5 Takeaways From CMS Nominee Seema Verma's Confirmation Hearing

During her confirmation hearing before the Senate Finance Committee on Thursday, Seema Verma offered up some clues about how she might steer the agency, but remained vague on other issues.

Here are 5 takeaways from Verma’s confirmation hearing.

1. She has experience designing plans that align with conservative ideas

Prior to her nomination, Verma was the president, CEO, and founder of SVC, Inc, a health policy consulting company. Her most notable accomplishment was the Healthy Indiana Plan, a high-deductible, consumer-driven health plan that expanded Medicaid under the Affordable Care Act (ACA) for able-bodied adults in that state.

She touted the positive effects of the program in her testimony, but acknowledged that “every state is different” and it likely could not be implemented nationwide. However, the plan includes several components of Republicans’ potential framework for replacing the ACA, like expanding the use of health savings accounts.

2. Her testimony indicated opposition to vouchers, but an open mind on block grants and capitation

In the confirmation hearing, Verma said she would not support turning Medicare into a voucher plan. She did indicate that the door would be left open to other cost-cutting strategies.

“I think anything should be on the table that can improve health outcomes for this very vulnerable population,” she said in response to a question on block grants from Senator Dean Heller, R-Nevada. “I think block grants, per capita cap, anything that we can do to help improve outcomes and create a level of accountability for states, I think we should explore all of those options.”

3. “Patient choice” a common theme throughout hearing

Consistent with her work developing Indiana’s consumer-directed health plan, Verma strongly supported patients’ ability to make their own healthcare choices. In particular, she rejected the idea that low-income beneficiaries might have more difficulty making optimal decisions about their care.

“We can empower individuals to take ownership for their health, and that people, just because they don’t have income, doesn’t mean that they’re not capable and that they don’t want to have choices,” she said.

Later, when asked whether plans should be required to cover certain essential benefits, Verma said that she “support[s] Americans being able to decide what benefit package works best for them.”

4. She faced tough questions from Democrats

Democratic senators did not hold back during their questioning of Verma in the hearing. In one of the most pointed inquiries, Senator Debbie Stabenow, D-Michigan, asked if she believed women should have to pay more for insurance that covers prenatal care and maternity services, which the ACA required insurers to cover without charging higher premiums. Verma, careful to avoid the appearance of supporting the ACA, did not directly answer the question.

“I’m a woman, so I obviously support women having access to the care that they need,” she said. When Stabenow pressed her to answer whether women should be charged more for insurance because of their gender, Verma answered that “women should be able to make the decisions that work best for them.”

5. Psychiatric services could be a potential conflict of interest

Senator Bob Melendez, D-New Jersey, asked Verma whether she would ensure Medicaid would provide similar levels of coverage across states for children with autism, but she could not answer that question. The Office of Government Ethics had advised her not to participate in discussions about mental health services since her husband is a child psychiatrist, she explained.

It remains unclear how issues relating to psychiatric services would be handled if Verma is confirmed as CMS administrator, which appears likely.