In a hearing Friday, senators pressed Dr. Mehmet Oz, the TV celebrity nominated to head Medicare and Medicaid, on Republican-led proposals that would significantly affect the health care coverage for nearly half of all Americans.

At his confirmation hearing before the Senate Finance Committee, Oz bantered with senators in a friendly atmosphere, joking about basketball and allegiances to college teams. He largely escaped tough questions from either side of the aisle, displaying his on-air charm as he deflected Democrats’ most pointed concerns about potentially radical changes in health coverage not only for those 65 and older but for poor children.Many senators seemed distracted by the fierce debate over the Republicans’ budget deal to avert a government shutdown, and they dashed in and out of Oz’s hearing. But he is poised to sail through the Senate for confirmation as the next administrator of the Centers for Medicare and Medicaid Services, an agency with $1.5 trillion in spending.

Sen. Elizabeth Warren, D-Mass., made a big deal of his financial conflicts before the hearing. But at the session, she did not press him on those issues. Instead, she focused on his views about whether private Medicare plans are overcharging the government, an area where she and Oz seemed to agree on the need to tackle potential fraud and waste.

Throughout the hearing, he displayed a facile knowledge of a variety of relevant agency issues, although he repeatedly reverted to stock answers that he would need to study the topic at hand more.

Several lawmakers, mainly Democrats, tried to force Oz to express his views on the Trump administration’s goals to cut back on health care costs and agency budgets, but he repeatedly sidestepped those minefields.

“It is our patriotic duty to be healthy,” he told senators. “It costs a lot of money to take care of sick people who are sick because of lifestyle choices.”

This refrain is in line with the Make America Healthy Again movement championed by Robert F. Kennedy Jr., the new secretary of the Department of Health and Human Services, and Oz’s soon-to-be boss if he is confirmed.

Medicare Advantage and privatization

Introductory remarks from Sen. Ron Wyden, D-Ore., held out an initial promise of some challenging questions. He accused Oz of dodging almost $500,000 in Social Security and Medicare taxes in recent years by using a tax exemption related to limited partnerships, something Democrats concluded after reviewing Oz’s tax returns. But there were no follow-up questions on it.

Wyden also raised the specter that he was going to grill Oz on his connection to TZ Insurance Solutions, a for-profit company that sells Medicare Advantage plans to older Americans. Oz has been a relentless promoter of these private plans — which have been criticized by lawmakers and regulators for systemic overbilling and denying patients care — on his show and YouTube channel.

Oz, 64, is also a registered broker for TZ Insurance in states across the country, according to a recent investigation into his finances by the New York Times. Again, Wyden flagged the issue and did not follow up.

Despite concerns by Democrats that Oz would most likely roll back some of the rules meant to rein in the plans, he instead committed to strong oversight. He acknowledged that some of the brokers now selling these plans were “churning policies,” switching people from one plan to another, regardless of whether the change in coverage benefited them.

“Part of this is just recognizing there’s a new sheriff in town,” Oz said. “We actually have to go after places and areas where we’re not managing the American people’s money well.”

Several times in the hearing, Oz addressed bipartisan concerns over whether Medicare Advantage plans are overpaid. In response to questions from a fellow physician, Sen. Bill Cassidy, R-La., Oz mentioned a study suggesting the federal government spends more on the private alternative to Medicare than the government-run program. “It’s upside down,” he said.

“We should examine whether some of the money should be reimbursed to the American people,” Oz said.

He also expressed interest in solving some of the bipartisan concern over insurers’ use of prior authorization for approving medical procedures by reducing the number of services that would be subject to review.

Republican plans to cut Medicaid

Democrats seemed most frustrated by Oz’s stance toward Medicaid, the state-federal program that covers 72 million low-income Americans. “All my colleagues want to know: Are you going to cut Medicaid?” asked Sen. Maria Cantwell, D-Wash.

But Oz, who has not spoken much about the program he would also oversee as head of the agency, did not answer directly. He said he did not know the details of the Republican budget discussions, in which lawmakers are looking at hundreds of billions of dollars in cuts that could result in people’s loss of coverage as it became more difficult to enroll and states had to shoulder more of the burden.

When questioned by Sen. Raphael Warnock, D-Ga., about Republican efforts to add burdensome monthly paperwork for some people to show they should get benefits, Oz said he favored the work requirements that Republicans want to limit eligibility. But he agreed with the senator about making sure people who should be eligible for Medicaid were not cut off.