The past few weeks have been quite busy for President-Elect Trump. In order to maintain his campaign promise of repealing and replacing ObamaCare, President-Elect Trump has nominated his administration’s Health and Human Services (HHS) Secretary and CMS Administrator.
HHS Secretary Nomination: Tom Price, a Georgia Republican Congressman
Tom Price is a retired orthopedic physician who entered politics with a goal of reforming healthcare and the relationship between provider and patient. Congressman Price has introduced numerous bills over the years to repeal and replace ObamaCare. As such, we can expect that he is going to play a critical role in shaping healthcare policy after the inauguration.
Price’s signature piece of legislation was The Empowering Patients First Act of 2015. The legislation was formed around the basic premise that as long as a person stayed insured, pre-existing conditions can’t be used to deny coverage or raise premiums. The individual mandate that is the driving force of ObamaCare has been removed in Price’s legislation. In order for his legislation to be affordable and provide broad coverage, the act included tax credits based on income levels.
Additionally, unlike the current system, Price’s legislation doesn’t define insurance or impose specific conditions for what qualifies as health insurance. His main focus is to reduce government involvement and let people choose the type of coverage and policy that is best for them.
As for a focus on providers and how his potential involvement could affect your agency, there are a lot of unknowns. Much of ObamaCare was left open for CMS Administrators to make decisions based on cost report data, quality data, fraud, waste and abuse risk, and information that was mandated to be reported. We could see more of the opened ended policy making in a new administration.
CMS Administrator Nomination: Seema Verma, President and Founder, SVC Consultants
Seema Verma is the current president of her own company which focuses on national health policy consulting. Her experience and expertise is widely considered as she sits and has sat on numerous boards transforming healthcare systems. Verma’s experience also includes redesigning Medicaid programs in states from Maine to Iowa. Her history indicates that she favors less government based programs and more reliance on managed care organizations.
With these two at the helm of HHS and CMS, we can likely expect a different experience from what we have right now. It will be interesting to see how a patient-centered care physician will interact with a CMS Administrator who seems to favor insurance companies more. Stay tuned for more updates! Please email us at firstname.lastname@example.org if you would like to receive email alerts on developing healthcare policy as we enter the Trump era.