16. Seema Verma

Administrator, Centers for Medicare and Medicaid Services (CMS)

Few if anyone in the Trump administration has the spending power of Seema Verma. The administrator of the Centers for Medicare & Medicaid Services oversees a budget of $1 trillion, or more than one-quarter of federal government spending, for coverage programs for more than 130 million Americans. 

Verma’s tenure — she was one of the first appointees of then-President-elect Donald Trump — included a decrease in average premiums in 2019, a first since the creation of exchanges was mandated by the Affordable Care Act. CMS also introduced the Medicaid and CHIP scorecard to increase transparency on how the government program is serving beneficiaries and took action to lower the cost of prescription drugs.

With Verma, previously president and CEO of healthcare consultancy SVC, in charge of CMS, the Trump administration also published guidelines calling on hospitals to post pricing information online and requiring them to update the information once a year.

However, spending has also landed Verma in the crosshairs of Democrats. Congressional committee leaders have accused her of wasting millions of dollars in taxpayer money to boost her own profile, including a consultant organizing a “girls’ night to honor the administrator.” 

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