Price, the ObamaCare Slayer

The Secretary of Health and Human Services is not usually a high profile post, but now that the Senate has taken the first step to repealing the Affordable Care Act, take a look at the man Trump has picked to oversee its demolition: Tom Price, Republican congressman from Geogia.

Price, who is also an orthopedic surgeon, has been among the most vociferous opponents of the ACA from the outset.  He has also proposed radical changes and cuts in Medicare and Medicaid that would eliminate or severely limit benefits for people currently covered under those programs.  Unlike Trump or the Republican congressional leadership, who have been unable to come up with any alternative for the ACA, Price has an actual plan, which he introduced as legislation in 2015.

The New York Times has an excellent summary of Price’s plan, which is definitely worth reading in full.  But here are the key points:

• Rolling back the expansion of Medicaid under the ACA, which would strip health care coverage for 14 million people living in 31 states and District of Colombia.
• Slashing government subsidies to people who purchased insurance under government exchanges.
• Eliminating the requirement for insurers to cover addiction treatment, birth control, maternity care, prescription drugs and other essential medical services.
• Limiting coverage for pre-existing conditions only to people who had uninterrupted insurance coverage for at least 18 months, i.e. if you had a gap in coverage between jobs, you could be out of luck.
• Converting Medicaid funding to block grants to the states, which would then determine what was covered and how much, i.e., many states–particularly those run by Republicans–would likely reduce the number of people covered (beyond those eliminated by repealing ObamaCare) and cut benefits.
• Turning Medicare into a voucher program with a set stipend, leaving seniors responsible for paying all expenses beyond that amount out of their own pockets.
• The net effect of all of these changes would likely be higher health care costs to most people and loss of coverage for up to 20 million Americans.

Even insurance companies (whose interests were accommodated under the ACA) are troubled by Price’s ideas.  They are particularly concerned by his plans to require insurers to accept billing by any doctor, not just those in their network, and “balance billing” which would allow doctors to charge more that what the insurer or Medicare allows.  They say that this would lead to major increases in health care costs.  And, of course, it opens lots of opportunity for fraud in what would be a much less regulated market.

Most people will have no idea about what the impact of any of these changes will be on them personally until they are actually implemented.   They will probably be in for a shock!

Some Republican congressmen are starting to have qualms about repeal because their constituents are realizing what it would mean for them.  But the party leadership is so committed ideologically to repealing ObamaCare and they are so invested in the disinformation campaign they have carried on against it, that the momentum is probably unstoppable.

Aside from ACA repeal, Democrats in the confirmation hearings have zeroed in on allegations that Price traded more than $300,000 in shares of health-related companies over the past four years while sponsoring and advocating legislation that potentially could affect those companies’ stocks.  According to the Wall Street Journal, this could be a violation of a 2012 law—the Stop Trading on Congressional Knowledge (STOCK) Act—that bars members and employees of Congress from using “any nonpublic information derived from the individual’s position…or gained from performance of the individual’s duties, for personal benefit.”  So far, Price has declined to provide detailed answers about any of this.

But we can hardly expect a Trump administration to be concerned with or even notice such relatively petty corruption, when Trump himself refuses to disclose his holdings or place them out of control of his immediate family to avoid conflicts of interest.  Like the rest of Trump’s cabinet nominations, Price seems determined to pervert the mission of the department he would head from serving the interests of the American public to increasing the wealth of members of a narrow and privileged group.

If you don’t think this is a good thing, let your senators know.