Transcripts For CSPAN HHS Nominee Representative Tom Price Testifies At Confirmation Hearing 20170125

Ordered. Id like to welcome everyone to this mornings hearing. Today, we will consider the nomination of dr. Tom price to be the secretary of the department of health and Human Services. And want to welcome dr. Price to the finance committee. I appreciate his willingness to in a position of this magnitude, especially at this particularly crucial time. Republicans in Congress Warned that the new health care law, basically, would harm patients, emilys and businesses. Too fine apine point on it, but we were right. That will address costs among other things. This will be an important endeavor. One that will and should get a lot of attention here today. But it should not be the sole focus of the next hhs soap secretary. Hhs has an annual budget of over 1 trillion. Let me repeat that. One department, 1 trillion. Hhs and purposes encompasses medicare and medicaid. Disease control and prevention, the National Institutes of whole, the federal Drug Administration and many others. This is no exaggeration to say that hhs affects the daily lives of more americans than any other part of u. S. Government. Believe that dr. Price has the experience and qualifications necessary to effectively lead this large and diverse set of agencies and many people share that view. He has had a tremendous , a wealth of experience in the practice of medicine, understands these progress process and has been a member of the house of representatives. Stronglyetaries support his nomination. Organizations who know his work, including the American Medical Association and most specialty groups, enthusiastically support him. The American Hospital association and other stakeholder groups do as well. Perhaps this Health Care Leadership council representing the broad swath of Health Care Provider that it does has said it is difficult to imagine capable careful of serving as the secretary of hhs and congressman tom price. Unfortunately, in the current political capable of serving as the secretary of environment, qualifications and endorsements from experts in Key Stakeholders sometimes dont seem to matter to some of our colleagues. At least that appears to be the case, as none of those who say they oppose dr. Prices nomination seem to be talking about whether he is qualified. Instead, we have heard grossly exaggerated and distorted attacks on his views and ethics. On top of that, we have heard complaints in the series of unreasonable demands revolving the confirmation prompts us. Process. My democratic friends have taken with this approach almost all of President Trumps cabinet nominees. As senate democrats, unprecedented efforts to derail the confirmation process and hasy new standards continued unabated. To that point, let me say this. I have been in the senate for years, in my record for being able to reach across the aisle is beyond any reasonable dispute. I have certainly done it with democrats on this committee. In fact, from time to time, i have taken lumps in conservative circles for working closely with my democratic colleagues. On some occasions, i have voted against confirming executive net , i haveh nominees who deferred to the occupants of the white house and choose allow them to choose who serves in their administration. I have taken lumps for that, who do. Brag. T bring this up to i really i bring this up because i want the people to know that i am serious that i am worried about what my colleagues are doing to the senate as an institution. Kurt courtesy among senators has been in decline for a number of years, but i never seen this level of rancor when it comes to fromng with the president an opposing party. I have never seen a party in the senate, from its leaders down, publicly commit to not only opposing virtually every nomination, but to attacking and maligning virtually every single nominee. Now let me be clear, i am not suggesting that the senate start rubbish rubberstamping nominee. Nor should i ask that they vote against their conscience or preferences out of respect for tradition or deference. What i am saying is that the same rules, processes, skirted courtesies and assumptions of good faith that have been a call ,ark hallmark of the senate especially this committee, should continue to apply regardless of who is president. If what we are seeing now is the new normal for every time control of the white house changes hands, the senate, quite frankly, would be a much lesser institution. Unfortunately, our committee has not been entirely immune to the of theoliticization nomination process. We saw that last week with a munition hearing. Aregret to say that we likely to see more of it today. I hope not. Case in point, i expect during todays hearing we are going to hear quite a bit about process and claims that dr. Prices nomination is being rushed and the nominee hasnt been fully vetted. These allegations are simply untrue. President trump announced his attempt intent to nominate dr. Price three weeks after the election. Dr. Price acquired tax returns and completed question on december 21. That was 35 days ago. And by any reasonable standard, that is sufficient time for a full and fair examination of the nominees record. By comparison, the Committee Held a hearing on the nomination of secretary sibelius, the democratic nominee, 16 days after she submitted her paperwork. For secretary burwell, it was 17 days. The time between the completion of dr. Prices file and his hearing has been more than that. More than that of the last two nominees, hhs secretaries combined. And by the way, both of those nominees received at least a few of the republican votes on this committee and on the floor. Outside of process demands, dr. Price has faced a number of unfair attacks on both his record as a legislator and his finances. On the questions surrounding finances, ill defer on any substantive discussion on how dr. Price can defend himself on what are distorted attacks. For now, i hope my colleagues do not invent new standards for finances, ethics, and disclosure that are different from those that have generally applied in the past. There is a saying about glass houses that might be applicable as well. With regard to dr. Prices views and voting record, i will say that virtually all the attempts ive witnessed to characterize dr. Prices views as being outside the mainstream have been patently absurd, unless the only ideas in the mainstream are those that endorsed the status quo on health care and our Entitlement Programs. In conclusion, i just want to note that the ugly partisan treatment of nominees and distortions of their records is a relatively new development on this committee. My hope is that we can begin to set a new standard here that we can all be proud of, and that we will work to reverse recent trends and have a fair and open discussion of the nominee and his qualifications. With that, i will turn to our distinguished Ranking Member senator wyden. , sen. Wyden thank you, mr. Chairman. Colleagues, the American Public has heard many promises about health care from the new administration. No cuts to medicare or medicaid. Nobody hurt by aca repeal. Insurance for everybody, much less expensive, much better. Congressman prices own record undercuts these promises. Im going just start with ethics and undisclosed assets. Congressman price owns stock in an australian biomedical firm called amino therapeutic. His first stock purchase came in 2013 after consulting representative chris collins. The companys top shareholder and a member of its board. In 2016, the congressman was invited to participate in a special stock sale called a private placement. The Company Offered a private placement to raise funds for testing on an experimental treatment it intends to put out for fda approval. Through this private placement, the congressman increased his stake in the company more than 500 . He has said he was unaware he paid a price below market value. It is hard to see how this claim passes the smell test. Company filings with the Australian Stock Exchange clearly state that this specific private placement would be made at belowmarket prices. The Treasury Department handbook on private placement states, they are offered only to sophisticated investors in a nonpublic manner. The congressman also said last week he declared the purchase himself, departing from what he said was typical practice. Then there was a matter of what was omitted from the congressmans notarized disclosures. The congressman stated it is congressmans estate is five times larger than the figure he reported to ethics officials when he became a nominee. He disclosed owning less than 50,000 of the innate stock. At the time the disclosure was filed, by my calculation, his shares had a value of more than 250,000. Today, his stake is valued at more than a halfmillion dollars. Based on the math, it appears that the private placement was excluded entirely from the congressmans financial disclosure. His companys fortunes could be affected directly by legislation and treaties that come before the congress. It also appears the congressmen failed to consult the House Ethics Committee following other trades of health care stock. That rose was required, as they are directly related to two bills he introduced and promoted. Even if some of those trades were not made at his direction, he would be made aware of them when he filed this periodic transaction report with the house of representatives. Set aside the legal issues. It is hard to see this as anything but a conflict of interest and an abuse of position. Another key question on the finance committees biographical questionnaire is whether nominees have been investigated for ethics violations. The congressman has been the subject of two investigations stemming from fundraising practices. This was not disclosed. The committee needs to look into these matters before moving the nomination forward. Now to policy. On the Affordable Care act and the scheme known as repeal and run, the secret replacement plan is still hidden, but already the Administration Charges ahead with a broad executive order that endangers americans health. As a budget chairman, congressman price is the architect of repeal and run. If his repeal bill became law, 18 million americans lose their health care in less than two years. In one decade, you go from 26 million uninsured to 59 million. Repeal and run raises premiums 50 in less than two years. Costs skyrocket from there. The market for individuals to buy Health Insurance collapses. Nocost contraceptive coverage for millions of women, gone. By defunding planned parenthood, nearly 400,000 women would lose access to care almost immediately. Hundreds of thousands more would lose their opportunity to see the doctor they trust. The price plan takes america back to the dark days when health care was for the healthy and wealthy. His other proposals do not offer much hope that the damage will be undone. There is a big gap between the trump pledge of insurance for everybody and Great Health Care and the congressmans proposal. In another bill, the congressman the empowering patients first act the congressman brings back , discrimination against people with preexisting conditions such as pregnancy or heart disease. Insurers get the power to deny care and raise costs on those with preexisting conditions if they didnt maintain coverage. In effect, the bill says Insurance Companies could take patients money and skip out for paying on the care they need. The price bill also gives insurers the ok to reinstate lifetime limits on coverage and charge women higher rates because they are women. It gutted the tax benefit that help working people afford highquality coverage. It slashed minimum standards to protect patients by defining exactly what health plans have to cover. All this from a bill called empowering patients first . I have seen a lot of bills with ironic titles. This one, colleagues, takes the cake. Heres the constant. The congressmans proposals push new costs on to patients. Massive cuts to medicare were proposed in the price budget. Another example, in my view, the congress has a duty to uphold the promise of medicare. It is a promise in guaranteed benefits. The congressman advocated privatizing medicare, cutting it almost a halftrillion dollars. After his nomination, he said he wanted to turn the program into one with vouchers with the first six to eight months of the administration. He supports balanced billing. Seniors would have to cover extra charges beyond what medicare pays when they go to the doctor. More extra cost for seniors on a tight budget. In addition, the congressman calls for block granting and capping medicaid, which would shred a vital safety net for our most vulnerable. Medicaid insurers 74 Million People. More americans rely on medicaid to pay for nursing home care and homebased care than any other program. The program pays for nearly half of all births and covers millions of children. Its a critical source of Mental Health coverage and Substance Abuse treatment, vital at a time when our communities are battling the opioid epidemic. I close with just two additional points. If confirmed, the head of hhs is the captain of the Trump Health Care team. The congressman says that patients should be at the center of care. I agree with that. When i looked however, at the , congressmans proposals, i dont see the patient at the center of health care. I see money and i see special interests at the center of health care. Finally, let me make a point with respect to the process, and the comments of my good friend chairman hatch. Colleagues, the process here is exactly the same process. To a t, it is the process that applies to tom daschle, it applied to ron kirk. I will enter into the record a specific set of details about how this is the process that is exactly what was done on a bipartisan basis for 20 years, and i will make that part of the record. Thank you, mr. Chairman. Chairman hatch thank you, senator. Im pleased to hand over the introduction, my normal witness introduction to our colleague, the distinguished senator from georgia, senator isakson, who will introduce dr. Price. Senator isakson, please proceed. Sen. Isakson i enjoy being a part of this committee. I couldnt be prouder than to introduce tom price today. This is the second time i have gotten to introduce tom in the last week. The first time i was called, it was for the Health Committee, which i also serve on. And i was proud to do that, and i gave the best introduction i can possibly give based on a man i have known for 30 years. I know him as a family man, a legislator, a member of our community a great physician, and , a great friend. It was easy to do, but since last week things have changed. I feel like i have been asked to be a character witness in a felony trial in the sentencing phase of a conviction. The things that have been said need to be refuted, so i am going to take all the positive things and say them at the end, but try and again by saying there are a few things out there that need a perspective all the way around. I am proud that tom has filed his tax returns. A couple of the things that the Ranking Member said or from those hearings. Some of the things that came out of the memo last night about property taxes, those were one late tax payment in nashville, tennessee, one in washington, d. C. Late, not unpaid. Just late, and i have done that myself a couple of times. On immunotherapeutic, that was the disclosure he made. That is a normal thing. It is in the eyes of the beholder placement in terms of , what uss it as. Tom is a good man. He is a physician, an honorable man. I am proud to be here today not to defend him, because he doesnt need defending but to , praise him for the things he has done. I think it is important for all of us to look at a secretary nomination, whether it is secretary of defense, whether it is health and Human Services. What am i looking for in terms of this person . First of all i am looking for a , person who understands the american family. Tom is a great family man. His wife is here. Raise your hand, betty. Betty is a great lady and wife. Your son robert i guess is still in nashville, tennessee singing country music, right . He could not be there today, but Lamar Alexander appreciates that. Tom is active in his church and community and understands the needs of families and understands relationship of health care to a good family. Secondly, who would i ask to spend 1. 1 trillion of my money . That is how much tom will oversee at hhs. What i would look for in a person to handle that much money, i look for experience, and, has it in terms of the legislator. I look for someone who understands where the cost is going. Tom is the right person. I look for somebody i would trust with that amount of money even though i dont have it, but if it were mine. Third, does he understand health care . Let me tell you about tom and his medical practice. It is called resurgence orthopedics. Resurgence orthopedics is the consolidation of a number of small orthopedic terms around the state of georgia. The largest orthopedic provider in our state. Tom was one of the leading persons who pulled that together and in fact, ran the practice for a while himself. They are my doctors. 26 years ago, resurgence saved the surgeons saved my sons leg in a terrible automobile accident. Ive never forgotten what they did for him in a terrible crisis in our family. They are a great medical firm. He understands medicine. He has run a comprehensive medical program. Fourth, i want to understand if you know the legislative process. When the president calls tom an in and says we are going to , sell our package, tom has to have the ability to convince people that the administration is right. You dont want somebody going out there who has not been in to a legislative bidding before, who had been in the political process before. Tom has done that. He is the type of guy you trust to make the sale. Fifth, i want somebody who is accountable. Tom is an accountable type of guy. In fact, i joked last week and said he is one of those rare ones of us that actually reads the bills. When i have a big question, i will call tom late at night and say, what do you know about h resolution 4742 . He will tell me. Hes not always exciting, hes sometimes boring. But he is always right. He understands you need to be accountable in this business, responsible for what you do, and responsible for what you say. There is a rumor going around about tom not supporting the saving of Social Security. Let me tell you a little story. A few weeks ago, i was called by aarp and tom was called by aarp. They said, would you go on the road for us and do presentations in your districts about how you are going to save Social Security . I guess it was alpharetta, georgia, the first place. Tom and i spent a whole night in a room full of seniors defending saving Social Security. Anyone who is passing that rumor around you ask aarp who is going , to save Social Security, the people active in that business. Tom understands the value of Social Security and medicare. Being eligible for both, i would not be promoting somebody who is going to take it away from me. One other thing, four years ago i sat in this committee and i asked all i could of sylvia burwell. When it came time for a vote, i voted for her because she was the right person at the right time. Dr. Tom price is the right man at the right time for the right job. He is my friend, he is a man ive known for 30 years, he has unquestioned character and unquestioned ability, and he will be a great secretary of hhs. I think all of you for taking all of my calls. I urge you to give the courtesy of your time to listen to what hes got to say. I hope you see it fit to nominate an honorable, good man to be the next secretary of health and Human Services. And i yield back, mr. Chairman. Chairman hatch thank you, tom,isakson i tell you, you could not have a better interviews are than senator isakson. I think he did a very good job talking about you and your future here in this committee. I have some obligatory questions for the nominee. First, is there anything that you are aware of in your background that my present a conflict of interest with the duties of the office of which you have been nominated . Rep. Price i do not. Chairman hatch do you know of any reason, personal or otherwise, that would in any way prevent you from honorably fulfilling this responsibility . Rep. Price i do not. Chairman hatch do you agree without reservation to respond to any reasonable summons to appear and testify before any committee of the congress if you are confirmed . Rep. Price i look forward to that. Chairman hatch finally, do you commit to providing a prompt response in writing to any questions that may be submitted to you or addressed to you by any senator of this committee . Rep. Price i do. Chairman hatch thank you. Those are the obligatory questions we really ask of everybody. Let me go on to some questions that i would like to ask. Before we go to the questions, i have a tendency to want to get going a little quicker than i should. Lets turn the time over to you, congressman price, to say whatever you would like to say to the committee this morning. Rep. Price thank you so much, chairman hatch, Ranking Member widen, and all the members of this committee for the opportunity to speak today and engage in discussion about the road ahead for our great nation. I want to thank senator Johnny Isakson so much for that incredibly gracious introduction. As he mentioned, we have known each other for 30 years or so. I am thankful for his friendship and kindness. Our state is so grateful for his leadership and service. We are blessed to have him. I wish also to thank my wife, betty, of 33 years. She joins me here today. Her encouragement, her advice, which i remind you is always correct, and her love that she has given me over the past 33 years, i am more grateful for that than i could ever say. Over the past couple of weeks and months, i have met with many of you individually and gained a real appreciation of the passion you have are the critical work done at the department of health and Human Services. Please know that i share that passion, which is why i am here today and why i am honored to have been nominated to serve as the next secretary of health and Human Services. We all come to Public Services in our own unique ways that inform who we are and why we serve. My first professional calling was to care for patients. That experience as a physician and later as a legislator has provided me a holistic view of the complex interactions that take lace every day across our communities. Today i hope to share with you how my experiences shaped my understanding of and appreciation for the department of health and Human Services. From an early age, i had an interest in medicine. My earliest memories, though, were growing up on a farm in michigan, where i lived until i was five years old, when my family moved to suburban detroit. I spent most of my formative years being raised bicycle mom. By a single mom. My grandfather was a physician. I would spend time with him and he would make rounds, which meant that we would get in the car and visit peoples homes for house calls. I will never forget warmth and love he showed in every single door. After graduating from medical school, i moved to atlanta, which i have called home for nearly 40 years. Thats where i met my wife. Thats where were you raised our son. I did my residency at Emory University, where i would later returned to serve as the medical director of an orthopedic clinic. Throughout my professional career, i cared for and treated patients from all walks of life, including many children. Anyone who has ever had the privilege of treating a child knows how fulfilling it is to look into the eyes of a mom or dad and say how we helped heal their son or daughter. My memories of grady are still filled with the gracious and patientsarents of the Health Care Specialists with whom i had the privilege of working. After 25 years of school in training, i started a solo orthopedic practice. Over the years, this practice grew and became one of the largest in the country, for which i eventually served as chairman of the board. During 20 years as a practicing physician i learned a good bit , about not just treating patients, but about the Broader Health care system and where it intersects with government. A couple of vivid memories stand out. One are the number of times where patients were remarkably angry about the individuals figuratively, not literally, but figuratively standing between themselves and their physician, in the clinic room, making it so that what the physician was recommending may or may not be possible, whether it was from insurance, regulators, government or the like. There was the day i remembered vividly when i realized there were more people in the Office Behind the door where we stop saw patients in the front clinic area trying to fight with insurance and regulators than there were in front of the door actually caring and treating patients. It became clear to me that our Healthcare 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 issues harming the delivery of medicine, so i ran for the Georgia State senate. I found the Georgia State senate to be a remarkably bipartisan place where collegiate relationships were the norm. This was the environment in which i learned to legislate, reaching across the aisle to get work done. In congress, i have been fortunate to be part of a collaboration that broke through party lines to solve problems. This past congress, as you may recall was a bipartisan effort , that succeeded in ridding medicare of a broken physician Payment System which has now become the creation of a system that, if implemented properly, will help ensure that seniors have access to Higher Quality care. If confirmed, my obligation will be to carry to the department both an appreciation for the bipartisan, team driven policymaking, and what has been a lifetime commitment to improving the wellbeing of the American People. The commitment extends to what i call the six principles of health care affordability, accessibility, quality, responsiveness, innovation, and choices. But health and Human Services is more than health care. There are real heroes in this department doing incredible work to keep our food safe, to develop drugs and Treatment Options driven by scientists conducting remarkable research. They are heroes among the talented men and women working to provide critical social services, helping families and particularly children have a Higher Quality of living and the opportunity to achieve their american dream. The role of the health and Human Services department in improving lives mean it must carry out its responsibilities with compassion. It also must be efficient, effective, and accountable, as well as willing to partner with those already doing remarkable work. Across the spectrum of issues and services this department handles, there endures a promise that has been made to the American People, and we have to strengthen our resolve to keep the promises our society has made to Senior Citizens and those most in need of care and support. That means saving and strengthening and securing medicare for todays beneficiaries and future generations. It means ensuring our nations medicaid population has access to quality care. It means maintaining and expanding americas leading role in medical innovation, and the treatment and eradication of disease. I share your passion for these issues, having spent my life in service to them. And yet there is no doubt that , we dont all share the same point of view when it comes to addressing these issues. Our approaches to policies may differ, but surely there exists a common commitment to Public Service and compassion to those we serve. We all hope to improve the lives of the American People, to help heal individuals and whole communities. With a healthy dose of humility and an appreciation of the scope of the challenges before us, with your assistance and with gods will, we can make it happen. I look forward to working with you to doing just that. Mr. Chairman, i think the opportunity to be with you today. Chairman hatch thank you, dr. Price. I cant think of anybody who could give a better analysis of why this position is important to them. The department of health and Human Services is one of the largest departments in government, employing nearly 80,000 employees and encompassing over 100 programs covering a large range of complex and diverse issues. You have described it to a degree, but if you can elaborate a little bit more can , you describe on how you would prioritize the large range of issues for which you would be responsible . And tell us what in your history has prepared you to lead the department of health and Human Services, such a multifaceted department . Rep. Price thank you, mr. Chairman. As you and the members know the , mission of the department is to improve the health, safety, and wellbeing of the American People. In order to do that, i am committed to that mission, but in order to do that, youve got to put together teams of individuals in each sector of health and Human Services. In my history, wherever i was whether i was in my clinical , practice or the state legislature or congress, or the work i did in communities, was just to bring forward the greatest quality of talent we could assemble. The second is to understand the scope and issues. Clearly having the experience both in the clinical arena as well as the legislative arena, understand the scope of the issues. Finally, focusing on results. I think oftentimes, it gets kind of muddy up here in washington. What we do, we name the programs, we make certain that the resources are there to be able to provide money for the programs, but often times think whether or ball on not we are actually accomplishing the mission. Are we truly improving the health, safety, and wellbeing of the American People . One of the goals i have is to look at the metrics of the department that we are looking at and making sure we are accomplishing that mission and goal. Chairman hatch thank you. The center for medicare and Medicaid Innovation has begun several initiatives, some of which have generated controversy. Could you tell us your position on the work at cmmi and how it should or should not be continued in the future . Rep. Price innovation is so incredibly important to health care and the vibrant quality we need to provide to our citizens. Innovation, in fact is what , leads Quality Health care, its what expands the ability of Health Care Professionals to treat patients. I am a strong supporter of an innovation. One of the roles we have as policymakers is to incentivize innovation. The center for medicare or Medicaid Innovation is a vehicle that might do just that. I think, however, the cmmi has gotten off track a bit. It is defining the areas where it is mandatorily dictating how areas must practice. Whether it is a Geographic Area that includes 68 or 67 areas in our country that have to perform a certain procedure in a certain way because the government says they have to, mandatorily, without exception, or whether it is 75 of the part b medicaid medicare drug demo, which dictates to physicians and other providers what drugs they must use. That, to me, is no longer a trial, no longer an experiment, no longer a Pilot Project to determine whether an Innovative Solution might work. That is changing the way american medicine is practiced by folks making decisions here in washington, as opposed to patients, families, and doctors making those decisions. A strong supporter of innovation. Hope that we can move cnmi in a direction for patients. Chairman hatch thank you so much. Medicare has lost 130 billion b tois with a be improper payments over the past three years. The program has also been above the legal billing error Rate Threshold of 10 . Given that trustees have raised great concerns out of medicare insolvency if we stay at the current levels, will your administration champion our medicare integrity programs so that we can recover a much higher percentage of the billions of taxpayer dollars lost each year to billing mistakes, and ensure that medicare will be in place for future american seniors . Also, as a former practicing physician who has experience with medicare and Medicaid Programs, do you have any insights into steps you think should be taken to address the multibilliondollar problem of waste, fraud, and abuse in these programs . Rep. Price nobody supports care being billed for that is not needed or has not been provided. This is one of those areas where i think we need to be very , very focused. I am certain that there are some bad actors out there. I think there are a minority, but there are bad actors. If we focused on all those bad actors in real time, which is what happens in every other industry in our country, where realtime of the nation is available and acted upon, and that instead of trying to figure out whether every single incident of care is necessary, we would focus on those individuals who were the bad actors. I think we would do a much better job of not just identifying the fraud that exists out there, but ending that fraud. Chairman hatch thank you. Senator wyden . Sen. Wyden congressman, i am going to start with the trading of health care stock. Your position is that the trading was legal because, in your view, it complied with house rules. I think there are debatable factors. Inmate immuno therapeutics is an Australian Company developed for treatment of immune system disorders and plans to seek fda approval. Its fortunes are affected by congressional action. Today, the total value of your shares is a halfmillion dollars. Yet on the office of government ethics disclosure form you filed as a nominee, you significantly undervalued the stock. You failed to include the value of more than 400,000 shares you bought at a significant discount during a private stock sale made available to specially chosen investors around labor day. You also significantly underreported the value of this purchase to the committee, it is worth more than twice what you reported. The house colleague is a Board Director of a drug company and the largest shareholder. You got in on private placements not available to the public. In these private placement, you bought over 400,000 shares at discounts that were as much as 40 cheaper than the price on the Australian Stock Exchange. And you were sitting at the time on committees that have jurisdiction over Major Health Care programs and trade policy. Yes or no, doesnt this show bad judgment . Rep. Price if what you said was true, it might. Sen. Wyden congressman, we have a paper trail for every comment i have made. Yes or no, doesnt this show bad judgment . Rep. Price no. Chairman hatch let him answer the question, too. You kind of indicated he did something wrong. Let him explain why it was not wrong. Sen. Wyden it was a yes or no chairman hatch i want him to be able to handle the problem. Maybe it would be helpful if you laid out the accusation, sir. Sen. Wyden well, you purchased stock from an Australian Company through private offerings at discounts not available to the public. Rep. Price if i may, they were available to every single individual that was an investor at the time. Sen. Wyden that is not what we learned from company filings. Company filings with the Australian Stock Exchange state that this specific private placement would be made below market rate. The Treasury Department says it is only offered to sophisticated investors in a nonpublic manner. We have a paper trail for every one of the statements that i have gone into. Trading in stocks while sitting on two committees, introducing legislation that directly impacts the value of the stocks rep. Price what legislation would that be, senator . Sen. Wyden we will take you through the various bills, but the reality is this has been cited on a number of occasions. Rep. Price the reality is everything i did was ethical, above board, legal, and transparent. The reason you know about these things is because we have made that Information Available in real time, as required by the House Ethics Committee. There is nothing you have here that has not been public knowledge. Sen. Wyden your stake in innate is five times larger than the figure you reported when you became a nominee. Rep. Price and if you listened to your committee staff, you would know that our belief is that it was a clerical error when it was filed. We dont know if it was on our end or the end of oge. But there was not any malicious sen. Wyden congressman, you also reported it in the question questionnaire to the committee, and you had to revise it yesterday because it was wrong. Rep. Price the reason is, when asked about the value, i thought it meant the value at the time i purchased the stock, not the value at some nebulous time when we supposedly sen. Wyden one other question, if i might. This weekend, the president issued an executive order to do Everything Possible to roll back the Affordable Care act. If confirmed, you will be the captain of the health team in charge of implementing the order. Yes or no, under the executive order, will you commit that no one will be worse off . Rep. Price what i commit to is working with you and every member of congress to make certain we have the highest Quality Health care, and that every single american has access to affordable coverage. Sen. Wyden that is not what i asked. I asked, will you commit that no one will be worse off under the executive order . You ducked the question. Will you guarantee that no one will lose coverage under the executive order . Rep. Price i guarantee you that the individuals who lost coverage under the Affordable Care act, we will commit to making certain they dont lose coverage under whatever replacement plan comes forward. Thats the commitment i provide. Sen. Wyden the question is, again, will anyone lose coverage, and you answered with something i did not ask. I will wrap up by saying, will you commit to not implement in the order until the replacement plan is in place . Rep. Price as i mentioned, what i commit to the American People is to keep patients at the center of health care. What that means to me is making sure every single american has access to affordable Health Coverage that will provide the highest Quality Health care that the world can provide. Sen. Wyden i will close by way of saying what the congressman is saying is the order could go into effect for before there is a replacement plan, and independent experts say that this is going to destroy the market on which millions of working families buy Health Coverage. And on the questions that i asked, will congressman commit that nobody will be worse off, nobody will lose coverage, we didnt get an answer. Thank you, mr. Chairman. Chairman hatch how can anybody commit to that . Let me just say. Dr. Price, you have been accused of investing in securities where you disclosed the wrong value of shares you have owned. Now dr. Price, let me just say this has a diversified or folio portfolio with Morgan Stanley in a broker directed account. I am wrong on any of this, dr. The portfolio , includes both health care and on health care stock. His Financial Advisor designed the portfolio and directed all trades in the account. The advisors and not dr. Price has the discretion to decide which securities to buy and sell. On march 2016, in march 2016, and a periodic rebalancing of the portfolio, the Financial Advisor to directed the purchase of 76 shares worth under 3000. The advisor notified dr. Price of the purchase on april 4, 2016, and dr. Price disclosed them on his house periodic transaction report on april 15. Dr. Price began his effort related to the joint replacement demonstration project in 2015. With one exception, all of dr. Prices stocks are held in free, brokerdirected accounts. Neither he nor his wife direct or provide input regarding investments in these accounts. Innate immunotherapeutics is the one exception. Dr. Price decided to invest , ill just call it based on Public Information regarding his work on multiple sclerosis treatments as a disease. He has been involved in trading for years. He directed the investments based on his own research and into the Company Invested , 10,000 in the company in january 2015, and reported the investments to the house of ethics in february in that year. He made additional investment in september 2016 and also disclosed that investment. His filing regarding his shares, he has agreed to divest all shares in the company. Is that correct . Rep. Price it is correct, sir. I just want to point out that anybody who knows me well knows that i would never violate their trust. I know the environment we are in. You mentioned it in your opening statement, but i appreciate you correcting the record. Mr. Chairman, just an inquiry, you just consumed about two minutes beyond your opening statements. In the interest of fair play, is it appropriate for someone to note that two minutes is also owed to senator wyden or somebody on our side . I just ask you to chairman hatch i am not going to relinquish my role as chairman. No i understand. Chairman hatch i have always been good about giving the time you need, so i will try to do that, but i am also not going to allow things that are false to go forward without some sort of comment. We just cant allow this to happen. Mr. Chairman, just the unanimous consent request, bipartisan disclosure memo, i would like it to be made part of the record because it will document what i stated. Chairman hatch without objection. Senator roberts . Sen. Roberts did you really wink at me and smile . Bless your heart. Thank you. Good doctor, thank you for coming. I think it is important to make clear off the bat that even if congress and the Incoming Administration were to do absolutely nothing amending or repealing parts of the Affordable Care act, the law is not working. It is collapsing. The prices are not affordable, the market is nonexistent, few options to several states and counties. This year, one of every three counties in this country only has one insurer offering coverage on the exchange. What tools do you have, or will you have when you are confirmed, which will be utilized over the next couple of months to provide stability and improve the individual Insurance Markets, make them more appealing so insurance carriers will want to come back and provide more Coverage Options as we transition away from the Affordable Health care act . Rep. Price i think it is incredibly important for us to admit what the American People know, and that is that this law is not working. Certainly isnt working for folks, the individuals and Small Group Markets. You have premiums that are up significantly. They were supposed to go down by 2500, and now they are up more than 2500 on average. Youve got deductibles that have escalated to 6,000 to 12,000. Youve got, as you mentioned, stakes where there is only one insurance provider, youve got 1 3 of the counties in this country where there is only one insurance carrier. It may be working for Insurance Companies and government but it , is not working for patients. We need to reconstitute the individual and Small Group Market. That begins, i believe by , providing stability in our conversation and tone. One of the goals i have a lower the temperature in this debate is to say to those providing the Insurance Products across this country that we understand the challenges you have. They are already exiting the market. What we need to do is to say, there is help on the way, to allow us to reconstitute the individual Small Group Market that allows for folks to gain the kind of coverage they want for themselves and friends of their family, not that the Government Forces them to buy, that allows them to purchase coverage at a reasonable amount that makes it so they dont have deductibles through the roof, where they dont have the ability to pay the premiums and adaptable as well. There are so many things we are so many things we opt to be focusing on to make certain that the American People have access to the highest quality care that is affordable to them. Sen. Roberts i have 84 critical hospitals in my state, part of the Rural Health Care Delivery System which is under great stress. As we have seen when i visit with hospital administrators all throughout kansas, there was a time where i knew every one of them, but they are scratching their heads over regulations coming out of hhs, cms. Hipaa and be hew and the list goes on and on. I mention the Meaningful Use Program for Electronic Health care records. Doctors used to spend 10, 15 minutes with patients. It is now down to about two or three, and then they have to report immediately with what is going on. Rule with critical hospitals. These regulations from washington did not translate to kansas or other rural areas. My question is, how will you work to ensure an effective, but less burdensome rulemaking process . Rep. Price this is critical, because as you mentioned, georgia is the largest state geographically east of the mississippi, and weve got a large rural population. Critical access hospitals are so important to communities around our state and truly around this nation. But the scheme that has been put in place is choking the individuals that are trying to provide the care, so much that youve got physicians and other providers leaving the practice, leaving the care of patients. S , care of patients. Not because they have grown tired of it, but because the onerous nature of the regulatory scheme coming out of washington dc. The meaningful use project you mentioned makes it that much more difficult. We have turned physicians into data entry clerks. You just have to ask them what they are doing. When you talk to patients, when they go in to see their doctor, they see the top of his or her head as they are punching me information into a computer, as opposed to the sharing of information that is so vile and necessary vital and necessary to Quality Health care. The recognition of the problem is incredibly important, the important several health care and how it needs to be bolstered up, and looking at the consequences of what we do as a government. Look at thewe dont consequences. We passed the world, we institute it, we think it is the greatest thing, but it is harming the individuals providing the care. You dont get that information unless you ask. Sen. Roberts i appreciate that. My time is up area take you, mr. Chairman. My times up. Thank you, mr. Chairman. , i enjoyed our visit yesterday. We had a discussion when you were kind enough to come visit have,out the fact that i in the state of florida, 4 million plus seniors on medicare. Of the idearified of privatized medicare. I talked to you about this, and talked about the premium support system that you are advocating, and you pointed to a. Tudy that was done by cbo you mentioned that you would send me a copy, and we have not gotten it, so what i did, i went and got the copy myself, and it is september of 2013. Is opposite ofes what you said with regard to highcost states like florida. Medicare is going to be spending 4 lower under the proposal you were talking about in this cbo report, lower than current law, and beneficiary costs will decrease eye 6 on the average by 6 on the average, which is what you said yesterday. Liken highcost regions florida, you were going to have a higher beneficiary cost then current law under your premium support proposal. Annual premiums in florida would 125 , according to the cbo chart on page 71. Cbo says the annual premium in a highcost region like florida would be 3600, compared to the current law of 1600. That is the 125 increase. So, please help clarify what you were saying yesterday as it applies to florida. Senator,e thank you, and i enjoyed our time together as well. Medicare, itabout is important for everybody to appreciate, as i know you do, that the medicare trustees, not republicans or democrats, have medicare inus that a very short time, less than 10 years, is going to be out of the kind of resources that will allow us as a society to keep the promise to beneficiaries of the medicare program. It is important to appreciate what that means. It means we will not be able to provide the services to medicare patients at that time, which is very close, if nothing is done. My goal is to work with each of you to make certain that we save and strengthen and secure medicare. I think it is a responsible for us as policymakers to allow a program to continue knowing that in a few short years, it is not going to be able to cover the services. That is the first point. The current medicare program, if nothing is done, goes broke. The second point is, if i am confirmed and have the privilege of serving as the secretary of health and Human Services, my role will be one of carrying out the law that you and Congress Passed eu in congress you in Congress Passed. Nelson let me be so rude as to stop, as im running out of time. Remember that donald trump in the campaign and said that he was not going to cut the care spending. Medicare spending. To you, and aoint legislative solution, one of the isatest examples of medicare 1983, when we were just about to oldust, and it took two irish men, reagan and oneill, to come to an agreement that made Social Security actuary sound for the next halfcentury. Representative price, you have that it was ant terrible idea of people who have preexisting conditions, that they would have the protection of insurance against those preexisting conditions. What i would like to ask you is, can you please, in light of President Trump expressing his desire to maintain this basic protection, you think his proposal to continue the ban on discriminating against people preexisting conditions is a terrible idea . Rep. Price i am not certain where you are getting that quote from. Nelson politico talking points memo, may the first, 2012. Rep. Price there is a reliable source. [laughter] rep. Price what i have always said, senator, is that nobody sen. Nelson you did not say it was a terrible idea . Rep. Price i dont believe i have made that statement. In a system that pays attention to patients, nobody ought to be priced out of the market for having a bad diagnosis. That may workem for Insurance Companies, may work for government, but it does not work for patients. We need is a system that recognizes that preexisting conditions do exist, and we need to accommodate it and make certain that no one loses their insurance or is unable to gain insurance because of a preexisting condition. Sen. Nelson as i close, i would like to insert in the record of the december 2013 Congressional Budget Office analysis of premium support system for medicare. You to please respond with the cbo report that you said yesterday supports your position, because this one does not. Rep. Price i look forward to that. Thank you, sir. Menendez congratulations, congressman price. Training anddical time spent as a practicing physician. I have a couple of yes or no questions. In your opinion, does hiv cause aids . Rep. Price i think the Scientific Evidence is clear that hiv and aids are linked. Sen. Menendez and your opinion, has it led to the outbreak of leprosy . Rep. Price i dont know what you are referring to, but i suspect there are instances when individuals have Infectious Disease sen. Menendez are not asking about Infectious Disease. Im asking about immigrants in the United States causing leprosy in the United States, in your opinion. Rep. Price again, i dont know the incident to which you refer. Are you referring to a specific incident . Sen. Menendez there are statements made in the Public Domain that immigrants have led outbreaks of that dorsey outbreaks of leprosy in the United States. As the director of the health and Human Services, i want to know if you and medical opinion there is such a causation. Get twoce anytime you individuals together in any relationship on the whether it is an immigrant or a visitor, and one individual has an axis disease as an Infectious Disease, it is possible that is transmitted. Sen. Menendez do abortions cause Breast Cancer in your medical opinion . Rep. Price the science is relatively clear that that is not the case. Sen. Menendez in your medical opinion, do vaccines cause autism . Rep. Price the science says it does not. Sen. Menendez i am not asking about individuals come i am talking about science. You will have a department in alternatence, not universes of peoples views, is going to be central to a 1 trillion both budget and the health of the nation. Can you commit to this committee and the American People that should you be concerned confirmed, you will debunk false claims to protect the Public Health . Rep. Price i will commit to doing the Due Diligence that the department is known for and must do to make sure factual information is conveyed. Sen. Menendez and that factual information will be dictated by science, i would hope . Rep. Price without a doubt. Sen. Menendez let me ask you about medicaid. I am a little taken aback on the question about immigrants and leprosy. Science is well dictated. One of the most beneficial components of the aca was the expansion of the Medicaid Program that resulted in 11 Million People nationwide gaining coverage, many for the first time. It is one of the biggest programs on the republican chopping block, with proposals to not only repeal the Affordable Care costs Medicaid Expansion, but gutting billions in federal funding to the state. This would result in catastrophic loss of coverage for tens of millions of low income families and lead to tens of billions of losses to safety net and other Health Care Providers. Do you recognize medicaid to be a valuable program and consider the coverage it provides the 74 million americans to be comprehensive . Rep. Price medicaid is a Vital Program for health care for many individuals in this country, but one that has significant challenges. One out of every three physicians who should be seeing medicaid patients are not taking any medicaid patients. There is a reason for that. If we are honest with ourselves, that would be asking the question why. Sen. Menendez if that is the case, that one in three dont treat medicaid, is that because medicaid reimbursements are low . And since providing reimbursements is setting at the havingevel, wont federal funding lead to lower provider rates . How many doctors would actually treat former medicaid beneficiaries when they no longer have any coverage or ability to pay . There is only one of three, there are still two of three providing the services. Imagine imagine if you dont have coverage. To in essenceated block grant medicaid. The essence of medicaid is an entitlement, which under the law, means if i meet these criteria, i have the right to have that coverage under the law. When you moved to a block grant, you remove the right and you make it a possibility subject to whatever funding there will be. Do you recognize that in doing so, you risk the potential of whoions of americans, presently enjoy coverage through medicaid, no longer having that right . Rep. Price i think it is important to appreciate that no the president has supported or i have supported would leave anybody without the opportunity to gain coverage. Nobody. Sen. Menendez that is not my question. Let me reiterate. Medicaid, under the law as it exists today, is a right. Rep. Price it is an Entitlement Program sen. Menendez doesnt that mean if you have the right if you meet the criteria, you are entitled to the services . Rep. Price one is eligible, that is correct. Sen. Menendez when he moved to a block grant, do you still have the right . Rep. Price it would be determined how it was set up that that was in fact what congress did. The role of the department of health and Human Services to administer the laws that you pass sen. Menendez i would sibley say to you, in our private conversation i appreciate you coming by to visit, you suggested your role was the administrator of a large department. That is not what the Vice President said when you were nominated. He expected your experience medically and legislatively to help drive policy, and even beyond the expectations of the Vice President in that regard, when we have regulatory abilities of the secretary to did take regulation, that is policy. I ame dont say to me that here just to do what congress says. I respect that he will follow the law and do what congress says, but you will have an and enormousmpact an impact, and based on your opinions on medicaid, block granting means a loss of life. That is a question of funding. We will have a bigger problem with the number of providers willing to provide. I hope we can get to a better understanding of your commitment to medicaid as it is, as an entitlement, as a right. Senator, your time is up. We will go to senator carpenter. Carpenter welcome to you and your wife. Scripture verse of that you mentioned, in the new testament, matthew 25, that says , when i was hungry, did you feed me . When i was naked, did you clothed me . You i was in prison, did visit me . When i was a stranger in your land, did you take me in . It doesnt say anything about to healthly access care was going to the emergency room, did you do anything about it. Room, the genesis of the Affordable Care act goes back to 1993 when Hillary Clinton the first lady was working on what was called hillary care. A group of senators led by john frome, the republican rhode island, developed legislation sponsored by 23 senators, including senator orrin hatch and senator grassley. What he did on the legislation was to use five major concepts. One, to create large purchasing pools for folks who otherwise may not have access to coverage. He called them exchanges or marketplaces. We also propose that there be a sliding scale tax credit to bring down the cost of people getting coverage in those exchanges. The third thing he proposed was the notion that there should be an individual mandate. You want to do make sure people got covered. He realized if they didnt mandate coverage, people getting coverage, they would end up with insurance pools that Insurance Companies couldnt begin to cover. It would be unworkable. He proposed as well, an employer well,e and he proposed as the notion that people shouldnt lose their coverage because of preexisting conditions. Those are not democrat ideas, those were proposed by republican leadership, actually. In the congress at the time. His governor romney brought own plan into massachusetts, a decade or so later, he borrowed liberally from those ideas. Recall, the institute of what others call romney care, they did a pretty good job covering people, but not such a good job on affordability. What took place over time is, they found out they had insurance pools are a lot of people were not young, they were not very healthy, they were older and needed more health care. As a result, the insurance stay in business had to raise premiums. I dont know if any of this sounds familiar to you, but it sure sounds familiar to what we have seen in the last six years or so with the Affordable Care act. Jp eas of senator chafee and governor romney, we have encouraged states to increase the number of people they cover under medicaid by two 135 of the Poverty Level that people could receive health care. There was a focus on prevention ness. We provide funding for contraception. We for provide funding for programs that are intended to reduce obesity. We have programs that are intended to reduce smoking, the use of tobacco. This is not a yes or no question. What was wrong with that approach . What is wrong with that approach . Before you answer, the Health Insurance Companies Found it difficult to stay in business in the state groups, the exchange across the country. One of the reasons why they were unable to is because i think, we didnt raise or refine, we didnt have the incentive high enough to get young, Healthy People onto the exchanges across the country. S p has just put out about a month ago, an update looking at the Financial Health of the Health Insurance companies in this country. They have tried to figure out how to price this product, and it seems like according to s p, they seem to have figured out, because the Health Insurance companies have begun to stabilize, your reaction to this please. Rep. Price as i mentioned either in my opening or in response to question, the principles of health care that all of us hold dear, affordability and accessibility and quality and choices for patients, i think are the things that we all embrace. Get tot step, how we accomplish and meet those goals and principles, is where it takes Work Together to do so. The program you outlined has much merit, whether it is making certain the individuals withting preexisting conditions can access coverage, whether it is the pooling mechanisms, there are a lot of merits there. What i am hopeful we are able to , in a collegial bipartisan way, Work Together to solve the remarkable challenges that we have. One of my physician colleagues used to tell me he never operated on a democrat patient or a republican patient, he operated on a patient. That is how i view the system. It is not republican or democrat, it is a system that folk hopefully is focused on patients to make sure they have access to the highest quality care possible. Sen. Carper let me conclude by ,aying, the recent analogy there is a large building and there are people in the building and was a fire in the large building but for some reason they couldnt use the stairways or the elevators. They looked up the windows and there were firefighters in the street, saying, go ahead and jump. We will save you. They dont have any safety nets. My fear is, if we repeal what i described, that we put in place, which were founded on republican ideas, good ideas, and we dont have something at least as good in place to catch those people as they fall from the building, we are going to do a disservice to them in our country and our country. Burr the Affordable Care act was not passed with one republican votes built in the house and senate. Couple questions to cut to the chase. Currentlyur assets disclosed publicly . Rep. Price they are now and they always have been. are you covered by the sock act passed by congress that requires you and every other member to publicly enclose all sales and purchases of assets within 30 days . Rep. Price yes, sir. Been accusedu have of not providing the Committee Information related to your tax and financial records that were required of you. You have any records been asked to provide that you have refused to provide . Rep. Price none whatsoever. Sen. Burr does it trouble you all that as a nominee, to serve in this administration, that someone will hold you to a different standard than you as a member of congress . I might say, the same standard they currently buy and sell and trade assets on, does it burn you that they want to hold you to a different standard now that you are a nominee than they are as a member . We know whatsl, going on here. Sen. Burr we do. Rep. Price as my wife tells me, i volunteered for this. Burr you and i have a lot in common. We both spoke out in opposition to obamacare early. We predicted massive premium increases. When the president promised, if you like your doctors, you can keep them, if you like your plan, you can keep it, we both said these promises would be. Roken, and they were over the last seven years, you and i, senator hatch, and others , have written our own Health Care Plans because we were i think brave enough to say, if youre going to be critical of something, put your ideas on the table. In your opinion, was it clear to the American People that repeal of obamacare was a promise that donald trump before he was elected president . Doubt that i have no it played a prominent role in this past election, and the president is committed to fulfilling that promise. Sen. Burr as the nominee and hopefully, i think you will be are the main, what goals of the obamacare replacement plan . Rep. Price they are outlined in the principles, it is imperative thatve a six a system is accessible and affordable for every single american, that incentivizes and provides the highest Quality Health care the world knows, and provides choices to patients so they are the ones selecting who is treating them, when, where, and the like. It is complicated to do, but it is Pretty Simple stuff. I want to thank you for not only testifying here, but in front of the Health Committee where john and i had you over there. You are brave to go through this , but the country will be much better off with your guidance and your knowledge. I yield back. Senator cardin. Din thank you and your family for being willing to do this. Fewnt to talk about a issues in the time i have. Yesterday, the president by executive order reinstituted the global guide rule, but he also did it in a way that is more comprehensive than the previous. The new policy would prohibit any federal aid to foreign organizations that provide or promote abortion. To organizations that get Global Health funding. Potential including potentially including Maternal Health programs and efforts to stop hiv and aids. My question is, if confirmed, how will you make sure that the u. S. Can fully participate in these Global Health efforts to help Maternal Health, to help stopping the spread and and the theand aids, to make sure next zika virus, that we can contain it so it doesnt cause the catastrophic effects, if the global gag rule is and forced in a way that prevents us from participating in International Health organizations rep. Price i appreciate the question. The department is full of all sorts of heroes, and incredibly talented individuals. My goal, if i am given the privilege of serving, is to theer the best minds and best talent we have within the department and without, and the wisest policy for this nation to have with regard to Infectious Diseases. Work, the worke the cdc does and the work done by others in our nation that try to prevent Infectious Disease, worked to detect the spread of Infectious Disease, and provide a logical and methodical and aggressive response to the outbreak of any Infectious Diseases, is vital to protect the American People and we are committed to doing so. Sen. Cardin i hope you will look at an unintended consequences from these executive orders that could compromise our ability to be as effective as we need to using all tools at our disposal. I want to get to tobacco regulation, an area that i think is now were within the medical. E, the impact tobacco has the family smoking prevention Tobacco Control act of 2009 authorizes the hhs secretary and the fda to regulate Tobacco Products, including restricting sale of tobacco to minors. It has been expanded to include the selling of ecigarettes. Initially, you do not support that legislation. If confirmed, can you commit to us that you would rigorously enforce to make sure our children are not subjected to the new forms of Tobacco Products . Rep. Price if im confirmed, but responsibility we will have is to enforce the law of the land, and we will do so. Sen. Cardin this requires keeping up with new technologies used by the industry that may , as we seeifications with ecigarettes. Are you prepared to not only enforce the law, but enforce our intent to make sure children are protected . Rep. Price i look forward to looking with working with you on that. We will continue to debate the merits of the Affordable Care act. Im a strong supporter, and i think the millions of people who have coverage that didnt have it before, the quality of coverage that americans have now, and the rate of growth of Health Care Premiums are lower than they would have been. We will debate that later. The question is, its coming along. We have heard you say several times that the principles the president has articulated as to what would be in place of the Affordable Care act, i would like to drill down on the Central Health benefit. We talked about Preventive Care being available. We have now Mental Health and Addiction Services available. We know we have pediatric dental now available, which is important in my state because of the tragic loss of the monte driver in 2007. Can you assure us, as you looked at what will be the Healthcare System moving forward, you are prepared to make sure americans have Quality Insurance coverage to deal with issues like Preventive Care, Mental Health services, Addiction Services, and pediatric dental . Rep. Price what i can commit to alli will do we will do we can within the department with the knowledge and expertise that is there to define whether or not the program is actually working as intended or not. If covered it coverage equals care, in many instances, many individuals have coverage, they have a card but they dont have any care because they cant afford the deductible that allows them to get the care. We are committed to making certain that the program works, not just for government and the Insurance Companies, but for the patient. we can talk about the specifics on Preventive Care going forward. I look forward to that. Senator isakson. Son secretary to be, let me ask you a few questions. You have been asked a lot of questions with the intent of getting you to say when you will cut medicare. Ll we are than hearing about the joint Replacement Program launched in 2015. We have raised concerns about the program, saying it could harm patient care. An administrative action to hhs that would cap would that cut benefits . Potentially yes. Reducing medicare spending on cancer drugs. Many of this oppose this. We are concerned with cutting benefits and there might be a cut to benefits for seniors. What about all the recent changes hhs has made to cut medicare . One thirds one third of beneficiaries. My point being, anyone of us can sit at this table and say, give me yes or no answers and demonstrate the point we want to make. Of us are interested in saving Social Security for seniors, making medicare work and saving taxpayer money, is that true . Rep. Price yes. If anyone of us can take a financial disclosure, something they called desperate impact, when you take two facts and make a wrong, anyone of us could do it to disrupt peoples thoughts on something. People haveen, taken things you have disclosed and try to extrapolate some evil that would keep you from being secretary when it shouldnt be true. For example, it if you go to the annual report, there is an income fund. The main the Major Holding is a pharmaceutical company, who we jumped all over for huge increase in products. We are not occur accusing the rank and member for raising prices. Could you indict someone and not accuse them . Rep. Price i think that is correct. We ought to be looking for the best person for the job, not trying to trick them into agreeing to something that is wrong. Rep. Price yes, sir. Thank you. Senator wyden. I do not trade and health care stocks. In health care stocks. Funds, mutual funds withholdings and pharmaceuticals. With holdings in pharmaceuticals. Continue on this point of personal privilege. Doom of joel particular, by do mutualxperts funds in particular by independent experts are they continued considered a different category . Even passed ethics experts meet that point and they have never seen anything like the has engaged in. Senator brown. Welcome, congressman price. I was troubled to your response by senator wyden. He asked, would you commit, if you were repealed the aca will you commit that no one will lose insurance . That is 22 million americans. He asked, will you commit that no one who loses will lose their insurance . You ignored the question and responded that no one who lost their insurance under the aca to my knowledge that is to4 Million People and almost all of. Hem ended up getting reinsured you said no one who lost their insurance in the aca will lose it aer it has been reinstated. You ignored the 22 million. That is the problem we face. Confirmed, you will play a role in the repeal of the aca. Yes or no questions, and they are yes or no restaurants. Marguerite is from ohio. She suffers from a chronic condition. She was turned down by Insurance Companies for 25 years before the aca. She will lose her insurance if the ban against discrimination based on preexisting conditions is weakened. If you are confirmed, will you maintain the current scope of the law and continue to vigorously enforce the law passed ban against discriminating against individuals with preexisting conditions . Rep. Price i commit to you that abandon individuals with preexisting illness or disease. Victoria is from ohio, a senior on medicare. Relies on Preventive Services provided by the aca. Will you commit to ensuring that seniors continue to get Preventive Care, no copays or deductibles, continue to get Preventive Care with no outofpocket costs . Rep. Price Preventive Care and Wellness Care is absolutely vital for so many members of our population. You will commit to that . Rep. Price i believe it is part of health care and Health Coverage. We did that. I dont mean to be rude. We did that hundred aca. Grace is 24, diagnosed stage for metastatic melanoma. She is still in her parents Health Insurance, purchase or the aca marketplace and benefits from the acas than on the annual Lifetime Coverage maximums. Her first three months of treatment cost 800,000. Secretary, if there is provided in fridays executive order, will you commit to stand up for patients like grace and refused to grant any insurer this exception . Rep. Price i think patients should be at the center and our goal is to make shirt and certain every patient you standto make sure firm on this present provision of canceling insurance because they are too expensive. Rep. Price nobody ought to lose their insurance because they get a bad diagnosis. Alice is from ohio. Prior to the aca, she could not afford birth control. Thanks to the law, she is covered for contraceptive coverage. Can you set aside any personal political views and protect the doctorpatient relationship by committing to ensure every womans right to access the form . F contraception best for her rep. Price contraception is absolutely imperative for many women. The system we ought to have in place is one that allows women to be able to purchase the kind of contraception they desire. As the law is not with the aca. President trump said he is working on a replacement plan for the aca, which will be revealed after a confirmation. Is that true . Rep. Price it is true he said that. Yes. [laughter] is nevern not that he done this before, but did the president lie . He says he is working with you. I know we dont use the worldwide here, but did the word lie here, but did he lie to the public . Rep. Price i have had conversations with the president about health care, yes. Sen. Brown which is not quite the answer. Do you commit to maintaining the protections for those ohioans you just committed to in the replacement plan . Rep. Price our commitment is to make certain that every single american has access to the highest quality coverage and care possible. Im still not sure if the president lied, not to you, but to us, the public, bu about whether he is working with you. It sounds like he did. I want to find out about the childrens Health Insurance program. Said it has been remarkably successful. You earlier said it sounds like socialized medicine to you. I dont quite know what that means. 95 of children in america are currently insured. 95 of americans are insured now partly because of Medicaid Expansion, partly because of chip. You discuss using the right metrics. My question is this. Funding for chip is set to expire in september. If confirmed, would you advise the president to support an , the pediatricip quality measures program, the aunt this year . Beyond this year . Rep. Price yes, but i want to expand, after last weeks hearing in the Health Committee, the same question was asked, quoting me on saying that chip was socialized medicine. I went back and looked at that article. It was a characterization in the article by the author of the article to push a political point of view. I knew that was the case, because i rarely, if ever, use that word. I talk about patients being the focus. Sen. Brown i want to ask you specifically on ship, are you willing last week there was a report to congress advising we expand the chip program for five more years. Do you agree with this yeah cap agree with this . Rep. Price i think it needs to be looked at, and it ought to be extended. Sen. Brown for five years . Rep. Price if we could extend it for eight, it would probably be better than five. The sen. Brown thank you. Mr. Chairman . Lets go to sen. Portman . Sen. Portman i have a lot of questions, so i am glad you are letting people get a couple minutes over. Chairman hatch we have let the other side going couple minutes over. Im not going to let our side go a couple minutes over. Brown sen. Portman i need that time back. [laughter] rep. Price a couple weeks ago sen. Portman we are setting up a process to replace the affordable air cap the Affordable Care act with policies that work better. To give people more choices in health care. I did join with water with my colleagues. We talked about introducing an would ensure we have more time for each step in the process. We have insurances for that to work more with you, frankly. We need someone to work with us you can make sure that the legislative and administrative allah sees are working together, and that this is done carefully. Administrative policies are working together, and that this is done carefully. If you look at what has happened due to the increased regulations and mandates, we have a dramatically decreased competitive market in ohio. We went from 17 insurers offering plans on exchanges last year to 11 now. Weve got 20 counties in ohio, one quarter of our counties, that only have one Healthcare Insurance Company offering plans. We used to have no counties in that situation. I know we are doing better than the rest of the country, because about a third only have one insurer. Some only have one in the entire state. Now that we have begun this hasess and the president issued an executive order, what can we do, briefly what actions can you take to ensure that my constituents have access to Affordable Health Care Coverage with the Insurance Market . Rep. Price what you laid out is the challenge we have a ross the nation. Ohio is doing better than others, if you noted. It is important to appreciate that things have gotten worse for the individual Small Group Market. We believe, i believe, that it is a direct result of policies that have come from washington, d. C. , directly from the Affordable Care act. If we are honest with ourselves and our constituents about trying to solve the challenges they have to gain access to coverage they want, we have to look at how to fix that. The way to fix that is to make sure individuals have the choices, one of the mechanisms we allow for poly mechanisms to allow individuals to recreate that Small Group Market, which now does not exist. Sen. Portman by the way, i appreciate your response to my colleague from ohio about the people who have preexisting conditions, and the way you do that is through risk pools. Many states have good risk pools before the Affordable Care act to help in that regard. As you know, congress recently passed legislation called ca ra, and it is meant to address the Opioid Crisis we face. We are now working to both fully fund and the funding is in place for this new program but now to implement it. Almost half the funding of the new Grant Programs go through hhs a. What should be done to ensure access for Addiction Treatment for those individuals currently getting Insurance Coverage through the exchanges or Medicaid Expansion, and do you commit to us today the fully today to fully implement the new legislation . Without a doubt, senator, this is a scourge that has gone across the country, destroying lives, destroying families, harming communities, and it is growing. What we must do is commit to carrying out the law as it was passed, but also, as i talked about with some other challenges, making certain weve got the right metrics in place. Are we actually helping with what we are doing . There may be things we ought to do that dont help, and we ought inbe identifying those realtime as much as possible so that we can bring a program that is working for the individuals that are being harmed. Sen. Portman one example of that quickly, you are aware of the world that says if you have an inpatient treatment center, it must be limited to 16 beds. Would you look into getting that number up . Rep. Price i think that is one of the rules that needs to be looked at. I think the threeday stay role and facilities, often time many of these individuals have Mental Illnesses as well. The limitation of being able to keep folks at an inpatient basis when all of the individuals and their carers say they ought to, but thats not whats covered, and therefore they are put on the street. That is a challenge you get in this revolving door. Sen. Portman final question, and maybe i could get this in writing because my time is expiring, with regard to the waivers, ohio apply for a waiver, the 1115 waiver for medicaid. We were rejected by cms three of by cms. Do you believe that during this replacement time, we should be covering people under Medicaid Expansion, but then could move to a program were flexible to provide care under medicaid . Rep. Price there have to be better ways to provide care to the medicaid population. There are big challenges. People we need to be listening to her the governors, the commissioners, the folks on the ground providing the care. If we listen to them, they will guide us in the right direction regarding policy. Chairman hatch senator bennett . Sen. Bennet i want to thank my colleagues for his graciousness in not going to dub over. Congressman price, in not over. Too congressman price, the goal here is highest quality coverage and care foruality health all americans . Is that where you would like to head . I think that is a worthy goal. Piggyback me on what sen. Portman . I am worried on what sen. Portman was asking. I am worried that people in arel parts of the country not getting the access they need to highQuality Health care, not getting the access they need to highquality choices in terms of insurance. I worry a little bit, and i think it is incumbent on all of us, whether we are trying to repeal the Affordable Health Affordable Health care, i think it is incumbent on all of us to not make matters worse for world america. I know you share that goal. Is oneked about pooling thing. I wanted to ask you a little bit about your projected quality of insurance in these markets, because one answer that i have heard from folks including yourself over the weeks has been making sure that people have the opportunity to buy coverage for catastrophic care. I wonder whether you also believe that it is essential there be a floor for insurance providers. Some of the things the Affordable Care act require for coverage include outpatient care, emergency services, hospitalization, Maternity Care, prescription drugs, preventative control, routine dental exams for children younger than 19. Not going to ask you to go through each one of those, but directionally are we headed to a world where people in Rural America have to settle for coverage for catastrophic care . Are we headed to a place where there is regulation of insurance providers that say, if you are going to be an Insurance Market, particularly in a world where you are across state lines, there has to be a floor of the services you are willing to pay for . Rep. Price i think there has to be absolutely credible coverage, and i think that the coverage ought to beuals able to purchase the coverage they want. Sen. Bennet i dont want to get to a place where people in america have to settle for something that no one else in the industrialized world has to settle for. Why should they have to pay outofpocket month after month for something that is not going to cover something as basic as a hospitalization or maternity thisces, or the rest of list . There may be certain things on the list we disagree with, but im worried we are headed toward a world where somehow that choice is accepting a world that no one else in the industrialized world has to accept. I accept your goal, and i hope we can Work Together to make it so. You mentioned that we should listen to the governors, which brings me to my second question, and your answer to sen. Portman . Heardorado, you may have of this. We have something called the Care Collaborative which is a unique approach to medicaid. It connects members with coordinated primary care providers while reducing barriers to access. It also provides coordinated care for those with dual eligibility for medicare and medicaid. I dont have it today, but i can show you that the cost curve is to turn around because of the court made it care. When asked about the need for more state flexibility, which is an argument that is made to carry out innovative programs like the one in colorado, or governors said, greater flexibility cannot make up for the lack of funding. Should the federal government pulled back its financial commitments, we simply cant afford to make up the difference. I would ask you if you agree with our governors excess meant our governors assessment that while it is critical, rep. Price the decision for funding is a legislative decision. That is a final component of the Affordable Care act, the expansion of medicaid. And you agree . Rep. Price the decision of whether or not to change that is a decision that you and every member of the committee and, this will be involved in. If i am fortunate enough to serve, i will carry out the law that you passed. Sen. Bennet i appreciate that. In your mind, though, does the repeal include a repeal of the expansion of medicaid, which was part of the passage of the Affordable Care act . Rep. Price any reform or improvement that i would envision for any portion of the Affordable Care act would be one that would include the opportunity for individuals to gain the kind of coverage they want for the highest Quality Health care . Sen. Bennet thats not the question i asked. Do you believe that a repeal, this is what the president ran on, a repeal of the Affordable Care act includes a repeal of the expansion of medicaid . Rep. Price that is a decision you all would make. What i believe is that any mustm or improvement include a coverage option an opportunity for every single american, including those that are currently or close to medicaid population in a given state. Chairman hatch senator wyden . Are you ok . Sen. Wyden yeah. Chairman hatch ok. Lets go to senator timmy. Sen. Toomey thank you, mr. Chairman. Congressman price, thanks for the great work you have done in the house and your willingness to serve in this important post. I appreciate the conversation we had a wild back. I do think it bears reminding everyone, as we talk about obamacare, that the individual market is in a classic death spiral. The adverse selection is destroying that market. It is in a freefall in pennsylvania. Consulting ends in the exchanges have a grand total of one choice. Include whatever they had before and were promised they could keep, which was never true. Weve got a system that is in collapse, and what we are trying to do is figure out a better way to go forward. When we talk about repeal, sometimes i hear people say weve got to keep coverage of preexisting conditions. , i think we are missing something. Theres obviously a number of americans who suffer from chronic, Expensive Health care needs. They have had these conditions all their lives or some other period of time. For many of them, the proper care for those conditions is unaffordable. I think we agree that we want to make sure those people get the health care they need. One way to force it is to force providee companies to Health Insurance coverage as soon as they show up, regardless of what condition they have, which is kind of like asking the Property Casualty company to rebuild the house after it has burned down. But that is only one way. Am i correct, is it your view that there are other perhaps more effective ways, since obamacare is in a collapse, to make sure that people with these chronic conditions get the health care that they need at an affordable price without necessarily having the guaranteed issue mandate in the general population . Rep. Price i think there are other options, and it is important to appreciate the position we currently find ourselves in with policy in this nation is that those folks are going to have nothing because of of the market. Sen. Toomey right. Second topic is, and i think you and i share a goal of having health care that is much more , families,viduals patients, consumer centric rather than bureaucratic centric. Do you agree that to get there, we need to do more about the transparency of health care informedso that consumers can evaluate among different physicians, different hospitals who really get the best outcomes . Do we need to do more . Rep. Price absolutely, and its not just in outcomes. We need to be measuring what actually makes sense from a quality standpoint and allow patients and others to see what those outcomes are. Andit is transparency pricing as well. If you are an individual out there and you want to know what something costs, it is virtually impossible to find out what that is. Ourselveshonest with as policymakers, and we want to make the system patientfriendly , not insurancefriendly or governmentfriendly, but patientfriendly, then we would make that a priority. If confirmed, i hope to do so. Cms canmey i think play a big role in advancing that. Ultimately, i think the more we oninish dependence thirdparty payers and allow the evolution of a market that response to individuals, individuals will demand that information the way they do in any other market. The last point i want to touch on has to do with nih research, specifically alzheimers. It is my view that we often think of alzheimers as a disease and the category of its own. I say that because there is no disease like it that we know of that afflicts americans today. 5. 2 million americans with the disease right now. It is 100 fatal. It is the sixth leading cause of death. There is no cure, no treatment, nothing. Yet, for fiscal year 2016, is a grand total of 168 per diagnosed patient. It seems to me that the expenditures are wildly out of line with the severity and scope of this disease. I wonder if you would commit to working with me and others who share this view to ensure that we have a better proportionality in terms of the allocation of resources and the breadth and severity of illnesses. Is. Price i think it absolutely imperative, and i look forward to working with you. Price, welcome, and thank you for your willingness to serve. A number of challenges ahead we need to take on. As i met with you a couple of weeks ago, one issue is the Indian Health service. In 2010, there were problems uncovered in south dakota. The administrative action plan was set in motion to help many of these findings. In 2015,ssue popped up and they continue to this day. After oversight hearings, it became abundantly clear that there was a lack of followthrough by the agency. My question is, will you continue to followup with me in writing that you will designate with someone designate someone at hhs to be a point of , one,t to ensure that reforms are being implemented and, two, we continue to collaborate with the ihs . Rep. Price absolutely. This is an area of significant concern. In the Indian Health service, there are so many areas where we are not eating the goal of the highest quality care to be provided to individuals accessing that system. We are not doing what we ought to do. A commitment to turning that system around. Sen. Thune as a shared with you, senator barrasso and i introduced a bill called the ihs accountability act, which we believe will bring a lot of structural changes with the ihs. Many times, that act, although we think it addresses a love of the problems that have cropped up and was based on concentration from the tribes, a first step in the process is necessary to improve that agency. If confirmed, what types of reports could you see yourself supporting when it comes to the ihs, starting with our legislation . You probably have not had a chance to look carefully at that yet, so i wont ask you to comment specifically to it, but are there reforms you could work with us on . Rep. Price i have the privilege of visiting some ihs the saudis in the state of wisconsin, and a couple this ihs facilities in the state of wisconsin, and a were doinglities remarkable work. If i am confirmed getting into this area of the department, what we have not done is identified best practices within the system itself and shared those incident last the ability incentivized the to provide quality care in certain areas and make certain we are able to expand that across the country. Sen. Thune we look forward to working with you on that. Best practices is a great place to start. Those who have not been employed in facilities in our state. In 2009, cms issued a final le that required Outpatient Services to be provided under direct supervision. Since then, the rule has been delayed. I share with you this as well. In my state, we have a lot of critical access hospitals, a lot of rural areas, it is sometimes difficult to get providers out of these areas. Toconfirmed, would you work permanently extend the nonenforcement of the regulation of these hospitals in order to remove this burden . Rep. Price i look forward to working with you on it area i think there are areas from it working on it. I think there are areas where we are missing access to hospitals. In any other industry out there, the information has arrived and moving at ross the land across the land with rapid speed and has done. However, it seems that in health care we have put up roadblocks with the expansion of technology, especially in the rural areas, and we are to be ensign uprising that so that patients can receive the highest all of the care. Incentivizing be that so that patients can be receiving the highest quality of care. To reach one of the world specialists in stroke treatment by telemedicine. That is improving the lives of care of patients across our state. There are so many things we can do that would mirror that kind of technological expansion. Sen. Thune one final point i will make, i know you probably have been west and a good amount about what happened have been questioned a good amount about what happens next with respect to replacing obamacare. I hope we can work with you in beginning to shift a lot of the moreving the states flexibility when it comes to designing plans at work in our states. I think one of the problems we have had with this is that there dictation from washington, d. C. , too much onesizefitsall. That is something most states would probably agree with and most providers would agree with as well. We look forward to working with you in designing programs to get that its ability to our states, and put them in charge of some that moves the power away from washington, where i think too many of the problems have been happening. Dr. Price, good to be with you again. I wanted to ask you a couple of questions that center on children and individuals with disabilities. First, with regard to children. I think if we are doing the right thing as not only a government, but as a society, if we are really about the business of justice and growing the economy. Lot and spentst a a lot of time making sure that every child has health care. The good news, despite a lot of not getting about point, not moving in the right direction, we have made a lot of progress. , in an apriltitute the report, i will not ask report to be made part of the record, but i will learead a. Ine from it it set as follows, on page three, it said that the decline uninsurance rate included a relatively steady pace and includes a significant drop following and limitation of the Affordable Care act key 71 e provisions from 7. 1 to 4. 8 . That is a significant drop. That 4. 8 uninsured rate for kids was an alltime low. That means we are at a 95 insured rate across the country for children. Kaiser foundation, a separate authority, tells us that even , even with all that progress made in the last couple of years, and even some progress before that, we still have more than 4. 1 million children uninsured. Would you agree with me that we should get that number down, the number of uninsured children . I think that throughout our population, we are to identify individuals that are uninsured and strive to make certain that they gain coverage. And you would agree in regard to children especially . The price everyone in population. Children are precious to her future. Sen. Casey we know the number we have arrived at, we know the percentage, would you commit, if successful in your confirmation, to maintain or reduce the uninsured number even further . In other words, that you would be able to commit to us today that the number of uninsured will not increase during her time as secretary, were you to be confirmed, and the percentage of uninsured will not increase . Rep. Price our goal is to decrease the number of uninsured individuals in the population aged under 18 and over 18. I hope you maintain that, because that is critically important. To reason i ask is not just validate that as a critically important goal for the nation, but your answer seems to be in conflict with what you have advocated for as a member of the only in your individual capacity, but as chairman of the Budget Committee. Looking at now, for reference, headed by Gene Sperling, of the council of economic advisers to two president s,. Linton and obama chair of the National Economic council, i should say, is the proper title. In an oped on christmas day, the fifth paragraph, heres what he said referencing you and your budget proposals. He said, together, meeting the two areas of policy you have a , full repeal of aca and block granting of , which we now know as Trump Administration policy, would cut medicaid in the Childrens Program funding by 2. 1 trillion over the next 10 years, a 40 cut. How can you answer the questions i just asked you about, making sure the number of uninsured children does not get worse under your 10 year, if that is the case under your 1 respect toh what your policies would be active your policies would be . Rep. Price with respect to you and mr. Sperling, its because you are looking at this in a silo. At this in a silo. We believe it is possible to put in place a system that allows for greater coverage for individuals, coverage that actually equals care. The aca actually increased coverage in this country. Sen. Casey its one of the things that actually did. The problem is a lot of folks have coverage, but they dont have care. They cut of a trillion dollars would adversely impact the childrens Health Insurance program and the Medicaid Program. It is totally unacceptable to most americans. Rep. Price and you are looking at that in a silo. Theare not looking at what reform and improvement would be. Sen. Casey we will see the rebuttal to not only what Gene Sperling has said, but a long line of Public Policy advocates and experts. I think the burden for you is to make sure you fulfill your commitment to make sure that no children will lose coverage while you are secretary. Rep. Price i look forward to working with you. Chairman hatch sen. Heller go sen. Heller chairman hatch senator heller . Sen. Heller thank you, mr. Chairman. As you can imagine, i committed that all have access to highquality, affordable Health Insurance. I have a letter that came to my attention january 10 from the nevada legislature. The leather can the letter came directly from the majority leader of our senate and the speaker of the assembly. Quick question. We have in nevada about 88,000 who have Health Insurance through the health and strange through the health exchange. Veterans nevadans receive Health Care Coverage under Medicaid Expansion. I. Chairman, if i may, can submit these questions to the record, on the record, and also, if i may, ask dr. Price if you could respond to this if he could respond to this particular letter . Chairman hatch im without objection. Sen. Heller also, if you could cc the governor . I think you are in a great position to answer these questions. You. If i may, can i get your opinion on the cadillac tax . Rep. Price i think the cadillac that has made it such that individuals who are gaining their coverage through their there may be a better way to make it so that employees to gain coverage through their employer are able to gain access to the kind of coverage they desire. Sen. Heller the tax would affect about 1. 3 million nevadans, school teachers, Union Members, Senior Citizens. There is some disagreement as to whether these individuals are wealthy are not. There are some who believe the tax increase on obamacare does not affect the middle class. Do you agree with that . Rep. Price it does. En. Heller i do too do you believe schoolteachers are wealthy . Rep. Price everyone has their own metric of what wealthy is. Different things to determine wealth, the greenback the sen. Heller i would argue most teachers do not think they are wealthy. Do you think Union Members are wealthy . Rep. Price i do not. Heller do you argue that most Senior Citizens are healthy . Are wealthy . Rep. Price not if they are on a fixed income. Sen. Heller i would argue they are not wealthy. Thats the problem, a middleclass tax increase of 1. 1 trillion. Question for you is, if i can get your commitment to work with this committee, to work with myself to repeal the cadillac tax . We will work to make certain that those who gain coverage through their employer have the access to the highest quality coverage possible in a way that makes the most sense for individuals from a financial standpoint. Sen. Heller does the cadillac tax make the most sense . Rep. Price i think there are other options that work better. Sen. Heller do you think it is a tax increase on middleclass america . Rep. Price i do. Sen. Heller ok. Nevada was one of 36 states that shows to expand eligibility for medicaid. We went from enrollment went from 350,000 to over 600,000. I guess the concern, and it is part of the i get to the chairman, is whether or not that will have an impact, and what we are going to do to see that those individuals are not impacted. It is probably the biggest question i have for you today. What are we going to do about those who are part of the Medicaid Expansion and how it is going to impact . I mentioned to the other side, i believe it is a policy question that needs to be worked out through both the house and senate. We look forward to working with you and others, if i am able to be confirmed, and making certain that individuals who are currently covered through Medicaid Expansion either retain that coverage or have coverage through a different vehicle, but every single individual ought to have access to coverage. Sen. Heller dr. Price, thank you. . Hairman hatch senator warner sen. Warner thank you, mr. Chairman, dr. Price. Since i have been governor, i have been working closely with on the issue of how americans address the end of life. I think we both share personal stories on that subject. Sen. Isakson i have legislation that we call the Care Planning havenator isakson and i legislation that we call the Care Planning act, which allows discussion with Health Care Providers or faith leaders as needed, in a way to prepare for that stage of life. This year, cmx took a step by ateracting introducing payment fee schedule for having conversations with these providers. A also ran a private ran Pilot Program that allows hospicetype benefits to be given to individuals that are still receiving some level of services called the medicare care choices. Important that we do not go backwards on these issues. We are maybe the only industrial nation in the world that has not had this kind of adult conversation on this part of life and not limiting anyones choices. If you are confirmed, would you continue to work with senator isakson and i and others on this issue . Rep. Price i would be i would look forward to doing so. Issues is liability, and i cant remember if we discussed that in your office, but the whole issue of liability surrounding these conversations israel. Talking about it openly and honestly, and working together to find a solution to just that. Sen. Warner i also think this is something that more families need to take advantage of. On friday, january 20, the president issued an executive that says federal agencies, especially hhs should do everything they can to delineate any fiscal burden on any state or any cost, tax penalty, or Regulatory Burden on individuals or providers. If you are confirmed in this position, will you use this executive order in any way to try to cut back on or following the individual mandate before there is a replacement plan in place . Rep. Price i think if i am tofirmed, i am humble enough appreciate that i dont have all the answers, and the people at the department have Incredible Knowledge and expertise. My first action within the department itself as it relates to this is to gain that insight, gain that information, so that whatever decisions we can make with you and governors and others can be the most informed and intelligent decision possible. Sen. Warner am not sure you answer my question. I understand your concerns with the cadillac tax. I know there are concerns you and others have raised about the individual mandate. There are some concern about the income tax surcharges during that its just remarkable to me, and its why so many of us tax surcharges. Its just remarkable me, and why so many of us are anxious, that the president has said he wants to keep people on their policies until 26, and at the same time it seems like there is a rush to get rid of all the things that paper that ability. I want your assurance that you would not use this executive order prior to a legal replacement to eliminate the , which il mandate believe would shore up the costs required . A replacement, an improvement of the program, i to bee, is imperative instituted simultaneously. Will not useyou this executive order as a reason to bypass the law . Rep. Price our commitment is to carry out the law of the land. Sen. Warner in the past, i know you have been a strong critic of the center for medicare and. Incaid innovation, cmmi your testimony last week, a you saw great promise in it. Achieve quality of care, weve got to have this kind of extermination. There was a Prevention Program but last year cms certified that saved money on a beneficiary basis. Cmmis delivery reform . I support making certain that we deliver care in a costeffective manner, but we must not do things that harm the quality of care being provided to patients. Sen. Warner the part of that quality of care, and i agree with you, would mean bundled payment models that move us toward quality over volume. Would you support those efforts . Rep. Price for certain populations, bundled payments make a lot of sense. Sen. Warner if these are successful, would you allow for expansion across the whole system . Rep. Price i think what we ought to do is allow for all sorts of innovation, not just in this area. There are things that have not been thought of that would actually improve quality and delivery of health care in our country, and we are to be incentivizing that innovation. An. Warner the cmmi is tool we are to not discard. Chairman hatch thank you, senator. Senator scott . Carolinat south launched the nations first statewide partnership with the use of medicaid funds. 28 percent of babies in South Carolina are born to first time low income mothers. We also have a much higher than average infant mortality rate. Nurse Family Partnership is an has alreadyed and shown real results, both in the health of the mother and the babys, but also in other mothers life, such as Graduation Rates for teen moms and unemployment rates area what are your thoughts on a pay for Success Model to achieve success metrics . Rep. Price that sounds like a Great Program that actually has the right metric. That is the quality of care and improvement of lives. It is having if that kind of success, it probably up to be put out as the best practice for other states to look at and try to model. Sen. Scott thank you. I believe you are the director of the clinic at Grady Memorial Hospital in atlanta. Rep. Price i was. Sen. Scott grady hospital has the highest number of uninsured origins. Uninsured georgians. You talked about having coverage, but not access. Can you talk about how your experience at grady may inform you and direct you as a relates to the uninsured population . Sen. Thune rep. Price it was an incredible privilege to work at grady for the number of years i did. We saw patients from many walks of life, many uninsured individuals. Same kinds of the concerns and challenges that every other individual has. They have an additional concern, and that is, is somebody going to be able to help me . So fulfillingwas to have the privilege of working at grady and assisting people at a time when they were not only challenge from a health care standpoint, but challenged from a concern about whether or not people would be there to help. Sen. Scott i know you are aware of title i of the every Student Succeeds act. It allows for the population of head start to have access to resources. It seems to me that it would be imperative for the secretary of hhs and the secretary of education to look at ways to synergize efforts to helping the underprivileged child. Can i get your commitment to you will look for ways to work with the secretary of education where it makes sense to help serve the students on head start . Will be wonderful for us the taxpayer on one hand, the child on the other hand, and look for ways to make sure they both win. You have identified that we dont seem to collaborate under jurisdictional lines, not just in congress, but certainly in the administrative side. I look forward to that. Having as a metric, how are the kids doing . Are they actually getting the kind of service in education that they need . Are they improving . Are we just being custodian . Are we just parking kids in a spot, or are we actually assisting in improving their lives . If we are not asking the right question, not looking at the right metrics, then we will not get the right answer to expand what is working or modify it and move it in a better direction. Sen. Scott that is one of the more important parts of your opportunity in this position, looking at those kids at those ages, before you ever get into prekindergarten. The development of a child and theres first three or four years in those first three or need their potential to be maximized. Sometimes we think the educational system will allow the child to catch up areas to catch up. I thank you for your willingness to work in that direction. The last question has to do with the employer Health Care System that we are so accustomed to in this country. In my home state, we have 2. 5 Million People covered by their employer coverage. Secretary,d as hhs how would you support american employers in their effort to provide family Health Coverage in a consistent and affordable manner . There has been some conversation about looking for ways to decouple having Health Insurance through your employer. I think the employer system has been a remarkable success on allowing individuals to gain coverage they might otherwise not gain. I think preserving the employer system is imperative. That being said, there may be for individual employers i have heard employers say, if you just give me the opportunity to provide my employee the resources so he or she is able to select the coverage they want , that makes more sense to them. If that works from a voluntary standpoint, then it may be something to look at. Sen. Scott that would be more like the hra approach. Rep. Price exactly. Sen. Scott the employee chooses the Health Insurance not necessarily under the umbrella of the employers. Rep. Price exactly. I think its the same tax benefit. Chairman hatch senator mccaskill . Sen. Mccaskill at the risk of being way away from you and you being somewhat i have worked with respected greatly, i want to gently correct something in your opening statement. The first nominee of president ofmp was confirmed by a vote 981. I would not consider that a person vote. The second nominee was confirmed via vote of 8811. Once again, i would not consider that a person vote. A partisan vote. We are trying to look at each nominee individually. I had a chance to review congressman prices questioning of secretary civilians, and i can assure you, mr. Chairman, it was no team back. Beanbag. I think all this looks different depending on where we are sitting, and i wanted to make that point. Withoutssing obamacare one democratic vote, we are about to repeal obama care without one democratic vote. This will be a partisan exercise under reconciliation. It will not be a bipartisan effort. What we have after the repeal is trumpcare. Whatever is left after the dust settles is trapped air trumpcare. I know the president likes to pay close attention to what he puts his name on. Have a feeling, congressman, even though you keep saying that congress will decide, you are not really believing, are you, that your new boss is not going to weigh in on what he wants congress to pass . We are not going to have a plan from him . Forward to we look working with you and others sen. Mccaskill my question is are we going to have a plan from the president. Rep. Price if i have the privilege to be confirmed, i look forward to working with the president and bringing a plan to you. Sen. Mccaskill great. So the plan will come from President Trump, and you will have the most Important Role in shaping that plan, correct . Rep. Price i hope i have input, yes, maam. Sen. Mccaskill ok, whatever t rumpcare inns of being, you will have a role in it. I hope that gets on the record. When we repeal obamacare, there will be a tax cut. Will americans making under 200,000 and if it . Benefit . Rep. Price thats a hypothetical. Sen. Mccaskill its not hypothetical. When we repeal obamacare, there are taxes, and when it is repealed, there was no question that taxes will be repealed. I promise you, the taxes will be repealed. When those taxes are repealed, will anyone in america who makes less than 200,000 in of it from the repeal . Rep. Price i look forward to working with you on that plan, and hopefully that will be the case. Mccaskill no, no. Im asking, the taxes in there now, does anybody making less than 200,000 pay those taxes . Depends on how you define the taxes. There are many individuals paying much more than they did prior to that point. Sen. Mccaskill im talking about taxes. The cadillac tax has not been implemented, so that it does not affect anybody. Im trying to get a simple question, and i dont think you want to answer it, which is that when obamacare is repealed, no one who makes less than 200,000 will benefit. Rep. Price when confirmed, i look forward to working with you. Sen. Mccaskill at southern answer. We will moved on. Move on. Your plan is converted medicare to private Insurance Markets with government subsidies, correct . Rep. Price not correct. Sen. Mccaskill we talked yesterday, and by the end of our conversation, you admitted to me that your plan for medicare in terms of people getting tax oredits or subsidies however you are going to pay for the medicare recipients will be having choices on the private market. You said, yes, it is similar to obamacare with the exception of a mandate. Did you not say that to me yesterday . Rep. Price with fairly significant exceptions. Sen. Mccaskill these people dont need to be mandated for insurance. Its not like a 27yearold who knows he wont get sick. You dont need a mandate for the elderly, so it is not as relevant. That didnt you admit admit to me but didnt you admit to me that obamacare in the private market are pretty similar . Rep. Price there are similarities. What i said, though, is the mandate is significant. Dontccaskill but we need a mandate for seniors, would you agree . Rep. Price what i hope is we dont need a mandate for anybody said they are able to purchase the kind of coverage they want, not what the Government Forces them to buy. Sen. Mccaskill ok. Finally, you want to block grant medicaid for states with an efficiency, correct . Rep. Price i believe medicaid is a system which is now not responding as necessary. It is incumbent on us as policy makers to look for a better way to solve the challenge. Sen. Mccaskill are you looking at a way to block grant medicaid . Its a really simple question, congressman. You are at a confirmation hearing for the most powerful Health Care Job in the country. I dont know why you are not willing to answer whether you are in favor of block granting medicaid . Favor ofe i am in making certain medicaid response to patients, not the government. Sen. Mccaskill i dont understand why you want to answer that. I know im over. I dont know if i will get another round, mr. Chairman. Should i ask my last russian, or will we get another chance . Chairman hatch i will allow additional questions. I hope not everybody will take the opportunity. Sen. Mccaskill ok. I wont disappoint you, im sorry. Chairman hatch let me just say that obamacare raised taxes on millions of families across income levels. The Nonpartisan Committee on joint taxation identified widespread tax increases on taxpayers earning under 200,000 contained in the aca. 2017, 13. 8, for million taxpayers with incomes below 200,000 will be hit with more than 3. 7 billion, with a b, in Obamacare Tax hikes, from an increase in the income floor for the medical expense deduction. Obamacare has led to. Iddleclass tax hikes it has led to fewer insurance options, higher deductibles, and higher premiums. Facts thatse are cant be denied. Sen. Mccaskill i look forward to looking at those back, because somewhere in this mix weve got alternative facts. Chairman hatch i think these are right. Sen. Mccaskill well i think mine are right. Mayor respond . Point, no alternative facts. The republicans at last years reconciliation bill cut taxes for one group of people. They cut taxes for the most fortunate in the country. That is a matter of public record. Its not an alternative factor or universe. People making 200,000 and up. Their taxes cut. Got their taxes cut. That was me reconciliation bill from republicans last year. Chairman hatch i dont agree with that, but we will see who is next. Senator grassley . Bow, senator castellini senator cassidy. Lets talk about medicaid. We getting a rosy scenario with obamacare, and the republican attempt to replace it seems odd. First, i want to note for the record that President Trump has said that he does not want people to lose coverage. Aswould like to coverag many people as under obamacare, those with cover preexisting conditions. Those will be your marching orders . Rep. Price absolutely. We both worked in Public Hospitals for the uninsured and the poorly insured, folks like medicaid. Medicaid. About why would we see patients on medicaid at a hospital for the uninsured . If they want to see an orthopedic in private practice, does medicaid cover the cost of seeing an orthopedic patient . Doesprice oftentimes it not. As you well know, one out of three physicians who ought to be patientsake medicaid do not take them, and there is a reason for that. That is notstem working for those patients, and we up to be honest about that and look at that and answer the question why an address that. Sen. Cassidy when the house version of the aca past, the New York Times wrote an article about an oncologist that had so many patients for medicaid that she was going bankrupt, and she had to discharge patients from her practice. Says we cantmber have alternative facts, and i agree with that, but we also know that a journal article speaking about medicaid , when theyrgan expanded, outcomes did not improve. I suppose that kind of informs you you say we need to make medicaid that needs to work better for patients. Rep. Price absolutely, and we need to look at the right missions. Anerage for individuals is admirable goal, but it ought not be the only goal. And health care especially to keep the patient in the center and realize what kind of coverage we are providing for people on the ground, real people in real life, and whether we are affecting them in a positive or negative way. If we are affecting them in a negative way, we need to be honest with ourselves and say, how can we improve that . Sen. Cassidy oftentimes, there is a conflation of per beneficiary payments from the state per medicare enrollee and block grants, which to me is conflation. I will note that bill clinton on the left and phil gramm and Rick Santorum on the right proposed per beneficiary payments some time ago. Would you agree this is how the federal Employee Benefit program pays for these federal employees . A insurer. Wouldnt it be great if it nt representative prize it is not a monolithic population. There different demographic groups within it, seniors and disabled and then healthy moms and kids by large. And we treat each one of those the same. Lks exactly senator cassidy is there any nuance . I dont see any offered in the question. Are you speaking about a per beneficiary payment . Are you speaking of each of those 4, 1 of those for . How do you dice that . Rep. Price absolutely. Those are the things we tend not to look at because they are more difficult to measure and more difficult to look at. That will we are talking about peoples lives, Peoples Health care, it is imperative that we do the extra work that needs to be done to determine whether or not yes, indeed, the Public Policy we are putting forward is going to help you and not harm you. Cassidy theres criticism about your proposal kurt beck accounts. Aboute are both your proposal for health bank accounts. I think we are both familiar with the rep. Price when people do engage in their health care, they tended to demand more. They tend to demand better services. And individuals that have greater opportunity for choices of who they see, where they are treated come up when they are treated and the like, have greater opportunity to gain Better Health care. Cassidy if we contrast the experience in Health Indiana with the experience in oregon, were a National Bureau of Economic Research published in the new england journal of medicine found no difference in outcomes in those that are fulfilled through a Medicaid Expansion nor again, contrasted that absence of outcomes, with that which indiana tried to engage payments become activated in their own care. Er usage fell, but outcomes improved. I kind of like your position. Thanks for bringing a nuanced, informed view into the debate. It is kind of a relief to have someone in your profession in this Important Role, particularly knowing the importance of the doctorpatient relationship. In my dealing with cms and hhs overall, i think the bureaucracy has been short of a lot of that handson information that people ought to have. My secondly, when youre in office, we discussed of the necessity of your responding to congressional inquiries and you very definitely said you would, tongueincheek said you are to say may be, because a lot of times they dont to do it. But since you said you would, i will hold you to that and appreciate anything you can do to help us do our oversight. Oversight, i got a legislation passed a few years ago called the patient position sunshine act. The only reason i bring this up is because it took said netter and maysenator wyden working hard to stop the house of representatives from cutting that legislation in the cures act to that past. Clear thatake very the legislation i am talking about doesnt prohibit anything. It has reporting requirements veryse it makes it very, well, it brings about the principle of transparency. It brings accountability. Ive got some studies here that we did and some newspaper reports on them, particularly one of about a psychiatrist at Emory University that was not reporting everything that they should report and even the president of Emory University came to my office and said thank you for making us aware of this stuff. In theto put those record. Since you are administering this legislation and senator blumenthal and i will think about expanding this and this legislation to include Nurse Practitioners and physicians assistants, i hope that i can get your commitment that you will enforce this act the way it was intended to be enforced. Even under the obama administration, after we got it passed, it was three years to get regulations carried out. In effect, it has only been working for two or two and a half years. So if you are confirmed, would you and the department of health and Human Services work with me to ensure this Transparency Initiative is not weakened rep. Price transparency in this area and some in the others is vital. Not just in outcomes or in pricing, but in so many areas so that patients are able to understand what is going on in their Health Care System. Senator grassley thank you. Vaccine one deals with safety. View our a physician. I think you would agree that immunization is very important for modern medicine and that we have enable to get rid of small 1977, worldwide polio in 1991, at least in the western hemisphere, and all that. Physician, would you recommend that families follow the recommended vaccine schedule that has been established by experts and is constantly reviewed . Rep. Price i think that science and health care has identified a very important aspect of Public Health and that is the role of vaccination. Senator grassley thank you very much. I yield back my time. Senator stevan now i would ask unanimous consent that a series of stories at a public or public forum with my colleagues, people concerned about policies that the nominee has authored and that was talked about today, that that be included in the record. Welcome congressman price. I appreciate a private discussion. Lots of questions. Lets see if we can move through some things quickly. You said this morning that you would not abandon people with preexisting conditions. Is that basically what youre talking about as high risk pools, one of the strategies you are thinking about . I heard that talked about this morning. High risk pools can be helpful in making sure that people with existing illness can be cared for in the highest quality manner possible. I think there are other methods as well. We talked about other pooling mechanisms, the destruction of the individual Small Group Market has made it such that individuals cannot find coverage that is affordable for them. One of the ways to solve that challenge is to allow folks in the Small Group Market the pull together. I think we talked about this in your office with the blue shield model being the template for individuals who are not economically aligned are able to pool together their resources solely for the purpose of purchasing coverage. Senator stabenow for about 35 years, we have tried high risk pools. 35 states had them before the Affordable Care act. Frankly, it did not produce great results. In 2011,. 2 of the people with. 2 ,xisting conditions, were actually in a high risk pool and the premiums were 150 to 200 higher than standard rates for healthy individuals, and they had lifetime and annual limits on coverage and cost states money. That was the reality before we passed the of formal care act. So when President Trump said last weekend that insurance was going to be much better, do you think that insurance without protections for those preexisting conditions or without maternity coverage or without Mental Health coverage or insurance that would reinstate tax on cancer treatments is better . Rep. Price i dont know that that is what he was referring to. Senator stabenow he said it would be better. If we went to highrisk pools instead of covering people with preexisting conditions or if we stop to the other coverage we have now, im just wondering if you define that as better. Rep. Price you would have to give me a specific senator stabenow let me give you an example. Rep. Price what may be better for you may not be better for me or anybody a lez. Patients need to be at the center of this, not government. Should government decide be deciding these things are patients senator stabenow . Prior tothe a formal care art, about 70 of a private plans that a woman could purchase in the marketplace did not cover basic Maternity Care. , notu think that is better to cover basic Maternity Care . Rep. Price i would presume she wouldnt purchase that coverage. Senator stabenow she would have to pay more just as in general for many women that being a woman with a preexisting condition. That is the reason why we have a basic set of Services Covered under health care. So its just a different way of looking at this. Sure,s something where, if a woman wanted to pay a premium, pay more, she could find Maternity Care. We said in the Affordable Care act thats pretty basic. Population,alf the for whom Maternity Care should be included. Mental Health Services should be a guaranteed benefit in all Health Insurance plans . Rep. Price ive been a supporter of Mental Health care inclusion, yes. Senator stabenow so Mental Health should be a defined benefit under Health Insurance plans. Health stabenow mental should be treated rep. Price Mental Health should be treated on the same model as physical health. Senator stabenow i agree with you. Discussionn a lot of with the nominee for Office Management Budget Office talking about Social Security. I think people in medicare should be worried right now in terms of what we are all hearing. My time is up. For my mom who is 90 years old, she does a lot more choices, she just was to be able to see her doctor and get the medical care that she needs. Supportive ofall the idea of medicare in some way being changed into premium support into a berkshire into a voucher. I am conveying to use someone who is getting there right now and she is not interested in more choices. She just wants care. Rep. Price i would convey to the medicare population that they dont have reason to be concerned. We look forward to assisting them in getting the gain and gain the caregivers that they need. Senator cantwell thank you, mr. Chairman. Congressman price, i think both and there haved been a merit of consequences. Rep. Price the weather. Senator cantwell rep. Price will got a system that has many controls that are providing greater cost to the provision of care. I think oftentimes we are not identifying the best practices in the medicaid system so that patients move through the system in a way that is much more economical and much more efficient and effective, not just from a cost standpoint, but from a patient standpoint. There are so many things that could be done, especially for the sickest of the sick in the medicaid population, where we could put greater resources and greater individual attention to individual patients. As you know, in a bell curve of patients in any population, there are those that are the , wheres on the high side the resources spent to be able to provide their care is significant. If you focus on those individuals, you oftentimes can provide a higher level of care and a higher level of quality of care for those folks in a more responsive care for those at a lower cost moving down into the mainstream of the bell curve eric velcro. Senator cantwell you bell curve. Startedcantwell if i that conversation, i would start with two big phenomenons. One, pitbull living longer. People living longer. The longer they live, the more they are going to consume. Or 15 yearsving 10 longer, they will consume our health care. And second, the baby boomer population reaching retirement age. Those two things are ballooning the cost of health care in general and specifically for the medicaid population. I want to make sure i understand where you are because i feel like the administration is creating a war on medicaid. You are saying that you want to cap and control the cost. All we have already established in the Affordable Care act the things that are best practice incentives and ways to give the medicaid population leverage and getting Affordable Health care, i want to understand that you are for these things. Example, we provided resources in the Affordable Care act to medicaid off of, for patients, off of nursing home care onto communitybased care because it is more affordable. Do you support that rebalancing effort . Rep. Price i would take issue with your description of the war on medicaid. Dot we desire and want to some make sure that they medicaid population is able to receive the highest quality care. Ive cared for thousands of medicaid patients. The last thing that we want is to decrease the quality of care that they have access to. Clearly, the system is working right now. So moving toward homebased care its rightg that, if for the patient, it is a wonderful thing to be able to do and we ought to be able to incentivize that area and there are so many things we can do in medicaid that would provide greater quality of care that we dont incentivize now. Senator cantwell we did incentivize it in the Affordable Care act. State and many other states took the money for the Affordable Care act georgia 57 million to make sure beneficiaries got care in communitybased care and were able to shift cost to that communitybased care. So huge savings. It is working. Are you for repealing a part of the Affordable Care act . Rep. Price im dedicated for the medicaid population and to have access to the highest quality care. Senator cantwell i would hope you would look at this model and you would also look at the basic health plan model, which is, again, what i think you are proposing and what the administration is refusing to refute when the president said im going to protect these things and when the white house chief of staff is saying no, no, we are going to cap medicaid spending, its a problem. What we want to do is give them leverage in the marketplace. That is what the basic health plan does. That is what the communitybased Health Care Plan does. It gives them the ability to get more Affordable Care act Better Outcomes and is saving us money. So if you could give us i see my time is expired look at those two programs and tell me whether you support to those Delivery Systems and the a formal care act. Rep. Price i would be happy to. That would end my first round. I would like to not go through a full second round. But we have had some additional senators here and would like to ask some more. We will start with senator wyden. i have some ideas on how to lower the price of medicine. Like to set those aside and start with the president s idea. Lower prices through bidding or negotiation. You will be the captain of the president s health game. And you will have to persuade republicans to change the law so that the president can fulfill his pledge more affordable prices for medicine through bidding. As captain of the health team, will you do that . Rep. Price as you know, we are committed to making sure that drug prices are able to be afforded by individuals so they can have access to the highquality care. Right now, that negotiation from a partd stand part d sampling, which i would remind people is a success story. The pbms are doing the negotiation right now. I think it is important to have a conversation over whether or not senator wyden im asking about a specific idea and it is not mine. President s. And the question is will you forcate to republicans authority to negotiate . Its yes or no. Rep. Price when i was going to respond, senator, if you will allow me, right now the pbms are doing that negotiation. To haveit is important a conversation and look at whether there is a better way to do that. And if there is, i am certainly open to it. Senator wyden on saturday, hundreds of thousands of women of all ages and backgrounds came to washington to speak out against policies that you have opposed. This includes the violence against women act, provisions in the Affordable Care act, preventing Insurance Companies from charging them more because they are women, access to nocost contraceptive coverage, and the choice to see the provider that they trust. Stated ryan has publicly that no one will be worse off if the Affordable Care act is repealed. But the nonpartisan Congressional Budget Office doesnt share that with you they have indicated nearly 400,000 women would lose access to care, including lifesaving cancer screenings in the first year if planned parenthood is defunded and cut off from medicaid so again, congressman, this is not my opinion, democrats, republicans. This is the nonpartisan Congressional Budget Office. You are going to be the point person for health. Would you advise the president to a to reject any proposal that cuts coverage for or otherwise limit a womans ability to see the provider that she trusts . There are multiple inaccuracies in your premise and i would take significant issue with the Congressional Budget Offices conclusion. Aslooks at it in a silo, saying this is what you are doing without doing anything else to provide coverage for individuals and that is simply thats not anybodys plan. Again, this is what is in the bill you wrote. And these silos, we keep hearing all kinds of happy talk about silos and dreams and the like. What we want to know is one thing above everything else. Is there going to be a replacement before there is repealed . Repeal . And you have been asked of this buy a whole host of members. We havent been able to get any answers. It seems to me that your own bill is out of step with what the new president has said. Twonew president said the would be intertwined. Was repeal and run. Repeal it now and come back another time. I will let my colleagues have a chance to ask their questions. Silos,n you talk about that is the view of someone i your right to stated. The nonpartisan congressional weret office said women speaking out in communities across this country, women are going to lose access to those vital cancer screenings. That is not a partisan statement. Thats from a nonpartisan agency. I hope you will reconsider your position. Rep. Price i respectfully disagree with the conclusion. Hopefully, we can finish in the next 20 minutes. Senator hardin thank you for your response to your questions. One of the major objectives of the afford of a character was the deal with the historic discrimination against minority communities in our Health Care System. And we can give you chapter in chapter and verse. The access to providers was always challenged in minority communities. The affordability and quality of Insurance Products. There were various provisions included in the Affordable Care act to deal with that. One was an amendment that i offer that elevated the National Institute for Minority Health and Health Disparity institute as well as creating offices for and healthalth disparities. Are you committed to continuing the progress so we have a focal point, so we call attention for the needs of communities . Rep. Price many in our society in the Minority Community coming if you look to the metrics, it is imperative on us to ask the question why. Planhen reach a strategic to correct that. Whether thats through the current offices ro a or a different mechanism, you have my commitment. I encourage you to look at that institute as a tol valuable resource to you carry out that commitment. The Affordable Care act increased dramatically the funding for qualified Health Centers to allow access to health care in minority communities. Protectdedicated to vital Health Centers. Rep. Price they play a vital role in our Health Care System are now. I think it is imperative that we retain them or improve the delivery of care in that area. Senator cardin now we get to the subject that has been talked up by many members medicaid. I appreciate your response that you do not want to disadvantage anyone that is currently in the medicaid system. Blacks, latinos, native americans, alaskans are almost twice as likely to be on medicaid than the white population. In my state, 70 of our medicaid but relation are people of color. So it is by far the dominant population that relies on medicaid. So i hope you understand our we talk aboutwhen changing medicaid, talk about block brand a medicaid, talk about new approaches to medicaid, it sends a signal that what we are going to do is cut the federal government commitment to access of minorities. Area of concern. You have seen in budget rounds were cuts to medicaid, dollar for dollar, would reduce access to minority communities for their health care needs. States have challenged budgets. The more you put on the state, the more likely it is that many states will not be able to meet to theull commitments medicaid population. Can you just share with me a little bit more your vision as to whether you look at the resources we put into health care, everybody wants to feel more efficiently, but if you look at the medicaid population, what you are doing is taking resources away from minority communities and making the problem even worse. How can you give me a Comfort Level that you are committed to the minority communities that depend so heavily on the Medicaid Program . Rep. Price let me try to assuage your concern. I think that i am the only one at this table would have who has treated patients in the medicaid system. As when we as a society use the only major metric for determining whether or not we are providing care for individuals in the medicaid system, the amount of money that we are putting in the system, instead of the outcome, whether or not people are getting covered, whether they are able to see the doctor they want to see, whether senator cardin i agree what you are saying. Rep. Price we are measuring the wrong things. My commitment to use is to make certain we are measuring the right things. Senator cardin i agree with you are but if you look at the relative resources going into the medicaid population versus the general populace and, you will find come in many cases, it is less resources. On quality education, money is not the only thing, but it is part of the problem. Werge a to recognize, yes, want a better outcome. We all want a better outcome in our system. But you dont do that by taking money from the most vulnerable. Senator nelson just a followup our last conversation, you said that you did not recall having. Aid its a terrible idea i quoted the source, politico. Inhethr, ths wiwi y, popanidronidhes. Su toato hau t wcero ok. Inadequate, but thank you. Thank you, senator casey. Thank you for the additional round of questioning. Representative price, wanted to move to the topic i hope i would have gotten to in the first round, which is individuals with disabilities, many of whom dont have the exact number but many of whom rely upon medicaid. One of them is a young man a child i just got a letter from had his mother about pam simpson, from coatesville, pennsylvania, thats in southeastern pennsylvania. Sen. Casey talking about her son rowan, rowan simpson, who was diagnosed in 2015 with autism. And among other things she said about the great care they get, that he gets and their family benefits from medicaid and she says without medicaid, quote, we would be bankrupt or my son would go without the therapy he sincerely needs, unquote. Can you guarantee today that hes going to have that kind of his family is going to benefit from and he, rowan simpson, will have that kind of coverage and protection that medicaid provides, that hell have that if youre secretary of health and Human Services . Rep. Price were absolutely committed to making certain that that child and every other child and area other individual in this nation has access to the highest quality care possible. Sen. Casey not access. They will he will have the medical care that he has right now. Or better, if you can come up with a better level of care, thats fine, but he will have at least the coverage of medicaid and all that that entails that he has right now . Thats either yes or no. Thats not rep. Price it is not a yes or no, because the fact of the matter is that in order for the current law to change, you all have to change it. If im given the privilege of leading up the department of health and Human Services sen. Casey look, we should stop talking around this. You have led the fight in the house, backed up by speaker ryan for years, to improve to block grant medicaid. Rep. Price to improve medicaid. Sen. Casey to block grant medicaid. What that means is states will have to decide whether or not this child gets the medicaid that he deserves. Thats what happens. So you push it back to the states and hope it work out. One estimate by senate and budget priorities, long before you were named, said here is the headline of a chart. House budget chairs plan would slash medicaid by one third by 2026. This wasnt developed because youre now in front of this committee. Thats what theyre saying, that medicaid would be cut by a third d by of ther, 1 trillion. So let me ask you this question rep. Price may i respond . Sen. Casey let me get this question in. Can you commit to us right now that no person with a disability who is currently covered by , medicaid, so thats everyone, thats rowan, thats everyone else, that no person with a disability who is currently covered by medicaid will lose healthCare Coverage, not access, coverage, under the block granting plan that the administration now embraces as of sunday. Rep. Price what i can commit to you is that in a medicaid system that if im given the privilege of serving and working with cms administrators, that the metrics we will use for rowan and every single other patient is the quality that theyre receiving and whether or not theyre receiving that care. Sen. Casey at sign. Rep. Price that is fine. Rep. Price the metric that you want to use sen. Casey metrics are fine. What im asking you again is will you commit to ensuring that rowan and every other person in the country that has disability, has a disability that benefits from medicaid today, will they have that same coverage, the same the same coverage and the same health care and coverage they have today . Rep. Price our commitment is to make it so that they have that coverage or greater. Sen. Casey thats a commitment youre making. Rep. Price thats a commitment. Sen. Casey for every person that benefits from medicaid, that is a disability. Rep. Price as i say, the goal is and our desire is, but our desire is to make sure people have Better Health care, not less healthcare. It is astounding to me sen. Casey here is the problem with that. Here is the problem with your answer. Until sunday, there was a question as to whether or not President Trump or his administration would fully embrace block granting of medicaid, because he said when he was campaigning that he would not cut medicare, medicaid, and Social Security. As of sunday, the administration has said, on the record, in at least one, maybe two interviews, that theyre going to pursue a block granting policy with regard to medicaid. What flows from that are the following. He has a majority in both houses. So what you have been working on the house for years that you can vote for now may become the law of the land. This is a live issue. This isnt theory or some policy among house republicans. This is a potential enactment of law to block grant medicaid, and i hope you can keep your promise to make sure that no one with a disability suffers any diminution of care or coverage. Thats the promise you just made and i hope you can make that in , light of a 1 trillion cut in medicaid pursuant to block granting. Senator mccaskill, the last one. Thank you. And thank you for your patience in letting us have another round of questions, mr. Chairman. We appreciate it. I would like to put in the record a table prepared by the taxpolicycenter. Org on december 15th, 2016, that lays out what happens with repeal of all aca taxes including premium credits, based on income level. If i could make that part of the record. Without objection. Sen. Mccaskill you were chairman of the Budget Committee. Im going to try i get frustrated when people wont answer especially when your , record is so clear on this, congressman. I dont really understand why you want to divorce yourself from your record. You were the chairman of the Budget Committee, correct . Rep. Price yes. Sen. Mccaskill and in that role you had the most important we all know the power of the chairman around here. You had incredible power to influence what was in that document, correct . Rep. Price which document . Sen. Mccaskill the budget that you prepared for 2017. Absolutely. Along with my colleagues. Sen. Mccaskill along with your colleagues. Was there anything in that document that you disagreed with on principle when you supported it . Absolutely. Sen. Mccaskill ok, what was in the document that you disagreed with on principle when you supported it . I would have to go back and look, but it i was combined effort, but again, you know, as i mentioned before, if im given the privilege of serving as secretary of health and Human Services, i appreciate and understand that thats a completely different role sen. Mccaskill i know it is a completely different role. Thats not what im asking you, congressman. Rep. Price your question referred to that role. Sen. Mccaskill im not asking you about the im not asking you about the difference in your roles. What im asking you is what do you believe in . What do you believe in . You have been respected around these halls for a man of integrity, because you believed in certain principles. And one of those was the principle that you embraced as chairman of the Budget Committee to block grant medicaid. No, on the contrary, what i believe in is this great country and the people of this great country and the principles of health care that i defined earlier. And those are the principles that we all share, i believe, and that is that we need a system that is affordable for everybody, we need a system that is is accessible for everybody. A system that is of the highest quality, accessible to patients sen. Mccaskill i get that. I understand. Rep. Price incentivizes innovation and a system that provides choices to patients. Thats what i believe in. Sen. Mccaskill i understand the aspirational goal you have. But there is a record. There is a record and the record is that as chairman of the Budget Committee, controlled by your party, you put out a budget document, and you said over and over again this you favored that you favored block granting medicaid. In fact, your budget, in 2017, that you were the chairman of, that you want to run away from today as if it never happened, and thats what i cant figure out why. Youre going to be influential. What you really believe matters. And you want to run away from that, you cut medicaid by a trillion in your 2017 budget, and yet today, you want to stand on some notion that, well, whatever you guys do is fine. And thats just not reality, congressman. What is reality is youve been chosen because of your beliefs, and your beliefs are reflected in your budget that you wrote as chairman of the Budget Committee, and thats all the point im trying to make. And i have a hard time understanding why you wont say, listen, it may not turn out the way i believe, but, yes, i favored block grants to medicaid. Rep. Price what i believe in is a medicaid system that is responsive to the patients and provides the highest quality care possible, and i would respectfully suggest to you that thats not the medicaid system that we currently have. It is incumbent upon you, it is incumbent upon me if im given the privilege of serving in this capacity, to Work Together to find the solution to that we so that we provide the highest quality care for medicaid patients and everybody else in this country. Sen. Mccaskill i understand. By the way, the argument being made in favor of block grants is that it gives more flexibility and efficiency to the states. Thats the argument you made before, the argument made around the budget that you crafted is that when you block grant things to states, it gives them more efficiency. So i want to turn to a block grant we have now. It is the social Services Block grant would you have voted repeatedly to repeal, you ofg ed to zero it out. Tintatse wleicinhehag itongks sitcan hat y. Je t