 Office of the Press Secretary |
ON-THE-RECORD PRESS CALL BY SENIOR ADMINISTRATION OFFICIALS ON PRESIDENT TRUMP'S HEALTHCARE VISION FOR AMERICA Via Teleconference 2:52 P.M. EDT MR. FIELDS: Thank you, Operator. And good afternoon, everyone, and thank you for joining today's briefing on the President's healthcare vision for America and his administration's commitment to providing quality healthcare at low cost. This briefing will be conducted by Alex Azar, United States Secretary of Health and Human Services; Seema Verma, Administrator for the Centers for Medicare and Medicaid Services; Brooke Rollins, Assistant to the President and Acting Director of the Domestic Policy Council; and Dr. John Fleming, Assistant to the President for Planning and Implementation. Both opening remarks and the question-and-answer portion to follow will be on record for all principals on the call, and on background for any senior administration officials who might be aiding with the call. And those people would be [senior administration officials]. All information on the call will be embargoed until the conclusion. And with that, I'm happy to introduce Secretary Alex Azar. SECRETARY AZAR: Great. Thank you very much. We apologize for the background noise. We're calling in from Air Force One here to you. Thank you for joining this call today for an update on our progress toward President Trump's healthcare vision. Today, the President will sign executive orders that direct HHS to take tangible steps toward delivering on the healthcare plan he's laid out for America: better care, more choice, and lower costs. In addition, the President will be laying out his broader plan for American healthcare and announcing other major steps to deliver lower healthcare costs following his drug pricing executive order in August. The President is delivering real results on healthcare where previous administrations have so often just delivered talk. The executive order today will address two problems that many American patients worry about: their ability to secure insurance if they have preexisting conditions and their risk of receiving surprise bills from hospitals. As the President has repeatedly said, his administration has always been committed to ensuring that patients with preexisting conditions can obtain affordable healthcare. To that end, the President is declaring that it is the policy of the United States to provide protections to ensure that Americans with preexisting conditions are protected, regardless of whether the Affordable Care Act is unconstitutional and its protections for preexisting conditions invalidated. This comes alongside our efforts to deliver lower costs and more options under the Affordable Care Act, which has seen premiums stabilized and then finally dropped under President Trump for the first time. Ultimately, the ACA failed to provide sufficient protection for Americans with preexisting conditions. They may have the ability to purchase a plan, but it may be utterly unaffordable given that premiums more than doubled in the four years following the ACA's implementation. The President is also taking action to address surprise billing, a source of financial insecurity for all Americans who do have insurance that has gone unaddressed for two years now. The President will direct me, as Secretary, to work with Congress to get surprise medical bill legislation passed by Congress that will protect patients against surprise medical bills. And if such legislation is not passed by January 1st, then he will instruct me to investigate executive actions and regulatory actions that we can take that will ensure that patients are nonetheless protected against surprise medical bills. What I want to emphasize for all of you is that the President's plan for healthcare is comprehensive, and it has already delivered results. The Affordable Care Act focused its most significant reforms on a tiny slice of American healthcare: the individual insurance market. The President's plan has delivered better care, more choice, and lower costs for far more Americans than the ACA's insurance provisions directly affected. Tens of millions of Americans who need prescription drugs, for instance, benefit from the fact that drug price inflation has been flat since the President launched his drug pricing blueprint in 2018 and unleashed historic levels of new generic drug competition. Starting January 2021, any American who needs a hospital service will be able to learn what it will cost them before they receive the service. Every American who needs to access their medical record will have an easier time and find greater use from it because of the President's historic interoperability rules. A significant share of Americans with kidney disease will soon begin benefitting from new payment models that put their health at the center. And approximately one fourth of seniors in Medicare will benefit from new primary care models that pay their doctors for keeping them healthy, rather than paying them for the procedures they conduct. Those are the results of the President's vision for healthcare, and these results will keep on coming. The average American's actual experience with healthcare will see more improvement, in terms of better care, more choice, and lower costs because of the actions taken by President Trump than we have seen under any administration ever. These actions represent not just a plan for better care, more choice, and lower costs, but a path to a system that puts you, the patient, in control and treats you like a person, not a number. That is how the President's plan is delivering an affordable, patient-centered healthcare system for every American. With that, I'll hand things over to Administrator Seema Verma. ADMINISTRATOR VERMA: Thank you, Mr. Secretary. And as the Secretary noted, President Trump will sign several executive orders today and outline his America First plan, which represents his vision for the future of American healthcare: lower costs, better care, and more choices. This vision is not some pie in the sky; rather, it is deeply rooted in the unparalleled success that his policies have already attained over the past four years. For decades, our healthcare system has been run by a uniquely destructive combination of Washington, D.C. and special interests. President Trump's policies accomplish the opposite. They wrest control from the bureaucrats, the drug companies, the health insurers, and the massive hospital monopolies, and instead, they empower American patients, putting them in control so that they and their doctors can make decisions about what works best for them. President Trump has tackled the many longstanding issues in our system that make healthcare so expensive. He is also turning his attention to issues like telehealth, kidney care, and rural health that other administrations have been content to ignore. The dysfunctions plaguing healthcare in America are varied and complex, but no president has been more comprehensive, methodical, and effective in addressing them than President Trump. At the outset, his vision requires protecting people with preexisting conditions. As the President has repeatedly said, he supports the longstanding bipartisan consensus that an unexpected diagnosis should not preclude any American from coverage, nor automatically reduce them to bankruptcy. Today's executive order reaffirms that commitment. President Trump has shown that he is not afraid to fight the status quo to take on the special interest groups to make this system work better for patients. That in the digital age, after the previous administration spent a billion dollars of taxpayer money, patients still lack electronic access to their medical records represents a damning example of public policy oriented to special interests at the expense of patients. That patients are kept in the dark about the price of their care until after they receive it signals deeply misaligned priorities. That doctors and nurses on the frontlines must spend more time on paperwork than caring for their patients reveals that Washington, D.C.'s heavy-handed meddling has run amok. Under President Trump's leadership, we have implemented real reform to address these underlying problems in our healthcare system that are driving up costs and putting care out of reach for too many Americans. We have mandated that hospitals be required to provide patients transparent information on healthcare prices before they purchase a service, and we have proposed the same transparency for health plans. We are working to ensure that all Americans are given control of their medical records so that they are portable, and patients have their complete medical history -- test results, medications, vaccinations -- wherever they seek care. We have made unprecedented strides in removing Washington, D.C., from the doctor-patient relationship, freeing doctors and nurses to focus on providing care to patients while delivering $6 billion in savings to the system. The results are in: These and other reforms have proven a resounding undisputable success. Employers can now fund individual insurance premiums so employees can buy portable health plans not tied to their job, but still receive the same tax advantages. People priced out of Obamacare now have access to more affordable options. And premiums have gone down across all of our programs, including in Healthcare.gov, which had been previously seeing double-digit rate increases. And we expect that 2021 premiums for a benchmark plan are down by another 2 percent, building on three years of consecutive premium declines that will result in an 8 percent drop from 2018. Three years ago, residents and half the counties in the United States had only one so-called choice of health insurance company. In 2021, that number will go down 9 percent. In the traditional Medicare program, seniors enjoy lower out-of-pocket costs for drugs and more options with respect to where they receive care. We've streamlined our rules and increased transparency for innovators to ensure that seniors have access to the latest medical innovations. And since 2017, CMS has covered more than 300 new devices, including numerous novel technologies. In Medicare Advantage, as we are announcing today, seniors’ premiums have gone down by 34 percent since 2017, a 14-year low. In some parts of the country, premiums have gone down by as much as 50 percent. Premiums in Part D Medicare's prescription drug benefits have decreased by 12 percent in 2017. No president has ever achieved this level of price reduction. His policies are putting dollars back into the pockets of American patients. Crucially, this price plunge has come with an explosion of plan options with new and better benefits like telehealth. More than 1,600 Medicare Advantage plans will offer insulin -- once very expensive -- for $35 a month. That's a massive average savings of $446 or 66 percent per year for the countless diabetic seniors that rely on the drug. In short, the President has already delivered real, tangible results. And today's executive orders represents a plan to take things to a new level. With these historic executive orders, President Trump has chosen to take a comprehensive problem-solving approach, and they will lead to nothing less than the most consequential healthcare reform in American history. Thank you. MS. ROLLINS: Everyone, this is Brooke Rollins. Thank you, Administrator Verma and Secretary Azar. I'm the Acting Director of the Domestic Policy Council here at the White House, and so grateful for all the many, many, many media outlets that are on the phone today. I know there’s been great interest in the President's vision and his plan for healthcare. Today, he is actually on his way to Charlotte, North Carolina, to unveil his America First healthcare plan. And you've also -- you already heard from Secretary Azar and Administrator Verma on certainly the framework of the plan and certain pieces of the plan, building on the accomplishments of what he has really been able to achieve over the last three, three and a half years. But building on that, and what does this look like moving forward? This plan is all about putting patients first. Patients and doctors should be running the system, not the government. The President is for more choice, lower costs, and better care. The contrast could not be clearer. The other side is for more government and more taxing and more spending and more bureaucrats. Today is a continuation of the four-year transformative changes that this President has implemented to benefit all 330 million Americans, not just a few Americans in Obamacare. “More choice”: First, The President is providing Americans with more healthcare options to put patients and doctors back in control. The President has given Americans more control over their healthcare dollars by repealing the individual mandate and expanding access to Health Savings Accounts and Health Reimbursement Arrangements. To give more flexibility, he's implemented affordable health plan options for individuals and families and has issued over one dozen waivers to states to manage their individual markets. The President also has championed -- and many of you have written about -- an expansion of telehealth services to millions, bringing a technological revolution to healthcare delivery, seemingly overnight. The President's vision includes expanding the availability of these Health Savings Accounts and permanently giving Medicare beneficiaries access to expanded telehealth services that has already benefitted millions of our fellow citizens during the pandemic, and we will continue to do so moving forward. Second, “lower costs”: President Trump is dramatically lowering healthcare costs for Americans. After seeing significant increases in premiums and prescription drugs from the last administration -- and both Secretary Azar and Administrator Verma went through some of those numbers -- he has lowered the price of prescription drugs through unprecedented approvals of generics, providing insulin at only pennies on the dollar, and allowing the importation of cheaper medications from Canada, as well as prohibiting surprise billing for COVID-19-related treatment. Today, the President continues the success of lowering the cost of healthcare by signing an executive order to end surprise billing. More on that when the President speaks in just a couple of hours. And then, third and finally, “better care”: President Trump has already taken unprecedented action to protect those with preexisting conditions, including the uninsured with COVID-19 and those struggling with substance abuse disorders, kidney failure, and HIV/AIDS. The President today will sign the first executive order in American history to declare it the policy of the federal government to protect individuals with preexisting conditions and ensure they have access to the care they can afford and they deserve. And as part of his vision, he will continue to invest heavily in research and innovative treatments for complex health conditions, including pediatric cancer, Alzheimer's disease, sickle cell disease, HIV/AIDS, and COVID-19. Finally, I'll just say President Trump's America First healthcare plan put patients and doctors back in charge of their healthcare, not politicians and bureaucrats. It is a unifying vision and a call to make America's healthcare system better and stronger than ever before. Our President will never stop fighting for an America where every man, woman, and child -- no matter from where they came or what their bank account looks like -- has the best healthcare in the world. It is now my honor to pass it to our fourth speaker, Assistant to the President for Planning and Implementation, Dr. John Fleming. Many of you probably know he was a congressman for a number of years and has been involved in the fight for better healthcare for a long, long time, not only in Congress but also as a practicing physician. Dr. Fleming, I'll turn it over to you. DR. FLEMING: Thanks, Brooke, so much. And a lot of things have been said, and the President is going to round this out, but let me just summarize a bit. The Affordable Care Act has been anything but affordable. Americans have seen their deductibles, their premiums skyrocket, doubling, perhaps even more than that. And at the same time, having depersonalized care: less choice, less options, less control over their care. President Trump wants for all Americans to have better choice, better care, and lower costs. And this is where we kick the football off today with this announcement. But I want to reiterate to everyone that whatever happens from this point on, the future legislation with rules and regulations that are passed, the President is absolutely committed to coverage for preexisting conditions. Already, he signed into law eight different bills that has improved your care during his tenure, and 12 regulations that has made life better for Americans with healthcare. So, with that, I will turn the program over for question and answer. Thank you. Q This question is for Secretary Azar. Just looking for some more details on the surprise billing. You mentioned that it protects patients from surprise billing from hospitals. Does that not include out-of-network physicians who work at hospitals? And then just maybe lay out a timeline for whether you see that this could get done with Congress and any details of how regulation would work. Thank you. Q Sure, thank you. So, no, the -- what the President is saying is that all the relevant players -- hospitals, doctors, insurance companies -- had better get their act together and get legislation passed through Congress that protects patients against surprise medical bills from anybody -- hospitals or doctors, doesn't matter. They are the ones who should be protected. And those interest groups -- those special interest groups need to sort it out and figure out how that would work. There have been -- there have been legislative packages that have come quite close on the Hill that are bipartisan, but it is -- the President is saying the time is now. And if they do not get legislation passed by January 1st, he is instructing me to use the full regulatory power of the U.S. government to protect patients against surprise medical bills. That pathway we'll be working on, so I don't have details for you at this point on that. But he's telling them: Get your act together, get something passed, or we'll be coming at it, and you'll get what you get from us. Q Hi. Thank you for doing this call. I guess this is for Secretary Azar. Someone on the call mentioned that the President is going to sign the first executive order in American history to declare -- an American policy -- to protect preexisting conditions. But Barack Obama had to sign into law to get insurers to do that. And so I guess I have two questions. One, do you have the authority to do this -- the legal authority by executive order? And if the Supreme Court overturns Obamacare, how would you get insurers to comply without that (inaudible)? SECRETARY AZAR: So, first, let's begin by tackling one of the -- one of the fallacies of the overselling of Obamacare. So this notion that Obamacare has genuinely protected people who suffer from preexisting conditions: If you're age 50, if you're a -- if you're a couple, aged 55, living in Missouri, making $70,000 a year, Obamacare is going to cost you $30,000 in premium and have a $12,000 deductible. I'm sorry, that is not affordable coverage of your preexisting conditions. That is an insurance card that you can't afford to actually use to take care of your preexisting conditions. So we have to start with that premise. If the Supreme Court striked out all or a large part of the Affordable Care Act, what the President is making clear in this executive order is that it is the policy of the United States that people who suffer from preexisting conditions will have their -- will be protected against those preexisting conditions in their insurance coverage, and that we will work with Congress or otherwise to ensure that they're protected. But he's making a clear, defined statement of United States policy that people with preexisting conditions are protected. Q Thank you. The Association of American Physicians and Surgeons is very much in favor of transparency. But we're concerned with the surprise billing. How are you going to protect patients’ ability to receive out-of-network care? In California, the surprise billing has really served the purpose of allowing insurance companies to dictate the upper level of prices that physicians can charge for procedures. And one reason for staying out of network is that you can't get remunerative payment for the procedures. So is this going to be a mechanism of imposing insurance-company-decided price controls? And how do you protect patients’ ability to get care if physicians cannot afford to provide it? SECRETARY AZAR: So just to be clear, what the President is instructing is that Congress must act and you and your members and the hospitals and the insurance companies must work with Congress to secure legislation that would protect the patient against surprise medical bills. The details are for you all to be working out with Congress. There are two legislative -- at least two legislative packages that have gone far, but they have not crossed the finish line. And the President is saying: If you do not get something passed by Congress by January 1st, then we will take any executive action, regulatory action that we can to protect patients. Q Thank you. Also on surprise billing -- I understand you were considering implementing executive action today on surprise billing, rather than just calling on Congress to act. Can you talk about why you decided to not announce the executive action today and instead call on Congress to act? SECRETARY AZAR: So the plan being announced today on surprise medical bills is the plan the President planned to announce and will announce. And so that's -- it is what it is, as described. Q Hi there. I was just wondering if you could talk a little bit more about the preexisting conditions executive order. Does this say exactly, you know, what preexisting conditions would be covered? For example, does this extend to ensuring women aren't paid as much? Does it extend to, you know, ensuring that older people aren't paying more for their coverage? And again, I mean, these are provisions that are currently included in the law. Can you talk a little bit about why you believe you have the authority to do this through an executive action? SECRETARY AZAR: So again, the executive order will state that it is the policy of the United States that people who suffer from preexisting conditions will be protected. If there is -- there is no -- there are no executive actions -- all conditions are protected under U.S. policy as preexisting conditions. The executive order will say that -- in answer to your question -- all conditions would be protected. This is the policy of the United States. And then, depending on the circumstances of the court litigation in the Texas case, or legislation with Congress, the President is establishing that he will always protect people who suffer from preexisting conditions. MR. FIELDS: Thank you, everyone, for joining today's call. Just to reiterate, all the question-and-answer and opening remarks were on the record. And if you have any additional questions, please reach out to the White House Press Office. Thank you, everyone, and have a great day. END 3:19 P.M. EDT |
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