- CMS Administrator Seema Verma is unable to provide any details on President Donald Trump's nebulous and long-promised healthcare plan, ostensibly for release in September. However, Verma did confirm the healthcare agency is "actively engaged in conversations" around the plan Thursday, noting CMS doesn't have the ability to make more sweeping changes to bring down healthcare costs or improve quality.
- "I think to some degree we've taken things as far as we can in terms of the regulatory changes that we've made," Verma told reporters. "If you look at what we're doing, we're already implementing the president's agenda and his plan on healthcare in all our initiatives."
- CMS is also "fast and furious" on the so-called International Pricing Index, a demonstration project to tie prices in Medicare Part B to those prices paid overseas. Verma called releasing a proposal for the IPI a "top priority" for the agency despite delays, but declined to provide a more specific timeline for the proposal.
The administration faces increasing pressure to release a concrete healthcare plan as Democratic presidential candidates are eager to keep the national conversation focused on healthcare heading into the 2020 election.
And, as the administration backs a lawsuit seeking to declare the Affordable Care Act unconstitutional, the president faces renewed accusations any potential plan won't protect patients with pre-existing conditions. The outcome of the litigation may not be clear until sometime next year, which would place it smack dab in the middle of the presidential campaign.
The healthcare industry and politicians alike are thirsty for details of the promised plan, first reported on by the Wall Street Journal earlier this month. The White House has released nothing concrete — the plan could be as simple as a renewal of 2016's "repeal and replace" effort or a comprehensive plan including protection for pre-existing conditions, incentivizing the sale of insurance across state lines or other efforts to spur competition in the system.
“It won’t be like the Affordable Care Act because the Affordable Care Act is not working," Verma told reporters Thursday in Washington, D.C.
Although Verma declined to comment on the timing and details of any potential healthcare plan, CMS is "implementing the president’s agenda on healthcare in all the work CMS does around quality, drug pricing, transparency" and more efforts to inject flexibility into the system such as the HRA rule and the expansion of association and short-term limited duration insurance.
But "I think we've been very clear that some of the changes that need to be made are outside our scope," Verma said. "I think to some degree we’ve taken things as far as we can in terms of the regulatory changes that we’ve made."
Some are skeptical Trump has a healthcare plan at all, with Republican lawmakers saying they weren't briefed on any potential legislation before departing for the August recess. But the CMS head pushed back against those accusations, noting the agency is in talks with legislators and the White House on the matter.
In contrast, the 2020 Democratic candidates have staked out clear positions on healthcare going into November of next year. Although frontrunner and ex-Vice President Joe Biden backs a more moderate public option, an expansion of the ACA, Sens. Bernie Sanders, I-Vt., and Elizabeth Warren, D-Mass., support Medicare for All — the creation of a government-run insurance program and the elimination of private insurance entirely.
Sanders and Warren are also performing well in the polls, with voters increasingly embracing more radical reform of the U.S. healthcare system. More than 50% of adults in a recent Kaiser Family Foundation poll said they favor a national health plan.
Verma also reiterated the agency is bullish on a proposed rule for the International Pricing Index Thursday, calling it a "top priority."
HHS released a notice of proposed rulemaking last October announcing the IPI. Although the healthcare agency originally planned to release a proposed rule by this spring and start the program next year, it was delayed following opposition from the pharmaceutical industry.
The Trump administration has faced a series of setbacks in its efforts to lower drug prices. It had to withdraw a proposed rule to eliminate the safe harbor for drug rebates in Medicare Part D following concerns it would raise premiums. Additionally, a federal judge blocked an HHS rule requiring drug manufacturers to publish list prices in direct-to-consumer TV advertisements last month.