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Indiana Waiver Approval Accelerates Trump Administration’s War on Medicaid

By February 2, 2018No Comments

Washington, DC – As the Trump Administration accelerates its war on Medicaid today by approving Indiana’s waiver proposal, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“By announcing today’s approval, Secretary Azar is escalating the Republican war on health care and its effort to demolish Medicaid from the inside out. The Trump Administration is choosing to cause real pain in Indiana by letting the state make Mike Pence and Seema Verma’s cruel, failing Medicaid ‘experiment’ even worse. Hoosiers with Medicaid will face a 6-month lockout for a simple paperwork mistake, reversing Obama-era progress to streamline enrollment and reduce administrative hurdles. A person caring for a sick child or parent, someone working to control their opioid addiction, or someone who has chronic health conditions that make it impossible to work will now have the added worry of losing their health insurance. This is just cruel. The truth is that imposing work requirements will do nothing to help Hoosiers find or keep jobs. In fact, it most likely will have the opposite effect.

“With today’s announcement, Secretary Azar is also showing that he is a Trump foot soldier who’s happy to help distract from CMS Administrator Verma’s conflicts of interest in Indiana: the agency she leads has just signed off on an even worse version of a badly failing program she personally made millions of taxpayer money off of thanks to Vice President Pence while he was Governor.

“Today’s announcement is a direct affront to Medicaid’s stated mission of improving people’s health.  This is not about work. It’s about taking away people’s health care. All it does is kick people while they’re down.”


In 2015, in order to expand Medicaid to over 350,000 Hoosiers, the Obama administration approved then-Indiana Governor Mike Pence’s experimental proposal to impose nominal “show” premiums (often $1) for people with Medicaid, and then take away their coverage with a “lockout” of at least 6 months if they missed a payment. Since then, 25,000 Hoosiers have been kicked off their coverage by lockouts.

CMS Administrator Verma’s Checkered Anti-Medicaid Past in Indiana & Beyond

Verma Created The “Healthy Indiana Plan 2.0” Under Pence, Which Put Restrictions On Medicaid Recipients That “Warranted A Six-Month Lockout From Coverage” If They Missed A Single Monthly Payment. According to the International Business Times, “Verma has an extensive history in the healthcare industry. Her consulting firm, SVC Inc., worked alongside Pence to reform Indiana’s Medicaid program following the induction of President Barack Obama’s Affordable Care Act (ACA). […]While Pence was governor of Indiana, Verma helped create Healthy Indiana Plan 2.0, which required users, including low-income recipients, to make monthly payments for their health insurance services with restrictions that warranted a six-month lockout from coverage if even a single payment was missed.” [International Business Times, 11/30/16]

A Mother Of Three In Indianapolis Was Kicked Out Of The Program For A Misplaced $1 Payment. According to NPR, “So how does it work in practice? For Amber Thayer, a mom of three who lives in a Volunteers of America family shelter in Indianapolis, it’s been a bit of a nightmare. Thayer is a recovering addict who has been clean for six months with the help of the medication Suboxone. And she’s training to be a nursing assistant. ‘It’s been quite, quite the struggle, but we’ve gotten there and we’re doing great, and we’re getting ready to get into our own home,’ she says. She pays $1 a month for her Medicaid insurance. In October, she got a bill for that $1 from a different company than the one she had been dealing with. She assumed the state had switched her. ‘It is only a dollar,’ she says. ‘I could pay a dollar a month, or I could pay $12 and that will cover me for the year. Unfortunately, at that time, I only had I believe it was like $2.38 on my card.’ So she called the company and used her bank card to pay the dollar. But the company, or perhaps the state, lost track of her dollar, and her insurance was cut off. She had her bank statement and a receipt from the insurer that proved she had paid. But she still spent six weeks, with multiple phone calls and visits to state health offices, trying to get her coverage restored.” [NPR via Houston Public Chronicle, 1/3/17]

Indiana Medicaid Recipients Could Be “Locked Out Of The Program” For Not Paying Their Premiums, “A Provision Even Commercial Insurance Does Not Impose.” According to The Guardian, “In Indiana, if people on Medicaid earning between $11,000 and $16,000 don’t pay their ‘premiums’, they can be locked out of the program for up to six months, a provision even commercial insurance does not impose. ‘If someone can’t scrape up the money for premiums for two months, they get dis-enrolled, and they get locked out for six months,’ said Kallow. ‘Then say they get cancer, they get hit by a truck, they have an accident. They have absolutely no place to turn for health coverage.’” [The Guardian, 12/4/16]

While Kicking People Off Of Medicaid, Verma’s Firm SVC, Inc. Was Contracted To Receive More Than $4.8 Million From The State Of Indiana Between 2014 And 2017. According to SVC’s contract with the Indiana Family and Social Services Administration, SVC Inc. was contracted to receive $4,851,400 between May 2014 and June 2017. [SVC Inc. Contract – Indiana Family and Social Services Administration, 6/17/16]

At The Same Time Verma Worked On The Redesign Of Indiana’s Medicaid Program Under A $3.5 Million State Contract She Was Working For “One Of The State’s Largest Medicaid Vendors,” Receiving More Than $1 Million.” According to the Indy Star, “Largely invisible to the public, Verma’s work has included the design of the Healthy Indiana Plan, a consumer-driven insurance program for low-income Hoosiers now being touted nationally as an alternative to Obamacare. In all, Verma and her small consulting firm, SVC Inc., have received more than $3.5 million in state contracts. At the same time, Verma has worked for one of the state’s largest Medicaid vendors — a division of Silicon Valley tech giant Hewlett-Packard. That company agreed to pay Verma more than $1 million and has landed more than $500 million in state contracts during her tenure as Indiana’s go-to health-care consultant, according to documents obtained by The Indianapolis Star. Verma’s dual roles raise an important question: Who is she working for when she advises the state on how to spend billions of dollars in Medicaid funds — Hoosier taxpayers or one of the state’s largest contractors?” [Indy Star, 8/26/14]

  • Indiana Lawmakers Were Unaware That Verma Was Working For The State And For HP Simultaneously. According to the Indy Star, “If Verma was a federal contractor, her dual roles ‘would certainly raise tremendous concern for regulators and purchasing officials,’ he said. ‘This is exactly the kind of thing that would land an agency in a hearing before a legislative oversight committee.’” [Indy Star, 8/26/14]

Verma’s Medicaid Reforms In Iowa Were “A Nightmare.” According to STAT News: “When President Donald Trump tapped policy consultant Seema Verma to run Medicaid and Medicare in his administration, he called her part of a health care ‘dream team.’ But the health policy changes she helped design in Iowa have felt more like a nightmare to providers serving poor and disabled residents across the state. Verma has helped several states revamp Medicaid, including Kentucky and Indiana. Here in Iowa, she worked on an aggressive effort to privatize the program, which provides health care to about 600,000 adults and children.” [STAT News, 1/24/17]

  • Ablekids Pediatric Therapy In Sioux Falls Reported Struggle to Keep Doors Open. According to a Des Moines Register editorial: “The Cedar Rapids Gazette has reported on billing problems experienced by outpatient rehabilitation clinics across the state. ‘We’re not even getting half of what we got with Iowa Medicaid,’ said Jessica McHugh, owner of AbleKids Pediatric Therapy in Sioux City, referring to the many years when the state administered Medicaid.” [Editorial – Des Moines Register, 7/16/16]