House in driver’s seat on healthcare

House in driver’s seat on healthcare
© Greg Nash

House Republicans are taking pole position in repealing and replacing ­ObamaCare with Donald TrumpDonald John TrumpJoe Arpaio loses bid for his old position as sheriff Trump brushes off view that Russia denigrating Biden: 'Nobody's been tougher on Russia than I have' Trump tees up executive orders on economy but won't sign yet MORE’s pick of Tom Price as secretary of Health and Human Services. 

The Republican lawmaker from Georgia, a confidant of Speaker Paul RyanPaul Davis RyanWary GOP eyes Meadows shift from brick-thrower to dealmaker Budowsky: Why I back Kennedy, praise Markey Democratic super PAC quotes Reagan in anti-Trump ad set to air on Fox News: 'Are you better off?' MORE (R-Wis.) and Vice President-elect Mike PenceMichael (Mike) Richard PencePence: Chief Justice Roberts 'has been a disappointment to conservatives' Students at school system Pence called 'forefront' of reopening now in quarantine Presidential debates demonstrate who has what it takes MORE, is a former physician with a deep understanding of both the thorny politics and wonky details of healthcare. 

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He’s deeply committed to repealing  ­ObamaCare and, if confirmed, would become the first health secretary with a medical background since Louis Sullivan, who led the department under former President George H.W. Bush. 

The move to nominate Price sends an unmistakable signal that Trump intends to work with House Republicans and Ryan, with whom he has fought in the past, on unwinding President Obama’s signature law. 

“It’s a signal that the House is in the lead,” said Tom Miller, a frequent healthcare consultant to the GOP. “It’s going to be much more of a House-driven process in the early stages.” 

The decision is also significant given Trump’s comments just weeks ago following a meeting in the White House with Obama. 

In an interview with The Wall Street Journal, Trump talked about his desire to keep parts of the healthcare law, such as its provisions prohibiting insurers from denying coverage to people with preexisting conditions, and allowing people under 26 years old to stay on their parents’ plans. 

While it remains possible, perhaps likely, that those two popular parts of the law will survive a repeal effort, the choice of Price suggests Trump is deadly serious about repealing  ­ObamaCare. 

Price voted against  ­ObamaCare when the Democratic-controlled House approved it and in the years since has become a leading GOP advocate for getting government out of healthcare. 

He offered his own plan to replace  ­ObamaCare in 2015, becoming one of the first Republicans to put forth a comprehensive blueprint to fix the law. His plan would have given subsidies to people based on their age to buy insurance on the private market, instead of the income-based coverage in  ­ObamaCare. 

Earlier this year, Price stood alongside Ryan as the House GOP leadership team unveiled its healthcare plan as part of a policy platform called “A Better Way.” 

While the plan lacked some details, Price touted it as being the first time that Republicans in Congress had lined up behind a blueprint to repeal and replace  ­ObamaCare — something Republicans had previously struggled to do.

“We want a system that’s accessible for everybody. We want a system that’s affordable for everybody,” Price, one of just four GOP committee chairman to work on the plan, said at the time. “We want a system that’s of the highest quality and we want a system that provides choices for the American people — for patients. And in fact the path that we’re on right now violates those principles.”

The GOP’s plan did keep  ­ObamaCare’s protections for people with preexisting conditions, and its provision allowing people under 26 to stay on their parents’ insurance. 

House Majority Leader Kevin McCarthy (R-Calif.) hailed Trump’s nomination and noted that Price had worked “very closely” on the details of “A Better Way.”

He said repealing and replacing the law would ultimately need the cooperation of both chambers of Congress as well as the Trump administration. But he also suggested the House was in a great position because of the blueprint Price had worked on. 

“I think the House is in a very strong position because of ‘A Better Way,’ ” McCarthy said. 

Several people familiar with Price’s leadership style as budget chairman have hailed him as a unifier in the House.

And while dozens of Democrats have fiercely opposed Price’s nomination, his confirmation appears likely. Republicans need a majority vote in the Senate to confirm Price, making it exceedingly difficult for Democrats to block his nomination. 

Price has stood out from other Republicans in offering specifics on replacing  ­ObamaCare. 

Miller, the health policy researcher at the right-leaning American Enterprise Institute, said he remembers reading early drafts of Price’s plan five or six years ago and thinking: “This is someone who did the work.”

“He’s someone who doesn’t just talk about the policy and issue the press release. He works it through,” Miller said.

None of this is to underplay the challenges for Trump and Price, as well as congressional Republicans, in replacing  ­ObamaCare. To replace or fix the law, Price will have to corral the same groups — from drugmakers to hospital groups — that Democrats battled with in approving the law. He’ll also have to deal with the challenge of taking away an entitlement that millions of people have become used to having. 

Rep. Phil Roe (R-Tenn.), who occasionally travels with Price as members of the House GOP Doctors Caucus, said the chairman knows that Republicans can’t go in and strip away healthcare plans for millions of people without a replacement. 

“That’s going to be the Democrats’ talking point — that all the sudden nobody’s going to have care if they had health insurance [under  ­ObamaCare],” Roe said. 

Roe said he’s been in the room while the soft-spoken Price has heard personal stories about the irksome bureaucracy surrounding healthcare. 

He insisted his colleague would not want to lessen healthcare coverage. The number of uninsured has fallen dramatically since  ­ObamaCare’s passage. Getting rid of the healthcare exchanges set up under the law, or the mandate that people buy insurance, could certainly raise the number of uninsured. 

“There’s nobody I’ve heard of that wants to lessen the number of people who have health insurance,” Roe said. 

Roe said he also believes that Price would be willing to take a stand against Trump on healthcare, pointing to his 20 years as a surgeon in high-stakes situations.  

“You can bet your bottom dollar he will tell the president, in a respectful way, if he comes up with some hare-brained scheme, if that’s what he believes,” Roe said.