HHS Secretary Alex Azar Answers to Congress After Proposed Budget Cuts

Top Trump health official testified to the House Ways and Means Committee on lowering prescription drug prices, increasing healthcare access, and strengthening Medicare.

Department of Health and Human Services (HHS) Secretary Alex Azar reiterated the Trump administration’s commitment Wednesday to providing affordable healthcare access, two days after the White House’s budget proposed a 21% cut to the department.

Azar told the House Ways and Means Committee that HHS holds a “deep commitment” to keeping Medicare solvent and accessible.

“We want people to have access to affordable health care,” Azar said. “Making our programs work for today’s Americans, sustaining them for future generations, and keeping our country safe is a sound vision for HHS, and I’m proud to support it.”

Azar laid out his main priorities for HHS, including increased access and affordability to health insurance, shifting Medicare toward a more value-based operation, lowering prescription drug costs, and embracing telehealth services.

Strengthening Medicare, changing ACA requirements

Referring to Medicare as a “bedrock of our society,” Azar said he is determined to keep the program solvent by driving out waste, fraud, and abuse. He said the recent White House budget proposal continues the shift toward value-based and outcome-based care, adding that “the future of Medicare must be driven by value.”

Azar supported the budget’s inclusion of the Graham-Cassidy proposal, which would maintain certain aspects of the Affordable Care Act, such as allowing individuals to stay on their parents’ plan until they turn 26, while also allowing states the flexibility to alter the health plans offered through block granting.

This would shift the power to address certain outstanding healthcare issues like risk-sharing and rising deductibles to the states, Azar said, while moving away from a “one-size-fits-all” approach from the federal government.

However, when asked about HHS’ response to Idaho’s decision to permit health plans that ignore some ACA requirements, Azar said the agency has not received a waiver request from the state or a solicitation for opinion.

Lower prescription drug costs, expanded telemedicine

Rep. Lloyd Doggett, D-Texas, asked Azar if the Trump administration had abandoned its mission to lower prescription drug costs for consumers, adding that former Secretary Tom Price did not respond to questions about what specific steps HHS planned to take.

Azar said bringing down prescription drug costs remains a primary objective for the Trump administration, noting the increase in generic prescription drug approvals by the FDA last year. He added that HHS would continue to work on restructuring the government’s negotiating power on Part B prescription drugs, though he did not expand on what changes Part D would face.

In addition to existing CMS initiatives lifting the burden on rural providers, Azar pledged his support to expanding telehealth services, praising the inclusion of language in the budget that increases the convenience of telemedicine for Medicare Advantage plans.

Azar also said he has not chosen a candidate yet to lead the CDC after the sudden resignation of Brenda Fitzgerald following media reports that she traded tobacco stocks while leading the agency’s anti-smoking efforts. He praised interim director Anne Schuchat, MD, (RADM, USPHS), referring to her as a “career professional.”

Democratic criticism in the hearing, afterward

Azar received criticism from Democrats on the committee over the proposed cuts to HHS funding in the White House budget plan, despite his counterargument that the department received an 11% increase in discretionary spending.

Democratic lawmakers said the cuts are significant and endanger the long-term viability of Medicaid, with Rep. John Lewis, D-Ga., calling the budget proposal an “affront to the average American.”

Following the hearing, 178 House Democrats authored a letter criticizing Azar’s support of the Trump administration’s proposed Medicaid work requirements. The letter stated the policy will “undermine access to health care” and contradict Congress’ “longstanding intent for the Medicaid program.”