Health and Human Services Secretary Alex Azar will consider various ways that states can make changes to Obamacare and Medicaid so they can offer more affordable health insurance to residents, a move that is likely to receive backlash from supporters of the law who have said the Trump administration is “sabotaging” the healthcare system.
“There is no single one right answer. I’m a big believer in state experimentation here. I think … one of the flaws of the Affordable Care Act was trying to do a one-size-fits-all approach,” said Azar, using the formal name for Obamacare.
Each state has different health insurance markets, networks of doctors and hospitals, and economic conditions, he said.
Azar, speaking in a wide-ranging interview with reporters at HHS headquarters Tuesday, said options to offer states’ flexibility on healthcare were through waivers on Medicaid, the health insurance program for low-income people, as well as through a 1332 waiver, which allows states to make changes to Obamacare with federal approval.
The Trump administration recently approved Medicaid waivers in Indiana and Kentucky that will require certain recipients work or train for work as a condition of staying enrolled in the program. Azar did not say which of the other proposals might get the green light from the administration, including the possibility of allowing states to implement limits on how long certain people could stay on Medicaid. He disclosed that he was still examining state options and what could be allowed under law. His goals, he said, included making the Medicaid program sustainable over the long-run.
Azar did not say whether he supports two bipartisan bills pending in Congress that are aimed at stabilizing Obamacare. The bills would help fund various aspects of the law in order to lower premiums for customers who don’t receive federal funding.
The administration has not released a specific statement of support about the stabilization bills, though the White House has given verbal agreements to senators that President Trump would support the measures. Azar noted the president’s budget supports a bill that would overhaul Obamacare, known as Graham-Cassidy, that allows states to create their own healthcare plans. For this bill some stabilization measures may be necessary in the short-term during the transition, he added.
The question without a “repeal and replace” measure, he said, was whether the administration has enough authority under current law to create plans that are more affordable for customers. Azar plans to work with Centers for Medicare and Medicaid Services Administrator Seema Verma to examine what may be allowed.
“I’m very interested to see, first, what our flexibilities would be to be able to work with states and second, what different states will come up with, because what works for one may not work for another,” he said.
“Let’s experiment and see what functions,” he added.
