The direction of major health care programs, from insurance exchanges to Medicaid expansion, may be a step closer to course reversal after President-elect Donald Trump tabbed new leaders for two key federal posts.
Trump named
Rep. Tom Price, R-Ga., a six-term congressman, former orthopedic surgeon and long-time Obamacare opponent, as his pick to lead HHS. To lead CMS, Trump chose
Seema Verma, a consultant who led the implementation of Indiana's Medicaid expansion during Vice President-elect Mike Pence's time as governor.
Both candidates will have to gain Senate confirmation before taking up their posts.
While the exact restructuring of federal programs, including the nation's vast insurance infrastructure, is likely to remain under wraps until Inauguration Day, previous work indicates the possibility of significant course change.
Price has been an outspoken critic of the Affordable Care Act (ACA) since the law's inception. "Obamacare is not working,"
said Price in a statement in March. "We need to start over with a new approach."
In the past, Price has also been in favor of privatizing Medicare and has been critical of programs such as the hospital franchise fee, says Daphne K. Saneholtz, attorney with Brennan, Manna and Diamond in Columbus, Ohio. " All this tells me that he will move HHS in a direction completely opposite of where it’s been going under the Obama administration," says Saneholtz.
In May 2016, Price introduced the Empowering Patients First Act into the House of Representatives. The bill would repeal the ACA and
replace it with a program centered largely around tax credits, the creation of high-risk pools, cross-state insurance plans and other elements. The bill allows individuals to opt out of federal insurance programs, such as Medicare, and use tax credits to pay for private insurance coverage.
As the nominee for the new head of CMS, Verma would take over a program marked by deep internal change in recent months. In 2015, the Medicare Access and CHIP Reauthorization Act (MACRA) overhauled the physician payment system and streamlined the path to value-based care.
Under the Indiana Medicaid expansion, Verma engineered a
program centered around high-deductible plans and health savings accounts (HSAs).
"Price and Verma are probably really going to shake things up," projects Saneholtz.
The AMA on Nov. 29 threw its support behind Price, citing
in a statement his expertise in health policies that "advance patient choice and market-based solutions as well as reduce excessive regulatory burdens."
Price has supported reduced administrative burden for physicians working under programs tied to the
MACRA legislation. He has supported the law in the past.