[chatter] [indiscernible chatter] [gavel] the hearing will come to order. The committee on health, education, labor, and pensions will come to order. Today, we are reviewing the nomination of dr. Tom price to be the secretary of health and Human Services. Dr. Price, we welcome you and congratulations on your nomination. Welcome to you and your wife, betty, who is here with you. I enjoyed having the opportunity to visit with you in my office and learn about your plans. Dr. Price will be introduced today in a few minutes by a member of this committee and dr. State senator. Before senator isaac introduces the nominee, senator murray and i will make a few introductory remarks. After the nominee makes his statement, we will have a usual round of questions. Now let me Say Something about , that round of questions. Last night, we had a hearing of 3. 5 hours. I tried as chairman to be fair by following the same precedent we had with president obamas two education nominees by having one round of five minute questions followed by senator murray and me asking questions and wrapping up. I do not want to argue that again because we spent a lot of the 3. 5 hours arguing about the 3. 5 hours. I have listened carefully to what my colleagues have said and the health ofat Human Services secretary, when that person came before our committee. Secretary burwell had one round of questions. One round, plus dr. Coburn asking questions. Six members ask questions in the second round. Thompson, one round, but it was a round of seven minutes. Six members ask a second round. So what i decided to do in an effort to treat president elect trumps nominee the same as we have treated other nominees is to have a single round of seven minute questions today. With secretary thompson, and that seems to me to give everyone in the senate more time to ask questions with the secretary. This is a courtesy hearing. Dr. Price will be before the finance committee on next tuesday. A number of members of this committee are also members of the finance committee. We do not vote on his nomination, they do. And we will be the ones who it to the floor if that is their decision. We have the hearing because we have some of the health care jurisdiction, important parts of it. We would like to talk to him about especially those issues. He has all of his paperwork in place before the finance committee, including the letter of agreement with the office of government ethics, available to this committee as well as others. So it is my hope that in our seven minute of questions, we have time to focus on the responsibilities of the department of health and Human Services rather than have a continuing discussion about the number of minutes. There will be an opportunity following the hearing to ask written questions of dr. Price as well. Dr. Price, if you are confirmed to lead the department of health and Human Services, you will run an organization that spends 1. 1 trillion a year. That has always troubled me, actually, that he will be in charge of spending more than Congress Actually appropriates every year. By that, i mean the part of the budget we reappropriate which is under good control, the part that has national defense, National Institutes of health, national parks, and national laboratories, over the last several years, that part is rising at about the rate of inflation. It is not adding to the budget. It is about one third of the total government spending. But it is a little less than the amount in your department every year. Most of which is mandatory spending, entitlement spending, which is going up at a rate like that while the rest of the budget is going like this. You will be overseeing medicare and medicaid. Mental and Substance Abuse programs. We enacted in december of last year and the president signed the most important of that, the programs of that decade. The food and drug administration, we made important changes there, giving them new authority to hire and pay the experts they need to move devices through the fda at a more rapid rate getting those into the medicine cabinets of the doctors office. That was a number one priority in we passed that into law in december. And then the implementation of obamacare and various proposals to replace it with concrete, Practical Alternatives. To give the American People more choices of lowercost Health Insurance. Dr. Price, i believe you are an excellent nominee for the job. Surgeon a practicing for nearly two decades. I read about the resident doctors in training who you taught. You served as medical director of the orthopedic clinic at the memorial hospital. In the house, you were chairman of the Budget Committee and have been a leader in deliberations over the future of our Health Care System. So you know the subject very well. One of the first responsibilities you will have is to give us your advice about how to repair the damage the Affordable Care act has caused so Many Americans and how to replace it or to replace parts of it, with concrete Practical Alternatives that give americans more choices of lower cost insurance. Let me give my view about how we might proceed and during the question answer session, i will ask you more about your view. Following the president ial election, president elect trump said on 60 minutes that replacement and repeal of obamacare would be done simultaneously. His word. To me, that means at the same time. And then recently speaker of the , house paul ryan said the repeal and replace of obamacare would be done concurrently. And then senator mcconnell said last week that we need to do ins promptly, but manageable pieces. I am trying to interpret what those words mean. To me, that means obamacare should be finally repealed only when there are concrete tactical reforms in place to give americans access to Affordable Health care. The American People deserve Health Care Reform done in the right way, for the right reasons. In the right amount of time. It is not about developing a quick fix. It is about working toward longterm solutions that work for everyone. One way to think about what simultaneously and concurrently mean is to think about obamacare the same way you think about a collapsing bridge in your hometown. Because that is just what is happening with obamacare in my home state and in many other states. According to the tennessee insurance commissioner, the obamacare Insurance Market in our state is very near collapse. Across the country, premiums and copays are up and employers have cut jobs in order to afford the mandates of obamacare. Medicaid mandates are consuming state budgets one third of , american counties, citizens of federal subsidies have only a single choice of company to buy insurance from on the Obamacare Exchanges. Without quick action next year, there may be zero choices on those exchanges. And their subsidies may be worth as much as as a bus ticket in a town where no buses run. In georgia or tennessee was very near collapse the first thing we would do is , send in a rescue crew to repair the bridge temporarily so no one else is hurt. Then we would build a better bridge or more accurately in the case of health care, many bridges to replace the old bridge. And finally, when the new bridges are finished, you would close the old bridge. That is how i suggest we proceed. Rescue those trapped in a collapsing system. Replace the system with functional markets. Market or markets as states , develop their own plans for providing access to truly Affordable Health care. Then repeal obamacare for good. First, we should offer rescue plans so 11 million americans who buy individual insurance now, can continue to do so while we build a better set of concrete, Practical Alternatives. Second, we should build better systems, providing americans with more choices of insurance that cost less. Note that i say systems, not one system. If anyone is expected senator mcconnell to roll a wheelbarrow on to the senate floor with a 4000 page copper has a comprehensive Republican Health care plan, they will be waiting a long time because we do not believe in that we do not want to replace a failed washington, d. C. Health care system with another failed washington, d. C. , Health Care System. So we will provide america with more choices of insurances that cost less and we will do this by moving more Health Care Decisions out of washington dc and into the hands of states and patients there, thereby reducing taxes. We will do this carefully and stepbystep so it is effective. Finally, we should then repeal what remains of the law that did the damage and created all of this. I know the president elect has said that after you are confirmed, which i hope is early in february, that he will propose a plan in congress. I look forward to that. And i know that you cannot tell us us what the plan is today. But i do look forward to hearing from you how you suggest we approach this. We want to do it right and do and we want to sequence these events carefully and adequately so americans have concrete Practical Alternatives in place of what is there today. We want to make sure that the parts of obamacare that are repealed are replaced before the repeal becomes effective. Senator murray. Sen. Murray thank you very much, chairman alexander, and all of our colleagues joining us today. Congressman price, congratulations on your nomination. And thank you to your wife who is here with you, as well. Before i speak about this nominee, i want to say that we remain deeply disappointed in last night, where democrats were blocked from asking more than one round of questions. , the nominee for secretary of education. And disappointed that we are rushing this hearing as well. Mr. Chairman, you said 7 minutes but i will just say, i do not think any of us in prior nominees that you keep pointing to ever thought if i dont ask , for another question, i have just set a precedent. I think there is no example of any senator asking to do a question before and being turned down. So these nominees in the new administration, that many people have questions about, deserve to be asked questions, scrutinized in public before we have a choice to make on the floor of the senate on both sides of the aisle in terms of whether we vote yes or no. That is why we take it is think it is extremely important that we are allowed the opportunity to ask second rounds of questions after we have heard all of the questions. And today, we have 3 or four Committee Hearings going on at the same time. It is extremely challenging, in on aallenging to be here subject that we care deeply about. I would like to point out again that several nominees that have come before, if were going to that, secretary leavitt, a nominee of the Bush Administration five bipartisan , senators participated in a second round. The president nominees obamas first secretary. Again, it is unprecedented for a chairman to turn down a member who has a question to ask. So for the record i would like , to ask consent to put parts of the record of the nominees of michael leavitt, and tom daschle into the record of the hearing. Mr. Chairman that would be fine. Sen. Murray again, our members have questions because this nominee is going to have jurisdiction over the health care and lives of millions of americans and we want to know where he stands before we make a decision, yes or no, for him to be there. So that is why it is so important to members of our committee. Having said that, i want to say the health of our families and communities could not the more could not be more important to our strengths as a nation. When a young child goes to School Healthy and ready to learn, she is better prepared. When women are empowered to plan their families and pursue all of their dreams, our community benefits. When workers asked for quality access to have Quality Health care that they can afford, our economy grows. And when seniors are able to trust that the guarantee of programs they have paid into, medicare and Social Security will be there when needed, we live up to some of our most vital responsibilities. The department of health and Human Services has a critical workto play in our ongoing to meet each of these goals and many more. That is why evaluating a nominee for secretary of health and Human Services, i consider whether the nominee has a record of putting people first and not politics or partisanship or those at the top, whether they will put science first and not ideology, and whether their vision for the health care in our country would help more families get Quality Health care or take us backward. Congressman price, i have serious concerns about your qualifications and plans for the department you hope to lead. And i am looking forward to hearing from you today on a number of topics. I start by laying out issues of what your record suggests about your approach to our nation S Health Care system. Just last week, you voted to begin the process of ripping apart our Health Care System without any plan to replace it , despite independent studies showing that nearly 30 Million People would Lose Health Care coverage. Even though more and more members of your own party are expressing serious doubt about its ability to unify around a plan and knowing in a matter of weeks, you could be leading the department whose core responsibility is to enhance Americas Health and wellbeing. My constituents are coming up to me with tears in their eyes , wondering what the future holds for their health care given the chaos republican efforts could cause. President elect trump and Republican Leaders have promised the American People that their plans to dismantle the Health Care Plan right away would do no harm and not lose anyone to lose coverage. Just days ago, president elect trump promised insurance for everybody. But congressman price, your own proposal would cause millions of people to lose coverage and force many people to pay more for their care and leave people with preexisting conditions vulnerable to Insurance Companies rejecting them or charging them more. I would be interested in hearing your explanation of how you have your plans for how we can keep the promises your party has made to the American People about their health care. Medicare is another issue i would be interested in hearing about today. President elect trump campaigned on promises to protect medicare and medicaid. You have said you plan to overhaul medicare in the first 68 months in this administration, in a way that would end the guarantee of full coverage that so many people and so many people with disabilities would rely on. Policies put forward that would shift one chilean dollars in medicaid costs to our state, squeezing their budgets and taking coverage away from struggling children and workers and families. While president elect trump has said medicare should be able to negotiate prices for seniors, you have opposed efforts to do that and went so far as to call legislation on that issue a solution in search of a problem. I disagree. It is absolutely critical for families in my home state, and i am eager to learn how you will reduce the burden of Prescription Drug costs in our community. As a woman, mother, grandmother, and United States senator, i am deeply troubled by the ways you r policies would impact womens access to health care and reproductive rights. And i have serious concerns about your understanding of womens need for basic Health Care Like birth control, given your expressed doubts on the topic. Your proposals to make women pay extra, out of pocket for birth control, and your repeated efforts to defund our nation s largest provider of womenS Health Care, planned parenthood. I am also very focused on the role of the department of health and Human Services in strengthening and protecting Public Health. I want to hear from you about whether and how you will uphold the Gold Standard of fda approval and, for example, how would you approach important programs and rules intended to keep Tobacco Companies from luring children. Into addiction. Finally as i discussed in the hearing yesterday, i believe firmly that especially as the president elect tries to blur lines around conflict of interest, it is critical we not only do everything in our power to hold him to high standards , but we do the same for cabinet nominees. That is why i was so appalled that with 4 of the president elects nominees currently serving in the house of representatives, House Republicans attempted right out of the gate to get rid of the independent office of congressional ethics. Luckily, they heard loud and clear from people across the country that it was not acceptable and they backed down. Congressman price the office of , congressional ethics has now been asked not only