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President-Elect Trump Names Rep. Tom Price, MD (R-GA) as HHS Secretary, Seema Verma, Health Care Consultant, as CMS Administrator

Posted in Affordable Care Act (ACA), American Medical Association, Centers for Medicare and Medicaid Services-CMS, Health and Human Services (HHS), MACRA - Medicare Access and CHIP Reauthorization Act

Medicare/Medicaid Reform and ACA Repeal on the Horizon, MACRA Moves Forward for Now

The new administration’s agenda for health care may have come into clearer focus with President-Elect Donald Trump’s nomination of House Representative Tom Price, MD, a Republican from Georgia, as Secretary of Health and Human Services (HHS) and Seema Verma, MPH, as CMS Administrator. The American Medical Association (AMA) released a statement of strong support for Congressman Price, encouraging a swift confirmation vote. “Dr. Price,” the AMA said, “has been a leader in the development of health policies to advance patient choice and market-based solutions as well as reduce excessive regulatory burdens that diminish time devoted to patient care and increase costs.”

Rep. Price, an orthopedic surgeon, is particularly known for his outspoken opposition to the Affordable Care Act (ACA) and bills introduced by him to repeal it. He currently serves as chair of the House Budget Committee, and is closely aligned with House Speaker Paul Ryan (R-WI) in calling for Medicare and Medicaid reform and ACA repeal. He supports making Medicare a “defined contribution” program, giving beneficiaries financial help to purchase their own health insurance coverage, and converting Medicaid into a block grant program, leaving it up to individual states to define and administer their programs with minimal federal requirements. Rep. Price sponsored the “Medicare Patient Empowerment Act of 2015” (H.R. 1650), a bill to allow physicians to privately contract with Medicare patients, and cosponsored the “Helping Families in Mental Health Crisis Act” (H.R. 2646); the latter bill passed the House in July of this year but has not been acted upon by the Senate.

Ms. Verma is a health care consultant who holds a Master in Public Health (MPH) degree from Johns Hopkins University. Ms. Verma has had extensive experience with the ACA and Medicaid, particularly in working with GOP governors in designing and implementing ACA Medicaid expansion in their states. She worked closely with Governor Mike Pence in establishing Indiana’s Medicaid expansion program and also advised Iowa on the Iowa Health and Wellness Plan, Iowa’s approach to Medicaid expansion, and, more recently, in privatizing Iowa Medicaid.

While Rep. Price voted in support of the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), as a member of the GOP Doctors Caucus, he joined in a October 6, 2016 letter to CMS outlining several concerns with MACRA implementation. “MACRA brings significant changes to physician workflows,” the letter says, “yet most physicians remain entirely unaware of MACRA or its implications.” When CMS released its final MACRA rule on October 14, Rep. Price issued a statement calling for careful scrutiny of the rule, noting that the GOP Doctors Caucus “is deeply concerned about how this rule could affect the patient-doctor relationship.” The GOP Doctors Caucus is an 18-member group of Republican representatives who also are health care providers.

Rep. Price recently issued a strong statement of support for House passage on November 17, 2016, of the Midnight Rules Relief Act, H.R. 5982. That bill would make it easier for Congress to halt rules adopted by federal agencies toward the end of the current administration through a joint resolution process affecting several rules rather than on a rule-by-rule basis. H.R. 5982 has yet to be considered by the Senate. Even if Rep. Price and the GOP Doctors Caucus remain concerned about MACRA, congressional nullification of the MACRA rule as “midnight” action is highly unlikely. Once Rep. Price assumes his new post as HHS Secretary, however, he could direct CMS to amend or delay the MACRA rule or certain aspects of it. The MACRA rule now is scheduled to go into effect on January 1, 2017.