Surgeon General Jerome Adams on Wednesday defended the Trump administration against Democratic attacks about Obamacare, saying that it was not opposed to healthcare coverage.
“I would be remiss if I did not … check the insinuation from several folks that the current administration is against coverage for folks,” Adams said in response to several Democrats blasting the Trump administration for supporting Obamacare repeal. “I do agree that there is a direct link between the health of a community and the number of people who are insured. The administration is not against being insured. We have a different mindset about how we can achieve that.”
During the hearing by the Senate Health, Education, Labor and Pensions Committee, which was intended to focus on how Congress could work to build healthier communities, Democrats focused much of their time blasting Republicans for their latest attempt at altering Obamacare. Senate Republicans have included a provision that would repeal the penalties for Obamacare’s individual mandate in the bill that has been written to overhaul the tax code.
Most Democrats did not question Adams about his stance on Obamacare, but Sen. Tim Kaine, D-Va., asked Adams whether he agreed with him that communities that have lower rates of uninsurance tended to be healthier.
While Adams acknowledged several times during the hearing that he agreed with the relationship, he revisited some of the statements Kaine had made about how states that had higher rates of insurance coverage tended to have healthier outcomes.
“I don’t want to debate your point … but there is primary, secondary and tertiary prevention, and you’re talking about tertiary prevention,” he said. “As a public health advocate I would be remiss if I did not say that we could focus all we want on healthcare but as long as we are over-consuming it because of a lack of wellness we aren’t going to solve the problem.”
States that have the highest wellness rates had them before Obamacare, too, he said.
“I think it’s important we always remember we need to focus on wellness and that healthcare and health insurance coverage is one part of the equation,” Adams said.
Sen. Al Franken, D-Minn., questioned Adams about the healthcare plan in Indiana, which used funds from Obamacare intended to go to Medicaid expansion. Adams was Indiana’s health commissioner when the plan was being developed and served part of his time under Vice President Mike Pence when he was governor.
The Obama administration gave Indiana a waiver so it could implement the expansion differently, including requiring some enrollees to contribute premiums for their coverage. Under Medicaid expansion, enrollees typically do not pay for their coverage, as it extends to people who make roughly $16,000 a year or less.
Adams touted the program during the hearing, but Franken pushed back, saying the program was made possible under Obamacare.
“You can’t have it both ways,” he said.
He noted that projections from the Congressional Budget Office showed that if the individual mandate were to be repealed, 13 million more people would be uninsured.
“Every plan offered by the administration and by Republicans, CBO has scored every one of them … tens of millions of Americans fewer having insurance,” he said. “You know that. You have to know that.”
The uninsurance figure is being re-evaluated by CBO, but the budget office won’t have a new projection prepared for several months. Republicans hope to pass a tax bill overhaul by the end of the year.
