Prospective Health and Human Services Secretary Tom Price, currently the chairman of the House Budget Committee, brings a distinctive to-do list to the agency. And, if confirmed by the Senate, he will have tremendous independent power to get things done.
While he will report to the president, heads of major agencies like HHS — with a budget of more than $1 trillion for the current fiscal year — can interpret laws in different ways than their predecessors, and rewrite regulations and guidance, which is how many important policies are actually carried out.
“Virtually everything people do every day is impacted by the way the Department of Health and Human Services is run,” said Matt Myers, president of the Campaign for Tobacco-Free Kids. HHS responsibilities include food and drug safety, biomedical research, disease prevention and control, as well as oversight over everything from medical laboratories to nursing homes.
Price, a Georgia physician who opposes the Affordable Care Act, abortion and funding for Planned Parenthood, among other things, could have a rapid impact without even a presidential order or an act of Congress.
Some advocates are excited by that possibility. “With Dr. Price taking the helm of American health policy, doctors and patients alike have sound reasons to hope for a welcome and long-overdue change,” said Robert Moffit, a senior fellow at the conservative Heritage Foundation, in a statement.
Others are less enthusiastic. Asked about what policies Price might enact, Topher Spiro of the liberal Center for American Progress said: “I don’t know if I want to brainstorm bad ideas for him to do.”
Here are five actions the new HHS secretary might take, according to advocates on both sides, that would disrupt health policies currently in force:
Birth control coverage: Under the ACA, most insurance plans must provide women with any form of contraception approved by the Food and Drug Administration at no additional cost. This has been particularly controversial in regards to religious employers who object to artificial contraception, leading to alterations in the rules, and resulting in a two separate Supreme Court rulings, one about private firms’ rights to make religious objections, and one about nonprofit religious hospitals and schools.
As secretary, Price would have two main options. He could expand the “accommodation” that already exempts some houses of worship from the requirement to any employer with a religious objection. Or, because the specific inclusion of birth control came via a regulation rather than the law itself, he could simply eliminate no-copay birth control coverage from the benefits insurance plans must offer. (This assumes continuing existence of the health law, at least for the short term.)
Medicare payment changes: The health law created an agency within Medicare, called the Center for Medicare and Medicaid Innovation, that was tasked with exploring new ways to pay doctors and hospitals that would reduce costs while maintaining quality. The HHS secretary has the authority to doctors and hospitals to participate in the experiments and new payment models. Some have proved unpopular with physician and hospital groups, in particular the idea of paying providers so-called bundled payments for packages of care, rather than allowing them to bill item-by-item; one such package covers hip and knee replacements, from the time of surgery through post-surgical rehabilitation. Price, as a former orthopedic surgeon himself, would likely act to scale back, delay or cancel that project, since he “has been a critic in the past,” said Dan Mendelson, CEO of Avalere Health, a Washington-based consulting firm.
Planned Parenthood funding: Republicans have been agitating to separate Planned Parenthood from its federal funding literally for decades. Congress would have to change Medicaid law to permanently defund the women’s health group, which also performs abortions (with non-federal funds) at many of its sites. But an HHS secretary has many tools at his disposal to make life miserable for the organization.
For example, during the Reagan and George H.W. Bush administrations, rules were put in place, and eventually upheld by the Supreme Court, that would have banned staff in federally funded family planning clinics from counseling or referring for abortion women with unintended pregnancies. The subsequent Clinton administration repealed the rules, but they could make a comeback under the new secretary’s leadership.
Price could also throw the weight of the department into the current investigations into Planned Parenthood’s ties to firms allegedly selling fetal tissue for profit.
Tobacco regulation: After years of discord, Congress finally agreed to give the Food and Drug Administration (limited) authority to regulate tobacco products in 2009. “The core authority is statutory,” said Matt Myers of the Campaign for Tobacco-Free Kids, who advocated for the law. That means Congress would have to act to eliminate many of its changes. But a secretary who opposes the law (Price voted against it at the time) could weaken enforcement, says Myers. Or he could rewrite and water down some rules, including recent ones affecting cigars and e-cigarettes.
“The secretary has very broad discretionary authority not to vigorously enforce or implement the statute in an aggressive manner,” Myers said.
Conscience protections: At the very end of the George W. Bush administration, HHS issued rules intended to clarify that health care professionals did not have to participate in performing abortions, sterilizations or other procedures that violated a “religious belief or moral conviction.”
Opponents of the rules complained, however, that they were so vague and sweeping that they could apply not just to opponents of abortion, but also to those who don’t want to provide birth control to unmarried women, or HIV treatment to homosexuals.
The Obama administration revised the rules dramatically, much to the continuing consternation of conservatives. They are among the few health-related items included on the president-elect’s website, which says “The Administration will act to protect individual conscience in health care.” Many expect the rules to be reinstituted in their original form.
–Julie Rovner, Kaiser Health News
footballen says
All that on what he MIGHT do.
RickG says
And @footballen what are you going to do when he does what he has said many times in the past? A leopard doesn’t change its spots.
palmcoaster says
Lets keep the watch, oppose his plan and like Obama says ,” bucket it” !
LC says
Ugh, having lived in Georgia for 30+ years and watching the state fall to pieces after republicans took over in 2000, Price is one of those tea bagger republicans who follows the crowd. I am scared to death what harm he might do to millions of U.S. citizens now. So much is going to change with all of Trump’s picks – for the WORSE, not better.
Hopefully many of these republicans who are all for these changes will be willing to part with their money to help those newly poor and homeless people who will be affected now by what’s in power.
Knightwatch says
I was in Washington during the Reagan years (1981-1989) and watched first-hand as he put people into leadership positions in agencies they had little or no knowledge of, personally hated, and vowed to disrupt and close if they could. I watched as professional educators, scientists, engineers and health care specialists, and subject matter experts at all levels of management were fired or otherwise forced out and political ideologues put into their jobs. I watched as this country turned backward on workplace protection, environmental protection, energy conservation, Wall Street controls, public education, women and children’s health and aid for less fortunate citizens. I watched as budding neocons took hold of the departments of State and Defense and stoked the fires of Middle Eastern and Central American unrest from which we still suffer.
I see the same pattern unfolding and expect the same results… smiling, ill-informed and unenlightened conservatives and a very frightening world. I grieve for this country.
Percy's mother says
CONJECTURE.
Again, someone trying to project negativity into the future. No one knows what will happen. For the last month, we’ve had nothing but a particular segment of the population projecting perceived issues, dangers and problems into the future because of the election results.
Why don’t we wait and see what will actually happen rather than continuously projecting doom into the future?
The Ghost of America says
Between this guy and paul ryan all of those boomers that voted for trump are going to be dead before the next election. But hey, at least there aren’t going to be death panels, right? Nope, just gonna let you die without even bothering to convene a panel.
PCer says
Good job Trumpsters…. you screwed up our nation and now you want to stick your head in the sand and try to keep blaming Obama. I wonder how much Trump knew about the Russian hacking and how much he had to do with it???? Was he involved?
Sherry says
Here’s the thing. . . if we ALL just roll over and let Trump and his appointees just do what ever they damn well choose. . . “undoing” their decisions will be much more DIFFICULT than stopping them to begin with! This should not be about partisan politics but about what is best for EVERY citizen in our nation. We must be vigilant about EVERYTHING because his highly rebellious style is to be a bull in a China shop and throw the baby out with the bath water. Thoughtful, well analyzed, reasonable reforms are good. . . but blasting through and exploding important regulations/legislation that often affect our day to day lives is terrifying.
Be very, very careful of who you trust and what you ask for. . . you may rue the day you voted for the rest of your lives!
Pogo says
The Bush crime family, Republican party, Religious Right (aka grifting TV preachers) stole 2000 and, as predicted, set the world on fire, looted everything they touched and drove the economy over a cliff.
Now they’re back. Wait to see? You don’t have to wait. They’re rubbing your nose in their naked greed and criminality.
Ask them (Trump, Conway, and the rest) the clearest and simple question and they ignore it completely, change the subject, and/or flat out lie. Every time. Even when there’s no need.
It’s pretty clear now that Trump’s tax returns would turn over a rock covering the entrance to Hell itself. Not only that – is there any doubt that Putin (trained and accomplished at murder, blackmail, and subversion and corruption of every kind) is – and has been – blackmailing Trump, and the rest of the Republican business people, military personnel, and politicians he’s been in business with? Is anyone so stupid that they think the Russians (Putin, et al) only hack Democrats?!
Jesus Christ! Wake up!
A.S.F. says
How many times do we have to repeat this same mistake before we remember that the “good old days” weren’t all that good? If they had been, the old policies would not have been changed in the first place. Funny how so many good Christian folk are so dead set against abortion until their daughter, sister, grand-daughter, girlfriend or spouse has to deal with an unintended or problem pregnancy.
Knightwatch says
Percy’s mother… I’m not projecting doom, just the ill effects of radical conservatism and its willful ignorance. And as far as giving Trump (still gag on that name!) a chance, look at his mind-boggling cabinet appointees – millionaires and billionaires all, with little or no particular knowledge of the issues they’ll face; look at his lack of interest in routine national security briefings (“I’m real smart”), or any rational attempt to understand complex world diplomacy; look at his continuation of infantile “tweets”, his demeaning personal insults and his thin-skinned responses to criticism; look at his ignorant denial of climate science without actually looking at the research data; look at his refusal to release any information to prove his divestiture of business conflicts; and look at his cozying up to a Russian thug and dictator.
Do you see any good projecting from his actions to-date? I see nothing but ugly happening to this once great democracy.