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Tom Price

Orthopedic surgeon Tom Price, a Republican congressman from Georgia, is President-elect Donald Trump’s nominee to head the $1 trillion Department of Health and Human Services.

Paul Morigi

Trump’s pick to run HHS has researchers speculating on how science will fare

Representative Tom Price (R–GA), the orthopedic surgeon and six-term congressman who President-elect Donald Trump yesterday picked to be his secretary of the Department of Health and Human Services (HHS), is a conservative spending hawk and fierce opponent of the Affordable Care Act (ACA) and abortion. But he has also spoken generally in favor of increasing funding for federal research agencies, including the National Institutes of Health (NIH), which he would oversee if confirmed to the job by the Senate.

Now, many research advocates are wondering how Price’s mix of views might play out in the new administration’s approach to a wide range of issues, including funding, research involving human embryonic stem cells and fetal tissue, and the appointment of a new NIH director.

“I have a lot of confidence that [Price] understands and supports the research mission and I hope that he will continue to do so,” says Michael M.E. Johns, an ear, nose, and throat surgeon who was the dean of the Johns Hopkins University School of Medicine in Baltimore, Maryland, and the chancellor of Emory University in Atlanta, and who is now a professor in Emory’s schools of medicine and public health.

In a statement announcing the pick, Trump said Price “has earned a reputation for being a tireless problem solver and the go-to expert on health care policy, making him the ideal choice to serve in this capacity.” And Price pronounced himself “humbled by the incredible challenges that lay ahead.”

As HHS secretary, the 62-year-old, who currently represents the affluent suburbs north of Atlanta, would oversee a department with an annual budget of some $1 trillion, and a domain that includes NIH, the Centers for Disease Control and Prevention (CDC), and the Food and Drug Administration. As such, his influence on biomedical research would be considerable.

“Picking who the next NIH director is—he will have a role there,” says Kevin Wilson, the director of public policy and media relations at the American Society for Cell Biology in Washington, D.C.

Adds Tony Mazzaschi, a longtime biomedical policy watcher who is the senior director of policy and research at the Association of Schools and Programs of Public Health in Washington, D.C.: “He would certainly be in a position to affect—either directly or indirectly— NIH’s funding priorities.”

Although Price is best known for his ceaseless efforts to undo the ACA—he is the only House of Representatives member who succeeded in landing a bill to do so on the desk of President Barack Obama, who issued a veto— Price has also during 12 years in Congress carved out a role as a budget hawk with an antiregulation bent. He has risen to chair the House Budget Committee, a post that he will need to relinquish, along with his congressional seat, to take the helm of HHS. He has also been an inveterate foe of abortion, a position that informed his repeated votes against expanding the number of human embryonic stem cell lines available to NIH-funded researchers during the George W. Bush administration. How ardently he might try to influence administration policy regarding human fetal tissue research, which congressional Republicans have targeted for elimination since 2015, is far from clear. The research is legal under a 1993 law, so it would take congressional action to criminalize it, as the 2016 Republican Party platform called for. “The secretary of health does not write law. Congress does,” Johns points out. NIH funded roughly $84 million in research using fetal tissue from abortions in 2016.

Yet Price is also on the record as supportive of NIH and of government-funded science. “I have been, as a physician, a strong supporter of the National Science Foundation. I believe strongly that, in fact, they need more money, not less,” he said in a 2007 speech on the floor of the House. The country should also, he argued, “provide much greater resources [for] the National Institutes of Health and the CDC and others that ultimately work and derive huge benefit to our entire society and, in fact, to the world.” (It should be noted that Price made those comments during a debate over an amendment, which he supported, that would have defunded a handful of NSF projects targeted as wasteful or unnecessary by GOP lawmakers; the hit list included grants to study bison hunting on the late prehistoric Great Plains and the sexual politics of waste in Dakar.)

More recently, Price made clear that his support for medical research is contingent on the country finding responsible ways to pay for it. Last spring, meeting with students and faculty at Emory, where Price trained as a bone surgeon and later returned as an assistant professor, he didn’t rule out a proposed $2 billion “bump” for the $32.3 billion NIH in the coming fiscal year, wrote Quinn Eastman of the Emory Report. But he made plain his view that this kind of discretionary spending must be linked to reform of the country’s massive entitlement programs, including the Medicare program for the elderly. He also returned to some favorite themes: the need to reduce the burden of government regulation on innovation and on science, and a desire to see Congress intervene a bit less in directing NIH’s spending toward certain diseases.

Price said “he wanted his fellow politicians to have a lighter touch in steering research dollars to one disease or area of medicine versus another, noting that the long-standing NIH set-aside for HIV/AIDS lasted too long before its elimination last year," according to the Emory Report. He also bemoaned FDA regulations that he said are driving innovators to test devices like heart valves first in other countries. Price’s antiregulation bent reappeared in his statement yesterday, in which he committed to creating a health care system “based on sensible rules to protect the wellbeing of the country while embracing its innovative spirit.”

Many medical research and physicians’ advocates praised Price’s appointment, expressing hopes that his experience in the trenches of both private medical practice and an academic medical center will make him sensitive to the challenges that researchers and teaching hospitals face.

“He’s always willing to talk, have a conversation, hear our side,” says Atul Grover, the executive vice president of the Association of American Medical Colleges (AAMC) in Washington, D.C., who noted that Price visited AAMC as a surrogate for the Trump campaign this past September. “He understands the issues of our academic medical centers as our safety net providers. And he knows and talks about the importance of support for biomedical research.” (AAMC also issued this statement calling Price a “strong choice” for HHS secretary.)

But some worry that Price’s appointment bodes ill for public health programs, pointing to his deep opposition to the ACA and his record of votes to defund women’s health provider Planned Parenthood, much of whose clientele is poor, and 3% of whose services consist of providing abortions.

“Trump Nominates Extreme Opponent of Women’s Health,” was the headline on the press release that Planned Parenthood issued on Tuesday. It detailed, among a long list of complaints, Price’s opposition to free birth control coverage under the ACA and his statement that “there’s not one” woman in the country who can’t afford to pay for birth control. (A 2014 Hart Research poll commissioned by Planned Parenthood found that 55% of women aged 18–34 have struggled to pay for contraception.) “The Senate should give Representative Price’s record the full examination it deserves,” the group cautioned.

Price was born and raised in Michigan and attended the University of Michigan as an undergraduate and a medical student. He completed his orthopedic surgery residency at Emory, practiced privately for nearly 20 years, and then directed the orthopedic clinic at Grady Memorial Hospital, a hospital with a large indigent patient population that is a training ground for Emory orthopedics residents. He served for 8 years in the Georgia state senate, leaving when he was elected to Congress in 2004.