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At This Hour

Live Coverage of Senate Hearing with Secretary of Health & Human Services Nominee. Aired 11:30a-12p ET

Aired January 18, 2017 - 11:30   ET


REP. TOM PRICE (R-GA), SECRETARY OF HEALTH & HUMAN SERVICES NOMINEE: We've had one large-term bill since March or early 2009 and then beyond that, tens of pieces of legislation to address the health care issue.


SEN. RAND PAUL (R), KENTUCKY: It's also been insinuated that America is this horrible, rotten place, you know, that we don't have compassion and I guess by extension, the physicians don't. Well, as you worked as an emergency room physician or as you worked as a physician, didn't you always agree as part of your engagement with the hospital to treat all comers regardless of whether they had an ability to pay?

PRICE: It's one of the things we pride ourselves upon and that is that anybody that showed up in need of care was -- was provided that care. And that was true not only in our residency, but in our -- our private orthopedic practice as well.

PAUL: And it's interesting that those who say we have no compassion, you know, extol the virtues of socialism. And you look at a country like Venezuela, with great resources and in utter disaster, where people can't eat, devolving into violence. And you know, I think it is important that we do have a debate ultimate (ph) our country between socialism and communism and America and capitalism.

One of the things that's extraordinary about our country is just two years ago, in 2014, we gave away $400 billion privately, not the government, individually to churches and to charities. We're in an incredibly compassionate society. And I think often, this was misplaced in sort of the wonky numbers of this number and that number within health care how much we do help each other.

Not only do we help each other within our country, most -- I'll bet you half the physicians in my community in (inaudible) have gone on international trips and done international charity work. And all that is lost in saying that we're this heartless, terrible country. And I would just argue the opposite. I think the greatness of our country and the greatness of the compassion of our country, we give away more than the gross domestic product of most of these socialized countries around the world.

So I think it is important. With regard to replacement, a couple of things. There are some big, broad ideas that I think would ensure more people. One is the idea of legalizing the sale of all types of insurance. Under Obamacare, we made it illegal to sell certain types of inexpensive insurance. Do you think we could insure more people (inaudible) some of the people actually don't get insurance under Obamacare, to get insurance if we would legalize the sale of more types of insurance?

PRICE: I think choice, as I mentioned, is absolutely vital. And I know that -- that if we keep -- if we have as a principle and as a goal having patients have those choices, then I believe that patients will select that kind of coverage that they want. The choices that ought to be available to them are a full array of opportunities.

PAUL: You think health savings accounts will help also some people that are not helped currently?

PRICE: I think health savings accounts and high deductible catastrophic coverage are things that -- that make a whole lot of sense for many individuals and we ought not force anybody to do anything. It ought to be a voluntary choice. But they ought to have the choice to be able to select them.

PAUL: And one of the things you've had different legislation on and I'm a big supporter of is allowing individuals to join together in groups to buy insurance. Do you think this has a possibility of what Senator Alexander talked, about the millions of people in individual market?

I have great sympathy for that, I was a small physician with four employees. And if one employee were to get sick, you know, it could be devastating to -- not only to them, but also to the economics of keeping them employed but letting us join together into pools, where instead of me buying insurance as one of four people, I could buy it in a big group, maybe 100,000 people, maybe a million people. And currently, the laws kind of prevent that.

But you had some bills for expanding that and I'm a big fan of that. Could you mention some of the association health plans and how that might help some people to get insurance who don't have insurance currently?

PRICE: Yeah, thank you. Association health plans are one of those entities that -- that would allow individuals who are economically aligned in some way to be able to purchase coverage together, even though they don't necessarily work together or in the same group.

Individual health pools, which I think is one of the secrets to being able to solve the individual and small group market conundrum that we find ourselves in, would allow anybody to pool with anybody else solely for the purpose of purchasing health coverage. But it's -- it's not a new idea. The model for it is actually the Blue Shield plan that -- that existed decades ago that allowed people to pool their resources together for major medical coverage in -- for hospitalization.

It just makes a lot of sense. It's spread -- it allows insurance to work the way it's supposed to work, which is to spread the risk. And then anybody's adverse health status doesn't drive up the cost for them or anybody else because the pool is large enough.

SEN. LAMAR ALEXANDER (R), TENNESSEE: Thank you, Senator Paul.

Senator Franken?

SEN. AL FRANKEN (D), MINNESOTA: I'll tell you how we could get a really big risk pool, be called Medicare for everyone. That would be the biggest risk pool.

Dr. Price, it was nice meeting you the other day.

PRICE: Yeah, it was good. FRANKEN: Did you enjoy meeting me?

PRICE: Thank you. I did, I did.


I enjoyed our discussion about our gray hair.


FRANKEN: Yeah. Dr. Price, what is the leading cause of preventable death in the United States?

PRICE: I'll defer to you. You've obviously got it on the page in front of you.

FRANKEN: I actually knew this before I put it on the page, it's smoking.

PRICE: That hits -- that hits home. I lost my dad too -- he was Lucky Strike smoker from World War II -- to emphysema, and he prided himself on the fact that he never smoked a cigarette with a filter for years and years, and it was -- it was incredible tragedy.

FRANKEN: I lost my dad, too.

PRICE: Yeah.

FRANKEN: As a physician, you may know, I guess you didn't, that smoking kills approximately 480,000 Americans each year and totals $170 billion each year in health care costs. And yet, between 1993 and 2012, you were a shareholder of tobacco -- big tobacco companies, meaning that you personally benefited from tobacco sales. Meanwhile, you voted against landmark legislation in 2009 that gave the FDA the authority to regulate tobacco.

Congressman Price, you're a physician, which means you took the Hippocratic oath, a pledge to do no harm. How do you square reaping personal financial gain from the sales of an addictive product that kills millions of Americans every decade with also voting against measures to reduce the death toll inflicted by tobacco?

PRICE: Well, it's an interesting question, Senator, and it's a curious observation.

I have -- I have no idea what stocks I held in the '90s or the 2000's or even now. All of these decisions for all of us, I suspect, through mutual funds and through pension plans. I would bet -- and I don't want (inaudible). I would suspect that in your pension plan, that there are -- there are components of that that are held, that may have something to do in some time in your history with tobacco. So...

FRANKEN: You know, I find it very hard to believe that you did not know that you had tobacco stocks. I find it a little hard to believe that in the questions about your stock portfolio, you said you didn't know things. Just over the last four years, you traded more than $300,000 in health-related stocks, while at the same time sponsoring and advocating legislation that could affect the performance of those stocks.

We talked a little bit about the Zimmer Biomet. Your broker, you say you didn't know this, bought it on March 17, 2016. You did introduce a bill later -- a week later on March 23, 2016. You say that you did not know then that you had this stock. It was a rule -- it was to delay a federal rule that would have reduce the profitability of the company's joint -- to delay a rule that would hurt the company.

What I don't understand is once you found out that your broker bought it, you kept the stock. You purchased this $50,000 to $100,000 worth of stock in a biomedical company called Innate Immuno, we've talked about a little bit. It's the (ph) single largest purchase in the past three years in a private deal that was not made available to the public. And I find it absolutely amazing that you responded that you did not know that you got a discounted price. That is absolutely amazing because we discussed this.

PRICE: By definition, I believe that's the nature of a private placement offering. What I've said to you and what I've said to others is that I paid exactly the same price as everybody else. I disclosed it.


FRANKEN: It was a private offering that only went to about 20 people, including Representative -- your colleague Chris Collins, his chief of staff and a prominent D.C. lobbyist. And you reported $50,000 to $100,000 in profits on this purchase. It really begs (inaudible), sir, when you say you did not know that you got a discount on this. This was a private offering to a very small number.

FRANKEN: When you have the chairman of the Budget Committee, when you have a congressman, his chief of staff -- these sound like sweetheart deals.


And I think our job in this body and in Congress and in government is to avoid the appearance of conflict. And boy, you have not done this.

I want to talk just about your latest plan, Empowering Patients First Act. Some of it is detailed in this article from the New England Journal of Medicine. It's called, "Care for the Vulnerable vs. Cash for the Powerful -- Trump's Pick for HHS."

I'll just read a random paragraph. "Price's record demonstrates less concern for the sick, the poor and the health of the public and much greater concern for the economic wellbeing of their physician caregivers." And I would commend this to every member of this committee before making a vote because what your plan does is -- one of the things, it gives a tax credit to Americans to buy health insurance. It's no different for someone who's poor, someone who makes $20,000, $30,000 and to Bill Gates.

It is an incredibly regressive system. You have talked about ending the -- you guys want to end the expansion of Medicaid. That has people in Minnesota scared out of their mind.

Look, I've heard a lot. Oh, Obamacare has been a disaster. First of all, you have to admit that has bent the cost curve, that the cost of health care in this country has grown less than it did in the previous 10 years. It's also covered 20 million more people, but forget them. You know, in 2008, I was going around the state of Minnesota. In every VFW hall, in every cafe, I would see a bulletin board where it would have a burger bash or spaghetti dinner for someone who had gone bankrupt because they had gone through their annual cap or their lifetime cap.

I am very frightened about what you are going to do and so are millions of Americans. And frankly, I -- I know that you do things that help the physician groups. You've put in provisions that would prevent these findings by efficiency and innovation boards that would have to be cleared by physician groups.

I see you as someone who was there for the doctor, and that this is a cover for -- this is not going to create access for all Americans, what you talked about, the Empowering Patients First Act. This is gonna unravel something that has given a lot of Americans peace of mind, knowing that their kids can stay on their health care until they're 26, knowing that they have -- if they have a pre- existing condition, that won't stop them from getting care.

That's what this hearing should be about. And I -- you're a smart man.

ALEXANDER: Senator, we're a minute over.

FRANKEN: OK. And my second round, I will be a minute short.


FRANKEN: OK, thanks.

ALEXANDER: You may be here by yourself.

(UNKNOWN): I'll be here with him.

FRANKEN: You know, the Benghazi hearing was 11 hours, that's all I'm saying. ALEXANDER: Thank you, Senator Franken.

Senator Isakson?

SEN. JOHNNY ISAKSON (R), GEORGIA: Congressman Price, since that question ended with him not having any time to give you a chance to respond to it, do you have any response to Senator Franken?

PRICE: Yeah. I would just -- I would just say that this is one of the things that makes it difficult to reach a solution here in Washington.

The concerns that were expressed by the senator are valid concerns. The conclusions that he drew on the policies that I promoted and will continue to -- to promote are absolutely incorrect. We all share a concern for the American people and how we best make certain that they have access to the highest quality care that the world knows.


And so I -- I hope and I understand why he's doing it, I mean, there's a political activity, I understand that.

But I hope we're able to work together, if I'm given the privilege of leading and -- and serving as the secretary of Health and Human Services, to truly solve these difficult challenges that we have in our nation.

ISAKSON: Congressman Price, isn't it true that by the date of May 15th of every year since you've served in Congress, you've had to make full disclosure on everything you own, everything your wife owns, what it's worth, when it was acquired and what it was sold for?

PRICE: Every single year, we do a yearly financial disclosure and the House requires a monthly periodic transaction form that updates that if there's any -- any significant change.

ISAKSON: Isn't it true that every transaction that's been referred to and questions of you (ph) were available to the public to find on the records of the Senate Ethics Committee and the House Ethics Committee?

PRICE: Absolutely and they -- and they remain so today.

ISAKSON: These are not discovered things that were hidden, they're in fact facts that we require you to disclose every year?

PRICE: No. In fact, there isn't a single bit of information that's out here that I didn't reveal to the public in the transparent process.

ISAKSON: Isn't it true that transparency is the antiseptic that creates the environment where there is no corruption?

PRICE: Sunshine cures disease, that's exactly right.

ISAKSON: Is it -- is it correct that you have worked throughout your career in the Georgia Senate, United States Congress and I'm sure you will as the secretary of HHS, to make sure there's always transparency?

PRICE: Absolutely, it's a hallmark and a key, especially in the area of health care and in the services that HHS provides.

ISAKSON: Is it not true that you love you country, you love your job and if you have the opportunity to be secretary of Health and Human Services, you'll do everything you can to disclose everything possible so there's never an appearance of any conflict of interest whatsoever?

PRICE: Without a doubt, and that's why I mentioned the Office of Government Ethics and the -- and the work, the diligence that they do to look at everybody's holdings and -- and assets who are -- who are scheduled to potentially serve as -- in the Cabinet.

And then, they make a recommendation, a very specific recommendation that's also available to be seen online. And -- and we have agreed to every single recommendation that they made to divest of whatever holdings we have that might even give the appearance of a possible conflict.

ISAKSON: Mr. Chairman, I yield back the balance of my time.

ALEXANDER: Thank you, Senator Isakson.

Senator Bennet?

SEN. MICHAEL BENNET (D), COLORADO: Thank you, Mr. Chairman, and thank you for this seven minutes as well. And I should tell you that I have never shown a knee -- my knee to any nominee before Dr. Price came to my office, but he gave me some free medical advice and I'm grateful for that.


PRICE: How you doing?

BENNET: Free health care -- I'm terrible, it's terrible but I'll talk to you after it's over.


It's not because of you...

PRICE: I can't -- I can't ask you, but I -- but I'm curious as to whether or not you've gotten the MRI?

BENNET: Today, 10 o'clock.

PRICE: Today? Good.


BENNET: Congressman, I enjoyed our conversation and it's good to see you here. I know you've been chair of the House Budget Committee. I know you're a member of the Tea Party, been a strong advocate of balancing the budget, introducing a Balanced Budget for a Stronger America, it's called.

What I've noticed is that after gaining control of the House, the Senate and the White House, the first order of business for the Republican majority here has been to pass a budget resolution repealing the ACA. And this budget resolution specifically authorizes $9 trillion in additional debt over the next 10 years. It also rigs the bill, in secret, to block any point of order to the bill because that bill will increase the deficit.

And let me read -- my colleague, a smart guy who's here, Senator Paul, so astutely highlighted in his floor speech on January 4th. He said quote, "The more things change, the more they seem to stay the same. Republicans won the White House, Republicans control the Senate, Republicans control the House. And what will be the first order of business for the new Republican majority? To pass a budget that never balances. To pass a budget that will add $9.7 trillion of new debt over 10 years."

This is a facsimile of his chart, "Is that really," he asked, "what we campaigned on? Is that really what we campaigned on?" The quote goes on, "Why would we vote on a budget that adds $9.7 trillion to the debt? Because we're in a hurry. We can't be bothered. It's just numbers. I was told again and again, swallow it, take it. They're just numbers. Don't worry, it's not really a budget. And yet, the legislation says it's a budget!"

Quote, "So this is what Republicans are for. This is the blueprint that the Republican Party says they're for. Ten trillion dollars worth of new debt. I'm not for it," said that honest man.

Rand Paul is right, the repeal law overrides two separate budget provisions already passed by the Senate that prevent increasing the deficit by more than $10 billion in a given year, increase the deficit more than $5 billion in years further down the road.


So I ask you, sir, are you aware that behind closed doors, Republican leadership wrote into this bill that any replacement to the Affordable Care Act would be exempt from Senate rules that prohibit large increases to the deficit?

PRICE: As you may know, Senator, I stepped aside as chairman of the Budget Committee at the beginning of this year, so I wasn't involved in the writing of...

BENNET: You have been the Budget Committee chairman during the rise of the Tea Party. You are a member of the Tea Party Caucus. You have said over and over again, as other people have, that the reason you've come to Washington is to reduce our deficit and reduce our debt. I assume you are very well aware of the vehicle that is being used to repeal the Affordable Care Act. This is not some small piece of legislation. This is the Republican budget.

PRICE: Yes. I'm aware of the bill. Yes.

BENNET: Do you support a budget that increases the debt by $10 trillion -- by $10 trillion dollars?

PRICE: What I support is an opportunity to use the reconciliation to address the real challenges in the Affordable Care Act and to make certain that we put in place, at the same time, a -- a -- a provision that allows us to move the health care system in a much better direction.

BENNET: Do you support the budget that was passed by the Senate Republicans...

PRICE: I support...

BENNET: ... to repeal the Affordable Care Act that adds $10 trillion to the budget deficit?

PRICE: Well, the Reconciliation Bill has yet to come. I support the process that allows for and provides for the fiscal year '17 Reconciliation Bill to come forward.

BENNET: Will you commit today -- will you commit today that any replacement plan for the Affordable Care Act will not, in any way, contribute to our deficit or our debt?

PRICE: I commit to working with you to make certain that that happens.

BENNET: Will you commit, as a member of the Tea Party, that no replacement for this dreadful Obamacare that allegedly created this deficit and debt, will add to the deficit and debt? Will you commit to that? Can't you tell the Tea Party you're not going to increase the deficit by repealing the Affordable Care Act?

PRICE: There are a lot of contributions to the debt and to the deficit as -- as you know, Senator.

BENNET: Really? Well -- well -- that's true. And you and I talked about that briefly.

Are you going to allow the repeal of the health care bill to be one of those contributors to our deficit and to our debt? The CBO has said that repeal of the health care law could increase our deficit by up to $353 billion. That's what they've said. Rand Paul, Senator Paul, an honest man, has gone to the floor and said the first thing we're doing is passing a budget that increases it by $10 billion. What do you say to the Tea Party about that?

PRICE: What I say to the...

BENNET: But for more and more important, people who live in Colorado?

PRICE: What I say to folks in Colorado and across this land, that the Congressional Budget Office and -- and the conclusions that they reached on that are in a silo. They're -- they're looking at it as if nothing else happened following the repeal of the Affordable Care Act.

And so, if you look at the whole constellation of things that will occur, I believe, in working with every member of Congress, should I be given the privilege of serving as the secretary, we -- we will make certain that it addresses the health care challenges that exist out there, that are very, very real. And we -- we -- we look forward to working with you and committing to work -- work with you on -- on being fiscally responsible as we can possibly be because the debt and the deficit is a real challenge.

BENNET: I -- with respect, and I have a lot for you. With respect, that's what every politician says about the CBO. It says the numbers aren't true and then we just run up the debt and run up the debt and run up the debt.

And the -- the -- you know, almost the entire theory of the case here, I think, from the Republican Party on this subject has been that the health care law has increased cost, that the health care law has increased our deficit, increased our debt. And I would hope that you could take a pledge today that would say that nothing that you would advocate for would pass or -- or have the president sign into law -- the president-elect sign into law would add $1 to our deficit or our debt.

PRICE: Well, I certainly hope that's the case and again look forward to working with you to insure that it is.

BENNET: Thank you.

Mr. Chairman, I yield back my time.

ALEXANDER: Thanks, Senator Bennet.

Senator Collins.

SEN. SUSAN COLLINS (R), MAINE: Thank you, Mr. Chairman.

Dr. Price, welcome.

PRICE: Thank you.

COLLINS: I too very much enjoyed our discussion on a wide range of health care issues in -- in my office. Many of us have expressed concern about what would happen to the millions of Americans who are in the individual market of the ACA on the exchanges. But there has been remarkably little debate on what would happen if Congress took no action with regard to the individual market.

Could you give us your answer as far as what you would see happening to the individual market if we do nothing?


PRICE: I -- I appreciate that and I appreciate the opportunity to come and visit you. We had a wonderful conversation about many, many different areas.

The American people know this. They appreciate that the individual small group market, where many of the millions, as the chairman pointed out, gain their coverage is -- is -- is breaking in many, many ways. We're in a downward spiral on being able to provide individuals the opportunity -- any opportunity at all. So one-third of the counties in this -- in this nation have -- have just one insurance provider. There are five states that have only one insurance provider. There are the -- the premiums are going up for folks, the deductibles.

I -- I -- I get calls almost weekly from my former fellow physicians who tell me that their patients are making decisions about not getting the kind of care that they need because they can't afford the deductible.

If you're a -- an individual out there making $30,00, $40,000, $50,000 a year and your deductible is now $6,000 or $12,000 for a family, which is not unusual on the exchange, you may have an insurance card, it may have a wonderful name of an insurance company on it, but you don't have any care because you can't afford the deductible. And so people are denying themselves the kind of care that they need and -- and those are the things that we ought to be addressing.

And again, I hope that in a bipartisan way we'll be able to do that.

COLLINS: Thank you. I think that's a very important point to clarify, that in the individual market, we're seeing double digit increases in premiums, higher deductibles, larger co-pays and we're also seeing far fewer choices as more and more insurers give up and flee the market. The co-ops have failed dramatically. All 23 of them are in financial trouble, only five are still operating. So for us to say that everything is going well with Obamacare is just not accurate. And that's why I feel that we do need to fix the flaws of what is a well intentioned but deeply problematic law.

I want to clarify another issue on the ACA. There's been much debate on whether we should repeal the law with no replacement. I think most people reject that idea. As you said, we don't want to pull the rug out from under people who are relying on the insurance that has been provided through the ACA.

Another group has advocated repeal with a two or three-year delay. I think that approach also doesn't work because it creates great anxiety for consumers and insurers would be unable to price their policies if they don't know what the rules are going to be. It's my understanding that your goal is to quickly pass a reform package that would provide access to affordable health insurance for all Americans with more choice than we have now. Is that accurate?

PRICE: Absolutely. We -- we -- it is -- it is vital -- we often times don't talk also about the 20 million folks that still don't have coverage out there. There are a lot of people that don't and -- and if we're -- if we're responsible policy makers and administrators of policy, it's incumbent upon us to step back and say, why is that? What's going on that's making that happen for those 20 million who don't have coverage, in spite of all of these grand things that -- that were done?

I would suggest that it's because the structure of what was done actually makes it virtually impossible for many individuals to gain that kind of coverage. We, on the other hand, I believe it's important that we work together to put forward a system that actually allows, again, every single American to have the opportunity to purchase the kind of coverage that they think is best for themselves and for their families.

COLLINS: So your goal is actually to have more people...


COLLINS: Thank you -- covered by insurance.

I have been baffled over the years by what CMS reimburses for and what it fails to reimburse for. Senator Jeanne Shaheen and I finally scored a victory of getting CMS to cover continuous glucose monitors for individuals with diabetes that have been covered by the vast majority of private insurers. But when those individuals aged into Medicare, they lost that coverage. Made no sense whatsoever.

COLLINS: What I'm finding now is that CMS frequently does not pay for services that helps to keep people well. There is a large practice in my state that has a nurse or a medical assistant call individuals with diabetes once a week and check on their blood sugar levels, their adherence to their diets and exercise regimes.


And it's had really positive results.