What the industry is saying about Trump's HHS, CMS picks

Advocates, lawmakers have mixed reactions

Some health care industry leaders are encouraged by President-elect Donald Trump's picks for HHS secretary and CMS administrator, but other stakeholders have expressed concerns.

Trump on Tuesday selected House lawmaker and former orthopedic surgeon Tom Price (R-Ga.) to lead HHS under his administration and Seema Verma—president, CEO, and founder of SVC, a health policy consulting firm—to serve as CMS administrator. Both positions require Senate confirmation.

Industry stakeholders see hopeful signs

Mario Molina—CEO of Molina Healthcare, which provides Medicaid coverage and individual plans under the Affordable Care Act (ACA)—said, "From our standpoint, we want to make sure that as many people as possible maintain coverage. I think the pieces of the health care puzzle are kind of coming together for us now."

Kathleen Harrington, chair of Policy of Government Relations for the Mayo Clinic, said, "We are very encouraged with the approach we're hearing so far from President-elect Trump in terms of having a focused review and removing certain parts of [the law]."

Several health care associations also appeared encouraged by the choices.

Calling for the Senate to "promptly consider" the nominations, the American Medical Association (AMA) in a statement said the group "strongly supports the nomination of" Price, noting, "His service as a physician, state legislator, and member of the U.S. Congress provides a depth of experience to lead HHS."

AMA cited Price's work on policies "to advance patient choice" and "reduce excessive regulatory burdens."

Similarly, the American Hospital Association in a statement said Price's "clinical knowledge along with his congressional experience make him an impressively qualified candidate for HHS secretary."

The Federation of American Hospitals (FAH) also said Price's background makes him fit to lead HHS. "His decades of experience in the medical field make him uniquely qualified to confront the challenges facing patients, families, and caregivers," the group said in a statement. "In light of expected legislative action on the ACA, it is noteworthy that his repeal and replace proposal recognizes the need to protect access to hospital care for millions of [U.S. residents] by restoring deep Medicare and Medicaid cuts."

FAH also applauded Verma's nomination, noting that she "has a solid reputation as an effective innovator in assisting states in reforming and modernizing Medicaid programs."

Bob Laszewski, president of Health Policy Strategy and Associates, said Verma is an "outstanding pick." He added, "She is the godmother of conservative Medicaid reform ideas and implementation."

Meanwhile, Darrell Kirch, president and CEO of the Association of American Medical Colleges, in a statement said, "As the architect of the Healthy Indiana Plan and advisor to other states navigating Medicaid reforms, [Verma] offers a unique perspective for overseeing policies that are crucial for maintaining a health care system that will improve the health of all [U.S.  residents]."

ACA advocates, Democrats less optimistic

However, other stakeholders are less optimistic about Trump's picks.

For example, Joan Alker, executive director of the Georgetown Center for Children and Families, said, "The vision of Medicaid under Verma is troubling. It's a vision where there will be many new barriers to coverage."

Citing concerns that Price could revoke the ACA's contraceptive coverage, Cecile Richards, the president of Planned Parenthood Federation of America, said, "Each senator must decide whether a man who wants take away no co-pay birth control coverage from 55 million women is the right choice to serve as the secretary of HHS."

Meanwhile, some Democratic senators have pledged to fight Price's nomination.

For instance, incoming Senate Minority Leader Chuck Schumer (D-N.Y.) said, "He is going to get a lot of very strong and very thorough questions about the kinds of things that he has proposed." He added, "And if he sticks with them, I think there's a chance that his nomination will fail."

Sen. Debbie Stabenow (D-Mich.), the top Democrat on the Senate Finance Committee's health care subcommittee, called Price "someone who supports dismantling Medicare, slashing Social Security, gutting women's health services, and eliminating health care for 20 million people."

GOP leaders discuss next steps on ACA repeal

Meanwhile, Republican congressional leaders on Tuesday signaled that any bill to repeal the ACA would include a transition period that would allow changes to be incorporated over time.

Senate Majority Whip John Cornyn (R-Texas) said, "There will be a multiyear transition into the replacement." He said the ACA "is a failed piece of legislation and it is coming apart at the seams, but it is going to take us awhile to make that transition from the repeal to actually replacing it."

According to Senate Finance Committee Chair Orrin Hatch (R-Utah), that transition could take up to three years.

House Majority Leader Kevin McCarthy (R-Calif.) said, "I don't think you have to wait" for a replacement plan in order to repeal the law, adding, "My personal belief, and nothing's been decided yet, but I would move through and repeal and then go to work on replacing" the ACA.

However, some Democrats maintain that repealing the ACA without a replacement will not work. 

For example, Sen. Dick Durbin (D- Ill.) said it the subsequent uncertainty could push insurers to leave the marketplace. "We'd find ourselves with even fewer options out there," he said (Humer, Reuters, 11/29; Dickson, Modern Healthcare, 11/29; Clark, McClatchy/Sacramento Bee, 11/30; AMA release, 11/29; FAH release, 11/29; AHA release, 11/29; Lightman [1], McClatchy/Sacramento Bee, 11/29; Frieden, MedPage Today, 11/29; Sullivan, The Hill, 11/29; Lightman [2], McClatchy/Sacramento Bee, 11/29; Werner, AP/Sacramento Bee, 11/29; Snell, "PowerPost," Washington Post, 11/30).

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