Trump’s pick to lead Medicare, Medicaid did work for LePage administration

Good morning from Augusta, where there’s an old connection to one of President-elect Donald Trump’s key health care appointees.

Earlier this week, the Republican picked Indiana health policy consultant Seema Verma to head the Centers for Medicare and Medicaid Services alongside U.S. Rep. Tom Price, R-Georgia, his nominee for health and human services secretary.

Trump’s stated goal is to repeal the Affordable Care Act, but Verma’s record shows that she has worked within the framework advanced by President Barack Obama and Democrats to advance conservative policy.

She was the architect of Medicaid expansion under the law in Indiana and other states. Indiana’s is one of the nation’s most conservative iterations, providing health care to 240,000 people, demanding that everyone make at least a small contribution to health accounts. People can lose coverage if they fall behind in payments.

Maine hasn’t gone that far. It’s one of 19 states that hasn’t approved expansion and Gov. Paul LePage, a Trump endorser, has vetoed it five times, with advocates now pushing a statewide referendum on the subject.

But Verma’s ideas have been heard in Maine. In 2012, her company made a long list of cost containment recommendations to the state’s MaineCare Redesign Task Force, including increasing the use of generic prescriptions and culling certain benefits that other states either don’t offer or aren’t as generous with.

Maine Department of Health and Human Services spokeswoman Samantha Edwards didn’t respond to questions about the contract awarded to Verma’s company on Wednesday.

The Obama administration has largely declined waivers for Medicaid expansion programs using Verma’s philosophy, which some advocates have criticized for erecting barriers to care. Under Trump, those waivers could be approved.

But Trish Riley, a former Maine health official in Democratic Gov. John Baldacci’s administration who now is executive director of the National Academy for State Health Policy, praised Verma to Modern Healthcare for helping “forge a middle ground” on expansion.

Maine state Rep. Drew Gattine, D-Westbrook, an expansion advocate who has fought LePage on welfare issues, said Verma was smart and said he often refers to her recommendations, also praising her for making expansion work.

LePage’s stance on expansion hasn’t changed, but Verma’s interactions with the state and federal governments provides us with something to watch in health policy as Trump takes office. — Michael Shepherd

Quick hits

  • Advocates and a bipartisan group of lawmakers said Thursday that they’re resubmitting a bill aimed at funding outreach on well water testing. Rep. Karen Vachon, R-Scarborough, will be sponsoring a new version of a bill vetoed last year by LePage that would establish new fees on water tests at a state-run lab to fund well water treatment outreach. A Dartmouth College study has said one in 10 Maine residents could be drinking from wells contaminated by chemicals including arsenic, which has been linked to lower IQ levels in Maine children. LePage called the bill “unnecessary” then and his administration didn’t reapply for a federal grant in 2015 that funded tests and outreach. The bill is being pushed by the Environmental Health Strategy Center, which held a Thursday press conference with Vachon, incoming House Majority Leader Erin Herbig, D-Belfast, Rep. Drew Gattine, D-Westbrook, Sen. Amy Volk, R-Scarborough, Sen.-elect Shenna Bellows, D-Manchester, and Rep.-elect Kent Ackley, I-Monmouth.
  • The University of Maine’s men’s basketball team may not beat Duke University, but they’ll gain attention for their silent protest of North Carolina’s transgender bathroom law. USA Today has an item on the Black Bears’ decision to wear shirts with a rainbow logo, a collaboration with You Can Play, a group that fights discrimination in sports, during their nationally televised game at Duke University on Saturday. It’s a protest against North Carolina’s law that makes it illegal for someone to use a public restroom different from the gender on their birth certificate, eschewing gender identity, which led the NCAA to pull championship events out of the state. But UMaine will have a tough slog on the court: Duke is ranked fifth in the nation; Maine went 8-22 last year and lost to the University of Maine at Fort Kent earlier this month.
  • Women are planning to march in Augusta in January on Trump’s inauguration day. The State House march from progressives will coincide with another planned march on Washington, D.C. that is running into problems because other groups have requested space on the National Mall. — Michael Shepherd

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Michael Shepherd

About Michael Shepherd

Michael Shepherd joined the Bangor Daily News in 2015 after covering state, federal and local issues for the Kennebec Journal for three years. He's a Hallowell native who now lives in Gardiner. He graduated from the University of Maine in 2012 and is a graduate student at the University of Southern Maine's Muskie School of Public Service.