The president s nominee for the next administrator for centers for medicare and Medicaid Services said all options should be considered to improve Program Quality and financial stability. Seema verma testified in a three our confirmation hearing yesterday. [inaudible conversations] the committee will come order. I would like to welcome everyone to this mornings hearing. Today we consider the nomination of seema verma to Service Administrator of the centers for medicaid, medicare and Medicaid Services. We are so happy to have you here and your family too. Appreciate your willingness to meet at the agency on this article time. I see your family has joined you today to lend support so i extend a warm welcome to all of you and them as well. Cms is the Worlds LargestHealth Insurer covering over one third of the Us Population through medicare and medicaid alone. It has a budget of over 1 trillion and processes over 1. 2 billion a year for Services Provided to some of our nations most vulnerable citizens. Seema verma having dealt with cms extensively as a consultant to numerous state and Medicaid Programs, you know well the challenges, agency deals on a daily basis. I suspect you also it is a thankless one. Fraught with numerous challenges. There are opportunities in those challenges and i believe they are the right person for the job with most of those opportunities to improve our Health Care System. The failings of obamacare are urgent and must be addressed in short order. For the past six years we have watched as the system created under obamacare increased costs, higher taxes, fewer choices, reduced competition and put more strain on the economy. Health insurance premiums are up by 25 this year alone. Under obamacare, billions of middleclass americans have been hit by new taxes. Under obamacare major insurers are no longer offering coverage in exchanges, and another Major Carrier will exit the market in 2018. As Congress Works to change course with regard to our ailing Healthcare System cms will play a major role in determining our success was i applaud the step the agency took under the leadership of secretary price with the poseable with its proposed to stabilize the individual Insurance Markets but there is more work to be done and im confident if you are confirmed and i expect you to be you will be a valuable voice in driving change. I would like to talk about medicaid for a moment. The Medicaid Program was destined to be a safety net for the most vulnerable americans. As such i understand the moral and social responsibilities the federal government has in ensuring Health Care Coverage for our most needy citizens. Im committed to working with state and other stakeholders as i think everyone on this committee is and the American Public to ensure the longevity of the Medicaid Program. We must also acknowledge the Medicaid Program is three times larger in terms of enrollment and expenditures than it was 20 years ago. Additionally the Medicaid Expansion exacerbated pressures on the program at a time many states were facing difficult choices about which benefits and populations to serve. As a result we have a responsibility to consider alternative funding arrangements that could help to preserve this important program. We also need to consider various reform proposals that improve the man that is the way medicaid operates. We need your assistance in both of these efforts and your experience in this area should serve you well. On the subject of the experience for the committee, she has been credited as a Creative Force behind the healthy indiana plan, the states medicaid alternative. This provides access and Quality Healthcare to its enrollees while ensuring they are engaged in their care decisions. It evolves while hitting key metrics overall. With their experience as i understand it. Major criticisms from the other side of the dais, we should note hhs and cms leaders under the Obama Administration repeatedly approved the waiver necessary to make this program a reality. Seema verma has assisted a number of other Medicaid Programs as well. Her efforts all have the same focus, getting needed highQuality Healthcare to engage patients in a fiscally responsible way. This is exactly the mindset you need in a cms administrator. Seema verma, challenges associated with medicaid are not enough to keep you busy. As cms administrator, you will also be tasked with helping to ensure the longevity and solvency of the Medicare Trust fund which is projected to go bankrupt in 2028, already down 2032. All told, between now and 2030, 76 million baby boomers will be eligible for medicare. Even factoring in deaths over that time the program will grow from 47 million beneficiaries today to 80 million in 2030. Maintaining solvency of the Medicaid Program to provide character and beneficiary base requires creative solutions. It will not be easy, we cannot put it forever. And they will speak more generally along recent events. As we dealt with President Trumps nominations. In the details of the past i will say recent developments do not become the new normal for our committee. As i said before i will do all i can to ensure and maintain customers of this committee which is already operated with assumptions of bipartisanship and good things with regard to considering nominations, that means a robust and fair vetting process. A rigorous discussion among Committee Members in an executive session. On that note maybe the treatment of nominees has started to fall today. At least i hoped tradition that has been absent before the session has been the introduction on many occasions of nominees by senators, from the nominees home state especially in cases where the nominee and home state senator having a relationship, i am pleased to say the senior senator from indiana in that condition by appearing here today and so is our other senator. I think the senators for taking time to appear today and introduce their constituent. I will give them a chance to do so in a you minutes. With that i look forward to sharing her vision and views here today and look forward to what i hope will be a full and Fair Committee process that allows us to process this nomination and report it to the full senate in short order. I will at this time recognize my cochair on this committee for his Opening Statement. Thank you, mister chairman and welcome to you, seema verma, i thought it was worth noting the hoosier basketball tradition looks like you have brought close to two slides of basketball players and we welcome you and your family today. It is obvious the healthcare posts we are going to discuss today are not exactly dinnertable conversation in much of america but the fact is it is one of the most consequential positions in government, agencies responsible for the health care of 100 million americans who count on medicare and medicaid plays a key role in implementing the Affordable Care act. That is why cms needs experience to qualify people for the job who know the ins and outs of the whole system, medicare, medicaid and insurance. The agency needs a strong and experienced authority and this is particularly true now when it does appear some of my colleagues on capitol hill and in the administration are looking to make radical changes in American Health care. In my view many of these proposals will take the country back to the days when healthcare was mostly for the healthy and the wealthy. We are going to start with the promise of medicare which has always been a promise of guaranteed benefits. That makes up more than half the agency spending, about 2 billion a day, more seniors entering the program each year, an awful lot to protect and in my view, update the medicare guarantee, that means addressing high cost of Prescription Drugs and making the program work better for chronic illnesses, the majority of medicare spending. Takes bipartisan support. It is the wrong direction to privatize medicare in my view. It is important to hear today, from policymakers for advocating those approaches to be interested in turning the program into a voucher. Additionally if confirmed, they will play a key role implementing the payment reforms, essential that they be implemented by the move healthcare paying for volume. And the private Insurance Market and many of those amounts to bedrock values. It means not discriminating against those with preexisting condition. It means setting the bar for the Medicare Insurance companies. And letting young people stay on their parents policy until 26. Unfortunately just yesterday the agency, a proposed will. And from where i sit the message from yesterdays rule, Insurance Companies are back in charge and patients take a best backseat. The open Enrollment Period was cut in half, and somebody dropped coverage during the year, Insurance Companies collect that premium before an individual for Health Insurance again and Insurance Companies, free reign to offer less generous coverage, the same or higher cost. It is going back to yesteryear when the Health Care System did work for the healthy and wealthy. The administration saying the best is yet to come. Evidence suggests otherwise. They have taken steps to create more stability on a bipartisan basis. And obviously creating market uncertainty and anxiety looking farther than humanas decision. And how you are going to implement the program that millions of americans count on. And it goes beyond disrupting the individual market. And this is an area where you have extensive experience was i want to discuss the tradeoffs associated with those efforts and particularly concerned about the possibility somebody making barely 12,000 a year from Health Coverage for no less than six month due to an upcoming rent check. There is an independent evaluation indicating people bumped from coverage, and the same report that 20,000 persons and comprehensive medicaid problem to navigate the system you all put in place. I want to wrap up two last points. With respect to taking these ideas on a nationwide tour, i am not there yet. I say that respect only, here is the point with respect to states, we touched on it in the office was we authored section 1332 of the Affordable Care act saying states can do better, states have an idea, better coverage, lower cost, we are for it. For the states to do worse. One last issue that i want to touch on deals with seema vermas work. You have Consulting Firms that were awarded, contract directly by the state to advise the state and that was by managing programs. At the same time as has been told to me you contracted with five other Companies Providing hundreds of millions of dollars of services and products to these programs, hp enterprises, Health Management associates, rose diagnostics and these firms determine the state contract appear to have had in effect overseen work that is performed. George w. Bush had an ethics lawyer named richard paynter. And he said yesterday this arrangement clearly should not happen since it is definitely improper. He said you were on both sides of the deal managing by vendors to the same programs. He said that was a conflict of interest. I want to hear you respond to his assertion. We know more about your work for companies and business with the state and one of the questions will be if you are the cms administrator would you recuse yourself from decisions that affect the company or her clients. I look forward to your testimony with the two indiana senators, very proud, thank you, mister chairman. Pleased to hand over my normal witness introduction duties today to a pair of distinguished colleagues that no senators from the Hoosier State a statement and testament to her work to her as a person. I asked the senior senator from indiana, mister donnelly, start the introduction to senator young. Go ahead and proceed. Ranking member wyden, chairman hatch, members of the committee, thank you for inviting me here today. It is a pleasure to be here with my friend and colleague, senator todd young to recognize this important accomplishment of a fellow hoosier. Anytime the president nominates an individual for leadership position in our government it is an honor of the trust and respect he has for that person. For this reason i am pleased to be here today, for the nomination for the next administrator for the centers for medicare and Medicaid Services and introduce her to this committee for consideration. And we accomplish more when we Work Together. In working collaboratively to help hoosiers get access to Quality Healthcare is something seema verma and i have done together. He has played a central role in crafting medicaid policy including our own. And in federal partners to take advantage of opportunities by the Affordable Care act to expand medicaid to the healthy indiana plan also known as tip. And the uninsured rate, improve healthcare outcomes and played a Critical Role in combating the opioid abuse and heroine epidemics. Hundreds of thousands of hoosiers have Health Insurance through hip 2. 0, the program is an example of what is possible when we Work Together. As i shared with seema verma and i will share with you im concerned about the future of healthcare in our country as well as the rhetoric surrounding the current debate. And medicaid and other care, building upon the progress of the aca, is fundamental to the Financial Wellbeing of thousands of americans across the country. It is my fear hope this Administration Working with this committee and others will approach medicare and medicaid with a thoughtful and pragmatic consideration these critical programs deserve. I watched seema verma take this common sense hoosier approach and hope theres an opportunity to share her vision how she can Work Together with all members of this committee and congress as a whole to expand access to Quality Healthcare and protect and build on the progress we have made over the last several years. With that, Ranking Member wyden, members of the committee, thank you for allowing me to introduce seema verma. To seema verma and her family congratulations on this tremendous honor. This arguably the most Important Office within the hhs. An office that covers the Health Care Needs of over 100 million americans. The budget of almost 1 trillion. You heard that 20 year career as an innovator in healthcare sector, shes worked extensively with a variety of stakeholders , both sides of the aisle to deliver better access to healthcare. The president , ceo and founder of sdc she helped several states redesign their archaic medicaid system. Including in my home state of indiana. Fema revolutionized the Medicaid Program as our healthy indiana plan which we know as it. The nations first consumer driven directed Medicaid Program. She transformed a complex medicaid system into one where hoosiers are back in control of their healthcare needs. Since 2007, hipp has achieved impressive results. Seniors are more likely to seek preventative care, keep their prescriptive medication and seek primary Care Services as their physicians office, not the emergency room. Femas innovative ideas work is now in a group of concepts that medicare can be more efficient than a onesizefitsall approach. She accomplished this with the support and buyin from people again on both sides of the aisle and at all levels of the process. By putting the mission above politics, she demonstrated a willingness to work with anyone. Anyone who was willing to do the same. She worked with democrats in the indiana state house, she worked with the Obama Administration to find Common Ground on how to best provide Quality Health care for hundreds of thousands of low income hoosiers. And it worked. As cms administrator, fema will have the ability to do extensive experience to help other states achieve what we have in indiana. Better Health Outcomes for our most vulnerable. I look forward to working with her. And thank yo