CMS Administrator Seema Verma’s prepared remarks for the House Committee on Energy and Commerce Oversight and Investigations Subcommittee tomorrow are nothing more than an attempt to cover up the damage she and the Trump administration have inflicted on Americans’ health care. From supporting repeal of the ACA through the Texas lawsuit, slashing the budget for open-enrollment, pushing junk insurance plans that don’t cover pre-existing conditions and dismantling Medicaid by pushing onerous work requirements that kick people off the rolls, Seema Verma has sought to undermine and attack Americans’ health care at every turn. 

Verma’s remarks are a fairy tale version of her time at CMS. Here is the real story of her relentless campaign to attack Americans’ health care and carry out Trump’s sabotage agenda.  

Below is a section-by-section breakdown of the untruths in Verma’s prepared testimony on “CMS Efforts To Empower Patients, Focus on Results, and Unleash Innovation.”

“PATIENTS OVER PAPERWORK”

Red Tape And Work Requirements Are Putting Medicaid For Millions Of Americans At Risk.  

Seema Verma Led The Charge To Push Disastrous Medicaid Work Requirements. According to the Kaiser Family Foundation, these onerous paperwork requirements could take health care away from up to 4 Million Americans. After Arkansas imposed the nation’s first so-called work requirements program, more than 18,000 residents lost Medicaid coverage. While these state efforts have been repeatedly blocked by a federal judge, the Trump administration, with the help of Verma, keeps fighting to impose work reporting requirements in Medicaid, appealing federal court rulings that blocked such requirements because they are illegal. Meanwhile, a recent GAO report found that the administrative costs to implement the failed work requirement programs in five states topped $400 million.  

More Than One Million Children Lost Coverage Due To Verma-Backed Efforts To Restrict Medicaid Access. As more than a million children disappeared from Medicaid rolls between 2017 and 2018, health care experts pointed to a “chilling effect” from Trump’s signature policies, including work requirements and frequent eligibility checks. Joan Alker, Executive Director of the Georgetown University Center for Children and Families, said: “This serious erosion of children’s health coverage is due in large part to the Trump Administration’s actions that have made health care harder to access and have deterred families from enrolling their children.” 

“STRENGTHENING MEDICARE”

President Trump And Republicans In Congress Want To Cut Medicare By Hundreds Of Billions All To Pay For Their Tax Cuts For The Wealthiest Americans. In 2017, President Trump signed a $1.5 trillion tax bill that disproportionately benefits the wealthy. Since then, Republicans have repeatedly tried to slash hundreds of billions of dollars from Medicare to pay for their tax breaks.  The 2018 budget resolution passed by Republicans in December 2017 cut Medicare by $473 billion, the FY2019 budget passed by Republicans on the House Budget Committee cut Medicare by an additional $537 billion, and worst of all, the Trump administration released an FY2020 budget that would cut, $845 million from Medicare, and repeal the Affordable Care Act.

President Trump Is Trying To Repeal The Affordable Care Act Through The Courts — A Move Which Would Raise Drug Costs For Millions Of People On Medicare.   The Trump administration and Republican attorneys generals are arguing in federal court that the entire Affordable Care Act should be overturned. If they get their way, the Medicare “donut” hole would be immediately re-opened. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 Centers on Medicare and Medicaid Services report.

Trump’s Executive Order On Medicare Opens The Door For Privatization. Trump’s proposal to “save” Medicare actually just pushes private plans that have higher administrative costs than Medicare and give significant profits to insurance companies. The proposed changes could lead to higher costs for patients and “potentially expose some to surprise medical bills.” 

“CHOICE AND AFFORDABILITY ON THE EXCHANGES”

The Trump Administration Is Pushing Junk Plans That Allow Discrimination Against People With Pre-Existing Conditions And Don’t Require Coverage For Prescription Drugs, Maternity Care, And Hospitalization. In August 2018, the administration finalized a rule that expands the availability of so called short-term, limited duration plans from three months to just under twelve months and allows them to renew such plans for up to three years. Since finalizing the rule, the Trump administration has urged groups that help people sign up for coverage to push consumers toward these junk plans and has issued guidance urging states to let ACA subsidies be used to purchase these skimpy plans. Short-term plans can exclude or deny key medical services such as prescription drug coverage, hospitalization, and maternity care. Even when plans say they cover prescription drugs, the benefit is often capped at a limit, such as $3,000. Adding insult to injury, short-term plans have a history of finding ways to deny coverage after people become sick. These plans put insurance companies back in charge, not consumers.

The Trump Administration Has Sabotaged Open Enrollment. CMS cut funding for navigator grants—programs designed to provide outreach, education, and enrollment assistance for marketplace consumers — from $37 million in 2018 to $10 million. In 2017, the Administration also cut the outreach advertising budget for Open Enrollment by 90 percent, from $100 million to just $10 million – which resulted in as many as 1.1 million fewer people getting covered.

“LOWERING DRUG PRICES” 

Drug Prices In 2019 Surged Compared To The Year Before. With Hikes At 5 Times Inflation — “More Than 3,400 Drugs Have Boosted Their Prices In The First Six Months Of 2019.” According to CBS News: “Price hikes on prescription drugs are surging in 2019, despite vows from the Trump administration to rein in pharmaceutical costs. So far in 2019, more than 3,400 drugs have boosted their prices, a 17% increase compared with the roughly 2,900 drug price increases at the same time in 2018, according to a new analysis by Rx Savings Solutions, a consultant to health plans and employers. The average price hike for those 3,400 drugs stands at 10.5%, or about 5 times the rate of inflation, the study found.” 

As The Cost Of Drugs Skyrocket, President Trump And His Republican Allies In Congress Refuse To Allow Medicare To Negotiate For Lower Prescription Drug Prices. Under current law, the Secretary of the Department of Health and Human Services (HHS) is explicitly prohibited from negotiating directly with drug manufacturers on behalf of Medicare Part D enrollees. Although it would decrease both federal spending and beneficiaries’ out-of-pocket costs for prescription drugs, Republicans in Congress have remained staunchly opposed to negotiation.  Despite his numerous campaign promises, a policy allowing the federal government to negotiate drug prices for Medicare beneficiaries was noticeably absent from President Trump’s prescription drug plan, and the administration has remained silent about whether it supports the House Democrats’ plan to allow negotiation and lower drug costs

Pharmaceutical Companies Reaped Huge Benefits From The Trump Tax Bill. The Trump tax scam means billions of dollars in tax breaks for pharmaceutical companies. An Axios study found that 21 health care companies collectively expected to gain $10 billion in tax savings during 2018 alone. Most of the tax break for health care companies is going toward share buybacks, dividends, acquisitions and paying down debt. According to Axios, nine pharmaceutical companies are spending a combined $50 billion on new share buyback programs. 

“TRANSFORMING MEDICAID”

Trump’s 2020 Budget Would Result In More Than $1 Trillion In Medicaid Cuts Over 10 Years. By shifting to a block grant program and eliminating funding for Medicaid expansion, the administration would cut Medicaid by more than $1 trillion over 10 years. 

Verma Has Sought To Dismantle Medicaid Through Block Grants. After reports that Verma was attempting to bypass Congress to allow states to block grant their Medicaid programs, Gov. Mike Dunleavy revealed Verma urged Alaska to be the first state to apply for these block grants. Other states have taken notice: Tennessee has moved to seek a block grant, with state officials saying that they have been “encouraged” by the CMS to pursue the policy. According to the Center on Budget and Policy Priorities, Medicaid block grants would slash federal funding, shift costs to states, and leave millions more uninsured.

 “UNLEASHING INNOVATION”

Trump’s Signature Health Care “Innovation” Proposals Rely On The Affordable Care Act — Which Would Be Eliminated If The Administration Has Its Way In Court. Trump’s proposal to shift dialysis care to patients’ homes relies on The Centers for Medicare and Medicaid Innovation, which would be eliminated if the Trump administration successfully convinces the courts to overturn the health care law. The president promoted a policy that would seek to close the gap between drug costs in the U.S. and overseas, which also relies on ACA authority. One Trump official even bragged that the ACA gives “tremendous authority” to issue executive orders on health care, even as the administration continues to undermine the health care law. 

“RETHINKING RURAL HEALTH” 

The Trump-Verma Health Care Agenda Fails Rural Communities. The Affordable Care Act opened the door to Medicaid expansion, which expanded coverage to 1.7 million rural Americans, reduced rural hospitals’ uncompensated care costs, and helped rural health providers keep their doors open. Following Medicaid expansion, the uninsured rate in rural parts of expansion states decreased by a median of 44 percent, and nearly one in four rural Americans now have health coverage through Medicaid. In addition to imposing work rules and other paperwork requirements to restrict Medicaid access, the Trump administration is arguing in court that the entire Affordable Care Act, including its Medicaid expansion, should be overturned. 

“ENSURING SAFETY AND QUALITY IN NURSING HOMES”

President Trump And Seema Verma Have Rolled Back Protections For Nursing Home Residents.  Under Seema Verma’s leadership, the Trump administration has cut the size of fines for health violations in nursing homes. Federal records show that the average fine dropped to $28,405 under Verma’s tenure, down from $41,260 in 2016.  Experts say that for large nursing homes, these smaller fines are merely a “rounding error” giving them less incentive to fix faulty and dangerous practices before someone gets hurt.

According to Toby Edelman, a senior policy attorney and expert on nursing home regulation at the Center for Medicare Advocacy, Verma’s record on regulating the worst of the worst in the nursing care industry is even worse. Edelmen found that found that the Trump administration has largely pulled back its enforcement of “special focus facilities,”  those nursing homes cited for a pattern of serious infractions, issuing increasingly small fines even though the government continued to cite them for serious violations.

The Trump administration has also rolled back an Obama-era regulation that blocked nursing facilities from requiring that disputes with residents be settled in private arbitration — a move that the nursing home industry had aggressively sought.  Families often feel pressured to sign arbitration agreements and only find out later that they are prevented from suing if they believe their loved ones received bad care. 

“WORKING WITH CONGRESS” 

Verma Has A Record Of Flouting Oversight And Ignoring Congress.  Less than a week ago Energy and Commerce Chairman Frank Pallone sent a letter to Verma and HHS Secretary Alex Azar demanding responses to several outstanding document requests of the Trump Administration’s implementation of the ACA.  Pallone has warned that any further attempts to obstruct legitimate oversight requests could result in “compulsory” measures, including subpoenas. Despite the clear will of the voters and the Congressional majority, Verma also claims that the administration is “working on” a plan to repeal the ACA that not even members of her own party are aware of.