really, what are you thinking? [laughter] nd i've said, no, what i am saying really is what i think. i believe in this country. i believe in the american people. i believe that people are more good than bad. i believe tragic things happen. i think there is evil in the world. but i think that, at the end of the day, if we work hard and if we are true to those things in us that feel true and feel right, that the world gets a little better each time. that is what this presidency has tried to be about, and i see that in the young people i have worked with. i could not be prouder of them. and so this is not just a matter of no drama obama. this is what i really believe.

it is true that behind closed doors i curse more. than i do publicly. [laughter] and sometimes i get mad and frustrated, like everybody else does. but at my core, i think we're going to be ok. we just have to fight for it, work for it, and not take it for granted, and i know you will help us do that. thank you, press corps. good luck. [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] [captions copyright national cable satellite corp. 2017] >> health and human services secretary nominee, congressman

tom price, testified on capitol hill today. that's next on c-span. after that, a round table discussion on the affordable care act. >> sean spicer hold as briefing with reporters as the incoming press secretary for the trump administration. we'll have live coverage tomorrow at 9:00 a.m. eastern on c-span3. later in the day, president-elect trump and vice president-elect pence will be part of a replaying -- wreath laying ceremony at arlington national cemetery. that starts at 2:45 eastern. and that's followed by a concert celebration at the lincoln memorial. ive coverage here on c-span. >> c-span's "washington journal," live every day with news and policy issues that impact you. coming up thursday morning, economic policy institute research and policy director

and program on the american economy and globalization co-director. they'll discuss the economic policy of the obama administration. and the impact it's had on job creation, unemployment, wages and federal debt. be sure to watch c-span's "washington journal," live at 7:00 a.m. eastern thursday morning. join the discussion. >> president-elect trump's choice for health and human services secretary, congressman tom price, took questions from a senate panel. the georgia republican who has a medical degree was asked about the affordable care act, his current stockholderings, and the cost of prescription drugs. the health, education, labor and pensions committee is chaired by senator lamar alexander of tennessee.

mr. chairman: the hearing will come to order. the committee on health, education, labor, and pensions will come to order. today, we are reviewing the nomination of dr. tom price to be the secretary of health and human services. dr. price, we welcome you and congratulations on your nomination. welcome to you and your wife, betty, who is here with you. i enjoyed having the opportunity to visit with you in my office and learn about our plans. dr. price will be introduced today in a few minutes by a member of this committee and dr. price's home state senator.

before senator isakson introduces the nominee, senator murray and i will make a few introductory remarks. after the nominee makes his statement, we will have a usual round of questions. now, let me say something about that round of questions. last night, we had a hearing of 3.5 hours. i tried as chairman to be fair y following the same precedent we had with president obama's two education nominees by having one round of five minute questions followed by senator murray and me asking questions and wrapping up. i do not want to argue that again because we spent a lot of the 3.5 hours arguing about the 3.5 hours. i have listened carefully to what my colleagues have said and i looked back at the health of human services secretary,

when that person came before our committee. secretary burwell had one round f questions. sebelius, one round, plus dr. coburn asked a question. daschle, one round, plus three senators asked a question. levet, six members asked questions in the second round. thompson, one round. seven was a round of minutes. seven minutes. so what i decided to do in an effort to treat president-elect trump's nominee the same as we have treated other nominees is to have a single round of seven inute questions today. that would be with secretary thompson, and that seems to me to give everyone in the senate more time to ask questions with the secretary.

this is a courtesy hearing. dr. price will be before the finance committee on next tuesday. a number of members of this committee are also members of the finance committee. we do not vote on his nomination, they do. and we will be the ones who reports it to the floor if that is their decision. we have the hearing because we have some of the health care jurisdiction, important parts of it. we would like to talk to him about especially those issues. he has all of his paperwork in place before the finance committee, including the letter of agreement with the office of government ethics, available to this committee as well as thers. so it is my hope that in our even minute of questions, we

have time to focus on the responsibilities of the department of health and human services rather than have a continuing discussion about the number of minutes. there will be an opportunity following the hearing to ask written questions of dr. price as well. dr. price, if you are confirmed to lead the department of health and human services, you will run an organization that spends $1.1 trillion a year. that has always troubled me, actually, that he will be in charge of spending more than congress actually appropriates every year. y that, i mean the part of the budget that we appropriate, which is under good control, the part that has national defense, national institutes of health, national parks, and national laboratories, over the last several years, that part is rising at about the rate of inflation. it is not adding to the budget.

it is about one third of the total government spending. but it is a little less than the amount in your department very year. most of which is mandatory spending, entitlement spending, which is going up at a rate like that while the rest of the budget is going like this. you will be overseeing medicare and medicaid. mental and substance abuse rograms. we enacted in december of last ear and the president signed the most important reforms those of programs in a decade, senator cassidy and senator murphy were the leaders of that in this committeethe food and drug administration, we made important changes there, giving them new authority to hire and , as well as senator murray. pay the experts they need to move devices through the fda at

more rapid rate getting those into the medicine cabinets of the doctor's office. that was a number one priority in we passed that into law in december. and then the implementation of obamacare and various proposals to replace it with concrete, practical alternatives. to give the american people more choices of lower-cost health insurance. dr. price, i believe you are an excellent nominee for the job. you were a practicing surgeon for nearly two decades. you were a professor at a school of medicine. i read about the resident doctors in training who you taught. you served as medical director of the orthopedic clinic at the memorial hospital. in the house, you were chairman of the budget committee and have been a leader in deliberations over the future of our health care system. so you know the subject very ell.

one of the first responsibilities you will have is to give us your advice about how to repair the damage the affordable care act has caused so many americans and how to replace it or to replace parts of it, with concrete practical alternatives that give mericans more choices of lower cost insurance. let me give my view about how we might proceed and during the question & answer session, i will ask you more about your view. following the presidential election, president-elect trump said on 60 minutes that replacement and repeal of obamacare would be done simultaneously. his word. to me, that means at the same time. and then recently, speaker of the house paul ryan said the repeal and replace of obamacare would be done concurrently. and then senator mcconnell said last week that we need to do

this promptly, but in "manageable pieces." i am trying to interpret what those words mean. to me, that means obamacare should be finally repealed only when there are concrete practical reforms in place that give americans access to affordable health care. the american people deserve health care reform done in the right way, for the right reasons. in the right amount of time. it is not about developing a quick fix. it is about working toward long-term solutions that work for everyone. one way to think about what simultaneously and concurrently mean is to think about obamacare the same way you think about a collapsing bridge in your hometown. because that is just what is happening with obamacare in my home state and in many other states. according to the tennessee insurance commissioner, the obamacare insurance market in our state is very near collapse.

across the country, premiums and co-pays are up and employers have cut jobs in order to afford the mandates of obamacare. medicaid mandates are consuming state budgets, one third of american counties, citizens of federal subsidies have only a ingle choice of company to buy insurance from on the obamacare exchanges. without quick action next year, there may be zero choices on those exchanges. and their subsidies may be worth as much as as a bus ticket in a town where no buses run. if your bridge in georgia or tennessee was very near collapse, the first thing we would do is send in a rescue crew to repair the bridge temporarily so no one else is hurt. then we would build a better bridge or more accurately in

the case of health care, many bridges to replace the old bridge. and finally, when the new bridges are finished, you would close the old bridge. that is how i suggest we proceed. rescue those trapped in a collapsing system. replace the system with functional markets. market or markets, as states develop their own plans for providing access to truly affordable health care. then repeal obamacare for good. first, we should offer rescue plans so 11 million americans who buy individual insurance now, can continue to do so while we build a better set of concrete, practical alternatives. second, we should build better systems, providing americans with more choices of insurance that cost less. note that i say systems, not one system. if anyone is expected senator mcconnell to roll a wheelbarrow n to the senate floor with a

4,000-page comprehensive health care plan, they're going to be waiting a long time because we do not believe in that we do not want to replace a failed washington, d.c. health care system with another failed washington, d.c., health care system. so we will provide america with more choices of insurances that cost less and we will do this by moving more health care decisions out of washington dc and into the hands of states and patients there, thereby educing taxes. we will do this carefully and step-by-step so it is effective. finally, we should then repeal what remains of the law that did the damage and created all of this. i know the president-elect has said that after you are confirmed, which i hope is early in february, that he will propose a plan in congress. look forward to that. and i know that you cannot tell us us what the plan is today.

but i do look forward to hearing from you how you suggest we approach this. we want to do it right and do -- and we want to sequence these events carefully and adequately so americans have concrete practical alternatives in place of what is there today. we want to make sure that the parts of obamacare that are repealed are replaced before the repeal becomes effective. senator murray. sen. murray: thank you very much, chairman alexander, and all of our colleagues joining us today. congressman price, congratulations on your nomination. and thank you to your wife who is here with you, as well. before i speak about this nominee, i want to say that we emain deeply disappointed in last night, where democrats were blocked from asking more than one round of questions. on betsy devos, the nominee for secretary of education. and disappointed that we are rushing this hearing as well. mr. chairman, you said 7

minutes but i will just say, i do not think any of us in prior nominees that you keep pointing to ever thought, if i don't ask for another question, i have just set a precedent. i think there is no example of any senator asking to do a question before and being turned down. so these nominees in the new administration, that many people have questions about, deserve to be asked questions, scrutinized in public before we have a choice to make on the floor of the senate on both sides of the aisle in terms of whether we vote yes or no. that is why we take it is -- think it is extremely important that we are allowed the opportunity to ask second rounds of questions after we have heard all of the questions. and today, we have 3 or four committee hearings going on at the same time. it is extremely challenging, in -- challenging to be here on a subject that we care deeply about.

i would like to point out again that several nominees that have come before, if we're going to talk about precedent, secretary leavitt, a nominee of the bush administration, five bipartisan senators participated in a second round. senator daschle, the president nominee's obama's first secretary. three bipartisan senators participated. again, it is unprecedented for a chairman to turn down a member who has a question to ask. so for the record, i would like to ask consent to put parts of the record of the nominees of michael leavitt, and tom daschle into the record of the hearing. mr. chairman: that would be fine. sen. murray: again, our members have questions because this nominee is going to have jurisdiction over the health care and lives of millions of americans and we want to know where he stands before we make a decision, yes or no, for him

to be there. so that is why it is so important to members of our committee. having said that, i want to say the health of our families and communities could not be more important to our strengths as a nation. when a young child goes to school healthy and ready to learn, she is better prepared. when women are empowered to plan their families and pursue all of their dreams, our ommunity benefits. when workers have access to quality health care that they can afford, our economy grows. and when seniors are able to trust that the guarantee of programs they have paid into, medicare and social security will be there when needed, we live up to some of our most vital responsibilities. the department of health and human services has a critical role to play in our ongoing work to meet each of these goals and many more.

that is why evaluating a nominee for secretary of health and human services, i consider whether the nominee has a record of putting people first and not politics or partisanship or those at the top, whether they will put science first and not ideology, and whether their vision for the health care in our country would help more families get quality health care or take us backward. congressman price, i have serious concerns about your qualifications and plans for the department you hope to lead. and i am looking forward to hearing from you today on a number of topics. i start by laying out issues of what your record suggests about your approach to our nation's ealth care system. just last week, you voted to begin the process of ripping apart our health care system without any plan to replace it, despite independent studies showing that nearly 30 million people would lose health care coverage. even though more and more members of your own party are

expressing serious doubt about its ability to unify around a plan and knowing in a matter of weeks, you could be leading the department whose core responsibility is to enhance america's health and well-being. my constituents are coming up to me with tears in their eyes, wondering what the future holds for their health care given the chaos republican efforts could cause. president-elect trump and republican leaders have promised the american people that their plans to dismantle the health care plan right away would do no harm and not lose anyone to lose coverage. just days ago, president-elect trump promised insurance for everybody. but congressman price, your own proposal would cause millions of people to lose coverage and force many people to pay more for their care and leave people with pre-existing conditions vulnerable to insurance companies rejecting them or harging them more.

i would be interested in hearing your explanation of how you have your plans for how we can keep the promises your party has made to the american people about their health care. medicare is another issue i would be interested in hearing about today. president-elect trump campaigned on promises to protect medicare and medicaid. you have said you plan to overhaul medicare in the first 6-8 months in this administration, in a way that would end the guarantee of full coverage that so many people , seniors and people with disabilities would rely on. you would put forward policies that would shift one chilean dollars in medicaid costs to our state, squeezing their budgets and taking coverage away from struggling children and workers and families. while president-elect trump has said medicare should be able to negotiate prices for seniors, you have opposed efforts to do that and went so far as to call

legislation on that issue a solution in search of a problem. i disagree. it is absolutely critical for families in my home state, and i am eager to learn how you will reduce the burden of prescription drug costs in our community. as a woman, mother, grandmother, and united states senator, i am deeply troubled by the ways your policies would impact women's access to health care and reproductive rights. and i have serious concerns about your understanding of women's need for basic health care like birth control, given your expressed doubts on the topic. your proposals to make women pay extra, out of pocket for birth control, and your repeated efforts to defund our nation's largest provider of women's health care, planned parenthood. i am also very focused on the role of the department of health and human services in strengthening and protecting public health.

i want to hear from you about whether and how you will uphold the gold standard of fda approval and, for example, how would you approach important programs and rules intended to keep tobacco companies from luring children into addiction. finally as i discussed in the hearing yesterday, i believe firmly that especially as the president-elect tries to blur lines around conflict of interest, it is critical we not only do everything in our power to hold him to high standards, but we do the same for cabinet nominees. that is why i was so appalled that with 4 of the president-elect's nominees currently serving in the house of representatives, house republicans attempted right out of the gate to get rid of the independent office of congressional ethics. luckily, they heard loud and clear from people across the country that it was not acceptable and they backed down. congressman price, the office of congressional ethics has now been asked not only by democrats, but by consumer

advocacy group public citizen to investigate serious concerns and questions about your medical stock trades during your time in the house. i and other democrats have repeatedly called for hearings on your nomination to be delayed until such an investigation is complete. it is disappointing to us that instead, republicans are moving forward with your nomination before we have all the facts. i hope you have come prepared to be fully transparent with us in your explanation. i have outlined a few of my questions and concerns about this nomination. i know in light of republican efforts, to take our health care system in a vastly different and harmful direction, that are shared by millions of people across the country that cannot be here today. it is crucial that the voice of the people who will be impacted every day by choices made under this administration are part of the process when it comes to the president-elect's cabinet

nominees. i want to say i am pleased that tomorrow, senator warren will host a forum with witnesses who can speak to the impact of health care providers, like planned parenthood. the importance of the work done to expand access to mental health care and substance abuse treatment, and the ways in which the full guarantee of medicare helps keep them financially and physically secure. there are stories across the country of lives saved and strengthened because of the progress we have made to expand quality affordable health care. i urge my republican colleagues to attend and prioritize what is best for women and men and families, not what is best for politics, as they consider each of the decisions in the coming weeks. congressman price, as we begin this hearing, i would ask you to be as transparent and frank as possible about your views and your plans for the department and urge you to

provide us with additional information and answers, to any follow-up questions we have, in a timely manner. i look forward to what i hope will be a rigorous and open discussion today and i hope the, -- hope that we all arrived to the right decision for the families and communities that we serve. mr. chairman: thank you. before i introduce senator isaacson, i would like to put nto the record the information from the last six hearings, without going into detail, one round of questions for the current secretary. and one round with one member, a second round. daschle, one round plus three. leavitt, six members asked a second round. thompson, one round of seven minutes each. my decision is rather than give six of 23 members a second

round, that it would be better to let every senator have 7 minutes. now, senator isaacson. sen. isaacson: thank you. i would like to ask consent of the remarks that were prepared for me to read this morning be ubmitted for the record. mr. chairman: they will be. mr. isakson: because i'm not going to read them. i have the unique honor and privilege to introduce a friend of mine for 30 years, someone i know to be a great politician, a great practicing legislator, a great family man and a great friend of mine and it is an honor to do so. i want to thank each of you today for listening to what tom has to say, because i think you will be impressed with what you ear. i approach the introduction, if i am being asked what i would look for in somebody that i want to interest with $1 trillion of my money, the

quality of my health care and the future of the american quality of health care. i would look for 5 things. first, does this man understand the american family? not only does he, but his wife that he does. stand up. she will tell you he understands the family. his son, robert, is not here because he is singing country music and writing country music songs. he is a fine young man i enjoy working with. tom is a great family man. remember, a member of the united methodist church, active in his community, doing what is right for his community, he is a man who understands the value of health care to every amily. $1 trillion is a lot of money, it is actually 1.1 trillion -- $1 trillion. it is a lot of money. he has been chairman of the udget committee. he has led appropriations for many years. he served in the georgia

legislature. and he has run one of the largest medical practices in he state of georgia. tom price put together what is known as resurgence orthopedics, they happened to be my doctors and in fact they saved my son's right leg in a ar accident. it is a practice set up as an example of how to do medicine in the 21st century. i want to know that my nominee understands the health care business, who better to understand health care than a doctor? even better, a doctor married to another doctor? they met and fell in love during their residencies. they fell in love with the practice of medicine. i have watched them participate in activities for the state. whether elected or not, they contributed to the betterment of health care in our state. the betterment of helicopters -- hospitals, the largest medical center

in the state of georgia, saving lives every single day. it would not have been it today if it were not for people like tom price, who gave time and effort to raise the money necessary to keep it open. they have some experience with i would want to know he had he has done an outstanding job being reelected seven, six times to the house of representatives in georgia and is a very active member of the congress of the united states of america. i would also want to know if he

was an accountable person and believes in accountability. tom price is one of the rare one of us -- in fact, he may be the only one of us, and i know this is true -- who reads all the bills. if i need to know something about a bill, rather than read it, i called tom price. sometimes he is boring, but he's always knowledgeable. it's because he does his homework, he does it right, and he believes in responsibility. i want to mention a couple of things that have been said negative about tom and address them straight up because they are wrong. case andumer took this try to make it into a major case. price's broker manager but stop for him to the months after the house acted on a medical device bill. the term called desperate impact when you take two facts that are unrelated and put them together to indict somebody for a wrong

when in fact nothing wrongs was done at all, and that is the case there. place without tom's knowledge because his account is managed by someone else. his knowledge of the purchase took place one month later after the disclosure was made. he did not even know about it. the allocations that were made are patently wrong by taking to the correct things putting together to make an incorrect thing. second, something else has been said, and i have working knowledge of it. tom was accused of being not for saving social security for seniors. i'm 72 years old and i'm not going to state of year and try to get you to improve somebody that is not for social security. let me tell you a story about tom price. he and i got a phone call six months ago, i guess now it has been eight months ago, asking us if we would travel to townhall forums for aarp saving social security. why would somebody call tom price, a congressman, or johnny isakson, a senator, to be in an

organization to represent seniors to go on the road and talk about saving social security if they were not for saving social security? it's just incongruent and does not make any sense. lastly,:, sylvia barwell came , she is an committee articulate and intelligent lady. there was a lot of reason for me as a republican in the minority to just do a throwaway vote and i will vote against her because she is a democratic nominee, but i listened to her answers, studied her history, watched her actions, and i proudly voted for her, and today, she is a professional friend of mine, and we will miss her in her office, but there is nobody that are qualified to replace sylvia burwell than tom price. i voted for sylvia burwell with pride, and in going to vote for tom price with pride because i know he is the right job at the right time for america. he is my friend and i commend him to you and i urge you to

vote for him in his confirmation. quick thank you, senator isakson. that is much better than what was written for you to say. price, welcome to the committee. dr. price: thank you, mr. chairman. chairman alexander, ranking member barry, and ultimate as of the committee, i want to thank you for the opportunity to speak with you today and engage in, as the ranking member said, the discussion about the road ahead for our nation. i want to thank johnny isakson for his generous introduction. as he said, we've known each other 30 years and am so grateful for his friendship and kindness and our state is blessed to have had his service and leadership. i wish also to especially thank my wife, who joins me here today, as jonny mentioned. her support and encouragement and advice, which i would suggest to you is virtually always correct, and her love means more to me than i can ever say. past few weeks, i have met with many of you

individually and have gained a real appreciation for the passion you have for the department of health and human services. please know that i share that passion. that's why i'm here today and why i'm honored to be the nominee for secretary of health and human services. we all come to public service in our own unique ways that inform who we are and why we serve. my first professional colleague -- calling was to care for patients, that experience as a physician and later as a legislator, has provided a holistic view of the complex interactions that take place every day across our communities, and today, i hope to share with you how my experience has helped shake me and my understanding and of theation for the work department of health and human services. from an early age, i had an interest in medicine. my earliest emery's are of growing up on a farm in the state of michigan. we lived on a farm in a michigan before we moved to suburban detroit. i spent most of my formative years being raised by a single mom.

some of my fondest memories are spending time with my grandfather who was a physician. when i was young, i would be able to go and spend weekends with him, and we would go on rounds, which at that time meant going on house calls. we would drive up to houses, and the images of people giving him a hug and welcoming him graciously are cemented in my mind. i did my residency at emory university and grady memorial hospital, where i would later return in my career to serve as the medical director of the orthopedic clinic. throughout my professional career, i have treated patients in all walks of life, including so many children, and anyone who has ever treated a child knows the remarkable joy you have when you are able to go till the mom and dad that we have helped save .heir child or help their child

my memories of grady are filled with the gracious comments of parents and patients for the team of health care specialists with whom i have the privilege of working. after 25 years of school and training, i started the solo orthopedic practice. over the years, the practice grew, as senator isaacs mentioned, and eventually became one of the largest nonacademic orthopedic groups in the country, for which i would eventually service chairman of the board. during 20 years as a practicing physician, i learned a good bit about not just treating patients, but about the broader health care system and where it intersects with government. memories standid out. one, many of my patients were never more irritated or angry when they recognized that there was somebody else in the exam room not physically, but figuratively, who was getting between the doctor and the decisions, ifing it was the insurance companies government, and then there was the day when i noticed in my office in the mid-90's when i realized that there are more individuals behind the door with

a clinical work was going on seeing patients than there were in front of the door, and those folks were filling out forms and making certain that we were andking all the boxes challenging or arguing with insurance companies or government about what was in the best interest of the patient. and it became clear to me that our health care system was losing focus on its number one priority, and that is the patient. as a result, i felt compelled to broaden my role in public service that helps solve the issues harming delivery of medicine, so i ran for the georgia state senate. i found the state senate of georgia to be remarkably bipartisan. this is the environment in which i learned to legislate, reaching across the aisle to get work done. in congress, i have been fortunate as well to be part of collaborations that broke through party lines to solve problems. this past congress, it was a bipartisan effort that succeeded

. if confirmed, my obligation will carry for the department of health and human services and appreciation for bipartisan comity in german policymaking and what has been a life long commitment to improving the health and well-being of the american people. that commitment extends to what i call the six principles of health care -- affordability, accessibility, quality, responsiveness, innovation, and choices. but health and human services is more than health care. there are real heroes at this department doing incredible work to keep our food safe, to develop new drugs and treatment options, driven by scientists conducting truly remarkable research. there are heroes among the talented, dedicated men and women working to provide critical social services, helping families, and

particularly children have a higher quality of living and the opportunity to rise up and achieve their american dream. it must be efficient, effective, accountable as well as willing to work with communities already doing incredible work on behalf of their citizens. across the spectrum of issues and citizens this department handles, there endures a promise that has been made to the american people. we must strengthen our resolve to keep the promises our society has made to our senior citizens and to those who are most in need of care and support. that means saving and strengthening and securing medicare for today's beneficiaries and future generations. it means ensuring that our nation's medicaid population has access to the highest quality care. it means maintaining and expanding america's leading role in innovation in the treatment and eradication of disease. i share your passion for these issues, having spent my life in

service to them, and yet, there's no doubt that we do not all agree or share the same point of view when it comes to addressing every one of these issues. our approaches to policy may differ, but surely, there exists a common commitment to public service and to compassion for those that we serve. we all hope that we can help improve the lives of the american people to help heal individuals and whole communities, so with a healthy ane of humility and appreciation for the scope of the challenges before us, with your assistance and with god's will, we can make it happen, and i look forward to working with you to do just that. chairman, i thank you for the opportunity to be with you today. >> thank you, dr. price. we will now begin a round of seven-minute questions, and i will start the questioning. talk about the of formal care act and the health care system. my belief is that the historic mistake in passage of the affordable care act was it sought to expand a system that

already costs too much, a health care system. what is our goal here, of those who want to repair the damage of obamacare and replace parts of it. is it to lower the cost of insurance or americans? is it to give them more choices of that lower-cost insurance? is it to put more decisions in the hands of states and into the ? nds of patients dr. price: thank you, mr. chairman. i think certainly the issues you raise with choices and access and costs are at the heart and center of where we ought to be putting our attention. as i mentioned, in the principles i have for health affordability is incredibly important. does not do you any good if you cannot afford health coverage. accessibility is incredibly important today, many folks have coverage but do not have care because they do not have access to the physicians they would

like to see, so choices are absolutely vital. >> isn't one of the primary means for achieving those choices moving more health care decisions out of washington, putting them back in the hands of states and patient consumers? duct or price: in many instances, the closer you can have those decisions to the patient, the better. >> as the response are headed toward the states or some spots abilities, would that not necessarily involve a fair amount of consultation with governors and state insurance departments about how to do that and what the implementation schedule ought to be? >> absolutely. folks at the state level know their populations better than we ever could know them. >> senator o'connell last week said obamacare would be replaced and repealed and manageable pieces. i want to suggest some pieces on a chart back here that it looks like there are four major areas where americans get health care insurance. one is medicare, 18% of

americans. one is employer insurance. 621% of americans get insurance on the job. one is medicaid, which is 22%, and one is the individual market. only 6%. the exchanges we hear so much about are just 4% of that 6%, but that's where so much of the turmoil is. let me ask you this -- is this the bill, any effort to replace and repeal obamacare -- is this he bill to reform medicare? >> absolutely not. >> so we would be focused on employer, medicaid, and individual insurance. are those accurate categories, or would you categorize them in a different way? >> the challenges we have to address immediately are those in the individual market and medicaid market, as you identified. >> is it possible to work on one of those areas at a time rather than in a comprehensive -- or let me put it this way -- i do not expect senator mcconnell to wheel in a wheelbarrow with a

big conference of republican health care plan because in my opinion, we do not believe in that. we do not believe in replacing a failed washington, d.c., health care plan with our own failed plan. we want to work on it step-by-step, large piece by piece. how do you respond to that? dr. price: i think that is fair. the american people need to appreciate that the last thing we want to do is go from a democrat health care system to a republican health care system. our goal would be to go from what we see as a democrat health care system to an american health care system that recognizes the needs of all. >> i know your plan will not be presented until after your confirmed, but the president-elect has said let's do appeal and replace simultaneously. that anyat must mean repeal of parts of obamacare would not take effect until

after some concrete practical alternative were in place for americans to choose. is that accurate, or do you have a different idea of what simultaneous might mean or what the sequencing might be as we move through this process? >> i think that is fair. one of the important things we need to convey to the american people is that nobody is interested in pulling the rug out from under anybody. we believe it is absolutely imperative that individuals that have health coverage be able to keep health coverage and move hopefully to greater choices and opportunities for them to gain the kind of coverage that they want for themselves and for their families, so i think there has been a lot of talk about individuals losing health coverage. that is not our goal, nor is it our desire, nor is it our plan. >> let me ask you how long this might take him of repairing damage, working on these three big areas. my sense of it is we have been working on this so long, although we have different opinions about it, we ought to

be able to make most of our votes in the next few months about what to do, but that the implementation of whatever we decide, especially since some of it will be going that to the states, to the department that you hope to lead might take several years. is there a difference between the votes we might take and a longer time for implementation of what we decide to do? price: no, i think that is fair. i would point out that our health care system is continually evolving and should he we ought to be always looking at how it is working, if it is working for patients, if it is working for the individuals that are working to provide the highest quality care for folks, and when it is, that's fine. when it is not, it is incumbent on policy makers to make certain that we do the kinds of things to adjust that policy so that it can work, especially for patients. >> my last question is about this individual market, the 6%. the obamacare exchanges are about 4% who have insurance.

our insurance provider into the city says the market is virtually collapsing. i'm told by many people that we basically need to have a rescue land, a reform plan for the individual market in place by march 1 so that insurance companies who make their decisions about the year 2018 can make those plans so that people have insurance to buy in all of these states. do you agree that the market is collapsing, that we need a rescue plan, and that march 1 is an important approximate date for a decision of action? >> we're clearly seeing changes that are adverse to the patient, if it's decreasing access to coverage, increasing premiums, higher deductibles. something is going badly wrong out there, and it is imperative, i believe, for us to recognize that and to put in place the kinds of solutions we believe to be most appropriate. and your plan we are likely to see in february will include recommendations for how to do

that? dr. price: we look forward to should i be given the honor to work with the department of health and human services -- we look forward to working with the president to carry forward that plan. i would liketart, to put forth a letter from all the democrats on this committee on the second round of questions on this nominee, and i ask unanimous consent to approve the record. opposing congressman price's nomination to lead the department of health and human services. i also have a petition signed by five hundred thousand people from across the country opposing .his nomination i ask if he placed on the record. , recent pressice reports about your investments in the australian biotech company in a chimera therapeutics raises serious questions about your judgment, and i want to review the facts. you purchased stock in innate

, the companyutic's developing new drugs on four separate occasions between january 2015 and august 8016. you made the decision to purchase that stock. not a broker. yes or no? dr. price: that was a decision i made, yes. >> you were offered an opportunity to purchase stock at a lower price than what was available to the general public. yes or no? dr. price: the initial purchase was at the market price. the secondary purchase in june through august, september 2016 was at a price that was available to individuals who were participating in a private placement offering. than what iser available to the general public, correct? >> i don't know that it was. it was the same price everybody pay for the private placement offering. >> congressman chris collins, who sits on president-elect trump's's transition team is an investor and board member of the company.

he was reportedly overheard just last week on the house floor bragging about how he had made people millionaires from a stock tip. congressman price, in our meeting, you informed me that you made his purchases based on conversations with representative collins. is that correct? >> and no -- >> that is what you said to me in my office. >> what i believe i said to you was that i learned of the company from congressman collins. i recall our conversation was that you had a conversation with collins and then decided to purchase the stock. >> no, that is not correct. >> that is what i remember hearing you say in my office. in that conversation, did representative collins tell you anything that could be considered "a stock tip," yes or no? dr. price: i don't believe so, no. >> if you are telling me he give you information about the company, you were offered shares at prices that available to the public, you bought those shares, is that not a stock to echo

>> that's not what happened. he talked about the company in the work they were doing and trying to solve the challenges in progressive multiple sclerosis, a debilitating disease, and when i had the opportunity to treat patients with -- >> i'm well aware -- >> i felt that it had some significant merit and promise and purchased the initial shares on the stock exchange -- >> congressman price, i have very limited time. let me go on. heights ofse decisions that could impact drug developers like innate immunotherapy being negotiated. again, days before you were notified to prepare for a final vote on the bill, congressman, do you believe it is appropriate or a senior member of congress actively involved in policy making the health sector to repeatedly, personally invest in a drug company that could benefit from those actions, yes or no? dr. price: that's not what

happened. >> let me just say i believe it is inappropriate and we need answers to this regarding if you and congressman collins used your access to non-public bought atn when you prices that were unavailable to the public -- >> i had no access to non-public information. >> well, we will go on. congressman price, just last week, you and republicans in congress voted to begin ripping apart our health care system, which would cause nearly 30 million people to lose their coverage and raise health care costs for families about telling the american people specifically what you plan to do instead. president-elect trump and republicans in congress have promised to deliver a plan that prevents anyone from losing coverage and leaves no one worse off. just days ago, president-elect trump said his plan would provide insurance for everybody. do you share those goals? dr. price: i think it's absolutely imperative we have a system in place that has

patients at the center and allows for every single american to have the opportunity to gain access -- >> you share his goal of insurance for everybody? >> that has been always my stated goal. it is what we have worked on throughout my entire career. plan was signed into law, would you consider these commitments to ensure all these americans and leaves no one worse off the mat? >> understanding the role of them given the privilege of role in congress was to always make sure individuals have the opportunity to gain access to the kind of coverage that they desire and that they have the financial feasibility to do so. that is what is different about the plans we put forward. it's really important that we have clear answers. let me say that your bill only allows people with pre-existing conditions to obtain health insurance if they maintain continuous insurance for 18 months prior. millions of americans with pre-existing health conditions lack insurance for short periods

of time. under your plan, insurance companies could deny those americans coverage for pre-existing conditions. yes or no? under your bill. >> it is a broader question than that because we would put in place high risk pools that would allow every single person in the individual small group market for the ones challenged with pre-existing illness to be able to gain access again to the coverage they want, so we believe through that plant that every single person would have the opportunity and financial feasibility to gain the coverage that they want. on theink we disagree consequences of that. your bill would also repeal dependent coverage available to dung adults up to age 26. that is correct, right? >> the bill that i offered did not include coverage of to age 26. the insurance companies have said that they were including that in their plans going forward, and so we felt it was covered. ok, and your bill takes away current benefits including prescription drugs, mental

health and substance use disorder that if it's, and maternity coverage, among others. that is correct, right? >> again, it is different than the legislative arena that is the administrative arena, but there are other factors we would put in place that would make certain individuals have the kind of care and coverage they needed for whatever diagnosis -- >> again, i disagree with the consequences. your bill did not cover that. your bill also repealed lifetime limits on coverage that help a lot of people who are sick and have high medical expenses like a person with cancer. yes or no? >> again, it is a larger question because we would put a different constructs in place that would allow every single person to gain access to the coverage they want and have nobody fault through the cracks. >> i think just with these questions, i'm very concerned that your vision for a health care system is very different than one that i think millions of americans are counting on. >> thank you, senator murray. chairman, andmr. thank you, dr. price for being

willing to serve and to go through this process. i call this gotcha management. and the idearred, is to get you to take questions on short notice in public that you would not have done what you normally do. i worked with you for the last two years, meeting with you at least once a week every week that we have been in session, so i know how you operate, and i appreciate how you operate, and the care and the focus and the concern and how comprehensively you think about, particularly, the medical things. concerns is always the rural areas because wyoming is the most rural state in the nation. i hesitate to do that because last night at the education from mrs. got to hear

who remembered a conversation that i had with her a month before with a problem which dealt with grizzly bears at a school in wyoming, and that became a major topic around here, and i'm glad everybody recognizes that need and concern. part of the story was that that is the gradeschool former senator craig thomas went there, and when he was there, they did not need that fence because he was tough. but there are different kinds of problems in different places in the health care area. i have a county that is the size of delaware. it has one community that would like to say that it has 2500 people. it does have a hospital, but when you have a rural community, a rural county that big in that small of a town, it's difficult to keep a doctor without at

least apa there. the hospital has to close. closes,hat hospital emergency care is 80 miles away. not a likely story and most of the places, and we need to make sure that those things are covered, and i have appreciated getting to share those with you over this time. i was always curious as to why you left a very successful practice and were willing to come back here and try to make a difference, and i want to congratulate you on the difference that you have made. now, one of the questions i would ask you is why are you 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?

rep. price: thank you, senator. when i think about the mission of the department of health and human services to improve the health, safety, and well-being of the american people, it's what i've literally spent my life trying to do, so to have the opportunity to participate, if confirmed, to service the secretary of health and human services and try to guide that organization in a direction that would further fulfill that mission, i can't think of anything more fulfilling or exciting. senator enzi: i think you have the background for doing that, given your background in the wide range of hospitals and practices and then coming here and going through a number of different committee situations.

what you are about to go through is a rather intense and that is followed by the most productive part, if senators happened to read the answers, and that is when we get to do written questions, which we hope you will provide a rapid response on. those are not nearly as much fun for the panelists because they are not in public. i will move to some questions that are a little bit more related here. we begin the serious and challenging task of restoring the health insurance markets, which are teetering on the brink. some counties, you can't get coverage. in wyoming, there is only one provider and it is my understanding that the incoming administration may have the ability to make key policy changes, some of the most critical changes for short-term stabilization might include reducing the number of special enrollment periods and requiring upfront verification or aligning grace periods with state law. my understanding from those in the insurance business is it is targeted actions by health and

human services may provide meaningful changes that could impact premiums for the next year. of those options you might consider? rep. price: absolutely. the insurers are deciding right now as they come forward in march and april with the premium levels will be for 2018. what they need to hear from all of us is a level of support and stability in the market, the kinds of things that are able to provide stability. there are counties in the state where there are only one provider. we must, as policymakers, ask what is going on. where are the problems out there? that may work for the insurers in certain instances, but it

does not work for patients. if we keep the patients at the center, we will get to the right answer. senator enzi: i appreciate that. i got to work with senator kenzie for many years desk kennedy for many years -- senator kennedy for many years on biologics. the fda has issued guidance documents since the law passed. i was concerned that in 2017, having gone near death through nearly two president -- having gone through nearly two presidential terms, we finally got a draft. i will ask that question in writing. rep. price: thank you very much. senator sanders: thank you, mr. chairman to read congressman

price, think you for the conversation we had the other day. 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, he will 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 7, 2015, he tweeted, "i was the first and only potential gop candidate to state there would be no cuts to social security, medicare, and medicaid go on april 18, he said "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 can't do that and it is not fair to the people who have been paying in four years." august 10, "i will save medicare, medicaid, and social security without cuts -- we have to do it, people have been paying in four years and many of these candidates want to cut it." march 20 9, 2016, "paul ryan wants to knock out social security, knock it down, way down, he wants to knock medicare down, way down, number one, you were going to lose the election if you are going to do that, i'm not going to cut it, i'm not going to raise ages, i'm not going to do all of the things they want to do, they want to cut it very substantially, i'm

not going to do that." 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 would not cut social security, medicare, and medicaid. a simple question. is the president-elect 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? rep. price: i have not had extensive discussions with them about the comments he made, but i have no reason to believe that he has changed his position. senator sanders: to the best of your knowledge, you are telling us, mr. trump will not cut social security, medicare, and medicaid. rep. price: i have no reason to believe that that position has changed.

senator sanders: quoting or at least paraphrasing, last week, he said , pharma is getting away with murder. you recall that tweet? rep. price: i do. senator sanders: there are many of us on our side of the aisle that are working on legislation to end the absurdity of the american people being ripped off by the pharmaceutical industry, who two years ago made $50 billion in profits, while one out of five americans can't afford to fill their prescriptions that doctors right. will you and will the president-elect join us in legislation we are working on, which would allow medicare to negotiate prices with the drug companies and lower prices and allow the american people to bring in less expensive medicine from canada and other countries? is that something you will work with us on? rep. price: issue of drug pricing and drug cost is one of

great concern to all americans. i think it is important to appreciate the areas where we have had significant success. whether it is the generic areas -- senator sanders: you are aware that we are paying by far the highest prices for restriction drugs. you don't disagree with that, do you? do you disagree with that? rep. price: i think that is the case. senator sanders: it is. rep. price: if we get to the root cause, i think we can solid bipartisan lee. senator sanders: one of the root causes is that every other major country negotiates drug prices with the pharmaceutical entry. in our country, they can raise the prices, they could double the price is today, there is no law to prevent them from doing that. will you work with us so that medicare negotiates prices with the pharmaceutical industry? rep. price: 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.

senator sanders: was not 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. you believe that health care is a right of all americans, whether they are rich or 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 they are americans? rep. price: if we are a compassionate society -- senator sanders: no, we are not a compassionate society. our record is worse than any country on earth in relation to poor and working people. half of our older workers have nothing set aside for retirement. compared to other countries, we are not particularly compassionate. i question is, in canada and other countries, all people have

the right to get health care. do you believe we should move in that direction? rep. price: if you want to talk about other countries' health care systems, there are consequences to the decisions they have made, just like there are consequences to the decisions we make. i look forward to making sure every single american has access to the highest quality care and coverage possible. senator sanders: access to does not mean they are guaranteed health care. i have access to buy a $10 million home, i don't have the money to do that. rep. price: that is why we believe it is appropriate to put in place a system to give every person the financial feasibility to purchase the coverage they want for themselves and their family, not with the government forces them to buy. senator sanders: that is a longer story. thank you very much. rep. price: thank you. senator hatch: welcome to the committee. we have worked with you over the years. i have found you to always be

very knowledgeable, very up front, very straightforward, very honest, and somebody who really understands health care in this country. you are just perfectly situated to be able to help turn it around and get us to a place that it works. we hear a lot from the other side about how bad the system is and so forth. i do think it is very good myself. we've got to work on it and get it done right, but i sure would like to have you hoping to get it done. you are one of the really premier people in the sole congress and in the world, as a matter of fact, understanding what needs to be done and recognize in the problems of getting it done. some of my colleagues have criticized you for your health related stock holdings while serving in the house. not only do house rules not prohibit members from trading stocks, but it is not an uncommon practice for members of congress, in fact, there were members on this committee, who have traded individual health

stocks, while serving on this committee. this appears to be nothing more than a hypocritical attack on your good character. i personally resent it. you have always disclosed -- let me just say this, can you confirm that you have always followed the law relating to trading in stocks while serving as a member of congress? rep. price: thank you, sir. everything that we have done has been aboveboard, transparent, legal, and his you know, there is an organization called the office of government ethics that looks that all of, for every cabinet nominee, looks at all of the possessions come all of the holdings, and the like, and makes a recommendation as to what the cabinet member must do to make sure there is no conflict of interest. the office of government ethics has looked at the holdings and given advice about what we need to be done in terms of divesting from stock holdings to make sure there is no conflict of interest.

we have read those and 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. senator hatch: and you follow their advice? rep. price: absolutely. the collapse of obamacare has dissolved our effectiveness. despite failed reforms, i don't think we can lose sight of the broader health system at risk. rare disease patients do not have access to life-saving treatments because policies that stem from obamacare prevent investments and innovative therapies that can cure and save lives. this is an issue i'm deeply passionate about. what steps do you believe will increase the pipeline for disease therapies to bring

treatments and cures to patients in desperate need of hope? rep. price: the act which past 30 years ago, it really has revolutionized the ability to treat rare diseases. it made the united states and the leader in coming forward with treatments for rare diseases. i think there are things we can do in terms of patent protection, liability, in terms of incentive is asian of resourceiz -- incentiveation -- incentivization of resources. senator hatch: we have some more drugs coming through because of that bill. all of a sudden, there is an explosion for populations of less than 200,000 people. it is a pretty important little bill. it was a republican bill.

rep. price: one of the success stories for public policy in the country. senator hatch: one of the essential duties of the hhs secretary is to be diligent and thoughtful when considering if federal regulation is necessary and assessing whether the regulations impede research, development, and innovation. over the years, the regulations about dietary supplements has changed dramatically. do you recognize dietary supplements in helping reach and maintain healthy lifestyles? rep. price: absolutely. senator hatch: will you commit to me and the members to protect public health while assuring that consumers continue to access to safe products? rep. price: this is one of those areas where it is incredibly important to gain the information you referred to, to

gather the individuals who know the most about this area. whether it is consumers, whether it is those providing the products to market, make sure that there are protections for products, but it is absolutely vital to get this right. i have to commend donald trump for picking you. you are clearly one of the premier people in all of congress who understands the problems with health care. you have the professional background that i don't think any other member of congress can match to help solve the problems that we have. we have a real messy situation. obamacare has not really helped. do you think obamacare has helped? rep. price: i think some of the things that have occurred with the passage of the aca have improved certain areas. the coverage has certainly improved. the consequences of that, that many people have coverage, but they don't have care, but there are so many things about the decision-making process, who

decides about our health care, should it be the federal government or patients and families and doctors and we certainly believe the latter as opposed to the former. senator hatch: i take it you believe getting health care closer to the people is a far better thing than everybody pontificating from washington dc. rep. price: i think the more involvement patients and doctors can have will result in higher quality care. senator hatch: i defended doctors, hospitals, health care providers, etc. in another life. what do you think we should do about medical liability? rep. price: this is a really difficult challenge because it is not just the malpractice rates that doctors or hospitals pray, but it is the practice of defensive medicine, the things that physicians do, but there are tests and procedures that are not necessarily needed to make a diagnosis -- senator hatch: that shows up in their history. rep. price: so if they are

called up into the court of law, so they say, i don't know what you wanted me to do, i did everything. if we look at it in that light and try to decrease the practice of defensive medicine to the benefit of patients, i think we can get to the right answer. there are exciting opportunities that have been bipartisan in the past. senator hatch: thank you, sir. senator casey: thank you mr. chairman and representative price. thanks for the visit to our office. i wanted to highlight something we probably don't spend enough time highlighting or talking about and that is the full protections of what was known as the original bill. we have a lot of short-term and -- shorthand terminology. i know you and i have a basic

disagreement. what a lot of people have forgotten about and the chairmen had a chart earlier that outlined the categories of americans that have health insurance by virtue of various programs. the number he had on the poster about the number of americans in the employer-sponsored coverage category and it was 178 million people. that is a lot of folks with coverage, who had coverage before, most of them had coverage before the legislation, and after, but they did not have protections. that only came with the passage of the legislation. we know that people have purchased health insurance to the individual marketplace. i wanted to ask you a couple questions about those basic

protections that are no law that were not law before. i think you would agree with me that you meet remarkably inspiring people in your work and once in a while in the senate, we do and we don't take enough time to have those opportunities, but one of the people i met in the lead up to the legislation passing was stacy ritter from manheim, pennsylvania. she did not have a personal challenge, it was the challenge faced by her two daughters. they were four years old, matalin and hannah. as stacy said about her daughters, she said that they would, at that time, would be punished and rejected because they had the misfortune of developing cancer as a child. her basic problem was the caps on treatment.

the first question i would ask you in terms of your work as secretary of health and human services should you be confirmed, will you commit to maintaining the protections that ensure that no child, no child is denied insurance coverage because of pre-existing conditions? rep. price: i think that pediatric cancer is one of those things that is remarkably challenging. i remember when i was in my residency and i did a rotation on the pediatric orthopedic ward and so many of those children had can't -- cancer and before i began that rotation, i'll most dreaded going through that month because i was worried about just the severity of the challenges i would meet. it was one of the most uplifting months i spent a medical school and 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 that they need and the care that they need and there are a number of ways to do that

and i look forward to working with you to make that happen. senator casey: i heard the word yes there. secondly, it is really hard to believe that we even have to ask a question about this next topic , which is victims of domestic violence. it was the stated law prior to the passage of the legislation that victims of domestic violence were considered americans without a pre-existing condition. it is still the law in some states that they are not protected. will you commit to maintaining the protections that ensure that victims of domestic violence will not be discriminated against when purchasing health insurance? rep. price: i think it is absolutely vital that victims of domestic violence and others, anybody, we need to have a system in place that ensures that individuals are not priced out of the market because they get a bad diagnosis, are not

eligible or able to purchase coverage that works for them -- senator casey: i don't want to get hung up on priced out of the market. what i'm asking for is an ironclad guarantee that that circumstance, that horrific circumstance will never be a bar to coverage, treatment, or care? rep. price: it certainly should not be. if i'm fortunate to be confirmed, that is an administrative role and a policy decision that the legislators -- senator casey: i think we can agree on that. number three, will you maintain to committing the protection that prohibits the discrimination based on health status or disability? yes or no? rep. price: again, i think it is absolutely imperative that we have a system in place that works for patients and anybody not being able to gain access to the coverage that they want or need is not a system that works for patients. senator casey: what i'm getting at here is that we had a state of the lobby for passage of the

aca where individuals like that, whether a child had a pre-existing condition, even if the parents were paying premiums for years, an insurance company could literally say, sorry, you have a pre-existing condition, you can't get coverage. women were discriminated against because they were women. just a remarkable stain on america that we allow that to happen. my concern now is not just a series of concerns about what you has proposed about a member of the house and what you could do a secretary, but i just heard earlier the three areas that will be a focus in whatever replacement plan there is and i'm anxious to see it would be and i wrote them down -- chairman alexander wanted to take off the table and that is a good thing, medicare, but i heard that there would be three

targets -- my word, of course -- the individual market, medicaid, and employer-sponsored coverage. i hope that if employer-sponsored coverage is a subject of change that will ensure all of those protections that are in place right now. that is why i'm asking those questions. i will follow up more in writing or if we get another round, mr. chairman put me on record as incorporating it everything ranking member marie said about questions and additional rounds. >> duly noted and i appreciate your using your seven minutes to ask questions. [laughter] deferred to senator paul. senator paul: as a fellow physician and a fellow physician who did some of my training at grady, congratulations and it

wish everybody at the commission could come to grady and see what it is like to work in one of our nation's biggest charity hospitals often doing work that is just incredible, gunshot wounds, contract -- compact fractures to the femur, you name it. i remember being there is a student as an intern, we used to calculate how many hours and divide by our income and say, we wish we could get minimum wage. i think it is critical to get someone with clear reasoning and critical skills to be in charge of our government. i think what i regret about this kind of hearing and what a lot of people in america regret about it is the vitriol and the rancor and the partisanship that -- we kind of all want the same things. to question your motives is insulting. to question whether you are honest is insulting. the whole question of -- did you go into public service to enrich

yourself or for public service? rep. price: i have a passion for public service and a passion for people and that is what guided our decision. some i think it was a foolish decision for both of us. senator paul: did you take a pay cut? rep. price: i did not consider the remuneration. senator paul: right, but i'm guessing it was a pay cut. i think we all want the most amount of 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? do you want more people to be insured? do you want more people to have health care? do we disagree on just how we do it and not necessarily just the motives? rep. price: as it tried to lay out earlier and i know time is short for everybody, the principles that i think are absolutely imperative for a health care system is one that

is affordable for everybody, one that provides access to health care and coverage, one that is of the highest coverage, that is responsive to patients. the system is not any good if it is not responding to patients to read one that incentivizes innovation because it is the innovation that drives high-quality health care. one that ensures choices are made and preserved by patients. patients should be choosing who is treating them. senator paul: republicans have been accused of having no replacement ideas. approximately how many bills to you have that would be, could be regarded as replacement bills ? rep. price: with that one large term of bills since march or early 2009. tens of pieces of legislation. senator paul: it's been insinuated america is this horrible, rotten place.

the physicians don't have passion. as you work as a physician did you always agree as part of your engagement with the hospitals to treat all comers regardless if they had the ability to pay? rep. price: it's one of the things we pride ourselves on. anyone in need of care was provided that care. not only in residency but in our private orthopedic practice. sen. paul: it is interesting that those who say we have no compassion extol the virtues of socialism. you look at venezuela, with great resources and i think it is important that we have a debate in a country ultimately between socialism, communism america, and capitalism. ,one of the things that is extraordinary about our country, away $400ago, we gave

billion to churches and charities. we are a compassionate society misplaced within health care how much we do help each other. betjust in our country, i most of the physicians in my onmunity have gone international trips. i would argue the opposite. we give away more than the gross domestic product in most of these socialist countries around the world. i think it is important. with regards to replacement, there are some ideas that would broadly ensure more people. one is the idea of legalization of all types of insurance. under obamacare we made it , illegal to sell certain types of inexpensive insurance.

do you think it would help to legalize sales of insurance? rep. price: i think choice is vital. patients having those choices, i think they will select the ones they want. they will choose the choices for the full array of opportunities. sen. paul: do you think health savings accounts will help those who are not helped currently? rep. price: i think savings accounts and catastrophic coverage makes a lot of sense for those individuals. we ought not force individuals to do it. sen. paul: one thing you had legislation on, individual big suppoert i'm a allowing individuals to buy insurance in groups.

i have sympathy for that. if an employee was to get sick, it would be devastating for the economics of keeping them in the employed. letting us join together into pools, we're instead of me buying insurance has one of 4 people, i can maybe buy it in groups of 100,000 people, or maybe one million people. currently the laws prevent that, but you had bills that expanded that and i am a big fan. can you explain how these association plans can help those that don't get coverage currently? rep. price: these are entities that allow the economically aligned to purchase coverage together, even though they don't necessarily work together. the individual health pools is a secret to solving the market conundrum we are in. it will allow anybody to pool with anybody for the purchase of health coverage. it is not a new idea. the model is the blue shield plan that existed decades ago and allowed people to put

resources together for medical coverage. it just makes a lot of sense and penalize insurance to work the way it is supposed to work. no one's adverse health status drives the cost for anyone because the pool is large enough. >> senator paul. sen. franken: i tell you how we get a really big risk pool. it is called medicare for everyone. that would be the biggest risk pool. it was nice meeting you the other day. did you enjoy meeting me? [laughter] rep. price: i enjoyed our discussion about our grey hair. sen. franken: what is the leading cause of preventable death in the united states? rep. price: i will defer to you. you obviously have it on the front page. sen. franken: i actually knew this before i put it on the

page. it is smoking. rep. price: that hits home. i lost my dad, who was a lucky strike 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 it was in an incredible tragedy. dad too.ken: i lost my as a physician, you may know, i guess you didn't, that smoking kills approximately 480,000 americans each year in health costs totaling $170 billion per year, and it between 1993 and between 1993 and, 2012, you were a shareholder of the tobacco meaning that you personally benefited from tobacco sales.

meanwhile, you voted against legislation in 2009 that did the fda the authority to regulate tobacco. congressman price, you are a physician. you took the hippocratic those, the oath to do no harm. how do you square personal gain from the sales of an addictive product that kills millions of americans every decade with voting against measures to reduce the death toll in inflicted by tobacco? rep. price: it is an interesting question and a curious observation. i have no idea what stocks i filled in the 1990's or 2000s, now.en all of these stocks i suspect are from mutual funds and pension plans. i would bet, and -- i don't want to bet -- i would suspect that being your pension plan, there are components of that may have something to do at some time in

your history with tobacco. sen. franken: i find it very hard to believe that you do not know that you had tobacco stocks. i find it a little hard to believe that, in the questions about your portfolio, you have said you didn't know things. you traded more than $300,000 in health related stocks. at the same time, you advocated legislation that could affect the performance of those stocks. it march 17,ought 2016. you introduced a bill one week later on march 23, where you said you did not know that that had this stock.

it was to delay a federal rule probabilityelay the that it would hurt the company. once you found out that your broker bought it, you kept the stock. to purchased this 50,000 $100,000 worth of stock in a biomedical company. bit,lked about it a little the single largest presaged in the last three years. 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. this.cussed by definition, i believe that is the nature of a

private placement offer. what i have said to others is that i paid exactly the same price as everybody else. sen. franken: kit was a private offering that went to about 20 people, including your colleague chris collins, whose chief of staff, and a prominent d.c. lobbyist. 50 thousandrted dollars to $100,000 on this purchase. when youredulity, sir, say you did not know that you got a discount on this. offering to ate very small number. when you have the chairman of the budget committee, a congressman as chief of staff, these sound like sweetheart deals. 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 about your latest plan, empowering patients first act. some of it is detailed in this article from the new england journal of medicine called "care for the vulnerable versus cash ick the powerful,: trump's p for hhs." price's bricker demonstrates less for the sick and poor and health of the public then much greater concern for the economic will begin of their position caregivers. everyd commend this to member of this committee before making a vote. is -- it'slan does

not different between someone that make $20,000 and bill gates. it is an incredibly regressive system. you guys want to end the expansion of medicaid. that has people in minnesota scared out of their mind. i have heard a lot, obamacare has been a disaster -- first of all, you have to admit it has bent the cost curve. the cost of health care in this country has grown less than it did in the previous 10 years. it has also covered 20 million more people. in 2008, i would go around hall, in, in every

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 l ifetime cap. i am very frightened about what you're going to do, and so are millions of americans. and frankly, i know you do things that help physician groups. you put in provisions that would byvent these findings efficiency and innovation boards that would have to be cleared by physician groups. as someone who is

therefore the doctor, and this 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 mind,ricans bees of knowing that their kids can stay on their health care until they knowing that if they have a pre-existing condition, that won't stop them from getting care. that is what this hearing should be about. man.re a smart >> senator, we are imminent over. -- we are a minute over. sen. franken: in my cigarette, i will be a minute short.

thanks. >> you may be here with yourself. >> i'll be here with him. >> thank you senator franken. did you have any response to senator franken? just saye: i would that this is one of the things that makes it difficult to reach a solution in washington. the concerns expressed by the senator are valid concerns. the conclusions that he drew on the policies i promoted and will continue to promote or absolutely incorrect. a concern for the american people than to make sure they have access to the highest quality care that the world knows. and i understand

this is a political activity, but i hope we are able to work --gether if i am you had to true by make full disclosure of everything that you own and what it was sold for? rep. price: every single year we do a daily financial disclosure. financial a monthly transaction. isn't it true that every transaction is available to the public? rep. price: absolutely. they remain so today. >> these were not hidden? rep. price: there isn't a single bit of information that i did not revealed to the public in a transparent process. >> prison it true that

transparency is the intercept antisceptic to corruption? to't it true you have worked make sure there is always transparency? rep. price: absolutely. it is key and health care and the services hhs provides. >> isn't it true that you love your country? and if you had the opportunity, you would do everything you could to disclose everything possible so there is no conflict of interest whatsoever? rep. price: without a doubt. that is why i mentioned the government ethics office, and the diligence they do to look at everyone's holding and assets who were scheduled to serve in the cabinet. they make a specific recommendation that is also available to be seen online. we have agreed to every recommendation we have made to the best of whatever holdings we have that might even give the

appearance of possible conflict. >> high-heeled the balance of -- i yield the balance of my time. >> thank you for the seven minutes as well. i have never shown my knee to any nominee before dr. price came to my office and gave me free medical and nice. i am grateful. rep. price: how are you doing? sen. bennet: terrible. it is not because of you. [laughter] i get the mri today. i know you have been chair of the house budget committee and are in member of the tea party, a strong advocate of balancing the budget for a stronger america. what i have noticed is that after gaining control of the house, senate, and white house, the first order of business for the republican majority here has been to pass a budget resolution thisling the aca, and

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. senatoread my colleague, r paul, who so astutely highlighted in his floor speech january 4, "the more things change, the more they stay the same. republicans won the white house, control the senate, 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 my $.7 trillion of new debt over years."-- over 10 he asked,"ally,"

what we campaigned on?" hadoes on "why would we $9.7 trillion to the? we can't be bothered. i was told again and again, swallow it, take it, they are just numbers. it is not really a budget. and yet the legislation says it is a budget!" this is what republicans are for. this is the blueprint that the republican party says they are for. $10 trillion worth of new debt. i am not for it said that honest man. rand paul is right. the repeal law overrides 2 separate budget provisions already passed by the senate that prevent increasing the deficit by more than $10 billion, 5 billion in years down the road. you awaresir, are that behind closed doors,

republican leadership broke into this bill that any replacement to the affordable care act would be exempt from senate rules to prohibit large increases to the deficit? as you may know senator, i stepped aside as chairman of the budget committee. i was not involved in the writing. sen. bennet: you have been the budget committee chairman during the rise of the tea party. you are a member of the tea party caucus. to have said over and over again the reason you have come to washington is to reduce our deficit and reduce our debt. i assume you are very well aware of the vehicle being used to repeal the affordable care act. this is not some small piece of legislation. this is the republican budget. rep. price: yes, i am aware of the bill. sen. bennet: to support the budget that increases the debt by $10 trillion? rep. price: what i support is an opportunity to use reconciliation to address the real challenges in the affordable care act, and to make certain we put into place at the

same time a provision that allows us to move the health care system in a much better direction. sen. bennet: do you support the budget passed by senate republicans revealing the affordable care act that adds $10 trillion to the budget? rep. price: the reconciliation bill is yet to come. i support the fiscal year 2017 reconciliation will to go forward. sen. bennet: will you commit today that any replacement plan for the affordable care act will not in any way contribute to our deficit or debt? rep. price: i commit to working with you that that happens. sen. bennet: when 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? can't you tell that he party you won't increase the deficit by revealing the affordable care act? rep. price: there are a lot of countries and to get. sen. bennet: that is true, and

you and i know that. allow one of to the health care bill reveals to be one of the contributors to deficit and debt? the cbo says the repeal of this law could increase our deficit by up to $350 billion. rand paul, senator paul, has gone to the floor and said the first thing we are doing is passing a budget that increases it by $10 billion. what do you say to the tea party about that? more importantly, people that live in colorado? conclusions that they reached oregon a == -- conclusions they reached are in a silo. if you look at the whole constellation of things that will occur, i believe, and working with every member of congress should i be given the privilege of serving secretary, we will make certain it addresses the health care

challenges that exist that are very real. we look forward to working with you on being as fiscally responsible as we can be. the debt and deficit is a real challenge. sen. bennet: with respect, and i have a lot for you -- that is what every politician says about the cbo, they say the numbers are true, and we just run up the debt. must the entire theory and case here from the republican party on this subject has been at the health care law has increased cost, has increased our deficit, increased our debt, and i would hope you could take a pledge that nothing he would advocate nothing you-- would add aate for dollar to our debt. rep. price: i hope to the case. i will work with you to make sure that it is.

sen. collins: dr. price, welcome. i too 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 exchanges. there has been remarkably little debate on what would happen if congress took no action with regard to the individual market. answer asgive us the far as what you would see happening to the individual market if we do nothing. i appreciate the

opportunity to visit with you. the american people know this. they appreciate the individual breaking in many ways. we are in a downward spiral on being able to provide individuals any opportunity at home. -- opportunity at all. one insurance provider, the premiums are going up for folks. i get calls almost weekly from my former fellow physicians that's only their patients are making decisions about not getting the care that they need because they can't afford the deductible. an individual making $40,000 and $50,000 per year, and your deductible is $6,000 for a family, which is not unusual, your insurance card

might be wonderful, but you can't have any care because you can't afford the deductible. people are denying themselves the care that they need. those are the things that we ought to be addressing. i hope that in a bipartisan way we can address that. sen. collins: i think that is an important point to clarify. in the individual market, we are seeing double-digit premiums, higher deductibles, larger co-pays, and far fewer choices as more insurers give up and flee the market. the co-ops have failed dramatically. all 23 of them are in financial trouble. only five were still operating. to say that everything is going well with obamacare is just not accurate. that is why i feel that we do need to fix the plugs of what is

a well-intentioned but deeply problematic law. i wanted to clarify another issue on the aca. there has been much debate on whether we should repeal the law with no replacement. i think most people reject the idea. as you said, we don't want to pull the rug out of people who are relying on the insurance provided through the aca. another group has advocated the repeal with a 2 year or 3 year delay. i think that approach doesn't work, because it creates great anxiety for consumers. would be-- insurers unable to price their policies if they don't know what the rules are going to the. 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 choices that we have now. is that accurate? rep. price: absolutely. it is vital. we often don't talk about the 20 million folks that still don't have coverage. there are a lot that don't. if we are responsible policymakers, it is incumbent upon us to say, why is that? what is making that happen for those 20 million that don't have it? i would suggest it is because of the structure actually makes it virtually impossible for many individuals to gain that coverage. i believe it is important to work together to put a system forward that allows every american to purchase a kind of coverage -- the kind of coverage they think is best for their families. sen. collins: your goal is to have more people covered by

insurance. thank you. i have been baffled over the years by what cms reimburses for, and what it fails to reimburse for. senator jeanne shaheen and i scored a victory in getting cms to cover continuous glucose monitoring for individuals with diabetes that have been covered by a vast majority of private insurers. when those individuals aged into medicare, they lost that coverage. whatsoever.e 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 medical assistant call individuals with diabetes once a week and check on their blood sugar levels, their appearance to diet and exercise regimes.

it has had positive results. the irony is that if diabetes gets out of control, and those individuals need amputations or go blind, cms will pay for that, but it won't be for that phone individualck on the helping to control their diabetes and keep them well. will you pledge to take a look at those kinds of policies, evaluate what we do pay for? rep. price: absolutely. it is imperative we whether you're getting the outcomes that we want. the process is obstructing or helping those outcomes. sen. collins: finally i want to touch on biomedical research, a passion of mine. i found it both the diabetes caucus in 1997.

i also am the founder of the alzheimer's task force in the senate, which senator warner is the cochair of. alzheimer's has become our nation's most expensive disease. society to $63 billion per year, $150 billion of that comes from medicare and medicaid. it is going to bankrupt those programs. it is devastating to those victims of the disease. 3abetes consumes 1 out of medicare dollars. if we invest in biomedical research, we have the possibility of only improving lives for americans and coming up with effective treatments, but also lowering health care costs. increases --rt the

do you support the increases for nih that we are on track to pass this year? rep. price: nih is a treasure for our country, and the kind of things we should be doing to cure those diseases. one of the core avenues is through nih. i support the increase. sen. collins: thank you. that goes along with your principle of innovation. thank you mr. chairman. >> we have been at this for about two hours. i am going to suspend the operation for about five minutes. then we will go to senator whitehouse. just so we can take a little break. we will recess for 5 minutes.

sen. alexander: the committee will come to order. senator whitehouse is next, followed by senator young. me ask first to put into the record a letter from our governor in rhode island which said that in rhode island, "we have actually seen exchange premiums decreased in 2 out of the last 3 years. this has saved consumers nearly $220 million since 2012." the story on the affordable care act in rhode island is quite a

good one. i would like to put this graphic to explain itd, briefly. the red line along the top is th e cbo estimate where our health go inosts were going to 2010. at this time, 2016, after the aca was in place, they looked at the actual experience, and did a new projection based on the affordable care act. in the following 10 years, from 2016-2026, they are forecasting $2.9 trillion in federal health not really active the affordable care act. this is where that came in.

ourhrow this thing out at peril if you care saving medicare, the savings to which are a significant part of this $2.9 trillion. now,row it out right according to the republican plan, with nothing to replace it. i have described that over the weekend at some like being asked to jump out of a plane without a parachute and being told, trust me, we will give you a parachute before you hit the ground. i was with an army ranger and jumped out of perfectly well operating aircraft. he insisted on just one parachute, but two spare. i think the american people are entitled to know what they will be offered as an alternative. there has been conversation in this hearing about how the republican ideas are floating around. i'm sure there are ideas floating around. there is no republican bill,

there is no plan, no proposal. our cards are on the table, it is obamacare. you want to improve it? we have always been open to suggestions. the other side of the table, there is nothing. it is hard to negotiate with nothing. i think the republicans have a responsibility to put a plan together. we talked about that, mr. price in my office. my recollection is that you told me you would want to keep letting people stay on their current policies -- the parent'ss -- their policies until they are 26 years old? rep. price: i think the insurance industry has applied the across-the-board. i don't see any reason why that would change. sen. whitehouse: and you want to keep the doughnut hole closed, you told me, to protect seniors against pharmaceutical costs?

my recollection is that it was more specific. you did not want to reopen the doughnut hole. are you saying you will consider reopening the donut hole? rep. price: you know well the reopening of the doughnut hole would be a legislative activity. rep. price: sen. whitehouse: you will be the secretary of health and human services. you'll do a lot of work to do this work for the administration. are you going to be proposing something that reopens the donut hole? i have a lot of seniors that want to hear about that. rep. price: i have no discussions about that. sen. whitehouse: okay. notes, you- in my say you will not return to any insurance caps or lifetime denial of pre-existing conditions, or looking back in the final for a tiny discrepancy, then throwing

someone off of their coverage when they come in with a significant claim -- is that true? rep. price: there are always ways we can protect coverage. i think the issues need to be continued. sen. whitehouse:, when, as , and if we get a counter proposal to obamacare, you would expect to see those things in it? rep. price: i don't know whether they would be in it for silent on it. that is a legislative question. sen. whitehouse: leave it in place. rep. price: does the legislative, administrative question. -- that is a legislative, administrative question. sen. whitehouse: you had a proposal that would allow states to throw what you called able-bodied people off of medicaid, unless they were working or looking for work, or in job training. people with addiction,

behavioral health, and mental health issues -- are the able-bodied in your definition? rep. price: we weren't as specific what the definition was. sen. whitehouse: i'm asking you now. what did you mean when you said able-bodied? rep. price: there are many individuals who have worked in this case for a long time who believe that providing for an opportunity for those without children who are able-bodied to seek employment-- sen. whitehouse: and what do you mean by able-bodied is the question? you just used that term again. rep. price: that would be defined in the regulation itself. sen. whitehouse: you don't know the term you're using without how you would define it? rep. price: people have eight understanding what able-bodied is. it were not include the things you described. sen. whitehouse: it was the simple answer to my question -- able-bodied does not include those with mental health or addiction issues. rep. price: that would involve

the work-- sen. whitehouse:, asking future work. i'm asking as you use the term in your budget. rep. price: those having challenges that would preclude them from being able to seek work or employment or education, to. ought to be attended i'm a fan of,e: and think they do good work at the american academy of pediatrics, and that the american lung association. i am a fan of the american public health association. all of those groups and many others have gone very clearly on changethat climate presents significant health issues.

they signed a declaration on climate change and health, which stated that the science is clear that this is happening. you on the other hand, have said , the carbon pollution standards of the obama administration "go against all that there are errors and obfuscation in the allegedly settled science of global warming." i will pursue this with you for questions of the record. time has expired. if you could give a brief answer. it appears to every scientific organization in the country, all the legitimate major ones, and to every a major american university, this is pretty darn settled science. the only people that disagree has a vast financial interest in

work getting done. it looks to me that you have taken the side of those vast special interests against actually settled science. if we can't trust you and finds the is as settled as climate science, how can we trust you on health science issues, whether it is a big special interest on the other side? rep. price: i don't agree with the premise of the insinuation. i will say the climate is obviously changing. the question from a scientific standpoint is what effect does human behavior and human activity have on that, then what can we do to mitigate that? i think that's a question that needs to be studied and get the best minds available. sen. whitehouse: start by finding a university that thinks the way you do. one. sen. alexander: we are running out of time.

senator roberts? sen. roberts: i hope my colleagues feel better with their anger. the audio system is working. i thought maybe senator bennett did not know that. marine d.i.me of my back in the good days. he'd shout, i can't hear you! i'd bring up that the audio system id working. dr. bruce, congratulations on your nomination. thank you for being here today.

as many as are colleagues have noted, you will play an important role in helping to stabilize the market well congress does repeal the law and repair the damage caused in the next reforms i believe will put our system back on track. we have three insurance carriers to deal with. with each individual having only access to two of those, our premiums rose this past year over 30%. down the road, it will be more difficult if we don't do something. there is no doubt with regard to even ifmonk consumers, congress and the incoming goinistration were to let it -- amending or repealing parts of

the affordable care act where the law isn't working. if we have to do something to meet that obligation, the prices are unaffordable, markets nearly nonexistent -- we are not as rural as wyoming, but we are rural in my home state of kansas. i have a concern, back in the day when we sat on this -- i don't know where that mark is today. night. today and was worried about something that i called the rationers, the and endent advisory board, the new coverage authorities giving to the u.s. preventative services task force. i would mention the patient centered outcomes research

institute. not many people are aware of these. i had someone call of the -- call them the 4 courses of the regulatory apocalypse. i am worried about the government dictating what kind of coverage you can receive. can you share any concerns that you have with regards to these, ,hat i would call, rationers with respect to what they are intent?o do with good rep. price: it is important that we recognize that the patient ought to be in the center of this. anything that gets in the way of the patients and physicians, making the decisions about what kind of help here they desire -- we won't not go down that road.

for example, the center for medicare and medicaid innovation, i am a strong advocate for innovation. i have seen what is coming out of cmmi is a desire to require certain kinds of treatment for a certain disease entities that may or may not be in the best interest of the patient. because it carries the full ,orce of the federal government it means we are answering the question, who decides about what kind of care patients receive? we answer by saying it is washington dc. ect where -- i rej those decisions ought to be made. sen. roberts: i appreciate that answer. i have been on this committee, especially being chairman of the always powerful senate agricultural committee, i am interested in hhs and the fda

work on food and nutrition policy. during the previous administration, the fda issued regulations with unrealistic compliance dates. this happened more recently with a nutrition's faxed panel provision. foodare the goal of safe and availability for consumers. i don't think the administration has adequately mitigated with the industry regarding the requirements. will you work with the secretary of agriculture and other that yourot mentioned department is issuing science-based guidance, and taking into consideration other regulatory burdens on establishing complaints in engaging other regulatory actions? rep. price: yes.

i believe that is not only imperative, but the science onto to be transparent to the public so that people can see the basis for the decisions being made. under the previous administration, we have seen increased regulatory action such as issuing voluntary guidance. question -- this administration requested additional resources under the food safety modernization act. i am concerned the administration did not prioritize fda's mission to prioritize our nation's food supply, instead focusing on nutrition policies. discussrmed, will you how you will focus on the court duties -- the core duties rather than agenda driven nutrition guidelines? rep. price: if i am given the privilege of leading, i would work specifically with the fda

to nature that it is science that is guiding our decisions, and that transparency is available for folks to see how decisions are being made. best what is going on in your state, and how it is being affected by the rules and regulations from washington, certainly in the agricultural arena. we ought to be having a dialogue with every individual of his interest to address needs appropriately. rep. price: thank you for your response. sen. baldwin: welcome congressman. you have already been asked about your investments in pharmaceutical companies as part of prior questioning.

for the record, have you received campaign contributions over the years from political action committees associated with many of these companies? rep. price: i don't know, but i assume so, just as many of us do. what the american people want to know, of course, when you get reviewed for potential conflicts of interest with the government ethics office, in your role, you are fighting for them, and not biased toward the powerful companies that you have invested in, and have invested in you. you have taken some questions on that. let me follow up a little bit. to ask first, do you think drug price increases we are seeing now, for example, the sixfold increased in the cost of an e pi-pen, is a problem for

americans? rep. price: as i have mentioned, there are certain areas where drug pricing seems to have little races in rational fundings -- little basis in rational funding. we should appreciate we have done some good things in drug pricing, whether it's the generic arena, or part d. sen. baldwin: my time is limited, so let me continue down this track. you have been asked already, but trump supports medicare drug negotiation. repeal therk to prohibition on medicare negotiating for better drug prices on behalf of the american people, if confirmed for this position? rep. price: i understand if i have the privilege of serving as secretary, the boss i have will be the president of the united states. sen. baldwin: will you work to

repeal the prohibition on medicare negotiating drug prices? rep. price: following discussion and being informed by the public and working with the president and carrying out his wishes. sen. whitehouse: was that a yes, or no? rep. price: is depends on that activity. sen. baldwin: stated his position recently that he supports price negotiation so that people on medicare can have the benefit. is that something you would press congress to do? in other words, repeal the prohibition on that negotiation? rep. price: i think we have to find solutions to the challenges of folks finding access to medication-- sen. baldwin: i'm not-- rep. price: as you know, the negotiations now occur for seniors. sen. baldwin: i have limited time, and you have not said yes or no -- you just talked about

transparency. would you support drug price transparency, mandating that any drug company that wants to increase prices on their drawings, released public information on how they sent their prices? so many of these appear to be without justification. rep. price: yeah, i think there is a lot of merit in transparency. certainly in this area. i look forward, if confirmed with you, exploring to find ways to make that work. sen. baldwin: i want to go back to the first round of questioning with the chairman, who showed a chart. it seems like what was implicit in the back and forth was that the act of repealing the affordable care act would only impact perhaps a very small part of the health care industry. you talked about 6% being covered on the individual market.

the protections, like coverage on your parents health insurance until you're 26, and pre- mandating that people be covered even if they have a pre-existing condition, things like ledinating caps that someone into medical bankruptcy -- those apply -- across the health care system. apeal in no way limits us to conversation about a small percentage of our population. this is about serious impacts for all of america. would you agree? rep. price: i think the discussion about what our health policy for financing health care to the american people is a broad subject. sen. baldwin: the you repeal the

affordable care act, the impact is not narrowly confined to medicaid and the individual market. it has impact on every american. medicare too. think of accountable care organizations, who are driving so much of our innovation. that is not confined to the individual market. in tax medicare very significantly. let me give you an example. when you visited, and thank you for your visit, we talked about the opioid epidemic. issues is significant access to treatment to overcome addiction. if the affordable care act is repealed, there will no longer be a mandate for substance abuse treatment being covered. is that something you agree with? would you assure that substance

abuse treatment would be covered under a replacement plan? rep. price: i think it is absolutely vital that substance abuse and other things-- sen. baldwin: so you would keep that protection of the affordable care act. rep. price: deputy legislative decision, but i look forward to working with you-- sen. baldwin: i want to make sure they heard the exchange. it sounds like you say you think insurers are going to continue to do it, so there is no need for there to an actual mandate saying they must. million young 5.7 people between the ages of 18 and 26, on their parent's health insurance, that is 5.7 million people who aren't in the , on their market first job boarding school. -- job or in school.

is it just a wink and a promise, or you by law support amending the 18 to 25-year-olds be able to stay on their parent's insurance? rep. price: it has been think into the insurance programs now. sen. baldwin: they can change their minds anytime. rep. price: i want to make sure that americans have coverage for the planes that they want and can purchase that coverage. you.alexander: think baldwin.you senator senator young. i had an opportunity to get to know you personally on the ways and means committee, and to learn your skills and. your depth of knowledge in health care, and your commitment

more importantly to seeking alternative perspectives, to try and identify where bipartisan consensus can be realized. ultimately, forging consensus around some viable solution. the one i find most notable is your success on the sustainable growth rate, something the members of this committee are familiar with. it is a blend instrument -- it is a blunt instrument that was in place. without your help on the house, i don't think we can have moved toward other purchasing models. these are skills that will help you in health and human services no doubt. speaking of bipartisanship, one part of the affordable care act that members of our party have periodically and vocally indicated their desire to repeal has been the center for medicare

and medicaid innovation. that is on account of the one-size-fits-all, prescriptive and mandatory demonstrations that occurred in recent years. you have indicated that you oppose the mandatory nature of demonstration projects. strongly believe there is great value in innovating and experimenting across all layers of health care. canther, i think cmmi continue to be a hopeful laboratory for health care experimentation, with respect to delivery models, payment models, and so forth. for medicare, medicaid, the children's insurance program, perhaps other areas. provide greater value, we see what doesn't work, scale up what does work. for me, it is common sense. this is the way scientists operate. they start with experiments,

then they evaluate, then they scale up. i would like to know your intention if you have strong convictions. do you intend to keep this innovation center, or a variant rep. price: i appreciate that. i am a strong advocate and supporter of innovation at every level. it is innovation that allows us to expand possibilities for increasing the quality of care. i'm a strong proponent of innovation. great possibility and promise that will be able to do things to allow us to find ways that we can change the payment model, and in ways in which we are treating disease and the like that will improve to the patient's benefit. i strongly support that. i have adamantly opposed to the mandatory nature with which cmmi has approached problems. let me mention, the first is the

replacement, which identified 67 or 68 geographic areas where if you were a patient, and you received a lower extremity joint replacement for a variety of problems, and it was dictated to your doctor what kind of prosthesis or surgical procedure your doctor could do for you, regardless of what's in your best interest. they may be aligned, but they may not be aligned. if they are not, then your physician is incumbent upon doing what the government says to do. the other area that was more egregious was covering 75% of the nation in the medicare part b drug demonstration model. not a demonstration model, if it is 75% of the country. that would stipulate what kind of medications your physician could use in an inpatient setting. in a mandatory way. the problem i have is that really is an experiment.

it's a demonstration to see whether it not it works. ,n every single experiment health care or medical, or scientific experiment that deals with real people, we demand and require that there be informed consent for the patient to participate in the experiment. so you say to the patient, we are trying this to see if it works better and we would love to have you join us. we think it may be to your benefit and more individuals across this land. if you don't want to do that, you do not have to. the federal government does not do that. they require individuals to participate. then times i suspect patient doesn't even know it's an experiment that is going on. if either of these models were put into a small area, a pilot project and we saw they worked, , as you say, then you scale them up. sen. young: thank you for the fulsome response and the rationale behind how you have arrived at that position. i look forward to working with

you to advance the next model of cmmi, whatever exactly it may look like. i would be remiss if i did not mention indiana's what we call healthy indiana plan 2.0, the vice president-elect pence showed a lot of leadership here . worked with our incoming cms administrator to develop a model for medicaid, which is unique to the state of indiana. it encourages recipients of medicare dollars to get some ownership over their health and uses private market insurance siers forto prepare hoo more self sufficiently -- sufficiency. i have been to believe it will in other states, if we can accommodate that and continue to work on new health care legislation.

this is an important proof of concept that medicaid can be more efficient than a one-size-fits-all approach. i want some reassurance that load star will be state flexibility and innovation in the medicaid space, so we can continue to accommodate plans 2.0 as opposed to a one-size-fits-all approach. rep. price: you are absolutely right. the medicaid program is one where the states know best how their medicaid population. the greatest amount of flexibility we can give for states to enact those kinds of programs, what indiana has done is really a best practice for many other states to follow and i look forward to working with you. sen. young: likewise. sen. alexander: thank you senator young, senator murphy: senato thank you for meeting with us. i hope you can understand our

frustration around trying to divine the nature of this replacement plan. we hear you and president trump all of these aspects of the affordable care act, and laid out goals that sound eerily familiar to what we have been living with for the last six years. you said that you don't want there to be a gap between the repeal and the replacement and that at least in many people will have coverage with the goal of more people having coverage, sick people will not face discrimination. young adults will get the stand their plans until age 26. and yet, we do not get any specifics as to how that is going to occur. it seems as if you and the president-elect want to do everything the affordable care act does, but do it in a different way. i'm going to give up on trying thist the specifics of secret replacement plan, and ask you about metrics about how we will measure what you propose as a replacement is meeting your

benchmarks. for instance, the number of people covered, the cost of health care to individuals, the amount of money out-of-pocket that people have to pay. when you are at the end of your four years, how will you look back on this replacement plan to success?ts and to the extent you can give me specifics as to how you will measure this, i appreciate it. rep. price: i thank you. you identified very specific areas that i think we need to be looking from a metric standpoint. what is the cost? is the out-of-pocket costs for individuals higher or lower than what it was? thet now, i would suggest cost is higher than it was when the program began for many of the individuals in the small group market. they were promised that premiums would go down and they went up. they were promised they would have access to their doctor.

in fact, many of them have not had access. from where we are today, if you look at the things that many of us believe that then harmed by have been harmed by the -- affordable care act, i hope we are able to decrease the out-of-pocket cost for individuals, increase choices, increase access to the doctors and providers they want. as opposed to what has happened. sen. murphy: increase the number of people that have insurance? rep. price: absolutely. as i mentioned, we still have 20 million individuals without coverage. as policymakers it is incumbent , upon us to say, what can we do to increase coverage? the goal is to make certain that every single american has access to coverage they want for themselves. murphy: i just want to note those are two different things. having coverage and having access to coverage. i want to bring up some issues. there is a great concern on behalf of the american people that this whole administration is starting to look like a get rich quick scheme.

we have a president who will not invest himself from his businesses and could potentially get rich off of them. a secretary of education last night who has big investments in the education space. a secretary of labor who could got protections and make money in his industry. i want to walk you through another set of facts and withine of your history the health industry, and get your reaction. on march 8 of 2016 earlier last year, cms announced a demonstration project to lower medicare reimbursements for part d drugs. that would have decreased incentives for physicians to prescribe expensive brand-name medications. drug companies that were affected organize a resistance campaign. days later, you announced your position to this demonstration project. one week later, you invested as much as $90,000 in a total of six pharmaceutical companies. 6. five, not 7,

all six, masonry made drugs that , would have been impacted by this demonstration project. there were a lot that would not have been affected, but you did not invest in those. you invested in six specific companies that would be harmed by the demonstration project. you submitted financial disclosures indicating that you knew that you owned stocks and two weeks after that, you became the leader in the united states congress in opposition to this demonstration project. you lead a letter with 242 members of congress opposing the demo. i know that's not easy. that takes a lot of work to get 242 people to sign on. rep. price: that is good staff work. sen. murphy: within two weeks of you taking the lead, the stock prices for four of the six companies went up. you didn't have to buy those stocks knowing you would take a

leadership role in the effort to inflate their value. have the american public takes a look at that -- as the american public takes a look at the sequence of events, tell me how it can possibly be ok that you were championing just positions on health care issues that have the effect of increasing your own personal wealth? timeline,damning representative crist. -- representative price. rep. price: my opposition to having the federal government dictate what drugs are available is long-standing. i do not know if you are here before, but i did not know any of those trades were being made. have a direct account broker. all of the trades were made without my knowledge as it is set up and individuals on this panel have the same kind of accounts. the reason you know about them is because i appropriately reported them and above board as an ethical and appropriate manner required by the house of representatives. sen. murphy: do you direct your broker around ethical guidelines?

do you tell him, for instance, not to invest in companies that are directly connected to your advocacy? it seems a great deal as a broker. he can sit back and take a look -- rep. price: sheep. senator murphy she can take a look and sit back, and look at the legislative positions you are taking and invest in companies she thinks will increase in value based on your legislative activities and you can claim separation because you did not have a conversation. rep. price: that's a nefarious arrangement that i am astounded by. the fact of the matter is i have had no conversations with my broker about any political activity at all other than her congratulating me on my election. sen. murphy: why wouldn't you at least tell her, listen, stay clear of any companies that are directly affected by my legislative work? rep. price: because the agreement we have is that she

provided a diversified portfolio, which is what exactly all of you have in your investment opportunities, and make certain that in order to protect one's assets, that there is a diversified arrangement for purchase of stocks. sen. murphy: you couldn't have a diversified portfolio while staying clear of the six companies directly affected by your work issue? rep. price: i didn't have any knowledge of those purchases. sen. alexander: thank you, senator murphy. senator murkowski. senator murkowski: thank you. there is added benefit to be the last in the change ask questions, because it gives me a clear idea of where you're coming from. we haven't had as much conversation about the moral aspects of health care, which are very important to me. we had a chance last night to hear from the nominee for education. i pointed out for her as i have

pointed out to you, that is unique. sometimes it is really unique. face allow us we to be somewhat innovative, but we need flexibility in order to innovate some of the innovations. i have had a chance to sit with a group of alaskans on saturday in anchorage. the director of division to the insurance, to the commissioner of health and social services. representatives of the only provider on the individual , representatives from --ll rule hospitals, doctors rural hospitals, doctors, the tribal health organization. it was a good mix of individuals. obviously, we got different views and opinions about where ofgo with this replacement the aca, and what that would

need to look like to help address the needs and issues in a very rural area, very frontier, very high cost, the very highest cost insurance and health care cost. we are down to one provider on the individual markets. we've got all the demographics that would tell you that this is a difficult place to be operating right now. we, as a state, moved forward with medicaid expansion a couple years ago and there are some 27,000 alaskans that have coverage now that did not see that before. there was also a good discussion about making sure that we are able to retain the protections for alaska natives that we saw under the indian health care reorganization act that came as part of the aca. recognizing there are certain exemptions that were included as

part of the aca, exemptions for medicaid cost-sharing provisions, 100% federal match for indians and -- american indians and alaska natives, went through the ihs facility, including the tribal facility. we have seen extraordinary collaboration that has gone on between our entities with our tribes, our tribal health organization, that has allowed for increased efficiency, improved health access. a great deal of discussion we have focused on, what will happen to those who have gained access through medicaid expansion, and what can we do to ensure that coverage options are provided for those in this new era of health care reform? a further question to that is

should a block grant approach be considered? what efforts would be made to ensure that this very unique responsibility for american indians and alaska natives are continued to be fulfilled? these were concerned -- concerns that were raised in the meeting in hopes i could ask you. rep. price: thank you for the opportunity. conversationerful about alaska and i learned much about your state. the medicaid system is imperative and vital for members of the population who receive care through the medicaid program. it is a federal state partnership as you know. it is one that we absolutely that individuals do not fall through the cracks in whatever transition occurs. whatever -- whether it is providing the same level of medicaid, or providing for something else that allows coverage that suits their needs,

we are committed and adamant that that coverage be able to be continued. they have our assurance that we will work with you to make sure that happens. the murkowski: what about concerns that were expressed by the tribal health organization, that perhaps if there is a block grant approach utilized, that it could impact some of the assurances and benefits that the tribal health organizations have seen? in its earlyhis is stage, obviously. it is a legislative decision that occurs. it is not a department decision. we would look forward to working with you to ensure that individuals, especially in the indian health services which have had challenges, we need to make sure and -- certain the metrics are clinical and correlated metrics that make a difference to the people receiving the care.

those promises that we have to make certain the indian health service works, and i think we can do a lot better at that. rep. murkowski: i look forward to more conversation on that. let me ask, some of the efforts made are relatively innovative as we have attempted to stabilize the market. the move forward with reforms to create a reinsurance programs for high-cost high-risk individuals. we submitted 32 state innovation waivers. again, all with the hope we will be able to somehow provide for some level of stabilization. what sort of considerations to federal support for high-risk pools or state-based reinsurance programs would you consider? rep. price: i think the whole array of opportunities available to make sure nobody falls through the cracks. the 32 waiver program is one

that is just beginning, but i think it holds significant promise in making certain we are able to ensure that things like reinsurance and high risk pulls pools make it so that individuals do not lose their opportunity to gain access to the highest quality care. sen. murkoski: finally, on our small rural hospitals, one of the concerns i heard repeatedly was the level of regulatory burden that particularly our smaller, rural hospitals are feeling stifled by. some of the innovative things that one of our hospitals that the peninsula is looking at advancing the kind of field -- they feel it is too risky to move forward with any level of the innovation they hoped to take on because they are facing regulatory burden and the uncertainty they are in right now.

you can do things administratively early on should you be confirmed to this position. have you looked to what regulatory issues could be addressed early on that could help reduce some of the regulatory burden particularly to some of the small, rural hospitals? rep. price: not specifically, senator. but i share the concern you have about the burden of regulatory guidelines and schemes that come out of washington, d.c., regulatory schemes that come out of washington. especially for the rural areas. it's not just the hospitals or doctors providing care. most of the folks in the rural area that tend not to have any be able toll to cover the cost of this regulation. i have heard from more than a few physicians and other providers, who because of the regulatory schemes that have come forward, say they cannot do it anymore. they have to close their doors. indian health services one of , them where they are having real challenges in terms of

providing services. when that happens, those individuals have no care. that's unacceptable to me. rep. murkowski: thank you. i look forward to working with you. sen. alexander: thank you, senator murkowski. warren,emaining senator senator hassan, senator kaine on the democratic side. senator warren. senator warren: thank you. congressman price more than 100 , million americans now received their health care through medicare and medicaid programs. these are seniors, people with disabilities, and middle-class families and countless numbers of young children that all benefit from these programs. i want to understand the changes to medicare and medicaid that you have already proposed. the budget that you recently authored as chair of the health budget committee would have cut spending on medicare by $449 billion over the next decade. is that right? rep. price: i do not have the

numbers in front of me. sen. warren: i have the numbers. rep. price: then i assume you are correct. sen. warren: you said he would billion. $449 your budget proposal also would have cut medicaid funding that goes to the state by more than $1 trillion. is that correct? i think the metrics that we used for the success of these programs is not necessarily -- senator warren: yes or no. were you going to cut $1 trillion for medicaid? do you want to read the numbers? rep. price: i'm sure you are correct, but what we believe is appropriate is to make certain the individuals receiving the care are actually receiving the care. sen. warren: i understand why you think you are right to cut it, i am just asking the question. did you propose to cut more than $1 trillion? rep. price: you have the numbers before you. sen. warren: is that a yes> ? rep. price: you have the numbers before you.

warren: i will take that as a yes. i'm sure you know president-elect trump was clear , on his views. president-elect trump said i am not going to cut medicare or medicaid. when president-elect trump said i am not going to cut medicare or medicaid, do you believe he was telling the truth? rep. price: i believe so. sen. warren: given your record of proposing massive cuts to the programs along with several other members of this committee, i sent the president elect a letter in december asking him to clarify his position and he has not responded yet. i was hoping you could clear this up. can you guarantee to this committee that you will safeguard president-elect trump's promise and while you are hhs secretary you will not use your administrative authority to carry out a single dollar of cuts to medicare or medicaid eligibility or benefits?

rep. price: what the question presumes is that money is the metric. in my belief, from a time -- from a scientific standpoint, if patients are not receiving care, even though we are providing resources, then it does not work. sen. warren: we are very limited in time. the metric is money. the quote from the president elect of the united states was not a long discourse on this. he said he would not cut dollars. that is the question i am asking you. can you assure this committee you will not cut one dollar from medicare or medicaid should you be confirmed to this position? rep. price: i believe the metric ought to be the care to the patients. sen. warren: can i take that as a no? rep. price: that's the wrong metric. we should be putting forth resources. senator warren: i'm not asking about the metric. i am asking you a question about dollars. yes or no? rep. price: we ought to put forward the resources to take

care of the patients. sen. warren: i am asking simple questions. frankly, the millions of americans who rely on medicare and medicaid today are not reassured by your notion that you have some metric other than the dollar that they need to provide services. you might want to print out president-elect trump's statement. i am not going to cut medicare or medicaid. post that above your desk in your new office. americans will be watching to see if you follow through on that promise. i would also like to follow up on senator franken's question. there was something there that did not get answered. as you know, the one goal of the affordable care act was to push the health care industry to provide higher quality care at lower cost. under the aca, medicare was recently allowed to change the way it pays hospitals for hip and knee replacements to

something called a bundle and that means medicare pays a set price for the care associated with hip and knee replacement and the hospitals, not congress, will decide the most effective implants, reduce second surgeries, better fight infections, how to spend their money to deliver better service at a higher cost. i have supported this change, because the research shows it really means to get better care at lower prices. i know the policy is controversial because it affects how hospitals are paid and how much money the manufacturers of hip and knee replacements can make. one of the companies is the company raised by senator franken and that is zimmer bio, the leading manufacturers of hip and needs, and -- and knees and they make more money if they can charge higher prices. the company knows this and so

does the stock analyst. on march 2016 you purchased stock in zimmer bio net exactly six days after you bought the stock on march 23, 2016, you introduced a bill in the house ip act the hit act -- h that would require the hhs secretary to suspend regulations that are for the hip any revelations. is that correct? what you referred to, i think i'm a strong supporter of -- warren: i'm just asking, did you buy the stock and then introduce a bill that would be helpful to the companies you bought the stock in? rep. price: the stock was bought by a broker that was making those decisions. i was not making those decisions. sen. warren: you said you weren't making the decisions. let me make sure i understand. these are your stock trades? they are listed under your name. rep. price: they are made on my behalf, yes. warren: was it through

an index fund or passively managed mutual fund? through actively managed mutual fund? rep. price: it's a broker directed. senator warren through a blind : trust? let's be clear, this is not just a stockbroker, someone you pay to handle paperwork. this is someone who buys stock at your direction, someone who buys and sells the stock you want them to buy and sell. rep. price: not true. that's not true, senator. sen. warren: so when you found out -- because you decide not to tell them and we are all supposed to believe that? rep. price: it is the manner in which members of this committee -- senator warren: i'm not one of them. rep. price: i appreciate that, but that is the case. sen. warren: i want to understand, when you found out your broker made this trade without your knowledge, did you reprimand her? did you fire her? did you sell the stock? rep. price: what i did was

comply with the rules of the house in an ethical and legal manner, and in a transparent way. sen. alexander: time has expired, senator warren. senator warren: i believe senator murkowski went over by two minutes. did i misread the clock? i think that's what it was. i just bring another 15 seconds. sen. alexander: keep burning it, you will be up to two minutes. senator warren: your periodic transaction report notes that you were notified of the trade on april 4 2016. did you take additional actions after that to advance your plans for the company that you now own stock? rep. price: i am offended by the insinuation. sen. warren: let me read what you did. you may be offended, but here's what you did. congressional records show after you were personally notified of the trade, which you said you did not know about in advance, that you added 23 out of your

bill's 24 cosponsors that also after you were notified, you sent a letter to cms calling them then to cease all current and future plan mandatory initiatives under the center for medicare and medicaid innovation. just so there is no misunderstanding about how -- who you are trying to help, you mentioned specifically knee replacements. sen. alexander: the time is up. who is next? senator isakson has three minutes. > i want to reclaim my three minutes by making out point. i respect everyone on this committee, but it's very important for us to understand candidate -- disclosure rules we have, the way it operates, nes -- any of us could make a mistake. i am sure senator franken had no idea he owned -- when he made the comment about tobacco companies. it is entirely possible for any of us to have somebody make an

investment on our behalf and us not know where the money is invested because of the very way it works. i do not say that in any way to embarrass mr. franken. of to make a point that any us who have mutual funds or investment managers, it is entirely possible for us not to know. and to imply that someone has been obfuscating something, or denying something, is not fair to do. >> this is different than mutual funds. >> it is an investment in philip morris. senator warren: and my question -- sen. alexander: senator, your time has been generously -- senator kaine. i'm sorry, senator hassan. toator hassan: i'm happy lead, but i think senator kassie was next and he just came back in. sen. alexander: he did, but i was going back and forth.

senator hassan: thank you. ranking member murray, thank you for the opportunity to participate. congressman, as you and i discussed, we share a sick -- a concern for patients. my husband and i have two kids that are adults, and at times, i have had up to 10 doctors and a dozen medications. our family knows the strengths and weaknesses of the health care system very well. as governor, i was pleased to work with members of both parties to build on the example that senator young talked about in indiana to have a bipartisan specific plan that is providing coverage to 50,000 hard-working granite staters. i have seen the advantages of the affordable care act and the flexibility the affordable care close.es states up

i have worked with the republican legislator -- legislature to pass it. it is the context i bring to this series of questions. first of all, as we talked about, opioid overdose deaths have been on the rise for several years, and have hit new hampshire particularly hard. we have about the second highest rate of drug overdose deaths in the country. under the medicaid expansion program that i talked about, made possible only by the affordable care act, thousands of new hampshire citizens are getting the opportunity to get treatment for substance abuse disorders. i talked to a woman named ashley who had an addiction for almost a decade. medicaid expansion gets passed under the affordable care act and she got treatment and she is now in recovery. after a year on medicaid, which by the way, we have done it in a

particular way so it has strengthened the insurance market in new hampshire because more insurers came in as a result of the way we did it. anyway, she's now working, and just switched over to private insurance because she has employer provided insurance. you have proposed repealing medicaid expansion in the budget at you proposed. yes or no, can you guarantee that you will make sure that americans with substance abuse disorders who have gotten insurance through medicaid expansion like ashley did will not lose their health insurance? rep. price: i joined the conversation as well, in those subjects, i think it's imperative we as a nation make certain that every single individual has access to the kind of mental health and substance abuse challenges they have. sen. hassan: is that a guarantee that you will find funds to actually provide the treatment? rep. price: it is a guarantee that i am committed to making certain we address that need.

sen. hassan: i am just concerned that you are not going to be able to backup the guarantee if the affordable care act is repealed. i am concerned about the impact on states and people like ashley who need the coverage. i also just want to talk about whether you agree that people with health insurance should have basic essential coverage is like checkups at the doctor's office. the you think health insurance should provide for that? rep. price: patients should be able to select the coverage they want. instead of somebody else decides for them. it is important we remember the center of all these discussions is a patient. the patient knows that's what he or she needs. that's the imperative i'm committed to making, that patients have choices available and if they choose that -- sen. hassan: but if insurance

companies don't offer it at all, and essential benefit under the affordable care act requires private insurance to cover substance abuse treatment. they didn't used to do that and they stopped covering a lot of things until the law requires them to. yes or no, the empowering patients first act would repeal the requirements that insurance companies cover substance abuse disorders? do you think that's still a good thing? rep. price: i think what's a good thing is to keep the patient at the center of all of this, and make certain we are providing the options and choices for patients so they can address their clinical and medical needs. the thing.: here's if insurance companies never offer it, they don't have the option. they can pay good premium dollars, but it's not offered. afford all caps says, here are some basic things offered. so that when a patient needs care, so when they need it, they

can get care. your answer would take that assurance away. it's not an option if insurance doesn't cover it. rep. price: the good news for you is that as an administrator , if i'm privileged to serve in that capacity, i follow the policies adopted by the congress of the united states and find by -- signed by the president. so we look forward to working with you to make certain those of things are covered and the patients receive the care they need. sen. hassan: and with respect, there has been lots of opportunity to make certain those things happen. until the affordable care act was passed, it never happened. people didn't get the care need the care they needed. because of that, a lot of people like ashley's of the world were not getting better and not getting treatment. providers do not exist to treat people if they cannot figure out how they will get reimbursed. the most important thing our community said in new hampshire was medicaid expansion

india the affordable care act made it possible for them to stand at a higher volume of treatment. i look forward to working with you, but i'm concerned about your unwillingness to commit to making sure that insurance companies cover these essential benefits. i am almost out of time and we have not even touched on the issue of women's health, which is obviously of great concern. that we just ask a couple of questions. yes or no, do you think an employer should be able to fire a woman because she uses birth control? rep. price: i don't believe so. sen. hassan: well, you voted in support of the resolution to disapprove the district of columbia's nondiscrimination law. the reproductive health nondiscrimination act, which protects women here in d.c. from being fired or penalized because of their reproductive health decisions. your vote would've had the effect of allowing employers to

fire a woman for using birth control or other decisions she makes about her own body and reproductive health. how is that vote consistent with the answer you just gave me? rep. price: i think the question was about who is paying for the product. sen. hassan: no, the question is whether an employer -- let's say a self-insured employer plan finds out that a female employee who earned the benefit with her hard work is using that benefit to provide birth control, to buy birth control, which the benefit provides, and then fires her because the employer disapproves of the use of birth control. rep. price: i don't think that is the case. sen. hassan: would you like us to provide examples? rep. price: yes, i would be happy to. sen. hassan: you would be willing to say that employers may not -- you would support a law or rule that employers may

not discriminate against women for their reproductive health decisions? rep. price: i do not think employers have the opportunity right now to be able to let somebody go based upon their health status -- sen. hassan: why did you vote against the d.c. provision? rep. price: i don't think that is what it did. sen. hassan: you don't think that was your vote? rep. price: i do not think that is what the bill did. sen. hassan: we will follow up on that. again, i wish i had more time, because i have about eight more questions that i will submit to the record. sen. alexander: thank you senator hassan. thank you.y: for the record that when john king came for an interview, i wanted to go for a second round and you wouldn't let me. i wanted to say that for two days. i have another set of questions and you said. "shut up" sen. alexander: it is nothing

personal. senator cassidy: nothing personal. -- i lovehit the laws what you are saying about the patient-physician relationship. you and i both worked in hospitals for the uninsured. i was a gastroenterologist and a liver doctor. we've been talking a lot about obamacare. we can talk about obamacare in the wonderful things it has done. i think about my patients with a $6,000 deductible. the patient you saw at grady, they do not have $400 in their accounts. sixth -- $6,000 deductible for they can be cared for. and just for the record, people don't believe me, i put it on my facebook page. a friend of mine from home, his renewal for his individual

policy for him and his wife, 60 and 61 years old,, was $39,000 a year, with a deductible. $6,000 i put it on my facebook page because nobody believes , this is like what a family pays for a mortgage, and that was their premium. i applaud you for looking for some alternative that is affordable. it may be working for new hampshire, california, massachusetts, but for state like mine and yours, people cannot afford $39,000 premiums. empowering-- did the patient lot repeal other laws? rep. price: i don't think so. cassidy: it does cover substance abuse. that law still remains in effect. secondly, we have been talking about the benefits. believer in health

savings accounts. i gather that can be used to pay for doctor's visits. even colonoscopies as necessary. rep. price: absolutely. sen. cassidy: just to also point that out. when you speak about giving the patient power over her health care to allow the herd to choose, when we choose for her, we have a $39,000 premium. but when she chooses, she's a more activated and infirmed -- informed consumer. other't agree with each and highly, but substantially, and i applaud you for that. now, al franken always calls me a luddite. different issues. i'm skeptical about many things. about electronic health records and the negative impact on productivity. skeptical about

electronic health records and the negative impact on productivity. i see that anderson laid off 5% of their staff. they blame it upon financial losses related to decreased productivity, attributable to the implementation of the rule. your department will be involved with meaningful use. an orthopedic surgeon asking someone about their smoking history is not a good use of that surgeons time. not that it isn't important, but he's not a person who will implement a program that shall be their internist. what thoughts to you have, what can we do about this time and issue, keeping that which is positive, but hopefully doing something better for the patient? rep. price: thank you. electronic medical record and health records are so important, because that can allow the patient the opportunity to have their health history with them

at all times, and be able to allow whatever physician or other provider access to that. we at the federal government have a role, but the rule should be operability to make sure different systems can touch with -- talk with each other. i have had more than one position -- physician tell me the final regulations related to meaningful use with a final straw for them, and they quit. they have no more gray hair than uri have. rep. price: when that happens, we lose incredible intellectual capital in our society that can care for people. sen. cassidy: what practical things can we do? rep. price: i think what is imperative is to find out things what things ought to be determined and checked, the metrics that are used, that they actually correlate with the quality of care provided as , opposed to some anything

-- of the things required right now, so they are wasting their time documenting things, and it doesn't result in a higher quality of care or outcome for that patient. we truly worked with those providing the care to figure out what we could ask to measure that would correlate with the outcome and the quality of care being provided, i suspect there are specific things we could use. sen. cassidy: it's interesting. you are emphasizing the patient physician relationship. a patient with breast cancer would be the one telling them, there's hope. this is not a death sentence. "there is hope." upan only imagine typing "there is hope." it is a different feel for the patient and the spouse. rep. price: we have turned many physicians into data entry clerks and it detracts from productivity and from their ability to provide quality care.

sen. cassidy: let me ask, one of our big challenges, how do we, with expensive medicines only used by a very few? how do we socialize that cost? we have some germ out there resistant to everything, and we have gene therapy only available for a few. how do we pay for that? i do not know if you have an answer. i just want your thoughts. i care deeply about those and so do you. sen. cassidy: i spoke earlier with another center -- senator about rare diseases, and the drug act that revolutionized the ability or incentives for bringing to market drugs that address rare diseases and it is incredibly important. incentivizaztion is important. to make certain that companies can come up with things that cure diseases, and that they are

appropriately compensated. sen. cassidy: in the era of , the cureed medicine could be one million people. anything specific about that? rep. price: we are entering a brave new world that is so exciting from a scientific standpoint, to be able to provide this kind of personalized healthcare services , to folks that will be able to cure things we would never dreamed about curing. and the challenges of how we can make that available to the society are real and i need -- we need to get the best minds together. i look forward to working with you on that. sen. cassidy: i will close by saying this. i have a perspective my colleagues do not. orthopedic surgeons are the ones called at 3:00 in the morning because someone got in an accident. there's no one else to fix them. they kiss their wife goodbye, they climb out of bed, drive to the hospital, they are up all

night, see the clinic scheduled the next day, they get home at midnight and kiss their wife goodbye before they go to bed. of persone exact kind to have this job. thank you, and i yield back. rep. price: thank you, senator. sen. alexander: thank you. senator kaine. senator kaine: thank you senator price, -- congressman price for the meeting the other day. my worry as a virginian is your position about a range of programs about access and coverage. sort of a safety net that provides coverage to millions. you have proposed turning medicaid into a black grant program. that is exciting a lot of controversy in our legislature with democrats and republicans. you have repeatedly voted against the chip program for kids, at one point calling it socialized medicine.

that is about 800,000 virginians. you propose the restructuring of medicare that would increase out-of-pocket cost for seniors, about 1.3 million virginians. you support the repeal of the affordable care act. there's about half a million virginians on the exchanges. hundreds of thousands otherwise benefit from it. you want to defund planned parenthood. tens of thousands use planned parenthood for their primary provider. these are the basic programs that provide health care coverage. for millions of virginians and tens of millions of americans , many of them have limited means. there is a sort of consistency to your position in some ways across these programs that i view as critical. i know that senators franken and murray use the hippocratic maxim, first do no harm, before i came. i think, and i think you would agree, as we discussed the

health care system access coverage, cost, quality, that , government and congress should strive to do no harm. do you agree ?we should not harm ? rep. price: absolutely. senator kaine: and we should not harm people by reducing the number of people who have coverage or reducing the quality of the insurance coverage we do have. we -- that is what we should strive for? rep. price: i think it is important to appreciate there are challenges currently. if we are honest and sincere about addressing these problems we ought to step back and say "what are we doing wrong?" one out of every eight physicians eligible, no longer sees medicare patients. if you are a new medicare patient trying to find a physician, it's almost impossible anywhere. sen. kaine: i am all with you on fixing challenges and going forward, more coverage, more affordable. rep. price: that is what my proposals have tried to do. sen. kaine: that is important. we shouldn't harm people by doing things that should increase their cost, correct?

rep. price: i think we need to drive down the cost for everybody. sen. kaine: we shouldn't harm people by creating anxiety about the most important thing in their lives, their health care? we shouldn't be doing that in congress, should we? rep. price: one of my goals and the entire debate is to lower the temperature about what we are talking about. this is real stuff for folks. these are their lives. sen. kaine: can we lower the temperature in russia at the same time? rep. price: i think we can move apace and lower the temperature. and provide stability to people. rugle need to know that no will be pulled out from under them. sen. kaine: i will join you in civility and lowering the temperature, but my experience in virginia is huge amounts of fear. we should not harm the american economy. the health sector is 1/6 of the american economy.

we should try to fix the problems you identified and do -- them in a way that provides stability. rep. price: certainty is incredibly important and i am reminded of the fact that the congressional budget office told us the aca has decreased the workforce by 2 million fte's. there are challenges we have throughout. i hope we are able to work together to solve those challenges. sen. kaine: do you agree with the president-elect that the replacement for the affordable care act must ensure there is insurance for everybody? rep. price: i have stated here and always that it is important that every single american have coverage that they desire. sen. kaine: and he stated in the same interview a couple days ago that we should negotiate with pharmaceutical companies under medicaid part d to bring down drug cost. do you support that position? rep. price: i think the cost of drugs is a real challenge for

folks and me need to do all we can to make sure we bring the cost down. sen. kaine: here is an offbeat question. it's just a coincidence based on today. i was at a hearing with governor nikki haley who was nominated to be u.n. ambassador. right before i came in. she played a significant role in moving her stayed away from use of the confederate battle flag in any official capacity. when you remember the georgia legislature you fought hard to , keep the confederate battle flag as part of the georgia state flag, and you sponsored resolutions to make april confederate history heritage month in georgia, and "urging schools to commemorate the time of southern independence." i would like to introduce that resolution. i read the resolution with interest because of the phrase " commemorating the time of southern independence." i know that the resolution commemorating that time mentions nothing about slavery.

why did you support that resolution, and do you still support it today? rep. price: i haven't thought about that in a long time, but i'm happy to look at that, and go back and refresh my memory. sen. kaine: the resolution aside, what is laudatory about the time of southern independence? rep. price: i think every heritage has things that are good about it. every heritage has things that are harmful about it. i think slavery was an abomination. sen. kaine: do you think history resolutions about confederate history month, that completely omits reference to slavery, meets the basic standards of fair and balanced? rep. price: i don't know that it presumed to be comprehensive. rep. price: i don't know that it presumed to be comprehensive. but i do know that i was the first senate leader in the history of georgia to make sure we came forward with a flag that did not have the confederate

battle flag on it that addressed all of the concerns of the state , and was adopted and supported by the state. we did so in a bipartisan way, and i was privileged to work -- and the georgia senate, to make sure we were able to do so. sen. kaine: you are aware there is an offer its -- office of minority health created in the affordable care act, and that if the aca is repealed, unless it is separately reauthorize, that would also expire? rep. price: that is a legislative question. if i'm privileged to serve and be confirmed, and be the secretary, i look forward to making certain we use the resources available to us and the agencies available to us within the department to make certain every single american has the highest quality health care available. sen. kaine: why did you use this phrase socialized medicine to explain your vote against the chip program? rep. price: i don't know that i recall the conversation, but i'm happy to go back and look at it. sen. kaine: thank you, mr. chair. sen. alexander: thank you mr.

kane. senator scott. senator scott: thank you, mr. chairman. i hope much success for you. did i hear that you were at emory university? rep. price: yes. his scott: my nephew is in first year of medical school at emory. i hope he gets a quality education. rep. price: he will, and he's got an exciting road ahead. sen. scott: i did have the privilege of serving with you in the house and i enjoyed our relationship and friendship, and looked for it to seeing your success as secretary of hhs. i have a couple of state questions, to south carolina. we had over 20 health centers in south carolina with about 165 service sites serving over 350,000 patients, in almost

every county in the state. every county in south carolina is either partially or completely designated as medically underserved by herself. rural hospitals continue to close, these dissenters address the need for many communities in the state. they work together with partners in the community to address impacts on health like food deserts and lack of transportation to preventative health services, which can save cost in the long run. a diabetic who does not take their medication because they cannot afford it, or has in way -- has no way of picking up the medication, will inevitably be a visit to the er. what role can you play and underserved areas? rep. price: community health service -- centers are a vital part of the health care we have now.

there are over 13,000 that are the entry point and often times the area of health care for so many individuals, and we need to do all we can to strengthen them, to make certain the that are within community health centers are of the highest quality, that they provide the highest quality care, and that they are able to to allow themes to provide that care. sen. scott: less than a decade ago in south carolina, emergency rooms were full of people >> less than a decade ago, emergency rooms were full of people waiting for psychiatric exam so they could be admitted.

have been cut from four days down to about 10 hours. the cost have been cut by almost two thirds. what do you see as the future of telemedicine, particularly to address access issues? what barriers can we anticipate as well? rep. price: telemedicine is one of those exciting innovations that i believe will allow for individuals, access to resources from a clinical standpoint to make decisions on patients that are before them without having to save resources and save patients in so many ways. we in the state of georgia have a program that is a spoken wheel program. there is a neurologist that works with telemedicine and has a network of clinics and hospitals around the state. if somebody comes in with symptoms of a stroke, that

physician is able to see that patient in real-time and determine whether or not they are having a stroke, if they can be treated in the community, or whether they have to be transferred to the academic center. in the past it was a call on the ground, no ability to talk with someone who has greater resources or knowledge. it was a huge waste of money and not having patients at the center of that decision. telemedicine is absolutely vital. i think we need to accentuate the ability to use telemedicine. telemedicine is not paid for, it is not compensated. the clinicians eat those costs. they help the patients, but make it so it's more difficult for them to provide the quality care necessary. sen. scott: thank you. another interesting topic i think you should be familiar with. georgia has a high percentage of

african-americans. breast cancer deaths are approximately one and a half times higher in african-american women. prostate cancer debts are to have times higher in african-american men, and new diagnoses are approximately twice as high. i would love to hear your perspective on addressing the health disparities in communities of color, specifically. rep. price: i think so often, what we do in this and other areas is to say we will set up this facility here, or this agency here. we have taking care of the problem. what i do not think we do is take a look at what is happening on the ground. the metrics as well as we could, or should. we ought to be defining whether or not we are defining the lives and helps for individuals in challenged communities. if we are not, we need to step back honestly and say, what can we do to make certain it works?

had the of months ago i privilege of being at a clinic in atlanta. i learned there was a zip code in the metropolitan area of atlanta that has incredible disparities in terms of health outcomes. higher mortalities, higher rates of diabetes, stroke, myocardial infarction. when we see those kinds of things, we need to drill down in those areas. why is that happening? an address the real problem on the ground as opposed to saying we have taken care of it because we have an agency that is addressed to take care of it. i think we need to do better metrics -- metrics and better accountability. sure you talked at some length about some diseases. sickle cell is being one of the more important ones in the african-american population. i would love to submit some questions for the record to get

your insight and perspective on how we tackle somewhat -- so many of those diseases moving forward. look forward to that senator. >> senator murray. murray: i did want to clarify your response to one of my previous questions. you admitted to me in our meeting that you, in your own words talked with congressman collins about innate in numeral -- in eight immuno. this inspired you to purchase its stock. you did so without a broker. yes or no? rep. price: no. sen. murray: without a broker? rep. price: i did not. told me you did this one on your own without the broker. it through a did broker. i directed the broker to purchase it through the stock. sen. murray: you directed the

broker to purchase that stock? rep. price: that is correct. answersray: those commit me to underscore an investigation. awould like to ask to enter note that congressman price was offered a lower price than other investors. that is an important part of the record. representative price, if you are confirmed as secretary of health and human services, you would be in charge of our nations family-planning programs and policies. you have said that you do not is an issue for women in buying birth control. bring me one woman that is left behind, bring me one, there is not one." you did say that, correct? rep. price: what i meant was, when i have patients in my office who are unable to afford

medication, we did everything we could to make sure they got that medication. to capture in that conversation was, if there are individuals who are unable to afford that medication or any medication, that there are avenues within the health care system that physicians and to make certain that individuals receive the medication they need. sen. murray: let me tell you about my constituent. she has india me trios is -- said me trios this -- she no cold paper's control is an essential tool helping women etriosis who endom would have to live with pain. she is just one. women are deeply concerned about the impact this election could have on their access to health care that they need.

i have heard from many of them. according to planned parenthood demand for iud's, which is a form of long-lasting contraception, it is up 900% since the election. all you commit to ensuring 18 fda approved message -- methods continue to become its about women do not have to go back to paying extra cost for birth control? rep. price: what i will commit to and are sure is that all women and americans, we believe strongly that every american ought to have access to the coverage and care they desire and want. that is our commitment. that runs across the board. sen. murray: birth control is an essential part of women's health care. if you are confirmed, i will be holding you accountable for that. also wanted to ask you, i am deeply concerned about the impact of your policies that

would have on women. in particular, women who also -- often face barriers getting health care. since the aca became law, the percentage of black women who report not having a regular doctor dropped by nearly 30%. that measure for latinos fell by 25%. bill andth care repeal your budget proposal to cut $1 trillion from medicaid would disproportionately hurt women of color, further compounding disparities and access to health care and undoing progress that was made in the affordable health care act. are you committed to ensuring that women of color remain access to affordable health care? rep. price: i do not agree. i support and the president supports that every individual has access to the coverage they want. nobody wants individuals to not have the opportunity to see the doctors that they want, to get the kind of care that they want

at a price that is affordable at the highest quality. i hope that we will be able to work together to achieve that goal. sen. murray: the office of minority health was authorized as part of the aca. would you commit to maintaining and supporting this office and its work? rep. price: i will commit that minorities are treated in a way that makes absolutely certain they have access. sen. murray: so you will not commit to it being maintained? our commitment, my commitment to you is to make sure minority patients at all patients in this country have access -- sen. murray: so you will not commit to the office of minority? rep. price: there are different ways to handle things. i cannot commit to a department i am not in. sen. murray: but you will be. rep. price: let me put forward a possible position that i might

find myself in. the individuals within the department come to me and say, we have a great idea for being able to find greater efficiencies within the department itself. it results in merging this agency and that agency and we will call it something else. we will address the issues of minority health. we will make certain that it is-- sen. murray: are you aware that black, latino, american india, alaska natives are twice as likely as white people to be covered under medicaid. do you think it is responsible to propose cutting trillions of dollars in funding without a credible alternative to replace it for them? with thee: i disagree premise. the solution we have is to ensure every american, regardless of their health and economic status, have the ability to purchase the kind of coverage that they want. sen. murray: i have a few seconds left.

we have members here who also have additional questions. i am deeply troubled by a number of responses. we have a lot of families who are very, very, very concerned since the election of what will happen to them personally. we have outlined some of those. , hope that congressman price as we will have a significant number of questions from my colleagues, you willfully submit them for the record. rep. price: thank you. dr. price, i want to thank you for being here. i only have a few comments, i do not have additional questions. i was reflecting back on sylvia's parents -- appearance and how impressed i was. i think you have done as well. i was impressed with her performance in the job. with a numberee of the policies she has taken, she has gone out of her way to adopt the same tone that i have heard from you today, which is

to try to accept and work with people of different points of view and see if we can come to a consensus. i think you for that and i am impressed with your beginning. i appreciate you being here today. based upon the figures i have, you have just injured the most extensive questioning of any secretary of health and human services since 1993. because of the round of questionings, secretary was in the hearing for two hours 10 minutes. than two hours. you have been here nearly four hours. next tuesday you will go before the finance committee, which will vote on whether you go forward to the president. i am very hopeful that your tone all help us come to

conclusion and a consensus in this very important area of providing concrete practical alternatives to give americans access to health care they can afford. i was reflecting on last night's hearings and today. they have been pretty testy. we often have strong opinions because of differences of opinions. i think that is a reflection of, one, the election, which became very civil. .ore so than i liked republicans can take our share of the blame for that. issue, which for six years we have been going at it like the mccoy's at west virginia until we forgot who killed who in the first place. know -- we are not clear what we are fighting about. mannerd take a bedside such as you have to lower the temperature as senator kaine suggested. he was among 12 democrats who

wrote a letter suggesting they were willing to work with republicans as we go forward. i think it will take a little temperature,r that just because we spent six years as hatfields and mccoy's, i am committed to trying. that is the way we usually work in the committee. get away fromo the testing as of last night and today, and back towards the way we have learned to work. a couple of other things, i hope those watching are reassured by what they heard from you. what i heard from you, i believe i am correct, while we intend to repair the damage of obamacare. that means major parts of it, that won't become effective until there are practical concrete alternatives in place to give americans access to health care. in other words, you said we don't want to pull the rug out from anybody. i am sure that is a shared view. thehave talked about

importance of march the first. one thing we have to work together on is what we do about the individual market. and the fact that counties have on insurer with people obamacare. we do not want to get into a situation this year or in 2018 where there is, as i said, like having a bus to get in a town with no buckets. -- buses. we may have to do things on both sides of the aisle that we would not normally do ring this thesetion period, so people continue to buy insurance for more than one person. i think it has also become clear that the timing we have talked about has yet to be resolved. sequencing is as important as the policy. how do we get from where we are to where we eventually hope to go? we go to work immediately on what i call a collapsing bridge, repair it, that is the market make sure the

people on we have new bridges up. i think we have come close to the decisions about the replacement or replacements. -- it could take several years to implement those decisions because in many years it will be transferring responsibilities to states and consumers will want to do that after talking with governors and insurance commissioners. .tates can accept legislators making decisions promptly, making them together, then implementing it step and carefully so that people are able to have lower costing hope i heardwhat i today. senator cassidy, senator whitehouse, several other members of the committee, maybe

all of us worked very hard. i know senator murray did as well on trying to deal with the electronic health care records. was an earlyhich adopter of the electronic health care records, they said stage one was very health -- helpful, stage two they could deal with and stage three was terrifying. i hope that we could delay stage three. i thought maybe it could be as simple as saying to the physicians and providers, if you are a doc and you are spending 50% of your time filling out forms, either you are doing something wrong or we are. to see if wegether can get that down to a manageable level, and create an environment where physicians and providers can spend their times talking instead of fighting. you have a bipartisan consensus here to work on that. at least we had last year when we passed the cheers bill we had

a number of revisions per at we had six hearings on the subject. i invite you to work with us, if you are confirmed, to complete that. senators wish to ask additional questions of our nominee. questions are due by the close of business on friday, january 20. all of the matters and the hearing record will remain open for 10 days. members may submit additional information for the record. the next meeting will be an executive session on january 24 at 10:00 a.m. thank you for being here today, the committee will stand adjourned. rep. price: thank you chairman.

>> those are 11 million people. insurance companies are saying by march the first, they need to have some indication of what we will do to stabilize the market. i think that is a rescue plan for the obamacare exchanges, which are collapsing. it is the first order of business. whati think we wait to see

the president elect suggests. work with the house of representatives and begin to see what new alternatives we can come up with. the governors will be here march 19 to the 22nd. to talk aboutime more medicaid flexibility. the employer market is a separate matter. a lot of that does not need to .e changed very much small group market probably does. there are steps we can probably take right away on that. medicare aside and focus on those three areas. there are a lot of steps we can take to begin a process that can go for several years. would be separate pieces of legislation. some might be in the first reconciliation bill. there is another regex -- reconciliation -- reconciliation bill that is accepted before summer. it would be good if we could

have a rescue plan for the individual market, making it 60 votes in the senate. step backe a good from the hatfields first is mccoy's. -- versus mccoy's. >> have you talk to any health analyst? anybody who has the data? market inte insurance tennessee is in for trouble collapse. in our state, premiums are up 40 to 60% this year. we have crossed the three biggest metropolitan markets. in two thirds of our counties, those who have obamacare subsidies only have one insurance company from which to buy. across the country, that is true in many other states. there is almost no one will tell you that the obamacare exchanges are not virtually collapsing in many parts of the country,

unless we act by around march the first people will not be able to buy insurance with the subsidies. we do not want that to happen. i want to ask you about the devos hearing from yesterday? >> we spoke about that yesterday. >> new york governor andrew cuomo met with president-elect donald trump at the trump tower. after the meeting governor cuomo spoke with reporters. the president-elect is about to embark o