On Tuesday, Nov. 29, 2016, President-elect Donald Trump announced his intention to nominate Thomas E. Price, MD, an orthopedic surgeon who has served in the U.S. House of Representatives for the last 12 years, to become the next secretary of Health and Human Services (HHS). Upon his expected confirmation in the first quarter of the New Year, Dr. Price will be the first medical doctor to become the secretary of Health and Human Services in 24 years, since 1993 when Dr. Louis Sullivan served President George H.W. Bush in this capacity.

During his 12 years representing the suburbs of Atlanta, Georgia, Representative Price was widely recognized for his strong opposition to sections of the Affordable Care Act (or “Obamacare”). Dr. Price’s anticipated nomination is a strong indication of the incoming Trump Administration’s intention to repeal parts or all of the Affordable Care Act within the 115th Congress. In fact, legislation that Dr. Price personally introduced in 2009 to counter the original creation of the Affordable Care Act has become the basis for the current Republican legislative initiatives in both chambers to replace it. Being a close friend of Speaker of the House Paul Ryan, from their days serving together on the House Budget Committee, Dr. Price should help to direct Congressional efforts to replace the Affordable Care Act, probably yielding more influence on Capitol Hill than any previous Secretary of Health and Human Services.

Medical & Political Background

After receiving his bachelor’s and Doctor of Medicine degrees from the University of Michigan, Dr. Price completed his orthopedic surgery residency at Emory University in Atlanta and entered private practice in suburban Atlanta. Shortly before he ran for public office, Dr. Price became an assistant professor at the Emory University School of Medicine. In 1996 Dr. Price won the November general election for Georgia’s 56th senate district. While maintaining his private practice, Dr. Price represented the 56th senate district for four terms in the Georgia State Senate, where he eventually rose to become the first Republican Majority Leader in the history of Georgia. In 2004 Dr. Price ran for the open House of Representative seat in Georgia’s 6th district to replace Representative Johnny Isakson, who would win that year’s U.S. Senate race. Dr. Price was victorious in the heavily Republican district representing the suburbs of Atlanta.

During his tenure in the House of Representatives, he has risen to become the chairman of the U.S. House Committee on the Budget, replacing Speaker Ryan, providing legislative oversight of the federal budget process, reviewing all bills and resolutions on the budget, and monitoring agencies and programs funded outside of the budgetary process. He is also currently a member of the House Committee on the Ways and Means, which has jurisdiction over all taxation, tariffs, and other revenue-raising measures.

Vision for Health Care Reform

Dr. Price’s vision for health care reform greatly reduces the federal government’s role in favor of a free-market framework built on privatization, state flexibility and changes to the tax code. In fact, he is the original sponsor of the Empowering Patients First Act (EPFA), which was first introduced in the 111th Congress and every subsequent Congress. A potential roadmap for replacing the Affordable Care Act, EPFA would create and expand tax deductions and credits to aid in the purchasing of health insurance, promote state-based high-risk insurance pools, create individual and small employer membership associations and association health plans, allow for interstate insurance markets, and reform malpractice lawsuits.

In addition to crafting a replacement for the Affordable Care Act, Dr. Price has advocated for significant changes to the funding for Medicaid, preferring to establish a block grant program capping the federal funding at a set amount every year, instead of a percentage of the program that fluctuates based on recipients’ usage. As for Medicare, Dr. Price would ensure that future beneficiaries receive some government help to purchase select commercial policies, instead of having essentially unlimited federally funded benefits.

Thoughts on Medicine & Policy

A seasoned health policy thinker, Dr. Price’s health care proposals have been shaped by his experience both as an orthopedic surgeon and medical school instructor. In a recently republished 2014 interview with MedPage Today, Dr. Price strongly advocated for medical decisions to remain out of the hands of non-professionals. “There is a remarkable level of nonmedical people making medical decisions. That makes it more and more difficult to truly be a patient’s advocate…Medical decisions should be made by patients, families, and doctors — not policymakers and insurance companies.”

He also stressed his belief in the vitreous future of medicine. “Caring for one’s fellow man is a privilege unmatched by any other. There is no more noble endeavor than caring for people. With the remarkable innovations just around the corner, the opportunity to treat and cure disease is going to be unparalleled.”

Conclusions

Dr. Price’s tenure as secretary will witness dramatic changes to the federal government health care programs. A Price-led department will likely structure a system designed to maintain aspects of the requirement for insurance companies to provide coverage for pre-existing conditions. Observers believe this will come in the form of preventing companies from denying coverage if a person has maintained health insurance for a set period of time. He also is expected to maintain the ability for children below the age of 26 to remain on their parents’ insurance plan.

A timeline for reforming the current health care programs is fluid, but Republican party officials in both chambers have indicated an intention to repeal the Affordable Care Act quickly in 2017. Their intention is to pass a new program shortly afterward, once congressional and administrative leaders iron out the policy differences between the House of Representatives and the Senate concepts.