Breaking: A Top Trump Appointee Just Resigned


Brian Neale is the Center for Medicare & Medicaid Services (CMS) Deputy Administrator, and the Director for the Center for Medicaid and CHIP Services. Neale is an ally of Vice President Mike Pence and was appointed to his role in the Medicaid program in March.

He was the healthcare policy director under Pence back when Pence was the governor of Indiana (their relationship goes back even further than that), and he helped design Indiana’s Medicaid expansion.

In his role as a Medicaid official in the federal government, he was a key factor in bringing about the work requirements that states are now allowed to require. With that goal accomplished, he’s now stepping down. It’s not too clear why, and no reasons have been stated, but it’s likely that he wanted a key accomplishment under his belt before leaving the raging dumpster fire that is the Trump administration.

“A year and then I’m out” has been a common mantra among high level Trump appointees—with exceptions. Some, like Stephen Miller, appear to be in it for the long haul. Others have not made it anywhere near a year. In any case, the Trump administration has bled staff at a historically high rate.

According to an internal staff memo obtained by Inside Health Policy,

‘Neale, a closely ally of Vice President Mike Pence, spent a year helping to craft the Trump administration’s new policy direction on Medicaid, and reasons for his departure remain unclear. “Next month, Brian will be leaving CMS to pursue other opportunities,” CMS Administrator Seema Verma wrote in the email to CMS staff Tuesday.’

He joins with many other high level Trump appointees who have left the administration.