Seema Verma sworn-in as Medicare, Medicaid chief amid partisan divide

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On March 14, Seema Verma, President Trump’s choice for Administrator of the Centers for Medicare and Medicaid Services, was sworn in by Vice President Mike Pence in a solemn ceremony at the White House. Surrounded by her husband Sanjay, daughter Maya, son Sean, as well as her mother and sister, Verma said she cannot wait to begin the work of overhauling key parts of the American healthcare system that covers more than 100 million Americans.

“Today, our healthcare stands at a crossroads, and we have no choice but reform it,” Verma said. President Trump has chosen “One of the leading experts” on state-based healthcare solutions in the country, said Vice President Pence introducing Verma. He credited her for designing Indiana’s Medicaid system, Healthy Indiana 2.0 while he was Governor of that state, and in states like Iowa, Ohio, Kentucky, Michigan and elsewhere to make health care a matter of “personal responsibility and effective care.”

“The President has asked you to bring your expertise to D.C.,” Pence said, adding, “We’re confident that you’ll help restore health care decisionmaking to the states, and in the process help make the best healthcare system in the world even better.”

The American Association of Physicians of Indian Origin which represents more than 60,000 physicians, welcomed Verma’s appointment. Ajay Lodha, president of AAPI, lauded Verma’s accomplishments in Indiana, and said he hoped that the problems faced by patients under the Medicare drug plan would be improved under her leadership. “Drug coverage has gone down and for patients under Medicare who are all above 65, and not healthy and needed medications – I hope she can do something for them.” Lodha said.

Dr. Sudhir Parikh, publisher of News India Times, who runs more than 20 clinics around the greater New York area, said Verma was critical to the changes being envisaged under President Trump’s plan to “repeal and replace” Obamacare. “Medicare and Medicaid are ctitical to the healthcare mix. Most of those under these programs cannot afford the care or are uninsured. Medicaid advantage and Medicare overhaul are necessary.”

“It’s very important for our Indian-American physicians because almost half of them work in inner cities and rural areas where these kinds of patients are in large numbers,” Parikh said. “It’s very critical that Seema Verma makes sure they are covered by the state programs,” he emphasized.

Verma was confirmed by a divided U.S. Senate which voted largely along party lines and after Democratic attempts to delay what was an inevitable appointment in a Republican majority Senate. This was unlike the confirmation of most other Indian-Americans in the past who have usually been endorsed in a bipartisan vote or by a large majority.

Even South Carolina’s Republican Governor, Nikky Haley was confirmed almost unanimously (96-4)this January to become the first Indian-American cabinet-level appointee, as U.S. Ambassador to the United Nations. Several Indian-Americans were appointed ambassadors to various countries including India, all of whom sailed through, even when it was a Republican controlled Senate.

Over the years, many Obama nominees, including judges have sailed through despite Republican concerns about liberal judges becoming majorities on federal benches. In May 2009, the Democratic majority Senate confirmed President Obama’s choice for Chief Technology Officer Aneesh Chopra in a unanimous vote; A slew of Indian-American federal judges were confirmed over the years with a unanimous vote. In May 2013, Judge Srikanth Srinivasan was confirmed by a 97-0 vote to sit on the 9th Circuit Court of Appeals, the 2nd highest court in the country; In May 2014, Manish Shah was confirmed unanimously for the federal bench in Illinois, followed by Judge Indira Talwani who was confirmed by a 94-0 for the 1st Circuit Court bench. To date, this “model minority” has been kindly treated on Capitol Hill. Which makes it amply evident that Verma’s appointment was driven not only by ideology but also by the critical position she occupies running a massive system that enrolls more than 100 million Americans.

The  seemingly wide ideological chasm between Democratic and Republican lawmakers on the role of Medicare and Medicaid, put Verma in the fault lines. As much as CMS is critical to the success of the GOP’s American Healthcare Plan, the bill making its way through Congress, and President Trump’s campaign promise to “repeal and replace” Obamacare (Affordable Care Act), conversely, for the Democrats, it is critical to have someone there whose agenda mirrors Obamacare.

All five of the Indian Americans in Congress have opposed the Republican healthcare plan. The Democrats did put up substantial resistance to Verma’s appointment until Republicans called a cloture vote to end debate. Senate Majority Leader Mitch McConnell Tweeted right after the vote, “Seema Verma has been confirmed by the #Senate to lead @CMSgov, With @SecPriceMD, she can help #RepealAndReplace the failure of #Obamacare”

Verma has found out-of-the-box solutions to design state Medicaid programs in Indiana and several other states, as the Chairman of the powerful House Ways and Means Committee Kevin Brady, R-Texas, noted in a statement. Describing Verma as “the perfect person” for the job, Brady said, “I look forward to working with her to return control of health care back to states and give patients across America more control over their own care”

Verma has a tough job ahead. Even as she was being confirmed and sworn-in, the Congressional Budget Office, considered a non-partisan body, estimated that the first tranche of the GOP’s American Healthcare Bill, for “repealing and replacing” Obamacare, would leave 14 million people uninsured in 2018 and 24 million by 2026. On the flipside it also estimated that the plan would reduce the budget deficit by $330 billion over a period of years.

Sen. Mark R. Warner, D-Virginia, member of the Senate Finance Committee, who voted against Verma, said that during the confirmation process, he was not satisfied by Verma’s answers to key questions regarding the future of Medicare, Medicaid, and the Children’s Health Insurance Program. “Now that she has been confirmed as CMS Administrator, I hope Ms. Verma will spend time focusing on areas where bipartisan agreement can be found, including ways that we can improve care for chronically ill Medicare patients, advance the discussion around end-of-life care, and move federal health insurance programs into the 21st century by expanding the use of technology to deliver care to patients.”