, of course, a large portion of U.S. health care. That includes Medicaid, which covers more than 74 million people, and Medicare, over 55 million.

His theme? A smaller role for the federal government. In Congress, Price backed a proposed cap on Medicare spending per person. Price also supported giving states fixed amounts, in block grants, to cover low-income people on Medicaid.

But his new boss, Donald Trump, said on the campaign trail he wouldn’t touch Medicare or Medicaid.

DONALD TRUMP, President of the United States: Save Medicare, Medicaid, and Social Security without cuts. Have to do it.

LISA DESJARDINS: Mr. Trump has not commented since becoming president, but he has stressed an area of agreement with Price: repeal of the Affordable Care Act. This was today at a joint press conference with Japanese Prime Minister Shinzo Abe.

PRESIDENT DONALD TRUMP: Obamacare, as you know, is a total and complete disaster. So, we’re going to end up with tremendous health care at a lower price, and I think people are going to be extremely happy.

LISA DESJARDINS: Meantime, the Associated Press estimates some 12 million Americans have signed up for the Affordable Care Act for the next year, and Republicans are feeling the pressure from many concerned about a replacement.

Last night at a town hall advertised as focused as health care, Utah Congressman Jason Chaffetz was bombarded by angry constituents on a variety of issues. And, in Tennessee, a similar scene for Representative Diane Black, as health care policy and politics collide.

Now that Secretary Price has been sworn in, let’s take a closer look at what he may try to do, more quickly, and over the long term.

Julie Rovner covers this for Kaiser Health News. She’s a friend of the “NewsHour.” And she joins me now.

Thank you, Julie.

JULIE ROVNER, Kaiser Health News: Thank you.

LISA DESJARDINS: Let’s talk with Republican agenda item number one, the Affordable Care Act.

In Secretary Price, we have a man who literally authored a bill to repeal it. We have both reported that Republicans see him as a major part of their repeal effort. But what can he actually do? What is he likely to do on the Affordable Care Act?

JULIE ROVNER: Well, what he can actually do and what he will likely do are two different things.

What he can actually do is quite a lot. For as long as the Affordable Care Act was, there are a whole lot of places where it says the secretary shall or the secretary may. So he has a lot of power to determine the details around what happens to the law.

And he can take apart a lot of the details that the Obama administration added to it. Now, what will he do? There’s an issue here with whether or not the Republicans want to make sure that there is still an individual insurance market next year in 2018, while they’re figuring out what to replace it with.

Insurers need to know that really by later this spring. And so some are expecting him to, on the one hand, try to take some things apart, on the other hand, try to make sure that the insurance industry stays in, and so to give them some security about what might be coming.

LISA DESJARDINS: And as he has to deal with the insurance market, which is one issue, he has to deal with, of course, all of us and our health care. And Obamacare has some preventative services in it. Included in that, contraception, screenings. What kind of say does he have over whether those will continue to be cost-free?

JULIE ROVNER: Well, he can change that if he wants to. Now, some of it was done by regulation. And in order to change regulations, there is a process that even departments have to go through of notice and public comment. And it can take several, many months sometimes.

There is also something that’s a little less formal called guidance, and guidance, he can undo pretty much whenever he wants. So, he has the power both ways. It’s just whether some things will be faster or slower.

LISA DESJARDINS: On contraception, a lot of people paying attention to that. That is one that could take a few months, but he could still do it? Is that right?

JULIE ROVNER: Yes, well, he can make it easier probably for religious organizations, employers to opt out of providing contraception. That’s been a huge issue.

In terms of keeping it cost-free, that would have to be changed through a regulation. That would take a little bit longer.

LISA DESJARDINS: Another one, Medicaid. Republicans on the Hill, I know, tell both of us that that is one of the biggest puzzles for them. They have to deal with how to expand it or not expand it, what they do.

But, Secretary Price, you report that he can change requirements for the poor who receive Medicaid?

JULIE ROVNER: That’s right.

Well, he can’t change the law, but he can change some of the regulations that have to do with who gets it, with who gets much. Of course, Congress is talking about turning Medicaid into a block grant, which would limit how much money states could get, although they would have much more flexibility.

He could through his own power give states a lot more flexibility than they have now, which is what many are expecting him to do. So things like requiring people on Medicaid to meet a work requirement, that’s something that the Obama administration resisted, but that new Secretary Price might not.

LISA DESJARDINS: That’s an old debate over welfare and work. Republicans have long been on one side and Democrats on the other.

These are just — these are major things we have touched on, but they just barely describe the reach of this agency. Can you talk about sort of the profound abilities or the profound areas that now Secretary Price oversees?

JULIE ROVNER: People forget just how big the Department of Health and Human Services is.

Its budget is more than $1 trillion a year. It oversees not just Medicare and Medicaid and the Affordable Care Act, but the Food and Drug Administration, the Centers for Disease Control and Prevention, the National Institutes of Health, the Indian Health Service. It touches, it’s said, almost one out of every two Americans.

So, it is a wide, sprawling agency. And the secretary, as I mentioned, has significant power to interpret how laws are implemented.

LISA DESJARDINS: Quickly, you have been covering health care for 30 years. How pivotal, how historic could this moment be in terms of American health care?

JULIE ROVNER: Well, we will see.

It’s not clear, as I said, exactly which way the secretary is going to go. We know that, from his congressional career, he’s been very conservative, would like to remake Medicare, remake Medicaid, repeal the Affordable Care Act.

That’s not exactly what President Trump ran on. He said in his confirmation hearings he will do what the president wants. We will have to see how that goes.

LISA DESJARDINS: All right, Julie Rovner, chief Washington correspondent for Kaiser Health News, thank you so much for joining us.

JULIE ROVNER: Thank you.

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