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Seema Verma

Administrator, Centers for Medicare and Medicaid Services

Seema Verma has spent her career in the health care field. Dubbed “The GOP’s Medicaid Rollback Engineer,” she is best known for her work as a state-level Republican consultant to help destroy government-subsidized health care programs for the poor. As administrator to Centers for Medicare and Medicaid Services (CMS), she now leads the very same programs she once helped states decimate.

HOW THEIR ROLE AFFECTS ACCESS TO REPRODUCTIVE HEALTH

Seema Verma controls Medicare and Medicaid and is responsible for managing access to basic health care for some of the most underserved Americans, but her past professional work weakened these very programs. Her previous work entailed building alternatives to the Affordable Care Act’s Medicaid expansion on the state level to mimic private insurance plans and strip vulnerable people of standard Medicaid protections. Verma is now using her role to try and do the same across other states with federal guidelines meant to demolish Obamacare — which mandates no co-pay birth control, among other provisions related to reproductive health.

The influence of the anti-abortion lobby has been clear in Verma’s tenure at the helm of CMS. She put forward a November 2018 proposed rule that would require health care issuers bill patients separately for abortion services and applauded Trump’s signature of a bill aimed at Planned Parenthood funding alongside anti-abortion activists.

PREVIOUS EMPLOYMENT OF NOTE

Senior Policy Advisor, Trump-Pence Campaign, 2016

Verma worked as a health care consultant at the Indiana-based firm she founded, SVC, Inc., from 2001 – 2017.

  • There, she was a health care consultant, aiding then-Governor Mike Pence in rolling out the state’s consumer-driven insurance Medicaid program for low-income Hoosiers.
  • She worked with Republican governors in states including Kentucky, Ohio and Iowa on conservative Medicaid plans, as well.

Marion County Health and Hospital Corporation in Indianapolis, Indiana

  • Vice President of Corporate Planning, 1999 – 2001
  • Director, Program Development, 1998 – 1999
  • Administrator, Healthy Babies, 1997 – 1998

Association of State and Territorial Health Officials (ASTHO)

  • Consultant, 1996 – 1997
  • Project Director, 1994 – 1995

TIES TO OTHER ANTI-CHOICE EXTREMISTS

Mike Pence:

Verma worked for then-Indiana Governor Pence while she was a consultant at the Indiana State Department of Health to build what has been called the “most conservative Medicaid expansion program in the country.” Pence has an egregious record when it comes to reproductive health. A close ally of extremist groups such as the Susan B. Anthony List (SBA List), Pence has said, “I want to live to see the day that we put the sanctity of life back at the center of American law, and we send Roe v. Wade to the ash heap of history, where it belongs.” As governor of Indiana, he signed legislation to ban so-called “selective” abortion, mandate forced ultrasounds and an 18-hour waiting period for women seeking abortions and require that fetal remains be cremated or buried. (Judges have since blocked the law.)

Marjorie Dannenfelser:

Verma spoke at a celebratory press conference in April 2017 with Dannenfelser, the president of anti-choice organization SBA List after Trump signed a bill taking aim at Planned Parenthood into law. Dannenfelser has said that her “perfect abortion bill” would ban abortion in all circumstances (including rape and incest), except for the life of the woman. SBA List consistently takes extremist positions on reproductive rights; the organization has supported a personhood measure, intended to amend the Constitution with the effect of ending legal abortion, banning several of the most common forms of birth control, restricting fertility treatments and putting an end to research using stem-cells or fetal tissue.

HIGHLIGHTS

During Her Senate Confirmation Hearing, When Asked If Women Should Have Maternity Coverage And Other Essential Services As Defined By The ACA, Verma Said It Should Be Optional:

“I think it is hard to know. What works for one person might not work for another person. And I think it is important that people be able to make the decisions that work best for them and their families…Some women might want maternity coverage and some women might not want it, might not choose it, might not feel like they need that.” [Senate Finance Committee Hearing, 2/16/17]

THE WHOLE STORY

Under Seema Verma CMS Has Installed Barriers To Obtaining Full Reproductive Health Care

Verma Put Out A November 2018 Proposed Rule That Would Create Additional Hurdles For Health Care Issuers Providing Abortion Care

In The Name Of Improving The “Integrity” Of The ACA, Verma’s CMS Wants To Require Issuers To Provide Separate Bills For Abortion Services. “The Centers for Medicare & Medicaid Services (CMS) today issued a proposed rule, ‘Patient Protection and Affordable Care Act (PPACA): Exchange Program Integrity.’ This proposal would safeguard taxpayer dollars by ensuring that people are accurately determined eligible for premium subsidies they receive through the Exchange. In addition, to better align federal regulations with statutory requirements and congressional intent, the rule proposes that issuers must send a separate bill and collect separate payments for the portion of the consumer’s premium attributable to certain abortion services for which public funding is prohibited. ‘This administration is committed to making sure taxpayer dollars are spent appropriately,’ said CMS Administrator Seema Verma. ‘Maintaining a high level of program integrity on the Exchange is essential, including ensuring that premium tax credits only go to those who are eligible for them. This proposed rule represents CMS’ commitment, consistent with the law, to continuously improve and strengthen oversight over the programs we administer on behalf of the American taxpayer.’” [cms.org, 11/7/18]

The Proposed Change Has Been Praised By Anti-Abortion Extremist Groups. “The Trump administration on Wednesday re-opened an abortion question from the days of Obamacare’s passage, proposing that individual market insurers isolate the add-on premium for plans that cover abortion and bill enrollees separately for the surcharge. The proposed rule would impact individual market insurers in 24 states and the District of Columbia that can cover abortions as long as they include the surcharge…The anti-abortion group Susan B. Anthony List welcomed the proposed rule as a ‘step in the right direction,’ although they still want Congress to ban any federally subsidized plan from covering elective abortions.” [Modern Healthcare, 11/7/18]

CMS Issued Final Rules On The ACA Marketplace That Provide Tax Exemptions To Anti-Abortion Health Care Consumers

Verma Said That The December 2017 Rule Changes Would Work Around The ACA’s Health Law Penalty To Provide Relief For “Pro-Life Americans.” “Object to abortion? You may be able to get an exemption from the Affordable Care Act tax penalty for people who don’t get health insurance. The Centers for Medicare and Medicaid Services announced final rules Monday for the ACA’s health insurance marketplaces, and expanded exemptions were part of the package… People who object to abortion can get an exemption if all available health plans in their area cover the procedure… Medicare and Medicaid administrator Seema Verma said the exemption for abortion objectors provides ‘pro-life Americans’ with relief if they are living in an area where the only available ACA plan covers abortion. About half the states already forbid ACA plans from covering abortion, so it’s also uncertain how many consumers would qualify for the new exemption.” [NY Daily News / Associated Press, 12/15/17]

Verma Praised A Law Trump Signed In April 2017 That Targeted Planned Parenthood And Reversed Obama-Era Safeguards For Birth Control Access

The Bill Passed Through The Republican-Controlled House And Senate After A Tie-Breaking Vote By Vice President Mike Pence — A Known Anti-Abortion Ideologue. “Vice President Mike Pence cast a tie-breaking vote in the U.S. Senate Thursday to shred family planning safeguards enacted under the Obama administration… HHS finalized the rule in the last weeks of the Obama administration — opening it up to repeal through the Congressional Review Act, an arcane procedural tool that GOP lawmakers can use to undo the last six months of Obama-era regulations within the first 60 days of the new Congress and with a Republican president willing to sign off on their efforts. The rule clarified existing law and sent a clear message that state officials can’t stop reproductive health-care providers from receiving federal Title X funds if they offer abortion care.” [Rewire.News, 3/30/17]

Extremist Anti-Abortion Lobbyists Hailed The Legislation. “‘Prioritizing funding away from Planned Parenthood to comprehensive health care alternatives is a winning issue,’ said Marjorie Dannenfelser, the president of the Susan B. Anthony List, an anti-abortion group, who attended the closed-door bill signing at the White House on Thursday. ‘We expect to see Congress continue its efforts to redirect additional taxpayer funding away from Planned Parenthood through pro-life health care reform after the spring recess.’” [New York Times, 3/13/17]

After Trump Signed The Bill Into Law, Verma Stood Next To SBA List’s Dannenfelser And Other Members Of The Anti-Abortion Lobby At A Celebratory White House Presser, Remarking That Trump’s Signature Indicated He Would Make Good On Anti-Abortion Campaign Promises. “I think that the president’s signature today is an important step as it shows that the president is keeping his campaign promises…the administration is…continuing to demonstrate and show that we want states to be in charge of the decision-making so that they can determine what works best for them and the citizens that they serve.” [C-SPAN, 4/13/18]

Verma Has A Long History Of Attacking The Government-Sponsored Health Care Programs She Now Runs

She’s Been Credited With Giving Republicans The Ideas They Needed To Pare Back The ACA’s Medicaid Expansion. “Obamacare expanded the Medicaid program in 2014 so that millions of adults, many of whom don’t have children, could newly qualify for care under the health coverage program for the poor. And since then, it has been in the crosshairs of conservatives who see it as an out-of-control entitlement. When President Donald Trump picked Seema Verma to be head of the U.S. Centers for Medicare & Medicaid Services—the $1 trillion agency overseeing health programs that insure more than 130 million Americans—he named the person who has already done as much as anyone to give Republicans around the country the ideas to pare it back.” [Politico, 9/8/17]

Verma Began Her Anti-Medicaid Policy Work In Indiana Working As A Health Care Consultant To Then Governor Mike Pence’s Administration. “It started in Indiana: During Vice President Mike Pence’s tenure as governor, Verma was a health consultant who developed an approach to inject some free-market spirit into the Obamacare Medicaid expansion that took effect there in 2015. Under her plan, Indiana added costs for low-income patients who enrolled, as well as job search incentives and coverage lockouts for people who missed monthly payments. That work also helped her score gigs with GOP officials in Kentucky, Ohio and Iowa, among other places, looking to use their state-level powers to clamp down on what they saw as a swelling federal giveaway.” [Politico, 9/8/17]

The Indiana Program, Verma’s “Brainchild,” Stripped Vulnerable Populations Of Medicaid Protections And Provisions. “Verma is best-known for her role in reshaping the Indiana Medicaid program under then-Governor Mike Pence. Despite Pence being an ardent critic of Obamacare, Indiana made the choice to expand Medicaid anyway. But they utilized a pathway known as the 1115 waiver to craft a program that diverged significantly from the guidelines under the standard Obamacare program, and quickly created the most conservative Medicaid expansion program in the country. That program, known as the Healthy Indiana Plan 2.0, was the brainchild of Verma and her health-care consulting company, SVC, Inc, then recommended as an experienced expert and consultancy firm with knowledge of the minutiae of CMS regulations… It quickly became clear that the HIP 2.0 program under Verma did not intend to be a very generous program. The plan sought to eliminate standard Medicaid protections and provisions for vulnerable people, exchanging them for a premium-based program that mimicked private plans.” [The Atlantic, 2/17/17]

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