Senate panel confirms Verma as CMS chief

The U.S. Senate’s Finance Committee yesterday approved Seema Verma as head of the Centers for Medicare & Medicaid Services, after the panel deadlocked at 9-9 earlier this week.

The panel of 14 Republicans and 12 Democrats voted along party lines in the 13-12 vote to send the nomination to the full Senate; Sen. Johnny Isakson (R-Ga.) did not appear in person so his proxy vote did not count. Sen. Tom Carper (D-Del.), who had voted by proxy for Verma in the earlier poll, switched and removed his support for the final tally.

As founder & CEO of health policy consulting firm SVC, Verma worked closely with Vice President Mike Pence, then Indiana’s governor, to craft the Hoosier State’s Medicaid expansion waiver under Obamacare. Their plan requires participants to pay a portion of their premiums (and face a lock-out if they miss a payment) and maintain health savings accounts. Verma and SVC also consulted with other states on their Medicaid expansion waiver programs, including Iowa, Kentucky and Ohio.

In a Feb. 16 hearing before the finance committee, Verma supported limits on the federal government’s role in healthcare, saying states and individuals should be given more flexibility in their healthcare choices. The nominee punted on providing more specific ideas about the nuts and bolts of CMS policy, saying it’s up to Congress to set that agenda.

Finance chairman Sen. Orrin Hatch (R-Utah), speaking ahead of yesterday’s vote, cited Verma’s “vast experience working with state governments to improve and modernize their Medicaid systems.”

“And she has the knowledge and temperament necessary to lead this important agency at this critical time,” Hatch said. “Long story short, if we’re going to make the needed changes to fix our healthcare system, we need competent and willing partners at CMS who will work with Congress to find the best solutions and then effectively implement those solutions. … I believe Ms. Verma will be that kind of leader at CMS. And I think there is bipartisan agreement on that point.”

Before the preliminary March 1 vote, Finance ranking member Sen. Ron Wyden (D-Ore.) said Verma’s vague answers at her confirmation hearing, and concerns about conflicts of interest, prompted him to vote against her confirmation.

“What we got is what I’m starting to call healthcare happy-talk because there’s just no content there. That’s deeply troubling for me when you are talking about a job that’s responsible for a trillion dollars of healthcare spending,” Wyden said. “I don’t expect to see eye to eye with every nominee to the Trump Administration. But I do expect good faith answers to questions that Senators from the committee of jurisdiction have.”

“I will again quote President George W. Bush’s ethics lawyer Richard Painter who said that Ms. Verma’s consulting arrangement in Indiana, ‘clearly should not happen and is definitely improper.’ Ms. Verma was on both sides of the deal, helping manage the state’s health programs while being paid by vendors to those same programs. Richard Painter called that a ‘conflict of interest.’ I agree, and I am concerned that if Ms. Verma is confirmed to lead CMS, where many of the companies she worked for are major vendors, there will not be adequate scrutiny of her past relationships with them, just as there wasn’t in Indiana.”

Material from Reuters was used in this report.

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