[Note: This report was co-authored by deputy biotech editor Ben Fidler.] Tom Price, the man who could oversee an overhaul of the U.S. healthcare system, answered often pointed questions this morning from U.S. senators about his views, his plans for Obamacare, and personal financial transactions.
Price, an orthopedic surgeon by training, is President-elect Donald Trump’s nominee for Health and Human Services Secretary. He would run the $1.1 trillion department that houses the nation’s medical insurance programs Medicare and Medicaid, the Food and Drug Administration, the National Institutes of Health, the Centers for Disease Control and Prevention, and more. With the repeal of the Affordable Care Act, or Obamacare, under way, former U.S. Senator Norm Coleman said last week that the nation’s health and medical systems were on the brink of “as great a moment of change as I’ve ever experienced in my four decades of public service.”
A U.S. congressman from Georgia since 2004, Price has been one of Obamacare’s most vocal opponents. As chair of the House Budget Committee, he has authored budget proposals of his own. He is fervently anti-abortion, with a 100 percent rating from the National Right to Life Committee and a zero from Planned Parenthood—which could lose its federal funding in the next Congressional session. He has also questioned whether federal insurance should pay for contraception.
Much of the fodder used by the committee’s Democrats to grill Price came from Price’s presumptive boss. Several of Trump’s public statements about healthcare have gone against conservative orthodoxy, such as promises not to cut Medicare and Medicaid funding, and last week’s promise to allow Medicare to negotiate drug prices that sent biopharma stocks tumbling.
Price sidestepped full agreement with Trump several times but said he would work to carry out the president’s wishes. “We need to find solutions” to problems like the cost of pharmaceuticals, he said, “and perhaps one way” is through negotiation. Sen. Bernie Sanders (I-VT) asked if Price and Trump would join Democrats and work on legislation not just to allow Medicare negotiation but also the importation of less expensive drugs from Canada and other countries.
Price said that there are many reasons for high drug costs in the U.S., and that “if we get to the root cause of what that is then I think we can actually solve it in a bipartisan way.” But he stopped short of saying he’d work with Democrats on the type of legislation Sanders proposed. “You have my commitment to work with your and others to make certain that the drug pricing is reasonable and that individuals across this land have access to the medications that they need,” Price said.
It’s unclear how Trump’s expanding record of pledges, comments, and tweets will translate into administration policy. “But we should assume that Price will do what Trump says,” says Adams Dudley, director of the Center for Healthcare Value at the University of California, San Francisco.
If the Trump administration in fact stumps for drug-price negotiation, Congressional Republicans will likely fight the effort. “It would come down to the president and an awful lot of support from the public,” said Dudley. “It means [Trump] using a lot of elbow grease to make a major push in Congress.”
Many of the questions today from the Health, Education, Labor and Pensions (HELP) Committee were dedicated to the repeal of Obamacare, which has already begun. There seems to be much less daylight between Trump, Price, and Congress on the issue. When asked about individual parts of Obamacare—such as mandatory coverage for substance abuse and mental health treatment, mandatory coverage for people with pre-existing conditions, or the rule to let young adults stay on their parents’ insurance to the age of 26—Price mainly averred, saying the fate of those details would be a “legislative decision.” (On mental health and substance abuse coverage, he told Wisconsin Democrat Tammy Baldwin that “he looked forward to working with you to make sure it continues.”)
As the repeal process began last week, Senate Democrats tried to preserve existing versions of certain Obamacare provisions but were voted down. Price said today he was committed to all Americans, even the 20 million still without insurance, getting access to insurance. There have been different words used lately by various Republican leaders to describe the timing of the so-called “repeal and replace” process. Trump, on 60 Minutes recently, said it would be done at the same time, while Mitch McConnell (R-KY) said “promptly but in manageable pieces.” Without providing details, Price indicated that there wouldn’t be a gap between the ACA and the new plan Congress puts together. “Nobody is interested in pulling the rug out from under anybody,” Price said. “It’s imperative that people with health coverage keep coverage and hopefully move to more choices for them and their families.”
Price said Tuesday issues with healthcare costs, accessibility, and choices—being able to see the doctor you want—are at the “heart and center of where we ought to be putting our attention.”
The market for individual insurance—the roughly 18 million people aren’t on Medicare or Medicaid plans, and don’t have insurance through their jobs—is in a “downward spiral” due to increasing costs and lack of options for patients, he said. “Patients are making decisions about not getting the kind of care they need because they can’t afford the deductible,” Price said.
Democratic senators also grilled Price over potential ethical breaches. They brought up allegations that he benefitted from inside information when trading the stock of Australian biotech Innate Immunotherapeutics. (Rep. Chris Collins (R-NY) is also under fire for his large ownership of the same company, which could benefit from new rules to speed up drug trials passed recently in the 21st Century Cures Act.)
They also questioned the timing of Price’s stock purchases in several biotech companies, including joint replacement manufacturer Zimmer Biomet Holdings (NYSE: ZBH). The Zimmer purchase came just days before he proposed a bill, the HIP Act, that would help the company. Price denied all impropriety and said his broker made the purchases without his knowledge. Still, Sen. Patty Murray (D-Wash) called for an independent investigation into the transactions.
Senators also challenged Price on his budget proposals that would cut Medicare spending by $449 billion and Medicaid funding to state governments by more than $1 trillion over the next 10 years, despite Trump’s assertions that such funding won’t be cut. Price didn’t address Trump’s comments specifically, saying instead that money isn’t the “metric” used to judge the success of those programs. “What we believe is appropriate is to make certain that the individuals who are receiving the care actually receive the care,” he said.
The HELP Committee won’t vote on Price’s nomination; that task goes to the Senate Finance Committee next Tuesday.