Rep. Tom Price, President Donald Trump's choice to be health secretary, is the latest of a handful of Cabinet nominees to eke out a confirmation victory in a bitterly divided Senate.
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Following the pattern of strictly party-line votes on two previous nominees — Attorney General-designate Sen. Jeff Sessions and Betsy DeVos for Education secretary — the Georgia congressman was approved early Friday on a 52-47 vote. Former Exxon-Mobil CEO Rex Tillerson fared somewhat better than Sessions and DeVos, but still won confirmation for secretary of state by only a 56-43 margin.
Two other controversial Trump selections are set for votes Monday. By a 53-46 margin, the Senate ended procedural hurdles to financier Steven Mnuchin's nomination to be Treasury secretary. Final approval for Mnuchin and for physician David Shulkin to be veterans affairs secretary was set for Monday.
Minority Democrats have used Senate rules, where possible, to delay elevation of some Trump's nominees. And following Price's confirmation to head the Department of Health and Human Services, Senate Minority Leader Chuck Schumer said: "The Republicans launch their first assault in their war on seniors."
Democrats prolonged the debate on the 62-year-old Price until nearly 2 a.m. EST Friday, in arguments tinged with bitter accusations, reflecting the raw feelings enveloping Washington early in Trump's presidency.
Just four of 31 votes for then-President Barack Obama's Cabinet vacancies drew at least 40 "no" votes, as did only two of 34 votes for Cabinet positions under President George W. Bush.
No. 2 Senate GOP leader John Cornyn of Texas said Democrats' "obstruction" of Cabinet nominees was a rejection of Trump's Election Day victory and threatened "the stability of the government and that peaceful transition of power" from President Barack Obama.
Republicans see Price, an orthopedic surgeon and seven-term House veteran, as a knowledgeable leader who will help scuttle Obama's health care overhaul, partly by issuing regulations weakening the law. Democrats describe an ideologue with a shady history of trading health care stocks and whose policies will snatch insurance coverage from Americans.
"He seems to have no higher priority than to terminate health coverage for millions of people," said Sen. Jeanne Shaheen, D-N.H. She said his preference for limiting women's access to free birth control was "not only wrong, it's arrogant."
Senate Majority Leader Mitch McConnell, R-Ky., said Price "knows more about health care policy than just about anyone." He said Price would help "bring stability to health care markets that Obamacare has harmed."
Price's nomination is part of a larger clash in which Republicans want to quickly enact priorities long blocked by Obama. Democrats, with few tools as Congress' minority, are making a show of resistance, stretching some floor debates to the maximum 30 hours Senate rules allow.
The high stakes plus Trump's belligerent style have fed the combativeness. They've also produced remarkable scenes, including Democratic boycotts of hearings, Republicans suspending committee rules to approve nominees and GOP senators voting to bar Sen. Elizabeth Warren, D-Mass., from joining a debate.
Sen. Orrin Hatch, R-Utah, accused Democrats of opposing Trump's nominees with "apocalyptic visions of a future world gone mad." He wondered how Democrats kept "their outrage settings turned to 11 without getting completely exhausted."
Sen. Patty Murray, D-Wash., said Trump was shaping a Cabinet that "benefits those at the top and their allies, but really hurts the workers and families."
Until recently chairman of the House Budget Committee, Price has proposed repealing Obama's health law and replacing it with tax credits, health savings accounts and high-risk pools for sick, costly consumers. Democrats say those ideas are inadequate and would leave people unprotected against significant health expenses.
Republicans have yet to produce a replacement plan and have differed over when they will do so.
Price has supported ending federal payments to Planned Parenthood, and paring Medicaid and giving states more power to shape the health care program for the poor. He'd reshape Medicare's guaranteed health coverage for the elderly into a program offering subsidies for people to buy policies.
Democrats have accused Price of lying about his acquisition of discounted shares of an Australian biotech company and benefiting from insider information. They've also asserted he pushed legislation to help a medical implant maker whose stock he'd purchased.
Price has said he's done nothing wrong. It's illegal for members of Congress to engage in insider trading.
By 53-46, the Senate ended procedural hurdles to financier Steven Mnuchin's nomination to be Treasury secretary. Final approval for Mnuchin and for physician David Shulkin to be veterans affairs secretary was set for Monday.
The Senate has approved the previous three consecutive Cabinet nominees along mostly party lines.
Sessions, an Alabama Republican, became attorney general by 52-47 after Warren was punished for reading a 1986 letter by Coretta Scott King criticizing him. DeVos was approved as education secretary, rescued by Vice President Mike Pence's tie breaker in a 51-50 vote.
That contrasts with the past four decades, when Senate records show most Cabinet selections have been approved overwhelmingly.
During that period, no secretary of state nominee received fewer than 85 votes. The closest tally for health secretary was the 65-31 roll call for Obama's 2009 pick, Kathleen Sibelius.
Just four of 31 votes for Obama Cabinet vacancies drew at least 40 "no" votes, as did only two of 34 votes for Cabinet positions under President George W. Bush.