Resigning from Trump administration would be 'a dereliction of duty' amid Covid pandemic, Medicare chief Verma says

"It was very disturbing. And it was, it was very, very hard to watch," Verma said of the attack on the Capitol, having witnessed events unfold from her office.

Resigning from Trump administration would be 'a dereliction of duty' amid Covid pandemic, Medicare chief Verma says

Seema Verma, administrator of the Centers for Medicare & Medicaid Services, speaks during the Milken Institute Global Conference in Beverly Hills, California, April 29, 2019.

Kyle Grillot | Bloomberg | Getty Images

Seema Verma never considered resigning from her job running the federal Medicare and Medicaid programs in the wake of last week's deadly assault on the U.S. Capitol, even after several Trump administration officials stepped down to protest the president's encouragement of a mob of angry protestors.

"From where I stand, given that we're in the middle of a pandemic, I felt like it would be a dereliction of my duty and my commitment to the agency and to the people that we serve, to leave my post and without ensuring a smooth transition to the Biden administration," Verma said in an interview Wednesday as the House began debate on impeaching the president for a second time.

The Administrator for the Centers for Medicare and Medicaid Services, which provide health insurance for the elderly, disabled and poor Americans, has been among the administration's closest allies to Vice President Mike Pence, having worked with him on health care initiatives since he served as the governor of Indiana.

Verma declined to comment on what discussions she's had with Pence in recent days, as tensions between President Donald Trump and his vice president have spilled into the public. Last week, she told staffers at the Centers for Medicare & Medicaid Services, CMS, she was repulsed by the way the vice president was treated outside and inside the administration, sources told NBC news.

"It was very disturbing. And it was, it was very, very hard to watch," she said of the attack on the Capitol, having witnessed events unfold from her office window which looks out on the complex. 

Touting accomplishments

In her waning days as administrator, Verma says she remains focused on ensuring a smooth transition to the Biden administration. She’s also tried to highlight her agency’s accomplishments the last four years, including the smooth operation of the Obamacare marketplace, even as the Trump administration pushed to overturn the Affordable Care Act.

"We made changes to healthcare.gov to make it a better experience for the customer, we streamlined the applications, we've provided over 15 waivers to states that has directly impacted their premiums and reduce them significantly," she said. " We have run the exchanges better than the way they were run before."  

Verma bristles at charges from critics that the Trump administration also presided over a decline in exchange enrollment, after cutting funding for consumer outreach during open enrollment.

"We did active and extensive outreach to health plans to bring them back to the market," she says. She noted that she brought down administrative costs by spending funds more efficiently. "And because of those efficiencies, we've actually been able to lower the user fee."

Advice to Successor

Among the things she's most of proud of were the actions her agency took during the pandemic to make sure Americans on Medicare and Medicaid could get access to Covid testing and vaccines at no cost, as well as the push for greater price transparency by hospitals. Starting this month, hospitals must post prices for procedures and provide consumers with an estimate of their actual costs.

"I think these are comprehensive changes, that are going to reverberate for many, many years to come," she said.

Verma says she hasn't thought about her next move. She joked about telling her husband her immediate plans were to be "a trophy wife" for a little while.  

Her advice to her successor – use the job to make an impact.

"It's one of the biggest muscles that the federal government has over the health care system. And they shouldn't underestimate the authority and power of CMS and what the team can do to influence the health care system," she said.