Rep. Tom Price, a seven-term congressman and an orthopedic surgeon by trade, had solid backing from Senate Republicans. | AP Photo Senate confirms Obamacare opponent Price to lead health department

The Senate early Friday morning installed Rep. Tom Price as the nation’s top health care official, putting him in charge of HHS and Republicans’ effort to make good on their pledge to repeal and replace the sweeping Affordable Care Act.

Price’s confirmation came by a slim 52-47 margin, ending weeks of partisan rancor marked by ethics allegations, boycotts and sharp breaks with Senate tradition and decorum. The seven-term congressman maintained full Republican support throughout the process, ensuring his path to HHS secretary was never in real danger. No Democrats voted for him.


But the bitter opposition to Price’s nomination — which culminated with Democrats delaying a final vote for nearly 30 hours — served as a preview of the fight to come over the future of American health care. And Price could well start that fight immediately by using his authority as secretary to roll back or not enforce select pieces of Obamacare — the mandated benefit package, perhaps, or the hot-button birth control coverage rules.

“I feel passionately about the fact that this is the wrong person to serve in that job,” Sen. Jeanne Shaheen (D-N.H.) said during a Thursday floor speech. “He seems to have no higher priority than to terminate health coverage for millions of people across this country.”

The Trump administration has hailed Price, a former orthopedic surgeon, as the quarterback of its plan to tear down Obamacare and construct a replacement package by year-end. The Georgia Republican, who has served as House Budget chairman, favors a far more conservative approach to health care. He authored a 2015 replacement bill that would have eliminated many of Obamacare’s broad health benefits, and he supports drastically rolling back funding for both Medicare and Medicaid.

At HHS, Price is expected to start immediately reshaping the health care system, using his administrative powers to ease Obamacare’s regulations and smooth the path for congressional Republicans to repeal and ultimately replace the law. That will likely start with relaxing rules for insurers, in hopes of soothing the industry’s nerves over participating in Obamacare’s insurance markets in the short term.

“He’ll be a very thoughtful leader and will help us hopefully, from an administrative standpoint, look at the essential health benefits,” Sen. Tim Scott (R-S.C.) said, referring to requirements that insurers cover certain health services such as maternity care. Scott said the goal is “to make them less prescriptive so there’s more flexibility, and hopefully that means there’ll be more competition in the marketplace.”

At the same time, Price, along with congressional leadership and the White House, will face the tough task of rallying the GOP around a single repeal and replacement strategy. Republican leadership wants to finish all that by the end of the year — a tight timeline, given the lack of consensus among Republican lawmakers — and are looking to Price to make it happen.

He’ll get no help from Democrats, who vowed to fight Obamacare’s replacement every step of the way. In the run-up to Price’s confirmation, they painted his health care beliefs as extreme and regressive, and they hammered him for potential conflicts of interest tied to his more than $300,000 in personal health-related stock investments.

“It’s hard to imagine who in America would be better off under Congressman Price’s leadership at HHS,” said Sen. Patty Murray (D-Wash.), ranking member of the HELP Committee and one of Price’s chief critics. “What makes his nomination even more troubling are the serious ethics questions that haven’t been resolved as it has been jammed through the Senate.”

The scrutiny over Price’s investments produced one of the most heated moments in the new Congress, when Democrats refused to show up for a committee vote on Price’s nomination. The impromptu boycott, which was in response to a Wall Street Journal report suggesting Price misled lawmakers about his stake in an Australian biotech firm, delayed the committee vote. The following day, Republicans suspended committee rules to force through Price’s nomination without any Democrats present.

“What a situation that our colleagues tried to put this good man in. It’s disreputable,” Finance Committee Chairman Orrin Hatch (R-Utah) said Thursday, still fuming over the boycott. “There ought to be some courtesy here, and I’m kind of shocked that there isn’t.”

Price has committed to divesting from his health care investments within 90 days of joining the Trump administration. But Democrats, who repeatedly called for investigations into Price’s financial holdings, warned that scrutiny will follow Price into his new job.

Price’s confirmation represents the last major piece Republicans say they need to start dismantling Obamacare. After more than seven years of waiting, the GOP must now figure out how exactly they will go about repealing and replacing a law that provides coverage to 20 million people — a question Republican lawmakers hope Price, one of the few to author a health care plan, will be able to answer.

“I think you have to admire that he was willing to make a serious proposal,” said Sen. Tom Cotton (R-Ark.). “That’s the kind of leadership we need.”