Rep. Tom Price (R-GA), President-elect Donald Trump's nominee for HHS Secretary, found himself in the hot seat Wednesday during a courtesy hearing held by the Senate Committee on Health, Education, Labor & Pensions (HELP) to discuss his background in the healthcare system. Committee members grilled Price – who if confirmed would have influence over the agency's $1.1 trillion in annual spending – over concerns ranging from his ties to healthcare companies to his plans for repealing parts of the Affordable Care Act.
Price's congressional actions on healthcare legislation and his shares in dozens of healthcare companies caused some committee members to call into question his ability to responsibly address important industry issues such as Medicare drug pricing and the uncertain fate of the ACA. About 500,000 people across the U.S. have signed petitions opposing his nomination, according to ranking member Sen. Patty Murray (D-WA).
While many HELP committee members won't not have a final say in whether Price's nomination can be confirmed, those who are also members of the Senate Finance Committee will. Price's Finance Committee confirmation hearing has been set for January 24.
HELP Committee members' main concerns
Most of the questioning on Wednesday revolved around three themes regarding Price's record: Healthcare stocks, Republicans' spending blueprint and the stability of the individual insurance market.
Price's stock portfolio has been a media darling since his formalized nomination. Since late November, reports found Price traded about $300,000 in healthcare stocks while in Congress working on healthcare legislation. A Kaiser Health News recently reported he received "a sweetheart deal" from Innate Immunotherapeutics, an Australian biotech company, where it privately offered stocks to "sophisticated U.S. investors" instead of taking the stock to the public market. Most recently, news broke Price purchased between $1,001 to $15,000 worth of shares for Zimmer Biomet about a week before introducing legislation which could have financially benefited the medical device maker.
Murray said she has "serious concerns" about Price's healthcare stock trades. She stated she had wanted his nomination to be delayed until after completion of an investigation over his healthcare stock but "Republicans want to move forward with your nomination before we have all the facts." According to Sen. Al Franken (D-MN), the private Innate Immunotherapeutics offering was available to only 20 people. “I am very frightened about what you’re going to do and so are millions of Americans,” Franken said.
Price admitted he decided to purchase the Immuno stock after Rep. Chris Collins (R-NY) gave him information on the deal. This contradicts the Trump transition's team justification of the Zimmer Biomet purchase where they stated Price did not have a direct hand in trading his stocks.
A couple of attendees expressed support for his nomination, such as Sen. Johnny Isakson (R-GA) who argued Price contributed to the betterment of hospitals in Georgia by raising the necessary funds, and doing his homework "right" and "responsibly." Isakson also defended Price's "sweetheart deals."
Sen. Orrin Hatch (R-UT) dismissed the concerns over Price’s stocks, saying there are members of the committee who have also traded individual health stocks. When asked if he has always followed the law with regards to trading stocks, Price stated “everything has been transparent and legal."
Earlier this month, Price agreed to divest shares in more than three dozen healthcare companies if confirmed as HHS Secretary.
Last week, Price voted on a budget resolution that paves the way for repealing parts of the ACA, though Republicans have yet to settle on a replacement plan. Murray questioned why he would support the possibility of stripping millions of Americans of their insurance coverage despite wanting to expand access to more individuals. In response, Price echoed the Trump team's messaging that ACA repeal would not lead to lost coverage.
“We need to convey that nobody is interested in pulling the rug out from anybody,” Price said. “It is not our goal, desire or plan for individuals to lose their coverage.”
Trump recently said in an interview his goal is to have "insurance for everyone." There was some confusion about what he meant. Paul Ryan, quoted in Axios, took the national stage and stated what Trump meant was "we want to make sure everyone has access to affordable healthcare coverage regardless of their health condition."
Noting the realities that more individuals have signed up for premiums under the ACA, Republicans are changing the tone of their message surrounding ACA replacement. As Ryan's comment underscores, current GOP messaging is health coverage does not equal access to care services. This will be important to watch as ACA replacement plans take form.
Aside from the impact on the consumer market, the budget resolution would also increase the federal deficit by estimates upwards of $10 million, Sen. Michael Bennet (D-CO) stated. Price pushed back by committing to working with other members of the government “to be as fiscally responsible” as possible while tackling the country’s healthcare challenges.
Concerns over the individual market’s stability have surfaced in recent years because premiums have substantially increased in some markets (HHS confirmed an average increase of 25% for 2017's benchmark ACA plan premiums in October) while competition has also been dramatically reduced in varying locales across the U.S. Last month, Standard & Poor's Global Ratings estimated the premium hikes in the individual market this year were a "one-time pricing correction." However, some are not convinced. Sen. Lamar Alexander (R-TN), who believes a reform plan for the individual market should be in put in place by March 1, argued the market in his state is “very near collapse.”
Price agreed patients have been adversely impacted, but said he would work with Congress to develop a plan that would include recommendations to address these issues, such as putting in place high risk pools.
One thing on EHRs....
While Price's hearing largely focused on the hot button issues, Sen. Bill Cassidy (R-LA) inquired about Price's views on managing electronic health records (EHRs) at the federal level, Stat's On Call reported. It's no secret many in the industry have found the systems to be more trouble than they're worth (and they're worth millions in some installs) and can lead to administrative burnout among physicians. However, technology still holds the promise to help modernize and make workflows efficient in the care delivery setting. Price, according to Stat, stated EHRs and their ability to track patients' medical history overtime are important tools. Still, Price posed the question to physicians: “What is it that we could ask you to measure that would really correlate with the outcome and quality of care being provided?"
One area where Price's viewpoint could differ from Trump's
Committee members brought up one area in which Trump and Price appear to be having opposing opinions: Medicare drug pricing.
At the hearing, Sen. Bernie Sanders (I-VT) read out loud a recent tweet from Trump in which he claimed drug companies are committing murder. “Will you and Trump join us in legislation we're working on which will allow Medicare to negotiate prices with drug companies?” Sanders asked Price. Price has disagreed with Trump’s belief that Medicare should be allowed to negotiate prices, as Murray pointed out.
Sanders was not pleased with Price’s vague answer: “You have my commitment to work with you to make sure that drug prices are reasonable and Americans have access to the medications they need.”