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Top Trump Health Care Nominee Caught In Middle Of Obamacare Repeal Fight

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President Donald Trump’s nominee to run the federal agency charged with administering Obamacare, Medicare and Medicaid was put in the hot seat Thursday at a nomination hearing, defending her involvement in state-level reforms that required even those below the poverty line contribute to their health care.

Seema Verma, Trump’s pick for administrator of the Centers for Medicare and Medicaid Services — the second highest health official in the administration — is the author of Indiana’s Medicaid expansion, which controversially featured several significant departures from the typical program. Verma faced a number of questions about the plan in a hearing with the Senate Finance Committee on Thursday.

The question of what to do with the Medicaid program, which 32 states expanded as part of the Affordable Care Act, has divided even those within the GOP. Some Republican-led states, including Ohio and Indiana, expanded the program through Obamacare.

Verma insisted that the “Medicaid program as a status quo is not acceptable,” and remained open to several changes congressional Republicans have raised to reform the program as part of a repeal of the Affordable Care Act.

The former Medicaid consultant would not rule out supporting a program to convert Medicaid into a system with block grants for each state, or establishing per capita caps on Medicaid spending, both systems that the GOP has proposed to deal with Medicaid going forward. (RELATED: Republican Plan To Repeal Obamacare Expected Soon)

Several Democratic senators hotly questioned Verma’s state Medicaid plan, the Healthy Indiana Plan 2.0. The Indiana system established health savings accounts for those under the poverty line, required a small monthly contribution and allowed individuals to make their own choices about how to use the funds. Verma defended the program as a means not only of giving those on Medicaid more choice when it comes to health care, but also of improving their health in the end.

“What we found is that the individuals that were actually making contributions were actually sicker individuals…and yet when they were making contributions to their care they were actually having better health outcomes,” Verma said of Indiana’s experience with the program. “Just because they’re lower income doesn’t mean they don’t want choices.” (RELATED: The Next Trump Health Official With A Looming Confirmation Fight)

With Obamacare repeal in the spotlight, the fate of states that accepted the health care law’s Medicaid expansion, whether as is or with significant changes, as in Indiana, are in question.

Verma’s role as administrator of the powerful, $1.1 trillion agency will give her significant latitude in making determinations about regulations when implementing new health care legislation in upcoming months.

However, the consultant punted on questions regarding the Trump administration’s first rule, released Wednesday, about making changes to Obamacare.

The Centers for Medicare and Medicaid Services proposed a rule Wednesday that would make several changes to the way Obamacare exchanges run this year, including cutting the open enrollment period in half; giving states more power to okay health provider networks in Obamacare plans, rather than relying on federal permission; and discouraging lapses in coverage by tightening the rules for signing up for insurance outside of the open enrollment period.

Verma maintained that she had no part in writing the regulation and would need time to review the specifics of the plan. Her responses to questions on several hotly debated Obamacare regulations were telling, however.

In response to Democratic Michigan Sen. Debbie Stabenow’s charge that before Obamacare, “being a woman” was treated as pre-existing condition, Verma insisted that providing consumers with choices was more important that mandating certain benefits for everyone.

“Women have to make the decisions [that’s] best for them and their family,” Verma said Thursday. When it comes to maternity care, “some women might not want it, might not choose, might not feel that they need that.”

That attitude may come into play if confirmed, as Verma will be the second highest health official writing regulations on future health care legislation.

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