Targets, with having advisors on the ground . Should we be at war in yemen . Cspan programs are available at cspan. Org. Right on our home page or by searching the video library. Up next, testimony from health and Human Services secretary tom price on President Trumps proposed 2018 budget request for his department. He discussed a range of issues including proposed cuts to medicaid and allowing businesses to opt out of providing insurance that covers Birth Control to female employees. Held by the Senate Finance committee, this is just over two hours. The committee will come to order. Were going to first listen to the distinguished senator from oregon who has to go to another Committee Hearing so well show that deference to him. I welcome everybody to this mornings hearing on the president s proposed budget for fiscal year 2018 with specific attention to the department of health and Human Services. But let me i want to thank secretary price for being here. These hearings are an annual event for the finance committee and, secretary price, since this is your first time around, ill just warn you that these hearings can be a little grueling. Of course, you already know that. Im grateful for the president and that the president and hhs are willing to work with congress to fix our Health Care System to ensure americans can access Affordable Health care coverage. For that, im going to turn to the Ranking Member who needs to get to another hearing and well show that deference. Mr. Chairman, thank you very much for this courtesy. I know this is a busy morning, and i am very grateful to you for doing this. I also want to say thank you to senator stabineau who in my absence is going to do an excellent job as she always does. This administration from day one has preferred alternative facts and convenient spin to the truth. One of the most recent examples was its Budget Proposal which double counted 2 trillion to maintain some whiff of fiscal responsibility while it slashed Health Programs and protections for basic and essential needs. The budget mass is fake, but the extreme agenda that would deprive millions of americans access to health care and wipe out Living Standards is not. Unfortunately this morning im going to be splitting my time between finance committee and Intelligence Committee so i will be brief. There are several issues im going to touch on. First is medicaid. Secretary price is the captain of the president S Health Care team. He has been the premiere advocate for trump care, a bill that cuts medicaid by 834 billion in order to pay for massive tax breaks for the wealthy. 14 million americans would lose coverage and if that wasnt enough of a cut, the Budget Proposal that came out a few weeks ago goes even further. It slashes hundreds of billions more from medicaid. A program that covers nearly half of all births, 37 million kids, millions of working families and people with disabilities and two out of three nursing home beds in america. These cuts would be a staggering blow to americans of all generations. These facts and figures have been met by a wave of the hand from secretary price. When asked if his proposed cuts would result in millions of americans losing access to medicaid he responded, and i quote, absolutely not. He went further claiming again, i quote, there are no cuts to the Medicaid Program and he also said, and i quote, nobody will be worse off financially. Ive heard secretary price and others make the baffling argument that people are actually worse off when they have medicaid coverage, that their health doesnt improve as a result of medicaid coverage. Often this argument is based on a brief and outdated study performed in my home state. Heres the bottom line on medicaid. 74 million americans rely on this program for basic health needs. Parents of sick kids, people with disabilities, seniors in Nursing Homes who have nobody to turn to for help if their benefits disappear. In addition, thousands of oregonians who are healthy under my home states model, it would be a tough sell to tell them they would be worst off without medicaid. The Program Needs a trillion dollars in cuts. Public opinion is very clear. Two out of three enrollees are very happy. Seven out of ten americans say congress ought to leave it as it is. No block grants. No per capita cuts. Fortunately the Budget Proposal hit the wall here in congress and theres a lot of debate to be had on trump care. Right now the administration is causing turmoil in the Insurance Markets and its already having disastrous effects for millions of families. The president issued a one day executive order undermining the Affordable Care act and nobody on the trump team can give a straight answer about whether the administration will continue making cost sharing reduction payments that are key to making insurance affordable for working families. Because of this sabotage, insurers are pulling out of the market and people are left without plans to choose from. You dont have to take my word for it, the insurers are very clear about why theyre making these decisions. Furthermore, on the campaign trail the president said he wouldnt cut medicare. The trump bill shrinks the life of medicare. The Budget Proposal expands the mandatory cuts under the budget sequester by more than 30 billion. The food and Drug Administration, the centers for disease control, the National Institutes of health all slashed in the budget. The same is true in programs aimed at basic human needs, programs that fund meals on wheels, child care, foster care. This is the budget you write if you think seniors and working families have it too easy. I want to thank the secretary for joining the committee. I apologize again for the hectic schedule. Its never an easy appointment for the cabinet secretary and i think he knows theres going to be some vigorous discussion this morning. I also again want to express my thanks to the chairman for his very gracious and ongoing courtesies on these kinds of matters. Thanks, senator stabineau for being willing to return in. I thank the chair. Thank you, senator. Let me just say im grateful that the president and hhs are in essence working on this effort. And are in essence willing to work with congress to fix our health care in order to make sure americans can access Affordable Health care coverage. This may not be something that is going to be that easy to do. And as we know, time is of the essence in regard to this effort. Earlier this week we received word that anthem is pulling out of ohios marketplace, potentially leaving 10,000 patients and consumers in 20 counties without any Insurance Options on ohios exchange for 2018. This news is particularly frightening as we expect to hear similar notices from anthem as they reevaluate their participation in Obamacare Exchanges throughout the United States, our whole country. Now this recent story is just the latest in a long line of failures that my colleagues on the other side seem to want to continue under the guise that this is working. Its not working. All of this demonstrates the need to move forward with repealing obamacare and replacing it with a more workable approach, one that will take serious that we can take seriously the blooming ballooning Health Care Costs impacting every american family. Let me talk for a few minutes about the specifics of the president s budget. The budget assumes 250 billion in total savings from the repeal and the replacement of obamacare and despite some insinuations to the contrary, the budget does not incorporate the specific legislative proposal. The American Health care act that is before congress right now, therefore, it is not accurate to associate the specific medicaid savings the cbo has estimated from enactment of the ahca from the president s budget. To do so would assume a level of specificity that for obvious reasons is just not there. Moreover, the president s budget does not cut 1. 5 trillion dollars from medicaid nor does it assume that the specific medicaid reform proposals from the ahca will be enacted into law. Im quite certain well hear a lot about that today but any attempt to make that connection is simply unfounded and any senator who harps on the ahca medicaid numbers here today either does not understand the explicit language and estimates provided in the president s budget or they are simply attempting to muddy the waters in order to scare americans who rely on medicaid for health care coverage. Ultimately, the president s budget appears to accept the reality that the senate will need to come up with its own Health Care Proposal that includes a fundamental fix to medicaid which is, quite frankly, long overdue. Anybody who doesnt agree with that isnt living in the real world. In addition to the savings assumed from the repeal of obamacare, the budget also explicitly assumes 610 billion in savings from putting medicare on a sustainable fiscal path by capping funding in fiscal year 2020 through per capita caps or block grants at the state option. All told, most of the budgets overall medicaid savings would be achieved by returning the focus of medicaid to serving those with the greatest needs, the elderly, disabled and needy mothers and children. By giving states more flexibility to run their own Medicaid Program. Any senator who would like to argue that the federal government should spend more medicaid dollars to provide coverage for nondisabled childless adults at the expense of disabled patients who remain on waiting lists should explain why. Furthermore, any senator who would like to argue that the states are ill equipped to handle their Medicaid Programs should explain why that is the case given that the overwhelming consensus weve heard from governors nationwide over the last few years is that states want more independence and flexibility to tailor the Medicaid Program. Washington needs to stop measuring the success of a federal program by how much money it spends or how many other programs are a part of it. Instead, washington needs to focus on how well a federal Program Helps those it is intended to serve and how efficient the program is at fulfilling its mandate. Long story short, we need to stop focusing on spending and pay more attention to outcome because we may not be able to spend more. It doesnt appear that were going to be able to. The rate things are going right now under the current system, its a national tragedy. I think the president s budget while it is by no means flawless largely recognizes this reality and the president and the administration deserve credit for that. I look forward to having an open and frank discussion with secretary price about his thoughts on these and other matters. Before we get to that, let me just say that id like to say today that we have the pleasure of being joined by secretary thomas e. Price. Secretary price, we want to thank you for coming. Secretary price is sworn in as the 23rd secretary of health and Human Services on february 10th, 2017, as a policymaker and as a physician, surgeon in particular, he brings to the department a lifetime of service and dedication to advancing the quality of health care in america. Secretary price first began his career in care for patients as an orthopaedic surgeon. He followed in the footsteps of his father and grandfather and began a solo medical practice in atlanta, georgia. That has grown to be one of the largest nonacademic orthopaedic practices in the country hoping to make a different impact on health care secretary price ran for public office. Was elected to four terms in the Georgia State senate and i believe would have continued on forever if he wanted to. During his tenure there, secretary price served as minority whip and later as the first Republican Senate majority leader in the history of georgia. Most recently secretary price served as u. S. Representative for georgias sixth Congressional District from 2005 to 2017. During his time in the house, secretary price served in various roles including chairman of the house budget committee, chairman of the House Republican policy committee and chairman of the republican study committee. Secretary price received his bachelor and doctorate of medicine degrees from the university of michigan after which he completed his orthopaedic surgery residency at emory university. Secretary price, were grateful to have you here. Well be happy to have you proceed with your testimony here today. Thank you so much, mr. Chairman. Ranking member stabineau and members i want to thank you for inviting me today to discus the president s budget for the health and Fiscal Services for 2018. It is an honor to be with you. Whenever a budget is released, the most common question in this town, in washington, is how much . How much does the budget spend on this program . How much does it cut from the other programs . As a former legislator, i understand the importance of this question, but too often its treated as the only question thats worth asking as it relates to the budget as if how much a program spends is more important or somehow more indicative of whether the Program Actually works. President trumps budget request does not confuse Government Spending with government success. The president understands that setting a budget is about more than establishing top line spending levels. Done properly, the budgeting process is an exercise in reforming our federal programs to make sure that they do their job and use tax dollars wisely. The problem with many of our federal programs is not that theyre too expensive or too under funded. The real problem is many of them simply dont work. Fixing a broken Government Program requires redesigning its structure and refocusing taxpayer resources to better serve most in need. Thats exactly what President Trumps budget will do in hhs and across the government. Consider medicaid thats been discussed. The primary source of medical coverage for millions of low income families and seniors facing Challenging Health circumstances. If the amount of Government Spending were truly a measure of success, medicaid would be haled as one of the most successful programs in history. 20 years ago actual spending on medicaid was less than 200 billion. Within the next decade its estimated to top 1 trillion a year. Despite these significant investments, onethird of physicians who ought to be seeing new medicaid patients dont and some Research Shows that enrolling in medicaid doesnt necessarily improve your Health Outcomes for the newly eligible medicaid population. This suggests we need Structural Reforms to power states to serve their unique medicaid populations in a way thats compassionate and sustainable. Federal rules prevent states from focusing on their most vulnerable communities to improve Health Outcomes and access to chair. This budget changes that. Hsss mission of protecting the health involves far for than overseeing the health care and insurance programs. Hss is the world leader in helping the Health Care Sector prepare for Cyber Threats and responding to and protecting against Public Health emergencies, recently i witnessed this important work first hand visiting ebola survivors in liberia and representing the United States at the g20 in berlin and the World Health Assembly in geneva. To support hsss unique role, the president s budget provides 4. 3 billion for Disaster Services coordination and response planning, biodefense and Infectious Disease research and developing and stockpiling of critical countermeasures. America faces a new set of Public Health crisis that have been far less successful if resolving. Those are serious mental illness, Opioid Crisis and childhood obesity. And the president s budget calls for investments in policy reforms that will enable to do just that. The budget calls for investments in high priority Mental Health initiatives for Psychiatric Care and suicide and homeless prevention and childrens Mental Health focusing especially on those suffering from severe mental illness. Over 52,000 americans died in over dose from opioids. This budget calls for 811 million to support the departments five part strategy to fight this epidemic. To invest in the health of the next generation and help nearly the 20 of