Indian-American Medicaid chief delivers first major policy speech on vision for program

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The Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma, on Nov. 7, addressed the National Association of Medicaid Directors (NAMD), at a conference in Arlington, Virginia, where she discussed her vision for the future of Medicaid. She also unveiled new CMS policies that the CMS hopes will encourage states to propose innovative Medicaid reforms, reduce federal regulatory burdens, increase efficiency, and promote transparency and accountability.

During her first major speech on the subject, Verma said that when the federal government established Medicaid, it was intended to be a partnership with state governments to care for society’s most vulnerable citizens. With the growth of the program over the last several years came increased federal and state spending, which led to increased federal oversight and regulation, said Verma, according to a news release from CMS.

“Our vision for the future of Medicaid is to reset the federal-state relationship and restore the partnership, while at the same time modernizing the program to deliver better outcomes for the people we serve,” said Administrator Verma. “We need to ensure that we are building a Medicaid program that is sound and solvent to help all beneficiaries reach their highest potential.”

Verma said she was committed to “turn the page in the Medicaid program” by giving states more freedom to design innovative programs, and pledged to remove impediments that get in the way of states achieving this goal. She announced several new policies and initiatives that she contended would break down the barriers that prevent state innovation and improvement of Medicaid beneficiary health outcomes. They include updated CMS Medicaid website to give states a clearer indication of how their reform strategies might align with a core objective of the Medicaid program of serving the nation’s vulnerable and low-income individuals and families.

Verma emphasized the agency’s commitment to considering proposals that would give states more flexibility to engage with their working-age, able-bodied citizens on Medicaid through demonstrations that will help them rise out of poverty.

“Every American deserves the dignity and respect of high expectations and as public officials we should deliver programs that instill hope and say to each beneficiary that we believe in their potential,” said Administrator Verma. “CMS believes that meaningful work is essential to beneficiaries’ economic self-sufficiency, self-esteem, well-being, and health of Americans.”

Another notable step Verma noted, was the CMS efforts to develop Scorecards that will provide greater transparency and accountability of the Medicaid program by tracking and publishing state and federal Medicaid outcomes, which is still in its early stages. Scorecards she said, were a “historic opportunity” to demonstrate to taxpayers how the $558 billion spent on Medicaid is producing positive results and improved health outcomes.

In what was a rebuttal of the Democratic view of Medicare, Verma noted that federal and state officials have a higher purpose than “just handing out Medicaid cards and being a financier of healthcare.”

“We will not just accept the hollow victory of numbers covered [in the program], but will dig deeper and demand more of ourselves and of you,” said Verma. “For those unable to care for themselves, we will create sustainable programs that will always be there to provide the care you need, to provide choices and allow you to live as independently as possible,” she said. “For those that just need a hand up, we will provide you the opportunity to take charge of your health care and assist and empower you to rise out of poverty and government dependence to create a better life for yourselves and your family,” she said.