Washington, D.C. - Congressman Michael C. Burgess, M.D. (R-TX), Chairman of the House Rules Committee, joined the Energy and Commerce Health Subcommittee in questioning Secretary Xavier Becerra of the Department of Health and Human Services (HHS) on the Fiscal Year 2025 Department of HHS Budget.

Chairman Burgess highlighted the Biden Administration's failed attempts of enhancing the wellbeing of Americans and questioned Secretary Becerra on what the Administration is doing to curb health care consolidation, preserve independent practices and small providers, and address high health care costs. 

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On the importance of preserving independent practice and addressing provider consolidation:

“Would you agree that provider consolidation is a problem that needs to be addressed?,” asked Chairman Burgess. 

"That's something we've had forever, there's no reason why consolidation should mean that there shouldn't be independent practice," said Secretary Becerra. 

"I’m glad you feel that way. I think that the presence of independent physicians is an invaluable counterweight to the rise of consolidation in our health care marketplace. What is this Administration doing to help preserve independent practice as an option for physicians and patients?” asked Chairman Burgess.

"We continue to work within the industry to make sure that no consolidation is occurring for monopolistic purposes. We work with the Department of Justice on that. We try to keep prices competitive. I would probably agree with you if you were to ask me if removing those independent practitioners is going to lead to higher prices and I would probably tell you it absolutely does," said Secretary Becerra.

"It's going to lead the worst patient care and that's really what we should be concerned about. I mean it's one thing to spend a lot of money, it's another thing to spend a lot of money and not deliver the care that people really need," said Chairman Burgess.

On requesting commitment from the Biden administration to address the current disruptive payment rules, preserve independent practice, reduce health care consolidation, and lower costs for American patients:

"Would you consider modifying the upcoming Physician Fee Schedule so that it does not involve the large budget neutrality adjustment and offers facility physicians stability, in cost contrast to many decades of disruptive payment rules?" asked Chairman Burgess.

"That's a dance we have to engage with together. Congress set the rules, the new budget neutrality rules we have to follow. More than willing to work with you because again, if it doesn't really deal with the reality of what the practitioner on the ground has to face, we all should take a closer look." said Secretary Becerra. 
 
"Well here's the problem. We need to ensure that this year's physician fee schedule doesn't continue the cycle of large budget neutrality adjustments that drive conversion factors down for providers," said Chairman Burgess.

"So look, we got a problem. The Affordable Care Act to CMMI was also going to save money, it doesn't. Poorly constructed models favoring large health organizations, consistent, disruptive payment rules, driving consolidation. What we just heard this week about the change health care problems driving consolidation. It seems intuitively obvious to the casual observer that this Administration prefers larger health care systems and neglect smaller providers.

For example, why hasn't this Administration embraced ideas, such as site neutral payment reform to lower costs for the patients and reduced consolidation, something that has been included in President's budget's for over a decade?" asked Chairman Burgess.

"I'd be more than willing to discuss with you the ways that we have continued to try to sustain the smaller providers because the smaller providers are typically the ones that are in rural America. They're typically the ones that are in lower income America, and we desperately need to keep them in place. We have promulgated a number of policies that support smaller providers. We want to avoid them being gobbled up by the big guys," said Secretary Becerra.

"Here's a pro tip. Site neutrality can replace budget neutrality. We can afford this. We have the dollars within the system, we can afford to do this, it is just the will to deliver on that," said Chairman Burgess. 

"What is the cost per enrollee in the Affordable Care Act?" asked Chairman Burgess.

"That would depend on the plan that they purchase, what their income level is, what the level of subsidy would be." said Secretary Becerra.

"You say that the cost of care is basically cost plus to Americans but it's not. Americans are paying this bill, and now they're paying highest interest rates on the money they're having to borrow for what you're giving away," said Chairman Burgess.

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