The House of Representatives committee of ways and means held a hearing Tuesday, February 28, 2012 to discuss the President’s Fiscal Year 2013 Budget with Kathleen Sebelius, Secretary of Health and Human Services (HHS). The hearing was slow to start since many representatives did not get to their seats until after Ms. Sebelius was finished with her opening address. Chairman Camp set the tone of the hearing with his opening remarks pointing out many disappointments and discrepancies with the performance of the HHS. Overall, Rep. Camp thought HHS lacked guidance and their budget does not show how health care will be more affordable with the Patient Protection and Affordable Care Act (PPACA) since premiums are still increasing. Additionally, HHS is requesting more money in their budget which does not help reduce the deficit, a promise the President made when elected. He closed his opening statement saying majority of the population does not support the Affordable Care Act because they believe it, even in part, is unconstitutional.
For much of the remainder of the hearing, Secretary Sebelius would play defense for the Department of Health and Human Services. She began her retort with stories of individuals who have benefited from PPACA. She used examples of expanding services, training, and innovation that have occurred because of PPACA. In reply to Chairman Camp’s criticism of the budget, Secretary Sebelius said the HHS budget underwent the same careful review as every other department. The reform in Medicare and Medicaid is focused on protecting the beneficiaries. She finished saying HHS is trying to help reduce fraud and waste which has a $7 return on every $1 invested; she thought this was a smart investment in the future.
As representatives went through the line with their questions for the secretary, some had questions about the progress of health care in the US and others tried to challenge her knowledge about PPACA. Sec. Sebelius stayed positive when talking about the progress of PPACA and the start-up of state insurance exchanges. Chairman Camp questioned if employers would dump more of their employees into the state health insurance exchanges since premiums are increasing. Sec. Sebelius replied that employers would make their decisions on a moment by moment basis. She also referenced the Massachusetts health insurance exchange since more employers ended up offering coverage instead of dropping employees. Chairman Camp then challenged the HHS secretary to explain the 30 percent or $111 billion increase in health insurance exchange expenditures from the budget FY 2012 to FY 2013 budget. Sec. Sebelius had no explanation.
Banter like this continued throughout the remainder of hearing. Sec. Sebelius sounded positive when she said PPACA has added 12 years onto the Medicare survival and the President’s budget has added another 2 years. On the other hand, Chairman Camp responded that Congress and the American people are looking for long term fixes on financial problems and not short term splints. Two years is not a sustainable fix and the president’s budget does not address the real problem. Other representatives questioned Sec. Sebelius about Medicaid and Medicare financing, Medicare Advantage, doctor reimbursements and IPAB implementation. The questions were direct and sharp and Secretary Sebelius answered with generalized and rehearsed answers. When an issue arose Sec. Sebelius could not answer, she said she would get back to the question later in writing.
All in all, the hearing was not as productive as desired. Direct questions were avoided or not properly answered. The representatives had many questions that could affect the fiscal budget, tax payers’ money and the progress of PPACA. Unfortunately, Secretary Sebelius was not able to answer many specific questions and avoided the real issues.