The Autistic Self Advocacy Network calls on Congress to reject the nomination of Seema Verma, a longtime proponent of harmful health care policies, as Director of the Centers for Medicare and Medicaid Services. Verma’s previous career as a consultant for State Medicaid programs raises serious concerns about her ability to safeguard access to health care for autistic people and others with disabilities.
The Director of the Centers for Medicare and Medicaid Services (CMS) plays an important role in overseeing state Medicaid programs. Many people with disabilities, including autistic people, rely on Medicaid for affordable, quality health care. Some people with disabilities qualify for Medicaid because they have proven that they have a disability that prevents them from working, but other people with disabilities are on the Medicaid “expansion” – a program that lets people qualify for Medicaid based on their income alone. This expansion is an important safeguard for people with disabilities who have trouble proving that they are unable to work or who need health care during the process of proving that they are unable to work – a process that can take several years.
In her past career as a consultant, Verma encouraged state Medicaid programs to seek “waivers” for the income-based “expansion” groups that would allow them to charge Medicaid recipients for their coverage. Normally, states are not allowed to take away health coverage from those who can’t pay, but the “waivers” that Verma helped design did exactly that. Medicaid beneficiaries, including people with disabilities, lost coverage for up to six months if they failed to make payments or who made payments late. People could lose coverage even if those late payments were due to a disability or due to administrative mistakes outside of their control. For example, one woman in Indiana lost her Medicaid coverage for six weeks because a private contractor lost track of a $1 payment.
This punitive approach to health coverage can be particularly harmful for Autistic individuals. Autistic people often experience executive functioning challenges that make it difficult to keep track of payment deadlines or respond to unexpected payment processing problems. The approach also leads to increased healthcare costs, as individuals kicked off of Medicaid rolls are forced to rely on expensive emergency-room care instead of regular doctor’s visits. As Director of CMS, Verma would be in a position to not only continue the harmful “waiver” programs that she helped create but also to expand them. For example, Verma would be in a position to approve proposals to take away Medicaid coverage for a full year from those who failed to pay. Previously, CMS has only approved penalties of up to six months.
Verma also admitted at her confirmation hearing that she has financial conflicts of interest that would prevent her from weighing in on critical issues such as Medicaid coverage for mental health and autism-related interventions. This means that these critical decisions may be made by other CMS officials who have not gone through the Senate confirmation process and whose policy positions are unknown.
Finally, we are concerned that Verma may use her position at CMS to promote other damaging policies that she has championed in the past, such as reducing the package of Essential Health Benefits that certain insurance plans – including Medicaid expansion plans – must provide. Low-income people, especially people with disabilities and people who have complex health conditions, need comprehensive coverage. Limited benefits plans are unlikely to offer the range of services that people with disabilities need to stay healthy and avoid serious long-term health consequences.
ASAN urges the Senate to reject this irresponsible approach to health coverage and to vote against Verma’s confirmation. For more information, please contact Samantha Crane, Director of Public Policy, at scrane@autisticadvocacy.org.
The Autistic Self Advocacy Network is a 501(c)(3) nonprofit organization run by and for autistic people. The Autistic Self Advocacy Network seeks to advance the principles of the disability rights movement with regard to autism. ASAN believes that the goal of autism advocacy should be a world in which autistic people enjoy the same access, rights, and opportunities as all other citizens. We work to empower autistic people across the world to take control of our own lives and the future of our common community, and seek to organize the autistic community to ensure our voices are heard in the national conversation about us. Nothing About Us, Without Us!