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Democratic leaders accuse CMS's Seema Verma of quid pro quo political deal with insurers

Democrats want Verma to explain news report she promised insurers a continuation of cost-sharing reduction payments in exchange for AHCA support.

Susan Morse, Managing Editor

Four Ranking Democrats have accused Seema Verma of using her position as administrator of the Centers for Medicare and Medicaid Services for political gain in a quid pro quo deal with insurers.

At a meeting of health insurance executives, Verma allegedly promised a continuation of cost-sharing reduction payments in return for their support of the GOP healthcare plan, according to a May 19 letter sent to the CMS head by the ranking members of four congressional committees.

[Also: AHIP, AHA, others urge Senate to take action on CSR funding]

The Senate and House committee leaders said they got their information from a story published by the Los Angeles Times, and ask Verma give an explanation by the end of day June 2.

"We write with serious concerns about a report that you recently sought health insurance executives' political support for Trumpcare in exchange for congressionally mandated cost-sharing reductions, or CSRs, required under the Affordable Care Act (ACA)," they wrote. "These efforts to use the American healthcare system – particularly a program designed to assist low-income Americans who benefit from lower deductibles and co-payments under the Affordable Care Act (ACA) – as a bargaining chip are unacceptable.

CMS denied the accusation, saying the LA Times got it wrong.

"The LA Times story is completely false," said CMS Communications Director Jane Norris. "The assertion that Administrator Verma offered to fund the CSR in exchange for support for legislation is preposterous."  

[Also: Fifteen states ask to intervene in CSR payment appeal over cost-sharing reduction payments]

The letter was written by Senate Finance Committee Ranking Member Ron Wyden of Oregon, Senate Health, Education, Labor, and Pensions Committee Ranking Member Patty Murray of Washington, House Energy & Commerce Committee Ranking Member Frank Pallone, Jr., of New Jersey and House Ways and Means Committee Ranking Member Richard Neal of Massachusetts.

Insurance companies that offer plans on the Affordable Care Act exchange market, and supporting organizations, have been urging the Trump Administration to keep the cost-sharing reduction payments to insurers that are in the ACA. CSRs allow insurers to offer lower-income consumers lower deductibles and out-of-pocket costs.

Without the CSRs, insurers have said they would have to raise premium prices for 2018 by double digits or consider exiting the market. The payers are under a June 21 deadline to file their premium rates for next year.

[Also: Insurers tell Seema Verma number one concern is cost-sharing reduction payments]

It is up the Trump administration whether to continue or ditch the CSRs.

"Your reported actions suggest you are using the operation of the American healthcare system as a tool to gain leverage in political negotiations," the letter said. "It is wholly inappropriate for you to use federally appropriated money intended to lower the cost of quality, affordable healthcare as a bargaining chip to garner political support for unpopular legislation being negotiated behind closed doors by the Trump Administration and Congressional Republicans.
The Democrats ask Verma to provide information on whether anyone else at CMS or the Department of Health and Human Services has made a similar or other offers of exchange, and if the proposal was vetted with the agency's general counsel or ethics officer.

They also ask for any documents including notes from the meeting with insurers and for a list of individuals who participated, and copies of communications relating to any other proposed quid pro quo deals, they said.

Twitter: @SusanJMorse