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7 key people who could shape Trump’s health care policy

Thought Leader: Brian Blase
July 31, 2024
Source: STAT

A second Trump administration would bring a new wave of health policy officials into power in Washington. But many of those faces may be familiar.

Aides and administration officials who shaped former President Trump’s most impactful health policy initiatives, from price transparency to prescription drug pricing to banning surprise medical bills, have scattered to think tanks and consulting firms. If Trump wins the election in November, they could be poised for a return.

Given Trump has few deeply held convictions about health care policy and the Republican Party’s platform has precious few details about its plan for the future, Trump’s potential selection of a team to run health agencies will have an outsize impact on his administration’s direction.

“A good baseline presumption is that personnel is going to be policy,” said Michael Cannon, who runs the health care policy program at the libertarian Cato Institute.

STAT identified seven former aides who could be poised for influence if Trump wins the election, whether in an official capacity or not.

Brian Blase, Paragon Health Institute

Blase worked on the Trump White House’s National Economic Council from 2017 to 2019. Since then, Blase has led the launch of Paragon Health Institute, which has served as the intellectual home for a cadre of former Trump administration staffers, including former White House official Theo Merkel and former Medicare chief Demetrios Kouzoukas.

The think tank could serve as a staffing firm for a new wave of Republican leadership, as well. For example, former Republican Study Committee policy staffer Drew Keyes had landed at Paragon as a senior policy analyst before he returned to work for House

Speaker Mike Johnson (R-La.) when he staffed up following his rapid ascent to power.

“I like to say that outside of Cato, Brian is the best thing that the free market movement has going on health policy,” Cannon said.

Recently, Blase has started to build the Republican case for opposing the continuation of extra Affordable Care Act subsidies. The subsidies, passed by Democrats during the pandemic, are set to expire after 2025. He published a paper with Paragon arguing that some people may be misstating their income in order to take advantage of the subsidies.

Scott Gottlieb, New Enterprise Associates

Gottlieb was a bit of a sensation as Trump’s first Food and Drug Administration commissioner, bringing a breakneck pace, funky socks, and an active presence on the social platform X to a traditionally stodgy office.

Having left the FDA on good terms in April 2019, he dodged being wrapped up in the Trump administration’s Covid-19 response directly. Instead, he became a regular presence as a Covid-19 commentator. Being good on TV is not a quality to be underestimated in the Trump universe. Another factor in Gottlieb’s favor: He’s been confirmed by Congress before on a bipartisan vote.

However, given some Republican voters’ distrust of vaccines and the pharmaceutical companies that make them, Gottlieb’s position as a board member at Pfizer could work against him.

Joe Grogan, Fire Arrow Consulting

Grogan, a fiery former Trump White House aide who directed the Domestic Policy Council from 2019 to 2020, shaped Trump’s largest policy pushes, including regulations on prescription drug pricing and legislation to ban surprise medical billing.

His background as a Gilead lobbyist gives Grogan a command of policy details and the machinations of the health care industry, expertise that’s somewhat rare to find in the Republican Party.

Since exiting the administration, Grogan has kept his ties in D.C. fresh as a consultant. He chairs the board of Blase’s group Paragon, and has written op-eds on drug pricing, pharmacy middlemen, and access to Alzheimer’s drugs for the Wall Street Journal.

Eric Hargan, The Hargan Group

The former deputy secretary of the Department of Health and Human Services has kept his name in the mix for a second Trump administration, multiple people in GOP health circles have told STAT. Hargan can boast his involvement in one of the Trump administration’s crowning health achievements, Operation Warp Speed, which delivered effective Covid-19 shots in record time. He also worked in senior HHS roles in the George W. Bush administration.

In the years since the end of Trump’s term, the former deputy secretary established The Hargan Group, a health care consulting group, where among other projects he’s been focused on some longtime policy passions: digital privacy and HIPAA, anti-kickback regulations, and hospitals’ interoperability. Hargan has cited all three as highlights of his time at HHS during the Trump administration.

Paul Mango

 Much like Hargan, Mango can point to his record during the Covid-19 pandemic and the rush for treatments and vaccines. He was HHS deputy chief of staff and the agency’s official liaison to the Operation Warp Speed project after a stint as chief of staff at the Centers for Medicare and Medicaid Services. These days, the former McKinsey consultant and unsuccessful candidate for Pennsylvania governor is a public adviser to Paragon, keeping him in the loop with many former Trump officials.

Mango wrote a 2022 book about the Warp Speed effort in which he denied reports that Trump pressured officials about producing a vaccine before Election Day. He also criticized Pfizer — maker of one of the first authorized vaccines — for a lack of transparency. (It was not the first time he came after Pfizer. He revealed to STAT a year earlier that they’d tussled over the company’s packaging during the vaccine rollout.)

While Mango has acknowledged at times that the administration could have communicated about Covid-19 vaccines and treatments better, he’s criticized the Biden administration’s effort to combat misinformation online. Mango has also downplayed notions that Trump would enact anti-vaccine actions or appoint anti-vax officials in a second term.

Theo Merkel, Paragon Health Institute, Manhattan Institute

Merkel was closely involved with work on price transparency, surprise medical billing, and drug pricing during his stint at the National Economic Council. Before that, he worked as a top aide to former Sen. Pat Toomey, a Pennsylvania Republican who sat on the Senate Finance Committee.

Merkel is known for his wonkiness. Take, for example, a recent 80-page manifesto for Paragon on health care and taxes, conveniently published ahead of a massive congressional fight over reauthorizing the Trump tax cuts next year. It covers decades of history of tax policy, as well as recommendations for the future.

Brooke Rollins, America First Policy Institute

Trump’s “woman in Washington” launched the pro-Trump America First Policy Institute just over two years ago, turning his failure to win a second term in 2020 into an action plan for the next election. The institute’s close ties to Trumpworld — he spoke at their 2022 policy summit, and AFPI leadership have been described as a “White House in waiting” — are undeniable.

Rollins was a White House adviser and acting Domestic Policy Council director, and is mostly credited for driving sweeping criminal justice reform to Trump’s desk in 2018. But she actually got her start in thank tanks trying to take down the Affordable Care Act. Under her leadership in 2010, the Texas Public Policy Foundation went up against the Obama administration over the law and states’ rights, a battle the foundation continues fighting.

Rollins was an early addition to Trump’s first administration and a longtime economic adviser to the former president. While she largely stuck to the economic space, AFPI staff under its health division chair Bobby Jindal have plunged into how Trump could rein in high drug costs, reform hospital price transparency and yes, even repeal Obamacare (a battle Trump insists he won’t revisit).

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