Top Health Care Movers and Shakers of 2015

Topics: Clinical Quality, Provider Ratings, Costs and Prices, Health Care Reform, Prescription Drugs, Health Plans/Insurance Companies, Exchanges, Legal Issues, Uninsured, Elections, 2016, Federal Government, Regulatory, Health Care Legislation, Public Health, Preventive Care

Chief Justice John Roberts

Roberts and his concurring counterparts in the Supreme Court had a hand in what some called the Affordable Care Act's solidification when he wrote the high court's opinion upholding the law's subsidies for health plans sold through the federal exchange. President Obama himself took a victory lap at the conclusion of King v. Burwell. While Republicans responded with threats to unravel the law through the budget reconciliation process, Roberts' King decision marked the second time the high court affirmed the ACA in a big way.

Insurers

For better or worse, the country's largest insurers started to shake up the health care landscape in 2015. Anthem and Cigna announced their intent to merge this summer, while Aetna and Humana did the same. The deals are still under review, but the insurers have set the groundwork for major changes in 2016. Meanwhile, UnitedHealth Group late this year voiced what more and more insurers seem to be thinking: The ACA isn't profitable. Projecting significant losses from plans sold through the exchanges, UnitedHealth has signaled that it may exit the exchanges altogether. And other insurers could follow suit.

Surgeon General Vivek Murthy

Vivek, confirmed by the Senate just weeks before 2015, outlined an ambitious public health agenda in April and said he wanted the U.S. to become a more "prevention-based society." The preventive outlook aligned well with the Obama administration's goals and touched on some of the most critical issues in the U.S.: chronic diseases, obesity, mental health and substance use disorders. He even got Obama on board, who just months later announced a preventive health campaign aimed at helping newly insured U.S. residents better understand and use their health coverage.

Sen. Marco Rubio (R-Fla.)

As the New York Times put it, Rubio -- who is seeking the Republican presidential nomination -- is one of the few Republicans to "actually [have] done something toward" dismantling the ACA. Through a display of "quiet legislative sabotage," Rubio last year helped sneak into a federal spending measure a policy rider that limits how much the federal government can spend on the ACA's risk corridors program, permits federal payments to health insurers to help offset the costs they might incur by enrolling a higher-than-expected number of sick people through the insurance exchanges. The federal government's latest spending agreement extended Rubio's measure, which specifically prevents the federal government from shifting funds to pay for the risk corridors program. So in a time when "everyone running [for the Republican presidential nomination] wants to dismantle Obamacare," Rubio has been more than talk and symbolic votes.

Texas Abortion Providers, Center for Reproductive Rights

The Supreme Court in November agreed to hear its first major abortion case in eight years after the Center for Reproductive Rights -- on behalf of several abortion providers in Texas -- challenged parts of an omnibus antiabortion-rights law (HB 2) that has already closed about half of the state's abortion clinics. The case centers on a Texas law that requires abortion clinics to meet the same standards as ambulatory surgical centers and mandates that abortion providers must have admitting privileges at nearby hospitals. Among many other high-profile rulings expected next year, the case could "produce the term's most consequential and legally significant decision," as it would affect millions of women and potentially reconstruct the constitutional right to abortion, according to the New York Times.

Honorable Mentions

HHS Secretary Sylvia Mathews Burwell has overseen a progressively smoother enrollment process since taking over for former HHS Secretary Kathleen Sebelius after the botched launch of HealthCare.gov. Burwell has also guided HHS' creativity in targeting new populations of uninsured residents.

Acting CMS Administrator Andy Slavitt stepped in for former Administrator Marilyn Tavenner, who resigned in February, and has since received Obama's official nomination for the roll. Slavitt has helped maintain CMS' transparency efforts, such as the agency's Compare websites, championed by his predecessor.

California state Sen. Ricardo Lara (D) penned legislation (SB 4) this year that will extend the state's Medicaid coverage to undocumented immigrants up to age 18, which could spur similar action in other states.

House and Senate committees -- led by Rep. Elijah Cummings (D-Md.) and Sen. Susan Collins (R-Maine), respectively -- have ramped up their efforts to investigate rising prescription drug prices.

CDC Director Tom Frieden has managed a full plate of work this year, including issues ranging from substance use disorders to superbug outbreaks and antismoking campaigns to lingering Ebola control efforts.

-- by Joe Infantino