Five days after saying changes were coming to her cabinet and senior staff, Gov. Nikki Haley announced the first shakeup – a change at the agency that oversees the state’s Medicaid program.
Health and Human Services director Tony Keck, who helped increase the number of South Carolinians with health insurance while opposing the federal law to expand coverage, is returning to the private sector, Haley said Monday.
Christian Soura, the governor’s budget expert, will take over the $7 billion-a-year agency if confirmed by the state Senate.
It would be Soura’s first job overseeing a public health agency. However, the 36-year-old said his previous work in Pennsylvania’s state government provided him with experience, including helping oversee that state’s employee insurance and health programs.
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As deputy chief of staff, Soura “was deeply involved in everything,” Haley said. “You can say he is the finance guy, but truly he was the health guy, the education guy, the restructuring guy. ... He was the man behind the curtain for a long time. People knew he was there, but they did not quite know what he did. I will tell you, he’s a problem solver.”
Soura joined the Haley administration in 2011 as a $1-a-year efficiency expert. Later, he became deputy chief of staff for budget and policy, paid an $128,698-a-year salary. He will get a raise to what Keck earns, $154,879.
Haley said she did not think she could find anyone better than Soura to run the health agency after watching him work with Keck during her first term.
Soura is the second high-level staffer in the governor’s office to take over a cabinet agency. Former Haley chief of staff Bryan Stirling was named Corrections Department director last year.
Soura takes over for Keck on Nov. 20.
The governor’s office distributed quotes from two Republican state senators praising Soura.
But state Sen. Joel Lourie, a Richland Democrat who sits on the Senate’s health budget panel, said Soura’s lack of experience in public health is “somewhat of a red flag.” Still, Lourie said he wants to hear what Haley’s new pick has to say before deciding how he will vote on his confirmation.
Keck, an original member of Haley’s cabinet, is heading to Johnson City, Tenn.,-based Mountain States Health Alliance, where he will be senior vice president and chief development officer.
The 25-year public health veteran was among the most respected of Haley’s cabinet heads.
Keck helped relieve a $228 million deficit at the state agency while adopting cost-saving programs, including one that reduced elective Caesarean-section births.
Health and Human Services also increased enrollment in Medicaid despite the state’s opposition to expanding the health care insurance program under the Affordable Care Act, pushed by President Barack Obama.
South Carolina’s Medicaid rolls increased by 38 percent to 1.1 million during Haley’s first term.
Many of those added to the insurance rolls were children, but some of the increase also came after South Carolinians rushed to apply for Medicaid last year. Much of the money – about 90 percent – that the state agency receives for Medicaid comes from the federal government.
Thornton Kirby, chief executive of the S.C. Hospital Association, said he was disappointed to see Keck leave even though his trade group disagreed with the Haley Administration’s opposition to expanding Medicaid.
Kirby praised Keck for being collaborative and flexible. Kirby said he did not expect to see a massive change in agency policy. Soura agreed Monday.
Lourie credited Keck for helping ease roadblocks to enroll in Medicaid. The senator called the health agency boss “one of the smartest people to be around. I would give him good grades for running the department.”