On Monday, March 13, the Senate confirmed healthcare consultant Seema Verma as administrator of the Centers for Medicare & Medicaid Services (CMS) in a 55-to-43 vote, putting her at the heart of efforts by President Trump and Congressional Republicans to execute strategic healthcare reform for the second time in less than 10 years. Verma’s actions moving forward are critical to nationwide healthcare accessibility and expenses.
Does she have what it takes? What are her plans for Medicare and Medicaid?
Verma takes over at CMS at a time when the agency is facing critical changes under the House Republican healthcare bill backed by Trump. This legislation would roll back primary elements of former President Barack Obama’s healthcare law, including its Medicaid expansion for low-income people. Furthermore, the bill would limit overall federal financing for Medicaid in the future.
Seema Verma’s Background in Public Health
Verma’s work with the Medicaid program in Indiana may be a preview of the program’s future nationally. She designed a “consumer-directed” version of Medicaid called Healthy Indiana Plan (HIP) that gives beneficiaries a Personal Wellness and Responsibility (POWER) account — very similar to a health savings account — to apply toward a $2500 deductible. Essentially, it was designed for people with low incomes and requires participants to make small monthly payments based on their incomes.
Under then-Governor Mike Pence, Verma helped create HIP 2.0, which reshaped the Indiana Medicaid program. Under HIP 2.0, the state accepted federal dollars under Obamacare, but mandated that low-income members had to pay moderate fees for the care they received. Anyone who could not pay these fees would no longer be qualified for healthcare services. These provisions are not allowed under traditional Medicaid, but Indiana got a federal waiver in order to implement them.
Verma’s implementation of this conservative Medicaid expansion under a Democratic law puts personal accountability on members since their own dollars are at stake, which deemed her as a very influential healthcare consultant among Republicans.
Plans for Medicare and Medicaid
Verma wants to improve healthcare instead of simply paying the bills. Historically, she has been critical of Medicaid, and even designed a Medicaid expansion along conservative lines in Indiana. During her confirmation hearing before the Senate Finance Committee in February, Verma claimed she was open to any Medicaid reforms that would improve health outcomes for beneficiaries.
Additionally, while she believes Medicaid needs a full overhaul, she does not support turning Medicare into a voucher program under which retirees would receive a fixed federal allowance to purchase private healthcare from government-regulated private insurance plans. Her boss, Department of Health and Human Services Secretary Tom Price, is a prominent supporter of this voucher approach.
Like President Trump, Verma upholds a small-government ideology. At her confirmation hearing, Verma said that physician participation in Medicare pilot projects for delivering and reimbursing medical care should not be mandatory. She also denounced federal regulations that might discourage physicians from participating in Medicaid and Medicare.
Verma’s role in shaping HIP 2.0 Medicaid expansion has faced much controversy. However, given that her partner in the developing the program is now the vice president, there is very much speculation that programs like HIP 2.0 could be the future of Medicaid during the Trump administration.
Only time will tell. We may be facing a new era for healthcare with Seema Verma as Chief of Centers of Medicare & Medicaid Services.
*Stay tuned for the next two blogs in the Healthcare Series, including news on the future of Medicare and Social Security under President Trump, as well as information on Republican plans for Obamacare.