Ep. 107: Representation Matters

Ceci Connolly: Hello her story fans. We have an incredibly special issue today of her story with CMS Administrator Chiquita Brooks Lahore. I am sure that many of you know her and the incredibly enormous job she has running the Centers for Medicare and Medicaid services. The administrator has been a longtime public servant working on Capitol Hill, working in several administrations and also in the consulting world. And as we are closing out Black History Month here and Black History Month and then Women’s History Month, I think it is an important historical tidbit to mention to our listeners that she is the first black female administrator of CMS. So with that, I am so pleased to introduce you, Chiquita. Welcome.

Chiquita Brooks-LaSure: Thank you so much and it’s really a pleasure to be here with.

Ceci Connolly: As her story is really about women leaders in healthcare, and we are hoping to share the journey that you have been on, including different hiccups and challenges along the way, what you’ve learned, how you think about mentorship and bringing other women along. And so maybe we can just start here. The convers. A little bit with your own journey to this very senior leadership position within the administration.

Chiquita Brooks-LaSure: I would love to I, sometimes I take a step back and I try to enjoy every moment of this job because it really is a privilege to be in this incredible role as CMS administrator. We have over a trillion dollar budget between what I like to say are the three msms, Medicare, Medicaid, and chip and marketplace coverage. I would say, how did I get here? It was, just, you can never predict what your life will look like. Of course. But I would say that, just a couple of things really stand out to me when I think about my life and my life’s. I would say first and foremost, I really had in my life many people who helped me to get here, and I would just, when I look back and think about how many bosses I had who were incredibly instrumental in helping me to grow as a person, helping me to understand public policy and the work. That we have and just really helping me to understand how to balance all of those things with being a person. Which I think is important in terms of this role of really understanding what life is like. I, one of the things that I focus on a lot is as people know is maternal health, and I am a mother and a lot of. Expertise in that area really comes from being a parent, some of the challenges that I’ve gone through, but also talking to other parents and realizing, oh, I didn’t experience some of these challenges because of my own walk in life. So I would say, when I think about how I got here, What really stands out is how many really supportive women and men, but many women really helped me. I learned partly by observation, really seeing them in action. Some people like Speaker Pelosi, I would say. Like I really watched her and how she conducted herself, and it’s not that, we had so many direct convers. But then other people my boss, it weighs a means about Borland. Nancy Yen gene Lamb Brew Mark Miller at the beginning of my career, just to name a few. I think that learned so much from observation and also d more direct me.

Ceci Connolly: You mentioned one of our favorite topics here, which is that work-life balance, and it can be so challenging for anyone, but certainly for women. And if you’re a mother, I think even more what kind of advice would you offer, especially for rising women leaders who may be right at that point in their career when they seem to be juggling everything? What good tips do you have for that balance?

Chiquita Brooks-LaSure: I won’t pretend that I have it all figured out. And I would start by saying I think that so often we p people in general, women in particular, and moms. Star it three times. Really feel like we have to go through these kinds of challenges alone. There is a lot of wisdom in talking to people and I still, honestly, last weekend I called up a friend with older kids and said, here’s what’s going on. Any advice you have for me. And I think that so often I see us struggling, but we are not the first people who had to figure out how to manage work-life. And I think so often, again, we think we have to solve these problems ourselves. My own suggestion and advice is that I think really understanding that being a parent, Can actually make you more efficient and better. And I was talking about this with one of my team who also is a mother. And it’s true. I think I’m much more ruthless about my time than I used to be. I have much more is this actually a critical conversation? Do we really need to have this? Is there a more efficient way to accomplish this? And I think a lot of that came. Just knowing that every moment I am choosing my time between the people who, you know, the 6,000 people that work at this agency, the Hill, the stakeholders, and being at home with my family. And so you get a little more I think, precise with your time. And I say that to say that I think so. We take, we think of our, whatever the things are about ourselves as a liability. They don’t have to be. That said, it is incredibly difficult sometimes to manage the, all of the things that are going on in our lives. And I think really making sure you tend to, the extent that you can have supports around you, whether they’re family members, whether. Friends support that is critical. And I think also it ideally A lot of that comes from employers. I try to create an environment at CMS. I will go out of my way to mention that. I like to take my daughter to. The bus. I don’t do that just because I wanna do those things, but I wanna make parents at CMS feel like it is okay to say I, am gonna be. I need this meeting to start at nine 15 rather than nine o’clock because I want to be able to take my child to school. That’s okay. That does require a level of grace from employers and and colleagues often too understanding that, we can’t always accommodate everybody’s issues, but often. We can, it’s okay to start that meeting at nine 15. It’s okay to not have meetings at after six. Sometimes there’s an emergency, that is a little bit of the advice that I would give.

Ceci Connolly: That’s excellent. I like the efficiency and also, Leading by example, which is so important. April, of course, is Medicaid awareness month, and you and I have spoken about the fact that we are about to enter this period of. Medicaid, redeterminations and across the country states will be starting. They’ll take a look at who may no longer qualify for Medicaid. Give a little sense. And I think tied in with Medicaid is one of your focus areas, which is. Equity. So as we are entering into this very critical period and knowing your focus on equity, how are you as a leader approaching this very important period.

Chiquita Brooks-LaSure: This time has been incredible leading up until our Medicaid re determin. We at CMS now oversee over 150 million lives across the country. And a big part of that has been the increase in enrollment in Medicaid and chip. And one of the reasons is because during the pandemic, people haven’t had to do redeterminations or go back to their state states and fill their paperwork out. The focus has to be very broad, where all of. Are thinking about how do we make sure that people know they’re gonna have to fill out additional paperwork to say, yes, I still live here. No, I don’t still live here. I’ve moved, I, my income has changed. And I really see this. And the approach that I want us as an organization and work with partners is to see this as a all hands on. Type of situation. So states are the primary ones with responsibility for Medicaid redeterminations, but health plans, stakeholders, private companies, nonprofits, advocacy organizations, all can play a critical role in making sure that people know that they need to fill out their paperwork and make sure that that the, those things happen. Because to go back to your question about health, At the core of health equity is making sure that everybody has the res, the opportunity to achieve optimal health regardless of their circumstances, and their circumstances. Could be income, geography, race, et cetera. You can’t achieve health equity without coverage. It’s necessary and not sufficient, but it is necessary because you need to be able to go to the doctor when you have a healthcare need. You need to be able to see a mental health professional if you’re having a challenge and so we’ve gotta hold on and build on the coverage gains that we’ve. Over the last couple of years, the uninsured rate is at an all-time low. It just, this is a constant thing where we have to continue to make sure that people stay in an M if that’s appropriate, or move to employer sponsored insurance. It doesn’t matter exactly what your coverage is, as much as it matters that you have it and then can actually get access to care when you.

Ceci Connolly: One of the questions that we really like to pose on her story is it my. What’s your superpower? Others may say, what is that characteristic or trait that really helps you, especially maybe at a critical time or you can just fall back on it? I will confess, mine used to be great sleeping. I’ve lost it, so I need

Chiquita Brooks-LaSure: Oh, bummer.

Ceci Connolly: I need to find a new superpower. But what’s yours?

Chiquita Brooks-LaSure: I would say that I love making the linkages, and I think that part of that is, I think of it as the RU figuring out the Rubik’s cube. It’s a puzzle. And even though I was really terrible at Rub figuring out the Rubik’s Cube and I can’t do it, but I think part of that has been, I’ve gotten an opportunity before I took this role of working on every m So when a Medicare issue comes up, I think. Guess what we do in Medicaid on this topic or when we’re talking about the innovation center, I feel like when we had this issue in marketplace coverage in the aca, this is how we resolved it. And I think also I’ve had a real diversity of experiences. Different administrations working on the hill, working in the private sector, which really helped me to understand how little the private sector sometimes understands how the government operates. And so it’s all brought, I think, me just having a ability to have an understanding that. Just where you sit makes a huge difference in how you resolve challenges. And I think I have more willing. To see that the answer may be elsewhere. So that’s what I would say. My superpower is that I love collaboration. I look for linkages, and it’s really what I’m trying to bring as CMS administrator that we think broadly, people now particularly cycle through their entire. Through different part of parts of our programs, they don’t care what you call them. Are they a Medicare beneficiary or a marketplace consumer or a, Medicaid enrollee, they care about. Their care. They care about whether they’re seeing their doctors. And I think it’s just really important that we understand that. And that’s what I, that’s what I like. That’s and that’s what I think I bring in terms of my superpower.

Ceci Connolly: I like it. And I read an article recently, I think it was an interview that you did with the news national Newspapers, publishers, and you commented in that article, representation Matters. Explain that.

Chiquita Brooks-LaSure: I think one of the things that has been the most surprising to me as the MS administrator is how moved people are to see a black person, to see a woman. In this incredibly powerful role. And it’s really shocked me, honestly. It’s moved me, I was at an event earlier this week where a young man chased me down to just tell me how inspired he was by my leadership and wanted to take a picture. And I, I never expected any of. And I think that so often people will come up to me. One young woman a couple of weeks ago said, you have an unusual name and you’re a woman of color, and you don’t go by your middle name, and how meaningful that was to her. I have never thought about anyone. Caring about me having an unusual name. But so often I hear how much people seeing me in this role helps them to realize it is possible. And something to. That, that it means something to them that that they’re in the role. I have someone on my team who used to be a certified nurse assistant she’s pretty young still. We were on with talking about nursing home issues. And the CNAs were really moved that she is a cna. Like the idea that someone helping to make decisions about nursing home care is someone who actually has done a job. Was incredibly meaningful to that group of individuals. And I think that we forget that so often as policy makers, how important it is that people feel like they are being seen and that people making decisions understand. What they’re going through, what our decisions mean. And so those are just two examples, but you could multiply that times a hundred where every time we go and we are bringing a more diverse perspective. And again, it can be a whole variety. It can be race of course, but it can also be things like experie. It makes a difference. It makes a difference to the people that are being served, and it absolutely makes a difference in how decisions are perceived.

Ceci Connolly: We know you have an incredibly busy schedule. So one quick closing question and that is, can you offer any advice to, in particular, because we’re the Her Story podcast, women in healthcare that are looking to grow themselves, their careers. Succeed as you have. What do you say to them?

Chiquita Brooks-LaSure: I would say so often, certainly in my personal life, I mean in my personal journey, but I hear from so many, you just never know when the opportunities will arise and being excellent in everything you do. Is meaningful is important. It’s sometimes the issue you’re working on that you is the least important is the one that leads to the greatest opportunities. That is one thing I would say. Second advice, I would say. Be a good person, and I don’t mean that light lightly. It’s the right thing to do, but it’s also, you never know the person who is the intern in the office could be your boss in two jobs. Not only is that. Possible. It’s also likely because in healthcare you just never know, and it’s really important to think about how you’re leaving everybody. How are the interactions? That’s what lasts over time. Not did you answer the question perfectly, but how did you collaborate with your team? How did you interact? How did you show? Show up. And then thirdly, I would say you have got to have people in your life that you’re learning from. You don’t do this on your own. See different perspectives. Take what you like. Don’t adopt the behaviors of that you, that don’t resonate with your personality or your skillset. We all are good at different things, but really learn from people and really have those relationships because, again, That’s been so key to my, certainly my career, but also to probably every career that I know of.

Ceci Connolly: Incredibly valuable advice, and I just wanna say on behalf of the whole team here at. Story. We are so grateful for this very special opportunity to talk to CMS Administrator Chiquita Brooks Lahore.

Chiquita Brooks-LaSure: Thank you so much.