LAS VEGAS — CMS Administrator Seema Verma outlined her response to the perennial question of what role government should take in healthcare during a keynote Sunday as the HLTH conference kicked off its second year.
The safety net for low-income and high-cost Americans should exist, but it must "avoid the pitfall of creating incentives that encourage government dependency and limit future opportunities," Verma said.
CMS will "soon outline new opportunities for states to flip the Medicaid paradigm and free themselves from federal micromanagement," she said.
CMS has approved controversial work requirement programs yoking health insurance to work or volunteering hours in nine states so far. In Arkansas, about 18,000 people lost coverage in a few months due to barriers in reporting work hours, according to the Georgetown University Health Policy Institute, and the programs are costing taxpayers some $408 million though they lead to fewer Americans receiving coverage.
Verma told reporters she has put in more detailed implementation guidelines to address these issues and that, as long as states continued to approach CMS with requests for work requirement programs, the agency would continue to approve them.
The CMS administrator said her ideal healthcare system recognizes a limited government role with three elements: a safety net for the most vulnerable including those with pre-existing conditions, ensuring the sustainability of government programs and ground rules for a "flourishing and competitive" healthcare market.
Verma called the motivation behind Democrats' "Medicare for All" and similar proposals "insidious" and "the complete annihilation of the private healthcare system." She cast the ideas as "the polar opposite of humility."
Many high-profile Democratic candidates for president back Medicare for All, a partial expansion of the public program or Medicaid, a more moderate public option or some proposal in between.
Kaiser Family Foundation polling from March shows 56% of overall respondents and nearly 80% of Democrats favored a single-payer health plan in America.
The Trump administration has made attempts to boost transparency of healthcare costs, with so far limited success.
The agency's proposal that drugmakers include list prices in their direct-to-consumer advertising was struck down by a federal court in July, a CMS idea to force payers and providers to reveal negotiated rates faces fierce industry backlash and the agency has no way to enforce a rule finalized January mandating hospitals publish their chargemasters online.
"We started putting our foot in the water" with that rule "but we understood that was a first step," Verma said.