Seema Verma Confirmed by Senate as CMS Chief

Disclosures

March 13, 2017

The Senate today 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 Donald Trump and Congressional Republicans to enact healthcare reform for the second time in less than 10 years.

Verma has specialized in working with state Medicaid programs to improve care while lowering costs. The Trump administration will count on her to achieve those goals in a federal program that stands to shrink in a House Republican bill that repeals and replaces the 7-year-old Affordable Care Act (ACA). The measure would eliminate expanded Medicaid eligibility that 31 states chose under the ACA, and convert open-ended federal contributions to state programs to a fixed, per-capita amount, putting the program on a budget, as it were.

Seema Verma, nominee to head CMS, listens during a Senate Finance Committee confirmation hearing in Washington, DC.

Pete Marovich/Bloomberg/Getty Images

During her confirmation hearing before the Senate Finance Committee in February, Verma said she was open to any Medicaid reforms that would improve health outcomes for beneficiaries. "The status quo is not acceptable," Verma said. "This is the United States of America. We can do better for these vulnerable populations."

Verma's work with the Medicaid program in Indiana may be a preview of the program's future. She designed a "consumer-directed" version of Medicaid called Healthy Indiana Plan (HIP) that gives beneficiaries a Personal Wellness and Responsibility (POWER) account — similar to a health savings account — to apply toward a $2500 deductible. And while Vice President Mike Pence was governor of the Hoosier State, she helped created HIP 2.0, which expanded Medicaid coverage under the ACA. Beneficiaries who contribute a small percentage of their income to their POWER accounts are entitled to extra benefits such as dental and vision coverage.

Like the president that nominated her, the new CMS administrator espouses a small-government philosophy that many physicians may find refreshing. At her confirmation hearing, Verma said that physician participation in Medicare pilot projects for delivering and reimbursing medical care should be voluntary, not mandatory. She also decried federal regulations that might discourage physicians from participating in Medicaid and Medicare, and the burdens that electronic health records impose on clinicians in connection with the meaningful use incentive program.

The Republican-controlled Senate Finance Committee approved Verma's nomination to be CMS administrator in a 13-to-12 party-line vote on March 2. Democrats on the committee faulted her for responding to their questions with what they called vague "healthcare happy talk." They also said she put herself in a conflict of interest when she consulted for the Indiana Medicaid program by working as a contractor for state Medicaid vendors at the same time. Verma defended herself by saying that state officials knew about her contractual relations with vendors, and that she recused herself from decisions when a potential conflict of interest arose.

In contrast, Republicans expressed enthusiasm about Verma heading up CMS. Orrin Hatch (R-UT), the committee chair, said that she had "vast experience working with state governments to improve and modernize their Medicaid systems."

"And, she has the knowledge and temperament necessary to lead this important agency at this critical time," Hatch said at the time of the committee vote.

Follow Robert Lowes on Twitter @LowesRobert

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