President Donald Trump nominated Seema Verma, president, CEO and founder of national health policy consulting company SVC, to head CMS. There, she would support confirmed HHS Secretary Rep. Tom Price by taking a hands-on role in the Trump administration's plan to repeal and replace the ACA.
The Senate Finance Committee will hold Ms. Verma's confirmation the week of Feb. 13.
Here are seven things to know about Ms. Verma.
1. At the helm of SVC, Ms. Verma has worked extensively on a variety of policy and strategic projects involving Medicaid, insurance and public health in conjunction with the Governor's office, state Medicaid agencies, State Health Departments, State Departments of Insurance, the federal government and private companies and foundations.
2. She is most widely known for her role as the architect of the Healthy Indiana Plan — the state's version of Medicaid expansion under the ACA. Indiana received a waiver from the Obama administration to implement the program, nicknamed HIP 2.0, in 2015.
Ms. Verma was also a key figure in Medicaid transformation in several other states, as detailed in point No. 7. Ms. Verma has said she considers Medicaid outdated. In her words: "The Medicaid program has not kept pace with the modern healthcare market," Ms. Verma said while giving testimony at a Congressional hearing in 2013, according to NPR. "Its rigid, complex rules designed to protect enrollees have also created an intractable program that does not foster efficiency, quality or personal responsibility."
3. Vice President Mike Pence — then governor of Indiana — hired Ms. Verma to design the Republican-friendly version of Medicaid expansion. The state paid her nearly $5 million over four years through 2017 through contracts of the arrangement, according to NPR.
4. HIP 2.0, which expanded coverage to about 246,000 previously ineligible for Medicaid, emphasizes enrollees' personal responsibility. For example, it requires Medicaid beneficiaries to make monthly payments for their insurance or otherwise lose benefits. Payments range from $1 to $27 and go into individual health savings accounts, to which the state also contributes. If enrollees get preventive care and vaccines, they are eligible for a discount on their premiums the next year, according to NPR.
5. HIP 2.0 also imposes penalties on beneficiaries. Those with incomes above the poverty line can be cut off from the program for six months if they miss a payment to their HSA. Those below the poverty line who fail to pay are moved to a plan with fewer benefits.
6. Ms. Verma received praise for garnering buy-in to her plan while working with both Republican and Democratic state legislators, the Obama administration and health system leaders, according to CNBC. "She was a very good listener and was able to put a lot of different perspectives into the mix," said Sarah Stelzner, MD, a pediatrician with Indianapolis-based Eskenazi Health, according to the report.
7. In addition to HIP 2.0, Ms. Verma and SVC have developed several other Medicaid reform programs, including 1115 Medicaid waivers for Iowa, Ohio and Kentucky. Her firm helped design Tennessee's coverage expansion proposal and also provided technical assistance to Michigan when the state implemented its Medicaid waiver. Ms. Verma and SVC helped guide the transition of Iowa's Medicaid program to a managed care program, and supported strategy efforts for Maine's Medicaid plan.
8. Before founding SVC, Ms. Verma served as vice president for the Health & Hospital Corporation of MarionCounty in Indiana and as a director with the Association of State and Territorial Health Officials in Washington, D.C.
9. Ms. Verma received her master's degree in public health with concentration in health policy and management from Baltimore-based Johns Hopkins University and a bachelor's degree in life sciences from the University of Maryland in College Park.