Early last Friday, the U.S. Senate confirmed Rep. Tom Price (R-GA) along a party line vote to be the next secretary of the Department of Health and Human Services (HHS).
Price, an orthopedic surgeon by training, had served in the U.S. House of Representatives since 2005. While in the House, he became a key figure in the Republican effort to repeal and replace the Affordable Care Act (ACA). His confirmation fills a significant seat in President Trump’s cabinet and signals the start of many things to come in the health care policy world.
As a member of Congress and former chairman of the Budget Committee and the Republican Study Committee – a group of approximately 170 conservative members – Price dedicated much of his time to the notion of less government intrusion. Price’s beliefs go hand in hand with President Trump’s recent executive order requiring two regulations be eliminated for every new one created. Although it remains unclear how the “two-for-one” order will be implemented, we can assume this type of action is something Price endorses.
After being sworn in, Price signaled he plans to get to work immediately. Just days later, the Centers for Medicare and Medicaid Services proposed a rule for 2018 to stabilize the individual insurance market by expanding pre-enrollment verification of eligibility, allowing issuers to collect premiums for prior unpaid coverage, providing greater flexibility to determine level of coverage, deferring to states on the question of issuer network adequacy, and shortening the annual open enrollment period.
We can expect to see further ACA-related regulations follow, perhaps by shifting more costs to consumers, allowing older enrollees to be charged higher premiums, altering the individual mandate or changing the definition of essential health benefits. For example, this week the Internal Revenue Service indicated it will accept and process tax returns where a taxpayer doesn’t indicate their coverage status, weakening enforcement of the individual mandate.
While Price and other agency leads advance efforts through the administrative powers at his disposal, Congress also continues to move forward on the repeal and replacement of ACA. Some leaders charged with creating the replacement plan have suggested a vote on plans could come by the end of March. Briefings are being held on Capitol Hill and members of Congress are meeting to discuss their options, and last week, President Trump hinted that repeal and replace is “complicated” and we may have something by the end of the year or possibly even 2018.
Price previously introduced legislation that would have revised reporting and compliance requirements for the EHR incentive programs. Last month during his confirmation hearing, Price said he supports redefining what metrics should be in place to determine quality care. Interoperability also came up during the hearing, with Price saying the role of the federal government should be ensuring different health IT systems talk to one another. He also mentioned being excited about personalized medicine but highlighted the challenge of making it affordable and available to Americans. He supports ensuring regulations don’t overly burden providers and disrupt clinical workflow – in his words, he doesn’t want physicians to be turned into data entry clerks.
A clear path for Trump’s other health nominations
Price’s confirmation clears the way for consideration of other health-related nominations. The Senate Finance Committee has a hearing scheduled today on Seema Verma’s nomination, Trump’s pick for CMS administrator. Verma’s consulting firm designed Indiana’s Medicaid expansion under then-Governor Mike Pence. We can look to Indiana’s plan as a model for the future of Medicaid. Additionally, the heads of the FDA, CDC and NIH will have to be confirmed as well. These are key leadership positions that greatly impact the nation’s health care agenda.
As the new HHS secretary, Price certainly has his work cut out for him. In addition to the repeal of the ACA, Price must focus on other issues that come before the department. HHS is responsible for almost a quarter of all federal outlays and administers more grant dollars than all other federal agencies combined. HHS provides coverage to more than 100 million beneficiaries through Medicare, Medicaid, CHIP and the health insurance marketplace. We’ll be watching him closely as his health care agenda unfolds.