Seema Verma, Trump's pick to head Medicare and Medicaid, avoids giving policy views

WASHINGTON — Seema Verma, the Indiana health care consultant tapped by President Trump to oversee the Medicare and Medicaid programs, told senators Thursday she doesn’t support turning Medicare into a voucher program.

But Verma resisted efforts by Democrats, and some Republicans, to take positions on other potential changes including:

• Raising Medicare's eligibility age and requiring the government to negotiate with drug companies for lower prices
• Changing the minimum benefits health plans must cover
• Capping the amount of money states receive for their Medicaid programs

“Ultimately, what direction we go into is up to Congress,” Verma said at her confirmation hearing to head the Centers for Medicare and Medicaid Services.

Sen. Orrin Hatch, the Utah Republican who chairs the Senate Finance Committee, which is vetting her nomination, told Verma she acquitted herself well and would be a strong and skilled leader at CMS. She is expected to be confirmed by the GOP-controlled Senate.

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Still, Oregon Sen. Ron Wyden, the panel’s top Democrat, said Verma needs to be more specific in the follow-up questions he will submit in writing.

“It’s important to get more of a sense of how she would approach it,” Wyden told reporters after. “This is an agency that has a lot of discretion.”

And two Republicans — Nevada Sen. Dean Heller and Ohio Sen. Rob Portman — raised concerns during the hearing about what would happen to the hundreds of thousands of their constituents who gained access to Medicaid under the Affordable Care Act.

Heller said he’s heard from elected officials and hospitals in Nevada worried about Medicaid being turned into a block grant.

“They’re concerned that we may not have the appropriate funding,” Heller said.

Verma, who worked with Indiana and several other states on their Medicaid programs, said she understands states don’t have “a whole lot of extra money.”

“But I think this is about putting states in leadership roles so that they can manage their programs better,” said Verma, who promised to usher in a “new era of state flexibility” with Medicaid.

Heller asked whether that means she’s pushing for block grants.

“I’m pushing an approach that improves the Medicaid program because I don’t think the status quo is acceptable,” she said.

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A policy brief given to House Republicans to review Thursday as they decide how to overhaul the Affordable Care Act includes limiting Medicaid funding to states and repealing the part of the ACA that expanded Medicaid eligibility to cover able-bodied adults making up to 138% of the federal poverty level.

Sen. Robert Menendez, D-N.J., asked Verma whether all those who gained access to Medicaid through the Affordable Care Act should keep it.

Verma said she views able-bodied individuals as a very different population than the aged, blind and disabled who were covered by Medicaid before the law changed. But she did not elaborate.

“You’ve got to give me more than that,” Menendez said. “I hope your responses to written questions will be more enlightening.”

Republicans on the committee praised Indiana’s alternative Medicaid program, which Verma was instrumental in creating.

Advocates say the Healthy Indiana Plan — known as HIP 2.0 — promotes individual responsibility because participants make monthly contributions into health accounts which help pay for their services. Beneficiaries living in poverty who don’t make the payments are put into a “basic” coverage program which has fewer services and requires some co-payments.

Verma said HIP recipients who make their payments get more preventive care, use the emergency room less and are better about taking prescription medicines.

“What it shows is we can empower individuals to take ownership for their health,” she said.

Wyden raised concerns about the program, including that someone making $12,000 a year is locked out of coverage for six months if a contribution is missed.

He also asked Verma about IndyStar’s report that while she was under contract with Indiana to work on its Medicaid program, her firm did work for one of the state’s largest Medicaid vendors.

“It sure looks to me like you were on both sides of the table as a lot of money was being decided,” Wyden said.

Verma said she was never in position where she negotiated with the state on behalf of another contractor while she was working on HIP for Indiana.

As part of her ethics agreement with the federal government, Verma said she will recuse herself on any matter that presents a potential conflict. That includes issues involving mental health because her husband is a psychiatrist with the Indiana Health Group, she said when Menendez asked whether insurance plans should be required to cover behavioral health therapies for conditions such as autism.

“He does treat children with autism,” Verma said. “They’ve asked me not to engage on matters that involve his practice.”