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Oversight of the Department of Health and Human Services, Hearing

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Oversight of the Department of Health and Human Services, Hearing OVERSIGHT OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES HEARING BEFORE THE SUBCOMMITTEE ON HEALTH OF THE COMMITTEE ON ENERGY AND COMMERCE HOUSE OF REPRESENTATIVES ONE HUNDRED FIFTEENTH CONGRESS SECOND SESSION FEBRUARY 15, 2018 Serial No. 115–101 ( Printed for the use of the Committee on Energy and Commerce energycommerce.house.gov U.S. GOVERNMENT PUBLISHING OFFICE 30–188 PDF WASHINGTON : 2018 VerDate Mar 15 2010 12:08 Oct 25, 2018 Jkt 037690 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 I:\115THCONGRESS\115X101HHSOVERSIGHTNDAZARQFRR\115X101HHSOVERSIGHTW COMMITTEE ON ENERGY AND COMMERCE GREG WALDEN, Oregon Chairman JOE BARTON, Texas FRANK PALLONE, JR., New Jersey Vice Chairman Ranking Member FRED UPTON, Michigan BOBBY L. RUSH, Illinois JOHN SHIMKUS, Illinois ANNA G. ESHOO, California MICHAEL C. BURGESS, Texas ELIOT L. ENGEL, New York MARSHA BLACKBURN, Tennessee GENE GREEN, Texas STEVE SCALISE, Louisiana DIANA DEGETTE, Colorado ROBERT E. LATTA, Ohio MICHAEL F. DOYLE, Pennsylvania CATHY MCMORRIS RODGERS, Washington JANICE D. SCHAKOWSKY, Illinois GREGG HARPER, Mississippi G.K. BUTTERFIELD, North Carolina LEONARD LANCE, New Jersey DORIS O. MATSUI, California BRETT GUTHRIE, Kentucky KATHY CASTOR, Florida PETE OLSON, Texas JOHN P. SARBANES, Maryland DAVID B. MCKINLEY, West Virginia JERRY MCNERNEY, California ADAM KINZINGER, Illinois PETER WELCH, Vermont H. MORGAN GRIFFITH, Virginia BEN RAY LUJA´ N, New Mexico GUS M. BILIRAKIS, Florida PAUL TONKO, New York BILL JOHNSON, Ohio YVETTE D. CLARKE, New York BILLY LONG, Missouri DAVID LOEBSACK, Iowa LARRY BUCSHON, Indiana KURT SCHRADER, Oregon BILL FLORES, Texas JOSEPH P. KENNEDY, III, Massachusetts SUSAN W. BROOKS, Indiana TONY CA´ RDENAS, California MARKWAYNE MULLIN, Oklahoma RAUL RUIZ, California RICHARD HUDSON, North Carolina SCOTT H. PETERS, California CHRIS COLLINS, New York DEBBIE DINGELL, Michigan KEVIN CRAMER, North Dakota TIM WALBERG, Michigan MIMI WALTERS, California RYAN A. COSTELLO, Pennsylvania EARL L. ‘‘BUDDY’’ CARTER, Georgia JEFF DUNCAN, South Carolina SUBCOMMITTEE ON HEALTH MICHAEL C. BURGESS, Texas Chairman BRETT GUTHRIE, Kentucky GENE GREEN, Texas Vice Chairman Ranking Member JOE BARTON, Texas ELIOT L. ENGEL, New York FRED UPTON, Michigan JANICE D. SCHAKOWSKY, Illinois JOHN SHIMKUS, Illinois G.K. BUTTERFIELD, North Carolina MARSHA BLACKBURN, Tennessee DORIS O. MATSUI, California ROBERT E. LATTA, Ohio KATHY CASTOR, Florida CATHY MCMORRIS RODGERS, Washington JOHN P. SARBANES, Maryland LEONARD LANCE, New Jersey BEN RAY LUJA´ N, New Mexico H. MORGAN GRIFFITH, Virginia KURT SCHRADER, Oregon GUS M. BILIRAKIS, Florida JOSEPH P. KENNEDY, III, Massachusetts BILLY LONG, Missouri TONY CA´ RDENAS, California LARRY BUCSHON, Indiana ANNA G. ESHOO, California SUSAN W. BROOKS, Indiana DIANA DEGETTE, Colorado MARKWAYNE MULLIN, Oklahoma FRANK PALLONE, JR., New Jersey (ex RICHARD HUDSON, North Carolina officio) CHRIS COLLINS, New York EARL L. ‘‘BUDDY’’ CARTER, Georgia GREG WALDEN, Oregon (ex officio) (II) VerDate Mar 15 2010 12:08 Oct 25, 2018 Jkt 037690 PO 00000 Frm 00002 Fmt 0486 Sfmt 5904 I:\115THCONGRESS\115X101HHSOVERSIGHTNDAZARQFRR\115X101HHSOVERSIGHTW CONTENTS Page Hon. Michael C. Burgess, a Representative in Congress from the State of Texas, opening statement .................................................................................... 2 Prepared statement .......................................................................................... 3 Hon. Gene Green, a Representative in Congress from the State of Texas, opening statement ................................................................................................ 5 Prepared statement .......................................................................................... 5 Hon. Doris O. Matsui, a Representative in Congress from the State of Cali- fornia, prepared statement .................................................................................. 7 Hon. Greg Walden, a Representative in Congress from the State of Oregon, opening statement ................................................................................................ 8 Prepared statement .......................................................................................... 9 Hon. Frank Pallone, Jr., a Representative in Congress from the State of New Jersey, opening statement .......................................................................... 10 Prepared statement .......................................................................................... 11 Hon. Ben Ray Luja´n, a Representative in Congress from the State of New Mexico, prepared statement ................................................................................ 13 WITNESS Alex M. Azar II, Secretary, Department of Health and Human Services ........... 14 Prepared statement .......................................................................................... 16 Answers to submitted questions ...................................................................... 94 SUBMITTED MATERIAL Letter of February 9, 2018, from Seema Verma, Administrator, Centers for Medicare & Medicaid Services, Department of Health and Human Services, to Mr. Pallone, with letter of January 31, 2018, from Mr. Pallone, et al., to Administrator Verma, submitted by Mr. Pallone ................................... 75 Letter of February 8, 2018, from Ms. Schakowsky, et al., to Alex Azar, Secretary, Department of Health and Human Services, submitted by Ms. Schakowsky .......................................................................................................... 79 Article of February 14, 2018, ‘‘Bevin’s Medicaid changes actually mean Ken- tucky will pay more to provide health care,’’ by Deborah Yetter, Louisville Courier Journal, submitted by Mr. Kennedy ..................................................... 81 Letter of December 1, 2017, from Ms. DeGette, et al., to Eric Hargan, Acting Secretary, Department of Health and Human Services, submitted by Ms. DeGette ................................................................................................................. 85 Article of February, 2018, ‘‘Immigrant rights group in email says it was warned not to mention abortion to teens,’’ by Ann E. Marimow and Maria Sacchetti, The Washington Post, submitted by Mr. Ca´rdenas ......................... 90 (III) VerDate Mar 15 2010 12:08 Oct 25, 2018 Jkt 037690 PO 00000 Frm 00003 Fmt 5904 Sfmt 5904 I:\115THCONGRESS\115X101HHSOVERSIGHTNDAZARQFRR\115X101HHSOVERSIGHTW VerDate Mar 15 2010 12:08 Oct 25, 2018 Jkt 037690 PO 00000 Frm 00004 Fmt 5904 Sfmt 5904 I:\115THCONGRESS\115X101HHSOVERSIGHTNDAZARQFRR\115X101HHSOVERSIGHTW OVERSIGHT OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES THURSDAY, FEBRUARY 15, 2018 HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON HEALTH, COMMITTEE ON ENERGY AND COMMERCE, Washington, DC. The subcommittee met, pursuant to call, at 12:33 p.m., in room 2123, Rayburn House Office Building, Hon. Michael C. Burgess (chairman of the subcommittee) presiding. Members present: Representatives Burgess, Guthrie, Upton, Shimkus, Latta, Lance, Griffith, Bilirakis, Bucshon, Brooks, Mullin, Hudson, Collins, Carter, Walden (ex officio), Green, Engel, Schakowsky, Butterfield, Matsui, Castor, Sarbanes, Luja´n, Schra- der, Kennedy, Ca´rdenas, Eshoo, DeGette, and Pallone (ex officio). Also present: Representatives Welch and Tonko. Staff present: Jennifer Barblan, Chief Counsel, Oversight and In- vestigations; Mike Bloomquist, Deputy Staff Director; Adam Buckalew, Professional Staff Member, Health; Kelly Collins, Staff Assistant; Zack Dareshori, Legislative Clerk, Health; Paul Eddatel, Chief Counsel, Health; Adam Fromm, Director of Outreach and Coalitions; Caleb Graff, Professional Staff Member, Health; Jay Gulshen, Legislative Clerk, Health; Ed Kim, Policy Coordinator, Health; James Paluskiewicz, Professional Staff Member, Health; Mark Ratner, Policy Coordinator; Kristen Shatynski, Professional Staff Member, Health; Jennifer Sherman, Press Secretary; Danielle Steele, Counsel, Health; Austin Stonebraker, Press Assistant; Josh Trent, Deputy Chief Health Counsel, Health; Hamlin Wade, Spe- cial Advisor, External Affairs; Jacquelyn Bolen, Minority Profes- sional Staff Member; Jeff Carroll, Minority Staff Director; Waverly Gordon, Minority Counsel, Health; Tiffany Guarascio, Minority Deputy Staff Director and Chief Health Advisor; Una Lee, Minority Senior Health Counsel; Miles Lichtman, Minority Policy Analyst; Rachel Pryor, Minority Senior Health Policy Advisor; Samantha Satchell, Minority Policy Analyst; Andrew Souvall, Minority Direc- tor of Communications, Outreach, and Member Services; Kimberlee Trzeciak, Minority Senior Health Policy Advisor; C.J. Young, Mi- nority Press Secretary. Mr. BURGESS. The Subcommittee on Health will now come to order. I ask everyone to please take their seats. And before we get started, I do want to take a moment to recog- nize yesterday’s devastating events in Florida. We will continue to learn more about how things occurred, and I know my colleagues (1) VerDate Mar 15 2010 12:08 Oct 25, 2018 Jkt 037690 PO 00000 Frm 00005 Fmt 6633 Sfmt 6633 I:\115THCONGRESS\115X101HHSOVERSIGHTNDAZARQFRR\115X101HHSOVERSIGHTW 2 and I will keep the victims, the injured, and their loved ones fore- most in our minds. Representative Bilirakis and Representative Castor, we will also be thinking of you, the entire Florida delegation, and the people of Florida during this difficult time. I would like to recognize myself 5 minutes for the purpose of an opening statement. OPENING STATEMENT
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