Republicans pushed President Donald Trump's choice for health secretary toward confirmation Thursday in the testy Senate's fourth consecutive brawl over Cabinet picks.
Rep. Tom Price, R-Ga., seemed certain to win confirmation to head the Health and Human Services Department by a mostly party-line vote, testament to each side's divergent views of him and the raw feelings that have enveloped Washington.
Republicans see the conservative seven-term House member and orthopedic surgeon as a knowledgeable leader who will help scuttle President Barack Obama's health care overhaul. Democrats describe an ideologue who has 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, 62, "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 battle in which Republicans want to quickly enact priorities long blocked by Obama. Democrats, with few tools as Congress' minority, are trying to impede them and have stretched some floor debates to the maximum 30 hours Senate rules allow.
The high stakes plus Trump's belligerent style have fed a combative mood. It's also produced unusual 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 said 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 most people unprotected against significant health expenses.
Republicans have yet to produce a replacement plan and have issued conflicting assessments of when they will do so.
Price has supported ending federal payments to Planned Parenthood as well as 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.
Trump has said he doesn't want to cut Medicaid or Medicare.
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 attacked him for buying stock in a medical implant maker and pushing legislation to help the company.
Price has said he's done nothing wrong. It's illegal for members of Congress to engage in insider trading.
After Price, Treasury nominee Steven Mnuchin, a financier, is next in line for Senate votes.
Underscoring the antagonism, the Senate has approved the previous three consecutive Cabinet nominees along mostly party lines.
Sen. Jeff Sessions, R-Ala., became attorney general by 52-47 after Warren was punished for reading a 1986 letter by Coretta Scott King criticizing him. Betsy DeVos was approved as education secretary, rescued by Vice President Mike Pence's tie breaker in a 51-50 vote, and Rex Tillerson won approval 56-43 as secretary of state.
Senate records show that over the past four decades, 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.