Trump nom­i­nates Pence ally to over­see health pro­grams

Kuwait Times - - HEALTH & SCIENCE -

The ar­chi­tect of Gov. Mike Pence’s Med­i­caid ex­pan­sion in In­di­ana is ex­pected to play a key role in de­ter­min­ing how Repub­li­cans re­place Pres­i­dent Barack Obama’s health care law.

Seema Verma, a con­sul­tant who helped de­sign Pence’s ap­proach to the Med­i­caid pro­gram for the poor in In­di­ana, was named Tues­day as Don­ald Trump’s choice to head up the fed­eral Cen­ters for Medi­care and Med­i­caid Ser­vices. Repub­li­cans praised her nom­i­na­tion. Pres­i­dent-elect Trump said in a state­ment that her decades of ex­pe­ri­ence “will trans­form our health care sys­tem for the ben­e­fit of all Amer­i­cans.”

But sup­port­ers of the cur­rent health care law were less pleased. They op­pose re­quire­ments that poor peo­ple pay for med­i­cal care, which is in­cluded in the Med­i­caid pol­icy adopted in In­di­ana and is up for con­sid­er­a­tion by other Repub­li­can-led states. “We’re re­ally con­cerned,” said Ju­dith Solomon, vice pres­i­dent for health pol­icy at the lib­eral Cen­ter for Bud­get and Pol­icy Pri­or­i­ties.

Prior to Pence, Verma was a con­sul­tant to for­mer Repub­li­can In­di­ana Gov. Mitch Daniels, who pushed for a pre­cur­sor to Pence’s cur­rent Med­i­caid plan. Her firm, SVC Inc., has been paid more than $6.6 mil­lion by the state of In­di­ana since 2011 for her con­sult­ing work, ac­cord­ing to records.

In a 2008 blog post on the web­site HealthAf­fairs, co-au­thored with a Daniels’ ad­min­is­tra­tion of­fi­cial, Verma out­lined a phi­los­o­phy that “melds two themes of Amer­i­can so­ci­ety that typ­i­cally collide in our health care sys­tem, rugged in­di­vid­u­al­ism and the Judeo Chris­tian ethic.”

In­di­ana’s Med­i­caid pro­gram “com­bines th­ese di­a­met­ri­cally op­posed themes by pro­mot­ing per­sonal re­spon­si­bil­ity while pro­vid­ing sub­si­dized health pro­tec­tion to those who can least af­ford it,” she wrote. The nom­i­na­tion, if ap­proved, would give Verma a sig­nif­i­cant voice in the poli­cies Trump’s pres­i­den­tial ad­min­is­tra­tion chooses to pur­sue if he makes good on a cam­paign prom­ise to re­peal and re­place the ACA.

Un­der Pence, In­di­ana ac­cepted fed­eral money made avail­able for low-in­come heath care un­der Obama’s law. But the state only took the money after the Obama ad­min­is­tra­tion agreed to an added twist: re­quir­ing poor peo­ple to pay nom­i­nal fees for the care they re­ceive. Those who don’t keep up on monthly pay­ments, which can be as low as $4, aren’t el­i­gi­ble for as many ser­vices.

In most states, the poor are not re­quired to pay such fees. The In­di­ana pro­gram has ex­tended health care ben­e­fits to more than 300,000 peo­ple in the state.

In Ken­tucky, where Verma con­sulted for Repub­li­can Gov. Matt Bevin, the state has re­quested fed­eral per­mis­sion to re­quire peo­ple on the state’s Med­i­caid plan to pay monthly pre­mi­ums, have a job or vol­un­teer for a char­ity to re­main el­i­gi­ble for health ben­e­fits.

Pence has said that re­quir­ing the poor to make pay­ments for Med­i­caid means they are tak­ing per­sonal re­spon­si­bil­ity and have “skin in the game.”

But some Repub­li­cans in his home state dis­agreed. Repub­li­can In­di­ana state Rep. Ed Clere, for­mer chair­man of a health care com­mit­tee in the state’s Gen­eral As­sem­bly, said re­quire­ments other than fees, such as quit­ting smok­ing or tak­ing steps to im­prove per­sonal health, also demon­strate “per­sonal re­spon­si­bil­ity” and could be more cost ef­fec­tive in the long run. “In my ex­pe­ri­ence there was an un­will­ing­ness to ex­pand the con­ver­sa­tion be­yond fi­nan­cial par­tic­i­pa­tion,” Clere said. — AP

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