Tom Price won't be replaced quickly—which is fine by healthcare lobbyists

The tenure of Tom Price, MD, as HHS Secretary lasted less than eight months, but healthcare organizations aren’t expecting a major shift from where the agency was headed under his leadership. They also predict filling the Cabinet role may be put off for months thanks to raw feelings on Capitol Hill over the Affordable Care Act (ACA) debate.

Price stepped down on Sept. 29, becoming the shortest-serving HHS Secretary in history, after a POLITICO investigation found he had expended more than $1 million in public funds traveling on private charter flights and military aircraft. The current acting secretary is Don Hargan, a lawyer from Chicago who had previously served in several positions at HHS under President George W. Bush.

Hargan may be carrying that title for a while, guessed Anders Gilberg, senior vice president of government affairs at the Medical Group Management Association (MGMA), because of the “partisan nature” of the current Congress when it comes to healthcare policy.

“Whereas previous Senates usually give some degree of deference to the president for their nominations, I don’t think that’s the case there,” Gilberg told HealthExec. “We might end up with an acting secretary throughout 2018. It might be very difficult to get a new secretary confirmed.”

Trump hasn't shown urgency in filling other Cabinet vacancies. When Homeland Security Secretary John Kelly left the post to become Trump's chief of staff on July 31, no nominee to fill the role on a permanent basis was announced until Oct. 12.

There are several names reportedly being floated for Price’s permanent replacement. Two names frequently mentioned are already serving in the Trump administration: CMS Administrator Seema Verma, MPH, a close ally of Vice President Mike Pence from their time working together on Indiana’s Medicaid program when Pence served as governor, and Food and Drug Administrator (FDA) Commissioner Doug Gottlieb, MD, who has earned praise for his focus on speeding up the FDA’s approval process and, like Price, is a physician.

A delay in naming a permanent replacement, however, wouldn’t likely affect day-to-day operation of HHS, according to Gilberg. Deregulation will remain a priority for the Trump administration, he said, no matter who’s running a specific agency.

From the perspective of stakeholders in the industry, it appears to be business as usual. Pamela Lane, interim CEO of the American Health Information Management Association (AHIMA), said members shouldn’t expect much of a change until a new, permanent secretary is confirmed by the Senate.

“I don’t think it’s going to stymie (the agency),” Lane told HealthExec. “It has the potential to change the flavor with whatever the new secretary’s background is, whatever their focus in their previous roles has been. I know there’s a commitment from our federal partners to move forward because they have to move forward.”

For both MGMA and AHIMA, their near-term priorities involve regulations on the second year of the Medicare Access and CHIP Reauthorization Act (MACRA) payment tracks. Those kind of rules have to move forward, with a final rule expected before Nov. 1, no matter what the status of the HHS Secretary position, meaning Price’s departure isn’t likely to change the substance of the regulation.