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Confirmation Hearing for HHS Pick Tom Price; Trump Executive Order Advances Controversial Oil Pipelines; Trump to Nominate Supreme Court Justice This Week. Aired 11:30-12p ET

Aired January 24, 2017 - 11:30   ET


SEN. BEN CARDIN (D), MARYLAND: I know initially you did not support that legislation.

[11:30:00] If confirmed, can you commit to us that you would rigorously enforce that act to make sure particularly our children are not subjected to the new forms of tobacco products?

REP. TOM PRICE (R-GA), NOMINEE FOR HEALTH & HUMAN SERVICES SECRETARY: Yeah, the response -- if -- if I'm confirmed, the responsibility that we will have is to enforce the law of the land and we'll do so.

CARDIN: What it also requires, the keeping up with new technologies that are being used by the industry that may require modifications, as we see with e-cigarettes. Are you prepared to not only enforce the law, but to enforce our intent to make sure our children are protected?

PRICE: I look forward to working with you Senator on just that.

CARDIN: I want to -- I was listening to some of the exchanges as it relates to the Affordable Care Act and we'll continue to debate the merits of the Affordable Care Act. I am a strong supporter of it. I think the millions of people who have coverage that didn't have it before, the quality of coverage that Americans now have that they didn't have before and the rate of growth of our health care premiums are far lower than it would have been, but for the act, we'll debate that later.

The question is what do we -- what do we -- what's coming along? We've heard you say several times the principles that the president has articulated, as to what would be in place of the Affordable Care Act.

I'd like to drill down, a little bit if I could, on the central health benefits. We've talked about preventive care now being available. We know that we have now mental health and addiction services that are available. We also know we have oral health -- pediatric dental, that's now available, which is particularly important in my state because of the tragic loss of the Deamonte Driver in 2007.

Can you assure us that, as you look at what will be the health care system moving forward. That you're prepared to make sure that Americans have quality insurance coverage to deal with issues such as preventive care, mental health services, addiction services and pediatric dental? PRICE: What I can commit to you, Senator, is -- is that we will do all that we can within the department with the -- the incredible knowledge and expertise that is there, to define whether or not the program is -- is actually working as intended or not. If coverage equals care, in many instances I would suggest that -- that folks -- many individuals right now have -- have coverage; they've have a card, but don't have any care because they can't afford the deductible that allows them to get the care.

So we're committed to making certain the system works, not just for government, not just for the insurance companies, but for the patients.

CARDIN: And as you know, we eliminated any co-pays on preventive care, but we can talk about the specifics going forward. I look forward to those discussions.

Thank you Mr. Chairman.

PRICE: Thank you.

SEN. ORRIN HATCH (R), UTAH: Thank you Senator.

Senator Isakson.

SEN. JOHNNY ISAKSON (R), GEORGIA: Thank you Mr. Chairman.

[11:32:41] WOLF BLITZER, CNN ANCHOR: We're going to break away from the hearing, the Senate Finance Committee hearing, the confirmation hearing for Tom Price to become the next secretary of Health and Human Services.

Over at the White House, President Trump has just signed some more executive actions, what they're being called, including, Jake, on the Keystone and Dakota Pipelines. We're about to get the videotape from the pool, the video of his latest actions in the White House.

JAKE TAPPER, CNN ANCHOR: And there has been a clamoring by opponents of Donald Trump that he holds stocks that are related to the Keystone Pipeline. I'm not sure about the Dakota Pipeline.

Oh, here's the tape.

BLITZER: Here's the tape.


DONALD TRUMP, PRESIDENT OF THE UNITED STATES: This is with regard to the construction of the Keystone Pipeline, something that's been in dispute, and it's subject to a renegotiation of terms by us. We are going to renegotiate some of the terms. And if they'd like, we'll see if we can get that pipeline built. A lot of jobs. 28,000 jobs. Great construction jobs.

OK, Keystone Pipeline. This is with respect to the construction of the Dakota Access

Pipeline. Dakota Access Pipeline. Again, subject to terms and conditions to be negotiated by us.

[11:34:50] OK. This is construction of pipelines in this country. We are, and I am, very insistent that if we're going to build pipelines in the United States, the pipes should be made in the United States. So, unless there's difficulties with that -- because companies are going to have to save Europe. Much pipeline is built from other countries. From now on, we're going to start making pipeline in the United States. We build it in the United States. We build the pipelines. We want to build the pipes. Going to put a lot of workers, a lot of steel workers back to work.

All right, we will build our own pipeline. We will build our own pipes. That's what it has to do with. Like we used to, in the old days.

This is about streamlining the incredibly cumbersome, long, horrible, permitting process and reducing regulatory burdens for domestic manufacturing. Many of the people that we've been meeting with over the last long period of time, but, yesterday, and others, the process is so long and cumbersome that they give up before the end. Sometimes it takes many, many years, and we don't want to that happen. And if it's a no, we'll give them give a quick no. And if it's a yes, it's like, let's start building.

The regulatory process in this country has become a tangled-up mess. Very unfair to people. That's a big one.

This is the expediting of environmental reviews and approvals for high-priority infrastructure projects. We intend to fix our country, our bridges, our roadways. We can't be in an environmental process for 15 years if a bridge is going to be falling down or if a highway is crumbling. So, we're expediting environmental reviews and approvals.


Thank you very much.


UNIDENTIFIED REPORTER: Any comment on the Standing Rock community? The protesters out there?

CONWAY: Thank you, Press.


CONWAY: Thank you.


TRUMP: Sometime next week. I'll be making my decision this week. We'll be announcing next week. We have outstanding candidates and we will pick a truly great Supreme Court justice. But I'll be announcing it sometime next week.


TRUMP: Thank you all very much.



BLITZER: There you see President Trump signing five executive actions. The first one on the Keystone oil pipeline, allowing it to go forward, subject to new renegotiations. Then the Dakota Oil Pipeline, another executive action, saying that the pipes, the pipelines, Jake, will be built here in the United States, made in the USA. Streamlining regulations on environmental restrictions, and also expediting environmental reviews, so that bridges, infrastructure, highways, roadways, can be built. Five more executive actions taken by the president.

TAPPER: And he also said that he would be making his decision about a Supreme Court pick to fill that ninth vacancy in the U.S. Supreme Court. He said he would be making his decision this week and making an announcement next week.

Just to put a button on what I was saying earlier before we ran the tape, Democrats and people who oppose the North Dakota Pipeline have jumped on the fact that in earlier financial disclosure forms, President Trump held stock in companies that will benefit from the building of the Dakota Pipeline. The spokeswoman for the then- candidate, now President Trump, Hope Hicks, has said that President Trump sold that stock, although we don't have anything to go by other than their word. But they did say he sold that stock.

The announcement of the Supreme Court pick, I think that's the biggest news out of what he just said. Because that is going to ignite a huge fight on Capitol Hill.

[11:40:01] BLITZER: And there's some finalists, but whoever is put forward, presumably, will generate that kind of fight. And unlike the confirmation process for the cabinet members, you need 60. You will need 60 votes in the United States Senate for confirmation of a Supreme Court justice. The Republicans have 52. They'll need a few Democrats to come along, as well.

TAPPER: And the Senate Democratic leader, on Sunday, Chuck Schumer, told me they would oppose anyone they thought was out of the mainstream. President Trump provided a list of 21 possible Supreme Court picks about three months ago. He said, are these people in the mainstream, and said he didn't have enough time to go over any name on that list. My guess is that a lot of Democrats, whoever he picks, they will find that person to be out of the mainstream. A lot of names that we're hearing about are definitely conservative judges, as one would expect, from a Republican president.

BLITZER: Let's see what happens on that front. Gloria, all these five executive actions signed by the president just

now, these are campaign commitments he made these commitments during the campaign. He's now living up to what he told the American voters he would do.

GLORIA BORGER, CNN CHIEF POLITICAL ANALYST: No, none of them come as a surprise, at all, to any of us, but I don't think it's going to make the environmental community very happy. More than sort of any interest group so far, I think the environmental community understands that they have big fights on their hands.

The Keystone Pipeline, you know, the president, former president of the United States, Obama, did not prove it for environmental reasons. He thought it would get in the way of a global climate change deal that he was doing.

You have Native American tribes saying that the other pipeline is a threat to their water. The Dakota Pipeline is a threat to their water supply.

And expediting environmental reviews is something that the community will also oppose and will be upset by, because that he believes that you need these reviews before you start fixing things, because you need to look at what the repercussions will be.

And I think, however, that Donald Trump deserves some credit here, for doing what he said he was going to do. Honestly, this is what -- this is what the American public wants. They want their infrastructure fixed and they want it fixed quickly. And this paves the way for a massive infrastructure bill, which, by the way, the Democrats are going to propose before Donald Trump does.

TAPPER: The environmental community always takes issue with Republican presidents, because they come at it from a very different perspective. But I have to say, it's probably a nightmare for the environmental community that a developer is actually now the president of the United States. Because that's what they do, environmentalists, they battle developers, day in, day out. Now one of the biggest developers to ever achieve any sort of power is in the White House.


BORGER: But they said they're going to pay for the pipes, too. Not pay for them. That Americans are going to supply the pipes. Well, there's a bidding process that goes on, so who's going to be the --


MATT LEWIS, CNN POLITICAL COMMENTATOR: The Obama State Department had actually green-lit the Keystone Pipeline after doing an environmental study. Look, Canada's going to find some way to ship this oil and it might actually be worse for the environment, but Obama, I think, because of his base, the environmentalists, did, you know, did not support Keystone. And now you have Donald Trump just yesterday, meeting with labor leaders. They like this deal. They like this order. So, you could be seeing this as part of Donald Trump's sort of reordering of coalitions, where Democratic-leaning labor unions are now more in the Trump camp.

DANA BASH, CNN CHIEF POLITICAL CORRESPONDENT: And can we just take a step back a little bit and just note the imagery of the new Trump White House, once again, just like yesterday, it was just from morning to night, picture after picture after picture, aimed at sending a signal to the American people, I'm here, I'm at work, look, here I am in the oval office, look, here I am in the Roosevelt Room, look, here I am in the cabinet room, doing things, as you said, that he promised to do in the campaign. Look, that's today's imagery. I just want to say, just to sort of say what we were all saying here, yesterday, I think we saw a lot of the men who were in charge of the -- who have leading roles in the Trump White House, now we see a couple of women in the picture.


BORGER: Oh, look!

BASH: It's hard to imagine that that's an accident. Kellyanne Conway is somebody who is one of the senior advisers there. And Hope Hicks, to her right, has been with Donald Trump since day one, was part of the small band of brothers and sisters who tried to get him and successfully got him elected. But I think that is something that is noteworthy. In that, look, he has told people privately that he wants to be like Ronald Reagan in terms of his style. He liked his style. And Michael Dever, who really helped create the imagery of Ronald Reagan, would have -- is probably, you know, looking down from heaven saying, applause, applause, applause, you're doing pretty well on day two.

[11:45:03] DAVID CHALIAN, CNN POLITICAL EDITOR: To your point, Dana, he relishes having cameras at his beck and call.


This is -- for all the contention that there is between the press and this White House, and we've been reading a lot about that, he is certainly making good use of the fact that within the same building that he resides, is an entire press pool, that when he can call them in to -- I keep thinking, my god, if he had this ability when he was a real estate developer in New York, if he had the ability to bring the cameras in every time he signed something, he is relishing this a little bit.


BORGER: It's Show-and-Tell a little bit. Don't you think?

HENDERSON: It is Show-and-Tell. It reminded me of a kindergarten teacher who's reading a storybook, the big bad Wolf is blowing down the house and showing it to the class. That's what he was doing.


HENDERSON: I think it absolutely works. It's very simple to understand. He's telling a story. He's showing everybody. People get to be a part of it. I think it's very effective.

LEWIS: The worst politicians are the ones who are great in person, great in private, but Trump, the fact that he loves the limelight, I think is more of a feature than a bust.

SYMONE SANDERS, CNN POLITICAL COMMENTATOR: I think we've known for a while that he's good about the theater that encompasses politics. But the question is about the pipeline. He basically said, no pipeline unless it's U.S. Steel. The Keystone Pipeline is foreign steel and foreign oil. I don't know if Mr. Trump knew that, but these are facts that are going to come out.

We also have the thing about imminent domain. The GOP does not like innocent domain. I'm from Nebraska. Nebraska farmers and ranchers are not here for imminent domain. There's still a state's rights issue here. So, while he, yes, delivered on the promise of signing on the dotted line on the Dakota Access Pipeline and the Keystone Pipeline, there are some other things that have to happen before this actually goes through.

TAPPER: I wonder what this means, also, in terms of the protests of the Dakota Pipeline.


TPPER: Because in the last few months of the Obama administration, that was a big story. The very emotional demonstrations by Native Americans and allies.


TAPPER: All going and stopping the construction or trying to stop the construction of the Dakota Pipeline. I wonder if this now means there's going to be a reigniting of the activism and protests there.

BASH: Hard to imagine it won't.

TAPPER: And what that will mean, and how it was very awkward and difficult for President Obama to deal with it. He ultimately dealt with it because the Army Corps of Engineers kind of overruled the people beneath them and said, we're suspending this for now, but that was just kicking the can down the road.

HENDERSON: And whether it gets back into the culture war. Part of their argument is that not only would this pipeline be damaging to the environment, but that it damages a culturally significant site. You imagine it's going to get into a back and forth with conservatives.

BLITZER: These signings were taking place just as Congressman Tom Price is continuing the confirmation process, the hearing before the Senate Finance Committee on various issues. It can be ethics issue, substantive issues involving Obamacare.

I want to play this exchange that Dr. Price had on his understanding, what the signing, the action that President Trump has already done, initial steps to repeal, eventually replace Obamacare. Listen to this.


SEN. RON WYDEN, (D), OREGON: Under the executive order, will you commit that no one will be worse off?

PRICE: What I commit to, Senator, is working with you and every single member of Congress to make certain that we have the highest quality health care and that every single American has access to affordable coverage.

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?

PRICE: I guarantee you that the individuals that lost coverage under the Affordable Care Act, we will commit to making certain that they don't lose coverage under whatever replacement plan comes forward. That's the commitment I provide to you.


BLITZER: Dr. Sanjay Gupta is with us, as well. He's an expert on the Affordable Care Act.

Sanjay, what's your understanding executive order that has now been signed by President Trump, an initial step. The fear among the supporters of Obamacare is it's more than just symbolic, it's going to hurt some folks.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORERSPONDENT: It's a little bit hard to fully understand what this executive order means, because it basically says there's authority now to remove any kind of burdens that the Affordable Care Act may have placed in various sectors of our society, insurance wise, or patient care. But it didn't define what the burdens were or what a maximum burden would be. I think a lot of that left is going to be left to Congressman Price, which I think is why the question was asked about would there be people who would lose coverage. And I think, you know, there's been a lot of data on this. This was sort of a loaded question, as you well know. The Congressional Budget Office has released estimates, if there's a repeal of the Affordable Care Act in year one of that repeal, year two, year three. They say some 30 million more people, within a few years, would not have health care coverage. I think that that's what was really getting at.

What Congressman Price has said to that question in the past -- he didn't really answer it today -- is that those numbers did not anticipate the replacement plan he has, and his replacement plan would not lead to that sort of loss of coverage. He has never said it wouldn't lead to loss of coverage at all.

[11:50:41] BLITZER: Sanjay, stand by. We're going back to the hearing.

But very quickly, Jake, what do you think? How is Congressman Price handling these questions, largely tough questions from the Democrats?

TAPPER: Tough questions from the Democrats, not so much from the Republicans. I think he's handling it well in terms of the theater of this. He insists he's done nothing wrong. I've not seen anything that will put his nomination in jeopardy. Ultimately, this is going to be a party line vote. Ultimately, Republicans will rally around him. He's very popular among Republicans on Capitol Hill. Of course, he has been a Republican congressman on the other side of Congress, on the House side, for several years. I can't imagine, even with these ethical concerns and even with Democrats, fighting the Obamacare repeal, tooth and nail, I can't imagine him not getting confirmed.

BLITZER: I agree.

Let's go back to the hearing right now.

PRICE: I think there has to be absolutely credible coverage and I think that it's important that the coverage that individuals ought to be able to purchase is coverage that they want.

SEN. MICHAEL BENNET (D), COLORADO: I -- I just don't want us 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 out of pocket month after month after month for something that's not going to cover something as basic as a hospitalization or maternity services or, you know, the rest of this list?

There may be certain things on the list we disagree with. But I'm worried that we're heading toward a world where somehow that choice is accepting a world that no one else in the industrialized world has to accept. And 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, in your answer to Senator Portman. In Colorado, you may have heard of this, we have something called the Accountable Care Collaborative that 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 don't have it today, but I could show you that the cost curve there is really starting to turn around because of the coordinated care that's happening out there.

When asked about the need for more state flexibility, which is an argument that's made to carry out innovative programs like the one in Colorado, our governor said that, quote, "Greater flexibility cannot make up for the lack of funding. Should the federal government pull back its financial commitments, we simply cannot afford to make up the difference."

So I'd ask you whether you agree with our governor's assessment that while flexibility is helpful, it isn't a replacement for critical funding needs. PRICE: I think some of that decision -- the decision for funding obviously is a legislative decision.

BENNET: So what do you think the plan -- but that's a -- that's a very fundamental component of the Affordable Care Act, is the expansion of Medicaid. Wouldn't you agree?

PRICE: And that -- and that decision whether or not to change that is a decision that you and every member of the committee and Congress will be involved in. And if I'm fortunate to serve as the secretary of health and human services, we'll carry out the law that you pass.

BENNET: So -- I appreciate that. In your mind, though, does the repeal of the Affordable Care Act include a repeal of the expansion of Medicaid that was part of the passage of the Affordable Care Act?

PRICE: Any reform or improvement that I would envision for any portion of the Affordable Care Act would be one that would include an opportunity for individuals to gain coverage, the kind of coverage, again, that they want to the highest quality health care.

BENNET: But that's not the question I asked. I'm sorry, Mr. Chairman, I realize I'm at the end of my time.

Do you believe that a repeal -- I mean, this is what the president ran on -- repeal of the Affordable Care Act, includes the repeal of the expansion of Medicaid that was a fundamental part of the Affordable Care Act?

PRICE: Again, that's a decision that you all would take.

BENNET: That's true.

PRICE: What -- what I believe is that any -- any reform or improvement must include a coverage option and opportunity for every single American, including those that are either currently or close to Medicaid population in a given state, which changes depending on the state.

BENNET: OK. Thank you, Mr. Chairman.

SEN. ORRIN HATCH (R), UTAH: Thank you, Senator Bennet.

Senator Wyden?


HATCH: Are you OK?


HATCH: All right, then let's go to -- let's go to Senator Toomey.


SEN. PAT TOOMEY (R), PENNSYLVANIA: Thank you, Mr. Chairman. Congressman Price, thank you for joining us.

PRICE: Thank you.

TOOMEY: Thanks for the great work you've done in the House and your willingness to serve in this extremely important post. I appreciate it. I enjoyed the conversation that we had a little while back.

I do think it bears reminding everyone as we talk about Obamacare that certainly the individual market is in a classic death spiral. The adverse selection is destroying that market. It is in a free fall. In Pennsylvania, 40 percent of all Pennsylvanians in the Obamacare exchanges have a grand total of one choice. And that very typically does not include whatever they had before and were promised they could keep, which of course was never true.

So -- so we've got a system that is in collapse. And what we're trying to do is figure out what's a better way to go forward.

Now, when we talk about repeal, sometimes I hear people say, "Well, we've got to keep coverage of preexisting conditions because, you know, we've go to keep that." And when I hear that, I think that we're missing something here. And here's what I'm getting at.

There's obviously a number of Americans who suffer from chronic, expensive health care needs. They've had these conditions sometimes all their lives; sometimes for some other period of time. And 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. Now, one way to force it is to force insurance companies to provide health insurance coverage for someone 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's burned down.

But that's only one way to deal with this. And so, am I correct, is it your view that there are other perhaps more effective ways, since after all Obamacare is in a collapse, to make sure that people with these preexisting, chronic conditions get the health care that they need at an affordable price, without necessarily having the guaranteed-issue mandate in the general population?

PRICE: I think there are other options. And I think it's important, again, to appreciate that the position that we currently find ourselves in with policy in this nation is that those folks are, in a very short period of time, are going to have nothing, because of the collapse of the market.

TOOMEY: Right. Second topic is, I think you and I share a goal of having health care that is much, much more driven by individuals -- families, patients, consumers, consumer-centric rather than bureaucratic-centric, which is what Obamacare is.

Do you agree with me that to get there, we need to do more about the transparency of health care outcomes, so that informed consumers can evaluate among different physicians, different hospitals, who really gets the best outcomes? Do we need to do more there?

PRICE: Absolutely. And this is an incredibly important point. And it's not just in outcomes. Outcomes are important and we need to be measuring what actually makes sense from a quality standpoint, and allow patients and others to see what those outcomes are.

But it's transparency and pricing as well. And right now, we don't have that. So if you're an individual out there and you in fact want to know what something costs, it's virtually impossible to find out what that is. There are all sorts of reasons for that, but if we're honest with ourselves as policy-makers, and we want to make the system patient-friendly, not insurance-friendly or government- friendly, but patient-friendly, then we would make that a priority.

And if I'm confirmed, I hope to do so.

TOOMEY: I think Medicare and Medicaid can play -- CMS can play a big role in advancing that. Ultimately, I think the more we diminish dependence on third-party payers, and allow the evolution of a market that responds to individuals, individuals will demand that information the way they do in every other market.

Last point I want to touch on, if I could, is -- has to do with NIH research, and specifically Alzheimer's. It is my view that we ought to think of Alzheimer's as a disease in a category of its own. And I say that because there is no disease like it that we know of that afflicts Americans today. There are 5.2 million Americans with the disease right now. It's 100 percent fatal. It's the sixth leading cause of death. There's no cure. There's no treatment. There's nothing.

And yet for fiscal year 2016, NIH spending 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 the breadth and the scope of this disease. And 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.


PRICE: I think it's absolutely imperative, Senator, and I look forward to working with you.