Satisfied, uncertain, fearful: Valley reactions to Price appointment as U.S. health secretary

Feb. 10--Reactions to the Senate confirmation of Tom Price as U.S. Health and Human Services secretary ranged from satisfaction to uncertainty to fear among health care providers, insurance brokers and community groups in the central San Joaquin Valley.

It was not unexpected that mixed feelings would result from the approval of Price, a Republican congressman from Georgia. He was approved on a party-line vote of 52-47.

Price, a retired orthopedic surgeon from Atlanta, has been a staunch opponent of funding for Planned Parenthood, has voiced support for replacing the Affordable Care Act and for controlling the costs of Medicare and Medicaid (known as Medi-Cal in California).

Socorro Santillan, executive director of Barrios Unidos, a southeast Fresno organization that works to reduce teen pregnancies, said: "We're truly scared that all the progress we've had in the last several years is going to be totally replaced."

Anthony Wright, executive director of Health Access California, painted an equally grim picture: "His appointment confirms on party lines that we are more likely to get significant cuts to the Medi-Cal program that half of the Central Valley residents depend on. It would mean millions of people losing coverage; there's no way around that."

But others saw the confirmation as a step forward to reforming a health care system in need of improvement.

Michael Der Manouel Jr., of the Der Manouel Insurance group and chairman of the GOP-backing Lincoln Club, said Price's confirmation "will not have anything to do with Medicare or Medicaid other than if he places an emphasis on reducing waste in those programs; that would be very helpful. But they're not going anywhere. That's the usual myth we hear from people."

Vic Gunderson, an insurance broker/consultant for employer groups at Der Manouel Insurance Group, is happy with Price's confirmation: " With him being a doctor and his background, he's also a politician and understands the workings of Washington."

And Gunderson said what replaces the Affordable Care Act, also called Obamacare, will be important for employers as well as for the millions of individuals who have coverage now. Obamacare has "become a very expensive addition to employer groups, along with all the other things they have to keep up with," he said.

Nathan Ahle, president and chief executive officer of the Fresno Chamber of Commerce, said it's too soon for his organization to take a position on Price's confirmation and what it could mean to health care reform, but the chamber is "supportive of legislation that allows employers to offer a minimum benefit plan, enabling small employers and their employees to buy health-care coverage at a more affordable price."

Daniel Jamison, a Fresno lawyer who specializes in health care, expects Price will support House Speaker Paul Ryan's "Better Way, which includes tax credits for premium costs, tax-free health savings accounts and high-risk pools for the otherwise uninsurable, among other changes.

None of the proposals addresses what he says is the biggest problem -- a lack of access to primary-care doctors to keep patients out of expensive emergency rooms.

Kaweah Delta Health Care District CEO Lindsay Mann said he is less concerned about Price's confirmation than about decisions made by Congress and President Donald Trump.

The Affordable Care Act has expanded coverage and reduced uncompensated care for the Visalia-based hospital, he said. In 2012, Medi-Cal paid for 34 percent of hospital patients and in 2016 that increased to 42 percent. From 2010 to 2016, the amount of uncompensated care Kaweah had to absorb fell from $15.4 million to $9.5 million.

How quickly any changes could be made to the Affordable Care Act, Medicare or Medi-Cal under Price's leadership remains to be seen.

"This is tough stuff," Der Manouel said. "It's going to be contentious."

And Mann said he doubts any resolution will come soon. "I believe the next year or two are going to be a very kind of wild ride for us."

Barbara Anderson: 559-441-6310, @beehealthwriter

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