Should Mehmet Oz, M.D., be confirmed to run the Centers for Medicare & Medicaid Services (CMS), the physician-turned-television personality-turned politician said this week he would abide by the Trump administration's stance against gender-affirming care services and "advancing a pro-life agenda."
The nominee has already been cleared by the Senate Finance Committee and will likely sail through the full Senate's future confirmation vote, largely on party lines. However, one potential Republican holdout was Missouri Sen. Josh Hawley, who signaled that he may break with his colleagues over Oz's previous positions on hardline conservative issues like transgender advocacy and abortion.
Hawley sent Oz a series of questions on the issues and, on Monday, posted the nominee's written reply on X. The responses, by and large, are in line with the administration's policies and Hawley's views.
For example, one of Hawley's questions highlighted instances in which Oz's television program featured transgender advocates, a surgeon who performed gender-affirming surgical procedures and minors who had transitioned, generally in support of gender-affirming care.
Oz responded that since that time, "medical research on this topic has shown that previous clinical approaches were not sufficiently evidence-based and contained inconsistencies."
Oz went on to write that he would "fully support" President Donald Trump's orders to review existing literature on gender-affirming care and cutting off federal funds to hospitals that perform those services, with his responses mirroring the controversial language used in those orders. He also committed to CMS never issuing a National Coverage Determination for gender-affirming care services.
Gender-affirming care services comprise a range of social, behavioral and medical interventions that affirm an individual’s gender identity when it conflicts with the gender they were assigned at birth.
The services are supported by major medical groups such as the American Academy of Pediatrics, the American Medical Association, the American Psychological Association and numerous others that warn of transgender individuals’ elevated risk for self-harm when denied affirming treatments.
Oz, again in response to Hawley's questioning, went on to write that he believes the Supreme Court's Dobbs ruling, which overturned Roe v. Wade, was decided correctly. He answered questions on prior comments from 2019 and 2022 regarding state and federal abortion limitations by writing that he is "unequivocally pro-life, and if confirmed, [looks] forward to advancing a pro-life agenda at CMS."
The nominee then signaled his support for enforcing the Hyde Amendment, a legislative provision restricting the use of federal funds to pay for most abortions, as well as laws and policies related to conscientious objection.
Oz also struck a more permissive tone on emergency abortion care, which the Biden administration stressed through guidance and in court was required under the Emergency Medical Treatment and Active Labor Act (EMTALA). The Department of Justice, now under the new administration, recently abandoned that position in an ongoing legal case.
Oz, responding to Hawley's question on the issue, said he "believe[s] CMS can simultaneously enforce EMTALA and respect the many state laws protecting the unborn and the right of conscience in healthcare. If confirmed, I will review this guidance and look forward to working with CMS as well as Congress to ensure that both can be achieved."
"I appreciate Oz's detailed replies to my questions," Hawley wrote in an X reply.
Finance Committee Senators question Oz on Medicaid cuts, Medicare Advantage scrutiny
Oz had faced a wide-ranging set of questions from lawmakers over how he would run the CMS during his March 14 hearing in front of the Senate Finance Committee.
That hearing was, by and large, far less confrontational than the hearings for Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr., with Oz often referring to previous conversations he had with senators. Democratic members were simultaneously trying to determine whether they’d vote with Republicans on the continuing resolution to fund the government before tonight’s deadline.
Democratic lawmakers ripped into House Republicans’ budget resolution plan to cut spending from the House Energy and Commerce Committee by $880 billion over 10 years, which will result in significant cuts to Medicaid.
Oz told several senators he is in favor of work requirements for Medicaid and is in favor of removing undocumented individuals from receiving benefits through the program. He refused to commit to not cut Medicaid, however, and did not defend the Affordable Care Act expanded tax credits either. Instead, the program should be more efficient, and Medicaid recipients shouldn’t have “money thrown at them,” he said.
“Would you agree this morning, since you want to cherish Medicaid, to oppose any cuts to the Medicaid program?” asked Sen. Ron Wyden, D-Oregon, in a yes or no answer format.
“I cherish Medicaid and I worked within the Medicaid environment quite extensively as I highlighted practicing at Columbia University," Oz said. "I want to make sure that patients today and in the future have the resources to protect them if they get ill. The way to protect Medicaid is by making sure it’s viable at every level, which includes having enough practitioners to afford the services, paying them enough to do what you request of them and making sure the patients are able to actually use Medicaid.”
Oz did not answer the question, Wyden replied.
Sen. Elizabeth Warren, D-Massachusetts, said the administration’s approach toward rooting out waste, fraud and abuse would be better applied toward eliminating upcoding and overpayments in Medicare Advantage (MA) instead of increasing the uninsurance rate by cutting Medicaid.
Yet Oz appeared to agree with Warren and others at several points in the hearing that the MA program needs improvement, perhaps surprising some healthcare onlookers who remember his comments supporting a push to a MA for All model.
Sen. Bill Cassidy, M.D., R-Louisiana, a supporter of MA, agreed the program should be improved to better protect people. He’s heard complaints that some MA plans are only covering care if it is explicitly covered, rather than only denying services if the policy says the service is not covered.
"“We share Dr. Oz’s goal of strengthening Medicare Advantage for seniors and taxpayers, and we look forward to working with him on policy solutions to accomplish this," said Better Medicare Alliance President and CEO Mary Beth Donahue in a statement to Fierce Healthcare.
Support is mixed for Oz. Some appreciate his experience as physician and believe he may be a crucial ally to reverse doc pay cuts.
"It’s been nearly 10 years since the CMS Administrator role has been filled by someone with practitioner experience, and longer for someone holding an MD, so he would bring a much-needed perspective to CMS that can turn these cuts around and help the Medicare system put patient access and outcomes first," said John Gallucci Jr., CEO of JAG Physical Therapy.
Others feel he is underqualified for the role.
"Vulnerable children and families, pregnant patients, people with disabilities, and our nation’s seniors, who have worked hard and paid into the system all their lives, deserve high-quality care. They won’t get it with Dr. Oz directing CMS,” said Nancy Hagans, president of National Nurses United, the country's largest union of nurses.
Oz agreed with lawmakers that determining the fate of a Biden-era nursing home final rule needs to be one of his first priorities should he earn confirmation, calling it a “complicated question.”
The nursing home industry opposes the rule, which mandates facilities meet a more strict nurse-per-resident standard. The Biden administration believed this would improve care, but nursing homes claimed they would not be able to meet the requirements amid a shortage of clinical workers for hire. This could lead to more financial strain on long-term care facilities.
Still, elder abuse attorney and former Deputy District Attorney Ed Dudensing believes Oz need to require nursing home standards to protect seniors as private equity and venture capitalists "expand control" over the industry.
"Eliminating nursing home staffing requirements—a position endorsed by key administration officials—will only exacerbate the crisis, increasing cases of elder neglect, preventable injuries and deaths at a time when the system is already under immense pressure," he said.
Cynthia Fisher, founder and chairman of Patient Rights Advocates, appreciated the commitment made by Oz to prioritize price transparency.
"Real prices protect all Americans from overcharges," she said in a statement. "We look forward to your leadership on delivering radical price transparency for American consumers.”
The nominee's other responses outlined his support for preventive care and addressing chronic disease, as outlined in RFK Jr.'s Make America Healthy Again initiative; reform of prior authorization; faster coverage of medical products that recently received regulatory approval; technological innovations such as artificial intelligence; and giving entities from outside of the government an opportunity to push back on the status quo of government healthcare programs.
Editor's note: For a senator-by-senator breakdown of the hearing, see Fierce Healthcare's live blog of Dr. Oz's confirmation hearing here.