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February 28, 2017 11:00 PM

Trump chooses Pence ally to lead Medicaid

Virgil Dickson
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    Brian Neale

    Brian Neale has been tapped by the Donald Trump administration as the new director of the Center for Medicaid and CHIP Services, according to the agency's former director Cindy Mann.

    He will report to Seema Verma, Trump's pick for CMS administrator once she is confirmed by the Senate. Neale didn't immediately return a request for comment on his new appointment.

    Neale most recently was ‎executive director at the United States Congress Joint Economic Committee and served as healthcare policy director for Vice President Mike Pence when he was Indiana governor. He worked with both Verma and Pence to create the Healthy Indiana Plan, the state's Medicaid expansion plan also known as known as HIP 2.0.

    Edmund Haislmaier, a senior fellow at the Heritage Foundation who also worked with Trump's transition team on health policy, recalled Neale as knowledgeable person on Medicaid matters and said that his appointment, along with that of Verma's means states can expect to see greater flexibility in how they run their Medicaid programs. They also will likely get approved for proposals that the Obama administration turned down, such as work search requirements, wider use of premiums and coverage lockouts for nonpayment.

    Given that three senior Trump administration officials helped create Indiana's program, it further lessens the chance the agency will look into claims that the state provided misleading information in the application to continue its Medicaid expansion experiment. The accusations are that false or flawed data was submitted to make HIP 2.0 appear more successful than it has been.

    Verma and Neale co-authored one of the most read Health Affairs pieces last year in which they touted the benefits of HIP 2.0.

    The expansion model “demonstrates the potential for consumer-driven health care as an alternative to the traditional Medicaid model,” the post read. “Enhancing state flexibility, particularly with respect to the low-income, able-bodied population, can help cultivate further state innovation, leading to a stronger and more effective Medicaid program.”

    As Congress considers changing the Medicaid program—either by including greater use of waivers or converting it to a block grant or per capita cap program—Neale's recent experience in Indiana will serve him well in his new role, added Jeff Van Ness, a spokesman for the Association for Community Affiliated Plans.

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