Senate Finance Committee OKs Tom Price, MD, for HHS Chief

February 01, 2017

The Senate Finance Committee today approved the nomination of Rep. Tom Price, MD, (R-Ga), to head the Department of Health and Human Services (HHS) and serve as President Donald Trump's point person in repealing and replacing the Affordable Care Act (ACA).

The 14 to 0 vote reflected the partisan tumult engulfing the nation's capital during Trump's first few weeks in office. All the votes came from Republican members of the committee because, for a second day in a row, the 12 Democratic members boycotted executive sessions to confirm both Dr Price and Steven Mnuchin, the president's nominee for Treasury secretary. Ranking member Sen. Ron Wyden (D-Ore) said the committee should not move forward on the nominations until it addresses "unanswered questions and misleading statements" by both men. Democrats contend that Dr Price has not come clean about alleged conflicts of interest regarding his investments in healthcare companies, which he has denied.

The committee normally needs at least one member from each party present to fulfill its quorum requirement, but Republicans suspended that rule so they could proceed to a vote.

Dr Price's nomination now goes before the full Republican-controlled Senate for a vote. Because the Senate changed its rules when Democrats were in power to exempt cabinet-level appointments from a filibuster, Dr Price needs only a simple majority, or 51 votes, for confirmation. Republicans hold 52 seats.

Just recently chair of the House Budget Committee, Dr Price has been an adamant foe of the ACA and government regulation that he considers burdensome for physicians. Trump has said that once confirmed, Dr Price will work with the White House to introduce a plan to replace the healthcare reform law, one that will provide "insurance for everybody." If confirmed, the orthopedic surgeon would then help implement the replacement plan.

As a congressman, Dr Price has introduced legislation that would allow individuals to opt out of Medicare, Medicaid, TRICARE, and Veterans Affairs benefits and purchase a private health plan using tax credits, a privatization plan similar to what House Speaker Paul Ryan (R-Wis) has proposed for Medicare. Like Trump, Dr Price says a replacement plan should not leave anyone currently insured through the ACA worse off, although Republicans have not yet settled on a way to do that.

Qualified Endorsement From the AMA

A number of major medical societies have lent varying degrees of support for Dr Price's nomination. The American College of Surgeons hailed him as a "stalwart champion for patients and their surgeons." The American Medical Association (AMA) also endorsed him, citing his breadth of medical and legislative experience and commitment to liberate physicians from burdensome regulations.

However, more than 6400 physicians in opposition to Dr Price have signed an online petition saying "The AMA Does Not Speak for Us." These physicians, like their allies in the American Medical Student Association and several other medical associations, criticize what they see as an unfriendly voting record on the ACA, LGBT rights, abortion, and the Children's Health Insurance Program. In response to the furor, the AMA qualified its endorsement by saying it does not necessarily agree with Dr Price on every policy matter.

Dr Price's perceived conflicts of interest are another point of controversy. He has invested in a number of healthcare-related companies that stand to gain by legislation or regulations that he backs. Dr Price argues that his investments have been legal, ethical, and aboveboard. With one exception, he said, his broker has picked the healthcare stocks in his portfolio.

That one exception, however, has generated the most heat. Dr Price owns an estimated $500,000 worth of stock that he personally bought in an Australian company called Innate Immunotherapeutics, which is developing a drug for secondary progressive multiple sclerosis. Most of that stock was purchased at a significant discount in a private placement — a sweetheart deal, according to Democrats — made available to him and fewer than 30 other "sophisticated US investors," including Rep. Chris Collins (R-NY), who sits on the company's board of directors.

Earlier this month, Dr Price told the US Senate Committee on Health, Education, Labor and Pensions that the stock price he got "was available to every single individual that was an investor at that time." The Wall Street Journal later reported that the company indeed offered the discounted price to all shareholders in Australia and New Zealand, but that only Dr Price and the select group of US investors had received an invitation to participate in the deal.

Dr Price supported passage of the 21st Century Cures Act, designed to speed up drug approvals by the US Food and Drug Administration. The law, written in part by Collins, presumably would benefit Innate Immunotherapeutics in seeking to market the drug here.

Dr Price promises that, if confirmed as HHS secretary, he would sell his holdings in Innate Immunotherapeutics and 42 other companies to avoid any real or perceived conflict of interest.

Follow Robert Lowes on Twitter @LowesRobert

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