Seema Verma, President Trump’s pick to run the Centers for Medicare and Medicaid Services (CMS), was approved by the Senate Committee on Finance on Thursday morning by a vote of 13 to 12. Now, her nomination will be passed onto the full Senate.
Verma, president, CEO and founder of SVC, Inc., a national health policy consulting company, first faced the Senate Committee on Finance two weeks ago for a lengthy hearing in which she emphasized reducing complexities of CMS rules and regulations, and putting decisions in the hands of doctors and patients.
The next step after that hearing was a vote by the committee, set to take place Wednesday March 1. But the scheduled vote yesterday resulted in a 9 to 9 tie from those committee members who were present. With proxies included, the votes were 15 to 11 in Verma’s favor, but proxy votes do not count, according to committee rules. Thus, the vote continued to today.
In his opening statement yesterday, Sen. Ron Wyden (D-Ore.), the committee’s ranking member, again brought up Verma’s past conflicts of interests like he did during her first Senate hearing. Wyden said in his statement that Verma “contracted directly with the state of Indiana while also contracting with at least five companies that provided hundreds of millions of dollars in services and products to the programs she was helping the state manage—Hewlett Packard, Health Management Associates, Milliman, Inc., Maximus, and Roche Diagnostics. In at least two cases— her contracts with HP and HMA —her answers show that Ms. Verma’s assignments for Indiana directly aligned with the work those outside firms were being paid to do.”
Verma has defended herself on the allegations multiple times in the past, saying she recused herself if any conflict of interest ever presented itself. But again in yesterday’s statement, Wyden said, “We are in the dark with any respect to how [Seema] Verma would pursue these issues. We need that information to make judgements on nominees who will be in charge of $1 trillion in healthcare spending.” As such, Wyden said he will be opposing her nomination for CMS administrator.
Meanwhile, Committee Chairman Orrin Hatch (R-Utah) said in his statement yesterday, in support of her nomination, that Verma “is a highly qualified nominee. I really don’t think there’s anyone who reasonably disputes that.” He added, “If we’re ever going to tackle our growing entitlement crisis and preserve our federal health programs—as well as Social Security—for future generations, we need to take hard looks at the system now and find common ground on improvements that will extend the life of these important programs. We need leadership at CMS that will both recognize the problems these programs face and understand the importance of the programs to the populations they serve. I believe Ms. Verma will be that kind of leader at CMS. And, I think there is bipartisan agreement on that point.”
As Healthcare Informatics reported shortly after Trump announced her nomination, Verma worked in Indiana first with former Gov. Mitch Daniels, and then Gov. Mike Pence, now the nation’s vice president, on healthcare policy following the passage of the Affordable Care Act (ACA). She was an architect behind the Healthy Indiana Plan, an insurance program that was designed for people with low incomes that requires participants to pay minimal monthly contributions based on their incomes. This sparked some controversy, as the requirement of the poor to pay even small monthly fees to remain eligible for healthcare services has been considered by Democrats to be unfair. Nonetheless, many Republican administrators applaud Verma for being able to put this plan in place under a Democratic healthcare law, Obamacare.
To this point, Wyden said in his statement yesterday, "Could a state Medicaid program be designed to lock someone out of the program for six months if they miss a payment, even if they are making as little as $12,000?” He added that Verma “doesn’t have a whole lot of background dealing with Medicare. The fact that this Committee barely has any notion of her views on prescription drugs costs or new payment models for doctors and how they affect rural communities makes it difficult to fulfill the Senate’s obligation to ‘advise and consent.’”
Wyden also noted that without clear indication from Verma regarding her own views, he assumes she shares the views of many in her party, including her new boss if she is confirmed, HHS Secretary Tom Price. Wyden said, “Their proposals say that Medicare’s guarantee of defined health benefits should be ended, that Medicaid should be cut to the bone, and that insurance companies should be put in charge and allowed to use loopholes to once again discriminate against people with expensive pre-existing conditions.”