Senate Vote Confirms Tom Price HHS Secretary

President Donald Trump will get his pick for Secretary of Health and Human Services (HHS). After defeating a Democratic fillibuster, the Senate voted early Friday to confirm Thomas Edmunds “Tom” Price, MD, (R-GA) to head the agency.

Price, 62, is the first physician to head HHS since former President George H.W. Bush appointed Louis W. Sullivan, MD, in 1989, and only the third doctor to serve as secretary of HHS in its 63-year history.

Price, an orthopedic surgeon, appears set to hit the ground running.

His physician background could bring an emphasis on delivering quality care to the Trump administration.

But his critics say Price’s confirmation comes at too high a price.

A political and social conservative, Price is a staunch opponent of abortion and LGBTQ rights. He is a member of the Association of American Physicians and Surgeons (AAPS) — a professional medical organization that has been criticized for advocating views including “vaccines cause autism” despite lack of scientific evidence.

The American Medical Association (AMA) endorsed Price for HHS secretary based on his advocacy for certain issues involving physicians and organized medicine, like trying to control medical malpractice damages. The AMA position puzzled some since the organization had also backed the Affordable Care Act (ACA), which Trump wants to dismantle. However, the endorsement prompted immediate backlash from some physicians who launched a campaign to make it clear that the AMA doesn’t speak for them.

Republican lawmakers have awaited a decision so they can move forward with their promises to undo the ACA. Senate Majority Leader Mitch McConnell (R-KY) shared his enthusiasm in getting Price confirmed so “he can get to work helping provide relief from Obamacare and stabilizing the healthcare markets,” The Hill reported.

Even without tackling the ACA, the HHS job is key to controlling medical costs and access to care. Insurers generally follow the lead of Medicare in setting policies for coverage and reimbursement to providers.

As HHS Secretary, the onus is on Price to update the Medicare physician fee schedule annually and set payment policies. Price was chairman of the House Budget Committee when nominated for HHS in November and announced Congress would aim to overhaul Medicare within the first six to eight months of the Trump Administration.

Price thoroughly outlined his plans to replace Obamacare in a proposal he authored, “Empowering Patients First Act”. Most notable is his idea to fully repeal the ACA’s Medicaid expansion, without a solid replacement. Price’s proposal serves as a blueprint for the health care plan House Speaker Paul Ryan’s later revealed, which policy analysts had dubbed as “Obamacare light”.

The administration has since backed off a bit, with Trump saying this week that ACA reforms will not likely happen until 2018.

The confirmation follows weeks of scrutiny over Price's personal stock transactions, ones Democrats charged may have violated federal law. Price was alleged to have bought stock in companies then pushed for legislation to benefit those companies, and of getting an improper inside deal on a stock before supporting favorable legislation that helped its price go up.

After beginning an inquiry into some of those charges in 2013, the federal Securities and Exchange Commission quietly dropped its search for committee documents surrounding information on his biomedical investments a few weeks before Trump’s inauguration. Price has maintained he did nothing wrong and that questionable trades were made by his broker without Price's knowledge.

After months of media attention, Price’s confirmation should not come as a surprise, particularly given Trump’s campaign vows to “repeal and replace” the ACA. Whether all his proposals will pass is still a mystery, but Price holds a powerful seat in implementing change.