Variation in levels of professionalism in healthcare policymaking during the Obama, Trump, and Biden administrations.

During the Trump administration it was widely asserted in the news media that the administration's agency appointees were less professional than appointees from previous administrations. Using qualitative data from 35 interviews with lobbyists, congressional staffers, and executive branch officials, and quantitative and qualitative data on years of relevant experience and job type at the date of nomination, it is demonstrated that indeed the Trump administration attracted less talent than the Obama and Biden administrations, which resulted in less supply and demand for expertise and thus a diminished role of expertise in the policymaking process.