Jahana Hayes: There Is No ‘Clear Guidance’ From HHS For Screening Health Care ‘Risk Factors’

4 months ago

Prior to the Congressional recess, Rep. Jahanna Hayes (D-CT) questioned Health and Human Services Director Xavier Becarra during a House Education and the Workforce Committee hearing.

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Transcript

00:00Thank you. I yield back. Ms. Hayes, you're recognized for five minutes. Thank you.

00:11And thank you, Mr. Secretary, for being here. I want to talk to you a little bit

00:16about social determinants of health, which, as you know, are conditions where

00:20the environment that people are born in, live in, work in, learn, play, worship,

00:25affect their health care outcomes. As of January 1st, 2024, the Center for

00:30Medicare and Medicaid Services began requiring health care organizations to

00:34screen for the five risk factors, which they determined to be food, food

00:40insecurity, interpersonal safety, housing insecurity, transportation, and utilities.

00:45I know that the department has done work in this area, but my concern is states

00:53are really unclear as to what this can look like. In California and West

00:58Virginia, they've done some of these things, but there really is no clear, I

01:01hesitate to use the word roadmap, because I know that the department has a roadmap,

01:05but it is not clear guidance. And the thing I want to ask you about today is

01:09that under the ACA, 85% of premium dollars are directed towards patient

01:14care, and then the other 15% are the medical loss ratio formula. The things I

01:20just talked about, those social determinants of health, are not included

01:24under the patient care section. Is there at what, can you speak a little bit to

01:30how we can change that and start to look at some of those determinants as part of

01:34the entire health care spectrum? Absolutely, and thank you for the

01:38interest in addressing social determinants of health. By statute, we

01:44are either constrained or permitted to do a certain number of things. Social

01:50determinants of health, if you look through most statutes, are not included

01:54in the provisions of most statutes. So what we're doing is trying to elevate

01:59the issue of what can cause bad health or bad health outcomes, which, as you just

02:05mentioned, includes social determinants of health. So we are making every effort

02:09we can to make sure that anyone who's out there doing health care recognizes

02:14that if you're not addressing these social determinants of health, you're

02:17missing the boat in trying to keep people healthy. Thank you, I appreciate

02:21that. I introduced legislation on the social, called the Social Determinants

02:25for Moms Act, which really talks about how all of these things, as they relate

02:30to maternal health, and my legislation was included as part of the Black

02:35Maternal Health Momnibus. It asked for the creation of a task force to better

02:40address these things in this country. Do you think that the creation of a task

02:45force to at least collect data on these things would be a step in the right

02:48direction? Absolutely, although we need to do more because we need to be able to

02:52change statutes or regulations to include social determinants of health.

02:56Switching gears here a little bit, I want to talk about the final rule that was

03:00issued recently by the Department of Health and Human Services. Can a doctor

03:07be investigated criminally or administratively for providing care to

03:12me for cancer? Can you repeat the question? For, is it, let me see how I want

03:22to ask this question. I'm trying to get somewhere. Can I be discriminated against

03:26for providing care if I had cancer? For not providing you care? Yes. Again, you

03:36have to put it in context. Is that, is the person working in a place that holds

03:40itself out as providing cancer care? As a woman, if I, I guess I'm trying to get to the point, if I

03:45had cancer, if I had heart disease, if I had a mental health condition, if I had

03:50osteoporosis, could a doctor, would a doctor be investigated for providing

03:56care? Would I be investigated for seeking care? Would I be investigated for

04:00obtaining care? I think, I think I hear, if they're receiving reimbursement from

04:05the federal government, then they would have to offer you the care. So if I,

04:08unless they have a religious objection. If I sought, if I sought abortion care,

04:13would I have the right to have that care or a doctor deny me that care? You would

04:19have the right to have that care if it, if they're seeking reimbursement by a

04:24federal Department of Health, Medicare or Medicaid, if it's required by law. Thank

04:30you. If it's required by law, thank you. My last, in my last few seconds, I do want

04:35to bring up something that I've heard talked about on the other side a lot

04:39about the care of unaccompanied minors at the border. I, I want to remind my

04:45colleagues that in the last administration, we had a crisis of

04:48understaffing, of children being lost, of us not really knowing, and I want to

04:52commend the department for some of the work that they've done to improve these

04:55programs. 24-7 caseworkers, increased shelter networks, increased post-release

05:00services. My time is running out, but I want to say that unlike the child

05:06welfare system, you don't have the ability to monitor children after they

05:10leave your custody, even if they are with a vetted sponsor. So I guess you could

05:15follow up and say what are some legislative fixes that Congress could

05:19make to make sure that our connection to these children goes beyond the point

05:25where they are turned over to family members or loved ones so that we can

05:28make sure that they are in fact safe and not falling victim to unsavory actors or

05:34trafficking or some of the other things that have been brought up in this

05:37committee hearing today. We'll invite Secretary to put those suggestions in

05:42writing.

Jahana Hayes: There Is No ‘Clear Guidance’ From HHS For Screening Health Care ‘Risk Factors’

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