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DHHS Secretary Tom Price in Town Hall Meeting on Health Care. Aired 9-10p ET
Aired March 15, 2017 - 21:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
WOLF BLITZER, CNN: Tonight, a CNN exclusive. President Trump's point person on repealing and replacing Obamacare takes your questions. We want to welcome our viewers here in the United States and around the world. I'm Wolf Blitzer.
DANA BASH, CNN: And I'm Dana Bash, and we want to welcome Dr. Tom Price. He practiced as an orthopedic surgeon for 20 years and is a former member of Congress from Georgia. He now serves as the secretary of the Department of Health and Human Services and is at the center of the health care debate in America.
BLITZER: And, Secretary Price, our audience is obviously very, very eager to hear your answers to their questions. But first, Dana and I have a few questions we'd like to get to.
First of all, in your effort to repeal and replace Obamacare, you talk about improving access, access to health care. But President Trump, as you well know, promised, quote, "insurance for everybody" during the campaign, not just "access to insurance" for everyone. How will this plan live up to the president's promise?
PRICE: Well, Wolf, Dana, good to be with you, and good to be with these wonderful folks here, here in the audience. I really appreciate the opportunity.
You know, serving as only the third physician to head the Health and Human Services Department, it really is an incredible honor and I'm pleased to be able to join you tonight.
The fact is that right now you've got individuals who, one, don't have access to care, and some of them have coverage, and you've got 20 million individuals who don't have any coverage at all, in spite of the fact that the plan that the former president put in place was supposed to get everybody covered.
We believe that if you use carrots and not sticks, if you allow individuals the opportunity to choose the kind of coverage that works for them and their family, then we can get more individuals covered, and our goal is clearly to make certain that every single American has coverage.
BASH: Secretary Price, according to the CBO report that just came out, under your plan, about 24 million more people will be uninsured in 10 years than under current law. So how is that an increase in access? PRICE: Yeah, this is -- this is very interesting and it's an
important question, because what the CBO looked at was just one-third of the plan. Looked at just the bill that's going through Congress right now. And that's not because they're doing a bad job. That's because that's what they were asked to look at, and that's all they could look at because of the rules.
The fact of the matter, it is this bill that's currently going through Congress, and then it's a portion that we can do at the Department of Health and Human Services, all those rules and regulations that the American people know about that happened in the previous administration, hundreds of them, literally, and then thousands of guidance letters which, in fact, have kind of the same authority as a rule, all of those were done through the Department of Health and Human Services. And we're going to look at every single one of those to see whether or not they help patients or hurt patients.
If they hurt patients, they need to go away. If they drive up costs or drive down costs, if they drive up costs, then they need to go away. And then there's a third phase, which is more legislation that can't be done in the reconciliation of the budget bill, so -- including things like medical malpractice reform and purchase across state lines. So what the CBO did was look at just a portion of the plan itself.
And second point I'd like to make on this is that the Congressional Budget Office does a pretty good job with numbers. They don't do a great job with coverage. In fact, when the former law was passed, Obamacare was passed, they said right now there would be 11 million people more insured than they are -- than there are right now. So they do a pretty good job with numbers. Coverage is not their strong suit.
BASH: I have to ask you, two years ago, when you were the chair of the Budget Committee in the House, you recommended, you wrote this letter recommending the current head of the CBO.
BASH: And now you're questioning his ability to do his job and the results of this, of this report. So how do you square the two?
PRICE: Well, a couple points. One, this isn't about who the director of the Congressional Budget Office is. This is about how we get care and coverage for the American people.
What they want is health care. They couldn't care less, no offense to Keith Hall, but they couldn't care less who the director of the Congressional Budget Office is. So we want to concentrate on care for the American people.
Second, we believe strongly -- and if I put my former Budget Committee hat on -- that there needs to be significant reform at the CBO. And we put forward a budget process reform bill in the last Congress that I hope somebody in this current Congress picks up, because there are a lot of changes that need to occur. BLITZER: We're going to drill down on all of these issues during the
course of this hour, but we have our first question. It's from Brian Kline from Pennsylvania. Brian, thanks very much. Early last year, Brian was diagnosed with stage three colon cancer. He's now cancer- free. Brian, you have a question?
QUESTION: Thank you, Wolf. Yes, Medicaid expansion saved my life and saved me from medical bankruptcy. Now, I earn $11.66 an hour at my retail job. And obviously, I cannot afford to pay for my cancer care out of pocket. My life really depends on having access to my doctors and medical care.
Getting a cancer diagnosis is bad enough. But Medicaid expansion gives me the economic security in knowing that funding is always going to be there for my cancer care. So my question for you, Secretary Price, is pretty straightforward. Why do you want to take -- why do you want to take away my Medicaid expansion?
PRICE: Brian, thanks for that question. And thank goodness that things are going well from your health care standpoint. As a physician, I practiced medicine over 20 years and took care of a lot of patients with cancer. And it was one of those challenges that, when it faces you as an individual or someone in your family, you want to make certain that you've got access to the highest quality care that you can receive.
The fact of the matter is that we don't. We don't want to take care away from anybody. What we want to make certain, though, is that every single American has access to the kind of coverage and care that they want for themselves.
If you look at the Medicaid program right now, we have one-third of the physicians in this nation, Brian, who are not seeing Medicaid patients. And so if we want to be honest with ourselves as a society, it's important that we step back and say, why is that? Why are those doctors not seeing Medicaid patients?
And let me just suggest it's because the Medicaid program itself has real problems in it. And so what we want to do is, one, reform the Medicaid system, make certain that individuals who are currently on Medicaid or on the expansion either are able to retain that or move to a system that might be much more responsive to them through a series of advanceable refundable credits, a way to get coverage that they choose for themselves and for their family, not that the government forces on them.
So, thanks. It's wonderful that you have received the care that you've received. And it's because of the incredible innovations and great doctors across this land. But that's not necessarily true for everybody.
BASH: Mr. Secretary, you mentioned doctors...
BLITZER: Well, let me just interrupt for one second, because I just want to get specific on the Medicaid issue, and this is so important to Brian and so many other people out there. Let me ask you, first of all, do you think the secretary answered your question?
QUESTION: Unfortunately, no. I don't believe he did answer my question, Wolf, because, like, according to my knowledge, the American Health Care Act under the Republican leadership bill is going to sunset Medicaid, I believe, in 2020. Now, of course, you have a faction of conservative Republicans who want to sunset it even sooner, so this is -- this is not going to help me.
PRICE: Well, again, Brian, it's important to appreciate that the program itself -- it may have worked extremely well for you, and that's wonderful, and we need to keep those aspects of the program in place. But the fact of the matter is that the program is -- is having extreme difficulty providing the care that's needed for all of the individuals on it.
So what we want to do is to strengthen that program, to make it so that it's more responsive for patients and allows physicians and other individuals who are providing care for patients to make be able to do so in a way that makes sense as opposed to one that may make it more difficult for individuals to receive the care that they need.
Now, I know that folks don't want to hear this, but the fact is that, again, one out of every three physicians in this nation aren't seeing Medicaid patients. And they should. Again, if we want to be honest, we ought to ask the question to ourselves and our society why and fix those challenges that exist in the program.
BASH: And now we can get to a doctor. You're talking about doctors. And this one, his name is Dr. Mitch Jacques. And he's a family physician in the southern coal fields of West Virginia.
QUESTION: Mr. Secretary, many people in West Virginia are suffering right now. Almost every day, I see someone in the clinic who worked in the coal industry who's now out of a job. Most of them can get care through the Medicaid expansion bill we just talked about, but our clinic estimate the current bill that's in front of Congress, if it becomes law, as many as one of five of our rural patients could lose their health insurance.
So my question to you, sir, is I ask respectfully -- because you and I are physicians...
QUESTION: ... do you think the members of Congress really understand the hardship that patients will have, particularly those on the edge if they lose their health insurance? And how can we help those patients who don't have health insurance?
PRICE: Yeah, we're not interested in having anybody lose health insurance. We believe strongly that the current system is failing many, many people. You know, there are 20 million folks in this country right now -- 20 million individuals -- who have told the federal government, in spite of the mandate, and in spite of the penalty, nonsense, don't throw me into that thing. I can't do that. I either can't afford it or I'm not interested, 20 million Americans. That's a system that's not working for everybody. So what we want to
make certain is that we put in place a system that will work for everybody. Again, we're not interested in having anybody lose their health coverage or have -- or lose access to coverage that they want for themselves and for their family, not that the federal government forces them to buy.
It's an important question. But it's also important to appreciate that much of what many folks have heard around this nation simply isn't true about the plan. The plan itself, as we've talked about, is three different phases. It's one that includes the bill that we're talking about right now, which is what most of these individuals are referring to.
BASH: Before you get to that, I'm sorry. I just want to follow up, because you've just had two questions about Medicaid expansion and concerns -- I know you're talking about people who don't have health care, but these are people concerned about those who did get health care because of Obamacare.
BASH: And you're talking about state choice and other issues. But in your plan, spending on Medicaid would be about 25 percent less in 10 years than under current law. So the question that was wrapped in both of these audience members' queries were, how are you going to keep the money coming from the federal government, or from anywhere, so that these people can continue to get the care that they got under Obamacare?
PRICE: Yeah. Dana, this is a really important question, because the premise of that question is that the way that you measure the success of Medicaid is by how much money goes into it. We believe the way that you measure the success of a program is whether or not it takes care of the individuals, the beneficiaries that are actually needing that program.
And let me suggest to you that there are many areas where the Medicaid patients aren't receiving the kind of care from this fine physician here or that this gentleman over here received.
The fact of the matter is that we believe there's a better way to provide the kind of care and services for Medicaid patients. And if we allow the states, not Washington, D.C., but the states to determine what kind of program they have for their indigent population -- Medicaid population, as you know -- and the good doctor knows -- is four different groups of Americans. It's elderly. It's disabled. It's, by and large, healthy moms and kids. And we, the federal government, tell them, the states, you've got to treat every one of those exactly the same from an insurance standpoint. That doesn't make any sense. You want to treat healthy kids who need -- who need quality health care the same as you're going to treat a disabled individual or an older individual? Their health challenges are different.
And we ought to allow the states to design a program that cares for those individuals in a way that's most responsive to them. When you do that, you're actually able to save money. That's the good news. And if we -- again, if we measure the success of the program by how we're caring for those individuals, not by how much money we're throwing at it, we'll get to the right answer.
BLITZER: Dr. Price, we have another question. This one comes from Petti Peach from Georgia. Patti?
QUESTION: Good evening. Good evening.
QUESTION: As a self-employed person, under Obamacare, I saw my previous, very reasonably-priced plan completely disappeared. My premium immediately tripled in cost while my deductible remained sky high, at almost $10,000. I was forced to carry coverage for things I didn't want or need. The words "pediatric dental" were even in the name of my plan, and I have no children. So my question is, how will the Republican plan help alleviate my exorbitant cost and actually provide me with insurance that I can use?
PRICE: This is a remarkably important question, because what it gets to is the fact that everybody under the previous -- under the current plan, under the current law, is treated exactly the same. And we know that every single patient -- the good doctor here knows, as well -- every single patient's unique.
When I treated a patient with one diagnosis and another patient with the same diagnosis, the treatment may have been completely different, because those patients are unique. And that's what we want, is a system that recognizes the uniqueness of -- of -- of patients.
And you can't recognize the uniqueness of patients by providing health coverage that's exactly the same for everybody. Because that doesn't respond to the patients' needs. For you, you had a coverage plan -- I suspect you had a coverage plan before that actually worked for you, was more responsive to the needs that you had.
QUESTION: Well, and it was lower priced. It was still a high deductible, but it was a much lower premium, so...
PRICE: So it was -- it was providing the kind of care that you desired at a much better price. Isn't that something that we ought to allow the American people to have an option to choose? That's what we're saying.
It's not that everybody wants the coverage that you would have or that you would select, but it's that you ought to be able to select the kind of coverage that you need for yourself and for your family, not the federal government. If we can return these kinds of decisions to people, so that the decisions are made between patients and families and doctors, not the federal government, we'll be in a much better spot.
BASH: Mr. Secretary, we've been talking about broadly the cost of care and the cost of insurance. I want to turn now to Teresa Caliari. She's a retired public school teacher from Staten Island, and she has a question about the costs for people in their 50s and early 60s who are not yet eligible for Medicare.
QUESTION: The ACHA hikes the cost of health insurance for millions of Americans with the biggest increase for older adults, like myself. Premiums and out of pocket costs will rise because the bill allows insurance companies to charge much higher premiums, five times higher, for people in my age group. How can you justify that change?
PRICE: Well, we justify it by the fact that insurers are leaving Obamacare, leaving the ACA in droves. One third of the counties in this nation that have just one insurer offering coverage in the exchange, have five states that only have one insurer offering coverage in the exchange. If you only have one choice, you don't have any choice at all.
So the fact of the matter is that if we're going to have any insurers -- and the ones that are remaining are saying, if you don't change this, if you don't stabilize this market, if you don't make it so that we can actually price to the risk of an individual, then we're not going to be able to stay here at all.
So it's very possible that under current law, which is one of the reasons that the CBO has gotten this wrong, under current law, they don't take into account anything that's happening out there in the real world. The fact of the matter is, there are going to be insurers that leaving the market.
We had 232 insurers in the insurance market last year providing health coverage in this nation, 167 this year. 232 last year, 167 this year. What that means is that patients are losing access to care. That's not responsive.
So you're going to have to figure out how we're going to -- how we're going to make it as a society possible for you to purchase the kind of coverage that you want. And we believe strongly, strongly, that the plan that we've put forward is so much better than the one that's there now. We believe, however, that -- as you say, as individuals age, their insurance costs more, which is why we provide a larger credit as individuals get older, so that they're able to purchase the kind of coverage that they want.
BASH: Secretary Price, you said earlier this week that you, quote, "firmly believe that nobody will be worse off financially in the process that we're going through." You just heard Teresa's story. Can you look at her and promise that she will not be worse off?
PRICE: Yeah, I -- what I can say is that I don't believe you'll be worse -- worse off financially from a health care standpoint, because that's the goal that we have and that's the kind of plan that we design. It's important that -- to take that into the context of what we're talking about, which is -- which is health care.
There's no way I can know what an individual's financial status is and situation is in life. But I can...
BASH: But do you acknowledge...
PRICE: But I can say that our goal and our plan, we believe, will make it so that individuals are -- are not -- that every single American is able to financially afford and have access to the kind of coverage that they want. That's the intention.
BASH: But do you acknowledge that Teresa could likely pay more because she is in that age group, 50s and early 60s? Because a lot of people in that age group, according to the numbers, are probably going to pay more.
PRICE: When you look at those numbers, the important thing that's left out of those numbers oftentimes is the deductible. If you -- and -- and for every individual for whom it's greater, there are individuals across this land for whom it is -- it is less.
The fact of the matter is, if you're an individual out there, regardless of your age, you're making $40,000, $50,000, $60,000 a year, and your premium is in the -- is in the $500 range a month, which is not unusual, and your deductible is $6,000, $8,000, you've got to spend $12,000, $14,000 a year before you even get insurance to kick in at all.
So this is an incredibly important question. And we're attempting to address it in a way that makes it so that every single American, including those between the age of 50 and 64, are able to access the kind of coverage that they need and want.
BASH: Teresa, were you going to say something?
QUESTION: At this point, I do not have a deductible in my insurance. And so I don't -- that's not a...
BASH: Are you happy with your insurance?
QUESTION: I love my insurance.
BASH: Can she keep it?
PRICE: What kind of insurance do you have?
QUESTION: I have -- through the government. I'm a retired teacher.
PRICE: So you have coverage through your employer.
PRICE: So this is an incredibly important question, because the employer-sponsored insurance, which is where the majority of Americans get their coverage, 175 million, isn't touched at all by our plan. Not one bit. So if you think about...
QUESTION: But the essentials -- you have your 10 essential things that need to be covered. And they have to be covered. You can't have people pick and choose what they want to be covered. They have to be covered. Those are 10 things that need to be covered.
PRICE: And there's nothing...
QUESTION: And you're getting better coverage for the more that you're paying.
PRICE: And there's nothing in that first bill -- there's nothing in that first bill that affects the essential health benefits, nothing at all.
BLITZER: Well, let me just press you on one point, Dr. Price, because you said there were four critically important categories of people who rely on Medicaid. According to the Congressional Budget Office, $880 billion is going to be cut from Medicaid over the next 10 years if your plan phase one goes into effect. How are you going to deal with all those people who are desperately in need of Medicaid -- expanded Medicaid coverage?
BASH: Wolf, you're falling into the same, old trap of individuals who are measuring the success of Medicaid by how much money we put into it. Our goal is to make certain that individuals in Medicaid are actually getting care, that they're receiving the kind of care that they need and that the outcomes of the care that they're receiving is actually making them better, that they're becoming more well, that they're utilizing preventive services and the things to make them -- make them healthier.
We don't have any desire to have anybody lose health status. We want to improve their health status. And we believe there's a better way to do it. And that's the key. We ought not be measuring programs by how much we put into it. We ought to measure them but whether or not they work. And let me suggest to you that when the rules and the dictates are coming out of Washington, D.C., for somebody anywhere across this land, it's not as responsive to them as it is if it's made in their own state.
BASH: Stand by. We have a lot more questions to come from our audience. We'll be right back with more of CNN's town hall with Secretary Tom Price.
BASH: Welcome back to the CNN town hall with Health and Human Services Secretary Tom Price. Thanks again for -- for being here.
PRICE: Thanks, Dana.
BASH: We want to go right to another audience question to talk about the opioid epidemic in this country. I want to bring in John Brogan. He's a recovering heroin addict who now works at a heroin addiction treatment center in New Jersey. John?
QUESTION: First and foremost, Secretary, thank you for your service.
PRICE: Thank you.
QUESTION: As well as a recovering heroin addict, I'm a United States Marine. I'm also a person in long-term recovery who overdosed four times before trying to take my own life. Today I'm the chief recovery specialist for prosecutors Ocean -- in Ocean County and Monmouth County for Coronado and Gorovicioni (ph). Had it not been for these men and Governor Christie, there wouldn't be -- there would be 100 more people on top of the 1,600 that we lost last year to this epidemic.
Secretary, I ask you, what is your administration's plan to attack this epidemic without putting them on another prescription or another pill? When you repeal Obamacare, what is going to be the plan for so many that don't have insurance? Out of that over 100 people that we've helped already just this year alone, almost none of them had insurance to begin with. So that would be the main question. How do we help these indigent people that have nothing find a new way of life?
PRICE: Yeah. Thanks for your service, and congratulations on your recovery. The opioid crisis and our kind of crisis is a scourge across the land, and it knows no bounds. It knows no racial barrier. It knows no economic barrier at all. It's destroying lives, it's destroying families, it's destroying communities, and it has to be addressed in a very aggressive way.
When I first got to the Department of Health and Human Services just a little over five weeks ago, I laid out three priorities from a health care standpoint for us to address, and we're going to do all that we can to put resources and research to make certain that we're doing all that we can.
First is mental illness. Second is childhood obesity. And the third is the opioid crisis. We all know folks that have had challenges from -- individuals either in our family or in our community who've had problems. And what we need to do is make certain that we're identifying individuals who are at risk, we need to make certain that we're identifying individuals who are beginning to fall into that trap, and put the resources in place to educate them and make certain that we're showing them a better way.
Once somebody falls into that trap, then we've got to make certain that we have treatment facilities. And not just -- not jails. Jails aren't treatment facilities for individuals who fall into this crisis and trap. We need treatment facilities that make certain that we bring folks out of this scourge of the opioid crisis. And we're going to make it a high priority at the Department of Health and Human Services.
BASH: If I might just follow up on that, the plan that is before the House that you have endorsed would end the requirement that Medicaid cover substance abuse treatment. And that would start -- it would end starting in 2020. So how will you do that help that you just described, if not through Medicaid? PRICE: Yeah. Well, it doesn't necessarily have to, one, be through
Medicaid. But even if it is through Medicaid, the Congress also at the end of last year, as you know, passed the cures Act and the CARA Act, which brings greater resources for this crisis.
Again, the fact of the matter isn't how much resources you're going to put into, but what are you going to care for the individuals that have this challenge? And this is an absolute priority. I've been meeting with the governors over the past couple weeks to talk, yes, about the plan, but also about other challenges that they have. And every single one of them knows the challenge and the scourge that the opioid crisis is in their state.
And they've got wonderful ideas about how to address it. Amazingly, many of them have been hamstrung by the federal government, not being able to do what they believe is most helpful for their vulnerable population. So there are wonderful ways I believe to address this in a positive way, if we keep our focus on the patient, not on government, but on the patient.
BLITZER: Dr. Price, I want to bring in Sheri Yeisley from Pennsylvania who's with us. She's a self-employed interior decorator who voted for President Trump in large part because of his promise to repeal Obamacare. You have a question, Sheri?
QUESTION: Yes. And the reason for that is I now don't have health insurance anymore because it went from $1,081 a month last year to $2,132 a month for a family of three. Because as you get older, it is more expensive in Pennsylvania already under Obamacare.
Anyway, my question is, in 2017, not one plan in Pennsylvania offered on the healthcare.gov website qualified for being able to open a health savings account. Under this new plan, what will the parameters be for being able to have a health savings account to be able to save money tax-free to help with medical expenses?
PRICE: Yeah, Sheri, I'm sorry that you've had that challenge, but it's one that we actually predicted when the law was passed, and you probably knew it yourself, because you could see what was going to happen. And that is, if you dictate out of Washington what every American must purchase in terms of health insurance and health coverage, then you get no choices and you get no competition in the system, so costs of necessity rise. And so your costs went up because of the law. Not because of something else that's going on out here. They went up because of the law.
So we believe strongly that if you increase competition and you increase choices for folks to make it so that you can select something that's right for you, then we'll drive down costs.
The other important thing that you mentioned is the health savings account. This is a wonderful vehicle that millions of Americans across this land are using to wonderful effect, to be able to save money for their health challenges, to make certain that they can pass it on, if needed, to either a relative or a child, spouse or a child, and these are the kinds of creative ways to be able to provide coverage for folks so that they're able to afford coverage and so that they're able to address their health challenges.
Now, in the bill itself, there are significant expansion of health savings accounts. And we believe that the more we can provide options and choices for individuals, whether it's through health savings accounts or whether it's through other areas and avenues of coverage, we believe that's how you get to the best system, because it works for patients, not for government.
BASH: Thank you. I want to now bring in another audience member, Katie Needle from Brooklyn. Katie?
PRICE: Hey, Katie.
QUESTION: Planned Parenthood provides an array of vital health services for women. And the majority of their patients are on Medicaid. I am a Medicaid enrollee, and I'm a Planned Parenthood patient, and I would be absolutely devastated in Planned Parenthood were defunded.
We've already seen in Texas that cutting access to Planned Parenthood means women have less access to health care. More women's health centers, they didn't just magically appear because Planned Parenthood was defunded. That just doesn't happen.
And I just want to call back -- this wasn't part of my question -- but I just want to call back, because you earlier brought up Medicaid specifically and complained about how one of the biggest problems under Obamacare was that only a third of doctors were accepting Medicaid. This plan chooses to cut a provider that sees over a million Medicaid patients every year.
So if that is your big problem with Obamacare, then how does that make any sense? That's not my question.
My actual question is, how do you expect the millions of low-income women nationwide who depend on Planned Parenthood for these vital human services, basic needs, to access these things if Planned Parenthood is defunded?
PRICE: Yeah, this is an important question, because the fact of the matter is that the American people have for decades said that they didn't want their tax dollars, their federal tax dollars, to be used for the provision of abortion services. And so what we have tried to do in -- when I was in Congress and now with the administration is to respond to the desires of the American people in a way that answers their concerns.
The fact of the matter is that what -- what the bill does that we -- that is before Congress right now actually increases -- increases money for women's health services. And we do so by providing those monies through community health centers. There are over 13,000, if my number's correct, over 13,000 community
health centers across this country, and they're in the hundreds of Planned Parenthood facilities. So what we're trying to do is respond to the American people and their concerns about having their tax dollars, federal tax dollars used for the provision of abortion services, and make certain that women not only have more ability to get to a health center, but have more resources to be able to do so.
BASH: You know, I want to throw out a number, and that is 105 counties -- 105 counties across the country have Planned Parenthood, and that is the only clinic offering a full range of contraceptive methods to women. So how are the women in those 105 counties going to access all of that?
PRICE: Well, I'd be interested in the list that you have, because the numbers that we have -- again, over 13,000 community health centers. And I'd be interested in the -- in the counties that don't have them.
And the fact of the matter is, that if the resources are available, then what will happen is that community health centers will spring up to provide services for individuals. In the meantime, there are other avenues to be able to get -- get services for women. There are community health centers. There are county health centers and the like.
But what we want to make certain is that we are responding to the concerns of the majority of the American people that federal taxpayers' dollars are not used for the provision of abortion services.
BASH: I have to ask you a follow-up on that in one second, but how are these community health clinics going to pop up in all of these places that are -- that currently...
... the people are just relying on Planned Parenthood. Do you really feel confident that that's going to happen?
PRICE: Well, again, I'd be interested in the -- in the counties that you have. I haven't seen that. And so I'd be interested in looking at that. If that is, indeed, the case, then we would be happy to take a look at it and see how to best provide those services.
What we want to make certain, again, is that we're not looking at the amount of resources going in, but what kind of care people are receiving. And the fact of the matter is, we believe that the women of this land are able to receive the kind of services that they need, can receive the kind of services that they need through the community health centers, and we're providing more resources for them.
BASH: And real quick, because you mentioned the abortion issue a couple times. Is it not true that, since 1977, the Hyde amendment, when that first went into effect, it is not legal to spend federal taxpayer dollars on abortion already?
So -- so describe how it's an issue. Because even Planned Parenthood isn't allowed to use federal funding for abortions.
PRICE: As you know, and all these good -- good economists in the audience know, that -- that money is fungible.
BASH: That is true.
PRICE: And so if you're spending money in one place and -- and you move money to another place, then, in fact, you are, indeed, using that money. And, again, the majority of the American people strongly -- feel strongly about this.
BASH: Thank you so much. We do have a lot more. Wolf?
BLITZER: Yeah, I want you to stand by. Everybody, stand by. We're going to be right back with more of CNN's town hall with Secretary Tom Price right after this.
BLITZER: Welcome back to our CNN town hall with the Health and Human Services Secretary Dr. Tom Price. We have another question from Karen Gottlieb from Connecticut. She's a registered nurse.
QUESTION: Thank you. The proposed plan allows insurers to charge 30 percent more to those who have a lapse in health insurance coverage. Working with the uninsured in the Americares Free Clinics for over 20 years, we've seen countless patients go on and off insurance because of their unsteady employment. Many of our patients can't afford premiums due to circumstances beyond their control and often have to make hard choices. How do you plan to help our patients in this situation?
PRICE: Yeah, Karen, thanks. And thanks for your work that you've done as a nurse. As an orthopedic surgeon for over 20 years, I know how much -- how important nurses were to me in my entire practice. And so I appreciate your service there.
This is an important question, because it gets to the issue of how are you going to price insurance and whether or not coverage is going to be available. And we recommend what's called continuous coverage, which means that if anybody keeps coverage and goes to a different plan, that they have to be able to be covered by that plan.
But the fact of the matter is that if you allow individuals to come onto a plan after they've gotten ill, then that changes the price point for what that cost is for everybody, not just that individual. And so what we -- what the plan recommended -- and there's an ongoing discussion right now as to whether or not it ought to remain -- but what the plan recommended is that we use something that's similar to what Medicare uses, and that if you -- if you don't sign up for Medicare, then there's a surcharge for signing up at a later date.
And so it's the kind of incentive to try to make certain that individuals have an incentive to maintain the coverage that they have. It's purely for the insurance costs and drives down the costs for other individuals.
BLITZER: But there's a problem here, Dr. Price, that your bill says there would be a 30 percent surcharge -- 30 percent surcharge for anyone who lets his or her coverage lapse for 63 days or more. Senator Rand Paul, Republican, he says this is a mandate for insurance companies, which is part of the reason he is calling your plan "Obamacare-lite." If people are penalized for not having coverage, isn't that a form of a mandate by another name?
PRICE: No, not at all. A mandate is when you dictate to somebody what they must buy, which is what we have right now. The federal government is telling every single American what kind of health coverage they must buy. You don't have any choices. You've got basically three plans that are available to you. That's what a mandate is.
What this is, is an attempt to try to incentivize individuals from a financial standpoint to maintain their coverage. Because when they maintain their coverage, they're able -- they're, one, able to drive down costs for everybody and they're able to select the kind of coverage through our plan that they desire, not that the government dictates to them. So it's...
BLITZER: That 30 percent surcharge goes to the health insurance companies, not to the government.
PRICE: That's right, because they're the ones that are providing the coverage. It's a similar type of construct that the Medicare program has itself. So -- and the reason for that is because the individuals who are the third-party administrators for the Medicare program understand and appreciate that if you don't have folks in the plan initially, then it costs more for everybody. And so there's an incentive, a financial incentive for seniors to sign up the day that they turn 65.
BASH: We have another question from the audience. Will Owen, who is a stay-at-home dad from Georgia. He is also a Navy veteran. Will?
QUESTION: My question for the secretary is, why are we talking about repeal and replace? Why shouldn't we just be talking about repeal? Because it's my belief that the federal government has no business in the business of delivering health care.
PRICE: Yeah. Will, thanks for the question, and thanks for your service.
We could just be repealing it. But the fact of the matter is that that would leave many Americans behind. And that's not what we want. It would pull the rug out from under Americans, and that's not what we want.
What we believe is important is to make certain that every single American has access to coverage, coverage that's affordable, that's of the highest quality, provides choices for patients and incentivizes innovation. And if you -- if you just simply repeal it, then that doesn't get to that goal.
And the individuals that talked about their insurance going away either on Medicaid or through the private sector, they would -- they would lose out. They'd have the rug pulled out from under them, and that's not what we want. So we believe it's most important -- and the president is strongly in favor of this -- and he heard about it all the time on the campaign trail -- that repeal and replace was what the American people desired.
BASH: Can I just follow up on the sentiment that I'm sure you're hearing from your former colleagues, some of them in the House? One is Mo Brooks, Congressman Mo Brooks, who said your plan is, quote, "the largest welfare plan sponsored by Republicans in history." And what he and other Republicans object to, mostly, is the refundable tax credits that you have in the plan to help people pay for insurance. Is this a new entitlement?
PRICE: No, not at all. And I think it's, again, important to review where people get their health care in this nation. The vast majority of individuals get it through their employer, about 175 million. About 55 million get it through Medicare, about 60 million through Medicaid. And then there individuals -- a number of individuals who receive it through the V.A.
But the remaining individuals receive it in the individual and small group markets. About 18 million people in this country. And for those individuals who make a significant amount of money and you provide simply a tax credit, then that might work.
But there a number of folks at the lower end of the economic spectrum who make more than makes them eligible for Medicaid, but less than they're able to utilize their disposable income for the purchase of coverage, they need this advanceable refundable credit, which allows them to be able to purchase the kind of coverage that they want. That's the key, is making it so that every single American has the financial feasibility and wherewithal to purchase the kind of coverage that they want.
BLITZER: Dr. Price, we have another question from Denise Edwards of Michigan. She voted for President Trump.
PRICE: Hey, Denise.
QUESTION: Thank you -- thank you, Secretary Price, for your service, and thank you for having me. Government health care invokes a one- size-fits-all assembly line order. My question to you is, will the repeal and replacement of Obamacare allow consumers to manage their health care as they see fit?
PRICE: Absolutely, Denise. And it's the key to what we're talking about. Because again, if you -- if all we do is say that the federal government is going to tell you what you must purchase, then the way that it does that -- and the way that it has done that -- is to tell you and you and you and you and you, and everybody in this room, and everybody across this land, that this is the coverage that you have to purchase.
And that doesn't make a whole lot of sense when you think about how unique you, Denise, how unique you are. And so what believe is that you ought to, as a unique individual American, you ought to be able to be the one to select the kind of coverage that you want, that works best for you, and potentially works best for you and your family. And that's what our plan's all about, is to make certain that we have the kind of competition, the choices available for folks, driving down costs, an array of opportunities for individuals to select the kind of coverage, so that you are able to select something that works for you and everybody else is able to select something that works for them.
QUESTION: OK, lasering it a little bit more, I'm thinking, say, for ethical or religious reasons, say, somebody doesn't want to take chemo. Say somebody doesn't want their child to have an immunization shot or doesn't want to have a blood transfusion. How would that work under that plan? Would you be penalized more or less if you say I want to go for a different form of therapy to get rid of a disease? How would that work in that?
PRICE: This -- this is key, because it gets to the uniqueness of each and every individual and how they view their health care. You may want a plan that allows one thing and not another. You may want a plan that allows this type of hospital to care for you or this type of facility to care for you or this doctor to be on the plan or another doctor to be on the plan or another provider, alternative provider. You ought to be able to select a plan that matches your needs instead of the federal government telling you, "This is what you got to buy. This is who you're going to see. This is where you're going to see them."
BLITZER: But you're a -- Dr. Price, you're a physician. You believe in immunizations. You believe all children should get a shot for polio and other diseases?
PRICE: It's a different question. The question that she asked is, is should Denise be able to buy the kind of coverage plan that she believes is most appropriate for her? The answer to that is an emphatic yes.
The question that you asked is what kind of health care ought to be provided to individuals. And there are certain things that we do -- ought to do as a society, and we encourage, that's the kind of education that is so important for folks, so that they know what's best for them and for their families.
BLITZER: But should it be required, measles, mumps, those kinds of immunizations?
PRICE: It's a perfectly -- I believe it's a perfectly appropriate role for -- for the government -- this happens, by and large, at the state government level, because they're the ones that have the -- the public health responsibility -- to determine whether or not immunizations are required for a community population, whether it's growing kids or the like, or if there's an outbreak of a particular infectious disease, whether or not an immunization ought to be required, or be able to be utilized.
BASH: I want to bring in another member of our audience, Sharon Carbine, a semi-retired tax attorney from Pennsylvania. Sharon?
QUESTION: Secretary Price, millionaires will receive about $157 billion of tax cuts within 10 years if the ACA is repealed. Are you willing to replace the ACA with a health care plan that will benefit all Americans, not just the wealthy? Millions believe repealing Obamacare will harm us financially and medically.
PRICE: Yeah, Sharon, thanks.
Thanks for the question. And clearly, that's not our goal, and clearly our goal is to make certain that, again, every single American has the financial feasibility to purchase the kind of coverage that they want for themselves and for their family. And we believe that that's the plan that's in place.
Contrast it with what we have right now. We have a plan that many individuals purchase coverage, they pay the premiums, they've got a deductible that won't allow them to obtain the kind of care that they need. And then again, you've got 20 million Americans who said what -- the rules of this game are ones that I don't want to play. I'm not interested in having that.
So they say, nonsense, I'll even pay a penalty, pay a penalty. The government's forcing me to buy something. And if I don't buy, and I have to pay a penalty, I'd rather pay the penalty than buy what the government wants me to buy. Shouldn't we have a system that works for everybody? And that's the goal that we have.
BASH: That's one tax issue. Another I have to ask you about is, in your bill, there is a tax break for health care company executives who make over $500,000 a year. Why do health care CEOs need a tax break?
PRICE: Yeah, I don't think it stipulates that it's health care executives. I think it's the level of income. If it's health care executives, then I'll take a peek at it. It doesn't make any sense.
BASH: It is. I mean, it's in there. It talks about -- I have it right here.
PRICE: I'll tell you what I think that is. I think that the previous administration singled out health care executives. You're absolutely right. And what they said is health care executives ought to be punished.
BASH: Well, not punished.
BASH: But limitation for wealthy people. It said -- Obamacare had a limitation for certain health insurance providers that exceeds $500,000 paid to an officer, director or an employee. That limitation in your bill goes away, and it effectively means a tax cut for these people.
PRICE: You think about what this is, Dana. This is the federal government before saying to a certain sector of society, a certain individual, you can't make what that company is willing to pay you for your services. That doesn't sound like America to me.
What we're saying is that we ought not single out certain individuals in this nation and have the federal government have the power to be able to say you're going to be treated differently than that individual, even though you make the same amount of money. If we want a health -- if we want an income system that taxes everybody at a certain income level the same, that's what I think the American system's all about.
BASH: Well, but the current tax system doesn't tax everybody the same. People are taxed differently.
PRICE: At a certain income level. And the fact of the matter is, what the previous administration did was to identify -- you read it -- identified individuals in certain sector of our society, and said you've got to pay more than the guy or the gal down the street who's making the exactly the same amount of money as you. That seems very dangerous to me.
BLITZER: All right, Dr. Price, we have another question from Karen Santana. She's from Brooklyn. In 2013, at the age of 30, Karen was diagnosed with breast cancer, but she's now cancer-free, and we're very happy about that. You have a question, Karen?
QUESTION: Yes. The proposed health care legislation requires that health insurance -- people that have pre-existing conditions are still covered. However, if the mandate is removed, how will insurance companies be able to afford to pay for people with pre-existing conditions, just like me?
PRICE: Yeah, Karen, wonderful news that you're now cured. That's great. And we used to celebrate that in our -- our medical office when folks would get that -- that wonderful news that that had happened.
The fact of the matter is that pre-existing conditions ought to be covered. We believe strongly, the president believes strongly that nobody who gets a bad diagnosis ought to be priced out of the market, just simply because of that diagnosis. That's a system that may work for government, it may work for insurance companies, but it doesn't work for people. And that's the key. It doesn't work for patients.
So when we drive down the cost of health coverage, then that makes it possible for every single American to purchase the kind of coverage that they want. And that's the key. If we -- if we continue down the road where we are right now, where costs are increased -- do you remember the line, if you want your doctor, you can keep it, if you want your -- if you want your plan, you can keep it? Costs are going to go down $2,500 for you and every single American family?
The fact of the matter is that they've gone up now about $3,000 for every single American family. So what we believe is that you've got to put in place a system that actually incentivizes and drives down costs so that you and every single American is able to afford coverage.
BLITZER: But, Dr. Price, if the mandate is removed, young, healthy people, what's the incentive for them -- the speaker of the House, Paul Ryan, says everybody should be free to buy health insurance or not buy health insurance, but if young, healthy people don't have an incentive to actually buy health insurance, how is that going to work out for people who do have pre-existing conditions and rely on a lot of healthy people to do this? And how are insurance companies going to be able to take care of all these people with pre-existing conditions, if young, healthy people don't have an incentive to go in and buy health insurance?
PRICE: So I think what you just said is that you want to force young individuals to purchase coverage so that they can participate in a government program. The fact of the matter is, the way that you incentivize individuals to purchase coverage, young or middle age or older...
BLITZER: But a lot of these young people will leave the health insurance business to begin with if they're not forced to actually go out and buy it with an incentive like a mandate.
PRICE: It's an interesting perspective. I happen to disagree with it. The fact of the matter is, that the way that you incentivize individuals, young, middle-aged, or old, to purchase is to provide a product that they actually want.
The reason young people across this land, by and large, are saying, "Phooey, that's not what I want," is because it doesn't serve their purposes. It's not what they need for themselves. So if you -- if we as a society and a health care financing and delivery system say, we're going to give you an array of options, in fact, we're going to actually tailor a system that will be able to provide you the kind of health coverage that you want, not that the government forces you to buy.
BLITZER: Very quickly, Karen, you wanted to respond.
QUESTION: I want to say that when I was diagnosed, I was 30 years old, and, you know, in the prime of my life, and I had a 9-month-old son. You know, I never thought -- I was very young. I never thought I was going to be diagnosed with this, especially at such a young age. And I know people that are in their 20s and are diagnosed with very severe diseases.
PRICE: And we want them all to have health coverage. Every single one of them.
QUESTION: Well, they should. They need to. PRICE: We want to make certain that they have the financial
feasibility to purchase the coverage that they want, not that the government forces them to buy.
BASH: We have to take a quick break. We are going to be right back with more from CNN's town hall with Secretary Tom Price.
BASH: Welcome back to CNN's town hall with HHS Secretary Tom Price. And I want to give you a chance to give some concluding remarks, but as you do, I want to ask you about something that the chairman of the House Freedom Caucus, Mark Meadows, said tonight, your former colleague. He said that he believes that they have the votes, these are Republicans, to block your Republican bill. How are you going to get this plan through Congress when you can't get these members of your own party to support it?
PRICE: Oh, thanks, Dana. It's -- this has been wonderful, by the way. I appreciate the opportunity to be with you, and I appreciate the questions from the audience. They were excellent, and they address many of the concerns that the American people have.
And the way that we'll get this through is by paying attention to the American people and what their concerns are. Almost regardless of ideological stripe, the American people want the same things in health care. They want a system that's affordable for everybody. They want a system that's accessible for everybody. They want a system of the highest quality. They want a system that incentivizes innovation so that you can have that quality. And they want a system that empowers patients through accountability and transparency and choices.
So as we work together in the policymaker side of the federal government and those of us who are privileged to implement that policy, what we'll do is try to listen to the principles that the American people have told us are dear to them and health care. And that's what the president has said. That's what he said in the joint session of Congress a couple of weeks ago. He wanted a system that made certain that we addressed pre-existing conditions, that made certain that every American had the financial feasibility to purchase coverage, that we made certain that the Medicaid system actually worked for patients, that we had purchase across state lines, that we were driving down drug costs, that we were making sure that the system had a transition to this new system that is going to work, I believe, so much better than where we currently are.
So we want to make certain that we're responding to the needs of the American people. And when we do that, I'm convinced that the individuals who are charged with then voting on that legislation will be supportive.
BLITZER: Dr. Price, thanks so much for joining us.
PRICE: Thank you, Wolf.
BLITZER: I suspect this debate is only just beginning, not only with your fellow Republicans, but Democrats, as well. We'll continue this conversation down the road. Dr. Price, thanks very much.
And be sure to watch "The Messy Truth" with Van Jones, another special town hall event on this stage tomorrow night, 9:00 p.m. Eastern, featuring Congressman Chris Collins and Kareem Abdul Jabbar.
BASH: And we want to thank Secretary Price for joining us. And thank you also to our studio audience. "CNN Tonight with Don Lemon" starts right now.