President-elect Donald Trump's pick for the Office of Management and Budget is a hard-line conservative who has voiced fierce opposition to the Affordable Care Act and Planned Parenthood.
Rep. Mick Mulvaney (R-S.C.) generally supports less government involvement in healthcare and has advocated for making Medicare a premium-support system and transforming Medicaid into block grants for states.
Mulvaney is a founding member of the House Freedom Caucus and was key to former House Speaker John Boehner's ouster. He was also one of the leaders of the 2013 standoff over the ACA that led to a government shutdown.
More recently he objected to an agreement averting another shutdown because Republicans surrendered on their demand to strip Planned Parenthood of all federal funding.
As budget director, he would be in charge of helping craft Trump's budget and pushing his fiscal agenda, including shepherding through his promised repeal of the ACA soon after Inauguration Day.
Mulvaney was an early supporter of Trump, and Republicans have widely praised his selection for OMB.
The section on Mulvaney's website devoted to healthcare states that the ACA has helped people afford insurance but has kept them for receiving care because of high deductibles. Reforms are needed, he says, but not in the manner carried out under the ACA.
“Many of the solutions can be found—as they so often are—in more personal control, free-market competition, common-sense reforms and a crackdown on frivolous malpractice lawsuits,” the website reads.
The site links to the plan House Republicans put forward this year, which features tax credits to buy insurance and more reliance on health savings accounts and high-risk pools.