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tv   HHS Nominee Representative Tom Price Testifies on Capitol Hill  CSPAN  January 18, 2017 10:03am-1:59pm EST

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[gavel] >> the hearing will come to order. the committee on health, education, labor, and pensions will come to order. today, we are reviewing the
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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 with you. i enjoyed having the opportunity to visit with you in my office and learn about your plans. dr. price will be introduced today and a few minutes by a member of this committee and dr. price plus his home state senator. isaac introduces the nominee, senator murray and i will make a few introductory remarks. after the nominee makes his will have a usual round of questions. let me say something about that round of questions. last night, we had a hearing of 3.1 hours. i tried as chairman to be fair by following the same precedent
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we had with president obama's two education nominees by having one round of five questions followed by senator murray and me asking questions and wrapping up. i do not want to argue that again because we spent a lot of the 3.5 hours arguing about the 3.5 hours. i have listened carefully to what my colleagues have said and i look back for the health of human services secretary, when that person came before our committee. secretary burwell has one round of questions. , asking a question. six members ask questions in the second round. members ask a second round. what i decided to do in an
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effort to treat president-elect as wes nominee the same treat other nominees is to have a single round of seven minute questions, with secretary thompson, and that seems to me to give everyone in the senate more time to ask questions with the secretary. this is a courtesy hearing. dr. price will be before the finance committee on next tuesday. a number of members of this committee are also members of the finance committee. they vote on his nomination and we will be the ones who reported to the floor if that is their decision. wehave the hearing because have some of the health care jurisdiction, important parts of it. we would like to talk to him about especially those issues.
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he has all of his paperwork in place before the finance committee, including the letter of agreement with the office of government ethics, available to this committee as well as others. for the seven minute of -- 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. confirmed, to lead the department of health and human services, you will run an organization that spends $1.1 .rillion a year that has always troubled me,
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that you will be in charge of spending more than congress actually appropriates every year. by that, i mean the part of the budget we re-appropriate which is under good control, the part that has national defense, national institutes of health, national laboratories, over the last several years, that part is rising at about the rate of inflation. it is not adding to the budget. it is about one third of the total government spending. a little less than the amount in your department every year. mandatoryich is spending, which is going up at a rate like that while the rest of the budget is going like this. you will be overseeing medicare and medicaid. substance abuse programs. we enacted in december of last year and the president signed that -- important of
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the fda, we made important them newgiving pay they to hire and experts they need to move devices through the fda at a rapid rate getting those into the medicine cabinets of the doctor's office. that was the doctor passes number one priority for we passed that into law in december. then the implementation of obama toe and various proposals replace it with concrete, practical alternatives. dr. price, i believe you are an
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excellent nominee for the job. or to peopleicing -- orthopedic surgeon for more than a decade. i read about the resident doctors in training who you taught. you served as medical director of the orthopedic clinic at the memorial hospital. you were chairman of the budget committee and have been a leader in deliberations over the future of our health care system. you know our subject very well. one of the first responsibilities you will have about how your advice to repair the damage the affordable care act has caused so many americans and how to replace it or to replace parts of it, concrete practical alternatives that give americans more choices of lower cost insurance. let me give my view about how we might proceed and during the question-and-answer session, i
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will ask you more about your view. following the presidential election, president-elect trump said on 60 minutes that replacement and repeal of obamacare would be done simultaneously. to me, that means at the same time. recently, speaker of the house paul ryan said the repeal and replace of obamacare would be done concurrently. senator mcconnell said last week that we need to do this probably but in manageable pieces. i am trying to interpret what the words mean. to me, that means obamacare should be finally repealed only when there are concrete tactical reforms in place to give americans access to affordable health care. the american people deserve health care reform done in the right way, for the right reasons. in the right amount of time. developing aut quick fix. it is about working toward
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long-term solutions that work for everyone. whatay to think about simultaneously and concurrently mean is to think about obamacare the same way you think about a collapsing bridge in your hometown. that is just what is happening with obamacare in my home state and in many other states. to the insurance commissioner, the obamacare insurance market in our state is very near collapse. andss the country, premiums co-pays are up and employers have cut jobs in order to afford the mandates of obamacare. consumingandates are state budget spirit one third of american counties, citizens of federal subsidies have only a to buychoice of company insurance from on the obamacare exchanges. without quick action next year, there may be zero choices on those exchanges.
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there subsidies may be worth as much as as a bus ticket in a town were no buses run. in georgia or in tennessee, very near collapse, the first thing we would do is send in a rescue crew to repair the bridge temporarily so no one else is hurt. better would build a bridge or more accurately in the case of health care, many bridges to replace the old bridge. finally, when the new bridges are finished, you would close the old bridge. that is how i suggest we proceed . rescue those trapped in a collapsing system. replace the system with .unctional markets as states develop their own plans for providing access to truly affordable health care. then repeal obama care for good. rescue plans so 11 million americans who buy canvidual insurance now,
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continue to do so while we build a better set of concrete, practical alternatives. build betterould systems, providing americans with more choices of insurance that cost less. note that i say systems. not one system. if anyone is expected senator mcconnell to roll a wheelbarrow and to the second floor with a 4000 page copper has a republican health care plan, they will be waiting a long time because we do not believe in that we do not want to replace a failed washington, d.c. health care system with another failed washington, d.c., health care system. so we will provide america with more choices of insurances that cost less and we will do this by moving more health care decisions out of washington dc into the hands of states and patients there -- thereby reducing taxes. we will do this carefully and step-by-step so it is effective.
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we should then repeal what remains of the law that did the damage and created all of this. i know the president-elect has said that after you are confirmed, which i hope is early in february, that he will propose a plan in congress. to that.rward us us whatcannot tell the plan is today. i look forward to hearing from you how you suggest we approach this. we want to do it right and do this carefully and adequately so americans have concrete practical alternatives in place of what is there today. we want to make sure that the ares of obamacare that repealed are replaced before the repeal becomes effective. senator murray. sen. murray: thank you very much, chairman alexander, and all of our colleagues joining us
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today. congressman price, congratulations on your nomination. thank you. speak about this nominee, i want to say that we remain deeply disappointed in last night, where democrats were blocked from asking more than one round of questions. the nominee for secretary of education. disappointed that we are rushing this hearing as well. chairman, you said seven minutes but i will just say, i do not think any of us in prior 22, everthat you keep thought, if i don't ask for another question, i have just set a precedent. i think there is no example of any senator asking to do a question before and being turned down. the nominees, a new administration, deserve to be asking questions, scrutinized in public before we have a choice
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to make on the floor of the senate on both sides of the aisle in terms of whether we vote yes or no. we take it is important we are allowed the opportunity to ask second rounds of questions after we have heard all of the questions. have three or foure committee hearings going on at the same time. , ins extremely challenging a subject that we care deeply about. i would like to point out again that several nominees that have come before, we will talk about secretary leavitt, church of you secretary,second five bipartisan senators participated in a second round. obama'sident nominee's first secretary. again, it is unprecedented for a chairman to turn down a member who has a question to ask.
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for the record, i would like to ask consent to put parts of the record of the nominees of michael leavitt, and tom daschle into the record of the hearing. 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, for him to be there. that is why it is so important to members of our community. having said that, i want to say the health of our families and communities could not the more important. when a young child goes to school healthy and ready to .earn, she is better prepared when women are empowered to pursue all of the dreams, our community benefits. when workers asked for quality
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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 most vital responsibilities. the department of health and human services has a critical role to play in ongoing work to meet each of these goals and many more. that is why evaluating a nominee for secretary of health and human services, i consider whether the nominee has a record of putting people first and not politics or partisanship or those at the top, whether they will put science first and not ideology, and whether their vision for the health care in our country would help more parents get quality health care or take us backward. price, i have serious concerns about your qualifications and plans for the department you hope to lead. i look forward to hearing from you today on a number of topics.
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i start by laying out issues of what your record suggests about your approach to our nation passes 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 lose health care coverage and even though more and more members of your own party are expressing serious doubt about the ability to unify the plan and knowing in a matter of weeks, you could be leading the department whose core responsibility is to enhance america's 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 republican efforts could cause. president-elect trump and republican leaders have promised the american people that their plans would somehow do no harm
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and would not cause anyone to lose coverage. just days ago, president-elect trump promised insurance for everybody. your own proposals would cause millions of people to lose coverage and force many people to pay more for their care and leave people with pre-existing conditions phone or both to insurance companies rejecting them or charging them more. be interested in hearing your explanation of how you have your plans for how we can keep the promises your party has made to the american people about their health care. issue i is another would be interested in hearing about today. president-elect trump campaigned on promises to protect medicare and medicaid. you have said you plan to in the firstcare 6-8 months in this administration in a way that would end the guarantee of full coverage that so many people and people will with disabilities
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would rely on. you put forward policies that would shift one chilean dollars in medicaid costs to our state, squeezing their budgets and taking coverage away from struggling children and workers and families. while president-elect trump has said medicare should be able to negotiate jog prices for seniors, you have opposed efforts to do that and went so far as to call legislation on that issue a solution in search of a problem. i disagree. it is absolutely critical for families in my home state, and i am eager to learn how you will reduce the cost of prescription drug costs in our community can it as a woman, mother, grandmother, and united states senator, i am deeply troubled by the ways you policies would impact women's access to health care and reproductive rights here and i have serious concerns about your understanding of
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women's need for basic health care like birth control, given your expressed doubts on the topic. your proposals to make women pay extra, out of pocket for birth control, and your repeated efforts to defund our nation passes 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. hear from you about whether and how you will uphold the gold standard of fda approval and, for example, how would you approach important programs and rules intended to keep tobacco companies from luring children. finally as i discussed in the hearing yesterday, i believe firmly that especially as the president-elect tries to blur the president-elect tries to blur lines around conflict 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.
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that is 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. muckler, they heard loud and clear from people across the country that it was not acceptable and they backed down. the office of congressional notcs has now been asked only by democrats but by 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 for your nomination to be delayed until such an investigation is complete. that disappointing to us 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 explanation. outlined a few of my
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questions and concerns about this nomination. i know in light of republican efforts, to take our health care system in a vastly different and harmful direction, that are shared by many to across the country who cannot be here today . it is crucial that the voice of the 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 cabinet nominees. i want to say i am pleased that tomorrow, senator warren will host a forum with witnesses who can speak to the impact of health care providers like land parenthood. donemportance of the work to expand access to mental health care and substance abuse treatment and the way in which full guarantee of medicare helps keep them financially and physically secure. there are stories across the country of lives saved and
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strengthened because of the progress we have made to expand quality affordable health care. i urge my republican colleagues to attend and prioritize what is men and women and families, not what is best for politics as they consider each of the decisions in the coming weeks. congressman price, as we begin this hearing, i would ask you to bs transparent and frank as possible about your views and your plans for the department and your -- urge you to provide us with additional information and answers, to any follow-up questions we have, in a timely manner. i look forward to what i hope will be a rigorous and open theussion today and i hope -- thank you.der: would like to put into the information from the last six hearings, without going
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into detail, one round of questions, secretaries of billy one round with one member, a second round, one round us three, leavitt, six members asked a second round, thompson, one round of seven miniature -- minutes each. my decision is rather than give six of 23 members a second round, that it would be better to let every senator have seven minutes. now, senator isaac. sen. isaac: thank you. i would like to ask consent of the remarks. becauseinto the record i will not read them. i have the unique honor and privilege to introduce a friend of mine for 30 years, someone i
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know to be a great politician, a great practicing legislator, a great family man and a great friend of mine and it is an honor to do so. -- nt to have each of you i think you will be impressed with what i hear -- with what you hear. i approach the introduction, if i am being asked what i would look for and somebody i want to trust with one truly -- $1 billion -- one troy dollars of my money, the quality of health care and the future of america quality of health care care, i look for five things. first, does this man understand the american family? not only does he, but his wife that he does. stand up. understandsl you he the family. his son, robert, is not here because he is singing country music and writing country music songs. he is a fine young man i enjoy working with. tom is a great family man. remember the debtor a member of
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the united methodist church, active in his community, doing what is right for his community, he is a man who understands the value of health care to every family. $1 trillion is a lot of money, pulling you get to $1.1 trillion, while wary? it is a lot of money. he has been sharing the budget committee. for manyprobation years and has run one of the largest medical practices in the state of georgia. tom price put together what is known as resurgence orthopedics,. they save my son's right leg in the mobile accident. it is ade it -- practice set up as an example of how to do medicine the 21st century. the nominee understands the health care business to better to understand than a doctor?
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even better, a doctor married to another doctor? comment that the met -- tom and betty made at the hospital and fell in love there and the love with the practice of medicine. i watch them dissipate in activities for the state. whether elected or not, they contributed to the betterment of possible dose in our state, like freddy moore hospital, the largest, center in the state of georgia, saving lives every single day. it would not have been it today if it were not for people like tom price, who gave time and effort to raise the money necessary to keep it open. they have some experience with the legislature because if you to come in services and convinced them of that we need to do to change the law, that is a tall order. you want to find some who served in public office. tom was the first elected republican leader of the georgia state senate in the citizenry of our state and served on the congress.
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he improved the six district remarkably when i left when he was elected to replace me. wayintellectual level went up when he came. i promise you. he has been reelected seven, six times to the house of representatives as budget chairman, study committee chairman and an active member of the united congress to the united states of america. believes in accountability. tom price believes in accountability, one of the rare ones. he may be the only one of us and i know it is true, that reads all the bills. when i need to know something about the bill, rather than read, i call tom price because i know he has read it. sometimes he is boring, but always knowledgeable because he does his homework, desert it right and believes in his responsibility. [laughter] i would mention a couple of things that have been set negative and i will address them because they are wrong. chuck schumer took this case of cymer and made it -- zimmer
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biomed, a stock that tom price asterisk manager -- tom price's manager managed for him. it is called desperate empires come or you take to the fact that are unrelated, put them together to indict someone for a wrong, when nothing was wrong. biomed, the stock without, took place tom's knowledge. his knowledge was one month later and he did not know about it at the time it was made, so the allegations that were made yesterday on the floor of the senate are wrong by taking to the correct things put together to make incorrect. second, something has been said that i have working knowledge of, tom was accused of not being supportive of saving social security for seniors.
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i am 72 years old and i would not talk about someone disapproving of social security. tom price and i got a phone call eight months ago from aarp asking if we were traveling to townhall forums on saving social security. why would someone call tom price, a congressman, art johnny do tom, a senator, to -- townhalls meetings about saving social security if they do not want to save social security? lastly, one of the best votes i cast four years ago was for sylvia burwell. when she came forward and the senate committee on the house, she is an articulate and intelligent lady. there was a lot of reason for me as a republican in the minority sheote against her because is a democratic nominee, but i listened to her answers, studied her history, watched her actions, and i proudly voted for
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her. today, she is a professional friend of mine and we will miss her in the office, but there is no one better qualified to replace soviet burwell the tom price. i voted or soviet burwell of pride and know about the tom price of pride because i know he is the right man for the right job, at the right time, for america. he is my friend and i commend him and i urge you to vote for him in his confirmation. you, senator thank isakson. much better than whatever was written for you to say. [laughter] dr. price, welcome to the committee. you, mr.: thank chairman. all members of the committee, i want to thank you for the opportunity to speak with you as thend engage and ranking member said about the discussion about the road ahead for our great nation, i want to thank senator isakson for his great introduction. am grateful for his friendship, kindness, and our state is blessed to have had his service
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and his leadership. i also wish to think my wife, betty 33 years -- my wife , for 33 years, and her love means more to me than i could ever say. over the past few weeks, i met with many of you individually and have gained a real appreciation for the passion you have for the department of health and human services. thate, no that i share passion play that is what i'm here today and honored to be the nominee for secretary of health and human services. we all come to public service in our own unique ways that in form who we are and why we serve. i first professional calling was to care for patients. that experience as a position and later as a legislator has of thed a holistic view complex interactions that take place every day across our communities.
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today, i hope to share with you, experience has helped shift me and my understanding and of theation for the work department of health and human services. from an early age, had an interest in medicine. my earliest memories or of going up on a farm in the state of michigan. we lived on a farm in michigan before he moved to suburban detroit when i was fighters old. i spent most of my formative years being raised by a single fondest some of my memories are spending time with my grandfather, a position. -- a physician. when i was young, we would spend weekends with him and we would go on rounds, which at that time meant house calls, so we would drive up to houses and i was -- the memories i have of individuals opening the door 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 called home for 40 years. that is where i met my wife, we raised our son, and i did a residency at emory university and grady memorial hospital,
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returned to serve as the medical director of the orthopedic clinic. throughout my career, i treated patients in all walks of life, including so many children. anyone who has treated a child knows the joy you have when you are able to tell the mom and dad that we have helped saved their child or helped their child back to helpfulness. my memories at grady are full of the gracious comments of patients and parents with a team of health care specialist had the privilege of working. after 25 years of school and training, i started a work practice. the practice group, as senator isakson mentioned, and became one of the largest nonacademic orthopedic groups in the country, for which i would serve as chairman of the board. during 20 years as a practicing physician, i learned a good about not just treating patients with about the broader health care system and where it intersects with government. the couple of vivid memories stand out.
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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 is getting between the doctor and the patient and making decisions, whether the insurance company or government. thathen there was the day i noticed my office, the mid 1990's, when i realized there were more individuals behind the door where the clinical work was going on seeing patients than in front of the door, and those folks were filling out forms and making certain that we were checking all the boxes and either challenging are arguing with insurance companies or the government about what was in the best interest of the patient. me that ourear to health-care system was losing focus on its number one priority , and that is the patient. as a result, i felt compelled to broaden my role in public service and help solve the the delivery of medicine comes iran for the georgia state senate. i found the state senate in
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georgia to be remarkably bipartisan and collegial relationships were the norm. this is the environment i learned to legislate, reaching across the aisle to get work done. in congress, i was fortunate to be part of the collaboration that broke through party lines to solve problems. this past congress, there was a bipartisan effort that succeeded in reading medicare of a broken physician payment system and has 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 would be to carry to the department of health and human services both been appreciation for bipartisan team driven policymaking in what has been a lifetime commitment to improving the health and well-being of the american people. that is for the six principles of health care, affordability, accessibility, quality, responsiveness, innovation, and choices.
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the health and human services is more than health care. ther real heroes of department doing incredible work to keep records safe, develop new drugs and treatment options, driven by scientists, conducting remarkable research. they are heroes among the talented dedicated men and women working to provide critical social services, helping families and 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 and improving lives they must carry up responsibilities with compassion, efficient and effective and accountable. withll as willing to work those in communities already doing incredible work on behalf of their citizens. the cross the spectrum of issues and services that the 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 a senior citizens, and to those most in need of meansnd support, and that
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saving and strengthening and securing medicare for today's beneficiaries and future generations. nation'sensuring our medicaid population has access to the highest quality care, maintaining and expanding america's leading role in medical innovation and treatment of radical disease. i show your passion for these issues, having spent my life in service to them. there's no doubt we do not all agree or share the same point of view when it comes to addressing every one of these issues. our purchase the may differ but surely, there exists a common commitment to public service and compassion. we can helpthat 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 their assistance and what god's will, we can make it happen, and
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i look forward to working with you to do just that. you mr.rman, thank chairman: for the opportunity to be with you today. two ui, dr. price. we will begin a round of seven minute questions and i begin -- let's have about the affordable care act and health-care system. my belief is that the historic mistake in passage of the affordable care act was it sought to expand the system that already cost too much. what is our goal here of those who want to repair the damage of obamacare and replace parts of it? the cost ofer insurance for americans? it is to give them more choices of that lower-cost insurance? and is it to put more decisions in the hands of states and into the hands of patients? dr. price: thank you, mr. chairman. the issues you raise with the choices and access and cost are at the heart and center of where
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we ought to be putting our attention. the sixtioned in principles i have for health care, affordability is incredibly important. it is no good if you cannot afford health coverage and acceptability is imperative. today, many folks have coverage but is they don't have access to the positions they would like to see. choices are vital. mr. chairman: isn't one of the primary means for achieving those choices moving more health care decisions out of washington and putting them back in the hands of states and patient consumers? dr. price: in many instances, the closer you can have those decisions to the patient, keeping the focus on the patient, the better. mr. chairman: if responsibilities are headed toward the states, would that not necessarily involve a fair amount of extensive consultation with governors and state insurance departments about how to do that and what implementation schedule ought to be? dr. price: absolutely.
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folks at the state level know their populations better than we can know them. mr. chairman: senator mcconnell said obamacare would be replaced and appealed and manageable pieces. i want to suggest pieces on a chart back here. looks to me there are four major areas where americans get our health care insurance and when this medicare. 18% of americans. one is employer insurance, 60 1% of americans get their insurance on the job. -- which isaid, and 22%, and one is the individual market, only 6%, and the exchanges we hear about are only 4% of that 6% but that is where so much of the turmoil is. to me ask, is this the bill reform medicare? dr. price: absolutely not rated -- absolutely not. mr. chairman: so we would focus on medicare, medicaid and
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individual -- are those accurate categories or would you categorize them in a different way? dr. price:-groep to address if they are in the individual or medicaid market. mr. chairman: is it possible to work on one of those areas at the time rather than in the conference of -- or let me put it this week, don't expect senator mcconnell to wheel and a wheelbarrow with a big, conference of republican health care plan and that is because in my opinion, we don't believe in are placing the washington, d.c. health care plan with their 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 is fair. for individuals -- 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 is to go from what we see as a democrat health care system to an american health care system that recognizes the
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needs of all. mr. chairman: i know your plan will not be presented until after you confirmed, but the president-elect has said let's do a repeal and replace simultaneously. that anyat must mean repeal of parts of obamacare would not take effect until after some concrete, practical alternative for in place for americans to choose. is that accurate or do have a different idea of what simultaneous might mean or what the sequencing might be as we move through this process? dr. price: i think it is fair. one of the important things 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 is imperative that individuals who have health coverage be able to keep health coverage and hopefully move to greater choices and opportunities for them to gain the coverage they want for themselves and families. i think there has been a lot of
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talk about individuals losing health coverage and that is not our goal nor our desire or plan. mr. chairman: let me ask you about how long it will take, repairing the damage, working on these three big areas, individual market, medicaid and employer. i sense is we have been working on this so long, although we have different opinions about this, we ought to make most of our votes in the next months about what to do but that the implementation of whatever we decide, especially since it will be going some of it back to the states, the department you hope my take several years, is there a difference between the boats and a longer time of implementation of what we do? dr. price:dr. price: i think it is fair. i would point out that our health care system is continually evolving and shade. we ought to be always looking at how it is working, whether it is working for patients, and whether it is working for are working to
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provide the highest quality care for books. when it is, that is fine. when it isn't, that is incumbent on policymakers to make sure to do the kinds of things to adjust that policy so it can work, especially for patients. mr. chairman: my last question is about the 6% individual market, obamacare exchanges are about 4% of all of us who have insurance. our insurance commissioner in tennessee says the market is virtually collapsing. i am told by many people that we need to basically have a rescue plan, a reform plan for the individual market in place by march 1. so that insurance companies who make their decisions by the year 2018 can make those plans so that people have insurance to buy in knowledge the states. do you agree that the market is collapsing and we need a rescue plan and that march 1 is an important approximate date for decision of action? dr. price: we are seeing changes in individual and small group work its adverse to the patient,
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whether it is decreasing access to coverage, increasing premiums, higher deductibles, something is going badly wrong is imperative it for us to recognize that and put in place the kinds of solutions that we believe to be most appropriate. mr. chairman: and your plan that we are likely to see in february will include recommendations for how to do that? dr. price: should i be given the honor of meeting with the human and help services, we look forward to working with congress to come forward with the plan. mr. chairman: thank you, dr. price. senator murray? senator murray: i would like to put a letter from chairman aexander on the importance of second round of questions on this nominee, and ask the consent to for the record, 25 lenders signed by organizations opposing congressman price's thenation to lead department of health and human services, and have a petition signed by 500,000 people from
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across the country opposing this nomination and i asked to put it in record. mr. chairman: it will be. murray: recent reports about your investments in the australian biotech company raises some serious questions about your judgment, and i want to review the facts. you purchased stock in a therapeutic company working to develop new drugs on four separate -- occasions between january 2015 in august 2016 and you made the decision to purchase an opera, yes or no? dr. price: that was a decision i make, yes. senator murray: you are offered the opportunity to purchase stock at a lower price than the no?ral public, yes or dr. price: the initial purchase and generates many 15 was at the market price. the secondary purchase in june ofough august, september
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i-16 was at a price available to individuals participating in a private basement offering. senator murray: lower than available to the general public, correct? dr. price: i do not know that it was, it was the same price that they had for the private place offering. senator murray: he is an investor and board member of the company, and he was reportedly overheard just last week on the house floor bragging about how he had made people millionaires from a stock tip. congressman price, in our meeting, you informed me you made the purchases based on conversations with representative collins, is that correct? dr. price: no. matt schlapp that is -- senator murray: that is what you said to me in my office. dr. price: what i believed i said to us that is what i want from representative collins. senator murray: i recall you had a conversation with collins and then decided to purchase the stock. dr. price: that is not correct. senator murray: that is what i
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remember you say in my office. in that conversation, did representative comments tell you anything that could be considered "a stock tip," yes or no? i do not believe so, no. dr. price: senator murray: if you are telling me he gave -- dr. price: i do not believe so, no. senator murray: if you're telling me that you bought those shares, is that not a stock tip? dr. price: that is not one happened. he talked about the company and the work they were doing and tried to solve the problem of secondary scoliosis, a debilitating disease and when i had the opportunity to treat patients -- senator murray: i am aware of that. dr. price: and it has a significant merit and promise and purchased the initial shares on the stock exchange. senator murray: congressman price, i have limited time. your purchases occurred while the 21st century cures act, which had several provisions that could impact drug developers like inmates therapeutics
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and days before you notify to have a final vote on the bill. do 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 is not what happened. senator murray: let me say i believe it is inappropriate and answers to this regarding whether you and congressman collins used your access to nonpublic information when you bought prices -- but at prices and available to the public. dr. price: i had no access to nonpublic information. senator murray: well, we were gone. congressman price, lastly, 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 and raise health care costs for families, without
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time the record before 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 wears off. days ago, president-elect trump said his plan would provide insurance for everybody. do you share those goals? dr. price: i think it is imperative 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 for the coverage they want. senator murray: you share his everybody?urance for dr. price:dr. price: that has always been my stated goal to what i worked on my entire public career. senator murray: if you repeal plan was signed into law, would you consider these commitments to ensure all americans live no one worse off? dr. price: the goal of the bills that i have worked on in congress and understanding the role that and give -- senator murray: i asking -- dr. price: my role in congress was to make certain individuals had the opportunity to gain access to the kind of coverage
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that they desired and that they had the financial feasibility to do so. that is what is different about the plans are put forward. senator murray: i think it is important we have clear answers, so your bill only allows people conditions tog obtain health insurance if they maintained continuous insurance for 18 months prior. millions of americans at the existing health conditions lacked health insurance and under your plan, they could deny those americans coverage for pre-existing conditions, yes or no, under your bill? dr. price: it is a broader question because we would put in high-risk pools and individual post that would allow every individual in the small group individual market and those challenge of facing on this to gain access to the coverage they want, so he believed through the plan that every single person would have the opportunity and financial feasibility to get the coverage that they want. senator murray: we disagree on the consequences of that. repeal -- your
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bill would repeal coverage available to adults up to age 26, correct? dr. price: the bill i authored did not include coverage of to age 26, the insurance companies said they were working that and including that in their plans going forward, so we felt it was covered. senator murray: your bill takes only current benefits, which include prescription drugs, mental health, substance abuse disorder, benefits and trinity coverage, among others, correct? is different in the legislative arena than administrative, but we would put factors in place that would measure individuals have the care and coverage needed. senator murray: i disagree with the consequences but your bill to not cover that. your builder appeals 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, a larger question because we would put a different construct in place that would allow every single
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person to gain access to the coverage they want and have nobody fall through the cracks. senator murray: just with these questions, i'm concerned your vision for a health care system is very different and when i think millions of americans are accounting on. mr. chairman: thank you. senator enzi? you, mr.nzi: thank chairman and dr. price for being willing to serve and go through this process. i call this gotcha management. barred and the idea is to get you to take questions on short notice, and public, that you would not have done what you normally do. i work to do for the last two years, immediately do at least once a week. every week we have been in session, so i know how you operate and i appreciate how you operate, and the care and the
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focus and the concern and how comprehensively you think about .he medical things one of my concerns is the rural areas because wyoming is the most rural state in the nation. i hate to do that -- i hesitate to do that because last night at the education hearing, i got to , whofrom mrs. devos remembered a conversation from a month before that i had on the rural problem, which dealt with grizzly bears by the property school in wyoming and that became a major topic around here. i am glad everybody recognizes that need and concern. part of the story was that that is the grade school that former senator craig thomas went to, and when he was there are different kinds of
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problems in different kinds of places in the health care area. i have a county the size of delaware that has one community with 2500 people. it does have a hospital, but when you have a rural community, a rural county that big with that small of a town, it is difficult to keep a doctor without at least a pa, the hospital has to close. if that hospital closes, emergency care is 80 miles away. not a likely story and most of the places and we need to make sure 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 had left a very successful practice and were willing to
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come back here to try to make a difference and i want to congratulate you on the difference you have made. now, one of the questions i would ask you is why are you willing to leave a place with so much responsibility and to beound and capability willing to be the secretary of health and human services? rep. price: thank you, senator. when i think about the mission of the department of health and human services to improve the health, safety, and well-being of the american people, it's what i've literally spent my life trying to do, so to have the opportunity to participate, if confirmed, to service 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 fulfilling or exciting. senator enzi: i think you have
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the background for doing that, given your background in the wide range of hospitals and practices and then coming here and going through a number of different committee situations. what you are about to go through is a rather intense and that is followed by the most productive part, if senators happened to read the answers, and that is when we get to do written questions, which we hope you will provide a rapid response on. those are not nearly as much fun for the panelists because they are not in public. i will move to some questions that are a little bit more related here. we begin the serious and challenging task of restoring the health insurance markets, which are teetering on the brink. some counties, you can't get coverage. in wyoming, there is only one provider and it is my understanding that the incoming
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administration may have the ability to make key policy changes, some of the most critical changes for short-term stabilization might include reducing the number of special enrollment periods and requiring upfront verification or aligning state law.ds with my understanding from those in the insurance business is it is health andtions by human services may provide meaningful changes that could impact premiums for the next year. of those options you might consider? rep. price: absolutely. are deciding right now as they come forward in march and april with the premium levels will be for 2018. what they need to hear from all of us is a level of support and stability in the market, the kinds of things that are able to provide stability.
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there are counties in the state where there are only one provider. must, as policymakers, ask what is going on. where are the problems out there? that may work for the insurers in certain instances, but it does not work for patients. if we keep the patients at the center, we will get to the right answer. senator enzi: i appreciate that. i got to work with senator kenzie for many years desk kennedy for many years -- senator kennedy for many years on biologics. the fda has issued guidance .ocuments since the law passed
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i was concerned that in 2017, having gone near death through nearly two president -- having gone through nearly two presidential terms, we finally got a draft. i will ask that question in writing. rep. price: thank you very much. thank you, mr.: chairman to read congressman price, think you for the conversation we had the other day. , 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 will be inaugurated this week. he won a number of states by rather slim margins.
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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. , "iay 7, 2015, he tweeted was the first and only potential gop candidate to state there would be no cuts to social security, medicare, and medicaid go on april 18, 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 is not fair to the people who have been paying in four years." "i will save medicare, medicaid, and social security without cuts -- we have to do it, people have been paying in four years and many of these candidates want to cut it."
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"paul ryan 2016, wants to knock out social security, knock it down, way down, he wants to knock medicare down, way down, number one, you were going to lose the election if you are going to do that, i'm not going to cut it, i'm not going to raise ages, i'm not going to do all of the things they want to do, they want to cut it very substantially, i'm not going to do that." point being, this is not something he said in passing. theink it is likely he won election because millions of working class people and senior citizens heard him say he would not cut social security, medicare, and medicaid. a simple question. is the president-elect 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? have not had
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extensive discussions with them about the comments he made, but i have no reason to believe that he has changed his position. senator sanders: to the best of your knowledge, you are telling us, mr. trump will not cut social security, medicare, and medicaid. rep. price: i have no reason to believe that that position has changed. wrote --anders: quoting mr. drum or at least paraphrasing, last week, he said , pharma is getting away with murder. you recall that tweet? rep. price: i do. sanders:-- senator there are many of us on our side of the aisle that are working on legislation to end the absurdity of the american people being ripped off by the pharmaceutical industry, who two years ago made $50 billion in profits, while one out of five americans can't afford to fill their prescriptions that doctors right. will you and will the
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president-elect join us in legislation we are working on, which would allow medicare to negotiate prices with the drug companies and lower prices and allow the american people to bring in less expensive medicine from canada and other countries? is that something you will work with us on? rep. price: issue of drug pricing and drug cost is one of great concern to all americans. i think it is important to appreciate the areas where we have had significant success. whether it is the generic areas -- senator sanders: you are aware that we are paying by far the highest prices for restriction drugs. you don't disagree with that, do you? do you disagree with that? rep. price: i think that is the case. senator sanders: it is. rep. price: if we get to the root cause, i think we can solid bipartisan lee. senator sanders: one of the root causes is that every other major
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country honors negotiates drug prices with the pharmaceutical entry. in our country, they can raise the prices, they could double the price is today, there is no law to prevent them from doing that. thatyou work with us so medicare negotiates prices with the pharmaceutical industry? rep. 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: was not 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. you believe that health care is a right of all americans, whether they are rich or poor? should people, because they are americans, be able to go to the doctor when they need to, be
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able to go into a hospital because they are americans? rep. price: if we are a compassionate society -- are notsanders: no, we a compassionate society. our record is worse than any country on earth in relation to poor and working people. half of our older workers have nothing set aside for retirement. compared to other countries, we are not particularly compassionate. andestion is, in canada other countries, all people have the right to get health care. do you believe we should move in that direction? rep. price: if you want to talk about other countries' health care systems, there are consequences to the decisions they have made, just like there are consequences to the decisions we make. i look forward to making sure every single american has access to the highest quality care and coverage possible. access to does: not mean they are guaranteed health care. i have access to buy a $10 million home, i don't have the money to do that. rep. price: that is why we believe it is appropriate to put
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in place a system to give every person the financial feasibility to purchase the coverage they want for themselves and their family, not with the government forces them to buy. senator sanders: that is a longer story. thank you very much. rep. price: thank you. senator hatch: welcome to the committee. we have worked with you over the years. i have found you to always be very knowledgeable, very up front, very straightforward, very honest, and somebody who really understands health care in this country. you are just perfectly situated to be able to help turn it around and get us to a place that it works. we hear a lot from the other side about how bad the system is and so forth. i do think it is very good myself. we've got to work on it and get it done right, but i sure would like to have you hoping to get it done. you are one of the really premier people in the sole congress and in the world, as a
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matter of fact, understanding what needs to be done and recognize in 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 not an uncommon practice for members of congress, in fact, there were members on this committee, 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. i personally resent it. you have always disclosed -- let me just say this, can you confirm that you have always followed the law relating to trading in stocks while serving as a member of congress? rep. price: thank you, sir. everything that we have done has been aboveboard, transparent, legal, and his you know, there is an organization called the office of government ethics that
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looks that all of, for every cabinet nominee, looks at all of the possessions come all of the holdings, and the like, and makes a recommendation as to what the cabinet member must do to make sure there is no conflict of interest. the office of government ethics has looked at the holdings and given advice about what we need to be done in terms of divesting from stock holdings to make sure there is 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: and you follow their advice? rep. price: absolutely. senator hatch: collects of obamacare -- the collapse of dissolved our effectiveness. , i don'tailed reforms
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think we can lose sight of the broader health system at risk. rare disease patients do not have access to life-saving treatments because policies that stem from obamacare prevent investments and innovative therapies that can cure and save lives. this is an issue i'm deeply passionate about. what steps do you believe will increase the pipeline for disease therapies to bring treatments and cures to patients in desperate need of hope? rep. price: the act which past 30 years ago, it really has revolutionized the ability to treat rare diseases. it made the united states and the leader in coming forward with treatments for rare diseases. i think there are things we can do in terms of patent protection, liability, in terms of incentive is asian of
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incentiveation -- resources.tion of senator hatch: we have some more drugs coming through because of that bill. all of a sudden, there is an explosion for populations of less than 200,000 people. it is a pretty important little bill. it was a republican bill. rep. price: one of the success stories for public policy in the country. senator hatch: one of the essential duties of the hhs secretary is to be diligent and thoughtful when considering if federal regulation is necessary and assessing whether the regulations impede research, development, and innovation. the regulations about dietary supplements has changed dramatically. do you recognize dietary supplements in helping reach and maintain healthy lifestyles? rep. price: absolutely.
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senator hatch: will you commit protectd the members to public health while assuring that consumers continue to access to safe products? rep. price: this is one of those areas where it is incredibly important to gain the information you referred to, to gather the individuals who know the most about this area. whether it is consumers, whether it is those providing the products to market, make sure for there are protections products, but it is absolutely vital to get this right. : senator hatch i will tell you this. i have to commend donald trump for picking you. you are clearly one of the premier people in all of congress who understands the problems with health care. you have the professional background that i don't think any other member of congress can problemshelp solve the
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that we have. we have a real messy situation. obamacare has not really helped. do you think obamacare has helped? rep. 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 have coverage, but they don't have care, but there are so many things about the decision-making process, who decides about our health care, should it be the federal government or patients and families and doctors and we certainly believe the latter as opposed to the former. senator hatch: i take it you believe getting health care closer to the people is a far better thing than everybody pontificating from washington dc. rep. price: i think the more involvement patients and doctors can have will result in higher quality care. defendedatch: i doctors, hospitals, health care providers, etc. in another life.
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what do you think we should do about medical liability? rep. price: this is a really difficult challenge because it is not just the malpractice rates that doctors or hospitals pray, but it is the practice of defensive medicine, the things that physicians do, but there are tests and procedures that are not necessarily needed to make a diagnosis -- senator hatch: that shows up in their history. rep. price: so if they are called up into the court of law, so they say, i don't know what you wanted me to do, i did everything. if we look at it in that light and try to decrease the practice of defensive medicine to the benefit of patients, i think we can get to the right answer. there are exciting opportunities that have been bipartisan in the past. senator hatch: thank you, sir. senator casey: thank you mr. chairman and representative price. thanks for the visit to our office. i wanted to highlight something
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we probably don't spend enough time highlighting or talking about and that is the full protections of what was known as the original bill. we have a lot of short-term and terminology. i know you and i have a basic disagreement. what a lot of people have forgotten about and the chairmen had a chart earlier that outlined the categories of americans that have health insurance by virtue of various programs. the number he had on the poster about the number of americans in the employer-sponsored coverage category and it was 178 million people. that is a lot of folks with coverage, who had coverage before, most of them had coverage before the legislation,
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and after, but they did not have protections. that only came with the passage of the legislation. we know that people have purchased health insurance to the individual marketplace. i wanted to ask you a couple questions about those basic protections that are no law that were not law before. i think you would agree with me that you meet remarkably in your workple and once in a while in the senate, we do and we don't take to have those opportunities, but one of the people i met in the lead up to the legislation passing was stacy ritter from manheim, pennsylvania. she did not have a personal challenge, it was the challenge faced by her two daughters. they were four years old, matalin and hannah.
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as stacy said about her daughters, she said that they would, at that time, would be 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 would ask as in terms of your work 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? rep. price: i think that pediatric cancer is one of those that is remarkably challenging. i remember when i was in my residency and i did a rotation on the pediatric orthopedic ward and so many of those children had can't -- cancer and before i began that rotation, i'll most dreaded going through that month because i was worried about just
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the severity of the challenges i would meet. it was one of the most uplifting months i spent a medical school and that was because the children were so uplifting. 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. secondly, it is 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 stated law prior to the passage of the legislation that victims of domestic violence were considered americans without a pre-existing condition. it is still the law in some states that they are not protected. will you commit to maintaining the protections that ensure that
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victims of domestic violence will not be discriminated against when purchasing health insurance? rep. price: i think it is absolutely vital that victims of domestic violence and others, anybody, we need to have a system in place that ensures that individuals are not priced out of the market because they get a bad diagnosis, are not eligible or able to purchase coverage that works for them -- senator casey: 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? rep. price: it certainly should not be. bei'm fortunate to confirmed, that is an administrative role and a policy decision that the legislators -- senator casey: i think we can agree on that. number three, will you maintain to committing the protection
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that prohibits the discrimination based on health status or disability? yes or no? rep. price: again, i think it is 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: what i'm getting at here is that we had a state of the lobby for passage of the that,ere individuals like whether a child had a pre-existing condition, even if the parents were paying premiums for years, an insurance company could literally say, sorry, you have a pre-existing condition, you can't get coverage. women were discriminated against because they were women. just a remarkable stain on america that we allow that to happen. just aern now is not series of concerns about what you has proposed about a member
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of the house and what you could do a secretary, but i just heard earlier the three areas that will be a focus in whatever replacement plan there is and i'm anxious to see it would be and i wrote them down -- chairman alexander wanted to take off the table and that is a good thing, medicare, but i heard that there would be three targets -- my word, of course -- the individual market, medicaid, and employer-sponsored coverage. i hope that if employer-sponsored coverage is a subject of change that will ensure all of those protections that are in place right now. that is why i'm asking those questions. i will follow up more in writing or if we get another round, mr. chairman put me on record as incorporating it everything ranking member marie said about questions and additional rounds. thank you.
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noted and i appreciate your using your seven minutes to ask questions. [laughter] deferred toson:'s senator paul. senator paul: as a fellow physician and a fellow physician who did some of my training at grady, congratulations and it was everybody at the commission could come to grady and see what it is like to work in one of our nation's biggest charity hospitals often doing work that is just incredible, gunshot wounds, contract -- compact fractures to the femur, you name it. i remember being there is a student as an intern, we used to hours andhow many divide by our income and say, we wish we could get minimum wage. i think it is critical to get someone with clear reasoning and critical skills to be in charge of our government. i think what i regret about this
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kind of hearing and what a lot of people in america regret about it is the vitriol and the rancor and the partisanship that -- we kind of all want the same things. to question your motives is insulting. to question whether you are honest is insulting. -- did youuestion of go into public service to enrich yourself or for public service? rep. price: i have a passion for public service and a passion for people and that is what guided our decision. some i think it was a foolish decision for both of us. paul: did you take a pay cut? rep. price: i did not consider the remuneration. senator paul: right, but i'm was a pay cut. i think we all want the most
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amount of 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? do you want more people to be insured? do you want more people to have health care? do we disagree on just how we do it and not necessarily just the motives? rep. price: as it tried to lay out earlier and i know time is short for everybody, the principles that i think are absolutely imperative for a health care system is one that is affordable for everybody, one that provides access to health care and coverage, one that is of the highest coverage, that is responsive to patients. the system is not any good if it is not responding to patients to read one that incentivizes innovation because it is the innovation that drives high-quality health care. one that ensures choices are made and preserved by patients. patients should be choosing who is treating them. senator paul: republicans have been accused of having no replacement ideas.
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approximately how many bills to you have that would be, could be regarded as replacement bills are ways to largerice: with that one term of bills since march or early 2009. the on that, tens of pieces of legislation. senator paul: it's been insinuated america is this horrible, rotten place. the physicians don't have passion. didou work as a physician you always agree as part of your engagement with the hospitals to treat all comers regardless if they had the ability to pay/ rep. price: it's one of the things we pride ourselves on. anyone in need of care was provided that care. not only in residency but in our private orthopedic practice. senator paul: it's interesting that those that say that we don't have compassion, and you look at a country like venezuela, great resources and
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an outer disaster were people cannot eat and devolving into violence. it is important we have a debate in our country between socialism and communism and america and capitalism. the things extraordinary about our country is just two years ago in 2014 we gave away $400 billion privately, not the government, individually through churches and charities. we are an incredibly compassionate society. i think often this was misplaced in the wonky numbers in health care how much we do help each other. not only do we help each other in our country. inhat you have to physicians my community have gone on international trips and got international charity work. all that is lost saying we are this heartless, terrible country. i would argue the opposite. the greatness of our country and the greatest of the compassion of our country, we give away
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more than the gross domestic product of most socialized countries around the world. it is important with regard to replacement a couple of things. there are some big, broad ideas of ensure more people. one is the idea of legalizing the sale of all types of insurance. under obamacare it became illegal to sell certain types of inexpensive insurance. could we ensure more people -- insure more people if we would legalize the sale of more types of insurance? rep. price: choice is absolutely vital. if we keep -- if we have as a principal and goal have patients have those choices they will select the kind of coverage they want. the choices that ought to be available are a full array of opportunities. senator paul: you think health savings accounts will help some people are not felt currently? rep. price: i think i did talk to vote -- high deductible catastrophic coverage will make a difference for many individuals. we should not force anyone to do
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anything. it ought to be a voluntary choice, but they ought to have the choice to select them. senator paul: one of the things you had different legislative on is allowing individuals to join together in groups to buy insurance. do you think this is a possibility of what senator alexander talk about millions of individuals in the market? i was a small position with four employees. itone were to get sick, could be devastating not only to them but to the economics of keeping them employed. letting us join together into pools where instead of me buying insurance as one of four, i could buy it in a big group of one million people. you had some bills for expanding that and i'm a big fan. could you mention some associated plans and how they could help some people get insurance who don't have insurance currently? rep. price: association health plans would allow individuals who are economically aligned to
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be on to purchase coverage together even though they don't necessarily work together or in the same group. one ofual health pools, the secrets to solving the individual small group market conundrum we find ourselves in what allow anyone to pool with anybody else solely for the purpose of purchasing health coverage. it is not a new idea. the model is the blue shield plan that existed decades ago that allowed people to pool resources together for major medical coverage for hospitalization. it makes a lot of sense. it allows insurance to work the way it is supposed to work, to spread the risk. and health status is not drive up the cost for them or anybody else because the pool is large enough. >> senator franken? senator franken: the way we could get a big risk will be medicare for everyone. dr. price, it was nice meeting
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you the other day. did you enjoy meeting me? [laughter] rep. price: i enjoyed our discussion about our gray hair. dr. price, what is the leading cause of preventable death in the united states? rep. price: i will defer to you. you obviously have it on the page in front of you. senator franken: i knew this before i put it on the page. it is smoking. rep. price: that hits home. i lost my dad. a lucky strikes smoker from world war ii to emphysema. he prided himself on the fact he never spent a cigarette for the filter for years and years. it was incredible tragedy. senator franken: i lost my dad, too. know, isician you may guess you didn't, smoking kills approximately 480,000 americans each year. $170 billion each year in health
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care costs. between 1993 in 2012 you are a shareholder of tobacco. big tobacco companies. meaning you personally benefited from tobacco sales. meanwhile you voted against landmark legislation in 2009 that gave the fda the authority to regulate tobacco. price, you are a physician which means you took a hippocratic oath, a pledge to do no harm. how do you square reading personal financial gain from the sales of an addictive product that kills millions of americans every decade went also voted against measures to reduce the death toll inflicted by tobacco? rep. price: it's an interesting question, senator, and a curious observation.
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i have no idea what stocks i held in the 1990's were the to thousands or even now. all of these decisions for all of us i suspect arthur mutual mutualnd -- are through funds and pension plans. suspectbet -- i would in your pension plan that there are components of that that are held that may have something to do in some type of history with tobacco. senator franken: i find it hard to believe that you did not know you had tobacco stocks. i find it hard to believe that in the questions about your stock portfolio you said you did not know things. just over the last four years you traded more than $300,000 and health related stocks. while at the same time sponsoring and advocating legislation that could affect the performance of stocks.
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we talked a little bit about the zimmer biomet. your broker, you say, bought it on march 17, 2016. you did introduce a bill later, a week later on march 23, 2016. you said you did not know then that you have this stock. it was to delay a federal rule to reduce profitability of the company's joint -- to delay a rule that would hurt the company. what i don't understand is what you found out your broker bought it, you cap the stock. -- kept the stock. to purchased this $50,000 $100,000 stock in a biomedical company. the single largest purchase in the past three years. in a private deal that was not
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made available to the public. i find it absolutely amazing that you responded that you did not know you got a discounted price. that is absolutely amazing. we discussed this. by definition i believe that's the nature of private placement offer. i paid exactly the same price as everybody else. i disclosed it. senator franken: it was a private offering the would to 20 people, including representative chris collins, his chief of staff in a prominent d.c. lobbyist. you reported $50,000 to $100,000 in profits on this purchase. when you say you did not know you got a discount on this. this was a private offering to a
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very small number. when you have the chairman of the budget committee, when you have congressman, his chief of staff, these sound like sweetheart deals. i think our job in this body in congress and in government is to avoid the appearance of conflict. this.ou have not done about youralk just latest plan, empowering patients first act. some of it is detailed in this article from the new england journal of medicine. is called "care for the runnable versus cash for the powerful." trump's pic for hhs. i will read a random paragraph. " price's record concerns less
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concern for the sick, before and the health of the public in much greater concern for the economic well-being of their physician "aregivers. i would commend this to every member of this committee before making a vote because what your plan does is -- one of the things is against tax credit the a health insurance. it's no different for someone who is poor, who makes $20,000, $30,000, and a bill gates. incredibly regressive system. you talked about ending -- you end thet to expansion of medicaid. that is the people of venice soda scared out of their minds. i've heard a lot about obamacare being a disaster. you have to admit that it meant
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the cost curve. that the cost of health care in this country has grown less than it did in the previous 10 years. it is also covered 20 million more people, but forget them. in 2008, i was going to run minnesota. in every vfw hall, every cafe, i would see a bulletin board where it would have a burger bash or spaghetti dinner for someone who it gone bankrupt because they had gone to their annual cap weather lifetime cap -- or their lifetime cap. i am frightened about what you are going to do and so are millions of americans. i know that you do things that help physician
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groups. thatave put in provisions findings byt these efficiency and innovation boards that would have to be cleared by physician groups. see you as someone who was there for the doctor, and this is a cover -- this is not going to create access for all americans, what you talked about. the empowering patients first act. this will unravel something that is given -- has given a lot of americans peace of mind, knowing kids can stay on health care until they are 26. knowing if they have a pre-existing condition, that
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will not stop them from getting care. that is what this hearing should be about. you are a smart man. >> senator, we are a minute over. senator franken: and my second round i will be a minute short. thank you. >> you may be here by yourself. >> i will be here with him. senator franken: the benghazi hearings were 11 hours, that's all i'm saying. >> senator isakson? senator isakson: do you have any response to senator franken? rep. price: i would just say this is one of the things that makes it difficult to reach a solution in washington. the current expressed by the senator are valid concerns.
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the inclusions he drew on the policies i promoted and will continue to promote are absolutely incorrect. we all share a concern for the american people in how we best make certain they have access to the highest quality care that the world knows. so, i hope and understand what he is doing it. it is a political activity. i understand -- i hope we are able to work together if i'm given the privilege of serving as the secretary of health and human services to truly solve these difficult challenges we have in our nation. senator isakson: isn't it true by may 15 every year since you have served in congress he had to make full disclosure on everything you own, everything your wife phones, what it was worth, when it was acquired and sold for? rep. price: the house requires a monthly -- a periodic transaction form. senator isakson: isn't it true
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that every transaction is available to the public to find in their how t -- in the house ethics committee? we require you to disclose facts every year? rep. price: there is not a single bit of information out here that i do not reveal to the public in a transparent process. senator isakson: transparency is the antiseptic that creates an environment where there is no corruption? rep. price: sunshine cures disease. senator isakson: you have worked throughout your career in the georgia senate, united states congress and is the secretary of hhs to make sure there was always print share is he -- there was always transparency? rep. price: it is a hallmark in a key. senator isakson: you love your job and if yet the opportunity to be secretary of health and human heiresses -- human services you will make sure there is never an appearance of conflict whatsoever? rep. price: that's what i'm
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mentioned the office of government ethics and the diligence they do to look at assetsdy's holdings and who are scheduled to potentially serve in the cabinet. aey make a recommendation, specific recommendation also available to be seen online. we have agreed to every single recommendation they make to the best of whatever holdings we have that might even give the appearance of a possible conflict. senator isakson: i yield back the balance of my time. >> senator bennett? senator bennett: i have never shown any nominee my knee before he came to my office. it's terrible, but i will talk to you after this is over. rep. price: i'm curious as to whether or not you get the mri. senator bennett: today at 10:00. i enjoyed our conversation in it's good to see you here.
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you have been chair of the house budget committee. i know you were a member of the tea party that's a strong advocate of balancing the budget for a stronger america. what i have noticed is after gaining control of the house and senate and white house, the first order of business for the republican majority in the past -- was the past a budget resolution appealing the aca. this budget resolution specifically authorizes $9 trillion in additional debt over the next 10 years. secret rigs the bill in to block any point of order to the bill because that bill will increase the deficit. let me read my colleagues's remarks it was duly highlighted in his floor speech in january for. -- january 4. "the more things change, the more they stay the same. republicans won the white house,
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control the senate, control the house. will be the first order of business? 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? is that will be campaigned on." "why would we vote on a budget that adds $9.7 trillion to the debt? because we are in a hurry. we can't be bothered. we are just numbered. i was told again and again to swallow it, take it, they are just numbers. it is not really a budget. yet the legislation says it is a budget. so this is what republicans are for. this is the blueprint that the republican party says they are for. $10 trillion worth of new debt. i am not for that, so the honest
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man." rand paul is right. it overrides to several budget provisions from the senate to prevent increasing the deficit by more than $10 billion, more than 5 billion years -- $5 billion in years further down the road. are you aware that republican leadership wrote a to this bill that any replacement for the formal care act would be exempt from senate rules that prohibit large increases to the deficit? ip. price: as you may know, stepped aside as chairman of the budget committee at the beginning of this year. i was not involved in the writing. senator bennett: you have been the committee chairman during the rise of the tea party, you are a member of the tea party caucus, you said over and over again the reason you have come to washington is to reduce our deficit and reduce our debt. i assume you are well aware of the vehicle that is being used to repeal the affordable care act.
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this is not some small piece of legislation. this is the republican's budget. rep. price: yes, i am aware of the bill. senator bennett: eu support a bill that increases the debt by $10 trillion? rep. price: i support the opportunity to use reconciliation to address real challenges in the affordable care act and to make certain we put in place at the same time a provision that allows us to move the health care system in a better direction. senator bennett: do you support the budget passed by the senate republicans? it has $10 trillion of debt to the budget. rep. price: the reconciliation bill is yet to come. i support the process that allows for and provides for fiscal year 17 reconciliation bill to come forward. senator bennett: but you commit today that any replacement plan for the formal care act will not in any way contribute to our deficit or debt? rep. price: i commit to working with you to make certain that happens.
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senator bennett: when 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? can you tell the tea party you will not increase the deficit by refueling -- repealing the affordable care act? rep. price: there are a lot of contributions to the debt. senator bennett: that's true and we talked about that briefly. will you allow the repeal of the health care bill to be one of those contributors to our deficit and debt? the cbo said the repeal of the health care law could increase our deficit by up to $353 billion. that is what they said. senator paul, and honest man, has got to the floor and said the first thing we are doing is passing a budget that increases the deficit by $10 billion. what you say to the tea party? or more important, people that live in colorado? rep. price: what i say to the folks across this land is of the
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congressional budget office are in a silo, looking at it as if nothing else happened after the repeal of the affordable care act. if you look in the constellation of things that will occur, and i believe working with every member of congress should i be given the privilege of serving as the secretary, we will make certain it addresses the health care challenges that exist out there that are very real. 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 deficit is a real challenge. senator bennett: with respect, and i have a lot for you, that is what every politician says about the cbo. the numbers are not true and we just run up the debt and run up the debt. almost the entire theory of case here, i think, from the republican party on this subject has been the health care law has increased cost. the law has increased our
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deficit, our debt. i would hope you can take a pledge today that would say nothing you would advocate for when pass or have they president signed into law that would add one dollar to the deficit or debt. rep. price: i certainly hope that is the case and look forward to working with you to ensure it is. senator bennett: i yield back my time. >> thank you, senator bennett. senator collins? senator collins: i very much enjoyed our discussion on a wide range of health careenjoyed oure 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. but there has been remarkably little debate on what would happen if congress took no
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action with regard to the individual market. answer asgive us your far as what you would see happening to the individual market if we do nothing? rep. price: i appreciate that and the opportunity to come visit you. we had a wonderful conversation about many different areas. the american people know this. they appreciate the individual and small group market were many of the millions gained their coverage is breaking in many ways. we're in a downward spiral on being able to provide individuals the opportunity -- any opportunity at all. one third of counties have just one insurance provider. there are five states that have only one insurance provider. the premiums are going up for folks. the deductibles.
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i get calls weekly from my former fellow physicians who tell me their patients are making decisions about not getting the kind of care they need because they can't afford the deductible. individual making 30,000, 40,000 dollars, $50,000 a year and your deductible is $6,000 or $12,000 which is not unusual on the exchange, you may have an insurance card with a wonderful name of an insurance company party don't have any care because you can't afford the deductible. people are denying themselves the kind of care they need. those of the things we ought to be addressing. again, i hope in a bipartisan way we are able to do that. senator collins: i think that's very important to clarify that in the individual market we are seeing double-digit increases in premiums, hired to dockable's, -- higher deductibles, larger co-pays and far fewer choices as more and more insurers give up and flee the market.
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the co-ops have failed dramatically. all 23 of them are in financial trouble. only five are still operating. so for us to say everything is going well with obamacare is just not accurate. that is why i feel 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 has 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 is been provided through the aca. another group that dedicated repeal with a two or three year delay, i think that also does
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not work because it creates great anxiety for consumers and insures would be unable to price their policies if they don't know what the rules are going to be. it is 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? rep. price: absolutely. it is vital. we oftentimes don't talk about the 20 million folks that still don't have coverage. there are a lot of people that don't. if we are responsible policymakers and administrators of policy, did is incumbent on us to step back and say why is that? for 20making that happen million they don't have coverage despite all these grand things that were done? i suggest the structure of what was done actually makes it
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virtually impossible for me individuals to gain that kind of coverage. we, i believe it's important we were together to put forward a system that allows every single american to have the opportunity to purchase the coverage they think is best for themselves and their families. senator collins: your goal is actually to have more people covered by insurance? i have been baffled over the fors by what cms reimburses and what it fails to reimburse for. inator jeanne shaheen and finally scored a victory of getting cms to cover continuous glucose monitors for individuals with diabetes that had been covered by the vast majority of private insurers. but when those individuals went to medicare they lost the coverage. it made no sense whatsoever. is thatm finding now
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cms frequently does not pay for services that helps to keep people well. there is a large practice in my state that has a nurse or patientsenter -- with with diabetes once a week. they check on their blood levels and diets and exercise regimes. they have had really positive results. the irony is that if diabetes gets out of control and those individuals and of having to have an be tatian's or go block -- amputations or go blind, cms will pay for that. but it will not pay for the phone call to check on the individuals it's helping to control their diabetes and keep them well. will you pledge to take a look at those kind of policies and reevaluate what we do pay for?
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rep. price: absolutely. it's imperative we are constantly determining if forgetting the outcomes we want and the processes are helping or obstructing those outcomes. senator collins: finally i want to touch on biomedical research, which is a passion of mine. inounded the diabetes caucus 1997. i'm also the founder of the alzheimer's task force in the senate that senator warner is the cochair. alzheimer's has become our nation's most. expensive disease it costs society $263 billion a year, $150 billion of that coming from medicare and medicaid. it will bankrupt those programs. it is devastating to families and the victims of the disease. diabetes consumes one out of three medicare dollars.
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if we invest in biomedical research, we have the possibility of not only americanslives for and cheering for coming up with an effective treatment for devastating diseases, but also 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? rep. price: nih is a treasure for our country in the kind of things 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. thank you, mr. chairman. >> would have been at this for about two hours. i will suspend the operation for about five minutes.
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then we will go to senator whitehouse. just so we can take a little break. the committee is recessed five minutes. [crowd noise]
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[crowd noise] this is the senate health
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education, labor committee in a nomination hearing with congressman tom price selected by donald trump to be his health and human services secretary. lamar alexander the chair in the center indicating a five-minute break. he indicated this is what they call a courtesy hearing, saying the senate finance committee will be the ultimate deciders on the confirmation of tom price. the health committee heard yesterday from that cd boss -- betsy duvox. you can find it -- betsy duvos . you can find it on c-span.org. on c-span 2, the hearing for the epa administrator position. testifying this morning before the senate environment committee. that is lived on c-span 2. and the south carolina governor nikki haley, selected to be the
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next u.s. ambassador to the united nations. that is over on c-span 3. we are streaming that one as well at c-span.org. any of these hearings you can find and listen for free in our free c-span radio app. also expecting live this coverage -- this afternoon coverage of president obama in his final news conference set for 2:15 eastern. if we are able, we'll have it live on c-span. look for live coverage of the c-span networks. on this hearing today, tom price's hearing we invite your comments, questions and thoughts on his nomination and how the hearing is going. facebook.com/c-span. all kinds of tweets. "i find it rates the democrats are suddenly worried about the debt. where have they been 4-8 years out of control?" another tweet saying about the hearing the tom price this
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morning, "no compassion for gop to let people die or go bankrupt. over health care -- bankrupt over health care." live coverage with the hearing about to resume here in the health education labor and pensions committee. noise] senator alexander: the committee will come to order. senator whitehouse is next, followed by senator young.
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senator whitehouse? senator whitehouse: thank you, chairman. let me put it to the record a letter from our governor in rhode island which says in rhode island, "we have actually seen exchange premiums decrease in two out of the last three years. nearlys saved consumers $220 million since 2012." the story on the affordable care act the rhode island is quite a good one. i would also like to put this .ittle graphic into the record the red line along the top is the cbo estimate of where our health care costs were going to go when they were making that estimate in 2010. time, 2016 this
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after the aca was in place, they look at the actual experience and they did a new projection going forward based on the affordable care act. just in the following 10 years, -- green period from 2016 estimate $2.9 are trillion in federal health care 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 very significant part of this $2.9 trillion. we throw it out right now according to the republican plan with nothing to replace it. i have described that over the weekend at home like being
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asked to jump out of the airplane with no parachute and we hope to build the parachute on the way to the ground. jump out actually did of perfectly well operating aircraft. he assisted not a just one parachute, but two, a spare. i think the american people are entitled to know what they are going to be offered as an alternative. there has been conversation in his hearing about how the republican ideas are floating around. i'm sure there are republican ideas floating around, but there is no republican bill, no republican plan, no republican proposal. our cards are on the table. it is obamacare. you want to improve it, make suggestions. we have always been open to that. but on the other side of the table there was nothing. it is hard to negotiate with nothing. i think the republicans have a responsibility to put a plan together. we talked about that when we met in my office. my recollection of our
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conversation is that you told me you would want to keep letting people stay on their parents' policies until the year 26. is that true? i think the insurance industry has included individuals up to the age of 26 on their parents policies across the board. i don't see any reason that would change. senator whitehouse: you would want to keep, you told me, the hole closed? rep. price: we discussed doing all he could to make sure seniors could afford the drugs they need. senator whitehouse: you did not want to reopen the donut hole for seniors. now you say you'll reconsider opening the donut hole? rep. price: i think it's important -- you know about reopening the donut hole would be a legislative activity, not an administrative activity. senator whitehouse: he would be secretary of health and human services.
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you would be doing a lot of technical work behind it for the administration. are you proposing in that role some that reopens the donut hole? i have a lot of seniors of what he hear about that. rep. price: i am not aware of any discussions to do that. senator whitehouse: my recollection is you told that you would not want to return to insurance company lifetime caps or insurance companies denial of pre-existing conditions or insurance companies going back and looking at the files for some little tiny discrepancy and throwing somebody off their coverage when they come in with a significant claim. is that true? rep. price: i think there are always ways we can improve coverage in other areas that exist right now and they need to be -- the issues need to be continued. senator whitehouse: when, as, and if we get a republican counterproposal to obamacare, you would expect to see those things in it? rep. price: i don't know whether they would be in it or be silent on it.
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that's a legislative question. senator whitehouse: they would leave it in place. rep. price: that is not an administrative question. senator whitehouse: one of your proposal thatd a would allow states to throw when 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? rep. price: we were not as specific as with the definition was. senator whitehouse: i'm asking you now, what did you mean when you set able-bodied in this provision? rep. price: there are many, many individuals who have worked in this space for a long time to believe providing for an opportunity for individuals who are able-bodied without children
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to seek or gain employment or to study -- senator whitehouse: what do you mean by able-bodied? rep. price: that is what would be defined in the regulation itself. i don't know. senator whitehouse: the used the term without the idea of how to define it? rep. price: i think people have an understanding what able-bodied is. senator whitehouse: that was a simple answer to my question. able-bodied does not mean people have addiction, mental health and behavioral health issues. as you use the word. i'm not asking about the future universe. as you use that term in your budget. rep. price: i think individuals that demonstrated they were in fact having challenges that would preclude that from being able to seek work or employment or education or the like, that they ought to be attended to. -- i amwhitehouse: now
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a fan and i think they do good work of the american candidate -- academy of pediatrics. i think they do good work at the american lung association. i am a fan and i think they do good work in the american public health association. all of those groups and many clearly on gone very changethat climate present significant health issues. they signed a declaration on climate change and health, which stated the science is clear that this is happening. you, on the other hand, have the carbon pollution standards of the obama administration "go against all common sense and that there are
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errors in obvious station -- obvious station and the climate of global warming." my time has expired. if you could get a brief answer because it appears to every scientific organization in the country, all the legitimate major ones, and to every american university that this actually is pretty darn settled science. the only people against that have biased financial interest in stopping the work getting done. you have taken the side of those mass special interests against actually settled science. if we can't trust you on science that is as subtle as climate science, captain can we trust you on public health science issues? where there are big special interests on the other side. rep. price: i don't agree with the premise of the insinuation. i do say the climate is obviously changing.
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it is continuously changing. 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 is a question that needs to be studied and evaluated and get the best minds available -- senator whitehouse: find one university that things the way you do. senator alexander: thank you, senator whitehouse. young i believe his next but i don't see him. senator roberts? rep. price: senator roberts: thank you for holding missing in -- this anger management hearing. i hope i colleagues feel better after one-day purging themselves of their restoration and anger. i would like to note i asked the technician that is running the sound system.
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the audio system is working. i thought maybe senator bennett did not know that. marine d.i.me of back in the good days when they would shout, "i can hear you." i just thought i would bring that up that the audio system is working. take care of yourselves. dr. price, congratulation on your nomin -- nomination. thank you for being here today. as many of our colleagues noted, you will play the most important role of confirming to help stabilize individual markets while congress does repeal the law and repair the damage it has caused. and enact the reforms i believe open our health care system back on track. my home state of kansas, we have three insurance carriers left. we feel fortunate we have three.
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each individual only having access to two of those. our premiums rose this past year over 30%. down the road it will be more difficult if we don't do something. there is no doubt with regard to uncertainty and angst among consumers, i think it's important to make clear even if congress and the incoming administration were to do nothing, letting go. just like in "frozen." let it go. amending or appealing parts of the affordable care act, if the law is not working and we have to do something to meet that obligation. the prices are unaffordable. the market is nonexistent. several states and counties, not as rural as wyoming, but in my state of kansas. i have a concern. back in the day when we set in this committee -- sat in this
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committee and dealt with the first version of the affordable care act, i don't know where that is today. it is sitting on a shelf. we went at it day and night. i was worried about something i called the independent payment semi, a board, wonderful acronym, and i would also mention the patients center outcome research institute. not many people are aware of these. i went to the floor of the senate and i called them the four horsemen of regulatory apocalypse. i am 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 of any concerns you have with regards
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whatese, what i would call they are trying to do with good intent? rep. price: i think it's imperative as we move forward recognize the patient often be at the center of this. 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. -- example, the senator center for medicare innovation, i'm a strong proponent in advocate for innovation, but i have seen in certain instances cmmi is aming out of desire to require certain kinds of treatment for certain diseases that may or may not be the best interest of the patient. because it carries the full force of the federal government
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and the payment for the services, it means we are answering the question of who decides about what kind of care patients receive by saying the answer on to be washington, d.c. i reject that is where those decisions ought to be made. senator roberts: i appreciate that answer. i have had a privilege of being a member of this committee, the finance committee, especially being chairman of the always powerful senate agriculture committee. i am particularly interested in hhs and the fda's work on food and nutrition policy. during the previous administration the fda issued numerous registration -- legislation went on realistic -- with unrealistic compliance dates. more recently with the nutrition facts panel revision. we share the goal of safe food supply and availability.
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i am concerned the administration is not clearly or consistently communicating with the food and i are culture industry regarding new or changing requirements. when you commit to working as the secretary of agriculture and other relevant agencies not mentioned the committee i serve on, and similar in the house, your department is issuing science-based guidance and taking into consideration other regulatory burdens when engaging in other regulatory actions? rep. price: that is not only imperative, for the science it is relied upon off to be transparent and available to the public so people can see exactly what was the basis for the decisions being made. senator roberts: under the previous administration we have seen increased activity and on nutritionts policies such as voluntary guidance. yet the same administration wants to request additional
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resources from congress to comply for the statutory requirements and the food modernization act. they did not prioritize fda's mission to protect the food supply. instead focusing on nutrition policy. if confirmed, can you discuss i you will focus on the court fda duties such as supplemented the law congress passed rather than agenda-driven nutrition policy guidelines. ip. price: if i'm confirmed, would work specifically with the fda commissioner to make sure we are relying on science. the science that is guiding the decisions that we are making. and again the transparency is available for folks so they can see what kind of decisions were made and how they are being made. in addition to working with policymakers, you know best what is going on in your state and how it's being affected by the rules and regulations coming down from washington in so many areas, but certainly in the agriculture arena.
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we ought to be having a dialogue with every single individual who has an interest to make certain we are addressing the needs appropriately. senator roberts: thank you for your response and thank you mr. chairman. senator alexander: thank you, senator roberts. senator baldwin? senator baldwin: you have been asked about your investments and medical device companies, pharmaceutical companies as part of the prior question. for the record, had he also received campaign contributions over the years from political action committees associated with many of these companies? rep. price: i don't know but i assume so, just as many of us do. senator baldwin: the american people want to know, of course, when you get review for potential conflicts of interest and procedures with the opposite government ethics is that in
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your role you are fighting for them and not biased towards the powerful companies you have invested in it have invested in you. and you have taken some questions on that, but let me follow up a little bit to ask do you think drug price increases we are seeing right now, for example the sixfold increase in the cost seven epipen is a problem for americans? rep. price: there are certain areas were drug pricing increases seem to have little basis in rational findings.
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repeal the prohibition on the negotiation. rep. price: 20 to find a solution to the folks needing medication. one of those is changing the way the negotiations occur for seniors with pbm's? senator baldwin: you have not said yes or nobody talked about transparency. would you support drug price transparency mandating that any drug company that wants to increase prices on their drugs, grilli's public information on how they accept their prices because so many of these appear to be without justification as you just mentioned. rep. price: there is a lot of merit in transparency in this area. i look forward to exploring and
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confirm with you the ways to be able to make that work. senator baldwin: i wanted to go back to the first round of chairmanng with the who showed a chart. it seemed like but was implicit in the back and forth was the active repealing the affordable care act would only impact perhaps a very small part of the health care industry. you talked about 6% being covered on the individual market. the protections, like coverage on your parents health insurance until you are 26 and mandating people the covered even if they have a pre-existing health condition, things like eliminating caps that led so many to medical bankruptcy. those applied across the health
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care system. way limits us to a small percentage of our population. this is about serious impacts for all of america. would you agree.
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repealed, there will no longer be a mandate for substance abuse treatment being covered. is that something you agree with? the opioid epidemic is rampant. sen. baldwin: which you are sure that treatment -- substance abuse treatment would be covered under a replacement plan? rep. price: it is vital that substance abuse and other things are treated. working -- rd to want to make i sure i heard the exchange. you think to me like
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insurers will continue to do it said there is no need for there to be an actual mandate saying they must. with 7.7 million young people between the ages of 18 and 26 on their parent's health insurance, that is 5.7 million people that are not in the individual market because they are in their first job after high school that is not how pet insurance are in school without -- is it just a wink and a promise? do you support having in law a to 25-year-old be able to stay on their parents health insurance. is. price: i understand it baked into the insurance programs. sen. baldwin: but they can change their mind at any time. rep. price: i am committed to making sure that every single american has the access to
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coverage they want. >> thank you, senator baldwin, senator young. senator young: i have enjoyed -- service together's together in the house of representatives. i had an opportunity to get to know you personally and to observe your quite impressive skill set, your depth of knowledge in health care and health policy, your commitment, more importantly to seeking alternative perspectives, trying to identify where bipartisan consensus can be realized and ultimately forging consensus around some viable solutions. the want i find most notable is growth rate,on the something the members of this with.tee are familiar
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it is a blunt instrument in place to control health care costs. i don't think we could have moved toward a more value-based purchasing model. these are skill sets that will serve you well over at health and human services. one area of the affordable care act, speaking of bipartisanship that members of my party, of your party have periodically and indicated their desire to repeal from time to time has been the center for medicare and medicaid innovation and that is 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 that there is great value in innovating and experimenting across all layers of health care.
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i think cmmi is and can continue a healthy laboratory for experimentation with delivery models, payment models, and so forth. for medicaid, medicare, and perhaps other areas. -- greater value and we see what does not work and scale up what does work. for me, it is common sense. this is the way sciences operate, they start with experiments and they evaluate and then they scale up. i would like to know your intention, if you have strong convictions. the you intend to keep this innovation center or perhaps develop a new one -- a variant of cmmi? rep. price: i appreciate that and i am a strong advocate and supporter of innovation at every level.
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it is innovation that allows us to expand possibilities for increasing the quality of care. i am a strong component of innovation. has great possibility and promise to be able to do things that will allow us to find ways in which we can change the payment model and ways in which we are treating disease and the like that will improve to the patient's benefit. i have adamantly opposed to the mandatory nation -- mandatory nature with which cmmi has approached problems. the first is thecjr program which identified 67 or 68 geographic areas where if you were a patient and received a lower extremity joint replacement for a variety of problems, then it was dictated to your doctor what kind of prosthesis, surgical procedure your doctor could do for you regardless of what is in your
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best interest. they may be aligned, but they may not be in if they are not, then your physician is incumbent upon doing what the government says to do. the other area that was more egregious was covering 75% of the nation of the medicare part b grow demonstration model. not a model if it is 75% of the country and that would stipulate what kind of medications your physician could use in an inpatient setting. the problem i have is that really is an experiment. to see whether not it works and in every single experiment, health care experiment or medical experiment or scientific experiment that deals with real people, we demand and require that there be informed consent for the patient to participate in that experiment and so you say to the patient, we are trying this to see if it works better and we would love to have you join us.
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if you don't want to do that, you do not have to. the federal government does not do that. they require individuals to participate. of these models were put into a small area -- a pilot project and we saw they worked, as you say, then you scale them up. sen. young: thank you for the fulsome response and the rationale behind how you have arrived at that position. i look forward to working with you to advance the next model of cmmi, whatever exactly it may look like. i would be remiss if i did not mention indiana's what we call healthy indiana plan 2.0, the vice president-elect pence showed a lot of leadership here with our incoming cms administrator to develop a model for medicaid, which is unique to
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the state of indiana. it encourages recipients of medicare dollars to get some ownership over their health and uses private market insurance concepts to replay or #-- prepare whose ears -- prepare hoosier. accommodate that as we work on new health care is a solution -- legislation. it is an important concept that medicare -- medicaid be more efficient than a one-size-fits-all approach. i want some reassurance that your loan star will beat state be statety -- will flexibility. i think you are absolutely right.
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the medicaid program is one where the states know best how to care for their medicaid population of the greatest amount of lexa billet we can give for states to an act those kinds of programs, what indiana has done is really a best practice for many other states to follow and i look forward to working with you. sen. young: likewise. >> thank you senator young, senator markey. 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 praised all of these aspects of the affordable care act and eerilygoals that sound familiar to what we have been living with for the last six years. you have said that you do not betweenre to be a gap the repeal and the replacement and that at least in many people will have coverage with the goal
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of more people having coverage, sick people will not face discrimination and young adults will get to stay on their plans until age 26 and yet, we do not get any specifics as to how that is going to occur. it seems as if you and the president-elect want to do everything the affordable care act does, but do it in a different way. i am going to give up at trying to get to the specifics of this secret replacement plan and maybe ask you mesh -- metrics about how we will measure 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 are at the end of your four years, how will you look back on this replacement plan to measure its success and to the extent you can give me specifics
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as to how you are going to measure the success of the replacement, i appreciate it. --. price: i think you and i i thank you and you identified areas we need to be looking at from a metric standpoint. what is the cost? is the out-of-pocket costs higher or lower than what it was? i would suggest the cost is lower than when it began for individuals in the small group market. they were promised that premiums would go down and they went up. as they were promised they would have access to their doctor. sen. murphy: i am talking about where we are today. rep. price: if you look at the things that many of us biggie -- believe have been harmed by the affordable care act, i hope we are able to decrease the out-of-pocket cost for individuals, increase choices, increase access to the doctors and providers they want. sen. murphy: increase the number of people that have insurance? rep. price: absolutely.
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we saw 20 million -- we still have 20 million individuals without coverage. it is incumbent upon us to say, what can we do to increase coverage? the goal is that every single american has access to the coverage they want. know there are two different things. and coverage.rage this whole administration is starting to look like a get rich quick scheme. we have a president that will not divest himself from his businesses and can potentially get risk -- get rich off of them and a secretary less by that has a big investment in the education space. i want to walk you through timeline and get your reaction.
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on march eighth of 2016 come earlier last year, cms announced a demonstration project to lower medicare embarrassments for part d drugs. drug companies that were affected organize a resistance campaign. two days later you announced your opposition. then you've invested as much as $90,000 in a total of six pharmaceutical companies. not five, not seven,. all six, amazingly, made drugs that would've been impacted by this demonstration project or it there are a lot of drug companies that would have been -- would not have been affected, but you did not invest in those. you invested in six specific companies that would be harmed by the project. use them at a disclosure indicating that you knew that you owned stocks and two weeks after that you became the leader states congress in
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opposition to this demonstration project. you wrote a letter with 242 members of congress opposing the demo. that takes a lot of work to get 242 people to sign on. rep. price: that is good staff work. sen. murphy: within two weeks of you taking the lead, the stock prices for four of the six up.anies went you did not have to buy those stocks knowing that you were going to take a leadership role in the effort to inflate their value. if the american public takes a look at the sequence of events, tell me how it can possibly be ok that you were championing just championing positions on health care issues that have the effect of increasing your own personal wealth. that is a damming timeline. rep. price: my opposition to having the federal government
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dictate what drugs are available is long -- long-standing. i do not know if you are here before, but i did not know any made.se trades were being i have a directed account and all of the trades were made without my knowledge as it is set up and individuals on this panel have the same kind of account. the reason you know about them is because i appropriately reported them and above board as an ethical and appropriate manner required by the house of representatives. sen. 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? it seems a great deal as a broker. he can sit back and take a look --rep. price: she can sit back. in. murphy: she can sit back this case and look at the legislative positions you are taking and invest in companies she thinks will increase in
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value based on your legislative activities and you can claim separation because you did not have a conversation. 1 that rep. price: -- that is a nefarious arrangement that i am astounded by. the fact of the matter is i have had no conversations with my broker about any political activity at all other than her congratulating me on my election. sen. murphy: why wouldn't you tell her, to stay clear from any companies that are directly affected by my legislative work. our agreement is i -- rep. price: our agreement is a diversified portfolio and it makes certain so that in order to protect one's asked that there is a diversified arrangement for a purchase of stocks. sen. murphy: you couldn't have a diversified portfolio while staying clear of the six companies directly affected by your work issue? rep. price: i didn't have any knowledge of those purchases.
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thank you senator markey. -- senator murphy.
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[no audio] >> opinions about where we go the acas replacement of and what that would need to look like to help address the needs rural, veryn a very front high cost, the highest cost insurance and health care cost. we are down to one provider on the individual markets. we have got all the demographics that would tell you that this is a difficult place to be operating right now.
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we, as a state, moved forward with medicaid expansion a couple years ago and there are some 27,000 alaskans that have coverage that did not see that before. there was also a good discussion about making sure that we are 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 there are certain exemptions that were included as , exceptions for medicaid cost-sharing provisions -- we have --
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in this new era of health care reform. -- make sure this very unique trust responsibility for american indians and alaska natives continue to be filled. these concerns were raised at the meeting and nooks hoped i would have -- folks hoped i would have an opportunity to ask
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you. rep. price: we had a wonderful conversation about alaska and i learned much about your state. the medicaid system is imperative and vital for members of the population who receive care through the medicaid --gram and it is a federal and sure individuals did not fall through the crack. whether it is the same level of medicaid which is a patient or providing an option for something else that allows them needs,e that suits their 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 sure that happens. what about the --sen. murkoski: what about the concerns by the tribal health organization that if there is a blocked approach that is utilized that that could impact some of the assurances
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and benefits that the tribal health organizations have seen? early --rep. the price: this is in the early sen. murkoski: the state moveion forward with some reforms and -- be able to somehow
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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? i think the whole array of opportunities available to make sure nobody falls through the crack. the waiver program is one that is just beginning and holds promise in making certain that we are able to ensure that things like reinsurance and high risk pulls make it so that individuals do not lose their opportunity to gain access to the highest quality care. sen. murkoski: finally, on our small rural hospitals, one of the concerns i heard repeatedly was the level of regulatory burden that particularly our
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smaller, rural hospitals are feeling stifled by. some of the innovative things thatone of our hospitals the peninsula is looking at advancing the kind of field -- they feel it is too risky to move forward with any level of the innovation they hoped to take on because they are facing regulatory burden and the uncertainty they are in right now. you can do things administratively early on should you be confirmed to this position. whatyou looked to regulatory issues could be addressed early on that could help reduce some of the regulatory burden particularly to some of the small, rural hospitals. rep. price: not specifically, but i share the concern you have about the burden of regulatory guidelines and schemes that come out of washington, d.c.,
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especially for the rural areas. folks in the rural area that tend not to have any margin to cover the cost of this regulation and i have heard from more than a few physicians and other providers because of the regulatory schemes that come forward and say they cannot do it anymore and they have to close their doors. one of them where they are having real challenge is to provide services. -- those individuals have no care and that is unacceptable to me. thank you senator murkowski. i have senator warren and kaine on the democratic side and scott, cassidy, isaacson has three minutes remaining. senator warren. .enator warren: thank you more than 100 million americans now received their health care
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through medicare and medicaid programs. these are seniors, people with disabilities and metalclad -- middle-class families and countless numbers of young children that 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 health budget committee would have cut --nding on medicare by 449% $449 billion over the next decade. is that right? rep. price: i do not have the numbers in front of me. sen. warren: i have the numbers. rep. price: then i assume you are correct. sen. warren: you said he would 440 $9 billion. your budget proposal also would have cut medicaid funding that thanto the state by more $1 trillion. rep. price: i think the metrics we used for the success of the
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program's is not necessarily --sen. warren: yes or no. rep. price: what we believe is appropriate. what we believe is appropriate is to make certain the individuals receiving the care are actually receiving the care. sen. warren: i understand why you think you are right to cut thei am just asking question. did you propose to cut more than $1 trillion? rep. price: you have the numbers before you. sen. warren: is that a yes> rep. price: you have the numbers before you. sen. warren: i will take that as a yes. was clearelect trump on his views. 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? rep. price: i believe so. your record given
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of proposing massive cuts to the 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 has not responded yet. 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 secretary you will not use your administrative authority to carry out a single to medicare or medicaid eligibility or benefits? rep. price: what the question presumes is that money is the metric. in my belief, from a time -- scientific state point -- standpoint, if patients are not receiving care, it does not work. sen. warren: we are very limited in time. the metric is money and the quote from the president elect of the united states was not a long -- discourse.
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he said he would not cut dollars. that is the question i am asking you. can you are sure this committee -- assure this committee you will not cut one dollar from medicare or medicaid should you be confirmed to this position? rep. price: i believe the metric auto be the care to the patients. sen. warren: can i take that as a no? a question about dollars. yes or no? rep. price: we ought to put forward the resources to take care of the patients. sen. warren: i am asking simple questions and the millions of americans will not be 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
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because americans will be watching to see if you follow through on that promise. i would also like to follow up question. franken 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. medicare was, recently allowed to change the way 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 the hospitals, not congress, will decide the most effective implants, reduce second surgeries, better fight infections, how to spend their money to deliver better service at higher cost. i have supported this change
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because the research shows it really means to get better care at lower prices. i know the policy is controversial because it affects howhospitals are paid and much money the manufacturers of hip and knee replacements can make. one of the companies is the company raised by senator ,ranken and that is zimmer bio the leading manufacturers of hip and knees and they make more money if they can charge higher prices. the company knows this and so does the stock analyst. on march 2016 you purchased stock in zimmer bio net exactly -- you introduced a bill in the house called the hip act that would require the secretary to suspend regulation --
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did you buy the stock and then introduce a bill that would be helpful to the companies you just bought stock in? rep. price: the stock was bought by a broker that was making those decisions. i was not making those decisions. sen. warren: you said you weren't making the decisions. let me make sure i understand. these are your stock trades? rep. price: they are made on my .ehalf it is a broker directed -- sen. warren: through a blind trust? is not justar, this a stockbroker, someone you pay to handle paperwork. this is someone who buys stock at your direction, someone who buys and sells the stock you want them to buy and sell.
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rep. price: not true. you foundn: so when out -- because you decide not to tell them and we are all supposed to believe that? rep. price: it is the manner in which members of this committee -- it is important to appreciate that is the case. sen. warren: i want to understand, when you found out your broker made this trade without your knowledge, did you reprimand -- reprimand her? did you fire her? did you sell the stock? rep. price: what i did was comply with the rules of the house and a lack of -- ethical and legal manner and in a transparent way. time has expired senator warren. i believe senator murkowski went over by two minutes. did i misread the clock?
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sen. warren: your periodic transaction report notes that you were notified of the trade on april 4 2016. did you take additional actions plansthat to advance your for the company that you now own stock? rep. price: i am offended by the insinuation. sen. warren: let me read what you did. you may be offended but records show after you were personally notified of the trade, which you said you did not know about in advance, that you added 23 out of your bill's 24 cosponsors that also after you were notified, you sent a letter to cms calling them then to cease and just soplans there was no misunderstanding about who you were trying to help, you specifically mentioned those in need of replacement. >> senator warren -- who is
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next? senator isakson has three minutes. >> i want to make a point that i respect everyone on this committee tremendously and i respect the nominee, but it is important that all of us understand the disclosure rules we have and the way it operates. had nore senator franken idea he owned -- when he made the comment about tobacco companies. it is entirely possible for any of us to have somebody make an investment on our behalf and us not know where the money is invested because of the very it works. very way i do not say that in any way to embarrass mr. franken. any of us who have mutual funds him it is entirely possible for us not to know and to imply that someone has been denying something is not the fair thing to do and i wanted to make that point.
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>> this is different than mutual funds. question -- n: my >> your time has been generously -- senator kaine. -- i am sorry, senator hassan. >> i am happy to lead but i think senator cassidy was next and he came back in. he did, but i was going back and forth. that is generous of you -- >> thank you. congressman price, thank you for being here this morning, mr. chairman, thank you for the opportunity to participate. , we share i discussed -- ourrn for patients
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adult son has had up to 10 doctors and a dozen medications. our family knows the strengths and weaknesses of the health care system 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 specific plan that is providing coverage to 50,000 hard-working granite staters. i have seen the advantages of the affordable care act and the -- republican the legislature to pass it. it is the context i bring to this series of questions. all, opioid deaths have been on the rise and hit new hampshire particularly hard. we have about the second highest rate of drug overdose deaths in
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the country. under the medicaid expansion program that i talked about, made possible only by the affordable care act, thousands of new hampshire citizens are getting the opportunity to get treatment for substance abuse disorders. i talked to a woman named ashley who had an addiction for almost a decade. medicaid expansion gets passed under the affordable care act and she got treatment and she is now in recovery. medicaid, which we have done it in a particular way so that it strengthened the insurance market in new hampshire because more insurers came in. she is now working and she just switched over to private insurance because she has employer provided insurance. you have proposed repealing medicaid expansion in the budget at you proposed. yes or no, can you guarantee
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that you will make sure that americans with substance abuse disorders who have insurance through medicaid expansion will not lose their health insurance? -- i think i think it is imperative that we as a nation make certain that every single individual has access to the kind of mental health and substance abuse challenges they have. sen. hassan: is that a guarantee that you will find funds to actually provide the treatment? rep. price: it is a guarantee that i am committed to making certain we address that need. sen. hassan: i am just concerned that you are not going to be able to backup the guarantee if the affordable care act is repealed and i am concerned about the impact 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 a sick essential -- basic
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essential coverage is like checkups at the doctor's office. the you think health insurance could provide for that -- should provide for that? rep. price: patients should be able to select the coverage they want. it is important that we remember that the center of all these discussions is a patient and the patient knows best what he or she needs and that is the imperative i would bring to you. i am committed to making sure that patients have the choices available and if they choose that kind of coverage -- sen. hassan: if insurance companies do not offer it at all , and essential benefit under the affordable care act requires private insurance to cover substance abuse treatment. they didn't used to do that and they stopped covering a lot of things until the law requires them to. yes or no, the empowering patients first act would repeal the requirements that insurance companies cover substance abuse disorders. do you think that is still a
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good thing? rep. price: i think what is a good thing is to keep the patient at the center of all of this and make sure we are providing the kind of options and choices for patients so they can address their clinical -- sen. hassan: here is the thing. if insurance companies never offer it, they do not have the option. they can pay good premium dollars and it is not offered. the affordable care act said, here are basic things you have to offer so that when a patient needs care, the coverage is there and they can get the care. your answer and the empowering patient act would take that assurance away. it is not an option if insurance does not cover it. rep. price: the good news for you is that as an administrator if i am privileged to serve in a capacity and i follow the policies adopted by the congress of the united states and find by the president, so we look forward to working with you to make certain those kind of things are covered sen. hassan:.
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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 did not get the care they needed. because of that, a lot of people like the ashley's of the world were not getting better and not getting treatment. providers do not exist to treat people if they cannot figure out -- to get them burst reimbursed. the most important thing our treatment immunity said to new hampshire was that medicaid expansion made it possible for them to stand at a higher volume of treatment. i look forward to working with you, that i am concerned about your unwillingness to commit to making sure that insurance companies cover these essential benefits. i am almost out of time and we have not even touched on the issue of women's health, which is obviously of great concern.
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that we 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? rep. price: i don't believe so. youvoted --sen. hassan: voted in support of a resolution to disapprove the district of columbia's nondiscrimination law. d.c.otects women here in from being fired or penalized because of their reproductive health decisions. your vote would've had the effect of allowing employers to fire a woman for using birth control or other decisions she makes about her own body and reproductive health. how is that vote consistent with the answer you just gave me? rep. price: i think the question was about who is paying for the product. sen. hassan: no, the question is whether an employer -- let's say a self-insured employer plan
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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 fires her because the employer disapproves of the use of birth control. rep. price: i don't think that is the case. sen. hassan: would you like us to provide examples? you would be willing to say that employers may not -- you would support a law or rule that employers may not discriminate against women for their reproductive health decisions? rep. price: i do not think employers have the opportunity right now to be able to let somebody go based upon their health status -- sen. hassan: why did you vote against the d.c. provision? rep. price: i don't think that is what it did. sen. hassan: you don't think
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that was your vote? rep. price: i do not think that is what the bill did. sen. hassan: we will follow up on that. -- let me say,: for the record that win john king came for an interview i wanted to go for a second round that you would not let me. i wanted to say that for two days. i have another set of questions and you said "shut up." >> it is nothing personal. cassidy: i love what you are saying about the patient-physician relationship. you and i both worked in hospitals for the uninsured. i was a gastroenterologist and a
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liver doctor. we can talk about obamacare in the wonderful things it has done. i think about my patients with a $6,000 deductible. ,he patient you saw at grady they do not have $400 in their accounts and they have a $6,000 deductible before they can be ,ared for and for the record people don't believe that i put it on my facebook page. a friend of mine from home, his renewal for his individual 60icy for him and his wife, and 61 years old was $39,000 a year with a 6000 other deductible. i put it on my facebook page because nobody believes that was there yearly premium. i applaud you for looking for some alternative that is affordable. it may be working for new hampshire, california,
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massachusetts, but for state like mine and yours, people cannot afford $39,000 premiums. - there are provisions -- that law still remains in effect. we have been talking about -- you are a big believer in health savings accounts. they will be used to
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pay for doctors visits and for medical services and rep. price: i have had more than
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one physician tell me that the
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rules for the final straw. sen. cassidy: and they quit. when that happens, we lose incredible intellectual capital in our society that can care for people. sen. cassidy: what practical things can we do? rep. price: i think what is imperative is to find out things what things ought to be determined and check the metrics that are used in that they correlate with the care that is being provided as opposed to some anything required right now so that they are wasting their time documenting these things and it doesn't result in a higher quality of care or outcome for that patient. we truly worked with those providing the care to figure out what would correlate with the outcome and the quality of care provided. i suspect there are specific things we could use. sen. cassidy: it is interesting because you are and for sizing
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emphasizing -- the husband would be the one crying and she would be the one telling them and looking them in the eye and telling them "there is hope." my only imagined if she were in practice typing up "there is hope." it is a different feel for the patient and the spouse. rep. price: we have turned many physicians into data entry clerks and it detracts from productivity and from their ability to provide quality care. sen. cassidy: how to become up with expensive medicines only used by few? think of and a biotics, we have some -- antibiotics, we have a germ resistant to everything and we come up with gene therapy for a few. how do we pay for that? i do not know if you have an answer. i just want your thoughts.
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i care deeply about those and so do you. sen. cassidy: i talked --rep. price: i talked earlier about rare diseases and the drug act that revolutionized the ability or incentives for bringing to market drugs that address rare diseases and it is incredibly important. in sensitization -- in incentivizan -- ztion is important. sen. cassidy: in the era of personalized medicine where it might be the end of one or 1000 is still very small, but the cure could be one million. anything specific? ap. price: we are entering brave new world that is so exciting to be able to provide this kind of personalized healthcare services to folks that will be able to cure things
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we would never dreamed about curing. and the challenges of how we can make that available to the society are real and i need -- we need to get the best minds together. sen. cassidy: i will close by saying this. i have a perspective my colleagues do not. orthopedic surgeons are the ones called at 3:00 in the morning because someone got in an accident. they climb out of bed and a drive to the hospital and they are up all night and see their clinic scheduled the next day and they make rounds in the evening and kiss their wife good night before they go to bed. kind of personct to have this job. thank you and i yield back. >> thank you senator cassidy. senator kaine. you senatore: thank price for the -- congressman
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price for the meeting the other day. yourrry as a virginian is position about a range of programs about access and coverage. sort of a safety net that provides coverage to millions. you have repeatedly voted against the chip program for kids and called it socialized medicine. 8000 virginians. you propose the restructuring of medicare that would increase out-of-pocket cost for seniors, about 1.3 million virginians any support to repeal the affordable care act, there are about half a million virginians on the exchanges. you want to defund planned parenthood. programs the basic that provide health care
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coverage. andmillions of virginians tens of millions of americans and many of them have very limited means. consistencyort of to your position in some ways across these programs that i view as critical. i know that senators franken and hippocratiche comments before i came and as we approach the discussion of the health care system access, coverage, cost, quality, that government and congress should strive to do no harm. we should not harm people by reducing the number of people who have coverage or reducing the quality of the insurance coverage we do have. we -- that is what we should strive for? rep. price: i think it is important to appreciate there are challenges currently. and sincerenest
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about addressing these problems we ought to step back and say "what are we doing wrong?" if you are a new medicare patient trying to find a new position that sees new medicare patients, it is almost impossible. sen. kaine: i am all with you on fixing challenges and going forward, more coverage, more affordable. rep. price: that is what my proposals have tried to do. sen. kaine: we should not harm people by doing things that should increase their cost, correct? rep. price: i think we need to drive down the cost for everybody. sen. kaine: we should not create anxiety for people about the most important thing in their lives. we should not be doing that. is. price: one of my goals to lower the temperature about what we are talking about because this is real stuff for folks. these are their lives. sen. kaine: can we lower the
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temperature in russia at the same time? rep. price: i think we can move apace and lower the temperature. people need to know that no road will be pulled out from under them. sen. kaine: i do not think lowering the temperature is consistent with rushing. my experience going amount of -- around russia is -- around virginia is huge amounts of fear and we should not harm the american economy. the health sector is 1/6 of the american economy. we should try to fix the problems you identified and do -- rep. price: certainty is incredibly important and i am reminded of the fact that the congressional budget office told us the aca has decreased the fte's.ce by 2 million i hope we are able to work
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together to solve those challenges. sen. kaine: do you agree with that thedent-elect replacement must ensure there is insurance for everybody? rep. price: i have stated here and always that it is important that every single american have coverage that they desire. we. kaine: and he stated should negotiate with pharmaceutical companies under medicaid part d to bring down drug cost. do you support that position? rep. price: i think the cost of drugs is a real challenge for folks and me need to do all we can to make sure we bring the cost down. sen. kaine: here is an offbeat question. add -- i was at a hearing with governor nikki haley who was ambassador. be u.n. she played a significant role moving her state away from the use of the confederate battle flag in any official capacity.
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you fought hard to keep the confederate battle flag as part of the georgia state flag any sponsored resolutions to make april confederate history heritage month and "urging schools to commemorate the time of southern and you sponsored resolutions to make confederate history urginge month and schools to commemorate the time of southern independence. i would like to introduce that resolution for the record. the resolution because of the phrase "commemorating the time of southern independence." i noted the resolution mentions nothing about slavery. why did you support that resolution and do you still support it today? price: i haven't thought about that in a long time and i am happy to go back and think about that. >> what is laudatory about
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southern independence? >> every heritage has things that are good about it and every heritage has things that are harmful about it. a specifico answer question -- i think slavery was an abomination. kaine: any reference to slavery kind of miss the basic standards of fair and balanced? price: i know that my work was to make certain that we came forward with a flag that did not have the confederate battle flag on it. that addressed all the concerns of the state and was adopted and supported by the state. we did so in a bipartisan way. --as privileged to work with to make certain we were able to do so. are aware there
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is an office of minority health created in the affordable care act and reauthorized. if the aca is repealed, it would also expire? that is a: legislative question. if i am privileged to serve and be confirmed, i look forward to making certain that we use those resources available. making sure that we have the highest available. sen. kaine: why did you use the phrase "socialized medicine." rep. price: i don't recall that quote but i'm happy to go back and look at it. scott?tor senator scott: thank you, mr. chair. i hear that you were at emory university medical school? rep. price: i did my residency at emory.
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sen. scott: my nephew is in his first year of medical school. i hope that he gets a quality education. rep. price: he will, and he's got an exciting road ahead. sen. scott: i had the privilege of serving with you in the house and enjoyed our relationship, our friendship. i look forward to seeing your success as the secretary of hhs. i have a couple of questions that are state specific. we have centers with about 165 service sites, serving 350,000 patients in almost every county in the state. it is either partially or completely designated as medically underserved. as rural hospitals continue to close, the centers have addressed and need for many communities in my state.
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we work together with partners in the community to address impacts on health like food deserts and lack of transportation. in it can save costs in the long run. the diabetic that does not take their medication because they cannot afford it and have no way of picking up what will inevitably be a long run to the emergency room. what rolled the you think community health centers can , particularly in rural and underserved areas? rep. price: community health centers are a vital part of the health care delivery system. so manyl a void in areas, as you mentioned, across your straight -- your state and across mine. are the entry point and oftentimes times the area of health care for so many individuals. we need to do all that we can to strengthen them. to make sure the providers and
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doctors are of the highest quality care. access resources, intellectual resources, to allow them to have that care. a decade ago in south carolina, emergency rooms were full of people waiting for psychiatric exam so they could either be admitted or discharged. of a implementation psychiatry network, wait times have been cut from four days to about 10 hours. almost twore cut by thirds. what do you see is the future of telemedicine to address access issues? what barriers can we anticipate as well? rep. price: telemedicine is one of those exciting innovations that i believe will allow for individuals, especially in rural
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and underserved areas, access to resources from a clinical standpoint to make decisions on patients that are before them without having to save resources and save patients in so many ways. we in a state of georgia have a spoken wheel program where the medical college of georgia, there is a neurologist that works with telemedicine and has a network of clinics and hospitals around the state. if somebody comes in with symptoms of a stroke, they can see that patient in real time and determine whether or not they need medication and if they can be treated in the community. to be they have transferred to the academic center. in the past, it was a call on the ground. all of those patients tried to get to the academic center. and notaste of money having patience at the center of
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that decision. i think we need to accentuate the ability to use telemedicine. oftentimes, telemedicine is not paid for. , the clinicians eat those costs. it else the patient but makes it much more difficult for them to be able to provide the quality care necessary. sen. scott: another interesting topic i think you should be fairly familiar with. georgia has a high percentage of african-americans. breast cancer deaths are 1.5 times higher in african-american women. prostate cancer deaths are 2.5 times higher in african-american men. i would love to hear your perspective on addressing some of the health disparities in communities of color specifically. rep. price: this is an important area.
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is to say,at we do ok, we will set of this facility here are the agency here. we have taken care of the problem. what i don't think we do is take a look at what is happening on the ground. to be defining specifically if we are actually improving the lives and health for individuals in challenged communities. and if not, we need to step back honestly and sincerely and say, what can we do to make certain that it works? i have the privilege of being at a clinic in atlanta and i code that hasis incredible disparities in terms of their health outcomes and status. irate of diabetes,'s broke -- diabetes, stroke, myocardial infarction.
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and when we see those kinds of things, we need to drill down into those areas. why is that happening? address the real challenge on the ground. now we have an agency that is addressed to take care of that. we need to do better metrics and better accountability. i'm sure you guys talked about rare diseases. sickle cell being one of the more important ones. i would love to submit questions for the record to get your insight on how we tackle so many of those diseases moving forward. murray: thank you, mr. chairman. togressman price, i wanted clarify a response to one of my previous questions. you admitted to me that you in
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your own words start with congressman collins about innate immune all. study thered you to company and purchase its stock. and you did so without a broker. yes or no? rep. price: no. sen. murray: without a broker. rep. price: i did not. me thatray: you told you did this one on your own without the broker. rep. price: no, i did it through a broker. i directed the broker to purchase the stock but i did it through a broker. sen. murray: you directed the broker to purchase particularly that stock. rep. price: that's correct. sen. murray: those answers commit me to underscore the need for a full independent investigation and i would like notek consent to enter a that congressman price was offered a lower price than other investors.
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mr. price, if you are confirmed, you will be in charge of our nations family-planning programs and policies. cost is an issue for women in statedbirth control is -- "bring me one woman that has been left behind. ring me one. there is not one." right? rep. price: what i said and what i meant was that when i had patients in my office that were unable to afford medication, we did everything we could to make certain that they got that medication. capture inmeant to that conversation was that if there are individuals that are unable to afford that medication , depositionstion or others take to make sure individuals receive the medication that they need.
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sen. murray: let me tell you about my constituent shannon. she has endometriosis. a common health condition impacting women. co-pay birth control is an essential tool helping women like me with endometriosis with chronic pain. so no co-pay birth control is extremely important to her. are deeply concerned about the impact this election could have on their access to health care that they need. deform of long-lasting contraception is up 900% since the election. if you can make all fda approved methods so women do not have to go back to paying extra costs for birth control? commit and i will
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assure that women and all wericans need to know that believe strongly that every single american will have access to the kind of coverage and care that they desire and want. that is our commitment and that runs across the board. rep. price: birth control is an essential part of women's health care, and if you are confirmed, i will be holding you accountable for that. you, i'mnted to ask deeply concerned about the impact your policies will have on women. women that face barriers to , since aca became law, the percentage of black women who report not having a regular doctor dropped by nearly 30%. your health care repeal bill would disproportionately hurt
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further color, compounding access to health care and undoing progress that was made. rep. price: i don't agree with the premise. nobody wants individuals to not at a priceportunity that is affordable and of the highest quality. we hope they will be able to work together to achieve that goal. sen. murray: the office of minority health was authorized as part of the aca. would you commit to maintaining and supporting this office and its work? rep. price: i will commit to be certain that minorities are treated in a way that makes absolutely certain that they have access to the highest quality care. sen. murray: you will not commit
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to the office of minority health be maintained? rep. price: it's important we think about the patient at the center of all this. my commitment is to make sure all patients in this country have access. rep. price: you won't come -- sen. murray: you won't commit to the office of minority? rep. price: there are different ways of handling things. i can commit to do something in a department that i'm not in. sen. murray: but you will be. rep. price: let me put forward a possible position that i might find myself in. the individuals come to me and they say, we've got a great idea for being able to find greater efficiencies within the department itself. thist results in merging agency and that agency and we will call it something else. we will address the issues of minority health. sen. murray: i hear your answer. you are not committed.
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are you aware that black, latina, indian, alaskan natives are almost twice as likely to be covered under medicaid? is it responsible cutting trillion dollars of funding without a credible alternative to replace it? rep. price: i disagree with the premise. a solution that would have would ensure that every single american, regardless of their health data's or economic status would have the ability. we have members here who also have additional questions. i am deeply troubled by a number of responses. this is a significant number of questions from our colleagues.
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>> i have a few comments, i don't have additional questions. sylvia'slecting on appearance. i think you have done as well. theve been impressed with performance in the job. i disagree with the number of policies taken but she's gone out of her way to adopt the same tone that i've heard from you to workhich is to try on different points of view and come to a consensus. questioning of any secretary of health and human services since 1993, because of the round of it fort have
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two others and you've been here nearly four. next tuesday, you will go through the finance committee which will vote on whether you go forward to the president. us come to a help conclusion and a consensus in this very important area of providing concrete fragile alternatives. today, they have been pretty testy. we have strong opinions here. the election over the last year became very uncivil. more so than i liked. republicans can take our share of the blame for that. for six years we've
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been going at it like the hatfields and the mccoys in west virginia until we forgotten who killed who in the first place -- it would know take a bedside manner. democrats, they were willing to work with republicans as they go forward. years ashey spent six hatfields and mccoys but i'm committed to trying. a couple of other things. while we intend to repair the damage of obamacare, it would
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mean repealing parts of it, major parts of it. that it won't become effective until there are practical and concrete alternatives in place to give americans access to health care. we don't want to pull the rug out from anybody. i'm sure this is a shared view. as i said, it's like having a bus ticket and a town with no buses. it ensures they are willing to sell into the market.
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i think it has also become clear that the timing we have talked about has yet to be resolved. had we get from where we are to where we hope to go? the way i think about it is we go to work immediately on a collapsing bridge, repair it. if the individual market to make sure people are hurt by it. there are decisions. they have to sit in a room. in my opinion, it would take several years to implement those decisions because, in many cases, it would be transferring responsibility to the state.
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states can accept their legislature. promptly,isions so that people are able to have access to lower-cost insurance. maybe all of us worked very hard. trying to deal with health care records. and meaningful use. , which was an early adopter of the electronic health care records, they said stage one was very helpful. stage two they could deal with. stage three was terrifying. i had hoped that we could delay
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stage three. maybe it could be as simple as andng to the physicians providers that if you are a doctor and you spend 50% of your time filling out forms, either you or we are doing something wrong. get you do see if we can 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. , aleast we had last year number of provisions in it. i invite you to work with us. senators wish to ask additional questions of the nominee, they are due by the close of business on friday, january 20. for all matters, the hearing record will remain open for 10 days.
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it will be an executive session, it has already been noticed. thank you for being here today and the committee will stand adjourned. rep. price: thank you, mr. chairman. [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] [captions copyright national cable satellite corp. 2017]
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[inaudible conversations] >> the insurance companies need to know by march what we are doing to stabilize the market. that is clearly the first order of business. and the president elect suggests that we work with the house of representatives to see what new alternatives we can come up with. the governors will all be here march 19 through 22. confirmed, they will talk about medicaid flexibility. the employer market is a separate matter. a lot of that doesn't need to be changed very much.
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the small group market probably does. there are steps we can take away. these are separate pieces of legislation. reconciliationr bill that is expected before summer. plan and a a rescue market. a good step back. >> heavy talks to a health -- have you talked to a health analyst? state insurance
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market is "in virtual collapse." in our state, premiums were up 40% to 60% this year. obama care subsidies only have one insurance company from which to buy. across the country, that is true in many other states. you the one to tell obamacare exchanges are not virtually collapsing in many parts of the country. buyle will not be able to insurance. >> i want to ask you yesterday. >> we had 3.5 hours of it.
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>> a nearly four-hour hearing for georgia congressman tom price to be the health and human services secretary. from the last four hours or so, tom price and members of the health, education, labor, and pensions committee. it is the number to call for democrats.

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