Come back here to try to make a difference. I want to congratulate you on the difference you have made. Now one of the questions i would ask you is why youre willing to leave a place with so much responsibility and background and capability to be willing to be the secretary of health and Human Services. Thank you, senator. When i think about the mission of the department of health and Human Services, which is to improve the health, safety, and wellbeing of the American People, its what ive literally spent my life trying to do. And so to have the opportunity to participate if confirmed, to be to serve as the secretary of health and Human Services and to try to guide that organization in a direction that would further fulfill that mission, i cant think of anything more exciting for fulfilling. I think you have the background for doing that too, with the wide range of experience you had between the different practices and hospitals and then coming here and going through a number of Different Committee situations. But what youre about to go through is a rather intense, and then thats followed by probably the most productive part, if senators happen to read the answers, and thats that we get to do written questions as well, which we hope youll provide a Rapid Response on. But those arent nearly as much fun for the panelists because they arent in public. Ill move to some questions that are a little bit more related here. Because we begin the serious and challenging task of restoring these Health Insurance markets which are teetering on the brink now. Some are collapsing. Some counties you cant get coverage. In wyoming theres only one provider. And its my understanding that the Incoming Administration may have the ability to make some key Policy Changes immediately. Some of the most critical changes for short term stabilization of the markets might include reducing the number of special enrollment periods and requiring up front verification or aligning grace periods for nonpayment of premiums with state law. My understanding from those in the Insurance Business is that some targeted actions by the department of health and Human Services may provide some meaningful changes that could impact premiums for the next year. Are those some options that you might consider . Absolutely. I think as the chairman mentioned, the insurers are deciding right now, as they come forward in march and april, what the premium levels, for calendar year 2018. What they need to hear from all of us, i believe, is a level of support and stability in the market. The kinds of things that make it so theyre able to provide product to patients out there. You mentioned that there are counties in your state where theres only one provider. There are five states in this nation where theres only one insurance provider. There are onethird of the counties in this country that only have one insurance provider. We must as policymakers, as folks administering these programs, we must ask resources, Whats Going On . Where are the problems out there . That may work for the insurers in certain instances. It may work for government. It doesnt work for patients. So if we keep the patients at the center of all of this, well get to the right answer. Thats what i hope to do with each and every one of you. I appreciate that. And i got to work for years with Senator Kennedy On Biologics and biosimilars and having the requirements for their biosimilarity and interchangeability has needed some additional information. The fda has issued Guidance Documents since the law passed. But they havent set policy on interchangeability with the reference project. I was concerned that in 2017, having gone through two full president ial terms, just yesterday we finally got a draft of the fdas interchangeability policy. Ill ask that question, since my time has expired, in writing. Thank you. Thank you, senator enzi. Senator sanders. Thank you, mr. Chairman. Congressman price, thanks for being here and for the conversation we had the other day. Thank you. Congressman, on may 7, 2015 let me begin by saying all of us know that we have come through a very unusual election process. President elect trump received almost 3 million votes less than secretary clinton. But he won the electoral college. Hes going to be inaugurated this week. He won a number of states by rather slim margins. During the course of his campaign, mr. Trump said over and over again that he would not cut Social Security, not cut medicare, not cut medicaid. Let me read some quotes. On may 7th, 2015, mr. Trump tweeted, i was the first and only potential gop candidate to state there will be no cuts to Social Security, medicare, and medicaid. On april 18th, 2015, he said, quote, every republican wants to do a big number on Social Security, they want to do it on medicare, they want to do it on medicaid, and we cant do that, and its not fair to the people who have been paying in for years and now all of a sudden they want it to be cut, end of quote. August 10th of 2015 mr. Trump said, quote, i will say medicare, medicaid, and Social Security will be saved without cuts. We have to do it. People have been paying in for years and now many of these candidates want to cut it. End quote. March 29th, 2016, trump said, you know, paul ryan wants to knock out Social Security, knock it down, way down. He wants to knock medicare way down. And frankly, well, two things. Number one, youre going to lose the election if youre going to do that. Im not going to cut it. And im not going to raise ages. And im not going to do all of the things they want to do. But they want to really cut it. And they want to cut it very substantially. The republicans. And im not going to do that. On and on and on. Point being, this is not something he said in passing. I think it is likely he won the election because millions of Working Class people and Senior Citizens heard him say he was not going to cut Social Security, medicare, and medicaid. Congressman price, a very simple question. Is the President Elect, mr. Trump, going to keep his word to the American People and not cut Social Security, medicare, and medicaid . Or did he lie to the American People . I havent had extensive discussions with him about the comments he made. But i have no reason to believe hes changed his position. So you are telling us that to the best of your knowledge, mr. Trump will not cut Social Security, medicare, and medicaid . As i say, i have no reason to believe that position has changed. Congressman price, quoting mr. Trump again, or at least paraphrasing him, just last week he said, roughly speaking, pharma is getting away with murder. Do you recall that tweet . I do. Okay. There are many of us on this side of the aisle who are working on legislation that would do at least two things. Number one, end the absurdity of the American People being ripped off by the Pharmaceutical Industry who two years ago made five Companies Made 50 billion in profits while one out of Five Americans cant afford to fill the prescription their doctors write. Will you and will the President Elect join us in legislation we are working on which, number one, will allow medicare to negotiate prices with the Drug Companies and lower prices, and number two, allow the American People to bring in less expensive medicine from canada and other countries . Is that something you will work with us on . The issue of drug pricing and drug costs is one of great concern to all americans. I think its important to appreciate that in a couple of areas weve had significant success, whether in the generic area, where costs i dont mean to interrupt, we dont have a lot of time. We are paying far higher prices for Prescription Drugs than anywhere else in the world. Do you disagree with that . I would have to look at the statistics. There are a lot of reasons for that. If we get to the root causes one of the root causes is that every other major country on earth negotiates drug prices with the Pharmaceutical Industry. In our country, the Drug Companies can raise their prices. Today they could double their prices. There is no law to prevent them from doing that. Will you work with us so that medicare negotiates prices with the Pharmaceutical Industry . You have my commitment to work with you and others to make certain that the drug pricing is reasonable and that individuals across this land have access to the medications that they need. Wasnt quite the answer to the question that i asked. Congressman price, the United States of america is the only major country on earth that does not guarantee health care to all people as a right. Canada does it. Every major country in europe does it. Do you believe that health care is a right of all americans whether they are rich or they are poor . Should people, because they are americans, be able to go to the doctor when they need to, be able to go into a hospital, because theyre americans . Yes, were a compassionate society. No, were not a compassionate society. In terms of our relationship to poor and working people, our record is worse than virtually every other country in the world. We have the highest rate of childhood poverty of any other major country on earth and half of our senior Older Workers have nothing set aside for retirement. I dont think compared to other countries we are particularly compassionate. But my question is, in canada, in other countries, all people have the right to get health care. Do you believe we should move in that direction . If you want to talk about other countries Health Care Systems, there are consequences to the decisions that theyve made, just as there are consequences to the decisions weve made. I look forward to working with you to make certain that every single american has access to the highest quality care and coverage that is possible. Has access to does not mean that they are guaranteed health care. I have access to buying a 10 million home. I dont have the money to do that. Thats why we believe its appropriate to put in place a system that gives every person the financial feasibility to be able to purchase the coverage that they want for themselves and for their family, again, not what the Government Forces them to buy. But if they well, thats a longer story. Thank you very much. Thank you. Senator hatch. Thank you, mr. Chairman. Welcome to the committee. Having worked with you over the years weve found you to be always very, very knowledgeable. Thank you. Very up front. Very straightforward. Very honest. And somebody who really understands the Health Care System in this country. And youre perfectly situated to be able to help turn it around and get it so it works. We hear a lot from our other side about how bad that system is and so forth. Ive got to tell you, i dont think its very good myself. And weve got to work on it and get it done right. But boy, i sure would like to have you right there helping to get it done. Youre one of the really premier people in this whole congress and in the world, as a matter of fact, understanding what needs to be done, yet recognizing the problems of getting it done. Now, dr. Price, some of my colleagues have criticized you for healthrelated Stock Holdings while serving in the house. Not only do house rules not prohibit members from trading stocks, but it is also not an uncommon practice for members of congress. In fact there are members on this committee who have, as i understand it, traded individual Health Stocks while serving on this committee. This appears to be nothing more than a hypocritical attack on your good character. And i personally resent it. Because you have always disclosed. Let me say this, can you confirm that you have always followed the law relating to trading in stocks while serving as an of me congress . Thank you, sir. Everything that we have done has been above board, transparent, and legal. As you and all members of this office of Government Ethics that for every Cabinet Nominee looks at possessions and holdings and the like and makes a recommendation as to what that Cabinet Member must do to make certain that there are no conflicts of interest. The office of Government Ethics has looked at our holdings and given advice about divesting from certain Stock Holdings to make sure there is no Conflict Of Interest. We have read those, agreed to those, signed those. That document is online for everybody to see so that everybody is absolutely certain that there will be no Conflict Of Interest whatsoever. Thank you. And you followed their advice. Absolutely. Dr. Price, the collapse of obamacare has exacerbated our Nations Health care problems. Too frequently my colleagues and i have seen european idealism strangle functional insurance design with cost prohibitive measures. Despite these failed reforms, i dont think we can lose sight of the Broader Health system that is at risk. For example ratio Disease Patients dont have access to lifesaving treatments because policies that stem from Obamacare Prevent Investments in innovative therapies that can cure and save lives. This is an issue that im deeply passionate about. Dr. Price, what steps do you believe will improve the pipeline for rare disease therapies to bring treatments and cures to patients in desperate need of hope . The Orphan Drug Act which passed i think 30 years ago or so really has revolutionized the ability to treat rare diseases. What it did was make the United States the leader in coming forward with treatments for rare diseases. And i think that there are things we can do in terms of patent production, in terms of liability, in terms of ince incentivi incentivizeation. We have a lot of drugs coming through because of that bill, we put some incentives into effect and suddenly theres an explosion in orphan drugs for Population Groups less than 200,000 people. It was an important bill. Didnt cost a lot of money but it was a republican bill. A lot of Success Stories in the country. Dr. Price, one of the central duties of the Hhs Secretary is to be diligent and thoughtful when considering if federal regulation is necessary in assessing whether or not the regulations impede research, development, and innovation. Over the years, the Regulatory Infrastructure guiding Dietary Supplements has changed dramatically. Do you recognize the importance of Dietary Supplements in helping americans maintain Healthy Lifestyles . Absolutely. Will you commit to me and other members of the committee to ensure appropriate regulation and implementation of the Dietary Supplementation Act so we can assure consumers condition to have access to Safe Products . This is one of those areas where its incredibly important to gain the information that you refer to, to gather the individuals that know the most about this area, whether its consumers, whether its those providing the product to market, make certain that there are protections for unadulterated products. Its vital that we get this right. Ill tell you this. I have to commend donald trump for picking you. Thank you. Youre clearly one of the premier people in all of congress who understands the problems of health care. And you have the professional background that i dont think any other member of congress could match to help solve the problems we have. We have a real messy situation here. Obamacare has not really helped. Do you think obamacare has helped . I think some of the things that have occurred with the passage of the aca have improved certain areas. The coverage is certainly improved. But the consequences of that that many people, as i mentioned before, have coverage but they dont have care. There are so many things about just the decisionmaking process, who decides about her health care, should it be the federal government or should it be patients and families and doctors. And we certainly believe the latter as opposed to the former. I take it you believe that Getting Health Care closer to the people is a far better thing than Everybody Pontificating from washington, dc. I think the more involvement that patients and families and doctors can have in medical decisions, the Higher Quality wear well have. I was a medical Liability Defense lawyer, defending doctors, nurses, hospitals, health care providers, et cetera. What do you think we should do about medical liability . This is a really difficult challenge, because its not just the malpractice rates that doctors or hospitals pay, but its the practice of defensive medicine, the things that physicians do that dont hurt anybody but there are tests and procedures and examinations that arent necessarily needed to make a diagnosis or to treat. It shows up in their history. It shows up in their history so if called into a court of law, they can say to the court and jury, i dont want what else you wanted me to do because i did everything. If we try to focus on decreasing the practice of defensive medicine to the benefit of patients, we can get to the right answer. There are some exciting opportunities out there that have been bipartisan in the past. Thank you, sir, i think youre a great nomination. Thank you. Senator casey. Thank you, mr. Chairman. Representative price, were grateful youre here and thank you for the visit to our office. Thank you. I wanted to highlight something we probably dont spend enough time highlighting or talking about, and thats the full protections of what was known as the original Patient Protection and Affordable Care act. Weve had a lot of Shorthand Terminology since then. I know you and i have a basic disagreement, its important to be candid about that. What a lot of people have forgotten about, and the chairman had a chart that outlined the categories of americans that have Health Insurance by virtue of various programs or i think the number he had on the poster about the number of americans in the employer sponsored Coverage Category i think was 178 Million People. Thats a lot of folks with coverage, who had coverage before, most of them i guess have had coverage before the legislation, and after, meaning theyre paying their premiums and had coverage, but they didnt have protections that only came with the passage of the legislation. We know that somewhere between 11 and 12 Million People have purchased Health Insurance through the individual marketplace. I want to ask you a couple of questions about those basic protections that are now law that were not law before. I think you would agree with me, and you know from your practice, that you meet remarkably inspiring people in your work, once in a while in the senate we do as well, we probably dont take enough time to have those opportunities. One of the people i met in the leadup to the Legislation Passing Was Stacy Ritter from manheim, pennsylvania. She didnt have a personal challenge, it was the challenge faced by her two daughters. They were 4 years old, madeleine and hannah. As she said, as stacy said about her daughters, she said, that they would be at that time, before the passage of the bill, punished and rejected because they had the misfortune of developing cancer as a child. And her basic problem was the caps on treatment. So the first question i would ask in terms of your work as secretary of health and Human Services should you be confirmed would be, will you commit to maintaining the protections that ensure that no child, no child is denied Insurance Coverage because of Preexisting Conditions . I think pediatric cancer is one of those things that is remarkably challenging. I remember when i was in my residency and did a rotation on the pediatric ward, so many of those children had cancer. Before i began that rotation, i also dreaded going to that month because i was worried about just the severity of the challenges that i would meet. It was one of the most uplifting months i spent in medical school. That was because the children were so uplifting. Absolutely, we need to make certain that every single child has access to the kind of coverage they need and the care that they need. And there are a number of ways to do that. I look forward to working with you to make that happen. I heard the word yes there. Secondly, its hard to believe we even have to ask a question about this next topic, which is victims of Domestic Violence. It was the state of the law prior to the passage of the legislation that victims of Domestic Violence were considered americans who had a preexisting condition. Its still the law in some states that they are not protected. So question number two is, will you commit to maintaining the protections that ensure that victims of Domestic Violence will not be discriminated against when purchasing Health Insurance, yes or no . I think its absolutely vital that victims of Domestic Violence and others, anybody, we need a system in place that ensures that individuals are either not priced out of the market because they get a bad diagnosis or are not eligible or able to purchase coverage that works for them because of their diagnosis. I want to interrupt. I dont want to get hung up on pricing of the market. What im asking for is an ironclad guarantee that that circumstance, that horrific circumstance, will never be a bar to coverage, treatment, or care. It certainly shouldnt be. If im fortunate to be confirmed, thats an administrative role, its a Policy Decision that the legislators would make. I think we can agree on that. Number three, will you maintain to committing the protections that prohibit discrimination in Health Insurance on the basis of Health Status or disability . Yes or no . Again, i think its absolutely imperative that we have a system in place that works for patients. And anybody not being able to gain access to the coverage they want or need is not a system that works for patients. And ill follow up with more questions. What im getting at here is that we had a state of the law before passage of the aca where individuals like that, whether they happened to have a child who had a preexisting condition, even if their parents were paying premiums for years, an Insurance Company could literally say, sorry, you have a preexisting condition, you cant get child. Women were discriminated against because they were women. Just a remarkable stain on america that we allowed that to happen. My concern, though, now is not just a series of concerns about what you have proposed as a member of the house and what you could do as secretary, but i just heard earlier that the three areas that will be of focus in whatever replacement plan there is, im anxious to see it, would be, and i wrote them down, i think chairman alexander wanted to take off the table, and thats a good thing, medicare. But i heard there will be three targets, thats my word, of course. The individual market, medicaid, and employersponsored coverage. So i hope if employersponsored coverage is a subject of change that will ensure all those protections that are in place right now. Thats why im asking those questions. Ill follow up more in writing or if we get another round. Mr. Chairman, put me on record as incorporating by Reference Everything Ranking Member murray said about questions and an additional round. Thank you. Thank you, senator casey. Duly noted. I appreciate your using your seven minutes to ask questions. Senator isakson has deferred to senator paul. As a fellow physician and as a fellow physician who did some of my training at grady, congratulations. I wish everybody on the committee could come to grady and see what its like to work in one of our nations biggsest charity hospitals, often doing work that is just incredible. Gunshot wounds, compound fractures of the femur, you name it. And i remember being there as a student and then as an intern. We used to always calculated how many hours and divide by income and say, we wish we could get minimum wage. I think it is important that we get somebody with that kind of clear reasoning and Critical Skills to be in charge of our government, both knowing about the medical aspect as well as the Public Policy aspect. I think what i regret about this kind of hearing and sort of i think what a lot of people in america regret about it is sort of the vitriol and the rancor and the partisanship that should go into something that we kind of all want the same things. To question your motives i think is insulting. To question whether youre honest is insulting. The whole question, and i guess this would be my first question to you, did you go into Public Service to enri Ricric Ricrich for Public Service . I have a passion for Public Service and a passion for people. Thats what guided our decision that some might think was a foolish decision for both of us. Did you take a pay cut to go into Public Service . I didnt consider the remuneration for Public Service. But im getting it would have been a pay cut. The motives as to what we should do, i think we all want the most amount of insurance for people at the least amount of cost. We want people to get access to health care. What are your motives . What are your goals . What shall we do with the Health Care System . Do you want more people to be insured, do you want more people to have health care, or do we disagree just on how we do it and not necessarily the motives . As i tried to lay out earlier, and i know time is short for everybody, but the principles that i think are absolutely interactive for a Health Care System is one thats affordable for everybody, one that provides access to health care and coverage for everybody, one that is of the highest quality, that is responsive to patients. The system isnt any good if it isnt responding to patients. One that incentivizes innovation, and one that ensures choices are made and preserved by patients. So patients ought to be the ones choosing who is treat them where, when, and the like. You and us by extension, republicans by extension, have been accused of having no replacement ideas, no ideas for how to fix the system. Approximately how many bills do you have that could be regarded as Replacement Bills or ways to improve the Health Insurance system in our health care . Weve had one large term bill since march or early 2009, beyond that, tens of pieces of legislation on health care. Its been insinuated that america is this horrible, rotten place, that we dont have compassion, by extension physicians dont. You worked as a physician, did you always agree as part of your engagement with the hospital to treat all comers regardless of whether they had an ability to pay . Its one of the things we pride ourselves on, anyone who showed up in need of care was provided that care. That was true not only in our residency but in our private orthopedic practice as well. Its interesting that those who say we have no compassion, you know, extol the virtues of socialism. When you look at a country like venezuela, with great resources and an utter disaster where people cant eat, evolving into violence. It is important that we have a debate in our country between socialism and communism and america and capitalism. One of the things thats extraordinary about our country, two years ago, in 2014, we gave away 400 billion privately, not the government, individually, through churches and charteitie. Were an incredibly compassionate society. This was misplaced in sort of 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 in our country, ill bet you half the physicians in my community in Bowling Green have gone on International Trips and Done International charity work. All of that is lost in saying that were this heartless, terrible country. 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, there are some big, broad ideas that would ensuinsure more peop. 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 and help some of the people who actually dont get insurance under obamacare to get insurance if we would legalize the sale of more types of insurance . I think choice, as he mentioned, is absolutely vital. I know if we have as a principle and as a goal, having patients have those choices, then i believe that patients will select the kind of coverage that they want, the choices that ought to be available to them are a full array of opportunities. Do you think Health Savings accounts will help some people that are not helped currently . I think Health Savings accounts and high deductible catastrophic coverage are things 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. One of the things youve had different legislation on, and im 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 the individual market, i have great sympathy for that, i was a small physician with four employees. If one employee were to get sick, it could be devastating 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. Im a big fan of that. You mentioned some of the Association Health plans and how that might help some people to get insurance. Association health plans are one of those entities that would allow individuals economically aligned in some way to purchase coverage together even though they dont necessarily Work Together or are 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, would allow anybody to pool with anybody else solely for the purpose of purchasing health coverage. Its not a new idea. The model for it is actually the blue shield plan that existed decades ago that allowed people to pool their resources together for Major Medical coverage for hospitalization. It just makes a lot of sense. It allows insurance to work the way its supposed to be work, which is to spread the work. Then anybodys Adverse Health circumstance doesnt drive up the cost for themselves or anybody else because the pool is large enough. Thank you, senator paul. Senator franken. Ill tell you how we get really big risk pool, its called medicare for everyone. That would be the biggest risk pool. Dr. Price, it was not might you the other day. Did you enjoy meeting me . Thank you. I did. [ laughter ] i enjoyed our discussion about our gray hair. Dr. Price, what is the leading cause of preventible death in the United States . Ill defer to you, youve got it on the page in front of you. I actually knew it before i had it on the page. Its smoking. That hits home, i lost my dad, a lucky strikes smoker from world war ii, to emphysema. He prided himself on the fact that he never smoked a cigarette with a filter for years and years. It was an incredible tragedy. I lost my dad too. As a physician, you may noknow, guess you didnt, 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 big tobacco companies, meaning that you personally benefitted from tobacco sales. Meanwhile, you voted against Landmark Legislation in 2009 that gave the fda The Authority to regulate tobacco. Congressman price, youre 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 . Well, its an interesting question, senator, and its a curious observation. I have no idea what stocks i held in the 90s or the 2000s or even know. All of these decisions for all of us, i suspect, are through mutual funds and through pension plans. I would bet, and i dont want well, i ought not bet here. I would suspect that in your pension plan, that there are components of that that are held that may have something to do at some time in your history in tobacco. 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, youve said you didnt know things. Just over the last four years, you traded more than 300,000 in healthrelated stocks, while at the same time sponsoring, advocating legislation that could affect the performance of those stocks. We talked a little bit about the zimmer biomed. Your broker, you say, you didnt know this, bought it on march 17th, 2016. You did introduce a bill later, a week later, on march 23rd, 2016. You say you did not know then that you had the stock. It was to delay a federal rule that would have reduced the profitability of the companys joint to delay a rule that would hurt the company. What i dont understand is, once you found out that your broker bought it, you kept the stock. You purchased this 50,000 to 1 100,000 of innate immuno, we talked about this, in a private deal not made available to the public. 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. By definition i believe thats the nature of a private placement offering. What i said to you and what ive said to others is that i paid exactly the same price as everybody else. 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 dc lobbyist. And you reported 50 to 100,000 in profits on this purchase. It really begs credulity, 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, 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 that 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 nnew england journal of medicine, its called care for the vulnerable versus care for the powerful trumps pick for hhs. Ill just read a random paragraph. Price demonstrates less concern for the sick, the poor, 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. Its no different for someone who is poor, or someone who makes 20,000, 30,000, and to bill gates. It is an incredibly regressive system. Youve talked about ending you guys want to end the expansion of medicaid. That has people in minnesota scared out of their mind. Look, ive heard a lot, obamacare has been a disaster. First of all, you have to admit that its bent the cost curve, that the cost of health care in this country has grown less than it did in the previous ten years. Its also covered 20 million more people. But forget them. You know, in 2008, i was going around the state of minnesota, and every vfw hall, in every cafe, i would see a bolton 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 know that you do things that help physician groups. Youve 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 is 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 going to unravel something that has given a lot of americans peace of mind, knowing that their kids can stay on their health care until theyre 26, knowing that they have if they have a preexisting condition, that wont stop them from getting care. Thats what this hearing should be about. And i. Youre a smart man. Senator, youre a minute over. Okay. In my second round i will be a minute short. Sure. Thanks. You may be here by yourself. Ill be here with him. You know the hearing in the past was 11 hours. Sindo you have any response Senator Franken . 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 ive promoted and will continue to promote are absolutely incorrect. We all share a concern for the American People in how we best make certain that they have access to the highest quality care that the world knows. And so i hope, and i understand why hes doing it, this is a political activity, i understand that. But i hope that were able to Work Together, if im given the privilege of leading and serving as the secretary of health and Human Services, to truly solve these difficult challenges that we have in our nation. Congressman price, isnt it true that by the date of may 15th of every year since youve served in congress, youve had to make full disclosure of everything you own, everything your wife owns, what it was worth, when it was acquired, and what it was sold for . Every year we do a yearly financial disclosure. The house requires a periodic transaction form that updates that if theres any significant change. Isnt it true that every transaction thats been referred to were available for the public to find in the records of the Senate Ethics committee and the house Ethics Committee . Absolutely, and they remain so today. These were not things hidden, theyre facts we require you to disclose every year . In fact there isnt a single bit of information out here that i didnt reveal to the public in the transparent process. Isnt it true that transparency is the antiseptic that creates the environment where there is no corruption . Sunshine cures disease, thats exactly right. Isnt it correct that youve worked throughout your career in the georgia senate, United States congress, and as secretary of hhs, to be sure theres always transparency . Absolutely. Its a hallmark and a key, especially in the area of health care and the services that hhs provides. Is it not true you love your country, you love your job, and youll do everything you can to disclose Everything Possible so theres never an appearance of any Conflict Of Interest whatsoever . Without a doubt. Thats why i mentioned the office of Government Ethics and the work, the diligence that they do to look at everybodys holdings and assets who are scheduled to potentially serve in the cabinet. And then they make a recommendation, a very specific recommendation thats also available to be seen online. 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. Mr. Chairman, i yield back the balance of my time. Thank you, senator isakson. Senator bennett. Thank you, mr. Chairman. Thank you for the seven minutes as well. I should tell you that i have never shown my knee to any nominee before. Dr. Price came to my office and gave free medical advice. How are you doing . Its terrible. But ill talk to you after its over. Its not because of you. Im curious whether you got the mri. Today. Ill let you know. Congressman, i join our conversation, its good to see you here. I know youve been chair of the house Budget Committee, i know youve been a member of the tea party that is a strong advocate for a balanced budget for a stronger america, its called. What ive noticed is 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 ten 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 is here, senator paul, its duly highlighted in his floor speech in january, he said, quote, the more things change, the more things seem to stay the same. Republicans won the white house, control the senate, control the house. And a 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 ten 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 were in a hurry. We cant be bothered. Its just numbers. I was told again and again, swallow it, take it, theyre just numbers, dont worry, its not really a budget. And yet the legislation says its a budget. Quote, so this is what republicans are for. This is the blueprint that the Republican Party says theyre for. 10 trillion worth of new debt. Im not for it, said that honest man. Rand paul is right. The repeal law overrides two separate Budget Recognitions already pa provisions that increase the deficit in i ask you, sir, are you aware that Behind Closed Doors Republican Leadership rowrote into this bi that anything from the Affordable Care act would be exempt that prevent large increases to the deficit . As you may know, senator, i stepped aside as chairman of the Budget Committee at the beginning of this year, and so i wasnt involved in the writing of 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 have come to washington is to reduce our deficit and reduce our debt. I assume youre a 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. Do you support a budget that increases the debt by 10 trillion . What i support is an opportunity to use 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 provision that allows us to move the Health Care System in a much better direction. Do you support the budget that was passed by the Senate Republicans to repeal the Affordable Care act. 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 . I commit to working with you to make certain that happens. Will you commit as a member of the tea party that no replacement for this dreadful obama care that allegedly created this devastating debt will add to the devastating debt . Will you commit to that . Cant you tell the tea party youre not going to increase the deficit by repeeling the Affordable Care act . There are a lot of contributions to the debt and to the deficit. Really . As you know, senator. Thats true, and you and i talked about that briefly. Thats right. Are you going to allow the repeal of the Health Care Bill to be one of those contributeors 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. Thats what theyve said. Rand paul, senator paul, an honest man, has gone to the floor and said the first thing were doing is passing a budget that increases it by 10 billion. What do you say to the tea party about that . What i say to the congressional more important, people that live in colorado. What i say to folks in colorado and across this land that the congressional budget office and the conclusions that they reached on that are asylum. They are looking at it as if nothing else happened following the repeal of the Affordable Care act. 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 will make certain that it addresses the Health Care Challenges that exist out there, that are very, very real. We look forward to working with you and work with you on being as fiscally responsible as we can possibly be because the debt and the deficit is a real challenge. Thats what every politician says about the cbo. The numbers arent true. Then we run up the debt and run up the debt and run up the debt. Almost the entire theory of the case here from the Republican Party on this subject has been that the Health Care Law has increased costs 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 have the president Sign Into Law the President Elect Sign Into Law, would add 1 to our deficit or our debt. I certainly hope thats the case, and, again, look forward to working with you to insure that it is. Thank you, mr. Chairman. I yield back my time. Thanks, senator bennett. Senator collins. Thank you, mr. Chairman. Dr. Price, welcome. Thank you. I too very much enjoyed our discussion on a wide range of Health Care Issues 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 . I appreciate that, and i appreciate the opportunity to come visit you. The American People know this. They appreciate that the individual small Group America where many of the millions, as the chairman pointed out, gain their coverage. Being able to provide individuals any opportunity at all. Onethird of the counties in this nation have just one insurance provider. There are five states that have only one insurance provider. There are the premiums are going up for folks. The deductibles. 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 cant afford the deductible. If you are an individual out there making 30,000, 40,000, 50,000 a year and your deductible is 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 there, but you dont have any care because you cant afford the deductible. People are denying themselves the kind of care that they need, and those are the things that we ought to be addressing. Again, i hope that in a bipartisan way well be able to do that. Thank you. I think thats very important point to clarify that in the individual market were seeing double digit increases in premiums, higher deductibles, larger copais, and were also seeing far fewer choices as more and more insurers give up and flee the market. The coops 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 obama care is just not accurate, and thats why i feel that we do need to fix the flaws of what is a wellintentioned but deeply problematic law. I want to clarify another issue on the aca. Theres been much debate on whether we should repeal the law with no replacement. I think most people reject that idea. As you said, we dont 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 doesnt work because it creates great anxiety for consumers and insurers being able to price their policies if they dont know what the rules are going to be. Its 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 choices that we have now. Is that accurate . Absolutely. It is vital we oftentimes dont talk also about the 20 million folks that still dont have coverage out there. There are a lot of people that dont. If were responsible Policy Makers and administrators of policy, its incumbent upon us to step back and say why is that . Whats going on thats making that happen for those 20 million who dont have coverage in spite of all of these grand things that were done. I would suggest that its 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, its 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. So your goal is actually to have more people did. Yes. 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 had a success of getting Glucose Monitors with individuals for diabetes that had been covered by the vast majority of private insurers, but when those individuals aged into medicare, they lost that coverage. Made no sense whatsoever