Originally published by Ben Lockhart in the Deseret News on June 26, 2017.

SANDY — U.S. Secretary of Health and Human Services Tom Price made his pitch for the health care reform bill currently pending in the Senate Monday during a stop in Utah.

Price also took questions from multiple business leaders about health care in the United States during a roundtable discussion inside Colonial Flag, 9390 S. 300 West. He called himself an emissary from President Donald Trump, whom he praised for having “charged the country with coming up with a better alternative” to the Affordable Care Act.

Kathy Smith, an organizer with Utah’s Freedom Conference and wife of late Smith & Edwards founder Bert Smith, told Price that thanks to Affordable Care Act regulations, the company will have to fill mostly part-time positions when it builds a store at a new location in Salt Lake City.

“The cost to them has risen so much,” Smith said during the discussion.

Improving health care in the country, Price said, includes involving the input of small businesses that “recognize that they can’t do what they want to do for employees — which they’ve been able to do for decades” before the Affordable Care Act.

“People are coming up to (the president) with tears in their eyes … about their inability to provide coverage or inability to gain care or afford care,” he said.

Price said “choices are down” for buyers on the individual and small group markets, and both premiums and deductibles have risen under the Affordable Care Act. He cited the closure of the Arches Health Plan in Utah as an example of decreased choice for consumers.

“Utah’s story is like the rest of the country,” Price said.

Paul Swenson, president of Colonial Flag, hosted the roundtable, most of which was closed to reporters. Others present at the discussion included Jonathon Johnson, board chairman of Overstock.com and Republican primary challenger for governor in 2016; Salt Lake Chamber President and CEO Lane Beattie; state Sen. Brian Shiozawa, R-Cottonwood Heights; Marc Bennett with health policy nonprofit HealthInsight; Juanita Morales Strong from Stronger Insurance; David Swenson with CMI Insulation; Andrew Croshaw with Leavitt Partners; Raymond Hall with Larry H. Miller Group of Companies; Fred Lampropoulos with Merit Medical Systems; and Rob Thurston with HR Consulting Group.

Q&A session

Price also met shortly afterward with selected employees of Colonial Flag and other businesses in a question and answer session. There, he again went after the Affordable Care Act, saying more than 78,000 Utahns paid over $17 million last year as a penalty for not buying insurance plans. Nationwide, about 6.5 million paid roughly $3 billion for the same reason, he said.

“That’s a system that may work for the government … but it doesn’t work for patients,” Price said.

Republicans want to ensure that “small businesses once again are able to afford the ability to provide health coverage for their employees,” he said.

Price added that even though the Affordable Care Act has led to more people being insured, their coverage is not useful to them because of unacceptably high deductibles.

“If folks (have) something they can’t use, it’s as bad as not being covered,” he said.

Price also detailed what he called high taxes, over-regulation, pricey malpractice protection and a lack of competition as the main reasons why he believes health care costs are so high even before considering the question of insurance.

The secretary said many criticisms of the Better Care Act, a Senate revision to the House-passed American Health Care Act, are made with what he believes is the false assumption that Americans are adequately insured under the status quo.

“All of those questions presume that the system we currently have is working just fine,” he said. “The system we have is collapsing for the individual and small group market.”

Price also said in an opinion piece that ran in Sunday’s Deseret News that the Better Care Reconciliation Act “would provide immediate relief to Utahns from the burdens of Obamacare.”

“Policymaking is about doing as much as you can, when you can, to help solve the most pressing problems of the moment,” Price wrote. “And right now, Utahns across this great state are in desperate need of solutions to Obamacare’s failures.”

The Department of Health and Human Services reported last month that health insurance premiums in Utah, on the individual market, went up 101 percent between 2013 and 2017.

In anticipation of Price’s visit, the Utah Health Policy Project released a statement Monday providing a counterpoint to those figures, reporting that 85 percent of Utahns receive substantial subsidies for their monthly premiums, covering an average of 69 percent of the costs.

The organization, a health policy think tank and nonprofit statewide enrollment network that helps people sign up for insurance, also said health plans cost less in 2013 than they do now because they were not required to provide as many protections for customers.

“The coverage they offered back then was far skimpier, and the deliberate denial of people with pre-existing conditions benefited the healthy people who were allowed to purchase coverage,” said Jason Stevenson, Utah Health Policy Project spokesman.

Defending Medicaid policy

Price, a former orthopaedic surgeon who represented Georgia as a Republican member of Congress before being appointed by Trump, said he is encouraged by the text of the Senate’s Better Care Reconciliation Act unveiled last week.

“The bill itself that is now before the Senate, we believe is a step in the right direction,” Price said, noting that the bill’s Medicaid provisions offer “greater flexibility” and “more choice.”

Price said Trump and Republican congressional leaders, including Utah’s Sen. Orrin Hatch, want to achieve health care reform that gives power to the states with regard to Medicaid decisions.

“(Hatch) has been an incredible leader on this to try to make certain (that) states have flexibility,” Price said. “You don’t want a system that works best for Florida. You want a system that works best for Utah.”

He also defended the bill’s estimated reduction in Medicaid spending by roughly $772 billion through 2026 as compared with expected levels under current law.

“Only in Washington is increasing spending … (called) a cut,” Price said.

The Utah Health Policy Project takes issue with how Medicaid would be financed under the Better Care Reconciliation Act. The bill would allow states to opt for either block grants or a per-capita spending cap system, as opposed to the current system: an open-ended source of federal matching funds.

In Utah, the federal government pays 70 percent of costs charged to Medicaid, to the state’s 30 percent.

Utah Gov. Gary Herbert has said he welcomes the block grant option because he feels it gives state officials the most flexibility. But the Utah Health Policy Project believes the end of the open-ended federal matching will make it so states themselves are left having to decide which populations must be restricted from benefits and which services must no longer be billable to Medicaid.

The group is also nervous about the bill no longer accounting for medical care-specific inflation beginning in 2026 in its block grants option, potentially posing a major financial risk at that time for states that chose that funding mechanism.

Utah Health Policy Project Executive Director Matt Slonaker said in a statement that the Better Care Reconciliation Act would lead to Utahns “pay(ing) higher out-of-pocket costs for less coverage and fewer benefits, especially those who are older, poorer and sicker or experience a significant medical event.”

Protesters upset

About 15 to 20 protesters stood outside the Colonial Flag property during Price’s visit, chanting “No cuts to Medicaid” and holding signs saying, “There is a Price to your lies” and “Health care not wealth care,” among other critical messages.

One member of the group, Disabled Rights Action Committee member Psarah Johnson, tried to enter the question and answer session, but was told it was a private event.

“We’re out here because patient voices are not being heard. … I don’t think it was a representative group” at that session, Johnson said. “It’s very clear to me (Price’s) only concern was … business leaders.”

Protester Kellie Henderson, co-founder of anti-Trump group Utah Indivisible, said she would much rather have been talking civilly with Price in person than reduced to shouting chants from the sidewalk.

“All we want is a seat at the decision-making table and we’re being denied that,” she said. “We want (Price) to understand we know what this bill is going to do and we’re not persuaded by it.”

CBO report

Also Monday, the Congressional Budget Office released its analysis of the Better Care Reconciliation Act, concluding it would ultimately increase the number of uninsured Americans by 22 million by the year 2026. The federal government would also spend $772 billion less on Medicaid than it is projected to do under current law and, when taking into account other factors, reduce federal spending overall by $321 billion, the report predicted.

Premiums on the individual market are projected to rise 20 percent above current levels in 2018, rise 10 percent above current levels in 2019 and fall 30 percent below current levels in 2020, according to the report. By 2026, premiums would be 20 percent lower than they are today, the Congressional Budget Office found.

Although premiums would be lower, in states that use a waiver to alter the essential health benefits required for insurers to cover, “most people purchasing (nongroup insurance) would have higher out-of-pocket spending on health care than under current law,” the report states.

Slonaker said he was alarmed by the findings.

“The Senate bill will shift substantial costs to consumers through higher deductibles and cost-sharing, as well as supplemental charges for newly excluded benefits like maternity care, mental health and prescription drugs,” he said in a statement.

Sen. Mike Lee, R-Utah, was hesitant to comment on the report Monday because he has problems supporting the bill it’s attached to, Lee spokeswoman Conn Carroll said.

“Sen. Lee is working hard with Senate leadership to make significant changes to the Senate health care bill. Any comment on a CBO score before those issues are resolved would be premature,” Carroll said.

Lee released a joint statement with three other senators saying they were “not ready” to support the bill in the form that it was first introduced to them.

Hatch touted the CBO report.

“As the Senate continues to work toward advancing legislation that will rescue the American people from the failures of Obamacare, Congress’ nonpartisan scorekeeper — the Congressional Budget Office — has been clear: the Senate health bill lowers premiums and reduces Obamacare’s tax burdens that have harmed middle-class families, all while drawing down the deficit,” Hatch spokesman Matt Whitlock said in a prepared statement.

Originally published by Ben Lockhart in the Deseret News on June 26, 2017.