Trump's picks to lead HHS, CMS: What you need to know

Price has opposed mandatory value-based payment programs

President-elect Donald Trump on Tuesday tapped House lawmaker and former orthopedic surgeon Tom Price (R-Ga.) to lead HHS under his administration and Seema Verma, a health care consultant, to serve as CMS administrator.

Both positions require Senate confirmation.

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Price, an ACA opponent, picked to lead HHS

Before joining Congress, Price worked in private practice as an orthopedic surgeon for nearly two decades before serving as an assistant professor at Emory University School of Medicine and as medical director of the orthopedic clinic at Grady Memorial Hospital in Atlanta. Price would be the first doctor to lead HHS in more than two decades; Dr. Louis Sullivan led the department from 1989 to 1993.

Price is currently chair of the House Budget Committee and sits on the health subcommittee of the House Ways and Means Committee. He has long opposed the Affordable Care Act (ACA) and has proposed legislation every year since 2009 seeking to replace the law, according to the New York Times.

Price's replacement bill (HR 2300), called the Empowering Patients First Act, in its current form would repeal the ACA and provide tax credits for U.S. residents to purchase health coverage that are based on an individual's age instead of income.

Among other provisions, his replacement plan also would make it easier for insurers to sell plans across state lines and provide states with $3 billion in grants to subsidize high-risk pools to provide coverage for individuals with pre-existing conditions.

Price on Medicaid, Medicare, value-based payments

Price also has proposed significant changes to the Medicaid and Medicare programs.

For example, he supports turning Medicaid into a block grant program with the aim of giving states more control and flexibility over the program. His plan also would require "able-bodied" beneficiaries to meet work requirements to receive benefits. He also would allow individuals to opt out of Medicaid, Medicare, or Veterans Affairs coverage—and instead use tax credits to purchase private plans.

Price supports switching Medicare from a "defined benefit" to a "defined contribution," under which the government would give beneficiaries financial assistant to help them buy private coverage.

Price has also supported the Medicare Access and CHIP Reauthorization Act (MACRA) and has broadly supported value-based payments. However, he has criticized certain aspects of MACRA's implementation, as well as its reporting requirements, Bruce Japsen writes for Forbes. In addition, Price has opposed mandatory payment programs implemented by the Center for Medicare and Medicaid Innovation (CMMI).

Price and nearly 180 House colleagues in a letter to CMS officials sent in September called on the agency to halt new mandatory payment reforms that the lawmakers argued could harm health care quality and exceed CMS' authority.

They specifically cited concerns over the mandatory Comprehensive Care for Joint Replacement Model, the proposed mandatory Cardiac Bundled Payment Model, and proposed mandatory changes to how Medicare reimburses physicians for drugs administered under Medicare Part B.

Comments on Price

In statement announcing his pick, Trump said Price "has earned a reputation for being a tireless problem solver and the go-to expert on health care policy, making him the ideal choice to serve in this capacity." He added that Price "is exceptionally qualified to shepherd our commitment to repeal and replace Obamacare and bring affordable and accessible health care to every American."

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Sen. David Perdue (R-Ga.) said Price "understands that we need to stop Washington's takeover of our health care system." He added, "As a doctor, he is seen as a leading voice on health care policy and has a common-sense plan to replace Obamacare that will lower costs and put patients in charge of their health care choices."

Meanwhile, incoming Senate Minority Leader Chuck Schumer (D-N.Y.) criticized the nomination. He said in a statement, "Congressman Price has proven to be far out of the mainstream of what Americans want when it comes to Medicare, the [ACA], and Planned Parenthood." He added, "Nominating Congressman Price to be the HHS secretary is akin to asking the fox to guard the hen house."

Trump picks CMS leader

In related news, Trump on Tuesday announced that he will nominate Seema Verma to be the next CMS administrator.

Verma is president, CEO, and founder of SVC, a health policy consulting firm. She worked with Vice President-elect Mike Pence to help Indiana expand its Medicaid program under a waiver. According to Politico's "Forty Five," Verma also has advised several Republican states on how to incorporate conservative initiatives, such as health savings accounts and employment requirements, into their Medicaid programs.

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Before her consulting work, Verma worked for the Health and Hospital Corporation of Marion County, Indiana and the Association of State and Territorial Health Officials in Washington, D.C.

Trump said that Verma "has decades of experience advising on Medicare and Medicaid policy and helping states navigate our complicated system," He added, "Price and Seema Verma are the dream team that will transform our health care system for the benefit of all Americans" (Holland, Reuters, 11/29; Pear, New York Times, 11/28; Goldstein/Rucker, "PowerPost," Washington Post, 11/29; Radnofsky/Nicholas, Wall Street Journal, 11/28; Levey, Los Angeles Times, 11/28; Modern Healthcare, 11/28; Kumar et al., McClatchy/Sacramento Bee, 11/28; Williams, Roll Call, 11/28; Neel, "Shots," NPR, 11/28; Jackson/Solis, USA Today, 11/29; Nelson, "Forty Five," Politico, 11/29; Diamond, "Pulse," Politico, 11/29; Japsen, Forbes, 11/29; Hallerman, Atlanta Journal Constitution, 11/29).

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