January 25,2018

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Taylor Harvey (202) 224-4515

Wyden: Trump’s Health Care Record is an Agenda of Discrimination

As Prepared for Delivery

A year ago, the president stormed into office promising better, cheaper health care for everybody. And he said he’d bring prescription drug prices down because, in his words, drug companies were, “getting away with murder.”

Let’s take stock after year number one. The Trump record on health care is worse than your garden variety case of a president failing to live up to his promises. This president has gone out of his way to hurt the people he promised to help.

Very shortly the Senate will vote on the nomination of Alex Azar to be the Secretary of Health and Human Services -- the captain of the president’s health care team. In my view, this debate is about a lot more than Mr. Azar’s C.V.  It’s a referendum on a year of failure, particularly on drug costs. And it’s a referendum on what I consider to be a health care agenda of discrimination.

Let me begin with skyrocketing prescription drug prices, which are a gut punch for millions of Americans every time they step up to the pharmacy window.

Few promises the president made with respect to health care resonated more than his promise to bring down drug prices. But now a year later, he’s chosen Alex Azar, a drug company executive with a documented history of raising drug prices, to lead HHS.

From 2012 until last year, Mr. Azar was the head of Eli Lilly’s American subsidiary, Lily USA. He chaired its U.S. pricing, reimbursement and access steering committee, which gave him a major role over drug price increases for every product Lilly marketed in this country. On Mr. Azar’s watch, Eli Lilly more than doubled the price of drugs used to treat diabetes, osteoporosis, heart disease, and ADHD. And those are only SOME of the drugs that were under his purview.

Mr. Azar told Finance Committee staff that he never even once approved a decrease in the price of a drug at Lilly USA. He said that’s just how the system works - prices always go up. Colleagues, Mr. Azar might have the facts straight, but that doesn’t make it right. He was a part of that broken system. And despite the overtures he’s made about wanting to work on this issue, Mr. Azar offered no concrete examples of how he’d change the system for the better.

Members of this body have come forward with specifics -- drug importation, more negotiating power for Medicare, and more -- but the most Mr. Azar could say was he’s open to ideas.

But this nomination is about a lot more than prescription drugs. After a year in office, the Trump administration is steadily enacting a health care agenda of discrimination. Discrimination against those with pre-existing conditions. Discrimination against women. Discrimination against LGBTQ Americans. Discrimination against those struggling to get ahead. The question up for debate today ought to be whether or not Mr. Azar is going to end that discrimination. In my view, he hasn’t given any indication that he will.

From day one, the Trump administration has been on a campaign of sabotage against the Affordable Care Act and the private health insurance markets. They cut the open enrollment period in half, slashed advertising budgets, and made it harder for people to sign up for coverage in person.

That’s a major reason why the number of Americans without insurance coverage increased by more than three million last year. Three million people one sudden illness or injury away from the nightmare of personal bankruptcy -- the result of policies the Trump administration pursued and cheered.

Even worse, the Trump administration is reviving junk insurance -- letting fraudsters get back into the insurance business with plans that aren’t worth the paper they’re printed on. It takes me back to my days at the co-director of the Oregon Gray Panthers. Back then, I met seniors who had 15, sometimes 20 private insurance policies to supplement their Medicare. Those were junk plans -- some of them little more than outright scams. So the Congress passed a law with teeth to change it and protect seniors, and it worked.

Then, eight years ago, some of the key parts of the Affordable Care Act were consumer protections put in place so that nobody of working age got stuck with junk insurance. Now the Trump administration wants to undo those protections. They’ve already taken steps on what are called Association Health Plans. Next up are short-term plans, which are likely to be even worse.

What this comes down to is the Trump administration turning back the clock, and allowing junk insurance to discriminate over pre-existing conditions and age.

This is going to be a major test for Mr. Azar if he’s confirmed -- is he going to look the other way and allow scam artists to peddle junk coverage, or is he going to protect people who need care and health coverage they can count on? 

There’s also an array of discriminatory policies with respect to women’s health. They tried to take away guaranteed, no-cost access to contraception -- essentially taxing women for their gender -- but that move has fortunately been held up in the courts. They overturned longstanding protections dealing with states and family planning in what amounts to an attack on a woman’s right to see the doctor of her choosing and an attack on Planned Parenthood. They’re broadening exceptions that give employers and universities say over what kind of health care women can access.

When he was asked for his views on these issues during his nomination hearing, Mr. Azar said that, “...We have to balance, of course, a woman's choice of insurance that she would want, with the conscience of employers and others...”

Absolutely not. There’s no balancing women’s choices against anything. A woman’s choice of health care is her choice -- nobody else’s.

In much the same way it’s going after women’s health care, the Trump administration is also permitting discrimination against LGBTQ Americans in need of health care.

Then finally there’s Medicaid. Just in the last few weeks, the administration has begun giving states a green light to slap punitive, new requirements and limitations on Americans covered by state Medicaid programs. This action by Health and Human Services goes after people across the country who are walking an economic tightrope, already balancing the costs of food, rent, gas, electricity. They’re people who are taking care of their kids or elderly parents, or struggling with a chronic condition.

These punitive new requirements won’t improve anybody’s health care. And as the first waivers are coming out from HHS, the public is learning some disturbing details.

In Kentucky, the state is introducing what sounds an awful lot like a literacy test for health care. No one in this body should have to be reminded that the history of literacy tests in America is ugly and discriminatory. That is the wrong direction to take health care.

Bottom line, M. President, the record after one year shows that the Trump agenda on health policy isn’t about improving care for all Americans. The Trump agenda on health care is ideological and discriminatory. So the question, as my colleagues come to cast their votes, is whether the Trump administration will be allowed to continue with its retrograde, discriminatory agenda. Given the opportunity to demonstrate that he would lead HHS in a new direction, Mr. Azar came up short. I will not support his nomination.

However, I’ve spent my career working on health care challenges, at every opportunity, on a bipartisan basis. I still believe in doing health care right, and that means bringing the two sides together. I hope Mr. Azar, if confirmed, will make his stated willingness to listen to ideas a reality and begin working with me and my Democratic colleagues on improving health care for everyone in America.

To me, that means getting to work right away on addressing high prescription drug prices and health affordability. If he is in fact ready to take up those issues head on, I’m ready to work.