On Feb. 17, numerous national media outlets were reporting the news that President Joe Biden is about to name Chiquita Brooks-LaSure to be the Administrator of the Centers for Medicare and Medicaid Services (CMS). The Washington Post first broke the news on Wednesday afternoon, followed by POLITICO and CNN.
On Wednesday afternoon, the Post’s Dan Diamond broke the news in an article contained in a broader, multi-reporter summary of news developments for the day. Diamond wrote that “Biden has selected Chiquita Brooks-LaSure to lead the Centers for Medicare and Medicaid Services, filling a major role in his health-care leadership team, according to three people who spoke on the condition of anonymity because they were not authorized to discuss it. Brooks-LaSure,” he added, “served in the Obama administration as a senior CMS official who helped implement the Affordable Care Act’s coverage expansion and insurance-market overhaul. She also previously worked on Capitol Hill for the House Ways and Means Committee, building ties with then-Rep. Xavier Becerra, Biden’s choice to lead the Health and Human Services Department.”
Later on Wednesday afternoon, POLITICO’s Adam Cancryn, Susannah Luthi, and Rachel Roubein reported that four sources close to the process had confirmed that Biden would nominate Brooks-LaSure as CMS Administrator, noting that “Brooks-LaSure had recently emerged as the clear front-runner to lead the Centers for Medicare and Medicaid Services, POLITICO reported earlier this month. Her selection was first reported by the Washington Post on Wednesday. CMS deferred comment to the White House, which has not yet responded. Brooks-LaSure did not immediately respond to a request for comment.”
Cancryn, Luthi, and Roubein noted that “Brooks-LaSure, who consults with states at Manatt Health, during the Obama administration was deputy director at a top CMS office overseeing the health insurance markets. She had previously helped enforce Obamacare insurance reforms at HHS. Prior to her stint in the Obama administration, she worked on parts of Obamacare during the law's drafting as a health staffer on the House Ways and Means Committee. It was there she forged working ties with then-Rep. Xavier Becerra, Biden's nominee to run the health department that houses CMS. The Senate is set to take up Becerra’s nomination next week after a lengthy delay, with hearings planned in the HELP and Finance committees,” they wrote, referring to the Senate Health, Education, Labor and Pensions Committee And its Finance Committee.
“Well-regarded in Washington policy circles,” they added, “Brooks-LaSure was an early favorite for the CMS post. She was chosen to co-lead Biden’s HHS agency review team during the transition. Becerra's nomination in early December seemed to boost Brooks-LaSure’s chances to helm CMS, given their past working relationship on Capitol Hill. One former colleague described Becerra as one of the ‘go-to’ lawmakers that Brooks-LaSure worked with on health care issues.
And late on Wednesday evening, CNN’s Arlette Saenz and Tami Luhby confirmed the reports posted by the other publications, citing “two sources familiar with the decision.”
As Saenz and Luhby noted, “Brooks-LaSure would be a key player in executing Biden's promises to rebuild the Affordable Care Act and strengthen Medicaid -- as well as institute a government-run public option and lower Medicare's eligibility age to 60, from 65. The $1 trillion agency, the largest within HHS, oversees much of Obamacare and the federal exchange, Healthcare.gov. In total, more than 145 million Americans receive their health coverage through programs the agency administers, including Medicare, Medicaid, the Children's Health Insurance Program (CHIP) and the Affordable Care Act. In recent years,” they added, “Brooks-LaSure has co-authored reports on expanding coverage through state Medicaid buy-in proposals and on advancing health equity. Last month, she and her colleagues at Manatt published a report on two potential public option models in Nevada.”
The POLITICO reporters also wrote that "Biden’s team has been mindful of avoiding a personality clash between two of the administration's most high-profile health care jobs, said one source familiar with the discussions. Trump's last HHS secretary, Alex Azar, and his CMS administrator, Seema Verma, infamously sparred over department priorities and personnel decisions, disrupting work on the previous administration's health agenda."
Brooks-LaSure currently works at the Manatt consulting firm, whose website describes it thus: “Manatt is a multidisciplinary, integrated national professional services firm known for quality and an extraordinary commitment to clients. We are keenly focused on specific industry sectors, providing legal and consulting capabilities at the very highest levels to achieve our clients’ business objectives. Our groundbreaking approach—bringing together legal services, advocacy and business strategy—differentiates us from our competitors and positions us to provide a unique and compelling value proposition. We strive to be essential to our clients. From our roots in banking, entertainment and government, we work with clients from industries as diverse as healthcare, financial services, media, technology, retail and consumer products, real estate, and energy.” Speaking of the firm’s healthcare practice, its website states that “We work with clients who are innovators and committed to change. If you are sitting at the intersection of complex issues that involve strategic, regulatory and legal opportunities, Manatt is the ideal partner to help you achieve your goals. We partner with a wide range of stakeholders, including state and federal policymakers and agencies; payers; healthcare providers and systems; foundations; associations; pharmaceutical, biotech and device companies; and product and service suppliers.”
With regard to Brooks-LaSure, who received her Master of Public Policy in 1999 from Georgetown University, Manatt’s profile of her states that “A former policy official who played a key role in guiding the Affordable Care Act (ACA) through passage and implementation, Chiquita Brooks-LaSure provides policy analysis and strategic advice to healthcare stakeholders across the private and public sectors. Her practice focuses on helping clients understand the implications of regulatory and legislative policies across private insurance, Medicaid and Medicare. Chiquita has more than 20 years of experience in health policy. As deputy director for policy at the Center for Consumer Information and Insurance Oversight within the Centers for Medicare & Medicaid Services, and earlier at the Department of Health & Human Services as director of coverage policy, she led the agency’s implementation of ACA coverage and insurance reform policy provisions.”
In addition, the Manatt profile states that, “Earlier in her career, Chiquita assisted House leaders in passing several healthcare laws, including the Medicare Improvements for Patients and Providers Act of 2008 and the ACA, as part of the Democratic staff for the U.S. House of Representatives’ Ways and Means Committee. She began her career as a program examiner and lead Medicaid analyst for the Office of Management and Budget, coordinating Medicaid policy development for the health financing branch. Her role included evaluating policy options and briefing White House and federal agency officials on policy recommendations with regard to the uninsured, Medicaid and the Children’s Health Insurance Program.”
Brooks-LaSure coauthored an article with Elizabeth Fowler of the Commonwealth Fund and Gay Mauser of Manatt, published in the March 2020 issue of Health Affairs, entitled “Building On The Gains Of The ACA: Federal Proposals To Improve Coverage And Affordability,” in which the authors wrote that a number of policy options exist for building on the strengths of the ACA, including “extend[ing] comprehensive coverage to all low-income Americans and increase[ing] coverage affordability for middle-income Americans.” The Medicaid program, they wrote, could also be built out by “expand[ing] eligibility for Medicaid in the early years of the ACA to states that have not yet expanded Medicaid and increasing Marketplace cost-sharing subsidies.” The authors also addressed the potential inherent in creating a public option. “A public option could also be implemented at the federal level, leveraging the administrative savings and bargaining power of Medicare as proposed in the Affordable Health Care for America Act, an earlier version of the ACA that was passed by the House of Representatives in 2009. In 2013 the Congressional Budget Office estimated that a public plan would reduce the deficit by $158 billion over ten years.24 A public option could be deployed everywhere or limited to certain geographic regions—such as markets with high premiums, areas with only one or two Marketplace plans, or states that have not expanded Medicaid.”
The authors wrote that, “Depending on how it was structured, a federally administered public option could result in lower federal spending, cost sharing, and provider reimbursement rates. Setting provider rates by either pegging them to a percentage of Medicare rates or negotiating rates directly would require striking a balance among health care stakeholders—as well as the political capital to overcome significant opposition.” The authors added that “The ten-year anniversary of the ACA presents an opportunity to reflect on the law’s success and identify areas for improvement. The continued desire of policy makers and the public to cover the uninsured and address affordability is encouraging. Intermediate policy options that build on the ACA could make a difference in the lives of millions of Americans and set the stage for future reforms.”
