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tv   At This Hour With Berman and Bolduan  CNN  January 24, 2017 8:00am-9:01am PST

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process. >> this is really critical, senator. as you mentioned in the rural areas, georgia is the largest state geographically east of the mississippi, and we've got a large rural population and critical access hospitals are so important to communities around our state and truly around this nation. but the regulatory chemothat's been put in place is joking the individuals that are actually trying to provide the care. so much so that you've got physicians and other providers who are leaving the process, were leaving the caring for patients, not because they've forgotten how to do it or grown tired of it, because the onerous nature of the regulatory scheme coming out of washington, d.c. meaningful use, a project you mentioned, makes it that much more difficult. we've turned physicians into data entry clerks. you just have to ask them what they're doing. and if you talk to patients, what they recognize is that when they go in to see the doctor, they see the top of his or her
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head as they're punching the information into a computer, as opposed to that sharing of information that's so vital and necessary between the physician and the patient for quality health care. so one, a recognition of the problem is incredibly important. a recognition of the importance of rural health care in our nation and how it needs to be bolstered up. and then looking at the consequences of what we do as a government. as i mentioned earlier, oftentimes, i don't think we look at the chemical weapoonseq pass the rule and regulation and think it's the greatest thing since sliced bread, but it's harming the very individuals who are trying to provide the care. you don't get tha iormation unless you ask. >> i appreciate that. my time is up. thank you, mr. chairman. >> thank you, mr. chairman congressman, i enjoyed our visit yesterday. we had a discussion when you were kind enough to come visit me about the fact that i have in
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the state of florida 4 million plus seniors on medicare. and they are petrified of the idea of privatized medicare. and i talked to you about this and you talked about the premium support system that you're advocating, and you pointed to a study that was done by cbo. you mentioned that you would send me a copy and we haven't gotten it. so what i did, i went and got the copy myself and it is september of 2013 and what it concludes is opposite of what
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you said with regard to high-cost states like florida. medicare is going to be spending 4% lower under the proposal that you were talking about in this cbo report. lower than current law and beneficiary cost will decrease by 6% on the average, which is what you said yesterday. but in high-cost regions like florida, you're going to have a higher beneficiary cost than current law. under your premium support proposal. annual premiums in florida would increase 125%, according to the
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the cbo chart on page 71. cbo says that the annual premium in a high-cost region would go up $436 compared to the current law of $1,600. that's the 125% increase. so please help clarify what you were saying yesterday as it applies to florida. >> thank you, senator. and i enjoyed our time together as well. when we talk about medicare, it's important for everyone to appreciate, as i know you and your colleagues do, that the medical trustees, not republicans or democrats, the medicare trustees, have told all of us that a medicare in a very short period of time, less than ten years, is going to be out of the kind of resources that will allow us as a society to keep
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the promise to beneficiaries. that means we will not be able to provide services to medicare patients at that time, which is very, very close, if nothing is done. so my goal is to work with each and every one of you to make certain that we save and strengthen and secure medicare. i think it's irresponsible of us as policymakers to allow a program to continue, knowing, knowing that in a few short years, it's not going to be able to cover the services we're providing. that's the first point. that is the current medicare program, if nothing so done, as some have described it, goes broke. second point is, my role, if i'm confirmed and have the privilege of serving of health and human services, my role will be one of carrying out the law that you all in congress pass.
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it's not the role of a legislator, i had when i was trying to formulate ideas to hopefully generate discussion -- >> okay, let me be so rude as to stop, because i'm running out of time. remember that donald trump in the campaign said he was not going to cut medicare spending. and i would also point to you in a legislative solution, one of the greatest examples on medicare was 1983, when we were just about to go bust, and it took two old irishmen, reagan and o'neil, to agree to come to made medicare -- in this case, it was not medicare, it was social security -- actuarial sound for the next half century. let me ask you, representative price, you had made a statement
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that it was a terrible idea of people who had when he existing conditions, that they would have the protection of insurance against those pre-existing conditions. and i would like to ask you is can you please, in light of president trump, expressing his desire to retain this basic protection, do you think his proposal to continue the ban on discriminating against people with pre-existing conditions is a terrible idea? >> i'm not certain where you're getting that quote from? >> it came from politico talking points memo, may 1st, 2012.
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>> oh, well, now there's a reliable source. what i've always said, senator, is that nobody -- >> you didn't say it's a terrible idea? >> i don't believe i've ever made that statement. what i've always said about pre-existing conditions, is that nobody, in a system that pays attention to patients, nobody ought to be priced out of the market for having a bad diagnosis. nobody. that's a system that may work for insurance companies, may work for government, but it doesn't work for patients. so i believe firmly that what we need is a system that recognizes that pre-existing conditions do indeed exist and accommodate it and make sure no one loses their insurance or is unable to gain insurance because of a pre-existing condition. >> mr. chairman, as i close, i would like to insert in the record the september 2013 congressional budget office analysis of premium support system for medicare.
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and i would invite you, congressman, to please respond with the cbo report yesterday that you says supports your position, because this one does not. >> look forward to that. >> senator menendez? >> thank you, chairman. congratulations, congressman price. let me ask you a series of questions. given your medical training and time spent as a practicing physician, i have a couple of simple yes or no questions to start off with. in your medical opinion, does hiv cause aids? >> i think that the scientific evidence is clear that hiv and aids are clinically directed -- or. >> in your medical opinion, have immigrants led to outbreaks of leprosy in the united states? >> i don't know what you're referring to, but i suspect that there are instances where individuals have an infectious disease and they come to the united states -- >> i'm not asking about an infectious disease, i'm asking specifically about immigrants in
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the united states causing leprosy in the united states, in your medical opinion and scientific background. >> again, i don't know what the incident to which you refer. are you referring to a specific incident? >> there are statements that have been made in the public domain that immigrants have led to outbreaks in the united states. as the person who's going to be directed as the health of human and service, that's not only the country's epicenter, i wan to know, in your opinion, is that a causation. >> anytime you get two individuals together, in any relationship, whether it's an immigrant or a visitor, and one person has an infectious disease, it's possible that individual transmits that infectious disease. >> including leprosy? >> any infectious disease. >> in your medical opinion, do abortions cause breast cancer? >> i think the science is relatively clear that that's not the case. >> in your medical opinion, do
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vaccines cause autism? >> again, i think the science in that instance is that it does not, but there are individuals across our country -- >> i'm not asking about individuals, i'm talking about science. because you're going to head a department in which science, not alternate universes of people's views, is going to be central to a $1 trillion budget and the health of the nation. can you commit to this committee and the american people today that should you be confirmed, you will swiftly, and unequivocally debunk false claims to protect the public health? >> what i'll commit to doing is doing the due diligence that the department is known for and must do to make certain that factual information is conveyed to -- >> and that factual information will be dictated by science, i would hope? >> without a doubt. >> okay. so let me ask you about medicaid, specifically. and let me just say, i'm a little taken aback about your answer on the question of
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immigrants and leprosy. i think the science is pretty well dictated if that regard, too. let me ask you this, one of the most beneficial components of the affordable care act was the expansion of the medicaid program, that resulted in 11 million people nationwide and over 500,000 in new jersey gaining coverage, many for the first time. it's one of the biggest programs on the republican chopping block, with prems to not only repeal the affordable care's medicaid expansion, but going further and gutting billions in federal funding to the states. there's no doubt that this would result in catastrophic loss of coverage for tens of millions of low-income families and lead to tens of billions in losses to safety net and other health care providers. do you recognize medicaid to be a valuable program and consider the coverage it provides to 74 million americans to be comprehensive? >> medicaid is a vital program for health care for many individuals in this country, but one that has significant challenges. there's one out of every three physicians who should be seeing
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medicaid patients, who are not taking any medicaid patients. there's a reason for that. if we're honest with ourselves, we would be asking the question why. >> well, if that's the case that one in three don't treat medicaid, you have to ask yourself, is that because medicaid reimbursements are so low? and since provider reimbursements are set at a state level, won't cutting federal funding and hitting states with higher costs only lead to lower provider rates? and how many doctors would actually treat former medicaid beneficiaries when they no longer have any coverage or ability to pay? so even if there's only one of three, there's still two of three that are providing the services. imagine if you don't have coverage, which goes to my next question. you have advocated to, in essence, block grant medicaid. the essence of medicaid is an entitlement, which under the law it means, if i meet these ci
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criteria, i have the right to have that coverage under the law. when you move to a block grant, you remove the right and make it a possibility, subject to whatever funding there's going to be. do you recognize that in doing so, you risk the potential of millions of americans who presently enjoy health care coverage through medicaid no longer having that right? >> i think it's important to appreciate that no system that any -- that the president has supported or that i have supported would leave anybody without the opportunity to gain coverage. >> that's not my question. so let me reiterate my question. >> medicaid under the law, as it exists today, is a right. is that not the case, yes or no? >> it's an entitlement. >> and as an entitlement, doesn't that mean that you have the right, if you meet the criteria -- >> one is eligible. >> meaning you have a right. when you move to a block grant, do you still have the right? >> no.
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i think it would be determined by how that was set up, if, in fact, that was what congress did. again, the role of the department of health and human services is to administer the laws that you pass -- >> but i would simply say to you, i know in our private conversation, i appreciate you coming by to visit me. you suggested that your role is that of an administrator of a large department. that's not even what the vice president said when you were nominated. he said, he expected your experience both medically and legislatively to help drive policy. and even beyond the expectations of the vice president in that regard, when we have regulatory abilities of the secretary to dictate regulation, that is policy. so please don't say to me, i'm just here to do what congress says. i respect you'll follow the law and do whatever congress says, but you will have an enormous impact. ultimately, block granting means
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a loss of a right. and then it's just a question of funding and then we'll have a bigger problem with the number of providers really provided. so i hope we can get to a better understanding of your commitment to medicaid, as it is an entitlement as a right. >> thank you, sir. >> senator, your time is up. we'll go to senator carper now. >> congressman price, welcome to you and to your wife. i there's a verse of scripture in the new testament that speaks to the least of these, when i was hungry, did you feed me, when i was naked, did you clothe me? when i was thirsty, did you get me to drink, when i was sick in prison, did you visit me. when i was a stranger in your land, did you take me in? it says nothing about, when my only access to health care coverage was going into the emergency room of a hospital,
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did you do anything about it? what we sought to do with the aca is to do something about it. and we didn't, in this room, invent the affordable care act. the genesis to the affordable care act goes back to 1993 when hillary clinton the first lady was working on what was called hillarycare. and a group of senators led by john chafy, a republican from rhode island, developed the legislation, co-sponsored by, i think, 23 senators, including, as i recall, senator orrin hatch and senator grassley. and what he did in his legislation, what he proposed in his legislation was to huge really five major concepts. one to create large purchasing pools for folks who may not otherwise have access to health care coverage. he called them exchanges or market places. and he proposed there would be a sliding scale tax credit to pie down the cost of people getting
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coverage in those exchanges. within the different states. third thing he proposed was the individual mandate. you would end up with insurance pools that health insurance companies could not begin to cover. it would be unworkable. he proposed, as well, employer mandates and proposed, as well, the notion that people shouldn't lose their coverage because of pre-existing conditions. those are not democrat ideas. those were proposed by republican leadership, actually, in the congress at the time. and when governor romney developed his own plan in massachusetts a decade or so later, he borrowed liberally from those ideas. when the institute of what i and
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others call romney care, they thought they were doing a pretty good job on covering people, but not such a good on affordability. and what took place over time, you found out you had insurance pools where a lot of people were not very young, they were not very healthy, they were older and needed more health care. and as a result, the insurance companies, in order to find -- be able to stay in business, had to raise the premiums. i don't know if any of this sounds familiar to you,ut it sure sounds familiar to what we've seen in the last six years so with the affordable care act. to the ideas of senator schchaf and governor romney, we've added some things. we've encouraged states to increase the number of people they cover under medicare by raising to about 135% the poverty level to which people can receive health care. we've encouraged a focus on prevention and wellness, not
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just treating people when they're sick, but trying to make sure people stay healthy in the first place. we provide funding for contraception, for problems that are intended to reduce obesity. we have programs to reduce smoking, the use of tobacco. this is not a yes or no question. what was wrong with that approach? what is wrong with that approach? and the last thing i say, before you answer, the health insurance companies found it difficult to stay in business and the state group exchange across the country, one of the reasons why they were unable to is because i think we didn't raise or have the incentive high enough to get young, healthy people, like my sons, into the exchanges across the country. s&p, i'm told, has just put out about a month ago, an update
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looking at the financial health of the insurance companies in this country. and it sounds like they have seemed to have sort of figured it out. because the health insurance companies has begun to stabilize. your reaction to this, please? >> as i mentioned, either in my opening or in response to questions, the principles of health care that all of us hold deal, affordability and accessible and choices for patients, i think are the things that we all embrace. the next step, how we get to accomplish and meet those goals and those principles, is where it takes work together to do so. the program that you outlined has much merit, whether it's making certain that individuals with pre-existing illness and disease are able to access coverage, whether it's the pooling mechanisms, which i've actively and aggressively
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supported for years, there's a lot of merit there. so, again, what i'm hopeful that we're able to do is to, in a collegial, bipartisan way, work together to solve the remarkable challenges that we have. one of my physician colleagues used to tell me that he never operated on a democrat patient or a republican patient, he operated on a patient. and that's the way that i view this system. it's not a republican system, it's not a democrat system, it's a system that hopefully we're focusing on the patients to, again, make certain that they have the access to the highest quality care possible. >> thank you for that. let me conclude, mr. chairman, by saying that -- i'll use an analogy. if there's a large build and there's people in the large building and there's a fire in the large build, but for some reason, they could not use the stairways or they could not use the elevators, and they looked out the window and there's firefighters down in the streets
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saying, go ahead and jump, we'll save you, but they don't have any safety nets. my fear is if we repeal what i've described -- the system i've described we put in place, the affordable care act, largely founded on republican ideas, i think were good ideas, and we don't have something, at least as good in place to catch those people that will fall from the building, we'll have done a disservice to them and their country. >> thanks, senator, your time is up. senator burke? >> thank you, mr. chairman. a quick reminder from the affordable care act was not passed with one republican vote in the house or the senate. so, dr. price, a couple of questions just to cut to the chase. are all of your assets currently disclosed publicly? >> they are now and they always have been. >> okay. are you covered by the stock act legislation passed by congress that requires you and every other member to publicly disclose all sales and purchases of assets within 30 days?
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>> yes, sir. >> now, you've been accused of not providing the committee of information related to your tax and financial records, that were required of you. are there any records you have been asked to provide that you have refused to provide? >> none, whatsoever. >> so all of your records are in? >> absolutely. >> now, i got to ask you, does it trouble you at all that your -- as a nominee, to serve in this administration, that some want to hold you to a different standard than you as a member of congress, and i might say, the same standard they currently buy and sell and trade assets on, does it burn you that they want to hold you to a different standard now that you're a nominee, than they are as a member? >> well, we know what's gong on
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here. >> well, we do. we do. >> it's -- and i understand. and as my wife tells me, i volunteered for this, so. >> so let's go to substance. you and i have a lot in common. we both spoke out in opposition to obamacare earlier bicep predicted massive premium increases. when the president promised, two if you like your doctors, you can keep them, if you like your plan, you can keep it web both said these promises would be broken, and in fact, they were. over the last seven years, you and i, senator hatch, congressman upton and others have actually written our own health care plans, because we, i think, brave enough to say, if you're going to be critical of something, then put your ideas on the table. in your opinion, was it clear to the american people that repeal of obamacare was a promise that donald trump made before he was elected president? >> i have no doubt that it played a very prominent role in
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this past election and that the president is committed to fulfilling that promise. >> and as the nominee and hopefully, and i think you will be the secretary of hhs, what are the main goals of an obamacare replacement plan? >> main goals are outlining those principles. it is imperative we have a system that's assemble for every single american, that's affordable for every single american, that incentivizes and provides the highest quality health care that the world knows, and provides choices to patients so they're the ones selecting who's treating them, where, when, and the like. so it's -- it's complicated to do, but it's pretty simple stuff. >> i want to thank you for not only testifying here, but testifying in front of the health committee where johnny and i both had you over there. you're brave to go through this,
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but the country will be much better off with your guidance and your knowledge in this slot. mr. chairman, i yield back. >> thank you, sir. >> thank you. senator carden. >> thank you, mr. chairman. dr. price, gen, thank you for your willingness to serve. and ewe also thank you your family for being willing to put up with your voluntary choices. i want to talk about a few issues in the time that i have. one, yesterday, the president, by kpeskt order, reininstituted the global gag rule, but he also id did it in a i what that is more that would provide or promote abortion. in the past, the policy only applied to agencies to gut family planning. now it applies to organizations that get global healthy money. potentially, help programs, and expansion of pepfar, the hiv/aids. my question is this.
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if confirmed, how would you make sure that the u.s. can fully anticipate in these global health efforts and make sure the next zika virus will be able to contain it, so it doesn't cause the catastrophic effects, if the global gag rule is enforced in a way that prevents us from participating in international health organizations. >> this is really important, senator, and i appreciate the question, the department's full of all sorts of heros, as you well know, and an incredibly talented individuals, and my goal, if i'm given the privilege and if confirmed and given the privilege of serving as the secretary of health and human services is to gather the beth minds and the best talent that we have within the department and without, and determine what is the wisest policy for this nation to have, as it relates to, in this instance, infectious disease. germs know know geographic
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boundaries. and we do incredible work. the work that the cdc does and the work that's done by others in our nation, to try to prevent work to prevent infectious disease, work to detect the spread of infectious disease, and then provide a logical and methodical and aggressive response to the outbreak of any infectious disease is absolutely vital to protect the american people and we're committed to doing so. >> i agree with that. i hope you'll look at perhaps unintended consequences from these executive orders that could compromise our ability to be as effective as we need to, using all tools at our disposal. i want to get to tobacco regulation. an area i think is now clear within the medical community, the impact that tobacco has. the fact that the family smoking prechkt gax kbol control act of 2009 authorizes the hhs secretary, through fda, to regulate tobacco products, including restricting the sale
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of tobacco products to minors. it also has been expanded to include the selling of recigarettes, et cetera. i know, initially, youdy not support that legislation. if cob firmed, coyou mitt to us that you would rigorously enforce that act to make sure, particularly, our children are not subjected to the new forms of tobacco products. >> if i'm confirmed, the responsibility i'll have to forbes the law of the land, i'll do so. >> also includes keeping up with new technologies that are ud by the industry that may require modifications that we see with e cigarettes. are you prepared to not only enforce the law, but enforce our intent to make sure our children are protected? >> i look forward to working with you, senator, on just that. >> i want to -- i was listening to some of the exchanges as it relates to the afrtable care act and we'll continue to debate the merits of the affordable care act. i'm a strong supporter of it, and i think the millions of
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people that didn't have coverage and now have it before, and a rate of growth of our health care premiums are far lower than it would have been, but for the act. we'll debate that layer. the question is, what do we -- what's coming along? we've heard you say several times the principles that the president has articulated as to what would be in place of the affordable care act. i like to just drill down a little bit on the central health benefits. we've talked about preventative care now being available. we know that we have now mental health and addiction services that are available. we also know we have oral health, pediatric dental that's now available, which is particularly important in my state, because of the tragic loss in 2007. can you ensure us that as you look at what will be the health care system moving forward, that you're prepared to make sure that americans have quality insurance coverage, to deal with issues such as preventative
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care, mental health services, addiction services, and pediatric dental? >> what i can commit to you, senator, is that we will do all we can within the department, with the incredible knowledge and expertise that is there, to define whether or not the program is actually working as intended or not. if coverage equals care, in many instances, i would suggest that many folks right now have coverage, they've got a card, but they don't have any care, because they can't afford the deductible that allows them to get the care. so we're committed to making certain that the program works not just for government, not just for the insurance companies, but for the patients. >> and as you know, we imined any co-pays on preventative care, but we can talk about the spefics going forward. i look forward to those discussions. thank you, mr. chairman. >> thank you, senator isakson. >> we're going to break away from the hearing, the senate finance committee for tom price to become the next secretary of health and human services.
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over at the white house, president trump has just signed some more kpeskt actions, what they're being called, including, jacques, on the keystone and dakota pipelines. we're about to get the videotape from the pool, the video of his latest actions in the white house. >> and there have been a clamoring by opponents of donald trump that he holds stocks that are related to the ketone pipeline, i'm not sure about the dakota pipeline. >> here's the tape. >> this is with regard to the construction of the keystone pipeline. something that's been in dispute, and it's subject to a renegotiation of terms by us. we are going to renegotiate some of the terms and if they'd like, we'll see if we can get that pipeline built.
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a lot of jobs. 28,000 jobs. great construction jobs. okay, keystone pipeline. this is with respect to the construction of the dakota access pipeline. dakota access pipeline. again, subject to terms and conditions to be negotiated by us.
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okay. this is construction of pipeline in this country. we are, and i am, very insistent that if we're going to build pipelines in the united states, the pipes should be made in the united states. so unless there's difficulties with that, because companies are going to have to save europe, much pipeline is built from other countries, from now on we're going to start making pipeline in the united states. we build it in the united states, we build the pipelines, we want to build the pipes. going to put a lot of workers, a lot of skilled workers back to work.
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> all right, we will build our own pipeline, we will build our own pipes. that's what it has to do with. like we used to, in the old days. this is about streamlining the incredibly cumbersome, long, horrible, permitting process and reducing regulatory burdens for domestic manufacturing, many of the people that we've been meeting with over the last long period of time, but, yesterday, and others, the process is so long and cumbersome that they give up before the end. sometimes it takes many, many years, and we don't want to that happen. and if it's a knob wehle give a quick no, and if it's yes, it's like, let's start building.
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the regulatory process in this country has become a tangled up mess. very unfair to people. that's a big one. this is the expediting of environmental reviews and approvals for high-priority infrastructure projects. we intend to fix our country, our bridges, our roadways. we can't be in an environmental process for 15 years if a bridge is going to be falling down or if a highway is crumbling. so we're expediting environmental reviews and approvals.
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okay? thank you very much. >> any comment on the standing rock community? the protesters out there? >> thank you, press. we're good. >> thank you. >> all right, some time next week, i'll be making my decision this week we'll be announcing next week, we have outstanding candidates and we will pick a truly great supreme court justice. but i'll be announcing it some time next week. thank you all very much. there y see president trump signing five executive actions. the first o on the keystone oil pipeline, allowing it to go forward, subject to renegotiations. then the dakota oil pipeline, another executive action, saying that the pipes, the pipelines,
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jake, will be built here in the united states, made in the usa. streamlining regulations on environmental restrictions and also expediting environmental reviews, so that bridges, infrastructure, highways, roadways, can be built. five more executive actions taken by the president. >> and he also said that he would be making his decision about a supreme court pick to fill that ninth vacancy in the u.s. supreme court. he said he would be making his decision this week and making an announcement next week. just to put a button on what i was saying earlier before we ran the tape, democrats have people who oppose the north dakota pipeline have jumped on the fact that in earlier financial disclosure forms, president trump held stock in companies that will benefit from the building of the dakota pipeline. the spokeswoman for the then-candidate, now president trump, hope hicks, has said that president trump sold that stock, although we don't have anything to go by other than their word.
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but they did say he sold that stock. the announcement of the supreme court pick, i think that's the biggest news out of what he just said. because that is going to ignite a huge fight on capitol hill. >> and there's some finalists, but whoever is put forward, presumably, will generate that kind of fight. and unlike the confirmation process for the cabinet members, you need 60. you will need 60 votes in the united states senate for confirmation of a supreme court justice. the republicans have 52. they'll need a few democrats to come along, as well. >> and the senate democrati leader on sunday, chuck schumer, told me they would oppose anyone they thought was out of the mainstream. president trump provided a list of 21 possible supreme court picks about three months ago. he said, are these people in the mainstream, and said he didn't have enough time to go over any name on that list. my guess is that a lot of democrats, whoever he picks, they will find that person to be out of the mainstream. a lot of names that we're hearing about are definitely conservative judges, as one
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would expect, from a republican president. >> let's see what happens on that front. gloria, all these five executive actions signed by the president just now, these are campaign commitments he made these commitments during the campaign. he's now living up to what he told the american voters he would do. >> no, none of them come as a surprise, at all, to any of us, but i don't think it's gong to make the environmental community very happy. more than sort of any interest group so far. i think the environmental community understands that they have big fights on their hands. the keystone pipeline, you know, the president, former president of the united states, obama, did not prove it for environmental reasons. he thought it would get in the way of a global climate change deal that he was doing. you have native american tribes saying that the other pipeline is a threat to their water, the dakota pipeline is a threat to their water supply. and expediting environmental
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reviews is something that the community will also oppose and will be upset by, because that he believe that you need these reviews before you start fixing things, because you need to look at what therepercussions will be. and i think, however, that donald trump deserves some credit here, for doing what he said he was going to do, honestly, this is what -- this is what the american public wants. they want their infrastructure fixed and they want it fixed quickly. and this paves the way for a massive infrastructure bill, which, by the way, the democrats are going to propose before donald trump does. >> the environmental community always takes issue with republican presidents, because they come at it from a very different perspective. but i have to say, it's probably a nightmare for the environmental community that a developer is actually now the president of the united states, because that's what they do, environmentalists, they battle developers, day in, day out. now one of the biggest
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developers to ever achieve any sort of power is in the white house. >> but they said they're going to pay for the pipes, too. not pay for them, that americans are going to supply the pipes. well, there's a bidding process that goes on, so who's going to be the -- >> the obama state department had actually green lit the keystone pipeline after doing an environmental study. look, canada's going to find some way to ship this oil and it might actually be worse for the environment, but obama, i think, because of his base, the environmentalists, did, you know, did not support keystone. and now you have donald trump just yesterday, meeting with labor leaders. they like this deal. they like this order. so bukd seeing this as part of donald trump's sort of reordering of coalitions, where democratic leaning labor unions are now more in the trump camp. >> and can we just take a step back a little bit and just note if imagery of the new trump white house, once again. just like yesterday, it was just from morning to night, picture
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after picture after picture, aimed at sending a signal to the american people, i'm here, i'm at work, look, here i am in the oval office, look, here i am in the roosevelt room, look, here i am in the cabinet room, doing things, as you said, that he promised to do in the campaign. look, that's today's imagery, i just want to say, just to sort of say what we were all saying, yesterday, i think we saw a lot of the men who were in charge of the, who have leading roles in the trumphitehoe, now we see a couple of women -- >> oh, look! >> it's hard to imagine that that's an accident. kellyanne conway is somebody who is one of the senior advisers there and hope hicks, to her right, has been with donald trump since day one, was part of the small band of brothers and sisters who tried to get him and successfully got him elected. but i think that is something that is noteworthy. in that, look, he has told people privately that he wants to be like ronald reagan in terms of his style.
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he liked his style. and michael dever, who really helped create the imagery of ronald reagan, would have -- is probably, you know, looking down from heaven saying, applause, applause, applause. you're doing pretty well on day two. >> to your point, dana, he relishes having cameras at his beck and call. this is -- for all the contention that there is between the press and this white house and we've been reading a lot about that, he is certainly making good use of the fact that within the same building that he resides, is an entire press pool, that when he can call them in to -- i keep thinking, my god, if he had this ability when he was a real estate developer in new york, if he had the ability to bring the cameras in every time he signed something, he is relishing this a little bit. >> it's show and tell a little bit. >> it is. it reminded me a kindergarten teacher who's reading a storybook, the big bad wolf is blowing down the house and showing it to the house.
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i think it absolutely works. it's very simple to understand. he's telling a story, he's showing everybody. people get to be a part of it. i think it's very effective. >> the worst politicians are the ones who are great in person, great in private, but trump, the fact that he loves the limelight i think is more of a feature than a bust. >> i think we've known for a while that he's good about the theater that encompasses politics. but the question is about the pipeline. he basically said, no pipeline unless it's u.s. steel. the keystone pipeline is foreign steel and foreign oil. i don't know if mr. trump knew th that, but these are facts that are going to come out. we also have the thing about imminent dplgain. the gop does not like ininnocent domain. so while he yes, delivered on the promise of signing on the dotted line on the dakota access pipeline and the keystone pipeline, there are some other things that have to happen before this actually goes through. >> i wonder what this means,
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also, in terms of the protests of the dakota pipeline. because in the last few months of the obama administration, that was a big story. the very emotional demonstrations by native americans and allies. >> yeah. >> all going and stopping the construction or trying to stop the conruction of the dakota pipeline. i wonder if this now means there's going to be a reigniting of the activism and protests there. >> hard to imagine it wont. >> and what that will mean, and how it was very awkward and difficult for president obama to deal with it. he ultimately dealt with it because the army corps of engineers kind of overruled the people beneath them. and said, we're suspending this for now, but that was just kicking the can down the road. >> and whether it gets back into the culture war. part of their argument is that not only would this pipeline be damaging to the environment, but that it damages a culturally significant site. you imagine it's going to get
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into a back and forth with conservatives. >> these signings were taking place just as congressman tom price is continuing the confirmation process, the hearing before the senate finance committee on various issues, it can be ethics issue, substantiative issues involving obamacare. i want to play they can change that dr. price had on his understand wh understanding, what the signing, the action that president trump has already done, initial steps to repeal, eventually replace obamacare, listen to this. >> under the executive order, will you commit that no one will be worse off? >> what i commit to, senator, is working with you and every single member of congress to make certain that we have the highest quality health care and that every single american has access to affordable coverage. >> that is not what i asked. i asked, will you commit that no one will be worse off under the executive order? you ducked the question. will you guarantee that no one
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will lose coverage under the executive order? >> i guarantee you that the individuals that lost coverage under the affordable care act, we will commit to making certain that they don't lose coverage under whatever replacement plan comes forward. that's the commitment i provide to you. >> dr. sanjay gupta is with us, as well. he's an expert on the affordable care act. sanjay, what's your understandingxecutive order that has now been signed by president trump, an initial step. the fear among the supporters of obamacare is it's more than just symbolic, it's going to hurt some folks. >> it's a little bit hard to fully understand what this executive order means, because it basically says there's authority now to remove any kind of burdens that the affordable care act may have placed in various sectors of our society. insurance wise, on patient care. but it didn't define, . i think a lot of that left is
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going to be left to congressman price, which i think is why the question was asked about would there be people who would lose coverage. and i think, you know, there's been a lot of data on this. this was sort of a loaded question, as you well know. the congressional budget office has released estimates if there's an repeal of the affordable care act. in year one, year two, year three. they say some 30 million more people within a few years would not have health care coverage. i think that that's what was really getting at. what congressman price has said to that question in the past, he didn't really answer it today, is that those numbers did not anticipate the replacement plan he has and his replacement plan would not lead to that sort of loss of coverage. he has never said it wouldn't lead to loss of coverage at all. >> sanjay, stand by. we're going back to the hearing. what do you think, how is congressman price handling these
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questions, largely tough questions from the democrats? >> tough questions from the democrats, not so much from the republicans. i think he's handling it well in terms of the theater of this. he insists he's done nothing wrong. i've not seen anything that will put his nomination in jeopardy. ultimately, this is going to be a party line vote. ultimately, republicans will rally around him. he's very popular among republicans on capitol hill. of course, he has been a republican congressman on the other side of congress, on the house side, for several years. i can't imagine, even with these ethical concerns and even with democrats, fighting the obamacare repeal tooth and nail, i can't imagine him not getting confirmed. >> i agree. let's go back to the hearing right now. >> and i think it's important, individuals ought to be able to purchase the coverage they want. >> i just don't want us to get to a place people have to settle for something that no one else
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in the industrialized world has to settle for. why should they pay out of pocket month after month after month to pay for something as basic as a hospitalization or maternity services or, you know, the rest of this list. there may be things on the list would he disagree with. but i'm worried we're headed to a choice tto one else in the industrialized world has to accept. i accept your goal and i hope we can work together to make it so. you mentioned we should listen to the governors, which brings me to my second question and your answer to senator portman. in colorado, you may have heard this. we have something called the accountable care collaborative that is a unique approach to medicaid. it connects members with coordinated primary care providers while reducing various taxes. it also provides coordinate care for those with dual eligibility for medicare and medicaid. i could show you the cost curve
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is really starting to turn around because of the coordinated care that's happening out there. when asked about the need for more state flex ikt, which is an argument made to carry out innovative programs like the one in colorado, our governor said, quote, greater flexibility cannot make up for the lack of funding, so the federal government pulled back its financial commitments, we simply cannot afford to make up the difference. i'd ask you if you agree with our governor's assessment, while flexibility is acceptable, it isn't a replacement for critical funding needs? >> i think that decision -- the decision for funding is, obviously, a legislative decision. >> so, what do you think the plan -- but that's a very fundamental component of affordable care act, the expansion to medicaid, wouldn't you agree? >> that decision whether or not to change that is a decision you and every member of congress will be involved in. if i'm fortunate enough to serve
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as secretary of health and human services, we'll carry out the law you pass. >> i appreciate that. in your mind, though, does the repeal of the affordable care act include a repeal of the expansion of medicaid that was part of the passage of the affordable care act? >> any reform or improvement that i would envision for any portion of the affordable care act would be one that would include an opportunity for individuals to gain coverage, the kind of coverage, again, they want to the highest quality health care. >> that's not the question i ask. i apologize, mr. chairman, i realize i'm at the end of my time. do you believe a repeal -- i mean, this is what the president ran on -- repeal of the affordable care act includes the repeal of the expansion of medicaid that was a fundamental part of the affordable care act? >> again, that's a decision you alley would make. >> that's true. >> what i believe is any reform or improvement must include a coverage option and opportunity for every single american, including those that are either currently or close to medicaid
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population in a given state, which changes depending on the state. >> thank you, chairman. >> senator widen? >> no, no. >> you okay? >> yeah. >> all right. let's go to -- let's go to senator toomey. >> thank you, chairman. senator price, thank you for joining us. thank you for your work in the house and willing to serve in this extremely important post. i enjoyed the conversation we had a little while back. i do think it bears reminding everyone, as we talk about obamacare, that certainly the individual market is in a classic death spiral. the adverse election is destroying that market. it is in a freefall. in pennsylvania, 43% of all pennsylvanians in the obamacare exchanges have a grand total of one choice. that very typically does not include whatever they had before and were promised they could
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keep, of course, which was never true. we with have a system that's in collapse. what we're trying to do is figure out what's a better way to go forward. now, when we talk about repeal, sometimes i hear people say, well, we got to keep coverage of pre-existing conditions because, you know, we have to keep that. and when i hear that, i think we're missing something. there's obviously a number of americans who suffer from chronic, expensive health care needs. they've had these conditions, sometimes all their lives, sometimes for some other period of time. for many of them the proper care for those conditions is unavoidable. i think we agree we want to make sure those people get the health care they need. now, one way to force it is to force insurance companies to provide insurance for someone when they show up, regardless of the condition they have. which is kind of like asking the property casualty company to rebuild the house after it's
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burned down. but that's only one way to deal with this. so, am i correct, is it your view that there are other, perhaps, more effective ways since obamacare is in a collapse, to make sure people with these pre-existing chronic conditions get the health care that they need at an affordable price without necessarily having the guaranteed issued mandate? >> i think it's important to understand the position we currently find ourselves in with policy and this nation is that those folks are in a very short period of time are going to have nothing because of the -- because of the collapse of the market. >> right. second topic is -- i think you and i share a goal of having health care that is much, much more driven by individuals, families, patients, consumers, consumer-centric rather than bureaucratic-centric, which is what obamacare is. do you agree with me that to get there, we need to do more about
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the transparency of health care outcomes so that informed consumers can evaluate among different physicians, different hospitals, who really get the best outcomes? do we need to do more there? >> absolutely. this is an incredibly important point. it's not just in outcomes. outcomes are important and we need to be measuring what actually makes sense from a quality standpoint and allow patients and others to see what those outcomes are, but it's transparency in pricing as well. right now we don't have that. so, if you're an individual out there and you, in fact, want to know what something costs, it's virtually impossible to know what that is. there a all sorts ofeasons for that, but if year honest with ourselves as policymakers, and we to want make the system patient-friendly, not insurance-friendly or government-friendly, but patient-friendly, then we would make that a priority. if i'm confirmed, i hope to do so. >> i think medicare and medicaid can -- cms can play a big role in advancing that.
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ultimately, i think the more we diminish dependents on third-party payers and allow the evolution of a market that responds to individuals, individuals will demand that information. >> right. >> the convway they do in every other market. last thing i want to touch on has to do with nih research, specifically alzheimer's. it is my view that we ought to think of alzheimer's has a disease in a category of its own. and i say that because it is -- there is no disease like it that we know of that afflicts americans today. there are 5.2 million americans with the disease right now. it's 100% fatal. it's the sixth leading cause of death. there's no cure. there's no treatment. there's nothing. and yet for fiscal year 2016, nih spending is a grand total of $168 per diagnosed patient. it seems to me that the expenditures are wildly out of
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line with the severity and the breadth and the scope of this disease. and i wonder if you would commit to working with me and others who share this view, to ensure that we have a better proportionality in terms of the allocation of resources and the breadth and severity of illnesses? >> i think it's absolutely imperative, senator. and i look forward to working with you. >> thank you, chairman. >> thank you, senator. senator thune. >> thank you, chairman. dr. price, welcome. thank you for your willingness to serve in this capacity. we have a lot of challenges ahead we need to take on. as i met with you a couple weeks ago, one of the issues that's of particular interest to me is this issue of indian health service. in 2010 there were some systemic problems that were uncovered in south dakota. administrative action plan was set in motion to help remedy many of these findings. similar issues popped up again throughout south dakota in 2015. and they continue to this day. after


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