U.S. Secretary of Health and Human Services Xavier Becerra talks health in Cottonwood

U.S. Secretary of Health and Human Services Xavier Becerra held a town hall at the Cottonwood Recreation Center on Wednesday, Aug. 7. Roughly a hundred residents showed up for the occasion.

The forum was hosted by U.S. Department of Agriculture Rural Development State Director Charlene Fernandez with additional comments from San Carlos Apache Tribe Department of Health and Human Services Executive Director David Reede, Cottonwood-based Steps to Recovery Executive Director Damien Browning and Northland Cares Executive Director Johnny Martinez.

Becerra said that the results of what he described as a first-ever negotiation between the federal government and unnamed pharmaceutical companies would likely be announced within the next couple of weeks.

“We have never, under the Medicare program, been allowed by law to negotiate to lower the price of drugs,” Becerra said. “We as Americans pay about two to three times more than most people around the world for the same drug. Oftentimes, that same drug is actually manufactured here in the U.S.”

Becerra’s remarks referred specifically to Medicare Part D, established in 2006, which prohibited the Centers for Medicare and Medicaid Services from negotiating drug prices for 50 million seniors. The federal government has in fact been negotiating drug prices since at least March

1989, when the National Institutes of Health added a reasonable pricing clause to its research and development agreements with private firms. The requirement was rolled back in 1995 due to industry lobbying.

The brand names of the drugs included in the current negotiation, which ran from February through Aug. 1, included Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara and Fiasp. Another round of negotiations for next year will bring the total number of price-negotiated drugs to 15, with the total expected to rise to 20 by 2030.

“The most that Medicare recipients will pay out of pocket for any and all [of] their medication will be $2,000 for the year,” Becerra said with regard to the changes planned for 2025.

Becerra also touted the Biden administration’s rollout of COVID-19 vaccines in rural areas and said that the administration wants to extend policies enacted during the COVID-19 pandemic response that removed geographic restrictions on which patients could make telehealth appointments rather than being required to travel to a health care facility. The exemptions are currently set to expire on Tuesday, Dec. 31.

Martinez subsequently said that telehealth services have been crucial in ensuring that Northland 

Cares has been able to continue to serve about 25% of the 270 patients who see its two physicians.

“[Telehealth] helps our clients reach these services a lot easier, especially when they can’t drive in,” Martinez said. “Because, you have people that are working daily and they’re constantly having to drive to appointments, [which] can sometimes be all-day events. Which is challenging if you’re traveling from Ash Fork. During [the] COVID [pandemic] it helped people to still be able to see our doctors, especially if they were showing symptoms or they were positive for COVID, they were still able to keep up with their appointments … In order to stay adherent [sic] with medications and with their regimen, they have to be able to see our doctors on a consistent basis. So telehealth really helps to break down a lot of those barriers.”

Kent Ellsworth, of the Sedona-based Verde Valley Caregivers Coalition, subsequently said that VVCC has been monitoring House Resolution 8261, proposed federal legislation that would extend telehealth location flexibility. The bill passed out of the U.S. House of Representatives Ways and Means Committee in May by a unanimous vote.

“We get people to medical appointments and health care locations every day. We’ve given people a ride to over 700 health care locations in the last 12 months,” Ellsworth said, expressing concern that an end to telehealth flexibility would put a further strain on his nonprofit.

“We’re trying to have Congress give us the flexibilities that we’ve had under COVID … to continue to provide telehealth,” Becerra said. “Because we found that telehealth was the most useful to folks in rural America … We need Congress to change the law, because today, the statutes don’t let us have that flexibility … Congress extended those emergency flexibilities. Now that the [COVID-19] public health emergency is gone, they extended it to the end of this year … If Congress does not pass a law to extend those flexibilities, hopefully permanently, then we cannot allow physicians … to continue to use telehealth the way we have.”

Browning, of Steps to Recovery, which recently celebrated its 11th year of operation, discussed how receiving $3.2 million in loans from USDA, $400,000 of which came from a loan originally made by the Arizona Community Foundation before the loan was bought out by USDA, had allowed the organization to make major capital improvements to its program, such as the purchase of a new mens’ facility, and how grants for job development and COVID-19 testing had improved residents’ lives.

Martinez outlined how HHS supports his organization by passing grants down to the Health Resources and Services Administration, which administers the Ryan White HIV/AIDS Program and provides Northland Cares with $900,000 in grants annually. They also receive a Centers for Disease Control prevention grant that provides $109,000 in annual funding.

“You need to insist to see not just the representatives, but the cabinet members in your community,” Becerra said several times during the forum. “It is tough to come to Cottonwood. It is tough to get out into rural parts of America, but it is something we must do, and you simply need to insist.”

Becerra did not identify any planned future visits by members of the cabinet to Yavapai County when asked by Larson Newspapers.