In Washington, D.C., it is often said that personnel is policy, and with a new administration comes new officials to lead the government agencies. Some of these nominees are up for positions relevant to the work of blood centers:
U.S. Department of Health and Human Services (HHS): Robert F. Kennedy, Jr. has been nominated as HHS Secretary, which would put him in charge of the 80,000 employees and a trillion-dollar budget for an agency that has broad authority over the U.S. healthcare industry, including public health, pharmaceuticals, and food safety. He has advocated for deregulation and cutting red tape, while at the same time signaling that he may use his position to ban food additives and water fluoridation. He also spent much of his career as an environmental lawyer, so we will watch to see if he pushes for any regulations that have both health and environmental impacts.
Jim O’Neill, who previously served at HHS in the George W. Bush Administration, has been nominated as the Deputy to the HHS Secretary. Mr. O’Neill has worked in venture capital for much of his career and is an outspoken critic of the U.S Food and Drug Administration (FDA), specifically advocating for FDA only to consider safety in approving drugs, while allowing efficacy to be determined post-market. He supports extensive deregulation in healthcare. Most notably, he has stated that he does not believe FDA has the authority to regulate Laboratory Developed Tests (LDTs) or Artificial Intelligence (AI).
Centers for Medicare and Medicaid Services (CMS): Dr. Mehmet Oz, best known for the Dr. Oz Show as well as his regular appearances on the Oprah Winfrey Show, has been nominated as Administrator of CMS. The agency is responsible for more than 150 million Americans’ health insurance and about a quarter of all U.S. healthcare spending, including setting Medicare reimbursement rates for inpatient and outpatient care, including blood and blood product transfusions. He recently lost a bid for a Senate seat in Pennsylvania. Concerns over his lack of disclosure of financial interests may impact his Senate confirmation; however, a few key senators have indicated support for his nomination. The announcement of Dr. Oz has indicated an intent to focus on chronic diseases by increasing discretion to local care teams to increase competition and lower patient costs.
FDA: Dr. Martin (Marty) Makary has been nominated as the FDA Commissioner. He is a Johns Hopkins surgeon and public policy researcher. Dr. Makary is known for his work in physician-led innovation and quality metrics in healthcare. He has frequently raised concerns about the power of government and drug companies over doctors and their practice of medicine. During the COVID-19 pandemic, he was outspoken in his opposition of mandates to both masking and vaccine, though he was not opposed to either masking or vaccination.
National Institutes of Health (NIH): Dr. Jay Bhattacharya has been nominated to be the NIH Director. He is a health economist with a focus on public policy and has focused on public health and areas where legislation has not made the impact that had been promised. During the COVID-19 pandemic, he was opposed to mandates (lockdowns, mask mandates, vaccine mandates, etc.), and instead advocated for herd immunity, primarily based upon his previous work with influenza (flu).
U.S. Surgeon General: Dr. Janet Nesheiwat has been nominated to be the next Surgeon General. She is medical director for an urgent care company in New York and worked as a front-line healthcare provider during the COVID-19 pandemic. As a teen, her father died as a result of an accidental discharge of a gun that fell from a shelf, hitting him in the head, an event she credits with her desire to go into medicine.
It is helpful to remember that not all positions within the agency will change with the election. Most of the agency staff are career officials who can remain in their positions regardless of the outcome of an election. These individuals do the bulk of the work at the agency and often impact policy through that work. However, keep in mind that at the end of President Trump’s first term, he issued an Executive Order that would have reclassified many “career” positions to be “political” positions if they are, “confidential, policy-determining, policy-making, or policy-advocating character.” This change could impact individuals America’s Blood Centers (ABC) interacts with in our work and allow the administration to make changes without the job protections currently given to these individuals.
Finally, it’s important to remember that these are the individuals who have been nominated for these positions, and they all require Senate confirmation. While it is true that the President’s party is also the majority party in the Senate (53 Republicans to 47 Democrats, with J.D. Vance as President of the Senate, allowing him to break a tie vote), that does not mean that every nominee will be confirmed. Additionally, we may see some individuals withdraw from consideration for various reasons, something we have already seen happen with other nominees.
This list of individuals continues to unveil more clues to what the new administration may undertake and provides some additional insight into areas where we may be able to move our advocacy agenda forward.