Verma: Public Option Like ‘Sending Your Referees to Compete in the Game’

Amid growing political discussion over growing the role of government in healthcare, Medicare chief Seema Verma is warning that the feds need to have “humility” in how they approach health reform.

In a keynote speech at HLTH on Sunday night, Verma outlined the Trump administration’s vision for the “appropriate role of government” in healthcare.

The administrator of the Centers for Medicare & Medicaid Services named three key goals that define the White House’s roadmap for the government’s role in health: providing a safety net, ensuring the sustainability of federal programs and nurturing a competitive market.

She said in an interview with FierceHealthcare at the conference that politicians need to be “humble” in their policymaking. In the speech, she said taking the “Medicare for All” path or creating a public option—both policy changes favored by some Democrats—is the “polar opposite of humility.”

Launching a public option, backed by several more moderate primary candidates, would allow the government to enter a market it regulates, which is unfair to plans already operating in the Affordable Care Act’s exchanges, she told Fierce.

“That’s like sending your referees to compete in the game,” Verma said. “Let’s pause and take a look at what the government has delivered so far.”

As the 2020 Democratic primary race kicks into high gear, Trump administration health officials have taken turns bashing policies posited by candidates, and “Medicare for All” in particular.

At a conference hosted last month by America’s Health Insurance Plans, Verma warned that insurers must shape up or face such an overhaul, especially as the American Medical Association narrowly rejected an endorsement of single-payer earlier this year.

Department of Health and Human Services Secretary Alex Azar has also rejected plans to expand the role of government in healthcare. A single-payer system, he said, would take away patients’ abilities to make health choices for themselves.

In the speech Sunday, Verma said that historical government “failures” highlight the need for restraint in growing the federal role: Medicare’s solvency in the future is a significant concern, for example, and Medicare’s historically low

By contrast, the Trump administration’s approach of boosting competition is already paying dividends, Verma said. The groundwork laid in 2017 and 2018 has led to lower premiums and more plans available on the ACA markets and lowered cost for Medicare Advantage as well, she said.

Benchmark premiums in the ACA exchanges are down 4% on average for the 2020 plan year, and several insurers have either re-entered or newly entered the market, data released last week by CMS shows.

Verma told Fierce that the administration took suggestions from insurers in taking steps to increase competition in the individual markets and touted the fact the number of states where just one payer offered an exchange plan has gone down from 10 to two.

“We listened to them from the beginning,” she said.

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