African-American women are more likely to be infected with HIV than other women, and many don’t know it. So public health officials and advocates are trying to get the word out about PrEP, pre-exposure prophylaxis. It’s a daily medication that helps prevent HIV infection.

“This is all about empowering women, especially black women, by giving them sexual health options and also embarking on a path of research,” says Linda Blout, president of Black Women’s Health Imperative, a nonprofit organization in Washington, D.C. The organization is helping to launch the capital’s first citywide program to promote use of PrEP among women.

The medication, which is sold under the brand name Truvada, was approved by the Food and Drug Administration in 2012 to prevent HIV infection. Research conducted in Africa, where HIV transmission in heterosexual couples is common, found that it is effective in preventing HIV infection when one partner is HIV positive. If the daily pill is taken consistently, it can reduce the risk of HIV infection by up to 92 percent.

In the U.S., the first priority was to get Truvada to men who have sex with men, who accounted for 83 percent of new HIV diagnoses in 2014, according to the Centers for Disease Control and Prevention.

But the drug isn’t just for men, says Dr. Eugene McCray, director of the CDC’s Division of HIV/AIDS Prevention. African-American women represent the highest percentage of HIV infections among women, McCray says. “That is alarming, and we at the CDC are working to address the issue by spreading knowledge. But in order for us to do that, we also need to encourage African-American women to get tested.”

According to the CDC, African-American women make up 62 percent of women diagnosed with HIV in the U.S. White women account for 18 percent, with Latinas at 14 percent.

McCray says the CDC is planning in the upcoming months to produce campaigns targeted at black women that educate them on their risk and how PrEP can be used as a preventive measure.

Women in the nation’s capital face a higher risk because about 2 percent of residents are already infected with HIV, making exposure more likely. In addition, Blout says, social issues like incarceration and poverty tend to increase the risk of HIV within the black community.

In addition, Blout also says there is a lack of empowerment among black women to ask their partners to either get tested or wear a condom. McCray agrees. “Many women do not know the status of their partners and they are weary of asking them to get tested,” he says.

“A lot of the issue has to do with misinformation or simply not being informed at all,” says Nancy Mahon, executive director of the MAC AIDS Fund, which is providing financial support for the effort. “When it comes to PrEP, many people still don’t even know it exists, especially heterosexuals. Many black women we’ve spoken to felt puzzled about why we were addressing how this drug is available to them. A component of the issue is that the drug is hard to obtain without a doctor.”

One of the challenges in getting women educated about PrEP is that primary care providers such as OB-GYNs often aren’t aware of it. That problem is compounded with low-income patients who don’t always get regular doctor visits and preventive care.

“The other problem here is that it generally takes five to 10 years for consumers to become socially acquainted with any drug,” McCray says. “That’s why we’re trying to push the information associated with PrEP to the communities in dire need of it.”

The push includes a D.C. Department of Health ad campaign that says: “#PrEPforher: Dominate your sex life.”

“Women simply don’t know the drug exists,” Blout said. “When they eventually do find out about it, they’re angry at their doctors for not telling them about it. It’s really about giving women the agency to protect their health.”

That includes information on using condoms or other methods to ensure safe sex, especially among married couples. “These are all factors that increase the exposure to HIV for black women,” Blout said.

According to Blout and Mahon, much of the program’s effort will concentrate on getting health care providers and public health clinics well-informed about the drug. Continuing education will be provided to health officials and providers in D.C. this year. “That’s the starting point,” Blout says.

The program was officially introduced on Dec. 1 by D.C. Mayor Muriel Bowser as part of her 90/90/90/50 plan for combating the HIV epidemic in the capital. The plan’s name entails having 90 percent of D.C. residents being aware of their status, 90 percent of D.C. residents who are diagnosed with HIV seeking treatment, another 90 percent who are already under treatment achieving viral load suppression and a 50 percent overall decrease in new HIV cases.

The program faces its biggest obstacle right as it rolls out, Blout says. “Stigma is our hardest hurdle.”

Mahon agrees. “This is a problem when it comes to PrEP and women, because it’s highly been stigmatized as a ‘gay drug’ or an easy way to promiscuity.” Outreach to women and health care providers will, she hopes, “get the open conversation going with a group of people who don’t even know they need to have this particular conversation.”

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Georgia Republican Tom Price, who is President-elect Trump’s choice to run the Department of Health and Human Services, is suddenly drowning in questions over the investments he has made while serving in the House of Representatives.

The issue: Did Price use his position to influence the stock prices of companies he had invested in? Or, alternatively, did he buy shares in companies ahead of actions in Congress that might boost their value?

Price says he followed all congressional ethics rules. But a handful of well-timed trades, and his apparent affinity for companies involved in health care, have raised concerns about his investing habits. Price has served as the Chairman of the powerful House Budget Committee and a member of the tax-writing Ways and Means Committee. As an orthopedic surgeon, he is a member of the health care and doctors caucuses. Any way you slice it, he has been deeply involved in making health policy.

Phillip Blando, a spokesman for Trump’s transition team, said in an email to Shots Thursday, “Dr. Price’s investment agreements for the broker-directed accounts provide the brokers with 100% investment discretion. He provides no direction regarding the investments in those three accounts.”

A broker directing investments doesn’t mitigate the appearance of conflict, says Rob Walker, the former chief counsel to the Senate and House ethics committees. “You can follow the rules and still enter into situations where the public and the press might have questions about whether there are divided loyalties, and conflicts between the personal interest and the public interest,” Walker told Shots.

So here are three problems Price is facing.

1) Innate Immunotherapeutics

Price owns shares in this Australia-based biotech company worth as much as $100,000. The concern among Democrats in the Senate is that he may have bought those shares while having access to confidential information.

Price told Sen. Patty Murray (D.-Wash.), during a hearing Wednesday before the Senate’s Health, Education, Labor and Pensions Committee, that he heard about the company, which is trying to develop drugs to treat multiple sclerosis, from Rep. Chris Collins, (R.-N.Y.). Price said he researched the company, thought it was a good investment and bought a small amount of the stock in April 2016 on the open market.

He later bought more shares, between $50,000 and $100,000 worth — in a so-called private placement, when stock is offered to a select group of hand-picked investors.

The fact that Collins serves on the company’s board and is one of its largest shareholders raises questions about whether he may have had inside information that he shared with a select group of people.

Since Price bought the second round of stock, the price has nearly quadrupled, according to Bloomberg.

Price told Murray that he didn’t believe he got any inside information from Collins.

2) Zimmer Biomet

In March 2016, Price bought 26 shares in this Indiana-based company, which is the world’s largest manufacturer of replacement hips and knees.

Under the Affordable Care Act, Medicare was testing so-called “bundled payments” for joint replacements, under which a hospital receives a flat fee for all the care surrounding the surgery — including the cost of the implant. The idea was to give hospitals an incentive to negotiate for lower prices for the replacement knees and hips that Zimmer Biomet and its competitors make.

Less than a week after buying the shares, Price introduced a bill called the HIP Act that would have suspended the pilot program.

Democrats on the Senate health committee, including Elizabeth Warren (D.-Mass.) and Al Franken (D.-Minn.) suggested Price bought the shares knowing his actions would soon boost the value.

Price told the committee he wasn’t aware he owned the stock because his shares are managed by his broker, who buys and sells on his behalf.

In heated questioning during Wednesday’s hearing, Warren made it clear that Price’s holdings weren’t in a blind trust and that he was regularly informed about the specific stocks his broker bought and sold.

She also outlined several actions Price took after he was notified that he owned Zimmer Biomet stock to advance the HIP Act, including convincing several colleagues to sign on to support the bill.

“I’m offended by the insinuation, senator,” Price said to Warren in one of the more heated moments of the hearing.

3) Othert Trades in Health Care Stocks

In December, The Wall Street Journal reported that Price traded in more than $300,000 in shares of companies involved in health care over four years. Price, as head of the House Budget Committee and a member of the tax-writing Ways and Means Committee, has influence over health care legislation, such as the Affordable Care Act and programs that include Medicare and Medicaid.

Price disclosed all the holdings to the House Clerk’s Office. Those disclosures are made regularly and the Journal compiled hundreds of pages of data and analyzed the trades.

Price hasn’t disputed the paper’s findings. In his agreement with the Office of Government Ethics, he said he would sell his stock in 40 companies, including Zimmer Biomet and Innate Immunotherapeutics.

“We have agreed to every single recommendation that they’ve made to divest of whatever holdings we have that might even give the appearance of a possible conflict,” he said.

The OGE made clear on Twitter Wednesday that it works with incoming members of the incoming administration to avoid future conflicts, but doesn’t investigate accusations of past misconduct.

“These trades were disclosed on his periodic transaction reports,” Walker said. “That doesn’t mean that they were pre-approved or pre-reviewed by an ethics official.”

He said to avoid an appearance of conflict, members of Congress should keep their investments to mutual funds, or in a blind trust.

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If you think that you won’t be touched by a Republican overhaul of Obamacare because you get health insurance through your job at a big company, think again.

Several of the law’s provisions apply to plans offered by large employers, too (with some exceptions for plans that were in place before the law passed in March 2010).

It’s not yet clear how President-elect Donald Trump and the congressional Republicans plan to revamp the federal health law. They have not agreed on a plan, and they do not have enough votes in the Senate to fully repeal the current statute. So they are planning to use a budgeting rule to disassemble part of the law, which will limit what they can change. But they also may seek revisions in important regulations and guidance that have determined how the law is implemented.

Nonetheless, as the tensions grow in Washington over the future of the health law, it is important to understand some of its effects on large-group plans.

No copays for preventive services

The health insurance offered by big companies is typically pretty comprehensive, the better to attract and keep good employees. But Obamacare broadened some coverage requirements. Under the law, insurers and employers have to cover many preventive services without charging people anything for them. The services that are required with no out-of-pocket payments include dozens of screenings and tests, including mammograms and colonoscopies that are recommended by the U.S. Preventive Services Task Force; routine immunizations endorsed by the federal Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices; and a range of services that are recommended specifically for children and for women by the federal Health Resources and Services Administration.

The change that affects the most people on an ongoing basis is likely the requirement that plans cover without cost sharing all methods of contraception approved by the Food and Drug Administration. (There are limited exceptions for religious employers.)

“In terms of sustained costs, birth control is probably the biggest,” said Caroline Pearson, a senior vice president at Avalere Health.

No annual or lifetime limits on coverage

Even the most generous plans often had lifetime maximum coverage limits of a few million dollars before the health law passed, and some plans also imposed annual coverage limits. The health law eliminated those dollar coverage limits.

Annual cap on out-of-pocket payments for covered services

The health law set limits on how much people can be required to pay in deductibles, copayments or coinsurance every year for covered care they receive from providers in their network. In 2017, the limit is $7,150 for individuals and $14,300 for families.

“Many employers often had an out-of-pocket limit anyway, but this guarantees protection for people with high needs,” said JoAnn Volk, a research professor at Georgetown University’s Center on Health Insurance Reforms, who has written on this issue.

Adult kids’ coverage expanded

The law allowed workers to keep their children on their plans until they reach age 26, even if they’re married, financially independent and live in another state. Republicans have said they may keep this popular provision in place if they dismantle the law.

Guaranteed external appeal rights

Consumers who disagree with a health plan’s decision to deny benefits or payment for services can appeal the decision to an independent review panel.

The provision applies to all new health plans including those offered by self-funded companies that pay their workers’ claims directly and who were previously exempt from appeals requirements.

No waiting periods to join a plan

Employers used to be able to make new employees wait indefinitely before they were eligible for coverage under the company plan. No more. Now the waiting time for coverage can be no more than 90 days.

No waiting periods for coverage of pre-existing conditions

Prior to the ACA, employers could delay covering workers’ chronic and other health conditions for up to a year after they became eligible for a plan. Under the ACA, that’s no longer allowed. As a practical matter, though, coverage of pre-existing conditions was rarely an issue in large-group plans, say some health insurance analysts.

Repeal could reopen the door to that prohibited practice, however.

Standardized plan descriptions

The law requires all plans to provide a “summary of benefits and coverage” in a standard format that allows consumers to understand their coverage and make apples-to-apples plan comparisons.

Basic coverage standards for large-group plans

The health law isn’t as prescriptive with large-group plans about the specific benefits that have to be offered. They aren’t required to cover the 10 essential health benefits that individual and small-group plans have to include, for example. But the law does require that big companies offer plans that meet a “minimum-value” standard, paying at least 60 percent of the cost of covered services, on average. Those that don’t could face a fine.

Initially, the online calculator that the federal Department of Health and Human Services provided to help large employers gauge compliance with the minimum value standard gave the green light to plans that didn’t cover hospitalization services or more than a few doctor visits a year. Now plans must provide at least that coverage to meet federal standards.

The result: Large employers generally no longer offer so-called “mini-med” policies with very skimpy benefits.

If the health law is repealed, that could change. In some industries with lower-wage workers and smaller profit margins, “they might begin to offer them again, and employees might demand it” to help make the premiums more affordable, said Steve Wojcik, vice president of public policy at the National Business Group on Health, a membership organization representing large employers.

Although the law strengthened coverage for people in large-group plans in several ways, consumer advocates have complained about shortcomings. It aimed to ensure that coverage is affordable by requiring that individuals be responsible for paying no more than 9.69 percent of their household income for individual employer coverage, for example.

If their insurance costs more than that, workers can shop for coverage on the marketplaces set up by the health law and be eligible for premium tax credits — if their income is less than 400 percent of the federal poverty level (about $47,000). But the standard does not take into consideration any additional costs for family coverage.

Consumer advocates also point to the wellness regulations as a problematic area of the law. The health law increased the financial incentives that employers can offer workers for participating in workplace wellness programs to 30 percent of the cost of individual coverage, up from 20 percent.

Such incentives can effectively coerce people into participating and sharing private medical information, critics charge, and unfairly penalize sick people.

“It potentially allows [plans] to discriminate against people with medical conditions, which the ACA is supposed to eliminate,” said Linda Blumberg, a senior fellow at the Urban Institute’s Health Policy Center.

Kaiser Health News is an editorially independent news service that is part of the nonpartisan Henry J. Kaiser Family Foundation. Follow Michelle Andrews on Twitter: @mandrews110.

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The Senate health committee heard from Rep. Tom Price Wednesday on his nomination to become the secretary of Health and Human Services. Obamacare was a top issue, and the congressman’s stock dealings in medical companies were also discussed.

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The first results from a major project to measure the reliability of cancer research have highlighted a big problem: Labs trying to repeat published experiments often can’t.

That’s not to say that the original studies are wrong. But the results of a review published Thursday, in the open-access journal eLife, are a sobering reminder that science often fails at one of its most basic requirements — an experiment in one lab ought to be reproducible in another one.

And the fact that they often aren’t could have big health implications. Many exciting ideas in cancer research never pan out. One reason is that findings from the initial studies don’t stand the test of time.

“Reproducibility is a central feature of how science is supposed to be,” says Brian Nosek, who spearheaded this research at the Center for Open Science.

Nosek is also a psychology professor at the University of Virginia. A few years ago, he organized a similar effort to examine research in his field. And his results garnered worldwide attention when two-thirds of the original findings in psychology couldn’t be reproduced.

Nosek decided to explore the work from cancer biology labs after two high-profile studies, from drugmakers Bayer and Amgen, reported dismal results when they tried to reproduce some cancer papers. Only 25 percent of the papers Bayer examined were reproduced. Amgen was able to replicate only six out of the 53 studies it examined.

“Those were earthshaking reports, in the sense that the community responded very strongly to these reports of challenges to reproduce some of these core findings,” Nosek says.

But scientists at Bayer and Amgen wouldn’t say which experiments they examined, so their work raised many questions but left no way for scientists to answer them.

“The cancer reproducibility project in cancer biology was an attempt to advance that discussion with an open project,” Nosek says.

This project is transparent about how it picked the studies to reproduce. It also published methods and study plans in advance. In collaboration with a California company called Science Exchange, the reviewers got grants to replicate key experiments from as many as 50 high-profile studies. (They will very likely run out of money before they’re able to complete that work, however.)

They’ve now published the results of their first five attempts, in eLife.

“Three of the five show very, very striking differences from the original,” says Timothy Errington, a biologist at the Center for Open Science and collaborator in the project. As for findings from the other two studies, he says, “I think you’ll get a lot of opinions about whether they replicate or not.”

Errington says he was quite surprised by the results.

In one case, the original scientists went the extra mile to help the labs doing the follow-up studies reduce potential sources of error. “The lab gave us the same drug. This is wonderful. Because that could have been a sticking point,” Errington says. “They gave us the same tumor cells that they used.”

Yet the replicating lab didn’t end up with the same results.

Scientists have had so much confidence in two of the original studies that drug companies already have sunk millions of dollars into efforts to try the concepts out in people. But the follow-up experiments for one of those didn’t validate the original results.

The inevitable question is whether the original science was wrong, or whether the scientists who tried to repeat that work somehow got tripped up.

The review project farmed out its actual laboratory work to commercial labs that perform experiments for the pharmaceutical industry, or to university “core facilities,” such as centralized labs that do a lot of research on mice. Those labs generally work to standards required by the Food and Drug Administration.

But research with living systems is never simple, so there are many possible sources of variation in any experiment, ranging from the animals and cells to the details of lab technique.

And there isn’t even clear agreement about when a study’s findings can be considered to have been reproduced.

Sean Morrison, an editor at eLife and a Howard Hughes Medical Institute investigator at the University of Texas Southwestern Medical Center, says that by his count, two studies’ findings were substantially reproduced. The findings of one other were not, he says, and two others have results that simply can’t be interpreted.

“One of the difficulties of the reproducibility project is they have limited time and resources to spend on any one study,” Morrison says. “As a result, they can’t go back and do these things over and over again when the first results turn out to be uninterpretable.”

Errington agrees that the reproducibility project leaves that big question hanging — but the scientists don’t plan to answer it.

“As exciting as that is, and as important as that is — and we hope someone else will follow up on it — we’re more curious about, ‘What does that look like when we do this across many, many, many studies.’ “

But Dr. Erkki Ruoslahti, at the nonprofit Sanford Burnham Prebys Medical Discovery Institute in La Jolla, Calif., is worried that the reproducibility project could do real damage. The reviewers couldn’t reproduce his original study but didn’t follow up to understand why.

“I am really worried about what this will do to our ability to raise funding for our clinical development,” he writes in an email to Shots. “If we, and the many laboratories who have reproduced our results, are right and the reproducibility study is wrong — which I think is the case — they will not be doing a favor to cancer patients.”

Dr. Irving Weissman, a professor of pathology and developmental biology at Stanford University, is also disappointed in how the reproducibility project handled his experiment. His paper reported finding a protein that’s present on all human cancer cells — a finding that Weissman says has been replicated many times in other labs.

The reproducibility project chose to repeat a peripheral part of Weissman’s paper — an experiment involving mice, not human tissues. And, Weissman says, the replicating lab stumbled over an early step in the experiment, but plowed ahead anyway.

Weissman says he offered to bring scientists into his lab to train them in the technique, but the Reproducibility Project didn’t do that. (That would undercut one of its goals, which is to see whether scientists working independently can verify published results.)

It’s important to replicate important studies, Weissman tells Shots, “but you can’t do it halfheartedly. You have to be serious about it.”

Errington and Nosek hope people who hear about the project’s findings don’t jump to any conclusions about why individual studies came to different conclusions. They’re trying to look at the big picture across dozens of studies, the two scientists say, and they don’t place too much confidence in any single result.

The reproducibility project is looking for patterns across cancer research and also trying to identify common reasons that labs might have trouble reproducing one another’s work. Are the directions offered in the methods section of a paper too sketchy? Or maybe experiments frequently work only under unusual conditions.

Morrison, who is involved as a journal editor rather than a participant, says the entire reproducibility project is itself one big experiment.

“I think it’s too early for us to know whether this approach is the right approach or the best approach for testing the reproducibility of cancer biology,” he says. “But it will be a data point, and it will start the conversation.”

The conversation is important because the vast majority of treatment ideas that come from the lab fail when they’re tried in people. Cathy Tralau-Stewart, a pharmacologist at the University of California, San Francisco, says scientists often don’t know why those clinical failures occur, “and so that’s why I think studies like this are really, really important.”

Unfortunately, Nosek says, there are few incentives today for scientists to repeat experiments from other labs. The rewards are for publishing new ideas, not the less glamorous, but still critical, work of verifying somebody else’s findings.

“If we’re going to take reproducibility seriously,” Nosek says, experiments that attempt to reproduce the findings of others “need to be a valued part of scientific contribution.”

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President-elect Donald Trump’s pick to run the Department of Health and Human Services is taking heat for his controversial stock holdings in companies affected by laws he has worked on and voted for. But federal records show several senators who will take part in confirmation hearings for Rep. Tom Price, a Georgia Republican, have substantial health-related holdings as well.

At least six members of the two Senate committees tasked with questioning or confirming Price, who was trained as an orthopedic surgeon, hold shares in health care companies. A Kaiser Health News analysis finds that the investments, which include shares in companies such as Merck, Medtronic and Gilead Sciences, have been held by Sens. Thomas Carper, D-Del., Bill Cassidy, R-La., Susan Collins, R-Maine, Tim Kaine, D-Va., Mark Warner, D-Va., and Sheldon Whitehouse, D-R.I.

“This conflict of interest problem is one that members [of Congress] have danced around over a period of years much too lightly,” said former Rep. Lee Hamilton, a Democrat, who founded the Indiana University Center on Representative Government after spending more than 30 years in Congress. “And I think it needs to be corrected in order to have confidence in the institution.”

KHN examined the most recent annual financial disclosures for the 40 senators who sit on either the Finance Committee; the Committee on Health, Education, Labor and Pensions; or both. The HELP Committee’s courtesy hearing with Price is Wednesday, and the Finance Committee’s more pivotal vote has been scheduled for Jan. 24.

About half the senators reported holding stocks in their households, but only six disclosed owning stocks in health and biomedical firms.

Of the six, Whitehouse and his family have the most health stocks, split among various IRAs, education savings accounts and other accounts and belonging to Whitehouse, his wife and his children. In all, they disclosed between $402,000 and $1.3 million in health-related holdings in 2015. The disclosures don’t give exact numbers and instead include ranges.

Price has been criticized following a Wall Street Journal investigation that found he traded more than $300,000 in health-related stocks while serving on a health subcommittee of the House Committee on Ways and Means. Democrats have called for investigations into whether Price made trades based on insider knowledge.

Earlier this month, Trump transition spokesman Phillip Blando blasted Democrats’ hypocrisy and singled out Carper, Warner and Whitehouse for owning health stocks, calling for similar questions to be asked about their trades and holdings. He declined last week to comment further on the senators’ stock holdings. Price has told ethics officials he would divest his stock in dozens of publicly traded companies.

Owning the stocks is legal, but not everyone agrees on whether it’s fair, said Tim LaPira, a political science professor at James Madison University, adding that the Senate is on average wealthier than the House. “Of course they can invest their money as they please,” he said.

The major concern, political analysts said, is that members of Congress will help pass laws to benefit companies in which they own stock. According to the Senate ethics rules, “A Member, officer, or employee may not use his or her official position for personal gain.”

Although insider trading has been illegal for members of Congress since 2012, it’s nearly impossible to prove, LaPira said.

Research studies have shown that members of Congress tend to make higher returns on the stock market than the general public. “We found that in general, they earn about 12 percent a year more than the average bear,” said Alan Ziobrowski, a retired Georgia State University real estate professor who published a 2004 study of Senate stock performance from 1993 through 1998. He did a similar study of House stock performance in 2011.

He said members of Congress could have access to information that can aid in stock picking, including earlier notice that laws are about to change or additional information gathered from industry lobbyists. Ziobrowski said a follow-up study by another researcher in 2013 found that members of Congress “quit fooling around on the stock market” after his study of the Senate was released, but that no one has repeated his analysis since.

Collins, Kaine and Whitehouse serve on the HELP Committee, whose jurisdiction includes measures pertaining to health, “biomedical research and development.” Carper and Warner are on the Finance Committee, which deals generally with money and taxes. But it also handles “health programs under the Social Security Act and health programs financed by a specific tax or trust fund.” Cassidy is on both committees.

Since 2015, Whitehouse appears to have been an active trader and filed 10 periodic transaction reports in 2016. Annual reports for 2016 aren’t due until mid-May, but periodic reports must be filed within 45 days of a trade, according to the 2012 STOCK Act, which stands for Stop Trading on Congressional Knowledge.

Around the time the House released its near-final version of the 21st Century Cures bill, which was intended to speed the FDA’s drug approval process, Whitehouse’s family purchased more stock in Gilead Sciences, which makes the pricey hepatitis C drugs Sovaldi and Harvoni.

The Whitehouses’ Gilead purchases that month ranged from $4,000 to $60,000. The family also purchased shares of Amgen and Abbott. Whitehouse later voted in favor of the bill. The Gilead stock decreased in value following these purchases but got a slight bump up just before the bill was signed into law on Dec. 13. Some of the Gilead stock was sold about a week later.

“Senator Whitehouse does not direct his trading and doesn’t control the allocation of investments among different types of assets,” his press secretary, Rich Davidson, said in an email.

When asked whether owning stocks could present an ethical conflict that could preclude Whitehouse from asking questions of Price, Davidson said, “Sen. Whitehouse has no day-to-day input into either the management of his investment account or the decisions to trade individual holdings or types of assets. If we told him this, it would be news to him.”

The family of Delaware Democrat Carper owned up to $285,000 in health stocks, though they could total as little as $54,000 due to the broad ranges in the reports. They are all in his wife’s name, but Hamilton said that’s irrelevant. His wife sold some of her stock in MetLife, a company that sells health and life insurance, on Dec. 15, according to his latest transaction report.

In an emailed statement, Carper defended his record and said he believes President-elect Trump’s Cabinet nominees should be scrutinized. “I have been a public servant for more than three decades and have always submitted thorough financial disclosures about my family’s income and holdings,” he said. “Any attempt to cast a shadow of impropriety on our financial decisions is inaccurate and unreasonable.”

Maine Republican Collins and her family had between $78,000 and $295,000 in health-related stocks in 2015. They were held in her husband’s name. He sold all of his Express Scripts stock on Dec. 16, a few days after the 21st Century Cures Act was signed into law. Express Scripts is a manager of prescription benefits. Collins’ office did not reply to requests for comment.

According to Lousiana Republican Cassidy’s annual disclosure, his wife owned between $1,000 and $15,000 in iShares US Pharmaceuticals, an exchange-traded fund based on an index of the drug industry.

Disclosure forms show that the family bought and sold other health related stock in 2016, including purchases of Johnson & Johnson, Abbott and Novartis shares in March. In October, Cassidy’s wife sold her stock in Johnson & Johnson and bought stock in CVS Health and Amgen. Cassidy’s office didn’t respond to requests for comment.

KHN compiled a database of assets listed as “corporate securities stock.” It included all stock owners in the immediate family, including spouses and dependent children. Two of the original 40 senators filed their reports on paper instead of electronically. The paper forms don’t classify assets as “corporate securities stock,” so those had to be examined individually.

Warner, who filed on paper, disclosed that his limited liability company, MRW Biotech Investors, holds between $250,000 and $500,000 in shares of Ziopharm Oncology Inc. Warner’s LLC invested in a venture capital fund that invested in Ziopharm before it went public. Ninety-six percent of the investment company is owned by Warner’s trust.

“Sen. Warner’s investments are managed by an independent trustee, and have been since before he became governor of Virginia in 2002,” said Rachel Cohen, Warner’s press secretary.

Kaine is new to the HELP Committee this year. His 2015 disclosure revealed that his children and their cousins collectively owned a trust set up by their grandmother that contained between $51,000 and $115,000 in health stocks, most of which were Bristol-Myers Squibb. His office declined to comment.

Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation. KHN’s coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation.

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On Wednesday, Rep. Tom Price, R-Ga., goes before the Senate Committee on Health, Education, Labor and Pensions in his first grilling since he was nominated to lead the Department of Health and Human Services. This isn’t an official confirmation hearing. That comes later, before the Senate Finance Committee. But with outspoken senators such as Elizabeth Warren, D-Mass., and Bernie Sanders, I-Vt., on the HELP committee, Price is certain to face tough questions.

Here are five things to look out for:

OBAMACARE

Price, who is an orthopedic surgeon, has been an ardent opponent of the Affordable Care Act since it was passed in 2010. He complains that the law gets in the way of good care. Democrats on the committee are certain to grill him on his own proposal for an Obamacare replacement, one that offers a fixed tax credit to buy coverage no matter your income.

They’ll also likely take the opportunity to put Price on the spot for comments made by Donald Trump on Sunday. The president-elect told The Washington Post “We’re going to have insurance for everybody,” but he provided no details on how he would make this happen.

Then on Tuesday, the Congressional Budget Office released an analysis projecting that the partial repeal of Obamacare envisioned by Republicans in Congress would result in 18 million people losing their insurance immediately, and 32 million losing it long term.

“Representative Price’s approach is moving us in exactly the wrong direction,” Sen. Bernie Sanders said after meeting with Price Tuesday.

THOSE STOCKS

Price’s financial disclosures show he was an active trader of individual company stocks, including shares in pharmaceutical and medical device companies. Several news outlets have reported that Price took actions in Congress to benefit medical companies that contributed to his campaign, and that he bought shares in some companies just before government actions boosted their value.

For example, CNN reported Tuesday that Price bought shares in Zimmer Biomet, which makes knee and hip implants, just before he introduced a bill to delay new regulations that could have hurt the company’s profits.

Trump transition spokesman Philip Blando said in an emailed statement that “these allegations are false.”

MEDICARE REFORM

Price was head of the House Budget Committee when it released A Balanced Budget for a Stronger America in March 2016. That plan calls for Medicare reform in which private insurers compete with Medicare for patients, a system many opponents described as “privatizing” Medicare. The details of the plan were included in Speaker Paul Ryan’s outline last summer to replace the Affordable Care Act.

The proposal actually says that traditional Medicare will remain an option, though many analysts believe that the ultimate goal is to move most seniors to private insurance by making Medicare an expensive option with fewer benefits.

Democrats have said they’re eager to take on Republicans over Medicare because the program is very popular.

DRUG PRICES

Prseident-elect Donald Trump sent drug company stocks into a tailspin last week when he promised in a news conference that he would have Medicare negotiate for lower drug prices with the pharmaceutical industry. Today the federal health program for the elderly is barred by law from negotiating for lower prices, even though it accounts for 29 percent of the approximately $325 billion the U.S. spends on pharmaceuticals each year.

Democrats have long advocated for Medicare to be able to negotiate better deals for itself, so this may be one area where the toughest questions come from Republicans. Sanders on Tuesday told reporters he plans to ask Price about drug prices in the hearing.

HIS MEDICAL PRACTICE

Price’s ethics disclosures show he intends to sell off all his stocks. However, he plans to maintain his interest in his private medical practice outside Atlanta. As HHS secretary he’ll have a lot of power over physicians, most directly by having power over Medicare and the rates it sets for doctors.

Price has promised to recuse himself from any government decision that directly affects his business, but it will be tough to avoid any decisions that impact physicians.

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A partial repeal of Obamacare could leave 18 million people who have insurance today with no coverage one year later, according to an analysis by the non-partisan Congressional Budget Office.

The report estimates that 32 million people would lose their insurance over 10 years.

The CBO based its estimates on a bill passed by Republicans and vetoed by President Obama in 2015. That bill amounted to a partial repeal of the Affordable Care Act, also called Obamacare, eliminating the penalty for people who didn’t have health insurance. It also cut out the government subsidies that currently help people pay their premiums.

The CBO estimated that getting rid of the penalty for people who do not purchase insurance would lead to 18 million fewer insured people with in a year, and that the number would eventually grow to 32 million after subsidies and a Medicaid expansion were also eliminated.

As NPR’s Alison Kodjak reported, “Congressional Republicans haven’t introduced legislation to repeal Obamacare yet [this year], but they’ve suggested they’ll follow the model of the previous [2015] bill.”

So far, lawmakers pushing for the repeal have no plan for encouraging people to have insurance without the mandate and subsidies.

“We’re not holding hard deadlines, only because we want to get it right,” House Speaker Paul Ryan, R-Wis., said last week.

On Monday, President-elect Donald Trump told The Washington Post he was working on a plan to replace the Affordable Care Act with a proposal that would provide “insurance for everybody.”

As we reported, “he did not get into any specific details about his health care plan during a telephone interview with the newspaper. But he did say it would be ‘much less expensive’ and would involve ‘much lower deductibles.’ “

He also told the newspaper he does not plan to cut benefits for Medicare and that he does not want a single-payer health care system.

The CBO analysis makes clear that repealing Obamacare would affect millions of Americans, even those who do not lose their health insurance outright. The report found that, in the first year after a repeal-without-replacement law, premiums would rise about 20 to 25 percent over the levels predicted with Obamacare, which itself has been criticized for its failure to control premium costs.

The analysis also found that, without the federal mandate requiring people to buy insurance, some insurance companies would stop offering plans, and in the first year “roughly 10 percent of the population would be living in an area that had no insurer participating” in the market for individuals buying health insurance.

By 2026, that would grow to 75 percent of the general U.S. population.

And, although Republicans have already taken steps toward a partial repeal, the marketplaces established by Obamacare are still operating. Open enrollment for 2017 ends Jan. 31, with a few exceptions, as we have reported.

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A Congressional Budget Office analysis requested by Democrats says a repeal of Obamacare could leave millions uninsured. But Republicans insist they will come up with a replacement law to provide insurance.

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Most patient advocacy groups get funding from the industry, a new study finds. That means they may have a conflict of interest when they are representing patients.

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