Sen. Portman Questions HHS Secretary Nominee, Secures Commitment to Expand Opioid Treatment, Implement CARA

WASHINGTON, Jan. 24 -- The office of Sen. Rob Portman, R-Ohio, issued the following news release:

U.S. Senator Rob Portman (R-OH), a member of the Senate Finance Committee, questioned Secretary of Health and Human Services (HHS) Nominee Dr. Tom Price and secured his commitment to help ensure access to addiction treatment for individuals currently getting insurance coverage through Affordable Care Act exchanges or Medicaid expansion as well as his commitment to fully implement the Comprehensive Addiction & Recovery Act (CARA). Portman urged Dr. Price to consider changes to the IMD exclusion to expand access to treatment for people on Medicaid. Portman also questioned Dr. Price on ways he will work to ensure that Ohioans "have access to affordable health care coverage with a healthy insurance market" and ways to provide better care under Medicaid.

Transcript of the questioning can be found below and a full video can be found here (https://www.youtube.com/watch?v=3BkuvbF6bgM&feature=youtu.be).

Senator Portman: "Dr. Price, thank you very much for your willingness to serve. As you know, a couple of weeks ago, Congress passed a budget resolution to set up a process that gives us the possibility of replacing the Affordable Care Act with policies that work better, particularly to reduce skyrocketing health care costs that have affected my constituents in Ohio. It's not just premiums. It is deductibles and co-pays. And also to give people more choices in health care. I did join with four of my colleagues in introducing an amendment that would have ensured we had enough time for the next step in the process. I believe we got assurances for that to ensure we have time to work with you, frankly. We need somebody at HHS in place to work with us to be sure that the legislative and administrative policies are working together and that this is done carefully.

"Prior to the Affordable Care Act, we had a very competitive insurance market in Ohio. Now we don't. In fact if you look at what's happened due to the increased regulations and mandates, we have a dramatically decreased competitive market. We went from having 17 insurers offering plans last year on the exchanges to 11 now. We've got 20 counties in Ohio now, more than one fourth of our counties, that only have one health care insurance company offering plans. We used to have no counties in that situation. I know we're doing better than the rest of the country, actually, because about one third of the counties [in the U.S.] have one insurer. And some have only one insurer in the entire state. Now that we've begun this process of replacement and the president has issued this executive order, what actions can you take through your authority as Secretary to ensure that my constituents in Ohio have access to affordable health care coverage with a healthy insurance market?"

Dr. Tom Price: "Well, what you laid out is the challenge that we have all across the nation and Ohio is doing better than other states as you noted. But it's important to appreciate that things have gotten worse for the individual and small group market and I believe that it's a direct result of policies that have come from Washington, D.C. Directly from the Affordable Care Act. If we are honest with ourselves and honest with our constituents about trying to solve the challenges that they have to gain access to coverage that they want, then we ought to look at that and say 'how do we fix that?' And the way that we fix that is make it so individuals have choices. As I mentioned, one of the principles that we allow for pooling mechanisms that provide for individuals to have opportunity to re-create and re-constitute that individual and small group market which now doesn't exist."

Portman: "And by the way, I appreciate your response to my colleague from Ohio about protecting people who have pre-existing conditions. And one of the ways you do that is through those risk pools, which again many states had good risk pools that were working before the Affordable Care Act to help in that regard.

"As you know, Congress recently passed legislation I authored with Senator Whitehouse called CARA, the Comprehensive Addiction and Recovery Act. It's meant to address this opioid crisis that we face with heroin and prescription drugs. We are now working to both fully fund, and the funding is there and in place for this new program, and now to implement it. And a lot of the implementation goes through SAMSHA, almost half of the funding on the new grant programs go through HHS and SAMSHA. What should be done to ensure access to addiction treatment for those individuals currently getting insurance coverage through the exchanges or Medicaid expansion? And do you commit to us today to fully implement and implement promptly the new legislation."

Price: "Without a doubt, as you know senator, this is a scourge that has gone all across the country and is in communities large and small. Destroying lives, destroying families, harming communities. And it's growing. And so what we must do is absolutely commit to carrying out the law as it was passed. But also, as I talked about with some other challenges, making certain that we have got the right metrics in place. Are we actually helping with what we're doing? There may be better things to do. There may be things that we think we ought to do that in fact don't help, and we ought to be identifying those in as much real time as possible so that we can bring about a program that is actually making it work for the patients, for the individuals that actually are being harmed."

Portman: "One example of that of that quickly. You're aware, I think, of the IMD rule that says if you have an inpatient treatment center it has to be limited to 16 beds. Would you be willing to look at that rule to see if we can get that number up to be able to provide more of this type of treatment?"

Price: "I think that's one of the rules that has to be looked at. I think the three day stay rule in facilities where often times many of these individuals have mental illnesses as well and that the limitation on being able to keep folks on an inpatient basis when all of the health care professionals involved in their care say they ought to, but in fact that's not what's covered and therefore they're put back out on the street. And the challenge... we just get in a revolving door."

Portman: "Final question, and maybe if you could respond to this in writing because my time is expiring based on the allocation here. With regard to the waivers, Ohio applied for a waiver, and this was a 1115 waiver for Medicaid to be able to better cover people under Medicaid. We were rejected by CMS. I know you've got Seema Verma coming in who's worked on these over time. Do you believe that during this replacement time we should be covering people under Medicaid expansion, but then we could move to a program that is more flexible to provide better care under Medicaid?"

Price: "I think there have to better ways to provide care to the Medicaid population because there are huge challenges right now as I mentioned before. And the people we need to be listening to are the governors and the state insurance commissioners and the folks on the ground actually providing the care. And if we listen to them, I think they will guide us in the right direction in terms of policy."

30VitinMar-5754819 30VitinMar