President-elect Donald Trump early Tuesday morning confirmed a mountain of industry hearsay when he announced he would nominate Rep. Tom Price (R-GA) for HHS Secretary. Healthcare Twitter was buzzing late Monday evening as speculations crescendoed about Price, who he is, what he's done and what the decision means for healthcare policy under a Trump administration. The whispered rumors over a Price HHS nomination late in the evening also allowed many healthcare reporters to forgo their evening plans and write up explainers to put the nomination in context. Here's the top points from these reports in addition to what the position entails.
What the HHS secretary does
The Department for Health and Human Services aims to protect Americans' health by, in their own words, "providing for effective health and human services and by fostering sound, sustained advances in the sciences underlying medicine, public health, and social services." The department includes 11 operating divisions, including the Centers for Medicare and Medicaid Services, National Institutes of Health, the Food and Drug Administration and the Substance Abuse and Mental Health Services Administration. In Gizmodo's George Dvorsky words, "This cabinet-level pick—which still requires Senate approval—makes Price the most powerful person in U.S. health policy."
Who is Tom Price?
Dr. Price is a orthopedic surgeon, current House Budget Committee chairman and a vocal opponent to the Affordable Care Act. He recently authored the Empowering Patients First Act, a plan to repeal and replace the law with tax credits for Americans to "purchase health coverage that are based on an individual's age instead of income," Daily Briefing reported. The plan, Vox's Sarah Kliff reported, would provide $3 billion over three years to help subsidize a high-risk pool as a means to help offset sick individuals with pre-existing conditions. This differs from House Speaker Paul Ryan's "Better Way" replacement plan, which uses $25 billion over 10 years for the same purpose.
In addition to being against Obamacare, Price has advocated for physician's rights especially toward malpractice suits as well as "putting patients back in charge," Stat's Dylan Scott reported, adding Price's view is that healthcare programs manned by the federal government restrict physicians as well as patients. To wit, this month after Trump was elected president, Price stated the GOP is looking to significantly change Medicare in 2017. Price shared that lawmakers plan could accomplish such plans using the budget reconciliation process, which might occur in the "first six to eight months" into a Trump administration.
He was previously served as medical director of the Orthopedic Clinic at Grady Memorial Hospital. Politico Pulse's Dan Diamond notes Price would be the first physician to take helm of HHS since Louis Sullivan, who left office in 1993.
Industry groups seem to support the pick
Many industry groups have blessed the pick. The American Hospital Association stated Price's experience "makes him uniquely qualified to lead" the agency and "his experience as a provider of care will serve patients well in this new role."
AHIP's Marilyn Tavenner stated Price will "bring a balanced and thoughtful perspective to his role as Secretary of HHS. We look forward to working with him to promote competition, increase choice, and lower costs for every consumer." The American Medical Association declared it "strongly supports" Price's nomination.
Not everyone in industry is jazzed on the nomination. For example, The New York Times reported Senate Minority Leader Charles Schumer (D-NY) stated, "Congressman Price has proven to be far out of the mainstream of what Americans want when it comes to Medicare, the Affordable Care Act, and Planned Parenthood...Nominating Congressman Price to be the HHS secretary is akin to asking the fox to guard the hen house."
Yes, it seems Trump is serious about dismantling Obamacare
It almost seemed impossible for anyone to not have a take on Price's nomination. From Slate and Gizmodo to Vox and varying Twitter feeds, the take of the morning was that Price's nomination signals Trump is serious about taking down Obamacare. As Think Progress noted, Price has spearheaded efforts to take down the law "in every Congress since 2009."
Brian Pinheiro, who leads Ballard Spahr's Employee Benefits Group, reminded Healthcare Dive that Price is one of the few legislators who has had an Obamacare replacement in mind. "I think it's going to be difficult for Congress to really make huge changes to the ACA in the short term so he's going to be in sort of the curious position of being an opponent of the ACA but still somebody charged with enforcing its mandates for at least the short term," Pinheiro told Healthcare Dive, adding health insurance is not an easy industry to reform.
More on the table
In addition to its ACA repeal/replace agenda, many think, especially in light of Price's previous comment over a Medicare overhaul, the GOP looks primed to go ahead and attempt Medicare and Medicaid reform. This is interesting as Trump himself has stated he isn't looking to reform the program and didn't campaign on the issue.
With the GOP in control of Congress as well as the White House, it seems, all GOP major agenda points are on the table. This could also potentially include preventive women's health services. As Dvorsky stated, "Price has opposed federal funding for abortion and Planned Parenthood at every opportunity, and it’s not likely he’ll stop now."
Still, Trump has yet to comment on many healthcare legislation proposals, let alone hold a press conference, so some of this is still conjecture. Though Price will not be a primary legislative author, Pinheiro notes Price will certainly have a spot at the table concerning any major healthcare overhaul, be it ACA repeal/replace or Medicare and Medicaid changes. He says individuals who write legislation certainly seek input from parties they deem to have useful information and if a Republican senator or congressman is looking to write healthcare legislation, it would make sense to call the head of HHS who prior to becoming head of HHS has a lot of legislative drafting experience in the healthcare area.
Price "certainly wouldn't be the introducer or primary drafter but you could bet that there will be legislation that will reflect some of his views as to how to make this process work going forward," Pinheiro stated.
The next HHS secretary and his or her actions will be under much deliberation among pundits as well as scrutiny from health policy wonks. As Larry Levitt, SVP of Kaiser Family Foundation, noted:
Just a reminder that we're at the BEGINNING of the next big health care debate. Everyone should probably pace themselves somewhat.— Larry Levitt (@larry_levitt) November 29, 2016