March 14,2019

Wyden Statement at Finance Committee Hearing on the President’s 2020 Budget with HHS Secretary Azar

It’s budget week on Capitol Hill. There’s a lot to discuss this morning, so I’ll get right to it.

The Trump administration seems to have an inexhaustible supply of destructive health care ideas that would harm vulnerable Americans.

Let’s start with the Arkansas paperwork requirements. With the Trump administration’s blessing, Arkansas went ahead inflicting a right-wing experiment onto people enrolled in Medicaid. They say it’s all about work requirements, not about reducing coverage. They’re wrong. 18,000 people in Arkansas have lost their health care. They’re people who want to work, and they’re people who are working.

Secretary Azar was asked on Tuesday why so many people in Arkansas have lost coverage. He answered that the administration was basically clueless. The Trump budget takes this experiment national. In fact, it makes it mandatory -- in every state.

Bottom line, this doesn’t make people healthier. It’s not about promoting work. This is a backdoor scheme to kick people off their Medicaid coverage by putting mountains of paperwork between patients and their doctors. 

Next issue, another hare-brained right-wing experiment. A cadre of Republican governors and attorneys general recently sued HHS in an attempt to get the entire Affordable Care Act ruled unconstitutional. Their legal argument wouldn’t get a passing grade in Con Law 101. But instead of defending the law of the land against this lawsuit, as is the longstanding bipartisan practice, the Trump Justice Department decided it would jump on board. 

And in fact, the Justice Department focused its attack on key protections for pre-existing conditions. It wants them ruled unconstitutional. The legal brief involved is so absurd, three career officials refused to put their names on it. One even resigned. After a political appointee agreed that he would be the public face of this attack, he was rewarded with a nomination to the Sixth Circuit Court of Appeals.

On the topic of hurting those with pre-existing conditions, let’s turn to junk insurance. The fight against junk insurance goes back decades. I was part of the effort to crack down on Medigap supplemental plans targeting seniors. More recently there was a similar effort in the private insurance market. The Trump administration said enough cracking down, let’s bring junk insurance back. Once again, scam artists are free to sell bargain-basement plans on the individual market that don’t cover the health care people actually need.

Next, the Trump administration wants to fillet Medicaid by block granting and capping the program. That’s an idea so destructive it couldn’t pass when the Congress was under unified Republican control. Not only would it put essential care on the chopping block for millions, including children and people with disabilities, it’s a surefire way to create a nationwide crisis of nursing home closures. Despite those dangers, the administration is now reportedly exploring how to block grant Medicaid through administrative fiat. 

The administration cut open-season for health insurance in half. It also slashed funding for the advertising and in-person assistance that helps people sign up for coverage under the ACA.

The budget would take away middle-class tax credits for health care. The list of health care sabotage goes on. Bottom line, it’s stunning how creative the Trump administration has been at making health care worse in America.

Now let’s turn now to the pharmaceutical checklist. Donald Trump made the skyrocketing costs of prescription drugs a core issue on the campaign trail. He’s talked a lot about it in office, even criticized a few companies on Twitter. He famously said in early 2017 that drug makers are “getting away with murder.”

Two years later, he gets a failing grade on doing anything about it. The president once said he wanted to let Medicare negotiate to bring down drug prices, but that’s nowhere to be found in his budget. There’s nothing in the budget that would force drug manufacturers to lower their prices. So far, there’s been no concrete action to back up the president’s promises.

I’ll close with two final issues. First on the separation of migrant children from their parents. Last year, Secretary Azar came before this committee and told us that HHS had everything under control, the kids were accounted for, and reunification would proceed smoothly.

He said the department and parents, I quote, “with just basic keystrokes, within seconds could find any child in our care.” 

Based on available evidence, it now appears that was dead wrong. Reports suggest the government cannot account for the whereabouts of potentially thousands of children who were in its care. HHS documents that were recently released also show that there were thousands of allegations of sexual abuse inflicted on children in government custody. So while Secretaries Azar, Nielsen and other Trump officials tried to send reassuring messages, behind the scenes these kids were subjected to chaos and abuse. This is an ongoing, horrifying scandal at the border, and now there’s evidence the Trump administration is working to intimidate and silence the journalists trying to expose it.

Finally, I need to address an issue dealing with foster care. In January, the Trump administration gave South Carolina a green light for religious discrimination in its foster care program. That announcement came with the assurance that it was only one state, it was a very particular set of circumstances, and there wouldn’t be any discrimination. Then the president got up at the National Prayer Breakfast and suggested that this policy could become national.

In my view, this road heads directly toward taxpayer funded discrimination on religious grounds. The first victims of that discrimination will be people who want to step up and provide safe and loving homes for foster kids. People who are Jewish, who are Catholic, who are Muslim, who choose to practice no religion, LGBTQ Americans, potentially others. The next victims will be vulnerable youngsters, since this policy would limit the number of foster homes available to them. There are also alarming questions about what this would mean for Jewish kids and Catholic kids who wind up in settings that are hostile to their faiths. What would it mean for LGBTQ kids, or children who are struggling with their sexual orientation?

I’m extremely troubled by what the administration is doing in this area. So I’m going to have more questions about that, as well as the other issues I’ve discussed today and more.