Dive Brief:
- The Senate on Tuesday confirmed health policy veteran Chiquita Brooks-LaSure as the Biden administration's Centers for Medicare and Medicaid Services head, following a drawn-out approval process. As administrator, Brooks-LaSure will have oversight over the Medicare and Medicaid insurance programs as well as the exchanges set up by the Affordable Care Act.
- Lawmakers voted 55-44 to confirm Brooks-LaSure, whose nomination was earlier held up by Senate Republicans over an unrelated Biden administration policy move to rescind a Texas Medicaid waiver.
- CMS is one of several powerful agencies that operates under the Department of Health and Human Services, and one of the last to get a confirmed chief under the Biden administration. No candidate has been nominated yet to run the Food and Drug Administration, however.
Dive Insight:
Brooks-LaSure has had a long career in public policy, working in the Office of Management and Budget as a Medicaid analyst before moving on to serve as deputy director for policy at the Center for Consumer Information and Insurance Oversight during the Obama administration. She was also a director of coverage policy at HHS before transitioning to the private sector, working as a Medicare and Medicaid policy consultant for Manatt Health.
With Tuesdays vote, Brooks-LaSure becomes the first Black woman to lead CMS.
Despite general support for the health policy veteran in Congress, Brooks-LaSure's confirmation process has been slow.
In April, Republicans in the Senate Finance Committee held up the process not due to Brooks-LaSure's record, but over HHS' withdrawal of a Medicaid waiver to Texas that had previously been approved by the Trump administration. The waiver would have given the state more than $100 billion over a decade in federal funding and allowed more flexibility in how it structures the safety-net insurance scheme.
Its withdrawal caused Sen. John Cornyn, R-Texas, to say he would delay the confirmation. Cornyn said losing the waiver would threaten vulnerable Texans' access to care by winnowing hospital funding, though progressives generally view the waivers as a stop-gap measure that doesn't address fundamental issues with medical access and lowering costs.
The committee eventually voted 14-14 along party lines to move the nomination to the full Senate floor, without a recommendation for confirmation.
On May 12, the full Senate once again advanced Brooks-LaSure's nomination, in a 51-48 procedural vote. Senate Democrats were joined by two Republican legislators in backing a discharge petition to bring her nomination to a floor vote after it was held up by the finance committee and GOP opposition to her confirmation.
Hospital and payer groups, progressive think tanks and patient advocates indicated support for her confirmation on Tuesday.
Many noted that Brooks-LaSure's experience in health policy, especially with the ACA and Medicaid, should help the agency expand access to low-cost care as medical prices continue to rise in the U.S.
Brooks-LaSure is one of the last major health policy appointments from the Biden administration. Previously, HHS Secretary Xavier Becerra faced grilling from Republicans over his abortion views, but was approved by a single-vote margin; while HHS deputy secretary Andrea Palm was confirmed in a 61-37 vote earlier this month.
But, four months into his administration, President Joe Biden still has not nominated anyone to fill the top spot at the Food and Drug Administration, a crucial post with oversight over drugs and vaccines, but also major public health issues like food safety and tobacco.