The Man With the Trillion Dollar Budget


After leading the team that saved, Andy Slavitt took the reins of Medicare, Medicaid, and Obamacare. He’s leaving soon, but his legacy is just getting started.

Andy Slavitt

Andy Slavitt left a successful career in the private sector to take what many would call a thankless job. For the past two plus years, he’s been the acting head of CMS, better known as the agency that runs Medicare and Medicaid. That job has the largest budget in the land — a trillion dollars — more than two-thirds larger than the Department of Defense. When we spoke earlier this Fall, Slavitt knew he was most likely going to be out of a job come January 21st — his role serves at the pleasure of the President, and no matter who won, it was probable he’d be replaced. However, his name was whispered as a candidate for other top positions in government, had Clinton won.

Trump’s election has eliminated any doubt of that, but it has also animated Slavitt’s Twitter feed, which was already spicy by government standards (though certainly not as spicy as the new President elect). Consider this tart rejoinder:

An Open Letter Healthcare.Gov: I Can’t Afford To Be Sick


The other day, I got several letters in the mail. One was from the healthcare marketplace, reminding me that enrollment for 2017 coverage begins on November 1st. The rest were medical bills, some of which are about to go to collections, that I can’t pay for. This isn’t new to me. When I first got sick back in 2010, I wasn’t insured at all. I have so much outstanding medical debt that subsequently went to collections that I’ll probably never be able to get loans for school, a house, a car, or anything else. My credit is under 600, and I don’t think it’s ever actually been over 600. I didn’t even have enough time to build credit — I was only 19 years old when I got sick.

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