Next Health Secretary Could Set Course for Insurance System

Price’s successor will put own stamp on Obamacare

President Donald Trump will nominate a new HHS Secretary now that Tom Price is out of the job. The new secretary could have a big effect on the fate of the health insurance system. (Bill Clark/CQ Roll Call File Photo)
President Donald Trump will nominate a new HHS Secretary now that Tom Price is out of the job. The new secretary could have a big effect on the fate of the health insurance system. (Bill Clark/CQ Roll Call File Photo)
Posted October 3, 2017 at 11:00am

With the health care debate sidelined on Capitol Hill, the next Health and Human Services secretary will have the ability to determine the Trump administration’s approach on the current health care law.

Despite seven years of promises, Republicans have been unable to roll back the 2010 health care law as they’d planned before the end of September. The vacancy left by former Secretary Tom Price, who resigned last week amid scrutiny of his private jet use, added another challenge to a politically divisive battle.

Now, Price’s successor will be able to put his or her own mark on the law that has been assailed by President Donald Trump as a disaster. Trump’s nominee to oversee the nation’s health care programs, including Medicare and Medicaid, and a budget of about $1 trillion is likely to face intense scrutiny about the future of the law known as Obamacare during confirmation hearings before the Senate Finance Committee.

7 Years of GOP Efforts to Repeal and Replace Obamacare

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“Dr. Tom Price’s resignation is truly unfortunate, especially during this time when our nation’s approach to health care policy is so divided,” Finance Chairman Orrin G. Hatch said in a statement.

With lawmakers shifting their primary legislative focus to a tax overhaul, it could be months before dismantling the law is again at the center of attention on Capitol Hill — even as some lawmakers express hope to roll back the law before the 115th Congress ends.

Trump has suggested he would let the law collapse to bring Democrats to the negotiating table. After a recent bipartisan effort in the Senate, some lawmakers have said the president is ready to work across the aisle on health care.

Whether HHS is friendly or antagonistic to the law could determine its success. For example, when the administration cut off advertising for in the final week of open enrollment in January, officials who had overseen the marketplaces during the Obama administration said it would decrease the number of people signing up for coverage in the final enrollment stretch.

Meanwhile, Sens. Lamar Alexander and Patty Murray have resumed efforts to craft a bipartisan plan to bring more stability to the individual market.

It’s not clear if the administration will change its approach to the law now that the repeal push has been sidetracked. One key indicator is whether the administration continues to reimburse insurers for the law’s cost-sharing reduction payments. Trump has continued the payments on a month-by-month basis, but hasn’t laid out a long-term plan.

Republicans have said that parts of the law that Congress could not repeal through the fast-track budget reconciliation process could be addressed by HHS, such as taking a look at certain regulations put in place by the Obama administration.

Price’s stamp

In his brief tenure, Price left his mark on the law.

Under Price’s leadership, the department slashed advertising related to open enrollment and funding for the navigator program that helps people sign up for insurance, which former HHS officials have said are critical to a successful open enrollment process. Current HHS officials have said consumers are aware of the program heading into its fifth year.

HHS also shortened to six weeks this year’s open enrollment period. Critics say the move could make it harder to sign up more people for insurance in that time frame.

Trump tapped Don Wright, a career HHS official who most recently served as acting assistant secretary for health, to act as interim secretary. Wright, in a statement, did not offer any clues on his approach.

“I look forward to ensuring that the important work of the Department in support of the President’s agenda continues to move forward during this interim period,” he said.

Congressional Democrats are already calling for Price’s replacement to uphold the health care law — and not “sabotage” it, as they say Price did.

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,” Oregon Sen. Ron Wyden, the ranking member of the Senate Finance Committee, said in a statement.

Connecticut Sen. Christopher S. Murphy said Price’s “real offense was overseeing and directing President Trump’s sabotage of health care for millions of people.”

“Insurers are raising premiums because this administration is intentionally undermining our health care system,” he said. “Millions may go without care because the administration is neglecting their responsibility to promote and facilitate enrollment in the Affordable Care Act exchanges.”

Senate Republicans would be able to confirm Trump’s nominee without any Democratic support, so long as 50 members of the GOP caucus support Price’s replacement. Vice President Mike Pence would break a potential tie.