Price, HHS nominee, says Trump doesn't want to 'pull the rug out on anyone'

WASHINGTON — Nobody, including those with mental health and addiction disorders, should lose access to health insurance, President-elect Trump's nominee to head the Department of Health and Human Services told a Senate panel repeatedly Wednesday.

The commitment by Rep. Tom Price, R-Ga., is at odds with Republican plans to replace the existing law with bills that would curtail the expansion of Medicaid and eliminate tax credits to buy insurance, which has helped provide health insurance to more than 20 million Americans. It also highlights the changing nature with which Obamacare replacements are being discussed by President-elect Donald Trump and his key nominees, such as Price.

After the hearing, Sen. Bob Casey, D-Penn., said in a statement that he remains concerned that Price "will use his position as HHS secretary to pursue the same radical policies that he has pursued as House Budget Chair" and harm children, senior citizens and those with disabilities.

Price's hearing started off with disputes between the chairman and ranking Democrat on the Senate Health, Education, Labor and Pensions Committee over the time members would get to question Price. It ended with committee chairman Lamar Alexander, R-Tenn., noting that the four hours spent grilling Price was far longer than any other health nominee faced since 1993.

"They’ve been pretty testy," Alexander said of his Democratic colleagues. "I’m very hopeful your tone will help us come to a consensus."

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Democrats alternated between focus on Price's ethics and his conservative approach to health care financing.

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The Wall Street Journal reported last month that Price traded about $300,000 in shares in the past four years in health companies while pursuing bills that could favorably affect them.

While Price's opposition to the Affordable Care Act is neither surprising nor likely to derail his support in Congress, the investments make confirmation murkier. But even key opponents on the panel, including Sen. Patty Murray, D-Wash., addressed "when" rather than "if" Price would lead HHS.

Price and his longtime friend, Senate Ethics Chairman Johnny Isakson, R-Ga., defended Price's purchases. Price said his broker bought shares in one medical device company without his knowledge and others were part of mutual fund or pension plan purchases that are made on behalf of many members. Sen. Christopher Murphy, D-Conn., raised the issue of Price's stock purchases in six companies that would have been hurt by a Centers for Medicare and Medicaid Services pilot project that Price led opposition to in the House.

More ominously, Murray peppered Price for details on his purchase of stock in the company Innate Immunotherapeutics after discussing the company with Trump transition official Rep. Chris Collins, R-N.Y., a large shareholder who sits on the company's board. Price acknowledged he directed his broker to make the purchases. Murray pointed out that was soon before Senate action on the 21st Century Cures Act, which benefited drug companies.

Costs of ACA repeal

Price's hearing followed a report out Tuesday by the non-partisan Congressional Budget Office that said repealing the ACA's insurance subsidies and mandate to buy insurance would increase the number of uninsured people by 18 million in the following open enrollment year. The number of uninsured Americans would reach 32 million by 2026, the report said.

When it comes to the ACA, Price seemed to favor continuing prohibitions on lifetime limits on insurance coverage and discrimination on the basis of preexisting conditions. Like many Republicans, he stressed the need for consumers to have more choice in the types of policies they can buy, which could lower premiums.

Democrats, however, said eliminating the ACA's "essential health benefits" — which includes coverage for addiction and mental health issues — would be a huge mistake. ACA supporters say consumers don't know whether they or family members are going to become diagnosed with costly diseases or disorders.

Senators Susan Collins, R-Maine, and Maggie Hassan, D-N.H., stressed the importance of continued access to addiction treatment as the opioid epidemic spreads across the country, including parts of Northeast that they represent.

Both addiction treatment and the Medicaid program that funds much of it are "absolutely vital," Price testified.

Price seldom answered definitely on his plans, noting instead that decisions were either up to Congress or would require extensive discussions within the department's massive bureaucracy.

He did give clues about one HHS department, though. Price is all for innovation, but not when it's promoted by the Center for Medicare & Medicaid Innovation (CMMI) and dictates what doctors have to do. CMMI conceived the pilot project against which Price led the House opposition. The proposed project would have cut reimbursements for doctors who do infusions by removing incentives for using pricier drugs, but it was scuttled by HHS after a massive drug maker-backed lobbying campaign.

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Price referred often to the importance of health care decisions being made by patients and doctors rather than insurers and federal regulators. He also repeatedly brought up the need to make health care more affordable, even though many of the ACA's provisions are designed to do that.

Former Rep. Phil Gingrey, also a Republican doctor from Georgia, agreed with Alexander's position that Price is well-qualified to navigate the contentious debate over the law's future.

"I think he has the negotiating skills necessary to navigate the waters of health care reform and open and maintain a dialogue with the congressional Democrats, both in the House and Senate," said Gingrey, a friend who worked with Price on the Doctors Caucus and on congressional committees.

Price, an orthopedic surgeon, has received strong backing from medical groups representing other doctors.  Of the $15 million that Price has received in campaign contributions during his career, Price has received more than $50,000 each from the American Medical Association, American Association of Orthopedic Surgeons, American College of Cardiology and several other health care trade associations, according to the nonprofit group Public Citizen.

The donations tie Price "too closely to the medical industry, raising questions about the extent to which he would represent patients," says Public Citizen.

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