Donald Trump recently announced his pick of Rep. Tom Price (R-Georgia) to head the Department of Health and Human Services (HHS) quickly followed by his announcement of picking Seem Verma to lead the Centers for Medicare and Medicaid Services (CMS). CMS is the part of HHS that oversees Medicare, Medicaid and the Children’s Health Insurance Program (CHIP).
Price is an orthopedic surgeon and Republican Representative from Georgia. Price is a well-known critic of the Affordable Care Act (ACA), having been in the forefront of numerous efforts to repeal the ACA, which President Obama vetoed. His approach is set forth in the Empowering Patients First Act, which can be found on this website.
Among its provisions, the Price bill would continue, in a more limited way, the prohibition to deny coverage to those with preexisting conditions, create state-based high-risk insurance pools subject to certain budgetary limitations, and eliminate of the ACA mandates to incentivize the healthy to join the insured pool. The Price bill would offer tax credits to purchase health coverage, which increase with age and other tax breaks for contributions into health savings accounts.
Critics of the Price bill will quickly note that the history of high-risk pools has not shown to be effective, particularly given the budgetary limitation, and that Price approach would not likely prevent the eventual death spiral of increasing premiums, as the healthy flee from coverage with no mandates incentivizing them to stay or become covered to help spread the cost to cover the sick.
Under Price would be Seema Verma who would head CMS. Verma is known for her work with Mike Pence as governor of Indiana to design the Health Indiana 2.0 plan. This plan expands Medicaid coverage under the ACA in Indiana but requires small monthly payments from Indiana citizens to access coverage or face a six month block-out from coverage, which appeals to conservatives. Verma had also been asked to consult by other Republican-led states so that they can submit their own Medicaid expansion proposals under the ACA which add this payment requirement.
Price seeks to overhaul Medicare and Medicaid, including the privatization of Medicare and the shifting of Medicaid responsibility to the states. Verma’s record suggests she would echo Price’s sentiments.