Seema Verma was recently selected by President-elect Trump to lead the Centers for Medicare and Medicaid Services (CMS). With her extensive experience redesigning Medicaid programs in several states and her tenure as an architect of the country’s first consumer directed Medicaid program, Healthy Indiana Plan, she is uniquely qualified for the role.

While Verma will need to acquire confirmation from the Senate, her selection raises some important questions. What does this mean for Medicaid expansion? Will she prove that her approach to expanding Medicaid can work on a national scale?

As inauguration day quickly approaches (January 20, 2017), there has been much speculation on the future of government programs, including Medicaid. While we cannot be certain, we suspect Verma’s career may be some indication of what the future holds. If that’s correct, the nearly 6,411,400 Medicaid beneficiaries living in the United States can rest assured that their benefits will not be affected [1].

See also: Uncertainties Begin to Subside with President-elect Trump’s Dream Team Selections

In a Washington Post interview, Patricia Miller, a former Republican member of the Indiana State Senate, echoed this idea by stating “I think you will see the trend of the federal government turning toward the Indiana HIP plan.” [2]

Following the passage of the Affordable Care Act (ACA), states took different approaches to Medicaid reform and expansion. A total of twenty-six states elected to expand their Medicaid programs, while another six expanded utilizing alternative models (1115 waivers) to meet their state-specific goals.

In 2008, using a 115 waiver, Indiana became the nation’s first consumer-directed Medicaid health program for uninsured Hoosiers, aged 19-54. The program has evolved greatly since, but shares the core principles that the state sought to embrace, including: reducing the uninsured population, improving access to care, promoting value based decision making, care and prevention, preventing chronic decisive progression, proving evidence based health care services, and ensuring state fiscal responsibility and management over the program.

The program now helps over 400,000 Medicaid beneficiaries to improve their health status and actively engage in their care.

Indiana’s Medicaid Expansion

  • 2008 – HIP 1.0 becomes the nation’s 1st consumer-directed Medicaid healthcare program [3]
  • January 29, 2013 – Governor Pence outlines guardrails for considering coverage expansion [3]
  • February 13, 2013 – Indiana submits HIP waiver extension to CMS [3]
  • September 3, 2013 – CMS approves 1-year extension of HIP [3]
  • June 30, 2014 – Indiana submits original HIP waiver extension request [3]
  • July 2, 2014 – Indiana submits HIP 2.0 waiver request [3]
  • October 2, 2014 – Governor Pence sends letter to President Obama regarding HIP negotiations [3]
  • November 17, 2014 – CMS approves 1-year extension of existing HIP program [3]
  • January 27, 2015 – HIP 2.0 waiver approved and state begins taking applications [3]
  • February 1, 2015 – HIP 2.0 Coverage begins [3]

In addition to her work in Indiana, Verma has worked with the States of Iowa, Ohio, and Kentucky to develop their own Medicaid Expansion proposals. The Healthy Indiana Plan (HIP) has also been viewed as a model for New York and Minnesota’s Basic Health Program (BHP) as well as Arkansas’ Private Option.

[1] http://kff.org/medicaid/state-indicator/distribution-of-medicaid-enrollees-by-enrollment-group/?dataView=1&currentTimeframe=0
[2] https://www.washingtonpost.com/national/health-science/cms-nominee-set-up-indianas-unusual-medicaid-expansion/2016/11/29/912a131a-b669-11e6-959c-172c82123976_story.html?utm_term=.0af0bae0051d
[3] https://www.in.gov/fssa/hip/files/HIP_timeline.pdf
[4] http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/

The views and opinions expressed by the authors on this blog website and those providing comments are theirs alone, and do not reflect the opinions of Softheon, Inc. or any employee thereof.

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Yvonne Villante
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Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
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