Trump’s next move? Choice for secretary may offer clue
WASHINGTON — President Donald Trump’s selection of a secretary of health and human services could be a turning point in a health care debate that has polarized Washington, as he faces a choice of working with Democrats to fix the current system or continuing his so-far failed efforts to dismantle his predecessor’s program.
The resignation of Tom Price as secretary late Friday over his use of costly chartered jets capped a week of setbacks on health care for a president who made the issue a centerpiece of his campaign and his first eight months in office. Trump’s decision on a successor could be an opportunity to shift the debate, but he faces the prospect of an arduous confirmation battle.
The president has sent mixed signals since the latest effort to repeal and replace President Barack Obama’s Affordable Care Act collapsed in the Senate. He has asserted that he has the votes to pass the repeal legislation and will try again in early 2018, while also saying he wanted to negotiate with Democrats who are adamantly against it.
Many will look to his choice for a secretary to see whether he wants to continue the battle or find a compromise.
Democrats urged him to use the moment to change course. “Let’s get a new HHS secretary who’s finally devoted to improving health care, move past these debates and come to bipartisan agreement on how to stabilize markets and make health care cheaper,” said Sen. Christopher Murphy of Connecticut.
Sen. Ron Wyden of Oregon, the senior Democrat on the Senate Finance Committee, said Price’s departure could begin “a new chapter for the Trump administration’s health care agenda.”
The White House had no comment Saturday, but the two most frequently mentioned candidates to succeed Price are two officials who work in the department: Seema Verma, administrator of the Centers for Medicare and Medicaid Services, and Scott Gottlieb, commissioner of the Food and Drug Administration. Both have previously been vetted by the White House, nominated by the president and confirmed by the Senate to their current jobs within recent months, a significant selling point.
Other names have been floated as well, including David Shulkin, secretary of Veterans Affairs and a favorite of the president’s, but he has been criticized for a European trip with his wife that mixed business and sightseeing and was partially financed by taxpayers. Some reports have floated former Gov. Bobby Jindal of Louisiana, an assistant secretary of health and human services under President George W. Bush. But he was a caustic critic of Trump during his own brief campaign for the White House that ended in late 2015 after he called the future president a “narcissist” and “egomaniacal madman.”
Trump may not necessarily fill the post quickly. He has left the Department of Homeland Security in the hands of an acting secretary since John Kelly left in July to become White House chief of staff. The president appears to be in no rush despite a series of hurricanes and a roiling immigration debate, issues managed by the department. He said Friday that he would make a decision “probably within a month.”
If Trump picks Verma to succeed Price at the Department of Health and Human Services, it would be taken as a sign among many that he wants to continue vigorous opposition to the Affordable Care Act, with the government doing the minimum required by the law to implement Price its provisions. Verma, an ally of Vice President Mike Pence, worked closely this year with Republicans in Congress on their proposals to undo the law and to cut Medicaid, the program for more than 70 million low-income people.
Still, some progressives have interpreted her work under the health care law in Indiana, where Pence was governor, to mean that while she opposed the Affordable Care Act, she was committed to finding ways to enforce it if it remained on the books.
Gottlieb has more experience in Washington and was seen at the time of his appointment as the more moderate of candidates being considered. In his first months at the FDA, he has deftly balanced the concerns of patients and pharmaceutical companies, while taking steps to combat the opioid epidemic and speed access to lowercost generic drugs. His nomination would be seen as a signal that the president might want to take a different approach to the health care debate.
“We have the votes on the substance but not necessarily on the process, which is why we’re still confident that we can move health care forward and get it done in the spring,” Sarah Huckabee Sanders, the White House press secretary, said before Price’s resignation.
Neither Verma nor Gottlieb had easy confirmations to their current post, but neither seems as strongly determined to undermine the Affordable Care Act as Price was.
Verma, who earned a bachelor’s degree in life sciences at the University of Maryland and a master’s degree in public health at Johns Hopkins University, founded her own health policy consulting firm, SVC, and worked with state agencies to carry out the Affordable Care Act. Working with Pence when he was governor, she was the architect of the Healthy Indiana Plan, which expanded Medicaid under the Obama-era law.