Tom Price confirmation hearing for health secretary: the key points

The former orthopedic surgeon, who has hardline stances against abortion, gay marriage and Obamacare, is being scrutinized for purchasing health stocks

Tom Price

Health and Human Services secretary

Background

Representative Tom Price has spent his political career as a penny-pinching, ideologically driven physician, who rarely crossed party lines on key votes. He is one of President Trump’s most controversial cabinet picks, because of his hardline stances against abortion, same-sex marriage and the Affordable Care Act. Even the medical community is split on Price’s 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 Health and Human Services Agency, overseeing everything from food safety to epidemic crisis management. He would also be in charge of administering the nation’s largest public insurance programs, which he has spent his career attempting to downsize.

This is Price’s second hearing, and it’s the one that matters. Price had a previous hearing before the Senate’s health committee, but the finance committee approves his nomination.

Key points to watch for

Obamacare repeal plan: Price helped author Republicans’ most comprehensive Affordable Care Act (“Obamacare”) 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.

The problem is, that imperils many of the ACA’s 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 a previous illnesses (neither of these things were required before Obamacare).

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

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. The company holds no patents, but has one drug in development to treat an advanced form of multiple sclerosis. Its largest investor is New York Republican congressman Chris Collins, who was part of Trump’s transition team, and other investors are connected to Collins. The deal occurred while negotiations on the 21st Century Cures Act were ongoing. A Trump transition spokesman told the Wall Street Journal that Price “complied fully with all applicable laws and ethics rules”, and Price said he “had no access to non-public information” during his first Senate hearing.

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

Price’s 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.

Cuts to Medicare and Medicaid: Price’s 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 even 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 Pence’s home state of Indiana, proposed work requirements for Medicaid. The Obama administration blocked them.

In general, Price and other Republicans have attempted to push commercial insurance-like provisions onto Medicaid recipients in the name of having “skin in the game”. Indiana was successful in instituting a tenet of commercial insurance – the premium. Premiums are monthly payments people make to ensure their health insurance does not lapse. In Indiana, even the state’s poorest citizens – people with no income – are required to pay $1 per month to maintain coverage, and they can be locked out of insurance if they miss payments.

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

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

Women’s 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 that 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 Women’s Law Center. Pregnancy was considered a pre-existing condition. The ACA made contraception available to women for no “copay” or prescription charge.