Wyden opposes Price nomination as HHS secretary

Senate Finance Committee Ranking Member Ron Wyden, D-Ore., delivered a statement on the Senate floor Wednesday night in opposition of Congressman Tom Price’s nomination to be the Secretary of the Health and Human Services Department (HHS).

“The debate on Congressman Price’s nomination is a referendum on the future of health care in America,” Wyden said. “This is about whether the United States will go back to the dark days when health care worked only for the healthy and wealthy.”

“Medicare is a program Congressman Price doesn’t believe in, and it offers a guarantee of services he doesn’t think seniors should have. Medicare is built on a promise that Congressman Price wants to break. A promise that when you turn 65, you will be guaranteed health care benefits regardless of your economic station in life or the status of your health.”

“When it comes to Congressman Price’s ethics, the real question is whether ethical responsibilities have been completely thrown out the window when it comes to vetting a nominee, let alone a sitting member of Congress. Congressman Price’s record is clear: he trades in health care stocks, advocates for policies that help his portfolio, and has gotten special access to promising stock deals while serving as a member of Congress. That’s extremely troubling behavior for a nominee who stands to responsible for the health care of over 100 million Americans.”

“This is a nominee with an extreme agenda. His proposals would strip tens of millions of Americans of their health coverage. His proposals would put Americans with pre-existing conditions in danger of losing coverage for the care they need. His proposals would slash Medicare. His proposals would shred Medicaid. And when it comes to ethics, he falls well short of the standard the American people expect nominees to meet. I will not support his nomination.”

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Wyden’s full remarks can be found below:

The debate on Congressman Price’s nomination is a referendum on the future of health care in America. This is about whether the United States will go back to the dark days when health care worked only for the healthy and wealthy.

Based on the public record, Medicare is a program Congressman Price doesn’t believe in, and it offers a guarantee of services he doesn’t think seniors should have.

On the Affordable Care Act, he is the architect of repeal and run – he wrote the bill himself. He proposed weakening protections for Americans with pre-existing conditions. He would slash Medicaid, shredding the health care safety net for the least fortunate among us. He would take away women’s health care choices.

Look for the common thread among his proposals: They take away people’s coverage, make health care more expensive for the individual, or both. That is what Congressman Price stands for when it comes to health care. Every Senator who casts a vote for Congressman Price has to stand by that agenda.

And beyond what this means for the future of American health care, there’s the lingering specter of serious legal and ethical issues.

Over the next 30 hours, this debate will tackle each of those issues and more. As it gets underway, I’m going to begin with Medicare.

In my view, Medicare is one of the great achievements in American policymaking. In any debate like this one, I recall my days at the head of the Oregon Gray Panthers, when I worked with seniors who couldn’t imagine life without Medicare.

So I want to start this discussion with a line from an op-ed Congressman Price wrote in 2009. It’s a quote that speaks volumes about his perspective. He wrote that, “nothing has had a greater negative effect on the delivery of health care than the federal government’s intrusion into medicine through Medicare.”

Here’s the bottom line. Medicare is built on a promise that Congressman Price wants to break. A promise that when you turn 65, you will be guaranteed health care benefits regardless of your economic station in life or the status of your health.

The reason Medicare was built to guarantee benefits is straightforward. Nobody knows how healthy they’ll be when they reach age 65. You could be a marathoner at age 50 and develop arthritis, Alzheimer’s or cancer a decade and a half later. Furthermore, nobody knows what the economy will look like years or decades into the future. For the less fortunate, high inflation or a stock market crash could all but wipe out what they’ve set aside over a lifetime of work. Seniors could find their benefits exposed to new danger with every financial downturn.

During the campaign, the American people heard a standard Trump pledge: no cuts to Medicare. But when you look at Congressman Price’s plans, it’s clear that pledge was on the ropes the minute he was nominated. In fact, he said that he wants to voucherize Medicare within the first six to eight months of the administration.

In his budget, Congressman Price called for privatizing Medicare and cutting it by nearly 500 billion dollars. He has also championed legislation to allow a practice called “balance billing” in Medicare. That means seniors could be forced to cover extra charges above what the program pays for the services they receive in the doctor’s office. Older Americans on fixed incomes, being forced to pay more for their care.

I believe that the Congress has no greater duty than to uphold the promise of Medicare. And there’s no need to mince words – privatizing Medicare as Congressman Price has sought to do means an end to the program’s guaranteed health benefits. It would end Medicare as we know it.

For seven years, there has been a steady drumbeat coming from my colleagues on the other side: repeal and replace, repeal and replace. Dozens of show votes. Hundreds of hearings and press conferences. A government shutdown. All built around a slogan: repeal and replace.

At one point, the president-elect himself said repeal and replace would happen “simultaneously.” Shortly before inauguration day he said they could come within the same hour. And he said Congressman Price was writing the replacement plan and it was nearly ready to be unveiled.

But the public heard a different story during Congressman Price’s Finance Committee hearing. Senator Brown asked, the president “said he’s working with you on a replacement plan for the Affordable Care Act, which is nearly finished and will be revealed after your confirmation. Is that true?”

Congressman Price responded, “It’s true that he said that, yes.” A moment later, he added, “I’ve had conversations with the president about health care, yes.”

So if you’re waiting for the curtain to rise on the Price replacement plan, it sounds like you’re going to have to wait a while longer. In fact, the president said this weekend that Americans might have to wait until next year to see the replacement. But the uncertainty about what comes next hasn’t slowed down the charge toward repeal.

In fact the president issued a day-one executive order instructing the executive branch to roll back the Affordable Care Act in any way possible.

When I asked Congressman Price during his nomination hearing whether he could guarantee that nobody would be worse off under the executive order, he ducked the question. I asked if he could guarantee that no one would lose coverage. He ducked. I asked if he would commit to holding off on implementing the executive order until a replacement plan was enacted. He ducked. But still, Americans are being told that the Affordable Care Act is the problem, and it must be repealed.

It looks to me like what Republicans have on offer now isn’t repeal and replace. It’s repeal and run, and Congressman Price is its architect. In fact he wrote the bill goring the ACA the last time around.

Under his plan, 18 million Americans would lose their health insurance in less than two years. By 2026, it would be 32 million who lose coverage. Today 26 million Americans are uninsured. In a decade it would be 59 million. Working Americans would make up four out of every five people who lose their coverage — people who are already struggling to climb the economic ladder.

No-cost contraceptive coverage for millions of women – gone. By defunding Planned Parenthood, nearly 400,000 women would lose access to care almost immediately. Hundreds of thousands more would lose their choice to see the doctors they trust.

Premiums would jump by hundreds of dollars a year as the individual market for health insurance collapses. Health care costs would skyrocket. It’ll be a gut punch to everybody – even those who get their health insurance at work.

And another issue that ought to set off alarm bells, in my view, is what Congressman Price has planned for people with pre-existing conditions.

At the heart of the Affordable Care Act is a guarantee that insurance companies cannot discriminate against Americans with pre-existing conditions. No denying coverage to pregnant women. To cancer patients. To children with autism. That’s the law of the land protecting every American – a strict ban on discrimination.

Congressman Price doesn’t believe in that the American public should have the protection of that kind of ban. In fact, he was quoted in 2012 saying that it was a “terrible idea.”

So he wants the law changed. And his way to change a law that guarantees universal protection is to get rid of the guarantee.

When Senator Nelson asked Congressman Price about this issue in his hearing before the Finance Committee, once again he ducked, he weaved, and he bobbed. Senator Nelson asked if the congressman thought the proposal, “to continue the ban on discriminating against people with pre-existing conditions is a terrible idea?”

Here’s the answer Congressman Price gave.

“What I’ve always said about pre-existing conditions is that nobody, in a system that pays attention to patients, nobody ought to be priced out of the market for having a bad diagnosis. Nobody.”

That might be a good soundbite if you’re trying to duck a question, but it’s not a real answer to what he was asked. And if you examine Congressman Price’s own proposals when it comes to pre-existing conditions, you see why he can’t give a straight answer.

Let’s look at one of the congressman’s bills, the ironically-named Empowering Patients First Act. Instead of a ban on discrimination against those with pre-existing conditions, his bill opened up loopholes to benefit insurance companies. The plan hinged on what’s called “continuous coverage,” something Americans are going to hear a lot about in the months ahead. It said that insurance companies had the right to inspect your recent past when you applied for coverage on the private market. If they found gaps when you went without insurance, they could deny coverage for your pre-existing condition for up to a year and a half, or they could hike your premiums by 50 percent. In short, insurance companies could take your money and skip out on covering the health care that you actually need. Worse health care at a higher cost.

Now let’s think about what that means for a cancer patient who suffers a job loss. Up to eighteen months without coverage for cancer treatment they need could be the difference between life and death.

But Congressman Price’s bill didn’t allow any special exceptions for certain gaps in coverage. No matter why you lost insurance – maybe a layoff, the death of a spouse, quitting your job to start a business or go back to school – insurance companies would be allowed to discriminate. And Congressman Price’s bill didn’t create any safeguards for particular patients with life-threatening illnesses. No matter what kind of pre-existing condition you have, you’d be at risk of losing access to care. And going by the practices those companies followed before the Affordable Care Act, more than 130 million Americans under age 65 may have a pre-existing condition.

It’s true that Republicans may not hold up Congressman Price’s bill as the final replacement. But Congressman Price would be the captain of the health care team for this administration. His proposals matter. And his approach is one that’s followed by just about every other Republican who has put forward a plan of their own.

In my view, there should not be any debate around this issue. The Affordable Care Act set a new standard in black letter law – nobody in America can be denied insurance due to a pre-existing condition. It would be unconscionable to wind back the clock and undermine that protection. But that’s what Congressman Price’s proposal would do.

Congressman Price’s plans to slash our health care programs don’t stop at Medicare and the Affordable Care Act. He’s also proposed unprecedented cuts to Medicaid. The vital importance of the Medicaid program is embodied by the nursing home benefit for seniors. Medicaid helps cover costs for two-thirds of seniors in nursing homes. These are older people who’ve worked hard, put their kids through school, and been a part of their communities. They saved what they could, but the fact is, it costs a lot to be a senior in America. So they’ve spent down their savings. Without Medicaid, they can’t afford the cost of a nursing home. Congressman Price has proposed slashing this program. His plan cut two trillion dollars out of Medicaid over the course of two stages.

First, he would repeal the expansion of Medicaid created under the Affordable Care Act. That would mean more than 11 million Americans would lose coverage. And it’s a plan that even Republican governors oppose. John Kasich of Ohio – nobody’s idea of a bleeding-heart liberal – recently warned, “So if all of a sudden, that goes away, what do we tell these 700,000 people? We’re closed? Can’t do that.”

But that is essentially what Congressman Price’s plans would tell those 700,000 Ohioans, along with millions of people in Oregon and across the country. That’s because he’s pushing to take away their coverage, and he hasn’t offered any real alternative that would preserve their access to care.

Congressman Price’s second Medicaid cut would turn the program into a block grant and introduce caps. That would slash another 30 percent of its funding and setting it up to be squeezed even more down the road.

I already talked about the nursing home benefit, but Medicaid goes a lot further than that. The fact is, Medicaid is taking on some of the biggest health care challenges in America. The opioid epidemic is one prime example.

Opioid addiction is ripping through American communities like wildfire. More than a million people struggling with substance abuse would lose access to care if the plan to repeal the Medicaid expansion goes through. And further cuts to Medicaid would make that problem even worse – and not just for adults. Tens of thousands of babies are born with a dependency to drugs each year, largely as a result of the opioid crisis. That number would only rise under Congressman Price’s plan to cut Medicaid, which is a key source of primary care, pre-natal care and substance use treatment for pregnant women.

Medicaid is also the biggest source of funding for community and home-based care for vulnerable people with serious disabilities. It’s a huge source of AIDS treatment in America, particularly with the Affordable Care Act expansion.

All in all, seventy four million Americans rely on Medicaid. They are not among the most fortunate. Half of all enrollees are children, including millions with special needs. The program covers nearly half of all births and millions of people with disabilities.

It covers people who toil through hard work, even multiple jobs, bringing home just enough to keep them out of poverty. For many, signing up for Medicaid brought an end to the years when they had to choose between visiting the doctor and putting food on the table. Medicaid is their health care safety net, and Congressman Price’s proposals would leave it in tatters. There’s no other backstop if their access to health care through Medicaid goes away.

One of the arguments made by proponents of block grants and caps is that it gives states flexibility, and they point to a section of the Affordable Care Act I wrote to support their case. But there’s a big difference between what I wrote in the Affordable Care Act and what block grants would do. The ACA lets states do better. The Republican plan to block grant and cap Medicaid lets states do worse.

Slashing Medicaid would also hit state budgets like a wrecking ball. That’s a big reason why governors are so skeptical – even Republican governors like John Kasich and Rick Snyder of Michigan.

Today Medicaid comes with an open-ended guarantee. Block granting and capping the program would change that. States would get a chunk of money each year. There’s a big risk that funding runs out – especially during times of economic downturn. That’s when Medicaid is needed most. The times when working Americans have the most trouble walking the economic tightrope.

This is in addition to the undeniable, routine demands on the program. An aging baby boomer population that will be in increasing need of nursing home and home-based care. Public health emergencies like the Zika virus that can come without warning. Natural disasters like Hurricane Katrina or the Flint water crisis that devastate communities. New high-cost drugs that can be cures but come with a steep price. And if a state’s block grant or capped amount of Medicaid funding suddenly runs out, that raises questions that ought to be alarming to anybody who cares about Americans having access to the care they need.

What would happen if seniors lost their nursing home benefits mid-year? Where would they have to go? Would patients in substance use treatment lose access to care? If a state’s Medicaid funding dries up mid-way through the fiscal year, who pays for births after that? Would the parents of a newborn child have bear the entire cost, a hospital bill that could reach tens of thousands of dollars?

When it comes time to pitch his extreme health care agenda to the public, Congressman Price routinely sticks to well-rehearsed language. That’s because it’s an agenda that would strip tens of millions of Americans of their insurance coverage and force people to pay much higher costs for much lesser care.

One of the priorities Congressman Price talks about most frequently is access – ensuring that Americans have access to care. In my view, it’s a hollow talking point for one basic reason. Access to health care doesn’t mean much if you can’t afford the cost.

The Congressman talks about flexibility for the patient. But under Congressman Price’s plans that wipe out consumer protections and minimum standards for coverage, it’s insurance companies that get the most flexibility.

Congressman Price talks frequently about using “metrics” to measure health care, but it’s never quite clear what metrics those are. When his proposals are challenged using facts and figures – including those that come from the nonpartisan scorekeepers at CBO and JCT – he dodges or disagrees. In fact he said during his hearing that he rejected a CBO assessment that defunding Planned Parenthood will deprive many women of access to preventive care. He objects to even the simplest of measures – how much funding his proposals cut from our health care programs – as calculated by the nonpartisan experts. In my view, you can’t run from the metrics when they don’t tell you what you want to hear.

Finally, the congressman and many others say patients should be at the center of care. Nobody would dispute that idea. When I look at Congressman Price’s proposals, I don’t see the patient at the center of health care. I see money and special interests at the center of health care.

His plans would tell vulnerable Americans that their health care will go only as far as their bank accounts will take them. The well-to-do might be able to afford Congressman Price’s proposals and the costs they push onto patients, but millions of working Americans cannot.

Now I’ll turn from Congressman Price’s destructive health care proposals to several glaring ethics issues.

I’ll begin with the Congressman’s significant investments in an Australian biomedical company called Innate Immunotherapeutics. A lot of information about those investments has come into view over the course of months of investigation and reporting. What the facts show is that in 2016, Congressman Price was part of an exclusive deal to buy stock at a discounted price – a deal called a “private placement.” On multiple occasions he was given opportunities to come clean and explain his participation in the special stock sale. He never has.

And now, the majority on the Finance Committee has cut off the vetting process before getting all the facts or having the Congressman correct the record.

Let me take a moment to lay out the facts. It’s well known that Congressman Price learned about the company from a House colleague – Congressman Chris Collins. But Congressman Collins isn’t just a casual observer of the Australian business pages. He is Innate’s largest shareholder and a member of its board. Many of the company’s other major shareholders are people in Congressman Collins’ orbit, family members and his chief of staff and others. After learning about the company from his colleague, Congressman Price made his first purchase of the company’s stock in 2015. He bought 61,000 shares.

Fast forward to August 2016 . Congressman Price bought another 400,000 shares of Innate as part of a private stock sale for U.S. investors. When the private sale took place, Innate’s shares were trading on the Australian Stock Exchange for the equivalent of 31 American cents. But participants in the private sale got the shares at a steep discount. That discount meant that Congressman Price paid tens of thousands of dollars less than a typical investor would have paid on the open market.

With respect to that purchase, the record remains unclear. It comes down to two issues – how he came to participate in the private placement, and whether he got special access that other investors didn’t have. On these issues, Congressman Price tells one story. Company officials, Congressman Collins and public documents tell another.

First let’s look at how Congressman Price came to participate in this private deal. As he tells it, he decided to make that purchase based on his own research into the company. But the Wall Street Journal and a little common sense say otherwise. I’ll read from a January 30th report:

“Mr. Price got in on the discounted sale after Mr. Collins filled him in on the company’s drug trial, according to Mr. Collins. … Mr. Collins said he told Mr. Price of the additional private placement. He said Mr. Price asked if he could participate in it. “Could you have someone send me the documents?” Mr. Collins recalled Mr. Price asking him.”

That paints a clear picture – Congressman Price got information from his colleague, the company’s top shareholder, and he got an invite to a special deal. The claim that his conversations with Congressman Collins had no effect on his decision to invest doesn’t pass muster.

Now that brings me to the second point – whether or not the deal was available to all company shareholders. Congressman Price insists it was. Here’s the exchange he and I had during his nomination hearing. I said, “you purchased stock in an Australian company through private offerings at discounts not available to the public.”

Congressman Price responded, “Well, if I may, those — they were available to every single individual that was an investor at the time.”

But that’s not what Innate management – including Simon Wilkinson, the CEO – told the Wall Street Journal. According to the Journal’s report, Congressman Price was one of six special American investors in a category called “friends and family.” I’ll read an extended passage from the story:

“The cabinet nominee was one of fewer than 20 U.S. investors who were invited last year to buy discounted shares of the company–an opportunity that, for Mr. Price, arose from an invitation from a company director and fellow congressmen…

“At Mr. Collins’s invitation, Mr. Price in June ordered shares discounted in the private placement at 18 cents apiece, and then more in July at 26 cents a share, Mr. Collins said in an interview. Those orders went through in August, after board approval. Mr. Price invested between $50,000 and $100,000, according to his disclosure form…

“Mr. Wilkinson said investors who had bought in a previous private placement were called to “make friends and family aware of the opportunity…We are always looking to increase our shareholder base. But those new parties have to meet the definition of sophisticated financial investor.”

“Only six U.S. investors, including Mr. Price, fell into the friends-and-family category, Mr. Collins said. About 10 more U.S. investors were offered discounted shares by the company because they had previously been invited to partake in private placement offerings.”

Furthermore, Congressman Collins and Mr. Wilkinson added further detail.

“The discounted stock offer in Innate Immuno, as the company is known, was made to all shareholders in Australia and New Zealand–but not in the U.S., according to Mr. Collins and confirmed in a separate interview with Innate Immuno CEO Simon Wilkinson.”

Bottom line, Congressman Price got in as a special guest – a “friends-and-family” guest of Congressman Collins. What he told the committee, that the deal was open to all shareholders, was dead wrong.

But the stock deals involving Innate are not the only ethical issue at hand.

He introduced legislation that would lower the tax bills of three major pharmaceutical companies he owned significant amounts of stock in. He invested 15,000 dollars in a medical equipment company then introduced legislation to increase the amount Medicare pays for that type of equipment. Parts of his bill went on to become law. And then there’s his investment in a company called Zimmer Biomet.

In 2015, Medicare was preparing a new pricing model that would change the way the program paid for hip and knee replacements. Instead of paying for each individual service, Medicare said it would try to make its payments more efficient by bundling the costs together in one lump sum. The new system, however, had the potential to affect Zimmer Biomet’s revenues.

On March 17th, 2016 , a few weeks before the CMS model was set to go into effect, Congressman Price bought thousands of dollars-worth of Zimmer Biomet stock through his brokerage account. On March 23rd, 2016 , less than a week later, he introduced H.R. 4848, the HIP Act, which would have delayed the implementation of CMS regulations for Medicare coverage of joint replacements. He was the lead Republican sponsor of the bill. So bottom line, Congressman Price introduced legislation that had the potential to add to his personal fortune.

Now, Congressman Price has argued that he didn’t purchase this stock and others – his broker made the deals. But at the very least, he would have known about the deals within days when he filed his Periodic Transaction Reports with the House.

On April 15th, 2016 , not only did Congressman Price file a report that he had purchased Zimmer Biomet along with dozens of other stocks, he initialed the entry for Zimmer Biomet in order to correct a mistake on the document – a correction making it clear that the Zimmer Biomet transaction was a stock purchase.

Congressman Price also claimed he adhered to all ethics and conflict of interest rules. All evidence says otherwise.

It is true that the House Ethics rules, like the Senate Ethics rules, allow a member to cast a vote on a matter relating to a company in which he or she owns stock. However, that standard only applies to casting votes. In the House Ethics Manual, it says that before undertaking active advocacy of legislation that will benefit a company in which a member owns stock, such as before introducing a bill, “the Member should first contact the [Ethics] Committee for guidance.”

Let’s look at the facts. Congressman Price did a lot more than cast votes. He introduced and advocated for legislation that directly affected the companies in which he owned stock.

He did not consult with the Ethics Committee regarding any of the trades I’ve spoken about. In a written question, I asked Congressman Price about this. I asked whether, in light of the House Ethics Manual’s recommendation, he had consulted with the Ethics Committee regarding his purchase of Zimmer Biomet and other stocks. He answered that “(n)o conflicts existed and no consultation was necessary.”

So as I wrap up, I’ll go back to the fact that when Congressman Price came before the Finance Committee, he did not give us the whole story. It’s that simple.

In effect, the Senate Finance Committee has set an ethical double standard. Look at the nominations of Senator Tom Daschle, Secretary Tim Geithner and Ambassador Ron Kirk at the outset of the Obama administration. The vetting process was rigorous and it was bipartisan. The committee turned over every stone, peered around every corner and followed every lead to its conclusion.

Now, when a glaring issue comes up that undeniably deserves investigation, the party in power shuts down the vetting process and continues moving toward to confirmation.

Put together with the way the congressman’s testimony before the committee, this sends sending a dangerous message to nominees in the future. If you want to duck, dodge, equivocate, and potentially lie to the Finance Committee, apparently the Finance Committee doesn’t care. The majority cut off the vetting process before it’s complete. That is wrong. Our constituents expect better.

This is a nominee with an extreme agenda. His proposals would strip tens of millions of Americans of their health coverage. His proposals would put Americans with pre-existing conditions in danger of losing coverage for the care they need. His proposals would slash Medicare. His proposals would shred Medicaid. And when it comes to ethics, he falls well short of the standard the American people expect nominees to meet. I will not support his nomination, and I urge my colleagues to join me in opposition.