Trump picks ACA foe as HHS chief, adds Pence associate

(Bloomberg) — President-elect Donald Trump said he’ll nominate one of the Congress’s main critics of the Affordable Care Act to lead the Department of Health and Human Services, the first of multiple Cabinet announcements expected Tuesday.

Republican Rep. Tom Price, 62, an orthopedic surgeon from Georgia and one of the original Tea Party caucus members, has served since 2015 as chairman of the House of Representatives’ Budget Committee. There, he was a leader of efforts dismantle the health law, also known as Obamacare, and has supported GOP plans to overhaul other major health programs.

Trump also chose Seema Verma, founder of the Indianapolis-based health policy consulting firm SVC Inc., as his pick for administrator of the Centers for Medicare & Medicaid Services. In Indiana, Verma worked with Gov. Mike Pence, now the vice president-elect, on Medicaid issues and the implementation of the ACA. In 2013, SVC produced ACA training videos for Indiana’s HealthCare.gov navigators.

The two nominees are “the dream team that will transform our health care system for the benefit of all Americans,” Trump said. Another Cabinet announcement will be made this afternoon, Trump spokesman Jason Miller said on CNN.

Trump’s health care nominees underscore his promise to repeal and replace the ACA, as well as to work with Republicans to significantly overhaul Medicare and Medicaid. Price has signed on to House Speaker Paul Ryan’s “Better Way” plan, which would raise the age at which Americans become eligible for Medicare, and would give people the option of taking a fixed sum to shop for private coverage under the program.

Health overhaul

If Price is confirmed by the Republican-controlled Senate, Republicans have promised a busy tenure. Price said Nov. 17 that Republicans plan to use a fast-track procedural measure known as reconciliation to make the changes to Medicare in 2017.

Trump and Republicans have also called for an overhaul of Medicaid, the joint U.S.-state program for the poor, as has Price. Verma has said the program is “dysfunctional,” with too much administration and oversight by the federal government. In Indiana, she was the architect of the Healthy Indiana Plan, which overhauled Medicaid for non-disabled adults and placed an emphasis on personal responsibility, according to her biography on SVC’s website. The state says Healthy Indiana has successfully encouraged the use of preventive care and decreased emergency room visits.

Career in Congress

Price’s departure from the House would cap a congressional career that began in 2005 after his election to an Atlanta-area House district. He had served previously as a state lawmaker, rising to become Senate majority leader.

He grew up in Michigan and graduated from the University of Michigan and its medical school, then worked for almost 20 years as a surgeon. His wife, Betty Price, was elected to the Georgia House of Representatives in July 2015.

Price was chairman of the Republican Study Committee, a caucus of the most conservative members in the U.S. House, in 2009 and 2010. In May 2015, he proposed a bill to replace the ACA that focused on tax credits, expanding health savings accounts and revising laws governing medical malpractice.

Incoming Senate Minority Leader Chuck Schumer of New York, a Democrat, said in a statement that Price’s nomination “is akin to asking the fox to guard the hen house.”

“Congressman Price has proven to be far out of the mainstream of what Americans want when it comes to Medicare, the Affordable Care Act, and Planned Parenthood,” Schumer said.

Doctors Caucus

Price is a member of the Doctors Caucus, which recently has raised concern over a proposal from the Centers for Medicare & Medicaid Services for a new payment system for physicians. The group said the system has the potential to “overcomplicate an already burdensome and complex” system.

Price is also an opponent of abortion, and has voted repeatedly to cut federal funds to health providers who perform the service.

The Chicago-based American Medical Association, which lobbies on behalf of doctors, said Tuesday that it strongly backed the nomination. “Dr. Price has been a leader in the development of health policies to advance patient choice and market-based solutions as well as reduce excessive regulatory burdens that diminish time devoted to patient care and increase costs,” the AMA said in a statement. The American Hospital Association, another Chicago-based lobbying group, also gave its support on Tuesday.

Price is an opponent of having Medicare negotiate drug prices directly with manufacturers, an idea Trump has backed, as have Democrats. In 2007, Price opposed a Democratic-backed bill that would do so, calling it “a solution in search of a problem” that would limit medicine availability and innovation by manufacturers.

Past roles, money

Price has received $596,825 in federal campaign campaign donations from pharmaceutical and health products companies, as well as $3.56 million from doctors, pharmacists and other health professionals, according to the Washington-based Center for Responsive Politics, which tracks campaign donations.

Both Price and Verma have been scrutinized for ties to industry and potential conflicts.

In early 2011, the House Ethics Committee announced it had dropped an investigation of Price and two other lawmakers into their fundraising appeals to Wall Street firms at the same time they were considering legislation to overhaul financial regulation.

The independent Office of Congressional Ethics had asked the committee to look because each of the three had “solicited or accepted contributions in a manner which gave the appearance” they were linked to an official act. Yet the Ethics Committee concluded that their positions on the legislation “were not connected to fundraising activities.”

Verma in Indiana

Verma was the “architect” of Pence’s “signature health care plan” who “quietly shaped much of Indiana’s public health care policy” for more than a decade, according to a 2014 report by the Indianapolis-based IndyStar on concerns about potential conflicts of interest in her consulting work with a division of Palo Alto, California-based Hewlett-Packard Enterprises Co., one of Indiana’s largest Medicaid vendors.

Verma said she had no role in HP’s state contracts, according to that report, and a Pence spokeswoman said Verma’s “advice and counsel” was appreciated.

She received a master’s degree in public health with a concentration in health policy and management from Johns Hopkins University and a bachelor’s degree in life sciences from the University of Maryland, according to the announcement.