WASHINGTON (AP) — President Joe Biden has picked a former Obama administration official to run the Centers for Medicare and Medicaid Services. The agency oversees government health insurance programs covering more than 1 out of 3 Americans and is a linchpin of the health care system.

If confirmed by the Senate, Chiquita Brooks-LaSure would be the first Black woman to head CMS, which has under its umbrella Medicare, Medicaid, children’s health insurance and the Affordable Care Act, better known as “Obamacare.” The programs cover more than 130 million people, from newborns to nursing home residents.

Brooks-LaSure has a long track record in government, having held health policy jobs at the White House, in Congress, and at CMS during the Obama administration. Most recently she led the Biden transition’s “landing team” for the Department of Health and Human Services, laying the groundwork for the new administration. Before her return to government service, Brooks-LaSure was a managing director at the Manatt Health consultancy.

Her nomination was confirmed by a person familiar with the White House decision, who spoke on condition of anonymity ahead of a formal announcement.

CMS also plays a central role in the nation’s $4 trillion health care economy, setting Medicare payment rates for hospitals, doctors, labs and other service providers. Government payment levels become the foundation for private insurers. The agency also sets standards that govern how health care providers operate.

Brooks-LaSure “gets the imperative of securing greater affordability for beneficiaries, taxpayers, and Medicare, Medicaid and the ACA marketplaces,” said Chris Jennings, a longtime health policy adviser to Democrats. “She is well-respected and liked by the department veterans who have worked with her in the past.”

Years ago, Brooks-LaSure worked with Biden’s nominee to run HHS, California Attorney General Xavier Becerra. She was a staffer on the House Ways and Means Committee and he was a senior member of the panel during the 2009-2010 drive to pass President Barack Obama’s health care law. Senate committees will hold hearings next week on Becerra’s nomination.

Under Biden, Brooks-LaSure will be expected to grow Obamacare enrollment by promoting HealthCare.gov and trying to persuade holdout states to adopt Medicaid expansion. She’s also expected to roll back Trump administration policies allowing states to impose work requirements on Medicaid recipients, as well as insurance rules seen as undermining Obamacare.

Throughout her career, Brooks-LaSure has worked on Medicaid policy, and that program has now grown to become a mainstay of coverage for many low-income working people. At CMS she’ll have to confront Medicare’s long-term financial problems, aggravated by a decline in payroll tax collections because of COVID-related job losses.

Prescription drugs will be a tricky policy area for Brooks-LaSure. Biden wants to legally authorize Medicare to negotiate prices with drugmakers, but he may not be able to marshal enough support in a closely divided Congress. Brooks-LaSure will be tasked with finding ways to use the agency’s rule-making powers to rein in prices.

Biden’s pick was first reported by The Washington Post.

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