SAN FRANCISCO 鈥 Stepping into the land of the Trump resistance, Seema Verma flatly rejected California鈥檚 pursuit of single-payer health care as unworkable and dismissed the Affordable Care Act as too flawed to ever succeed.
Speaking Wednesday at the Commonwealth Club here, the administrator of the Centers for Medicare & Medicaid Services said she supports granting states flexibility on health care but indicated she would not give California the leeway it would need to spend federal money on a single-payer system.
鈥淚 think a lot of the analysis has shown it鈥檚 unaffordable,鈥 Verma said during a question-and-answer session following her speech. 鈥淚t doesn鈥檛 make sense for us to waste time on something that鈥檚 not going to work.鈥
During her speech, Verma issued a broader warning to advocates pushing for a Medicare-for-all program nationally. She said that 鈥渟ocialized鈥 approach to medicine would endanger the program and the health care it provides for millions of older Americans.
鈥淲e don鈥檛 want to divert the purpose and focus away from our seniors,鈥 Verma said in the address before more than 200 people. 鈥淚n essence, Medicare for all would become Medicare for none.鈥
Single-payer has emerged as a key issue in the California governor鈥檚 race this year. The current front-runner for governor, Gavin Newsom, a Democrat and the current lieutenant governor, has vowed to pursue a state-run, single-payer system for all Californians if elected in November. Many California lawmakers have endorsed that idea as the next step toward achieving universal coverage and to tackling rising costs.
California has enthusiastically embraced the Affordable Care Act, and state leaders have struggled with 鈥 and even bucked 鈥 the Trump administration on a variety of health-policy fronts. The state stands to lose more than any other if the Trump administration is successful in further dismantling the ACA.
About 1.4 million Californians buy coverage through the state鈥檚 Obamacare exchange, Covered California, and nearly 4 million have joined Medicaid as a result of the program鈥檚 expansion under the law.
Verma wields enormous power as head of CMS, overseeing a $1 trillion budget. The agency sets policy for Medicare, Medicaid and the federal insurance exchanges under the ACA.
The landmark health law, she said, was so flawed it could not work without further action from Congress.
鈥淚t wasn鈥檛 working when we came into office and it continues not to work,鈥 Verma said, responding to a question from moderator Mark Zitter, founder of the Zetema Project, a nonprofit organization that promotes debate on health care across partisan lines. 鈥淭he program is not designed to be successful.鈥
Zitter billed the event as a rare chance for Californians to hear directly from a top Trump administration official, although Verma’s remarks broke little new ground, he said.
Trump health care policies figure into many of California鈥檚 congressional races this fall in which incumbent Republicans are fending off Democratic challengers. And in court, California Attorney General is leading a coalition of attorneys general who are defending the constitutionality of the ACA in a Texas case with national implications.
The Trump administration has sided with the officials waging the lawsuit, choosing not to defend the health law鈥檚 protections for people with preexisting conditions. Separately, the administration has backed work requirements for many people on Medicaid.
California鈥檚 state Senate passed a law in May banning such requirements as a condition for eligibility in Medi-Cal, the state鈥檚 Medicaid program. The bill is pending in the state Assembly.
鈥淢aking health insurance coverage contingent on work requirements goes against all we鈥檝e worked for here in California,鈥 state Sen. Ed Hernandez (D-West Covina), author of , said in May.
State lawmakers also are considering bills that would limit the GOP-backed sale of short-term health policies and prevent people from joining association health plans that don鈥檛 have robust consumer protections.
In an interview after the speech, Verma criticized those legislative efforts in California because they would limit consumer choice.
鈥淎ny efforts to thwart choice and competition and letting Americans make decisions about their health care is bad health policy,鈥 she said.
Peter Lee, executive director of Covered California, the state鈥檚 ACA marketplace, has criticized the Trump administration for promoting those cheaper, skimpier policies as an alternative to ACA-compliant plans. He said he fears consumers will be harmed by 鈥渂ait-and-switch products鈥 that don鈥檛 provide comprehensive benefits.
鈥淭here have been a series of policies from Washington that have the effect of raising costs, particularly for middle-class Americans, and pricing them out of coverage,鈥 Lee said in an interview last week. 鈥淭his is not a failure of the ACA. This is entirely happening since the new administration.鈥
Most of Verma鈥檚 speech in San Francisco focused on Medicare. She outlined a number of initiatives designed to strengthen the program and protect taxpayers from ballooning costs. After the speech, CMS announced proposed changes to Medicare payment policies for outpatient care that could yield savings for the government and patients.
In her remarks, Verma reiterated the Trump administration鈥檚 efforts to reduce prescription drug prices, improve patients鈥 access to their own medical records and eliminate burdensome regulations on doctors and other medical providers.
Verma received a polite round of applause at the beginning and end of her appearance.
This story was produced by聽, which publishes聽, an editorially independent service of the聽.
