CMS Administrator Seema Verma gave her first major speech on Medicaid Tuesday, promising to reduce federal oversight of the program and restore it to what she sees as its original intent — a partnership between states and the federal government.
"Medicaid is central to our promise to the American people," Ms. Verma said in remarks at the National Association of Medicaid Directors Fall Conference. "We fail to live up to that promise when Medicaid merely provides a card without care. That's why we're ushering in a new day for Medicaid at CMS, not closing the book, but turning the page and starting a new chapter."
Here are three key changes Ms. Verma will make to advance her vision for the future of Medicaid.
1. Broader interpretation of Section 1115 waivers. These waivers allow states to redesign their Medicaid programs to expand coverage, change delivery systems or adjust benefits. Under the Trump administration, CMS will now consider proposals that include work requirements to receive Medicaid benefits, which marks a change from the previous administration. "Let me be clear to everyone in this room, we will approve proposals that promote community engagement activities," Ms. Verma said. "Believing that community engagement requirements do not support or promote the objectives of Medicaid is a tragic example of the soft bigotry of low expectations consistently espoused by the prior administration. Those days are over."
2. Streamlined waiver review processes. CMS also plans to streamline and expedite the review process for Section 1115 waivers and 1915 waivers, which are for specific Medicaid populations. The administration will approve some waivers for up to 10 years, use a fast track review process and require less reporting. States who apply with a waiver similar to one that has already been approved will experience an expedited review.
3. Medicaid and CHIP scorecards. Lastly, Ms. Verma introduced future scorecards to hold the Medicaid and CHIP programs accountable and ensure taxpayer dollars are being spent appropriately. These score cards will report how dollars are spent and the quality of care delivered, including birth outcomes, which Ms. Verma mentioned specifically in her remarks. "We will not just accept the hollow victory of numbers covered [in the program], but will dig deeper and demand more of ourselves and of you," Ms. Verma said.
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