Donald Trump intends to nominate celebrity TV physician Dr. Mehmet Oz to head the Centers for Medicare & Medicaid Services (CMS), the $1 trillion federal institution in charge of two of the country’s most influential health insurance programs.

“He is an eminent Physician, Heart Surgeon, Inventor, and World-Class Communicator, who has been at the forefront of healthy living for decades,” Trump said in a statement. “Dr. Oz will work closely with Robert F. Kennedy Jr. to take on the illness industrial complex, and all the horrible chronic diseases left in its wake.” Trump has nominated Kennedy as the secretary of the Department of Health and Human Services, which houses CMS.

Oz, who lost a race for one of Pennsylvania’s U.S. Senate seats in 2022, gained prominence in the early 2000s as Oprah Winfrey’s physician. He has no government experience. If confirmed, in addition to running Medicare and Medicaid — the latter of which covers half of the nation’s births — Oz would have oversight over the Children’s Health Insurance Program and the individual marketplaces for insurance created by the Affordable Care Act.

Oz has a history of making degrading remarks about women, including asking Martha Stewart what sex was like “at [her] age.” He also told an attendee at a political rally that he had been watching her “pretty smile the whole time.”

Oz has also promoted pseudoscience on his long-running TV program, “The Dr. Oz Show.” A study from 2014 found that less than half of the claims made on Oz’s television show were accurate. In 2014, Oz said that uninsured Americans have “no right to health” and instead should receive basic 15-minute screenings in a “festival-like setting.” 

During his 2022 Senate run against Sen. John Fetterman, the Oz campaign repeatedly mocked Fetterman’s disability. The strategy was roundly condemned by disability advocates. 

During the campaign Oz also said he opposes the Affordable Care Act, the law that expanded access to health insurance for millions of Americans and that outlawed charging people more for coverage if they had preexisting medical conditions, a provision that disproportionately affected women and LGBTQ+ people, who were more likely to be charged higher rates. The 2022 platform would have expanded privatization of health insurance for older adults. Medicare Advantage plans are popular, but can make accessing care difficult for people with more complex health care needs. According to the National Institutes of Health, 85 percent of Americans over age 65 — the majority of whom are women — have a disability or chronic condition. 

During his Senate campaign, he said he opposed vaccine mandates and abortion. He called it “murder” at any stage and argued that “life starts at conception” — a viewpoint known as fetal personhood, which could be used to outlaw not only abortion but also medical treatments such as in vitro fertilization. In that same race, he expressed support for banning transgender athletes from playing on sports teams that match their gender.

CMS has broad authority to dictate American health care. Medicare and Medicaid together cover more than one in three adults, per KFF, a nonpartisan health policy research, journalism and polling organization.

Under President Joe Biden, CMS has become a key tool for expanding access to insurance for pregnant Americans in particular, extending the period in which many are eligible for Medicaid. The current administrator, Chiquita Brooks-LaSure, prioritized using her authority to combat the prevalence of pregnancy-related deaths, particularly among Black women. 

The Trump administration and its allies are weighing cuts to Medicaid, which insures low-income people to finance tax cuts, The Washington Post reported Monday. That could include imposing work requirements — which research shows do not result in more people working but do result in them losing insurance because of the paperwork burden — and more frequently checking if people are still eligible for the program, a policy that could hurt people whose income varies based on the seasons.

CMS is also in charge of enforcing the Emergency Medical Treatment and Labor Act, the federal law known as EMTALA that requires most hospitals to provide necessary care to patients in emergencies. The Biden administration has used EMTALA as a lever to require hospitals to provide abortions to patients when it is the necessary emergency treatment — one of the few avenues the federal government has found to secure some abortion access since the overturn of Roe v. Wade.