On Tuesday, November 29, President-elect Trump announced the nomination of Republican Representative Tom Price of Georgia to be Secretary of Health and Human Services (HHS). Price is an orthopedic surgeon who has represented the northern suburbs of Atlanta since 2005. Before coming to Washington, he was a state senator in Georgia for four terms and, in 2002, was the majority leader of the state Senate. Price worked for almost two decades in private practice as an orthopedic surgeon, including as an Assistant Professor and Medical Director of the Orthopedic Clinic at Grady Memorial Hospital in Atlanta.
Price has often said the reason he entered politics was because, as a doctor, he saw that the politicians who were making the decisions and laws that impacted on patient care didn’t have medical backgrounds. Therefore it is no surprise that since coming to Congress in 2005, he has put his medical expertise to good use, spending considerable time and energy mastering the intricacies of health policy. As a member of the Ways and Means Committee, which has jurisdiction over the Medicare program, and as chairman of the Budget Committee, Price has put forward bill after bill which, viewed collective, give us a good understanding of his perspective on health policy and what HHS might look like under his leadership.
In analyzing the healthcare legislation to which Price has signed his name during his time in Congress, common themes emerge: increase patient choice, reduce federal interference in the practice of medicine, empower states and individuals in their health decisions, and increase market forces in government health programs. The legislation he has introduced has spanned a range of health policy issues, including: repealing and replacing the Affordable Care Act (ACA), modifying the durable medical equipment (DME) competitive bidding process, reforming the State Children’s Health Insurance Program (SCHIP), establishing performance-based quality measures for use in medical malpractice litigation, allowing patients and physicians to privately contract for healthcare services, returning the regulation of health insurance back to the states, and delaying the negative impact of meaningful use standards for health information technology (HIT).
Earlier this year, Price led two letters to CMS regarding the Center for Medicare and Medicaid Innovation (CMMI). One asked CMS to “stop [CMMI from] experimenting with Americans’ health and cease all mandatory demos and to ensure that future models comply with current law.” The second asked CMS to withdraw the Part B Drug Payment Model proposed rule.
The last bill that Price introduced was in September of this year. It would delay the current CMS demonstration project that established a prior authorization review process for home health services.
While Price is a conservative member of the House, he has, throughout his political career, continuously worked across the aisle to put forward innovative policy proposals and solutions. One example is a 2006 health bill he co-authored with then-Rep. Tammy Baldwin, a Democrat from Wisconsin’s 2nd congressional district, entitled “Health Care Partnership Through Creative Federalism Act.” This bill set up a federal commission to which states or groups of states could submit innovative plans to reduce the number of uninsured in their state or group of states. The commission would then select a number of the proposals to submit to Congress, where they would be given expedited consideration and could not be amended. When promoting this legislation, Price often said that its goal was to allow states to be incubators of innovation; to give them the freedom to choose the plan that is best for their residents. Whether states would choose free market reforms or single-payer policies would be up to them.
Price served on the Ways and Means Committee with Speaker Ryan and succeeded him as chairman of the Budget Committee after Ryan was elected Speaker of the House in late 2015. Their association led Price to embrace many of the entitlement reforms first introduced by Ryan, including allowing Medicare Advantage plans to vary their benefit designs, creating a “Medicare exchange” where seniors could choose between private insurance plans competing alongside traditional Medicare, publicly reporting performance metrics for traditional fee-for-service Medicare and Medicare Advantage, and reforming Medicaid to allow states to choose either a per capita allotment or block grants.
Since the announcement, critics have focused on the fact that Price doesn’t have any experience running anything near the size and scope of HHS, which has 11 agencies, nearly 80,000 employees and a budget of over $1 trillion. However, there are few members of Congress who have more passion for health policy and have spent more time on the details of the ACA and Medicare policy. And if confirmed, Price will be the first physician to run the department since 1993.
