Original article via Partisan Jousting Marks Price Hearing for HHS Post
WASHINGTON — Pres. Trump’s nominee to lead the Health and Human Services Department, Rep. Tom Price, MD (R-Ga.), endured another round of aggressive questions from Democrats during a confirmation hearing before the Senate Committee on Finance on Tuesday.
Both the president and the vice president are on the record saying Price will be a critical player in designing a replacement for the Affordable Care Act, which Trump ordered repealed in an executive order signed Jan. 20, so Democrats attacked with a laser focus.
A former orthopedic surgeon, Price’s own plan “The Empowering Patients First Act” includes common Republican themes: buying insurance across state lines, establishing risk pools, and offering refundable tax credits instead of subsidies to make coverage more affordable.
Committee chairman Sen. Orrin Hatch (R-Utah) said Price had “the experience and the qualifications necessary” to run the vast agency which includes the Centers for Medicare and Medicaid Services, the National Institutes of Health, and the FDA and CDC.
Hatch said Price has been the target of “grossly exaggerated and distorted attacks,” referencing Senate Democrats’ investigation into Price’s stock trades as well as aggressive questioning last week during a “courtesy hearing” before the Senate HELP Committee.
“I have never seen this level of partisan rancor” Hatch said.
The Affordable Care Act and the administrations’ promised repeal were front and center during the discussion.
Sen. Ron Wyden (D-Ore.), the ranking minority member of the committee, asked Price whether he would guarantee that no one would lose coverage, under the executive order that Trump issued on Friday — an order that directed government agencies to “change, delay or waive provisions of the law that they deemed overly costly.”
He also demanded that Price to promise he would not enact any such changes before a replacement had been implemented.
To which Price said he would ensure “every single American has access to affordable healthcare.”
As with last week’s Senate Committee on Health, Education, Labor and Pensions (HELP) hearing, Price returned to the term “access” again and again, when asked about guaranteeing coverage for any certain population. Several Senate Democrats underscored that “access” to coverage, does not equal coverage.
Sen. Mark Warner (D-Va.), cited Trump’s promise of “insurance for everybody” alongside other commitments: to continue the ban preventing insurance companies from discriminating against those with pre-existing conditions and to continue to allow individuals under 26 years of age to stay on their parents’ health insurance.
Warner was one of several senators to press the question of continuing the ban on insurers charging more or excluding those with pre-existing conditions.
While Price promised not to abandon such individuals, when asked by Sen. Pat Toomey (R-Pa.) whether that meant preserving the guaranteed mandate, Price allowed that “there are other options.”
Price said high-risk pools were helpful for those with pre-existing conditions.
Sen. Debbie Stabenow (D-Mich.) said that approach had been tried for 35 years, and “frankly it didn’t produce good results,” she said, noting that high risk pool premiums were 150-200% higher than standard rates.
Healthcare for Children
Medicaid and access to healthcare for children, were among Sen. Bob Casey (D-Pa.) key questions. Casey noted that the percent of uninsured children under 18 fell from 7.1% to 4.8% under the ACA and the Children’s Health Insurance Program (CHIP) and he asked Price to pledge that it would remain at that level or improve.
Price told the committee he was committed to lowering the rate of uninsured children and adults.
However Casey questioned how Price could make such a pledge while endorsing combined cuts to Medicaid and CHIP of close to $1-trillion in the 2017 Budget. As chair of the House Budget Committee, Price had allowed such cuts to be enacted, several senators noted.
“You all are looking at this in a silo. We believe it is possible to imagine and put in place a system of greater coverage,” Price said.
Sen. Claire McCaskill (D-Mo.) pressured Price to clarify his position with more details: Is he or isn’t he in favor of block grants?
Again, Price hedged, “I’m in favor of making certain that Medicaid is a system that responds to patients not the government.”
Sen. Bill Cassidy, MD (R-La.), later clarified that there are different ways to structure Medicaid reform including per beneficiary payments, which is how the federal employees health benefit program works.
Sen. Johnny Isakson (R-Ga.) stressed that Price understood the value of Medicare and was not plotting to privatize the program.
Price for his part promised to “save and strengthen” the program, noting that it will go broke if nothing is done to fix it.
Few Democrats on the committee were heartened by these statements and believe Price like Speaker Paul Ryan (R-Wis.) favors a plan to shift the program from a social insurance program supported with payroll taxes providing defined benefits to a voucher system. Ryan argues such a program would allow seniors more options.
Stabenow said her 90-year-old mother, a Medicare beneficiary, doesn’t want more options “she just wants to keep her care.”
Innovation and Science
A few senators peppered Price with questions about the Centers for Medicare and Medicaid Innovation (CMMI) program, which Price argued has “gotten off track a bit.”
Price said he would not endorse mandatory programs such as the Part B Demonstration, which dictated to physicians what drugs to provide or how to perform certain procedures — likely referencing the Comprehensive Care for Joint Replacement Rule . He however, clarified that “bundled payments make a lot of sense,” for certain populations.
Price said he supported innovation and hoped to move CMMI “in a direction that made sense for patients.”
Conflicts of Interest
Two weeks ago, CNN reported Price had bought shares in Zimmer Biomet, a medical device manufacturer, in March 2016, and within a week introduced a bill that would have delayed regulations that could have negatively impacted the company. Democrats had called for an ethics probe into Price’s stock holdings in early January.
Wyden charged that Price had “significantly undervalued” stock in Innate ImmunoTherapeutics, an Australian company which was planning to seek FDA approval for one of its products.
Wyden said the total value of Price’s stocks in Innate exceeded a half million dollars, but Price disclosed owning less than $50,000. “This company’s fortunes could be affected directly by legislation and treaties that come before Congress,” Wyden said.
Price said he all his actions were “aboveboard” and that other discrepancies could have been due to a “clerical error.”
Hatch defended Price’s investment behavior as did Isakson, who alleged that Wyden himself had questionable healthcare investments in BlackRock Funds.
Wyden retorted that mutual funds are “a completely different category” from individual stocks.
No confirmation vote by the committee has been scheduled yet. If Price’s nomination is approved, which is widely expected, it would then go to the full Senate for a final vote.
Joyce Frieden contributed to this article.