The Senate voted 55 to 44 on Monday to confirm Seema Verma as the next administrator for CMS.
Senate Republicans, minus Sens. Marco Rubio (R-FL) and Johnny Isakson (R-GA), who did not vote, unanimously supported Verma and were joined by Sens. Joe Donnelly (D-IN), Joe Manchin (D-WV), Heidi Heitkamp (D-ND), and Angus King (I-ME).
- Prior to being nominated by President Donald Trump to lead CMS, Verma was a healthcare consultant who worked with several state governments on Medicaid reform and expansion.
Reaction among lawmakers to the nomination and subsequent confirmation of Verma as CMS administrator has been split along party lines. However, several industry groups have come out in favor of the selection.
Verma supporters point to her experience advising states, including Indiana, Michigan and Tennessee, on their Medicaid plans. She is perhaps best known for contributions to the Healthy Indiana Plan (HIP) 2.0, which was implemented in the state during Vice President Mike Pence’s tenure as governor.
In an August 2016 post for the Health Affairs Blog, Verma described HIP 2.0, which was enabled by a waiver approved by the administration of President Barack Obama, as "the most significant departure from traditional Medicaid" ever seen. Modeled after commercial health insurance products, HIP 2.0 pairs a $2,500 deductible health plan with a health savings account loaded with $2,500. Beneficiaries are required to make monthly contributions equaling 2% of their income to the plan and their coverage can be dropped if they fail to make payments.
Policies implemented in Indiana have been heralded by Republican lawmakers at the national level, who tend to believe individual consumers should be more responsible for their own healthcare costs. HIP 2.0 “empowered people to take greater responsibility for their own health by providing incentives to use healthcare resources efficiently,” Senate Finance Committee Chair Orrin Hatch (R-UT) said during debate preceding the confirmation.
Democrats have attacked the departure from traditional Medicaid for the burden it places on low-income individuals. While lawmakers have argued over Verma’s accolades, industry groups seem to appreciate her experience. The American Hospital Association, Federation of American Hospitals, Association of American Medical Colleges, and American Health Care Association each came out in favor of Verma shortly after she was nominated and issued statements applauding her experience in state Medicaid programs.
With a healthcare reform bill pending in Congress, Verma might oversee a massive overhaul of the healthcare system. Of course, there are significant obstacles that must be overcome before the bill can pass and there is no guarantee that Republican lawmakers can succeed in their efforts to repeal and replace the Affordable Care Act. However, Verma still has a unique opportunity to make her mark on the healthcare landscape. On the same day she was confirmed, HHS reminded states they can apply for waivers that would allow for significant changes to their Medicaid programs. Verma could guide other states down the same path that she took Indiana.