***SPAM*** MH: Trump's Picks for HHS, CMS Signal Move to Medicaid Cost Sharing & Block Grants

NYAPRS Note: Numerous media reports indicate that Dr. Tom Price will head up HHS and that Indiana’s Dr. Seema Verma will be appointed head of CMS. Their choices signal a preference for cost-sharing requirements for low-income individuals and for allowing people to opt out of Medicare, Medicaid or Veterans Affairs benefits and receive a tax credit to buy an individual plan, Medicaid block grants and value based payment approaches.

Trump said to pick Rep. Tom Price for HHS secretary
By Modern Healthcare | November 28, 2016

U.S. Rep. Tom Price is expected to be named HHS secretary by President-elect Donald Trump, according to a person familiar with the decision.

Price, an orthopedic surgeon from Georgia, would be a key part of Trump's promise to begin repeal and replace of the Affordable Care Act immediately after inauguration in January.

Price currently has a powerful position as chairman of the House Budget Committee. The Republican is also on the health subcommittee of the House Ways and Means Committee.

Trump adviser Newt Gingrich tweeted his approval, calling Price "the right leader to help Congress replace Obamacare."

Price has been a staunch critic of the ACA and was one of the first to put forward his own replacement plan in the form of the Empowering Patients First Act.

It involves age-adjusted tax credits to help people buy insurance as well as increased reliance on health savings accounts and high-risk pools at the state level. It would allow people to opt out of Medicare, Medicaid or Veterans Affairs benefits and receive the tax credit to buy an individual plan. The legislation has not been scored by the Congressional Budget Office.

Experts have also guessed he would concentrate on state reform efforts and noted he has worked across the aisle. Price has been a strong supporter of looking to state governments for proposals of how to spend their healthcare dollars, even if the ideas are more left-leaning than he might personally advocate.

He would likely encourage states to seek waivers for using Medicaid and Medicare money their own way.

Price has recently touted the healthcare plan spearheaded by House Speaker Paul Ryan, which has many of the same elements.

Another likely area of focus for Price at HHS would be rolling back abortion rights. He has previously called for defunding Planned Parenthood and has supported many pieces of anti-abortion legislation. In 2015, he co-sponsored a bill that would ban abortion after 20 weeks.

He has also opposed the ACA provision that requires plans to cover birth control as a no-cost preventive measure. Joe Antos, a health policy expert at the conservative-leaning American Enterprise Institute, said that Republican control of Congress and the White House could make abortion a more active issue than it has been before, although it would likely be decided in the courts.

Price appears to favor continuing bipartisan efforts to move away from fee-for-service reimbursement and focus on paying for the value and quality of care.

He voted for the Medicare Access and CHIP Reauthorization Act and put forward a path for value-based reimbursement methods in Medicare. Recently, however, he has criticized some aspects of the law's implementation. He has specifically said reporting requirements are a burden to physicians and should be streamlined.

Price has said the CMS Innovation Center, which develops and pilots value-based payment models and has been a frequent target for conservatives, has too much authority and should defer more to Congress.

Price joined Congress in 2004 after four terms in the Georgia state Senate. He worked in private practice for nearly 20 years and has taught residents at Emory School of Medicine and Grady Memorial Hospital in Atlanta.

Health professionals have been a major donor to Price throughout his career. Individual and political action committees in the healthcare sector have donated more than $4.8 million to him. The American Association of Orthopaedic Surgeons is a top donor group.

The last HHS secretary with a medical background was Louis Wade Sullivan who served during President George H. W. Bush's administration and was Founding Dean of the Morehouse School of Medicine.

Other potential picks included Louisiana Gov. Bobby Jindal, who served in HHS in the George W. Bush administration.

Price would likely work closely with Paula Stannard, a former deputy general counsel and acting general counsel at HHS, who reportedly been tapped by the Trump team to work more broadly on health reform initiatives. Stannard oversaw the food and drug, civil rights and legislation divisions of the 450-attorney HHS Office of the General Counsel. She also provided legal advice and counsel to senior HHS officials, including secretaries Tommy Thompson and Michael Leavitt.


Trump's Meeting With Dr. Seema Verma May Offer Clues to His Health Plans
governing.com | November 28, 2016

Donald Trump has consistently vowed to repeal and replace Obamacare. But he has yet to explain what he intends to replace it with.

His meeting schedule today might offer a clue of what he is pondering. On the agenda is a chat with Seema Verma, an architect of Indiana’s unusual healthcare program for the poor.

Indiana is among a handful of red states that took federal aid through the Affordable Care Act to expand Medicaid eligibility to poor, childless adults. But unlike most traditional Medicaid expansions, Indiana set up a system that requires many low-income residents on the program to pay small monthly contributions for their health coverage.

Conservatives, including the state's governor, Vice President-elect Mike Pence, have argued that this makes poor patients take greater responsibility for their health. And healthcare advocates in Indiana generally supported the program, in large part because it was seen as the only way to expand health protections in the deeply conservative state.

But cost-sharing requirements for low-income patients remains controversial, and a number of states that have experimented with it in the past stopped after concluding it was too expensive and difficult to administer.

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