Trump’s Medicaid chief wants poor to pay for health care

It’s pretty clear from this NPR profile of Seema Verma, Trump’s pick to head the Centers for Medicare and Medicaid Services, how she sees the future of Medicaid. She wants low-income people to pay at least something for their health care. That’s how she designed the Indiana program that revised and expanded Medicaid under Mike Pence. Key quote from Cindy Mann, former Medicaid official under President Obama: Verma was “very committed to extending coverage to low-income families,” and also “very committed to a particular ideology” — personal responsibility.

What it means: Not every state is going to do what Indiana did, but there are other Republican governors who would like to make poor people contribute to their health care — and Verma will have the power to grant waivers to let them do it. The story shows how the idea can cause problems for people who are barely getting by, but it never really grapples with the debate that lies ahead: Is it fair or unfair to expect them to make monthly payments like people with private health insurance? That’s where this story is headed, especially during Verma’s confirmation hearings.