President Trump’s nominee for Secretary of the Department of Health & Human Services (HHS), Congressman Tom Price (R-Ga.), has now completed two confirmation hearings in the Senate. If confirmed, Rep. Price will direct more than $1 trillion of annual spending, as well as assist in developing and implementing a replacement for the Affordable Care Act (ACA). First, the Senate Committee on Health, Education, Labor & Pensions (HELP) held a courtesy hearing January 18, and then the Senate Finance Committee, which has jurisdiction over the nomination, held its hearing January 24. The following is a summary of what we learned – or did not learn – over the course of those hearings.
Rep. Price testified he is committed to the medical research carried on at HHS. He specifically praised the work of the Food and Drug Administration (FDA), National Institutes of Health (NIH), and the Centers for Disease Control and Prevention (CDC). He appeared committed to the United States continuing to lead the search for innovation and breakthroughs in healthcare.
Despite being pressed for details over the course of the hearings, Rep. Price declined to go into specifics of a plan to replace the ACA. However, he did cite aspects of the law he perceives as problematic, including the government second-guessing physicians on how to treat patients; excessive paperwork and regulatory burdens for providers; the individual mandate; increased premiums combined with decreased quality of care; and lack of provider choice in many U.S. counties.
When pressed about whether a replacement would maintain the status quo on covering those with pre-existing conditions and covering women’s contraceptives, Rep. Price declined to give a specific answer. However, he seemed open to continuing to cover preventive care and mental health care, as well as open to allowing insurers to offer high-deductible catastrophic plans. Finally, while not promising “coverage” for all, he did commit to “access” for all. It is important to note that there is not yet consensus on how the Administration and Congress will proceed with respect to the ACA. It appears Rep. Price and President Trump have not yet ironed out the details of a replacement plan.
When asked about Medicare, Rep. Price would not commit to President Trump’s promise not to make cuts to the program. When asked about his past proposals to turn Medicare into a system of vouchers that individuals would use to purchase care, Rep. Price was noncommittal. Although he did say he did not expect the ACA repeal and replacement effort to include Medicare reform.
Whether the ACA replacement would convert Medicaid into a system of block grants was another significant topic of discussion. Basically, under block-granting, states would get fixed federal grants to cover their Medicaid-eligible population. Although Rep. Price would not commit to whether this sort of Medicaid reform will be present in the ACA replacement, President Trump has previously endorsed the idea of turning Medicaid into a block-grant system.
Finally, Rep. Price’s past healthcare and medical stock trading was a hot topic in both hearings, mostly along party lines with Republicans defending Price’s record and Democrats attacking it. Although the issues regarding Rep. Price’s stock trading are likely to continue throughout his confirmation, the Republican majorities on the Finance Committee and in the Senate as a whole make it likely that Rep. Price will have the votes to be confirmed. At this time, the date of Rep. Price’s confirmation vote has not been set.