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Tom Price confirmation hearing for health secretary: the key points

The longtime Obamacare critic slammed the current system but did not provide details on what a replacement might look like under Trump


Tom Price

Health and human services secretary

Background

Representative Tom Price has spent his political career as a penny-pinching, ideologically driven physician who has rarely crossed party lines on key votes. He is one of Donald Trumps most controversial cabinet picks, because of his hardline stances against abortion, same-sex marriage and the Affordable Care Act (ACA, also known as Obamacare). The medical community is split on Prices appointment.

Before his career in politics, Price was an orthopedic surgeon in a well-heeled suburb north of Atlanta, Georgia. His wife, Betty, also a doctor, serves as a Republican member of the Georgia house of representatives.

If confirmed, Price would head the sprawling $1.1tn Department of Health and Human Services, overseeing everything from food safety to epidemic crisis management. He would also be in charge of administering the countrys largest public insurance programs, which he has spent his career attempting to downsize.

This is Prices second hearing, and its the one that matters. Appearing before the finance committee, which holds the power to approve his nomination, Price was diplomatic and respectful, without revealing much about his views or what the new administrations healthcare plans will look like.

Key points and takeaways

Obamacare repeal plan: Price helped author Republicans most comprehensive ACA replacement plans, and Democrats will look for clues about what Republicans new plan will include (as well as its weaknesses).

A term that will likely be heard again and again is access. Where Democrats strived for all Americans to have insurance, Republican alternatives have strived for all Americans to have access to coverage. In other words, Republicans want people to have the option, but not the requirement, to buy insurance.

That imperils many of the ACAs most popular provisions, such as a guarantee that young adults can stay on their parents insurance until they are 26 years old, or a requirement that insurance be sold to people even if they have had previous illnesses.

Trump has also contradicted his nominee, promising insurance for everybody in an interview with the Washington Post.

During Tuesdays hearing, Senate Democrats repeatedly pressed Price on what the replacement plan for Obamacare would look like under Trump, but he declined to provide any specifics. Ohio senator Sherrod Brown asked if it was true that Price and Trump were working together on a plan, to be revealed after Prices confirmation. Its true that he said that, yes, Price said, to laughs from the room. After Brown asked if Trump lied, Price said, I have had conversations with the president about healthcare, yes.

Price, a longtime ACA critic, slammed the current healthcare system. Many individuals have coverage, they have a card, but they dont have any care … Its imperative we have a system that is accessible for every American, affordable for every American, he said, without providing any additional detail on what that might look like.

Stocks, docs and devices: In his first hearing, Price was pressed on his purchase of health stocks while he was a leading voice on health policy in the House of Representatives, and the subject is likely to come up again.

His most notable purchase was for an Australian company called Innate Immunotherapeutics, where he bought between $50,000 and $100,000 of stock at a discount(it is now worth around $500,000). The company holds no patents, but has one drug in development to treat an advanced form of multiple sclerosis. Its largest investor is the New York Republican congressman Chris Collins, who was part of Trumps transition team, and other investors are connected to Collins. The deal occurred during negotiations on the 21st Century Cures Act.

The former surgeon has advocated on behalf of laws that benefit doctors, including limits on medical malpractice suits.

Prices other investments include $15,000 of stock in Zimmer Biomet, a producer of joint replacement devices. It was purchased less than a week before he introduced the HIP Act, which would have delayed reforms that would have cost the device company money, though the legislation died in committee. An aide told CNN that Price was unaware of the transaction because a broker managed his account.

During Tuesdays hearing, Democratic senator Ron Wyden quizzed Price repeatedly on his Immunotherapeutics stocks, asking him if his purchases of stocks while sitting on committees responsible for healthcare policy shows bad judgment. Price responded that everything I did was above board, ethical, legal and transparent, noting that there wasnt any maliciousness involved in saying his stocks were worth between $50,000 and $100,000 when in reality they are worth nearly half a million dollars, as I thought it meant the time at which I purchased the stock.

Republicans jumped in to defend Prices financial investments. Senator Richard Burr of North Carolina noted that he believed the nominee made his financial disclosures public as asked and yet was getting criticized by the Democrats: Does it burn you that they want to hold you to a different standard? he asked. Price replied: We know whats going on here. And I understand. And as my wife tells me, I volunteered for this.

Tom
Tom Price, testifies on Capitol Hill in Washington, Tuesday 24 January. Photograph: Andrew Harnik/AP

Cuts to Medicare and Medicaid: Prices past proposals to replace the ACA have been radical.

He proposed changing Medicaid, a health program for the poor, into a block grant, something experts say and history shows would almost certainly precipitate cuts. He has advocated for privatizing Medicare, a public health program for the elderly. And he has voted against expanding public health programs that insure impoverished children.

Price has also advocated adding work requirements to Medicaid for able-bodied adults. Some states, such as vice-president Mike Pences home state of Indiana, proposed work requirements for Medicaid. The Obama administration blocked them.

At Tuesdays hearing, numerous senators questioned Price on Medicaid. After queries from Democrat Bob Menendez, Price said Medicaid was a vital service but one that has significant challenges, noting that one in three physicians who should have been accepting Medicaid would not do it.

McCaskill and other senators pressed Price on whether he was in favor of block grants, which give states a set amount of money to spend on Medicaid.

Im in favor of making certain Medicaid is a system that responds to patients, not the government, Price said. McCaskill continued on the topic later, noting that Price served as chairman of the budget committee and the 2017 budget pushed for block grants. You said over and over again that you favored block granting Medicaid … you cut Medicaid by a trillion dollars in your 2017 budget. And yet today you want to stand on some notion of whatever you guys do is fine. And thats just not reality, Congressman. Whats reality is youve been chosen for your beliefs and your beliefs are reflected by your budget that you wrote as chairman of the committee.

Price objected to the Washington Democratic senator Maria Cantwells suggestion that the administration is creating a war on Medicaid. I would respectfully, Senator, take issue with your description of a war on Medicaid, Price said. What we desire and want to do is make certain that Medicaid population is able to receive the highest quality care.

Controlling drug prices: Trump has advocated for foreign imports of prescription drugs and government negotiations with drug companies Price has voted against both.

Its another issue in which the president and Price find themselves on opposite sides. Allowing the federal government to negotiate drug prices through the Medicare program has typically been a Democratic platform, and its one that Democrats will push as good policy during Prices hearing.

During the hearing, Wyden asked Price about Trumps plan to lower the price of medicine through negotiation with drug companies, which Price has opposed in the past. Were committed to making certain that drug prices are able to be afforded by individuals, Price said. After a tense exchange with Wyden, he added: I think it is important to have the conversation and look at whether or not there is a better way to do that. If there is, then Im certainly open to it, Price said.

Womens healthcare: At every turn, Price has attempted to shut doors to abortion access. He voted in favor of the Pain-Capable Unborn Child Act, which would have banned abortion at 20 weeks.

Price is in favor of defunding Planned Parenthood, and introduced a bill to do so through the budget reconciliation process, which was vetoed by Obama last year.

A repeal of the ACA would have drastic impacts for women. Before the ACA went into effect, women paid more for insurance simply because they were women, according to the National Womens Law Center. Pregnancy was considered a pre-existing condition. The ACA made contraception available to women for no copay or prescription charge.

Asked about ensuring access to free contraception, Price said during the hearing: I think contraception is absolutely imperative for many, many women and the system that we ought to have in place is one that allows women to be able to purchase the kind of contraception they desire.

Menendez questioned Price on some dangerous health myths, including whether abortions cause breast cancer and whether vaccinations cause autism. Price responded by pointing to the science, which overwhelmingly says no. Menendez asked if Price would debunk false claims regarding public health, to which the nominee responded that he would do due diligence in providing factual public health information based on science.

Mazin Sidahmed contributed to this report

Read more: https://www.theguardian.com/us-news/2017/jan/24/tom-price-confirmation-hearing-live-key-points