Price resigns. Who could be the next HHS secretary?

HHS Secretary Tom Price resigned Friday in the wake of federal investigations and growing criticism over his use of private planes for official business.

President Trump has appointed Don Wright to serve as acting secretary for the department, which operates on an annual $1.15 trillion budget and oversees CDC, CMS, FDA, and NIH. Wright currently serves as the deputy assistant secretary for health and the director of the Office of Disease Prevention and Health Promotion.

Background

Politico first broke news of Price's use of private planes for work-related travel, which later spurred and investigation by HHS' Office of Inspector General (OIG).

Politico has identified at least 26 instances since May when Price, a physician and former Republican House representative from Georgia, flew on private jets for official business at an estimated cost of more than $400,000 to U.S. taxpayers. Politico also is reporting that Price traveled via military aircraft for multi-national trips to Africa, Europe, and Asia, at a cost of more than $500,000.

Price on Thursday said he would reimburse the federal government for "[his] seat" on private jets, totaling roughly $51,000, and would no longer use charter flights for official business. However, that offer was not enough to stem the controversy, and the White House Friday afternoon confirmed that Price had offered his resignation to Trump earlier in the day.

Price's resignation

In his resignation letter to Trump, Price said, "I have spent 40 years both as a doctor and public servant putting people first. I regret that the recent events have created a distraction from these important objectives. Success on these issues is more important than any one person. In order for you to move forward without further disruption, I am officially tendering my resignation."

The White House said going forward all travel on "government-owned, rented, leased, or chartered aircraft" must be approved by chief of staff John Kelly.

During his tenure as HHS secretary, Price, a longtime Affordable Care Act opponent, has overseen budget cuts to programs intended to promote the ACA's upcoming open enrollment period and scaled back the period during which individuals can enroll in exchange coverage. Price also defended the Trump administration's fiscal year (FY) 2018 HHS budget proposal, which included steep cuts to his department, particularly Medicaid.

Under Price, HHS also proposed to eliminate three planned Medicare mandatory bundled payment models and scale back a fourth. More recently, Price and CMS Administrator Seema Verma have solicited ideas to revamp CMS' Center for Medicare and Medicaid Innovation (CMMI) and the payment models the center creates. Price in October 2016 was among a group of House lawmakers who criticized CMMI's use of mandatory bundled payment models.

Who will be the next HHS secretary?

While the administration has not commented on whom Trump will nominate to replace Price, several media outlets are reporting that Verma and FDA Commissioner Scott Gottlieb are possible candidates.

Others on the rumored short list include:

  • Florida Gov. Rick Scott (R), a former hospital executive who became CEO of Columbia/HAS;
  • Former Louisiana Gov. Bobby Jindal (R), who served as assistant secretary of HHS under President George W. Bush;
  • Sen. John Barrasso (R-Wyo.), a physician;
  • Rep. Marsha Blackburn (R-Tenn.), who has no background in the health care industry but led the House's investigation into Planned Parenthood funding last year; and
  • Veterans Affairs Secretary David Shulkin, a physician and former health administrator whom Trump kept on from the Obama administration.

Politico reports Wright also may be a candidate. Wright is a public health expert who has focused on emergency preparedness and infectious disease.

Democrats' reactions

Senate Democrats on Friday signaled they would insist that regardless of whom Trump nominates, the next HHS secretary should continue implementing the ACA.

Senate Minority Leader Chuck Schumer (D-N.Y.) on Friday said, "The next HHS secretary must follow the law when it comes to the Affordable Care Act instead of trying to sabotage it."

Senate Finance ranking Democrat Ron Wyden (Ore.) said, "Tom Price’s replacement needs to be focused on implementing the law as written by Congress and keeping the president's promise to bring down the high cost of prescription drugs."

Price was confirmed on a party-line vote, with Republicans voting in favor of Price's confirmation and Democrats voting against it (Baker et al., New York Times, 9/29; Baker, Axios, 9/29; Diamond et al., Politico, 9/30; Peck, MedPage Today, 9/29; Baker/Pear, New York Times, 9/30; Kenen/Haberkorn, Politico, 10/1; Baker, "Vitals," Axios, 10/2).

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