Actuaries warn of premium increases from repealing ObamaCare mandate
Price resignation sets off frenzy of speculation over replacement
The resignation of embattled Health and Human Services Secretary Tom Price for using private jets for government travel is setting off a frenzy of speculation about who will replace him.
While it's still early, health policy insiders see two current officials as perhaps the most likely candidates: Centers for Medicare and Medicaid Services Administrator Seema Verma and Food and Drug Administration (FDA) Commissioner Scott Gottlieb.
Hard-line conservatives, meanwhile, have floated national figures like former Louisiana Gov. Bobby Jindal (R) and former Pennsylvania Sen. Rick Santorum (R).
But before the race even started, two potential names took themselves out of the running.
Sen. Ron Johnson (R-Wis.) was suggested by Heritage Action, but he told reporters late Monday that he was not interested in the job.
And one name that surfaced over the weekend, Sen. John Barrasso (R-Wyo.), has taken himself out of consideration.
The pick could provide a window into President Trump's approach to ObamaCare going forward, after the GOP failed to repeal the law in dramatic fashion in recent months.
Will he pick another strident opponent of the health-care law, like Price, which would indicate that the battle will continue, or a more pragmatic choice that could indicate a new phase in ObamaCare politics?
The nomination of Verma could signal that Trump wants to keep up the intense battle against ObamaCare. The former health-care consultant was a key figure in efforts to repeal the law this year, making frequent trips to Capitol Hill to try to win over wavering lawmakers.
She is also close to Vice President Pence. Verma worked on putting a conservative twist on Indiana's Medicaid program while Pence was governor.
Gottlieb would be seen as a more pragmatic choice, signaling that fighting ObamaCare might not be front and center.
A doctor, Gottlieb is best known for his work on drug policy. He worked at the FDA under President George W. Bush and also was a scholar at the right-leaning American Enterprise Institute.
He has steered clear of partisan controversies so far at the FDA and has been relatively press friendly, with frequent tweets and speeches.
Another name floated, Veterans Affairs Secretary David Shulkin, would also be a less partisan choice.
A holdover from the Obama administration, he was confirmed as VA secretary by a 100-0 vote earlier this year. But he is now facing his own controversy over taxpayer-funded flights after The Washington Post reported the government paid for a flight to Europe for him and his wife, where he combined business meetings with sightseeing.
The conservative group FreedomWorks, meanwhile, is pushing for Jindal. A former presidential candidate, Jindal has a long background in health care, serving in the Department of Health and Human Services (HHS) in the George W. Bush administration, and is a strong opponent of ObamaCare.
As a candidate, he touted his plan for replacing the health-care law.
But one hurdle is his past disparagement of Trump. In 2015, Jindal called Trump an "unstable narcissist."
Any nominee is sure to face a tough confirmation process.
Senate Democrats have been warning about the "sabotage" of ObamaCare at HHS so far, including a 90 percent cut to the advertising and outreach budget that encourages people to enroll in the health insurance marketplace.
Democrats plan to seek commitments from a nominee about how they would carry out ObamaCare, according to a Senate Democratic aide.
It is possible that Trump might not even nominate a replacement anytime soon. The president has not nominated a new Homeland Security secretary since the post became vacant in July.
A delay would leave acting Secretary Don Wright, who vaulted from obscurity into the position with Price's resignation, in place for the near future.
Wright, a doctor, was a career official in the department, serving under both Bush and President Obama. His background is in public health, a less partisan area in contrast to the battles over ObamaCare.
Joseph Antos, a health-care expert at the American Enterprise Institute, said the failure of GOP efforts to repeal ObamaCare has taken some of the luster out of the HHS position.
"The job is not the same job that one might have imagined in February," Antos said. "There's not going to be legislation."
Instead, the job will be more focused on regulations, which Antos said can be "really tedious stuff."
Antos said that reality might scare off more high-profile contenders.
Florida Gov. Rick Scott (R) is often mentioned as a possible nominee. He is the former CEO of a hospital company.
But he is a considering a run for Senate in 2018. And a spokesman said Monday that Scott "has no plans to pursue" the HHS position.
Housing and Urban Development Secretary Ben Carson, famous for his work as a neurosurgeon, is also a possibility, but he told Trump in November that he was not interested in the HHS job.
Michael Leavitt, a former HHS secretary under Bush, wrote in an email that the next secretary has the opportunity to use administrative actions to shift ObamaCare in a rightward direction.
"This is a powerful tool, and while not providing the political victory the President and Congress promised, it could, nonetheless, make constructive changes consistent with Republican ideology," he wrote. "The selection may provide insight on whether the President sees that opportunity."