4 contenders for Trump’s HHS Secretary

President-elect Donald Trump has outlined healthcare changes, particularly the repeal of the Affordable Care Act (ACA), as one of the top priorities of his administration, so his pick to run HHS will be a crucial indicator of how quickly and cleanly he may proceed with his repeal-and-replace promises.

One early favorite, former presidential candidate and John Hopkins neurosurgeon, Ben Carson, MD, has said he’s not interested in the job. 

Here are four contenders for the role and their experience in government and healthcare:

1. Gov. Bobby Jindal

POLITICO has identified the former Louisiana governor as the favorite for the position, considering his years of experience in healthcare regulation. At the age of 24, Jindal was appointed to run the Louisiana Department of Health and Hospitals, which at the time was dealing with allegations of fraud and waste in its $4 billion Medicaid program. Jindal later touted his tranformation of the program, citing a three-year surplus of $220 million.

From 2001 to 2003, he served under President George W. Bush as HHS Assistant Secretary for Planning and Evaluation. He resigned to make an unsuccessful run for governor in Louisiana, but won a race for Congress in 2004 and then won the governorship in 2007. During Jindal's tenure, Louisiana didn’t accept Medicaid expansion and cut the program by hundreds of millions of dollars.

His presidential campaign in 2016 wasn’t so successful, as he dropped out of the race by Nov. 2015, but he did lay out detailed plans to replace the ACA. His plan revolved around providing $100 billion over 10 years for state healthcare grants with only a few restrictions, such as “guaranteed access” for individuals with pre-existing conditions. He is also for turning Medicaid into a state block grant program as Trump has favored.

One factor working against Jindal is how he reacted to Trump during his presidential campaign, calling him a “egomaniacal madman” and the “second worst” choice for voters.

2. Gov. Rick Scott

Scott is among the richest of Trump’s Cabinet contenders—with a net worth around $147 million—but also has experience as a health executive. In 1987, he founded the Columbia Hospital Corporation, which later merged with the Hospital Corporation of America, eventually becoming the largest for-profit health care company in the U.S.

His tenure there ended in controversial fashion, however, as the company was being investigated for Medicare fraud. It later settled the charges, which included allegations of attaching false diagnosis codes and ordering unnecessary tests, with a record $840 million settlement. Scott himself was never personally implicated in the investigation.

After some lucrative years as a venture capitalist, Scott formed the ACA opposition group, Conservatives for Patients’ Rights, which claimed the law would lead to healthcare rationing. He has served as Florida’s governor since 2012 and endorsed Trump during the primary campaign.

Since the election, he has spoken strongly in favor of repealing, not amending, the ACA, in remarks delivered to the Republican Governors’ Association on Nov. 14.

“We cannot afford to ‘tweak’ Obamacare—that’s a terrible idea” Scott’s prepared remarks said. “For the good of the country, we need to repeal it before it’s too late. The clock is ticking. Premiums are skyrocketing as we speak, and many Americans and businesses simply cannot afford it. Of course, we will need to unwind it in a fair way, but we absolutely must repeal it. And remember, Obamacare was sold to the American people based on a lie in the first place.”

3. Gov. Mike Huckabee

Huckabee would bring plenty of government experience, having served as Arkansas’ governor from 1996 to 2007, but little in the way of direct health administration credentials.

During his two runs for president, Huckabee advocated for lifestyle changes to prevent health problems, noting his own struggles with weight gain and being diagnosed with type 2 diabetes while in office. He has said healthcare needs to focus more on prevention than treatments.

Policy-wise, he was against the Affordable Care Act and also appeared in favor of insurance companies denying coverage based on preexisting conditions, a part of the ACA Trump said he wants to keep.

4. U.S. Rep. Tom Price, MD, R-Ga.

With Carson taking himself out of the running, Price is the only rumored choice with a medical degree. He was orthopedic surgeon in the Atlanta area and director of Grady Memorial Hospital's orthopedic clinic before entering Congress in 2005. Unlike some other Cabinet contenders, he appears open to taking the job.

“I’m willing to serve wherever I can best serve my constituents in Georgia and the citizens of the country,” the Roswell Republican said Nov. 9, according to the Atlanta Journal Constitution.

Price was a vocal critic of the ACA from its inception, and proposed several bills to repeal parts of it, including the law’s medical-loss ratio provision. He also sponsored a bill to prevent the Treasury Department from implementing tax subsidies or penalties related to buying (or not buying) health insurance. 

His opposition to the ACA and healthcare experience make him an intriguing choice, according to anonymous sources which spoke to POLITICO.

“Tom Price has been loyal to Donald Trump from the outset and his knowledge of health care is second to none," said a Republican source close to the Trump campaign. “Him being in contention for HHS secretary makes perfect sense."