Tom Price, Trump's Pick For HHS, Has An Obamacare Alternative In Mind : Shots - Health News Rep. Tom Price has proposed an alternative to Obamacare that emphasizes tax credits, health savings accounts and continuous insurance coverage as a way to deal with existing health conditions.
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5 Things To Know About Rep. Tom Price's Health Care Ideas

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5 Things To Know About Rep. Tom Price's Health Care Ideas

5 Things To Know About Rep. Tom Price's Health Care Ideas

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ARI SHAPIRO, HOST:

President-elect Donald Trump has named more Cabinet officials. And now we're going to hear about two nominations to his health care team. Georgia Congressman Tom Price, an orthopedic surgeon, is his choice to lead the Department of Health and Human Services. And a private health care consultant named Seema Verma is his nominee to run the Medicare and Medicaid programs. Joining us is NPR health policy correspondent Alison Kodjak to discuss these appointments. Hi. Thanks for being here.

ALISON KODJAK, BYLINE: Hey. Thank you, Ari.

SHAPIRO: Tell us a little bit about Congressman Tom Price.

KODJAK: Well, as you said, he is a doctor. He's an orthopedic surgeon from outside Atlanta. He's been in Congress for six terms and has risen to become the House Budget Committee chairman, which is a really powerful position. It's what Paul Ryan was before he became speaker.

As head of HHS, he'd oversee an agency with a trillion-dollar budget, which is twice the budget of the Defense Department, and two of the biggest federal programs - Medicare and Medicaid. A little bit about him - he's a big opponent of abortion rights. He's an opponent of gay rights. And he's been a real critic of Obamacare right from the start.

SHAPIRO: So if President Trump goes forward with his promise to repeal and replace Obamacare, does that suggest that Price will be leading this repeal effort?

KODJAK: Well, he won't be leading it in the sense that he won't be in Congress working on the legislation. Although over the last few years, he has introduced many times bills to repeal and replace Obamacare that have great detail. And many of those proposals have been adopted by Speaker Ryan in the proposal he's laid out, which we think is probably the best roadmap to what may happen.

In addition, as head of HHS, if and when any repeal and replacement goes through, his agency will be writing the regulations on how it's implemented.

SHAPIRO: What does Price's version of a replacement to Obamacare look like?

KODJAK: Well, he does call for full repeal of Obamacare, which means no more health insurance exchanges, no more Medicaid expansion. Instead, what he proposes is giving people a fixed, refundable tax credit. For somebody who's about, 30 it would be about $1,200 a year to go out on the private market and buy their own health insurance.

That amount would go up with age because as you age, you use more health care, and your insurance is more expensive. But it wouldn't be adjusted for income, which is one of the main things that Obamacare does - which is give more support to lower-income people.

SHAPIRO: Do they have any way of guaranteeing that people with pre-existing conditions will still get coverage, which is one of the most popular parts of the Affordable Care Act, Obamacare?

KODJAK: There is a - you know, some protections in Price's plan - not as much as in Obamacare - in that if you keep your insurance and don't let it lapse, then you cannot be excluded for having a pre-existing condition, and an insurer must cover that.

But if you do let your insurer - insurance lapse, then an insurance company can charge you more and can refuse to cover that condition for up to 18 months.

SHAPIRO: Tell us about Seema Verma, who President Trump has chosen to lead the Centers for Medicare and Medicaid.

KODJAK: Well, she's been a pretty private figure, working behind the scenes on Medicaid programs around the country. She's a private consultant, and her company and she specifically worked with Indiana, with Mike Pence and his predecessor on their Medicaid expansion.

One of the hallmarks of that program has been that it requires low-income people to pay a premium to get their Medicaid. They also were trying very hard to get a work requirement to go with that plan. That was rejected by the Obama administration. But those are some hints at what she may be looking for if she looks to change Medicaid as the head of CMS.

SHAPIRO: That's NPR's Alison Kodjak, our health policy correspondent. Thanks a lot.

KODJAK: Thank you.

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