President Trump’s next pick to lead the Department of Health and Human Services could send a major signal about how committed the administration is to using executive powers to unwind the 2010 health care law.
Tom Price, a longtime foe of President Obama’s program, resigned as secretary last week amid questions about pricey plane trips, just as Mr. Trump faces new decisions about enrollment and payments ahead of the 2018 season.
Democrats say Mr. Trump should use his HHS nominee to change the tune, arguing Mr. Price damaged the law by slashing the 2018 enrollment period in half and championing budget cuts to federal programs.
“It’s time for this administration to work with Democrats to improve and update the Affordable Care Act,” House Minority Leader Nancy Pelosi said. “This pivot should start with the nomination of a new secretary who will stop this administration’s sabotage of hard-working Americans’ health care.”
It’s unclear if Mr. Trump will heed that call.
Lobbyists and health consultants say top candidates include longtime Obamacare critics such as Florida Gov. Rick Scott and former Louisiana Gov. Bobby Jindal.
Less partisan candidates include Federal Drug Administration Director Scott Gottlieb, who also served in the Bush administration, and VA Secretary David Shulkin, a holdover from the Obama administration. Both are considered proven leaders who can weather the confirmation process.
Seema Verma, administrator at the Centers for Medicare and Medicaid Services, is perhaps the most natural candidate to slot into the top job at HHS. Though hardly a friend to Obamacare, she helped Indiana test the boundaries of the law when Vice President Mike Pence served as governor, securing federal dollars to expand Medicaid while imposing conservative guardrails on the insurance program for the poor.
Likewise, Mr. Trump will be leaning on his new secretary to test the limit of the law through administrative action since congressional Republicans couldn’t repeal and replace his predecessor’s law.
“So much of the ACA implementation is left to the discretion of the administrative state. That will allow President Trump the opportunity to shape the course of the law,” said Lanhee J. Chen, a fellow at Stanford University’s Hoover Institution who advised 2012 GOP nominee Mitt Romney on health care. “Having an HHS secretary who understands the ins and outs of the law, as well as ways its implementation can be impacted, will be critical.”
Robert Laszewksi, a health policy consultant in Virginia, is among those who think Ms. Verma will stay put at CMS since her expertise is in Medicaid.
He says Mr. Scott, a former hospital CEO and “seasoned politician,” is a better fit. Hours before Mr. Price stepped down, Mr. Scott had lunch with Mr. Trump and Mr. Pence to coordinate the response to Hurricane Irma in Florida and Hurricane Maria in Puerto Rico, so he already has the president’s ear.
Yet he’s also believed to be eyeing a 2018 challenge to Sen. Bill Nelson, Florida Democrat, and Mr. Scott’s office threw cold water on speculation around the HHS job Monday.
“Gov. Scott has no plans to pursue that position. He is totally focused on continuing to serve Florida families,” spokeswoman Kerri Wyland said.
Mr. Jindal, meanwhile, called Mr. Trump an “unstable narcissist” during the GOP presidential primary contest in 2015, so he might not shoot to the top of the list.
But he also blasted Obamacare in a Politico op-ed this year as a “top-down, one-size-fits-all” approach that robs local government of their decision-making powers.
Devolving power from Washington to the states was the central theme of the most recent attempt at repeal, which foundered in the Senate last week when GOP leaders couldn’t muster enough votes.
Rick Santorum, a former Republican senator who cheered on the recent repeal fight, would be a good fit for the top HHS job, according to John Desser, a former Bush administration health official and senior vice president for government affairs at eHealth, a website that connects users with insurance.
He noted that Mr. Santorum, prior to his newfound role as a health policy whisperer, was an early proponent of giving Americans without job-based insurance a refundable tax credit to help them afford coverage.
Democrats argue voters are getting repeal fatigue, so Congress should fix Obamacare instead of reinventing the health care system.
“President Trump’s first nine months have been one health care disaster after another,” said Sen. Christopher Murphy, Connecticut Democrat. “Let’s get a new HHS secretary who’s finally devoted to improving health care, move past these debates and come to bipartisan agreement on how to stabilize markets and make health care cheaper.”
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