Alex Azar (Photo: Senate HELP) Alex Azar (Photo: Senate HELP)

The Senate might be about to confirm a U.S. Department of Health and Human Services (HHS) chief who is opposed to the Affordable Care Act essential health benefits (EHB) coverage mandate, and to the idea that all major medical policies should cover maternity and newborn care.

Sen. Debbie Stabenow, D-Mich., made that observation today on the Senate floor, during a discussion about whether the Senate should clear the way for debate on the nomination of Alex Azar II to be the next HHS secretary.

Azar is a former pharmaceutical executive.

Members of the Senate ended up voting 54-43 to adopt a “cloture motion,” or time limit on debate about the nomination. The Senate is preparing to begin final consideration of the Azar nomination around 2:15 p.m.

(Related: HHS Nominee Backs Interstate Health Coverage Sales)

Most Republicans who voted backed the cloture motion, and most Democrats who voted opposed it.

Five Democrats, and one independent who normally votes with the Democrats, crossed party lines to support cloture.

Sen. Rand Paul, R-Ky., cast the only Republican vote against cloture.

Stabenow, who voted against the cloture motion and said she strongly opposes the Azar nomination, said that, when she questioned Azar, he appeared to be vague about whether he supports either the Affordable Care Act EHB benefits mandate or a federal requirement that health insurance cover maternity and newborn expenses. Affordable Care Act EHB Mandate

Drafters of the Affordable Care Act developed the EHB package in an effort to ensure that all individual and fully insured small-group major medical coverage sold provides solid coverage, and in an effort to help consumers and others comparable major medical coverage on an apples-to-apples basis.

The EHB package includes 10 classes of benefits, including some, such as coverage for inpatient hospital and coverage for physician services, that were available through most major medical plans before the EHB rules took effect, in January 2014.

Before January 2014, some issuers of individual major medical coverage tried to hold claims, and premiums, down by leaving out coverage for a normal pregnancy and delivery. Supporters of that approach argued that most people should be able to save enough money ahead of time to pay for routine maternity care, and that major medical insurance should be used mainly to pay for large, unexpected medical expenses.

Opponents of no-deductible, or low-deductible, insurance coverage for routine maternity care argue that that approach reduces patients’ “skin in the game,” or out-of-pocket costs, and encourages providers to increase the cost of maternity care. Stabenow and Azar

Stabenow said that, when she asked Azar about the EHB package mandate, “He avoided really answering the question.”

Azar said that “he would, quote, ‘Work to ensure the least disruptive approach to implementing these policies, and to appropriately consider the concerns expressed by stakeholders that need health care, during the rule-making process,’” Stabenow said.

“We don’t need the ‘least disruptive approach’ to implement bad rules,” Stabenow said. “We need an approach that doesn’t disrupt people’s health care.”

Stabenow said she also asked Azar specifically about whether all health plans should be “required to cover maternity care and newborn care at no additional cost.”

“He once again ducked, saying only that, quote, ‘It is critical that every woman have access to high-quality prenatal care,’” Stabenow.

—Read CMS: Essential Health Benefits Benchmark Picks Due Sept. 30 on ThinkAdvisor.

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