Senate confirms Chiquita Brooks-LaSure as head of CMS

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CMS now has an administrator.


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Dive Brief:

  • The Senate has confirmed health policy veteran Chiquita Brooks-LaSure as the Biden administration’s head of CMS, following a drawn-out approval process. As CMS administrator, Brooks-LaSure will have extensive oversight over the massive Medicare and Medicaid insurance programs and the exchanges set up by the Affordable Care Act.
  • The body voted 55-44 to confirm the nominee Tuesday morning. A majority of the Senate on Monday voted to limit debate on her nomination, queuing up Tuesday’s final vote. Brooks-LaSure’s nomination was earlier held up by Senate Republicans over an unrelated Biden administration policy move to rescind a Texas Medicaid waiver.
  • Industry groups including the Federation of American Hospitals and the Surgical Care Coalition cheered her confirmation, saying Brooks-LaSure’s policy know-how and experience managing insurance programs should help increase equitable access to affordable care in the U.S.

Dive Insight:

Brooks-LaSure has a long career in public policy, working in the Office of Management and Budget as a Medicaid analyst before moving on to serve as deputy director for policy at the Center for Consumer Information and Insurance Oversight during the Obama administration. She was also a director of coverage policy at HHS before transitioning to the private sector, working as a Medicare and Medicaid policy consultant for Manatt Health.

With Tuesdays vote, Brooks-LaSure becomes the first Black woman to lead CMS.

Despite general support for the health policy veteran in Congress and a lack of any partisan fireworks during her hearings, Brooks-LaSure’s confirmation process has been slow.

In April, Republicans in the Senate Finance Committee held up the process not due to Brooks-LaSure’s record or experience, but due to HHS’ withdrawal of a Medicaid waiver to Texas that had previously been approved by the Trump administration. The waiver would have given the state more than $100 billion over a decade in federal funding and allowed more flexibility in how it structures the safety-net insurance scheme.

Its withdrawal caused Sen. John Cornyn, R-Texas, to say he would delay the confirmation. Cornyn said losing the waiver would threaten vulnerable Texans’ access to care by winnowing hospital funding, though progressives generally view the waivers as a stop-gap measure that doesn’t address fundamental issues with medical access and curbing downstream costs.

Eventually, the committee voted 14-14 along party lines to move the nomination to the full Senate floor, without a recommendation for confirmation.

And on May 12, the full Senate once again advanced Brooks-LaSure’s nomination, in a 51-48 procedural vote. Senate Democrats were joined by two Republican legislators in backing a discharge petition to bring her nomination to a floor vote after it was held up by the finance committee and GOP opposition to her confirmation.

Hospital and payer groups, progressive think tanks and patient advocates were pleased with the confirmation on Tuesday.

Many noted that Brooks-LaSure’s experience in health policy, especially with the ACA and Medicaid, should help expand access to low-cost care as medical prices continue to rise in the U.S.

“We congratulate Ms. Brooks-LaSure on her historic confirmation,” FAH President and CEO Chip Kahn said in a statement. “While the fight against COVID is not over, as the pandemic winds down we need to move forward on the broader health care agenda and I am confident our new Administrator is exceptionally equipped to provide the leadership that is crucial for CMS at this time and beyond.”

Brooks-LaSure is the last major health policy appointment from the Biden administration. Previously, HHS Secretary Xavier Becerra faced grilling from Republicans over his abortion views, but was approved by a single-vote margin; while HHS deputy secretary Andrea Palm was confirmed in a 61-37 vote earlier this month.

But, four months into his administration, President Joe Biden still has not nominated anyone to fill the top spot at the Food and Drug Administration, a crucial post with oversight over drugs and vaccines, but also major public health issues like food safety and tobacco.


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