In the courtesy confirmation hearing taking place in the Health, Education, Labor and Pensions (HELP) Committee in the United States Senate on Wednesday, Rep. Tom Price has been undergoing very rigorous questioning from Democratic senators, while receiving praise and support from Republican senators, as he seeks to become the next Secretary of Health and Human Services, as nominated by President-elect Donald Trump.
Rep. Price (R-Ga.) was introduced to the HELP Committee by HELP Committee Chairman Sen. Lamar Alexander (R-Tenn.), who, as he began his questioning of Price, made a series of comments about the Affordable Care Act (ACA), which Republicans in Congress are attempting to repeal and replace. Alexander, who is one of two key Senate committee chairs with jurisdiction over any action the Senate might take to repeal or even modify the ACA, stated that he supported repeal “when there are concrete practical reforms in place that give Americans affordable access to healthcare. It’s not about developing a quick fix,” he added. That statement will be read widely for its possible import in that evolving situation.
Meanwhile, turning to. Price, Alexander asserted that “The individual health insurance market in Tennessee is collapsing,” placing the blame for what he characterized as a “collapse” on the ACA. “I’m told that we need to have a rescue plan in place by March 1. Do you agree that the market is collapsing and that we need a rescue plan and that March 1 is an important date for action?” Price agreed, saying that “Something is going badly wrong out there, and it's imperative for us to put things into place” to fix that situation.
Several times throughout the hearing, Price reiterated the six pillars of what he thinks make up an effective healthcare system: affordability; accessibility; quality; innovation; responsibility; and choices. When asked by Alexander about ACA “repeal and replace” processes, Price hammered home these six pillars time after time. He was asked multiple times about the fear of Americans losing healthcare coverage with whatever new plan the Trump administration puts in place, to which he said, “That is not our goal, nor is it our desire,“ adding, "options will need to move out of D.C. and into the hands of patients and their families.” The two Congressman together said that if Price were to get confirmed as HHS Secretary, his federal healthcare plan would likely be revealed sometime in February.
Sen. Patty Murray questions Rep. Tom Price in a HELP Committee hearing on Wednesday
Pressed hard on the question of whether he regarded healthcare, and health insurance coverage, as a right, by Sen. Bernie Sanders (D.-Vt.), Price averred that he supported “access” to affordable health insurance for Americans. Sanders shot back that “I have access to buying a $10 million house, but that doesn’t mean that I can afford to buy one.” When Sanders pressed him on the promise made during the presidential election campaign by Donald Trump, and whether President-elect Trump would honor his campaign promise to not cut or harm Social Security, Medicare, or Medicaid programs, he said that he had no reason to believe that Trump would do so.
Sanders and Price continued a contentious discourse in which the Senator said the U.S. is the “only major country on Earth that doesn’t guarantee healthcare to all people as a right.” Price said, “We are a compassionate society,” a statement which Sanders refuted. “No, we’re not. Compared to other countries, we are not particularly compassionate,” Sanders said. Price then noted that other countries’ healthcare system decisions have consequences. “I want to make sure every American has access to healthcare,” he said. Sanders replied, “That’s not a guarantee.”
Moments earlier, Sen. Patty Murray (D-Wash.) had criticized Republicans for “rushing” the confirmation process, and told Price that she had “serious concerns about your qualifications and plans for the department you hope to lead.” She noted that, “Just last week, you voted to begin the process of ripping apart our healthcare system without any plan to replace it,” Murray said. “My constituents are coming up to me with tears in their eyes, wondering what the future holds for their healthcare given the chaos Republican efforts could cause.”
Murray also questioned Price very closely on his investments in healthcare firms. Among Price’s holdings are some in Innate Immunotherapeutics, Ltd., a biomedical company in which another lawmaker, Rep. Chris Collins (R-N.Y.) is a major shareholder. According to his financial disclosure statements, on Aug. 31 he bought between $50,001 and $100,000 worth of stock the firm, as noted in an article in the online publication STAT. Murray strongly challenged Price’s explanations of how he came to invest in Innate Immunotherapeutics. That involvement has loomed as an issue that could potentially hurt Price’s chances as HHS Secretary.
Indeed, throughout the hearing, Price was pressed by Democratic senators about the Innate Immunotherapeutics investment as well his purchase of shares in medical device manufacturer Zimmer Biomet last year. A CNN report this week noted that “Price bought between $1,001 to $15,000 worth of shares last March in Zimmer Biomet, and “less than a week after the transaction,” Price introduced legislation “that would have delayed until 2018 a Centers for Medicare and Medicaid Services (CMS) regulation that industry analysts warned would significantly hurt Zimmer Biomet financially once fully implemented.”
Sen. Al Franken (D-Minn.) was not buying Price’s claim that the Zimmer Biomet stock was purchased by a broker, without the Congressman’s knowledge, and noted during the hearing, “How can you say you didn’t know? These sound like sweetheart deals [in reference to the Innate Immunotherapeutics purchasing opportunity that was allegedly a private offering only available to 20 people].” Sen. Franken continued, “In Congress, we want to avoid the appearance of conflict, and you have not done this.”
But, Republican senators Rand Paul (R-Ky.) and Orrin Hatch (R-Utah) jumped to the defense of Price regarding these ethical questions that have been brought up. “I consider this an attack on you,” Sen. Hatch said. Sen. Paul added, “To question the motives and your honesty is insulting. You didn’t go to the public service to take a pay cut, did you?” In response to all this, Price had this to say during the hearing: “Everything we have done as been above board, legal, ethical, and transparent,” further making note of various ethics committees that had to approve these deals. “Not a single piece of information was [held from] the public,” Price said.
Pressed by Sen. Tammy Baldwin (D.-Wis.) on whether he would support the stated position of President-elect Trump that he would push for a change of law to allow Medicare to negotiate drug prices with pharmaceutical companies, Price refused to say.
When Sen. Pat Roberts (R.-Kan.) criticized a number of agencies within the Department of Health and Human Services, most specifically the Centers for Medicare and Medicaid Innovation (CMMI), Price agreed strongly with him, saying, “I’m a strong proponent for innovation, but in some cases, what’s coming out of CMMI is the desire to require certain kinds of treatment for certain disease entities that may not be in the patient’s best interest. But because it carries the full force of the federal government,” the force of CMMI rules or recommendations is overbearing and burdensome to providers and patients, he asserted.
And, later on, Sen. Elizabeth Warren (D-Mass.) went back to the Zimmer Biomet question, pressing Price on how the stock purchases were made. Did not Price himself make the purchases? “The stock was bought by a broker; I wasn’t making those decisions,” Price said. “Was the stock purchased through an index fund?” Warren asked him. “A passively managed mutual fund? An actively managed mutual fund? A blind trust? Let’s be clear: this is not a stockbroker, this is someone who buys and sells stock at your direction.,” she said. “When you found out that your broker had made this trade without your knowledge, did you reprimand her? Did you fire her? Did you sell the stock?”
“What I did was comply with the rules of the House in an ethical and transparent way,” Price responded.
“Your periodic transaction report notes that you were notified of this trade on April 4, 2016,” Warren told him. “Congressional records showed that after you were personally notified of this trade, that you added 23 out of your bill’s 24 cosponsors. You sent a letter to CMS calling on them to cease all current and future initiatives around this bundles.”
What’s more, as Adam K. Raymond and Margaret Harmann reported in New York Magazine on Monday, “Appearances only got worse as 2016 went on and Zimmer Biomet’s PAC cut Price a check for $1,000.” The magazine quoted Larry Noble of the Campaign Legal Center, who had told CNN, “It clearly has the appearance of using your influence as a congressman to your financial benefit.”
Things may become more complicated around this issue, as Senate Democrats focus on it as a possible obstacle to confirmation. In a pair of tweets on Monday evening, Sen. Charles Schumer tweeted, first, this, referencing the Office of Congressional Ethics: “OCE needs to conduct an immediate, thorough investigation into Rep. Price's potential violations of the STOCK Act before nom moves forward.” And then he tweeted this: “This isn't just a couple of questionable trades, but rather a pattern of Rep Price trading stock & using his office to benefit those cos.”
Wednesday’s hearing in the Senate HELP Committee is referred to as a “courtesy” hearing; the Senate Finance Committee is the confirming committee, the committee that will actually vote on the Price nomination, scheduled for Jan. 24
Healthcare Informatics will continue to update readers on this evolving story.