Trump’s health secretary won’t say if administration still supports ACA repeal

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(Bloomberg) — Health and Human Services Secretary Tom Price wouldn’t say whether the Trump administration still supports repeal of the Affordable Care Act, days after his party’s efforts to overhaul the law broke down.

“We find ourselves right now in a position that the current system is not working,” Price said Wednesday in a House subcommittee hearing, when asked repeatedly whether the administration is aiming to repeal the ACA. “We have to fix the problem.”

Price and other members of the administration will play a crucial role in the success or failure of the ACA, also known as Obamacare, over the coming year. Decisions on whether to encourage people to sign up during the enrollment period later this year and how to enforce the law’s requirement that all people buy insurance coverage could either bolster or undermine the program.

Pressed by Representative Mark Pocan, (D-Wisc.), on whether the administration still wants to repeal the law, Price said: “What we’re trying to do is make sure individuals have access to coverage and care.”

Mixed signals
Republicans have sent mixed signals about their intentions for Obamacare. Even as President Donald Trump says the law is “exploding,” he’s said he’s ready to work with Democrats on healthcare legislation. On Tuesday, some House Republicans said they were still looking for ways to resurrect their failed effort to repeal and replace the ACA. Press secretary Sean Spicer said the White House is in an “ongoing discussion” with House Republicans to try to gain a majority on health legislation.

“We’re not going to create a deal for the sake of creating a deal,” he said Wednesday. “You got to know when to walk away.”

Stuck in neutral, Price and the rest of the Trump administration find themselves responsible for a law they’ve repeatedly called a failure. Meanwhile, Democrats in Congress are looking for reassurance that the administration won’t sabotage the health coverage program, and will instead work with them to improve it.

“We would welcome your sincere interest in bipartisan work to improve quality, lower costs, and expand coverage,” 44 Senate Democrats wrote in a letter to Trump released Wednesday asking him to stop efforts to repeal the ACA. “We urge you to use your executive authority to support a stable, competitive insurance marketplace.”

‘On the books’
Price wouldn’t say whether he’d commit to encouraging people to sign up for ACA plans, which the Obama administration had pushed heavily. The Trump administration pulled some outreach in the final days of the 2017 sign-up season, a move that’s been blamed for hurting enrollment.

Insurers “aren’t certain given the current construct of the law they are going to be able to continue to provide coverage for folks,” Price said. “We want to make sure that every American has access to affordable coverage, whatever we can do to make that happen.”

During the hearing, held by the House Subcommittee on Labor, Health and Human Services, Education and Related Agencies, Price was also questioned about enforcement of the law’s requirement for individuals to be insured.

“So long as the law is on the books we at the department are obliged to uphold the law,” he said.

HHS budget
The wide-ranging hearing was held to address the budget for HHS, the agency that oversees the National Institutes of Health, the Centers for Disease Control and Prevention, the Medicare program for the elderly and the Medicaid program for the poor.

The administration has proposed $1.23 billion in cuts to research funded by NIH this fiscal year, as part of Trump’s wider agenda to reduce non-military spending and increase support for the armed forces. Trump has already proposed cutting biomedical research at the NIH by $5.8 billion next fiscal year, or about 18 percent. The administration has requested $65.1 billion for the Department of Health and Human Services in fiscal 2018, down from $84.6 billion in 2016.

Other programs targeted by the administration for 2017 cuts include a worldwide initiative to help people with HIV and AIDS known as PEPFAR that focuses on patient treatment in Africa. Congress has the final say on spending levels, and the administration’s proposals are unlikely to become law.

Tom Cole, the Republican congressman from Oklahoma who chairs the subcommittee, said at the start of the hearing that he’s hesitant to reduce investment in cutting-edge biomedical research and voiced support for controlling disease in Africa.

“I’d much rather fight Ebola in West Africa than in West Dallas,” he said. “Defense is generally important. These things are part of the defense of the country and its development too.”

Bloomberg News