HHS Secretary Nominee Mike Leavitt Calls for ‘Greater Flexibility’ in State Medicaid Programs at Hearing
Environmental Protection Agency Administrator Mike Leavitt, who President Bush last month nominated as the new HHS secretary, on Tuesday told senators at a confirmation hearing that states should have "greater flexibility" to determine Medicaid benefits to allow more individuals to receive "quality basic care," the New York Times reports.
At the first of two confirmation hearings, Leavitt told members of the Senate Health, Education, Labor and Pensions Committee, "We have a substantial obligation to care for the poor. We can expand the number of people served with quality basic care by giving states additional flexibility."
Leavitt several times at the hearing referred to Medicaid reforms -- such as a "limited benefit plan" -- that he had implemented as governor of Utah in 2002 and said that the reforms could serve as a model for other states. "It was an effort to take limited resources and provide basic health care to all of those who don't have it," Leavitt said (Pear, New York Times, 1/19).
In response to a question from Sen. Edward Kennedy (D-Mass.), who asked whether the Bush administration is "going to be squeezing and denying health benefits" with Medicare and Medicaid reforms, Leavitt said, "It's always been my belief that we can expand the number of people we serve with the available resources" (AP/Washington Times, 1/19).
Leavitt said that Utah, as a result of reductions in benefits for Medicaid beneficiaries, could not provide "the kind of health care we'd want them to receive," but he added that expansion of enrollment in the program was important (CQ Healthbeat, 1/18). According to the Deseret Morning News, Kennedy "was clearly skeptical about the quality of that 'basic' health care, but he didn't push the point" (Spangler, Deseret Morning News, 1/19).
Leavitt at the hearing also said that public health care programs should "teach self-reliance," adding that Medicaid "is not meeting its potential to do good in the lives of the poor" (Bourge, UPI/Washington Times, 1/19). He said, "I passionately believe that we could and should use Medicaid as part of the transformational movement in the delivery of health care in general" (Smith, Salt Lake Tribune, 1/19).
Sen. Judd Gregg (R-N.H.) at the hearing called FDA an "agency in crisis" and asked Leavitt whether Bush would name a permanent agency commissioner by the end of January (AP/Washington Times, 1/19).
Leavitt said that that Bush would name a permanent FDA commissioner in the near future but did not confirm whether the nomination would occur this month (New York Times, 1/19). "I share with you the view that the agency needs permanent leadership," Leavitt said, adding, "I will do all I can to see that it occurs, and it's my sense that it will happen soon" (AP/Washington Times, 1/19).
Leavitt also said that he would work with Congress on reforms to the FDA system to monitor the safety of prescription drugs on the market and would seek to improve the reputations of FDA, NIH and CDC. "I will be the guardian of the integrity of those brands," Leavitt said (New York Times, 1/19). Leavitt also said several times that he would work to "find balance" between the promotion of prescription drug safety and the development of new medications (Salt Lake Tribune, 1/19).
According to UPI/Washington Times, Leavitt provided "little insight to lawmakers about how he will run the agency, beyond his support for the White House's stated policies" (UPI/Washington Times, 1/19).
Leavitt said that "he did not know enough about the new Medicare law" to predict whether the program would cost more than the amount Congress approved: $400 billion over 10 years. The White House has said that the cost will exceed $530 billion over 10 years (New York Times, 1/19). Leavitt said, "It's been my practice as a manager to operate within my budget" (Salt Lake Tribune, 1/19). Although Leavitt expects "flaws" in the implementation of the new Medicare law, which he called the "main event" at HHS this year, he said that "we will not fail" (AP/Washington Times, 1/19).
Leavitt also said that the federal government should not have the authority to negotiate directly with pharmaceutical companies for prescription drug discounts. Leavitt said that he favored the promotion of a competitive market to help limit prescription drug price increases (New York Times, 1/19).
In addition, Leavitt said that reform of "medical liability, something that badly needs to be improved," and the use of electronic medical records and other information technology could help reduce health care costs. However, Leavitt "provided no specifics about how the administration, particularly one so attuned to free-market principles, would make such practices industry standard," UPI/Washington Times reports (UPI/Washington Times, 1/19).
According to Reuters, Leavitt "won bipartisan praise" at the hearing, although he "provided few specifics on his vision for the nation's health system" and "gave no hints as to Bush' precise intentions" (Reuters, 1/18). Republican and Democratic lawmakers on Tuesday said that they expected no problems with Senate confirmation of Leavitt as HHS secretary (New York Times, 1/19). "As a former governor, he knows how HHS works and doesn't work," Kennedy said (Deseret Morning News, 1/19).
Leavitt on Wednesday will testify before the Senate Finance Committee, "which plans to examine his views on Medicaid more thoroughly," the Times reports (New York Times, 1/19). According to the Salt Lake Tribune, the issue of prescription drug reimportation likely will "dominate" the hearing (Salt Lake Tribune, 1/19).