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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.

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  • What about clawback? Medicaid is not a free program. Under the Omnibus reconciliation act, unlike Obama exchange plan recipients, medicaid recipients are required to pay back their care and may also be required to pay back the state for capitated amounts.

    So, this would mean that a Medicaid recipient who does not use services can still be held liable under clawback for capitated amounts paid to health insurers for no care and/or substandard care if they try to work their way out of poverty into the middle class. Their heirs would held subject to an estate tax that may cause their entire estate to be seized and leave them homeless and out on the streets.

    Do VP Pence and President Trump understand that these American citizens will be left homeless and out in the streets because they are trying to better themselves? What about veterans who need home health care? Do VP Pence and President Trmp understand that they may be throwing veterans and/or their families out of their homes and on to the streets?

  • As in Iowa, the Republicans won quite handsomely, it means that Iowans have been very appreciative of Verma’s work. So, all well what ends well.

    If that is not the case, then I will help the good folk of Iowa to shoot themselves also in the other foot!

  • Tapping Semma Verma to run Medicaid and Medicare is not the step in the right direction for providing safe high quality care that is cost effective. Verma was instrumental to “revamping” Iowan Medicaid by suddenly privatizing the program. If this is the route we are going for the future of CMS, all patients and providers should be very concerned.

    The abrupt privatization and shift to for-profit managed care organization of Medicaid in Iowa is creating serious disruptions in care. As a nurse in Iowa, I hear stories from patients almost every day about Iowan’s using the new Medicaid and not getting the care they need (skilled nursing, rehab, home health, mediations etc). Many end up waiting for extra weeks (yes weeks) in the hospital because no one will accept them. Many are told to go to the ED because then their doctor “has to see them.” If we want to provide high quality care while cutting costs, nominating Verma is clearly a step in the wrong direction.

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