by James A. Bacon
Governor-elect Glenn Youngkin has appointed a new Secretary of Health & Human Resources to lead the fight against the COVID-19 epidemic and also to pursue long-term reforms in mental health and healthcare.
Youngkin’s pick, John Littel, is a Virginia Beach resident and recent president of Magellan of Virginia and chief external affairs officer for parent company Magellan Health. Magellan of Virginia provides behavioral health services to Virginia Medicaid and FAMIS enrollees.
“The COVID-19 pandemic has had devastating impacts on Virginians across the Commonwealth, and John will play a pivotal role in overseeing our efforts in protecting Virginians’ lives and livelihoods,” said Youngkin in a press release.
“Starting on Day One, John’s experience will be an asset as we fix our broken mental and behavioral health system, ensure Virginians have access to affordable, free-market healthcare options, and reform our healthcare safety net to save taxpayer dollars and improve healthcare outcomes,” he added.
Littel has 30 years of public policy experience, most of it with medical insurance companies, including Amerigroup and Anthem. He also served as a deputy Secretary of Health and Human Resources in Virginia, chairs the Virginia Health Care Foundation, and has served as rector on the College of William & Mary Board of Visitors.
Bacon’s bottom line. Let’s parse Youngkin’s statement to get a sense of the incoming administration’s healthcare priorities.
- Fighting COVID-19. Youngkin opposes vaccination mandates but urges Virginians to get vaccinated voluntarily. It will be interesting to see if and how the Governor-elect’s position evolves as evidence surfaces that the Pfizer and Moderna vaccines provide limited protection against the now-dominant Omicron strain of the virus. Presumably Littel will be a key player in reappraising the ever-evolving viral threat.
- Mental health. Virginia, like the rest of America, is experiencing a mental-health epidemic. Anxiety, depression, suicide, substance abuse and drug overdoses were all aggravated by the social isolation policies imposed as a result of COVID-19. But the negative trends long preceded the epidemic, and they will likely persist after the epidemic subsides. Littel’s professional background is behavioral health. If personnel is policy, as the saying goes, Littel’s appointment backs up Youngkin’s stated intention to make mental health a priority.
- Free-market healthcare options. Youngkin’s use of the phrase “affordable, free-market healthcare options” hints that the Governor-elect favors a market-driven approach to healthcare reform, but it’s not clear exactly what he has in mind. Given Littel’s background in healthcare insurance, we may conjecture that Youngkin leans towards the kind of market-oriented reforms favored by healthcare insurers — such as greater hospital pricing transparency, rolling back Certificate of Public Need (COPN) regulation, and promoting greater competition between healthcare providers.
- Reform healthcare safety net. Youngkin says he wants to “save taxpayer dollars” and “improve healthcare outcomes.” The two go hand-in-hand. Improving healthcare outcomes typically results in fewer patient-days in the hospital, fewer resources expended, and lower public expenditures. Youngkin seems to be signaling this kind of win-win approach to healthcare. But, again, specifics are lacking. The only clue we have is the fact that Magellan of Virginia contracts with Medicaid to deliver behavioral health solutions to Medicaid patients. Whatever solutions Littel has in mind for Virginia’s healthcare system, they likely will be informed by his experience as an intermediary between state government and Medicaid patients.
- The dog that didn’t bark. Equally revealing is what Youngkin did not say. He did not talk about expanding state spending or creating new programs in general healthcare. It appears that, as a general philosophy, he wants to accomplish more with the resources we’re already devoting to healthcare.