[Senate Hearing 115-228]
[From the U.S. Government Publishing Office]
S. Hrg. 115-228
NOMINATION OF TOM PRICE TO SERVE AS SECRETARY OF HEALTH AND HUMAN
SERVICES
=======================================================================
HEARING
OF THE
COMMITTEE ON HEALTH, EDUCATION,
LABOR, AND PENSIONS
UNITED STATES SENATE
ONE HUNDRED FIFTEENTH CONGRESS
FIRST SESSION
ON
NOMINATION OF TOM PRICE TO SERVE AS SECRETARY OF HEALTH AND HUMAN
SERVICES
__________
JANUARY 18, 2017
__________
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COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS
LAMAR ALEXANDER, Tennessee, Chairman
MICHAEL B. ENZI, Wyoming PATTY MURRAY, Washington
RICHARD BURR, North Carolina BERNARD SANDERS (I), Vermont
JOHNNY ISAKSON, Georgia ROBERT P. CASEY, JR., Pennsylvania
RAND PAUL, Kentucky AL FRANKEN, Minnesota
SUSAN COLLINS, Maine MICHAEL F. BENNET, Colorado
LISA MURKOWSKI, Alaska SHELDON WHITEHOUSE, Rhode Island
SUSAN M. COLLINS, Maine TAMMY BALDWIN, Wisconsin
BILL CASSIDY, M.D., Louisiana CHRISTOPHER S. MURPHY, Connecticut
TODD YOUNG, Indiana ELIZABETH WARREN, Massachusetts
ORRIN G. HATCH, Utah TIM KAINE, Virginia
PAT ROBERTS, Kansas MAGGIE HASSAN, New Hampshire
LISA MURKOWSKI, Alaska
TIM SCOTT, South Carolina
David P. Cleary, Republican Staff Director
Lindsey Ward Seidman, Republican Deputy Staff Director
Evan Schatz, Minority Staff Director
John Righter, Minority Deputy Staff Director
(ii)
C O N T E N T S
__________
STATEMENTS
WEDNESDAY, JANUARY 18, 2017
Page
Committee Members
Alexander, Hon. Lamar, Chairman, Committee on Health, Education,
Labor, and Pensions, opening statement......................... 1
Murray, Hon. Patty, a U.S. Senator from the State of Washington,
opening statement.............................................. 4
Isakson, Hon. Johnny, a U.S. Senator from the State of Georgia... 8
Enzi, Hon. Michael B., a U.S. Senator from the State of Wyoming.. 20
Sanders, Hon. Bernard, a U.S. Senator from the State of Vermont.. 22
Hatch, Hon. Orrin G., a U.S. Senator from the State of Utah...... 25
Casey, Hon. Robert P., Jr., a U.S. Senator from the State of
Pennsylvania................................................... 27
Paul, Hon. Rand, a U.S. Senator from the State of Kentucky....... 30
Franken, Hon. Al, a U.S. Senator from the State of Minnesota..... 32
Bennet, Hon. Michael F., a U.S. Senator from the State of
Colorado....................................................... 36
Collins, Hon. Susan M., a U.S. Senator from the State of Maine... 38
Whitehouse, Hon. Sheldon, a U.S. Senator from the State of Rhode
Island......................................................... 40
Roberts, Hon. Pat, a U.S. Senator from the State of Kansas....... 44
Baldwin, Hon. Tammy, a U.S. Senator from the State of Wisconsin.. 46
Young, Hon. Todd, a U.S. Senator from the State of Indiana....... 48
Murphy, Hon. Christopher, a U.S. Senator from the State of
Connecticut.................................................... 50
Murkowski, Hon. Lisa, a U.S. Senator from the State of Alaska.... 53
Warren, Hon. Elizabeth, a U.S. Senator from the State of
Massachusetts.................................................. 56
Hassan, Hon. Margaret Wood, a U.S. Senator from the State of New
Hampshire...................................................... 60
Cassidy, Hon. Bill, M.D., a U.S. Senator from the State of
Louisiana...................................................... 62
Kaine, Hon. Tim, a U.S. Senator from the State of Virginia....... 66
Scott, Hon. Tim, a U.S. Senator from the State of South Carolina. 69
Witness
Price, Tom, B.A., M.D., Nominee for Secretary of Health and Human
Services, Roswell, GA.......................................... 10
Prepared statement........................................... 13
ADDITIONAL MATERIAL
Statements, articles, publications, etc.
Resolution designating Confederate History and Heritage Month
in Georgia................................................. 77
Kaiser's Health News Article................................. 79
Petitions Opposing Tom Price's Nomination.................... 81
Letters:
Senator Murray and 11 signed Democrats....................... 81
State of Rhode Island Letter with Chart, Gina M. Raimondo,
Governor................................................... 82
Letters of Opposition........................................ 84
(III)
NOMINATION OF TOM PRICE TO SERVE AS SECRETARY OF HEALTH AND HUMAN
SERVICES
WEDNESDAY, JANUARY 18, 2017
U.S. Senate,
Committee on Health, Education, Labor, and Pensions,
Washington, DC.
The committee met, pursuant to notice, at 10:05 a.m., in
room 430, Dirksen Senate Office Building, Hon. Lamar Alexander,
chairman of the committee, presiding.
Present: Senators Alexander, Enzi, Isakson, Paul, Collins,
Cassidy, Young, Hatch, Roberts, Murkowski, Scott, Murray,
Sanders, Casey, Franken, Bennet, Whitehouse, Baldwin, Murphy,
Warren, Kaine, and Hassan.
Opening Statement of Senator Alexander
The Chairman. The hearing will come to order. The Committee
on Health, Education, Labor, and Pensions will come to order.
Today we're reviewing the nomination of Dr. Tom Price to be
the Secretary of Health and Human Services.
Dr. Price, we welcome you, and congratulations on your
nomination. Welcome to you and your wife Betty, who is here
today with you. I enjoyed having the opportunity to visit with
you in my office and to learn from you about your plans.
Dr. Price will be introduced today in a few minutes by
Johnny Isakson, a member of this committee and Dr. Price's home
State Senator. Before Senator Isakson introduces the nominee,
Senator Murray and I will each make a few introductory remarks.
After the nominee makes his statement, we'll have the usual
round of questions. Let me say something about the round of
questions.
Last night we had a hearing of 3\1/2\ hours. I had tried as
chairman to be fair by following the same precedent we had for
President Obama's two Education nominees by having one round of
5-minute questions followed by Senator Murray and me asking
questions and wrapping up. I don't want to re-argue that
because we spent a lot of that 3\1/2\ hours arguing about the
3\1/2\ hours.
I have listened carefully to what my colleagues have said
and I looked back at the precedent for the Health and Human
Services Secretary when that person came before our committee.
Secretary Burwell had one round of questions; Sebelius one
round, plus Coburn, Dr. Coburn asked a question; Daschle one
round, plus three Senators asked a question; Leavitt, six
members asked questions in the second round; Thompson one
round, but it was a round of 7 minutes; Shalala, six members
asked a second round.
What I've decided to do, in an effort to try to treat
President-elect Trump's nominee approximately the same as the
way we've treated other nominees, is to have a single round of
7-minute questions today. That would be the precedent followed
with Secretary Thompson, and that seems to me to give every
member of the Senate more time to ask questions of the
Secretary.
This is a courtesy hearing. Dr. Price will be before the
Finance Committee next Tuesday. A number of the members of this
committee are also members of the Finance Committee.
We don't vote on his nomination. They vote on his
nomination and will be the ones that report it to the floor, if
that's their decision. We have the hearing because we have some
of the health care jurisdiction, some important parts of it,
and we would like to talk to him about those issues,
especially.
He has all of his paperwork in place before the Finance
Committee, including the Letter of Agreement with the Office of
Government Ethics, which is on the website and available to
members of this committee, as well as others. It's my hope that
in our 7 minutes of questions that we'd have time to focus on
the responsibilities of the Department of Health and Human
Services rather than have a continuing discussion about the
number of minutes.
There will be an opportunity following the hearing to ask
written questions of Dr. Price as well.
Dr. Price, if you're confirmed to lead the Department of
Health and Human Services, you'll be running an organization
that spends $1.1 trillion a year. It's always troubling to me,
actually, that you'll be in charge of spending more than the
Congress actually appropriates every year. By that I mean the
part of the budget that we appropriate and which is under
pretty good control, which is the part that has national
defense, the National Institutes of Health and national parks
and national laboratories over the last several years and for
the next several years, that part is rising at about the rate
of inflation. It's not adding to the budget. It's about a third
of the total amount of Federal Government spending.
It's a little less than the amount that's in your
department every year, most of which is entitlement spending,
mandatory spending, and which is going up at a rate like that,
while the rest of the budget is going like this.
You'll be overseeing Medicare and Medicaid, mental health
and substance abuse programs. We just enacted in December of
last year, and the President signed, the most important reforms
of those programs in a decade. Senator Cassidy and Senator
Murphy were the leaders on that in this committee, along with
Senator Murray.
We made important changes in the Food and Drug
Administration, giving them new authority, new responsibility;
for example, new authority to hire and pay the experts they
need to move products and devices through the FDA at a more
rapid rate, saving time and money and getting those devices
into the medicine cabinets of the doctors' offices. That was
Dr. Califf 's No. 1 priority. We passed that into law in
December.
And then the implementation of Obamacare and the various
proposals to repair the damage done by Obamacare and replace it
with concrete, practical alternatives for the American people
to give them more choices of lower cost health insurance.
Dr. Price, I believe you're an excellent nominee for this
job. You were a practicing orthopedic surgeon for nearly two
decades. You were a professor at Emory University School of
Medicine. I read about the resident doctors in training who you
taught. You served as medical director of the orthopedic clinic
at Grady Memorial Hospital. In the House you were chairman of
the Budget Committee, and you've been a leader in deliberations
over the future of our health care system. You know the subject
very, very well.
One of the first responsibilities that you will have is to
give us your advice about how to repair the damage that the
Affordable Care Act has caused to so many Americans and how to
replace it, or to replace parts of it with concrete, practical
alternatives that give Americans more choices of lower cost
insurance.
Let me give my view about how we might proceed on that, and
then during the question and answer session I will ask you more
about your views.
Following the presidential election, President-elect Trump
said on 60 Minutes that replacement and repeal of Obamacare
would be done simultaneously--his word. To me that means at the
same time. Recently Speaker of the House Paul Ryan said that
repeal and replacement of Obamacare would be done concurrently.
Then Senator McConnell said last week that we need to do this
promptly but in ``manageable pieces.'' Trying to interpret what
those words mean. To me that means Obamacare should be finally
repealed only when there are concrete, practical reforms in
place that give Americans access to truly affordable health
care.
The American people deserve health care reform that's done
in the right way, for the right reasons, in the right amount of
time. It's not about developing a quick fix. It's about working
toward long-term solutions that work for everyone. One way to
think about what ``simultaneously'' and ``concurrently'' mean
is to think about Obamacare the same way you'd think about a
collapsing bridge in your hometown, because that's just what's
happening with Obamacare in my home State and in many other
States.
According to the Tennessee insurance commissioner, the
Obamacare insurance market in our State is ``very near
collapse,'' and across the country premiums and co-pays are up,
employers have cut jobs in order to be able to afford the
mandates of Obamacare. Medicaid mandates are consuming State
budgets. In one-third of America's counties, citizens with
Federal subsidies have only a single choice of a company to buy
insurance from on the Obamacare exchanges. Without quick action
next year, there may be zero choices on those exchanges. The
subsidies may be worth as much as a bus ticket in a town where
no buses run.
If your local bridge in Georgia or in Tennessee were very
near collapse, the first thing you'd do, I would think, is to
send in a rescue crew to repair the bridge temporarily so no
one else is hurt. Then you would build a better bridge or, more
accurately in the case of health care, many bridges to replace
the old bridge. And finally, when the new bridges are finished,
you would close the old bridge. That's how I suggest we
proceed, rescue those trapped in a collapsing system, replace
that system with functional markets, market or markets, as
States develop their own plans for providing access to truly
affordable health care, and then repeal Obamacare for good.
First we should offer a rescue plan so the 11 million
Americans who buy insurance now on the exchange can continue to
do so while we build a better set of concrete practical
alternatives. Second, we should build better systems, providing
Americans with more choices of insurance that cost less. Note
that I say systems, not one system. If anyone is expecting
Senator McConnell to roll a wheelbarrow onto the Senate floor
with a 4,000-page comprehensive Republican health care plan,
they're going to be waiting a long time because we don't
believe in that. We don't want to replace a failed Washington,
DC. health care system with another failed Washington, DC.
health care system. We'll build better systems, providing
Americans with more choices of insurance that cost less, and
we'll do this by moving more health care decisions out of
Washington, DC. and into the hands of States and patients, and
by reducing harmful taxes, and we'll do this carefully, step by
step, so that it's effective.
Finally, we should then repeal what remains of the law that
did the damage and created all this risk. I know that the
President-elect has said that after you are confirmed, which I
hope is fairly early in February, that he will propose a plan
to Congress. I look forward to that plan, and I know you can't
tell us what that plan is today, but I do look forward to
hearing from you, how you suggest we approach this.
We want to do this right. We want to sequence the events
carefully and adequately so that Americans have concrete,
practical alternatives in place of what is there today. We want
to make sure that the parts of Obamacare that are repealed are
replaced before the repeal becomes effective.
Senator Murray.
Opening Statement of Senator Murray
Senator Murray. Thank you very much, Chairman Alexander.
Thanks to all of our colleagues that are joining us today.
Congressman Price, congratulations on your nomination, and
thank you to your wife Betty who I know is there with you as
well.
Before I speak about this nominee, I do want to say that we
remain deeply disappointed in last night where Democrats were
blocked from asking more than one round of questions on Betsy
DeVos, who is the nominee for Secretary of Education, and are
disappointed that we are rushing this hearing as well, Mr.
Chairman. You said 7 minutes, but I will just say I don't think
any of us in prior nominees that you keep pointing to ever
thought if I don't ask for another question, I've just set a
precedent. In fact, I think that there is no example of any
Senator asking to do a question before and being turned down.
These nominees in a new administration that many people
have questions about deserve to be asked questions, scrutinized
in public before we have a choice to make on the floor of the
U.S. Senate, on both sides of the aisle, in terms of whether we
vote yes or no. That is why we think it's extremely important
that we are allowed the opportunity to ask second rounds of
questions after we have heard all of the questions, and today
we have three or four committee hearings going on at the same
time as this, so it is extremely challenging for our Senators
to be here on a nomination they care deeply about, on a subject
that we care deeply about.
I would just like to point out again that several nominees
that have come before, if we're going to talk about precedent,
Secretary Leavitt, President George Bush's second HHS
secretary, five bipartisan Senators participated in a second
round. Senator Daschle, President Obama's first HHS Secretary,
three bipartisan Senators participated. Again, it is
unprecedented for a chairman to turn down a member who has a
question to ask.
For the record, I would just like to ask consent to put
parts of the record of the nominees of Michael Leavitt, Andrew
von Eschenbach, and Tom Daschle into the record of this
hearing.
The Chairman. That will be fine.
[Due to the high cost of printing the information referred
to may be found in the following hearings: Michael Leavitt's--
S. Hrg. 109-56; Andrew Von Eschenbach--S. Hrg. 109-816; and Tom
Daschle--S. Hrg. 111-469.]
Senator Murray. Again, our members have questions because
this nominee is going to have jurisdiction over the health care
and lives of millions of Americans, and we want to know where
he stands before we make a decision, yes or no, our imprimatur
to him to be there. That is why it is so important to members
of our committee.
Having said that, I want to say this. The health of our
families and communities could not be more important to our
strength as a Nation. When a young child goes to school healthy
and ready to learn, she's better prepared to succeed. When
women are empowered to plan their families and pursue all of
their dreams, our communities benefit. When workers have access
to quality health care that they can afford, our economy grows.
When seniors are able to trust that the guarantee of programs
they have paid into, Medicare and Social Security, will be
there when needed, we live up to some of our country's most
vital responsibilities.
The Department of Health and Human Services has a critical
role to play in our ongoing work to meet each of these goals
and many more. That is why, in evaluating a nominee for
Secretary of Health and Human Services, I consider whether the
nominee has a record of putting people first, not politics, not
partisanship, or those at the top; whether they will put
science first, not ideology; and whether their vision for our
health care in our country would help more families get
quality, affordable care, or take us backward.
Congressman Price, I have serious concerns about your
qualifications and plans for the department you hope to lead,
and I am looking forward to hearing from you today on a number
of topics. I'll start by laying out issues with what your
record suggests about your approach to our Nation's health care
system.
Just last week, you voted to begin the process of ripping
apart our health care system without any plan to replace it
despite independent studies showing that nearly 30 million
people would lose health care coverage, even though more and
more members of your own party are expressing serious doubts
about its ability to unify around a plan, and knowing that in a
matter of weeks you could be leading the department whose core
responsibility is to enhance Americans' health and well-being.
My constituents are coming up to me with tears in their
eyes, wondering what the future holds for their health care
given the chaos Republican efforts could cause. President-elect
Trump and Republican leaders have promised the American people
their plans to dismantle our health care system right away
would somehow do no harm and would not cause anyone to lose
coverage. In fact, just days ago, President-elect Trump
promised ``insurance for everybody.'' Congressman Price, your
own proposals would cause millions of people to lose coverage,
force many people to pay more for their care, and leave people
with pre-existing conditions vulnerable to insurance companies
rejecting them or charging them more. I will be very interested
in hearing your explanation of how your plans would keep the
promises your party has made to the American people about their
health care.
Medicare is another issue I will be interested in hearing
about today. President-elect Trump campaigned on promises to
protect Medicare and Medicaid. You have said you plan to
overhaul Medicare in the first 6 to 8 months of this
administration, in a way that would end the guarantee of full
coverage that so many seniors and people with disabilities rely
on. You have put forward policies that would shift $1 trillion
in Medicaid costs to our States, squeezing their budgets and
taking coverage away from struggling children and workers and
families. While President-elect Trump has said that Medicare
should be able to negotiate lower drug prices for seniors, you
have repeatedly opposed efforts to do that. You even went so
far as to call legislation on that issue ``a solution in search
of a problem.'' I disagree. This is absolutely critical for
families in my home State, and I am eager to hear how you would
reduce the burden of prescription drug costs in our
communities.
As a woman, a mother, a grandmother, and a U.S. Senator, I
am deeply troubled by the ways in which your policies would
impact women's access to health care and their reproductive
rights. I have serious concerns about your understanding of
women's needs for basic health care like birth control given
your expressed doubts on this topic, your proposals to make
women pay extra out-of-pocket for birth control, and your
repeated efforts to defund our Nation's largest provider of
women's health care, Planned Parenthood.
I am also very focused on the role of the Department of
Health and Human Services in strengthening and protecting
public health. I will want to hear from you about whether and
how you would uphold the gold standard of FDA approval; and,
for example, how you would approach important programs and
rules intended to keep tobacco companies from luring children
into addiction.
Finally, as I discussed at our hearing yesterday, I believe
firmly that, especially as the President-elect tries to blur
lines around conflicts of interest, it is critical we not only
do everything in our power to hold him to high standards but we
do the same for Cabinet nominees. That's why I was so appalled
that with four of the President-elect's nominees currently
serving in the House of Representatives, House Republicans
attempted right out of the gate to get rid of the independent
Office of congressional Ethics. Luckily they heard loud and
clear from people across the country it wasn't acceptable, and
they backed down.
Congressman Price, the Office of Congressional Ethics has
now been asked not only by Democrats, but by the consumer
advocacy group Public Citizen, to investigate serious concerns
and questions about your medical stock trades during your time
in the House. I and other Democrats have repeatedly called for
hearings on your nomination to be delayed until such an
investigation is complete. It is disappointing to us that
instead, Republicans are moving forward with your nomination
before we have all the facts. I hope you have come prepared to
be fully transparent with us in your explanations.
I have outlined just a few of my questions and concerns
about this nomination, and I know, in light of Republican
efforts to take our health care system in a vastly different
and harmful direction, they are shared by millions of people
across the country who can't be here today. With that in mind,
it's crucial that the voices of people who will be impacted
every day by choices made under this administration are part of
the process when it comes to the President-elect's Cabinet
nominees. I just want to say I'm very pleased that tomorrow,
Senators Warren and Stabenow will be hosting a forum with
witnesses who can speak to the impact of health care providers
like Planned Parenthood, the importance of the work done in the
Affordable Care Act to expand access to mental health care and
substance abuse treatment, and the ways in which the full
guarantee of Medicare has helped keep them financially and
physically secure.
There are stories across the country like this, of lives
saved and strengthened because of the progress we've made to
expand quality, affordable health care. I urge my Republican
colleagues to attend and to prioritize what is best for these
women and men and families, not what's best for politics, as
they consider each of their decisions in the coming weeks.
Congressman Price, as we begin this hearing I would ask you
to be as transparent and frank as possible about your views and
your plans for the Department, and urge you to commit to
providing us with additional information and answers to any
followup questions we have in a timely and thorough manner.
I am looking forward to what I hope will be a rigorous and
open discussion today, and I hope that we all arrive at the
right decision for the families and the communities that we
serve.
Thank you, Mr. Chairman.
The Chairman. Thank you, Senator Murray.
Before I introduce Senator Isakson, I'd like to put into
the record the information about the last six hearings that
we've had here, without going into detail. The current
Secretary, one round of questions; Secretary Sebelius, one
round with one member asking a second round; Daschle, one round
plus three; Leavitt, six members ask a second round; Thompson,
one round of 7 minutes each; and Shalala, six members ask a
second round. My decision is that rather than give 6 of 23
members a second round, that it would be better to let every
Senator have 7 minutes.
Senator Isakson.
Statement of Senator Isakson
Senator Isakson. Thank you, Mr. Chairman.
I'd like to ask unanimous consent that the remarks that
were prepared for me to read this morning be submitted for the
record.
The Chairman. They will be.
[The information referred to was not available at time of
press.]
Senator Isakson. Because I'm not going to read them.
I have a unique honor and privilege to introduce a friend
of mine for 30 years, someone I know to be a great politician,
a great practicing legislator, a great family man, a great
community servant, and a great friend of mine, and it's an
honor for me to do so.
I want to thank each of you for taking my call before this
meeting today when I called you to ask you to listen to what
Tom had to say, because I think you'll be impressed with what
you hear no matter how tough the question might be.
I approached this introduction as if I'm being asked what I
would look for in somebody who I wanted to entrust with $1
trillion of my money, the quality of my health care, and the
future of the American quality of health care. I'd look for
five things.
First, does this man understand the American family. Not
only does he understand it, but his wife Betty is here.
Betty, stand up.
She'll tell you he understands the family.
His son Robert is not here because he's in Nashville, TN,
singing country music and writing country music songs. I know
the Chairman would appreciate that. He's a fine young man, and
I enjoy working with him.
Tom is a great family man, a member of Roswell United
Methodist Church, active in his community, active in the State
legislature, active in doing what's right for his community.
He's a good man and understands the family and the value of the
family and the value of health care to every family.
Second, I'd want to know is he capable of handling $1
trillion. You know, $1 trillion is a lot of money. It's
actually $1.1 trillion, but when you get to $1.1, why worry
about it? It's a lot of money. It's more than we appropriate,
as the Chairman said.
He's been chairman of the Budget Committee in the House of
Representatives. He served in the Georgia legislature, leading
appropriations for many, many years. He's run one of the
largest medical practices in the State of Georgia. In fact, Tom
Price is one of those people who put together what's known as
Resurgens Orthopaedics. They happen to be my doctors. In fact,
they saved my son's right leg 26 years ago in a terrible
automobile accident. I understand the value of Resurgens
Orthopaedics and what Tom has done. It's now the largest
practice center up-state, a well-run practice, and a practice
that's set up as an example of how to do medicine in the 21st
century.
I'd want to know that my nominee for Health and Human
Services knew and understood the health care business. Well,
who better to understand the health care business than a
doctor? Even better than that, a doctor who is married to
another doctor? Tom and Betty met at Grady Memorial Hospital
when they were doing their residencies. They fell in love
there, and they fell in love with the practice of medicine.
I've watched them over the last 30 years participate in
activities in our State, whether elected or not. They
contributed to the betterment of health care in our State, the
betterment of hospitals like Grady Memorial Hospital, which is
the largest crisis hospital and trauma center we have in the
State of Georgia, saving lives every single day. They would
have probably not been there today had it not been for people
like Tom Price, who gave of his time and his effort to see to
it to raise the money necessary to keep Grady open.
I'd want to know they had some experience with the
legislature, because if you get a chairman of Health and Human
Services to come in, you give him a $1.1 trillion budget, and
then you say go talk to those 435 people over there and
convince them what we need to do to change the law, that's a
pretty tall order. You'd want to find somebody who served in
public office. Tom has been in the State Senate in Georgia, was
the first elected Republican leader of the George State Senate
in the history of our State. He served in the Congress of the
United States. In fact, he improved the 6th District remarkably
when I left and he was elected to replace me. The intellectual
level went way up when Tom came, I can promise you that.
He has done an outstanding job being re-elected six times
to the U.S. House of Representatives, serving, as I said, as
Budget chairman, as Study Committee chairman, and as a very
active member of the Congress of the United States of America.
I'd want to also know if he was an accountable person and
believed in accountability. Tom Price believes in
accountability. He's one of the rare one of us--in fact, he may
be the only one of us, and I know this is true, that reads all
the bills. When I need to know something about a bill, rather
than read, I call Tom Price to give me advice because I know
he's read it. Sometimes he's boring, but he's always
knowledgeable.
[Laughter.]
It's because he does his homework, he does it right, he
believes in his responsibilities.
I'm going to mention a couple of things that have been said
negative about Tom, and I want to address them straight up
because they're wrong. In fact, I did so on the floor of the
Senate yesterday afternoon when Chuck Schumer took this case of
Zimmer Biomet and tried to make it into a major case.
Zimmer Biomet is a $26-a-share stock that Tom Price's
broker who manages his account bought for him at a time Tom was
unaware of the purchase. It was 2 months after the House had
acted on a medical device bill. There's a term of art called
``disparate impact'' where you take two facts that are
unrelated and you put them together to indict somebody for a
wrong when, in fact, nothing wrong was done at all, and that's
the case there. Zimmer Biomet, a $2,674 stock purchase, took
place without Tom's knowledge because his account is managed by
someone else. His knowledge of that purchase took place 1 month
later after the disclosure was made. He didn't even know about
it at the time that it was made. The allegations that were made
yesterday on the floor of the Senate are patently wrong by
taking two correct things and putting them together to make an
incorrect thing.
Second, something else has been said that I have working
knowledge of. Tom was accused of not being for saving Social
Security for seniors. I'm 72 years old. I'm not going to stand
up here and get you all to approve somebody who is not going to
protect Social Security, because I've got some of it. Let me
tell you a little story about Tom Price.
He and I got a phone call 6 months ago--I guess now it's
been 8 months ago--from AARP asking us if we would travel and
do town hall forums for AARP on saving Social Security. Why
would somebody call Tom Price, a Congressman, or Johnny
Isakson, a Senator, to be the organization that represents
seniors to go on the road and do town hall meetings about
saving Social Security if they weren't for saving Social
Security? It's just incongruent and it doesn't make any sense.
Last, one of the best votes I cast 4 years ago for Cabinet
members was a vote for Sylvia Burwell. When she came before
this committee and the Senate Committee on Finance, I was on
both committees, as I am today. She's an articulate,
intelligent lady. There was a lot of reason for me as a
Republican, in the minority, to say, ``Oh, I'll just throw away
a vote and vote against her because she's a Democratic
nominee.'' I listened to her answers, I studied her history, I
watched her actions, and I proudly voted for her, and today
she's a professional friend of mine, and we'll miss her in her
office. There's nobody better qualified to replace Sylvia
Burwell than Tom Price.
I voted for Sylvia Burwell with pride, and I'm going to
vote for Tom Price with pride because I know he's the right man
for the right job at the right time for America.
He's my friend and I commend him to you, and I urge you to
vote for him in his confirmation.
The Chairman. Thank you, Senator Isakson. That's much
better than whatever was written for you to say.
[Laughter.]
Dr. Price, welcome to the committee.
STATEMENT OF TOM PRICE, B.A., M.D., NOMINEE FOR SECRETARY OF
HEALTH AND HUMAN SERVICES, ROSWELL, GA
Dr. Price. Chairman Alexander, Ranking Member Murray, and
all the members of the committee, I want to thank you all for
the opportunity to speak with you today and engage, as the
Ranking Member said, in a discussion about the road ahead for
our great nation.
I want to thank Senator Johnny Isakson for his generous
introduction. As he said, we've known each other for 30 years,
and I'm so grateful for his friendship and his kindness, and
our State is blessed to have had his service and his
leadership.
I wish also to especially thank my wife Betty of 33 years
who joins me here today. As Johnny mentioned, her support and
encouragement and advice, which I would suggest to you is
virtually always correct, and her love means more to me than I
could ever say.
Over the past few weeks I've met with many of you
individually and have gained a real appreciation for the
passion that you have for the Department of Health and Human
Services. Please note that I share that passion. That's why I'm
here today and why I'm honored to be the nominee for Secretary
of Health and Human Services.
We all come to public service in our own unique ways that
inform who we are and why we serve. My first professional
calling was to care for patients. That experience as a
physician and later as a legislator has provided an holistic
view of the complex interactions that take place every day
across our communities, and today I hope to share with you how
my experience has helped shape me and my understanding and
appreciation for the work of the Department of Health and Human
Services.
From an early age I had an interest in medicine. My
earliest memories are of growing up on a farm in the State of
Michigan. We lived on a farm in Michigan before we moved to
suburban Detroit when I was 5 years old. I spent most of my
formative years being raised by a single mom, so my fondest
memories are spending time with my grandfather, who was a
physician. When I was young we would go--I would be able to go
spend some weekends with him and we'd go on rounds, which at
that time meant going on house calls. We'd drive up to houses,
and the memories I have of individuals opening the door and
giving him a hug and welcoming him graciously are cemented in
my mind.
After graduating from medical school from the University of
Michigan, I moved to Atlanta, which I've called home for nearly
40 years. That's where I met my wife, where we raised our son.
I did my residency at Emory University and Grady Memorial
Hospital, where I would later return in my career to serve as
the medical director of the orthopedic clinic.
Throughout my professional career I've treated patients in
all walks of life, including so many children. Anyone who has
ever treated a child knows the remarkable joy that you have
when you're able to go tell a mom and dad that we have helped,
we have helped save their child or helped their child back to
healthfulness. My memories of Grady are filled with the
gracious comments of parents and of patients for the team of
health care specialists with whom I had the privilege of
working.
After 25 years of school and training, I started a solo
orthopedic practice. Over the years this practice grew, as
Senator Isakson mentioned, and eventually became one of the
largest non-academic orthopedic groups in the country, for
which I would eventually serve as chairman of the board.
During 20 years as a practicing physician I have learned a
good bit about not just treating patients but about the broader
health care system and where it intersects with government. A
couple of vivid memories stand out. One, many of my patients
were never more irritated or angry when they recognized that
there was somebody else in the exam room, not physically but
figuratively, who was getting between the doctor and the
patient in making decisions, whether it was the insurance
company or government. Then there was the day when I noticed in
my office--it was in the mid-1990s when I realized that there
are more individuals behind the door where the clinical work
was going on seeing patients than there were in front of the
door. Those folks were filling out forms and making certain
that we were checking all the boxes and challenging or arguing
with insurance companies or government about what was in the
best interest of the patient.
It became clear to me that our health care system was
losing focus on its No. 1 priority, and that is the patient. As
a result, I felt compelled to broaden my role in public service
and help solve the issues harming the delivery of medicine, so
I ran for the George State Senate. I found the State Senate in
Georgia to be often remarkably bipartisan and that collegial
relationships were the norm. This is the environment in which I
learned to legislate, reaching across the aisle to get work
done.
In Congress I've been fortunate as well to be part of
collaborations that broke through party lines to solve
problems. Just this past Congress it was a bipartisan effort
that succeeded in ridding Medicare of a broken physician
payment system and which has now begun the creation of a new
system which, if implemented properly, will help ensure that
seniors have better access to higher-quality care.
If confirmed, my obligation will be to carry to the
Department of Health and Human Services both an appreciation
for bipartisan, team-driven policymaking and what has been a
lifetime commitment to improving the health and well-being of
the American people. That commitment extends to what I call the
six principles of health care: affordability, accessibility,
quality, responsiveness, innovation, and choices.
Health and Human Services is more than health care. There
are real heroes at this department doing incredible work to
keep our food safe, to develop new drugs and treatment options,
driven by scientists conducting truly remarkable research.
There are heroes among the talented, dedicated men and women
working to provide critical social services, helping families
and particularly children have a higher quality of living and
the opportunity to rise up and achieve their American Dream.
The role of Health and Human Services in improving lives
means it must carry out its responsibilities with compassion.
It also must be efficient and effective and accountable, as
well as willing to work with those in communities already doing
incredible work on behalf of their citizens.
Across the spectrum of issues and services that this
department handles, there endures a promise that has been made
to the American people. We must strengthen our resolve to keep
the promises our society has made to our senior citizens and to
those who are most in need of care and support. That means
saving and strengthening and securing Medicare for today's
beneficiaries and future generations. It means ensuring that
our Nation's Medicaid population has access to the highest
quality care. It means maintaining and expanding America's
leading role in medical innovation and the treatment and
eradication of disease. I share your passion for these issues,
having spent my life in service to them.
Yet there's no doubt that we don't all agree on or share
the same point of view when it comes to addressing every one of
these issues. Our approaches to policies may differ, but
surely, surely there exists a common commitment to public
service and to compassion for those that we serve. We all hope
that we can help improve the lives of the American people to
help heal individuals and whole communities.
So with a healthy dose of humility and an appreciation for
the scope of the challenges before us, with your assistance and
with God's will, we can make it happen, and I look forward to
working with you to do just that.
Mr. Chairman, I thank you for the opportunity to be with
you today.
[The prepared statement of Dr. Price follows:]
Prepared Statement of Congressman Tom Price, B.A., M.D.
Thank you Chairman Alexander, Ranking Member Murray, and all the
members of this committee for the opportunity to speak with you today
and engage in a discussion about the road ahead for our great Nation.
These proceedings, and this entire process, would not be possible
without the work of your staff, and so I want to extend my appreciation
to them as well for the great service they provide. Thanks so much to
Senator Johnny Isakson for his generous introduction. We've known each
other for nearly 30 years and I'm so grateful for his friendship and
kindness, and our State is blessed to have had his service and
leadership. I wish also to especially thank my wife of 33 years, Betty,
who joins me today. Her support, encouragement and advice (which is
always correct) mean more than I could ever say.
Over the past few weeks, I have had the chance to meet with many of
you individually and have gained a real appreciation for the passion
you all have about the critical work of the Department of Health and
Human Services. Please know that I share that passion. That is why I am
here today and why I'm honored to have been nominated by the President-
elect to serve as the next Secretary of HHS.
We all come to public service in our own unique ways that inform
who we are and why we serve. My first professional calling was to care
for patients. That experience as a physician and later as a legislator
has provided a holistic view of the complex interactions that take
place every day across our communities and across this country that,
when done correctly, are in service to the greater good we seek to
achieve. Today, I hope to share with you how my experience has helped
shape my understanding of and appreciation for the work of the
department and its team, which I hope to lead.
From an early age, I had an interest in medicine. My earliest
memories are of a farm in Michigan where my family and I lived before
moving to suburban Detroit at the age of 5. I spent most of my
formative years being raised by a single mom, and I assumed a lot of
responsibility since there were five of us. Some of my fondest memories
were spending time with my grandfather, a physician, as he made house
calls to see patients. Having both a father and grandfather as
physicians surely influenced my path toward medicine. It was very
likely that the orthopedist who treated my many broken bones in my
youth gave me a particular fascination for fixing things--and not just
broken bones.
After graduating with a medical degree from the University of
Michigan, I went south to Atlanta, GA--which I've called home for
nearly 40 years. It's where I met my wife, Betty; and where we raised
our son. I did my residency at Emory University and Grady Memorial
Hospital in downtown Atlanta. I would return to Grady later in my
career to serve as medical director of the orthopedic clinic.
Throughout my professional career I treated patients of every age from
all walks of life--including many children. Anyone who has ever treated
a child knows how fulfilling it is to look into the eyes of a parent
and tell them our team has helped heal their son or daughter--to give
them peace of mind. My memories of Grady are filled with the gracious
comments from parents and patients for the team of health care
specialists with whom I had the privilege of working. I cherished my
time there.
After 25 years of school and training, I hung out my shingle to
start a solo private orthopedic practice. Over the years, this practice
grew and eventually became one of the largest, non-academic orthopedic
groups in the country--a group I would eventually serve as chairman of
the board. Whether as part of that team or on staff at a hospital, it
was apparent early on that every person involved in the delivery of
care, no matter their role--doctors, nurses, lab techs, orderlies--all
had one goal in mind and that was to get our patients well again, to
heal them. It was always a team effort and wherever you fit into that
team, you appreciated the value of those working with you.
During 20 years as a practicing physician--both in office and
hospital setting--I learned a good bit about not just treating patients
but about the broader health care system and where it intersects with
government--local, State and Federal. A couple of lessons stand out.
One lesson was that many patients I knew or treated were never more
angry and frustrated than when they realized that there was someone
other than themselves and/or their physician making medical decisions
on their behalf--when there was someone not involved in the actual
delivery of care that was standing between them and their doctor or
treatment.
Another lesson came the day I noticed that there were more
individuals within our office who were dealing with paperwork,
insurance filings, and government regulations than there were
individuals actually seeing and treating patients. It was in those
moments that it became crystal clear that our health care system was
losing focus on the No. 1 priority--the individual patient. Having had
no greater joy than taking care of patients, I felt compelled to
broaden my role in public service, and help solve the issues harming
the delivery of medicine, so I ran for the State Senate in Georgia.
Anyone here who has ever served at the State level knows that State
government has a different feel to it, it's a different pace. In
Georgia, I found the State Senate to be a remarkably bipartisan place
where collegial relationships were the norm. This is the environment in
which I learned to legislate--reaching across the aisle to get the work
done--needing the buy-in and the support of more than just one party. I
worked with Democrats including then-State Senator, now-Atlanta mayor,
Kasim Reed. He and I did not see eye to eye on everything, for sure,
but we were successful in finding our way together through some really
challenging issues for our State.
In Congress, I have been fortunate to have been a part of
collaborations that broke through party lines to solve problems
including those pertaining to health care. Early in my congressional
career, I was privileged to work alongside then-representative, now
Senator, Tammy Baldwin to introduce legislation that would have
empowered States to come up with new ideas to provide health care
coverage to their uninsured populations. Just this past Congress, it
was a bipartisan, bicameral effort that actually succeeded in ridding
Medicare of a broken physician payment system and which has now begun
the creation of a new system that, if implemented properly, will help
ensure that seniors have better access to higher quality care.
If confirmed, my obligation will be to carry to the Department of
Health and Human Services both an appreciation for bipartisan, team-
driven policymaking and what has been a lifetime commitment to work to
improve the health and well-being of the American people. That
commitment extends to what I call the six principles of health care--
six principles that, if you think about it, all of us hold dear:
affordability, accessibility, quality, choices, innovation, and
responsiveness. We all want a health care system that's affordable,
that's accessible to all, of the highest quality, with the greatest
number of choices, driven by world-leading innovations, and responsive
to the needs of the individual patient.
HHS is more than just health care. There are real heroes at this
department doing incredible work to keep our food safe, to develop new
drugs and treatment options--driven by scientists conducting truly
remarkable research. The Centers for Disease Control and Prevention--
which we in Atlanta are proud to have headquartered in our city, is the
first place the world turns to when there's a health care threat that
requires the greatest, most capable minds to solve.
There are heroes among the talented, dedicated men and women
working to provide critical social services--helping families and,
particularly, children have a higher quality of living and the
opportunity to rise up and strive to achieve their American Dream--
something we all want for ourselves and our loved ones.
The role of HHS in improving lives means it must carry out its
responsibilities with compassion. It also must be efficient, effective
and accountable, as well as being willing to partner with those in our
communities already doing remarkable work. In every aspect of the
department, across the spectrum of issues and services it handles,
there is embedded a promise that has been made to the American people.
Governor Michael Leavitt, during his confirmation hearing in 2004 to
take on this task, spoke of our highly regarded ``brands''--the CDC,
FDA, NIH, and others--and how they must be preserved and strengthened
because they guarantee that those promises are kept.
Today's challenges make it even more important that we strengthen
our resolve to keep the promises we, as a society, have made to our
senior citizens and to those among us who are most in need of care and
support. That means saving, strengthening, and securing Medicare for
today's beneficiaries and future generations. It means ensuring that
our Nation's Medicaid population has access to quality care. It means
maintaining, and expanding, America's leading role in medical
innovation and the treatment and eradication of disease.
As I noted at the outset, I share your passion for these issues--
having spent my life in service to them. Yet, there's no doubt that we
do not all share the same point of view when it comes to addressing
each and every one of them. Our approaches to policies may differ, but
there surely exists a common commitment to public service and
compassion for those we serve. We all hope, by our actions, to help
improve the lives of the American people, to help heal individuals and
whole communities. With a healthy dose of humility and appreciation for
the scope of the challenges before us, with your assistance and with
God's will, we can make it happen. I look forward to working with you
to do just that.
Thank you very much for the privilege of appearing before you
today.
The Chairman. Thank you, Dr. Price.
We will now begin a round of 7-minute questions, and I'll
start the questioning.
I'll just talk about the Affordable Care Act and the health
care system. My belief is that the historic mistake in the
passage of the Affordable Care Act was it sought to expand a
system that already cost too much, a health care system.
What is our goal here of those who want to repair the
damage of Obamacare and replace parts of it? Is it to lower the
cost of insurance for Americans? Is it to give them more
choices of that lower-cost insurance? Is it to put more
decisions in the hands of States and into the hands of
patients?
Dr. Price. Thank you, Mr. Chairman. I think certainly the
issues that you raised with choices and access and cost are at
the heart and the center of where we ought to be putting our
attention. As I mentioned in the six principles that I have for
health care, affordability is incredibly important. It doesn't
do you any good if you can't afford health coverage.
Accessibility is absolutely imperative. Today many folks have
coverage but they don't have care because they don't have
access to the physicians that they'd like to see. So choices
are absolutely vital.
The Chairman. Well, isn't one of the primary means for
achieving those choices moving more health care decisions out
of Washington, putting them back in the hands of States and
patient consumers?
Dr. Price. I think in many instances the closer that you
can have those decisions to the patient, keeping the focus on
the patient, the better.
The Chairman. If the responsibilities are headed toward the
States, or some responsibilities, would that not necessarily
involve a fair amount of extensive consultation with Governors
and State insurance departments about how to do that and what
the implementation schedule ought to be?
Dr. Price. Absolutely. Folks at the State level, as you
well know, having served there, know their populations better
than we can know them.
The Chairman. Senator McConnell said last week that
Obamacare would be replaced and repealed in manageable pieces.
I want to suggest some pieces to you on a chart back here. It
looks to me like there are four major areas where Americans get
our health care insurance. One is Medicare, 18 percent of
Americans. One is employer insurance. Sixty-one percent of
Americans get their insurance on the job. One is Medicaid,
which is 22 percent. One is the individual market, only 6
percent, and the exchanges we hear so much about are just 4
percent of that 6 percent, but that's where so much of the
turmoil is.
Let me ask you this. Is this bill an effort to replace and
repeal Obamacare, is this the bill to reform Medicare?
Dr. Price. Absolutely not.
The Chairman. We would be focused on employer, Medicaid,
and individual insurance. Are those accurate categories, or
would you categorize them in a different way?
Dr. Price. I think the challenges that we have to address
immediately are those in the individual market and in the
Medicaid market, as you identified.
The Chairman. Is it possible to work on one of those areas
at a time rather than in a comprehensive--or let me put it this
way. I said don't expect Senator McConnell to wheel in a
wheelbarrow with a big comprehensive Republican health care
plan. That's because, in my opinion, we don't believe in that.
We don't believe in replacing a failed Washington, DC. health
care plan with our own failed plan. We want to work on it step
by step, large piece by piece. How do you respond to that?
Dr. Price. I think that's fair. I think that for
individuals to--the American people need to appreciate that the
last thing we want to do is go from a Democrat health care
system to a Republican health care system. Our goal would be to
go from what we see as a Democrat health care system to an
American health care system that recognizes the needs of all.
The Chairman. I know your plan won't be presented until
after you're confirmed, but the President-elect has said let's
do repeal and replace simultaneously. To me that must mean that
any repeal of parts of Obamacare wouldn't take effect until
after some concrete, practical alternative were in place for
Americans to choose. Is that accurate, or do you have a
different idea of what ``simultaneous'' might mean or what the
sequencing might be as we move through this process?
Dr. Price. No, I think that's fair. I think one of the
important things that we need to convey to the American people
is that nobody is interested in pulling the rug out from under
anybody. We believe that it's absolutely imperative that
individuals that have health coverage be able to keep health
coverage and move, hopefully, to greater choices and
opportunities for them to gain the kind of coverage that they
want for themselves and for their families. I think there's
been a lot of talk about individuals losing health coverage.
That is not our goal, nor is it our desire, nor is it our plan.
The Chairman. Let me ask you about how long this all might
take, this repairing the damage, this working on these three
big areas--individual market, Medicaid, and employer. My sense
of it is that we've been working on this so long, although we
have different opinions about it, we ought to be able to make
most of our votes in the next few months about what to do, but
that the implementation about whatever we decide, especially
since some of it will be going back to the States, to the
department that you hope to lead, might take several years. Is
there a difference between the votes we might take and then a
longer time for implementation of what we decide to do?
Dr. Price. No, I think that's fair. I would point out that
our health care system is continually evolving, and should. We
ought to be always looking at how it's working, whether it's
working for patients, whether it's working for the individuals
that are working to provide the highest quality care for folks,
and when it is, that's fine. When it isn't, then it's incumbent
upon policymakers to make certain that we do the kinds of
things to adjust that policy so that it can work, especially
for patients.
The Chairman. My last question is about this individual
market, the 6 percent. The Obamacare exchanges are about 4
percent of all of us who have insurance. Our insurance
commissioner in Tennessee says the market is virtually
collapsing. I'm told by many people that we need to basically
have a rescue plan, a reform plan for the individual market in
place by March the 1st so that insurance companies who make
their decisions about the year 2018 can make those plans so
that people have insurance to buy in all of these States. Do
you agree that the market is collapsing, that we need a rescue
plan, and that March the 1st is an important approximate date
for a decision of action?
Dr. Price. Well, we're clearly seeing changes in the
individual and small group market that are adverse to the
patient. Whether it's decreasing access to coverage, whether
it's increasing premiums, whether it's higher deductibles,
something is going badly wrong out there, and it's imperative,
I believe, for us to recognize that, and then to put in place
the kinds of solutions that we believe to be most appropriate.
The Chairman. And your plan that we're likely to see in
February will include recommendations for how to do that?
Dr. Price. We look forward to, should I be given the honor
of leading the Health and Human Services, along with the
President, we look forward to working with Congress to come
forward with that plan.
The Chairman. Thank you, Dr. Price.
Senator Murray.
Senator Murray. Thank you, Mr. Chairman.
Before I start, I want to ask consent to put a letter to
Chairman Alexander from all 11 Democrats on this committee on
the importance of a second round of questions on this nominee;
and I ask unanimous consent to put in the record 25 letters
signed by 193 organizations opposing Congressman Price's
nomination to lead the Department of Health and Human Services;
and I also have a petition signed by 500,000 people from across
the country opposing this nomination I ask to put in the
record.
The Chairman. They will be.
[The information referred to may be found in Additional
Materials; however due to the high cost of printing some
letters are being retained in committee files.]
Senator Murray. Congressman Price, recent press reports
about your investments in the Australian biotech company Innate
Immunotherapeutics raises some serious questions about your
judgment, and I want to review the facts.
You purchased stock in Innate Immunotherapeutics, a company
working to develop new drugs, on four separate occasions
between January 2015 and August 2016. You made the decision to
purchase that stock, not a broker; yes or no?
Dr. Price. That was a decision that I made, yes.
Senator Murray. You were offered an opportunity to purchase
stock at a lower price than was available to the general
public; yes or no?
Dr. Price. The initial purchase in January 2015 was at the
market price. The secondary purchase in June through August/
September 2016 was at a price that was available to individuals
that were participating in a private placement offering.
Senator Murray. It was lower than was available to the
general public, correct?
Dr. Price. I don't know that it was. It was the same price
that everybody paid for the private placement offering.
Senator Murray. Well, Congressman Chris Collins, who sits
on President-elect Trump's transition team, is both an investor
and a board member of the company. He was reportedly heard just
last week off the House floor bragging about how he had made
people millionaires from a stock tip.
Congressman Price, in our meeting, you informed me that you
made these purchases based on conversations with Representative
Collins. Is that correct?
Dr. Price. No. What I----
Senator Murray. Well, that is what you said to me in my
office.
Dr. Price. What I believe I said to you was that I learned
of the company from Congressman Collins.
Senator Murray. What I recall our conversation was that you
had a conversation with Collins and then decided to purchase
the stock.
Dr. Price. No, that's not correct.
Senator Murray. Well, that is what I remember you said in
my office. In that conversation, did Representative Collins
tell you anything that could be considered a stock tip? Yes or
no?
Dr. Price. I don't believe so, no.
Senator Murray. Well, if you're telling me he gave you
information about a company, you were offered shares in the
company at prices not available to the public, you bought those
shares, is that not a stock tip?
Dr. Price. That's not what happened. What happened was that
he mentioned--he talked about the company and the work that
they were doing and trying to solve the challenge of
progressive secondary multiple sclerosis, which is a very
debilitating disease and one that I----
Senator Murray. I'm well aware of that.
Dr. Price [continuing]. When I had the opportunity to treat
patients when I was in practice.
Senator Murray. I'm aware----
Dr. Price. I studied the company for a period of time and
felt that it had some significant merit and promise and
purchased the initial shares on the stock exchange itself.
Senator Murray. Congressman Price, I have very limited
time. Let me go on.
Your purchases occurred while the 21st Century Cures Act,
which had several provisions that could impact drug developers
like Innate Immunotherapeutics, was being negotiated; and
again, just days before you were notified to prepare for a
final vote on the bill.
Congressman, do you believe it is appropriate for a senior
Member of Congress actively involved in policymaking in the
health sector to repeatedly personally invest in a drug company
that could benefit from those actions? Yes or no?
Dr. Price. That's not what happened.
Senator Murray. Well, let me just say that I believe it's
inappropriate, and we need answers to this regarding whether
you and Congressman Collins used your access to non-public
information when you bought at prices that were unavailable to
the public and----
Dr. Price. I had no access to non-public information.
Senator Murray. Well, we'll move on.
Congressman Price, just last week you and Republicans in
Congress voted to begin ripping apart our health care system,
which would cause nearly 30 million people to lose their
coverage and raise health care costs for families, without
telling the American people specifically what you plan to do
instead. President-elect Trump and Republicans in Congress have
promised to deliver a plan that prevents anyone from losing
coverage and leaves no one worse off. Just days ago President-
elect Trump said his plan would provide insurance for
everybody. Do you share those goals?
Dr. Price. I think it's absolutely imperative that we have
a system in place that has patients at the center and allows
for every single American to have the opportunity to gain
access to the kind of coverage they want.
Senator Murray. You share his goal of insurance for
everybody?
Dr. Price. That's been always my stated goal. It's what
we've worked on throughout my entire public career.
Senator Murray. OK. If your repeal plan, the Empowering
Patients First Act, was signed into law, would you consider
these commitments to insure all Americans and leave no one
worse off to be met?
Dr. Price. The goal of the bills that I've worked on here
in Congress, and understanding that the role, if I'm given the
privilege of leading----
Senator Murray. I'm asking about you, though.
Dr. Price [continuing]. Is different, but my role in
Congress was to always make certain that individuals had the
opportunity to gain access to the kind of coverage that they
desired, and that they had the financial feasibility to do so.
That's what's different about the plans that we put forward.
Senator Murray. Well, I think it's really important that we
have clear answers, so let me just say this. Your bill only
allows people with pre-existing conditions to obtain health
insurance if they maintained continuous insurance for 18 months
prior. Millions of Americans with pre-existing health
conditions lack insurance for short periods of time. Under your
plan, insurance companies could deny those Americans coverage
for pre-existing conditions. Yes or no? Under your bill.
Dr. Price. It's a broader question than that because we
would put in place high-risk pools and individual health pools
that would allow every single person in the individual small
group market who are the ones challenged with pre-existing
illness to be able to gain access again to the coverage that
they want. We believe through that plan that every single
person would have the opportunity and financial feasibility to
gain the coverage that they want for themselves and for their
families.
Senator Murray. We disagree on the consequences of that.
Your bill would repeal dependent coverage available to
young adults up to age 26. That is correct, right?
Dr. Price. The bill that I authored did not include
coverage up to age 26. The insurance companies have said that
they were working on that, that they were including that in
their plans going forward, and so we felt it was covered.
Senator Murray. OK, and your bill takes away current
benefits, which includes prescription drugs, mental health and
substance use disorder benefits, and maternity coverage, among
others. That is correct, right?
Dr. Price. Again, it's different in the legislative arena
than it is in the administrative arena, but there are other
factors that we would put in place that would make certain that
individuals had the care and the kind of coverage that they
needed for whatever diagnosis would befall them.
Senator Murray. Again, I disagree with the consequences.
Your bill didn't cover that.
Your bill also repeals the lifetime limits on coverage that
helps a lot of people who are sick and have high medical
expenses, like a person with cancer. Yes or no?
Dr. Price. Again, it's a larger question because what we
would put is a different construct in place that would allow
for every single person to gain access to the coverage that
they want and have nobody fall through the cracks.
Senator Murray. Well, I think just with these questions I'm
very concerned that your vision for a health care system is
very different than one that I think millions of Americans are
counting on.
The Chairman. Thank you, Senator Murray.
Senator Enzi.
Statement of Senator Enzi
Senator Enzi. Thank you, Mr. Chairman.
Thank you, Dr. Price, for being willing to serve and to go
through this process. I call this ``gotcha management.''
Nothing is barred, and the idea is to get you to take questions
on short notice in public that you wouldn't have done what you
normally do. I've worked with you for the last 2 years, meeting
with you at least once a week every week that we've been in
session. I know how you operate, and I appreciate how you
operate, and the care and the focus and the concern and how
comprehensively you think about particularly the medical
things.
One of my concerns is always the rural areas, because
Wyoming is the most rural State in the Nation. I hesitate to do
that because last night at the Education hearing I got to hear
from Mrs. DeVos, who remembered a conversation from a month
before that I had on a rural problem which dealt with grizzly
bears by the Wapiti School in Wyoming. That became a major
topic around here, and I'm glad everybody recognizes that need
and concern. Part of the story was that that's the grade school
that former Senator Craig Thomas went to. When he was there,
they didn't need that defense because he was tough.
[Laughter.]
There are different kinds of problems in different places
than the health care area. I have a county that's the size of
Delaware. It has one community that would like to say it has
2,500 people. It does have a hospital. When you have a rural
community, a rural county that big with that small of a town,
it's difficult to keep a doctor. Without at least a PA there,
the hospital has to close. If that hospital closes, emergency
care is 80 miles away, not a likely story in most of the
places, and we need to make sure that those things are covered.
I've appreciated getting to share those with you over the
period of time.
I was always curious as to why you left a very successful
practice and were willing to come back here and try to make a
difference, and I want to congratulate you on the difference
that you have made. One of the questions I'd ask you is why are
you willing to leave a place with so much responsibility and
background and capability to be willing to be the Secretary of
Health and Human Services.
Dr. Price. Thank you, Senator. When I think about the
mission of the Department of Health and Human Services, which
is to improve the health, safety, and well-being of the
American people, it's what I literally spend my life trying to
do. To have the opportunity to participate, if confirmed, to
serve as the Secretary of Health and Human Services and try to
guide that organization in a direction that would further
fulfill that mission, I can't think of anything more exciting
or fulfilling.
Senator Enzi. Well, I think you have the background for
doing that too, with the wide range of experience you had
between the different practices and hospitals, and then coming
here and going through a number of different committee
situations. What you're about to go through is rather intense,
and then that's followed by probably the most productive part,
if Senators happen to read the answers, and that's when you get
to do written questions as well, which we hope you'll provide a
rapid response on. Those aren't nearly as much fun for the
panelists because they aren't in public.
I'll move to some questions that are a little bit more
related here.
Because we begin the serious and challenging task of
restoring the health insurance markets which are teetering on
the brink now, some are collapsing--in some counties you can't
get coverage. In Wyoming there's only one provider, and it's my
understanding that the incoming administration may have the
ability to make some key policy changes immediately. Some of
the most critical changes for short-term stabilization of the
markets might include reducing the number of special enrollment
periods and requiring up-front verification, or aligning grace
periods for non-payment of premiums in State law. My
understanding from those in the insurance business is it's
targeted actions by the Department of Health and Human Services
may provide some meaningful changes that could impact premiums
for the next year. Are those some options that you might
consider?
Dr. Price. Absolutely. The insurers, as I think the
Chairman mentioned, are deciding right now as they come forward
in March and April, what the premium levels will be for 2018--
calendar year 2018. What they need to hear from all of us, I
believe, is a level of support and stability in the market, the
kinds of things that make it so that they're able to provide
product to patients out there.
You mentioned that there are counties in your State where
there is only one provider. There are five States in this
Nation where there's only one insurance provider. One-third of
the counties in this country only have one insurance provider.
We must as policymakers and as folks administering these
programs, we must ask ourselves what's going wrong, where are
the problems out there. That may work for the insurers in
certain instances, it may work for government, but it doesn't
work for patients. If we keep the patients at the center of all
of this, we'll get to the right answer, and that's what I hope
to do with each and every one of you.
Senator Enzi. I appreciate that. I got to work for years
with Senator Kennedy on biologics and biosimilars, and having
the requirements for their biosimilarity and their
changeability has needed some additional information. The FDA
has issued guidance documents since the law passed, but they
haven't set policy on interchangeability with the reference
product. I was concerned that in 2017, having gone through
nearly two full presidential terms, that just yesterday we
finally got a draft of the FDA's interchangeability policy.
I'll ask that question, since my time has expired, in
writing. Thank you.
Dr. Price. Thank you very much, Senator.
The Chairman. Thank you, Senator Enzi.
Senator Sanders.
Statement of Senator Sanders
Senator Sanders. Thank you, Mr. Chairman.
Congressman Price, thanks for being here, and thanks for
the conversation we had the other day.
Dr. Price. Thank you.
Senator Sanders. Congressman, on May 7, 2015--let me begin
by saying all of us know that we have come through a very
unusual election process. President-elect Trump received almost
3 million votes less than Secretary Clinton, but he won the
electoral college. He's going to be inaugurated this week. He
won a number of States by rather slim margins.
During the course of his campaign, Mr. Trump said over and
over again that he would not cut Social Security, not cut
Medicare, not cut Medicaid. Let me read some quotes.
On May 7, 2015, Mr. Trump tweeted, ``I was the first and
only potential GOP candidate to state there would be no cuts to
Social Security, Medicare and Medicaid.''
On April 18, 2015, he said,
``Every Republican wants to do a big number on Social
Security, they want to do it on Medicare, they want to
do it on Medicaid, and we can't do that, and it's not
fair to the people that have been paying in for years,
and now all of a sudden they want to be cut.''
August 10, 2015, Mr. Trump said,
``I will save Medicare, Medicaid, and Social Security
without cuts. We have to do it. People have been paying
in for years and now many of these candidates want to
cut it.''
March 29, 2016, Trump said,
``You know, Paul Ryan wants to knock out Social
Security, knock it down, way down. He wants to knock
Medicare way down. Frankly--well, two things. No. 1,
you're going to lose the election if you're going to do
that. I'm not going to cut it, and I'm not going to
raise ages, and I'm not going to do all of the things
they want to do. They want to really cut it, and they
want to cut it very substantially, the Republicans, and
I'm not going to do that.''
On and on and on.
The point being, this is not something he said in passing.
I think it is likely he won the election because millions of
working-class people and senior citizens heard him say he was
not going to cut Social Security, Medicare and Medicaid.
Congressman Price, a very simple question: Is the
President-elect, Mr. Trump, going to keep his word to the
American people and not cut Social Security, Medicare and
Medicaid, or did he lie to the American people?
Dr. Price. I have--I haven't had extensive discussions with
him about the comments that he made, but I have no reason to
believe that he's changed his position.
Senator Sanders. All right. You are telling us that, to the
best of your knowledge, Mr. Trump will not cut Social Security,
Medicare and Medicaid.
Dr. Price. As I say, I have no reason to believe that that
position has changed.
Senator Sanders. Congressman Price, quoting Mr. Trump
again, or at least paraphrasing him, just last week he said,
roughly speaking, pharma is getting away with murder. Do you
recall that tweet?
Dr. Price. I do.
Senator Sanders. OK. There are many of us on this side of
the aisle who are working on legislation that would do at least
two things: No. 1, end the absurdity of the American people
being ripped off by the pharmaceutical industry, who 2 years
ago the top five companies made $50 billion in profits, while
one out of five Americans can't afford to fill the
prescriptions their doctors write.
Will you and will the President-elect join us in
legislation we are working on which, No. 1, will allow Medicare
to negotiate prices with the drug companies and lower prices;
and No. 2, allow the American people to bring in less expensive
medicine from Canada and other countries? Is that something you
will work with us on?
Dr. Price. The issue of drug pricing and drug costs is one
of great concern to all Americans. I think it's important to
appreciate that in a couple of areas we've had great success,
whether it's in the generic area where the costs are
significantly less than they have been, and in----
Senator Sanders. You are aware, sir--I don't mean to
interrupt. I don't have a lot of time. We are paying by far the
highest prices in the world for prescription drugs. You don't
disagree with that, do you?
Do you disagree with that?
Dr. Price. I think that's the case. I'd have to look at the
statistics.
Senator Sanders. It is, it is.
Dr. Price. I think there are a lot of reasons for that, and
if we get to the root cause of what that is, then I think we
can actually solve the bipartisan----
Senator Sanders. Well, one of the root causes is that every
other major country on earth negotiates drug prices with the
pharmaceutical industry. In our country, the drug companies can
raise their prices. Today they could double their prices. There
is no law to prevent them from doing that.
Will you work with us so that Medicare negotiates prices
with the pharmaceutical industry?
Dr. Price. You have my commitment to work with you and
others to make certain that the drug pricing is reasonable and
that individuals across this land have access to the
medications that they need.
Senator Sanders. It wasn't quite the answer to the question
that I asked.
Congressman Price, the United States of America is the only
major country on earth that does not guarantee health care to
all people as a right. Canada does it. Every major country in
Europe does it. Do you believe that health care is a right of
all Americans, whether they're rich or they're poor? Should
people, because they are Americans, be able to go to the doctor
when they need to, be able to go into a hospital, because they
are Americans?
Dr. Price. Yes. We're a compassionate society----
Senator Sanders. No, we are not a compassionate society. In
terms of our relationship to poor and working people, our
record is worse than virtually any other country on earth. We
have the highest rate of childhood poverty of any other major
country on earth, and half of our senior older workers have
nothing set aside for retirement. I don't think compared to
other countries we are particularly compassionate.
My question is, in Canada, in other countries, all people
have the right to get health care. Do you believe we should
move in that direction?
Dr. Price. If you want to talk about other countries'
health care systems, there are consequences to the decisions
that they've made, just as there are consequences to the
decisions that we made. I believe, and I look forward to
working with you to make sure that every single American has
access to the highest quality care and coverage that is
possible.
Senator Sanders. ``Has access to'' does not mean that they
are guaranteed health care. I have access to buying a $10
million home. I don't have the money to do that.
Dr. Price. That's why we believe it's appropriate to put in
place a system that gives every person the financial
feasibility to be able to purchase the coverage that they want
for themselves and for their family, again not what the
government forces them to buy.
Senator Sanders. Yes, but if they don't have any--well,
it's a longer story. Thank you very much.
Dr. Price. Thank you.
The Chairman. Thank you, Senator Sanders.
Senator Hatch.
Statement of Senator Hatch
Senator Hatch. Well, thank you, Mr. Chairman.
Welcome to the committee. Having worked with you over the
years, I found you to be always very, very knowledgeable----
Dr. Price. Thank you.
Senator Hatch [continuing]. Very up front, very
straightforward, very honest, and somebody who really
understands the health care system of this country. You're just
perfectly situated to be able to help turn it around and get it
so it works. We hear a lot from the other side about how bad
the system is and so forth, and I'm going to tell you I don't
think it's very good myself, and we've got to work on it and
get it done right. Boy, I'd sure like to have you right there
helping to get it done, because you're one of the really
premiere people in this whole Congress and in the world, as a
matter of fact, understanding what needs to be done, and yet
recognizing the problems of getting it done.
Dr. Price, some of my colleagues have criticized you for
your health-related stock holdings while serving in the House.
Not only do House rules not prohibit members from trading
stocks but it is also not an uncommon practice for Members of
Congress. In fact, there are members on this committee, as I
understand it, who have traded individual health stocks while
serving on this committee. This appears to be nothing more than
a hypocritical attack on your good character, and I personally
resent it because you have always disclosed.
Let me just say this. Can you confirm that you have always
followed the law related to trading in stocks while serving as
a Member of Congress?
Dr. Price. Thank you, sir. Everything that we have done has
been above board, transparent, ethical and legal. As you know,
and the members of this committee know, there's an organization
that's called the Office of Government Ethics that looks at
all--for every Cabinet nominee, looks at all of the
possessions, all the holdings and the like, and makes a
recommendation as to what that Cabinet member must do in order
to make certain that there's no conflict of interest. The
Office of Government Ethics has looked at our holdings and
given advice about what would need to be done in terms of
divesting from certain stock holdings to make certain that
there's no conflict of interest. We have read those and agreed
to those, signed those. That document is online for everybody
to see so that everybody is absolutely certain that there will
be no conflict of interest whatsoever.
Senator Hatch. Well, thank you. And you followed their
advice?
Dr. Price. Absolutely.
Senator Hatch. Well, Dr. Price, the collapse of Obamacare
has exacerbated our Nation's health care problems. Too
frequently my colleagues and I have seen European idealism
strangle functional insurance design with cost-prohibitive
measures. Despite these failed reforms, I don't think we can
lose sight of the broader health system that is at risk. For
example, rare disease patients do not have access to life-
saving treatments because policies that have stemmed from
Obamacare prevent investments in innovative therapies that can
cure and save lives. This is an issue that I'm deeply
passionate about.
Dr. Price, what steps do you believe will improve the
pipeline for rare disease therapies to bring treatments and
cures to patients in desperate need of hope?
Dr. Price. The Orphan Drug Act, which passed I think 30
years ago or so----
Senator Hatch. That was my first bill, by the way.
Dr. Price. It really has revolutionized the ability to
treat rare diseases. What it did was make the United States the
leader in coming forward with treatments for rare diseases. I
think that there are things that we can do in terms of patent
protection, in terms of liability, in terms of incentivization
resources to be able to encourage the discovery of cures for
rare diseases.
Senator Hatch. We have a lot more drugs coming through,
even some blockbuster drugs that came because of that little
bill.
Dr. Price. Yes.
Senator Hatch. We just put some incentives in effect, and
all of a sudden there's an explosion in orphan drugs for
populations of less than 200,000. It's a pretty important
little bill.
Dr. Price. One of the successful ones.
Senator Hatch. It didn't cost a lot of money, but it was a
Republican bill.
Dr. Price. Yes, one of the success stories truly for public
policy in the country.
Senator Hatch. All right. Dr. Price, one of the central
duties of the HHS Secretary is to be diligent and thoughtful
when considering if Federal regulation is necessary in
assessing whether the regulations impede research, development,
and innovation. Over the years the regulatory infrastructure
guiding dietary supplements has changed dramatically. Do you
recognize the importance of dietary supplements in helping
Americans reach and maintain healthy lifestyles?
Dr. Price. Absolutely.
Senator Hatch. Will you commit to me and other members of
the committee to work to ensure appropriate regulation and
implementation of the Dietary Supplement Health and Education
Act so that we can protect public health while assuring
consumers continued access to safe products?
Dr. Price. This is one of those areas where it's incredibly
important to gain the information that you referred to, to
gather the individuals that know the most about this area,
whether it's consumers, whether it's those providing the
product to market, to make certain that there are protections
for unadulterated products. It's absolutely vital that we get
this right.
Senator Hatch. Well, I'll tell you this, I have to commend
Donald Trump for picking you.
Dr. Price. Thank you.
Senator Hatch. You are clearly one of the premiere people
in all of Congress who understands the problems of health care,
and you have the professional background that I don't know if
any other Member of Congress can match to help solve the
problems that we have. We've got a real messy situation here,
and Obamacare has not really helped. Do you think Obamacare has
helped?
Dr. Price. I think some of the things that have occurred
with the passage of the ACA have improved certain areas. The
coverage has certainly improved. The consequences of that, that
many people, as I mentioned before, have coverage but they
don't have care. There are so many things about just the
decisionmaking process, who decides about our health care.
Should it be the Federal Government, or should it be patients
and families and doctors? We certainly believe the latter as
opposed to the former.
Senator Hatch. I take it you believe that getting health
care closer to the people is a far better thing than everybody
pontificating from Washington, DC.
Dr. Price. I think the more involvement that patients and
families and doctors can have in medical decisions, the higher
quality care we'll have.
Senator Hatch. In my earlier life--one of the things I did
was--I was a medical liability defense lawyer, defending
doctors, hospitals, nurses, health care providers, et cetera.
What do you think we should do about medical liability?
Dr. Price. This is really a difficult challenge because
it's not just the malpractice rates that doctors or hospitals
pay, but it's the practice of defensive medicine, which are the
things that physicians do that don't hurt anybody but there are
tests and procedures and examinations that aren't necessarily
needed to either make a diagnosis or to treat patients.
Senator Hatch. But show up in their history.
Dr. Price. It shows up in their history so that if they're
called into a court of law they can say to the judge and the
jury I don't know what you wanted me to do because I did
everything, when in fact everything is rarely necessary to
either treat or to diagnose the patient.
If we look at it in that light and try to focus on
decreasing the practice of defensive medicine to the benefit of
patients, then I think we can get to the right answer, and
there are some exciting opportunities out there that have been
bipartisan in the past.
Senator Hatch. Well, thank you, sir. I think you're a great
nomination.
Dr. Price. Thank you.
The Chairman. Thank you, Senator Hatch.
Senator Casey.
Statement of Senator Casey
Senator Casey. Thank you, Mr. Chairman.
Representative Price, we're grateful you're here, and
thanks for the visit to our office.
Dr. Price. Thank you.
Senator Casey. I wanted to highlight something we probably
don't spend enough time highlighting or talking about, and
that's the full protections of what was known as the original
bill, the Patient Protection and Affordable Care Act. We've had
a lot of shorthand terminology since then. I know you and I
have a basic disagreement; I think it's important to be candid
about that.
I think what a lot of people have forgotten about is that--
and the Chairman had a chart earlier that outlined the
categories of Americans that have health insurance by virtue of
various programs, or I think the number he had on the poster
about the number of Americans in the employer-sponsored
coverage category I think was 178 million people. That's a lot
of folks with coverage, who had coverage before. Most of them
had coverage before the legislation and after, meaning they
were paying their premiums and had coverage. They didn't have
protections that only came with the passage of the legislation.
We know that somewhere between 11 and 12 million people
have purchased health insurance through the individual
marketplace. I want to ask you a couple of questions about
those basic protections that are now law that were not law
before.
I think you'd agree with me, and you know from your
practice that you meet just remarkably inspiring people in your
work, and once in a while here in the Senate we do as well,
probably don't take enough time to have those opportunities.
One of the people I met in the lead-up to the legislation
passing was Stacey Ridder. She was from Manheim, PA. She didn't
have a personal challenge. It was the challenge faced by her
two daughters. They were 4 years old, Madeline and Hana. As
Stacey said about her daughters, she said that they would be at
that time, before the passage of the bill, punished and
rejected because they had the misfortune of developing cancer
as a child. Her basic problem was the caps on treatment.
The first question I'd ask you in terms of your work as
Secretary of Health and Human Services, should you be
confirmed, will you commit to maintaining the protections that
ensure that no child, no child is denied insurance coverage
because of pre-existing conditions?
Dr. Price. Pediatric cancer is one of those things that is
remarkably challenging. I remember when I was in my residency
and did a rotation on the pediatric orthopedic ward, and so
many of those children had cancer. Before I began that rotation
I almost dreaded going to that month because I was worried
about just the severity of the challenges I would meet.
I'll tell you, it was one of the most uplifting months I
spent in medical school, and that was because the children were
so uplifting.
So, absolutely, we need to make certain that every single
child has access to the kind of coverage that they need and the
care that they need, and there are a number of ways to do that,
and I look forward to working with you to make that happen.
Senator Casey. I heard the word ``yes'' there.
Second, and it's really hard to believe that we even have
to ask a question about this next topic, which is victims of
domestic violence. It was the State of the law prior to the
passage of the legislation that victims of domestic violence
were considered Americans who had a pre-existing condition.
It's still the law in some States that they are not protected.
Question No. 2 is will you commit to maintaining the
protections that ensure that victims of domestic violence will
not be discriminated against when purchasing health insurance?
Yes or no?
Dr. Price. I think it's absolutely vital that victims of
domestic violence and others, anybody--we need a system in
place that ensures that individuals are either not priced out
of the market because they get a bad diagnosis or not eligible
or able to purchase coverage that works for them because of
their diagnosis.
Senator Casey. I have limits--I don't want to interrupt. I
don't want to get hung up on ``priced out of the market.'' What
I'm asking for is an ironclad guarantee that that circumstance,
that horrific circumstance will never be a bar to coverage,
treatment, or care.
Dr. Price. It certainly shouldn't be. As you well know, I
think if I'm fortunate to be confirmed, that's an
administrative role and it's a policy decision that the
legislators would----
Senator Casey. I think we can agree on that.
No. 3, will you maintain the commitment and the protections
that prohibit discrimination in health insurance on the basis
of health status or disability? Yes or no?
Dr. Price. Again, I think it's absolutely imperative that
we have a system in place that works for patients, and anybody
not being able to gain access to the coverage that they want or
need is not a system that works for patients.
Senator Casey. I'll followup with more questions. What I'm
getting at here is that we had a state of the law before
passage of the ACA where individuals like that, whether a child
had a pre-existing condition, even if their parents were paying
premiums for years, an insurance company could literally say,
``Sorry, you have a pre-existing condition, so you can't get
coverage.'' Women were discriminated against because they were
women, just a remarkable stain on America that we allowed that
to happen.
My concern, though, now is not just a series of concerns
about what you have proposed as a member of the House and what
you could do as Secretary, but I just heard earlier that the
three areas that will be of focus in whatever replacement plan
there is--and I'm anxious to see it--would be--and I wrote them
down. I think Chairman Alexander wanted to take off the table--
and that's a good thing--Medicare. I heard that there will be
three targets--that's my word, of course--the individual
market, Medicaid, and employer-sponsored coverage.
I hope if employer-sponsored coverage is a subject of
change, that we'll ensure all those protections that are in
place right now, and that's why I'm asking those questions.
I'll followup more in writing or if we get another round.
Mr. Chairman, put me on record as incorporating by
reference everything Ranking Member Murray said about questions
and an additional round. Thank you.
Dr. Price. Thank you, Senator.
The Chairman. Thank you, Senator Casey. Duly noted, and I
appreciate your using your 7 minutes to ask questions.
Senator Isakson has deferred to Senator Paul..
Statement of Senator Paul
Senator Paul. As a fellow physician, and as a fellow
physician who did so much at Grady, congratulations. I wish
everybody on the committee could come to Grady and see what
it's like to work in one of our Nation's biggest charity
hospitals, often doing work that is just incredible--gunshot
wounds, compound fractures of the femur, you name it. I
remember being there as a student and then as an intern. We
used to always calculate how many hours and divide by our
income and say, ``Boy, we wish we could get minimum wage.''
I think it is important that we get somebody with that kind
of clear reasoning and critical skills to be in charge of our
government, both knowing about the medical aspect as well as
the public policy aspect.
I think what I regret about this kind of hearing and what I
think a lot of people in America regret is the vitriol and the
rancor and the partisanship that should go into something that
we should--we kind of all want the same things, and to question
your motives I think is insulting. To question whether you're
honest is insulting.
The whole question of--and I guess this would be my first
question to you--did you go into public service to enrich
yourself or for public service?
Dr. Price. I have a passion for public service and a
passion for people, and that's what guided our decision that
some might think was a foolish decision for both of us.
Senator Paul. Did you take a pay cut to go into public
service?
Dr. Price. I didn't consider the remuneration for public
service.
Senator Paul. Right, but I'm guessing it would have been a
pay cut.
The motives as to what we should do--I think we aren't
separated that much on our motives. I think we all want the
most amount of insurance for people at the least amount of
cost. We want people to get access to health care.
What are your motives? What are your goals? What should we
do with the health care system? Do you want more people to be
insured? Do you want more people to have health care, or do you
think we disagree on just how we do it and not necessarily the
motives?
Dr. Price. As I tried to lay out earlier, and I know time
is short for everybody, but the principles that I think are
absolutely imperative for the health care system is that it's
one that's affordable for everybody, one that provides the
access to health care and coverage for everybody, one that is
of the highest quality, that is responsive to patients--the
system isn't any good if it's not responding to patients--one
that incentivizes innovation because it's the innovation that
drives the high quality health care, and then one that ensures
choices are made and preserved by patients. Patients ought to
be the ones choosing who is treating them where, when, and the
like.
Senator Paul. You, and us by extension, Republicans by
extension, have been accused of having no replacement ideas, no
ideas for how to fix the system. Approximately how many bills
do you have that could be regarded as replacement bills or ways
to improve the health insurance system and our health care?
Dr. Price. We had one large term bill since March of early
2009, and then beyond that tens of pieces of legislation to
address the health care issue.
Senator Paul. It's also been insinuated that America is
this horrible, rotten place, that we don't have compassion, and
then I guess by extension the physicians don't. When you worked
as an emergency room physician, or you worked as a physician,
did you always agree as part of your engagement with a hospital
to treat all comers regardless of whether they had an ability
to pay?
Dr. Price. It's one of the things that we pride ourselves
upon, and that is that anybody that showed up in need of care
was provided that care, and that was true not only in our
residency but in our private orthopedic practice as well.
Senator Paul. It's interesting that those who say we have
no compassion extoll the virtues of socialism, and you look at
a country like Venezuela, with great resources and an utter
disaster where people can't eat, evolving into violence, I
think it is important that we do have a debate in our country
between socialism and communism and America and capitalism.
One of the things that's extraordinary about our country is
that just 2 years ago, in 2014, we gave away $400 billion,
privately, not the government, individually through churches
and through charities. We're an incredibly compassionate
society, and I think often this was misplaced in the wonky
numbers, this number and that number within health care, how
much we do help each other. Not only do we help each other in
our country; I'll bet you half the physicians in my community
in Bowling Green were going on international trips and have
done international charity work, and all that is lost in saying
that we're this heartless, terrible country, and I would just
argue the opposite.
I think the greatness of our country and the greatness of
the compassion of our country, we give away more than the gross
domestic product of most of these socialized countries around
the world. I think it is important.
With regard to replacement, a couple of things. There are
some big, broad ideas that I think would insure more people.
One is the idea of legalizing the sale of all types of
insurance. Under Obamacare, we made it illegal to sell certain
types of inexpensive insurance. Do you think we could insure
more people and help some of the people who actually don't get
insurance under Obamacare to get insurance if we would legalize
the sale of more types of insurance?
Dr. Price. I think choices, as I mentioned, is absolutely
vital. I know that if we have as a principle and as a goal
having patients have those choices, then I believe that
patients will select the kind of coverage that they want. The
choices that ought to be available to them are a full array of
opportunities.
Senator Paul. Do you think health savings accounts will
help also some people that are not helped currently?
Dr. Price. I think health savings accounts and high-
deductible catastrophic coverage are things that make a whole
lot of sense for many individuals. We ought not force anybody
to do anything. It ought to be a voluntary choice, but they
ought to have the choice to be able to select them.
Senator Paul. One of the things you've had different
legislation on and I'm a big supporter of is allowing
individuals to join together in groups to buy insurance. Do you
think this has the possibility of what Senator Alexander talked
about, the millions of people in the individual market? I have
great sympathy for that. I was a small physician with four
employees, and if one employee were to get sick, it could be
devastating not only to them but also to the economics of
keeping them employed.
Letting us join together into pools, where instead of me
buying insurance as one of four people, I could buy it in a big
group, maybe 100,000 people, maybe a million people. Currently
the law kind of prevents that, but you had some bills for
expanding that, and I'm a big fan of that. Could you mention
some of the association-held plans and how that might help some
people to get insurance who don't have insurance currently?
Dr. Price. Association health plans are one of those
entities that would allow individuals who are economically
aligned in some way to be able to purchase coverage together
even though they don't necessarily work together or in the same
group. Individual health pools, which I think is one of the
secrets to being able to solve the individual and small group
market conundrum that we find ourselves in, would allow anybody
to pool with anybody else solely for the purpose of purchasing
health coverage.
It's not a new idea. The model for it is actually the Blue
Shield plan that existed decades ago that allowed people to
pool their resources together for major medical coverage for
hospitalization, and it just makes a lot of sense. It allows
insurance to work the way it's supposed to work, which is to
spread the risk, and then anybody's adverse health status
doesn't drive up the cost for them or anybody else because the
pool is large enough.
The Chairman. Thank you, Senator Paul.
Senator Franken.
Statement of Senator Franken
Senator Franken. I'll tell you how we could get a really
big risk pool. It would be called Medicare for everyone. That
would be the biggest risk pool.
Dr. Price, it was nice meeting you the other day.
Dr. Price. Yes, it was good.
Senator Franken. Did you enjoy meeting me?
[Laughter.]
Dr. Price. I did, I did. I enjoyed our discussion about our
gray hair.
Senator Franken. Dr. Price, what is the leading cause of
preventable death in the United States?
Dr. Price. I'll defer to you. You've obviously got it on
the page in front of you.
Senator Franken. I actually knew this before I put it on
the page. It's smoking.
Dr. Price. That hits home. I lost my dad, who was a Lucky
Strikes smoker from World War II, to emphysema. He prided
himself on the fact that he never smoked a cigarette with a
filter for years and years, and it was an incredible tragedy.
Senator Franken. I lost my dad, too.
As a physician, you may know--I guess you didn't--that
smoking kills approximately 480,000 Americans each year and
totals $170 billion each year in health care costs. Yet,
between 1993 and 2012, you were a shareholder of tobacco, of
big tobacco companies, meaning that you personally benefited
from tobacco sales. Meanwhile, you voted against landmark
legislation in 2009 that gave the FDA the authority to regulate
tobacco.
Congressman Price, you're a physician, which means you took
the Hippocratic Oath, a pledge to do no harm. How do you square
reaping personal financial gain from the sale of an addictive
product that kills millions of Americans every decade with also
voting against measures to reduce the death toll inflicted by
tobacco?
Dr. Price. Well, it's an interesting question, Senator, and
it's a curious observation. I have no idea what stocks I held
in the 1990s or the 2000s, or even now. All of these decisions
for all of us, I suspect, are made through mutual funds and
through pension plans. I would bet--well, I won't bet here. I
would suspect that in your pension plan, that there are
components of that that are held that may have something to do
at some time in your history with tobacco.
Senator Franken. I find it very hard to believe that you
did not know that you had tobacco stocks. I find it a little
hard to believe that in the questions about your stock
portfolio you said you didn't know things. Just over the last 4
years you traded more than $300,000 in health-related stocks,
while at the same time sponsoring and advocating legislation
that could affect the performance of those stocks.
We talked a little bit about the Zimmer Biomet. Your
broker--you say you didn't know this--bought it on March 17,
2016. You did introduce a bill later, a week later, on March
23, 2016. You say that you did not know then that you had this
stock. It was to delay a Federal rule that would have reduced
the profitability of the company's--to delay a rule that would
hurt the company.
What I don't understand is once you found out that your
broker bought it, you kept the stock. You purchased this
$50,000 to $100,000 worth of stock in a biomedical company
called Innate Immuno. We talked about it a little bit. It's the
single largest purchase in the past 3 years, in a private deal
that was not made available to the public, and I find it
absolutely amazing that you responded that you did not know
that you got a discounted price. That is absolutely amazing,
because we discussed this.
Dr. Price. By definition, I believe that's the nature of a
private placement offering. What I said to you and what I've
said to others is that I paid exactly the same price as
everybody else. I disclosed it----
Senator Franken. It was a private offering that only went
to about 20 people, including, Representative, your colleague
Chris Collins, his chief of staff, and a prominent D.C.
lobbyist, and you reported $50,000 to $100,000 in profits on
this purchase. It really begs credulity, sir, when you say you
did not know that you got a discount on this. This was a
private offering to a very small number. When you have the
chairman of the Budget Committee, when you have a Congressman
and his chief of staff, these sound like sweetheart deals, and
I think our job in this body and in Congress and in government
is to avoid the appearance of conflict. And, boy, you have not
done that.
I want to talk just about your latest plan, Empowering
Patients First Act. Some of it is detailed in this article from
the New England Journal of Medicine. It's called ``Care for the
Vulnerable vs. Cash for the Powerful, Trump's Pick for HHS.''
I'll just read a random paragraph.
``Price's record demonstrates less concern for the
sick, the poor, and the health of the public, and much
greater concern for the economic well-being of their
physician caregivers.''
I would commend this to every member of this committee
before making a vote, because what your plan does is--one of
the things, it gives a tax credit to Americans to buy health
insurance. It's no different for someone who is poor or someone
who makes $20,000, $30,000, to Bill Gates. It is an incredibly
regressive system.
You have talked about ending--you guys want to end the
expansion of Medicaid. That has people in Minnesota scared out
of their minds.
Look, I've heard a lot that Obamacare has been a disaster.
First of all, you have to admit that it's bent the cost curve,
that the cost of health care in this country has grown less
than it did in the previous 10 years. It's also covered 20
million more people, but forget them.
In 2008, I would go around the State of Minnesota and in
every VFW hall, in every cafe, I would see a bulletin board
where it would have a Burger Bash or a Spaghetti Dinner for
someone who had gone bankrupt because they had gone through
their annual cap or their lifetime cap. I am very frightened
about what you are going to do, and so are millions of
Americans. Frankly, I know that you do things that help the
physician groups. You've put in provisions that would prevent
these findings by efficiency and innovation boards that would
have to be cleared by physician groups.
I see you as someone who is there for the doctor and that
this is a cover for--this is not going to create access for all
Americans, what you talked about, the Empowering Patients First
Act. This is going to unravel something that has given a lot of
Americans peace of mind, knowing that their kids can stay on
their health care until they're 26, knowing that if they have a
pre-existing condition, that won't stop them from getting care.
That's what this hearing should be about. You're a smart man--
--
The Chairman. Senator, you're a minute over.
Senator Franken. OK. In my second round, I will be a minute
short.
The Chairman. Sure.
Senator Franken. Thanks.
The Chairman. You may be here by yourself.
Senator Murray. I'll be here with him.
Senator Franken. You know, the Benghazi hearing was 11
hours. That's all I'm saying.
The Chairman. Thank you, Senator Franken.
Senator Isakson.
Senator Isakson. Congressman Price, since that question
ended with him not having any time to give you a chance to
respond to it, do you have any response to Senator Franken?
Dr. Price. Yes. I would just say that this is one of the
things that makes it difficult to reach a solution here in
Washington. The concerns that were expressed by the Senator are
valid concerns. The conclusions that he drew on the policies
that I've promoted and will continue to promote are absolutely
incorrect.
We all share a concern for the American people and how we
best make certain that they have access to the highest quality
care that the world knows. I hope--and I understand why he's
doing it. I mean, it's a political activity. I understand that.
I hope that we're able to work together, if I'm given the
privilege of leading and serving as the Secretary of Health and
Human Services, to truly solve these difficult challenges that
we have in our Nation.
Senator Isakson. Congressman Price, isn't it true that by
the date of May 15 of every year since you've served in
Congress, you've had to make full disclosure of everything you
own, everything your wife owns, what it's worth, when it was
acquired, and what it was sold for?
Dr. Price. Every single year we do a yearly financial
disclosure, and the House requires a monthly periodic
transaction form that updates if there's any significant
change.
Senator Isakson. Isn't it true that every transaction
that's been referred to and questions of you are available to
the public and on the record of the Senate Ethics Committee and
the House Ethics Committee?
Dr. Price. Absolutely, and they remain so today.
Senator Isakson. These are not discovered things that were
hidden. They were, in fact, facts that we require you to
disclose every year?
Dr. Price. In fact, there isn't a single bit of information
that's out here that I didn't reveal to the public in a
transparent process.
Senator Isakson. Isn't it true that transparency is the
antiseptic that creates an environment where there is no
corruption?
Dr. Price. Sunshine cures disease, that's exactly right.
Senator Isakson. Isn't it correct that you have worked
throughout your career in the Georgia Senate, the U.S.
Congress, and I'm sure you will as the Secretary of HHS, to
make sure there is always transparency?
Dr. Price. Absolutely. It's a hallmark and a key,
especially in the area of health care, and in the services that
HHS provides.
Senator Isakson. Is it not true that you love your country,
you love your job, and if you had the opportunity to be
Secretary of Health and Human Services you'll do everything you
can so there's never any appearance of any conflict of interest
whatsoever?
Dr. Price. Without a doubt, and that's why I mentioned the
Office of Government Ethics and the work, the diligence that
they do to look at everybody's holdings and assets who are
scheduled to potentially serve in the Cabinet, and then they
make a recommendation, a very specific recommendation that's
also available to be seen online, and we have agreed to every
single recommendation that they made to divest of whatever
holdings we have that might even give the appearance of a
possible conflict.
Senator Isakson. Mr. Chairman, I yield back the balance of
my time.
The Chairman. Thank you, Senator Isakson.
Senator Bennet.
Statement of Senator Bennet
Senator Bennet. Thank you, Mr. Chairman, and thank you for
the 7 minutes as well. I should tell you that I have never
shown a knee, my knee, to any nominee before Dr. Price came to
my office, but he gave me some free medical advice and I'm
grateful for that.
Dr. Price. How are you doing?
Senator Bennet. Free health care. It's terrible, but I'll
talk to you after it's over. It's not because of you.
Dr. Price. I can't ask you, but I'm curious as to whether
or not you got the MRI.
Senator Bennet. Today at 10 o'clock, so I'll let you know.
[Laughter.]
Congressman, I enjoyed our conversation, and it's good to
see you here. I know you've been chair of the House Budget
Committee. I know you're a member of the Tea Party. You've been
a strong advocate for balancing the budget, introducing a
Balanced Budget for a Stronger America, it's called.
What I've noticed is that after gaining control of the
House, the Senate, and the White House, the first order of
business for the Republican majority here has been to pass a
budget resolution repealing the ACA, and this budget resolution
specifically authorizes $9 trillion in additional debt over the
next 10 years. It also rigs the bill in secret to block any
point of order to the bill because that bill will increase the
deficit.
Let me read what my colleague--a smart guy who is here--
Senator Paul, what was duly highlighted in his floor speech on
January 4. He said,
``The more things change, the more they seem to stay
the same. Republicans won the White House, Republicans
control the Senate, Republicans control the House, and
what will be the first order of business for the new
Republican majority? To pass a budget that never
balances, to pass a budget that will add $9.7 trillion
of new debt over 10 years.''
This is a facsimile of his chart. ``Is that really what we
campaigned on? ''
The quote goes on. ``Why would we vote on a budget that
adds $9.7 trillion to the debt? '' Because we're in a hurry. We
can't be bothered. It's just numbers. I was told again and
again swallow it, take it, they're just numbers, don't worry,
it's not really a budget. Yet the legislation says it's a
budget.
``So this is what Republicans are for. This is the
blueprint that the Republican Party says they're for,
$10 trillion worth of new debt. I'm not for it.''
Said that honest man.
Rand Paul is right. The repeal law overrides two separate
budget provisions already passed by the Senate to prevent
increasing the deficit by more than $10 billion, to increase
the deficit more than $5 billion in years further down the
road.
I ask you, sir, are you aware that behind closed doors
Republican leadership wrote into this bill that any replacement
to the Affordable Care Act would be exempt from Senate rules
that prohibit large increases to the deficit?
Dr. Price. As you may know, Senator, I stepped aside as
chairman of the Budget Committee at the beginning of this year,
and so I wasn't involved in the writing of----
Senator Bennet. You have been the Budget Committee chairman
during the rise of the Tea Party. You're a member of the Tea
Party caucus. You have said over and over again, as other
people have, that the reason you've come to Washington is to
reduce our deficit and reduce our debt. I assume you're very
well aware of the vehicle that is being used to repeal the
Affordable Care Act. This is not some small piece of
legislation. This is the Republican budget.
Dr. Price. Yes, I'm aware of the bill. Yes.
Senator Bennet. Do you support a budget that increases the
debt by $10 trillion?
Dr. Price. What I support is an opportunity to use the
reconciliation to address the real challenges in the Affordable
Care Act and to make certain that we put into place at the same
time a provision that allows us to move the health care system
in a much better direction----
Senator Bennet. Do you support the budget that was passed
by the Senate Republicans to repeal the Affordable Care Act
that adds $10 trillion of debt to the budget deficit?
Dr. Price. The reconciliation bill is yet to come. I
support the process that allows for and provides for the fiscal
year 2017 reconciliation bill to come forward.
Senator Bennet. Will you commit today that any replacement
plan for the Affordable Care Act will not in any way contribute
to our deficit or our debt?
Dr. Price. I commit to working with you to make certain
that that happens.
Senator Bennet. Will you commit as a member of the Tea
Party that no replacement for this dreadful Obamacare that
allegedly created this deficit and debt will add to the deficit
and debt? Will you commit to that? Can you tell the Tea Party
you're not going to increase the deficit by repealing the
Affordable Care Act?
Dr. Price. There are a lot of contributions to the debt and
to the deficit.
Senator Bennet. Really?
Dr. Price. As you know, Senator.
Senator Bennet. That's true, and you and I talked about
that briefly.
Dr. Price. That's right.
Senator Bennet. Are you going to allow the repeal of the
health care bill to be one of those contributors to our deficit
and to our debt? The CBO has said that repeal of the health
care law could increase our deficit by up to $353 billion.
That's what they've said. Rand Paul, Senator Paul, an honest
man, has gone to the floor and said the first thing we're doing
is passing a budget that increases it by $10 billion.
What do you say to the Tea Party about that?
Dr. Price. What I say to the congressional----
Senator Bennet. Or more important, the people that live in
Colorado?
Dr. Price. What I say to folks in Colorado and across this
land is that the Congressional Budget Office and the
conclusions that they reached on that are in a silo. They're
looking at it as if nothing else happened following the repeal
of the Affordable Care Act. If you look at the whole
constellation of things that will occur, I believe, in working
with every Member of Congress, should I be given the privilege
of serving as the Secretary, we will make certain that it
addresses the health care challenges that exist out there that
are very, very real, and we look forward to working with you
and committing to working with you on being as fiscally
responsible as we can possibly be, because the debt and the
deficit is a real challenge.
Senator Bennet. With respect, and I have a lot for you,
with respect, that's what every politician says about the CBO.
It says the numbers aren't true, and then we just run up the
debt and run up the debt and run up the debt. Almost the entire
theory of the case here, I think, from the Republican Party on
this subject has been that the health care law has increased
costs, that the health care law has increased our deficit,
increased our debt, and I would hope that you could take a
pledge today that would say that nothing that you would
advocate for or would pass or have the President-elect sign
into law, would add one dollar to our deficit or our debt.
Dr. Price. Well, I certainly hope that's the case, and
again I look forward to working with you to ensure that it is.
Senator Bennet. Thank you.
Mr. Chairman, I yield back my time.
The Chairman. Thanks, Senator Bennet.
Senator Collins.
Statement of Senator Collins
Senator Collins. Thank you, Mr. Chairman.
Dr. Price, welcome.
Dr. Price. Thank you.
Senator Collins. I, too, very much enjoyed our discussion
on a wide range of health care issues in my office.
Many of us have expressed concern about what would happen
to the millions of Americans who are in the individual market
of the ACA on the exchanges. There has been remarkably little
debate on what would happen if Congress took no action with
regard to the individual market.
Could you give us your answer as far as what you would see
happening to the individual market if we do nothing?
Dr. Price. I appreciate that, and I appreciate the
opportunity to come visit you. We had a wonderful conversation
about many, many different areas.
The American people know this. They appreciate that the
individual and small group market, where many of the millions,
as the Chairman pointed out, gain their coverage is breaking in
many, many ways. We're in a downward spiral in being able to
provide individuals any opportunity at all. One-third of the
counties in this Nation have just one insurance provider. There
are five States that have only one insurance provider. The
premiums are going up for folks, the deductibles. I get calls
almost weekly from my fellow former physicians who tell me that
their patients are making decisions about not getting the kind
of care that they need because they can't afford the
deductible.
If you're an individual out there making $30,000, $40,000,
$50,000 a year, and your deductible is now $6,000, or $12,000
for a family, which is not unusual on the exchange, you may
have an insurance card, it may have a wonderful name of an
insurance company on it, but you don't have any care because
you can't afford the deductible. People are denying themselves
the kind of care that they need, and those are the things we
ought to be addressing. Again, I hope that in a bipartisan way
we'll be able to do that.
Senator Collins. Thank you. I think that's a very important
point to clarify, that in the individual market we're seeing
double-digit increases in premiums, higher deductibles, larger
co-pays, and we're also seeing far fewer choices as more and
more insurers give up and flee the market. The coops have
failed dramatically. All 23 of them are in financial trouble.
Only five are still operating.
For us to say that everything is going well with Obamacare
is just not accurate, and that's why I feel that we do need to
fix the flaws of what is a well-intentioned but deeply
problematic law.
I want to clarify another issue on the ACA. There's been
much debate on whether we should repeal the law with no
replacement. I think most people reject that idea. As you said,
we don't want to pull the rug out from under people who are
relying on the insurance that has been provided through the
ACA. Another group has advocated repeal with a 2- or 3-year
delay. I think that approach also doesn't work because it
creates great anxiety for consumers, and insurers would be
unable to price their policies if they don't know what the
rules are going to be.
It's my understanding that your goal is to quickly pass a
reform package that would provide access to affordable health
insurance for all Americans with more choices than we have now.
Is that accurate?
Dr. Price. Absolutely. It is vital--we often talk also
about the 20 million folks that still don't have any coverage
out there. There are a lot of people that don't, and if we're
responsible policymakers and administrators of policy, it's
incumbent upon us to step back and say why is that? What's
going on that's making that happen for those 20 million who
don't have coverage in spite of all of these grand things that
were done?
I would suggest that it's because the structure of what was
done actually makes it virtually impossible for many
individuals to gain that kind of coverage. We, on the other
hand--I believe it's important that we work together to put
forward a system that actually allows, again, every single
American to have the opportunity to purchase the kind of
coverage that they think is best for themselves and for their
families.
Senator Collins. Your goal is actually to have more
people----
Dr. Price. Yes.
Senator Collins. Thank you--covered by insurance.
I have been baffled over the years by what CMS reimburses
for and what it fails to reimburse for. Senator Jeanne Shaheen
and I finally scored a victory of getting CMS to cover
continuous glucose monitors for individuals with diabetes that
have been covered by the vast majority of private insurers.
When those individuals aged into Medicare, they lost that
coverage. That made no sense whatsoever.
What I'm finding now is that CMS frequently does not pay
for services that help to keep people well. There is a large
practice in my State that has a nurse or a medical assistant
call individuals with diabetes once a week and check on their
blood sugar levels, their adherence to their diets and exercise
regimes, and it's had really positive results. Well, the irony
is that if diabetes gets out of control and those individuals
end up having to have amputations or go blind, CMS/Medicare
will pay for that, but it won't pay for that phone call to
check on the individual that's helping to control their
diabetes and keep them well.
Will you pledge to take a look at those kinds of policies
and reevaluate what we do pay for?
Dr. Price. Absolutely. It's imperative that we're
constantly looking and determining whether or not we're getting
the outcomes that we want and the processes are either helping
or obstructing those outcomes.
Senator Collins. And finally, I want to touch on biomedical
research, which is a passion of mine. I founded both the
Diabetes Caucus in 1997, and I also am the founder of the
Alzheimer's Task Force in the Senate, which Senator Warner is
the co-chair of.
Alzheimer's has become our Nation's most expensive disease.
It costs society $263 billion a year; $150 of that comes from
Medicare and Medicaid. It's going to bankrupt those programs.
It's devastating to families and the victims of the disease.
Diabetes consumes one out of three Medicare dollars.
If we invest in biomedical research, we have the
possibility of not only improving lives for Americans and
curing or coming up with effective treatments for devastating
diseases, but also actually lowering health care costs. Do you
support the increases for NIH that we have passed in the last
year and are on track to pass this year as well?
Dr. Price. NIH is a treasure for our country and the kinds
of things that we should be doing to find cures for those
diseases. One of the core avenues to be able to make that
happen is through NIH, and I supported the increase.
Senator Collins. Thank you. That goes along with your
principle of innovation.
Dr. Price. Absolutely.
Senator Collins. Thank you.
Thank you, Mr. Chairman.
The Chairman. We've been at this for about 2 hours. I'm
going to suspend the operation for about 5 minutes, and then
we'll go to Senator Whitehouse, just so we can take a little
break.
The committee is recessed for 5 minutes.
[Recess.]
The Chairman. The committee will come to order.
Senator Whitehouse is next, followed by Senator Young.
Senator Whitehouse.
Statement of Senator Whitehouse
Senator Whitehouse. Thank you, Chairman.
Let me ask, first, to put into the record a letter from our
Governor in Rhode Island, which says that in Rhode Island,
``We have actually seen exchange premiums decrease in
2 out of the last 3 years, and that this has saved
consumers nearly $220 million since 2012.''
The story on the Affordable Care Act in Rhode Island is
actually quite a good one.
The Chairman. We will put it in the record.
[The information referred to may be found in Additional
Materials.]
Senator Whitehouse. I'd also like to put this little
graphic into the record, which, to explain it briefly, the red
line along the top is the CBO estimate of where our health care
costs were going to go back when they were making that estimate
in 2010; and then at this time, 2016, after the ACA was in
place, they took a look at the actual experience up to that
point and then they did a new projection going forward based on
the Affordable Care Act, and just in the following 10 years,
this green period, from 2016 to 2026, they're forecasting $2.9
trillion in Federal health care savings that relate back to the
Affordable Care Act. This is where that came in.
We throw this thing out at our peril if you care about
saving Medicare, the savings to which are a very significant
part of this $2.9 trillion, and we throw it out right now,
according to the Republican plan, with nothing to replace it.
I described that over the weekend at home. It's like being
asked to jump out of an airplane with no parachute but being
told, ``Trust us, we'll build the parachute before you hit the
ground.'' I'm the junior Senator to Jack Reed, who was an Army
Ranger and actually did jump out of perfectly well-operating
aircraft. He insisted not on just one parachute but two, a
spare, and I think the American people are entitled to know
what they're going to be offered as an alternative.
There's been some conversation in this hearing about how
there are Republican ideas floating around, and sure there are
Republican ideas floating around, but there's no Republican
bill, there's no Republican plan, there's no Republican
proposal.
Our cards are up on the table. It's Obamacare. You want to
improve it? Make suggestions. We've always been open to that.
On the other side of the table, there's nothing, and it's
really hard to negotiate with nothing. I think the Republicans
have a responsibility to put a plan together.
We talked about that, Mr. Price, when you and I met in my
office, and my recollection of our conversation is that you
told me that you would want to keep letting people stay on
their parents' policies until they're 26. Is that true?
Dr. Price. I think that the insurance industry has included
individuals up to the age of 26 on their parents' policies
virtually across the board, and I don't see----
Senator Whitehouse. And you would want to keep that?
Dr. Price. I don't see any reason why that would change.
Senator Whitehouse. You would want to keep, you told me,
the doughnut hole closed to protect seniors against those
pharmaceutical costs. Is that also true?
Dr. Price. I think the discussion we had was about
pharmaceutical costs and making certain we did all we could so
that seniors were able to afford the drugs that they need.
Senator Whitehouse. My recollection was more specific than
that, that you did not want to reopen the doughnut hole for
seniors. Are you saying now that you're going to consider
reopening the doughnut hole for seniors?
Dr. Price. No, that's not what I'm saying at all. I think
that it's important--you know well that the reopening of the
doughnut hole would be a legislative activity, not an
administrative activity.
Senator Whitehouse. You'll be the Secretary of Health and
Human Services. You will be doing a lot of work to prepare this
legislation and to do the technical work behind it for the
Administration. Are you going to be proposing in that role
something that reopens the doughnut hole? I've got a lot of
seniors who want to hear about that, if that's your plan.
Dr. Price. I'm not aware of any discussions to do that.
Senator Whitehouse. OK. Then finally, my recollection of
that meeting and my notes is that you told me you would not
want to return to insurance company lifetime caps or insurance
company denial of pre-existing conditions, or insurance
companies going back and looking in the files for some little
tiny discrepancy and then throwing somebody off their coverage
when they come in with a significant claim. Is that true?
Dr. Price. I think there are always ways that we can
improve coverage, and those are areas that are existent right
now, and I think the issues need to be continued.
Senator Whitehouse. When, as, and if we ever get a
Republican counter-proposal to Obamacare, you would expect to
see those things in it?
Dr. Price. I don't know whether they'd be in it or whether
they would be silent on it. Again, that's a legislative
question.
Senator Whitehouse. You'd leave it in place.
Dr. Price. It's a legislative question, not an
administrative question.
Senator Whitehouse. In one of your budgets you had a
proposal that would allow States to throw what you called
``able-bodied people'' off of Medicaid, unless they were
working or looking for work or in job training. People with
addiction, behavioral health, mental health issues, are they
able-bodied in your definition?
Dr. Price. Well, we weren't as specific as to what the
definition was. The fact of the matter is----
Senator Whitehouse. Well, you used words, so I'm asking you
now, what did you mean when you said ``able-bodied'' in this
provision?
Dr. Price. The fact is that there are many, many
individuals who have worked in this space for a long, long time
who believe that providing for an opportunity for individuals
who are able-bodied without children to seek or gain employment
or to study to gain employment----
Senator Whitehouse. What do you mean by ``able-bodied'' is
the question. You just used that term again.
Dr. Price. That's what would be defined in the regulation
itself. I don't know the----
Senator Whitehouse. You're using a term without any idea of
how you would define it?
Dr. Price. I think people have an understanding of what
``able-bodied'' is. It doesn't have the kinds of things that
you described, I believe.
Senator Whitehouse. OK. That was the simple answer to my
question. ``Able-bodied'' does not include people who have
addiction, mental health and behavioral health issues.
Dr. Price. Again, it's the work that would be done to
develop the regulation.
Senator Whitehouse. I'm asking as you used the word. I'm
not asking about in some future universe. As you used that term
in your budget.
Dr. Price. I think individuals that demonstrated that they
were, in fact, having challenges that would preclude them from
being able to seek work or employment or education or the like,
that they ought to be attended to.
Senator Whitehouse. I'm a fan of and think they do good
work at the American Academy of Pediatrics. I'm a fan of and
think they do good work at the American Lung Association. I'm a
fan of and think they do good work at the American Public
Health Association. All of those groups and many others have
gone very clearly on record that climate change presents
significant health issues. They signed a declaration on climate
change and health which stated that the science is clear that
this is happening.
You, on the other hand, have said that the carbon pollution
standards of the Obama administration ``go against all common
sense,'' and that ``there are errors and obfuscation in the
allegedly settled science of global warming.'' I'll pursue this
with you through questions for the record because my time has
expired, but if you could give a brief answer, because it
appears to every scientific organization in the country, all
the legitimate major ones, and to really every American
university that this actually is pretty darn settled science,
and that the only people who disagree with it are people who
have vast financial interests in preventing any work getting
done.
It looks to me like, in making this statement, you have
taken the side of those vast special interests against actually
settled science. If we can't trust you on science that is as
settled as climate science, how can we trust you on public
health science issues, where there's a big special interest on
the other side?
Dr. Price. I don't agree with the premise or the
insinuation, but I will say that the climate is obviously
changing. It's continuously changing. The question from a
scientific standpoint is what effect does human behavior and
human activity have on that, and what we can do to mitigate
that. I believe that that's a question that needs to be studied
and evaluated and get the best minds available to make certain
that we're doing the right thing from a public policy
standpoint.
Senator Whitehouse. Start by finding the university that
thinks the way you do, No. 1.
The Chairman. OK, we're running out of time.
Thank you, Senator Whitehouse.
Senator Young, I believe, is next. I don't see him.
Senator Roberts.
Statement of Senator Roberts
Senator Roberts. Well, thank you, Mr. Chairman. Thank you
for holding this anger management hearing.
[Laughter.]
I truly hope my colleagues feel better, at least for 1 day,
after purging themselves of their concern, their frustration,
and their anger.
I would like to note that I asked the technician here who
is running the sound system, the audio system is working. I
thought maybe Senator Bennet didn't know that. He reminded me
of my Marine DI back in the good old days where the DI would
shout, ``I can't hear you.'' I just thought I'd bring that up,
the audio system is working.
Take care of yourselves.
Dr. Price, congratulations on your nomination. Thank you
for being here today.
Dr. Price. Thank you.
Senator Roberts. As many of our colleagues have already
noted, you will play a most important role, if confirmed, in
helping to stabilize the individual market while Congress does
repeal the law and repair the damage it has caused, and enacts
the reforms we believe, I believe will put our health care
system back on track.
My home State of Kansas, we have three insurance carriers
left, and we feel very fortunate we have three, with each
individual only having access to two of those, and our premiums
rose this past year over 30 percent. Down the road it's going
to be more difficult if we don't do something.
There's no doubt with regard to uncertainty and angst among
consumers. I think it's important to make clear that even if
Congress and the incoming administration were to do nothing,
let it go, just like in Frozen, let it go, amending or
repealing parts of the Affordable Care Act, the law is not
working, and we have to do something to meet that obligation.
The prices are unaffordable, markets nearly non-existent, with
few or no options in several States and counties. We are not as
rural as Wyoming, but we are rural in my State of Kansas.
I have a concern back in the day when we sat on this
committee and reviewed the first version of the Affordable Care
Act. I don't know where that mark is today. It's sitting on a
shelf somewhere. We went day and night, and day and night, and
day and night, and I was worried about something I called the
rationers. I'm talking about the Independent Payment Advisory
Board, IPAB, the Centers for Medicare and Medicaid Innovation,
CMMI--that's a wonderful acronym--and the new coverage
authorities given to the U.S. Preventive Services Task Force,
and I would also mention the Patient Center Outcomes Research
Institute, which is called CORI.
Not many people are aware of these. I even went to the
floor of the Senate and had four people riding a horse and
called them the Four Horses of Regulatory Apocalypse. I'm
worried about it and the provisions which could interrupt the
doctor/patient relationship, allowing the government to dictate
what coverage you can receive.
Can you share some concerns that you have with regards to
these, what I would call four rationers, with all due respect
to what they're trying to do, which was with good intent?
Dr. Price. I appreciate that, Senator. I think that it's
imperative that as we move forward, that we recognize again
that the patient ought to be at the center of this, and
anything that gets in the way of the patient and their families
and physicians making the decisions about what kind of health
care they desire, we ought not go down that road.
For example, the CMMI, the Center for Medicare and Medicaid
Innovation, I'm a strong, as I mentioned, a strong proponent
and advocate for innovation, but I've seen in certain instances
what's coming out of CMMI is a desire to require certain kinds
of treatment for certain disease entities that may or may not
be in the best interest of the patient. Because it carries the
full force of the Federal Government and the payment for those
services, it means that we're answering the question of who
decides about what kind of care patients receive by saying that
the answer to that ought to be Washington, DC, and I simply
reject that that's where those decisions ought to be made.
Senator Roberts. I appreciate that answer.
I have the privilege of being a member of this committee,
the Finance Committee, especially being the chairman of the
always powerful Senate Agriculture Committee. I'm particularly
interested in HHS and, more importantly, FDA's work on food and
nutrition policy. During the previous administration the FDA
issued numerous regulations with limited or delayed guidance
and unrealistic compliance dates. This was the case with the
implementation of the Food Safety Modernization Act, called
FSMA, and more recently with the Nutrition Facts Panel
revision.
I know we all share the goal of a safe food supply and
availability of accurate information for consumers, but I'm
concerned the Administration has not clearly or consistently
communicated with the food and agriculture industry regarding
new or changing requirements. Will you commit to working with
the Secretary of Agriculture and other relevant agencies, not
to mention the committee I serve on, and similar in the House,
that your department is issuing science-based guidance and
taking into consideration other regulatory burdens when
establishing compliance and dates and other regulatory actions?
Dr. Price. Yes. I believe that's not only imperative, but
the science that's relied upon ought to be transparent and
available to the public so that people can see exactly what was
the basis for the decisions that were being made.
Senator Roberts. Under the previous administration, we have
seen increased activity and regulatory action on nutrition
policies such as issuing voluntary guidance, yet the same
administration continued to request additional resources from
Congress to comply with statutory requirements under the Food
Safety Modernization Act. I'm concerned that the Administration
did not prioritize FDA's mission to protect our Nation's food
supply, instead focusing on nutrition policies.
If confirmed, can you discuss how you will focus on the
core FDA duties such as implementing the law the Congress
passed rather than agenda-driven nutrition policy guidelines?
Dr. Price. This is really important, Senator, and if I'm
confirmed and given the privilege of leading, I would work
specifically with the FDA commissioner to make certain that we
are relying on science, that it's science that is guiding the
decisions that we're making, and again that the transparency is
available for folks so that they can see what kinds of
decisions are made and how they're being made.
In addition to working with policymakers, you know best
what's going on in your State and how it's being affected by
the rules and regulations that are coming down from Washington
in so many areas, but certainly in the agricultural arena. We
ought to be having a dialog with every single individual who
has an interest to make certain that we're addressing the needs
appropriately.
Senator Roberts. I thank you for your response.
Thank you, Mr. Chairman.
The Chairman. Thank you, Senator Roberts.
Senator Baldwin.
Statement of Senator Baldwin
Senator Baldwin. Thank you, Mr. Chairman.
Welcome, Congressman.
Dr. Price. Thank you.
Senator Baldwin. You've already been asked about your
investments in medical device companies, pharmaceutical
companies, as part of the prior questioning. For the record,
have you also received campaign contributions over the years
from political action committees associated with many of these
same companies?
Dr. Price. I don't know, but I assume so, just as many of
us do.
Senator Baldwin. OK. In terms of what the American people
want to know, of course, when you get reviewed for potential
conflicts of interest and the procedures with the Office of
Government Ethics, is that in your role you're fighting for
them and not biased toward the powerful companies that you've
invested in and that have invested in you. You've taken some
questions on that, but let me just followup a little bit to ask
first, do you think the increases in drug prices that we're
seeing right now, for example the sixfold increase in the cost
of an EpiPen, is a problem right now for Americans?
Dr. Price. Oh, as I mentioned, I think there are certain
areas where drug pricing increases seem to have little basis in
rational findings. I do think, however, as I mentioned again, I
think I did, that it's important to appreciate that we've done
some good things in drug pricing, whether it's in the generic
arena where the prices have been held down significantly, or in
the Part D area where prices have----
Senator Baldwin. Since my time is limited, let me continue
down this track. You've been asked already, but Trump supports
Medicare drug negotiation. Will you work to repeal the
prohibition on Medicare negotiating for better drug prices on
behalf of the American people if confirmed for this position?
Dr. Price. Well, I understand that if I'm confirmed and if
I have the privilege of serving as Secretary, that the boss
that I have will be the President of the United States.
Senator Baldwin. Will you work to repeal the prohibition on
Medicare negotiating drug prices?
Dr. Price. Following discussion and being informed by the
individuals within the Department and working with the
President, and then carrying out his wishes.
Senator Baldwin. Is that a yes, or was that a no?
Dr. Price. It depends on that activity. I would hope that--
--
Senator Baldwin. He stated his position, very recently, in
fact, that he supports price negotiation so that people on
Medicare can have the benefit of that. Is that something that
you would press Congress to do? In other words, repeal the
prohibition on that negotiation?
Dr. Price. I think we need to find solutions to the
challenges of folks gaining access to needed medication, and it
may be that one of those is changing the way the negotiations--
as you know, the negotiations right now occur for seniors with
the PBM, with the privacy benefit managers.
Senator Baldwin. Since I have limited time and you haven't
said yes or no, you just talked about transparency, would you
support drug price transparency mandating that any drug company
that wants to increase prices on their drugs release public
information on how they set their prices? Because so many of
these appear to be without justification, as you just
mentioned.
Dr. Price. Yes, I think there's a lot of merit in
transparency in every area, and certainly in this area. I'd
look forward to exploring, if I'm confirmed, with you the ways
to be able to make that work.
Senator Baldwin. Thank you.
I wanted to go back to the first round of questioning with
the Chairman, who showed a chart. It seemed like what was
implicit in the back and forth was that the act of repealing
the Affordable Care Act would only impact perhaps a very small
part of the health care industry. You talked about 6 percent
being covered on the individual market.
The protections, like coverage on your parents' health
insurance until you're 26 and mandating that people be covered
even if they have a pre-existing health condition, things like
eliminating caps that led so many into medical bankruptcy,
those apply across the health care system. Repeal in no way
limits us to a conversation just about a small percentage of
our population. This is about serious impacts for all of
America. Would you agree?
Dr. Price. I think that the discussion about what our
health policy for financing and delivery of health care to the
American people is a very, very broad subject, and we need to
discuss----
Senator Baldwin. If you repeal the Affordable Care Act, the
impact is not narrowly confined to Medicaid and the individual
market. It has impact on every American. Medicare, too. Think
of accountable care organizations where you're driving so much
of our innovation. That's not confined to the individual
market. In fact, it impacts Medicare very, very significantly.
Let me give one example. We, in our office, when you
visited--and thank you for your visit--we talked about the
opioid epidemic. One of the significant issues is access to
treatment to overcome an addiction. If the Affordable Care Act
is repealed, there will no longer be a mandate for substance
abuse treatment being covered. Is that something you agree
with?
Dr. Price. Look, the opioid epidemic is rampant and is
harming families and communities all across this Nation.
Senator Baldwin. Would you assure that substance abuse
treatment would be covered under a replacement plan that you
would propose to the Congress?
Dr. Price. I think it's absolutely vital that substance
abuse and other kinds of things are able to be treated.
Senator Baldwin. You would keep that protection of the
Affordable Care Act?
Dr. Price. That's a legislative decision, but I look
forward to working with you to make certain that we're ensuring
that individuals are able to get the care they need.
Senator Baldwin. Then on 26-year-olds' coverage, I want to
make sure I heard the exchange because it sounded to me like
you're saying you think insurers are just going to continue to
do it, so there's no need for there to be an actual mandate
saying they must. Mind you, with 5.7 million young people
between the ages of 18 and 26 on their parents' health
insurance, that's 5.7 million people who aren't in the
individual market because they're in their first job after high
school that doesn't have health insurance or in school without
it. Is it just a wink and a promise, or do you support having
in law a mandate that 18- to 25-year-olds be able to stay on
their parents' health insurance?
Dr. Price. As I say, I think it's been baked into the
insurance programs that are out there right now. What I
absolutely am committed to----
Senator Baldwin. They could change their mind at any time.
Dr. Price. What I'm absolutely committed to is making
certain that every single American has access to the kind of
coverage that they want and has the financial feasibility to be
able to purchase that coverage.
The Chairman. Thank you, Senator Baldwin.
Senator Young.
Statement of Senator Young
Senator Young. Dr. Price, good to see you here today.
Dr. Price. Thank you.
Senator Young. I've enjoyed our service together over the
last 6 years in the House of Representatives, particularly the
4 years we spent on the Ways and Means Committee. I had an
opportunity not just to get to know you personally there but to
observe your quite impressive skill set, your depth of
knowledge in the area of health care and health policy, your
commitment, more importantly, to seeking alternative
perspectives, to trying to identify where bipartisan consensus
could be realized, and ultimately forging consensus around some
viable solutions.
The one that I find most notable is your success on the
sustainable growth rate, which is something Members of this
committee are familiar with, but it's a blunt instrument that
was in place to control health care costs, and without your
leadership over on the House side I don't think we could have
moved toward a more value-based purchasing model.
Dr. Price. Thank you.
Senator Young. These are skill sets that will serve you
well over at Health and Human Services, no doubt.
One area of the Affordable Care Act, speaking of
bipartisanship, that members of my party, of your party have
periodically and quite vocally indicated their desire to repeal
from time to time has been the Center for Medicare and Medicaid
Innovation, and that's perhaps on account of the one-size-fits-
all prescriptive and mandatory demonstrations that occurred in
recent years, and you have already indicated that you oppose
the mandatory nature of demonstration projects.
I strongly believe, for one, that there's great value in
innovating and experimenting across all layers of health care.
Further, I think CMMI is and can continue to be a helpful
laboratory for health care experimentation with respect to
delivery models, payment models, and so forth, for Medicare,
for Medicaid, for the Children's Health Insurance Program, and
perhaps other areas--save taxpayer money, provide greater
value, see what doesn't work, scale up what does work. For me
it's common sense. This is the way scientists operate; they
start with experiments and then they evaluate, and then they
scale up.
I'd like to know your intentions, if you have strong
convictions in this area. Do you intend to keep this innovation
center or perhaps develop a new one, a variant of CMMI? Speak
to this, please.
Dr. Price. Well, I appreciate that. I am, as I mentioned, a
strong advocate and supporter of innovation at every single
level. It's only through innovation that we expand the
possibilities, especially in the area of health care, for
increasing the quality of care. I'm a strong proponent of
innovation.
The CMMI entity I believe has great possibility and great
promise to be able to do things that will allow us to find ways
in which we can change the payment model, ways in which we're
treating disease and the like that will improve to the
patient's benefit, and I strongly support that. I have
adamantly opposed the mandatory nature with which CMMI has
approached some specific problems, and let me mention two in
particular, if I may.
The first is the Comprehensive Joint Replacement, the CJR,
program, which identified from CMMI 67 or 68 geographic areas
where if you were a patient and you received a lower extremity
joint replacement for a variety of problems, then it was
dictated to your doctor what kind of prosthesis, what kind of
surgical procedure your doctor could do for you, regardless of
what's in your best interest. They may be aligned, but they may
not be aligned. If they're not aligned, then your physician is
incumbent upon doing what the government says to do.
The other area that I think was even more egregious was
covering 75 percent of the Nation in the Medicare Part B drug
demonstration model, in fact not a demonstration model if it's
75 percent of the country, and that would stipulate what kind
of medications your physician could use in an inpatient setting
in a mandatory way. The problem that I've got with that is that
really is an experiment. It's a demonstration to see whether or
not it works. In every single experiment, health care
experiment or medical experiment or scientific experiment that
deals with people, real people, we demand, we require that
there be informed consent for the patient to participate in
that experiment. You say to the patient we're trying this to
see if it works better, we'd love to have you join us, we think
it may inure to your benefit and the benefit of more
individuals across this land, but if you don't want to do that,
you don't have to.
The Federal Government doesn't do that. They require
individuals to participate, and oftentimes, I suspect most
often, the patient doesn't even know that it's an experiment
that's going on.
If either of these models were put in a small area, a pilot
project somewhere and we saw that, in fact, they worked, then,
as you say, you scale them up.
Senator Young. I thank you for the fulsome response and the
rationale behind how you've arrived at that position. I look
forward to working with you to advance the next model of CMMI,
whatever exactly it might look like.
I'd be remiss in my remaining 90 seconds if I didn't
mention Indiana's what we call Healthy Indiana Plan 2.0. Our
Vice President-elect Pence showed a lot of leadership here,
worked with our incoming CMS administrator, Seema Verma, to
develop a model for Medicaid which is unique to the State of
Indiana. It encourages recipients of Medicare dollars to get
some ownership over their health. It uses private market
insurance concepts to prepare Hoosiers for more self-
sufficiency. I happen to believe that it will be replicated in
other States if we can accommodate that as we continue to work
on new health care legislation.
HIP 2.0 is an important proof of concept that Medicaid can
be more efficient than a one-size-fits-all approach, and I just
need some assurance from you that your lone star will be State
flexibility and innovation in the Medicaid space so we can
continue to accommodate plans like HIP 2.0 as opposed to a one-
size-fits-all approach.
Dr. Price. I think you're absolutely right. The Medicaid
program is one where the States know best how to care for, in
the best way, their Medicaid population, and the greatest
amount of flexibility that we can give for States to enact
those kinds of programs. What Indiana has done is really a best
practice for many other States to follow. I look forward to
working with you.
Senator Young. Likewise.
The Chairman. Thank you, Senator Young.
Senator Murphy.
Statement of Senator Murphy
Senator Murphy. Thank you, Mr. Chairman.
Good to see you again, Representative Price.
Dr. Price. Thank you.
Senator Murphy. I hope you can understand our frustration
around trying to divine the nature of this replacement plan. We
hear you and President Trump praise all of these aspects of the
Affordable Care Act and lay out goals that sound eerily
familiar to what we've been living with for the last 6 years.
You've said that you don't want there to be a gap between the
repeal and the replacement, that at least as many people will
have coverage, with the goal of more people having coverage,
sick people won't face discrimination, young adults will get to
stay on their plans until age 26, and yet we don't get any
specifics as to how that's going to occur. It seems as if you
and the President-elect want to do everything the Affordable
Care Act does but just do it in a totally different way.
I'm going to kind of give up on trying to get at the
specifics of this secret replacement plan and maybe ask you
about metrics, about how we will measure whether what you
propose as a replacement is meeting your benchmarks. For
instance, the number of people covered, the cost of health care
to individuals, the amount of money out-of-pocket that people
have to pay. When you're at the end of your 4 years, how will
you look back on this replacement plan to measure its success?
To the extent you can give me specifics as to how you're going
to measure the success of this replacement, I'd appreciate it.
Dr. Price. Well, I thank you, and you identified some very
specific areas that I think we need to be looking at from a
metric standpoint. What is the cost? Is the out-of-pocket cost
for individuals higher or lower than it was? Right now I would
suggest that the cost is higher than it was when the program
began for many of those individuals in the individual and small
group market. They were promised that the premiums would come
down. In fact, the premiums have gone up. They were promised
that they would have access to their doctor. In fact, many of
them have not had access to their doctor.
Senator Murphy. I'm talking about from where we are today--
--
Dr. Price. From where we are today, if you look at the
things that many of us believe have been harmed by the
Affordable Care Act, I hope that we're able to turn that around
and decrease the out-of-pocket costs for individuals, increase
choices for individuals, increase access to the doctors and the
providers that the patients want, as opposed to what's happened
over the past few years.
Senator Murphy. Increase the number of people who have
insurance.
Dr. Price. Increase the--absolutely. As I mentioned, over
here we still have 20 million individuals without coverage. I
think as policymakers it's incumbent upon us to say what can we
do to increase that coverage. The goal is to make certain that
every single American has that access to coverage that they
want for themselves and for their families.
Senator Murphy. I'd just note that those are two different
things, having coverage and having access to coverage, and I
think we've gone around on that a number of times.
I want to come back to this question of some of the
conflict of interest issues that have been raised, and I raise
them because I think there's a great concern on behalf of the
American people that this whole administration is starting to
look like a bit of a get-rich-quick scheme, that we have a
president who won't divest himself from his businesses and
could potentially get rich off of them, we had a Secretary of
Education last night who has big investments in the education
space, a Secretary of Labor who could gut worker protections
and make a lot of money for his industry. I want to walk you
through another set of facts, another timeline regarding some
of your interactions with the health care industry and get your
reaction to it.
On March 8, 2016, earlier last year, CMS announced a
demonstration project to lower Medicare reimbursements for Part
D drugs. That would have decreased incentives for physicians to
prescribe expensive brand-name medications, and drug companies
that were affected by this immediately organized a resistance
campaign. Two days later you announced your opposition to this
demonstration project. One week later you invested as much as
$90,000 in a total of six pharmaceutical companies--not five,
not seven, six. All six, amazingly, made drugs that would have
been impacted by this demonstration project. There are a lot of
drug companies that wouldn't have been affected, but you didn't
invest in any of those. You invested in six specific companies
that would be harmed by the demonstration project.
You submitted financial disclosures indicating that you
knew that you owned these stocks, and then 2 weeks after that
you became the leader in the U.S. Congress in opposition to
this demonstration project. You read a letter with 242 Members
of Congress opposing that demo. I've read those letters. I know
that's not easy. It takes a lot of work to get 242 people to
sign on.
Dr. Price. That's good staff work, Senator.
Senator Murphy. Then, guess what? Within 2 weeks of you
taking the lead on opposition to that demonstration project,
the stock prices for four of those six companies went up. You
didn't have to buy those stocks, knowing that you were going to
take a leadership role in the effort to inflate their value.
As the American public takes a look at that sequence of
events, tell me how it can possibly be OK that you were
championing positions on health care issues that have the
effect of increasing your own personal wealth. That's a damning
timeline, Representative Price.
Dr. Price. Well, my opposition to having the Federal
Government dictate what drugs are available to patients is
longstanding. It goes back years and years. The fact of the
matter is--I don't know whether you were here before--but the
fact of the matter is that I didn't know any of those trades
were being made. I have a directed account broker, a directed
account. All of those trades were made without my knowledge, as
is set up, and the individuals on this panel have the same
kinds of accounts.
The reason that you know about them is because I
appropriately reported them in an above-board and ethical and
appropriate manner, as required by the House of
Representatives.
Senator Murphy. Do you direct your broker around ethical
guidelines? Do you tell him, for instance, not to invest in
companies that are directly connected to your advocacy? Because
it seems like a great deal as a broker. He can just sit back,
take a look at the positions that you're taking----
Dr. Price. She, she can sit back.
Senator Murphy. She can sit back in this case, look at the
legislative positions you're taking, and invest in companies
that she thinks are going to increase in value based on your
legislative activities, and you can claim separation from that
because you didn't have a conversation.
Dr. Price. Well, that's a nefarious arrangement that I'm
really astounded by. The fact of the matter is that I have had
no conversations with my broker about any political activity at
all, other than her congratulating me on my election.
Senator Murphy. Why wouldn't you at least tell her, ``Hey,
listen, stay clear of any companies that are directly affected
by my legislative work?''
Dr. Price. Because the agreement that we have is that she
provide a diversified portfolio, which is actually what
virtually every one of you have in your investment
opportunities, and make certain that in order to protect one's
assets, that there's a diversified arrangement for purchase of
stocks. I knew nothing about those purchases.
Senator Murphy. You couldn't have a diversified portfolio
while staying clear of the six companies that were directly
affected by your work on that issue?
Dr. Price. Well, as I said, I didn't have any knowledge of
those purchases.
Senator Murphy. OK.
Thank you, Mr. Chairman.
The Chairman. Thanks, Senator Murphy.
Senator Murkowski.
Statement of Senator Murkowski
Senator Murkowski. Thank you, Mr. Chairman.
There is added benefit to being one of the last in the
chain here to ask questions, because it certainly gives me a
clear idea of where you're coming from, Congressman, on some of
these issues that are so important to us.
We haven't had as much conversation about the rural aspects
of health care which, of course, are very important to me. We
had a chance last night to hear from the nominee for Education,
and I pointed out to her, as I have pointed out to you, that
Alaska is a little bit unique. Sometimes it's really unique,
and the challenges that we face allow us to be somewhat
innovative, but we need some flexibility in order to implement
some of the innovations.
I had a chance to sit with a group of Alaskans on Saturday
in Anchorage. They were from the--everyone from the director of
the Division of Insurance to our commissioner of Health and
Social Services, our representative of the only provider on the
individual market, representatives from small rural hospitals,
doctors, representatives from the tribal health organizations.
It was a good mix of individuals. Obviously, we got different
views and opinions about where we go with this replacement of
the ACA and what that would need to look like to help address
the needs and issues in a very rural, very frontier, very high
cost--the highest cost insurance, the highest cost health care
costs. We're down to one provider on the individual market.
We've got all the demographics that would tell you that this is
a difficult place to be operating right now.
We as a State moved forward with Medicaid expansion a
couple of years ago. There's some 27,000 Alaskans that now have
coverage that didn't see that before. There was also good
discussion about making sure that we're able to retain the
protections for Alaska Natives that we saw under the Indian
Health Care Reorganization Act that came as part of the ACA.
Recognizing that there are certain exemptions that were
included as part of the ACA, exemptions for Medicaid cost-
sharing provisions, 100 percent Federal match for American
Indians and Alaska Native Medicaid enrollees when they receive
their care through an IHS facility, including the tribally
operated facilities.
Again, we have seen some very extraordinary collaboration
that has gone on between our entities with our tribes, our
tribal health organizations, that have allowed for increased
efficiency, improved health access. A great deal of the
discussion was focused on what will happen, what will happen to
those who have gained access through Medicaid expansion, and
what can we do to ensure that coverage options are provided for
those in this new era of health care reform.
A further question to that is should a block grant approach
be considered. What efforts, then, would be made to ensure that
this very unique trust responsibility for American Indians and
Alaska Natives is continued to be fulfilled? These were
concerns that were raised in this meeting, and folks had hoped
that I'd have an opportunity to ask you publicly.
Dr. Price. Yes. Thanks so much, Senator, I appreciate it.
We had a wonderful discussion about Alaska, and I learned much
about your State, your glorious State.
The Medicaid system is one that is absolutely imperative
and vital for members of our population who receive their care
through the Medicaid program, and it's a Federal-State
partnership, as you well know, and it's one that we absolutely
must ensure that individuals don't fall through the cracks in
whatever transition occurs.
Whether it's retaining the same level of Medicaid
participation or whether it's providing an option for something
else that allows them coverage that suits their needs, we are
committed and adamant that that coverage be able to be
continued. They have our assurance that we will work with you
to make certain that that happens.
Senator Murkowski. What about the concerns that were
expressed by the tribal health organizations that perhaps if
there is a block grant approach that is utilized, that that
could impact some of the assurances and the benefits that the
tribal health organizations have seen?
Dr. Price. Yes, and this is in its early stage, obviously,
and it's a legislative decision that occurs. It's not a
Department decision that occurs, a legislative decision. We
would look forward to working with you to, again, ensure that
individuals, especially in the Indian Health Service, which has
had some real challenges, we need to make certain that the
metrics, as was mentioned over here, the metrics that we're
looking at are actually clinical correlated metrics, that we're
looking at actually what makes a difference to the people
receiving the care. It's one of those promises that we have to
make certain that the Indian Health Service works, and I think
we can do a lot better at that.
Senator Murkowski. Well, I look forward to more
conversation on that.
Let me ask about some of the efforts that Alaska has made,
I think relatively innovative, as we have attempted to
stabilize our individual health care market. The State moved
forward with some reforms that created a reinsurance program
for high-cost, high-risk individuals. We've submitted a 1332
State innovation waiver, and again all with the hope that we're
going to be able to somehow provide for some level of
stabilization. What sort of considerations to Federal support
for high-risk pools or State-based reinsurance programs would
you consider?
Dr. Price. I think the whole array of opportunities that
are available to again make sure that nobody falls through the
cracks. The 1332 waiver program is one that's just beginning,
but it's one that I think holds significant promise in making
certain that we're able to ensure that things like reinsurance,
things like high-risk pools make it so that individuals do not
lose their opportunity to gain access to the highest quality
care.
Senator Murkowski. Good.
Then finally, on our small rural hospitals, one of the
concerns that I heard repeatedly was the level of regulatory
burden that particularly our smaller rural hospitals are just
feeling stifled by. In fact, some of the innovative things that
one of our hospitals down on the peninsula is looking at
advancing, they kind of feel that it's too risky right now to
move forward with any level of innovation that they had hoped
to take on because they're facing some of the regulatory
burden, but also the uncertainty that they are in right now.
You can do things administratively early on should you be
confirmed to this position. Have you looked to what regulatory
issues could be addressed early on that could help reduce some
of the regulatory burden, particularly to some of these small
rural hospitals?
Dr. Price. Not specifically, Senator, but I share with you
the concern that you have about the burden of regulatory
guidelines and regulatory schemes that come out of Washington,
DC, especially for the rural areas, and it's not just the
hospital. It's the providers and the docs who are providing the
care. Most of the folks in the rural areas tend not to have any
margin at all to be able to cover the cost of this regulation,
and I've heard from more than a few physicians and other
providers who, because of the regulatory schemes that have come
forward, have said they just can't do it anymore. They're
having to close their doors, and the Indian Health Service is
one of them. They're having real challenges in terms of being
able to provide the services. When that happens, then those
individuals have no care, that's unacceptable to me.
Senator Murkowski. Thank you. I look forward to working
with you on this. Thank you.
The Chairman. Thank you, Senator Murkowski.
I have remaining Senator Warren, Hassan, and Kaine on the
Democratic side; Senator Scott, Cassidy, Burr, and Senator
Isakson has 3 minutes remaining.
Senator Warren.
Statement of Senator Warren
Senator Warren. Thank you, Mr. Chairman.
Congressman Price, more than 100 million Americans now
receive their health care through Medicare and Medicaid
programs. These are seniors, people with disabilities, middle-
class families who have parents in nursing homes, countless
numbers of young children, and they all benefit from these
programs.
I want to understand the changes to Medicare and Medicaid
that you have already proposed. The budget that you recently
authored as chair of the House Budget Committee would have cut
spending on Medicare by $449 billion over the next decade. Is
that right?
Dr. Price. I don't have the numbers right in front of me.
Senator Warren. I have the numbers.
Dr. Price. Well, then I assume you're correct.
Senator Warren. All right. You said you'd cut Medicare by
$449 billion. Your fiscal year 2017 budget proposal also would
have cut Medicaid funding that goes to the State governments by
more than $1 trillion. Is that correct?
Dr. Price. I think, Senator, the metrics that we used for
the success of these programs----
Senator Warren. I'm just asking. That's an easy yes or no.
Did you propose to cut $1 trillion from Medicaid?
Dr. Price. What we believe is appropriate----
Senator Warren. Do you want me to read you the number out
of this?
Dr. Price. I'm sure you're correct. What we believe is
appropriate is to make certain that the individuals receiving
the care are actually receiving the care.
Senator Warren. I understand why you think you're right to
cut it. I'm just asking the question, did you propose to cut
more than $1 trillion out of Medicaid over the next 10 years?
Dr. Price. You have the numbers before you.
Senator Warren. Is that a yes?
Dr. Price. You have the numbers before you.
Senator Warren. I'll take it as a yes.
I'm sure you're aware, during his campaign for president,
President-elect Trump was very clear about his views on
Medicare and Medicaid. As Senator Sanders has quoted
extensively, President-elect Trump said I am not going to cut
Medicare or Medicaid.
When President-elect Trump said I am not going to cut
Medicare or Medicaid, do you believe he was telling the truth?
Dr. Price. I believe so, yes.
Senator Warren. OK. Given your record of proposing massive
cuts to these programs, along with several other members of
this committee, I sent the President-elect a letter in December
asking him to clarify his position, and he hasn't responded
yet, so I was hoping you could clear this up. Can you guarantee
to this committee that you will safeguard President-elect
Trump's promise and while you are HHS Secretary you will not
use your administrative authority to carry out a single dollar
of cuts to Medicare or Medicaid eligibility or benefits?
Dr. Price. What the question presumes is that money is the
metric.
Senator Warren. Yes, I am asking about money.
Dr. Price. In my belief, from a scientific standpoint, if
patients aren't receiving care even though we're providing the
resources, then it doesn't work for patients.
Senator Warren. I'm sorry to interrupt, but we're very
limited on time. The metric is money, and the quote from the
President-elect of the United States was not a long discourse
on this. He said he would not cut dollars from this program, so
that's the question I'm asking you.
Can you assure this committee that you will not cut one
dollar from either Medicare or Medicaid should you be confirmed
to this position?
Dr. Price. Senator, I believe that the metric ought to be
the care that the patients are receiving.
Senator Warren. I'll take that as a no?
Dr. Price. It's that it's the wrong metric. We ought to be
putting forth the resources----
Senator Warren. I'm not asking you whether or not you think
you have a better metric. I'm asking you a question about
dollars. Yes or no?
Dr. Price. What we ought to do is put forward the
resources----
Senator Warren. Congressman, these are really simple
questions. Frankly, the millions of Americans who rely on
Medicare and Medicaid today are not going to be very reassured
by your notion that you have some metric other than the dollars
that they need to provide these services. You might want to
print out President-elect Trump's statement, ``I am not going
to cut Medicare or Medicaid,'' and post that above your desk in
your new office, because Americans will be watching to see if
you follow through on that promise.
I also would like to followup on Senator Franken's
question. I think there was something there that didn't quite
get answered. As you know, Congressman, the one goal of the
Affordable Care Act was to push the health care industry to
provide higher quality care at lower cost, and under the ACA
Medicare was recently allowed to change the way that it pays
hospitals for hip and knee replacements to something called a
bundle, and that means Medicare pays a set price for the care
associated with hip and knee replacement, and then the
hospitals, not Congress, will decide the most effective
implants, reduced second surgeries, how to better fight
infections, how to spend their money to deliver better service
at lower cost.
I supported this change because the research shows that it
really means you get better care at lower prices. I know the
policy is controversial because it affects how hospitals are
paid, which in turn affects how much money the manufacturers of
these hip and knee replacements can make. One of the companies
is the company raised by Senator Franken, and that is Zimmer
Biomet. They're one of the world's leading manufacturers of
hips and knees, and they make more money if they can charge
higher prices and sell more of their products. The company
knows this, and so do the stock analysts.
On March 17, 2016, you purchased stock in Zimmer Biomet.
Exactly 6 days after you bought the stock, on March 23, 2016,
you introduced a bill in the House called the HIP Act that
would require HHS Secretary to suspend regulations affecting
the payment for hip and knee replacements. Is that correct?
Dr. Price. I think the BPCI program--to which I think you
referred--I'm a strong supporter of because it keeps the
decisionmaking in the----
Senator Warren. I'm not asking you about why you support
it. I'm just asking did you buy the stock, and then did you
introduce a bill that would be helpful to the companies you
just bought stock in?
Dr. Price. The stock was bought by a broker who was making
those decisions. I wasn't making those decisions.
Senator Warren. OK. You said you weren't making those
decisions. Let me just make sure that I understand. These are
your stock trades, though. They are listed under your name,
right?
Dr. Price. They're made on my behalf, yes.
Senator Warren. OK. Was the stock purchased through an
index fund?
Dr. Price. I don't believe so.
Senator Warren. Through a passively managed mutual fund?
Dr. Price. No. It's a broker----
Senator Warren. Through an actively managed mutual fund?
Dr. Price. It's a broker-directed account.
Senator Warren. Through a blind trust? Let's just be clear,
this is not a stock broker, someone you paid to handle the
paperwork. This is someone who buys stock at your direction.
This is someone who buys and sells the stock you want them to
buy and sell.
Dr. Price. Not true.
Senator Warren. When you found out that----
Dr. Price. That's not true, Senator.
Senator Warren. Because you decide not to tell them--wink,
wink, nod, nod--and we're all just supposed to believe that?
Dr. Price. It's what members of this committee, it's the
manner in which this committee----
Senator Warren. No, I'm not one of them.
Dr. Price. I understand that, but it's important to
appreciate that that's the case.
Senator Warren. Let me just keep asking you about this. I
want to understand, when you found out that your broker had
made this trade without your knowledge, did you reprimand her?
Dr. Price. What I did was comply----
Senator Warren. When you found out that she made it, did
you fire her? Did you sell the stock?
Dr. Price. What I did was comply with the rules of the
House in an ethical and legal and above-board manner----
Senator Warren. I didn't ask about the rules of the House--
--
Dr. Price [continuing]. And in a transparent way.
Senator Warren. All right. Let's just stipulate----
The Chairman. Your time has expired, Senator Warren.
Senator Warren. I believe Senator Murkowski went over by 2
minutes. Did I misread the clock here?
The Chairman. By 2 minutes?
Senator Warren. I think that's what it was, and I just
burned another 15 seconds.
The Chairman. Well, keep burning them and you'll be up to 2
minutes.
Senator Warren. OK.
Your periodic transaction report notes that you were
notified of this trade on April 4, 2016. Did you take
additional actions after that date to advance your plan to help
the company that you now own stock in?
Dr. Price. I'm offended by the insinuation, Senator.
Senator Warren. Well, let me just read what you did. You
may be offended, but here's what you did. Congressional records
show that after you were personally notified of this trade
which you said you didn't know about in advance, that you added
23 out of your bill's 24 co-sponsors; that also after you were
notified of this stock transaction, you sent a letter to CMS
calling on them to cease all current and future planned
mandatory initiatives under the Center for Medicare and
Medicaid Innovation; and just so there was no misunderstanding
about who you were trying to help, you specifically mentioned
hip and knee replacement.
The Chairman. Your 2 minutes are up, Senator Warren. Thank
you.
Who's next? Senator Isakson has 3 minutes..
Senator Isakson. I wanted to reclaim my remaining 3 minutes
by just making a point. I respect everybody on this committee
tremendously. I respect the nominee. It's very important for us
to all understand that under the disclosure rules that we have
and the way it operates, any of us could make the mistakes that
are being alleged. I'm sure Senator Franken had no idea that he
owned part of Phillip Morris when he made the statement he made
about tobacco companies. He has a Wisdom Tree Equity Income
Fund investment disclosed in his disclosure, which owns Phillip
Morris. It's entirely possible for any of us to have somebody
make an investment on our behalf and us not know where that
money is invested because of the very way it works.
I don't say that to in any way embarrass Mr. Franken but to
make a point that any one of us who has mutual funds or
investment managers, people who do that, it's entirely possible
for us not to know, and to try and imply that somebody is
obfuscating something or is otherwise denying something that's
a fact is just not the fair thing to do, and I just wanted to
make that fact.
Senator Franken. This is different than mutual funds.
Senator Isakson. It's an investment in Phillip Morris.
Senator Warren. My question was about what do you do after
you have notice?
The Chairman. Senator Warren, your time has been
generously--Senator McCain.
I'm sorry; Senator Hassan.
Senator Hassan. I'm happy to lead, but I think Senator
Cassidy was next, and he just came back in.
The Chairman. He did, but I was going back and forth. I'll
be glad to--that's generous of you, but----
Senator Hassan. Well, then, thank you..
Statement of Senator Hassan
Senator Hassan. Congressman Price, thank you for being here
this morning.
Mr. Chairman and Ranking Member Murray, thank you for the
opportunity to participate.
As you and I discussed, Congressman, we share a concern for
patients. My husband and I have two kids, and our adult son at
times has had up to 10 doctors and a couple of dozen
medications. The Hassan family knows the strengths and the
weaknesses of our health care system very, very well.
As Governor, I was pleased to work with members of both
parties to build on the example that Senator Young talked about
in Indiana to have a bipartisan New Hampshire-specific Medicaid
expansion plan that's providing coverage now to over 50,000
hard-working Granite Staters. I've seen the advantages of the
Affordable Care Act and the flexibility that the Affordable
Care Act gives States right up close, and I worked with a
Republican legislature to pass it. It's that context that I
bring to this series of questions.
First of all, as we talked about, opioid overdose deaths
have been on the rise for several years and have hit New
Hampshire particularly hard. We have about the second highest
rate of drug overdose deaths in the country.
Under the Medicaid expansion program that I just talked
about, made possible only by the Affordable Care Act, thousands
of New Hampshire citizens are getting the opportunity to get
treatment for substance use disorder, and I talked with one of
them last week, a woman named Ashley who had had an addiction
for almost a decade. Medicaid expansion gets passed under the
Affordable Care Act. She got treatment, and she is now in
recovery. After a year on Medicaid--which, by the way, we've
done it in a particular way so that it's actually strengthened
our insurance market in New Hampshire because more insurers
came in as a result of the way we did Medicaid expansion--she
is now working, and she just switched over to private insurance
because she's got employer-
provided insurance.
You have proposed repealing Medicaid expansion in the
budget that you proposed. Yes or no, can you guarantee that you
will make sure that Americans with substance use disorders who
have gotten insurance through Medicaid expansion, just like
Ashley did, will not lose their health insurance?
Dr. Price. I think I enjoyed our conversation as well and
the subjects that we delved into. I think that it's absolutely
imperative that we as a nation make certain that every single
individual have access to the kind of mental health and the
kind of substance abuse challenges that they have.
Senator Hassan. Is that a guarantee that you will find
funds to actually provide the treatment?
Dr. Price. It's a guarantee that I'm committed to making
certain that we address that need which is so vital and
important across this land.
Senator Hassan. I'm just concerned that you're not going to
be able to back up that guarantee if the Affordable Care Act is
repealed, and I'm concerned about the impact that will have on
States and people like Ashley who need the coverage.
I also just want to talk about whether you agree that
people with health insurance should have some very basic
essential coverage, like checkups at the doctor's office. Do
you think health insurance coverage should provide for that?
Dr. Price. I think that, as we mentioned, with choices for
patients to be able to select the kind of coverage that they
want instead of somebody else deciding for them, it's so very
important that we remember that the center of all of these
discussions is a patient, and the patient knows best what he or
she needs, and that's the imperative that I would bring to you,
that I'm committed to making sure that patients have the
choices available, and if they choose to select that kind of
coverage, then it ought to be available for them.
Senator Hassan. Insurance companies don't offer it at all,
like substance use disorder. An essential benefit under the
Affordable Care Act now requires private insurers to cover
substance misuse treatment. They didn't used to do that. They
also have stopped covering a lot of things until the law
requires them to.
So, yes or no, the Empowering Patients First Act would
repeal the requirements that insurance companies cover
substance use disorders. Do you think that's still a good
thing?
Dr. Price. I think that what's a good thing, again, is to
keep the patient at the center of all of this and make certain
that we're providing the kind of options and choices for
patients so that they can address their clinical and medical
needs.
Senator Hassan. See, here's the thing: If insurance
companies never offer it, they don't have the option. They can
pay good premium dollars, but it's just not offered, and the
Affordable Care Act said to the insurance industry, here are
some basic things you've got to offer so that when a patient
needs care, the coverage is there and they can get the care.
Your answer and the Empowering Patients Act would take that
assurance away. It's not an option if insurance doesn't cover
it.
Dr. Price. The good news for you is that as an
administrator, if I'm privileged to serve in that capacity,
that I follow the policies that are adopted by the Congress of
the United States and signed by the President. We look forward
to working with you to make certain that those kinds of things
are covered and those patients receive the care that they need.
Senator Hassan. With respect, there has been lots of
opportunity to make certain that those things happened, and
until the Affordable Care Act was passed, it never happened,
and people didn't get the care they needed. Because of that, a
lot of people like the Ashleys of the world weren't getting
better, weren't getting treatment. Providers don't exist to
treat people if they can't figure out how they're going to get
reimbursed.
The most important thing that our treatment community said
in New Hampshire was Medicaid expansion through the Affordable
Care Act made it possible for them to stand up a higher volume
of treatment.
I look forward to working with you too, but I'm concerned
about your unwillingness to commit to making sure that
insurance companies cover these essential benefits.
I am almost out of time and we haven't even touched on the
issue of women's health, which is obviously of great concern.
Let me just ask a couple of questions.
Yes or no, do you think an employer should be able to fire
a woman because she uses birth control?
Dr. Price. No, I don't believe so.
Senator Hassan. Well, you voted in support of a resolution
to disapprove the District of Columbia's non-discrimination
law, the Reproductive Health Non-Discrimination Act, which
protects women here in D.C. from being fired or penalized
because of their reproductive health decisions.
Your vote would have had the effect of allowing employers
to fire a woman for using birth control or for other decisions
she makes about her own body and reproductive health. How is
that vote consistent with the answer you just gave me?
Dr. Price. Well, again, I think the question was about who
is paying for that product.
Senator Hassan. No. The question is whether an employer
who, let's say, in a self-insured employer-provided health
insurance plan finds out that a female employee who earned the
benefit with her hard work is using that benefit to provide
birth control, to buy birth control, which the benefit
provides, and then fires her because the employer disapproves
of the use of birth control.
Dr. Price. I don't think that's the case.
Senator Hassan. You don't think that--would you like us to
provide examples for you?
Dr. Price. I'd be happy to.
Senator Hassan. You would be willing to say that employers
may not--you would support a law, a rule, that employers may
not discriminate against women for their reproductive health
decisions?
Dr. Price. I don't think that employers ought to--that
employers have the opportunity right now to be able to let
somebody go based upon their health status or the medications
that they use.
Senator Hassan. Why did you vote against the DC provision
that made clear----
Dr. Price. I don't think that's what it did.
Senator Hassan. You don't think that that was your vote?
Dr. Price. I don't think that's what the bill did.
Senator Hassan. Thank you. We'll followup on that.
Dr. Price. Thank you.
Senator Hassan. Again, I wish I had more time because I
have about eight more questions. I'll submit them in writing.
Thank you.
Dr. Price. Thank you.
The Chairman. Thank you, Senator Hassan.
Senator Cassidy.
Statement of Senator Cassidy
Senator Cassidy. Thank you, Mr. Chair. You all seem worn
out, but I've been gallivanting with high school students, so
I'm pretty energized.
The Chairman. Well, good.
[Laughter.]
Senator Cassidy. Let me say for the record that when John
King came for an interview, I wanted to ask a second round and
you wouldn't let me, I confirmed with staff. I've been wanting
to say that for 2 days now, and I'm just going to say it. I had
another set of questions, and you said ``Shut up.''
[Laughter.]
The Chairman. Nothing personal.
Senator Cassidy. Nothing personal.
[Laughter.]
Congressman Price, how would HIPAA laws regard now a
grandfather taking his grandson on house calls? You know what
I'm saying? Somehow I think your grandfather would have been
busted, but that's another----
Dr. Price. Probably.
Senator Cassidy. Probably.
I love what you're saying about the patient-physician
relationship. You and I both worked in hospitals for the
uninsured, I as a gastroenterologist/liver doctor, and we've
been talking a lot about Obamacare and the wonderful things
it's done, but I keep on thinking of my patients at the
hospital for the uninsured with a $6,000 deductible.
Dr. Price. That's right.
Senator Cassidy. I mean, the patients you saw at Grady, not
those who were on Medicaid but those who were working, they
don't have $400 in their account.
Dr. Price. That's right.
Senator Cassidy. They've got a 6K deductible before they
can be otherwise cared for.
And just for the record, if people don't believe me, I put
it on my Facebook page. A friend of mine from home, his renewal
for his individual policy for he and his wife, 60 and 61 years
old, no kids, no health stuff, was $39,000 for a year, with a
$6,000 deductible. I put it on my Facebook page because no one
believes--this is like what a family pays for a mortgage, and
then some, and that was their yearly premium.
I applaud you for looking for some alternative that's
affordable. It may be working for New Hampshire, California,
Massachusetts. God bless you. For States like mine and yours
and Arizona, people cannot afford $39,000 premiums.
Did the Empowering Patients Act repeal, explicitly repeal
the mental health parity laws?
Dr. Price. I don't believe so.
Senator Cassidy. Yes, I don't think so either. Mental
health parity will still apply, and that does cover substance
abuse. There are those provisions--that law still remains in
effect.
Second, we've been talking about does it have to be a
covered benefit. You're a big believer in health savings
accounts. I gather health savings accounts can be used to pay
for doctors' visits and for essential medical services, and
even colonoscopies if necessary?
Dr. Price. Absolutely.
Senator Cassidy. As a gastroenterologist that comes to
mind, so just to also point that out. When you speak about
giving the patient power over her health care to allow her to
choose, when we choose for her, we have a $39,000 premium. When
we allow her to choose, she has something which is affordable
and she becomes a more activated and informed consumer, and
there's a lot of academic literature to look at that, and I
applaud it.
Dr. Price. Absolutely.
Senator Cassidy. We don't agree with each other entirely
but substantially, and I applaud you for that.
Franken always calls me a Luddite--different issue--because
I am skeptical about--he calls me many things, but a Luddite
among them, because I am skeptical about electronic health
records and their negative impact upon productivity. Again, he
thinks I'm just some guy who calls a mouse a little furry thing
when most people have moved beyond that a little.
I see that M.D. Anderson just laid off 5 percent of their
staff. They're blaming it on financial losses related to
decreased productivity, again directly attributable to
implementation of the EHR. Your department is going to be
involved with meaningful use and such like that, and I often
find that an orthopedic surgeon asking somebody about their
smoking history is not really a good use of the orthopedic
surgeon's time. Not that it isn't important, but nonetheless
he's not the person to implement the cessation program. It
should be their internist or--you see what I'm saying.
Dr. Price. Mm-hmm.
Senator Cassidy. What thoughts do you have? What can we do
about this time and productivity sump that has become the
electronic medical record and meaningful use, keeping that
which is positive but hopefully doing something better for the
patient and for the physician?
Dr. Price. Yes. Thanks, Senator. The electronic medical
record and electronic health records are so important because
they, from an innovative standpoint, allow the patient the
opportunity to have their health history with them at all times
and be able to allow whatever physician or other provider
access to that. We in the Federal Government I think have a
role in that, but that role ought to be interoperability to
make certain that different systems can talk to each other so
that it inures to the benefit of the patient.
I've had more than one physician tell me that the final
regulations and rules related to meaningful use were the final
straw for them.
Senator Cassidy. They quit, they retired.
Dr. Price. They quit, and they've got no more gray hair
than you or I have. When that happens, we lose incredible
intellectual capital in our society that can care for people.
Senator Cassidy. What can we do about that? What practical
things can we do?
Dr. Price. I think the thing that's absolutely imperative
is to find out what things ought to be determined and checked
and the metrics that are used, that they actually correlate
with the quality of care that's being provided, as opposed to
so many things that are being required right now of the
physician or the provider that make it so that they're wasting
their time documenting these things so that it fits into some
matrix somewhere but it doesn't result in a higher quality of
care or outcomes for that patient.
If we truly worked with those providing the care to say
what is it that we could ask you to measure that would really
correlate with the outcome and the quality of care being
provided, I suspect there are some very specific things that we
could use.
Senator Cassidy. It's interesting because you're
emphasizing the patient-physician relationship. My wife is a
retired breast cancer surgeon, and she used to say that really
she cared for the husband as much as the wife because the
husband would be the one who was crying, but she would be the
one telling them, looking them in the eye, ``There's hope, this
is not a death sentence. There is hope.'' I can only imagine if
she were now in practice typing up, ``There is hope.'' It's a
little bit of a different feel for the patient and her spouse.
Dr. Price. Yes. We've turned many physicians and other
providers into data entry clerks, and it detracts, as you said,
from their productivity, but it detracts greatly from their
ability to provide quality care.
Senator Cassidy. Let me ask as well, one of our big
challenges, how do we come up with expensive medicines that are
only used by a very few? How do we socialize that cost? Think
of antibiotics. We just had some gorilla, some germ out there,
bacteria, that's apparently resistant to everything, or we can
come up with gene therapy for a very few, very expensive to
develop. How do we pay for that? I just want your thoughts. I
don't know if you have an answer. I care deeply about those,
and so do you, with these rare diseases but devastating. How do
we care for them and socialize that cost?
Dr. Price. I talked earlier with Senator Hatch during his
time about rare diseases and about the Orphan Drug Act and the
like that revolutionized the ability or the incentives for
bringing to market drugs that address rare disease, and it's so
incredibly important. The incentivization from an FDA
standpoint is important, incentivization to make certain that
if individuals or companies are able to come up with things
that cure diseases, that they are appropriately compensated.
Senator Cassidy. In the era of personalized medicine where
it might be an N of 1, or an N of 1,000, it's still very small,
but the cure could be 1 million; anything specific about that?
Dr. Price. We are entering a brave new world that is so
exciting from a scientific standpoint to be able to provide
this kind of personalized health care service to folks, that
we'll be able to cure things that we never dreamed about
curing, and the challenges about how we afford to make that
available to our society are real, and I think we need to get
the best minds together to figure out how to make that happen,
and I look forward to working with you to do so.
Senator Cassidy. I'll close by saying this, and I have a
perspective that my colleagues cannot, because I know
orthopedic surgeons are the ones that are called at 3 in the
morning when there's a car wreck and someone so busted up
there's no one else to fix them, but if they don't fix them,
they die. They kiss their wife goodbye, they climb out of bed,
they drive to the hospital, they're up all night, and then they
see their clinic schedule the next day. They make rounds in the
evening. They get home at midnight and kiss their wife
goodnight before they go to bed.
Price, you're the exact kind of person to have this job.
Thank you, and I yield back.
Dr. Price. Thank you, Senator.
The Chairman. Thank you, Senator Cassidy.
Senator Kaine.
Statement of Senator Kaine
Senator Kaine. Thank you to the committee leadership, and
thank you, Congressman Price, for your visit the other day in
the office.
An observation, and then a few questions. Forgive me. I was
at another hearing, so I might be a little repetitive, but I'll
try to move quickly.
My worry as a Virginian is your position about a whole
range of programs that are basically about access and coverage,
sort of the safety net that provides coverage to millions of
people. You proposed turning Medicaid into a block grant
program. That's exciting a lot of controversy in Virginia right
now in our legislature, both Democrats and Republicans, and you
have repeatedly voted against the CHIP program for kids, at one
point calling it socialized medicine. That's a combined,
Medicaid and CHIP, about 800,000 Virginians.
You've proposed a restructuring of Medicare that CBO found
would increase out-of-pocket costs for seniors. That's about
1.3 million Virginians.
You support repeal of the Affordable Care Act. There's
about half-a-million Virginians on the exchanges and hundreds
of thousands of others that are otherwise benefited.
You want to defund Planned Parenthood. Tens of thousands of
Virginians use Planned Parenthood as their primary health care
provider.
These are the basic programs that provide health care
coverage for millions of Virginians. There's some overlap
there, but it would be millions, and tens of millions of
Americans, and many of them have very limited means. There's a
sort of consistency to your position in some ways across all
these programs that I view as critical to the health safety
net.
I know that Senators Franken and Murray used the
Hippocratic maxim, First Do No Harm, in comments before I came,
and I think, and I would hope you would agree, that as we
approach the discussion of the health care system--access,
coverage, cost, quality--that the President and Congress should
strive to do no harm. Would you agree with me?
Dr. Price. Absolutely.
Senator Kaine. We shouldn't harm people by reducing the
number of people who have health coverage or reducing the
quality of the insurance coverage they have. That's what we
should strive for, right?
Dr. Price. I think it's important to appreciate that there
are challenges in these programs currently. One out of every
three physicians who ought to be able to see Medicaid patients
across this country doesn't see Medicaid patients. If we're
honest and sincere about addressing these problems, we ought to
step back and say why is that? What are we doing wrong? One out
of every eight physicians who are eligible to see seniors no
longer sees Medicare patients. If you're a new Medicare patient
trying to find a new physician that sees new Medicare patients,
it's almost impossible anywhere in this country.
Senator Kaine. I am all with you on fixing challenges and
going forward, more coverage, more affordable, better for
health care providers----
Dr. Price. That's what we're trying to do. That's what my
proposals have tried to do.
Senator Kaine. That is important. We shouldn't harm people
by doing things that would increase their costs, correct?
Dr. Price. I think we need to drive down the cost for
everybody.
Senator Kaine. Right. We shouldn't harm people by creating
an anxiety about the most important thing in their lives, their
health care and the health care of their families. We shouldn't
be doing that in Congress, should we?
Dr. Price. One of my goals in this entire debate--and I
appreciate you bringing this up--is to lower the temperature
about what we're talking about, because this is real stuff for
folks. These are their lives and their health.
Senator Kaine. Can we lower the temperature and rush at the
same time?
Dr. Price. I think we can move apace but lower the
temperature and provide stability to folks out there. People
need to know that no rug is going to be pulled out from under
them.
Senator Kaine. I'll join you in stability, and I'll join
you in lower temperature. I don't think lowering the
temperature is consistent with rushing. In fact, my experience
in going around Virginia is huge amounts of fear. We shouldn't
harm the American economy--health care is the biggest sector of
the American economy, one-sixth of it--by injecting uncertainty
into it. We should again try to fix the problems that you've
identified or those that I might identify and do it in a way
that provides some stability and certainty. Shouldn't that be
our goal?
Dr. Price. Certainty is incredibly important. I'm reminded
of the fact that the Congressional Budget Office has told us
that the ACA has actually decreased the workforce by the
equivalent of 2 million FTEs. There are challenges we have
throughout, and I hope that what we're able to do is work
together to solve those challenges.
Senator Kaine. Do you agree with the President-elect that
the replacement for the Affordable Care Act must ensure that
there's insurance for everybody?
Dr. Price. I have stated here and always that it's
incredibly important that we have a system that allows for
every single American to have access to the kind of coverage
that they need and desire.
Senator Kaine. He stated in the same interview a couple of
days ago that we should negotiate with pharmaceutical companies
under Medicare Part D to try to bring down prescription drug
costs. Do you support that position of the President-elect?
Dr. Price. I think that the cost of drugs is in many
instances a real challenge for folks, and we need to do all
that we can to make certain that we bring those costs down.
Senator Kaine. Here is kind of an offbeat question. It's
kind of a coincidence based on today. I was at a hearing with
Nikki Haley, Governor Haley, who is nominated to be U.N.
Ambassador, right before I came in. She played a really
significant role in moving her State away from use of the
Confederate Battle Flag in any official capacity.
When you were a member of the Georgia legislature, you
fought pretty hard to keep the Confederate Battle Flag as part
of the Georgia State flag, and you sponsored resolutions to
make April Confederate History Heritage Month in Georgia and
``urging schools to commemorate the time of southern
independence.''
I'd like to introduce that resolution for the record, Mr.
Chair.
[The information referred to may be found in Additional
Materials.]
Senator Kaine. I read the resolution with interest because
it defrays commemorating the time of southern independence, and
I pulled it up, and I note that the resolution that
commemorated the time of southern independence mentions nothing
about slavery. Why did you support that resolution, and do you
still support it today?
Dr. Price. I haven't thought about that in a long time,
Senator, but I'm happy to look at that and go back and try to
refresh my memory about that time.
Senator Kaine. Setting the resolution aside, what is
laudatory about the time of southern independence?
Dr. Price. Well, I think every heritage has things that are
good about it. Every heritage has things that are harmful about
it. I'm happy to answer a specific question. I think slavery
was an abomination.
Senator Kaine. Do you think a resolution about Confederate
History Month that completely omits any reference to slavery
kind of meets the basic standards of fair and balanced?
Dr. Price. I don't know that it presumed to be
comprehensive. What I do know is that the work that I did as
the first Republican Senate Majority Leader in the history of
the State of Georgia was to make certain that we came forward
with a flag that did not have the Confederate Battle Flag on
it, that addressed all of the concerns of the State and was
adopted and supported by the State, and we did so in a
bipartisan way, and I was privileged to work with now Atlanta
Mayor Kasim Reed when he was in the Georgia Senate at that time
to make certain that we were able to do so.
Senator Kaine. You're aware that there's an Office of
Minority Health----
Dr. Price. Absolutely.
Senator Kaine [continuing]. At HHS that was created in the
Affordable Care Act, reauthorized in the Affordable Care Act?
Dr. Price. Yes.
Senator Kaine. If the ACA is repealed, unless it's
separately reauthorized, that office would also expire?
Dr. Price. Again, that's a legislative question. If I'm
privileged to serve and be confirmed and be Secretary of Health
and Human Services, I look forward to making certain that we
use the resources available to us and the agencies available to
us within the Department to make certain that every single
American has the highest quality health care available.
Senator Kaine. Why did you use the phrase ``socialized
medicine'' to explain your vote against the CHIP program?
Dr. Price. I don't know that I recall that conversation or
that quote, but I'm happy to go back and look at it.
Senator Kaine. OK. Thank you.
Thank you, Mr. Chair.
The Chairman. Thank you, Senator Kaine.
Senator Scott.
Statement of Senator Scott
Senator Scott. Thank you, Mr. Chairman.
Dr. Price.
Dr. Price. Senator.
Senator Scott. Good to see you here today.
Dr. Price. Likewise.
Senator Scott. I'm hoping for much success for you. I hear
that you were at Emory University?
Dr. Price. I was.
Senator Scott. Medical School?
Dr. Price. No, I did my residency at Emory University.
Senator Scott. OK. My nephew is just in his first year of
medical school at Emory. I hope that he gets a quality
education.
Dr. Price. He will, and he's got an exciting road ahead.
Senator Scott. Excellent, excellent.
Well, I did have the privilege of serving with you in the
House and enjoyed our relationship, our friendship, and look
forward to seeing your success as the Secretary of HHS. I have
a couple of questions that are State specific to South
Carolina.
We have over 20 health centers in South Carolina, with
about 165 service sites, serving over 350,000 patients in
almost every county in the State. Every county in South
Carolina is either partially or completely designated as
medically underserved by HRSA. As rural hospitals continue to
close, these centers have addressed a need for many communities
in my State. They work together with partners in the community
to address impacts on health like food deserts and lack of
transportation to preventive health services, which can save
costs in the long run.
A diabetic who does not take their medications because they
cannot afford it or who has no way of picking up what will
inevitably be a long run to the emergency room, what role do
you think community health centers can play, particularly in
rural and medically underserved areas?
Dr. Price. Thank you, Senator. Community health centers are
a vital part of our health care delivery system right now. They
fill a void in so many areas. As you mentioned, across your
State and across mine and literally across the country, I think
there are 13,000 that are the entry point and oftentimes the
area of health care for so many individuals, and we need to do
all that we can to strengthen them, to make certain that the
providers, the docs and other providers that are within
community health centers are of the highest quality, that
they're providing the highest quality care, and that they're
able to access resources, intellectual resources and clinical
resources that allow them to broaden that care.
Senator Scott. A decade ago in South Carolina, emergency
rooms were full of people waiting for psychiatric exams so they
could either be admitted or discharged. After implementation of
the statewide tele-psychiatry network, wait times have been cut
from 4 days down to about 10 hours. The costs have been cut by
almost two-thirds. What do you see as the future of
telemedicine, particularly to address access issues? What
barriers can we anticipate as well?
Dr. Price. Telemedicine is one of those exciting
innovations that will, I believe, allow for individuals,
especially in rural and underserved areas, access to that
intellectual capital and resources from a clinical standpoint
to make decisions on patients that are before them without
being able to save resources and save patients in so many ways.
We, in the State of Georgia, have a stroke program that's kind
of a spoke and wheel program where at the Medical College of
Georgia there's a neurologist that works with telemedicine and
has a network of clinics and hospitals around the State where
if somebody comes in with symptoms of a stroke, that physician
is able to literally see that patient in real time and
determine whether or not they need medication, whether or not
they're having a stroke, whether they can be treated in the
community, or whether they have to be transferred to the
academic center.
In the past, it was a call on the ground, no ability to be
able to talk with somebody who might have greater resources or
knowledge, and all of those patients tried to get to the
academic center, a huge waste of money and not having patients
at the center of that decision. Telemedicine is absolutely
vital, and I think we need to accentuate the ability to use
telemedicine.
As you well know right now, oftentimes telemedicine and
tele-health is not paid for, it's not compensated. People eat
those--the clinicians eat those costs. They assume those costs
that help the patient, yes, but make it so it's much more
difficult for them to be able to provide the quality care
necessary.
Senator Scott. Thank you. Another interesting topic that
you should be fairly familiar with from a minority perspective.
South Carolina has a high percentage of African Americans. As
you probably know, breast cancer deaths are approximately 1\1/
2\ times higher in African American women. Prostate cancer
deaths are approximately 2\1/2\ times higher in African
American men, and new diagnoses are twice as high.
I would love to hear your perspective on addressing some of
the health disparities in communities of color specifically.
Dr. Price. This is really an important area, Senator, and I
appreciate you bringing it up, because I think so often what we
do in this and other areas is to say, ``OK, we're going to set
up this facility here or this agency here and we've taken care
of the problem.'' What I don't think we do is look at what's
happening on the ground, the metrics, as well as we could or
should. We ought to be defining specifically whether or not
we're actually improving the lives and health for individuals
in challenged communities. If we're not, then we need to step
back honestly and sincerely and say what can we do to make
certain that it works.
I learned a couple of months ago, I had the privilege of
being at a clinic in Atlanta, and I learned that there's a zip
code in Atlanta, within this metropolitan area of Atlanta that
has incredible disparities in terms of their health outcomes
and their health status, higher mortality, higher rates of
diabetes, higher rates of stroke, higher rates of myocardial
infarctions, and they're surrounded by incredible health care
facilities. When we see those kinds of things, we need to drill
down into those areas to see what's going on, why is that
happening, and address the real challenge on the ground, as
opposed to saying, ``OK, we've taken care of it because now we
have an agency that's addressed to take care of that.'' I think
we need to do better metrics and better accountability for
what's going on.
Senator Scott. I'm sure that you guys have talked at some
length about rare diseases.
Dr. Price. We have.
Senator Scott. Sickle cell being one of the more important
ones in the African American population. I would love to
perhaps submit some questions for the record to get your
insight and your perspective on how we tackle so many of those
diseases moving forward.
Dr. Price. Look forward to that, Senator. Thank you.
Senator Scott. Thank you.
The Chairman. Thank you, Senator Scott.
Senator Murray.
Senator Murray. Thank you, Mr. Chairman.
Congressman Price, I did want to clarify your response to
one of my previous questions. You admitted to me in our meeting
that you, in your own words, talked with Congressman Collins
about Innate Immuno. This inspired you to, in your own words,
study the company and then purchase its stock, and you did so
without a broker. Yes or no?
Dr. Price. No.
Senator Murray. Without a broker.
Dr. Price. I did not.
Senator Murray. You told me that you did this one on your
own with the broker, yes?
Dr. Price. No, I did it through a broker. I directed the
broker to purchase the stock, but I did it through a broker.
Senator Murray. You directed the broker to purchase
particularly that stock.
Dr. Price. That's correct.
Senator Murray. Yes.
Well, Mr. Chairman, those answers really commit me to
underscore the need for a full and independent investigation,
and I would like to ask consent to enter into the record an
article from Kaiser Health News that notes that Congressman
Price was offered a lower stock price for sophisticated
investors. I think that's an important part of the record.
The Chairman. It will be included.
[The information referred to may be found in Additional
Material.]
Senator Murray. Representative Price, if you are confirmed
as Secretary of Health and Human Services, you will be in
charge of our Nation's family planning programs and policies.
You have said that you don't think cost is an issue for women
in buying birth control and stated, ``Bring me one woman who
has been left behind. Bring me one. There is not one.'' You did
say that, correct?
Dr. Price. I think what I said and what I meant was that
when I had patients in my office who were unable to afford
medication, we did everything we could to make certain that
they got that medication. What I meant to capture in that
conversation was that if there are individuals who are unable
to afford that medication or any medication, that there are
avenues within the health care system that physicians and
others take to make certain that individuals receive the
medication that they need.
Senator Murray. Well, let me tell you about my constituent
Shannon. Shannon has endometriosis. It's a common health
condition impacting women. And she said,
``No co-pay birth control is an essential tool
helping women like me with endometriosis who otherwise
would have to live with chronic pain.''
No co-pay birth control was extremely important to her.
Women are really deeply concerned about the impact this
election could have on their access to health care that they
need. I have heard from many of them. According to Planned
Parenthood, demand for IUDs, which is a form of long-lasting
contraception, is up 900 percent since the election.
I want to ask you, will you commit to ensuring all 18 FDA-
approved methods of contraception continue to be covered so
that women do not have to go back to paying extra costs for
birth control?
Dr. Price. What I will commit to and assure is that women
and all Americans need to know that we believe strongly that
every single American ought to have access to the kind of
coverage and care that they desire and want, and that's our
commitment, and that runs across the board.
Senator Murray. Well, let me be clear. Birth control is an
essential part of women's health care, and if you are
confirmed, I will be holding you accountable for that.
I also wanted to ask you, I'm deeply concerned about the
impact your policies would have on women, obviously, and in
particular women who often faced barriers to access in the
health care they need. According to HHS data, since the ACA
became law, the percentage of black women who report not having
a regular doctor dropped by nearly 30 percent, while that
measure for Latinas fell by almost 25 percent. Your health care
repeal bill and your budget proposal to cut a trillion dollars
from Medicaid would disproportionately hurt women of color,
further compounding disparities in access to health care and
undoing progress that was made in the Affordable Care Act.
Are you committed to ensuring that women of color maintain
access to quality, affordable health care?
Dr. Price. Senator, I appreciate it. I don't agree with the
premise. The program that I support and that I believe the
President-elect supports is to make certain that every
individual has access to the kind of coverage that they want.
Nobody wants individuals to not have the opportunity to see the
doctors that they want, to get the kind of care that they want
at a price that's affordable and that's of the highest quality.
That's what we believe in, and I hope that we'll be able to
work together to achieve that goal.
Senator Murray. Well, the Office of Minority Health was
reauthorized as part of the ACA. Will you commit to maintaining
and supporting this office and its work?
Dr. Price. I will commit to being certain that minorities
in this country are treated in a way that makes absolutely
certain that they have access to the highest quality care.
Senator Murray. You will not commit to the Office of
Minority Health being maintained?
Dr. Price. I think it's important that we think about the
patient at the center of all this. Our commitment, my
commitment to you is to make certain that minority patients and
all patients in this country have access to the highest quality
care.
Senator Murray. In particular you won't commit to the
Office of Minority Health?
Dr. Price. Look, there are different ways to handle things.
I can't commit to you to do something in a department that, No.
1, I'm not in, I haven't gotten there yet----
Senator Murray. Well, you will be.
Dr. Price. Let me put forward a possible position that I
might find myself in. The individuals within the Department
come to me and they say we've got a great idea for being able
to find greater efficiencies within the Department itself, and
it results in merging this agency and that agency, and we'll
call it something else. We will address the issues----
Senator Murray. I just have a minute left, and I hear you
that you're not committed. OK.
Dr. Price [continuing]. In a way that is responsive to
patients.
Senator Murray. Let me just ask one final question. Are you
aware that black, Latina, American Indian, Alaska Natives are
almost twice as likely as white people to be covered under
Medicaid? Do you think it's responsible to propose cutting
trillions of dollars of funding without a credible alternative
to replace it for those people?
Dr. Price. Again, I disagree with the premise. The solution
that we have would ensure that every single American,
regardless of their health status and regardless of their
economic status, have the ability, financial feasibility to
purchase the kind of coverage that they want.
Senator Murray. Well, I have a few seconds left, Mr.
Chairman. As you can see, we have members here who also have
additional questions. I am deeply troubled by a number of
responses. We have a lot of families who are very, very, very
concerned since this election with what will happen to them
personally. We have outlined some of those, and I hope that,
Congressman Price, as we will have a significant number of
questions from our colleagues, that you will fully submit them
for the record.
Dr. Price. Thank you.
The Chairman. Thank you, Senator Murray.
Dr. Price, I want to thank you for being here. I only have
a few comments. I don't have additional questions.
I was reflecting back on Sylvia Burwell's appearance before
this committee and how impressed I was with her appearance. I
think you've done as well.
I've also been impressed with her performance in the job
because while I disagree with a number of the policies she's
taken, she's gone out of her way to adopt the same tone that
I've heard from you today, which is to try to accept and work
with people with different points of view and see if we can
come to a consensus. I thank you for that, and I'm impressed
with your beginning, and I appreciate your being here today.
Based upon the figures I have, you've just endured the most
extensive questioning of any Secretary of Health and Human
Services since 1993. Because of the round of questioning,
Secretary Burwell was in the hearing for 2 hours and 10
minutes, Sebelius for 2 hours and 28 minutes, Daschle for 2
hours and 10 minutes, Leavitt less than 2 hours. I don't have
it for two others. You've been here nearly 4 hours, and next
Tuesday you'll go before the Finance Committee, which will vote
on whether you go forward to the President.
I'm very hopeful that your tone will help us come to a
conclusion and a consensus in this very important area of
providing concrete, practical alternatives to give Americans
access to health care they can afford.
I was reflecting last night on the hearing, and today.
They've been pretty testy. We often have strong opinions here
because we have differences of opinion, but I think that's a
reflection of, No. 1, the election over the past year, which
became very uncivil, more so than I liked, and Republicans can
take our share of the blame for that; but also this issue which
for 6 years we've been going at it like the Hatfields and the
McCoys in West Virginia, until almost we've forgotten who
killed who in the first place, and we're not absolutely clear
what we're fighting about.
It would take a bedside manner such as you have to lower
the temperature, as Senator Kaine suggested. He was among 12
Democrats who wrote a letter suggesting they were willing to
work with Republicans as we go forward. I think it will take a
little while to lower that temperature just because we spent 6
years as the Hatfields and the McCoys, but I'm committed to
trying. That's the way we usually work in the committee on very
contentious issues, and I'd like to get away from the testiness
of last night and today and back toward the way we've learned
to work.
A couple of other things. I hope those watching were
reassured by what they heard from you. What I heard from you--I
believe I'm correct about this--is that while we intend to
repair the damage of Obamacare, and that would eventually mean
repealing parts of it, major parts of it, that that won't
become effective until there are practical, concrete
alternatives in place to give Americans access to health care.
In other words, you said we don't want to pull the rug out from
anybody, and I'm sure that's a shared view.
You've talked some about the importance of March the 1st.
One thing we have to work together on is what do we do about
the individual market and the fact that in a third of the
counties there's already just one insurer for people with
Obamacare subsidies, and we don't want to get into a situation
later this year or in 2018 where there's--as I said, it's like
having a bus ticket in a town with no buses. We may have to do
some things on both sides of the aisle that we wouldn't
normally do during this transition period to make sure that
insurers are willing to sell into the market so these 11
million people continue to buy insurance, hopefully for more
than one person.
I think it's also become clear that the timing that we've
talked about has yet to be resolved, really, and the sequencing
is as important almost as the policy. I mean, how do we get
from where we are to where we eventually hope to go? The way I
think about it is that we go to work immediately on what I call
a collapsing bridge, repair it--that's the individual market--
make sure that people aren't hurt by it, and then work together
to build new bridges, and then close the old bridge only when
we have new bridges up.
I think we can make most of the decisions about the
``replacement'' or replacements or the new systems, new
bridges, in a relatively short period of time. We've been
working on this for years. We have our opinions. We ought to be
able to sit in a room and come to a conclusion.
In my opinion, then, it will take several years to actually
implement those decisions because in many cases we'll be
transferring responsibilities to States and consumers. We'll
want to do that after talking with Governors and insurance
commissioners, do it on a schedule that States can accept.
Their legislatures sometimes only meet every 2 years. Making
decisions promptly, making them together if we possibly can,
and then implementing it step by step and carefully so that
people are able to have access to lower cost insurance is what
I hope I heard today.
One other thing. Senator Cassidy, Senator Whitehouse,
several members of this committee, maybe all of us worked very
hard--I know Senator Murray did as well--on trying to deal with
the electronic health care records and meaningful use. In
Vanderbilt, which was an early adopter of the electronic health
care records, they said stage 1 was very helpful, stage 2 they
could deal with, and stage 3 was terrifying. I had hoped that
we could delay stage 3. I thought that maybe it could be as
simple as saying to the physicians and providers of the world,
``Look, if you're a doc and you're spending 50
percent of your time filling out forms, then either
you're doing something wrong or we're doing something
wrong, and let's work together for the next couple of
years to see if we can get that down to a manageable
level and create an environment where physicians and
providers can spend their time talking instead of
typing.''
You've got a bipartisan consensus here to work on that, at
least we had last year when we passed the Cures bill, which had
a number of provisions in it. We had six hearings on the
subject, and I invite you to work with us if you're confirmed
to complete that.
If Senators wish to ask additional questions of our
nominee, questions for the record are due by the close of
business on Friday, January 20. For all other matters, the
hearing record will remain open for 10 days. Members may submit
additional information for the record within that time.
The next meeting of our committee will be in executive
session on January 24 at 10 a.m., which has already been
noticed.
Thank you for being here today.
The committee will stand adjourned.
Dr. Price. Thank you, Mr. Chairman.
[Additional Material follows.]
ADDITIONAL MATERIAL
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
[Kaiser Health News (KHN), January 13, 2017]
Trump's HHS Nominee Got a Sweetheart Deal From a Foreign Biotech Firm
(By Jay Hancock and Rachel Bluth)
When tiny Australian biotech firm Innate Immunotherapeutics needed
to raise money last summer, it didn't issue stock on the open market.
Instead, it offered a sweetheart deal to ``sophisticated U.S.
investors,'' company documents show.
It sold nearly $1 million in discounted shares to two American
Congressmen sitting on House committees with the potential power to
advance the company's interests, according to company records and
congressional filings. They paid 18 cents a share for a stake in a
company that was rapidly escalating in value, rising to more than 90
cents as the company promoted an aggressive plan to sell to a major
pharmaceutical company. Analysts said the stock price could go to $2.
One of the beneficiaries was Rep. Tom Price, a Georgia Republican
poised to become secretary of the Department of Health and Human
Services, which regulates pharmaceuticals. Price told HHS ethics
officials Thursday that if appointed, he will divest himself of the
Australian stock as well as stock in about 40 other companies that
could pose conflicts. He said he would sell within 90 days of
appointment and abstain from any decisionmaking about companies in
which he or his family has had an interest.
He has already seen about a 400-percent paper gain in his
investment in Innate Immuno, stock trading records show.
The other and more substantial August investor was Rep. Chris
Collins, a Republican from up-state New York, who along with family
members owns about 20 percent of the foreign company. A key supporter
of the President-elect, Collins sits on a key health subcommittee.
The outlines of the stock deal, first reported by the Wall Street
Journal, resurrected concerns about powerful public officials gaining
investment opportunities unavailable to the public, including from
companies whose profits might be influenced by political decisions.
A review of corporate documents raises a more unusual aspect of the
deal. Innate Immuno is a foreign company which, in documents and
presentations, is explicit about a business strategy targeting the U.S.
market, where the amount that can be charged for a new drug is
generally far higher than in other countries.
Innate Immuno has hinged its strategy on winning a preliminary
green light for a new multiple sclerosis drug, known as MIS416, from
the HHS's Food and Drug Administration. It says in its private
placement offering documents that money raised in the United States
will help it finance the FDA approval process, which can take years.
Innate Immuno CEO Simon Wilkinson could not be reached for comment.
Price's financial disclosures show that he acquired his first small
stake in Innate Immuno in January 2015, investing about $5,000. He made
two more small purchases in the company that year, declaring a small
loss on the stock in his 2015 financial disclosure.
His largest purchase was on August 31, 2016, valued at between
$50,000 and $100,000, his disclosures show.
Government ethics experts said this week that Price's stake in
Innate Immuno as it tries to develop a blockbuster drug would clash
with his public duties, making divestiture mandatory.
While ethics rules for Congress are relatively relaxed, ``the
minute you go to the executive branch, it's a lot stricter,'' said
Richard Painter, a University of Minnesota law professor who was
President George W. Bush's chief ethics lawyer.
``Dr. Price takes his obligation to uphold the public trust very
seriously,'' said Phil Blando, a spokesman for the Trump transition. He
has ``complied fully with all applicable laws and ethics rules
governing his personal finances.''
Innate Immuno told investors it would seek ``investigational new
drug'' status from the FDA, which could shorten the approval process.
The FDA would not confirm this week whether the company has filed an
application.
The drug is in a small clinical trial in New Zealand due to end in
April. MS drugs are especially expensive for patients, costing $5,000 a
month or more.
Positive trial results could set the stage for Innate Immuno's
stock to reach $2, said Australian stock analysts. In that scenario,
Price's investment of between $50,000 and $100,000 would be worth
between $555,000 and $1.1 million. House financial disclosures require
reporting of ranges of value but not specific amounts.
``You could easily picture a drug that is in the billions of
dollars in revenues, but that's assuming the [trial] data is there,''
said David Blake, an analyst at Bioshares, a newsletter covering
Australian life sciences stocks. ``It's really got to deliver.''
A physician who chairs the House Budget Committee, Price also sits
on the House Ways and Means Committee and the Congressional Health Care
Caucus. He has a history of contacting the FDA on behalf of industry
campaign donors.
His ownership of Innate Immuno while serving in the House creates
its own appearance of a conflict of interest, ethics authorities said.
``There is an appearance problem . . . to have Members of Congress
buying and selling stocks that are affected by the work of the
committees they sit on,'' Painter said. ``It could be perfectly legal,
but it looks terrible and shows lack of judgment.''
Price's Innate Immuno stake is one of more than 40 companies he
identifies as potential conflicts with the HHS job, including stock in
Pfizer, Eli Lilly and Bristol Myers Squibb.
Collins, who sits on Innate Immuno's board, has been a major
shareholder in the company since 2011 and has gradually increased his
family's holdings to about 20 percent, corporate documents show. His
investment in the private placement last summer was worth $720,000,
according to regulatory documents.
``Congressman Collins has followed all ethical guidelines related
to his personal finances during his time in the House and will continue
to do so,'' said spokesman Michael McAdams.
All told, including Price, Collins and other U.S. investors, the
sale raised $1.8 million. In addition to funding the FDA approval
process, the company said it would use the money to finance the
clinical trial and develop potential manufacturing for the drug.
All U.S. investors in the August deal received a 12 percent
discount to the stock's market price at the time, which is not unusual
in private placements, said Stuart Glazebrook, a biotech analyst for
Gordon Capital Research, a securities research company in Melbourne,
Australia.
For small companies, private issues can be more efficient than
selling new public shares, he said. Selling at less than the market
price raises odds of attracting investors, he said.
``It's an incentive,'' he said. ``It's like Amazon offering 20
percent off today only if you commit today.''
Ethics rules for FDA officials are especially strict, said Joshua
Sharfstein, a former agency deputy commissioner.
``For the agency's leaders, even holding onto a single share of
stock in a regulated company is prohibited,'' he said.
A decade ago FDA Commissioner Lester Crawford resigned and pleaded
guilty to two criminal misdemeanors after being charged with concealing
stock ownership in food and drug companies the agency regulated.
Innate Immuno executives have talked openly about selling the
company to one of a number of pharmaceutical company suitors if its
clinical trial is successful. Many small pharmaceutical companies with
hot drugs go that route, reaping shareholders millions in quick
profits.
The larger company would have the deep pockets to invest in more
clinical trials that might be needed to obtain regulatory approval,
analysts said.
Note: Christina Jewett contributed to the reporting.
Petitions Opposing Tom Price's Nomination
Enclosed are samples from 14 separate petitions totaling 510,715
signatures* the committee has received voicing their opposition to
Representative Tom Price's nomination for Secretary of Health and Human
Services. The list of petitions includes:
---------------------------------------------------------------------------
* Below are the listings of those petitions. Due to the high cost
of printing the petitions referred to are being retained in committee
files.
National Council of Jewish Women (395 signatures)
All Above All (8,773 signatures)
American Federation of Teachers (23,862 signatures)
Physicians for a National Health Program (2,010 signatures)
UltraViolet (26,817 signatures)
Condensed petitions:
Planned Parenthood Action Fund (82,959 signatures)
MoveOn (24,546 signatures)
Public Citizen (19,816 signatures)
CREDO (269,858 signatures)
National Physicians Alliance (1,450 signatures)
National Women's Law Center (NWLC) (13,075 signatures)
Make It Work Action (2,708 signatures)
Moms Rising (19,557 signatures)
NARAL (16,899 signatures)
______
U.S. Senate,
Washington, DC 20510-6300,
January 18, 2017.
Hon. Lamar Alexander, Chairman,
Senate HELP Committee,
428 Dirksen Senate Office Building,
Washington, DC 20510.
Dear Chairman Alexander: As concerns grow about potential ethical
violations by Congressman Price, and in light of your apparent
unwillingness to delay his hearing to allow time for said concerns to
be fully investigated, we write to request that all committee members
be afforded the opportunity to ask all reasonable questions at today's
hearing on Congressman Price's nomination to be Secretary of the
Department of Health and Human Services (HHS). This has proved
increasingly difficult as multiple hearings of controversial nominees
have been scheduled at the same time. Today's schedule features four
simultaneous hearings including the hearing for Scott Pruitt to lead
the Environmental Protection Agency.
As we made clear at yesterday's hearing of Elisabeth DeVos to be
Secretary of Education, we object in the strongest terms to your
decision to allow only a single 5-minute round of questions from
committee members. As you know, nomination hearings are a critical
opportunity for members to obtain vital information about a nominee's
qualifications, views, and intentions.
If confirmed, nominees like Ms. DeVos and Representative Price will
have tremendous responsibility and will exert significant influence
over Americans' daily lives. Nominations of such importance require
more than a ``check the box'' hearing.
At yesterday's hearing, you stated that your decision to limit
questions to one 5-minute round was consistent with the precedent set
by prior nomination hearings. We do not agree. We have found no example
where a request by a Member of the committee to pose additional
questions to a nominee was denied, much less a blanket denial to each
of us. Additionally we have determined that Secretaries Shalala and
Leavitt and Senator Daschle's HHS nominations hearings were multiple
rounds, while at several additional cabinet level nominations hearings
members were offered 10-minute rounds for questions.
We appreciate your respect for the work of this committee, and are
confident you agree that the Senate has a critical role to play in
providing the President with advice and consent on his nominees.
Accordingly, we hope you recognize that Senators must have the
opportunity to engage in a robust exchange with each of the nominees
before this committee, consistent with precedent.
Sincerely,
Patty Murray,
U.S. Senator.
Robert P. Casey, Jr.,
U.S. Senator.
Michael F. Bennet,
U.S. Senator.
Tammy Baldwin,
U.S. Senator.
Elizabeth Warren,
U.S. Senator.
Margaret Wood Hassan,
U.S. Senator.
Bernard Sanders,
U.S. Senator.
Al Franken,
U.S. Senator.
Sheldon Whitehouse,
U.S. Senator.
Christopher S. Murphy,
U.S. Senator.
Tim Kaine,
U.S. Senator.
State of Rhode Island and Providence Plantations,
Providence, RI 02903-1196,
January 6, 2017.
Hon. Kevin McCarthy, Majority Leader,
U.S. House of Representatives,
H-107, U.S. Capitol Building,
Washington, DC 20515.
Dear Leader McCarthy: The Affordable Care Act (ACA) is working in
Rhode Island. Since 2011, when Rhode Island began the work of ACA
implementation, our uninsured population has dropped from nearly 12
percent to under 4.5 percent, one of the lowest rates in the country.
Nearly 110,000 Rhode Islanders now have access to affordable, life-
saving care through the Medicaid expansion or our State health
insurance exchange.
By fully leveraging the flexibility and resources available to us
under the ACA, Rhode Island has developed a more competitive
environment for health insurance and positioned itself to make the
health care system more efficient and affordable. We have been
successful controlling Medicaid costs without reducing benefits or
eligibility. Unlike some States which have seen dramatic premium growth
on the exchange, we have actually seen exchange premiums decrease in 2
out of the last 3 years. In fact, some consumers are seeing a decrease
of as much as 5 percent as they compare plans and enroll for 2017. Our
aggressive rate review process, strengthened by ACA funding, has saved
consumers nearly $220 million since 2012.
Our progress toward full insurance has enabled Rhode Island to set
its sights on a full-scale health system transformation that would not
have been possible prior to the ACA. We have been working to modernize
our payment and delivery systems by focusing on the value, not volume,
of care and services delivered to Rhode Islanders. There remains a lot
of work to do, and the ACA is not perfect. It is clear, however, that
these reforms could not be successful without the framework provided by
the ACA.
Although the ACA has been successful in Rhode Island, it is clear
that it could be improved. I would be open to discussing modifications
to the law. However, I would urge that you and your colleagues grant
the utmost priority to the following principles as you consider any
changes to the ACA:
Maintain the existing coverage gains States have realized
under the ACA. We cannot allow the newly covered to lose access to
care.
Avoid transferring costs to States. Any such shifts would
be unaffordable and unworkable for the States. Likewise, we must avoid
increasing the burden of uncompensated care for our hospitals.
Preserve the stability of the health insurance market. Any
destabilizing changes to the financing structure or market structure
could result in rate shock and insurer flight from the individual
market.
Continue to allow States the freedom to experiment and
adopt reforms which are appropriate to their environment. In Rhode
Island, the ACA model has proven successful, and we must be given the
discretion to retain the pieces which work in Rhode Island.
Finally, I urge you to retain the critical public health
investments included in the ACA. Federal support for public health and
prevention infrastructure has been critical to improving the health of
our most vulnerable populations and reducing rates of obesity,
diabetes, heart disease, stroke, tobacco use, and other conditions.
Dollars spent on prevention not only improve health, but they also help
reduce utilization of more expensive forms of care.
Thank you for inviting me to provide you with feedback as you
consider the value of the ACA and the progress that has been made over
the past several years. I welcome the opportunity to discuss any of
these matters further with you and your colleagues.
Sincerely,
Gina M. Raimondo,
Governor.
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Letters of Opposition
American Civil Liberties Union (ACLU),
Washington, DC 20005,
January 6, 2017.
Hon. Lamar Alexander, Chairman,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Hon. Patty Murray, Ranking Member,
Committee on Health, Education, Labor and Pensions,
U.S. Senate,
Washington, DC 20510.
Re: Confirmation Hearings Should Cover the Nominees' Commitment to
Banning Taxpayer Funds from Being Used to Discriminate
Dear Chairman Alexander, Ranking Member Murray, and members of the
HELP Committee: As the committee considers the nominations of Betsy
DeVos to serve as Secretary of Education, Tom Price to serve as
Secretary of Health and Human Services, and Andrew Puzder to serve as
Secretary of Labor over the coming weeks, the American Civil Liberties
Union urges robust questioning regarding their commitment to ensuring
that taxpayer dollars are never used to fund discrimination.
Freedom of religion and belief is a core American value. Religious
liberty protects the right to both believe and act on religious
beliefs, but it does not authorize actions that discriminate against or
harm others. These three nominees, if confirmed, will oversee a wide
range of programs that impact millions of Americans' education, health
care, and employment, and it is critical to determine where they stand
on this principle--and to emphasize to the nominees the importance of
this fundamental civil rights principle.
Both Mrs. DeVos' and Mr. Price's track records raise serious
concerns. Mrs. DeVos, who is being considered to oversee the Nation's
public education system, has a long history of advocating for the use
of public dollars to support private schools, including those that
engage in discrimination and lack the protections of our Nation's civil
rights laws. Mr. Price, who could not only set the national health
policy agenda if confirmed, but also have authority to administer
health care programs affecting nearly all Americans, has supported
numerous policies during his congressional career that would enable
discrimination against women and members of the LGBT community. In the
114th Congress, for example, he co-sponsored the so-called ``First
Amendment Defense Act,'' legislation that could permit sweeping,
taxpayer-funded discrimination against LGBT people, single mothers, and
unmarried couples. He also voted for the Conscience Protection Act and
cosponsored the Health Care Conscience Rights Act, bills that would
discriminate against women seeking abortion care under the guise of
protecting religious liberty, and voted to block D.C.'s non-
discrimination law that prohibits workplace discrimination based on
employees' personal reproductive health care decisions.
Mr. Puzder, if confirmed, would head a Department tasked with
enforcing President Obama's historic 2014 Executive order to prohibit
businesses that contract with the Federal Government from engaging in
discrimination on the basis of sexual orientation and gender identity.
These nondiscrimination requirements are built on protections that have
been in place since the Administration of President Lyndon Johnson and
have been enforced by every administration 'Democratic and Republican--
since. Given his outspoken opposition to protections for individuals in
the workplace, Mr. Puzder should be asked about his commitment to
faithfully enforce these nondiscrimination protections.
The Departments of Education, Health and Human Services, and Labor
all dispense significant sums in the form of Federal grants and
contracts. There is a bipartisan tradition in this country of
prohibiting taxpayer-funded discrimination, including by recipients of
Federal grants and contracts. To permit the recipients of these
taxpayer dollars--including those that are religiously affiliated--to
engage in discrimination based on religion or religious tenets would
significantly undermine our Nation's commitment to civil rights.
We urge you to robustly question these three nominees about their
commitment to this civil rights principle, and make clear, if
confirmed, you will hold them accountable for safeguarding policies
that prohibit taxpayer-funded discrimination.
Sincerely,
Karin Johanson,
Director.
Ian Thompson,
Legislative Representative.
Georgeanne Usova,
Legislative Counsel.
Advocates for Youth,
Washington, DC 20036,
January 16, 2017.
Hon. Lamar Alexander, Chairman,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Hon. Patty Murray, Ranking Member,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Dear Chairman Alexander and Ranking Member Murray: Advocates for
Youth (Advocates) is a national nonprofit organization that partners
with youth leaders, adult allies, and youth-serving organizations to
advocate for policies and champion programs that recognize young
people's rights to honest sexual health information; accessible,
confidential, and affordable sexual health services; and the resources
and opportunities necessary to create health equity for all youth. We
write in strong opposition to Representative Tom Price's nomination to
serve as our Nation's Secretary of Health and Human Services.
The mission of the Department of Health and Human Services (HHS) is
``to enhance and protect the health and well-being of all Americans.''
\1\ Representative Price's record indicates that he would not serve the
stated mission of HHS.
---------------------------------------------------------------------------
\1\ U.S. Dept. of Health and Human Services. ``About Us.''
Retrieved 12 January 17, from http://www.hhs.gov/about/index.html#.
---------------------------------------------------------------------------
During his 11 years in Congress, Representative Price has
consistently championed policies that would undermine the health and
well-being of women and young people. He has worked to weaken the same
programs that he has been nominated to oversee--programs that tens of
millions of people rely on to protect the health of their families. His
record should disqualify him for the office of HHS Secretary.
Specifically, we are deeply concerned about the Congressman's
opposition to the Affordable Care Act (ACA); his commitment to
undermining Medicaid, Medicare and other key parts of our Nation's
social safety net; his extreme opposition to abortion care and access
to contraception; and his complete disregard for the needs of the LGBTQ
community.
The Affordable Care Act has improved the lives of tens of millions
of people. It has enabled 6.1 million previously uninsured young people
(ages 19 to 25) to gain access to affordable, comprehensive health care
coverage.\2\ Young people need access to a full range of sexual and
reproductive health care services. The ACA has made critical healthcare
services more accessible to young people, including screenings for
sexually transmitted infections (STIs) and HIV, contraceptive care,
pregnancy-related care, HPV immunizations, and gender-affirming
healthcare for transgender youth, among other services. Since young
people ages 15 to 24 are more likely to experience unintended
pregnancies and STIs than most other age groups,\3\ increased access to
these services has made a real difference in many young people's lives.
After the implementation of the ACA, young people are significantly
more likely to receive a routine examination including preventive care
services.\4\
---------------------------------------------------------------------------
\2\ U.S. Dept. of Health and Human Services, Office of the Asst.
Secretary for Planning and Evaluation. (2016, March). Health Insurance
Coverage and the Affordable Care Auk 2010-2016. Retrieved 12 January
2017, from https://aspe.hhs.gov/sites/default/files/pdf/18755/ACA2010-
2016.pdf.
\3\ Centers for Disease Control and Prevention. Sexually
Transmitted Disease Surveillance 2012. Atlanta: U.S. Department of
Health and Human Services; 2013. Finer LB and Zolna MR, Shifts in
intended and unintended pregnancies in the United States, 2001-2008,
American Journal of Public Health, 2014, 104(S1): S44-S48.
\4\ Lau JS, et al. ``Improvement in Preventive Care of Young Adults
after the Affordable Care Act.'' JAMA Pediatrics, October 27. 2014.
---------------------------------------------------------------------------
The ACA represents a tremendous step forward for young people's
health. Millions now have the peace of mind of knowing that if they or
their family members have a health emergency they will be able to
afford care. Fifty-five million women have benefited from the ACA's
coverage of preventive services, including well-woman visits, screening
for intimate partner violence, counseling, and breast feeding support,
among others.\5\
---------------------------------------------------------------------------
\5\ U.S. Dept. of Health and Human Services. (2015, May). The
Affordable Care Act is Improving Access to Preventive Services for
Millions of Americans. Retrieved 12 January 2017, from https://
aspe.hhs.gov/pdf-report/affordable-care-act-improving-acess-preventive-
services-millions-
americans.
---------------------------------------------------------------------------
If confirmed, Rep. Price would roll back these important gains for
women and all young people and thereby strip beneficiaries of important
protections concerning access to coverage and care. His record on these
issues is clear. Rep. Price has voted over 60 times to repeal the
ACA.\6\
---------------------------------------------------------------------------
\6\ Planned Parenthood Federation of America. (2016, November). Tom
Price. Trump's Pick to Lead HHS, Would Take Away Millions of Women's
Health Care. Retrieved 12 January 2017, from https://
www.plannedparenthoodaction.org/blog/tom-price-trumps-pick-to-lead-hhs-
would-take-away-millions-of-womens-access-to-health-care.
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Rep. Price has also targeted low-income people by seeking to cut
funding for Medicaid and to eviscerate the program through the use of
block grants and per capita caps.\7\ Millions of young people rely on
Medicaid for care throughout their lives--from reproductive and
maternal health services to other lifesaving care. Block granting or
capping Medicaid would devastatingly undermine the critical role that
Medicaid plays in supporting the health and well-being of millions of
people in this country.
---------------------------------------------------------------------------
\7\ Ibid.
---------------------------------------------------------------------------
Finally, Rep. Price's extreme record on reproductive health care
alone should disqualify him for the job. Rep. Price has co-sponsored
legislation that would outlaw abortion, stem cell research, forms of
contraception, and in vitro fertilization.\8\ He has vigorously opposed
women's constitutionally recognized right to abortion care, voting to:
deny abortion coverage for women with private health insurance,\9\ ban
abortion care as early as 20 weeks,\10\ and deny low-income women
coverage for abortion care.\11\
---------------------------------------------------------------------------
\8\ The Right to Life Act, H.R. 552 (2 February 2005).
\9\ Stupak amendment to the Health Care for America Act, H.R. 3962,
(7 November 2009); Camp motion to recommit Health Care and Education
Reconciliation Act, H.R. 4872, (21 March 2010); No Taxpayer Funding for
Abortion Act, H.R. 3, (4 May 2011); Protect Life Act, H.R. 358, (13
October 2011); No Taxpayer Funding for Abortion Act, H.R. 7, (28
January 2014); No Taxpayer Funding for Abortion Act, H.R. 7, (22
January 2015).
\10\ Pain-Capable'' Unborn Child Protection Act, H.R. 3808, (31
July 2012); ``Pain-Capable'' Unborn Child Protection Act, H.R. 1797,
(18 June 2013); Motion to recommit the ``Pain-Capable'' Unborn Child
Protection Act, H.R. 36, (13 May 2015); ``Pain-Capable'' Unborn Child
Protection Act, H.R. 36, (13 May 2015).
\11\ No Taxpayer Funding for Abortion Act, H.R. 3, (4 May 2011); No
Taxpayer Funding for Abortion Act, H.R. 7, (28 January 2014); No
Taxpayer Funding for Abortion Act, H.R. 7, (22 January 2015).
---------------------------------------------------------------------------
Rep. Price is a proven opponent of access to sexual and
reproductive healthcare, no matter the public health impact. He has
repeatedly voted to defund Planned Parent hood,\12\ which provides
essential preventive health services like cancer screenings, birth
control, STI testing, and HIV testing to 2.5 million people annually--a
program that particularly benefits young people and low income people.
Defunding Planned Parenthood will have a disproportionate impact on
communities that historically face systemic barriers to care and
negatively affect the state of sexuality education in this country, as
Planned Parenthood Health Centers are the largest provider of sex
education in the country.\13\
---------------------------------------------------------------------------
\12\ Pence amendment to fiscal year 2008 Labor, Health and Human
Services, and Education Appropriations Act, H.R. 3043, (19 July 2007);
Pence amendment to fiscal year 2010 Labor, Health and Human Services,
and Education Appropriations Act, H.R. 3293, (24 July 2009); Pence
amendment to fiscal year 2011 Continuing Resolution, H.R. 1, (18
February 2011); fiscal year 2011 Continuing Resolution H.R. 1, (19
February 2011); Enrollment resolution to fiscal year 2011 Continuing
Resolution, H. Con. Res. 36, (14 April 2011); Defund Planned Parenthood
Act, H.R. 3134, (18 September 2015); Women's Public Health and Safety
Act, H.R. 3495, (29 September 2015); fiscal year 2016 Continuing
Resolution, H. Con. 79, (30 September 2015); Restoring Americans'
Healthcare Freedom Reconciliation Act, H.R. 3762, (23 October 2015);
H.R. 3762, (6 January 2016); Veto override of H.R. 3762, (2 February
2016).
\13\ Planned Parenthood Federation of America. (2016). The Urgent
Need for Planned Parenthood Health Centers. Retrieved 13 January 2017,
from https://www.plannedparenthood.org/files/4314/8183/5009/
20161207_Defunding_fs_d01_1.pdf.
---------------------------------------------------------------------------
The Secretary of HHS oversees health care policy, health care
research and as well as allocates resources to important agencies like
the CDC, FDA, and NIH. The person who takes this role has an important
impact on all Americans. Rep. Tom Price would clearly take our health
care system backward and is not the right choice for this important
position. We urge you to reject this nominee.
Sincerely,
Diana Rhodes,
Director of Public Policy.
AFSCME,
Washington, DC 20036-5687,
December 22, 2016.
Hon. Lamar Alexander, Chairman,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Hon. Patty Murray, Ranking Member,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Dear Senators: On behalf of the 1.6 million members of the American
Federation of State, County and Municipal Employees (AFSCME), I write
to urge you to oppose the confirmation of Rep. Tom Price to serve as
Secretary of the Department of Health and Human Services. We also wish
to convey our very strong opposition to the effort to repeal the
Affordable Care Act and restructure and cut funding for Medicare and
Medicaid, proposals that Rep. Price champions.
Rep. Price is the wrong choice to lead the Federal agency charged
with protecting the health and well-being of all Americans. His budget
and health care proposals demonstrate that he does not understand the
challenges of ordinary Americans. In fact, he has supported and
sponsored budgets that prioritize the wealthy and profitable
corporations at the expense of working families, seniors, people with
disabilities and the poor.
Rep. Price supports the repeal of the Affordable Care Act, which
would take health care coverage away from 30 million people. His
proposal for replacing the ACA would provide limited help to those who
buy insurance on their own, gut regulations that make coverage
meaningful and drive up costs. He would even restore the ability of
insurance companies to discriminate against many with pre-existing
conditions.
Rep. Price would turn Medicare into a voucher that would fail to
keep pace with the growth in health costs. Over time, seniors and
people with disabilities would face steeper and steeper costs to
purchase less and less adequate coverage. His proposal to restructure
Medicaid would shift costs to States and force cuts in enrollment and
services and likely cuts in other State services to compensate for lost
Federal funding.
In November, Rep. Price unveiled a new proposal to change the
congressional budget process. The proposal calls for automatic across-
the-board cuts in Federal spending to meet deficit targets. Deficit
reduction, not job creation or poverty reduction, would be the top
priority of the Federal Government under this scheme. His plan is so
radical it would impose automatic cuts in Social Security benefits.
Yet, the plan is designed to allow cuts in Social Security and all
other programs to take effect without a vote, presumably intended to
shield Members of Congress from the consequences of a harmful and
deeply unpopular action.
Leading HHS is a critical job. It should be held by an individual
who is committed to policies that will make the lives of ordinary
Americans better. Rep. Price fails this test and should be rejected by
the Senate.
Sincerely,
Scott Frey,
Director of Federal Government Affairs.
Feminist Majority Foundation,
January 16, 2017.
Hon. Lamar Alexander, Chairman,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Hon. Patty Murray, Ranking Member,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Dear Chairman Alexander and Ranking Member Murray: The Feminist
Majority Foundation writes in strong opposition to Representative Tom
Price's nomination to serve as the Secretary of the U.S. Department of
Health and Human Services. His extreme opposition to Medicaid,
Medicare, Affordable Care Act, the provision of abortion care, and the
increased access to birth control disqualify him for this nomination.
The agencies and programs of HHS are vital to the health and well-
being of women and their families. During his tenure in the House of
Representatives, Representative Price has been a leading advocate
against the Affordable Care Act and has voted against it over 60 times.
He has been a leading voice in Congress to dramatically reduce Medicaid
coverage and would end Medicare as we know it. He has been an advocate
against the very programs that he has been nominated to lead--programs
that tens of millions of people desperately need for health care.
The Affordable Care Act has improved the lives of tens of millions
of people. Thirty-two million people now have health care coverage
either through the health insurance exchanges of ACA or the expansion
of Medicaid provided by the ACA. Fifty-five million women have
benefited from the ACA's preventive care package services without co-
pays or deductibles, including well-woman visits, a variety of birth
control options and counseling, vaccinations, and breast feeding
support. Fifty-two million people with pre-existing conditions can now
have comprehensive health insurance coverage. Of course, millions of
young people until the age of 26 have coverage through their
parent(s)'s health insurance.
Rep. Price's record shows all of these life-saving features of ACA
would be in jeopardy if his policies were implemented. His opposition
to ACA is not the only threat to millions of people's health care. His
appointment would be a serious threat to Medicare and Medicaid.
Medicare has provided life-saving care to millions of older people--the
majority of whom are women--and people with disabilities, who otherwise
could not afford it. Instead of working to strengthen this critically
needed program, Rep. Price has advocated unrealistic privatization
plans that would end Medicare as we know it. What insurance companies
would insure the elderly as completely as Medicare does at a reasonable
rate that, for example, the average elderly woman who survives on
Social Security annual income ($13,150 in 2014) could afford? As the
person ages under Medicare, what insurance company would continue to
provide full coverage at affordable premiums? What's more American
workers have paid into Medicare all their working lives and have earned
this coverage.
Rep. Price's policies for drastically cutting Medicaid funding
through inadequate block grant funding and per capita caps and changing
it from a guaranteed program as needed for eligible persons to a
limited block grant program is especially harmful to low-income women
and families. Millions of women need Medicaid for reproductive health
services including family planning and healthy pregnancies. Today some
two-thirds of nursing homes costs are paid through Medicaid. The
current Medicaid Federal payments are guaranteed on an ``as-needed''
basis to eligible low-come, elderly, disabled and/or children. Block
granting or in other words capping Federal Medicaid payments to States
would be devastating not only to the millions of eligible persons but
also to hospitals, nursing homes, and would undermine the entire
medical system of the Nation.
Especially frightening to women and impacting men's health and
well-being is Rep. Price's extreme opposition to abortion and family
planning including co-sponsoring legislation to outlaw abortion, stem
cell research, some forms of contraception, and in vitro fertilization.
He even opposes private health insurance coverage of abortion. He has
supported measures to totally defund Planned Parenthood which provides
not only excellent, low-cost reproductive health care to women but also
cancer screenings, STI and HIV testing as well as other health care
needs. Recklessly he has voted to eliminate title X funding, the
national family program which was founded with bipartisan support in
1970 and has helped millions of women with what would be otherwise
unaffordable and essential reproductive health care.
Women and men cannot go back to a day of back alley and unsafe
abortions, and a day without the ability to control their own
reproductive lives. Older people, disabled people, low-income people,
and children cannot go back to a day without any access to affordable
health care. We urge you to vote no on the confirmation of
Representative Tom Price for Secretary of the U.S. Department of Health
and Human Services.
For Women's Equality,
Eleanor Smeal,
President.
Human Rights Campaign
January 17, 2017.
Hon. Lamar Alexander, Chairman,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Hon. Patty Murray, Ranking Member,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Dear Chairman Alexander and Ranking Member Murray: Systemic
discrimination, a lack of insurance, and increased rates of poverty and
homelessness compound already stark health disparities within the LGBTQ
community. In recent years we have witnessed the Department of Health
and Human Services meet these challenges head on with a commitment to
research, public education, and civil rights. LGBTQ people nationwide
have come to depend upon the critical programs and leadership provided
by HHS. We are standing at a crossroads in the fight for LGBTQ equality
in healthcare. We cannot afford a Secretary like Representative Tom
Price, whose anti-equality voting record and harmful rhetoric foster
stigma and fear of LGBTQ people--compounding existing healthcare
disparities.
Over the past two decades, Representative Price has spent his
career dedicated to an agenda that undermines the health and well-being
of the entire LGBTQ community. Partnering with anti-LGBTQ
organizations, Representative Price has vocally opposed legislation
that would protect our community not only from discrimination, but also
from acts of violence. He has also dedicated the past 7 years to
systematically undermining the Affordable Care Act--one of the most
significant tools this country has ever had to combat health
disparities in our community. Perhaps most troubling is his belief that
LGBTQ people, equality, and same-sex relationships have negative public
health and economic implications for the Nation.
While marriage equality is now the established law of the land,
LGBTQ families still face the real fears of being turned away from
care, denied the right to visit a child or spouse, or treated unfairly
by doctors or other providers. These families deserve a Secretary who
will actively work to ensure that discrimination has no place in
federally funded healthcare programs and that every patient is treated
with equal dignity regardless of their sexual orientation or gender
identity. Instead of providing this security, Representative Price has
a public record of demeaning and marginalizing LGBTQ people. His
harmful, misguided, and flatly erroneous ideology categorically
dismisses LGBTQ equality, the needs of our families, and the impact of
marginalization and discrimination on healthcare outcomes.
The healthcare disparities and challenges we are facing are real,
but they are not impossible. It is essential that the next Secretary
exhibit a true commitment to meeting these challenges with policies
based on science and research, a dedication to ensuring equal access to
healthcare, and a vision for compassionate leadership. Representative
Price's record shows that he's clearly not up to the job.
Sincerely,
Chad Griffin,
President.
Immunize,
January 17, 2017.
Hon. Lamar Alexander, Chairman,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Hon. Patty Murray, Ranking Member,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Hon. Orrin G. Hatch, Chairman,
Committee on Finance,
U.S. Senate,
Washington, DC 20510.
Hon. Ron Wyden, Ranking Member,
Committee on Finance,
U.S. Senate,
Washington, DC 20510.
Dear Chairman Alexander, Chairman Hatch, Ranking Member Murray, and
Ranking Member Wyden: Vaccines are one of the greatest success stories
in public health and are among the most cost-effective ways to prevent
disease. Indeed, we know that for each dollar invested in the U.S.
childhood immunization program, there are over $10 of societal savings
and $3 in direct medical savings. Moreover, it is estimated that the
benefits which will be accrued from the Vaccines For Children Program
for children born over the first 20 years of the program will prevent
322 million illnesses, 21 million hospitalizations, 732,000 deaths, and
nearly $1.4 trillion in societal costs.
While immunization rates remain high for children, pockets of
undervaccinated communities remain at risk of deadly vaccine-
preventable diseases. Immunization rates for adolescents and adults
remain woefully low, leaving them vulnerable to diseases including
several deadly cancers, and to serving as vectors for the transmission
of deadly diseases, such as pertussis to young children. It has been
reported that the United States spends nearly $27 billion annually
treating four vaccine-preventable diseases that afflict adults over 50
years of age: influenza, pertussis, pneumococcal disease and shingles.
Costly outbreaks of vaccine preventable diseases continue to
challenge the Nation's public health system. In the past 3 years 904
Americans were diagnosed with highly contagious measles, 4,625 cases of
mumps were detected and pertussis (which is particularly deadly to
infants) was diagnosed in more than 67,000 people. In addition, each
year, more than 200,000 individuals are hospitalized and 3,000--49,000
deaths occur from influenza-related complications.
As the nominee for the Secretary of Health and Human Services it is
our hope that Chairman Tom Price will support our Nation's public
health infrastructure by fostering investments in the science and
technology that informs our national immunization policy, providing a
safety net to uninsured poor adults for vaccine purchases, monitoring
the safety of vaccines, educating providers and performing community
outreach, and conducting surveillance, laboratory testing, and
epidemiology to respond to disease outbreaks.
As you work through the confirmation process, we urge you to ensure
that Chairman Price is committed to protecting the citizens of this
Nation from vaccine preventable diseases.
Sincerely,
Alliance for Aging Research, American Academy of Family Physicians,
American Academy of Pediatrics, American Association for Dental
Research, American Association of Colleges of Pharmacy, American
College of Osteopathic Pediatricians, American College of
Preventive Medicine, American Congress of Obstetricians and
Gynecologists, American Immunization Registry Association, American
Pharmacists Association, American Public Health Association,
American Sexual Health Association, American Sexually Transmitted
Diseases Association, American Society for Colposcopy and Cervical
Pathology, American Society for Reproductive Medicine, American
Society of Tropical Medicine & Hygiene, Arizona Partnership for
Immunization, Association for Professionals in Infection Control
and Epidemiology, Association of Immunization Managers, Association
of Public Health Laboratories, Autism Science Foundation, Boost
Oregon, California Academy of Family Physicians, California
Immunization Coalition, Center for Vaccine Awareness and Research--
Texas Children's Hospital, Center for Vaccine Ethics and Policy/
GE2P2 Global Foundation Central Oklahoma Immunization Coalition,
Cervivor, Columbia County Immunization Coalition--Wisconsin,
Commissioned Officers Association of the U.S. Public Health
Service, Inc., Coulee Region Immunization Coalition--Wisconsin,
Emily Stillman Foundation, EverThrive Illinois, Every Child By
Two--Carter/Bumpers Champions for Immunization, Families Fighting
Flu, FIND--Switzerland, Gerontological Society of America, Green
County Health Department--Wisconsin, Gregg County Health
Department--Texas, Head and Neck Cancer Alliance, Hep B United,
Hepatitis B Foundation, Immunization Action Coalition, Immunization
Action Coalition of Washington, Immunization Coalition of
Washington, DC, Immunization Collaboration of Tarrant County--
Texas, Immunize Kansas Coalition, Immunize Nevada, Immunization
Partnership--Texas, Indiana Immunization Coalition, Infectious
Diseases Society of America, International AIDS Vaccine Initiative,
International Vaccine Institute, Iowa County Health Department,
Kelsey-Seybold Clinic, LA BioMed/South LA Health Projects, Langlade
County Immunization Coalition--Wisconsin, March of Dimes,
Massachusetts Chapter of the American Academy of Pediatrics,
Meningitis Angels, Mid America Immunization Coalition, Minnesota
Chapter of the American Academy of Pediatrics, Minnesota Childhood
Immunization Coalition, National Association of County and City
Health Officials, National Association of Pediatric Nurse
Practitioners, National Association of School Nurses, National
Consumers League, National Foundation for Infectious Diseases,
National Meningitis Association, National Network of Public Health
Institutes, National Recreation and Park Association, Novavax,
Ocean State Immunization Collaborative, Ohio State Univ.
Comprehensive Cancer Center/James Cancer Hospital & Solove Research
Institute, PATH, Pediatric Infectious Diseases Society, Pierce
County Immunization Coalition--Washington, Public Health--Seattle &
King County, Sabin Vaccine Institute, San Diego Immunization
Coalition, Sheboygan County Immunization Coalition--Wisconsin,
Society for Adolescent Health and Medicine, Society for Maternal-
Fetal Medicine, Southeast Minnesota Immunization Connection,
Southern Wisconsin Immunization Consortium, TB Alliance, Team
Maureen/Cervical Cancer-Free MA, Research Institute, Trust for
America's Health, Vaccinate California, Vaccine Education Center at
the Children's Hospital of Philadelphia, VillageReach, Voices for
Vaccines, Walgreens, Washington Chapter of the American Academy of
Pediatrics, Washington Global Health Alliance, Washtenaw County
Public Health, West Virginia Immunization Network.
Main Street Alliance,
January 17, 2017.
Hon. Lamar Alexander, Chairman,
Committee on Health, Education, Labor, and Pension,
U.S. Senate,
835 Hart Senate Office Building,
Washington, DC 20510.
Hon. Patty Murray, Ranking Member,
Committee on Health, Education, Labor, and Pension,
U.S. Senate,
648 Dirksen Senate Office Building,
Washington, DC 20510.
Hon. Orrin G. Hatch, Chairman,
Committee on Finance,
U.S. Senate,
104 Hart Senate Office Building,
Washington, DC 20510.
Hon. Ron Wyden, Ranking Member,
Committee on Finance,
U.S. Senate,
221 Dirksen Senate Office Building,
Washington, DC 20510.
Dear Chairman Hatch, Chairman Alexander, Ranking Member Wyden, and
Ranking Member Murray: The Main Street Alliance writes to oppose the
confirmation of Representative Tom Price to serve as Secretary of the
Department of Health and Human Services (HHS). We also wish to express
opposition to the harmful efforts to repeal the Affordable Care Act,
privatizing Medicare and block-granting Medicaid.
The Main Street Alliance is a national network of small business
owners who engage on local, State, and national policy issues of
concern to small businesses, their employees, and their community.
Access to safe and affordable health coverage is a longstanding
priority for small business owners in our network. HHS-administered
programs, such as the ACA, Medicaid, and Medicare, have provided much-
needed relief to small business owners, who have long struggled to
obtain affordable, quality coverage in the private market. Since the
implementation of the ACA, the uninsured rate for employees in small
businesses has dropped--fallen from 27.4 percent to a historic low of
19.6 percent--and one in five marketplace enrollees are small business
owners or sole proprietors. Similarly, Medicare and Medicaid have
ensured that our most vulnerable business owners--often without a
company pension or retirement--have a basic measure of health security.
Unfortunately, Representative Price's record on these programs is
dismal. Representative Price is a proponent of radical proposals to cut
billions from Medicare, converting it to a voucher which would lose
value over time and shift more and more costs onto seniors and people
with disabilities. He also supports increasing the age of Medicare
eligibility from 65 to 67, which would increase the number of older
adults--many of whom are small business retirees--without health care
coverage. Furthermore, Representative Price supports the repeal of the
Affordable Care Act (ACA), a plan that would cause 30 million people to
lose their coverage by 2019, including over 4 million business owners;
collapse the individual market; and cause premiums for small business
owners to skyrocket.
Beyond the direct health and financial costs to small business
owners, Representative Price's plan to dismantle the current health
care system would syphon billions of dollars out of local economies,
starve State funding, and under-resource vital programs that small
businesses rely on. The economic ripple effects of repealing the ACA
and cutting Medicaid would be far-reaching. Nearly 3 million jobs would
be lost, and gross State products would fall by $1.5 trillion between
2019 and 2023, business output would drop $2.6 trillion. As evident
from the Great Recession, the ensuing contracting economy would
disproportionately harm small business growth.
Simply put, Representative Price's policy agenda would cripple
small business owners. For these reasons, I ask that you oppose the
nomination of Representative Tom Price for Secretary of Health and
Human Services. If you need additional information, please contact
Michelle Sternthal at [email protected] or (202) 263-
4529.
Sincerely,
Amanda Ballantyne,
National Director.
MomsRising.org,
January 17, 2016.
Hon. Lamar Alexander, Chairman,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
428 Dirksen Office Building,
Washington, DC 20510.
Hon. Patty Member, Ranking Member,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
428 Dirksen Office Building,
Washington, DC 20510.
Dear Chairman Alexander and Ranking Member Murray and members of
the Senate Committee on Health, Education, Labor, and Pensions:
MomsRising is an on-the-ground and online grassroots organization of
more than a million people, including people from every State in our
Nation, who are working to increase family economic security, decrease
discrimination against women and moms, and to build a nation where
businesses and families can thrive. As such, we and our members across
the country were dismayed by President-Elect Trump's nomination of
Representative Tom Price as Secretary of Health and Human Services
because Representative Tom Price has said he would act to roll back
health care coverage gains made through the Affordable Care Act and
would weaken programs like Medicaid, which are essential to the health
of families.
Therefore we strongly urge you to reject the nomination of
Representative Tom Price for Secretary of Health and Human Services.
Since the passage of the Affordable Care Act (ACA), we have seen
the largest reduction in the uninsured in four decades. This reduction
lifts our economy and our families. In fact, about 16.4 million
previously uninsured people have gained access to health coverage.\1\
In addition, millions more have benefited from such positive and
popular improvements as financial protections for those facing severe
illness, no longer being discriminated against for pre-existing
conditions, parents being able to keep their adult children on their
plan until they are 26, and preventative care, such as well-visits,
vaccinations, and mammograms, being covered free of charge.
---------------------------------------------------------------------------
\1\ Health and Human Services. ``The Affordable Care Act is
Working.'' https://www.hhs.gov/healthcare/facts-and-features/fact-
sheets/aca-is-working/index.html?language=es.
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Representative Price opposes the ACA and would support scraping the
law altogether, leaving 30 million people, including 4 million
children, without health insurance.\2\ Instead he has proposed a
program that is far weaker, and leaves many struggling families out.
Representative Price wants to offer a weak replacement, which guts
access to health insurance and eliminates the essential health benefits
package--allowing insurers to determine whether or not things like
maternity care should be covered.\3\
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\2\ Linda J. Blumberg, Matthew Buettgens and John Holahan.
``Implications of Partial Repeal of the ACA through Reconciliation.''
Urban Institute, December 6, 2016. http://www.urban.org/research/
publication/implications-partial-repeal-aca-through-reconciliation;
http://www.urban
.org/research/publication/implications-partial-repeal-aca-through-
reconciliation; http://www.
urban.org/research/publication/implications-partial-repeal-aca-through-
reconciliation.
\3\ Sarah Kliff. ``By picking Tom Price to lead HHS, Trump shows
he's absolutely serious about dismantling Obamacare.'' Vox, November
28, 2016. http://www.vox.com/2016/11/28/13772342/trump-tom-price-
obamacare; http://www.vox.com/2016/11/28/13772342/trump-tom-price-
obamacare. http://www.vox.com/2016/11/28/13772342/trump-tom-price-
obamacare.
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This would hurt moms like Amy who writes:
``Our daughter Addie was diagnosed with Type 1 diabetes at
age 6--an autoimmune disease for which there is no cure, but
does have very expensive treatments. When my husband lost his
job a few years ago, prior to the Affordable MomsRising.org
Care Act, no one would insure us--at any cost. We were denied
coverage because of Addie's Type 1 diagnosis. Thanks to the
Affordable Care Act, we no longer have to worry about being
denied coverage and I can sleep at night knowing that Addie
will always have access to her life saving medications--or will
she? ''
While the ACA is not perfect, it has allowed millions of families
to afford health insurance for the first time. Rather than getting rid
of the entire program, which would inevitably hurt the health and well-
being of our families and economy, we support building upon the ACA and
making improvements to it.
In addition to his opposition to the ACA, Representative Price has
spent his years in Congress casting votes and proposing legislation
that opposes Medicaid. Medicaid is a vital health service to millions
of low-income children, pregnant women, people with disabilities and
chronic illnesses, and the elderly--including the 70 percent of all
nursing home residents.\4\
---------------------------------------------------------------------------
\4\ FamiliesUSA. ``Our Work: Medicaid.'' http://familiesusa.org/
issues/medicaid.
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Medicaid is also a boost to our families and our economy. A study
by the National Bureau of Economic Research found that investments in
Medicaid strengthen our economy because children who are covered by
Medicaid insurance receive a boost in their future earnings for
decades, and in return pay more taxes and pump more money back into
their local economies.\5\
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\5\ National Bureau of Economic Research ``Medicaid as an
Investment in Children: What is the Long-Term Impact on Tax Receipts?
'' http://www.nber.org/papers/w20835.
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We have heard from hundreds of moms who have families that have
been kept afloat from Medicaid. Moms like Kelly who writes:
``My son Andrew was born premature, 29 weeks, weighing only 1
pound 6 ounces. He was in the hospital for 3 months. He had
multiple surgeries. My husband and I were both working when my
son came early but we were not able to manage the financial
burdens that followed. If it wasn't for Medicaid stepping in to
pay for his surgeries and NICU he may not have lived.''
And Lisbeth:
``When my mother was diagnosed with Alzheimer's we used her
entire Social Security and pension, plus my father's VA pension
and Medicaid to cover the cost of a skilled nursing facility.
My mother was a nurse for over 30 years and dedicated her life
to taking care of others. In turn, she and our whole family
relied on Medicaid to take care of her.''
While Medicaid was helping to bring better health, and literally
saving the lives, of millions of families, Representative Price has
proposed budgets that would significantly reduce funding for Medicaid,
shifting the burden of cost to States, leading to fewer benefits and a
reduction in the number of people covered.\6\
---------------------------------------------------------------------------
\6\ New York Times Editorial Board. ``Tom Price, Radical Choice for
Health Secretary.'' November 30, 2016. https://www.nytimes.com/2016/11/
30/opinion/tom-price-a-radical-choice-for-health-secretary.html.
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We need a health secretary who actually shows concern for our
families' health. It is our fear that if our elected officials were to
follow Representative Price's lead, we would see millions of people
without health insurance and a nation that is sicker and less
productive.
It is for these reasons that MomsRising members across the country
oppose Representative Tom Price for Secretary of Health and Human
Services--and urge your committee to do the same and reject his
nomination.
Sincerely,
Kristin Rowe-Finkbeiner,
Executive Director/CEO and Co-Founder.
NARAL Pro-Choice America,
January 11, 2017.
Hon. Lamar Alexander, Chairman,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate.
Hon. Patty Murray, Ranking Member,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate.
Dear Chairman Alexander and Ranking Member Murray: On behalf of
NARAL Pro-Choice America's one-million member activists, I write to
express strong opposition to the nomination of Rep. Tom Price for
secretary for the U.S. Department of Health and Human Services (HHS).
Given his long record of hostility toward reproductive rights and
access to basic health-care services, Rep. Price has demonstrated that
he is not fit to carry out the responsibilities of this position.
The mission of HHS is ``to enhance the health and well-being of
Americans by providing for effective health and human services and by
fostering sound, sustained advances in the sciences underlying
medicine, public health, and social services.'' \1\ This charge
inherently includes enhancing the health and well-being of women--and a
central part of women's health care is reproductive-health care.
---------------------------------------------------------------------------
\1\ The Department of Health and Human Services website at https://
www.hhs.gov/about/strategic-plan/introduction/index.html# (January 5,
2017).
---------------------------------------------------------------------------
However, during his 12 years in the House of Representatives, Rep.
Price has firmly established his opposition to reproductive-health care
and the work of many of HHS's agencies and programs by casting 46 anti-
reproductive-health votes.\2\ For example, throughout his tenure in
Congress, Rep. Price has continuously worked to undermine women's
access to contraception. He repeatedly voted to defund Planned
Parenthood health centers\3\ and voted to eliminate the title X family
planning program. Planned Parenthood and other title X providers not
only furnish millions of women with birth control, but also deliver
reproductive-health services ranging from STD testing to breast-cancer
screenings to millions of men and women.\4\ Ensuring the provision of
these health services is an integral component of the department's
work.
---------------------------------------------------------------------------
\2\ NARAL Pro-Choice America, Congressional Record on Choice, 2005-
16.
\3\ Pence amendment to fiscal year 2008 Labor, Health and Human
Services, and Education Appropriations Act, H.R. 3043, 7/19/07; Pence
amendment to fiscal year 2010 Labor, Health and Human Services, and
Education Appropriations Act, H.R. 3293, 7/24/09; Pence amendment to
fiscal year 2011 Continuing Resolution, H.R. 1, 2/18/11; fiscal year
2011 Continuing Resolution, H.R. 1, 2/19/11; Enrollment resolution to
fiscal year 2011 Continuing Resolution, H. Con. Res. 36, 4/14/11;
Defund Planned Parenthood Act, H.R. 3134, 9/18/15; Women's Public
Health and Safety Act, H.R. 3495, 9/29/15; fiscal year 2016 Continuing
Resolution, H. Con. 79, 9/30/15; Restoring Americans' Healthcare
Freedom Reconciliation Act, H.R. 3762, 10/23/15; H.R. 3762, 1/6/16;
Veto override of H.R. 3762, 2/2/16.
\4\ Fiscal year 2011 Continuing Resolution, H.R. 1, 2/19/11.
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Rep. Price also vehemently opposes the Affordable Care Act
(ACA),\5\ which has been transformational in improving women's access
to basic health care by ensuring coverage and affordability of
maternity care, family planning services, and other reproductive-health
services. Rep. Price has authored legislation and repeatedly voted to
repeal the ACA, and has particularly targeted the contraceptive-
coverage policy,\6\ despite its broad popularity and positive impact on
women's lives.
---------------------------------------------------------------------------
\5\ Empowering Patients First Act, H.R. 2300, 114th Cong. (2015);
Press Release, Price Statement on Obamacare Repeal, Feb. 3, 2016,
available at https://tomprice.house.gov/press-release/price-statement-
obamacare-repeal (last visited Dec. 5, 2016).
\6\ Brief Amicus Curiae of 207 Members of Congress in Support of
Petitioners, David Zubik, et al. v. Sylvia Burwell, Secretary of et
al., 2015 WL 39475865 (U.S.).
---------------------------------------------------------------------------
Moreover, Rep. Price opposes a woman's constitutional right to
legal abortion, cosponsoring so-called ``personhood'' legislation that
would--if it went into effect--make abortion illegal nationwide in
almost all cases, and ban some of the most common forms of
contraception, along with stem-cell research and in vitro
fertilization.\7\ Many of these health services and research areas fall
within HHS' jurisdiction; Rep. Price's position puts him directly at
odds with these activities--not to mention far outside the mainstream
of American public opinion.
---------------------------------------------------------------------------
\7\ H.R. 552, 2/2/05.
---------------------------------------------------------------------------
All told, someone who opposes so much of the department's work
simply cannot successfully fulfill its mission. Rep. Price's extreme
opposition to reproductive rights and health make him unfit for the
position of secretary of HHS. I urge you to oppose Rep. Price for this
office.
Sincerely,
Ilyse G. Hogue,
President.
National Center for Transgender Equality,
Washington, DC 20036,
December 24, 2016.
Hon. Lamar Alexander, Chairman,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Hon. Patty Murray, Ranking Member,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Dear Senators: On behalf of the more than one million transgender
Americans, the National Center for Transgender Equality writes to
express our strong opposition to the confirmation of Congressman Tom
Price to serve as Secretary of the Department of Health and Human
Services (HHS). We also wish to convey our deep opposition to the
effort to repeal the core elements of the Affordable Care Act,
privatize Medicare and cap Medicaid funding to the States.
HHS's mission is to ``enhance and protect the health and well-being
of all Americans.'' Rep. Price's record stands in stark contrast to
this mission. His repeated efforts to strip health insurance from
millions of people and eliminate consumer protections in health care
represent not only an attack on the very programs he has been nominated
to oversee, but also an attack on some of the Nation's most vulnerable
people. Efforts to cut billions and limit eligibility for Medicare and
Medicaid at the expense of poor, disabled, and elderly Americans are of
particular concern to NCTE. In 2015 NCTE conducted a national survey of
nearly 28,000 transgender adults, which found that transgender
Americans are twice as likely to live in poverty, making them
particularly vulnerable to such radical cutbacks.
Price's long history of extremely divisive views and comments
toward lesbian, gay, bisexual, and transgender people, immigrants and
their children, and other communities--including his past statements
that efforts to provide equal opportunity for LGBT people would harm
public health because of their ``outside the norm'' ``lifestyles''--
indicate he will not work to protect ``all Americans.'' Price has voted
to permit refusing services to domestic violence victims because they
are LGBT, and sought to ban the most common forms of contraception.
Price's views are far from the mainstream, and we consider him to
be unfit to lead an agency that has such a profound impact on the
health and well-being of every person and family in the Nation. We urge
you to reject his confirmation.
Sincerely,
Mara Keisling,
Executive Director.
National Council of Jewish Women (NCJW),
January 20, 2017.
Hon. Lamar Alexander, Chairman,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Hon. Patty Murray, Ranking Member,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Dear Chairman Alexander and Ranking Member Murray: On behalf of the
National Council of Jewish Women (NCJW), and its 90,000 members and
supporters nationwide, I write to share serious concerns about the
nomination of Representative Tom Price (R-GA) to be the next Secretary
of Health and Human Services (HHS). NCJW is a grassroots organization
of volunteers and advocates who turn progressive ideals into action.
Inspired by Jewish values, NCJW strives for social justice by improving
the quality of life for women, children, and families and by
safeguarding individual rights and freedoms.
Rep. Price's record shows he opposes several values that are
fundamental to the diverse constituency that NCJW represents and
serves. NCJW is firmly committed to pursing justice, breaking down
barriers that threaten our neighbor's moral autonomy, health, economic
security, or well-being particularly for those who face structural
obstacles to exercising those basic rights. We believe each of us is of
equal worth. Everyone person deserves the ability to care for their
bodies, health, and families per their own faith, regardless of income,
gender, age, race, or other factors. Guided by these values, NCJW
further believes that each of us deserves access to quality,
comprehensive health care without risking other basic needs; the
ability to make personal decisions without interference; respect for
religious liberty; as well as dignity and compassion.
NCJW urges you to reject Rep. Price's confirmation to the critical
cabinet post of Secretary of the U.S. Department of Health and Human
Services. His leadership could threaten the health and well-being of
millions, most harming those struggling to make ends meet,
disproportionately including women, people of color, and others already
experiencing barriers to health care.
Throughout his career, Rep. Price has demonstrated contempt for the
majority consensus that we all deserve access to affordable, quality
health coverage, regardless of gender, income, race, or other factors.
Championing legislation to dismantle the Affordable Care Act (ACA),
Rep. Price drafted a proposal that would leave individuals without
affordable, quality coverage. Experts from the Center on Budget and
Policy Priorities estimated his ACA replacement plan could alarmingly
take away insurance or access to care from millions who have gained it
thanks to the health reform law. Further, the Congressman has led
efforts to gut social safety net programs, including Medicaid and
Medicare. For example, Price-supported proposals to institute deeply
harmful cuts to Medicaid would force States to eliminate critical
health benefits or reduce program eligibility; individuals and families
would be forced to choose between their health, financial future, or
other essentials. Such efforts would most harm the health and economic
security of individuals struggling to get by, falling hardest on women
and women of color.
Rep. Price is also dangerously out of touch with women's health
needs. He expressed troubling skepticism about women facing barriers to
contraception, wrongly declaring that ``not one'' woman has experienced
such obstacles--despite clear data to the contrary. Research shows that
more than half of women between 18-34 years old, including Latina and
African American women, faced cost barriers to prescription birth
control; thanks to the ACA, 55 million women have gained affordable
access to the birth control that works best for them. Rep. Price has
further cosponsored legislation to bar access to comprehensive
reproductive health care and coverage, supporting measures to push safe
abortion out of reach. Making abortion more difficult to access can
have far-reaching consequences on a woman and her family. Yet Rep.
Price maintains support for policies such as bans on abortion coverage
that make this critical health care harder to obtain, especially
harming individuals struggling to make ends meet.
Relatedly, Price has led bills to restrict access to comprehensive
care while imposing a single religious viewpoint on everyone. For
instance, he sponsored a proposal to enshrine into law one faith
perspective about when life begins as well as a bill to permit doctors,
insurers, and other health entities to use religion to discriminate by
denying care or coverage that doesn't align with their faith. As a
Jewish organization, NCJW cherishes our country's foundational right to
religious liberty. We respect each person's right to hold their own
religious beliefs and to make personal decisions about their health
accordingly. We ask no less for ourselves. Backing these measures--
which could outlaw several forms of birth control and other key
services--indicates Price would not only place a woman's health in
jeopardy by denying care, but defy our Nation's bedrock principle of
religious liberty. His leadership could let politicians interfere in an
individual's ability to make personal health decisions according to
their own beliefs and values.
Also of deep concern is Rep. Price's opposition to the principle
that we all deserve fair treatment under the law--a belief that could
leave people without protection from health system discrimination. The
Congressman has consistently worked against efforts to make existing
law more inclusive. Rejecting values that affirm compassion and the
dignity of all people, he voted against the Matthew Shepherd and James
Byrd. Jr Hate Crimes Prevention Act and opposed reauthorization of the
Violence Against Women Act. Given this record, Rep. Price's HHS
leadership could mean women, immigrants, people who are lesbian, gay,
bisexual, transgender, gender-nonconforming, or queer (LGBTQ), and
others experiencing barriers to health and safety might be refused
health care, safety, or related services simply because of their
gender, sexual orientation, immigration status or other factors.
The cabinet member who leads the Department of Health and Human
Services must be committed to advancing access to affordable, quality
health care for all, and the basic ideals that we each deserve dignity,
fair treatment, compassion, and respect to make our own personal,
faith-informed decisions about our health and future--regardless of
income, gender, race, or any other factor. Rep. Price's record shows he
rejects these values and commitments.
NCJW fears Rep. Price would threaten the health and well-being of
individuals and families nationwide and thus respectfully urges you to
reject his confirmation as HHS Secretary.
Sincerely,
Nancy K. Kaufman,
CEO, National Council of Jewish Women.
National Institute for Reproductive Health,
January 16, 2017.
Hon. Lamar Alexander, Chairman,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Hon. Patty Murray, Ranking Member,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Dear Chairman Alexander and Ranking Member Murray: The National
Institute for Reproductive Health is a non-profit advocacy organization
working across the country to increase access to reproductive health
care and seeks to preserve women's right to affordable and accessible
abortion and contraception as part of the comprehensive range of health
services that each person needs and deserves. We write in opposition to
Representative Tom Price's nomination to serve as our Nation's
Secretary of Health and Human Services.
The mission of the Department of Health and Human Services (HHS) is
``to enhance and protect the health and well-being of all Americans.''
\1\ Representative Price's record indicates that he would not serve the
stated mission of HHS.
---------------------------------------------------------------------------
\1\ U.S. Dept. of Health and Human Services. ``About Us.''
Retrieved 12 January 17, from https://www.hhs.gov/about/index.html#.
---------------------------------------------------------------------------
During his 11 years in Congress, Representative Price has
consistently championed policies that would undermine the health and
well-being of women. He has worked to weaken the same programs that he
has been nominated to oversee--programs that tens of millions of
people--and disproportionately women--rely on to protect their health
and the health and well-being of their families. His record should
disqualify him for the office of HHS Secretary.
Specifically, we are deeply concerned about the Congressman's
extreme opposition to abortion care and access to contraception; his
opposition to the Affordable Care Act (ACA); and his commitment to
undermining Medicaid, Medicare and other key parts of our Nation's
social safety net.
Rep. Price's extreme record on reproductive health care alone
should disqualify him for the job. Rep. Price has co-sponsored
legislation that would outlaw abortion, stem cell research, forms of
contraception, and in vitro fertilization.\2\ He has vigorously opposed
women's constitutionally recognized right to abortion care, voting
repeatedly and consistently to: deny abortion coverage for women with
private health insurance,\3\ withhold such coverage from low-income
women,\4\ and ban abortion care nationwide as early as 20 weeks.\5\ He
has voted multiple times in favor of the Select Panel to investigate
abortion providers, a partisan witch-hunt that has harassed and
endangered researchers and abortion providers.\6\
---------------------------------------------------------------------------
\2\ The Right to Life Act, H.R. 552 (2 February 2005).
\3\ Stupak amendment to the Health Care for America Act, H.R. 3962,
(7 November 2009); Camp motion to recommit Health Care and Education
Reconciliation Act, H.R. 4872, (21 March 2010); No Taxpayer Funding for
Abortion Act, H.R. 3, (4 May 2011); Protect Life Act, H.R. 358, (13
October 2011); No Taxpayer Funding for Abortion Act, H.R. 7, (28
January 2014); No Taxpayer Funding for Abortion Act, H.R. 7, (22
January 2015).
\4\ No Taxpayer Funding for Abortion Act, H.R. 3, (4 May 2011); No
Taxpayer Funding for Abortion Act, H.R. 7, (28 January 2014); No
Taxpayer Funding for Abortion Act, H.R. 7, (22 January 2015).
\5\ ``Pain-Capable'' Unborn Child Protection Act, H.R. 3808, (31
July 2012); ``Pain-Capable'' Unborn Child Protection Act, H.R. 1797,
(18 June 2013); Motion to recommit the ``Pain-Capable'' Unborn Child
Protection Act, H.R. 36, (13 May 2015); ``Pain-Capable'' Unborn Child
Protection Act, H.R. 36, (13 May 2015).
\6\ H.Res. 461, (7 October 2015); H.Res. 933, (1 December 2016).
---------------------------------------------------------------------------
Rep. Price is a proven opponent of access to family planning
services, no matter the public health impact. He has repeatedly voted
to defund Planned Parenthood,\7\ which provides essential preventive
health services like cancer screenings, birth control, STI testing, and
HIV testing to 2.5 million people annually. Defunding Planned
Parenthood and barring Federal funds for family planning services to
any health entity that also provides abortion will have a
disproportionate impact on communities that historically face systemic
barriers to care--people of color, people living in rural areas, and
people with low incomes.\8\ He has also voted to eliminate title X, our
Nation's family planning program, which provides millions of people
with basic health care services.\9\
---------------------------------------------------------------------------
\7\ Pence amendment to fiscal year 2008 Labor, Health and Human
Services, and Education Appropriations Act, H.R. 3043, (19 July 2007);
Pence amendment to fiscal year 2010 Labor, Health and Human Services,
and Education Appropriations Act, H.R. 3293, (24 July 2009); Pence
amendment to fiscal year 2011 Continuing Resolution, H.R. 1, (18
February 2011); fiscal year 2011 Continuing Resolution, H.R. 1, (19
February 2011); Enrollment resolution to fiscal year 2011 Continuing
Resolution, H.Con.Res. 36, (14 April 2011); Defund Planned Parenthood
Act, H.R. 3134, (18 September 2015); Women's Public Health and Safety
Act, H.R. 3495, (29 September 2015); Fiscal year 2016 Continuing
Resolution, H.Con. 79, (30 September 2015); Restoring Americans'
Healthcare Freedom Reconciliation Act, H.R. 3762, (23 October 2015);
H.R. 3762, (6 January 2016); Veto override of H.R. 3762, (2 February
2016).
\8\ Planned Parenthood Federation of America. (2016). The Urgent
Need for Planned Parenthood Health Centers. Retrieved 13 January 2017,
from https//www.plannedparenthood.org/files/4314/8183/5009/
20161207_Defunding_fs_d01_1.pdf.
\9\ Fiscal year 2011 Continuing Resolution, H.R. 1, (19 February
2011).
---------------------------------------------------------------------------
In addition to specifically targeting women's access to abortion
and contraception, Rep. Price has made clear his opposition to
affordable health care for everyone. The Affordable Care Act has
improved the lives of tens of millions of people. It has enabled nearly
9.5 million previously uninsured women to gain access to affordable,
comprehensive health care coverage.\10\ Millions now have the peace of
mind of knowing that if they or their family members have a health
emergency they will be able to afford care. Fifty-five million women
have benefited from the ACA's coverage of preventive services,
including well-woman visits, screening for domestic violence,
contraceptive methods and counseling, and breastfeeding support, among
others.\11\
---------------------------------------------------------------------------
\10\ U.S. Dept. of Health and Human Services, Office of the Asst.
Secretary for Planning and Evaluation. (2016, March). Health Insurance
Coverage and the Affordable Care Act, 2010-2016. Retrieved 12 January
2017, from https://aspe.hhs.gov/sites/default/files/pdf/187551/ACA2010-
2016.pdf.
\11\ U.S. Dept. of Health and Human Services. (2015, May). The
Affordable Care Act is Improving Access to Preventive Services for
Millions of Americans. Retrieved 12 January 2017, from
https:..aspe.hhs.gov/pdf-report/affordable-care-act-improving-access-
preventive-services-millions-americans.
---------------------------------------------------------------------------
If confirmed, Rep. Price would roll back these important gains for
women and families and strip beneficiaries of important protections
concerning access to coverage and care. His record on these issues is
clear. Rep. Price has voted over 60 times to repeal the ACA.\12\
---------------------------------------------------------------------------
\12\ Planned Parenthood Federation of America. (2016, November).
Tom Price, Trump's Pick to Lead HHS, Would Take Away Millions of
Women's Health Care. Retrieved 12 January 2017, from https://
www.plannedparenthoodaction.org/blog/tom-price-trumps-pick-to-lead-hhs-
would-take-away-millions-of-womens-access-to-health-care.
---------------------------------------------------------------------------
Rep. Price's opposition to affordable health care extends beyond
the ACA. His appointment represents a serious threat to Medicaid and
Medicare. Rep. Price has specifically targeted low-income women and
families by seeking to cut funding for Medicaid and to eviscerate the
program through the use of block grants and per capita caps.\13\
Millions of women rely on Medicaid for care throughout their lives--
from reproductive and maternal health services to nursing home care.
Block granting or capping Medicaid would devastatingly undermine the
critical role that Medicaid plays in supporting the health and well-
being of millions of people in this country.
---------------------------------------------------------------------------
\13\ Ibid.
---------------------------------------------------------------------------
In addition to his attacks on Medicaid, Rep. Price has sought to
severely undermine the Medicare safety net, which has delivered life-
saving health care and coverage to millions of older adults--the
majority of whom are women--and people with disabilities, who otherwise
could not afford it. Instead of working to strengthen this vital
American institution, as the next HHS Secretary should, Rep. Price
would weaken Medicare through privatization.\14\
---------------------------------------------------------------------------
\14\ A Better Way Our Vision for a More Confident America--Health
Care. (22 June 2016). Retrieved 13 January 2017, from http://
abetterway.speaker.gov/_assets/pdf/ABetterWay-HealthCare-
PolicyPaper.pdf; Rep. Tom Price. (22 June 2016). A Better Way to Fix
Health Care [Press Release]. Retrieved 13 January 2017, from https://
tomprice.house.gov/press-release/better-way-fix-health-care.
---------------------------------------------------------------------------
Rep. Tom Price would clearly take our health care system backward.
We urge you to reject this nominee.
Sincerely,
Andrea Miller,
President.
National Latina Institute For Reproductive Health,
January 16, 2017.
U.S. Senate,
Committee on Health, Education, Labor, and Pensions,
428 Senate Dirksen Office Building,
Washington, DC 20510.
Dear Member of the Senate Committee on Health, Education, Labor,
and Pensions: National Latina Institute for Reproductive Health [NLIRH]
writes to express its strong opposition to the confirmation of Tom
Price as Secretary of Health and Human Services. NLIRH is the only
national reproductive justice organization dedicated to building Latina
power to advance health, dignity, and justice for 28 million Latinas,
their families, and communities in the United States through leadership
development, community mobilization, policy advocacy, and strategic
communications. The Secretary of Health and Human Services is the
Nation's most senior official tasked with enhancing and protecting the
health and well-being of all communities in the United States. Mr.
Price's record is entirely inconsistent with the mandate of the U.S.
Department of Health and Human Services (HHS).
Mr. Price has consistently attacked the Affordable Care Act (ACA),
landmark legislation that has improved access to healthcare for the
Latinos/a community in the United States. In the 114th Congress, Mr.
Price introduced the Empowering Patients First Act, which if passed,
would have repealed the ACA and replaced it with a plan that would harm
those who are struggling to make ends meet and those who are ill.\1\
Due to the ACA, over 4 million Latinos/as were able to gain
coverage.\2\ In fact, 71 percent of Latino/a registered voters before
the 2016 election said that the ACA is working well and should remain
as it is or that it is working well and can be improved by decreasing
out-of-pocket costs.\3\ The ACA has opened the door to meaningful
access to affordable, quality, culturally competent health coverage and
care, including reproductive healthcare, for Latinos/as. The gains
communities of color have made under the ACA will be reversed if Mr.
Price is confirmed.
---------------------------------------------------------------------------
\1\ Empowering Patients First Act, H.R. 2300, 114th Cong. (2015).
\2\ U.S. Department of Health and Human Services. The ACA is
Working for the Latino Community. July 21, 2016. http://www.hhs.gov/
healthcare/facts-and-features/fact-sheets/aca-working-latino-community/
index.html?language=es.
\3\ National Council of La Raza and Latino Decisions. Press
Briefing: The Views of Latinos on the Economy, Health Care, and the
2016 Election. October 27, 2016. http://publications.nclr.org/
bitstream/handle/123456789/1641/
theviewsoflatinosontheeconomyhealthcareand
2016election.pdf?sequence=l&isAllowed=y.
---------------------------------------------------------------------------
Mr. Price's record reflects xenophobic sentiments. Mr Price is a
member of the Association of American Physicians and Surgeons
(AAPS).\4\ In 2005, the namesake journal of this organization published
an article advocating for rescinding the citizenship of individuals
born in the United States whose parents are foreign-born.\5\ Mr. Price
has also cosponsored H.R. 1940. the Birthright Citizenship Act of 2007,
in the 110th Congress which would deny citizenship to some who are born
here in the United States of immigrant parents.\6\ His support of anti-
immigrant legislation will impact the ability of HHS to engage in
health issues concerning immigrant communities in this country.
---------------------------------------------------------------------------
\4\ John Commins, AAPS Membership May be Liability for Price, Says
Group's Leader, Health Media Leaders, Dec. 7, 2016. http://
www.healthleadersmedia.com/physician-leaders/aaps-membership-may-be-
liability-price-says-groups-leader#.
\5\ Madeleine Pelner Cosman, Illegal Aliens and American Medicine,
Journal of American Physicians and Surgeons, 10(1); 9, 2005. Available
at: http://www.jpands.org/vol10no1/cosman.pdf.
\6\ Birthright Citizenship Act of 2007, H.R. 1940, 110th Cong.
(2007).
---------------------------------------------------------------------------
Mr. Price's hostile views regarding the LGBTQ community would
undermine the important work that the ACA has achieved in advancing the
health and dignity of LGBTQ individuals. Under the Obama
administration, the ACA's nondiscrimination provision has been
interpreted to include protections on the basis of gender identity.\7\
Additionally, in 2015, preventive services under the ACA were clarified
so that transgender persons would have access to these services
regardless of their gender identity, sex assigned at birth, or recorded
gender.\8\ Mr. Price has voted against legislation that would ban
employment discrimination on the basis of sexual orientation\9\ and
legislation that would fight hate crimes.\10\ Recently, he called the
Obama administration's guidelines allowing transgender students to use
the bathroom that aligns with their gender identity as ``absurd.'' \11\
If confirmed, the important gains in health equity for the LGBTQ
community will dissipate, leading to severe health disparities.
---------------------------------------------------------------------------
\7\ Nondiscrimination in Health Programs and Activities, 81 Fed.
Reg. 31375 45 CFR 92 (May 18, 2016).
\8\ U.S. Department of Health and Human Services, Advancing LGBT
Health and Well-being: 2016 Report of the HHS LGBT Policy Coordinating
Committee, Dec. 6, 2016, https://www.hhs.gov/programs/topic-sites/lgbt/
reports/health-objectives-2016.html.
\9\ Employment Non-Discrimination Act of 2007, H.R. 3685, 110th
Cong. (2007).
\10\ Local Law Enforcement Hate Crimes Prevention Act of 2009, H.R.
1913, 111th Cong. (2009).
\11\ Matt Hennie, Transgender Bathroom Backlash Grows in Georgia,
Project Q Atlanta, May 16, 2016, http://www.projectq.us/atlanta/
transgender_bathroom_backlash_grows_in_
georgia?gid=17800.
---------------------------------------------------------------------------
Mr. Price has consistently supported efforts to undermine a woman's
ability to make personal, reproductive healthcare decisions. As a
member of the House of Representatives, he has cast anti-choice votes
on access to abortion care and coverage and other reproductive health
issues.\12\ His support of anti-choice legislation only further harms
women of color who face multiple challenges in accessing quality,
affordable reproductive health services. For example, due to barriers
to healthcare, Latinas face the highest rates of cervical cancer
incidence and Black women face the highest cervical cancer mortality
rates.\13\ His objection to the contraceptive coverage benefit on the
grounds of religious liberty\14\ ignores the fact that women of color
had previously struggled to afford this care.\15\ Mr. Price will
undoubtedly continue to support anti-choice policies as head of HHS.
---------------------------------------------------------------------------
\12\ NARAL Pro-Choice America, Congressional Record on Choice,
2005-16.
\13\ Centers for Disease Control and Prevention. Cervical Cancer
Rates by Race and Ethnicity. August 20, 2015. The U.S. Department of
Health and Human Services. Available at http://www.cdc.gov/cancer/
cervical/statistics/race.htm.
\14\ Olga Khazan, Tom Price: ``Not One'' Woman Struggled to Afford
Birth Control, The Atlantic, Nov. 29, 2016. http://www.theatlantic.com/
health/archive/2016/11/tom-price-not-one-woman-cant-afford-birth-
contro1/509003/.
\15\ Planned Parenthood Federation of America. Survey: Nearly Three
in Four Voters in America Support Fully Covering Prescription Birth
Control. https://www.plannedparenthood.org/about-us/newsroom/press-
releases/survey-nearly-three-four-voters-america-support-fully-covering
-prescription-birth-control. Accessed on December 12, 2016.
---------------------------------------------------------------------------
As Secretary of HHS, Mr. Price would undermine and reverse the
gains this country has made in advancing access to quality, affordable
health care, including reproductive health care, for communities of
color, LGBTQ communities, and women of color. If confirmed, the
policies Mr. Price pursues will severely harm Latinas and their
families.
Accordingly, we strongly encourage the committee to oppose the
confirmation of Mr. Price as Secretary of HHS.
Sincerely,
Jessica Gonzalez-Rojas,
Executive Director, National Latina Institute
for Reproductive Health.
National Network of Abortion Funds,
January 16, 2017.
Hon. Lamar Alexander, Chairman,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Hon. Patty Murray, Ranking Member,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Dear Chairman Alexander and Ranking Member Murray: The National
Network of Abortion Funds builds power with members to remove financial
and logistical barriers to abortion access by centering people who have
abortions and organizing at the intersections of racial, economic, and
reproductive justice. We envision a world where every reproductive
decision, including abortion, takes place in thriving communities that
are safe, peaceful, and affordable. We envision a world where all
people have the power and resources to care for and affirm their
bodies, identities, and health for themselves and their families--in
all areas of their lives. As we shift the conversation about abortion,
it will become a real option, accessible without shame or judgment.
We write in strong opposition to Representative Tom Price's
nomination to serve as our Nation's Secretary of Health and Human
Services.
The mission of the Department of Health and Human Services (HHS) is
``to enhance and protect the health and well-being of all Americans.''
\1\ Representative Price's record indicates that he would not serve the
stated mission of HHS.
---------------------------------------------------------------------------
\1\ U.S. Dept. of Health and Human Services. ``About Us.''
Retrieved 12 January 17, from https://www.hhs.gov/about/index.html#.
---------------------------------------------------------------------------
During his 11 years in Congress, Representative Price has
consistently championed policies that would undermine the health and
well-being of women. He has worked to weaken the same programs that he
has been nominated to oversee--programs that tens of millions of people
rely on to protect the health of their families. His record should
disqualify him for the office of HHS Secretary.
Specifically, we are deeply concerned about the Congressman's
opposition to the Affordable Care Act (ACA); his commitment to
undermining Medicaid, Medicare and other key parts of our Nation's
social safety net; and his extreme opposition to abortion care and
access to contraception.
The Affordable Care Act has improved the lives of tens of millions
of people. It has enabled nearly 9.5 million previously uninsured women
to gain access to affordable, comprehensive health care coverage.\2\
Millions now have the peace of mind of knowing that if they or their
family members have a health emergency they will be able to afford
care. Fifty-five million women have benefited from the ACA's coverage
of preventive services, including well-woman visits, screening for
domestic violence, contraceptive methods and counseling, and breast
feeding support, among others.\3\
---------------------------------------------------------------------------
\2\ U.S. Dept. of Health and Human Services, Office of the Asst.
Secretary for Planning and Evaluation. (2016, March). Health Insurance
Coverage and the Affordable Care Act, 2010-2016. Retrieved 12 January
2017, from https://aspe.hhs.gov/sites/default/files/pdf/187551/ACA2010-
2016.pdf.
\3\ U.S. Dept. of Health and Human. Services. (2015, May). The
Affordable Care Act is Improving Access to Preventive Services for
Millions of Americans. Retrieved 12 January 2017, from https://
aspe.hhs.gov/pdf-report/affordable-care-act-improving-access-
preventive-services-millions-americaas.
---------------------------------------------------------------------------
If confirmed, Rep. Price would roll back these important gains for
women and families and strip beneficiaries of important protections
concerning access to coverage and care. His record on these issues is
clear. Rep. Price has voted over 60 times to repeal the ACA.\4\
---------------------------------------------------------------------------
\4\ Classed Parenthood Federation of America. (2016, November). Tom
Price, Trump's Pick to Lead HHS, Would Take Away Millions of Women's
Health Care. Retrieved 12 January 2017, from https://
www.plannedparenthoodaction.org/blog/tom-price-trumps-pick-to-lead-hhs-
would-take-away-millions-of-womens-access-to-health-care.
---------------------------------------------------------------------------
Rep. Price's opposition to affordable health care extends beyond
the ACA. His appointment represents a serious threat to Medicare and
Medicaid. Medicare has delivered life-saving health care and coverage
to millions of older adults--the majority of whom are women--and people
with disabilities, who otherwise could not afford it. Instead of
working to strengthen this vital American institution, as the next HHS
Secretary should, Rep. Price would weaken Medicare through
privatization.\5\
---------------------------------------------------------------------------
\5\ A Better Way: Our Vision for a More Confident America--Health
Care. (22 June 2016). Retrieved 13 January 2017, from http://
abetterway.speaker.gov/_assets/pdf/ABetterWay-HealthCare-
PolicyPaper.pdf; Rep. Tom Price. (22 June 2016). A Better Way to Fix
Health Care (Press Release]. Retrieved 13 January 2017, from https://
tomprice.house.gov/press-release/better-way-fix-health-care.
---------------------------------------------------------------------------
In addition to his attacks on Medicare, Rep. Price has also
targeted low-income women and families by seeking to cut funding for
Medicaid and to eviscerate the program through the use of block grants
and per capita caps.\6\ Millions of women rely on Medicaid for care
throughout their lives--from reproductive and maternal health services
to nursing home care. Block granting or capping Medicaid would
devastatingly undermine the critical role that Medicaid plays in
supporting the health and well-being of millions of people in this
country.
---------------------------------------------------------------------------
\6\ Ibid.
---------------------------------------------------------------------------
Finally, Rep. Price's extreme record on reproductive health care
alone should disqualify him for the job. Rep. Price has co-sponsored
legislation that would outlaw abortion, stem cell research, forms of
contraception, and in vitro fertilization.\7\ He has vigorously opposed
women's constitutionally recognized right to abortion care, voting to:
deny abortion coverage for women with private health insurance,\8\ ban
abortion care as early as 20 weeks,\9\ and deny low-income women
coverage for abortion care.\10\ He has voted multiple times in favor of
the Select Panel to investigate abortion providers, a partisan witch-
hunt that has harassed and endangered researchers and abortion
providers.\11\
---------------------------------------------------------------------------
\7\ The Right to Life Act, H.R. 552 (2 February 2005).
\8\ Stupak amendment to the Health Care for America Act, H.R. 3962,
(7 November 2009); Camp motion to recommit Health Care and Education
Reconciliation Act, H.R. 4872, (21 March 2010); No Taxpayer Funding for
Abortion Act, H.R. 3, (4 May 2011); Protect Life Act, H.R. 358, (13
October 2011); No Taxpayer Funding for Abortion Act, H.R. 7, (28
January 2014); No Taxpayer Funding for Abortion Act, H.R. 7, (22
January 2015).
\9\ ``Pain-Capable'' Unborn. Child Protection Act, H.R. 3808, (31
July 2012); ``Pain-Capable'' Unborn Child Protection Act, H.R. 1797,
(18 June 2013); Motion to recommit the ``Pain-Capable'' Unborn Child
Protection Act, H.R. 36, (13 May 2015); ``Pain-Capable'' Unborn Child
Protection Act, H.R. 36, (13 May 2015).
\10\ No Taxpayer Funding for Abortion Act, H.R. 3, (4 May 2011); No
Taxpayer Funding for Abortion. Act, H.R. 7, (28 January 2014); No
Taxpayer Funding for Abortion Act, H.R. 7, (22 January 2015).
\11\ H.Res. 461, (7 October 2015); H.Res. 933, (1 December 2016).
---------------------------------------------------------------------------
Rep. Price is a proven opponent of access to family planning
services, no matter the public health impact. He has repeatedly voted
to defund Planned Parenthood,\12\ which provides essential preventive
health services like cancer screenings, birth control, STI testing, and
HIV testing to 2.5 million people annually. Defunding Planned
Parenthood will have a disproportionate impact on communities that
historically face systemic barriers to care--people of color, people
living in rural areas, and people with low incomes.\13\ He has also
voted to eliminate title X, our Nation's family planning program, which
provides millions of people with basic health care services.\14\
---------------------------------------------------------------------------
\12\ Pence amendment to fiscal year 2008 Labor, Health and Human
Services, and Education Appropriations Act, H.R. 3043, (19 July 2007);
Pence amendment to fiscal year 2010 Labor, Health and Human Services,
and Education Appropriations Act, E.R. 3293, (24 July 2009); Pence
amendment to fiscal year 2011 Continuing Resolution, H.R. 1, (18
February 2011); fiscal year 2011 Continuing Resolution, H.R. 1, (19
February 2011); Enrollment resolution to fiscal year 2011 Continuing
Resolution, H. Con. Res. 36, (14 April 2011); Defund Planned Parenthood
Act, H.R. 3134, (18 September 2015); Women's Public Health and Safety
Act, H.R. 3495, (29 September 2015); fiscal year 2016 Continuing
Resolution, H. Con. 79, (30 September 2015); Restoring Americans'
Healthcare Freedom Reconciliation Act, H.R. 3762, (23 October 2015);
H.R. 3762, (6 January 2016); Veto override of H.R. 3762, (2 February
2016).
\13\ Planned Parenthood Federation of America. (2116). The Urgent
Need for Planned Parenthood Health Centers. Retrieved 13 January 2017,
from https://www.plannedparenthood.org/files/4314/8183/5009/
20161207_Defunding_fs_d01_1.pdf.
\14\ Fiscal year 2011 Continuing Resolution, H.R. 1, (19 February
2011).
---------------------------------------------------------------------------
Rep. Tom Price would clearly take our health care system backward.
We urge you to reject this nominee.
National Organization for Women (NOW),
Washington, DC 20005,
January 17, 2017.
Hon. Lamar Alexander, Chairman,
Senate HELP Committee,
428 Dirksen Senate Office Building,
Washington, DC 20510.
Hon. Patty Murray, Ranking Member,
Senate HELP Committee,
428 Dirksen Senate Office Building,
Washington, DC 20510.
Dear Chairman Alexander, Ranking Member Murray and committee
members: On behalf of the National Organization for Women (NOW), the
largest grassroots feminist activist organization in the United States
with hundreds of chapters in every State and the District of Columbia
and hundreds of thousands of members and contributing supporters, we
wish to state our strong opposition to the confirmation of Rep. Tom
Price as Secretary of the Department of Health and Human Services.
First, we are deeply concerned by reports that have recently
surfaced about Rep. Price's alleged introduction of legislation
beneficial to a company shortly after he acquired stock in that same
company. Because these reports raise serious questions whether Rep.
Price may have violated the law, no hearing should even be taking place
until all the facts are established and made public.
Beyond his alleged potential conflicts of interest, Rep. Price's
record of promoting anti-woman policies, including repeal of the
Affordable Care Act and defunding Planned Parenthood, should disqualify
him from this critically important position. Rep. Price's opposition to
one of the most common medical procedures undergone by women--
abortion--is a special problem. Women's access to legal and safe
abortion care as well as their ability to obtain affordable
contraception under the Affordable Care Act, through the Planned
Parenthood network and other providers, is a vital part of the U.S.
health care delivery system. Shamefully, Rep. Price appears ready to
dismantle that network.
Rep. Price's views on reproductive health are far out of the
mainstream and would endanger women's lives, halt stem cell research
into effective treatments for serious diseases, ban abortion at 20
weeks, prohibit private insurance coverage of abortion care; deny low-
income women coverage for abortion care and prohibit the use of certain
forms of contraception and in vitro fertilization. As an indication of
Rep. Price's willingness to abuse elective office, he has voted several
times to continue the McCarthyesque House Select Investigative Panel, a
``witch hunt'' led by Republican members which has harassed and
endangered the safety of women's health care providers and researchers,
making unsubstantiated and/or simply false claims of wrongdoing against
them. Rep. Price has stood by as the Panel took actions in
contravention of House rules.
Equally concerning is Rep. Price's support for converting Medicare
to a private voucher system and converting Medicaid to a block-granted
program with per capita limitations on spending. These moves would
result in reduced access to health care services and higher out-of-
pocket expenses for seniors, lower income adults and their children as
well as for persons with disabilities.
In Rep. Price's efforts to draft an Affordable Care Act replacement
(and Rep. Paul Ryan's elaboration on Price's proposal) we see a
suggested plan that would place a higher burden on low- and moderate-
income individuals and families to pay for their health insurance; an
expansion of Health Savings Accounts which are a boon for Wall Street
and wealthier persons; a very limited provision for insurance coverage
of persons with pre-existing health conditions; and, a proposal for
high risk pools for persons who are not able to get affordable health
insurance on the private market which we have already seen fail in many
States due to under-funding. The proposal limits the amount of money
that companies can deduct from their taxes to discourage them from
providing ``overly generous'' insurance coverage. In sum, this is a
plan that would narrow and make far more costly health insurance
coverage for the vast majority of the public, especially negatively
affecting current ACA beneficiaries and others who have had difficulty
paying for health insurance. Not only would these cruel measures fall
most harshly on the most vulnerable, they would leave the country with
a system that covers fewer of us while costing more.
For all of the foregoing reasons, Rep. Price must not be confirmed
as Secretary of Health and Human Services.
Sincerely,
Terry O'Neil,
President.
National Partnership For Women & Families,
Washington, DC 20009,
January 13, 2017.
Hon. Lamar Alexander, Chairman,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Hon. Patty Murray, Ranking Member,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Dear Chairman Alexander and Ranking Member Murray: The National
Partnership for Women & Families is a nonprofit, nonpartisan
organization that has fought for decades to strengthen our health care
system and advance the rights and well-being of women. On behalf of
women across the country who are the health care decisionmakers for
themselves and their families, we write in opposition to Representative
Tom Price's nomination to serve as our Nation's Secretary of Health and
Human Services.
The mission of the Department of Health and Human Services (HHS) is
``to enhance and protect the health and well-being of all Americans.''
\1\ We do not believe Representative Price intends to serve the stated
mission of HHS.
---------------------------------------------------------------------------
\1\ U.S. Dept of Health and Human Services. ``About Us.'' Retrieved
12 January 17, from https://www.hhs.gov/about/index.html#.
---------------------------------------------------------------------------
During his 11 years in Congress, Representative Price has
consistently championed policies that would undermine the health and
well-being of women and families. He has worked to weaken the same
programs that he has been nominated to oversee--programs that tens of
millions of people rely on to protect the health of their families. It
is a record that should disqualify him for the office of HHS Secretary.
Specifically, we are extremely concerned about the Congressman's
opposition to the Affordable Care Act (ACA); his determination to make
devastating changes to Medicaid, Medicare and other key parts of our
Nation's social safety net; and his radical opposition to abortion care
and access to contraception. Given these concerns, we strongly oppose
Rep. Price's nomination to oversee implementation of these programs--
programs that are critical to the health and economic security of
millions of women and their families.
Since its passage, the Affordable Care Act has indisputably
improved the lives of tens of millions of people. It has enabled
millions of previously uninsured women to gain access to affordable,
comprehensive health care coverage.\2\ Millions of women now have the
peace of mind of knowing that if they or their family members have a
health emergency or are due for a wellness check-up, they will be able
to afford care. Fifty-five million women have also benefited from the
ACA's coverage of preventive services, including well-woman visits,
screening for domestic violence, contraceptive methods and counseling,
and breast feeding support, among others.\3\
---------------------------------------------------------------------------
\2\ U.S. Dept. of Health and Human Services, Office of the Asst.
Secretary for Planning and Evaluation. (2016, March). Health Insurance
Coverage and the Affordable Core Act, 2010-2016. Retrieved 12 January
2017, from https://aspe.hhs.gov/sites/default/files/pdf/187551/ACA2010-
2016.pdf.
\3\ U.S. Dept of Health and Human Services. (2015, May). The
Affordable Care Act is Improving Access to Preventive Services for
Millions of Americans. Retrieved 12 January 2017, from https://
aspe.hhs.gov/pdf-report/affordable-care-act-improving-access-
preventive-services-millions
-Americans.
---------------------------------------------------------------------------
Before the ACA, insurance companies could legally deny coverage to
women because they had survived breast cancer or given birth by
cesarean section, or had required medical treatment due to domestic
violence. The ACA put an end to these unethical practices.
If confirmed, Rep. Price would roll back these important gains for
women and families and strip beneficiaries of important protections
that have enhanced access to coverage and care. His record on these
issues is clear. Rep. Price has voted over 60 times to repeal the
ACA.\4\ In his zeal to dismantle the law, Rep. Price has even supported
measures that would again allow insurance companies to reject people
with pre-existing conditions.\5\
---------------------------------------------------------------------------
\4\ Planned Parenthood Federation of America. (2016, November). Tom
Price, Trump's Pick to Lead HHS, Would Take Away Millions of Women's
Health Care. Retrieved 12 January 2017, from https://
www.plannedparenthoodaction.org/blog/tom-price-trump-pick-to-lead-hhs-
wouId-take-away-millions-of-womens-access-to-health-care.
\5\ Zachary Bernstein. (2012, May). GA Rep. Price: Opening Health
Insurance to People With Pre-Existing Conditions Is A ``Terrible
Idea.'' ThinkProgress. Retrieved 12 January 2017, from https://
thinkprogress.org/ga-rep-price-opening-health-insurance-to-people-with-
pre-existing-conditions-is-a-terrible-idea-125a58acd050#.1yyao56rf.
---------------------------------------------------------------------------
Rep. Price's opposition to affordable health care extends beyond
the ACA. His appointment represents a serious threat to Medicare and
Medicaid. In 2008, Rep. Price wrote ``nothing has had a greater
negative impact on health care in this country than governmental and
regulatory intrusion, primarily through Medicare.'' \6\ In fact, the
opposite is true. Medicare has delivered life-saving health care and
coverage to millions of older adults--the majority of whom are women--
and people with disabilities, who otherwise could not afford it.
Medicare is also instrumental in driving the delivery system and
payment reforms necessary to improve care in the doctor's office and in
the hospital.
---------------------------------------------------------------------------
\6\ Rep. Tom Price. (2008, June). Reform of the American Health
Care System is Still Achievable. Human Events. Retrieved 12 January
2017, from http://humanevents.com/2008/06/24/reform-of-the-american-
health-care-system-is-still-achievable/.
---------------------------------------------------------------------------
Instead of working to strengthen this vital American institution,
as the next HHS Secretary should, Rep. Price would weaken Medicare
through privatization. Rep. Price supports restructuring Medicare by
moving the program toward private coverage that would transfer costs to
patients and make quality health coverage unaffordable for many
Medicare enrollees on fixed incomes.\7\
---------------------------------------------------------------------------
\7\ A Better Way: Our Vision for a More Confident America--Health
Care. (22 June 2016). Retrieved 13 January 2017, from http://
abetterway-speaker.gov/_assets/pdf/ABetterWay-HealthCare-
PolicyPaper.pdf; Rep. Tom Price. (22 June 2016). A Better Way to Fix
Health Care [Press Release). Retrieved 13 January 2017, from https://
tomprice.house.gov/press-release/better-way-fix-health-care.
---------------------------------------------------------------------------
In addition to his attacks on Medicare, Rep. Price has also
targeted low-income women and families by seeking to cut funding for
Medicaid and to eviscerate the program through the use of block grants
and per capita caps.\8\ Millions of women rely on Medicaid for care
throughout their lives--from reproductive and maternal health services
to nursing home care. Block granting or capping Medicaid would cut
funding for health coverage for underserved populations and allow
States to limit enrollment and benefits, undermining the critical role
that Medicaid plays in supporting the health and well-being of millions
of people in America.
---------------------------------------------------------------------------
\8\ Ibid.
---------------------------------------------------------------------------
Finally, Rep. Price's radical record on women's health and
reproductive health care alone should disqualify him for the job of
America's top public health and family planning official. Rep. Price
has co-sponsored legislation that would outlaw abortion, stem cell
research, some forms of contraception and in vitro fertilization.\9\ He
has vigorously opposed women's constitutionally recognized right to
abortion care, repeatedly voting to deny abortion coverage for women
with private health insurance,\10\ ban abortion care as early as 20
weeks\11\ and deny low-income women coverage for abortion care.\12\
---------------------------------------------------------------------------
\9\ The Right to Life Act, H.R. 552 (2 February 2005).
\10\ Stupak amendment to the Health Care for America Act, H.R.
3962, (7 November 2009); Camp motion to recommit Health Care and
Education Reconciliation Act, H.R. 4872, (21 March 2010); No Taxpayer
Funding for Abortion Act, H.R. 3, (4 May 2011); Protect Life Act, H.R.
358, (13 October 2011); No Taxpayer Funding for Abortion Act, H.R. 7,
(28 January 2014); No Taxpayer Funding for Abortion Act, H.R. 7, (22
January 2015).
\11\ ``Pain-Capable'' Unborn Child Protection Act, H.R. 3808, (31
July 2012); ``Pain-Capable'' Unborn Child Protection Act, H.R. 1797,
(18 June 2013); Motion to recommit the ``Pain-Capable'' Unborn Child
Protection Act, H.R. 36, (13 May 2015); ``Pain-Capable'' Unborn Child
Protection Act, H.R. 36, (13 May 2015).
\12\ No Taxpayer Funding for Abortion Act, H.R. 3, (4 May 2011); No
Taxpayer Funding for Abortion Act, H.R. 7, (28 January 2014); No
Taxpayer Funding for Abortion Act, H.R. 7, (22 January 2015).
---------------------------------------------------------------------------
Recently, he voted multiple times in favor of the Select Panel to
investigate abortion providers, a partisan witch-hunt that has harassed
and endangered researchers and abortion providers.\13\
---------------------------------------------------------------------------
\13\ H.Res.461, (7 October 2015); H.Res.933, (1 December 2016).
---------------------------------------------------------------------------
Rep. Price is also a proven opponent of access to family planning
services, no matter the public health impact. He has repeatedly voted
to defund Planned Parenthood,\14\ which provides essential preventive
health services like cancer screenings, birth control, STI testing, and
HIV testing to 2.5 million people annually. Defunding Planned
Parenthood will have a disproportionate impact on communities that
historically face systemic barriers to care--people of color, people
living in rural areas, and people with low incomes.\15\ He has also
voted to eliminate title X, our Nation's family planning program.\16\
---------------------------------------------------------------------------
\14\ Pence amendment to fiscal year 2008 Labor, Health and Human
Services, and Education Appropriations Act, H.R. 3043, (19 July 2007);
Pence amendment to fiscal year 2010 Labor, Health and Human Services,
and Education Appropriations Act, H.R. 3293, (24 July 2009); Pence
amendment to fiscal year 2011 Continuing Resolution, H.R. 11, (18
February 2011); Fiscal year 2011 Continuing Resolution, H.R. 1, (19
February 2011); Enrollment resolution to fiscal year 2011 Continuing
Resolution, H. Con. Res. 36, (14 April 2011); Defund Planned Parenthood
Act, H.R. 3134, (18 September 2015); Women's Public Health and Safety
Act, H.R. 3495, (29 September 2015); fiscal year 2016 Continuing
Resolution, H. Con. 79, (30 September 2015); Restoring Americans'
Healthcare Freedom Reconciliation Act, H.R. 3762, (23 October 2015);
H.R. 3762, (6 January 2016); Veto override of H.R. 3762, (2 February
2016).
\15\ Planned Parenthood Federation of America. (2016). The Urgent
Need for Planned Parenthood Health Centers. Retrieved 13 January 2017,
from https://www.plannedparenthood.org/files/4314/8183/5009/
20161207_Defunding_fs_d01_1.pdf.
\16\ Fiscal year 2011 Continuing Resolution, H.R. 1, (19 February
2011).
---------------------------------------------------------------------------
Rep. Price once claimed that ``there's not one'' woman who lacks
access to contraception.\17\ Yet independent researchers have found
that some 20 million women would not be able to afford contraception
without financial assistance.\18\ A person so willfully blind to facts
and opposed to women's health should not be overseeing our Nation's
essential public health programs, including family planning efforts,
Medicare, Medicaid and the ACA.
---------------------------------------------------------------------------
\17\ Scott Keyes & Travis Waldron. (2012, February) House
Republican Leader Price: ``There's Not One Woman'' Who Doesn't Have
Access To Birth Control. ThinkProgress. Retrieved 5 January 2017, from
https://think progress.org/house-republican-leader-pice-theres-not-one-
woman-who-doesn't-have-access-to-birth-control-5a13b090799c#.xdec3scze.
\18\ Guttmacher Institute. (2016, September). Publicly Funded
Family Planning Services in the United States. Retrieved 12 January
2017, from https://www.guttmacher.org/fact-sheet/publicly-funded-
family-planning-services-united-states.
---------------------------------------------------------------------------
The Constitution invests in the Senate the responsibility of advice
and consent to the President's nominees for high office. The Nation
deserves a leader of the Department of Health and Human Services who
will advance its mission. Rep. Tom Price would clearly take our health
care system backward. He is not the right person for this job. We urge
you to reject this nominee.
Sincerely,
Debra L. Ness,
President.
National Women's Law Center,
Washington, DC 20036,
January 16, 2017.
Hon. Lamar Alexander, Chairman,
Senate Committee on Health, Education, Labor, and Pensions,
428 Senate Dirksen Office Building,
Washington, DC 20510.
Hon. Patty Murray, Ranking Member,
Senate Committee on Health, Education, Labor, and Pensions,
154 Russell Senate Office Building,
Washington, DC 20510.
Dear Senators Alexander and Murray: On behalf of the National
Women's Law Center (``Center''), an organization that has worked for 45
years to advance and protect equality and opportunity for women and
girls in every aspect of their lives, including health care and income
security, we write in strong opposition to the confirmation of
Representative Thomas Price as Secretary of Health and Human Services
(HHS).
As the Nation's top health official, the Secretary of HHS leads the
important work of implementing laws, programs, and initiatives that
directly affect the health and well-being of all people, and most
especially women, in our country. These include the Affordable Care
Act--which eliminates sex discrimination in health care and ensures
that women receive comprehensive affordable health insurance; the
Medicaid program--which has given low-income women and their families
necessary health coverage across all stages of life for more than 50
years; and Medicare--a literal lifeline for older women.
The Secretary of HHS oversees other critical programs as well that
help alleviate poverty and expand opportunity for low- and moderate-
income women and families, including vital services for seniors and
people with disabilities and heating assistance for struggling
families. Rep. Price's record of seeking to weaken these very programs,
placing ideology over the health and well-being of people in our
country and his lack of understanding of the challenges facing the
majority of Americans demonstrate that he should not be confirmed to
this important position.
Rep. Price has a record of seeking to dismantle the very programs
he would be charged with implementing.
Rep. Price has led the charge to simply eliminate the Affordable
Care Act (ACA) and along with it all the important gains it provides to
women in health care and health insurance without proposing any true
substitute. He sponsored and pushed the 2015 budget reconciliation bill
that, for example, would have gutted key provisions of the ACA had it
not been for President Obama's veto.\1\ In total, he has supported 65
attempts to repeal the law.\2\ His replacement bill, the ``Empowering
Patients First Act,'' contained none of the provisions in the ACA most
important to women's health.\3\ For example, the bill did not ban the
insurance industry practice of charging women more than men, it did not
require coverage of services important to women like maternity care and
women's preventive services, and it would not stop insurance companies
from excluding coverage for people with ``pre-existing conditions,''
including a woman subjected to domestic violence, rape, or a cesarean
delivery.
---------------------------------------------------------------------------
\1\ H.R. 3762, 114th Cong. (2016).
\2\ Miriam Berg, Planned Parenthood Action Fund, Tom Price, Trump's
Pick to Lead HHS, Would Take Away Millions of Women's Access to Health
Care (Nov. 29, 2016, 11:58 AM), https://
www.plannedparenthoodaction.org/blog/tom-price-trumps-pick-to-lead-hhs-
would-take-away-millions-of-womens-access-to-health-care.
\3\ H.R. 2300, 114th Cong. (2015); Press Release, Price Statement
on Obamacare Repeal, Feb. 3, 2016, available at https://
tomprice.house.gov/press-release/price-statement-obamacare-repeal (last
visited Dec. 5, 2016).
---------------------------------------------------------------------------
As HHS Secretary, Rep. Price would oversee the administration of
Medicaid, but he has a history of working to cut HHS's administrative
and funding roles in that program. The 2015 budget reconciliation bill
that Rep. Price sponsored removed funding for Medicaid expansion,\4\
which has benefited millions of low-income people, disproportionately
women. The House of Representatives proposed budget for 2017, which
Rep. Price oversaw as budget chair, sought to block-grant Medicaid,\5\
cutting funding by more than $1 trillion over a decade and
significantly restructuring the program to allow States to limit
eligibility, reduce or eliminate services, and lower provider payment
rates.
---------------------------------------------------------------------------
\4\ H.R. 3762 114th Cong. 207 (2016).
\5\ H.R. Con. Res. 125, 114th Cong. (2016); see also U.S. House of
Rep. Comm. On the Budget, A Balanced Budget for a Stronger America:
Fiscal Year 2017 Budget Resolution 26 (2016), http://budget.house.gov/
uploadedfiles/fy2017_a_balanced_budget_for_a_stronger
_america.pdf pg. 26.
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As Secretary of HHS, Rep. Price would oversee numerous government
programs that are critical in supporting low-income women and their
families, such as Head Start, child care assistance, the Low Income
Home Energy Assistance Program, and Temporary Assistance for Needy
Families. Rep. Price, however, has a history of proposing cuts to these
key programs. For example, although low-income programs account for
just 28 percent of total non-defense program spending and just 24
percent of total spending,\6\ the fiscal year 2017 budget plan approved
by his committee would take nearly two-thirds of its cuts from low-
income programs.\7\ The brunt of these draconian proposed cuts would be
borne by women, who are more likely than men to be poor at all stages
of their lives due to ongoing employment discrimination,
overrepresentation in low-wage jobs, and greater responsibilities for
unpaid caregiving.\8\
---------------------------------------------------------------------------
\6\ Richard Kogan and Isaac Shapiro, House GOP Budget Gets 62
Percent of Budget Cuts from Low- and Moderate-Income Programs, Center
on Budget and Policy Priorities (Mar. 28, 2016) http://www.cbpp.org/
research/Federal-budget/house-gop-budget-gets-62-percent-of-budget-
cuts-from-low-and-moderate-income.
\7\ Id.
\8\ Katherine Gallagher Robbins and Julie Vogtman, Cutting Programs
for Low-Income People Especially Hurts Women and Their Families,
National Women's Law Center (Feb. 2015) http://www.nwlc.org/sites/
default/files/pdfs/lowincomefactsheet_february2015.pdf.
---------------------------------------------------------------------------
Rep. Price has a record of extreme opposition to women's access to
reproductive health care.
The Secretary of HHS has responsibility over key Federal programs,
such as Medicaid and title X, that ensure individuals, and most
particularly women, receive important preventive care, including birth
control, breast exams, and testing for sexually transmitted infections.
Rep. Price has voted repeatedly to block Planned Parenthood from
participation in these programs,\9\ which directly undermines his
ability to administer these programs. Voting to shut down Planned
Parenthood prioritizes an anti-women's health agenda over individual
access to health care, since if Planned Parenthood were to be defunded,
it is estimated that 390,000 women would lose access to preventive care
within a year and up to 650,000 would face additional barriers to
care.\10\
---------------------------------------------------------------------------
\9\ See e.g., 153 Cong. Rec. 8167 (2007) (voting in support of
Amendment to defund Planned Parenthood in annual appropriations bill);
155 Cong. Rec. 8789 (2009) (voting in support of Amendment to defund
Planned Parenthood in annual appropriations bill); 157 Cong. Rec. 1235
(2011) (voting in support of Amendment to defund Planned Parenthood in
annual appropriations bill); 161 Cong. Rec. 6166 (2015) (voting in
support of the ``Defund Planned Parenthood Act''); 161 Cong. Rec. 6336
(2015) (voting in support of the ``Women's Public Health and Safety
Act'').
\10\ CBO. (2015, September 16). ``Cost Estimate: H.R. 3134 Defund
Planned Parenthood Act of 2015.'' Washington, DC: CBO, https://
www.cbo.gov/sites/default/files/114th-congress-2015-2016/costestimate/
hr3134.pdf.
---------------------------------------------------------------------------
Rep. Price opposes the health care law's requirement that insurance
plans cover birth control alongside other preventive services without
additional cost to the individual. When asked about the benefit, he
falsely stated that ``there's not one woman'' who would be unable to
access birth control without insurance coverage.\11\ In fact, a recent
study found that 20.2 million women in the U.S. were in need of
publicly funded family planning services like birth contro1.\12\ Rep.
Price's comments, by either refusing to recognize the facts or
purposely misstating them, demonstrate he cannot reliably fulfill the
Secretary of HHS's role of implementing the health care law's birth
control benefit and the other programs under HHS purview that provide
women with low-cost or free birth control.
---------------------------------------------------------------------------
\11\ TP Clips, Rep. Price: ``Bring me one woman'' who doesn't have
access to contraception, YouTube (Feb. 10, 2012), https://
www.youtube.com/watch?v=K_mu8CS0aWA&feature=you
tube.
\12\ Jennifer J. Frost, et al., Guttmacher Institute, Contraceptive
Needs And Services, 2014 Update 2016, htpps://www.guttmacher.org/
report/contraceptive-needs-and-services-2014-update.
---------------------------------------------------------------------------
Rep. Price also has been willing to allow the religion of others to
override women's own religious beliefs and ability to access health
services in dramatic new ways. In Congress, Rep. Price voted for a
major expansion of existing Federal laws that allow institutions and
individual health care providers to refuse to provide women with
abortion care.\13\ Therefore, rather than demonstrate that as Secretary
of HHS Rep. Price would enforce existing programs and protections for
women's access to reproductive health care, his record indicates he
would put HHS energy and priorities behind seeking to undermine them.
---------------------------------------------------------------------------
\13\ H.R. 4828, 114th Cong. (2016).
---------------------------------------------------------------------------
Rep. Price's record of support for policies that discriminate on
the basis of sex, includes extreme positions against LGBTQ rights.
Rep. Price has supported legislation that would allow
discrimination against individuals because of their sexual orientation
or gender identity\14\ and co-sponsored Constitutional amendments to
define marriage as between one man and one woman.\15\ When the Supreme
Court decided Obergefell v. Hodges, recognizing the constitutional
right of same sex couples to marry, Rep. Price called it ``a sad day
for marriage.'' \16\ Rep. Price's record is directly contradictory to
the HHS Secretary's role of implementing key legal protections for
LGBTQ individuals--such as the law prohibiting discrimination in health
care on the basis of gender identity--and administering programs--such
as those that provide critical funding for HIV research and treatment--
that benefit LGBTQ individuals.
---------------------------------------------------------------------------
\14\ H.R. 2802, supra note 14.
\15\ H.R. J. Res. 88 109th Cong. (2006).
\16\ Robert Pear, Tom Price, Obamacare Critic, Is Trump's Choice
for Health Secretary, N.Y. Times (Nov. 28, 2016), http://
www.nytimes.com/2016/11/28/us/politics/tom-price-secretary-health-and-
human-services.html.
---------------------------------------------------------------------------
Our Nation's top health official should expand and protect access
to health care and income supports, not undermine it. Given Rep.
Price's extreme record, the Center urges you to reject his nomination
to be Secretary of Health and Human Services.
Sincerely,
Marcia Greenberger,
Co-President.
Nancy Duff Campbell,
Co-President.
Physicians for Reproductive Health,
December 3, 2016.
Hon. Charles Schumer,
U.S. Senator,
322 Hart Senate Office Building,
Washington, DC 20510.
Hon. Richard Durbin,
U.S. Senator,
711 Hart Senate Office Building,
Washington, DC 20510.
Hon. Patty Murray,
U.S. Senator,
154 Russell Senate Office Building,
Washington, DC 20510
Hon. Debbie Stabenow,
U.S. Senator,
731 Hart Senate Office Building,
Washington, DC 20510.
Dear Senators: Physicians for Reproductive Health (Physicians) is a
doctor-led national advocacy organization that uses evidence-based
medicine to promote sound reproductive health policies. Physicians
unites the medical community and concerned supporters, and together, we
work to improve access to comprehensive reproductive health care,
including contraception and abortion, especially to meet the health
care needs of economically disadvantaged patients. We, the board of
directors of Physicians for Reproductive Health, thank you for your
leadership on ensuring access to comprehensive reproductive health
care. We offer our support and solidarity as you and your fellow
Senators and respective committees thoroughly examine and vet cabinet
level appointees during the confirmation processes for the incoming
Trump administration and prepare for the next Congress.
As physicians, we believe that our patients should have timely and
affordable access to the full range of reproductive health care
services, including abortion. Reproductive health care is vital not
only to our patients' health and well-being, but also to that of their
communities. Our patients deserve care that is rooted in evidence and
compassion. We hope that actions taken by incoming cabinet officials
will be based on what is in the best interest and safety of patients
seeking health care, but are deeply concerned by several of the
announced appointments by President-elect Donald Trump.
President-elect Trump's plan to nominate Representative Tom Price
(R-GA) to be the Secretary of Health and Human Services (HHS) signals
an alarming direction for reproductive health. Representative Price has
been a staunch opponent of women's health and the Affordable Care Act
during his time in Congress. Although he has insisted that ``patients,
families and doctors should be making health decisions, not Washington,
DC,'' he has acted directly contrary to this statement by supporting
legislative efforts that interfere with the doctor-patient
relationship. For example, Price has voted for bans on abortion,
defunding Planned Parenthood and their vital family planning services,
and repealing the Affordable Care Act (ACA). He is also a member of the
Association of American Physicians and Surgeons, a group that falsely
claims that abortion increases the risk of breast cancer.
Representative Price, though he is a physician, seems to disregard
the strong medical evidence that access to safe and legal abortion and
contraception protects not just a woman's health, but that of her
family and community. He has even expressed disbelief that a woman
would ever have trouble affording birth control. We can attest to the
difficulties women encountered prior to the enactment of the
contraceptive coverage rule under the ACA. Our patients have benefited
tremendously. The elimination or weakening of this rule would be a step
backward for women's health.
As you know, attacks on access to reproductive care
disproportionately target low-income women, women of color, young
women, and immigrant women, communities that already suffer from health
disparities and inequalities. Should Representative Price be confirmed
as HHS secretary, he would be in a position to create even more
barriers to comprehensive reproductive health care for these
communities. The leader of HHS needs to understand and apply evidence-
based medicine to improve health outcomes, not worsen them.
The plan to nominate Representative Price is part of a disturbing
pattern of appointments in the weeks since the election. President-
elect Trump has also announced plans to nominate Senator Jeff Sessions
(R-AL) to become U.S. Attorney General. Sessions has opposed Roe v.
Wade and protections against clinic violence and supports bans on
insurance coverage for abortion and defunding Planned Parenthood.
Additionally, President-elect Trump has named Betsy DeVos, a supporter
of so-called crisis pregnancy centers that deliberately mislead women
about their pregnancy options including abortion, as his choice for
Secretary of Education.
You have all been staunch supporters of women's health and we want
you to know that Physicians and our members stand with you and will
support your efforts to fully evaluate nominees and advocate against
damaging legislation. In addition to weakening or repealing the ACA and
access to contraceptive coverage, we are alarmed at the prospect of
legislation that would limit Planned Parenthood's ability to provide
vital health services, the reduction or elimination of funding for
title X, further entrenching of the Hyde Amendment, more protections
for those who refuse to provide or insure evidence-based care, and
continued efforts to restrict safe and legal abortion. All of these
measures would be devastating for our patients.
We know that we are entering into a challenging time for
reproductive health care and very much appreciate your service and
dedication. Thank you for your defense of women, their families, and
their communities.
In solidarity,
Willie J. Parker, M.D., MPH, MSc,
Board Chair,
Birmingham, AL.
Jodi Magee, MSW, President
& CEO,
New York, NY.
Curtis Boyd, M.D.,
Albuquerque, NM.
Fredik F. Broekhuizen, M.D.,
Milwaukee, WI.
Michelle Debbink, M.D., Ph.D.,
Ann Arbor, MI.
Duane L. Dowell, M.D., FAAP,
Chicago, IL.
Megan Evans, M.D., MPH,
Boston, MA.
Patricia T. Glowa, M.D.,
Lebanon, NH
Cassing Hammond, M.D.,
Chicago, IL.
Adam Jacobs, M.D.,
New York, NY.
Angela Janis, M.D.,
Madison, WI.
Nazanin Ahmadieh,
Medical Student, Vallejo, CA.
Nancy J. Auer, M.D.,
Mercer Island, WA.
Jill Meadows, M.D.,
Des Moines, IA.
Jason Rafferty, M.D., MPH, EdM,
Providence, RI.
Shayne Sebolde, M.D.,
Nashville, TN.
Nancy L. Stanwood, M.D., MPH,
New Haven, CT.
Michelle Staples-Horne, M.D., MS, MPH,
Decatur, GA.
Alyssa Yee, M.D.,
Brooklyn, NY.
Positive Women's Network, USA,
Oakland, CA 94612,
January 17, 2017.
Hon. Lamar Alexander, Chairman,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Hon. Patty Murray, Ranking Member,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Dear Chair Alexander and Ranking Member Murray: On behalf of
Positive Women's Network--USA (PWN-USA), we write in opposition to
Representative Tom Price's nomination to serve as our Nation's
Secretary of Health and Human Services.
Based in Oakland, CA, PWN-USA is a national membership body of
women living with HIV and our allies that exists to strengthen the
strategic power of all women living with HIV in the United States. We
work to prepare and involve all women living with HIV, in all our
diversity, in all levels of policy and decisionmaking, including
reproductive justice for women living with HIV, which means upholding
our full spectrum of sexual and reproductive rights.
The mission of the Department of Health and Human Services (HHS) is
``to enhance and protect the health and well-being of all Americans.''
\1\ Representative Price's record indicates that he would not serve the
stated mission of HHS.
---------------------------------------------------------------------------
\1\ U.S. Dept. of Health and Human Services. ``About Us.''
Retrieved 12 January 17, from https://www.hhs.gov/about/index.html#.
---------------------------------------------------------------------------
During his 11 years in Congress, Representative Price has
consistently championed policies that would undermine the health and
well-being of women. He has worked to weaken the same programs that he
has been nominated to oversee--programs that tens of millions of people
rely on to protect the health of their families. His record should
disqualify him for the office of HHS Secretary.
Specifically, we are deeply concerned about the Congressman's
opposition to the Affordable Care Act (ACA); his commitment to
undermining Medicaid, Medicare and other key parts of our Nation's
social safety net; and his extreme opposition to abortion care and
access to contraception.
The Affordable Care Act has improved the lives of tens of millions
of people. It has enabled nearly 9.5 million previously uninsured women
to gain access to affordable, comprehensive health care coverage.\2\
Millions now have the peace of mind of knowing that if they or their
family members have a health emergency they will be able to afford
care. Fifty-five million women have benefited from the ACA's coverage
of preventive services, including well-woman visits, screening for
domestic violence, contraceptive methods and counseling, and breast
feeding support, among others.\3\
---------------------------------------------------------------------------
\2\ U.S. Dept of Health and Human Services, Office of the Asst.
Secretary for Planning and Evaluation. (2016, March). Health Insurance
Coverage and the Affordable Care Act, 2010-2016. Retrieved 12 January
2017, from https://aspe.hhs.gov/sites/default/files/pdf/187551/ACA2010-
2016.pdf.
\3\ U.S. Dept of Health and Human Services. (2015, May). The
Affordable Care Act is Improving Access to Preventive Services for
Millions of Americans. Retrieved 12 January 2017, from https://
aspe.hhs.gov/pdf-report/affordable-care-act-improving-access-
poreventive-services-millions-americans.
---------------------------------------------------------------------------
If confirmed, Rep. Price would roll back these important gains for
women and families and strip beneficiaries of important protections
concerning access to coverage and care. His record on these issues is
clear. Rep. Price has voted over 60 times to repeal the ACA.\4\
---------------------------------------------------------------------------
\4\ Planned Parenthood Federation of America. (2016, November). Tom
Price, Trump's Pick to Lead HHS, Would Take Away Millions of Women's
Health Care. Retrieved 12 January 2017, from https://
www.plannedparenthoodaction.org/blog/tom-price-trumps-pick-to-lead-hhs-
would-take-away-millions-of-womens-access-to-health-care.
---------------------------------------------------------------------------
Rep. Price's opposition to affordable health care extends beyond
the ACA. His appointment represents a serious threat to Medicare and
Medicaid. Medicare has delivered life-saving health care and coverage
to millions of older adults--the majority of whom are women--and people
with disabilities, who otherwise could not afford it. Instead of
working to strengthen this vital American institution, as the next HHS
Secretary should, Rep. Price would weaken Medicare through
privatization.\5\
---------------------------------------------------------------------------
\5\ Better Way: Our Vision for a More Confident America--Health
Care. (22 June 2016). Retrieved 13 January 2017, from http://
abetterway.speaker.gov/assets/pdf/A/betterWay-HealthCare-
PolicyPaper.pdf. Rep. Tom Price. (22 June 2016).A Better Way to Fix
Health Care [Press Release]. Retrieved 13 January 2017, from https://
tomprice.house.gov/press-release/better-way-fix-health-care.
---------------------------------------------------------------------------
In addition to his attacks on Medicare, Rep. Price has also
targeted low-income women and families by seeking to cut funding for
Medicaid and to eviscerate the program through the use of block grants
and per capita caps.\6\ Millions of women rely on Medicaid for care
throughout their lives--from reproductive and maternal health services
to nursing home care. Block granting or capping Medicaid would
devastatingly undermine the critical role that Medicaid plays in
supporting the health and well-being of millions of people in this
country.
---------------------------------------------------------------------------
\6\ Ibid.
---------------------------------------------------------------------------
Finally, Rep. Price's extreme record on reproductive health care
alone should disqualify him for the job. Rep. Price has co-sponsored
legislation that would outlaw abortion, stem cell research, forms of
contraception, and in vitro fertilization.\7\ He has vigorously opposed
women's constitutionally recognized right to abortion care, voting to:
deny abortion coverage for women with private health insurance,\8\ ban
abortion care as early as 20 weeks,\9\ and deny low-income women
coverage for abortion care.\10\ He has voted multiple times in favor of
the Select Panel to investigate abortion providers, a partisan witch-
hunt that has harassed and endangered researchers and abortion
providers.\11\
---------------------------------------------------------------------------
\7\ he Right to Life Act, H.R. 552 (2 February 2005).
\8\ Stupak amendment to the Health Care for America Act, H.R. 3962,
(7 November 2009); Camp motion to recommit Health Care and Education
Reconciliation Act, H.R. 4872, (21 March 2010); No Taxpayer Funding for
Abortion Act, H.R. 3, (4 May 2011); Protect Life Act, H.R. 358, (13
October 2011); No Taxpayer Funding for Abortion Act, H.R. 7, (28
January 2014); No Taxpayer Funding for Abortion Act, H.R. 7, (22
January 2015).
\9\ ``Pain-Capable'' Unborn Child Protection Act, H.R. 3808, (31
July 2012); ``Pain-Capable'' Unborn Child Protection Act, H.R. 1797,
(18 June 2013); Motion to recommit the ``Pain-Capable'' Unborn Child
Protection Act, H.R. 36, (13 May 2015); ``Pain-Capable'' Unborn Child
Protection Act, H.R. 36, (13 May 2015).
\10\ No Taxpayer Funding for Abortion Act, H.R. 3, (4 May 2011); No
Taxpayer Funding for Abortion Act, H.R. 7, (28 January 2014); No
Taxpayer Funding for Abortion Act, H.R. 7, (22 January 2015).
\11\ H. Res. 461, (7 October 2015); H. Res. 933, (1 December 2016).
---------------------------------------------------------------------------
Rep. Price is a proven opponent of access to family planning
services, no matter the public health impact. He has repeatedly voted
to defund Planned Parenthood,\12\ which provides essential preventive
health services like cancer screenings, birth control, STI testing, and
HIV testing to 2.5 million people annually. Defunding Planned
Parenthood will have a disproportionate impact on communities that
historically face systemic barriers to care--people of color, people
living in rural areas, and people with low incomes.\13\ He has also
voted to eliminate title X, our Nation's family planning program, which
provides millions of people with basic health care services.\14\
---------------------------------------------------------------------------
\12\ Pence amendment to fiscal year 2008 Labor, Health and Human
Services, and Education Appropriations Act, H.R. 3043, (19 July 2007);
Pence amendment to fiscal year 2010 Labor, Health and Human Services,
and Education Appropriations Act, H.R. 3293, (24 July 2009); Pence
amendment to fiscal year 2011 Continuing Resolution, H.R. 1, (18
February 2011); fiscal year 2011 Continuing Resolution, H.R. 1, (19
February 2011); Enrollment resolution to fiscal year 2011 Continuing
Resolution, H.Con.Res.36, (14 April 2011); Defund Planned Parenthood
Act, H.R. 3134, (18 September 2015); Women's Public Health and Safety
Act, H.R. 3495, (29 September 2015); fiscal year 2016 Continuing
Resolution, H.Con. 79, (30 September 2015); Restoring Americans'
Healthcare Freedom Reconciliation Act, H.R. 3762, (23 October 2015);
H.R. 3762, (6 January 2016); Veto override of H.R. 3762, (2 February
2016).
\13\ Planned Parenthood Federation of America. (2016). The Urgent
Need for Planned Parenthood Health Centers. Retrieved 13 January 2017,
from https://www.plannedparenthood.org/files/4314/8183/5009/
20161207_Defunding_fs_d01_1.pdf.
\14\ Fiscal year 2011 Continuing Resolution, H.R. 1, (19 February
2011).
---------------------------------------------------------------------------
Rep. Tom Price would clearly take our health care system backward.
We urge you to reject this nominee.
Note: Positive Women's Network--United States of America (PWN-USA)
is a national membership body of women living with HIV working to
prepare and involve all women living with HIV, in all our diversity,
including gender identity and sexual expression, in all levels of
policy and decisionmaking to improve the quality of women's lives. PWN-
USA applies a gender equity and human rights lens to the HIV epidemic
to achieve Federal policies grounded in the reality of women's lived
experiences.
Sincerely,
Naina Khanna,
Executive Director.
YWCA USA,
Washington, DC 20036,
January 17, 2017.
Hon. Lamar Alexander,
Hon. Patty Murray,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Dear Chairman Alexander, Ranking Member Murray, and Members of the
U.S. Senate Health, Education, Labor, and Pensions Committee: On behalf
of YWCA USA, team writing to express our opposition to the nomination
of Tom Price for Secretary of the Department of Health and Human
Services (HHS).
As one of the oldest and largest women's organizations in the
country, YWCA USA has significant concerns about Representative Price's
record as a member of the U.S. House of Representatives. Representative
Price voted against the Violence Against Women Act (VAWA) in 2013 and
has led efforts in Congress to limit access to reproductive healthcare.
Representative Price has repeatedly promoted budget proposals and tax
cuts that would cut billions from Medicare, Medicaid, and other
important programs that reduce poverty and hunger. These issues are
central to women's empowerment and to the well-being of millions of
American families, including many of the families we serve.
YWCA is particularly concerned that Representative Price repeatedly
voted to repeal the Affordable Care Act (ACA), despite the harm this
would cause to women's health. A repeal of the ACA, without the
contemporaneous adoption of a comprehensive, well-vetted, comparable
replacement plan, would be detrimental to the health of women across
the country. Any replacement plan must maintain the ACA's provision of
mammograms and other preventative screenings, access to low- or no-cost
birth control and reproductive health care, and other supports for
women's health. A replacement must also maintain the ACA's prohibition
on discriminatory premium rates, to prevent sending us back to the time
when women paid more for their health insurance policies than men,
simply because of their gender. Given the role he is expected to play
in shaping any replacement of the ACA, YWCA USA cannot support a
candidate for Secretary of Health and Human Services who does not
understand these imperatives. Representative Price's record indicates
that he does not.
The Secretary of Health and Human Services is expected to enhance
and protect the health and well-being of all Americans.\1\ YWCA USA
supports the mission of the Department of Health and Human Services and
is committed to the health and safety for all women. Representative
Price's voting record indicates that he is not a leader who will
champion the concerns of women and families if he is confirmed as
Secretary of HHS. As a member of the Senate Health, Education, Labor,
and Pensions Committee, please ask him direct questions regarding the
concerns we have raised in this letter and oppose his nomination as
Secretary of the Department of Health and Human Services.
---------------------------------------------------------------------------
\1\ See ``About HHS'': https://www.hhs.gov/about/.
---------------------------------------------------------------------------
Best Regards,
Dara Richardson-Heron, M.D.,
CEO, YWCA USA.
YWCA USA is on a mission to eliminate racism, empower women, stand
up for social justice, help families, and strengthen communities. We
help overt million women, girls, and their families each year at YWCAs
across the country. To read more about YWCA USA, visit www.ywca.org.
[Whereupon, at 1:54 p.m., the hearing was adjourned.]
[all]