Biden picks health policy veteran to run CMS

Chiquita Brooks-LaSure has talked about building on the current health coverage system, rather than scrapping it.

Chiquita Brooks-LaSure started out working as a program examiner in HHS at the White House Office of Management and Budget (OMB) from 1999 through 2003. (Photo: House Ways and Means Committee)

President Joe Biden today said he will nominate Chiquita White Brooks-LaSure to be his nominee for the post of administrator for the Centers for Medicare and Medicaid Services (CMS).

As the head of CMS, Brooks-LaSure would manage or help regulate about $3 trillion in spending by Medicare plans, Medicaid plans, and the individual and group major medical insurance policies that come under the Health Insurance Portability and Accountability Act and the Affordable Care Act (ACA).

Related: CMS finalizes price transparency rule aimed at health plans

Biden has picked a nominee who helped set up the major ACA commercial health insurance programs, including the ACA public health insurance exchange system. She also has a long record of recommending ways to add to the current, largely private health coverage system to get more people covered.

In June 12, 2019, for example, she testified before the House Ways and Means Committee, at a hearing on “Pathways to Universal Coverage,” on proposals for using government programs to offer new coverage options.

“These proposals do not endeavor to replace our existing healthcare system, but rather to provide a new, affordable insurance option by leveraging the existing insurance and delivery structure,” Brooks-Lasure said at the hearing, which was originally streamed live on the web.

“Unlike single-payer proposals, these proposals also envision that commercial insurance markets and other facets of the existing health care system remain in place,” she said.

Her nomination is subject to confirmation by the Senate.

CMS explained

CMS is an arm of the U.S. Department of Health and Human Services (HHS).

CMS officials usually represent HHS in “tri-agency” projects — joint efforts by HHS, the U.S. Treasury Department’s Internal Revenue Service and the U.S. Labor Department’s Employee Benefits Security Administration (EBSA) to implement federal health insurance laws and regulators.

CMS is directly in charge of running Medicare and HealthCare.gov.

It also works with the IRS and with state insurance regulators on regulation of individual major and family medical insurance.

The agency shares responsibility with the IRS and EBSA for setting regulations for fully insured group health plans, and its policies appear to influence the regulations EBSA sets for employers’ self-insured health plans.

Seema Verma served as the CMS administrator under former President Donald Trump. Liz Richter now is serving as Biden’s acting CMS administrator.

Brooks-LaSure’s accomplishments

Brooks-LaSure grew up in New Jersey and earned a bachelor’s degree from Princeton University in 1996. She earned a master’s degree in public policy from Georgetown University in 1999.

She started out working as a program examiner in the Health and Human Services Branch at the White House Office of Management and Budget (OMB)  from 1999 through 2003. From 2001 through 2004, OMB includes her in the list contributors to the federal budgets.

For the next four years, she was a director at Avalere Health, a health care consulting firm.

She then returned to working for the federal government from 2007 through 2014. She spent two years on the staff of the House Ways and Means Committee, about three years as director of coverage policy at the HHS Office of Health Reform, and 18 months, from 2012 through 2014, as deputy director of policy and regulation at the Center for Consumer Information and Insurance Oversight (CCIIO).

The ACA public exchange system came to life Oct. 1, 2013, with the first coverage sold through the system taking effect Jan. 1, 2014.

CCIIO is the CMS division directly responsible for starting and running ACA commercial health insurance programs.

While at CCIIO, Brooks-LaSure helped set up the framework for the exchange system. She began attracting media attention in 2013, when she was trying to explain how the ACA public exchange system might work to state officials and health insurance company executives.

In July 2013, a few months before HealthCare.gov was about to go through a painful birth, she told an Associated Press reporter, “We really feel very much on target for Oct. 1 and ready for open enrollment. We are meeting critical implementation deadlines.”

In August 2013, she participated in an ACA public exchange panel discussion that was organized by the Alliance for Health Reform and The Commonwealth Fund.

Health insurance company executives that they received a large amount of confusing, rapidly changing information from CCIIO about the ACA public exchange system, but Brooks-LaSure said at the 2013 panel discussion that CCIIO wanted to be good partner for health insurers interested in selling exchange plans.

“We’ve been working very closely with issuers to make sure that they have the information available that they need in order to offer products for 2014,” Brooks-LaSure said.

After CCIIO

Since 2014, Brooks-LaSure has worked as a health policy consultant, first at Breakaway Policy Strategies, and then, as a managing director, at the Manatt Health arm of Manatt, Phelps & Phillips LLP, which is a law firm.

“Chiquita Brooks-LaSure provides policy analysis and strategic advice to healthcare stakeholders across the private and public sectors,” according to Manatt. “Her practice focuses on helping clients understand the implications of regulatory and legislative policies across private insurance, Medicaid and Medicare.”

Brooks-LaSure appeared in March 2019 in a panel discussion, organized by America’s Health Insurance Plans, on “Navigating What’s Next for State Relief and Empowerment Waivers.”

She is a member of the Virginia Health Benefit Exchange Advisory Committee and of FAIR Health, a health price data transparency organization.

Her husband, M. Allyn Brooks-LaSure, is a Citadel College alumnus who has worked as a deputy press secretary for former Sen. Jon Corzine, a New Jersey Democrat, and as a press secretary for Sen. Robert Menendez, D-N.J. Brooks-LaSure is now the vice president for communications at the Robert Wood Johnson Foundation.

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