Trump administration unlikely to approve single-payer waivers, says CMS head

CMS Administrator Seema Verma implied the Trump administration will not approve state waivers for single-payer healthcare in a speech July 25 at the San Francisco-based Commonwealth Club, a nonprofit, nonpartisan public affairs forum.

"It doesn't make sense for us to waste time on something that's not going to work," she said.

Many Democrats are running on a Medicare for All platform in the 2018 midterm elections, as well as in gubernatorial elections like California's. These platforms are often based on a traditional single-payer system, while others more closely align with public option models that would allow patients to opt in to the program. To install a Medicare for All program, states would need to file a waiver and get a stamp of approval from CMS.

CMS evaluates proposals to see if they are fiscally sustainable and within the confines of the law. Ms. Verma said the current administration believes Medicare for All, or a single-payer system, is unaffordable and limits choice for patients.

"Ideas like Medicare for All would only serve to hurt and divert focus from seniors, all the while expanding the regulatory burden and the misaligned and perverse incentives of a government-run system," she said. "In essence, Medicare for All would become 'Medicare for None.'"

Ms. Verma's speech also touched on the challenges facing the Medicare program and initiatives underway to address those challenges, including those to improve price transparency, EHR interoperability, competition and drug prices. Watch the full speech here.

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