June 7, 2018

A new name for HHS? Trump eyes sweeping changes.

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    President Trump reportedly is eyeing a proposal that would recommend reorganizing, and potentially renaming, HHS, sources familiar with the proposal have told Politico.

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    Proposal details

    According to Politico, two sources familiar with the proposal said the White House Office of Management and Budget (OMB) is slated to release proposal report in June that will recommend significant changes for a number of federal agencies. The sources said the administration has been working on the proposal for months, but noted that it is still not finalized, meaning aspects of the proposal could change. According to Politico, the proposal is related to an executive order Trump signed in March 2017 that directed OMB to comprise a plan to redesign the federal government for greater efficiency.

    Sources familiar with the proposal told Politico that it will recommend moving some safety-net programs—such as the federal food assistance program known as the Supplemental Nutrition Assistance Program, or SNAP—under HHS' oversight. In addition, the sources said the proposal would recommend changing HHS' name.

    According to Politico, it remains unclear exactly how HHS would be reorganized under the proposal, but sources said the department's new name would emphasize HHS' role in providing assistance to low-income U.S. residents and could potentially include the term "welfare," which had previously been a part of the department's name. HHS currently oversees some entitlement programs, such as Medicaid and Medicare. HHS also oversees the federal Temporary Assistance for Needy Families (TANF) program, which is commonly referred to as a "welfare" program, according to Politico.

    The sources told Politico that officials at OMB largely have indicated their support for reorganizing HHS to house a number of safety-net programs that currently fall under various departments' jurisdictions, including the U.S. Department of Agriculture (USDA). A source familiar with the proposal said, "You have low-income assistance in a bunch of different shops without one point of oversight and without a whole lot of communication. Why not have one federal agency responsible for execution?"

    Reaction

    According to Politico, at least two aspects of the proposal—moving several multimillion-dollar safety-net programs under HHS' jurisdiction and renaming HHS—are unlikely to be implemented because such changes generally require Congress' approval. However, Politico reports that the proposal indicates where the administration stands on several domestic policy issues.

    According to Politico, conservatives are likely to support the proposal, partly because HHS in recent months has encouraged states to implement work requirements for certain Medicaid beneficiaries.

    Kristina Rasmussen, vice president of federal affairs at the conservative Foundation for Government Accountability, said, "Generally speaking, we're in favor of the idea. HHS has been doing some pretty exciting things on the work requirements front for able-bodied adults."

    Tom Scully, who served as CMS administrator and an OMB official under former President George W. Bush's administration, said he does not see a downside to the proposal. Referring to his time at HHS and OMB, he said, "It drove me crazy that food stamps are in one place, housing is another, Medicaid is somewhere else. From the beneficiary's point of view, it makes sense" to house the programs in one place. Scully also commented on the reported proposal to change HHS name, noting that he oversaw CMS' name change from the Health Care Financing Administration. "Every 25 years, change the name to freshen things up. Just make sure you use the old (HHS) stationary until it runs out so you're not wasting money," Scully said.

    However, staffers on several congressional committees have raised concerns about shifting oversight of safety-net programs, saying such a move could result in jurisdiction fights. According to Politico, federal lawmakers spend years working toward committee leadership positions and could oppose changing the committees' oversight responsibilities.

    OMB spokesperson Jacob Wood declined to comment on the proposal, Politico reports. HHS and USDA referred media inquiries to OMB, according to Politico (Sullivan, The Hill, 6/6; Morse, Healthcare Finance News, 6/6; Bottemiller Evich/Restuccia, Politico, 6/6; Diamond, "Pulse," Politico, 6/7).

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