On Thursday, February 16, 2017, the Senate Finance Committee held a hearing to consider the nomination of Seema Verma for Administrator of the Centers for Medicare and Medicaid Services (CMS). The hearing was noticeably less combative than the hearings held for previous nominees, including Tom Price, who was recently sworn in as Secretary of the Department of Health and Human Services (HHS).  Ms. Verma was very professional throughout the hearing, even when asked pointed questions designed to elicit responses that might contradict the Administration’s stated stance on a particular issue.   Overall, as expected,  Democrats took a more critical approach while Republicans were more supportive.

Commitment to Affordable Prescription Drugs

When asked during the hearing whether Medicare should negotiate drug prices, Ms. Verma indicated that there wasn’t a simple yes or no answer to the question. She did state that competition is key to keeping down the cost of drug prices. At his hearing, Secretary Price also declined to directly answer questions about whether the government should negotiate drug prices.  In the past, President Trump has promised to crack down on rising drug prices, saying that pharmaceutical companies were “getting away with murder.” We expect making drugs more affordable for seniors and other vulnerable populations will remain  an important priority of this Administration.

Health Insurance Exchange Market Stabilization

Ms. Verma was also asked her opinion on the Department of Health and Human Services’ market stabilization proposal that would continue the Affordable Care Act’s health insurance exchanges through at least 2018.  Noting that she was not part of the development of that rule, Ms. Verma did not offer a stance on its contents, stating that she wanted to review the rule and its implications before commenting.

Ensuring a Sustainable Medicare Program

Ms. Verma was asked specifically about policies that have been tied to possible Republican health care proposals. When asked about moving Medicare to a voucher program, Ms. Verma stated she did not support a voucher system, but said was supportive of exploring ways to make Medicare more sustainable, although no specifics were offered. Additionally, Ms. Verma gave an indirect answer when asked by Senator Bill Nelson (D-FL) about raising the eligibility age of Medicare to 67. Ms. Verma  replied that Congress would have to make that determination, but she hoped that there would be other ways to extend the solvency of the Medicare program.

Addressing Ethical Concerns

During the hearing, Sen. Robert Menendez (D-NJ) asked Ms. Verma about providing equal access to coverage for children with autism. In response, Ms. Verma stated that the Office of Government Ethics asked her not to discuss matters relating to mental health issues that could affect her husband’s practice as a child psychiatrist, and therefore could not answer his question directly.  However, Ms. Verma did say that she believes all Americans should have access to the health care services they need.

At the end of the hearing, Sen. Wyden discussed a report from the Indianapolis Star that Ms. Verma’s consulting firm had state contracts while also working for companies that were doing business with the state. While acknowledging that Ms. Verma had not violated Indiana ethics since they did not apply to her as a state contractor, he did question why it was okay for her to design and implement state health programs and then be paid by these companies that were state contractors. Ms. Verma replied that they had sought an ethics opinion, and that when there was any potential for overlap, they recused themselves.

Rural Health Remains Important to the Senate Finance Committee

Throughout the hearing, other senators asked questions about areas specifically relevant to their constituent populations. For example, Senators John Thune (R-SD), Pat Roberts (R-KS), Enzi (R-WY), and Ranking Member Wyden (D-OR) asked about issues facing rural providers. Ms. Verma noted that rural health care providers face unique challenges and hoped to help address their needs through open conversation and collaboration with those providers. Other questions revolved around innovation in health care policy and payment and the reauthorization of CHIP, both of which Ms. Verma expressed support for. In addition, Sen. Sherrod Brown (D-OH) asked Ms. Verma about MOON notices. In response, Ms. Verma said she wished to further review that area and would work with the senator on that issue.

Senate Confirmation Expected

Ms. Verma’s nomination will face a vote in both the Finance Committee and the entire Senate chamber. Both votes are expected to pass. Full video of the hearing, opening statements from Chairman Orrin Hatch (R-UT) and Ranking Member Wyden, and Ms. Verma’s witness testimony are available here.