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Latest Top (4) News

Statement from HHS Secretary Alex Azar ahead of World AIDS Day

HHS Secretary Alex Azar issued the following statement ahead of the 30th anniversary of World AIDS Day:

“The observance of World AIDS Day is an annual reminder of the need to remain vigilant in our efforts to combat the HIV/AIDS pandemic, and also of the potential we have for further progress. Advances in HIV prevention, treatment, and care services have enabled us to significantly reduce the rate of HIV infections and improve the health of those living with HIV. We have seen progress both at home, through initiatives such as the Ryan White HIV/AIDS Program, and abroad, through the success of the U.S. President’s Emergency Plan for AIDS Relief, which marks its 15th anniversary this year. We must also continue our work to remove the stigma that surrounds HIV so that no one is afraid to learn their HIV status, and receive treatment or take steps to prevent infection.

“Bringing federal resources to the battle against infectious diseases such as HIV has been a special focus of my public career, and the Trump administration is strongly committed to achieving the goals of our National HIV/AIDS Strategy. By ensuring access to and the availability of the effective tools we have today, such as pre-exposure prophylaxis (PrEP) and daily antiretrovirals, and strong support for new methods of HIV prevention and treatment that are in the research pipeline, we are optimistic that we can continue our advances toward ending the HIV/AIDS pandemic.”

For more information on HIV, go to HIV.gov

Friday, November 30, 2018 - 14:15

Reforming America’s Healthcare System Through Choice and Competition




The President
The White House
Washington, DC 20500

Dear Mr. President:

On October 12, 2017, through Executive Order 13813, you directed the Administration, to the extent consistent with the law, to facilitate the development and operation of a health care system that provides high-quality care at affordable prices for the American people by promoting choice and competition.  We are pleased to provide you with this report, prepared by the Department of Health and Human Services (HHS) in collaboration with the Departments of the Treasury and Labor, the Federal Trade Commission, and several offices within the White House.  This report describes the influence of state and federal laws, regulations, guidance, and polices on choice and competition in health care markets and identifies actions that states or the Federal Government could take to develop a better functioning health care market.

As health care spending continues to rise, Americans are not receiving the commensurate benefit of living longer, healthier lives.  Health care bills are too complex, choices are too restrained, and insurance premiums and out-of-pocket costs are climbing faster than wages and tax revenue.  Health care markets could work more efficiently and Americans could receive more effective, high-value care if we remove and revise certain federal and state regulations and policies that inhibit choice and competition.

The Administration has already taken significant steps to improve health care markets by addressing government rules and programs that limit choice and competition and produce higher prices for the American people.  Among the most significant actions:

  • In October 2018, the Departments of HHS, the Treasury, and Labor proposed a rule that would provide employers with significant new flexibility in how they fund health coverage through Health Reimbursement Arrangements (HRAs).  If finalized, this flexibility would empower individuals to take greater control over what health insurance benefits they receive.  The Treasury estimates that more than 10 million employees would benefit from this change within the next decade.
  • In August 2018, the Departments of HHS, the Treasury, and Labor finalized a rule to expand Americans’ ability to purchase short-term, limited-duration insurance—coverage for which premiums are generally much more affordable than Affordable Care Act (ACA) plans.  Millions of Americans, including middle-class families who cannot afford ACA plans, will benefit from the additional choice and competition resulting from this reform.
  • In June 2018, the Labor Department finalized a rule to expand the ability of employers, including sole proprietors without common law employees, to join together and offer health coverage through Association Health Plans.  For many employers, employees, and their families, these employee benefit plans will offer greater flexibility and more affordable benefits.
  • In May 2018, HHS released “American Patients First,” a historic blueprint for actions to bring down the high price of drugs and reduce out-of-pocket costs. HHS has taken a number of actions that were laid out in the blueprint to empower consumers and promote competition, building on accomplishments such as the Food and Drug Administration’s record pace of generic drug approvals.
  • In December 2017, you signed the Tax Cuts and Jobs Act, which eliminated the onerous and regressive individual mandate tax penalty.  This freed Americans to finance their health care needs in the way that works best for them.
  • The Administration has enacted reforms to deliver better value through choice and competition in the Medicare program, including payment changes that establish site-neutral payment policies for a number of Medicare services, a simplification of how physicians are paid for evaluation and management visits, new consumer-transparency measures, and flexibility for insurers to offer more options and benefits in Medicare Advantage.
  • HHS and the Treasury have issued revised guidance under section 1332 of the ACA that significantly expands the ability of states to reform their individual insurance markets while ensuring that people with pre-existing conditions are protected.

While the Administration has made much progress in reforming the American health care system significant obstacles remain.  This report identifies four areas where federal and state rules inhibit adequate choice and competition and offers recommendations for improving public policy in each of these four areas.

Health Care Workforce and Labor Markets:  Reduced competition among clinicians leads to higher prices for health care services, reduces choice, and negatively impacts overall health care quality and the efficient allocation of resources.  Government policies have suppressed competition by reducing the available supply of providers and restricting the range of services that they can offer.  This report recommends policies that will broaden providers’ scope of practice while improving workforce mobility, including telehealth, to encourage innovation and to allow providers more easily to meet patients’ needs.  The report also recommends that the Federal Government streamline funding for graduate medical education to allocate taxpayer dollars efficiently and to address physician supply shortages.

Health Care Provider Markets:  State policies that restrict entry into provider markets can stifle innovative and more cost-effective ways to provide care while limiting choice and competition.  These policies have resulted in higher health care prices and fewer incentives for providers to improve quality.  This report makes several recommendations to promote choice and competition in provider markets, including state action to repeal or scale back Certificate of Need laws and encourage the development of value-based payment models that offer flexibility and risk-based incentives for providers, especially without unduly burdening small or rural practices.

Health Care Insurance Markets:  Government mandates often reduce choice and competition in insurance markets and increase overall premiums.  In the individual and small group markets, many consumers face limited coverage options that cover services they do not want or need and that drive up premiums, while others have been completely priced out of the market.  Regulations that limit coverage choices should be changed so that states have more flexibility to develop policies that account for diverse consumer preferences.  This report recommends scaling back government mandates, eliminating barriers to competition, and allowing consumers maximum opportunity to purchase health insurance that meets their needs.

Consumer-Driven Health Care:  Our health care system’s excessive reliance on third-party payment insulates consumers from the true price of health care and offers them little incentive to search for low-cost, high-quality care.  When federal and state health policies give consumers more control over their health care dollars, they can use that power to demand greater value.  For example, promoting and expanding Health Saving Accounts (HSAs) and HRAs would expand personal control and introduce more consumer power into the health care market.  The report recommends expanding access to HSAs, implementing reference pricing where appropriate, and developing price and quality transparency initiatives to ensure that newly empowered health care consumers can make well-informed decisions about their care.

We know the United States health care system too often fails to deliver the value it should.  This report identifies barriers on the federal and state levels to market competition that stifle innovation, lead to higher prices, and do not incentivize improvements in quality.  It recommends policies that will foster a health care system that delivers high-quality care at affordable prices through greater choice, competition, and consumer-directed health care spending.  While American consumers and many providers would significantly benefit from the reforms laid out in this report, there are entrenched and powerful special interest groups that reap large profits from the status quo.  It will take bold leadership to confront these incumbents and implement reforms, but under your direction, we are convinced we can significantly improve the American health care system.

We look forward to working with you as we create a more effective and efficient health care market that provides information for consumers as they make health care decisions for their families, rewards quality, encourages innovation, and delivers care at prices the American people can afford.


Alex M. Azar II
U.S. Department of Health and Human Services

Steven T. Mnuchin
U.S. Department of the Treasury

Alexander Acosta
U.S. Department of Labor

Download the report

People using assistive technology may not be able to fully access information in this file. For assistance, contact Roman Burleson at digital@hhs.gov.

Monday, December 3, 2018 - 13:45

HHS Secretary Azar Declares Public Health Emergency in Alaska Due to Earthquake Damage

Following President Trump’s lead in declaring an emergency in Alaska after the Nov. 30 earthquake, Health and Human Services (HHS) Secretary Alex Azar today declared a public health emergency in Alaska. The declaration triggers other legal authorities that give the HHS Centers for Medicare & Medicaid Services (CMS) beneficiaries, their healthcare providers and suppliers greater flexibility in meeting emergency health needs in the aftermath of the earthquake.

“HHS is working closely with state health authorities and monitoring the needs of healthcare facilities,” Secretary Azar said. “This declaration will help ensure that Americans who were affected by the earthquake and rely on Medicare, Medicaid, and the Children’s Health Insurance Program have continuous access to the care as the area recovers.”

With the declaration in place, CMS can use legal authority provided under the Social Security Act section 1135 to grant waivers that will aid healthcare facilities in providing uninterrupted care and services for the elderly and people with disabilities living in long-term care facilities. The waivers also support the Alaska Medicaid Agency’s administrative processes, ensuring that Medicaid funds continue to flow despite the temporary closure of the agency’s offices.

As part of the federal response to the earthquake, the Substance Abuse and Mental Health Services Administration’s Disaster Distress Helpline is available to assist residents in the impacted areas in coping with the stress of the disaster. The Disaster Distress Helpline provides immediate 24/7, 365-days-a-year crisis counseling and support to people experiencing emotional distress related to natural or human-caused disasters. This toll-free, multilingual, and confidential crisis support service is available to all residents in the United States and its territories. Stress, anxiety, and other depression-like symptoms are common reactions in disasters. Call 1-800-985-5990 toll free or text TalkWithUs to 66746 to connect with a trained crisis counselor.

Additionally, the HHS Office for Civil Rights (OCR) has guidance available for territory agencies and community organizations to help ensure equal access to emergency services and the appropriate sharing of medical information during emergencies, including how federal civil rights laws apply in an emergency and how HIPAA laws apply in an emergency. OCR also provides a HIPAA Disclosures for Emergency Preparedness Decision Tool.

In declaring the public health emergency in Alaska and authorizing flexibilities for CMS beneficiaries, Secretary Azar acted under his authority in the Public Health Service Act and Social Security Act. These actions and flexibilities are retroactive to Nov. 30, 2018.

Monday, December 3, 2018 - 17:00

Secretary Azar Announces Senior Advisor for Drug Pricing Reform

On Thursday, Health and Human Services Secretary Alex Azar announced that John O’Brien, will serve as Senior Advisor to the Secretary for Drug Pricing Reform. Previously, O’Brien had served as Advisor to the Secretary for health reform and drug pricing, as well as Deputy Assistant Secretary for Health Policy within the Office of the Assistant Secretary for Planning and Evaluation.

“John O’Brien has already been an integral leader in HHS’s efforts to bring down the high price of prescription drugs,” said Secretary Azar. “As a senior advisor, he will carry forward the legacy of our departed colleague Dan Best and build on the substantial progress that has already been made. John will continue to play an important role in our overall efforts to deliver Americans better, more affordable healthcare.”

Prior to his time at HHS, O’Brien, a pharmacist, was Vice President of Public Policy for CareFirst BlueCross BlueShield. He has also worked at the Centers for Medicare & Medicaid Services, the Notre Dame of Maryland University College of Pharmacy, and various pharmacy and pharmaceutical organizations.

O’Brien has a master’s degree in public health from the Johns Hopkins Bloomberg School of Public Health, a doctor of pharmacy degree from Nova Southeastern University, and studied pharmacy and public policy at the University of Florida.

Thursday, December 6, 2018 - 08:30