New Congress Brings Changes in Health Policy Leadership
Republicans have gained control of the Senate by a majority of 53-47. There will be 12 new senators—six from each party.
The 119th Congress will see significant changes in health policy leadership beginning in January, with key committee transitions:
Senate:
- John Thune (R-SD) assumes the senate majority leader post replacing Mitch McConnell (R-KY).
- John Barrasso (R-WY) is the new majority whip (he led the effort with Sen. Debbie Stabenow [D-MI] to pass Medicare Part B coverage for counselors).
- Tom Cotton (R-AR) will be the GOP conference chair.
- Shelley Capito (R-WV) takes over as the GOP policy committee chair.
- The Finance Committee gains three new Republican members, and Mike Crapo (R-ID) takes over as chairman.
- Bill Cassidy (R-LA) will serve as chairman of the Health, Education, Labor and Pensions (HELP) Committee. Cassidy is a physician.
- The Bipartisan Telehealth Caucus expands to 47 members.
- Last year, U.S. Senators Alex Padilla (D-CA), Thom Tillis (R-NC), Tina Smith (D-MN.), and Joni Ernst (R-IA) announced the launch of their bipartisan Senate Mental Health Caucus, which serves as a bipartisan forum “where senators can work together to elevate mental health issues as a national priority by holding informational briefings to pursue common legislative goals and raise awareness of important mental health issues.”
House:
- Energy & Commerce Committee leadership shifts with several current members retiring.
- Ways & Means Committee adds five freshman representatives.
- The Mental Health Task Force reorganizes under new co-chairs.
The Republicans will maintain majority control of the House by an extremely slim margin of 220–215. The House will vote on leadership positions likely in early January.
Republican priority areas are expected to include telehealth expansion, drug pricing reform, and mental health parity enforcement. Committee staff projections indicate that the first hearings will begin in February 2025.
The President's Cabinet Begins to Take Shape
President-elect Trump has nominated Robert F. Kennedy, Jr., to lead the Department of Health and Human Services (HHS), a $2 trillion agency that oversees critical health care programs like Medicare and Medicaid, and key mental health agencies like the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration (HRSA). Appointments for SAMHSA and HRSA are pending.
Under Kennedy’s proposed “Make America Healthy Again” initiative, he would support tighter controls on ultra-processed foods and food dyes and address chronic disease conditions. He has been criticized for his views on vaccines and eliminating nutrition programs run by the FDA.
Mehmet Oz, MD, has been nominated to serve as the administrator of the Centers for Medicare and Medicaid Services (CMS). In addition to the two largest public insurance programs, CMS also oversees the management of the Affordable Care Act.
The confirmations of Kennedy and Oz may be tough in the Senate but could pass by a narrow margin to provide Trump the federal health care agency team he would like to have in place as soon as possible.
In other health care and mental health care policy nominations:
Jay Bhattacharya, MD, of Stanford University, is on track to lead the National Institutes of Health (NIH).
Marty Makary has been nominated to lead the Food and Drug Administration (FDA). He is currently a surgical oncologist at Johns Hopkins University. He has been critical of federal health agencies’ lack of attention to addressing improvements in chronic disease care.
Dave Weldon has been selected to run the Centers for Disease Control (CDC). Weldon served in the House of Representatives for 14 years. He has also said that federal agencies need to do more in the chronic disease management area.
Janette Nesheiwat, MD, has been nominated as U.S. Surgeon General.
CMS, FDA, CDC, NIH, and the Surgeon General’s Office all fall under the purview of the HHS Secretary.
Former Congressman Doug Collins has been nominated as Secretary of Veterans Affairs. The VA has widespread responsibilities for providing health care and mental health services to millions of veterans.
All cabinet roles require Senate confirmation and historically average 3–4 months for approval; however, the confirmations could see an accelerated approval process through recess appointments that bypasses the normal confirmation process.
What do these nominations mean for counselors? Several of the health agency nominees support better chronic disease management, wellness, and health promotion initiatives. These priorities bode well for counselors whose skills match these areas. NBCC will advocate for our participation in new programs implemented by key health agencies, especially efforts that integrate physical health and mental health by key health agencies.
