(Sarah Parnass/The Washington Post)

President Trump’s choice for health secretary declined Tuesday to promise that no Americans would be worse off under Trump’s executive order to ease provisions of the Affordable Care Act — and distanced himself from the president’s claim to have an almost-
finished plan to replace the law.

At a testy Senate confirmation hearing on his nomination to lead the Department of Health and Human Services, Rep. Tom Price (R-Ga.) sought to play down the influence he would have on reshaping the health-care system along conservative lines, while attempting to deflect accusations from Democrats about his ethics.

He repeatedly flashed his long-standing distaste for federal insurance standards and other government strategies to guide medical care. And although he embraced certain policies popular within the GOP, such as special insurance pools for patients with preexisting medical conditions, he steered clear of other ideas he has supported, including the transformation of Medicaid from an entitlement program for lower-income people to a set of block grants to states.

By the time the hearing ended after four hours, the Senate Finance Committee’s partisan divisions appeared as bitter as they had at the beginning, with the Republicans aligned solidly behind the nominee despite sharp Democratic attacks on his investment and legislative practices.

Chairman Orrin G. Hatch (R-Utah) praised Price as a singularly qualified nominee and took broad swipes at Senate Democrats, saying they were tearing at the fabric of the chamber as an institution with their attempts to undercut Trump’s Cabinet ­choices.

(Senate Committee on Finance)

The committee’s ranking Democrat, Sen. Ron Wyden (Ore.), countered that Price, if confirmed, would “take America back to the dark days when health care was for the healthy and the wealthy.” Focusing on the private investments in health-care companies that could have benefited from bills Price sponsored, Wyden said that “it is hard to see this as anything but a conflict of interest and an abuse of position.”

A fresh allegation Tuesday was that Price underreported to the committee and the Office of Government Ethics the value of shares he holds in an Australian company, Innate Immunotherapeutics. Price, who purchased some of that stock through a discounted, private offering, attributed the under­reporting to “a clerical error” and a misunderstanding of the question.

“The reality is that everything that I did was ethical, above­board, legal and transparent,” Price said — a message Republicans sought to reinforce throughout the hearing.

Democrats targeted most of their questioning on the direction that Price, if confirmed, would try to take the health-care system. Price demurred repeatedly.

For instance, he sidestepped a series of questions about the effects of the sweeping order Trump issued just hours after his ­swearing-in that directed agencies to lift or soften federal rules implementing aspects of the ACA. Price declined to commit that no one would be harmed, that no one would lose insurance coverage or that the regulations would be rewritten only after a plan exists to replace the 2010 health-care law.

He similarly deflected a question about whether the new administration would try to stop enforcement of the ACA’s individual insurance requirement prior to a replacement plan.

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“I commit to working with you,” Price finally told Wyden after reiterating that his goal is to ensure all Americans have an opportunity for access to health insurance. The ACA’s goal is universal coverage.

“We didn’t get an answer,” Wyden retorted.

Price also skirted questions by Sen. Sherrod Brown (D-Ohio) about Trump’s statements the weekend before his inauguration that the health-care plan he was completing would provide “insurance for everybody.”

Brown asked: “President Trump said he’s working with you on a replacement plan for the ACA, which is nearly finished and will be revealed after your confirmation. Is that true?”

Price replied: “It’s true that he said that, yes.”

The packed hearing room broke into laughter.

Brown persisted: “Did the president lie about this, that he’s not working with you?”

The nominee gave an oblique answer, saying, “I’ve had conversations with the president about health care.”

Tuesday’s hearing was the more significant of two appearances Price has made in the past week on Capitol Hill because the Finance Committee has jurisdiction to vote on his nomination. A date has not been set.

Democrats’ numerous attacks on Price in the past week prompted Sen. Johnny Isakson (R-Ga.), who officially introduced Price to his Finance Committee colleagues, to say, “I feel like I’ve been asked to be a character witness in a felony trial in the sentencing phase of a conviction.”

Price has promised to divest financial interests in any companies that could pose a conflict of interest for him as HHS secretary. But some lawmakers, as well as the advocacy group Public Citizen, are calling for an investigation by the Office of Congressional Ethics. They also have filed complaints against Price with the Securities and Exchange Commission.

The 62-year-old lawmaker practiced as an orthopedic surgeon for two decades before entering politics. He was in the Georgia state Senate and first elected to Congress in 2004. He is chairman of the House Budget Committee.

In the Trump administration, Price would oversee one of the government’s largest agencies, with a $1 trillion budget and sweeping responsibility over programs that, in one way or another, affect the lives of nearly all Americans. They include public-health disease surveillance, biomedical research, drug approvals and the nation’s main welfare program.

Though he played down his role on Tuesday, Price would be one of the central figures in designing and carrying out a plan by the new administration and the Republican-led Congress to replace the 2010 health-care law.

In response to other questioning, Price emphasized the need for innovations in health care, but he said that an HHS “innovation center,” created as part of the ACA, “has gotten off track a bit” by “mandatorily dictating to physicians how they must practice.”

In another tense exchange, Sen. Robert Menendez (D-N.J.) pressed Price to concede that if policymakers made Medicaid a block-grant program, Americans would no longer be automatically entitled to receiving its coverage.

“When you move to a block grant, do you still have a right?” Menendez asked.

“No,” Price said. “I think it would be determined by how that was set up, if in fact that’s what Congress did.”

But Menendez said that Price, if confirmed “will have an enormous impact” on the program’s future. “So please don’t say to me that ‘I am just here to do just what Congress says,’ ” the senator said.

Even as the Senate hearing was underway, the process leading toward the ACA’s repeal was continuing in the other chamber of Congress. The House Budget Committee was discussing the law’s “failures,” and the House Ways and Means Committee was set to meet in the afternoon on the ACA’s individual mandate — the least popular feature of the law and one likely to disappear in forthcoming GOP health-care plans.

And next week, the House Energy and Commerce Committee is scheduled to hold a pair of hearings on lowering insurance costs and reforming Medicaid, according to a person familiar with the plans.