President-elect Donald Trump's HHS secretary nominee repeatedly and pointedly said on Wednesday that all Americans should have access to healthcare coverage—but he stopped short of saying all Americans should be covered, despite Trump's recent statement that the replacement for the Affordable Care Act would include “insurance for everyone.”
Rep. Tom Price (R-Ga.) answered questions for nearly four hours at a courtesy hearing before the Senate Health, Education, Labor and Pensions Committee. His official confirmation will be before the Senate Finance Committee, which has scheduled a hearing for Tuesday.
Republicans referenced the replacement plan Trump alluded to over the weekend but offered no new details, and some in the party reportedly are not sure Trump's plan actually exists.
Price said he shared Trump's goal of coverage for everyone and believed the Republicans' plan would accomplish that. But he emphasized the importance of access to coverage and the financial feasibility to buy it, dodging a question from Sen. Bernie Sanders (I-Vt.) about whether healthcare is a right.
“It's been always my stated goal,” he said. “That's what I've worked on my entire career.”
The replacement plans Price has endorsed and put forward, however, would not maintain coverage for up to 30 million Americans who obtained it under provisions of the ACA. And it is unlikely the replacement plans would provide the financial assistance many Americans would need to afford coverage.
Karen Pollitz, senior fellow at the Kaiser Family Foundation, said whether the Empowering Patients First Act that Price put forward in May 2015 would achieve the goals of access to affordable coverage for everyone depends on how coverage is defined.
The plan provides tax credits to help people purchase insurance, but they are based on age, not income. Insurance companies would likely produce plans that could be afforded with these credits, but they would cover far less than plans must cover to qualify under the ACA, Pollitz said.
“The basic framework is a return to the way private markets and Medicaid worked before the ACA,” she said.
During Wednesday's hearing, Price also insisted his ideas for replacement would put patients at the center of their care by providing them with more choices and fewer mandates.
Several Democratic senators said, however, that if certain benefits are not mandated, as the ACA did, insurance companies could choose not to offer them.
That includes free preventive care, free contraceptive services, substance abuse services and the assurance that children could stay on their parents' insurance until age 26. Price's plan does not have those provisions.
“Here's the thing, if insurance companies don't offer it, it's not an option.” Sen. Maggie Hassan (D-N.H.) said.
The hearing did not clear up confusion regarding the timing of the Republican promise to repeal and replace the ACA. While Trump has said repeal should happen immediately, HELP Committee Chairman Sen. Lamar Alexander (R-Tenn.) said Wednesday it should go “step by step and carefully.”
“In my opinion, then, it will take several years to actually implement,” Alexander said.
Price also said the legislation to repeal the ACA should not be a vehicle for changes to Medicare. He said he understands that Trump has promised not to cut Medicare, but he declined to make the same promise.
Asked about the future of the CMS Innovation Center, Price did not commit to keeping it or removing it. He said the center “has great possibility and great promise,” but he is adamantly opposed to the center, which pilots valued-based programs, to require provider participation. He specifically named the mandatory Comprehensive Care for Joint Replacement model, which CNN reported, Price attempted to delay through legislation after having purchased stock in Zimmer Biomet, a leading manufacturer of hip and knee implants. Price said the CJR model, which would have cut payments to providers and devicemakers, should have been a pilot that could be expanded if shown to be successful.
Price faced tough questions from Democrats about his investment in healthcare companies that directly benefited from legislation he helped enact.
Price Wednesday contradicted a statement from the Trump transition team when he said he did direct his broker to purchase a stock in the Australian Biotech firm Innate Immunotherapeutics after hearing about the company from Rep. Chris Collins (R-N.Y.).
He said he was “offended at the insinuation” that he used legislation to benefit companies he held stock in and said he has divulged and plans to divest his holdings.
