Mattie Quinn, in governing.com, reports on the debate over how much freedom the Trump administration should give the states to change their healthcare systems. More flexibility, she notes, would make it easier to adopt healthcare industry-backed changes — and let conservatives enact policies rejected by the Obama administration.

Among her observations:

“Advocates of greater flexibility are likely to find an ally in Seema Verma, the new administrator of the federal Centers for Medicare and Medicaid Services (CMS). Verma was an architect of Indiana’s system. In a 2013 congressional hearing, she described the Medicaid bureaucracy as a set of ‘rigid, complex rules’ that have ‘created an intractable program that does not foster efficiency, quality or personal responsibility.”’

“But as veterans of efforts to streamline government bureaucracy and improve program efficiency know all too well, there are always going to be up-front costs. Health policy experts worry that the kind of large, across-the-board cuts to Medicaid funding being proposed in Congress would work against the kind of flexibility initiatives that appeal to the program’s state administrators.”

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