5 burning topics for Seema Verma
CMS Administrator Seema Verma testified before a Senate panel last week for the first time since her confirmation hearing, giving lawmakers a rare public opportunity to bring up policy issues that are key for their states. Here are five things senators wanted to know more about.
1 Pre-existing conditions and the Obamacare lawsuit
This summer, the Trump administration made waves with its refusal to defend the Affordable Care Act in a lawsuit filed by Republican attorneys general from 20 states. The Justice Department also asked the federal judge in Texas presiding over the case to overturn the law’s consumer protections, including guaranteed issue for people with pre-existing conditions.
Verma said congressional leadership should hold a vote on those protections. “I’m deeply concerned about people with pre-existing conditions,” said Verma, who wouldn’t comment on the pending litigation. “My job is to implement the law. If the law changes, I would work with Congress to make sure there is protection for pre-existing conditions.”
2 Medicaid work requirements
Verma has previously said she is concerned about work requirements in states that haven’t expanded Medicaid because of the so-called subsidy cliff—since ACA tax credits can’t be applied to people below 138% of poverty. She defended the concept of work requirements for the expansion population, emphasizing the CMS’ guidance that requires states not to include kids, pregnant women or the disabled and medically frail in their proposals.
3 Medicare wage index
Verma said the CMS will look at the methodology and noted the agency included a request for information from stakeholders in the rule, adding that she is concerned about disparities that are particularly detrimental to rural areas. She said she hopes the Trump administration will be able to do something on the wage index.
4 Medicare and opioid abuse
Verma defended the Trump administration’s decision to not negotiate for naloxone in Medicare Part D, where prices for opioid overdose reversal drugs are spiking in response to increased demand, especially compared to what the VA health system pays for the same drug.
5 Medicaid drug classification
Verma said the CMS only had guidance authority to address the problem of manufacturers misclassifying drugs for the Medicaid drug program so they get paid more per drug, adding that Congress would need to give the agency authority to levy penalties on offending manufacturers; an example is Mylan’s EpiPen, whose misclassification led to hundreds of millions of dollars in losses for the government. Verma said she would support congressional action to expand the CMS’ authority.