Tom Price Is Sworn In as Health Secretary Amid Senate Disunity

WASHINGTON — President Trump’s secretary of health and human services, Tom Price, took office on Friday with a promise to fix what he called a “broken health care system” that was “harming Americans and their families.”

Mr. Price was sworn in by Vice President Mike Pence just hours after the Senate, by a party-line vote of 52 to 47, confirmed his nomination in the early hours of Friday morning.

Republicans said that Mr. Price, 62, an orthopedic surgeon, would bring a physician’s insights to managing a federal agency that they said had become addicted to heavy-handed federal regulation and blind to problems spawned by the Affordable Care Act, also known as Obamacare.

“Dr. Price has a thorough understanding of health care policy and the damage that Obamacare has caused,” said Senator Lamar Alexander, Republican of Tennessee, where consumers this year saw rate increases averaging 44 percent to 62 percent in the law’s marketplace.

Mr. Alexander, the chairman of the Senate health committee, said Mr. Price would be “an excellent partner” as Congress tries to devise a replacement for the health care law championed by former President Barack Obama.

Senate Democrats and the chamber’s two independents said they feared the worst, based on Mr. Price’s 12-year record as a Republican member of the House of Representatives from Georgia. They said that Mr. Price had led efforts to repeal the health care law and slow the growth of Medicare and Medicaid by shifting some costs to beneficiaries and trimming payments to some health care providers.

“This is a sad evening,” said Senator Chuck Schumer of New York, the Democratic leader. “People will look back and say that the Republicans’ war on seniors began at 2 a.m. Friday morning when the Senate unfortunately confirmed Representative Price.”

The depth of concern about Mr. Price was illustrated by the comments of Senator Angus King, independent of Maine, who caucuses with Democrats but is not given to hyperbole.

“To put somebody in charge of the Department of Health and Human Services that is inimical to Medicare, Medicaid and the Affordable Care Act — this guy is a wrecking ball,” Mr. King said. “He is not a secretary. He is going into this agency to destroy it. He wants to undercut and diminish and, in some cases, literally destroy some of the major underpinnings of providing health care to people in this country.”

By contrast, at the swearing-in ceremony, the vice president said Mr. Price had emerged as “the most principled expert on health care policy in the House of Representatives, if not the entire Congress.”

Mr. Trump said again on Friday that the Affordable Care Act was “a total and complete disaster.” With the confirmation of Mr. Price, he said, the administration will “get down to the final strokes,” devising a plan that can provide “tremendous health care at a lower price.”

In a farewell address to the House submitted for publication in the Congressional Record, Mr. Price said that, as chairman of the Budget Committee, he had begun an important effort to “fix our nation’s broken health care system” and “get Washington out of the way” of patients and doctors.

One of the first challenges facing the new secretary is to stabilize insurance markets and decide the future of financial assistance provided to insurance companies that say they have lost large amounts of money treating patients under the Affordable Care Act.

A judge on the United States Court of Federal Claims ruled on Thursday that the Obama administration had illegally reneged on a promise to pay subsidies to an Oregon insurer, Moda Health Plan. Many other insurers have filed similar claims. The Obama administration’s failure to pay the claims was cited as a reason for the collapse of many nonprofit insurance cooperatives created under the Affordable Care Act.

In the Moda case, Judge Thomas C. Wheeler ordered the government to pay $214 million that the company was expecting under a program meant to limit insurers’ losses in their first few years operating under the Affordable Care Act. Federal officials’ failure to keep their promise was “hardly worthy of our great government,” the judge wrote.

The Trump administration has not decided whether to appeal the decision.

The next prospective member of Mr. Trump’s cabinet to be voted on will be Steven T. Mnuchin, the Treasury secretary nominee, on Monday evening.

Congressional reaction to Mr. Mnuchin, as to Mr. Price, has been divided along party lines. Republicans have been impressed with the former Goldman Sachs banker’s business acumen, while Democrats have argued forcefully that he is ill-equipped to steer America’s economy.

Those divisions were on stark display during Mr. Mnuchin’s confirmation hearing at the Senate Finance Committee last month, when Democrats questioned him over his business record and ultimately boycotted votes on his nomination.

The most significant concern among Democratic critics of Mr. Mnuchin was that he failed to disclose nearly $100 million of his assets and that he did not mention his role as a director of an investment fund based in the Cayman Islands, a well-known tax haven.

Mr. Mnuchin has also been accused by Senate Democrats of lying to Congress when he said during his hearing that OneWest Bank did not engage in the foreclosure practice of “robo-signing” when he was its chief executive. Local news reports suggested that the bank did engage in such practices in some states.

Senator Elizabeth Warren, Democrat of Massachusetts, said on Friday that such discrepancies should disqualify Mr. Mnuchin, who she said was unlikely to look out for working-class Americans.

“There’s nothing in Mr. Mnuchin’s record to suggest that he would want to stand up to Wall Street,” Ms. Warren said in a speech on the Senate floor. “Mr. Mnuchin is the ultimate Wall Street insider.”

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