The selection of U.S. Supreme Court Chief Justice John Roberts and President Barack Obama for the top two spots in the 14th annual Modern Healthcare 100 Most Influential People in Healthcare reflects the continuing centrality in healthcare of the Affordable Care Act and the ongoing political battle over its future.
Just behind them in the top 10 are several major health system leaders, along with a prominent physician who has spurred national healthcare conversations through his journalism and book authorship. Finishing out of the top 10 is a veteran CEO who has driven the recent health insurance consolidation trend.
Roberts' written opinion in King v. Burwell in June saving the ACA's premium subsidies in all 50 states made him the obvious choice for the Most Influential title, just as his decision to uphold the constitutionality of the ACA's individual mandate made him the logical choice in 2012. Supreme Court Justice Anthony Kennedy, the other conservative justice who voted to keep the premium subsidies, made the list this year for the first time, at No. 23.
Obama, who promised to veto any Republican bills to repeal or roll back the ACA, took the No. 2 spot on the Most Influential list, after winning the top spot last year—for the third time.
Dr. Atul Gawande, a Boston surgeon, health-services researcher and author, finished in the top 10 for the first time, as his bestselling book, Being Mortal: Medicine and What Matters in the End, helped spark a national discussion about end-of-life decisionmaking and long-term care.
In total, there were 23 people who made the list for the first time, with acting CMS Administrator Andy Slavitt placing the highest at No. 20.
Slavitt, Roberts, Kennedy and HHS Secretary Sylvia Mathews Burwell are among 13 non-elected federal officials on the roster. At No. 6, Burwell placed the highest among the list's 27 women.
Besides Obama, there were four other elected officials. They include House Ways and Chairman Paul Ryan (R-Wis.), who topped the list in 2011 and is No. 30 this year; Senate Majority Leader Mitch McConnell (R-Ky.), who placed at No. 44 and made the list for the first time; Speaker of the House John Boehner (R-Ohio), who made the list for the fourth time, at No. 52; and Kentucky's Democratic governor, Steve Beshear, who made the list for the first time at No. 67. Beshear championed his state's successful Medicaid expansion and the establishment of a state-run insurance exchange.
Along with Beshear and McConnell, a third Kentuckian made the list for the first time: Benjamin Breier, the new CEO of Kindred Healthcare, a Louisville-based post-acute-care provider, with 103,000 employees and $7.2 billion in revenue in 2014. Breier placed No. 71.