Rep. Steven Horsford grilled Health and Human Services Secretary Alex Azar about the administration’s proposed budget cuts, which he believes would exacerbate Nevada’s doctor shortage and lead to rising prescription drug costs.

During the House Ways and Means Committee hearing Thursday, Horsford said the proposed budget cuts by the administration would cut the Graduate Medical Education (GME) program by $52 billion over the next 10 years.

“This does not work for my home state of Nevada. We need more doctors — not cuts to the very program that trains them,” Horsford said in the hearing. “Nevada needs us to strengthen and expand the GME program, not make billions of dollars in cuts to it to eliminate the opportunity for new doctors to train and stay in our State. How do you justify this to Nevadans who desperately need to see a doctor but cannot find one?”

Nevada ranks 48th per capita in the nation for primary care doctors in 2018, according to a report by the University of Nevada Reno School of Medicine. There are a little over 180 full-time doctors in Southern Nevada per 100,000 residents, compared with 303 per 100,000 on average in the U.S. UNLV’s newly accredited medical school has been promoted in an effort to close that gap.

The Trump budget also turns its back on the president’s promise to lower drug prices, including a target of only $135 billion in savings for prescription drugs— falling much lower than the estimated $500 billion in savings under legislation passed by the House, which would give Secretary Azar the power to directly negotiate lower drug prices for all Americans.

“I literally have parts of my district in the rural areas that do not have OBGYN services available and there are only 250 OBGYN’s in the entire state of Nevada,” Horsford said.

Azar argued that the “more flexible fund” proposed in the budget would allow states to “refocus primary care on OBGYN and rural” which he said would benefit the state despite the cut in funds.

“Your state might actually benefit from those changes,” Azar said.

“No, we won’t,” said Horsford. “We need more resources, not less.”

Earlier in the week, Democrats and some Republicans sharply questioned Azar about whether a $2.5 billion spending plan was enough to combat coronavirus cases in the U.S., and repeatedly questioned Azar about a shortage of millions of face masks for health care workers that would be needed in the virus spread.

“This is not the time to try to shortchange the American people … This is the time to step up,” said Republican Alabama Sen. Richard Shelby of the spending plan.