Senate Confirms Tom Price, MD, as HHS Chief

February 10, 2017

The Senate early this morning narrowly confirmed Rep. Tom Price, MD (R-GA), as secretary of the US Department of Health & Human Services (HHS) in a 52 to 47 vote.

President Donald Trump and Congressional Republicans say they will depend heavily on Dr Price as they try to deliver on their promise to repeal and replace the Affordable Care Act (ACA), which the orthopedic surgeon adamantly opposes.

Dr Price is the first physician to head the sprawling agency and its $1 trillion-plus budget since Louis Sullivan, MD, during the George H. W. Bush administration. His experience as a physician was a big reason why the American Medical Association and several other major medical societies supported his nomination. They cited his legislative record in trying to shield the physician-patient relationship from government intrusions.

His nomination nevertheless divided the medical profession, with more liberal physicians objecting to his voting record on the ACA, abortion, LGBT rights, and the Children's Health Insurance Program. In an online survey of almost 1100 physicians conducted by the recruiting firm Merritt Hawkins in December 2016, 46% generally felt positive about Dr Price as HHS secretary while 42% leaned negative. And, significantly, 47% of physicians predicted that he would detract from the ability of patients to obtain access to quality care compared with 42% who believed the opposite.

The biggest controversy that beset his nomination, however, was Dr Price's investments in healthcare companies that struck Congressional Democrats and others as examples of insider trading as well as conflicts of interest, given his role in passing legislation that could help or hurt these companies. Dr Price, along with his defenders, countered that his investments were legal and ethical. He promised that if he became HHS secretary, he would sell his stock holdings in 43 companies to avoid any appearance of a conflict of interest.

As a member of Congress, and recently as chair of the powerful House Budget Committee, Dr Price has sponsored legislation that would supply many of the pieces for any GOP plan to replace the ACA. One Price bill, called Empowering Patients First Act, would allow individuals to opt out of Medicare, Medicaid, TRICARE, and Veterans Affairs benefits and buy a private health plan using tax credits. The legislation also would expand the use of health savings accounts, fund high-risk insurance pools, and allow the sale of health insurance across state lines, all of them favorite Republican prescriptions.

Echoing Trump, Dr Price has said that he wants a replacement for the ACA that wouldn't leave anyone worse off than they were before. So far, Congress hasn't settled on an ACA successor plan. Trump said the White House would issue its own proposal after Dr Price is confirmed as HHS secretary.

Follow Robert Lowes on Twitter @LowesRobert

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