As with so many different agencies under President Joe Biden, the Centers for Medicare and Medicaid Services will look very different over the next four years than under his predecessor. At the forefront of this change is likely to be the newly appointed administrator Chiquita Brooks-LaSure, who is expected to focus on health care access and justice.
Although a date has not yet been set for Brooks-LaSure’s Senate confirmation hearing, her nomination was referred to the Senate Finance Committee on February 22, according to The Washington Post. For reference, the former CMS administrator Seema Verma was nominated for the role on November 29, 2016 and confirmed on March 13, 2017.
Brooks-LaSure is currently the managing director of Manatt, a national service company. But she has a lot of experience in government. Previously, she was Associate Director of Insurance Policies at the CMS Center for Consumer Information and Insurance Supervision and Director of Insurance Protection at the Department of Health and Human Services. If confirmed, she will be the first black woman to lead the prosecution at CMS.
One of Brooks-LaSure’s top policy priorities is likely to be expanding access to health care and insurance coverage, said Jennifer Kreick, a health care attorney with the Haynes and Boone law firms.
Brooks-LaSure’s interest in expanding access, particularly through the Affordable Care Act, is well documented. Just last year she co-authored a paper on the subject published in Health Affairs.
To expand access to care, it could set permanent guidelines that were temporarily put in place during the Covid-19 pandemic, Kreick said. For example, CMS waived certain Medicare coverage requirements for telehealth services in order to improve access to care during the public health emergency. This included allowing Medicare to cover telemedicine visits for beneficiaries in their homes in any area, rather than only covering telemedicine when made available to individuals in specific areas and at a health facility.
The new nominee’s focus on expanding coverage will likely include encouraging states to expand Medicaid and adopt innovation waivers that build on the Affordable Care Act, Cynthia Cox, vice president of the Kaiser Family Foundation, said in an email.
“I suspect some states may want to look at public options, additional subsidies, or other measures that could make coverage more affordable and uptake,” she said. “A supporting CMS can help make this possible through ACA waivers.”
This is in line with Brooks-LaSure’s article in Health Affairs, which explored options to expand coverage to all low-income Americans and to make coverage more affordable for middle-income people. These options included increasing the cost-sharing subsidies in the ACA market and extending tax credits to those with incomes above the current eligibility threshold.
Access won’t be Brooks-LaSure’s only focus. In the past, she has shown a strong personal interest in topics such as maternal health, said Stephanie Kennan, senior vice president of the federal public affairs team at McGuireWoods Consulting, in a telephone interview.
The racial differences in maternal health outcomes in the United States are well known, and in another article co-authored by Brooks-LaSure, she argued that Medicaid plays a critical role in improving national health outcomes for pregnant and postpartum women.
Brooks-LaSure will likely continue to investigate health equity issues during her tenure as CMS administrator, particularly with regard to improving quality, said Kenan, who knows Brooks-LaSure from her days as part of the Democratic workforce on the House Ways and Means Committee of 2007-10.
The Biden government has a comprehensive health care agenda and it is imperative to implement it in the context of the Covid-19 pandemic. This means Brooks-LaSure and CMS have a busy and challenging first year ahead of them.
But Brooks-LaSure’s previous government experience will benefit her as she knows the government language, Kenan said.
“She was a congressional worker, she worked in the White House, so she saw the government in both branches,” she said. “And I think that’s really important to understanding where you fit in, how you can help, and how you can get other people to support you in trying to advance the initiatives of the Biden administration.”
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