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Careful, Tom

Tom Price is now health secretary. Here’s what that means for the future of Obamacare

Tom Price is now Health Secretary. Here’s what that means for the future of Obamacare

The U.S. Senate narrowly confirmed Tom Price as Secretary of Health and Human Services just after 2 a.m. Friday morning, after Democrats stalled the vote for hours of additional debate. The vote broke cleanly along party lines, with 47 Democrats opposing him and 52 Republicans voting yes.

As secretary of health, Price will be in charge of a sprawling federal agency with a $1 trillion budget that oversees the Food and Drug Administration, Medicare, Medicaid, the Centers for Disease Control and Prevention, and the National Institutes of Health, among others.

Price, a Republican congressman from Georgia, is best known for his virulent opposition to Obamacare, otherwise known as the Affordable Care Act. He has proposed a bill to replace it every year since the health law was first passed, in 2011. Many see his most recent proposition, from 2015, as a blueprint for what an eventual Obamacare replacement would look like.

Price’s proposed replacement plan would allow insurance companies to charge people what they want by replacing Obamacare government subsidies with age-adjusted tax credits (as opposed to income-adjusted) to encourage people to buy coverage on the individual market. It does not ban insurance companies from discriminating against people with pre-existing conditions or those who cost more to insure.

His plan gets rid of Obamacare’s “essential benefit packages,” which required insurance companies to cover certain basic services no matter what, including maternity and pregnancy care. Price’s plan essentially benefits the young and healthy while disadvantaging the sick, old, and poor, or anyone else who is more expensive to insure.

Price has advocated repealing Medicaid expansion — the social program that covers millions of low-income people — without offering a replacement. He also wants to replace Medicare — for older people —  with “block grants,” which Democrats have called a voucher program.

Price cannot unilaterally end Obamacare on his first day as secretary of Health and Human Services; that will have to go through Congress, which remains deeply divided over how to approach the issue. But he will have the ability to dismantle large parts of the law on his own that could lay the foundation for a fuller repeal later. For instance, Price could stop enforcing the individual mandate option for insurance companies, which would throw the entire health system into chaos. Or he could take away the provision that requires insurers to cover contraception at no cost to women, Politico points out, something Price has long opposed.

Democrats fought Price’s appointment fiercely, but it was largely for show, considering that no Republicans have publicly said they wouldn’t vote for him.

Democratic Sen. Sherrod Brown called Price’s plans to change Medicaid and Medicare — specifically raising the Medicare eligibility age above 65 — as “radical” and “immoral,” on the Senate floor Thursday.

But Price is well-liked by his fellow Republicans. Senate Majority Leader Mitch McConnell praised Price, a former orthopedic surgeon, for knowing “more about healthcare policy than just about anyone.”

During his confirmation hearings last month, Price promised that people who currently have Obamacare will be fine when it goes away.

“I think there has been a lot of talk about individuals losing health coverage, and that is not our goal nor our desire,” the Georgia congressman told the Senate Health, Education, Labor, and Pensions Committee. It is “imperative” for those who have health coverage now to be able to keep it, Price added, but also for people to be able to choose their own health insurance on the individual market.

Trump’s choice of Price was clearly motivated by Republicans’ promise to quickly repeal and replace Obamacare. Soon after President Trump was elected, he promised to dismantle Obamacare immediately and replace it with something vaguely better more or less simultaneously, but in an interview on Fox News before the Super Bowl he backtracked on timing, saying it could be next year before his administration has a viable replacement.

“Yes, I would like to say by the end of the year, at least the rudiments, but we should have something within the year and the following year,” he told Fox News’ Bill O’Reilly.

Instead of fully replacing the law, some Republicans are now hinting at a softer “repeal and repair” strategy. Republican Sen. Orin Hatch told CNN last week that his party should “try and repair the law.”

But not everyone in the GOP seems to be on the same page. “I want to clarify this, [because] there’s a miscommunication going on,” House Speaker Paul Ryan said on “Fox & Friends.” “If we’re going to repair the U.S. healthcare system and get back to a patient-centered system that actually does lower costs and gives people peace of mind, you must repeal and replace Obamacare.”

 

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