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From Health Law Daily, January 24, 2017

Do Price’s political beliefs override his qualifications for HHS Secretary?

By Kathryn S. Beard, J.D.

Rep. Tom Price (R-Ga), President Donald Trump’s nominee for HHS Secretary, is well respected by his Congressional colleagues, but many Democrats have concerns about Price’s legislative record. In a bitterly partisan hearing before the Senate Finance Committee on January 24, 2017, Price, a licensed physician and orthopedic surgeon, fielded questions for four hours. Price attempted to distinguish between the work done by a member of Congress—writing laws—and the work done by a cabinet-level Secretary position—implementing laws and policy. He characterized many questions that he said looked at an issue as if it took place "in a silo," that is, without regard to outside issues or other legal or regulatory changes that would make up for the perceived negative impacts of a potential policy change.

In addition to questions about Price’s views on Medicare, Medicaid, and the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148), as well as laws written or sponsored by Price and comments made by him during his Congressional career, Price was grilled on a Washington Post article that raised questions about his investments in health-related companies. This was the second hearing held on Price’s nomination; the Senate Committee on Health, Education, Labor and Pensions questioned him last week (see Is HHS Secretary too high for Price?, January 19, 2017). Although both committees have jurisdiction over HHS, the Finance Committee will determine whether it approves of Price before sending the nomination to the full Senate for a vote. For cabinet-level positions, including HHS Secretary, only a simple majority is required to consent to the appointment.

The hearing began with statements from Chairman Orrin Hatch (R-Utah), who said that Price has the necessary experience and qualifications to be HHS Secretary, but cautioned that the "current political environment" is such that experience and qualifications do not seem to matter to Price’s opponents. Ranking Member Ron Wyden (D-Ore) spoke next, questioning whether allegations about Price’s investments constitute abuse of his position in Congress, and calling Price "the architect of repeal and run," or the concept of repealing the ACA but delaying repeal until a suitable replacement can be passed. Price’s statement revealed that he is honored by the nomination to help with HHS’ "critical work," and shared his six principles of health care: affordability, accessibility, quality, responsiveness, innovation, choices.

For many questions, Price declined to provide definitive statements about the results of potential changes in health care law because of the inherent uncertainty of such guesses. When asked about President Trump’s ACA-related Executive Order (see Trump Administration previews health care plans with Executive Order, regulatory freeze, January 23, 2017), Price would not commit that no one would be worse off or guarantee that no one would lose coverage. Instead, he said, "I guarantee that those who lost coverage under the ACA won’t lose it under whatever happens." Sen. Sharrod Brown (D-Ohio) said that his understanding was that only two to four million individuals lost their coverage under the ACA, and most of those have since been reinsured, and pressed Price for a firm answer about the 20 million Americans who gained coverage under the ACA.

Many questions were related to the problems rural areas face in providing coverage, providers, and coverage choices; Price agreed that it is a serious problem, and looks forward to working with states and Congress to seek innovative solutions. He repeatedly noted that merely because a single solution to a problem has been suggested or put in place does not suggest that there are no other viable solutions, and indicated that he would seek as many possible solutions to problems as possible.

Additional questions related to privatizing Medicare, Medicaid block grants, the prevalence of false medical claims (e.g., the popular but false beliefs that vaccines cause autism or abortions cause breast cancer), extension of the Children’s Health Insurance Program (CHIP), and the Indian Health Service (IHS). Most senators questioning Price brought up specific worries faced by their constituents, including fears of losing coverage due to pre-existing conditions, and not being able to visit the health care providers they want to visit.

Price also reiterated his belief in mental health parity, providing seniors with health care, and seeking a path to negotiate prescription drug prices. Overall, there were very few questions about the non-CMS agencies that would fall under Price’s jurisdiction in HHS, including the FDA, the National Institutes of Health, the Centers for Disease Control and Prevention, and the Office of Inspector General. Price did get a laugh from the crowd in the hearing when Brown asked, "President Trump said he’s working with you on a replacement plan for the A.C.A., which is nearly finished and will be revealed after your confirmation. Is that true?" Price responded, "It’s true that he said that, yes."

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