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Next president should eat with Congress, insider says

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Mike Leavitt, a former governor of Utah who served as Health and Human Services secretary from 2005 to 2009, said today that the next president should spend more time dining with members of Congress.

The next president should consider heading over to the U.S. Capitol for breakfast every other week, Leavitt suggested in Nashville at a panel discussion organized by the Nashville Health Care Council.

“People will respond to the president of the United States,” Leavitt said, in a response to a question about the difficulties Congress and the Obama administration have had with passing legislation.

Nancy-Ann DeParle, who was administrator of the Centers for Medicare & Medicaid Services under President Bill Clinton and President Obama’s Office of Health Reform director from 2009 through 2011, said the kinds of problems the Affordable Care Act public exchange system and other ACA programs are having now are similar to the problems the program now known as Medicare Advantage had in the 1990s.

“We do know how to fix this,” DeParle said. “We can if there’s political will to fix this.”

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The Nashville Health Care Council brought Leavitt and DeParle together with Tom Daschle, a former Democratic Senate majority leader, to talk about the presidential election. Any of the participants could show up in the cabinet of President Trump or President Hillary Clinton.

The moderator was Bill Frist, a former Republican Senate majority leader. 

Panelists agreed that Medicaid could change. (Photo: Allison Bell/LHP)

Panelists agreed that Medicaid could change. (Photo: Allison Bell/LHP)

Health policy panelists said Medicaid could be a major focus

Leavitt suggested that a Trump administration backed by a Republican-led Senate and a Republican-led House could shift the Medicaid program, which uses a combination of state and federal money, more toward block grants, or contributions of fixed amounts of cash that states can use as they wish.

The Democrats on the panel were cooler to the idea of block grants, but all of the panelists agreed that a change in administration could lead to more flexibility in Medicaid rules and more states accepting ACA Medicaid expansion funding.

DeParle and Daschle noted that the Medicaid program took decades to reach all 50 states, and that Medicare took decades to reach its current form.

Leavitt said one challenge to Medicaid expansion acceptance in some states is that the federal government has ignored state lawmakers’ interest in getting a chance to shape how Medicaid expansion would work in their states.

Interest rates are likely to rise soon and increase the size of interest payments on the federal budget deficit by hundreds of billions of dollars per year, and that may change how people think of federal health care programs, Leavitt said.

Daschle said efforts to reduce spending on health care might lead to new efforts to increase spending on transportation, employment programs, and other programs that cut health care spending by improving people’s overall well-being.


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