By Edward Cates, Chairman, TSCL
With a new presidential administration, only one thing is inevitable: change. As the Trump administration has taken power, the changes made at the top of the Social Security and Medicare agencies can give important clues about how the programs will evolve over the next four years.
In this article, we’ll look at who the administration has chosen to lead the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS). We will also look at the new head of the Social Security Administration.
HHS Secretary:
The Trump administration’s head of the Department for Health and Human Services (HHS), Robert F. Kennedy Jr., was confirmed on February 13th. The former activist began the 2024 election cycle as a democrat before later switching to run as an independent and eventually endorsing President Trump in the run-up to the election.
Some of Kennedy’s priorities as HHS Secretary will be combatting chronic diseases, such as obesity, diabetes, neurological diseases, autoimmune diseases, and allergies. He sees these conditions as an existential threat to not just Americans’ health but also the economy and national defense because of their impact on people’s day-to-day lives. In his confirmation hearing, he cited dietary and environmental factors as major drivers of such diseases.
As he did during his independent presidential campaign, Kennedy faced questions during his confirmation hearing for past remarks expressing skepticism about COVID-19 and vaccines. He asserted that he supports vaccinations throughout the hearing. He also addressed accusations of being a conspiracy theorist by claiming he earned the moniker by asking hard questions about healthcare’s vested interests.
Since taking office as secretary, Kennedy has stayed busy. HHS has kicked off a major organizational transformation effort, including a planned 25 percent reduction in the agency’s workforce. (So far, the cuts have not touched CMS, the agency that oversees Medicare.) Under Kennedy’s leadership, HHS has required the Food and Drug Administration (FDA), which it oversees, to close a loophole that allows food manufacturers to self-affirm the safety of their ingredients.
CMS Administrator:
Dr. Mehmet Oz—yes, that Dr. Oz—will be the new administration’s Centers for Medicare and Medicaid Services (CMS) administrator after being confirmed on April 3rd. The 65-year-old cardiothoracic surgeon rose to fame as a regular guest on the Oprah Winfrey Show. He then built on that success with his own talk show before running for the Pennsylvania Senate as a Republican in 2022.
Much like Kennedy, Oz said that addressing chronic disease should be a major priority for public health agencies during his Senate confirmation hearing, linking poor lifestyle choices to high U.S. healthcare costs. He expressed interest in working with Congress to stabilize insurance markets, enact policies that prevent disease by incentivizing healthy lifestyles, and increase transparency for Medicare and Medicaid beneficiaries. Additionally, Oz said he would like to promote the use of AI in the healthcare system, especially to reduce paperwork and other administrative burdens. He will also target reducing fraud, waste, and abuse across CMS.
During his confirmation hearing, Oz faced questions about how his experience prepared him for the job. Senators questioned whether Oz could effectively lead CMS without any background in leading a public health agency, although he has treated patients on Medicare and Medicaid as a physician.
He also faced questions about conflicts of interest, having previously endorsed Medicaid Advantage—a private alternative to traditional Medicaid that critics see as less effective and more expensive—while owning stock in a major Medicare Advantage provider (he has said he will divest while serving his term). Additionally, Oz came under fire for recommending questionable nutritional supplements and holistic treatments on television and questioning government policy during the COVID-19 pandemic.
SSA Commissioner:
Frank Bisignano, the former CEO of payment processing company Fiserv and a veteran of the banking and finance industry, will be the new head of the Social Security Administration (SSA). After nominating Bisignano to lead the agency in December, President Trump highlighted the nominee’s “tremendous track record of transforming large corporations,” on his social media platform, Truth Social.
According to Bisignano’s remarks at his Senate confirmation hearing, he plans to take a bipartisan approach to improving Social Security’s service quality during his term, which ends in 2031. He’s committed to reducing wait times to speak to an agency representative over the phone, the length of the disability claim process, and Social Security’s payment processing error rate.
Under Senate questioning, Bisignano said he did not want to privatize Social Security. He also reported that he would take steps to address concerns that attempts to reduce fraud, waste, and abuse by the Department of Government Efficiency (DOGE) could put beneficiaries’ personally identifiable information (PII) at risk. Despite stating that he broadly favors DOGE due to his background in implementing financial controls to improve efficiency and quality, he said he would investigate its work at the SSA and address any security issues it may have caused.
