In an early morning vote, the U.S. Senate voted to approve the nomination of Tom Price as Secretary of the U.S. Department of Health and Human Services (HHS) to serve in the Administration of President Donald Trump.
Price, a Republican Congressman from Georgia and a former orthopedic surgeon, was confirmed in the Senate at 2 am Friday as the nation’s 23rd HHS Secretary in a vote that split along party lines. The vote was 52-47 with all Republicans voting to confirm, and all Democrats, and Independent Senator Bernie Sanders, voting against confirmation. One Democrat, Sen. Claire McCaskill (MO), didn’t vote.
Upon confirmation, Congressman Price resigned his seat as the U.S. Representative for Georgia's 6th Congressional District.
As previously reported by Healthcare Informatics, the party line split on Price’s nomination has made for a contentious nomination process. On Feb. 1, Republicans on the Senate Finance Committee advanced Price’s nomination without committee Democrats present. The move to vote on Price’s nomination with just Republicans present goes against committee rules, which calls for 13 members—including at least one Democrat—to be present for the vote. Republicans voted to suspend the rule that had required at least one Democrat to be present for business to be conducted after Democrats on the committee boycotted the committee vote on Price’s nomination.
In a statement, Senator Lamar Alexander (R-Tenn.), who voted in favor of Price’s confirmation, said, “As the former chairman of the House Budget Committee, Dr. Price has a thorough understanding of health care policy and the damage that Obamacare has caused. He can see the view from the doctor's office as well as from the lawmaker's office and will be an excellent partner as Congress works to rescue Americans trapped in the failing Obamacare system and to build better health care systems.”
Reaction from healthcare industry associations and health IT organizations have been mostly positive and supportive. In a statement, the Healthcare Information and Management Systems Society (HIMSS) stated, “Dr. Price is uniquely aware of the healthcare challenges facing our nation. He has been an advocate for utilizing health IT to improve health outcomes for patients, while decreasing unnecessary burden on providers. HIMSS looks forward to working with Secretary Price to ensure we realize the full value of health IT in ensuring interoperability, improving care, increasing access, and driving better health outcomes to patients. HIMSS also recognizes the potential to explore the broadening of technology’s impact through expanded use of telehealth, increased cybersecurity preparedness, and implementation of 21st Century Cures,” HIMSS officials stated.
HIMSS officials also stated, “During our many engagements with Secretary Price at HIMSS Annual Conferences, our Government Health IT Conference, and as a congressional sponsor for the HIMSS Foundation’s Institute for e-Health Policy, we have found Secretary Price to be an advocate and an ally to those transforming healthcare.”
The Federation of American Hospitals (FAH) wrote of Price becoming HHS Secretary: “His experience as a thoughtful detailed-oriented legislator, combined with his decades working in the medical field make him uniquely qualified to confront the challenges facing patients, families and caregivers. …Further, we look forward to working with Secretary Price to make sure hospitals have the resources to provide essential health services in the communities we serve.”
The Healthcare Leadership Council, a coalition of chief executives from healthcare industry sectors, applauded the Senate vote confirming Price and HLC president Mary R. Grealy said Price’s healthcare and policy expertise will be “an invaluable asset in improving population health, advancing high-quality care for all Americans.” “We view this as a vote for patients and for strengthening our nation’s healthcare system. Dr. Price brings to HHS the healthcare insights of a practicing physician and the policy knowledge he demonstrated as House Budget Committee chairman. These are assets that will enable him to begin work immediately enhancing the quality and accessibility of care for all Americans.”
She added, “Throughout his tenure in Congress, Dr. Price has been a champion for combating the rise in chronic disease, emphasizing wellness and prevention, expanding the use of health data to improve care, and strengthening the Medicare program for future generations of beneficiaries. We look forward to working with him on these priorities in his leadership at HHS,” Grealy stated.
However, there have also been some negative reactions to Price’s confirmation. President of the National Partnership for Women and Families, Debra Ness, described Price as “an extreme opponent of the Affordable Care Act (ACA) and federal funding for women’s health care.” “This vote may cost millions of women and families the access to essential health services they need,” Ness stated. Further, she stated, “Price’s opposition to the ACA, his willingness to cut Medicaid and Medicare, and his relentless opposition to abortion and contraceptive care are deeply disturbing. The ACA has been the greatest advance for women’s health in a generation; it provided coverage to 20 million previously uninsured people and millions with pre-existing conditions who could not get insurance before it became law. Yet Price voted more than 60 times to repeal it. The replacement proposals he supports are wholly inadequate and would leave millions without affordable, comprehensive health coverage.”
Additionally, Carol Paris, M.D., president of Physicians for a National Health Program, a nonprofit research and education organization of more than 20,000 doctors who support single-payer national health insurance, said in a statement that Price’s confirmation as HHS Secretary “is a body blow to the health and welfare of all Americans.”
"Price’s vision for reforming U.S. health care would result in millions of Americans losing their existing health insurance coverage, and millions more having to make do with bare-bones policies that offer little to no meaningful protection. He can also be expected to push high-deductible health plans, which already result in millions of people forgoing needed care, and to undermine Medicare, the Medicaid program and safety-net hospitals,” Paris stated.
As head of HHS, Price will play a large role in President Trump’s future plans regarding healthcare policy, including Trump’s stated plans to repeal and replace the Affordable Care Act (ACA), former President Barack Obama’s landmark legislation. President Trump on Jan. 20 signed an executive order that could open the door for federal agencies to curtail some aspects of the ACA, and in particular, the order aims to reverse "unwarranted economic and regulatory burdens" resulting from the ACA.
Price has been a vocal critic of the ACA, and, according to The Washington Post, the 62-year-old lawmaker, who represents a wealthy suburban Atlanta district, has played a leading role in Republican opposition to the law and has helped draft several comprehensive bills to replace it. “The GOP-led House has voted five dozen times to eliminate all or part of the ACA but has never had a chance to accomplish its goal as long as President Obama has been in the White House,” the Washington Post article stated. Two years ago, Price introduced the Empowering Patients First Act, which called for a full repeal of the ACA.
And, according to The New York Times, as chairman of the House Budget Committee, Price supported “proposals to shift Medicare away from its open-ended commitment to pay for medical services and toward a fixed government contribution for each beneficiary, which could be used for either private insurance or traditional Medicare.”
During two Senate confirming hearings, Senate Democrats sharply questioned Price about his positions on the future of the ACA, the scope of Medicare and Medicaid and the Trump Administration's plan to repeal and replace the ACA.
During the second confirmation hearing, Senator Mark Warner (D-VA) asked Price, “If you’re confirmed in this position, will you use this executive order in any way to try to cut back on implementation or following the individual mandate before there is a replacement plan in place?” Warner continued “One of the reasons so many of us are anxious to see your replacement plan is that the President [Trump] says he wants to have insurance for everybody and he wants to keep the prohibition on pre-existing conditions and keep people on policies until 26 and it seems there is, at the same time, a rush to eliminate all the things that pay for the ability for Americans to have those services. I want assurances that you wouldn’t use this executive order prior to a legal replacement to eliminate the individual mandate, which I would believe helps to shore up the cost coverage and the shifting of cost that is required in an insurance system.”
Price replied, “Any replacement or reform or improvement of the program is imperative to be instituted simultaneously.”
Regarding health IT issues, Secretary Price will need to address a number of issues, including appointments to the Office of the National Coordinator for Health IT (ONC), the future of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and Meaningful Use and implementing provisions in 21st Century Cures, which passed into law last year.
21st Century Cures has many health IT-related provisions, including instructing the Secretary of HHS to work with healthcare providers, payers and vendors to reduce regulatory and administrative burdens relating to the use of electronic health records. The bill also authorizes $15 million for ONC’s certification process to improve interoperability and fight information blocking. The legislation would establish a grant program to create an unbiased reporting system to engage stakeholders and gather information about EHR usability, interoperability, and security to help providers better choose EHR products.
Price has previously criticized Meaningful requirements has too restrictive and burdensome and remarked that “Meaningful Use has turned physicians into data entry clerks.”
Price’s nomination had been dogged by questions about his investments in healthcare firms and his trading in health care stocks during his time in Congress. Democrats have criticized Price, saying that he has shown bad judgment by actively trading shares of medical and pharmaceutical companies while shaping health policy in Congress. Among Price’s holdings are some in Innate Immunotherapeutics, Ltd., an Australian biomedical company in which another lawmaker, Rep. Chris Collins (R-N.Y.) is a major shareholder. In the second Senate hearing, Price said, “Everything I did was ethical, above board, legal and transparent, and he reason you know about these things is because we made that information available in real time as required by the House ethics committee.”