Rebecca
Pifer Oct. 28, 2019
LAS VEGAS — CMS
Administrator Seema Verma outlined her response to the perennial question of
what role government should take in healthcare during a keynote Sunday as the
HLTH conference kicked off its second year.
The safety net
for low-income and high-cost Americans should exist, but it must "avoid
the pitfall of creating incentives that encourage government dependency and
limit future opportunities," Verma said.
CMS will
"soon outline new opportunities for states to flip the Medicaid paradigm
and free themselves from federal micromanagement," she said.
CMS has
approved controversial work requirement programs yoking health insurance to
work or volunteering hours in nine states so far. In Arkansas, about 18,000
people lost coverage in a few months due to barriers in reporting
work hours, according to the Georgetown University Health Policy
Institute, and the programs are costing taxpayers some $408 million though
they lead to fewer Americans receiving coverage.
Verma told
reporters she has put in more detailed implementation guidelines to address
these issues and that, as long as states continued to approach CMS with
requests for work requirement programs, the agency would continue to approve
them.
The CMS
administrator said her ideal healthcare system recognizes a limited government
role with three elements: a safety net for the most vulnerable including those
with pre-existing conditions, ensuring the sustainability of government
programs and ground rules for a "flourishing and competitive"
healthcare market.
Verma called
the motivation behind Democrats' "Medicare for All" and similar
proposals "insidious" and "the complete annihilation of the
private healthcare system." She cast the ideas as "the polar opposite
of humility."
Many
high-profile Democratic candidates for president back Medicare for All, a
partial expansion of the public program or Medicaid, a more moderate public
option or some proposal in between.
Kaiser Family
Foundation polling from March shows 56% of
overall respondents and nearly 80% of Democrats favored a single-payer health
plan in America.
The Trump
administration has made attempts to boost transparency of healthcare costs,
with so far limited success.
The agency's
proposal that drugmakers include list prices in their direct-to-consumer
advertising was struck down by a federal
court in July, a CMS idea to force payers and providers to reveal negotiated
rates faces fierce industry backlash
and the agency has no way to enforce a rule
finalized January mandating hospitals publish their chargemasters online.
"We
started putting our foot in the water" with that rule "but we
understood that was a first step," Verma said.
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