Senators Casey and McCaskill Question Health and Human Services Secretary Nominee Price on Medicaid Block Grants
January 25, 2017 | Zach Baldwin
On January 24, 2017, Congressman Tom Price testified before the Senate Finance Committee on his nomination to be the Secretary of the Department of Health and Human Services. During the confirmation hearing, Congressman Price responded to questions about Medicaid and the possibility of block grants from Senators Bob Casey (D – PA) and Claire McCaskill (D – MO).
Both Senators Casey and McCaskill questioned Congressman Price about his record as Chairman of the House Committee on the Budget that proposed to cut Medicaid by nearly one trillion dollars and convert it to a block grant system. During the hearing, Congressman Price made a commitment to Senator Casey that no one with a disability would suffer a reduction in coverage.
Medicaid is a healthcare program that pays for medical services for qualified people, including people with disabilities and low-income individuals. Currently, Medicaid serves 10 million non-elderly people with disabilities. This past Sunday, the Trump Administration released more details on their plan to replace the Affordable Care Act, which proposes to convert Medicaid to a block grant system (New York Times). This is in-line with other Congressional proposals.
Currently the federal government covers a percentage of states’ Medicaid costs. Under Medicaid block grants, the federal government would pay the state a specific lump sum (likely based on historical spending), rather than a percentage of the state’s costs. This option drastically reduces federal funding for state Medicaid programs (National Council on Independent Living).
AAPD applauds Senators Casey and McCaskill for focusing on the life-saving coverage that Medicaid provides to individuals with disabilities and the dangers of converting the program to a block grant. We appreciate Congressman Price’s promise that no people with disabilities will lose coverage and hope that he holds true to that promise as Medicaid block grants are considered. AAPD joins other disability rights organizations in opposing block granting Medicaid as it will result in people with disabilities losing the services and supports they rely on.
Below are clips and transcripts from Congressman Price’s hearing with the Senate Finance Committee. Please note: The transcripts included below are CART transcripts obtained from CSPAN and have been lightly edited for corrections.
Senator Casey Questions Congressman Price on Medicaid Block Grants
Senator Casey: Thank you, Mr. Chairman and thank you for the additional round of questioning. Representative Price, I wanted to move to the topic I hoped I would have gotten to in the first round, which is individuals with disabilities, many of whom – don’t have the exact number – but many of whom rely upon Medicaid. One of them is actually a young man – a child – I just got a letter from had his mother, Pam Simpson, from Coatesville, Pennsylvania, that’s in southeastern Pennsylvania, talking about her son Rowan, Rowan Simpson, who was diagnosed in 2015 with Autism. And, among other things she said about the great care that he gets and their family benefits from Medicaid, she says without Medicaid, quote, “we would be bankrupt or my son would go without the therapy he sincerely needs,” unquote. Can you guarantee today that he’s going to have that kind of — his family is going to benefit from and he, Rowan Simpson, will have that kind of coverage and protection that Medicaid provides, that he’ll have that if you’re Secretary of Health and Human Services?
Congressman Price: We’re absolutely committed to making certain that that child, every other child, and every other individual in this nation has access to the highest quality care possible.
Senator Casey: Not access. They will — he will have the medical care that he has right now. Or better, if you can come up with a better level of care, that’s fine, but he will have at least the coverage of Medicaid and all that that entails that he has right now? That’s either yes or no. That’s not –
Congressman Price: No, it is not a yes or no. Because the fact of the matter is that in order for the current law to change, you all have to change it. If I’m given the privilege of leading at the department of
Senator Casey: Look, we should stop talking around this. You have led the fight in the house, backed up by Speaker Ryan, for years, block grant Medicaid.
Congressman Price: To improve Medicaid.
Senator Casey: To block grant Medicaid. What that means is states will have to decide whether or not this child gets the Medicaid that he deserves. That’s what happens. So you push it back to the states and hope it work out. One estimate by senate and budget priorities, long before you were named, said – here is the headline of a chart – House Budget Chair’s Plan Would Slash Medicaid by One Third by 2026. This wasn’t developed because you’re now in front of this committee. That’s what they’re saying, that Medicaid would be cut by a third and by way of the number, a trillion dollars. Let me ask you this question –
Congressman Price: May I respond?
Senator Casey: Let me get this question in. Can you commit to us right now that no person with a disability who is currently covered by Medicaid – so that’s everyone, that’s Rowan, and that’s everyone else – that no person with a disability who is currently covered by Medicaid will lose healthcare coverage, not access, coverage, under the block granting plan that the administration now embraces as of Sunday?
Congressman Price: What I can commit to you is that in a Medicaid system that, if I’m given the privilege of serving and working with CMS [Centers for Medicare and Medicaid Services] administrators, that the metrics that we will use for Rowan and every single other patient is the quality that they’re receiving and whether or not they’re receiving that care. The metric that you want to use –
Senator Casey: The metrics are fine. What I’m asking you again is will you commit to ensure that Rowan and every other person in the country that has a disability that benefits from Medicaid today, will they have that same coverage, — the same coverage and the same health care and coverage that they have today?
Congressman Price: Our commitment is to make it so that they have that coverage or greater.
Senator Casey: That’s a commitment you’re making?
Congressman Price: That’s a commitment.
Senator Casey: For every person that benefits from Medicaid, that has a disability?
Congressman Price: As I say, the goal is and our desire is, but our desire is to make sure people have better health care, not less healthcare. It is astounding to me –
Senator Casey: Here is the problem with that. Here is the problem with your answer. Until Sunday, there was a question as to whether or not President Trump or his administration would fully embrace block granting of Medicaid because he said when he was campaigning that he would not cut Medicare, Medicaid, and social security. As of Sunday, the administration has said on the record, in at least one, maybe two interviews, that they’re going to pursue a block granting policy with regard to Medicaid. What flows from that are the following. He has a majority in both houses. So what you have been working on the house for years that you can vote for now may become the law of the land. This is a live issue. This isn’t theory or some policy among house republicans. This is a potential enactment of law to block grant Medicaid, and I hope you can keep your promise to make sure that no one with a disability suffers any diminution of care or coverage. That’s the promise you just made and I hope you can make that in light of a trillion dollar cut in Medicaid pursuant to block granting.
Senator McCaskill Questions Congressman Price on Medicaid Block Grants
Senator McCaskill: Thank you. And thank you for your patience in letting us have another round of questions, Mr. Chairman. We sincerely appreciate it. I would like to put in the record a table prepared by the TaxPolicyCenter.org on December 15, 2016, that lays out what happens with repeal of all ACA taxes including premium credits, based on income level. If I could make that part of the record. You were Chairman of the budget committee. I’m going to try not be – I get frustrated when people won’t answer, especially when your record is so clear on this, Congressman. I don’t really understand why you want to divorce yourself from your record. You were the Chairman of the budget committee, correct?
Congressman Price: Yes.
Senator McCaskill: And in that role, you had the most important — we all note the power of the Chairman around here – you had incredible power to influence what was in that document, correct?
Congressman Price: Which document?
Senator McCaskill: The budget that you prepared for 2017.
Congressman Price: Absolutely. Along with my colleagues.
Senator McCaskill: Along with your colleagues. Was there anything in that document that you disagreed with on principle when you supported it?
Congressman Price: Absolutely.
Senator McCaskill: Okay, what was in the document that you disagreed with on principle when you supported it?
Congressman Price: I would have to go back and look, but it was combined effort, but, again, you know, as I mentioned before, if I’m given the privilege of serving as Secretary of Health and Human Services, I appreciate and understand that that’s a completely different role –
Senator McCaskill: I know it is a completely different role. That’s not what I’m asking you, Congressman. I’m not asking you about the – I’m not asking you about the difference in your roles. What I’m asking you is what do you believe in? What do you believe in? You have been respected around these halls for a man of integrity because you believed in certain principles. And one of those was the principle that you embraced as Chairman of the budget committee to block grant Medicaid.
Congressman Price: No, on the contrary. What I believe in is this great country and the people of this great country. And the principles of health care that I defined earlier. And those are the principles that we all share, I believe, and that is that we need a system that is affordable for everyone, we need a system that is accessible for everybody, we need system that is of the highest quality, that is responsive to patients not to insurance companies and governments, we need a system that incentivizes innovation, and a system that provides choices to patients. That’s what I believe.
Senator McCaskill: I understand the aspirational goal you have. But there is a record, Congressman. There is a record and the record is that as Chairman of the budget committee, controlled by your party, you put out a budget document and you said over and over again that you favored block-granting Medicaid. In fact, your budget, in 2017, that you were the Chairman of, that you want to run away from today as if it never happened, and that’s what I can’t figure out why. You’re going to be influential. What you really believe matters. And you want to run away from that, you cut Medicaid by a trillion dollars in your 2017 budget. And yet today, you want to stand on some notion that, well, whatever you guys do is fine. And that’s just not reality, Congressman. What is reality is you’ve been chosen because of your beliefs. And your beliefs are reflected in your budget that you wrote as Chairman of the budget committee. And that’s all the point I’m trying to make. And I have a hard time understanding why you won’t say, “listen, it may not turn out the way I believe, but, yes, I favor block grants to Medicaid.”
Congressman Price: What I believe in is a Medicaid system that is responsive to the patients and provides the highest quality care possible. And I would respectfully suggest to you that’s not the Medicaid system that we currently have. It is incumbent upon you, it is incumbent upon me if I’m given the privilege of serving in this capacity, to work together to find the solution so that we provide the highest quality care for Medicaid patients and everybody else in this country.