What would Rep. Tom Price do if confirmed as the next HHS secretary? In a warm-up hearing before a Senate committee he at least affirmed where he stands—even if he declined to clarify how the administration will proceed on the Affordable Care Act, Medicare and Medicaid reform and value-based pay.
Price, a conservative orthopedic surgeon from Georgia, said repeatedly that all Americans should have access to healthcare coverage—but he stopped short of saying all Americans should be covered, despite President Donald Trump's recent statement that the replacement for the Affordable Care Act would include “insurance for everyone.”
Price 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 Jan. 24.
Trump has said his team will have a plan ready to replace the ACA when Congress moves to repeal it, but Price offered no new details.
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,” Price said. “That's what I've worked on my entire career.”
The replacement plans Price has endorsed, 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, which Price introduced in 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 the coverage would be far less comprehensive than the minimum benefits required under the ACA, Pollitz said. “The basic framework is a return to the way private markets and Medicaid worked before the ACA.”
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.
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.
Last week the Obama administration announced that 359,000 clinicians would participate in the CMS' stable of value-based payment models in 2017, many of them crafted and administered by the CMS Innovation Center, which Price has criticized as overstepping its authority.
Price declined to commit to keeping or killing the Innovation Center. While saying it has “great possibility and great promise,” he reiterated his opposition to pilots that require providers to participate. “I am a strong proponent and advocate for innovation, but I have seen in certain instances what is coming out of CMMI is a desire to require certain kind of treatment for certain diseases that may or may not be in the best interest of the patient,” Price said. “I simply reject that (Washington) is where those decisions ought to be made.”
The mandatory Comprehensive Care for Joint Replacement model, he said, should have been a pilot that could be expanded if successful. CNN reported Price introduced legislation to delay that program after having purchased stock in Zimmer Biomet, a leading manufacturer of hip and knee implants.
Democrats on the panel repeatedly challenged Price to explain media reports of investments in healthcare companies that directly benefited from legislation he helped enact. He said he was “offended at the insinuation.” Yet he said he plans to divest his holdings.