Tomorrow, Secretary of Health and Human Services Alex Azar will testify before the Senate Finance Committee on President Trump’s budget, which slashes over $1 trillion from vital health care programs like Medicare and Medicaid and leaves vulnerable populations at further risk. So far, the Trump administration has failed to explain why they are determined to cut these programs, so ahead of Secretary Azar’s testimony we have several questions he needs to answer: 

1. The president’s budget lists $844 billion worth of cuts to health care expenditures attributed to the “president’s health care vision” while giving no details. What specifically did you cut and why did you hide it from the American people?

  • The New York Times: Trump’s Budget “Leaves To The Imagination” Just What His Health Care Vision Is, But The Cuts “Are Not Consistent With Modest Tweaks.” The New York Times reported that “while the budget failed to detail an alternative to the Affordable Care Act, it did include a very specific savings target that would entail significant changes: $844 billion in cuts over a decade to execute what the budget called the ‘president’s health care vision’…Mr. Trump is running for re-election this year, so his budget can be read as a policy blueprint for his second term if he wins. The budget leaves to the imagination just what that vision is…But the deep cuts enshrined in the budget’s numbers are not consistent with modest tweaks.”

2. The president claims to have “saved” protections for pre-existing conditions when in fact your administration has repeatedly put these protections at risk. Can you point to one instance where the administration has taken such a step?

  • Trump Has Repeatedly Claimed That He Will Protect People With Pre-existing Conditions Despite Efforts To Dismantle The Affordable Care Act. He did so last week in the State of the Union. By the next day, independent analysts and fact-checkers pointed out that that statement is somewhere between misleading and a lie. In reality, Trump has tried repeatedly to strip protections from 135 million Americans with pre-existing conditions through failed attempts to repeal the Affordable Care Act in Congress and now through his ongoing federal lawsuit Trump himself claimed would “terminate” the Affordable Care Act and its consumer protections.
  • The Trump Administration Has Expanded Access To Short-Term Junk Plans, Which Are Not Required To Cover People With Pre-existing Conditions. Kaiser Health News recently rated Trump’s claim that these plans are “less expensive and better” as mostly false: “given the limitations of short-term plans, they’re not better than ACA plans for most people, because policyholders could face potentially significant financial risk — or find their treatment needs are not covered. They’re definitely not better for people who qualify for federal subsidies to buy ACA insurance, especially those at the lower end of that income range, where the subsidies are larger.

3. How many Medicaid recipients will lose coverage if the administration successfully implements hundreds of billions in cuts, transitions state funding to “block grants,” and pushes onerous paperwork requirements intended to boot people off the rolls?

  • Block Grants Are Designed To Throw People Off Medicaid. Experts and leading patient groups have said the Trump administration’s Medicaid block grant guidance encourages states to cut enrollment and reduce benefits, threatening access to care for patients. AARP said that block grants “could put at risk the health coverage for millions of vulnerable Americans.”
  • Medicaid Work Requirements Cost More And Cover Less.  After Arkansas imposed the nation’s first so-called work requirements program, more than 18,000 residents lost Medicaid coverage. While these state efforts have been blocked by a federal judge several times, the Trump administration keeps fighting to impose work reporting requirements in Medicaid, appealing federal court rulings that blocked such requirements because they are illegal. According to the Kaiser Family Foundation, these onerous requirements could take health care away from up to 4 million Americans. Meanwhile, a recent GAO report found that the administrative costs to implement the failed work requirement programs in five states topped $400 million.

4. Does the administration have a plan for the 20 million people who will lose their insurance if the lawsuit you’re backing to overturn the Affordable Care Act is successful? Why has the president been falsely claiming to have an alternative “plan” for months but failed to produce one? 

  • Trump Is All-In On The Texas Lawsuit, Threatening Health Care For Millions. After failing to repeal the health care law, Trump took his war on America’s health care to a new level and went to court seeking to strike down the entire Affordable Care Act–including protections for pre-existing conditions. If President Trump and Republicans have their way, 20 million Americans will lose their insurance coverage, 135 million Americans with pre-existing conditions will be stripped of their protections, and costs will go up for millions.

5. Why did President Trump pull his support on giving Medicare the power to negotiate for lower drug prices, and did you advise him to do so?

  • 9 In 10 Americans Support Medicare Negotiation. Polling from the Kaiser Family Foundation shows that about 9 in 10 Americans (88 percent) support allowing the federal government to negotiate prices for Medicare beneficiaries, including 92 percent of Democrats, 90 percent of independents, and 85 percent of Republicans.
  • Trump Continues To Stand With Big Pharma As Drug Prices Have Soared. Donald Trump promised that he would lower drug costs, but instead he gave drug companies billions in tax breaks. The year after the tax bill passed, the largest drug companies made $50 billion in profits and subsequently used their savings to invest billions more in stock buybacks for their shareholders. Meanwhile, more than 3,400 drugs saw price increases in the first half of 2019 alone. Trump has rejected common sense reforms, like giving Medicare the power to negotiate for lower prices.