WASHINGTON — President-elect Donald Trump named his top health care team Tuesday, making picks that signal a strong, rightward ideological shift in powerful agencies that manage a vitally important swath of America’s economy, particularly in Massachusetts.
Trump announced he would nominate Representative Tom Price of Georgia, one of the fiercest critics of the Affordable Care Act, to lead the Health and Human Services Department. Price, an early adherent of the Tea Party movement who also has deep experience in health policy, has spent years working to repeal President Obama’s signature accomplishment. He has also advocated for privatizing Medicare, something that Trump has not endorsed.
For another crucial post, the director of the agency that runs Medicare and Medicaid, Trump named Seema Verma, an Indiana health care consultant who worked with the state government of Vice President-elect Mike Pence. She is a proponent of establishing health savings accounts within Medicaid and requiring some Medicaid recipients to work as a condition of receiving coverage.
In selecting Price, 62, for health secretary, Trump gave his first indications of how he might fulfill one of his oft-repeated campaign promises — to “repeal and replace Obamacare,’’ which the law is colloquially called. Unlike some other conservative lawmakers — and Trump himself — Price has offered detailed legislation that would supplant the health law with an option that relies heavily on the private sector.
In Boston, where changes in the health care industry could send shock waves through the local economy, industry leaders, many of whom favored the expansion of health insurance in the state and nationally, reacted with caution.
“If there’s a repeal of the ACA, there’ll have to be a replacement,’’ said Bob Coughlin, president of the Massachusetts Biotechnology Council, an industry trade group. “I’d hate to see us go back to a day where so many people are uninsured or can’t get insurance because of preexisting conditions.’’
Even though Massachusetts consumers are insulated from some changes in national health policy because the state passed its own health reforms under former governor Mitt Romney, any changes in a Trump administration could still have far-reaching effects, experts said.
“Based on the strength of his views about undoing the ACA, it causes a concern,’’ said Lynn Nicholas, president of the Massachusetts Health and Hospital Association. “Fundamentally, it’s like a sweater with threads, if you pull a few out, you gotta repair that somehow.’’
Trump’s choice of Price was praised by Republicans and slammed by Democrats, who characterized Price as a far-right hard-liner intent on shrinking programs that help low-income families.
But it was working-class families, particularly whites, who supported Trump in the presidential election, attracted by his promise to shrink government. As a Trump spokesman reiterated Tuesday, the administration still plans to begin working to reverse the Affordable Care Act on “Day 1.’’
House Speaker Paul Ryan, another critic of the health care law, praised Price as an “excellent nomination’’ by Trump.
“This is the absolute perfect choice,’’ Ryan said. “As a legislator, he has played a leading role in developing conservative health care solutions that put patients first. We could not ask for a better partner to work with Congress to fix our nation’s health care challenges.’’
Representative Nancy Pelosi, who leads the Democratic minority in the House, said the selection of Price could prove disastrous for those who rely on government for insurance.
As of March 2016, nearly 20 million Americans had received coverage through the Affordable Care Act, according to the Obama administration.
“If Tom Price has his way with the Affordable Care Act, millions of families who have finally found affordable coverage for themselves and their children will be pushed back into the cold,’’ Pelosi said.
Before beginning his political career in 1996, Price was an accomplished doctor and hospital administrator. A third-generation physician, he ran multiple orthopedic clinics in the Atlanta area for 20 years, including at Grady Memorial Hospital, the largest hospital in the state. He later was elected to the state Senate in Georgia, and in 2004 to the House of Representatives.
In a statement announcing both selections, Trump called Price a “renowned physician’’ who has a “reputation for being a tireless problem solver and the go-to expert on health care policy.’’ Price and Verma are a “dream team that will transform our health care system for the benefit of all Americans,’’ Trump said.
To serve, both will have to be approved by the GOP-controlled Senate.
For years, Price has introduced legislation that would replace the Affordable Care Act with a system that offers tax credits to subsidize the purchase of individual or family health insurance policies. Price’s plan would steer individuals who cannot afford coverage and have a preexisting condition into a high-risk pool backed by a $3 billion investment, but unlike the current health care law, it would not force insurance companies to offer coverage. The plan also allows companies to penalize consumers for a lapse in coverage, according to copy posted on Price’s website.
Over the years, Price has expressed interest in increasing private involvement in Medicaid and Medicare, two popular government programs that provide health coverage to low-income families, people with disabilities, and people 65 and older.
But how much license Trump will give him to drive change in those programs remains to be seen. Throughout his presidential campaign, Trump promised voters he would protect entitlement programs such as Social Security, Medicare, and Medicaid.
Verma has called for Medicaid recipients, most of whom are low-income families, to have more “skin in the game,’’ including requiring some beneficiaries to get jobs and pay for a portion of their own care, according to STAT, a health and science news site.
Questions also loom about the future of Medicaid funding for the state.
This month, Governor Charlie Baker’s administration reached a five-year agreement with federal officials that includes $29.2 billion from the federal government. But that deal may have to be revisited if the Trump administration fundamentally changes the way Medicaid works.
Massachusetts Health and Human Services Secretary Marylou Sudders said, at this time, she’s pushing ahead with implementing the new agreement, as she has received no indication to do otherwise.
Price is a staunch abortion opponent who has advocated stripping all federal funds from Planned Parenthood. He once said the organization participated in barbaric practices.
Senator Chuck Schumer of New York, who will be minority leader in 2017, highlighted Price’s opposition to Planned Parenthood in his statement explaining his opposition to Trump’s selection.
“Congressman Price has proven to be far out of the mainstream of what Americans want when it comes to Medicare, the Affordable Care Act, and Planned Parenthood,’’ Schumer said. “Nominating Congressman Price to be the HHS secretary is akin to asking the fox to guard the hen house.’’
Astead W. Herndon can be reached at astead.herndon @globe.com.
