Rep. Tom Price, President-elect Donald Trump’s choice to head the Department of Health and Human Services, faced a contentious Senate hearing Wednesday as Democrats questioned his ideas for the future of Americans’ health coverage and whether his personal investments in health-care companies presented conflicts during his years in Congress.

Democrats on the Senate Health, Education, Labor and Pensions Committee grilled Price (R-Ga.) over his stock transactions in health, biomedical and pharmaceutical companies while he was supporting legislation that could benefit them.

The half-day hearing was one of four held Wednesday by Senate committees on the president-elect’s Cabinet choices. The generally genial sessions with billionaire investor Wilbur Ross, Trump’s pick to head the Commerce Department, and South Carolina Gov. Nikki Haley (R), his selection for U.N. ambassador, contrasted with the more confrontational questioning of Price and Scott Pruitt, the Oklahoma attorney general, who is in line to lead the Environmental Protection Agency in a Trump administration.

In Price’s case, Democrats, who have called for ethics investigations, pressed hard on whether he used insider knowledge to enrich himself or pushed bills benefiting companies in which he had a financial stake. Some exchanges were particularly sharp: Sen. Elizabeth Warren (D-Mass.) lectured Price so persistently on his stock trading that he declared himself “offended.”

The nominee maintained that he had not sought to take advantage of his public position and that he was not aware of what precise stocks he held in the past or at present. “Everything that we have done has been aboveboard, ethical, transparent and legal,” he said. He denied the existence of any conflict stemming from stock purchases, saying he’d had “no conversations with my broker about any political activity at all, other than her congratulating me on my election.”

Price began by laying out central elements of his years-long attempt to replace the Affordable Care Act. In doing so, he signaled ways in which Trump’s more populist message could collide with the core beliefs of congressional Republicans. He told senators that “it is absolutely imperative” for the government to ensure that all Americans “have the opportunity to gain access” to insurance coverage — a more modest goal than the “insurance for everybody” declaration that the incoming president made this past weekend.

Trump said a replacement plan was nearly finished. The nominee indicated that it would be ready by March but did not elaborate.

And Price expressed views that go beyond those articulated by the president he would serve if confirmed, such as requiring some Medicaid recipients to work as a condition of their benefits and not guaranteeing that young adults can stay on their parents’ health plans until age 26.

The courtesy hearing before the Senate panel marked the first time Price had appeared before lawmakers since his selection by Trump. His formal confirmation hearing before the Senate Finance Committee is set for Tuesday.

The committee’s chairman, Sen. Lamar Alexander (R-Tenn.), and top Democrat, Sen. Patty Murray (Wash.), made clear they were searching for more specific details on the president-elect’s plans to replace the ACA.

Alexander began the hearing by reading conflicting comments by Trump, House Speaker Paul D. Ryan (R-Wis.) and Senate Majority Leader Mitch McConnell (R-Ky.) about how they planned to replace the 2010 law “simultaneously,” “concurrently” and in “manageable pieces.”

“Trying to interpret what those words mean, to me, that means Obamacare should be finally repealed only when there are concrete practical reforms in place to give Americans access to truly affordable health care,” he said. “It’s not about developing a quick fix.”

Murray criticized Republicans for “rushing” the confirmation process and told the nominee that she had “serious concerns about your qualifications and plans for the department you hope to lead.”

“Just last week, you voted to begin the process of ripping apart our health-care system without any plan to replace it,” Murray said. “My constituents are coming up to me with tears in their eyes, wondering what the future holds for their health care given the chaos Republican efforts could cause.”

Sen. Sheldon Whitehouse (D-R.I.) said that the ACA has slowed the rise in U.S. health-care spending. “So we throw this thing out at our peril,” he told Price. “And we throw it out with nothing to replace it. It’s like being asked to jump out of an airplane without a parachute and saying, ‘Trust us, we will build a parachute.’ ”

The 62-year-old Price, who practiced as an orthopedic surgeon for nearly two decades before entering politics and has advanced physicians’ interests as a lawmaker, reprised a longtime theme of his — that the health-care system needs to enable doctors to focus more on their patients than on insurance paperwork and government rules.

The department he would run is one of the government’s largest, with a $1 trillion budget. It would place Price at the fulcrum of some of the most incendiary domestic issues facing the incoming administration. Beyond the future of the Affordable Care Act, the HHS secretary has a role in setting policy for reproductive health, major entitlement programs, vaccines and other public health matters.

A Michigan native who went to medical school at Emory University in Atlanta, Price left his practice to serve in the Georgia state Senate. He became the first GOP majority leader in the chamber’s history. While serving in the state Senate, he advocated for reducing jury awards when physicians were found guilty of malpractice.

During questioning, he reiterated his support for what would be a fundamental change to Medicaid — requiring “able-bodied” people to be in work activities to qualify for benefits. Whitehouse pressed him repeatedly on whether people with addictions or mental health problems would be required to work.

After dodging the question a few times, the nominee responded, “I think people have an understanding of what able-bodied is, and it doesn’t [involve] the things you described.”

Rep. Tom Price (R-Ga.), President-elect Trump's nominee for secretary of health and human services, repeatedly came under fire from Democrats questioning his financial dealings, during a hearing on Jan. 18 at the Capitol. (Video: Peter Stevenson/Photo: Bill O'Leary/The Washington Post)

At one point, after Price repeated his commitment to ensuring Americans had access to insurance, Sen. Bernie Sanders (I-Vt.) shot back: “ ‘Has access to’ does not mean that they are guaranteed health care. I have access to buying a $10 million home. I don’t have the money to do that.”

Trump has pledged not to cut Medicaid or Medicare, but Price did not do the same. After Warren asked whether he had authored budget resolutions that would have cut the Medicaid program by $1 trillion over 10 years, he replied, “You have the numbers before you.” At another point, the nominee told lawmakers: “Nobody’s interested in pulling the rug out from under anybody. . . . I think there’s been a lot of talk about individuals losing health coverage. That is not our goal, nor is it our desire, nor is it our plan.”

Though Trump vowed this past weekend to curb drug prices in Medicare and Medicaid by negotiating directly with pharmaceutical firms, Price declined to endorse that idea. When Sanders argued that the United States has the world’s highest drug costs specifically because it does not negotiate with the industry, the congressman replied that “there are a lot of reasons for that” and said he wanted to “get to the root causes of that.”

Price said he would work to ensure that “drug prices are reasonable and individuals across the country have access” to needed prescriptions.

Yet his own financial dealings attracted as much attention as his policy positions Wednesday.
In December, the Wall Street Journal reported that since 2012, Price had traded more than $300,000 in shares in about 40 health, biomedical and pharmaceutical companies while he was involved with legislation that might affect those firms’ stocks.

Three such trades involved drugmakers Amgen, Eli Lilly and Bristol-Myers Squibb, which stood to receive massive tax breaks under a bill that Price later introduced in Congress.

The bill, which did not pass, sought a permanent tax break for American businesses with manufacturing and other production activities based in Puerto Rico. All three of those pharmaceutical companies have production facilities in Puerto Rico.

Murray and Sen. Al Franken (D-Minn.) sharply questioned Price on numerous stock purchases, including one in which he got a discount rate in a private offering by medical device manufacturer Zimmer Biomet. The purchase, CNN reported Monday, was made shortly before Price introduced legislation that would have helped the company.

Murray asked whether Rep. Chris Collins (R-N.Y.) had suggested Price invest in Zimmer Biomet, noting that Collins, a board member, had been overheard recently boasting that he had helped other lawmakers make money by giving them stock tips. “Is that a stock tip?” she asked.

“That’s not what happened,” Price replied. “I had no access to nonpublic information.”

Price noted that his initial purchase in 2015 was through the stock exchange, while a subsequent trade in 2016 was through the “private placement offering.” Initially he said he didn’t know the 2016 trade was at a discount rate, but he later told Franken, “By definition, I believe that’s the nature of a private placement offer.”

“It really begs credulity, sir, when you say you did not know that you got a discount on this,” Franken said, given that only “about 20 people” were able to participate. “These sound like sweetheart deals.”

Vice president-elect Mike Pence said Wednesday on MSNBC’s “Meet the Press Daily” that he and Trump stood behind Price and called him “a man of tremendous integrity.”

Price told the committee that he has already agreed to divest of any holdings that the Office of Government Ethics recommends he sell.

Sean Sullivan and Alice Crites contributed to this report.