WASHINGTON — As a congressman, Georgia Republican Tom Price has been thwarted in his hopes to repeal the Affordable Care Act and transform Medicare into a voucher-like program for future participants.

Now, as President-elect Donald Trump’s choice to run the Department of Health and Human Services, Price will wield great power as Trump’s top health policy adviser and preside, Republicans hope, over the dismantlement of President Barack Obama’s signature health care law.

Price, 62, carries himself with a surgeon’s confidence and possesses deep knowledge of health policy. He is one of very few Republicans to actually propose a replacement for Obamacare, and promises to be a staunchly conservative voice in Trump’s Cabinet. Price is buttoned down and unfailingly polite, but he is not shy about swinging his elbows in the heat of debate.

As chairman of the House Budget Committee, Price emerged as a top advocate of Speaker Paul Ryan’s plan to transform Medicare from a program that supplies a defined set of benefits into a “premium support” model that would, similar to Obamacare, offer subsidies for participants to purchase health care directly from insurance companies. He also wants the Medicare eligibility age to rise to 67.

Price said last month that “every single day Obamacare is making the quality of health care in this country worse … Patients and taxpayers cannot afford Obamacare, and clearly this law was doomed from the start.”

Any changes to Medicare and the health care law would be far-reaching, affecting some 85 million Americans.

Price also backs, as does Trump, a plan by House Republicans to sharply cut the Medicaid health program for the poor and disabled and turn it over to the states to run. Like Trump and most other Republicans, Price wants federal funding withdrawn from Planned Parenthood, which has come under attack for its practice of supplying tissue from aborted fetuses to medical researchers.

Trump has said he opposes GOP plans to provide vouchers for future Medicare beneficiaries, and GOP support for the idea has never been tested beyond its inclusion in non-binding budget blueprints. Price’s plan would require people who are now in their late 50s to accept the Medicare subsidies, which critics say would fail to keep pace with inflation and force higher out-of-pocket costs like deductibles and co-payments.

Trump named Price on Tuesday and called him “a tireless problem solver and the go-to expert on health care policy, making him the ideal choice” to run HHS.

“He is exceptionally qualified to shepherd our commitment to repeal and replace Obamacare,” Trump said.

While Republicans are generally united in their desire to repeal Obama’s health law, there’s no consensus on what should replace it. Price has offered a solution that would provide tax credits to subsidize the purchase of individual and family health insurance policies. His proposal would also allow insurers to sell policies across state line, boost incentives for health savings accounts and create high-risk pools to help individuals afford coverage, while barring assistance for nearly all abortions.

It will fall to Price, once confirmed, to be the prime go-between Trump and Capitol Hill Republicans in what are certain to be difficult and complicated negotiations over replacing the health care law. Price serves on the powerful Ways and Means Committee, which has jurisdiction over Obamacare, but he hasn’t been seen as an inside player in much of the panel’s work.

The HHS secretary also has great power over the workings of Medicare and Medicaid and the medical profession in general.

Price led the House Republican Study Committee, a powerful band of conservative voices, during the first two years of the Obama administration. He lost a close election in 2012 to become the No. 4 Republican in House GOP ranks despite the support of Ryan, a friend and confidante. At the time, Republicans faced criticism for a lack of diversity in their leadership ranks, and GOP leaders like former Speaker John Boehner of Ohio swung behind Rep. Cathy McMorris Rodgers of Washington state.

Democrats reacted with alarm to the naming of Price, though they lack the power to block him because of a change to filibuster rules they orchestrated when controlling the Senate.

“Congressman Price has proven to be far out of the mainstream of what Americans want when it comes to Medicare, the Affordable Care Act and Planned Parenthood,” said incoming Senate Minority Leader Charles Schumer, D-N.Y. “Thanks to those three programs, millions of American seniors, families, people with disabilities and women have access to quality, affordable health care. Nominating Congressman Price to be the HHS secretary is akin to asking the fox to guard the hen house.”