Rep. Tom Price (R-Ga.), a veteran lawmaker and vehement critic of the Affordable Care Act, has been picked as President-elect Donald Trump's choice to lead the Department of Health and Human Services. (Jenny Starrs/The Washington Post)

REP. TOM PRICE (R-Ga.) will govern the nation’s sprawling health-care programs next year — if, that is, the Senate confirms him to head the Department of Health and Human Services. Since President-elect Donald Trump tapped Mr. Price to join the Cabinet, senior Democrats have signaled they may make his confirmation difficult, in part because he has pushed very conservative ideas about how to remake health-care policy — including an Obamacare replacement plan that would be tougher on the poor and the sick than some other GOP proposals.

Mr. Price’s appointment should mark the beginning of a new national debate on health care. But the nomination itself does not warrant Senate opposition. Mr. Price is a longtime member of Congress who has shown a particular interest in health-care policy. Though we disagree strongly with his Obamacare replacement plan, he at least fleshed out his proposal with numbers and legislative text, which is more than many of his colleagues have done. He is qualified to serve in the Cabinet. Democrats should not object to him simply because they dislike the direction he wants to take health-care policy. Opposing executive confirmations should be an option reserved for truly exceptional circumstances: when nominees are simply unqualified or threaten more fundamental American values.

That does not mean that Democrats or anyone else should roll over when it comes to the policy the next administration may pursue. Mr. Price and his Republican colleagues in Congress may put the country through the second major health-care overhaul in less than a decade. The details will determine how many people will have access to decent coverage and care — and to what degree the recent progress on reducing the number of uninsured Americans will be rolled back.

In their effort to reduce regulations and spend less money, Republicans will be tempted to come down hardest on those with the least political muscle — that is, the poor and near-poor. This tendency is already visible in the replacement plans from Mr. Price and other Republicans. For example, they propose extending tax credits to help people buy health insurance, but they do not vary the credits’ value by income. Federal money would therefore be wasted helping relatively wealthy people, while too little would go to helping those who really need the boost.

Then there is the question of what to do to the Medicaid program that Obamacare expanded in many states, which covers millions of low-income people. The expansion has been a key driver of the trend toward greater health-care coverage over the past several years. GOP policymakers have a variety of ideas to choose from — ranging from leaving the program basically alone to totally upending it. If they decide to pursue more radical options, “reform” could easily become a euphemism for eroding a crucial cord in the safety net, to the detriment of particularly vulnerable people.

These are just two of a plethora of choices Republicans will have to make if they are serious about repealing and replacing Obamacare. As they proceed, they must remember that millions of Americans’ health — indeed, their lives — are at stake.